Ka Wai Ola - Office of Hawaiian Affairs, Volume 11, Number 7, 1 July 1994 — ʻAi pono, e ola Eat right and Iwe well [ARTICLE+ILLUSTRATION]

ʻAi pono, e ola Eat right and Iwe well

by Dr. Terry Shintani

Pacific lslanders, diet and healih

Over the years, I have been discussing what has happened to native Hawaiian health due to diet and lifestyle change front traditional to modern Western ways. In this article, l'd like to share with vou what has haDDened to

our cousins in the Pacific who did the sante. Heallh surveys of Pacific islanders show an increase in coronary heart disease, cholesterol, high blood pressure, obesity and diabetes, along with other chronic health conditions, when the pop-

ulation begins to adopt a Western lifestyle. This includes Hawaiians, Northern Mariana and Caroline Islanders, Cook Islanders, Maon in Aotearoa, Samoans, Tongans, and the people of Nauru and the Tokelau Islands. Micronesians In an early study published in 1970. Dr. J. Hankin and her eolleagues looked at the native Chamorros of the Northern Marianas and Caroline Island. Diet and heahh statistics were compared for three locations with different degrees of urbanization. One loeaiion was Belau (Palau), where the lifestyle had hardly changed from traditional ways, and Rota, where the traditional diet and way of life was somewhat preserved. Another was

Guam, whieh is substantially urbanized. The final loeahon was in California, where the Chamorros had adopted an American lifestyle. Traditional Chamoru diets eonsisted chiefly of taro, cassava.

I potatoes, some vegI etables, fruit and I coconut, and various I amounts of fish. 1 Total dietary fat was I 20 percent in Belau I and increased proI gressively in Rota I and Guam, to a high of 40 percent in California. The survey found that total serum cholesterol

levels rose from around 150 milligrams per deciliter (mg/dl) to 170 mg/dl in Belau. to 200 mg/dl to 220 mg/dl in California. Triglyceride levels and glucose levels were also progressively higher with increasing Westernization. Samoans Samoans have a similar pattern of increase in diet-related disease. In Western Samoa more traditional foods are consumed, while in American Samoa. more canned goods are eaten and a niore modernized dietary pattern is followed. Samoans in Hawai'i lead a typically American lifestyle. Cardiovascular disease increases with modernization, along with risk factors for coronary disease such as obesity and hypertension. The prevalence of obesity is 45

percent in Western Samoa, eompared to nearly 80 percent among Samoans who migrate to the U.S. Hypertension among Samoans also increases with Westernization. Maoris Among the Maori populations. migrant studies have been eonducted comparing their heahh status in Pukapuka (Cook Islands), where traditional lifestyle has changed little, in Rarotonga (Cook Islands), where there is sonte Westernization of the diet, and in Aotearoa (New Zealand) where there is strong Western influence in dietary patterns. In Pukapuka, the main foods are taro, cassava, coconut, fresh fish, and some rice. In Rarotonga, there is mueh more consumption of modern foods such as canned

corned beef, canned fish and sugar. although taro, rice, bananas and other vegetables are a large part of the diet. Cholesterol levels in Pukapuka were found to be 187 for men / 200 for women, as eompared to 212 for men / 235 for women in Rarotonga, and 232 for men / 225 for women in Aotearoa. Prevalance of hypertension was 2 to 4.4 percent in Pukapuka, as compared to 16.9 percent to 25 percent in Aotearoa. Nauruans Nauru is of special interest because it has among the highest prevalence of diabetes in the world, estimated at 44 percent, similar to that of the Pima Indians of Arizona. Nauru also happens to be among the most Westernized of the Pacific islands due to its weahh. It is an independent nation and is considered to

be one of the wealthiest nations īn the world due to its phosphate (guano) mining industry. What has happened to native Hawaiians in terms of their shaip

rise in deaths from chronic dietrelated diseases such as heart disease, cancer and diabetes, is actually a reflection of what is happening around the world. In the Pacific, the examples are quite clear, but no ethnic group is immune. Next month I'U discuss what happens to people around the world when they sb"ay from their traditional diet and cultural ways. The similarities are striking. Perhaps this will foster the understanding that in this world, we may be many cultures, but we are all one people. Parts ofthis article are adapted from one recently puhlished in the Journal of Cardiovascular Risk hy Claire Hughes and Terry Shintani, M.D. Dr. Shintani, physician and nutritionist, is the director of preventive medicine at the Wai'anae Coast Comprehensive Health Center. For answers to questions about nutrition, eall his radio show Sundays 7 to 9 p.m. on K-108 radio.