title: Improvements in circulating cholesterol, antioxidants, and homocysteine after dietary intervention in an Australian Aboriginal community.
abstract: BACKGROUND
  Poor nutrition contributes to high rates of coronary heart disease among Australian Aboriginal populations. Since late 1993, the Aboriginal community described here has operated a healthy lifestyle program aimed at reducing the risk of chronic disease.
  
  
  OBJECTIVE
  We evaluated the effectiveness of a community-directed intervention program to reduce coronary heart disease risk through dietary modification.
  
  
  METHODS
  Intervention processes included store management policy changes, health promotion activities, and nutrition education aimed at high-risk individuals. Dietary advice was focused on decreasing saturated fat and sugar intake and increasing fruit and vegetable intake. Evaluation of the program included conducting sequential, cross-sectional risk factor surveys at 2-y intervals; measuring fasting cholesterol, lipid-soluble antioxidants, and homocysteine concentrations; and assessing smoking status. Nutrient intakes were estimated from analysis of food turnover in the single community store.
  
  
  RESULTS
  There was a significant reduction in the prevalence of hypercholesterolemia (age-adjusted prevalences were 31%, 21%, and 15% at baseline, 2 y, and 4 y, respectively; P < 0.001). There were significant increases in plasma concentrations of alpha-tocopherol, lutein and zeaxanthin, cryptoxanthin, and beta-carotene across the population. Retinol and lycopene concentrations did not change significantly. Mean plasma homocysteine concentrations decreased by 3 micromol/L. There was no significant change in smoking prevalence between the 2 follow-up surveys. There was an increase in the density of fresh fruit and vegetables and carotenoids in the food supply at the community store.
  
  
  CONCLUSIONS
  This community-directed dietary intervention program reduced the prevalence of coronary heart disease risk factors related to diet.
authors.affiliation: University of Melbourne, Department of Medicine, St Vincent's Hospital, Fitzroy, VIC, Australia. kevinr@medstv.unimelb.edu.au
authors.forename: K G
authors.initials: KG
authors.lastname: Rowley
authors.forename: Q
authors.initials: Q
authors.lastname: Su
authors.forename: M
authors.initials: M
authors.lastname: Cincotta
authors.forename: M
authors.initials: M
authors.lastname: Skinner
authors.forename: K
authors.initials: K
authors.lastname: Skinner
authors.forename: B
authors.initials: B
authors.lastname: Pindan
authors.forename: G A
authors.initials: GA
authors.lastname: White
authors.forename: K
authors.initials: K
authors.lastname: O'Dea
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000704:Analysis of Variance; D000975:Antioxidants / Q000378:metabolism*; D001315:Australia; D002784:Cholesterol / Q000097:blood*; D003153:Community Health Services; D003327:Coronary Disease / Q000209:etiology / Q000517:prevention & control*; D004032:Diet; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008019:Life Style; D008297:Male; D012307:Risk Factors; D017678:Sex Distribution
chemical_list: D000975:Antioxidants; D006710:Homocysteine; D002784:Cholesterol