GLOBAL HEALTH CASE STUDY - POHNPEI

MAND, POHNPEI, FEDERATED STATES OF MICRONESIA

Community Food System Data Tables

Introduction

Pohnpei is one of the four states of the Federated States of Micronesia (FSM), a developing country located in the western Pacific Ocean. FSM, including also Chuuk, Yap, and Kosrae, consists of 607 islands (volcanic and atoll) spread over a million square miles of water (Figure1). The Pohnpei case study took place in the community of Mand, Pohnpei. The study aims were to document the Pohnpei traditional food system and test CINE methodology, using a participatory, multiple-methodology, ethnographic approach.

Forty-seven households were randomly selected for the study, aiming at reaching over half of all households. All adult members (aged 15 to 65) in the randomly selected households were asked to join the adult health assessment for weight, height, fasting blood sugar and blood pressure measurements, and other relevant information including physical activity levels and food purchases. Two dietary assessment methods, a repeated quantitative 24 hour recall for two non-consecutive days (n=44 adults, n=27 children) and a 7 day food frequency questionnaire (FFQ) (n=47) were used in order to better assess the usual diet in Mand. The survey took place from May through August, 2005.

The study team comprised of the following:

• Adelino Lorens, Pohnpei Agriculture of the Office of Economic Affairs; and Chairman, Island Food Community of Pohnpei;
• Dr. Lois Englberger, PhD, Academic Advisor/Researcher;
• Podis Pedrus, Traditional Leader, Mand Community;
• Kiped Albert, Traditional Leader, Mand Community; Pohnpei Agriculture of the Office of Economic Affairs;
• Amy Levendusky, U.S. Peace Corps Volunteer, Island Food Community of Pohnpei;
• Welsihter Hagilmai, College of Micronesia-FSM Land Grant;
• Rohaizad Suaidi, College of Micronesia-FSM;
• Yumiko Paul, Pohnpei Department of Health;
• Dr. Marcella Gallen, Pohnpei Department of Health;
• Douglas Nelber, Pohnpei State Department of Lands and Natural Resources;
• Ali Alik, COM-FSM Work Study Student;
• Pelihna Moses, Mand Community;
• Sarah Shaeffer, Emory University, USA;
• Clayton Santos, Pohnpei Environmental Protection Agency;
• Mari Yanagisaki, Japan Overseas Cooperation Volunteers.

Notes on food groups

Efforts were made on determining the foods and varieties available and/or consumed in Pohnpei, and in particular in the community of Mand.

Information on 381 different foods collected was divided into 10 groups:

1. Starchy Staples
2. Coconut and other Palms
3. Fruits
4. Nuts
5. Vegetables
6. Drinks, Spices
7. Fish
8. Other Seafood
9. Meat (Pork and Other)
10. Poultry

Notes on food components

Starchy staples, including breadfruit, banana, taro, yam and cassava, are the basis of the traditional diet in Pohnpei, along with coconut, fish and seafood, and some fruits and vegetables. Research has shown that Pohnpei people, young and old, maintained excellent health while on this type of diet and adequate physical activity. However, since around the 1970s there have been many changes in the diet, an increased consumption of imported processed food, including white rice, flour and sugar and other processed refined foods, and a decreased level of physical activity. Following this has been a great increase in health problems, in particular, diabetes, heart disease, cancer and vitamin A deficiency.

A lack of information on the rich nutrient content of the local foods is one reason that locally grown foods were neglected (Dignan et al. 2004; Murai et al., 1958). Thus, efforts were initiated in 1998 to determine the nutrient content of some of the deep yellow- and orange-fleshed varieties of bananas, giant swamp taro, breadfruit and pandanus (Englberger et al. 2003a, b; Englberger 2003, Englberger et al. 2006). This on-going project has identified many banana varieties and other foods that contain significant levels of provitamin A carotenoids, which protect against vitamin A deficiency. Carotenoid-rich foods have been shown to also help protect against chronic diseases, such as cancer, diabetes, and heart disease. Giant swamp taro varieties were identified that are rich sources of essential minerals, zinc, iron, and calcium. The analyses were done in the following laboratories: the Institute of Applied Sciences/University of the South Pacific, Fiji; DSM Nutritional Products, Switzerland; Atlanta Center of Nutrient Analysis, Food and Drug Administration, USA; University of Washington, USA; Anresco Laboratory, USA; and University of Adelaide, Australia.

The data presented in the Pohnpei Datatable are on nutrient content for a selection of Pohnpei foods that have been analyzed and identified as rich sources of nutrients. A focus was made on those foods and varieties having cultural importance, as well as some foods, such as skipjack liver, that are nutrient-rich but have not been fully utilized despite the potential for tasty dishes with important health benefits, particularly to nutritionally-at-risk children and women. Some foods were analyzed only for particular nutrients (e.g. beta-carotene, other provitamin A carotenoids and essential minerals including zinc, iron, and calcium). The results of those analyses are presented with asterisks. Data on other nutrient levels were taken for the particular local food unspecified as to variety (Dignan et al. 2004). The collection of information on the nutrient content of Pohnpei foods is an on-going process. Thus, readers should note that it is expected that these tables will be continually updated as more data on Pohnpei foods are made available.

1. Dignan, C., Burlingame, B., Kumar, S. & Aalbersberg, W. 2004. The Pacific Islands food composition tables, second edition. Rome, FAO.
2. Englberger L. 2003. A community and laboratory-based assessment of the natural food sources of vitamin A in the Federated States of Micronesia. PhD Thesis. University of Queensland, Australia.
3. Englberger, L., Aalbersberg, W., Ravi, P., Bonnin, E., Marks, G.C., Fitzgerald, M.H. & Elymore, J. 2003a. Further analyses on Micronesian banana, taro, breadfruit and other foods for provitamin A carotenoids and minerals. Journal of Food Composition and Analysis, 16(2): 219-236.
4. Englberger, L., Schierle, J., Marks, G.C. & Fitzgerald, M.H. 2003b. Micronesian banana, taro, and other foods: newly recognized sources of provitamin A and other carotenoids. Journal of Food Composition and Analysis, 16(1): 3-19.
5. Englberger, L., Aalbersberg, W., Fitzgerald, M.H., Marks, G.C. & Chand, K. 2003c. Provitamin A carotenoid content and cultivar differences in edible pandanus fruit. Journal of Food Composition and Analysis, 16(2): 237-247.
6. Englberger, L., Schierle, J., Aalbersberg, W., Hofmann, P., Humphries, J., Huang, A., Lorens, A., Levendusky, A., Daniells, J., Marks, G.C. & Fitzgerald, M.H. 2006d. Carotenoid and vitamin content of Karat and other Micronesian banana cultivars. International Journal of Food Science and Nutrition. 57: 399-418.
7. Murai M, Pen F, Miller CD. 1958. Some Tropical South Pacific Island Foods. Description, History, Use, Composition, and Nutritive Value. Honolulu, Hawaii: University of Hawaii Press.