Factors influencing fruit and vegetable intake among urban Fijians: A qualitative study.

Low fruit and vegetable intake is an important risk factor for micronutrient deficiencies and non-communicable diseases, but many people worldwide, including most Fijians, eat less than the World Health Organization recommended amount. The present qualitative study explores factors that influence fruit and vegetable intake among 57 urban Fijians (50 women, 7 men) of indigenous Fijian (iTaukei) and South Asian (Indian) descent. Eight focus group discussions were held in and around Suva, Fiji's capital and largest urban area, which explored motivation for eating fruit and vegetables, understandings of links to health and disease, availability and sources, determinants of product choice, and preferred ways of preparing and eating fruit and vegetables. Data were analysed using thematic content analysis. Regardless of ethnicity, participants indicated that they enjoyed and valued eating fruit and vegetables, were aware of the health benefits, and had confidence in their cooking skills. In both cultures, fruit and vegetables were essential components of traditional diets. However, increasing preferences for processed and imported foods, and inconsistent availability and affordability of high-quality, low-priced, fresh produce, were identified as important barriers. The findings indicate that efforts to improve fruit and vegetable intake in urban Fijians should target the stability of the domestic fruit and vegetable supply and access

Declines and plateaux in smoking prevalence over three decades in Fiji

Objectives: To examine trends from 1980 to 2011 in daily tobacco smoking by sex, ethnicity, age, and urban/rural in Fiji Melanesian (i-Taukei) and Indian adults aged 25-64 years. Methods: Unit record data from five population-based surveys (n = 14 528) allowed classification of participants as: (1) never-smoker, ex-smoker, or non-daily smoker; or (2) daily smoker, reporting smoking 30 years) based on empirical unit record data (n = 14 528). Cardiovascular disease is a leading cause of mortality throughout the Pacific Island region. This is the first study to show evidence of substantial declines over several decades in a cardiovascular disease risk factor in a Pacific Island country, and provides important evidence for further research into the interventions and events which may have facilitated this decline

Diabetes incidence and projections from prevalence surveys in Fiji

Background: Type 2 diabetes mellitus (T2DM) incidence is traditionally derived from cohort studies that are notalways feasible, representative, or available. The present study estimates T2DM incidence in Fijian adults from T2DMprevalence estimates assembled from surveys of 25–64 year old adults conducted over 30 years (n = 14,288).Methods: T2DM prevalence by five-year age group from five population-based risk factor surveys conducted over1980–2011 were variously adjusted for urban-rural residency, ethnicity, and sex to previous censuses (1976, 1986, 1996,2009) to improve representativeness. Prevalence estimates were then used to calculate T2DM incidence based on birthcohorts from the age-period (Lexis) matrix following the Styblo technique, first used to estimate annual risk oftuberculosis infection (incidence) from sequential Mantoux population surveys. Poisson regression of year, age,sex, and ethnicity strata (n = 160) was used to develop projections of T2DM prevalence and incidence to 2020based on various scenarios of population weight measured by body mass index (BMI) change.Results: T2DM prevalence and annual incidence increased in Fiji over 1980–2011. Prevalence was higher in Indiansand men than i-Taukei and women. Incidence was higher in Indians and women. From regression analyses, absolutereductions of 2.6 to 5.1% in T2DM prevalence (13–26% lower), and 0.5–0.9 per 1000 person-years in incidence (8–14%lower), could be expected in 2020 in adults if mean population weight could be reduced by 1–4 kg, compared to thecurrent period trend in weight gain.Conclusions: This is the first application of the Styblo technique to calculate T2DM incidence from population-basedprevalence surveys over time. Reductions in population BMI are predicted to reduce T2DM incidence and prevalence inFiji among adults aged 25–64 year

Continued increases in hypertension over three decades in Fiji, and the influence of obesity

© Copyright 2016 Wolters Kluwer Health, Inc. All rights reserved. Objectives: To analyse trends during 1980-2011 in hypertension prevalence and SBP/DBP by sex in Fiji Melanesian (i-Taukei) and Indian adults aged 25-64 years; and to assess effects of BMI. Methods: Unit record data from five population-based surveys were included (n=14191). Surveys were adjusted to the nearest previous census to improve national representativeness. Hypertension was defined as SBP at least 140mmHg and/or DBP at least 90mmHg and/or on medication for hypertension. Regression (Poisson and linear) was used to assess period trends. Results: Over 1980-2011 hypertension prevalence (%) and mean blood pressure (BP) (SBP/DBP mmHg) increased significantly (P < 0.001) in both sexes and ethnicities. Increases in hypertension were: from 16.2 to 41.3% in i-Taukei men (mean BP from 122/73 to 135/81); from 20.5 to 37.8% in Indian men (mean BP from 122/74 to 133/81); from 25.9 to 36.9% in i-Taukei women (mean BP from 126/76 to 132/81); and from 17.6 to 33.1% in Indian women (mean BP 117/71 to 130/81). The age-adjusted trend in hypertension and mean BP (over 32 years) declined after adjusting for BMI, with effects of obesity greater in women than men, and in India ns than i-Taukei. BMI explained 45% of the age-adjusted increase in DBP over the period in Indians (both sexes), and 16% (men) and 38% (women) in i-Taukei. Conclusion: Significant increases have occurred in hypertension prevalence and SBP/DBP in both sexes and ethnicities of Fiji during 1980-2011 with no indication of decline, contributing to significant premature mortality from cardiovascular disease