Background:
The relatively rapid transition from traditional island lifestyles to a more modern or "westernized" lifestyle in the Pacific has created health problems for many island people. Although infectious disease, previously the primary cause of illness and death, is now better controlled, chronic or non-communicable diseases (NCD's) now threaten island populations.

Under and over nutrition contribute towards the incidence of NCD's such as overweight and obesity, diabetes, cardiovascular disease, and under nutrition in the form of vitamin A and iron deficiencies are still found in a number of islands.

Traditional diets high in fiber and complex carbohydrates are increasingly replaced with processed foods high in salt, protein, fat and refined carbohydrates.

Lifestyles have also changed from an active, farming and fishing based subsistence economy to a more sedentary lifestyle coupled with waged employment and money based economy.

Coupled with these factors is evidence which suggests that Pacific Islanders may be genetically predisposed to store fat for times of scarcity (thrifty gene phenotype) and new evidence that prenatal under-nutrition modifies fetal development, predisposing individuals to adult obesity and chronic diseases.

The challenge today is to encourage people to adopt the best of both worlds. To adopt healthy lifestyle choices, combining both traditional and modern elements, in a way which respects cultural identities, increases self-sufficiency and provides the knowledge needed for individuals to make informed choices.