Its not exactly what you expect it to be. People usually visit these islands for the sun, sea, relaxation and recreation and those who cant afford it just yet long to visit but the residents of the Pacific islands have another reality awaiting them as they live a life of imported/canned food, remote access to healthcare facilities and very little exercise which results in the most obese nations in the world.
According to World Health Organisation (WHO), nine out of the top 10 most obese nations in the world are Pacific islands making these paradise the fattest regions on earth. Little wonder people go to these places to laze around. According to Temo Waqanivalu, who is a Fijian native and a program officer with the WHO’s Prevention of Non-communicable Diseases department, he says; “Up to 95% of the adult population are overweight or obese in some countries, in Polynesia the perception of ‘big is beautiful’ does exist,” he says. “[But] big is beautiful, fat is not. That needs to get through.” According to WHO reports, obesity ranges from 35% to 50% throughout the islands with the Cook island ranking highest with just over 50% obesity percentage. “It’s a deadly epidemi” says Waqanivalu.
Also, “One third of the world is either overweight or obese right now,” says Emmanuela Gakidou, professor of Global Health at the Institute for Health Metrics and Evaluation. Gakidou’s recent paper used data from countries across the world to identify the global burden of obesity and trends seen in different populations. “The Pacific islands have a lot of countries with very high levels of obesity,” she adds. Obesity can be measured through an individual’s body mass index (BMI) and a measurement above 30kg/m² is defined as clinically obese.
Pacific islanders tend to have a naturally big build, says Jonathan Shaw, associate director of Baker IDI Heart and Diabetes Institute, Australia. “With Pacific islanders, their frame is typically bigger,” he explains, “but that still doesn’t account for the obesity we see.” Poor diets and reduced exercise are a major source of concern to public health in the region as they are not only a cause of obesity but also associated diseases such as heart disease, stroke and diabetes, the latter of which has a known genetic basis among locals.
The epidemic has been attributed to very high demands for highly processed and energy-dense food such as white rice, flour, canned foods, processed meats and soft drinks imported from other countries effectively abandoning local traditional diets of fresh fish and vegetables. One of the root causes of the change is the price tag. “All over the world, poor quality and highly energy-dense food is the cheapest,” says Shaw. As demand for healthier alternatives remain low, their market is small.
This is exemplified by fishermen often selling the fish they catch to in turn purchase canned tuna. “[You] can buy a few meals with what you get selling fish,” says Waqanivalu. The new food environment locals find themselves living in has accelerated the trend towards consuming processed food. “It’s significantly cheaper,” adds Waqanivalu. “It’s cheaper to buy a bottle of coke than a bottle of water.”
Increased urbanization and sedentary office cultures have further aided the rise in obesity among Pacific islanders.”A lot of physical activity was in the domain of work,” says Waqanivalu, referring to fisherman heading out to sea and others working their land on plantations. “The concept of leisure-time activity is new,” he says.
“In tropical countries there is a desire to avoid physical work and even walk,” says Shaw. “We’re all driven to conserve energy.”
A concept known as the ‘Thrifty Gene’ hypothesis which some scientists believe is that the Pacific island populations have evolved to maintain their large builds. The concept is based on the fact that the islanders once endured very long sea journeys and those who fared best stored enough energy in form of fat to survive. “We have the remnants of those people … and their metabolism as well,” says Waqanivalu.
The increased risk of obesity among native Pacific islanders is shown on the islands of Fiji, where the population has a more mixed ethnicity. The country stands at the lower end of the region’s spectrum with 36.4% of the adult population classed as obese. Just more than half of the Fijian population are native iTaukei, with the remainder mostly of Indian origin, according to the CIA World Factbook. “That explains the lower rates,” says Waqanivalu.
The WHO has made a series of recommendations to improve the situation and is implementing them through policy changes in the countries. “Type II diabetes is emerging in young children 10-11 years old,” says Waqanivalu, who has also heard reports of a child as young as seven years old being affected. “[It’s the] tip of the iceberg in children.”
But Waqanivalu is confident his department is making some progress through recommendations such as increased taxation on soft drinks, improving trade in the region, controlled marketing of products targeting children through schools, and policies to promote healthier diets and exercise.
“The whole food environment needs to be changed,” he says. This has been the ambition of the Healthy Islands Vision which aims to combat obesity and diabetes among its health priorities. Health systems also need strengthening to better handle the consequences of obesity. “We have definitely made steps but need to make strides for this to be sorted in our time,” says Waqanivalu.
