Littérature scientifique sur le sujet « Aboriginal nutrition »

This thesis incorporates social history and consultative action research to analyse the development of cross-cultural nutrition services for Indigenous communities in the Northern Territory from 1974-2000 and promote the development of stronger partnerships in 1999-2001.The historical development of nutrition services is analysed against current theory and a model of capacity building for health promotion. Nutrition infrastructure and services have developed systematically, incrementally and substantially. Strengths include the development of enduring and successful inter-cultural partnerships and leadership.Two facilitative narratives which aim to improve inter-cultural knowledge sharing, strengthen capacity and promote participatory action in community based projects were developed, implemented and partially evaluated. Services can be further strengthened by long-term commitments to examining power issues, promoting improved Indigenous control and problem solving and comprehensive bi cultural evaluation that identifies significant indicators to improving outcomes. Participatory action research, facilitative story telling, capacity building, Indigenous education theory and critical social science can inform and guide these efforts in complementary ways.<br>Master of Arts (Hons) (Critical Social Science)

This thesis incorporates social history and consultative action research to analyse the development of cross-cultural nutrition services for Indigenous communities in the Northern Territory from 1974-2000 and promote the development of stronger partnerships in 1999-2001.The historical development of nutrition services is analysed against current theory and a model of capacity building for health promotion. Nutrition infrastructure and services have developed systematically, incrementally and substantially. Strengths include the development of enduring and successful inter-cultural partnerships and leadership.Two facilitative narratives which aim to improve inter-cultural knowledge sharing, strengthen capacity and promote participatory action in community based projects were developed, implemented and partially evaluated. Services can be further strengthened by long-term commitments to examining power issues, promoting improved Indigenous control and problem solving and comprehensive bi cultural evaluation that identifies significant indicators to improving outcomes. Participatory action research, facilitative story telling, capacity building, Indigenous education theory and critical social science can inform and guide these efforts in complementary ways.

This thesis explores the impact of climate changes on the harvest of traditional foods and characterizes the implication of these changes on the diet of Aboriginal Peoples in northern Canada. Combinations of qualitative and quantitative methods were used to document and estimate the local harvest pattern of key species of traditional food. Overall results between the estimated amount of available food from the harvest and the estimated amount of dietary intake did not agree, however, strong agreements were seen in two species: moose and whitefish. The relationship of harvest data to dietary intake is complex and requires two accurate and complete data sets. If these exist, predicting the intake of traditional foods from harvest data is possible. Qualitative results portray that community members are witnessing variable changes in climate which are affecting their traditional food harvest and are altering their harvest mechanisms to adapt to these changes.<br>Cette thèse regard l'impact des changements environmentales sur la récolte des aliments traditionnels et characterise l'implication de ses changements sur la diète des membres de la communauté. Une combinaison de méthode quantitative et qualitative ont été utilisé pour documenter et estimer la séquence de la récolte des animaux clées locales. En général, les résultats entre la nourriture disponible estimé provennant de la récolte et le montant estimé pour la consumption alimentaire n'étaient pas égaux, parcontre, la ratio entre aurignal et poisson blanc étaient bonne. La relation entre les résultats numériques concernent la récolte et la consumption alimentaire sont complèxes et requièrent deux coordonnées d'informations numériques completes. Si cela existe, il serait possible de prédir la consumption des aliments traditionalles provenant de la récolte. Les résultats qualitatifs dénoncent des changements climatiques affectant la récolte des aliments traditionnels et alterent la façon dont les membres de la communauté font leur récolte pour adapter à ces changements climatiques.

It has been established that diabetes does have an effect and impacts greatly on the life expectancy of Indigenous Australians. A possible explanation is that Indigenous Australians generally have different needs, primarily because of the variation in culture differences. For this reason it is imperative that health officials have an understanding of these additional pre-disposing factors and the associated complications which have resulted as a part of the colonisation process. These factors including diet, nutrition, exercise, obesity and have influenced and resulted, in a change to the way of life for many Indigenous Australians, primarily from a traditional to modern diet.

Globally, the prevalence of Type 2 diabetes is rising. The most affected populations are those that have undergone recent and rapid transition towards a Western lifestyle, characterised by energy-dense diets and physical inactivity.¶ Two major hypotheses have attempted to explain the variation in diabetes prevalence, both between and within populations, beyond the contributions made by adult lifestyle. The thrifty genotype hypothesis proposes that some populations are genetically well adapted to surviving in a subsistence environment, and are predisposed to develop diabetes when the dietary environment changes to one that is fat and carbohydrate rich. The programming hypothesis focuses on the developmental environment, particularly on prenatal and early postnatal conditions: nutritional deprivation in utero and early postnatal life, measured by low birthweight and disrupted child growth, is proposed to alter metabolism permanently so that risk of diabetes is increased with subsequent exposure to an energy-dense diet. Both hypotheses emphasise discord between adaptation (genetic or developmental) and current environment, and both now put forward insulin resistance as a likely mechanism for predisposition.¶ Diabetes contributes significantly to morbidity and mortality among Australia’s Indigenous population. Indigenous babies are more likely to be low birthweight, and typical patterns of child growth include periods of faltering and rapid catch-up. Although there have been numerous studies in other populations, the programming hypothesis has not previously been tested in an Australian Indigenous community. The framework of the programming hypothesis is thus expanded to consider exposure of whole populations to adverse prenatal and postnatal environments, and the influence this may have on diabetes prevalence.¶ The present study took place in Cherbourg, a large Aboriginal community in southeast Queensland with a high prevalence of diabetes. Study participants were adults with diagnosed diabetes and a random sample of adults who had never been diagnosed with diabetes. Data were collected on five current risk factors for diabetes (general and central obesity, blood pressure, age and family history), in addition to fasting blood glucose levels. A lifestyle survey was also conducted. Participants’ medical records detailing weight growth from birth to five years were analysed with regard to adult diabetes risk to determine whether childhood weight and rate of weight gain were associated with subsequent diabetes. Adult lifestyle factors were xiialso explored to determine whether variation in nutrition and physical activity was related to level of diabetes risk.¶ Approximately 20% of adults in Cherbourg have diagnosed diabetes. Prevalence may be as high as 38.5% in females and 42% in males if those who are high-risk (abnormal fasting glucose and three additional factors) are included. Among those over 40 years, total prevalence is estimated to be 51% for females and 59% for males.¶ Patterns of early childhood growth may contribute to risk of diabetes among adults. In particular, relatively rapid weight growth to five years is associated with both general and central obesity among adult women. This lends some qualified support to the programming hypothesis as catch-up growth has previously been incorporated into the model; however, although the most consistent association was found among those who gained weight more rapidly, it was also found that risk is increased among children who are heavier at any age.¶ No consistent associations were found between intrauterine growth retardation (as determined by lower than median birthweight and higher than median weight growth velocity to one and three months) and diabetes risk among women or men. A larger study sample with greater statistical power may have yielded less ambiguous results.¶ Among adults, levels of physical activity may be more important than nutritional intake in moderating diabetes risk, although features of diet, such as high intake of simple carbohydrates, may contribute to risk in the community overall, especially in the context of physical inactivity. A genetic component is not ruled out. Two additional areas which require further investigation include stress and high rates of infection, both of which are highly relevant to the study community, and may contribute to the insulin resistance syndrome.¶ Some accepted thresholds indicating increased diabetes risk may not be appropriate in this population. Given the relationship between waist circumference and other diabetes risk factors and the propensity for central fat deposition among women even with low body mass index (BMI), it is recommended that the threshold where BMI is considered a risk be lowered by 5kg/m2 for women, while no such recommendation is made for men.¶ There are a number of social barriers to better community health, including attitudes to exercise and obesity, patterns of alcohol and tobacco use and consumption of fresh foods. Some of these barriers are exacerbated by gender roles and expectations.¶

碩士<br>弘光科技大學<br>食品科技所<br>102<br>The research is aimed at investigating the relevance and relationship among nutritional knowledge, attitudes and eating behaviors of Taiwanese aboriginal junior high school students. Based on the students in the school district, 1063 questionnaires are given and 938 of them are retrieved (the response rate is up to 88.24%). 839 questionnaires are valid to be analyzed in the survey. The statistics approaches include descriptive statistics, average value and standard variation, independent sample t test, one-way ANOVA, Pearson’s Correlation and univariate. Two of the findings are worth summarizing: 1 Fundamental variances: First, gender is obviously relevant to nutritional knowledge and eating behaviors. Besides, there is significant relation between glade and eating behaviors. Parents’ educational degree has great effect on nutritional knowledge; however, only father’s educational degree influences upon eating behaviors significantly. What’s more, the economic conditions of the students’ families play an important role in nutritional attitudes and eating behaviors. School education is the main source of the information about nutrition and food. 2 The score regarding nutritional knowledge is not good; in contrast, the one regarding nutritional attitudes is better. In addition, the score related to eating behaviors is the most excellent, which reveals their positive eating behaviors. Further, nutritional knowledge and attitudes correlate positively, and so do nutritional attitudes and eating behaviors. Suggestions of the research result: 1 Tribal culture should be included in school education in the aboriginal area to enhance the students’ absorption about nutritional knowledge and understanding about the characteristics of their tribal eating culture. 2 Encourage the parents to upgrade their nutritional knowledge and improve their eating behaviors in expectation of affecting children’s eating attitudes. 3 To increase the books on nutrition in the school library to make the students absorb relevant information. 4 Cultivate good nutritional attitudes and eating behaviors by means of the provision of educational resources to the aboriginal tribal churches and the holdings of the activities concerning nutrition supported by community resources. 5 The incorporation of health education and lunch hygiene education into school courses can contribute to promote students’ knowledge and attitudes with reference to nutrition.

Research Doctorate - Doctor of Philosophy (PhD)<br>Aboriginal Australians have high rates of many chronic diseases, the causes of which are multi-factorial. Optimal nutrition throughout life is protective against a number of adverse health outcomes, and can begin with setting the scene for lifelong health in utero and in the first years of life. However, little is currently known about the dietary intakes of Aboriginal Australian women in pregnancy and in the postpartum period, and their children, particularly in early infancy. This thesis by publication is presented as a series of published research articles. Specific research aims and the results of studies arising from this thesis are summarised below. Dietitians are well-placed to support and work alongside Aboriginal communities in developing and supporting strategies to optimise nutrition for Aboriginal woman and children. Dietitians must demonstrate cultural competency, however opportunities for practical experiences working with Aboriginal communities are limited during undergraduate nutrition degree programs. The aim of the first study was to evaluate the cultural awareness experiences of student and new-graduate dietitians working in an Aboriginal ArtsHealth setting. Six participants reported on their experiences through either written feedback (via email) or oral feedback (via semi-structured interview). A generic inductive approach was used for qualitative data analysis. Key themes emerged around ‘building rapport’ and ‘developing cultural understanding’. Some participants reported an increased understanding of the context around health disparity for Aboriginal Australians, and the experiences of the student and new-graduate dietitians were overwhelmingly positive. To optimise nutrition, current nutrition practices and dietary intakes need to be quantified. The second study of this thesis reports on the dietary intakes and anthropometric and body composition measures of a sample of women and their infants from the Gomeroi gaaynggal study, a prospective longitudinal cohort of Aboriginal women and their children in regional NSW from pregnancy to five years postpartum. A cross-sectional analysis of n=73 mother-child dyads from three months to five years postpartum found a breastfeeding initiation rate of 85.9%, with a median (interquartile range [IQR]) duration of 1.4 months (0.5 – 4.0). Introduction of infants to solid foods and cow’s milk were at 5.0 months (4.0–6.0) and 12.0 months (10.0–13.0) respectively. At one year postpartum 66.7% of women were overweight or obese, and 63.7% were overweight or obese at 2 years postpartum. Results from the Gomeroi gaaynggal cohort were preliminary, but suggest that women in this cohort may benefit from further support to optimise nutrition for themselves and their children. Providing women with tailored nutrition advice requires appropriate tools for dietary assessment. Image-based dietary records are emerging as a novel method for dietary assessment that limits some of the participant burden associated with traditional methods of dietary assessment. The Diet Bytes and Baby Bumps study used image-based dietary records captured via smartphones and a purpose-built brief tool (the Selected Nutrient and Diet Quality [SNaQ] tool) to assess nutrient and food group intakes of pregnant women and to inform the delivery of tailored nutrition advice to participants during their pregnancy. Twenty-five women (27 recruited, including 8 Aboriginal Australians, one withdrawn, one incomplete), had image-based records appropriate for analysis. Median intakes of core food groups of grains and cereals, vegetables, fruit, meat and dairy were reported as being below recommendations, but intakes of energy-dense, nutrient-poor foods exceeded recommendations. Cohen kappa showed moderate to substantial agreement between the SNaQ tool and the nutrient analysis software when assessing adequacy of micronutrient intakes. Relative validity was established by comparison of the image-based dietary records and 24-hour food recalls. There were significant correlations between the two methods of dietary assessment for energy, macronutrients and micronutrient intakes (r=.40–.94, all P<.05), with acceptable agreement between methods. Seventeen women reported changing their diets as a result of receiving personalised nutrition advice. The DietBytes method of image-based dietary assessment was well-received, with 88% of participants stating they would use the method again, including all Aboriginal participants. A systematic review was conducted to identify existing programs that have aimed to improve nutrition-related outcomes in Indigenous pregnant women worldwide, and to identify positive factors contributing to successful programs. This review consisted of 27 studies (20 programs) from Australia, Canada, and the United States of America; the most prevalent outcome measures were breastfeeding initiation/duration (n=11 programs) and birth weight (n=9 programs). Activities employed within programs that resulted in statistically significant improvements in health and/or nutrition outcomes included individual counselling and education, and involvement of peer counsellors or other Indigenous program staff. In successful programs, emphasis was placed on designing nutrition interventions in collaboration with Indigenous communities. This research thesis has highlighted key areas for improving dietary intake and nutrition-related health of Aboriginal Australian women and their children, including breastfeeding duration, appropriate timing of introduction to solid food and cow’s milk, nutrient and food group intake of pregnant and postpartum women, and improving rates of overweight and obesity in women postpartum. An image-based dietary record method of dietary assessment has demonstrated relative validity and acceptability for dietary assessment of Aboriginal pregnant women and acceptability to guide nutrition counselling. Dietitians can best support Aboriginal women and children by working in collaboration with communities to optimise nutrition, and support practice-based student experiences during university training where possible to assist in development of cultural competency skills.