The problem with relying on dietary surveys:sociocultural correctives to theories of dietary change in the Pacific islands

Background Dietary surveys are frequently used as the basis for theorising nutritional change and diet-related non-communicable disease emergence (DR-NCD) in the Pacific islands. However, findings from historical survey data do not always align with ethnographic evidence. Aims This paper aims to examine the extent to which the two types of evidence can lead to similar conclusions, and draw out the implications for current theories of, and interventions addressing, nutritional change. Subjects and methods Dietary surveys carried out on Nauru between 1927 and 1979 are reviewed and compared with ethnographic evidence documented by social researchers across the colonial and post-colonial periods. Results This comparison reveals several shortcomings of survey data. Nutritional issues considered to be relatively recent—such as high-fat, low-fibre diets and transition to imported foods—occurred a century ago in our analysis and point to a long history of nutrition policy and intervention failure. Further, there is limited evidence that caloric intake overall increased significantly over this period of time in Nauru. Conclusions Theories of dietary change and DR-NCD emergence and resulting interventions could be improved through a more holistic approach to nutrition that integrates sociocultural and historical evidence about both the target population and the scientists doing the research.</p

Hookworm Infection in Oceania

Hookworm disease and its associated morbidities continue to be a major public health problem in many tropical and subtropical nations and remain endemic throughout the Oceania region. Three species of hookworm cause patent infection in humans in this region: Necator americanus, Ancylostoma duodenale and Ancylostoma ceylanicum. Historical hookworm infection rates of up to 90 % throughout many parts of Oceania have significantly declined; however, the disease remains a major problem requiring ongoing public health intervention. The effectiveness of such interventions is evident in northern Australia, where once widespread hookworm disease is now limited to a few remaining endemic foci of isolated communities in the far north of the country. Outside of Australia, there is limited data available in the literature on hookworm prevalence, but a few recent (since 2000) studies have found hookworm prevalence rates of between 3 and 23 %. Infections with A. caninum, leading to eosinophilic enteritis, and sporadic cases cutaneous larva migrans caused by dermal migration of animal hookworm larva are also reported from several regions. This chapter provides a comprehensive review of both the historical and current literature on species of hookworms infecting humans and the geographical prevalence and distribution of hookworm disease in the Oceania region