title: Reduced prevalence of impaired glucose tolerance and no change in prevalence of diabetes despite increasing BMI among Aboriginal people from a group of remote homeland communities.
abstract: OBJECTIVE
  To examine trends in glucose tolerance and coronary risk among Aboriginal people from a group of homeland communities in central Australia during a 7-year follow-up period.
  
  
  METHODS
  Community-based screenings of adult volunteers were performed in 1988 (n = 437; 93% response rate) and in 1995 (n = 424; 85% response rate). A health promotion intervention program commenced after the 1988 survey that focused on the benefits of exercise and appropriate diet.
  
  
  RESULTS
  Mean (95% CI) BMI increased significantly from 22.8 kg/m2 (22.3-23.2) to 24.2 kg/m2 (23.8-24.7) during the follow-up period (P < 0.001). This increase was similar for men and women and across all age-groups. The increase in BMI was greater among subjects residing adjacent to a store compared with those residing in communities located far from a store (P < 0.001). Decreases were evident in the prevalence of impaired glucose tolerance (IGT) (from 22.5 to 10.1% among women, P < 0.001; from 12.2 to 6.5% among men, P = 0.074) and hypercholesterolemia (from 36.7 to 25.8% among women, P < 0.01; from 52.4 to 44.0% among men, P = 0.147), but no change was evident in the prevalence of diabetes. Smoking remained rare among women (<4%) and decreased among men (from 52.9 to 40.8%, P < 0.05).
  
  
  CONCLUSIONS
  The trends in glucose intolerance were clearly better than have been observed in other Aboriginal communities. The institution of an intervention program corresponded with reductions in the prevalence of IGT, hypercholesterolemia, and smoking. The prevalence of diabetes remained unaltered despite a significant increase in mean BMI, possibly because of the promotion of increased physical activity levels.
authors.affiliation: Centre for Population Health and Nutrition, Monash Medical Centre, Monash University, Clayton, Victoria, Australia.
authors.forename: K G
authors.initials: KG
authors.lastname: Rowley
authors.forename: A
authors.initials: A
authors.lastname: Gault
authors.forename: R
authors.initials: R
authors.lastname: McDermott
authors.forename: S
authors.initials: S
authors.lastname: Knight
authors.forename: T
authors.initials: T
authors.lastname: McLeay
authors.forename: K
authors.initials: K
authors.lastname: O'Dea
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D015992:Body Mass Index; D005260:Female; D018149:Glucose Intolerance / Q000453:epidemiology*; D006293:Health Promotion; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015995:Prevalence; D012424:Rural Population; D012907:Smoking