Study finds Pacific accounts for nine of the 10 most obese countries in the world, Cook Islands grapples with highest childhood obesity rates in the world

Study finds Pacific accounts for nine of the 10 most obese countries in the world

New analysis published in the Lancet has found that Pacific island countries account for nine out of 10 of the top countries in the world with the highest prevalence of obesity among women and men aged 20 and above.  

Looking at data from 2022, the study found that more than 1 billion people in the world are now living with obesity. Worldwide, obesity among adults has more than doubled since 1990, and has quadrupled among children and adolescents (5 to 19 years of age). The data also show that 43 percent of adults were overweight in 2022. The World Health Organisation (WHO) contributed to the data collection and analysis informing the report.  

In the Pacific, overweight, obesity and diet-related noncommunicable diseases have progressively increased in every age group over recent decades and have become a major cause of early death and disability. Being overweight or obese increases the risk of developing noncommunicable diseases such as diabetes, high blood pressure and heart disease. Not only does this threaten lives and affect quality of life, it stands in the way of economic and development goals by reducing the number of years that people can play an active part in the workforce.  

Health leaders in the Pacific have long been aware of the increasing epidemic of obesity. However, while efforts have been made, progress has not been fast enough. Part of the challenge is that many of the factors contributing to rising rates of obesity are out of the control of those working in the health sector.  

“The drivers of obesity are complex,” said Dr Mark Jacobs, WHO Representative to the South Pacific. 

“In many parts of the Pacific, unhealthy food is cheap, convenient, and pushed heavily through advertising. Healthy food, on the other hand, may be increasingly difficult to get and more expensive in the face of the droughts, floods and rising seas caused by climate change. What we eat, how much we eat, and whether we are physically active also comes down to things like the culture around us and whether there is a safe and comfortable place to exercise.”  

Recognising the need for new approaches, health leaders at the Fifteenth Pacific Health Ministers Meeting hosted by Tonga last September committed to a series of eight actions to address the complex drivers of obesity, particularly in children and young people.  

In particular, they stressed the need to engage other government ministries, particularly the ministries of environment, trade, finance, customs, agriculture, fisheries and social development.  

They also committed to empowering networks and organisations already working at the community level, such as civil society organisations, persons with lived experience, youth groups, schools, traditional leaders, local governments and faith-based organisations.  

“It’s only by working together, across the whole of government and across the whole of society, that we will be able to halt rising rates of obesity,” continued Dr Jacobs.  

WHO’s advice to people in the Pacific is to bring different parts of government together with health workers, parents, teachers, sports stars, community organisations and church leaders to:  

*Make unhealthy foods and drinks more expensive (such as via taxes on sugary drinks) or make it harder for them to be imported;  

* Make healthy food and drinks easier to access and cheaper; 

* Support healthy eating in pregnancy and ensure infants are exclusively breastfed for the first six months of life; 

*Establish healthy habits in childhood and regularly monitor children’s height and weight; 

*Change expectations around what a good meal looks like and show that we love our families and friends by serving them healthy food and drinks; and, 

*Create safe and pleasant places to exercise and show how fun it can be. 

WHO is working to support Pacific island countries and areas to promote healthier behaviours, such as through the Health Promoting Schools initiative, as well as supporting health workers to test for, monitor and treat noncommunicable diseases.  

Funding from the European Union and New Zealand makes WHO’s work on obesity and noncommunicable diseases in the Pacific possible.

Cook Islands grapples with highest childhood obesity rates in the world

Cook Islands has the highest childhood obesity rate, with over 30 percent of children having obesity, a recent study on worldwide trends in underweight and obesity reveals. 

Bob Williams, Secretary for Te Marae Ora Ministry of Health, said they are concerned with the statistics. 

Williams said the Healthy Island and Healthy School screening done last year for schools on Rarotonga and the Southern Group Islands also indicated obesity among children at around 30 per cent. 

“TMO is concerned and parents should be concerned too,” Williams said. “This is all attributed from the lifestyle that we allow ourselves and our children to have.” 

The main causes are the sugary drinks and the processed or unhealthy food that we allow our children to drink and eat, he said. 

Williams added that there is also an increase in the rate of physical inactivity among our people and children. 

“We have also discovered smoking and vaping amongst children as well,” he said. “These are key health risk factors not only affecting our children but majority of our people.” 

The study published in The Lancet medical journal last week shows that global obesity rates among adult women more than doubled between 1990 and 2022, while rates among adult men tripled. Childhood obesity rates were four times higher in 2022 compared to 1990. 

The estimates say more than a billion people are living with obesity globally, which includes about 880 million adults and 159 million children, according to 2022 data. 

The nations of Tonga and American Samoa had the highest adult female obesity rates, while Nauru and American Samoa had the rates among adult males, making up 60 per cent of each population. 

Cook Islands and Niue had the highest childhood obesity rates, where over 30 percent of kids have obesity. 

Senior researcher Professor Majid Ezzati, of Imperial College London, told the BBC: “In many of these island nations, it comes down to the availability of healthy food versus unhealthy food.” 

“In some cases, there have been aggressive marketing campaigns promoting unhealthy foods, while the cost and availability of healthier food can be more problematic.” 

Sir Collin Tukuitonga, who is an associate professor, associate dean Pacific, and a research director at Auckland University’s medical school, said the results for children were especially concerning. 

“The local data here will show that two-thirds of young Pacific girls are obese, overweight. There’s increasing trends in childhood obesity,” Tukuitonga told RNZ. 

He said obesity was a longstanding fight for Pacific nations. 

“The problem of course is that it’s so difficult to tackle, and it’s all to do with our food systems, how people are not as active as they used to be.” 

Williams said Te Marae Ora is working with the Ministry of Education to sign up schools to be “healthy schools”. 

“All schools in the Southern Group Islands have signed up with one primary school on Rarotonga in 2023,” he said. 

As a “Healthy School”, they agree to ban fizzy drinks on school grounds and designate days for healthy breakfast or lunch options. 

Williams said TMO also provides financial support for the schools to establish sustainable healthy programmes as part of the agreement. 

“We plan to sign-up some more schools on Rarotonga next month and the Northern Group Island schools this year,” Williams said. 

“TMO support the schools by supplying all students water bottles, tooth brush and tooth pastes. TMO is grateful to ADB (Asian Development Bank) for installing or improving water fountains in schools and in public places. TMO also supplies the schools with First Aid Kits sponsored by the Bank of the South Pacific.” 

Williams expressed appreciation for the support of the government and the Minister of Health, Vainetutai Rose Toki Brown, for launching the Healthy and Smoke-Free Islands initiative in February 2023. 

“This initiative is also supported by our development partners World Health Organisation (WHO) and UNICEF since the launch.” 

As of last week, Williams said the Food and Agriculture Organisation (FAO) indicated support for providing gardening equipment and resources to schools to increase the availability of nutritious food. 

“This will also be supported by an app that the Ministry of Agriculture and TMO is working with FAO to be developed to allow everyone in the Cook Islands to monitor their nutrition intake and the Cook Islands food profiles necessary to support our people in making a healthy lifestyle transformation.” 

TMO also plans to partner with all health and fitness groups and sports groups to increase physical activity levels among children and adults. Some groups have already applied healthy meal plans for their members, and TMO is grateful and willing to support them, Williams said. 

“TMO is working with WHO to finalise a dietary guideline and a physical activity guideline for the Cook Islands before TMO proposes other policy reforms.” 

The ultimate goal is for Cook Islands children to be free of non-communicable diseases and dental caries by 2030+, Williams said. 

“This also mean no more obese children by 2030+,” he said.