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Despite its isolation, the Aboriginal community of Looma has much in common with societies the world over – a Western diet high in sugars and saturated fats and a largely sedentary population. Monash researchers are helping the people of Looma to make better choices about what they eat.

By David Bruce

The Looma project is about helping residents make healthier choices about their lifestyles, particularly improving their diet and level of exercise.

Looma lies beside the Fitzroy River, about 120 kilometres south-east of Derby in Western Australia’s Kimberley region. The community of the Nyikina, Walmatjarri and Mangala people, the "river people" of the Fitzroy Valley, regularly hunt for goanna, black-headed python and blue-tongued lizard and fish their river and billabongs for barramundi, catfish, bream, cherrabin and turtle.

So, when the community of 500 undertook a mass health check in 1993 and found that 42 per cent of those over 15 years were either overweight or obese, and that 25 per cent had diabetes, it confirmed the suspicions of local health workers that the people of Looma were an unhealthy group despite the ready access to healthy bush food.

Looma is a fairly typical Aboriginal community of the Kimberley in many ways – including its high rate of non-insulin dependent diabetes, caused mainly by obesity, poor diet and inadequate exercise.

The link between obesity and diabetes is well established. Unlike diabetes that depends on insulin injections, non-insulin dependent diabetes is a silent killer, often leading an unsuspecting sufferer to more complex cardiovascular diseases, such as heart attack and stroke, and kidney disease.

After the 1993 survey, the Looma Healthy Lifestyle program began with the support of Professor Kerin O’Dea, then of Deakin University and now at Monash. Initially the program targeted those either with diabetes or at high risk of becoming diabetic, but within a few years it was extended to the whole community.

Professor Kerin O'Dea.

The community took over the management of the general store and immediately stocked better food choices. Nutritious meals started being prepared and enjoyed and most people became more active in their daily lives. The old people went for long bush walks, the football team thrived and, for the first time, even the middle-aged women demanded time on the basketball court.

And yet, an interesting thing happened. Despite sustained improvements in diet and exercise and some excellent reductions in cardiovascular risk factors, four years after the program began the number of people who were obese and the number with diabetes remained about the same.

For the team of researchers led by Professor O’Dea, of Monash’s Centre for Population Health and Nutrition in the Faculty of Medicine, the apparent lack of change in these key indicators was no surprise.

"The research from around the world on this is pretty clear," explained Professor O’Dea. "No society in the world has shown a reduction in obesity outside of either famine or war. The best you can hope for is to slow or steady the rate and reduce the severity of diabetes-linked diseases. And this has been achieved at Looma. But you have to go back to childhood to make a real impact with obesity and diabetes."

Armed with this knowledge, the Looma Healthy Lifestyle Program was broadened in 1997, with children as the prime targets.

The community-run school canteen radically altered its fare. Within a year, the typical lunchbox contents of a meat pie with sauce, a cake, an apple and cordial were replaced with a wholemeal roll with meat, cheese, lettuce, tomato, cucumber and margarine, a tub of low-fat yoghurt, a dish of fresh fruit salad, and pure orange juice.

Last year the community decided to add a breakfast program since many children were coming to school without having had breakfast. The school sports and exercise program was intensified.

"It is too early to see the results in these kids," explained Professor O’Dea. "There is some evidence of a general improvement in their health but it will only become evident when they become adults whether the program is working or not."

The Monash researchers are continuing their regular health checks of the Looma community. With the children, they are combining these checks with records on their school attendance and visits to the health clinic with the aim of fully documenting the links between a healthy lifestyle, a nutritious diet, and performance at school.

The researchers and the Looma community know that the formula for healthy adult lives must be worked out now for the children of Looma, as it is for their peer groups in other societies.

"There is now a great deal of evidence in Westernised societies in the developed world suggesting that children are less active than ever before in human history," said Professor O'Dea. "Once sedentary behaviour and poor dietary patterns are established in childhood, they are very difficult to reverse in adulthood. Right now, I think we are sitting on a time bomb in terms of future generations, and we need to act fast."

Looma is a fairly typical Kimberly Aboriginal community in many ways - including its high rate of non-insulin dependent diabetes, due mainly to obesity, poor diet and inadequate exercise.

To make a donation to keep the Looma Healthy Lifestyle Program going, contact the Monash Centre for Population Health and Nutrition on (03) 9594 5510.