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RelativeResourceManager - Globalization and Health Research...

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Bio Med Central Page 1 of 8 (page number not for citation purposes) Globalization and Health Open Access Research Overweight in the Pacific: links between foreign dependence, global food trade, and obesity in the Federated States of Micronesia Susan Cassels* Address: Center for Studies in Demography and Ecology, University of Washington, Box 353412, Seattle WA 98195, USA Email: Susan Cassels* - scassels@u.washington.edu * Corresponding author Abstract The Federated States of Micronesia (FSM) has received considerable attention for their alarming rates of overweight and obesity. On Kosrae, one of the four districts in the FSM, 88% of adults aged 20 or older are overweight (BMI > 25), 59% are obese (BMI > 30), and 24% are extremely obese (BMI > 35). Recent genetic studies in Kosrae have shown that obesity is a highly heritable trait, and more work is underway to identify obesity genes in humans. However, less attention has been given to potential social and developmental causes of obesity in the FSM. This paper outlines the long history of foreign rule and social change over the last 100 years, and suggests that a combination of dietary change influenced by foreigners, dependence on foreign aid, and the ease of global food trade contributed to poor diet and increased rates of obesity in Micronesia. The last section of the paper highlights the Pacific tuna trade as an example of how foreign dependence and global food trade exacerbates their obesity epidemic. 1. Background Obesity and overnutrition are becoming major global health issues. In 2000, the World Health Organization stated that overeating is the "fastest form of malnutri- tion", and estimates that the number of people worldwide that are overweight and malnourished equals the number of people that are underweight and malnourished, at 1.1 billion people [1]. Body Mass Index (BMI) is the most common measure of body fat; BMI equals an individual's weight in kilograms divided by their height in meters squared. Nearly one in three Americans is obese (BMI > 30) and obesity rates have risen steadily over the last 40 years, from 13.3% to 30.5%. While such growth is con- cerning, these rates are not the highest in the world. On the island of Kosrae, a district in the Federated States of Micronesia (FSM), 88% of adults aged 20 or older are overweight (BMI > 25), 59% are obese (BMI > 30), and 24% are extremely obese (BMI > 35) [2]. Kosrae has received international attention for their alarming rates of obesity and has become the keystone study site for trying to identify genetic causes of obesity [2- 5]. A census of the entire adult population of Kosrae has recently been completed, which included individual DNA samples, individual-level data on height, weight, blood pressure, and glucose levels, as well as information about the identity and medical status of family members. The goal of this ongoing work is to establish the possible rela- tionship of genetic variation to human obesity. However, these studies note that Kosraean's have not always been
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RelativeResourceManager - Globalization and Health Research...

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