OBJECTIVE: To assess attitudes to body size and obesity in Samoans, a Paci®c island group characterised by very high levels of obesity and traditionally strong positive cultural views of large bodies. DESIGN: Cross sectional study of Samoan adults in Samoa and New Zealand. SUBJECTS: 84 female and 77 male Samoans in Samoa and 41 female and 24 male Samoans in Auckland, New Zealand, aged 25±55 y. MEASUREMENT: Body mass index (BMI), standardised survey questionnaires of perceptions of bodyweight and health, diet and exercise, and perception of body sizes on a continuous scale. RESULTS: Although Samoans in both countries display high population levels of obesity, ideal body sizes are slim and body dissatisfaction and attempted weight losses were apparent. However, women and men above normal weight did not characteristically perceive themselves as obese, were as positive about their body size, weight and health, and obese women were no more likely to be attempting to lose weight than their slimmer peers. CONCLUSIONS: The traditional Samoan veneration of large bodies is not apparent as ideal body sizes are slim. An important difference in values with Western industrialised societies is the absence of a strongly negative view of obesity.

Objective: The minor allele of rs373863828, a missense variant in CREBRF, is associated with higher BMI but lower odds of type 2 diabetes in Pacific Islanders. Methods: To test if this protective effect operates through metabolically favorable body fat distribution, we examined the association of the minor A allele with body composition, measured using dual-energy x-ray absorptiometry (DXA), in a cross-sectional study of n=421 Samoan adults. Results: We replicated our earlier finding that this allele was associated with higher weight and BMI, although it was statistically significant only in women. There was no significant association of genotype with percent body fat, visceral adiposity or fat distribution, although in women, the A allele was associated with greater total fat mass (p=0.02), android (p=0.009) and trunk fat (p=0.01). In both sexes, age- and height-adjusted average lean mass was significantly greater per copy of the A allele: 2.16 kg/copy in women and 1.73 kg/copy in men. Conclusions: These data do not support a primary role of fat distribution in mediating the association between rs373863828 genotype and type 2 diabetes risk. We suggest an alternative hypothesis: those with the A allele may more efficiently regulate blood glucose because of their greater absolute lean mass.

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