Predictors of Dietary Diversity of Indigenous Food-Producing Households in Rural Fiji.

Lydia O’Meara,Philip Brown,David Hickes,Susan L Williams

doi:10.3390/nu11071629

Abstract

Fiji, like other Pacific Islands, are undergoing economic and nutrition transitions that increase the risk of noncommunicable diseases (NCDs) due to changes of the food supply and dietary intake. This study aimed to examine dietary diversity (DD) in indigenous food-producing households in rural Fiji. Surveys were conducted with households from the Nadroga-Navosa, Namosi and Ba Provinces of Western Fiji in August 2018. Participants reported on foods consumed in the previous 24 h per the Household Dietary Diversity Score. Data was analysed using multinomial logistic regression. Of the 161 households, most exhibited medium DD (66%; M = 7.8 ± 1.5). Commonly consumed foods included sweets (98%), refined grains (97%) and roots/tubers (94%). The least consumed foods were orange-fleshed fruits (23%) and vegetables (35%), eggs (25%), legumes (32%) and dairy (32%). Households with medium DD were more likely to be unemployed (OR 3.2, p = 0.017) but less likely to have ≥6 occupants (OR = 0.4, p = 0.024) or purchase food ≥2 times/week (OR = 0.2, p = 0.023). Households with low DD were more likely to have low farm diversity (OR = 5.1, p = 0.017) or be unemployed (OR = 3.7, p = 0.047) but less likely to have ≥6 occupants (OR = 0.1, p = 0.001). During nutrition transitions, there is a need for public health initiatives to promote traditional diets high in vegetables, fruits and lean protein and agricultural initiatives to promote farm diversity.

Highlights

Nutrition-related noncommunicable diseases (NCDs) account for more than 36 million deaths each year and almost 80% of these deaths occur in low- and middle-income countries [1]
This high dietary quality contrasts to studies conducted in the remote Papua New Guinean (PNG) highlands and small island atoll of Kiribati, where 60% of participants did not consume the minimum number of food groups [44,62]
Households with higher farm diversity or with more household occupants were significantly more likely to have higher dietary diversity. These findings demonstrate how important access to land and fishing grounds is to enable dietary diversity of poor households

Summary

Introduction

Nutrition-related noncommunicable diseases (NCDs) account for more than 36 million deaths each year and almost 80% of these deaths occur in low- and middle-income countries [1]. Over the last 30 years, the prevalence of NCDs has risen faster in the Pacific region compared to the rest of the world [2,3,4]. In this region, a majority of premature deaths (before 60-years-old) are related to NCDs such as diabetes and cardiovascular disease (CVD) [5,6,7], which has resulted in “a human, social and economic crisis” [8].

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