Date
: July 28th 2010
Pacific islanders
pay heavy price for abandoning traditional diet
Pacific islanders pay heavy
price for abandoning traditional diet replacing traditional
foods with imported, processed food has contributed to the
high prevalence of obesity and related health problems in
the Pacific islands. Jane Parry reports.
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. Mandating clear, consistent labelling is crucial,
says Bell. "The simpler, the better. Simple nutrition
signposts can be useful and should be encouraged, and ingredient
labels are really important for monitoring food safety and
quality."
Increasing the proportion
of locally grown, nutritious and less energy-dense traditional
foods in the diets of Pacific islanders is also essential,
says Waqanivalu. "We are also challenging our own agriculture
and fishing sectors to strike a balance between local supply
and commercialization. There have been 'go local' campaigns
in [the Federated States of] Micronesia and other countries
to promote local foods."
The summit in April emphasized
the needs of infants and how breastfeeding might improve their
nutrition. Breastfeeding is more prevalent in the Pacific
islands than in many other countries in WHO's Western Pacific
Region, says Dr Tommaso Cavalli-Sforza, regional adviser on
nutrition for WHO's Western Pacific Regional Office, one factor
being formula manufacturers opting not to push into the Pacific
islands.
"There is less interest
in promoting infant formula because the population is much
smaller than in Asian countries and so the industry spends
a lot less on advertising there than it does in, for example,
the Philippines," he says. "However in some countries,
such as Samoa, infant formula is still found in large quantities
in local stores."
However, the trend is for
high initial rates of breastfeeding to fall by more than half
at six months, and to continue downwards, according to Seini
Kurusiga, nutrition specialist at the United Nations Children's
Fund's (UNICEF's) Pacific office in Suva, Fiji. "There
is a need for greater support for breastfeeding, to build
renewed interest and make it fashionable to breastfeed,"
she says. "Support for maternal and infant
nutrition in the region is much more likely to receive the
attention it deserves if it is on a regional agenda."
Tackling such widespread
health problems in the region will require changes in food
imports and agricultural policy that can best be achieved
by cooperation between different sectors and throughout the
region. Establishing the importance of collaboration was one
of the key successes of the summit, says Waqanivalu.
"What the summit has
brought out is the multisectoral approach. We tried to put
things in terms of health and development and a need to work
hand-in-hand if we are going to make an impact."
But any regional collaborative
efforts must be flexible, says Bell, to take into account,
for example, the Pacific islands' vulnerability to the impact
of climate change on food supply. "There is a need for
data on food security to encourage informed decision-making
in the face of climate change and other threats," he
says.
The high cost of conducting
national food consumption surveys limits the extent to which
they can collect information on the causes of vitamin and
mineral deficiencies. In an effort to overcome this, countries
are working with WHO and partner agencies to pool the data
and resources of different sectors, to improve data collection,
analysis and use for planning. This month, the Secretariat
of the Pacific Community in collaboration with The World Bank
is holding a workshop of national statistics officers to improve
data collection and use.
Life expectancy data make
clear the urgent need for action. The average age at which
people develop diabetes and cardiovascular disease is getting
lower. In Fiji, only 16% of the population is aged more than
55 years due to premature deaths primarily caused by noncommunicable
diseases, says Waqanivalu.
"These diseases are
finally receiving the attention they rightfully deserve at
a regional and global level, with the Pacific Food Summit
and more recently the United Nations General Assembly resolution
on the prevention and control of noncommunicable diseases,"
he says.
For the first time ever,
the United Nations General Assembly will hold a summit in
September 2011 to address the threat posed by noncommunicable
diseases particularly in low- and middle-income countries.
At the Pacific Food Summit, participating countries and territories
unanimously endorsed a framework for action on food security.
Information on the framework can be found at www.foodsecurepacific.org.
For further information,
kindly contact: Dr Paison Dakulala, Acting secretary for health
on phone number 323 6421 begin_of_the_skype_highlighting 323
6421 end_of_the_skype_highlighting. |
