BackgroundObesity has been increasing in adolescents in Fiji and obesogenic dietary patterns need to be assessed to inform health promotion. The objective of this study was to identify the dietary patterns of adolescents in peri-urban Fiji and determine their relationships with standardized body mass index (BMI-z).MethodsThis study analysed baseline measurements from the Pacific Obesity Prevention In Communities (OPIC) Project. The sample comprised 6,871 adolescents aged 13–18 years from 18 secondary schools on the main island of Viti Levu, Fiji. Adolescents completed a questionnaire that included diet-related variables; height and weight were measured. Descriptive statistics and regression analyses were conducted to examine the associations between dietary patterns and BMI-z, while controlling for confounders and cluster effect by school.ResultsOf the total sample, 24% of adolescents were overweight or obese, with a higher prevalence among Indigenous Fijians and females. Almost all adolescents reported frequent consumption of sugar sweetened beverages (SSB) (90%) and low intake of fruit and vegetables (74%). Over 25% of participants were frequent consumers of takeaways for dinner, and either high fat/salt snacks, or confectionery after school. Nearly one quarter reported irregular breakfast (24%) and lunch (24%) consumption on school days, while fewer adolescents (13%) ate fried foods after school. IndoFijians were more likely than Indigenous Fijians to regularly consume breakfast, but had a high unhealthy SSB and snack consumption.Regular breakfast (p<0.05), morning snack (p<0.05) and lunch (p<0.05) consumption were significantly associated with lower BMI-z. Consumption of high fat/salt snacks, fried foods and confectionery was lower among participants with higher BMI-z.ConclusionsThis study provides important information about Fijian adolescents’ dietary patterns and associations with BMI-z. Health promotion should target reducing SSB, increasing fruit and vegetables consumption, and increasing regularity of meals among adolescents. Future research is needed to investigate moderator(s) of inverse associations found between BMI-z and consumption of snacks, fried foods and confectionery to assess for potential reverse causality.
Background There is a crisis of non-communicable diseases (NCDs) in the Pacific Islands, and poor diets are a major contributor. The COVID-19 pandemic and resulting economic crisis will likely further exacerbate the burden on food systems. Pacific Island leaders have adopted a range of food policies and regulations to improve diets. This includes taxes and regulations on compositional standards for salt and sugar in foods or school food policies. Despite increasing evidence for the effectiveness of such policies globally, there is a lack of local context-specific evidence about how to implement them effectively in the Pacific. Methods Our 5-year collaborative project will test the feasibility and effectiveness of policy interventions to reduce salt and sugar consumption in Fiji and Samoa, and examine factors that support sustained implementation. We will engage government agencies and civil society in Fiji and Samoa, to support the design, implementation and monitoring of evidence-informed interventions. Specific objectives are to: (1) conduct policy landscape analysis to understand potential opportunities and challenges to strengthen policies for prevention of diet-related NCDs in Fiji and Samoa; (2) conduct repeat cross sectional surveys to measure dietary intake, food sources and diet-related biomarkers; (3) use Systems Thinking in Community Knowledge Exchange (STICKE) to strengthen implementation of policies to reduce salt and sugar consumption; (4) evaluate the impact, process and cost effectiveness of implementing these policies. Quantitative and qualitative data on outcomes and process will be analysed to assess impact and support scale-up of future interventions. Discussion The project will provide new evidence to support policy making, as well as developing a low-cost, high-tech, sustainable, scalable system for monitoring food consumption, the food supply and health-related outcomes.
This paper presents an adaptation of a group communication system called JazzEnsemble to tolerate Byzantine failures. The work described here emphasizes scalability and good performance in the normal case, i.e., when there are no failures, while providing strong semantics to the application. The paper presents the main concepts and protocols that enable the Byzantine tolerant version of JazzEnsemble to obtain these goals. In particular, this includes fuzzy mute and fuzzy verbose failure detectors, an efficient Byzantine vector consensus protocol, and a novel Byzantine uniform broadcast protocol, as well as modifications at each layer of the system to overcome potential Byzantine attacks. Additionally, high-level protocols only rely on the oral messages model, and thus messages need to be signed only once at a low level of the system. Finally, the paper presents an extensive performance evaluation, which demonstrates the system's scalability and efficiency. This is also used to analyze the sources of performance degradation associated with various aspects of overcoming Byzantine failures.
Objective To estimate the proportion of products meeting Fiji government labelling regulations, assess compliance with national sodium reformulation targets, and examine the sodium and total sugar levels in packaged foods sold in selected major supermarkets. Design We selected five major supermarkets in 2018 and collected the product information and nutritional content from the labels of all packaged foods sold. We organised 4,278 foods into 14 major food categories and 36 sub-categories and recorded the proportion of products labelled in accordance with the Fiji labelling regulations. We looked at the levels of sodium and total sugar in each food category and assessed how many products complied with the Fiji reformulation targets set for sodium. We also listed the companies responsible for each product. Setting Suva, Fiji. Results Fourteen percent of packaged foods in fourteen major categories met Fiji national labelling regulations. Sodium was labelled on 95.4% products, and total sugar labelled on 92.4%. The convenience foods category had the highest sodium levels (1699mg/100g) while confectionery had the highest content of total sugar (52.6g/100g). Forty percent of eligible products did not meet the proposed voluntary sodium reformulation targets. Conclusions Our findings indicate significant room for improvement in nutrient labelling, as well as a need for further enforcement of reformulation targets and monitoring of changes in food composition. Through enacting these measures and establishing additional regulations such as mandatory front-of-pack labelling, government and food industry can drive consumers towards healthier food choices and improve the nutritional quality of packaged foods in Fiji.
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