Fish, food security and health in Pacific Island countries and territories: a systematic literature review

Characterizing pathways of seafood access in small island developing states

Ensuring healthy and sustainable food systems in increasing social, economic, and ecological change is a key global priority to protect human and environmental health. Seafood is an essential component of these food systems and a critical source of nutrients, especially in coastal communities. However, despite rapid transformations in aquatic food systems, and our urgent need to understand them, there is a dearth of data connecting harvested food production to actualized food consumption. Many analyses suggest institutional, legal, or technological innovations to improve food systems, but few have analyzed the pathways through which people already gain access to nutritious food. Here, using a random forest model and cluster analysis of a nationally representative data set from Kiribati, we operationalize access theory to trace the flows of consumptive benefit in a fisheries-based food system. We demonstrate that the market access mechanism is the key mechanism mediating seafood access in Kiribati, but importantly, the highest seafood consumption households showed lower market access, pointing to the importance of non-market acquisition (e.g., home production and gifting). We reveal six distinct household strategies that employ different sets of access mechanisms to ensure high levels of local seafood consumption in different contexts. We demonstrate the impacts of these strategies on the composition of household seafoods consumed, stressing the need to support these existing successful strategies. Finally, we point to key policy and management insights (e.g., improved infrastructure, shifts in species management) that may be more effective in reinforcing these existing pathways than commonly proposed food system interventions.

Impacts of microplastic on fisheries and seafood security - Global analysis and synthesis

This review paper collected, collated, analysed, interpreted, synthesised, and documented the research investigations conducted on microplastic (MPs) pollution impacts on seafood organisms (including fish, sharks, shrimps, lobsters, crabs, oysters, mussels, and seaweeds) during the last ten years (2012-2022) covering fifty-seven locations/countries in the world. MPs contaminated 926 seafood species comprising 895 finfish, 09 crustaceans, 20 molluscs and 02 seaweeds. Seafood from Asia was found to be most contaminated with MPs. High MP contamination/ingestion was revealed in several seafood organisms. The ingestion of MPs can reduce fish growth and fish fitness, leading to reduced yield/fish production. Fish and seafood play a significant role in supporting the economy, employment, food sources, and livelihoods of people across the globe, which can be threatened due to the contamination of seafood organisms with MPs. MPs have bioaccumulated in fish skin, gills, stomachs, liver, intestine, and muscles as well as dry fish and canned fish. Hence, the consumption of MP-contaminated fresh fish, whole fish, dried fish or canned fish poses risks as it may be a pathway of MP transfer to humans. MPs can increase the health risks to seafood fish consumers since there is a probability that high risks pollutants adsorbed on MPs (heavy metals, pesticides, and oil compounds) can transfer to humans via the food chain. Several of the chemicals (heavy metals, DDT, PAHs) adsorbed onto MPs are carcinogenic. MPs have also been detected in fish meals, therefore, farmed livestock such as aquaculture fish and chicken fed to fish meals can be exposed to MPs and ultimately to humans. Preventive and safety measures are suggested to reduce the exposure of MPs to humans. In addition, several policy strategies are recommended to reduce the impacts of plastic waste and plastic pollution on the environment, aquatic biota, wildlife, seafood and human health.

Food insecurity, COVID-19 and diets in Fiji - a cross-sectional survey of over 500 adults

INTRODUCTION

Food insecurity is associated with inadequate nutrition and increased rates of chronic disease. The primary aim of this study was to assess self-reported food insecurity and the perceived impact of COVID-19 on food security, in two regional districts of Central Fiji, as part of a broader program of work on strengthening and monitoring food policy interventions. The secondary aim was to explore the relationship between food insecurity and salt, sugar and fruit and vegetable intake.

METHODS

Seven hundred adults were randomly sampled from the Deuba and Waidamudamu districts of Viti Levu, Fiji. Interview administered surveys were conducted by trained research assistants with data collected electronically. Information was collected on demographics and health status, food security, the perceived impact of COVID-19 on food security, and dietary intake. Food insecurity was assessed using nine questions adapted from Fiji's 2014/5 national nutrition survey, measuring markers of food insecurity over the last 12 months. Additional questions were added to assess the perceived effect of COVID-19 on responses. To address the secondary aim, interview administered 24-hour diet recalls were conducted using Intake24 (a computerised dietary recall system) allowing the calculation of salt, sugar and fruit and vegetable intakes for each person. Weighted linear regression models were used to determine the relationship between food insecurity and salt, sugar and fruit and vegetable intake.

RESULTS

534 people participated in the survey (response rate 76%, 50.4% female, mean age 42 years). 75% (75.3%, 95% CI, 71.4 to 78.8%) of people reported experiencing food insecurity in the 12 months prior to the survey. Around one fifth of people reported running out of foods (16.8%, 13.9 to 20.2%), having to skip meals (19.3%, 16.2 to 22.9%), limiting variety of foods (19.0%, 15.9 to 22.5%), or feeling stressed due to lack of ability to meet food needs (19.5%, 16.4 to 23.0%). 67% (66.9%, 62.9 to 70.7%) reported becoming more food insecure and changing what they ate due to COVID-19. However, people also reported positive changes such as making a home garden (67.8%, 63.7 to 71.6%), growing fruit and vegetables (59.5%, 55.6 to 63.8%), or trying to eat healthier (14.7%, 12.0 to 18.0%). There were no significant associations between food insecurity and intakes of salt, sugar or fruit and vegetables.

CONCLUSION

Participants reported high levels of food insecurity, exceeding recommendations for salt and sugar intake and not meeting fruit and vegetable recommendations, and becoming more food insecure due to COVID-19. Most participants reported making home gardens and/or growing fruit and vegetables in response to the pandemic. There is an opportunity for these activities to be fostered in addressing food insecurity in Fiji, with likely relevance to the Pacific region and other Small Island Developing States who face similar food insecurity challenges.

Effects of thermal and salt water soaking pre-treatment on the physicochemical and nutritional properties of sundried tilapia fish (Oreocromis niloticus) products

The effects of saltwater soaking (10-30 %, w/v) and thermal (60°C-90 °C) pre-treatment on the physicochemical and nutritional quality of sundried tilapia fish (Oreocromis niloticus) products were assessed. The wet reduction was 14.47 % in the sample treated with a 30 % salt solution at 90 °C, whereas the wet reduction of 21.23 % was observed in the sample without treatment (control). Protein, lipid, and ash content were increased significantly (P < 0.05) with higher pre-treatment salt concentration and temperature, while the moisture content showed the opposite trend. The content of essential and non-essential amino acids in the treated samples ranged from 7149.97 mg/100 g to 8063.42 mg/100 g and 10530.66 mg/100 g to 11365.59 mg/100 g, respectively, whereas the values were 7018.55 mg/100 g and 10400.84 mg/100 g, respectively in the control. The fatty acids composition, particularly ω-3 polyunsaturated fatty acids, was higher in pretreated samples (6.14-7.08 %) compared to the control. Mineral content was found to improve with saltwater and thermal pre-treatment, and the levels of heavy metals, including Ni and Cu, were significantly lower in the sundried tilapia fish. The sample pretreated with 10 % salt solution and 75 °C showed the highest rehydration capacity of 66.63 %. These findings suggest that saltwater and thermal pre-treatment can effectively enhance the physicochemical and nutritional properties of sundried tilapia fish products.

Exploring the barriers and enablers of diabetes care in a remote Australian context: A qualitative study

OBJECTIVE

This qualitative study explored the current barriers and enablers of diabetes care in the Indian Ocean Territories (IOT).

METHODS

A constructivist grounded theory approach that incorporated semi-structured telephone interviews was employed. Initial analysis of the interview transcripts used a line-by-line approach, to identify recurring themes, connections, and patterns, before they were re-labelled and categorised. This was followed by axial coding, categorisation refinement, and mapping of diabetes triggers in the IOT.

PARTICIPANTS AND SETTING

The IOT, consisting of Christmas Island and the Cocos (Keeling) Islands, are some of the most remote areas in Australia. When compared with mainland Australia, the prevalence of type 2 diabetes in the IOT is disproportionately higher. There were no known cases of type 1 diabetes at the time of the study. Like other remote communities, these communities experience difficulties in accessing health services to prevent and manage diabetes. Twenty health care professionals and health service administrators in the IOT took part in semi-structured telephone interviews held during April-June 2020. Participants included GPs, nurses, dietitians, social and community services workers, school principals, and administrators. The interview questions focused on their perceptions of the current diabetes care in place in the IOT and their views on the challenges of providing diabetes care in the IOT.

RESULTS

We identified four main barriers and two main enabling factors to the provision of effective diabetes care in the IOT. The barriers were: (i) societal influences; (ii) family; (iii) changing availability of food; (v) sustainability and communication. The two main enablers were: (i) tailoring interventions to meet local and cultural needs and values; and (ii) proactive compliance with the medical model of care.

CONCLUSION

Due to the cultural and linguistic diversity within the IOT, many of the identified barriers and enablers are unique to this community and need to be considered and incorporated into routine diabetes care to ensure successful and effective delivery of services in a remote context.

Dietary Recommendations for Ethiopians on the Basis of Priority Diet-Related Diseases and Causes of Death in Ethiopia: An Umbrella Review

Food-based dietary guidelines (FBDG) need to be evidence-based. As part of the development of Ethiopian FBDG, we conducted an umbrella review to develop dietary recommendations. Protein-energy malnutrition (PEM), deficiencies of vitamin A, zinc, calcium, or folate, cardiovascular diseases (CVD), and type 2 diabetes mellitus (T2DM) were selected as a priority. Systematic reviews were eligible if they investigated the impact of foods, food groups, diet, or dietary patterns on priority diseases. After a search, 1513 articles were identified in PubMed, Scopus, and Google Scholar published from January 2014 to December 2021. The results showed that 19 out of 164 systematic reviews reported the impact of diet on PEM or micronutrient deficiencies. Daily 30-90 g whole-grain consumption reduces risk of CVD and T2DM. Pulses improve protein status, and consuming 50-150 g/d is associated with a reduced incidence of CVD and T2DM. Nuts are a good source of minerals, and consuming 15-35 g/d improves antioxidant status and is inversely associated with CVD risk. A daily intake of 200-300 mL of milk and dairy foods is a good source of calcium and contributes to bone mineral density. Limiting processed meat intake to <50 g/d reduces CVD risk. Fruits and vegetables are good sources of vitamins A and C. CVD and T2DM risks are reduced by consuming 200-300 g of vegetables plus fruits daily. Daily sugar consumption should be below 10% of total energy to lower risk of obesity, CVD, and T2DM. Plant-based fat has favorable nutrient profiles and modest saturated fat content. The association of saturated fatty acids with CVD and T2DM is inconclusive, but intake should be limited because of the low-density lipoprotein cholesterol-raising effect. Plant-based diets lower risk of CVD and T2DM but reduce micronutrient bioavailability. The review concludes with 9 key dietary recommendations proposed to be implemented in the Ethiopian FBDG. This review was registered at PROSPERO (CRD42019125490).

Local and Traditional Ecological Knowledge of Fish Poisoning in Fiji

Fish poisoning (FP) affects human health, trade and livelihood in Fiji, where management has depended mainly on traditional ecological knowledge (TEK). This paper investigated and documented this TEK through a 2-day stakeholder workshop, group consultation, in-depth interviews, field observations, and analyses of survey data from the Ministry of Fisheries, Fiji. Six TEK topics were identified and classified as preventative and treatment options. The preventive approach involves identifying toxic reef fishes, the spawning season of edible seaworms, hotspot areas of toxic fishes, folk tests, and locating and removing toxic organs. For example, 34 reef fish species were identified as toxic. The FP season was associated with the spawning of balolo (edible seaworm) and the warmer months of October to April (cyclone seasons). Two well-known toxic hotspots associated with an abundance of bulewa (soft coral) were identified. Folk tests and locating and removing toxic fish organs are also practised for moray eels and pufferfish. At the same time, various locally available herbal plants are used to treat FP as the second line of defence. The TEK collated in this work can help local authorities better identify the sources of toxicity, and applying TEK preventive measures could stem the tide of fish poisoning in Fiji.

Chlamydial and gonorrheal neglected sexually transmitted diseases among Pacific Islanders of the Western Pacific Region-A narrative review and call to action

The Pacific Island countries of the Western Pacific Region have some of the highest rates of sexually transmitted Chlamydia trachomatis and Neisseria gonorrhoeae infections in the world. Despite this, there are few research studies that include Pacific Islanders. We conducted a narrative review of original research and surveys, including World Health Organization and Pacific Community reports, to determine the prevalence, management, and treatment of C. trachomatis and N. gonorrhoeae compared to HIV and syphilis from 1980 to 2022. Available epidemiologic data on C. trachomatis and N. gonorrhoeae indicated an extremely high prevalence-approximately 30% and 13%, respectively-among Pacific Islanders during this timeframe. These neglected sexually transmitted infections represent a significant burden and health disparity. Robust epidemiologic research is needed to identify modifiable risk factors for designing interventions and control strategies. Appropriate policies along with regional and international advocacy and aid are required to improve reproductive health among these vulnerable, understudied populations to avert preventable infections and sequelae.

Trace element accumulation in the muscles of reef fish collected from southern new Caledonian lagoon: Risk assessment for consumers and grouper Plectropomus leopardus as a possible bioindicator of mining contamination

Flesh of 141 fish specimens collected along the southern coast of New Caledonia, close to the mining industry Prony Resources New Caledonia, were analyzed for 10 elements (As, Cd, Co, Cr, Cu, Fe, Hg, Mn, Ni and Zn). The leopard coral grouper Plectopomus leopardus revealed significant spatial variations for Cr, Fe, Mn and Zn and size-dependent accumulation of Hg. Sanitary risk assessment suggests that Hg and Me-Hg could potentially be a concern for heavy fish consumers. A previous study in New Caledonia had demonstrated the capacity of P. leopardus to differentially accumulate Ag, Cd, Cu, Hg and Zn and as such its potential as bioindicator specie to monitor contamination status in urban areas (Metian et al., 2013). Our results demonstrate that this specie can also to be used as a bioindicator to monitor the contamination status of Cr, Fe and Mn in New Caledonian lagoon in relation to mining activities.

School food programmes in the Pacific Islands: exploring opportunities and challenges for creating healthier school food environments

OBJECTIVE

The school setting can provide an environment that supports healthy behaviours, including the provision of food. School food activities, that is, school feeding, are commonplace globally, but not well understood in the Pacific Islands region. The aim of this research is to explore learnings associated within existing school food programmes (SFP), and adoption resistors in those Pacific Island Countries and Territories (PICT) without SFP, with the intent of improving current and future SFP interventions.

DESIGN

This observational cross-sectional study utilised four facilitated workshop sessions to explore SFP within an existing framework.

SETTING

Pacific Islands region.

PARTICIPANTS

Fourteen participants representing the education and health sectors from eleven PICT, and two participants representing regional organisations.

RESULTS

Most countries reported some form of related policy, but key critical constraints to the use of SFP included local food environments, strategic alignment to organisational priorities, advocacy and organisational leadership, and community and cultural connections and collaboration. There are opportunities for integration of SFP into existing frameworks (i.e. Health Promoting Schools), increased collaboration, greater professional development and awareness activities, improved monitoring and evaluation, improved awareness of SFP and promotion of healthy eating for the wider school community.

CONCLUSIONS

Given the current health, social and economic challenges faced by countries and territories in the Pacific Islands region, SFP should be considered as an opportunity for food provision and associated nutrition education for students and their wider community. Further research is needed to understand the critical constraints of SFP in this region and how to support stakeholders to advocate for, develop and sustain SFP that are contextually and culturally appropriate.

Food literacy in Pacific Island countries: a scoping review protocol

OBJECTIVE

The aim of this scoping review is to identify how food literacy is characterized and measured in the context of the Pacific Islands, and describe food literacy initiatives that may inform future policy, practice, and research.

INTRODUCTION

"Food literacy" is an emerging term used to describe the knowledge, skills, and behaviors required from individuals, households, communities, or nations to make healthy food choices. Given the complexity of changing food systems and the significant health challenges facing Pacific Island communities, understanding the evidence on food literacy in these communities may contribute to ensuring adequate nutrition for this population.

INCLUSION CRITERIA

The scoping review will examine all evidence that broadly defines, describes, measures, or explores food literacy and/or its components in residents of Pacific Island countries and territories, of any age or gender. Evidence on initiatives implemented to improve food literacy within this population will also be considered. Countries will be limited to member countries of "the Pacific Community."

METHODS

Key information sources to be searched for publications will include databases CABI, EBSCO, and Scopus, along with Google Scholar and Google for gray literature. Experts from relevant organizations and agencies will be contacted to locate additional sources. Results will be restricted to sources from the previous 30 years, available in English and French. Data will be extracted by two or more independent reviewers using a data extraction tool. Results will be presented with a narrative summary, accompanied by tabulated and/or charted results.

Prevalence and risk factors of adverse birth outcomes in the Pacific Island region: A scoping review

Background

Prevalence and exposures of adverse birth outcomes is well studied in low-and-middle-income countries but not well-established for the Pacific Island region. Our study mapped the available evidence on low birth weight (LBW), preterm birth, and small for gestational age (SGA)’s prevalence and their corresponding risks in the region.

Methods

We followed the five-staged Arksey and O'Malley's framework with clinicians’ consultation in the region. Five scholarly databases and non-indexed studies were searched and extracted data were analysed as numerical and thematic summaries mapping the outcomes and exposures.

Findings

We included 20 studies representing 11 Pacific Island countries with the following mean prevalence and associations at 95% confidence interval. Estimated mean prevalence for LBW and preterm births were 12% and 13%, respectively. LBW were associated with malaria in pregnancy [aOR 3.3 (1.00, 10.60)], and betel nut and tobacco [aOR 2.4 (1.00, 6.00)]. Preterm births were associated with malaria in pregnancy [aOR 6.6 (2.46, 17.62)] and maternal obesity [aOR 1.5 (1.00, 2.30)]. SGA were associated with short stature [aOR 1.7 (1.22, 2.41)] and no antenatal bookings [aOR 4.0 (2.12, 7.57)]

Interpretation

Several significant factors identified were malaria infection, obesity, betel nut and tobacco and no antenatal care, also validated by clinicians consulted.

Funding

Australia National Health and Medical Research Council.

Vulnerability to Food Insecurity in a Telecoupled World: Insights From Vanuatu

Food insecurity is a pressing problem in many regions across the world. Drivers of food insecurity are becoming increasingly embedded in sociocultural and economic processes that transcendent multiple spatial and temporal scales. This is due to the increasingly globalized interconnections of places and people. Understanding this complexity is essential to devise locally relevant and effective adaptation strategies to tackle existing vulnerabilities causing food insecurity. This article analytically addresses the complexity in cross-scale dynamics by combining a case study from northern Vanuatu with a conceptual analysis of the broader socioeconomic dynamics within the telecoupling framework. Our aim is to identify drivers of vulnerability that span multiple temporal and spatial scales and contribute to food insecurity in a given location while exploring the relevance and applicability of the framework for the holistic assessment of vulnerability to food insecurity. The transdisciplinary approach used in this work involved local community members and local agriculture extension officers at all stages of the study process. For this, we used complementary research methods, such as workshops, participant observations, and in-depth interviews. The results showed that potential vulnerability to food insecurity in northern Vanuatu is likely to be related to individual choices aimed at maximizing income, enabled by economic development and driven by socio-cultural changes. These choices and their consequences are perceived in many cases to be responsible for lower subsistence food production and the overuse of natural food resources. However, economic changes in particular can also enable additional livelihoods that complement existing (subsistence-based) strategies, leading to a reduction in one-sided dependencies and thus to an overall increase in the resilience of local livelihoods. We find the telecoupling approach to be a useful tool to holistically capture a local vulnerability context. However, we also encountered challenges in describing telecouplings that operate over longer time scales.

Local practices and production confer resilience to rural Pacific food systems during the COVID-19 pandemic

Resilience of food systems is key to ensuring food security through crisis. The COVID-19 pandemic presents an unprecedented shock that reveals varying levels of resilience of increasingly interconnected food systems across the globe. We contribute to the ongoing debate about whether increased connectivity reduces or enhances resilience in the context of rural Pacific food systems, while examining how communities have adapted to the global shocks associated with the pandemic to ensure food security. We conducted 609 interviews across 199 coastal villages from May to October 2020 in Federated States of Micronesia, Fiji, Palau, Papua New Guinea, Solomon Islands, Tonga, and Tuvalu to understand community-level impacts and adaptations during the first 5-10 months of the COVID-19 crisis. We found that local food production practices and food sharing conferred resilience, and that imported foods could aid or inhibit resilience. Communities in countries more reliant on imports were almost twice as likely to report food insecurity compared to those least reliant. However, in places dealing with a concurrent cyclone, local food systems were impaired, and imported foods proved critical. Our findings suggest that policy in the Pacific should bolster sustainable local food production and practices. Pacific states should avoid becoming overly reliant on food imports, while having measures in place to support food security after disasters, supplementing locally produced and preserved foods with imported foods when necessary. Developing policies that promote resilient food systems can help prepare communities for future shocks, including those anticipated with climate change.

Local practices and production confer resilience to rural Pacific food systems during the COVID-19 pandemic

Resilience of food systems is key to ensuring food security through crisis. The COVID-19 pandemic presents an unprecedented shock that reveals varying levels of resilience of increasingly interconnected food systems across the globe. We contribute to the ongoing debate about whether increased connectivity reduces or enhances resilience in the context of rural Pacific food systems, while examining how communities have adapted to the global shocks associated with the pandemic to ensure food security. We conducted 609 interviews across 199 coastal villages from May to October 2020 in Federated States of Micronesia, Fiji, Palau, Papua New Guinea, Solomon Islands, Tonga, and Tuvalu to understand community-level impacts and adaptations during the first 5-10 months of the COVID-19 crisis. We found that local food production practices and food sharing conferred resilience, and that imported foods could aid or inhibit resilience. Communities in countries more reliant on imports were almost twice as likely to report food insecurity compared to those least reliant. However, in places dealing with a concurrent cyclone, local food systems were impaired, and imported foods proved critical. Our findings suggest that policy in the Pacific should bolster sustainable local food production and practices. Pacific states should avoid becoming overly reliant on food imports, while having measures in place to support food security after disasters, supplementing locally produced and preserved foods with imported foods when necessary. Developing policies that promote resilient food systems can help prepare communities for future shocks, including those anticipated with climate change.

Scaling-up food policies in the Pacific Islands: protocol for policy engagement and mixed methods evaluation of intervention implementation

BACKGROUND

There is a crisis of non-communicable diseases (NCDs) in the Pacific Islands, and poor diets are a major contributor. The COVID-19 pandemic and resulting economic crisis will likely further exacerbate the burden on food systems. Pacific Island leaders have adopted a range of food policies and regulations to improve diets. This includes taxes and regulations on compositional standards for salt and sugar in foods or school food policies. Despite increasing evidence for the effectiveness of such policies globally, there is a lack of local context-specific evidence about how to implement them effectively in the Pacific.

METHODS

Our 5-year collaborative project will test the feasibility and effectiveness of policy interventions to reduce salt and sugar consumption in Fiji and Samoa, and examine factors that support sustained implementation. We will engage government agencies and civil society in Fiji and Samoa, to support the design, implementation and monitoring of evidence-informed interventions. Specific objectives are to: (1) conduct policy landscape analysis to understand potential opportunities and challenges to strengthen policies for prevention of diet-related NCDs in Fiji and Samoa; (2) conduct repeat cross sectional surveys to measure dietary intake, food sources and diet-related biomarkers; (3) use Systems Thinking in Community Knowledge Exchange (STICKE) to strengthen implementation of policies to reduce salt and sugar consumption; (4) evaluate the impact, process and cost effectiveness of implementing these policies. Quantitative and qualitative data on outcomes and process will be analysed to assess impact and support scale-up of future interventions.

DISCUSSION

The project will provide new evidence to support policy making, as well as developing a low-cost, high-tech, sustainable, scalable system for monitoring food consumption, the food supply and health-related outcomes.

Gender-specified mediation of depression between sleep quality and short-term memory in older adults: Study in a semi-closed Island of Xiamen, China

BACKGROUND

Both the quality of sleep and depression impact short-term memory (STM) while they influence each other. However, the underlying mechanisms are not yet clear. Herein, we aimed to explore the mediating effect of depression between sleep quality and STM in older adults and further test the gender differences in this relationship.

METHODS

A cluster sampling survey was carried out among 903 residents that were aged 60+ years in a semi-closed island of Xiamen, China, in 2019. The subjects' sleep quality and depression were measured using the Pittsburgh Sleep Quality Index (PSQI) and the 15-item Geriatric Depression Scale (GDS-15), respectively. The three-item recall test was utilized to measure STM function. Mediation analyses were performed using the structural equation model and bias-corrected bootstrap method. Next, the Wald-test was utilized to determine gender differences in the pathway.

RESULTS

Overall, 355 men and 508 women, with a mean age of 69.55 and 70.97, respectively, had valid data on the main variables. Depression was found to mediate the effect of sleep quality on STM (a*b = -0.076, p < 0.05). Interestingly, while this indirect effect existed in the female group (a_f *b_f  = -0.126, p < 0.05), it did not in the male group (a_m *b_m  = 0.017, p = 0.677). The Wald-test indicated no gender differences in the pathway from sleep quality to depression (p = 0.303). However, the pathway from depression to STM function was found to be significantly stronger for females than males (p = 0.0198).

CONCLUSION

Higher sleep quality was found to be associated with improved STM function. Furthermore, the association was found to be regulate indirectly by lower depressive symptoms for females, but directly for males. Therefore, appropriate psychological interventions may be beneficial to the maintenance of STM for older adults, particularly for women.

Multibiomarker responses to polycyclic aromatic hydrocarbons and microplastics in thumbprint emperor Lethrinus harak from a South Pacific locally managed marine area

To determine the baseline threat of microplastics and polycyclic aromatic hydrocarbons (PAHs) in an important seafood fish from Vueti Navakavu locally managed marine area, a multibiomarker risk assessment was conducted on the thumbprint emperor fish Lethrinus harak. Condition factor, a measure of relative general health condition of fish, was significantly lower in samples from the wet season compared to the dry season but no significant differences were observed for hepatosomatic index, a measure of relative stored energy/nutrition, between seasonal groups. PAHs levels of four metabolites in emperor fish from Fiji waters are reported here for the first time; seasonal groups showed no significant differences, but all samples presented levels of biliary PAHs. Each specimen also contained at least one microplastic in its gastrointestinal system; fibres were the predominant form-type and ingestion levels showed that more than 80% of fragment sizes were below 1.0 mm. Biochemical responses were observed for ethoxyresorufin-O-deethylase and glutathione S-transferase biotransformation activity, oxidative stress (glutathione peroxidase and glutathione reductase activity; lipid peroxidation) and genotoxicity (micronuclei assay). Though there were no statistically significant differences found, there were biological significances that were important to note; relatively low levels of pollutant exposure and low levels of biochemical responses showed enzymes response in thumbprint emperor were as expected to their roles in the body. In this multibiomarker approach, the observation of pollutants presence and histopathological injuries are considered biologically relevant from a toxicological perspective and serve as a baseline for future pollution studies in seafood fishes in Fiji, with site differences and the inclusion of fish species comparison. We recommend adopting a suite of biomarkers in future regional biomonitoring studies to develop holistic baseline information for other marine settings in Fiji and other Pacific Island countries.

Assessing the Physiological Effects of Traditional Regional Diets Targeting the Prevention of Cardiovascular Disease: A Systematic Review of Randomized Controlled Trials Implementing Mediterranean, New Nordic, Japanese, Atlantic, Persian and Mexican Dietary Interventions

Traditional regional diets are considered as sustainable dietary patterns, while many have been examined with regard to their health benefits. The aim of the present systematic review was to aggerate all evidence on the physiological effects of regional diets among adults at high risk for cardiovascular disease (CVD). Three databases were searched for randomized controlled trials (RCTs) implementing any regional diet (Mediterranean (MedD), Persian, Southern European Atlantic, Japanese, Chinese, new Nordic, or other) while examining cardiovascular risk factors among adults at increased risk. Primary outcomes included anthropometric indices and secondary outcomes involved blood lipid concentrations, glucose metabolism, inflammation and other markers of CVD progression. Twenty RCTs fulfilled the study’s criteria and were included in the qualitative synthesis, with the majority implementing a MedD. Adherence to most of the regional diets induced a reduction in the BW and anthropometric indices of the participants. The majority of RCTs with blood pressure endpoints failed to note a significant reduction in the intervention compared to the comparator arm, with the exception of some new Nordic and MedD ones. Despite the interventions, inflammation markers remained unchanged except for CRP, which was reduced in the intervention groups of one new Nordic, the older Japanese, and the Atlantic diet RCTs. With regard to blood lipids, regional diet interventions either failed to induce significant differences or improved selective blood lipid markers of the participants adhering to the experimental regional diet arms. Finally, in the majority of RCTs glucose metabolism failed to improve. The body of evidence examining the effect of regional dietary patterns on CVD risk among high-risk populations, while employing an RCT design, appears to be limited, with the exception of the MedD. More research is required to advocate for the efficacy of most regional diets with regard to CVD.

COVID-19 and food systems in Pacific Island Countries, Papua New Guinea, and Timor-Leste: Opportunities for actions towards the sustainable development goals

CONTEXT

The COVID-19 pandemic has impacted global food systems. This has led to different strategies by communities, governments, and businesses involved in food systems to mitigate and adapt to the unfolding pandemic. Small Island Developing States are particularly exposed to the conflation of risks from COVID-19 disease, economic downturns, underlying climate vulnerabilities and biosecurity risks.

OBJECTIVE

Our study aimed to identify the food systems vulnerabilities, impacts, and opportunities for supporting resilience and sustainable development in selected Pacific Island countries, Papua New Guinea, and Timor-Leste. The study focused on the impacts from the first six months of the pandemic (February-July 2020), with remote data collection and analysis done between May and July 2020.

METHODS

We conducted 67 interviews, and triangulated information with desktop and news sources emerging at the time. We present results on the effect on smallholder livelihoods, supply chains, governance, communities and employment. Overall, the major impacts of COVID-19 have been on economies, posing risks to future food security and further hampering progress towards key Sustainable Development Goals.

RESULTS AND CONCLUSIONS

We found that unemployment and economic contraction have been the most severe effects to date, with long-term consequences for food value chains and smallholder farmers. Disruptions to tourism, labour migration, and remittances have led to varying socio-economic impacts throughout the region. Vulnerable groups, notably women, urban poor, and youth, have been disproportionately affected by unemployment. Timor-Leste has had some social protection measures, whereas in Pacific Countries these have been varied. The lockdowns and State of Emergency initially influenced the distribution and marketing of food, but local food economies are starting to stabilise. The continued functioning of international food supply chains reduced the risk of food insecurity in high import dependent nations, notably import dependent countries like Tuvalu and Kiribati.

SIGNIFICANCE

The results have significance for three recovery pathways. The first recovery pathway relates to revisiting value chains in light of restricted travel. The second recovery pathway exists through leveraging the adaptive capacities of communities to stimulate innovative agriculture that also integrates climate adaptation and nutrition. The third recovery pathway relates to addressing the structural challenges that perpetuate inequalities and poverty while finding new ways of implementing inclusive policies and research. Our study presents a set of comparative examples of managing a food system shock that can inform future systems-oriented research and policy for sustainable development.

Dietary assessment methodology and reporting in Pacific Island research: a scoping review protocol

OBJECTIVE

This scoping review aims to identify and describe the methods used to collect and analyze dietary intake data in residents of Pacific Island countries.

INTRODUCTION

Dietary assessment explores associations between dietary factors and health outcomes. In regions, including the Pacific Islands, where diet-related, non-communicable diseases are increasing, this is a growing area of research. As this information is used to inform food and nutrition policies and practice, accurate collection, analysis, and interpretation of dietary assessment data relies on robust methods. A greater understanding of how nutrition studies are designed can strengthen the evidence on nutrition and health in Pacific Island settings and inform future research approaches.

INCLUSION CRITERIA

The scoping review will consider studies published in peer-reviewed journals, including quantitative and qualitative study designs and gray literature, including government reports, research and technical reports, theses and dissertations that measure and/or assess dietary intake in resident populations of the Pacific Island member countries of the Secretariat of the Pacific Community: American Samoa, Commonwealth of the Northern Mariana Islands, the Cook Islands, the Federated States of Micronesia, French Polynesia, Guam, the Independent State of Papua New Guinea, the Independent State of Samoa, the Kingdom of Tonga, New Caledonia, Niue, Pitcairn Islands, the Republic of Fiji, the Republic of Kiribati, the Republic of the Marshall Islands, the Republic of Nauru, the Republic of Palau, the Republic of Vanuatu, Solomon Islands, Tokelau, Tuvalu, and Wallis and Futuna.

METHODS

There will be no time limit and searches will be conducted in PubMed, CINAHL, CABI, Scopus, Cochrane Library, and Web of Science. Results will be limited to English-language articles. Data will be extracted independently by two reviewers into a charting table. Results will be presented graphically and with tables accompanied by a narrative summary.

Packaged food supply in Fiji: nutrient levels, compliance with sodium targets and adherence to labelling regulations

OBJECTIVE

To estimate the proportion of products meeting Fiji government labelling regulations, assess compliance with national Na reformulation targets and examine the Na and total sugar levels in packaged foods sold in selected major supermarkets.

DESIGN

We selected five major supermarkets in 2018 and collected the product information and nutritional content from the labels of all packaged foods sold. We organised 4278 foods into fourteen major food categories and thirty-six sub-categories and recorded the proportion of products labelled in accordance with the Fiji labelling regulations. We looked at the levels of Na and total sugar in each food category and assessed how many products complied with the Fiji reformulation targets set for Na. We also listed the companies responsible for each product.

SETTING

Suva, Fiji.

RESULTS

Fourteen percentage of packaged foods in fourteen major categories met Fiji national labelling regulations. Na was labelled on 95·4 % products, and total sugar labelled on 92·4 %. The convenience foods category had the highest Na levels (1699 mg/100 g), while confectionery had the highest content of total sugar (52·6 g/100 g). Forty percentage of eligible products did not meet the proposed voluntary Na reformulation targets.

CONCLUSIONS

Our findings indicate significant room for improvement in nutrient labelling, as well as a need for further enforcement of reformulation targets and monitoring of changes in food composition. Through enacting these measures and establishing additional regulations such as mandatory front-of-pack labelling, government and food industry can drive consumers towards healthier food choices and improve the nutritional quality of packaged foods in Fiji.

The Design and Development of a Food Composition Database for an Electronic Tool to Assess Food Intake in New Caledonian Families

The food environment in New Caledonia is undergoing a transition, with movement away from traditional diets towards processed and discretionary foods and beverages. This study aimed to develop an up-to-date food composition database that could be used to analyze food and nutritional intake data of New Caledonian children and adults. Development of this database occurred in three phases: Phase 1, updating and expanding the number of food items to represent current food supply; Phase 2, refining the database items and naming and assigning portion size images for food items; Phase 3, ensuring comprehensive nutrient values for all foods, including saturated fat and total sugar. The final New Caledonian database comprised a total of 972 food items, with 40 associated food categories and 25 nutrient values and 615 items with portion size images. To improve the searchability of the database, the names of 593 food items were shortened and synonyms or alternate spelling were included for 462 foods. Once integrated into a mobile app-based multiple-pass 24-h recall tool, named iRecall.24, this country-specific food composition database would support the assessment of food and nutritional intakes of families in New Caledonia, in a cross-sectional and longitudinal manner, and with translational opportunities for use across the wider Pacific region.

Prevalence and risk factors of adverse birth outcomes in the Pacific Island region: a scoping review protocol

Introduction

Fetal growth restriction, preterm birth, low birth weight and stillbirth are adverse birth outcomes that are prevalent in low-income and middle-income settings such as the Pacific Island region. It is widely accepted that the excess burden of adverse birth outcomes is attributable to socioeconomic and environmental factors that predispose families to excess risk. Our review seeks to determine the prevalence of adverse birth outcomes in the Pacific Island region and to identify the risk factors of adverse birth outcomes in the Pacific Island region.

Methods

This scoping review will follow the five-staged Arksey and O’Malley’s framework and consultation with Solomon Islands’ health stakeholders. A preliminary literature review was undertaken to understand the scope of the review. We will use Medical Subject Heading and keyword terms for adverse birth outcomes to search CINAHL, Medline, Scopus, ProQuest and Springer Link databases for articles published from 1 January 2000. The subsequent searches will be undertaken via Google Scholar and the internet browser to world health organisation and regional health organisations for published and unpublished reports on non-indexed studies. All articles retrieved will be managed with EndNote software. Eligible studies will be screened using Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow chart for final selection. In the charting phase, we will extract the data into Excel spreadsheets. The results will be presented as numerical and thematic summaries that map risk factors and prevalence to the population and cultures of the Pacific Island region.

Ethics and dissemination

Formal ethical approval is not required as primary or administrative data will not be collected. However, we will seek ethics approval for the stakeholder consultation from the Research Office of Curtin University and the Solomon Islands. The findings of this study will be published in peer-reviewed journals and presented in national and regional conferences and disseminated to stakeholders.

Ethics approval

There will be no direct contact with human or patients in the case of the scoping review; therefore, no ethics will be required. However, we will seek ethical approval from the Research Ethics Office of Curtin University and the Health Research and Ethics Committee in the Solomon Islands for stakeholder consultation. Dissemination will be made through regional conferences and publication in peer-reviewed journals.

Exploring Food Literacy Domains in an Adult Samoan Population

Samoan food systems have undergone a dramatic nutrition transition, with dietary patterns changing concurrently with increased rates of obesity and non-communicable disease. Whilst policy action and environmental interventions play an important role in improving access to and consumption of healthy food, the success of these relies on a greater understanding of individuals’ food knowledge and behaviours. This study aimed to explore these behaviours using the construct of food literacy in an adult Samoan population. A cross-sectional interviewer-administered questionnaire of a convenience sample of 150 adult Samoans (≥20 years) assessed the four domains of food literacy: plan/manage, select, prepare, and eat. Participants generally plan to include healthy food (87%) and budget money for food (87%). The majority know where to find nutrition labels (68%), of which 43% always use them to inform their food choices. Participants were mostly confident with cooking skills, although food storage practices require further investigation. Over 90% agreed or strongly agreed that food impacts health, although understanding of the Pacific Guidelines for Healthy Living was lacking. Understanding the ability of Samoans to plan/manage, select, prepare, and eat food is an important consideration for future interventions aiming to assist this population in navigating the modern-day food system.

A qualitative study of patient perspectives of diabetes and diabetic retinopathy services in Vanuatu

ISSUE ADDRESSED

Diabetes mellitus is an increasing global health problem, particularly in Vanuatu, where it poses a major health burden. There is paucity of information on how patients in Vanuatu perceive diabetes, diabetic retinopathy, access to services and management, health promotion and intervention services to alleviate the issues. This study aimed to explore the perceptions of diabetic patients in Vanuatu on these issues, to help inform the design of health promotion materials and community activities to empower people to self-manage and shape diabetic services that are integrated and people-centred.

METHODS

Qualitative Talanga and Kakala Pacific research methodologies were applied. Participants were diabetic patients from both urban locations and rural villages in Vanuatu. Data were collected from four (two male, two female) focus group interviews and thematically analysed.

RESULTS

There were 26 participants. System failures became apparent, including the inability of the health care services to meet the complex needs of patients with diabetes. The protective factors to reduce the risk and increasing incidence of diabetes and diabetic retinopathy included comprehensive village-based health promotion and community development programmes at the primary prevention level.

CONCLUSION

This study described patients' experiences of their diabetic care and identified key barriers and facilitators of service delivery pathways. SO WHAT?: Vanuatu needs to expand nationwide health promotion and education programmes on nutrition and exercise, food insecurity and access through trade agreements and provide well-trained nursing and medical specialists for early diagnosis and adequate management of diabetes that all people can access and afford.

Coping or adapting? Experiences of food and nutrition insecurity in specialised fishing households in Komodo District, eastern Indonesia

BACKGROUND

There is growing recognition of the need for fish to be better integrated into nutrition-sensitive strategies for addressing malnutrition. Fish are overwhelmingly produced by the small-scale sector, which supports food and nutrition security directly through the provision of fish and indirectly through the generation of income which can be used to purchase other desired foods. However, there has been relatively little research on the extent of food and nutrition security in specialised fishing communities. This study assessed food and nutrition security among households in specialised fishing communities in Komodo District, eastern Indonesia.

METHODS

We assessed the seasonal nutrition quality of household diets using the Food Consumption Score for nutritional analysis and food insecurity using the Household Food Insecurity Access Scale in 66 households across three communities, using a modified cluster sampling strategy. We calculated and generated descriptive statistics for these indicators with Microsoft Excel and ran a logistic generalized linear mixed model to determine factors associated with severe food insecurity using SPSS. We used semi-structured interviews and focus group discussions to understand perceptions of, change over time, and strategies for dealing with food shortfalls.

RESULTS

While most households have acceptable access to nutritious foods, especially protein and heme iron-rich foods, nearly one half of households consumed vitamin A rich foods on less than 3 days of the 7-day recall period in either season. More than half of households reported experiencing a moderate or severe level of food insecurity, with higher food insecurity in the wet season. Low maternal education (OR: 3.8, 95%CI 1.5-9.9) and lower household wealth (OR: 0.5, 95%CI 0.3-0.9) were found to be associated with a severe level of food insecurity. Household's consumptive and non-consumptive response strategies reflect adaptation to chronic food insecurity but are nutritionally and economically unsustainable.

CONCLUSION

Households in specialised fishing communities in Komodo District consumed diets with low diversity and experienced high levels of food insecurity. There is a need for culturally-appropriate nutrition-sensitive strategies to enhance food and nutrition security in vulnerable fishing communities.

Aquatic Foods and Nutrition in the Pacific

National rates of aquatic food consumption in Pacific Island Countries and Territories are among the highest in the world, yet the region is suffering from extensive levels of diet-related ill health. The aim of this paper is to examine the variation in consumption patterns and in nutrient composition of aquatic foods in the Pacific, to help improve understanding of their contribution to food and nutrition security. For this examination we analysed nutrient composition data and trade data from two novel region-specific databases, as well as consumption data from national and village level surveys for two Melanesian case studies, Vanuatu and Solomon Islands. Results demonstrated that consumption depends on availability and the amount and type of aquatic food consumed, and its contribution to nutrition security varies within different geographic and socio-demographic contexts. More data is needed on locally relevant species and consumption patterns, to better inform dietary guidelines and improve public health both now and into the future. Advice on aquatic food consumption must consider the nutrient composition and quantity of products consumed, as well as accessibility through local food systems, to ensure they contribute to diverse and healthy diets.

Mapping the global evidence on nutrition transition: a scoping review protocol

INTRODUCTION

Nutrition transition has emerged as an important concept in health research used to describe shifts in dietary consumption and energy expenditure that coincide with economic, demographic and epidemiological changes at a population level. Better understanding of the shifts in dietary patterns across populations and their drivers could possibly hold the key to prevention of diet-related disease risk. An increasing number of studies have reported on nutrition transition in populations around the world, however, global evidence has not been summarised.

OBJECTIVE

This scoping review is aimed to identify, explore and map the literature on nutrition transition with a specific focus on dietary changes in populations across the world. The review would allow better clarification around the concept of nutrition transition, classification of published studies and provide a framework for further research.

METHODS AND ANALYSIS

The scoping review will be designed based on the methodology by Arksey and O'Malley, refined by Levac et al. and developed in conjunction with guidance on conducting systematic scoping reviews by Peters et al. The main research question addressed by the scoping review will be: 'What is the evidence on nutrition transition defined based on dietary changes reported in general adult population across the world?' Electronic databases (PubMed, ScienceDirect and Web of Science), grey literature sources and the reference lists of key studies will be searched to identify studies appropriate for inclusion in the review. Two reviewers will independently screen all abstracts and full-text studies for inclusion. Data will be abstracted into tables and logically organised according to items addressed in the specific research questions.

ETHICS AND DISSEMINATION

Dissemination of results will be sought through a peer-reviewed publication, conference presentations and stakeholder meetings. The data used are from publicly available secondary sources, so no ethical review would be required for this study.

A Systematic Literature Review of Concepts and Factors Related to Pro-Environmental Consumer Behaviour in Relation to Waste Management Through an Interdisciplinary Approach

Although there has been a steady increase in the number of studies on consumer behaviour in relation to sustainable development, there is limited focus on the product disposal phase. This systematic literature review intends to: (1) clarify how concepts related to pro-environmental consumer behaviour are understood and analysed in the academic literature on waste management; (2) discover any interplay between pro-environmental consumer behaviour and generic consumer behaviour, and the conditions and factors that favour it. A typical systematic literature review methodology was applied to the papers available on Web of Science, Science Direct and EBSCO (Elton Bryson Stephens Company) host between 1975 and 2019, leading to the selection of 699 final papers. The findings reveal that: (1) Although scholars tend to create a variety of pro-environmental consumer behaviour models depending on their specific field of inquiry, all approaches can be traced back to a limited number of reference theories; (2) The overall level of interplay between pro-environmental consumer behaviour and generic consumer behaviour is limited, nevertheless a favourable context or a supportive institutional-legal framework can significantly influence it; (3) A plethora of conditions and factors favour this type of interplay, involving social psychology, laws, economics, institutions and more; (4) Several critical issues appear in the analysed papers, especially some scholars’ assumptions to be able to identify all key factors. It follows the need for a more interdisciplinary approach, a deeper analysis of the effectiveness of the intervention measures at the governmental and institutional level, and a clear classification of factors and conditions (as proposed by this review).

Dietary diversity and fish consumption of mothers and their children in fisher households in Komodo District, eastern Indonesia

Small-scale coastal fisheries contribute directly and indirectly to the food and nutrition security of marine-dependent households. Fishers can apportion part of their catch for household consumption or use the income earned to purchase staples and other desired foods. Fish are an important animal-source food rich in micronutrients essential for cognitive development of children and for adult health, and a valuable addition to rice-based diets. Furthermore, the engagement of women in fisheries value chains and increased control over income may facilitate decision-making which improves nutrition outcomes for women and their children. Despite these contributions, food insecurity remains prevalent in many low and middle income fish-producing countries. This paper reports findings from an exploration of the interplaying factors leading to food and nutrition insecurity in three marine-dependent coastal communities in eastern Indonesia, focusing on the consumption pathway, that is, the contribution of fish to the diets and nutrition of women and children. The research was undertaken as a mixed-methods case study. The study found that over 50% of mother-child pairs failed to meet the minimum recommended dietary diversity, and, while fish was the main animal-source food in diets, the introduction of fish to infant and young child diets was delayed due to fears of allergies and illnesses. Moreover, access to nutrient-dense foods was affected by variable and insufficient income from fisheries-based livelihoods, isolation from markets, and the broader food environment. Given the shift towards 'nutrition-sensitive interventions' to improve the livelihoods and well-being of fisher households, these results highlight the need for analysis of the intra-household sharing of fish within fisher households, culturally-appropriate strategies to improve the quality of family and especially complementary foods, and efforts to increase physical access to nutrient-dense foods.

Supporting Women's Participation in Developing A Seaweed Supply Chain in Kiribati for Health and Nutrition

Seaweeds are a source of food throughout the Pacific region. Kiribati, however, does not have a strong history of using seaweed in their diets, despite having reliable access to indigenous edible seaweeds. A series of peer-led seaweed training workshops held in Kiribati between 2018 and 2019 provided women with knowledge, skills, and motivational support needed to engage in the seaweed supply chain, from harvesting, processing, and marketing to consumption. This study aimed to identify opportunities and enablers to support women’s participation across the seaweed supply chain. Structured interviews with 49 women explored their interest and expected costs and benefits from involvement in the supply chain. There was high interest in most seaweed-related activities and the key motivators were health and nutrition for themselves and their family. Participants were also interested in developing and sharing new skills and saw the potential for income generation. However, there were also clear barriers including a desire for further training in seaweed harvesting, processing, and recipe creation; additional social support; and in public promotion. Given the natural resources and desire of women to engage in developing this new edible seaweed supply chain in Kiribati, there is now a need for capacity development to build social and economic wellbeing and food security across the broader community. Additional peer-to-peer training opportunities may look to other Pacific Islands where seaweed is already an established and traditional food.

Malnutrition in rural Solomon Islands: An analysis of the problem and its drivers

Solomon Islands, like many Pacific Island nations, suffer from the burden of malnutrition. External drivers including population growth, declining agriculture and fisheries productivity and global food trade have contributed to the transition to greater reliance on imported foods. Globally, diets are recognized as both a cause of and solution to the burden of malnutrition. Using a mixed‐method approach this study assessed nutritional status and key determinants of malnutrition among women and young children in rural Solomon Island communities. Quantitative 24‐hour recall surveys identified diets of women and young children in these communities to be very limited in diversity. Typical daily diets comprised of fish, sweet potato (and/or rice) and slippery cabbage (a leafy green) usually boiled in coconut milk or baked. Participatory research using problem tree and biocultural approaches identified basic determinants of poor diets and opportunities to address these challenges. We highlight three domains of opportunity to improve diets across multiple scales; 1) improve nutrition‐sensitive agriculture and fisheries to produce and distribute diverse, productive and nutrient rich foods; 2) nutrition education and empowerment, focusing on the first 1000 days of life, to influence and inform choices regarding food consumption; and 3) reducing the consumption of imported, energy‐rich nutrient poor foods through national and regional policies. These multi‐scale domains highlight that food system approaches that strengthen integrated policy and empower people are essential for healthy and sustainable diets in Solomon Islands and more broadly in the Pacific region.

Food Purchasing Behaviors of a Remote and Rural Adult Solomon Islander Population

The aim of this study was to investigate the food purchasing behaviors of an adult Solomon Islander population within a transitioning food system in Auki, Malaita. Food purchasing behavior measures included; venue type and transportation for purchasing food, previous day expenditure on food purchases, number of weekly shopping experiences for store foods (generally long-life shelf and frozen items) and fresh foods (such as fruits and vegetables and fresh fish) and the importance of factors (i.e., price) on purchasing decisions. One hundred and thirty-three adults (aged 18 to 74 years; female: 63%, males: 37%) completed an interviewer administered questionnaire during December 2018. Food items were primarily sourced from Auki markets (n = 70) and stores (n = 40). Food purchasing differed between fresh and semi-perishable foods (store food). Participants reported similar shopping experiences for store food and fresh food (M = 3.87 and M = 3.25 times a week, respectively) and spending between $1 and $200 (M = $56.12) Solomon Island dollars on food in the previous day. The most reported purchased item was white rice (n = 117, 88%), with taste, freshness and family preference the most important factors reported as influencing food purchasing choices. While our findings are from a small sample in Auki, further research could build upon this work by investigating food purchasing behaviors at other times of the year, and more widely in the Solomon Islands and greater Pacific region.

Dietary Diversity of an Adult Solomon Islands Population

Ongoing dietary transitions in the Solomon Islands has resulted in an over-reliance on commercially sourced foods, leading to food insecurity, and a subsequent rise in multiple forms of malnutrition. The aim of this study was to investigate the individual dietary diversity and food preferences of the adult population living in Auki, Solomon Islands. A cross-sectional study involving 133 adults was undertaken in the Auki district via an interviewer-administered questionnaire. Individual dietary diversity scores (DDS) were determined based on the results of a 24-h recall method. Overall mean DDS was 7.27 (range 2-12). Females and participants who lived outside the Auki town center had significantly higher dietary diversity scores. Low consumption of a variety of nutritious foods within food groups and high consumption of energy dense processed foods, indicates that diet quality is likely limited in some of this population. Participants desire for a diverse diet including local foods suggests that current dietary diversity status in this population may be influenced by food security rather than food preference.

Mercury Exposure in Mother-Children Pairs in A Seafood Eating Population: Body Burden and Related Factors

Background: Mercury is a neurotoxin that affects neurodevelopment in children; however, its association at the lowest concentration is not clear. The main objective of this study is to measure and evaluate mercury concentrations in mother–child pairs and its association demographics, lifestyle, and dietary factors within the Pacific Island Families living in Auckland, New Zealand. Methods: Mercury exposure was assessed in a sub-sample of mother–child pairs who were a part of the Pacific Island Families birth cohort, in Auckland, New Zealand at the 6-year phase. Hair samples were collected from both mothers and their children to determine mercury concentrations. Total mercury was measured using inductively coupled plasma mass spectrometry for hair samples. An interviewer-based reliable food frequency questionnaire (FFQ) examined the frequency of seafood by all the participants. Other variables such as sociodemographic (ethnicity and gender), lifestyle factors (income, education, and smoking status) and health outcomes (child behaviour and obesity) were also collected. Results: In this study, 41% of both mothers and their children had mercury concentrations above the US Environmental Protection Agency (EPA) recommended value of 1 µg/g. Most of the participants ate fish 3 or more times a week. A significant correlation was observed between mother and child hair mercury concentrations (Spearman Rho 0.79 (95% confidence interval (CI): 0.65, 0.88)). Conclusions: Mercury levels in children can be affected by their mothers’ levels due to similar eating patterns.

Access to a Nutritious Diet in Samoa: Local Insights

The adult obesity prevalence in Samoa is the third highest globally, and diet is a significant contributor. Our study aimed to explore the behavioral and demographic factors which influence diets in Samoa. The most important findings for strategic policy design were: i) cost was the most important reason for food choice, ii) participants reported high rates of consumption of sugary and fatty energy foods - along with high rates of food insecurity, and iii) the food frequency questionnaire findings from our small sample are in line with the existing evidence that the nutrition transition is underway in Samoa.

Potential impacts of climate-related decline of seafood harvest on nutritional status of coastal First Nations in British Columbia, Canada

BACKGROUND

Traditional food systems are under pressure from various stressors, including climate change which is projected to negatively alter the abundance of marine species harvested by coastal First Nations (FNs) in British Columbia (BC).

OBJECTIVE

To model the potential impacts of the climate-related declines in seafood production on the nutritional status of coastal BC FNs. In addition, we projected potential changes in nutrient intakes, under different scenarios of substitution where traditional seafood is replaced with alternative non-traditional foods.

METHODS

The study design is a mixed-method approach that combines two datasets: projected scenarios of climate-related change on seafood catch potential for coastal BC FNs and data derived from the cross-sectional First Nations Food, Nutrition, and Environment Study. The consumption of seafood was estimated using a food frequency questionnaire among 356 FNs. The contribution of seafood consumption to protein, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), vitamins (A, B12, D, niacin), and minerals (zinc, selenium and iron) requirements was assessed using Dietary Reference Intakes (DRIs).

RESULTS

Traditional seafood consumption provided daily recommendations of EPA+DHA (74-184%) and vitamin B12 (84-152%) and substantial levels of niacin (28-55%), selenium (29-55%), vitamin D (15-30%) and protein (14-30%). Projected climate change was estimated to reduce the intakes of essential nutrients by 21% and 31% under 'strong mitigation' (Representative Concentration Pathway, RCP2.6) and 'business-as-usual' (RCP8.5) climate change scenarios, respectively, by the year 2050 relative to 2000. The hypothetical substitution of seafood with selected alternative non-traditional foods does not provide adequate amounts of nutrients.

CONCLUSION

Traditionally-harvested seafood remains fundamental to the contemporary diet and health of coastal BC FNs. Potential dietary shifts aggravated by climate-related declines in seafood consumption may have significant nutritional and health implications for BC FN. Strategies to improve access to seafood harvest potential in coastal communities are needed to ensure nutritional health and overall well-being and to promote food security and food sovereignty in coastal FNs.

Contribution of fat, sugar and salt to diets in the Pacific Islands: a systematic review

OBJECTIVE

Pacific Island countries are experiencing a high burden of diet-related non-communicable diseases; and consumption of fat, sugar and salt are important modifiable risk factors contributing to this. The present study systematically reviewed and summarized available literature on dietary intakes of fat, sugar and salt in the Pacific Islands.

DESIGN

Electronic databases (PubMed, Scopus, ScienceDirect and GlobalHealth) were searched from 2005 to January 2018. Grey literature was also searched and key stakeholders were consulted for additional information. Study eligibility was assessed by two authors and quality was evaluated using a modified tool for assessing dietary intake studies.

RESULTS

Thirty-one studies were included, twenty-two contained information on fat, seventeen on sugar and fourteen on salt. Dietary assessment methods varied widely and six different outcome measures for fat, sugar and salt intake - absolute intake, household expenditure, percentage contribution to energy intake, sources, availability and dietary behaviours - were used. Absolute intake of fat ranged from 25·4 g/d in Solomon Islands to 98·9 g/d in Guam, while salt intake ranged from 5·6 g/d in Kiribati to 10·3 g/d in Fiji. Only Guam reported on absolute sugar intake (47·3 g/d). Peer-reviewed research studies used higher-quality dietary assessment methods, while reports from national surveys had better participation rates but mostly utilized indirect methods to quantify intake.

CONCLUSIONS

Despite the established and growing crisis of diet-related diseases in the Pacific, there is inadequate evidence about what Pacific Islanders are eating. Pacific Island countries need nutrition monitoring systems to fully understand the changing diets of Pacific Islanders and inform effective policy interventions.

Decreased retention of olfactory predator recognition in juvenile surgeon fish exposed to pesticide

Dory, the animated surgeonfish created by the Pixar Animation studios, famously suffered from short-term memory loss leading to many adventures. In reality, many fishes have excellent cognitive abilities and are able to learn and retain important information such as the identity of predators. However, if and how cognition can be affected by anthropogenically altered oceanic conditions is poorly understood. Here, we examine the effect of a widely used pesticide, chlorpyrifos, on the retention of acquired predator recognition in post-larval stage of the surgeonfish Acanthurus triostegus. Through associative learning, post-larvae of A. triostegus were first observed to forage significantly less in the presence of conspecific alarm cues and alarm cues associated to a predator's odor. The retention of this anti-predator behavior was estimated to last between 2 and 5 days in the absence of pesticide. However, environmentally-relevant concentrations of chlorpyrifos (1 μg.L^-1) induced the loss of this acquired predator recognition. This reduced ability to recognize learned predators is discussed as it may lead to more vulnerable fish communities in coastal areas subjected to organophosphate pesticide pollution.

High seas fisheries play a negligible role in addressing global food security

Recent international negotiations have highlighted the need to protect marine diversity on the high seas-the ocean area beyond national jurisdiction. However, restricting fishing access on the high seas raises many concerns, including how such restrictions would affect food security. We analyze high seas catches and trade data to determine the contribution of the high seas catch to global seafood production, the main species caught on the high seas, and the primary markets where these species are sold. By volume, the total catch from the high seas accounts for 4.2% of annual marine capture fisheries production and 2.4% of total seafood production, including freshwater fisheries and aquaculture. Thirty-nine fish and invertebrate species account for 99.5% of the high seas targeted catch, but only one species, Antarctic toothfish, is caught exclusively on the high seas. The remaining catch, which is caught both on the high seas and in national jurisdictions, is made up primarily of tunas, billfishes, small pelagic fishes, pelagic squids, toothfish, and krill. Most high seas species are destined for upscale food and supplement markets in developed, food-secure countries, such as Japan, the European Union, and the United States, suggesting that, in aggregate, high seas fisheries play a negligible role in ensuring global food security.

Occurrence of anisakid parasites in marine fishes and whales off New Caledonia

Anisakid nematodes are the most infamous parasites occurring in seafood with ability to infect humans. In the present study, the infective stages of five anisakid larval types, including Anisakis types I and III, Terranova types I and II and Contracaecum larval type, as well as adult Anisakis paggiae are reported from 16 host species from New Caledonian waters. The specific identity of the larval types was investigated using ITS sequence data. Anisakis larval types I and III were identified as Anisakis typica and Anisakis brevispiculata, respectively, based on identical ITS sequences. However, the specific identity of the Terranova larval types and Contracaecum larval type remains unknown until a matching ITS sequence from a well-identified adult is available. Several fish host species are reported for the first time for anisakid larval types found in this study. Considering that third-stage larvae of anisakids are known to be the infective stage of the parasite for humans and the popularity of seafood in New Caledonia, presence of these parasites in New Caledonian fish is of high importance in terms of public health and raising awareness among various stakeholders. Although adult nematodes in the present study were identified as Anisakis paggiae, the spicule length is shorter in our specimens and falls within the range reported for Anisakis oceanicus previously reported in Pacific waters from black fish (genus Globicephala) and later synonymised with Anisakis physeteris. However, our specimens are different from A. physeteris in morphology of ventriculus. Anisakis paggiae has been reported from whales in southern hemisphere and this is the first report from the Pacific regions.