Ultra-processed food consumption in the central division of Fiji.

Background: Processed packaged foods are readily available in Fiji; however, the extent to which ultra-processed foods (UPFs) currently contribute to energy and nutrient intake is unknown. This study aimed to assess the contribution of UPFs to total energy intake and nutrients of concern (sodium, sugar, fat) in a representative sample of adults in the central division of Fiji, identify the main food category sources of UPFs and assess variation by sociodemographic characteristics.

Methods: A random sample of 700 adults was selected from two statistical enumeration areas (one semi-urban, one rural).

Assessing Knowledge, Attitudes and Behaviours toward Salt and Sugar Consumption in the Central Division of Fiji.

Objectives: This study aimed to assess salt and sugar-related knowledge, attitudes and behaviours (KAB) of adults in the Central Division of Fiji.

Methods: A randomised stratified sample of 700 adults were selected. Questions on salt and sugar-related KABs were developed.

Energy, nutrient and overall healthiness of processed packaged foods in Fiji, a comparison between 2018 and 2020.

In Fiji, packaged foods are becoming increasingly available. However, it is unknown if nutrition composition of these foods has changed. This study aims to assess changes in energy, nutrient content and healthiness of packaged foods by comparing data from five major supermarkets in Fiji in 2018 and 2020.

Proportion and Correlates of Children in the US-Affiliated Pacific Region Meeting Sleep, Screen Time, and Physical Activity Guidelines.

Introduction: Limited data on 24-hour movement behaviors of children aged 5-8 years exist globally. We describe the prevalence and sociodemographic associations of meeting physical activity (PA), sedentary recreational screen time (ST), and sleep guidelines among children from 11 jurisdictions in the US-Affiliated Pacific region.

Methods: Cross-sectional representative data from 1192 children aged 5-8 years living in the US-Affiliated Pacific region were drawn from the baseline 2012-2014 Children's Healthy Living Program.

When one size does not fit all: aid and health system strengthening for Small Island Developing States.

Health System strengthening is high on the agenda of the global health community. We review some of the specific challenges faced by Small Island Developing States in the development of their health systems. We propose a list of action points for aid actors willing to adapt their health programs and interventions.

Food insecurity, COVID-19 and diets in Fiji - a cross-sectional survey of over 500 adults.

Introduction: Food insecurity is associated with inadequate nutrition and increased rates of chronic disease. The primary aim of this study was to assess self-reported food insecurity and the perceived impact of COVID-19 on food security, in two regional districts of Central Fiji, as part of a broader program of work on strengthening and monitoring food policy interventions. The secondary aim was to explore the relationship between food insecurity and salt, sugar and fruit and vegetable intake.

Lessons for strengthening policymaking for obesity and diet-related noncommunicable disease prevention: A narrative synthesis of policy literature from the Western Pacific Region.

Obesity and diet-related noncommunicable diseases (NCDs) have a profound impact on individuals, households, health care systems, and economies in low- and middle- income countries (LMICs), with the Western Pacific Region experiencing some of the highest impacts. Governments have committed to improving population diets; however, implementation challenges limit effective policy action. We undertook meta-narrative synthesis of the academic literature and used theories of policymaking and implementation to synthesize current knowledge of issues affecting the adoption and implementation of policies to prevent obesity and diet-related NCDs in LMICs in the Western Pacific Region.

Developing Trust in Collaborative Research: Utilizing Indigenous Pacific Methodologies to Create Dialogue Within Research Teams.

This article explores the processes involved in developing international, cross-cultural research teams. Scholarship on Indigenous and Pacific Methodologies demonstrate the importance of employing methodologies that center Indigenous approaches to research and relationships. This article explores using these methodologies within research teams as a preliminary step in developing sustainable and impactful international, cross-cultural research teams.

Asia-Pacific consensus statement on integrated 24-hour activity guidelines for the early years.

Background: Early childhood is a vital period for development and growth. Promoting beneficial lifestyle behaviours in early childhood can help optimise children's health, development and learning, shape their behaviours in adulthood and offer the best protection against future non-communicable diseases (NCDs). In the Asia-Pacific region, NCDs are significant causes of healthcare burden and mortality.

Research protocol for impact assessment of a project to scale up food policies in the Pacific.

Background: One of the challenges for countries implementing food policy measures has been the difficulty in demonstrating impact and retaining stakeholder support. Consequently, research funded to help countries overcome these challenges should assess impact and translation into practice, particularly in low-resource settings. However, there are still few attempts to prospectively, and comprehensively, assess research impact.

Incorporating a gender lens into nutrition and health-related policies in Fiji: analysis of policies and stakeholder perspectives.

Background: Gender equality, zero hunger and healthy lives and well-being for all, are three of the Sustainable Development Goals (SDGs) that underpin Fiji's National Development Plan. Work towards each of these goals contributes to the reduction of non-communicable diseases (NCDs). There are gender differences in NCD burden in Fiji.

Strengthening implementation of diet-related non-communicable disease prevention strategies in Fiji: a qualitative policy landscape analysis.

Background: Noncommunicable diseases (NCDs) are the leading cause of death globally, and the World Health Organization (WHO) has recommended a comprehensive policy package for their prevention and control. However, implementing robust, best-practice policies remains a global challenge. In Fiji, despite political commitment to reducing the health and economic costs of NCDs, prevalence of diabetes and cardiovascular disease remain the highest in the region.

Assessing the progress on the implementation of policy and legislation actions to address the Non-Communicable Diseases crisis in the Pacific.

Aim: To assess the progress on the implementation of Non-Communicable Diseases (NCD) related policies and legislations in the Pacific Island Countries and Territories (PICTs).

Materials And Methods: The Pacific Monitoring Alliance for NCD Action (MANA) Dashboard was used to assess the progress on the implementation. The MANA Dashboard includes 31 indicators across four different domains such as leadership and governance; preventative policies and legislations; health system response programs; and monitoring This progress assessment was conducted between 2019 and 2020 for all 21 PICTs.

The tide of dietary risks for noncommunicable diseases in Pacific Islands: an analysis of population NCD surveys.

Objective: To describe changes over time in dietary risk factor prevalence and non-communicable disease in Pacific Island Countries (PICTs).

Methods: Secondary analysis of data from 21,433 adults aged 25-69, who participated in nationally representative World Health Organization STEPs surveys in 8 Pacific Island Countries and Territories between 2002 and 2019. Outcomes of interest were changes in consumption of fruit and vegetables, hypertension, overweight and obesity, and hypercholesterolaemia over time.

Gender roles, generational changes and environmental challenges: an intersectional interpretation of perceptions on healthy diets among iTaukei women and men in Fiji.

Objective: To investigate perceptions of iTaukei Fijian women and men around diet and the ability to consume a healthy diet.

Design: Six focus groups were conducted with women and men separately. Six to ten women and men participated in each group.

Applying systems thinking to identify enablers and challenges to scale-up interventions for hypertension and diabetes in low-income and middle-income countries: protocol for a longitudinal mixed-methods study.

Introduction: There is an urgent need to reduce the burden of non-communicable diseases (NCDs), particularly in low-and middle-income countries, where the greatest burden lies. Yet, there is little research concerning the specific issues involved in scaling up NCD interventions targeting low-resource settings. We propose to examine this gap in up to 27 collaborative projects, which were funded by the Global Alliance for Chronic Diseases (GACD) 2019 Scale Up Call, reflecting a total funding investment of approximately US$50 million.

Strengthening Sugar-Sweetened Beverage Taxation for Non-Communicable Disease Prevention: A Comparative Political Economy Analysis Case Study of Fiji and Tonga.

Diet-related fiscal policy is an effective NCD prevention strategy. However, current sugar-sweetened beverage (SSB) taxes in Fiji and Tonga have not had the desired effect; SSB consumption in Fiji, for example, contributes to mortality more than double the global rates and is highest in the WHO Western Pacific Region. We therefore aimed to better understand the perceived underlying political economy drivers that have and continue to affect change in each country.

Scaling-up food policies in the Pacific Islands: protocol for policy engagement and mixed methods evaluation of intervention implementation.

Background: There is a crisis of non-communicable diseases (NCDs) in the Pacific Islands, and poor diets are a major contributor. The COVID-19 pandemic and resulting economic crisis will likely further exacerbate the burden on food systems. Pacific Island leaders have adopted a range of food policies and regulations to improve diets.

Barriers and facilitators to the introduction of import duties designed to prevent noncommunicable disease in Tonga: a case study.

Background: In Tonga, import duties were lowered on tinned fish and seafood in 2013 and raised on soft drinks, dripping and other animal fats. Additional import duties were applied to soft drinks and dripping and other fats in 2016 and duties were also applied to high fat meats, mutton flaps and turkey tails. The objective of this study was to describe barriers to and facilitators of these import duties from a policy-maker perspective.

Packaged food supply in Fiji: nutrient levels, compliance with sodium targets and adherence to labelling regulations.

Objective: To estimate the proportion of products meeting Fiji government labelling regulations, assess compliance with national Na reformulation targets and examine the Na and total sugar levels in packaged foods sold in selected major supermarkets.

Design: We selected five major supermarkets in 2018 and collected the product information and nutritional content from the labels of all packaged foods sold. We organised 4278 foods into fourteen major food categories and thirty-six sub-categories and recorded the proportion of products labelled in accordance with the Fiji labelling regulations.

Childhood Obesity in the Pacific: Challenges and Opportunities.

Purpose Of Review: Childhood obesity is increasing substantially in many Pacific island countries and poses an urgent and serious challenge. The Sustainable Development Goals set by the United Nations and the NCD Roadmap created at the request of the Pacific Finance and Economic Ministers identify prevention and control of noncommunicable diseases as core priorities. Among the various risk factors responsible for the development of noncommunicable diseases (NCDs), overweight and obesity are particularly of concern with the potential to negate many of the health benefits that have contributed to increased life expectancy.

The political economy of restricting marketing to address the double burden of malnutrition: two case studies from Fiji.

Objective: To draw lessons from Fiji regarding the challenges and opportunities for policy initiatives to restrict (i) food marketing to children and (ii) marketing of breast milk substitutes, to inform policy for the double burden of malnutrition.

Design: Qualitative political economy analysis of two policy case studies.

Setting: Fiji.