title: Overweight, obesity, physical activity and sugar-sweetened beverage consumption in adolescents of Pacific islands: results from the Global School-Based Student Health Survey and the Youth Risk Behavior Surveillance System.
abstract: BACKGROUND
  Overweight, obesity and their consequences are challenges to sustainable social and economic development in Pacific island countries and territories (PICTs). Complementing previous analyses for adults, the purpose of this paper is to synthesise available data on overweight, obesity and their risk factors in adolescents in the region. The resulting Pacific perspective for the younger generation will inform both the national and regional public health response to the crisis of noncommunicable diseases.
  
  
  METHODS
  We examined the prevalence of overweight, obesity, physical activity and carbonated sugar-sweetened beverage (SSB) consumption, by using published results of two cross-sectional surveys: the Global School-Based Student Health Survey (GSHS) and the Youth Risk Behavior Surveillance System (YRBSS). GSHS was conducted in ten PICTs between 2010 and 2013 and provided results for 13-15 year olds. YRBSS surveys, conducted repeatedly in five PICTs between 1999 and 2013, provided results for grade 9-12 students (approximately 14-18 years) and enabled examination of trends.
  
  
  RESULTS
  Obesity prevalence ranged from 0 % in female students in Vanuatu to 40 % in males in Niue (GSHS). Among grade 9-12 students (YRBSS), obesity was highest in American Samoa (40 % of males; 37 % of females). Approximately 60 % of students in the Cook Islands, Niue and Tonga (GSHS) and American Samoa (YRBSS), were overweight. In both surveys, less than half of students reported engaging in sixty minutes of physical activity on at least 5 days of the past week. Daily consumption of carbonated SSBs in the past month was reported by over 42 % of students in six PICTs (GSHS), and in the past week by more than 18 % of students in three PICTs (YRBSS). In PICTs conducting YRBSS, obesity prevalence remained high or increased within the period 1999-2013.
  
  
  CONCLUSIONS
  There is a need for urgent action on overweight, obesity and their risk factors in Pacific youth. The multiple social, economic and physical determinants of this public health crisis must be addressed. This requires all sectors within government and society in PICTs to implement and evaluate policies that will protect and promote the health of their populations across the life course.
authors.affiliation: Public Health Division, Secretariat of the Pacific Community, BP D5 98848 Noumea, New Caledonia.
authors.forename: Tara
authors.initials: T
authors.lastname: Kessaram
authors.affiliation: Public Health Division, Secretariat of the Pacific Community, BP D5 98848 Noumea, New Caledonia.
authors.forename: Jeanie
authors.initials: J
authors.lastname: McKenzie
authors.affiliation: Public Health Division, Secretariat of the Pacific Community, BP D5 98848 Noumea, New Caledonia.
authors.forename: Natalie
authors.initials: N
authors.lastname: Girin
authors.affiliation: Public Health Division, Secretariat of the Pacific Community, BP D5 98848 Noumea, New Caledonia.
authors.forename: Onofre Edwin A
authors.initials: OE
authors.lastname: Merilles
authors.affiliation: Public Health Division, Secretariat of the Pacific Community, BP D5 98848 Noumea, New Caledonia.
authors.forename: Jessica
authors.initials: J
authors.lastname: Pullar
authors.affiliation: Public Health Division, Secretariat of the Pacific Community, BP D5 98848 Noumea, New Caledonia.
authors.forename: Adam
authors.initials: A
authors.lastname: Roth
authors.affiliation: Public Health Division, Secretariat of the Pacific Community, BP D5 98848 Noumea, New Caledonia.
authors.forename: Paul
authors.initials: P
authors.lastname: White
authors.affiliation: Public Health Division, Secretariat of the Pacific Community, BP D5 98848 Noumea, New Caledonia.
authors.forename: Damian
authors.initials: D
authors.lastname: Hoy