I was a big fan of the reboot of Hawaii Five-0 that recently ended after a ten year run. It was an exciting crime drama against a beautiful tropical backdrop. But one things that always bothered me was how the main actors were always buff movie stars and the native Hawaiians were for the most part overweight, and in some cases morbidly obese. Actors Taylor Wily and Shawn Garnett (above) played two cousins that ran a shrimp truck and both topped the scales at over 400 pounds. I worried about them. Both are relatively young men, but I can only imagine the health problems that await them as they age.
After doing more research, it now turns out that Pacific islanders in general are among the fattest people on the entire planet. Of the top 10 nations for weight, 9 of them are in the Pacific ocean. But why here and why these people?
Up until World War 2, Pacific islanders lived pretty much as they always had, subsisting on local fruits and crops as well as fish from the sea. Then during the war the islands were occupied by the Japanese and then the Americans and other Europeans, and by the 1950's were opening up to all things Western- tourism, pop culture, and food. The native foods have given way to cheaper processed foods and croplands have been taken over by big plantations and mining operations.
The islands were introduced to foods that weren't popular elsewhere like turkey tails, fatty lamb cuts, and other meat by-products. Soon afterwards they discovered processed foods of all types, laden with fat and sugar at much higher levels than their old diets. With the new diet their weights have ballooned and so have assorted illnesses like diabetes and heart disease.
Because of the perverse price incentives in Western diets, bad foods are cheaper than healthy foods. Obesity is hitting low-income communities harder. Native Americans are 50% more likely, and non-Hispanic black Americans are almost 20% more likely, to be obese than non-Hispanic whites. It's a vicious cycle of poverty as job prospects diminish with increasing obesity and health care costs skyrocket.
Consider the tiny country of Nauru, population 12,000, in the middle of the Pacific. an amazing 70% of the island's inhabitants are obese, and diabetes is rampant. Because the island had large sources of phosphates, miners came and stripped much of the land to get at it. The people there were left to rely on cheaper imported processed foods instead of their usual diet. This pattern, I fear has repeated itself all over the Pacific. In Hawaii, it was tourism, pineapple, sugar, and macadamia nut plantations that took over the economy, and the people have had to adapt to a new unhealthy normal.
To their credit, Pacific islanders don't believe in fat shaming, and big bodies are accepted there unlike elsewhere in the world. In many cases obesity is seen as a sign of wealth. We all have to be careful not to hold unreasonable standards of beauty for people and look to the human inside. But for a pure public health perspective, theirs is a real obesity problem that could be headed our way. They are the canary in the coal mine that shows us what could await us all in the near future.
Some believe that the Pacific islanders were genetically vulnerable to the sugary foods that took over. Their ancestors had to survive long lean periods either on tiny islands or on long sea voyages. Through evolution, their bodies figured out how to latch onto every calorie they ate so they could survive long periods of food shortages. Now, however, with an overabundance of food, their bodies still hold onto the calories, at a rate larger than anywhere in the world.
Polynesians aren't any more gluttonous than anybody else. But they are paying for the standard American diet in worse ways than the rest of us. I've been fortunate to go to Hawaii twice in my lifetime and consider it a paradise on Earth. There's trouble in paradise now, and I wish our Pacific brothers and sisters well. Hopefully they can get a handle on this crisis and teach us all a thing or two.
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