Non-Communicable Disease Risk Factors in Rarotongan Adolescents: Examining links to early-life experiences

Siobhan Tu’akoi1, Karen Tairea2, Mark H. Vickers1, Jacquie Bay1

1. Liggins Institute, University of Auckland, New Zealand; 2. Te Marae Ora, Cook Islands Ministry of Health, Cook Islands

Background: The Cook Islands has extremely high rates of noncommunicable diseases (NCDs). It is estimated that in the Cook Islands NCDs contribute to 74% of all deaths, 36% of which occur prematurely, prior to age 60. With an obesity rate of 67.9% in reproductive-age females, there is an increased risk of pregnancy complications and offspring obesity later in life. The Developmental Origins of Health and Disease (DOHaD) concept looks at the influences of the early-life environment on later health.

This pre-feasibility study was a collaboration between the Cook Islands Ministry of Health (CIMoH) and the Liggins Institute, funded by the University of Auckland Faculty of Medical and Health Science Undergraduate Summer Studentship Programme. It explored whether using existing CIMoH data, associations between early-life environmental exposures and adolescent obesity could be examined to potentially inform life-course based NCD risk interventions.

Methods: By matching data from the Rarotongan Hospital Obstetric Registers and CIMoH School Health Examination data, a sample group of 68 adolescents was formed. Trends were explored between the birth factors found in the registers (e.g. birth weight) and the health examination data of each adolescent (BMI, blood pressure).

Results: This study found that children whose births had antenatal risk factors listed (e.g. preeclampsia, gestational hypertension) were more likely to have overweight/obese BMIs and (pre)hypertension than those without listed factors. It was also found that first-borns were more likely to be overweight/obese in adolescence compared to non-first-borns. These relationships suggest that the early-life environment can influence later health and obesity risk in the Cook Islands population.

Conclusion: This pre-feasibility study identified that using standard data collected by CIMoH to investigate associations between early-life environmental exposures and adolescent overweight/obesity would be viable and could inform opportunities for early-life obesity prevention.

Tu’akoi, S., Tairea, K., Vickers, M.H., & Bay, J.L. (2016). Non-communicable disease risk factors in Rarotongan adolescents: Examining links to early-life experiences. The Annual Cook Islands Health Conference 2016, Rarotonga, Cook Islands.