OBJECTIVE:The prevalence of obesity varies considerably between countries when compared using the common international standard. This study investigated body size and body composition in Tongan and Australian Caucasian adults. DESIGN: Cross-sectional comparative study. SUBJECTS: A total of 543 Tongans and 393 Australians. MEASUREMENTS: Weight, height, waist and hip circumference, four skinfolds, midarm circumference, elbow breadth, and body composition by bioelectrical impedance using sex-and ethnic-specific regression equations. RESULTS: Tongan women (mean body mass index (BMI) AE s.e. ¼ 32.6 AE 0.4 kg=m 2 ) were larger than Australian women (BMI ¼ 25.8 AE 0.4 kg=m 2 ), with more fat-free mass (FFM; 52.2 AE 0.4; 42.6 AE 0.3 kg), fat mass (37.1 AE 0.7; 26.6 AE 0.8 kg) and percentage body fat (%fat) (40.5 AE 0.4; 37.0 AE 0.5%), respectively. Tongan men also had higher BMI (Tongan ¼ 30.3 AE 0.3 kg=m 2 ; Australian ¼ 26.5 AE 0.3 kg=m 2 ), FFM (70.2 AE 0.5; 62.3 AE 0.6 kg) and fat mass (23.5 AE 0.6; 20.7 AE 0.7 kg). When compared with Australians within the same BMI range, Tongans had significantly higher FFM, elbow width, midarm muscle area and significantly lower %fat. The %fat at BMIs of 25 and 30 kg=m 2 in Australian women was equivalent to the %fat found in Tongan women at 28.8 and 35.1 kg=m 2 , respectively. BMIs of 25 and 30 kg=m 2 in Australian men corresponded with 27.5 and 35.8 kg=m 2 in Tongan men. Skinfold thicknesses, waist, hip and WHR measurements suggested differences in fat distribution and body shape between ethnic groups, particularly in women. CONCLUSION: These results suggest that the standard healthy weight ranges recommended for international use may not be appropriate standards for use in the Tongan population.

A total of 443 school students aged 11-16 years underwent anthropometric measures of height and weight and provided self-reported measures of physical activity and dietary behaviours. Results Mean body mass index (BMI) was higher among girls than boys (23.7 kg m(-2) vs. 21.8 kg m(-2) and tended to increase with age. A total of 36.0% of boys and 53.8% of girls were overweight or obese using the international cut-off points, whereas 25.0% of boys and 37.6% of girls were classified in this way using Polynesian-specific cut-off points. Tinned mutton or beef was the food that most participants (56.9%) reported eating once or more per day. Over half of the young people did not eat taro, fruit or vegetables at least once per day. Regular physical activity outside of school hours was reported by 20.7% of respondents, and 58.2% watched 1 h or more of television per day. Physical activity participation was the only behaviour independently associated with a lower risk of overweight or obesity. Conclusions Using Polynesian-specific cut-off points for overweight and obesity the prevalence of these conditions was still among the highest found in adolescents. The prevalence of physical inactivity and poor dietary habits indicate that risk factors for chronic disease are well established during adolescence in Tonga.

A health and weight awareness program was initiated in 1995 by the Tonga National Food and Nutrition Committee to combat a high prevalence of obesity and its associated non-communicable diseases. The strategy of the program was to provide a fun activity in which people wanted to join, and at the same time gain health benefits. Three successive weight loss competitions were organized, of 4 to 6 months in length, in which radio, television, and newspaper media were major elements. A Tongan version of the 1993 South Pacific Commission weight for height chart was produced, allowing identification of overweight/obesity using body mass index. Participants were registered and given individual encouragement on diet/exercise. Prizes donated by local businesses added to the campaign, as well as the involvement of His Majesty King Taufa'ahau Tupou IV. Aerobic exercise, public walks, weigh station manager training, and weight watcher group meetings were special activities. An unexpected element was the interest by the international press, which proclaimed the Tonga national weight loss competitions to be the first in the world. A total of 3429 participants registered in the three competitions, with 1617 competing to the end. First place winners lost from 25.5 to 28.4 kg in the competitions. Difficulties encountered included problems of coordination, funds, scales, newness of the healthy weight concept, and weight gain at the close of the competition. The activity was received positively by the community, with requests for the competitions and exercise activities to continue, and much awareness on health issues relating to overweight was achieved.

OBJECTIVE: The prevalence of obesity in Tonga is high and increasing. Attempts to address this major health issue would be assisted by a realistic concept of current and preferred body sizes. In this study, body size perception in Tongans was compared with that of Australians. DESIGN: Cross-sectional comparative study. SUBJECTS: 542 Tongans, 89 of whom were enrolled in a weight-loss programme (WLP); 481 Australians. Measurements: Subjects were weighed and measured. Two series of photographs (one female, one male), representing speci®c body mass indexes (BMIs) were used to assess body perception. RESULTS: The BMIs of the Tongans were higher than those of the Australians (Tongans: female 32.6 AE 0.35 (mean AE s.e.m); male, 30.4 AE 0.33; Australians: female, 25.6 AE 0.33; male 26.3 AE 0.26 kgam 2 ). Tongan women underestimated their body size; Tongan men and Australians overestimated. WLP and younger Tongan women preferred smaller body sizes for themselves and for men and women in general. There were gender differences in preferred healthy and attractive female sizes (men: 27 kgam 2 ; non-WLP women: 25 kgam 2 ; WLP women: 23 kgam 2 ) and male sizes (men: 29 ± 30 kgam 2 ; women: 26 ± 27 kgam 2) chosen by Tongans. Preferred, attractive and healthy body sizes chosen by Australian men and women were similar; about 24 kgam 2 for males and 21 ± 22 kgam 2 for females. CONCLUSION: Tongans preferred larger body sizes than did Australians, particularly the men, but WLP women's preferences were similar to those of Australians. There is evidence that preferences are changing in Tonga with time, and probably with increasing Western in¯uence.

It has been noted since the earliest European contact that Polynesian body shape and size differ from those of Europeans. The muscular build of Polynesians, such as Tongans, raises questions as to the accuracy of simple anthropometric indicators, validated for use in European populations, in Polynesians. Body mass index (BMI), total body fat and an abdominal fat window were measured in a sample of Tongan [28 male (M), 28 female (F)] and Australian Caucasian adults (39 M, 46 F), with standard anthropometric and densitometric methods. Tongan males (BMI, 32.8+/-4.6 kg/m(2)) were heavier than Australian males (BMI, 27.1+/-3.7 kg/m(2)); but differences in total body percent fat (28.9+/-8.3 vs. 25.9+/-8.1, p=0.15), abdominal fat (1.84+/-0.69 vs. 1.55+/-0.60 kg, p=0.07) and abdominal percent fat (30.3+/-8.6 vs. 28.5+/-8.3, p=0.40) were non-significant. Tongan females (BMI, 34.3+/-5.5 kg/m(2)) were also heavier than their Australian counterparts (BMI, 26.2+/-6.3 kg/m(2)); with the difference in total body percent fat (41.9+/-5.2 vs. 38.7+/-8.9, p=0.05) and abdominal percent fat (39.3+/-4.8 vs. 33.6+/-8.9, p=0.001) less than expected, given the difference in BMI. This study demonstrates significant body composition variations between Tongans and Caucasians.