A new Aboriginal?led health initiative on Ngarrindjeri Ruwe (Country)—the Lower River Murray, Lakes and Coorong region—in South Australia has recently concluded a pilot to explore outcomes from a culturally grounded approach to improving type 2 diabetes and metabolic syndrome in Aboriginal communities.
Detailed in a new study led by Flinders University and Riverland Mallee Coorong Local Health Network published in BMJ Open, the program, Nra:gi Ya:yun—meaning ‘very good foods/very good eating’—is a 28?week co?designed low?carbohydrate remission pilot created with Ngarrindjeri Elders, community members, clinicians and researchers.
The pilot brings cultural knowledge together with clinical science to address what community and researchers describe as an urgent and growing health challenge.
Type 2 diabetes affects 10.7% of Aboriginal and Torres Strait Islander adults, driven by the ongoing impacts of colonization, disrupted food systems and social determinants of health.
Principal Investigator, Associate Professor Courtney Ryder, says the project emerges from community?driven conversations.
“Nra:gi Ya:yun responds to that call by honoring lived experience and cultural foundations that guide well-being,” says Associate Professor Ryder from Flinders Health and Medical Research Institute (FHMRI).
Project coordinator Shanti Omodei?James, a Research Officer within the Discipline of Trauma and Injury in the College of Medicine and Public Health, says, “Nra:gi Ya:yun works to honor the lived experience of its participants and support them along their remission journey”.
Ten co?design workshops shaped the model, with community leaders strongly favoring a low?carbohydrate approach backed by emerging evidence.
“Low?carb nutrition can support metabolic improvements but community?led delivery is the essential ingredient,” says Associate Professor Ryder.
Participants progressed through a control period, a 12?week remission phase and a maintenance phase. Supports included fresh meal boxes, continuous glucose monitoring, yarning sessions and tailored resources. Group yarning provided a culturally safe way to share experiences, build trust and strengthen motivation.
The program intends to build on the positive outcomes from this pilot to create sustainable metabolic changes in community. Two-way learning was paramount as the team of Aboriginal and non-Aboriginal clinicians, researchers and health workers developed relationships of trust, building community research capacity for all.
The pilot will determine feasibility for a larger clinical trial and explore early metabolic and well-being outcomes.
Publication details
Shanti Omodei-James et al, Protocol for a non-randomised stepped-wedge pilot trial for ‘Nra:gi Ya:yun’ (very good foods): a co-designed type 2 diabetes and metabolic syndrome initiative with Aboriginal people living on Ngarrindjeri Ruwe, BMJ Open (2025). DOI: 10.1136/bmjopen-2025-106319
Journal information:
BMJ Open
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