Nutrition and health in modernizing Samoans: temporal trends and adaptive perspectives

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.