Nutrition Transition in Papua New Guinea (PNG): An Assessment of the Nutrition Transition for Three Diverse Populations, Including the Contributing Factors, Food Insecurity, and Health Risks

Abstract

Background Nutrition transition refers to changes in diets and physical activity patterns as countries undergo economic growth, urbanisation with increased reliance on the global food supply. It is associated with a rapid increase in obesity and diet-related non-communicable diseases (NCDs). Although NCDs are increasing worldwide, the rise in low-and middle-income countries (LMICs) has become more rapid, with greater implications because of the double burden of diseases with the concurrent burden of infectious diseases. In high income or developed countries this phenomenon is well established. Unfortunately, information from LIMCs are more limited and are intertwined with food insecurity issues. In Papua New Guinea (PNG) studies that explore such important issues are scarce especially at this crucial period when the country is experiencing rapid transformation due to economic development. This research explores the nutrition transition in PNG by investigating dietary and physical activity patterns to provide an insight into characteristics of changes and their effects on health outcomes. Processes and Methods of Data Collection There are two main components to this research. The first is development and validation of data collection methods and confirmation of survey processes. The second component is a population survey of adults that explored the diets, physical activity (PA) and food insecurity across sites selected to provide a sample of populations (Highland and Coastal, rural and peri-urban) affected to a varying extent by major projects and economic development. The first component was undertaken in four study sites (Asaro, Karkar, Hides/Komo and Hiri) to document dietary patterns and practices, and develop the dietary data collection methods and interview aids. This included participatory and in-depth interviews to establish a rich base of qualitative dietary data on diet. The 24-hour recall method was trialled for quantitative dietary data collection and protocols developed. This component also included a tracing study of adult participants in the Asaro and Hiri sites was undertaken to establish common activities to construct the PNG-Physical Activity Questionnaire (PNG-PAQ). This was validated in a separate sample against an accelerometer. The food insecurity questions were based on the eight-statement food insecurity measure for Maori and Pacific Islanders in New Zealand and tested across the four sites. The second component was undertaken in a representative sample of adults from Asaro, Karkar, and Hiri. The 24-hour recall method, PNG-PAQ and food insecurity questions were asked through interview. Demographic and socioeconomic data were available through the routine demographic surveillance undertaken for these sites. vii Financial support This PhD placement at the School of Public Health under the Faculty of Medicine was made possible by the Australian Awards Scholarship. I thank the Australian Government and the people of Australia for this opportunity.

What Do We Know about the Diets of Pacific Islander Adults in Papua New Guinea? A Scoping Review

“…While the PNG government's 2021-2030 National Health Plan recognises nutrition as a determinant of health and includes nutrition in their KRAs [2], there is a scarcity of contemporary dietary intake data amongst the PNG population. Most studies identified in this scoping review were published prior to the year 2000 and, therefore, are not reflective of the current food environment or the recent dietary changes, particularly in urban areas experiencing the nutrition transition [62]. It is important to understand the social and cultural contextualisation of dietary behaviours in PNG.…”

Health and Nutrition Promotion Programs in Papua New Guinea: A Scoping Review

“…As with other Low to Middle-Income Countries (LMIC) across the Pacific, PNG is undergoing rapid economic growth, social transition and urbanisation due to increasing resource development [4]. This has coincided with the nutrition transition phenomenon whereby the population's traditional diet and physical activity behaviours have shifted to more processed, high-energy dense foods, increased dependence on global food supply and sedentary activity [4].…”

“…As with other Low to Middle-Income Countries (LMIC) across the Pacific, PNG is undergoing rapid economic growth, social transition and urbanisation due to increasing resource development [4]. This has coincided with the nutrition transition phenomenon whereby the population's traditional diet and physical activity behaviours have shifted to more processed, high-energy dense foods, increased dependence on global food supply and sedentary activity [4]. Similar to other Pacific LMICs, where the economic and nutrition transition have been associated with increased NCD prevalence [5,6], in PNG, the nutrition transition is more apparent in regions with higher exposure to urbanisation and modernisation and therefore, the peri-urban and urban populations are at higher risk of NCDs such as CVD and T2DM compared to their rural counterparts [7,8].…”