Measuring Prevalence: Obesity, diabetes and associated cardiovascular risk factors among Torres Strait Islander people

Leonard, Dympna; McDermott, Robyn; O’Dea, Kerin; Rowley, Kevin; Pensio, Poi; Sambo, Edna; Twist, Aletia; Toolis, Raima; Lowson, Simone; Best, James D.

doi:10.1111/j.1467-842x.2002.tb00907.x

Cited by 78 publications

(80 citation statements)

References 16 publications

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“…Renal disease, largely attributed to glomerulonephritis and type 2 diabetes, is a serious health problem in the Torres Strait and in Australian Aboriginal communities (Hoy, 1996;Leonard et al, 2002;AIHW, 2005). It is identified in major strategies as a priority health problem needing applied research into its causes and prevention (Torres Strait and Northern Peninsula Area Health Council, 1993;National Aboriginal and Torres Strait Islander Health Council, 2000).…”

Section: Discussionmentioning

confidence: 99%

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Urinary excretion of cadmium among Torres Strait Islanders (Australia) at risk of elevated dietary exposure through traditional foods

Haswell‐Elkins

Imray

Satarug³

et al. 2006

J Expo Sci Environ Epidemiol

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This study explored urinary cadmium levels among Torres Strait Islanders in response to concerns about potential health impact of high levels of cadmium in some traditional seafood (dugong and turtle liver and kidney). Cadmium levels were measured by inductively coupled mass spectrometry in de-identified urine samples collected during general screening programs in 1996 in two communities with varying dugong and turtle catch statistics. Statistical analysis was performed to identify links between cadmium levels and demographic and background health information. Geometric mean cadmium level among the sample group was 0.83 mg/g creatinine with 12% containing over 2 mg/g creatinine. Cadmium level was most strongly associated with age (46% of variation), followed by sex (females 4males, 7%) and current smoking status (smokers 4non-smokers, 4.7%). Adjusting model conditions suggested further positive associations between cadmium level and diabetes (p ¼ 0.05) and residence in the predicted higher exposure community (p ¼ 0.07). Positive correlations between cadmium and body fat in bivariate analysis were eliminated by control for age and sex. This study found only suggestive differences in cadmium levels between two communities with predicted variation in exposure from traditional foods. However, the data indicate that factors linked with higher cadmium accumulation overlap with those of renal disease risk (i.e. older, females, smokers, diabetes) and suggest that levels may be sufficient to contribute to renal pathology. More direct assessment of exposure and health risks of cadmium to Torres Strait Islanders is needed given the disproportionate level of diet-related disease and the cultural importance of dugong and turtle. This study highlights the need to consider social and cultural variation in exposure and to define ''safe'' cadmium levels during diabetes given its rising global prevalence.

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Section: Discussionmentioning

confidence: 99%

“…Voluntary adult (415 years of age) health screening was performed in 1996 in these two Torres Strait Island communities following an invitation from the communities to the regional public health unit (Leonard et al, 2002).…”

Section: Community Programsmentioning

confidence: 99%

Urinary excretion of cadmium among Torres Strait Islanders (Australia) at risk of elevated dietary exposure through traditional foods

Haswell‐Elkins

Imray

Satarug³

et al. 2006

J Expo Sci Environ Epidemiol

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“…In addition, there are important differences between the two ethnic groups which have an impact on health outcomes. Reported prevalence of high BMI and diabetes is higher among the population of Torres Strait Islanders (TSI) than Aborigines (8,9) , and there are also differences in reproductive outcomes. More than 25 % of Aboriginal and 15 % of TSI mothers, compared to less than 5 % of nonindigenous mothers in far north Queensland (FNQ), are less than 20 years of age.…”

Section: Nutrition Indigenous Womenmentioning

confidence: 99%

The health and nutrition of young indigenous women in north Queensland – intergenerational implications of poor food quality, obesity, diabetes, tobacco smoking and alcohol use

McDermott

Campbell

et al. 2009

Public Health Nutr.

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Objective: To document nutritional status and health behaviours of young indigenous women of childbearing age in rural communities in north Queensland. Design: Cross-sectional survey of 424 Aboriginal and 232 Torres Strait Islander (TSI) women aged 15-34 years, conducted in twenty-three rural and remote communities of far north Queensland in 1999-2000, with follow-up of a smaller cohort (n 132) in 2006-2007. Main outcome measures: Weight, waist circumference, intake of fruit and vegetables, smoking, alcohol intake, fasting blood glucose, blood pressure, HDL cholesterol, g-glutamyltransferase, red cell folate (RCF), interval weight and waist gain and incidence of diabetes. Results: Forty-one per cent of Aboriginal and 69 % of TSI had central obesity, 62 % were smokers, 71 % drank alcohol regularly and of those, 60 % did so at harmful levels. One third of Aboriginal and 16 % of TSI women had very low RCF levels. In the group followed up, there was a mean annual waist gain of 1?6 cm in Aboriginal women and 1?2 cm in TSI, 0?5 kg/m 2 in BMI and 1?5 kg in weight. Incidence of new type 2 diabetes mellitus in this cohort was 29?1 per 1000 person-years (py) (95 % CI 14?0, 52?8) in Aboriginal women and 13?9 per 1000 py (95 % CI 5?6, 28?5) among TSI. Conclusions: High prevalence and incidence of central obesity and diabetes, poor nutrition, high rates of alcohol use and tobacco smoking together with young maternal age, provide a poor intra-uterine environment for many indigenous Australian babies, and contribute to high perinatal morbidity and future disability. Community level interventions to improve pre-pregnancy nutrition and health behaviours in young women are urgent. Keywords Nutrition Indigenous WomenEpidemiological, clinical and physiological research over the past two decades has greatly improved our understanding of the importance of the intra-uterine environment in 'fetal programming' and how this predicts, at a population level, the immediate and long-term health of the next generation. Low birth weight increases risk of diabetes, CVD (1) , renal disease (2) and some cancers in adulthood; low maternal intake of micronutrients increases risk of neurodevelopmental disorders in the offspring; low concentrations of dietary and circulating folate during pregnancy are associated with increased risks of preterm delivery, low birth weight in infants and fetal growth retardation (3) ; high maternal glycaemia in pregnancy increases perinatal morbidity and also the risk of early obesity and diabetes in the offspring (4) ; and fetal exposure to maternal tobacco and alcohol is teratogenic (5,6) . Babies of teenage mothers, especially those with low educational attainment, are at a higher risk of immediate and long-term ill-health (7) .Indigenous women have babies at a younger age, and their babies suffer higher perinatal mortality and morbidity than non-indigenous babies in north Queensland. In addition, there are important differences between the two ethnic groups which have an impact on health outcomes. Reported ...

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“…24 This study also found the incidence in the below 35 year old age group to still be relatively high at 5.3%. Another study used community based screening to find that obesity rates for Torres Strait Islanders were three times higher and diabetes rates six times higher than for other Australians 25 (Fig. 4).…”

Section: Dietmentioning

confidence: 99%

Improving cross-cultural awareness. A review of Australian indigenous health for UK dentists

Popat

Dinnage²

2006

Br Dent J

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Measuring Prevalence: Obesity, diabetes and associated cardiovascular risk factors among Torres Strait Islander people

Cited by 78 publications

References 16 publications

Urinary excretion of cadmium among Torres Strait Islanders (Australia) at risk of elevated dietary exposure through traditional foods

Urinary excretion of cadmium among Torres Strait Islanders (Australia) at risk of elevated dietary exposure through traditional foods

The health and nutrition of young indigenous women in north Queensland – intergenerational implications of poor food quality, obesity, diabetes, tobacco smoking and alcohol use

Improving cross-cultural awareness. A review of Australian indigenous health for UK dentists

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