Objective: Obesity and diabetes are particularly high in indigenous populations exposed to a Western
diet and lifestyle. The prevalence of obesity, diabetes, hyperglycemia, dyslipidemia, and hypertension in
one such population, the Micronesian island of Kosrae was described.
Design and Methods: Longitudinal screenings for metabolic traits were conducted on adult Kosraens
20 years of age in 1994 and again in 2001. Data was obtained on 3,106 Kosraens, comprising 80% of
the adult population. Diabetes was diagnosed using World Health Organization guidelines. Prevalences of
obesity, hyperglycemia, dyslipidemia, and hypertension were assessed.
Results: The overall age-adjusted prevalence of diabetes increased from 14 to 21%. The most
significant change observed in the population was increases in obesity and hyperglycemia, especially
among young Kosraens and women. Obesity age-adjusted prevalence increased from 45 to 62%, and
hyperglycemia age-adjusted prevalence increased from 19 to 44%. Of note, Kosraens as a group had
unusually low high density lipoprotein (HDL) levels with 80% classified as low HDL by NCEP-ATPIII
criteria, despite lacking the usually accompanying increase in triglycerides.
Conclusion: Comparison to reports from other populations shows that Kosrae experiences one of the
highest rates of obesity, hyperglycemia, and low HDL globally while maintaining relatively healthy levels
of triglycerides. Our study shows a dramatic increase in obesity and hyperglycemia in Kosrae in just 7
years and forebodes significantly increased health risks for this part of the world.