Background: Pacific islanders (PI) have some of the highest prevalence of obesity and type 2 diabetes in the world. Data related to PI are often reported as though the group is an aggregate; however, PI are a group of very diverse peoples.
Objective: To explore the obesity problem in PI by: 1) characterizing the major ethnic groups in the Pacific; 2) describing the most recent US census data on PI and their recent immigration patterns; and 3) synthesizing the literature on obesity in PI and type 2 diabetes mellitus.
Methods: Census information and anthropologic resources on the Pacific Islands and its peoples were obtained through an Internet search. Literature on obesity, diabetes, and body composition in PI were obtained through a systematic analysis of citations listed on Medline.
Results: Pacific Islanders (PI) are diverse people, culturally, biologically, and linguistically. Polynesians and some Micronesians have a very high prevalence of obesity and diabetes. Melanesians are among the most diverse ethnic groups in the world. Body mass index (BMI) cut-point values for Polynesians may be inaccurate.
Conclusions and recommendations: The cause of obesity and diabetes in PI is unclear. Some factors involved are related to urbanization and migration. Obesity research should distinguish between island ethnicities and not aggregate all PI together. Research is needed to define body fat distribution of Polynesians in relationship to obesity co-morbidities, to determine normal growth of Polynesian children, to determine the relationship between growth abnormalities and adult obesity, and to determine the impact of immigration on PI.