Effects of Nutritional Interventions on Cardiovascular Disease Health Outcomes in Aboriginal and Torres Strait Islander Australians: A Scoping Review

Abstract

Nutrition interventions can support Aboriginal and Torres Strait Islander peoples to reduce their risk of cardiovascular disease (CVD). This review examines nutritional interventions aiming to improve CVD outcomes and appraises peer-reviewed interventions using an Aboriginal and Torres Strait Islander Quality Appraisal Tool. Five electronic databases and grey literature were searched, applying no time limit. Two reviewers completed the screening, data extraction and quality assessment independently. The study quality was assessed using the South Australian Health and Medical Research Institute and the Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange Aboriginal and Torres Strait Islander Quality Appraisal Tool (QAT). Twenty-one nutrition programs were included in this review. Twelve reported on anthropometric measurements, ten on biochemical and/or hematological measurements and sixteen on other outcome domains. Most programs reported improvements in measurable CVD risk factors, including reduced body mass index (BMI), waist circumference (WC), weight, blood pressure and improved lipid profiles. Most programs performed well at community engagement and capacity strengthening, but many lacked the inclusion of Indigenous research paradigms, governance and strengths-based approaches. This review highlights the need for contemporary nutrition programs aimed at improving cardiovascular health outcomes to include additional key cultural components.

Keywords: Aboriginal; Torres Strait Islander; cardiovascular disease; first nations; first peoples; health promotion; nutrition.

Figure 1

PRISMA Flow Diagram.

Figure 2

The 2018 SAHMRI CREATE Aboriginal and Torres Strait Islander Quality Appraisal Tool results of peer-reviewed programs presented as an adapted traffic light plot. Q1 Did the research respond to a need or priority determined by the community?; Q2 Was community consultation and engagement appropriately inclusive?; Q3 Did the research have Aboriginal and Torres Strait Islander research leadership?; Q4 Did the research have Aboriginal and Torres Strait Islander governance?; Q5 Were local community protocols respected and followed?; Q6 Did the researchers negotiate agreements in regards to rights of access to Aboriginal and Torres Strait Islander peoples existing intellectual and cultural property?; Q7 Did the researchers negotiate agreements to protect Aboriginal and Torres Strait Islander peoples’ ownership of intellectual and cultural property created through the research?; Q8 Did Aboriginal and Torres Strait Islander peoples and communities have control over the collection and management of research materials?; Q9 Was the research guided by an Indigenous research paradigm?; Q10 Does the research take a strengths-based approach, acknowledging and moving beyond practices that have harmed Aboriginal and Torres Strait peoples in the past?; Q11 Did the researchers plan to and translate the findings into sustainable changes in policy and/or practice?; Q12 Did the research benefit the participants and Aboriginal and Torres Strait Islander communities?; Q13 Did the research demonstrate capacity strengthening for Aboriginal and Torres Strait Islander individuals?; Q14 Did everyone involved in the research have opportunities to learn from each other? The symbol § represents the overall rating of peer-reviewed programs. A final rating of “very good” was assigned to papers that answered yes to over 75% of questions, “good” to those that answered yes to over 50% of questions, “fair” to those that answered yes to fewer than 50% of questions, and “poor” to those that answered yes to fewer than 25% of questions.