Dietary intake of modernizing Samoans: implications for risk of cardiovascular disease.

OBJECTIVE: To describe the dietary intake of American and Western Samoans, with emphasis on nutrients conventionally related to risk factors for cardiovascular disease. DESIGN: Cross-sectional dietary survey. Intake estimates were based on 24-hour recall interviews. SUBJECT: Community-based samples of 946 men and women (455 American Samoans, 491 Western Samoans) aged 25 to 55 years. STATISTICAL ANALYSES: Tests of differences in means (t tests) and proportions (chi 2 tests). Correlation and multivariate linear regression analyses were conducted to describe correlates of energy and nutrient intakes. RESULTS: Few differences were noted between the energy and nutrient intakes of men and women, but substantial differences were found between residents of American Samoa and those of the less modernized country of Western Samoa. American Samoans consumed significantly more energy as carbohydrate (47% vs 44%) and protein (18% vs 13%) and less as fat (36% vs 46%) and saturated fat (16% vs 30%). Energy-adjusted intakes of cholesterol and sodium were higher among American Samoans. These differences persisted after adjustment for age, gender, years of education, occupation, and categories of a 10-point material lifestyle score. Samoans in the lowest category of material lifestyle had significantly lower energy-adjusted intakes of protein, cholesterol, and sodium and higher intakes of saturated fat than those in the upper 2 categories. Additional analyses described the contribution of specific foods to the intakes of energy and macronutrients. CONCLUSIONS/APPLICATIONS: The observed energy and nutrient intake patterns are consistent with previously reported levels of obesity and risk factors for cardiovascular disease among Samoans and suggest dietary modification for those at highest risk. Dietetics practitioners who counsel Samoan and other Pacific Islander clients should be aware of these intake patterns, which seem particularly malleable to levels of personal income. More generally, results from this study illustrate that the food choices of certain ethnic groups may be profoundly affected by the process of modernization within a country or by migration to a more economically developed locale.

Why are Polynesian children admitted to hospital for asthma more frequently than European children?

Polynesian children have higher hospital admission rates than European children. This study compared 156 Polynesian children with 199 European children admitted to hospital for asthma. After controlling for socioeconomic status Polynesian children were similar to European children for many variables, but there were a number of important differences. The number of previous hospital admissions for asthma was higher in Polynesians than Europeans (mean (SD), 3.9 (4.6) v 2.8 (3.8) respectively p = 0.028). Despite this, 33% of Polynesian children were not receiving any asthma drugs in the 24 hours prior to admission to hospital compared with 14% of Europeans (relative risk (RR) = 1.94, 95% confidence interval (CI) = 1.25-3.00) and fewer were taking sympathomimetics and cromoglycate. A similar trend in asthma drug usage was seen six months later. Polynesian children were less likely to be referred to hospital by a general practitioner than European children (42% v 64% respectively, RR = 0.72 95% CI = 0.58-0.89). The differences in hospital admission rates are not explained by genetic or socioeconomic factors but seem to be related more to patterns of medical management.

Parenteral absorption of insulin from the lung in diabetic children.

Semi-synthetic human insulin was delivered via a novel nebulizer to the respiratory tracts of six diabetic children. Blood glucose control obtained was at least as good as a control day when they received their usual dose of subcutaneous insulin.

Lactose malabsorption in Polynesian and white children in the south west Pacific studied by breath hydrogen technique.

Lactose malabsorption was studied by a breath hydrogen technique in 139 Samoan and 68 white schoolchildren. The Samoans were studied in four locations, two in Western Samoa and two in New Zealand, and the white children in both the Cook Islands and New Zealand. The prevalence of malabsorption varied with location: for Samoans it ranged from 41% to 60% in Western Samoa and 0% to 35% in New Zealand; white children had rates of 27% in the Cook Islands and 5% in New Zealand. Environmental factors rather than genetic factors are likely to play the main part in initiating if not perpetuating lactose malabsorption. In both races lactose malabsorption had no effect on the acceptance of, consumption of, and number of gastrointestinal symptoms caused by milk and milk biscuits. Children who had symptoms after consuming a particular dairy product were more likely to say they disliked it than those who reported no symptoms.