'The Obesity Epidemic in the Pacific Islands' an article by Michael Curtis, Journal of Development and Social Transformation

The diseases associated with obesity have especially affected the inhabitants of the Pacific Islands, with some of the highest levels of obesity in the world found in the region. For example, the rates of overweight and obese persons have been reported to be as high as 75% in the populations of Nauru, Samoa, American Samoa, the Cook Islands, Tonga, and French Polynesia (Hughes, 2003). More prevalent in urban areas, the health problems are less common in areas that have had little contact with Western civilization (Prior in Ringrose & Zimmet, 1979). In fact, Polynesians and Micronesians that have maintained a traditional diet have diabetes rates lower than those of Western populations. For thousands of years, the inhabitants of the Pacific Islands were isolated from the rest of the world, allowing their social, cultural and economic patterns to develop untouched (Zimmet, 1979). When the Europeans began arriving in the 17th and 18th centuries, the people of the Pacific were described as “strong, muscular and mostly in good health” (Hughes, 2003). The health of these islanders was community-based and “a shared sense of well-being” permeated the collective. Food had “symbolic and economic importance” as opposed to a physiological or biological imperative. This concept was epitomized in the aristocracy of these island populations and, as a result, they were usually the largest people in the community (Hughes, 2003). Diamond offers a different slant on the history of obesity in the Pacific. He notes that ancient Pacific Islanders were highly skilled in ocean travel and “often undertook inter-island canoe voyages lasting several weeks” (2003, p. 601). Many died en route, but the most obese survived. He surmises this is why Pacific Islanders are so large today. Zimmet (1979, p.145) identifies two “disastrous waves” of diseases previously unknown to the people of the Pacific. First, there were the communicable diseases, which came as early as 1521, coinciding with Magellan’s voyage around the world. The second wave is that of the chronic non-communicable diseases, such as diabetes and hypertension that accompanied the introduction of Western habits in the culture. Everything changed after World War Two. The military, with bases in and around the Pacific Islands, “parachuted” the region into the 20th century in the span of a few years. For Western peoples, there was a gradual acclimation to the technology and scientific accomplishments of the 20th century. For Pacific Island populations, on the other hand, the process was “telescoped into a period of less than 30 years” (Zimmet, 1979, p.145). As the indigenous island populations have replaced their traditional subsistence style of living with a more modern way of life, dramatic changes have occurred. Specifically, traditional foods of past generations have been supplanted with food purchased from Western nations, such as the United States, Australia, New Zealand and Japan (Ringrose and Zimmet, 1979). The traditional foods of the islands such as fresh fish, meat, and local fruits and vegetables have been replaced by rice, sugar, flour, canned meats, canned fruits and vegetables, soft drinks and beer. The diet is high in calories and with little nutritional value (Zimmet, 1979). Many Pacific Islanders have come to depend on food imported from abroad. Consequently, commercial ventures on the islands tend to stock these high-fat, energy-dense foods. Over time, purchasing these imported goods has become a sign of social status in the community and traditional foods have decreased in importance. Even before World War Two, missionary wives and other women from the West were strongly advising the women of the Pacific on the “proper way” to feed their families. The island women were taught to “bake tarts and serve a roast beef dinner in order to keep their families healthy” (Pollock, 1992, p.182). The ingredients for these meals could only be obtained from sources outside the islands, and so a situation of “dietary colonialism” resulted (Pollock, 1992, p.182). Consequently, food imports, as a proportion of total imports, has risen to around 25% for many island nations (Pollock, 1992). Further, the increasing use of modern technology and the shift from agriculture-based occupations to civil servant office work has resulted in a sharp decrease in the day-to-day physical activity of many Pacific Islanders (WHO, 2002). The significant changes connected with the transition to a cash economy have also brought great stress to the people. The desk jobs the majority of the populations occupy contrast greatly with their traditional way of life. Further, these new nations must now compete with and adapt to the new global economy and participate in the complicated politics of the world (Zimmet, 1979, p. 148). With the institution of a modern way of life, they have traded in their canoes for motorized boats and have become accustomed to using cars instead of walking (Zimmet, Seluka, et. al, 1977)... Big is beautiful Culturally, large physical size is considered a mark of beauty and social status in many Pacific Island countries. At the community and policy making level, there is resistance to the view that obesity is a health problem. Generally, Pacific Islanders have larger frames and more muscle than Asians and Europeans, so the challenge for the Pacific Islanders becomes understanding the difference between being big as a result of hereditary factors versus as a result of overeating. Complicating the task for health officials and policy proponents is the common attitude among Pacific Islanders that obesity traditionally has been a sign of high social position and wealth (Ringrose and Zimmet, 1979, p. 1340). Since a high value was placed on a well- fed person, a commitment was made to prepare large quantities of foods for the traditional leaders and great effort was required to feed them (Pollock, 1992)... Read full article here:http://www.maxwell.syr.edu/uploadedFiles/moynihan/dst/curtis5.pdf Journal of Development and Social Transformation 41