Against the Tide of Change: Diet and Health in the Pacific Islands

Abstract

Rates of chronic disease in Pacific island countries are among the highest in the world and they are the leading causes of morbidity and death. Recent reports indicate that many Pacific populations are also experiencing high levels of vitamin and mineral deficiency diseases. Prevalence of iron-deficiency anemia in 16 Pacific countries now ranges from 7% to 57% (highest among women and children). Iodine deficiency disorders and vitamin A deficiency are also severe problems in some of the Pacific countries. The situation varies across countries, but is illustrated by the Federated States of Micronesia (FSM). Vitamin A deficiency affects 55% to 76% of children in Chuuk State, 51% in Pohnpei, 63% in Kosrae, and 34% in Yap; and anemia is common (38% women, 33% children). Malnutrition occurs among the preschool children (10% stunted, 13% underweight), whereas obesity (33% of women), hypertension (17%), and diabetes (12%) continue to increase in adults. Left unabated, this crushing burden of disease will not only lead to premature death and disability for thousands of people, but it threatens to overwhelm already-stretched health resources and services. This commentary briefly summarizes nutritional issues common among the Pacific island populations that have been aggravated by advancing cultural changes and that have had an adverse impact on health.