Nutrition assessment
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Fiji

Fiji, in transition towards increasing industrialisation, is facing nutritional problems associated with both undernutrition and overnutrition. Lack of access to food due to economical shortages is one of the major causes of malnutrition in the country. One quarter of the population is living below the poverty line. The problem of overnutrition on the other hand may be associated with the change in the consumption patterns towards a diet high in energy but low in fibre, vitamins and minerals and a sedentary lifestyle. Fiji relies heavily on food imports, which account for more than half of the national dietary energy supply (FAOSTAT, 2002).

Comparison of the National Nutrition Survey in 1980 with the one in 1993 and data from a longitudinal survey conducted in Naduri Village from 1952 to 1994, seems to indicate a change in the food consumption pattern of the population of Fiji. This change is characterized by an increase in the consumption of cereals, animal fat and processed imported foods, along with a decrease in the consumption of traditional root crops and other local food products, especially for Fijians (Saito, 1995).

Malnutrition in children resulting from insufficient dietary intake is a concern. The 1993 National Nutrition Survey reported a low prevalence of underweight and stunting and a medium prevalence of wasting in children under five years of age, according to WHO classification. However, ethnical comparisons reveal that the prevalence of underweight and wasting is much higher in Indian children than in Fijians. Among Indian children less than five years, underweight and wasting have a medium and high prevalence respectively, whereas among Fijian children prevalences are low. When comparing anthropometric data on the basis of the same cut-off points, the very different body sizes of these two ethnic groups must be taken into consideration (Saito, 1995).

Underweight was identified as a problem among Fijian infants in the weaning period. Nutritionally inadequate complementary foods, reduced feeding frequencies and poor sanitation, besides adverse socio-economic conditions, seem to be the main contributing factors (Schultz and Seniloli, 1995).

The prevalence of overweight and obesity in adults is increasing in Fiji. In the National Nutrition Survey of 1993, more than one quarter of the population was overweight, and one fifth of the women were obese. The prevalence of overweight and obesity is particularly high among Fijian women. The risk for mild energy deficiency, however, is much higher for Indian men and women than for their Fijian counterparts (Saito, 1995).

The prevalence of iodine deficiency disorders (IDD) is high in Fiji. Almost half of the population had goitre detected by ultrasound in 1994. The prevalence of goitre in school age children (6 to 12 years old) was nearly 75% in Ba and Sigatoka Valley. A new survey will reveal if the legislation on the exclusive import of iodised salt in 1996 has had an impact on the IDD prevalence (Gutekunst, 1994).

Iron deficiency anaemia is a major public health problem mainly affecting women of childbearing age and children less than five years. Anaemia is more prevalent in Indian women, but the rates among Fijians are also increasing. Pregnant women are the group most at risk, more than half of them being anaemic, particularly Indian women (Saito, 1995; MOH, 1998).