Absolute cardiovascular risk in a Fiji medical zone

Abstract

BackgroundThe population of Fiji has experienced emergence of non-communicable disease (NCD) and a plateau in life expectancy over the past 20 years.MethodsA mini-STEPS survey (n = 2765) was conducted in Viseisei in Western Fiji to assess NCD risk factors (RFs) in i-Taukei (Melanesians) and those of Indian descent aged 25–64 years (response 73 %). Hypertension (HT) was defined as systolic blood pressure (BP) ≥140 mmHg or diastolic BP ≥90 mmHg or on medication for HT; type 2 diabetes mellitus (T2DM) as fasting plasma glucose ≥7.0 mmol/L or on medication for T2DM; and obesity as a body mass index (kilograms/height(metres)2) ≥30. Data were age-adjusted to 2007 Fiji Census. Associations between RFs and ethnicity/education were investigated. Comparisons with Fiji STEPS surveys were undertaken, and the absolute risk of a cardiovascular disease (CVD) event/death in 10 years was estimated from multiple RF charts.ResultsNCD/RFs increased with age except excessive alcohol intake and daily smoking (women) which declined. Daily smoking was higher in men 33 % (95 % confidence interval: 31–36) than women 14 % (12–116); women were more obese 40 % (37–43) than men 23 % (20–26); HT was similar in men 37 % (34–40) and women 34 % (31–36), as was T2DM in men 15 % (13–17) and women 17 % (15–19). i-Taukei men had an odds ratio (OR) of 0.41 (0.28–0.58) for T2DM compared to Indians (1.00); and i-Taukei (both sexes) had a higher OR for obesity and low fruit/vegetable intake, daily smoking, excessive alcohol intake and HT in females. Increasing education correlated with lesser smoking, but with higher obesity and lower fruit/vegetable intake. Compared to the 2011 Fiji STEPS survey, no significant differences were evident in obesity, HT or T2DM prevalences. The proportion (40–64 years) classified at high or very high risk (≥20 %) of a CVD event/death (over 10 years) based on multiple RFs was 8.3 % for men (8.1 % i-Taukei, 8.5 % Indian), and 6.7 % for women (7.9 % i-Taukei, 6.0 % Indian).ConclusionsThe results of the survey highlight the need for individual and community interventions to address the high levels of NCD/RFs. Evaluation of interventions is needed in order to inform NCD control policies in Fiji and other Pacific Island nations.

Understanding Sociocultural Influences on Physical Activity in Relation to Overweight and Obesity in a Rural Indigenous Community of Fiji Islands

“…It generates success and creates valuable iTaukie role models for families and communities. Many studies reported that being Indigenous, iTaukie people are more likely to have natural athletic ability, which is already a significant aspect of Indigenous men’s lives [ 4 , 8 , 13 , 27 , 53 ]. ITakuie females in the rural community require specific attention when developing physical activity health promotion programs.…”

“…Therefore, the iTaukie community, as part of efforts to improve Indigenous health and wellbeing, suggests that this issue of physical activity be given attention [ 3 ]. Adults with high body mass index (BMI) are at risk for NCDs, including hypertension, stroke, cardiovascular diseases, diabetes, and multiple cancers [ 4 ]. Studies confirm daily exercise is an effective primary and secondary prevention measure to prevent NCDs [ 5 ].…”

Understanding socio‐cultural influences on food intake in relation to overweight and obesity in a rural indigenous community of Fiji Islands

“…Each study used a different definition of overweight and obesity and adopted different methodology, which impede an accurate estimation of period trends [6]. In 2002, the World Health Organisation (WHO) utilised the STEPS survey to report that 18% of the adult Fijian population was obese [6,7]. In 2013, using the same study, the prevalence of obesity was reported to be 30.6% [8].…”

“…6 In 2002, the World Health Organisation (WHO) utilised the STEPS survey to report that 18% of the adult Fijian population was obese. 6,7 In 2013, using the same study, the prevalence of obesity was reported to be 30.6%. 8 The staple food of Indigenous Fijian people (known as iTaukei) has been influenced by global food transition, the adoption of a western lifestyle, which contributed to the epidemic of overweight and obesity.…”

Sport and ethno-racial formation: imagined distance in Fiji

“…This limiting of participation to certain groups has wider consequences, such as the touted physical and mental benefits of sport, particularly in a nation like Fiji, beset with NCDs (Gyaneshwar et al, 2016), along with the social development opportunities associated with participation (Burnett 2006). But crucially, for this discussion, sport is complicit in maintaining an imagined distance between groups in a context that has struggled with the consequences of ethnic division (Robertson 2012).…”