Bulgarr Ngaru Medical Aboriginal Corporation

Grafton, Australia

Bulgarr Ngaru Medical Aboriginal Corporation

Grafton, Australia
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Black A.P.,University of South Australia | Black A.P.,Bulgarr Ngaru Medical Aboriginal Corporation | Vally H.,La Trobe University | Morris P.S.,Royal Darwin Hospital | And 4 more authors.
Medical Journal of Australia | Year: 2013

Objective: To evaluate the impact of a fruit and vegetable subsidy program on short-term health outcomes of disadvantaged Aboriginal children. Design, setting and participants: A before-and-after study involving clinical assessments, health record audits and blood testing of all children aged 0-17 years (n = 167) from 55 participating families at baseline and after 12 months; three Aboriginal community-controlled health services in New South Wales. A assessments were completed between December 2008 and September 201C Intervention: A weekly box of subsidised fruit and vegetables linked to prevent health services and nutrition promotion at an Aboriginal Medical Service. Main outcome measures: Change in episodes of illness, health service and emergency department attendances, antibiotic prescriptions and anthropometry. Results: There was a significant decrease in oral antibiotics prescribed (- 0.5 prescriptions/year; 95% CI, - 0.8 to - 0.2) during 12 months of participat in the program compared with the 12 months before the program. The proport of children classified as overweight or obese at baseline was 28.3% (38/134) and the proportion in each weight category did not change (P = 0.721) after 12 months. A small but significant increase in mean haemoglobin level (3.1 g/L 95% CI, 1.4-4.8 g/L) was shown, although the proportion with iron deficiency (baseline, 41%; follow-up, 37%; P = 0.440) and anaemia (baseline, 8%; follow-up, 5%; P = 0.453) did not change significantly. Conclusion: This fruit and vegetable subsidy program was associated with improvements in some indicators of short-term health status among disadvantaged Aboriginal children. A controlled trial is warranted to investigat the sustainability and feasibility of healthy food subsidy programs in Australia.


Black A.P.,University of South Australia | Black A.P.,Bulgarr Ngaru Medical Aboriginal Corporation | Vally H.,La Trobe University | Morris P.,Charles Darwin University | And 6 more authors.
British Journal of Nutrition | Year: 2013

Healthy food subsidy programmes have not been widely implemented in high-income countries apart from the USA and the UK. There is, however, interest being expressed in the potential of healthy food subsidies to complement nutrition promotion initiatives and reduce the social disparities in healthy eating. Herein, we describe the impact of a fruit and vegetable (F&V) subsidy programme on the nutritional status of a cohort of disadvantaged Aboriginal children living in rural Australia. A before-and-after study was used to assess the nutritional impact in 174 children whose families received weekly boxes of subsidised F&V organised through three Aboriginal medical services. The nutritional impact was assessed by comparing 24 h dietary recalls and plasma carotenoid and vitamin C levels at baseline and after 12 months. A general linear model was used to assess the changes in biomarker levels and dietary intake, controlled for age, sex, community and baseline levels. Baseline assessment in 149 children showed low F&V consumption. Significant increases (P< 0·05) in β-cryptoxanthin (28·9 nmol/l, 18 %), vitamin C (10·1 μmol/l, 21 %) and lutein-zeaxanthin (39·3 nmol/l, 11 %) levels were observed at the 12-month follow-up in 115 children, although the self-reported F&V intake was unchanged. The improvements in the levels of biomarkers of F&V intake demonstrated in the present study are consistent with increased F&V intake. Such dietary improvements, if sustained, could reduce non-communicable disease rates. A controlled study of healthy food subsidies, together with an economic analysis, would facilitate a thorough assessment of the costs and benefits of subsidising healthy foods for disadvantaged Aboriginal Australians. © The Authors 2013.


Black A.P.,University of South Australia | Black A.P.,Bulgarr Ngaru Medical Aboriginal Corporation | Vally H.,La Trobe University | Morris P.,Charles Darwin University | And 5 more authors.
Australian and New Zealand Journal of Public Health | Year: 2014

Objective: To evaluate the impact of a fruit and vegetable (F&V) subsidy program for disadvantaged Aboriginal children in Australia, implemented alongside the introduction of mandatory folic acid fortification of bread-making flour. Methods: A before-and-after evaluation was undertaken of a F&V subsidy program at three Aboriginal community-controlled health services in New South Wales. The program provided a weekly box of subsidised F&V linked to preventive health services and nutrition promotion for families. In this analysis, red blood cell (RBC) folate was assessed together with self-reported dietary intake at baseline and 12 months later in a cohort of 125 children (aged 0-17 years). Results: No children had low RBC folate at baseline or at follow-up; however, 33 children (26%) exceeded the reference range of RBC folate at baseline and 38 children (30%) exceeded the reference range at follow-up. Mean RBC folate levels increased substantially in children at follow-up (mean RBC folate z-score increased +0.55 (95%CI 0.36-0.74). Change in F&V intake (p=0.196) and mean bread intake (p=0.676) were not statistically significant predictors for change in RBC folate levels. Conclusions: RBC folate levels increased among these disadvantaged Aboriginal children following mandatory folic acid fortification and participation in a subsidised F&V program. Even before mandatory folic acid fortification, none of these children had low RBC folate. Implications: The effect on health of mandatory fortification of foods with folate is not clear, hence, ongoing population-based monitoring of folate levels to assess the impact of mandatory folic acid fortification is important. © 2014 The Authors.

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