title: Behavioral risk factors for obesity during health transition in Vanuatu, South Pacific.
abstract: The South Pacific archipelago of Vanuatu, like many developing countries, is currently experiencing a shift in disease burdens from infectious to chronic diseases with economic development. A rapid increase in obesity prevalence represents one component of this "health transition."
  
  
  OBJECTIVE
  To identify behaviors associated with measures of obesity in Vanuatu.
  
  
  METHODS
  Five hundred and thirty four adults from three islands varying in level of economic development were surveyed. Height, weight, waist, and hip circumferences; triceps, subscapular and suprailiac skinfolds; and percent body fat (%BF) by bioelectrical impedance were measured. Diet through 24-h dietary recall and physical activity patterns using a survey were assessed. We analyzed prevalence of obesity and central obesity based on multiple indicators (body mass index, %BF, waist circumference, and waist-to-height ratio), and analyzed differences among islands and associations with behavioral patterns.
  
  
  RESULTS
  Obesity prevalence was lowest among rural and highest among suburban participants. Prevalence of central obesity was particularly high among women (up to 73.9%), even in rural areas (ranging from 14.7 to 41.2% depending on the measure used). Heavier reliance on animal protein and incorporation of Western foods in the diet-specifically, tinned fish and instant noodles-was significantly associated with increased obesity risk.
  
  
  CONCLUSIONS
  Even in rural areas where diets and lifestyles remain largely traditional, modest incorporation of Western foods in the diet can contribute to increased risk of obesity. Early prevention efforts are thus particularly important during health transition. Where public health resources are limited, education about dietary change could be the best target for prevention.
authors.affiliation: Department of Psychiatry, McGill University; Psychosocial Research Division, Douglas Hospital Research Center, Montreal QC, Canada. . kelseydancause@gmail.com
authors.forename: Kelsey Needham
authors.initials: KN
authors.lastname: Dancause
authors.forename: Miguel
authors.initials: M
authors.lastname: Vilar
authors.forename: Michelle
authors.initials: M
authors.lastname: Wilson
authors.forename: Laura E
authors.initials: LE
authors.lastname: Soloway
authors.forename: Christa
authors.initials: C
authors.lastname: DeHuff
authors.forename: Chim
authors.initials: C
authors.lastname: Chan
authors.forename: Len
authors.initials: L
authors.lastname: Tarivonda
authors.forename: Ralph
authors.initials: R
authors.lastname: Regenvanu
authors.forename: Akira
authors.initials: A
authors.lastname: Kaneko
authors.forename: J Koji
authors.initials: JK
authors.lastname: Lum
authors.forename: Ralph M
authors.initials: RM
authors.lastname: Garruto
mesh_terms: D000293:Adolescent; D000328:Adult; D003906:Developing Countries; D004032:Diet; D015930:Diet Records; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D015438:Health Behavior; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000209:etiology*; D056128:Obesity, Abdominal / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population; D012737:Sex Factors; D013383:Suburban Population; D009514:Vanuatu / Q000453:epidemiology