Nutritional diversity and community perceptions of health and importance of foods in Kiribati: a case study

Abstract

Over the twentieth century, small island states in the Pacific experienced a dietary shift from traditional foods characteristic of the region to imported foods of poor nutritional quality. In Kiribati, noncommunicable diseases including diabetes and hypertension are now the largest burden of disease in the country and the primary cause of premature mortality. Food and nutritional security in Kiribati are now a major public health challenge. Climate change is likely to negatively affect traditional food production systems. In this study, twelve gender-segregated focus groups in six communities were carried out across Kiribati. Food charts were obtained from each focus group, where all food items mentioned by communities were listed and scored for health and importance. These were analysed using Excel and Stata. Health scores were on average 42.4% lower for imported food compared to local food with strongly significant findings at a p value of <0.001. This significance however disappears entirely for importance scores, with a p value of 0.943, indicating that while local foods are perceived as healthier, they are not seen as more important. Nutritional diversity is greater in rural communities compared to urban communities in Kiribati. Taking local perceptions of food into account, this study informs policymakers on new strategies to improve food and nutritional security and help island communities become more climate resilient through a renewed focus on local agricultural production, which would also improve health outcomes. Food access and availability issues in Kiribati mean that public health policies should factor these in future policymaking.