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

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, gamma-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/m2 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.