Modernization and the diet of adults on Rarotonga, the Cook Islands

Abstract

Populations in the Pacific region have shown a clear rise in overweight and obesity across the second part of the twentieth century, this increase being attributed to economic modernization and the dietary change that has gone with it. This study examined the relationships between socioeconomic factors and dietary intakes of adult Cook Islanders living a largely modernized lifestyle on Rarotonga, the Cook Islands. A cross‐sectional volunteer sample of 379 Cook Islanders aged 22 to 86 years estimated their habitual food intake by short food frequency questionnaire. Of the modernization variables examined, the number of years of education was most consistently associated with diet, male Cook Islanders with more years of education having a lower frequency of consumption of traditional staple foods than those with fewer years of education. Females with more years of education had an apparently higher frequency of alcohol consumption relative to those with fewer years of education. Adults born on Rarotonga ate fresh fish significantly less often than those born elsewhere in the Cook Islands, while males ate imported staple foods more frequently than did females. There are statistically significant associations between the frequency of consumption of a triad of traditional food items: coconut, fresh fish, and traditional staple foods, suggesting that core patterns of traditional food consumption remain strong and similar for both males and females. Subtle differences in food habits between the sexes, outside of the traditional core food consumption habits, include the regular incorporation of imported meat and fish in the triad of traditional food items by women, but not men. For the men, the frequency of consumption of fresh fish is negatively associated with the frequency of consumption of imported meat and fish, suggesting that the latter food category often displaces the consumption of fresh fish in the triad of traditional food items habitually eaten by them.