Summary
Tonga has a very high prevalence of obesity with steep increases during youth, making adolescence a critical time for obesity prevention. The Ma'alahi Youth Project, the Tongan arm of the Pacific Obesity Prevention in Communities project, was a 3‐year, quasi‐experimental study of community‐based interventions among adolescents in three districts on Tonga's main island (Tongatapu) compared to the island of Vava'u. Interventions focused mainly on capacity building, social marketing, education and activities promoting physical activity and local fruit and vegetables. The evaluation used a longitudinal design (mean follow‐up duration 2.4 years). Both intervention and comparison groups showed similar large increases in overweight and obesity prevalence (10.1% points, n = 815; 12.6% points, n = 897 respectively). Apart from a small relative decrease in percentage body fat in the intervention group (−1.5%, P < 0.0001), there were no differences in outcomes for any anthropometric variables between groups and behavioural changes did not follow a clear positive pattern. In conclusion, the Ma'alahi Youth Project had no impact on the large increase in prevalence of overweight and obesity among Tongan adolescents. Community‐based interventions in such populations with high obesity prevalence may require more intensive or longer interventions, as well as specific strategies targeting the substantial socio‐cultural barriers to achieving a healthy weight.
Objective: To provide an overview of the prevalence of noncommunicable diseases (NCDs) and their risk factors in several Pacific island countries and territories (PICTs), in accordance with global NCD targets.
Methods: For six risk factors, data for adults (aged 25–64 years) from published reports of the World Health Organization STEPwise approach to NCD surveillance, or methodologically similar surveys, were collated, age standardised and compared across fifteen PICTs.
Results: In the majority of PICT populations, more than half of male current drinkers drank heavily and more than 40% of men and 20% of women were current smokers. In 10 populations, about 50% or more of women were insufficiently physically active. Prevalence of hypertension and diabetes exceeded 20% and 25%, respectively, in several populations. Near or more than half of men and women in all populations were overweight; in most, more than one‐third of both sexes were obese.
Conclusions: The prevalence of NCDs and risk factors varies widely between PICTs and by sex. The evidence shows the high and alarming present and future burden of NCDs in the region.
Implications: Strengthened political commitment and increased investment are urgently required to tackle the NCD crisis, successfully achieve targets and ensure continuing sustainable development in the Pacific islands.
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