Scattered across the Pacific Ocean are thousands of islands which make up three regions known as Melanesia, Micronesia and Polynesia. Beyond the image of white sandy beaches and carefree lifestyles, the Pacific islands are facing serious health problems, the prime culprit being imported foods.
In at least 10 Pacific island countries, more than 50% (and in some, up to 90%) of the population is overweight according to World Health Organization (WHO) surveys. More seriously, obesity prevalence ranges from more than 30% in Fiji to a staggering 80% among women in American Samoa, a territory of the United States of America (USA).
WHO defines overweight as having a body mass index (BMI) equal to or more than 25, and obesity as a BMI equal to or more than 30. Diabetes prevalence among adults in the Pacific region is among the highest in the world; 47% in American Samoa compared with 13% in mainland USA, and it ranges from 14% to 44% elsewhere in the region.
Micronutrient deficiencies are also common in this region. In 15 of 16 countries surveyed, more than one fifth of children and pregnant women were anaemic. In Fiji, Papua New Guinea and Vanuatu, iodine deficiency and related goitre are endemic although, in Fiji and Papua New Guinea, great progress was made recently through salt iodization. In many other Pacific countries and territories the situation is yet to be assessed. Vitamin A deficiency is also a significant public health risk in Kiribati, the Marshall Islands, the Federated States of Micronesia and Papua New Guinea.
About 40% of the Pacific island region's population of 9.7 million has been diagnosed with a noncommunicable disease, notably cardiovascular disease, diabetes and hypertension. These diseases account for three quarters of all deaths across the Pacific archipelago and 40-60% of total health-care expenditure, according to a meeting on obesity prevention and control strategies in the Pacific held in Samoa in September 2000.
Dr Temo K Waqanivalu, technical officer for nutrition and physical activity at the Office of the WHO representative for the South Pacific in Suva, Fiji, partly blames poor diet for the region's health problems. "Promotion of traditional foods has fallen by the wayside. They are unable to compete with the glamour and flashiness of imported foods," he says.
People in the Pacific islands may know what constitutes healthy eating but, as in many parts of the world, governments struggle to change people's behaviour. In eight countries, less than 20% of people surveyed reported eating the recommended five or more portions of fruit and vegetables a day. The often calorie-rich and nutrient-poor imported foods have a stronger appeal.
A major challenge for Pacific island countries is to reinforce nutrition education in schools by promoting healthy eating practices. "Even as kids we know what we are supposed to eat and not eat; there is a very good level of nutrition education in Fiji," says Ateca Kama, senior nutritionist at Fiji's National Food and Nutrition Centre. "The challenge is for us to translate knowledge into behaviour. For example, schools teach good nutrition as part of the curriculum, and then they sell junk food in the school canteen because they need to make a profit."
At the Pacific Food Summit held in Vanuatu in April, delegates agreed that the region's governments need new laws to better regulate the food industry. "There isn't a lot of clarity in regulating the food industry, which is saying it wants a level playing field. For example, food labels vary as much as the countries the food comes from," says Dr Colin Bell, technical officer, noncommunicable diseases, at WHO's Western Pacific Regional Office in Manila.
Historically, food was imported from Australia and New Zealand, but now it comes from much further afield: China, Malaysia and the Philippines. Nutrition labels are not only inconsistent but often not in English, the common language spoken in most Pacific island countries. …