Overweight and obesity prevalence among adult Pacific peoples and Europeans in the Diabetes Heart and Health Study (DHAHS) 2002-2003, Auckland New Zealand.
OBJECTIVE
This paper describes and compares proportions of overweight, obese, and average BMI and their relationship with physical activity for Pacific ethnic groups (Samoan, Tongan, Niue, Cook Islands) and European New Zealanders by gender who participated in the 2002-03 Diabetes Heart and Health Study (DHAHS).


METHODS
The DHAHS was a cross-sectional population based study of people age 35-74 years carried out in Auckland between 2002-03. A total of 1011 Pacific people comprising of 484 Samoan, 252 Tongan, 109 Niuean, 116 Cook Islanders and 47 'Other Pacific' (mainly Fijian) and 1745 European participants took part in the survey. Participants answered a self-administered questionnaire to assess their participation in physical activity, perceived weight, and their perception of their current weight. Following this participant's height and weight was measured for calculation of BMI. Ethnic-specific cut offs were used for classification of overweight (Pacific > or = 26.0-<32.0, European > or = 25.0-<30.0) and obesity (Pacific > or = 26.0, European > or = 32.0).


RESULTS
Approximately 95% of Pacific men and 100% Pacific women were 'overweight or obese'. Proportions of obesity were for men: all Pacific 53%, Samoan 58%, Cook Island 23%, Tongan 60%, and Niuean 49%; and for women: all Pacific 74%, Samoan 75%, Cook Island 69%, Tongan 78%, and Niuean 76%. Pacific people were as accurate at estimating their body weight as Europeans, and included similar proportions who under-estimated their weight. The Cook Islands group were most likely to accurately report their weight and were significantly less likely to underestimate their weight. A significantly higher proportion of Pacific people reported that they were heavier than a year ago (22.7%) compared to Europeans (17.2%), but significantly fewer Pacific people (55.6%) reported thinking that they were overweight compared to Europeans (64.9%). After adjustment for possible confounding variables, older Pacific adults were over 11 times more likely to be obese than their Europeans counterparts.


CONCLUSIONS
The continued rise in overweight and obesity in older Pacific adults means that almost all are now overweight or obese. This raises concerns about interventions focussed on overweight and obesity, and will require the adoption of a total Pacific population 'environmental change' approach rather than dietary or physical activity interventions targeted to overweight individuals.
Sundborn
Gerhard
G
Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Auckland, New Zealand. gerhard.sundborn@aut.ac.nz
Metcalf
Patricia A
PA
Gentles
Dudley
D
Scragg
Robert
R
Dyall
Lorna
L
Black
Peter
P
Jackson
Rod
R
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000208:ethnology*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000208:ethnology*; D005006:Ethnicity; D005060:Europe / Q000208:ethnology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009520:New Zealand / Q000453:epidemiology; D009765:Obesity / Q000208:ethnology*; D050177:Overweight / Q000208:ethnology*; D010139:Pacific Islands / Q000208:ethnology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution