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The prevalence of metabolic syndrome has reached epidemic levels in the Samoan Islands. In this cross-sectional study conducted in 2002-2003, dietary patterns were described among American Samoan (n = 723) and Samoan (n = 785) adults (> or =18 y) to identify neo-traditional and modern eating patterns and to relate these patterns to the presence of metabolic syndrome using Adult Treatment Panel III criteria. The neo-traditional dietary pattern, similar across both polities, was characterized by high intake of local foods, including crab/lobster, coconut products, and taro, and low intake of processed foods, including potato chips and soda. The modern pattern, also similar across both polities, was characterized by high intake of processed foods such as rice, potato chips, cake, and pancakes and low intake of local foods. The neo-traditional dietary pattern was associated with significantly higher serum HDL-cholesterol in American Samoa (P-trend = 0.05) and a decrease in abdominal circumference in American Samoa and Samoa (P-trend = 0.004 and 0.01, respectively). An inverse association was found with metabolic syndrome, although it did not reach significance (P = 0.23 in American Samoa; P = 0.13 in Samoa). The modern pattern was significantly positively associated with metabolic syndrome in Samoa (prevalence ratio = 1.21 for the fifth compared with first quintile; 95% CI: 0.93.1.57; P-trend = 0.05) and with increased serum triglyceride levels in both polities (P < 0.05). Reduced intake of processed foods high in refined grains and adherence to a neo-traditional eating pattern characterized by plant-based fiber, seafood, and coconut products may help to prevent growth in the prevalence of metabolic syndrome in the Samoan islands.

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 .

Introduction In 1988, David Tua, a Samoan raised on the island of Upolu, stormed the world's heavyweight boxing circles. He is one of the many Samoans who have become known internationally for their athleticism, whether in the boxing ring, on the rugby field, in American football or in paddling traditional outrigger canoes. While such athletes train and remain fit, Samoan communities in the archipelago and abroad are experiencing the negative health effects of the nutrition transition. Shifts in diet and physical activities are leading to chronic positive energy balance and high prevalence rates of obesity and related non-communicable diseases (NCD). In 2003 in the nation of Samoa, about one-third of men and over half of women aged 25 to 74 years were obese by Polynesian standards for body mass index (BMI). In 2002, 100 km across the ocean in American Samoa, about 60% of men and almost three-quarters of women were obese by the same standard. Along with these marked levels of adulthood overweight and obesity, Samoan people suffer from high levels of cardiovascular disease, type 2 diabetes, and other associated metabolic disorders (McGarvey 2001; McGarvey et al . 2005). Recently there has been a distinct rise in childhood and adolescent obesity in Samoa (Roberts et al . 2004), which threatens to exacerbate NCDs at earlier ages in the future. This chapter describes the putative causes and health consequences of the changes in nutritional status among Samoans in the early twenty-first century.

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.