Access to good nutrition the key to improving heart health for Indigenous Australians

Coronary heart disease is a major cause of death among Aboriginal people, even though the prevalence of two classic risk factors, high blood pressure and high cholesterol level, is not excessive in many Aboriginal communities.

In an article in the latest issue of the Medical Journal of Australia, Drs Kevin Rowley, Alicia Jenkins, David O'Neal and Professor James Best and Mr Jacob Cohen from the University of Melbourne; Drs Karen Walker and Qing Su from the Monash Medical Centre; and Professor Kerin O'Dea from the Menzies School of Health Research in Darwin look at the relationship between coronary heart disease risk and inflammation in an Aboriginal community.

Ninety-five women and 76 men from a remote Aboriginal community in Western Australia were surveyed in 1996.

Participants had high plasma levels of two markers of inflammation and damage to the lining of the arteries (C-reactive protein and soluble E-selectin). Smoking, diabetes and insulin resistance — factors that cause inflammation of the arteries — were common in the survey sample. Moreover, the high levels of inflammatory markers were associated with low levels of diet-derived antioxidants from fruit and vegetables such as carotenoids, which protect against damage to the blood vessels.

A high proportion of study participants exhibited the metabolic syndrome associated with heart disease, that is they had three or more conditions out of a list including abdominal obesity, high plasma triglyceride level, high blood pressure and high fasting plasma glucose level. This group also had high levels of the inflammatory markers.

The findings suggest that vascular inflammation is a major factor contributing to increased risk of coronary heart disease, which, in turn, is associated with adverse social environmental circumstances and a high prevalence of the metabolic syndrome in this population.

The authors conclude that there is a need for long-term support of broad-based community directed interventions, including improved nutrition and increased physical activity. Good nutrition and physical activity are, in turn, determined by issues such as food supply, education, infrastructure, social inequalities and psychosocial factors.

The Medical Journal of Australia is a publication of the Australian Medical Association.

CONTACT: Dr Kevin Rowley, 03 9288 2574

Judith Tokley, AMA, 0408 824 306