No quick fix for soaring child obesity in Polynesia - Pacific health leader

Child and adolescent obesity is soaring in Polynesia and there is no quick fix, according to an eminent Pacific health leader.

The most obese 5-19-year-olds globally live in three Pacific Island nations, a UNICEF report found.

The report, Feeding Profit: How Food Environments are Failing Children 2025, reveals that Niue - with a population of 1600 - tops the lot, with nearly 40 percent of children and youth being obese.

The Cook Islands came second with 37 percent and Nauru followed with 33 percent.

The report said 2025 marks an historic turning point as it is the first time global obesity has surpassed those who are underweight in the 5-19-year-old age group.

One fifth of the world's children and adolescents are now overweight and half of them are obese.

The report said global obesity was mainly driven by a shift from traditional diets to cheap, imported, ultra-processed foods and soft drinks.

Auckland University professor Sir Collin Tukuitonga said obesity is not a region-wide issue in the Pacific.

"Overweight and obesity is more of a problem in Polynesia and to a certain extent Micronesia," Sir Collin said.

"But in Melanesia - Papua New Guinea, Solomon Islands, and Vanuatu, under-nutrition, iron and micronutrient deficiency is still a major problem," he said.

Sir Collin said many people now live in urban or peri-urban areas with no access to land to grow food, and convenience was a major factor.

"The idea that people will return to growing their own staples and catching fish, I don't see that as being realistic," he said.

"What needs to happen is better information and support so people moderate or reduce their consumption of ultra-processed foods."

He said another major factor in the trend was a rapid decline in breast feeding in the region.

While many mothers breastfed initially, this dropped dramatically after three months, due to pressures to return to work or church and village commitments.

Associated with that was a change in what he called "weaning foods".

"Traditionally it was like fresh staples and fish, but things have changed and kids are weaned off the breast on sugar and processed food items," he said.

Countries had put a lot of effort into trying to prevent adult obesity but the focus should now be on youth, Sir Collin said.

"Given our limited capacity and resources we should put more of an effort into educating and informing young people about healthy diets... then we might in fact end up with a generation that is able to respond to the causes of it."

He said young obese people can later face health problems in adulthood, such as type-2 diabetes, heart disease and some cancers.

"We have a burden of disease, that's the jargon, particularly diabetes, which then leads to kidney failure and blindness, and the social and economic costs to families and nations is enormous."

The way children were growing up had also changed, he said.

"They have become more sedentary, using devices, families have more money to buy imported food items, and fresh fruit and vegetables are not widely eaten."

While there is good data on adult obesity, research into children and adolescents is relatively recent, he said.

"There's always been the debate over whether the Body Mass Index (BMI) is an appropriate measure for children, so there are methodological issues, but that doesn't change the findings," Sir Collin said.

He said while obesity is a major concern in the Pacific, finding solutions won't be easy.

"Despite the best efforts of a whole lot of people, we don't seem to have found any way of curbing the rapid rise in overweight and obesity in children and young people," he said.

One possible solution was for governments to impose a tax on unhealthy food stuffs, including soft drinks.

The report stated that children are considered to be overweight when they are significantly heavier than what is healthy for their age, sex and height.

UNICEF defines overweight as a body mass index greater than one standard deviation above the World Health Organisation's median for healthy growth.

Obesity is more than two standard deviations above and leads to a higher risk of developing life-threatening diseases.

The report warns that ultra-processed and fast foods - high in sugar, refined starch, salt, unhealthy fats and additives - are shaping children's diets through unhealthy food environments, rather than personal choice.

It said these products dominate shops and schools, where digital marketing gives the food and beverage industry powerful access to young people.

Without interventions to prevent childhood overweight and obesity, countries could face lifetime health and economic impacts exceeding, for example, US$210 billion in Peru, due to obesity-related health issues.

By 2035, the global economic impact is expected to surpass US$4 trillion annually.