Background: Non-communicable diseases (NCDs) such as Type 2 diabetes, cardiovascular
disease and certain cancers, have been recorded in the Pacific at some of the highest global rates.
Pohnpei, a Pacific island-state within the Federated States of Micronesia (FSM), bears this
increasing disease burden. Without interventions, it is projected that almost half of Pohnpei’s
current population will become diabetic in the next quarter century. Pohnpei is in the midst of a
nutrition transition: a shift from a traditional, high fiber, low-fat diet to a diet consisting of
imported foods high in saturated fat and sugar accompanied by a more sedentary lifestyle. These
factors in addition to economic, social and cultural changes have led to increased lifestyle
diseases. Intervention strategies to promote healthy food consumption are required to counteract
this trend. Programs reintegrating the local food (defined as locally grown, carbohydrates) have
shown to decrease the risk of non-communicable diseases. Necessary to the adaptability,
sustainability and cultural appropriateness of these interventions is the data to determine current
dietary patterns and the factors influencing food decision-making behavior. The data collected in
this study will inform health prevention programs. In addition, the networks created with
collaborators around this project serve as future platforms and social capital for follow up
research and health intervention delivery.
Objectives: The objectives of this exploratory study were: 1) To describe the food patterns and
trends of a Pohnpei adult sample population; 2) To gain insight into the knowledge, attitudes,
beliefs, and practices relating to health and food consumption among the Pohnpei adult sample
population; 3) To recommend communication channels and strategies for interventions.
Methods: Both quantitative and qualitative methods were employed. A 52-item structured survey
including a 7-day Food Frequency Questionnaire was delivered to 293 participants. The study
sample was women between the ages of 15 and 64 attending a children’s educational screening
program. The survey was integrated into an island-wide education testing program targeting five
sites that covered the island’s six municipalities. An ethnographic approach consisting of indepth
interviews, informal focus groups and observation was also utilized to capture the factors
related to food-decision making and consumption.
Results: Findings from this research conclude that certain less nutritious, imported foods are
popular and consumed frequently. However, there still exists frequent consumption of local food
items. Factors including availability, affordability, convenience, and status of food items were
found to determine food-decision behaviors.
Discussion: Due to a trend towards increased consumption of less nutritious foods this is a
critical period within the nutrition transition. Innovative strategies that take advantage of existing
resources to promote local foods by utilizing existing channels, key individuals and local
organizations are necessary. In addition, an Information, Education and Communication strategy
to encourage local food consumption is required.