ABSTRACT Background Traditional Pacific diets have many health benefits, including maintenance of a healthy weight and prevention of various diseases. Few studies have evaluated the frequency at which traditional diets are consumed in the Pacific, especially among children. Objectives This study examined the frequency of traditional and acculturated fruit and vegetable (F&V) intake among children in the US-affiliated Pacific (USAP) region. Methods Diet records of 3319 children ages 2 to 8 y old were analyzed for frequency of traditional or acculturated F&V intake within USAP jurisdictions of American Samoa, Commonwealth of the Northern Mariana Islands (CNMI), Federated States of Micronesia (FSM; FSM island states include Chuuk, Kosrae, Pohnpei, and Yap), Guam, Hawaii, Republic of the Marshall Islands (RMI), and Republic of Palau. Results Of the 95,304 food items recorded among participating children in the USAP jurisdictions, 15.2% were F&Vs. Of the 10 jurisdictions, children in the islands of Chuuk, Kosrae, Yap, and Pohnpei recorded the highest frequencies of traditional F&V intake relative to their total F&V intake (67.8%, 64.8%, 56.7%, and 52.5%, respectively). American Samoa and RMI recorded moderate frequency of traditional F&V intake (38.9% and 46.4%, respectively), whereas children in Hawaii, Guam, and CNMI recorded the lowest frequencies of traditional F&V intake relative to their total F&V intake (10.4%, 12.4%, and 15.3%, respectively). Children in Hawaii, Guam, Palau, and CNMI recorded high frequencies of acculturated F&V intake (37.8%, 31.2%, 34.5%, and 27.9%, respectively). Conclusions Overall, children in the USAP jurisdictions participating in this study recorded a low frequency of F&V intake. The differences in traditional F&V intake found between the USAP islands may be due to variation in economic income level and external influences on social and cultural norms among the island populations and variations of cost, accessibility, and convenience of each category of food to each island's population.

https://academic.oup.com/cdn/article-pdf/6/7/nzac101/44905947/nzac101.pdf

Consumption of Traditional Fruits and Vegetables among Children in the US-Affiliated Pacific Region

Acculturation/enculturation has been found to impact childhood health and obesity status. The objective of this study is to use cross-sectional data to examine the association between proxies of adult/caregiver acculturation/enculturation and child health status (Body Mass Index [BMI], waist circumference [WC], and acanthosis nigricans [AN]) in the U.S.-Affiliated Pacific Islands (USAPI), Alaska, and Hawaiʻi. Study participants were from the Children’s Healthy Living (CHL) Program, an environmental intervention trial and obesity prevalence survey. Anthropometric data from 2–8 year olds and parent/caregiver questionnaires were used in this analysis. The results of this study (n = 4121) saw that those parents/caregivers who identified as traditional had children who were protected against overweight/obesity (OWOB) status and WC > 75th percentile (compared to the integrated culture identity) when adjusted for significant variables from the descriptive analysis. AN did not have a significant association with cultural classification. Future interventions in the USAPI, Alaska, and Hawaiʻi may want to focus efforts on parents/caregivers who associated with an integrated cultural group as an opportunity to improve health and reduce child OWOB prevalence.

Acculturation and Health Status in the Children’s Healthy Living Program in the Pacific Region

To characterize the dietary patterns of Marshallese mothers of young children in Northwest Arkansas, informing the cultural adaptation of nutrition education curricula. An exploratory cross-sectional study was conducted, in which Marshallese women with children under 12 months completed 3 telephone-administered 24-hour dietary recalls with a trained bilingual Marshallese interviewer. Diet quality was characterized using the Healthy Eating Index (HEI)-2020. A food-level analysis identified top food groupings contributing to total energy and HEI-2020 components. Northwest Arkansas. Marshallese mothers with children <12 months. 29 women were recruited, 20 completed 2 or 3 dietary recalls. Median age was 25.5 years. Diet quality by HEI-2020 was 46.4 (max score 100). White rice was the top contributor to total energy; high seafood/plant protein and fatty acid diet quality component scores were influenced by high fish intakes. Diet quality was low. Key adaptations include reducing rice portion sizes, while emphasizing lean proteins and fruits/vegetables. Cultural adaptation of nutrition education is essential to improve diet quality among communities with varying dietary practices. 

Diet Quality of Marshallese Mothers of Young Children in Northwest Arkansas: An Exploratory Study

Indigenous peoples of the Pacific have seen major shifts in dietary patterns due to foreign colonization, which introduced an array of new foods. Today, foods considered traditional and acculturated are consumed in various extents. However, the definitions and identity of traditional versus acculturated foods has become unclear as many introduced foods have been incorporated into Pacific cultures. The purpose of this study was to capture culturally relevant definitions of traditional, acculturated, and locally grown foods among 10 jurisdictions of the US-Affiliated Pacific (USAP) region with a focus on fruits and vegetables. Questionnaires were used to capture definitions of these terms, and to identify a list of foods (n=121) as traditional, acculturated, and/or locally grown in addition to classify them into food groups (ie, fruit, vegetable, starch, and/or grain). For the most part, definitions of traditional, acculturated, and locally grown were agreed upon by participating USAP jurisdictions, with some supplementary caveats presented by different jurisdictions. More foods were identified as acculturated (n=75) than traditional (n=37). Fruits (n=55) were the most frequent designation and about a third were vegetables (n=44). The majority of the jurisdictions reported growing at least half of the food items. This is the first study to identify and classify foods of the Pacific from the perspective of those indigenous to the USAP region. Understanding these similarities and differences in how food is classified and identified, through the lens of those from the Pacific, is crucial for nutrition education, and understanding what foods are locally grown is important for future sustainability.

Exploring Foods of the Pacific: Cultural Food Identity in the US Affiliated Pacific Region.

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Exploring Foods of the Pacific: Cultural Food Identity in the US Affiliated Pacific Region.