Obesity in the Pacific

Author: Jordan Alphonse

Obesity is excessive fat accumulation that may damage the health of an individual [1]. Obesity is commonly measured by using body mass index (BMI), defined as the weight in kilograms divided by the square of the height in meters (kg/m2) [2]. The World Health Organization (WHO) categorizes obese adults as those with a BMI greater than or equal to 30 [1]. For children under 5 years of age, they are considered obese when their weight-for-height is greater than 3 standard deviations above the WHO Child Growth Standards median [1]. Children aged between 5-19 years reach obese level when their weight-for-height is greater than 2 standard deviations above the WHO Growth Reference median [1].

The Pacific Island nations currently has the highest adult obesity prevalence in the world [3]. The obesity epidemic is commonly increasing in low-income countries, thus the case for most Pacific Island countries [3]. The top 10 most obese nations in the world includes Pacific Island Nations [4]. American Samoa is at the top of the list with 75% of the population reported as obese [4]. Followed by Nauru and Cook Islands with 71% and 63% obese population respectively [4]. The list goes on with Tokelau, Tonga, Samoa, Palau, Kiribati, Marshall Islands and Kuwait in a descending order [4].

It is identified that adolescent obesity leads to adult obesity so it is important to prevent unhealthy weight gain during adolescence [3]. The Pacific children population in New Zealand reveals to have one of the highest prevalence levels of obesity in the world [3]. About 50% of 5 to 6-year old children of Pacific population in New Zealand are obese [3].

The major cause for Obesity is the increased intake of energy-dense foods high in fat and sugars and increase in physical inactivity due to sedentary forms of work, changing modes of transportation and increasing urbanization [1]. The Pacific Islanders were inferred to be genetically predisposed to obesity but research shows that the rise in obesity prevalence in Pacific Island countries is due to the introduction of Western diet [4]. It all leads back during the colonial period that the Western meal was brought into the Pacific region by colonizers like Australia, America, British and French nations [4]. After World War 2, the Pacific Islanders lifestyle changed drastically, with a shift from traditional Pacific culture to the Western culture [4].

Obesity poses serious risks of non-communicable diseases such as type 2 diabetes, cardiovascular disease, hypertension and stroke, and certain forms of cancer [2]. Child obesity is the most dangerous form of obesity and may lead to premature death and disability in adulthood [1, 2]. Amy McLennan, a research student from the University of Oxford did some studies in a Pacific Island country and described her experience [5]. Amy [5] stated, “I was at the hospital one evening when a young mother was rushed following a heart attack. Her family accompanied her in the car that screamed up to the Emergency Ward; children and adults wailed as her body was wheeled away on a steel table, and one of her teenage sons cried out loud and punched the wall so many times that he drew blood.” She [5] continued, “Amputations resulting from diabetes complication were not uncommon, on more than one occasion I met someone younger than me who was about to have their foot amputated”. “I knew of at least one funeral every week; at times there would be two or three in one day. And these people were not necessarily elderly. Quite often they were middle-aged women and men who had children, jobs and families”, said Amy [5].

Obesity can be prevented at an individual and national level. For individuals the best preventative action is to limit energy intake from total fats and sugars, increase consumption of fruits and vegetables and engage in regular physical activity [1]. A multi-sectoral population-based approach is required for a community to battle obesity [2]. The initiation of public policies that promote the availability and accessibility of a wide range of low-fat, high-fibre foods, and that provide opportunities for physical activity [1, 2]. A very encouraging approach done in the Pacific to prevent adolescent obesity was the launching of the Pacific Obesity Prevention in Communities project that specifically targeted Fiji, Tonga, New Zealand and Australia [3]. The WHO has also taken a global approach in the battle against obesity by introducing the “WHO Global Strategy on Diet, Physical Activity and Health”. The strategy directs all stakeholders to take action at global, regional and local levels to improve diets and physical activity patterns at the population level [1].

Therefore, Obesity is a common enemy of the Pacific region and also globally. The best approach to combat this non-communicable disease is for every individual to be responsible of their diet and stay fit. The Pacific Island countries need to align their strategies with the WHO and work together to seriously fight the obesity prevalence in the Pacific region.

Reference

1. World Health Organization (WHO). Obesity and Overweight [Homepage on the internet] c2020. Available from https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight

2.  World Health Organization (WHO). Obesity and Overweight; 2003

3. Swinburn B.A, Millar L, Utter J, et al. The Pacific Obesity Prevention in Communities project: project overview and methods. Deakin University, Melbourne, Victoria, Australia: International Association for the Study of Obesity; 2011

4. Healthcare. Why the Pacific Islands are the most Obese Nations in the World [Homepage on the internet] c2020. Available from https://www.healthcareglobal.com/hospitals/why-pacific-islands-are-most-obese-nations-world

5. Mclennon A, Obesity in the Pacific Islands. University of Oxford, United Kingdom; 2011