title: A conceptual framework for managing modifiable risk factors for cardiovascular diseases in Fiji.
abstract: OBJECTIVE
  The current review will look at modifiable lifestyle (physical inactivity, poor nutrition, risky alcohol behavior and cigarette smoking) and cardio-metabolic (obesity, diabetes mellitus, high cholesterol and high blood pressure) cardiovascular disease (CVD) risk factors among Indigenous-Fijian and Indo-Fijian subgroups. A framework for monitoring and managing these risk factors will be presented.
  
  
  METHODS
  National health surveys were identified where available. Electronic databases identified sources for filling missing data. The most relevant data were identified, organized and synthesized.
  
  
  RESULTS
  Compared to Indo-Fijians, Indigenous-Fijians have higher rates of obesity (17% vs 11%) and hypertension (21% vs 16%), but lower rates of diabetes mellitus (12% vs 21%) and high cholesterol (33% vs 39%). Indigenous-Fijians report higher rates of prescribed physical activity (25% vs 21%), but poorer recommended vegetable intake (48% vs 56%), greater risky alcohol behavior (17% vs 15%) and a much greater prevalence of cigarette smoking (45% vs 24%). Both Indigenous-Fijians and Indo-Fijians report a low prevalence of recommended fruit intake (17% vs 15%).
  
  
  CONCLUSIONS
  Fiji is progressing through demographic and epidemiological transitions, including a decline in infectious diseases and improved life expectancy. However, in concert with other developing nations, 'modernization' is accompanied by increased mortality from non-communicable diseases, with CVD being the most prevalent. This transition has been associated with changes to socio-cultural aspects of Fiji, including poor lifestyle choices that may contribute to a cluster of cardio-metabolic conditions which precede CVD.
authors.affiliation: School of Sport and Exercise, Massey University, New Zealand trevorgwitter@gmail.com.
authors.forename: Trevor
authors.initials: T
authors.lastname: Witter
authors.affiliation: Health & Fitness Management Program, Office of the Dean, Clayton State University, Morrow, GA, USA.
authors.forename: Melanie
authors.initials: M
authors.lastname: Poudevigne
authors.affiliation: Institute of Food, Nutrition and Human Health, Massey University, Wellington, New Zealand.
authors.forename: Danielle M
authors.initials: DM
authors.lastname: Lambrick
authors.affiliation: School of Sport and Exercise, Massey University, Wellington, New Zealand.
authors.forename: James
authors.initials: J
authors.lastname: Faulkner
authors.affiliation: School of Sport and Exercise, Massey University, Wellington, New Zealand.
authors.forename: Adam A
authors.initials: AA
authors.lastname: Lucero
authors.affiliation: Institute of Food, Nutrition and Human Health, Massey University, Wellington, New Zealand.
authors.forename: Rachel
authors.initials: R
authors.lastname: Page
authors.affiliation: Western Carolina University, Cullowhee, NC, USA.
authors.forename: Lane G
authors.initials: LG
authors.lastname: Perry
authors.affiliation: Warnell School of Forestry, University of Georgia, Athens, GA, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Tarrant
authors.affiliation: School of Sport and Exercise, Massey University, Wellington, New Zealand.
authors.forename: Lee
authors.initials: L
authors.lastname: Stoner
mesh_terms: D006801:Humans; D000428:Alcohol Drinking / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000208:ethnology; D003906:Developing Countries; D004032:Diet; D015444:Exercise; D005367:Fiji; D015438:Health Behavior; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D008019:Life Style; D050177:Overweight / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology
keywords: Fiji; culture; disparity; health gap; heart disease; lifestyle; nutrition