Exploring nutritional attitudes and practices of Rarotongan 13-16 year olds via a population wide school-based survey: Implications for NCD vulnerability and school-based health-promoting interventions

Jacquie Bay¹, Karen Tairea², Delaney Yaqona³, Celeste Barrett-Watson⁴, Tania Morgan⁴, Mark H. Vickers¹, Upokoina Herrmann⁵ on behalf of the Cook Islands Pacific Science for Health Literacy Project team

1. Liggins Institute, University of Auckland, New Zealand; 2. Te Marae Ora, Cook Islands Ministry of Health, Cook Islands; 3. Nukutere College, Rarotonga, Cook Islands; 4. Tereora College, National College of the Cook Islands, Rarotonga, Cook Islands; 5. Maraurau o te Pae Api’I, Cook Islands Ministry of Education, Cook Islands.

Background: The Cook Islands is burdened with very high rates of adult obesity and related noncommunicable disease (NCD) morbidity and mortality. Adolescence is now identified by WHO as a key behavioral intervention point to support primary NCD risk reduction for youth and their future offspring. This study assesses the nutritional attitudes and practices of 13 to 16 year-olds attending schools on the island of Rarotonga, providing evidence to inform development and assessment of school-based nutritional interventions.

Methods: A school-based survey of Rarotongan Year 9 and 11 students was conducted under supervision in class-time during 2014 and 2015. Permission was sought from parents of all eligible adolescents (n=641). Participation from 63% of eligible adolescents (n=402) was achieved, male 50.8%, female 49.2%. The cohort comprised 59.5% Year 9 students (median age 13y10m) and 40.5% Year 11 students (median age 15y6m).

Results: 17.8% of participants (female 15.2%, male 20.4%) consume at least 2 fruit and 3 vegetable servings daily. 70% of participants do not meet WHO recommendations for sugar sweetened beverage consumption; 80% of participants consume doughnuts weekly; 38% consume doughnuts >2 days per week; 35%, when eating doughnuts consume > 2 servings. Weekly consumption of hot-chips is normal for 85% of participants with 42% eating hot-chips >2 days per week. Breakfast is consumed daily by 22.7% of participants (male 27.1%, female 18.3%). 50% of participants eat an evening meal with family at least 5 days per week. 95% of participants consume deep-fried takeaways regularly; 55% consuming these more than once a week.

Conclusion: Nutritional behaviors associated with increased NCD vulnerability are clearly evident, and it is known that nutritional behaviors established in adolescence carry through to adulthood. 50% of secondary students in Rarotonga are overweight. Investment in empowering youth, educators and families to understand and address this risk should be prioritized.

Bay, J.L., Tairea, K., Yaqona, D., Barrett-Watson, C., Morgan, T., Vickers, M.H., & Herrmann, U. (2016). Exploring nutritional attitudes and practices of Rarotongan 13-16 year olds via a population wide school-based survey: Implications for NCD vulnerability and school-based health-promoting interventions. The Annual Cook Islands Health Conference 2016, Rarotonga, Cook Islands.