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Adolescent dietary patterns in Fiji and their relationships with standardized body mass index

Jillian T Wate12*, Wendy Snowdon23, Lynne Millar3, Melanie Nichols34, Helen Mavoa3, Ramneek Goundar12, Ateca Kama5 and Boyd Swinburn36

Author Affiliations

1 School of Health and Social Development, Deakin University, Melbourne, Australia

2 Pacific Research Centre for Prevention of Obesity and Non-communicable Diseases (C-POND), Fiji National University, Suva, Fiji

3 WHO Collaborating Centre for Obesity Prevention, Deakin University, Melbourne, Australia

4 British Heart Foundation Health Promotion Research Group, Department of Public Health, University of Oxford, Oxford, UK

5 Fiji National Food and Nutrition Centre, Suva, Fiji

6 School of Population Health, University of Auckland, Auckland, New Zealand

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International Journal of Behavioral Nutrition and Physical Activity 2013, 10:45  doi:10.1186/1479-5868-10-45

Published: 9 April 2013



Obesity has been increasing in adolescents in Fiji and obesogenic dietary patterns need to be assessed to inform health promotion. The objective of this study was to identify the dietary patterns of adolescents in peri-urban Fiji and determine their relationships with standardized body mass index (BMI-z).


This study analysed baseline measurements from the Pacific Obesity Prevention In Communities (OPIC) Project. The sample comprised 6,871 adolescents aged 13–18 years from 18 secondary schools on the main island of Viti Levu, Fiji. Adolescents completed a questionnaire that included diet-related variables; height and weight were measured. Descriptive statistics and regression analyses were conducted to examine the associations between dietary patterns and BMI-z, while controlling for confounders and cluster effect by school.


Of the total sample, 24% of adolescents were overweight or obese, with a higher prevalence among Indigenous Fijians and females. Almost all adolescents reported frequent consumption of sugar sweetened beverages (SSB) (90%) and low intake of fruit and vegetables (74%). Over 25% of participants were frequent consumers of takeaways for dinner, and either high fat/salt snacks, or confectionery after school. Nearly one quarter reported irregular breakfast (24%) and lunch (24%) consumption on school days, while fewer adolescents (13%) ate fried foods after school. IndoFijians were more likely than Indigenous Fijians to regularly consume breakfast, but had a high unhealthy SSB and snack consumption.

Regular breakfast (p<0.05), morning snack (p<0.05) and lunch (p<0.05) consumption were significantly associated with lower BMI-z. Consumption of high fat/salt snacks, fried foods and confectionery was lower among participants with higher BMI-z.


This study provides important information about Fijian adolescents’ dietary patterns and associations with BMI-z. Health promotion should target reducing SSB, increasing fruit and vegetables consumption, and increasing regularity of meals among adolescents. Future research is needed to investigate moderator(s) of inverse associations found between BMI-z and consumption of snacks, fried foods and confectionery to assess for potential reverse causality.

Adolescents; Dietary patterns; Overweight and obesity