Associations between sociodemographic and behaviour factors, and dietary risk factors for overweight and obesity, in Samoan women.

Adults in Samoa have the third highest obesity prevalence in the world, and the prevalence is higher in women than men. The nutritional status of a household in most low- and middle-income countries is positively influenced by the level of control women have over financial resources. Our analysis examined how consumption of specific dietary groups was associated with different sociodemographic and individual health risk factor groups for women who participated in the 2014 Samoa Demographic and Health Survey. Our research question was explored through multivariate analysis of the 2014 Samoa Demographic and Health Survey dataset. The sociodemographic and health behaviour groups included in our analysis were: urban vs. rural residence, wealth quintile, education level, participation in physical activity program, lives with husband/partner, household size, parity, age, smoking, and alcohol consumption. The following diet variables were included: fruit, vegetables, seafood, high-fat food, sugary drinks, high-salt food, and high-sugar food consumption. There was a high prevalence of unhealthy food consumption and unhealthy dietary patterns among a) a large proportion of the population, and b) across sociodemographic and health behaviour groups, with a higher prevalence of particular at-risk patterns in some specific groups including women of younger age and women of higher wealth. Our analysis highlighted some specific opportunities for policy action, including the need to create an enabling environment for healthier food consumption for Samoan women.

Access to a Nutritious Diet in Samoa: Local Insights.

The adult obesity prevalence in Samoa is the third highest globally, and diet is a significant contributor. Our study aimed to explore the behavioral and demographic factors which influence diets in Samoa. The most important findings for strategic policy design were: i) cost was the most important reason for food choice, ii) participants reported high rates of consumption of sugary and fatty energy foods - along with high rates of food insecurity, and iii) the food frequency questionnaire findings from our small sample are in line with the existing evidence that the nutrition transition is underway in Samoa.

The influence of grandmothers on breastfeeding rates: a systematic review.

BACKGROUND: Exclusive breastfeeding for the first six months of an infant's life has enormous potential to reduce mortality and morbidity. The older generation, particularly the infant's grandmothers, play a central role in various aspects of pregnancy and child rearing decision-making within the family unit. This is particularly true in low- and middle-income countries where older women are seen as owners of traditional knowledge. Despite this, most health programs target the individual person most directly involved in the target behaviour--usually new mothers--without a commensurate understanding of who else influences those decisions. In this systematic review we aim to quantify the impact of the grandmother on influencing a mother's breastfeeding practices. METHODS: We conducted a systematic review using Web of Science, Scopus, and Medline databases using search terms for grandmother and breastfeeding. Eligible studies reported on the duration of exclusive breastfeeding and included estimates of effect of a grandmother's influence including whether or not the grandmother lived with the infant's family, the grandmother's education, and the grandmother's attitudes towards and prior experience with breastfeeding. RESULTS: We identified 568 articles and, after review, 13 articles were assessed as meeting the selection criteria. They were conducted in both developed and developing countries and included cross-sectional surveys, prospective cohort studies and one randomised controlled trial. Eight studies examined the effects of attitudes or experiences of older generations with respect to breastfeeding and five of the eight found a significant positive impact on breastfeeding when grandmothers of the infants had had their own breastfeeding experience or were positively inclined towards breastfeeding, resulting in effects of between 1.6 to 12.4 times more likely to exclusively breastfeed or refrain from introducing solid foods. A Chinese study however found that highly educated grandmothers were associated with decreased exclusive breastfeeding. The majority of the studies were assessed to be of weak or moderate quality. CONCLUSIONS: This review found evidence that demonstrates that grandmothers have the capacity to influence exclusive breastfeeding. Programs that seek to influence exclusive breastfeeding should include grandmothers in their interventions to achieve maximum impact.

Barking up the wrong tree: injuries due to falls from trees in Solomon Islands.

OBJECTIVE: To investigate tree-related injuries in Solomon Islands by the types of trees involved, who is affected and the types of injuries caused. DESIGN AND SETTING: Descriptive case series of all cases of injuries related to trees presenting to the National Referral Hospital in Honiara from 1994 to 2011. Data were collected by the attending clinician using a Trauma Epidemiology form, which provides information on age, sex, cause of injury and type of fracture. MAIN OUTCOME MEASURES: Number of injuries by tree type, sex and age. RESULTS: Of the 7651 injuries in the database, 1107 (14%) were caused by falls from trees. Falls from coconut trees led to the highest number of injuries, followed by falls from mango, guava, apple and nut trees. Overall, 85% of injuries occurred in individuals aged < 20 years. For injuries involving guava trees, 77% of patients were aged < 10 years, compared with 46% for the five most commonly involved tree types. Overall, 71% of injuries occurred among males. Of all injuries, 92% were fractures, 3% were dislocations and 5% were non-fracture, non-dislocation injuries. The arm (including wrist, elbow and hand) was the most common location of injury across all tree types. Distal radius fractures in the forearm were particularly common, as were ulna fractures. CONCLUSION: While mangos and guavas are undeniably delicious, the quest for their flesh can be hazardous. Children will always climb trees, but the search for food among children in lower-income settings may lead to higher rates of injury.

An Analysis of Healthy Food Access Amongst Women in Peri-urban Honiara.

Highly processed and energy-dense foods are contributing to the high and rising rates of non-communicable diseases and nutrient deficiencies in Solomon Islands. Non-communicable diseases currently cause 69% of deaths in Solomon Islands, and the rate is rising, fuelled in part by limited health system capacity to treat these conditions. Solomon Islands also has the highest reported undernourishment rate in the Pacific. Recent decades have seen several factors change the food and economic environment in Solomon Islands. Importantly, rural-to-urban migration has caused a disconnect between urban residents and access to land and home gardens. This study aimed to examine the complexities of nutritious food access in urban Solomon Islands. Data were collected from 32 women in Honiara, the islands' capital, using a novel survey instrument. There were 3 important findings: (1) the dominant influencers of the diet patterns described by participants in this study were food affordability and access to land on which to grow it, (2) all participants experienced food insecurity, and (3) reported diet patterns reflected unhealthy diets which were particularly high in processed and sugary foods. These findings suggest a need for improvements in the food environment in Honiara.