Health and Diet among People Living in an Isolated Area: Case Study of Pingelap Island in Pohnpei State, the Federated States of Micronesia
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Site and Data Collection
2.2. Anthropometric Measurement
2.3. Dietary Assessment
2.4. Data Analysis
2.5. Ethical Approval
3. Results
3.1. Demographic Information and Behavior Data about the Sample
3.2. Health Outcome
3.3. Diet
4. Discussion
4.1. Health Outcome
4.2. Diet
4.2.1. Geographical Condition and Food Availability
4.2.2. Modernized Diet
4.3. Limitation
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Food Item | Scores in Statistical Analysis | |
---|---|---|
Rice, local crops, coffee/tea | 1 | Never |
2 | Seldom | |
3 | Less than once a day, but sometimes in a week | |
4 | Once a day | |
5 | Twice a day | |
6 | 3 times a day | |
7 | More than 3 times a day | |
Ramen and noodles, bananas, bread, doughnuts and sweetened bread, potato chips/snacks, sashimi, fried fish, fish in soup, canned fish, fried chicken, fried pork, canned meat, coconut juice, coke, soda/other sweetened juice alcohol drink, sakau | 1 | Never |
2 | Seldom | |
3 | Less than once a week, but sometimes in a month | |
4 | 1–2 times a week | |
5 | 3–4 times a week | |
6 | 5–6 times a week | |
7 | Every day | |
Fried banana, meal cooked with coconut milk, vegetables | 1 | Never |
2 | Seldom | |
3 | Sometimes | |
4 | Frequently |
Male | Female | ||||||||
---|---|---|---|---|---|---|---|---|---|
Mand (N = 19) | Pingelap (N = 30) | Mand (N = 29) | Pingelap (N = 20) | ||||||
Age | Mean ± SD | 41.3 ± 14.4 | 45.0 ± 15.7 | 37.7 ± 15.9 | 44.2 ± 14.7 | ||||
Ethnicity | Pingelapese | 19 | (100.0) | 30 | (100.0) | 29 | (100.0) | 20 | (100.0) |
Marital status | Married | 10 | (52.6) | 16 | (53.3) | 24 | (82.8) | 17 | (85.0) |
Single, never married | 8 | (42.1) | 9 | (30.0) | 4 | (13.8) | 3 | (15.0) | |
Widowed | 1 | (5.3) | 5 | (16.7) | 1 | (3.4) | 0 | (0.0) | |
Family member | 1~2 | 10 | (52.6) | 12 | (40.0) | 9 | (31.0) | 3 | (15.0) |
3~5 | 9 | (47.4) | 12 | (40.0) | 17 | (58.6) | 15 | (75.0) | |
More than 6 | 0 | (0.0) | 6 | (20.0) | 3 | (10.3) | 2 | (10.0) | |
Education achievement | Elementary school graduated | 8 | (42.1) | 12 | (40.0) | 8 | (27.6) | 8 | (40.0) |
High school graduated | 2 | (10.5) | 14 | (46.7) | 13 | (44.8) | 10 | (50.0) | |
2/4-year-college graduated | 4 | (21.1) | 4 | (13.3) | 8 | (27.6) | 2 | (10.0) | |
Professional (graduate, postgraduate) | 5 | (26.3) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | |
Employment status | Self-employed | 4 | (21.1) | 3 | (10.0) | 7 | (24.1) | 0 | (0.0) |
Government employee | 6 | (31.6) | 9 | (30.0) | 1 | (3.4) | 6 | (30.0) | |
Non-government employee | 0 | (0.0) | 3 | (10.0) | 2 | (6.9) | 8 | (40.0) | |
Housemaker | 0 | (0.0) | 3 | (10.0) | 4 | (13.8) | 0 | (0.0) | |
Retired | 1 | (5.3) | 4 | (13.3) | 0 | (0.0) | 2 | (10.0) | |
Unemployed | 8 | (42.1) | 8 | (26.7) | 15 | (51.7) | 4 | (20.0) | |
Household income (US$ per 2 weeks) | Less than 25 | 5 | (26.3) | 10 | (33.3) | 3 | (10.3) | 3 | (15.0) |
25–100 | 2 | (10.5) | 10 | (33.3) | 4 | (13.8) | 6 | (30.0) | |
100–250 | 7 | (36.8) | 4 | (13.3) | 12 | (41.4) | 2 | (10.0) | |
250–500 | 4 | (21.1) | 5 | (16.7) | 5 | (17.2) | 7 | (35.0) | |
500–750 | 1 | (5.3) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) | |
More than 750 | 0 | (0.0) | 1 | (3.3) | 3 | (10.3) | 0 | (0.0) | |
Do not know | 0 | (0.0) | 0 | (0.0) | 2 | (6.9) | 2 | (10.0) | |
Remittance | Yes (regularly) | 8 | (42.1) | 18 | (60.0) | 24 | (82.8) | 9 | (45.0) |
No | 10 | (52.6) | 12 | (40.0) | 2 | (6.9) | 7 | (35.0) | |
Sometimes | 1 | (5.3) | 0 | (0.0) | 3 | (10.3) | 4 | (20.0) | |
Remittance amount (US$ per month) | Mean ± SD | 271.9 ± 116.1 | 204.4 ± 157.2 | 392.1 ± 249.0 | 205.6 ± 115.8 | ||||
Food expense (US$ per 2 weeks) | Mean ± SD | 107.6 ± 74.2 | 51.9 ± 51.5 | 129.3 ± 93.0 | 61.0 ± 32.1 | ||||
Smoking habit | Yes | 14 | (73.7) | 19 | (63.3) | 6 | (20.7) | 0 | (0.0) |
No | 5 | (26.3) | 11 | (36.7) | 23 | (79.3) | 20 | (100.0) | |
Experience of alcohol consumption (have drunk any alcohol in lifetime) | Yes | 15 | (78.9) | 25 | (83.3) | 13 | (44.8) | 3 | (15.0) |
No | 3 | (15.8) | 5 | (16.7) | 16 | (55.2) | 17 | (85.0) | |
Underage | 1 | (5.3) | 0 | (0.0) | 0 | (0.0) | 0 | (0.0) |
Male | Female | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Mand (N = 19) | Pingelap (N = 30) | p-Value | Mand (N = 29) | Pingelap (N = 20) | p-Value | |||||||||
Height (cm) | 160.7 | ± | 5.0 | 163.4 | ± | 6.5 | 0.11 | 151.2 | ± | 5.4 | 150.5 | ± | 5.3 | 0.64 |
Weight (kg) | 71.4 | ± | 16.1 | 73.4 | ± | 13.6 | 0.65 | 80.8 | ± | 19.7 | 82.5 | ± | 15.1 | 0.74 |
BMI | 27.6 | ± | 6.3 | 27.4 | ± | 4.3 | 0.88 | 35.2 | ± | 7.4 | 36.5 | ± | 6.4 | 0.52 |
SBP (mmHg) | 131.8 | ± | 17.8 | 136.5 | ± | 13.8 | 0.34 | 128.8 | ± | 14.5 | 123.4 | ± | 8.0 | 0.23 |
DBP (mmHg) | 76.0 | ± | 11.4 | 75.6 | ± | 6.8 | 0.91 | 76.4 | ± | 9.8 | 75.3 | ± | 8.0 | 0.69 |
Male | Female | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Mand (N = 19) | Pingelap (N = 30) | p-Value | Mand (N = 29) | Pingelap (N = 20) | p-Value | |||||||||
Energy intake (MJ) | 8.6 | ± | 3.6 | 7.9 | ± | 2.9 | 0.46 | 8.0 | ± | 2.6 | 7.7 | ± | 2.7 | 0.76 |
Protein intake (g) | 85.5 | ± | 49.6 | 62.3 | ± | 28.5 | 0.07 | 74.6 | ± | 24.2 | 63.8 | ± | 25.5 | 0.14 |
Fat intake (g) | 58.9 | ± | 44.2 | 48.8 | ± | 42.7 | 0.29 | 59.0 | ± | 25.8 | 48.6 | ± | 29.4 | 0.21 |
Carbohydrate intake (g) | 295.5 | ± | 95.0 | 296.6 | ± | 89.6 | 0.97 | 266.8 | ± | 111.0 | 285.6 | ± | 124.8 | 0.59 |
Proportion of protein (%) | 16.3 | ± | 4.2 | 13.5 | ± | 4.7 | 0.03 | 16.2 | ± | 3.9 | 14.0 | ± | 4.5 | 0.09 |
Proportion of fat (%) | 24.0 | ± | 8.7 | 20.9 | ± | 10.2 | 0.27 | 28.2 | ± | 10.4 | 23.6 | ± | 12.6 | 0.18 |
Proportion of carbohydrate (%) | 59.5 | ± | 11.3 | 65.2 | ± | 9.8 | 0.08 | 55.3 | ± | 12.5 | 61.8 | ± | 13.6 | 0.10 |
Male | Female | |||||
---|---|---|---|---|---|---|
Mand (N = 19) | Pingelap (N = 30) | p-Value | Mand (N = 29) | Pingelap (N = 20) | p-Value | |
Rice | 6.0 (5.0–6.0) | 5.0 (5.0–6.0) | 0.61 | 6.0 (5.0–6.0) | 6.0 (5.0–6.0) | 1.0 |
Local crops | 4.0 (4.0–5.0) | 4.0 (2.0–5.0) | 0.25 | 4.0 (3.0–5.0) | 3.5 (3.0–5.0) | 0.67 |
Coffee/Tea | 4.0 (2.0–5.0) | 5.0 (4.0–6.0) | 0.07 | 4.0 (1.0–4.0) | 4.0 (2.0–4.0) | 0.55 |
Ramen & Noodle | 4.0 (4.0–5.0) | 4.0 (4.0–5.0) | 0.28 | 4.0 (4.0–5.0) | 4.0 (3.8–5.0) | 0.24 |
Banana | 4.0 (4.0–5.0) | 5.0 (4.0–5.0) | 0.64 | 4.0 (4.0–5.0) | 4.0 (4.0–5.0) | 0.11 |
Bread | 4.0 (4.0–6.0) | 4.5 (4.0–5.0) | 0.46 | 5.0 (4.0–6.0) | 4.5 (4.0–5.0) | 0.14 |
Doughnut & Sweetened bread | 4.0 (3.5–5.5) | 4.0 (3.3–5.0) | 0.27 | 4.0 (3.0–5.0) | 5.0 (3.5–5.0) | 0.86 |
Potato chips/snack | 4.0 (3.5–5.0) | 1.0 (1.0–2.8) | <0.001 | 4.0 (4.0–5.0) | 2.0 (1.0–4.0) | 0.003 |
Sashimi | 5.0 (4.0–6.0) | 5.0 (2.5–5.0) | 0.25 | 5.0 (4.0–5.0) | 5.0 (2.0–5.0) | 0.26 |
Fried fish | 4.0 (4.0–5.0) | 5.0 (5.0–6.0) | 0.07 | 4.0 (4.0–5.0) | 5.0 (5.0–6.3) | <0.001 |
Fish in soup | 4.0 (2.0–4.5) | 4.5 (3.0–5.0) | 0.44 | 4.0 (4.0–5.0) | 5.0 (3.0–5.0) | 0.68 |
Canned fish | 5.0 (4.0–5.0) | 4.0 (2.0–4.0) | 0.002 | 5.0 (4.0–5.0) | 4.0 (1.0–4.0) | 0.004 |
Fried chicken | 4.0 (4.0–5.0) | 2.5 (1.3–4.0) | <0.001 | 4.0 (4.0–5.0) | 2.0 (1.0–4.3) | 0.01 |
Fried pork | 2.0 (1.0–3.0) | 2.0 (1.0–2.0) | 0.21 | 2.0 (1.0–2.0) | 2.0 (1.0–2.0) | 0.90 |
Canned meat | 4.0 (2.0–5.0) | 4.0 (2.0–4.0) | 0.44 | 4.0 (4.0–5.0) | 4.0 (2.8–4.3) | 0.53 |
Coconut juice | 4.0 (3.5–5.0) | 5.0 (5.0–5.0) | 0.02 | 4.0 (3.0–5.0) | 5.0 (4.8–6.3) | 0.002 |
Coke, Soda/sweetened juice | 5.0 (4.0–5.0) | 4.0 (1.3–4.0) | <0.001 | 4.0 (4.0–5.0) | 4.0 (1.0–4.0) | 0.10 |
Alcohol drink | 3.0 (2.0–4.0) | 1.0 (1.0–2.0) | 0.001 | 1.0 (1.0–2.0) | 1.0 (1.0–1.0) | <0.001 |
Sakau | 2.0 (1.0–3.0) | 1.0 (1.0–1.0) | 0.003 | 2.0 (1.0–4.0) | 1.0 (1.0–1.0) | <0.001 |
Fried banana | 3.0 (2.0–3.0) | 3.0 (1.3–3.0) | 0.63 | 3.0 (2.0–3.0) | 3.0 (1.0–3.0) | 0.83 |
Meal cooked with coconut milk | 3.0 (3.0–3.0) | 3.0 (3.0–3.0) | 0.16 | 3.0 (3.0–3.0) | 3.0 (3.0–3.0) | 0.60 |
Vegetable | 3.0 (3.0–3.0) | 3.0 (1.0–3.0) | 0.01 | 3.0 (3.0–3.0) | 3.0 (2.0–3.0) | 0.03 |
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Sakai, M.; Nakazawa, M.; Abraham, D. Health and Diet among People Living in an Isolated Area: Case Study of Pingelap Island in Pohnpei State, the Federated States of Micronesia. Int. J. Environ. Res. Public Health 2020, 17, 7839. https://doi.org/10.3390/ijerph17217839
Sakai M, Nakazawa M, Abraham D. Health and Diet among People Living in an Isolated Area: Case Study of Pingelap Island in Pohnpei State, the Federated States of Micronesia. International Journal of Environmental Research and Public Health. 2020; 17(21):7839. https://doi.org/10.3390/ijerph17217839
Chicago/Turabian StyleSakai, Moeno, Minato Nakazawa, and Delpihn Abraham. 2020. "Health and Diet among People Living in an Isolated Area: Case Study of Pingelap Island in Pohnpei State, the Federated States of Micronesia" International Journal of Environmental Research and Public Health 17, no. 21: 7839. https://doi.org/10.3390/ijerph17217839
APA StyleSakai, M., Nakazawa, M., & Abraham, D. (2020). Health and Diet among People Living in an Isolated Area: Case Study of Pingelap Island in Pohnpei State, the Federated States of Micronesia. International Journal of Environmental Research and Public Health, 17(21), 7839. https://doi.org/10.3390/ijerph17217839