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

Abstract

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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Telehealth: a new opportunity to discuss smoking cessation with indigenous cancer patients and their families

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