Long-Term Survey of Food Consumption on Pingelap Island, Pohnpei State, the Federated States of Micronesia

Abstract

The diets of developing countries are shifting rapidly, and overweight and obesity have emerged as major public health problems in some of these countries(Popkin and Gordon-Larsen, 2004). In 2016, the prevalence of obesity exceeded 20% in several Polynesian and Micronesian countries(NCD Risk Factor Collaboration, 2017), and the World Health Organization (WHO)(2018) reported that noncommunicable diseases (NCDs), including cardiovascular diseases and diabetes, account for an estimated 75% of all deaths in the Federated States of Micronesia(FSM). The FSM is composed of approximately 600 small islands lying just above the equator in the Western Pacific, and consists of four states(Yap, Chuuk, Pohnpei, and Kosrae; Fig. 1). Pohnpei State(population 36,196 as of the 2010 census; Government of the Federated States of Micronesia, 2014)consists of the main island, Pohnpei Island, and eight smaller outer islands, including Pingelap Atoll. Before the 1950s, the people of the FSM ate a traditional diet based on staple starchy crops and marine resources (Murai, 1954). After the United States Department of Agriculture started a supplementary feeding program in the 1960s, the traditional diet began to be replaced by a modern diet rich in rice, wheat flour, sugar, and other imported