Associations between overweight and obesity and risk factors for cardiovascular disease and fatty liver in young offenders serving community orders

The health of young offenders supervised in the community has not been studied previously. This paper describes the prevalence of overweight, obesity and obesity-associated cardiovascular and hepatic risk factors in a sample of young offenders supervised in the community in New South Wales, Australia. During 2003-05, 800 (85% male) young offenders took part in a comprehensive health survey that included direct measurement of height and weight as well as blood sampling. The prevalence of combined overweight and obesity was 33.7% in boys and 35.3% in girls; both rates were higher than those of a comparable community sample. Cardiovascular risk factor prevalence was extremely high compared with other published studies, with over 40% of boys and over 20% of girls having low levels of high density lipoprotein (HDL) cholesterol, and over 10% of both boys and girls having elevated low density lipoprotein (LDL) cholesterol. Risk factors for fatty liver disease were also prevalent, with almost 15% of boys, and 30% of girls having raised alanine aminotransferase (ALT), suggesting hepatic cell injury. Cardiovascular and fatty liver disease risk factors were significantly associated with overweight and obesity among boys but not girls in this sample. Young people of Aboriginal or Torres Strait Islander decent were at no greater risk than the rest of the population. Young offenders are among the most disadvantaged people in Australian society and are particularly vulnerable to a range of health problems. The high prevalence of risk factors represents a substantial health burden for these young people in early adulthood. Timely intervention is required to address the complex health needs of this under-served population.