A conceptual framework for managing modifiable risk factors for cardiovascular diseases in Fiji

Perspect Public Health. 2015 Mar;135(2):75-84. doi: 10.1177/1757913913500045. Epub 2013 Oct 14.

Abstract

Aims: The current review will look at modifiable lifestyle (physical inactivity, poor nutrition, risky alcohol behavior and cigarette smoking) and cardio-metabolic (obesity, diabetes mellitus, high cholesterol and high blood pressure) cardiovascular disease (CVD) risk factors among Indigenous-Fijian and Indo-Fijian subgroups. A framework for monitoring and managing these risk factors will be presented.

Methods: National health surveys were identified where available. Electronic databases identified sources for filling missing data. The most relevant data were identified, organized and synthesized.

Results: Compared to Indo-Fijians, Indigenous-Fijians have higher rates of obesity (17% vs 11%) and hypertension (21% vs 16%), but lower rates of diabetes mellitus (12% vs 21%) and high cholesterol (33% vs 39%). Indigenous-Fijians report higher rates of prescribed physical activity (25% vs 21%), but poorer recommended vegetable intake (48% vs 56%), greater risky alcohol behavior (17% vs 15%) and a much greater prevalence of cigarette smoking (45% vs 24%). Both Indigenous-Fijians and Indo-Fijians report a low prevalence of recommended fruit intake (17% vs 15%).

Conclusions: Fiji is progressing through demographic and epidemiological transitions, including a decline in infectious diseases and improved life expectancy. However, in concert with other developing nations, 'modernization' is accompanied by increased mortality from non-communicable diseases, with CVD being the most prevalent. This transition has been associated with changes to socio-cultural aspects of Fiji, including poor lifestyle choices that may contribute to a cluster of cardio-metabolic conditions which precede CVD.

Keywords: Fiji; culture; disparity; health gap; heart disease; lifestyle; nutrition.

Publication types

  • Review

MeSH terms

  • Alcohol Drinking / epidemiology
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / ethnology
  • Developing Countries
  • Diet
  • Exercise
  • Fiji
  • Health Behavior*
  • Humans
  • Hypercholesterolemia / epidemiology
  • Hypertension / epidemiology
  • Life Style*
  • Native Hawaiian or Other Pacific Islander
  • Overweight / epidemiology
  • Prevalence
  • Risk Factors
  • Smoking / epidemiology