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Objective To describe the dietary intake of American and Western Samoans, with emphasis on nutrients conventionally related to risk factors for cardiovascular disease. Design Cross-sectional dietary survey. Intake estimates were based on 24-hour recall interviews. Subject Community-based samples of 946 men and women (455 American Samoans, 491 Western Samoans) aged 25 to 55 years. Statistical analyses Tests of differences in means ( t tests) and proportions (Chi 2 tests). Correlation and multivariate linear regression analyses were conducted to describe correlates of energy and nutrient intakes. Results Few differences were noted between the energy and nutrient intakes of men and women, but substantial differences were found between residents of American Samoa and those of the less modernized country of Western Samoa. American Samoans consumed significantly more energy as carbohydrate (47% vs 44%) and protein (18% vs 13%) and less as fat (36% vs 46%) and saturated fat (16% vs 30%). Energy-adjusted intakes of cholesterol and sodium were higher among American Samoans. These differences persisted after adjustment for age, gender, years of education, occupation, and categories of a 10-point material lifestyle score. Samoans in the lowest category of material lifestyle had significantly lower energy-adjusted intakes of protein, cholesterol, and sodium and higher intakes of saturated fat than those in the upper 2 categories. Additional analyses described the contribution of specific foods to the intakes of energy and macronutrients. Conclusions/applications The observed energy and nutrient intake patterns are consistent with previously reported levels of obesity and risk factors for cardiovascular disease among Samoans and suggest dietary modification for those at highest risk. Dietetics practitioners who counsel Samoan and other Pacific Islander clients should be aware of these intake patterns, which seem particularly malleable to levels of personal income. More generally, results from this study illustrate that the food choices of certain ethnic groups may be profoundly affected by the process of modernization within a country or by migration to a more economically developed locale. J Am Diet Assoc. 1999;99:184–190 .

This article describes pathways through which trade policy change in two Pacific Island countries has contributed to changes in the food supply, and thereby to the nutrition transition. The effect of various trade policies from 1960 to 2005 on trends in food imports and availability is described, and case studies are presented for four foods associated with the nutrition transition and chronic disease in the Pacific. Trade policies (including liberalization, export promotion, protection of the domestic meat industry and support for foreign direct investment) have contributed to a reduced availability of traditional staples, and increased availability of foods associated with the nutrition transition, including refined cereals (particularly polished rice and white flour), meat, fats and oils, and processed food products. This study suggests that promoting healthier imports and increasing production of healthier traditional foods, in both of which trade policy has an important effect, has the potential to improve diets and health, in conjunction with other public health intervention.

Blood pressure (BP) levels were studied in 524 youth ages 4-19.9 years who reside in Samoa. The data were collected in two separate cross-sectional samples taken in 1979 (n = 292) and in 1991-93 (n = 232). BP was compared between these two study samples to evaluate the temporal change in BP among youth in response to the processes of economic modernization in Samoa, and specifically on how temporal increases in body size influenced BP levels. Proportions of youth with elevated BP levels were estimated using the Second Task Force criteria. In males and females 10-19 years, age-adjusted systolic BP was significantly higher in the 1991-93 sample than in the 1979 sample, and the difference became insignificant after adjustment for body mass index. The proportion of those ages 10-19 years with elevated BP ranged from 11-15% in the 1979 study sample and was approximately 25% in the 1991-93 study sample. There appears to be a temporal trend of increasing adiposity and BP in those 10-19 years and the BP differences are attributable to the higher levels of adiposity.

Pancreatic extracts, even in high doses, usually fail to completely control steatorrhoea in cystic fibrosis (CF), due to inactivation of the enzymes by acid and pepsin. Pancrease is a new formulation consisting of pH-sensitive, enteric coated beads which protect the pancreatic enzymes from acid and pepsin denaturation. Twelve patients with CF entered an outpatient study to examine the effectiveness of this product compared with that of a conventional product (Viokase®). Two doses for each product were used during four sequential 4-week periods. Twenty-two capsules of Pancrease® daily was significantly better than 32 capsules of Viokase® daily (faecal fat excretion 8.7 ± 4.1 g/day, 17.3 ± 9.1 g/day, p < 0.01; coefficient of absorption 89.5 ± 4.2%, 79.3 ± 9.9%, p < 0.01; bowel actions/day 1.7 ± 0.7, 2.2 ± 0.9, p < 0.05; rank scores of stool odour and stool consistency, both p < 0.05; parent's treatment preference p < 0.01). No difference was detected between Viokase® 32 capsules daily and Pancrease® 11 capsules daily, but both were significantly better than 16 capsules of Viokase® daily.