CONTEXT: Obesity is a major public health problem in North America, particularly in Aboriginal people. OBJECTIVE: To determine if a household-based lifestyle intervention is effective at reducing energy intake and increasing physical activity among Aboriginal families after 6 months. DESIGN, PARTICIPANTS, AND INTERVENTION: Randomized, open trial of 57 aboriginal households recruited between May 2004 and April 2005 from the Six Nations Reserve in Ohsweken, Canada. Aboriginal Health Counsellors made regular home visits to assist families in setting dietary and physical activity goals. Additional interventions included provision of filtered water, a physical activity program for children, and educational events about healthy lifestyles. RESULTS: 57 households involving 174 individuals were randomized to intervention or usual care. Intervention households decreased consumption of fats, oils and sweets compared to usual care households (-4.9 servings per day versus -3 servings/day, p = 0.006), and this was associated with a reduction in trans fatty acids (-0.2 versus +0.6 grams/day, p = 0.02). Water consumption increased (+0.3 versus -0.1 servings/day, p < 0.04) and soda pop consumption decreased (-0.3 versus -0.1 servings/day, p = 0.02) in intervention households compared to usual care. A trend toward increased knowledge about healthy dietary practices in children, increased leisure-time activity and decreased sedentary behaviours was observed, although these differences were not statistically significant. CONCLUSION: A household-based intervention is associated with some positive changes in dietary practices and activity patterns. A larger and longer-term intervention which addresses both individual change and structural barriers in the community is needed.

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