Obesity in Samoans and a perspective on its etiology in Polynesians.

For Samoans, modernization produces obesity and adiposity and concomitant increases in cardiovascular disease risk factors and outcomes. Massive adiposity and high prevalence of obesity characterizes modernizing adult Samoans. Mean body mass index (in kg/m2) at ages 25-54 y is 30-32 for males and 32-36 for females. Prevalence of overweight in female adults is 46% in traditional Western Samoans and 80% in migrants in Hawaii. Five-year longitudinal data show striking weight and fat gain, especially in younger adults and females. An evolutionary perspective on Polynesian adiposity is based on scenarios of the fates of sailors on the voyages of discovery and of settlers in the pioneer island villages. Efficient metabolisms producing rapid adipose-tissue growth could have increased survival among the first Polynesians. Rapid dietary and physical activity changes caused by modernization interacting with such population genetic predispositions may lead to the documented massive adiposity.