Self-reported and accelerometry measures of sleep components in adolescents living in Pacific Island countries and territories: Exploring the role of sociocultural background.

OBJECTIVES: The objective of this study is to assess the concordance and its association with sociocultural background of a four-question survey with accelerometry in a multiethnic adolescent population, regarding sleep components. Based on questions from the Pittsburgh Sleep Quality Index and adapted to a school context, the questionnaire focussed on estimating sleep onset time, wake-up time and sleep duration on both weekdays and weekends. This subjective survey was compared with accelerometry data while also considering the influence of sociocultural factors (sex, place of living, ethnic community and socio-economic status). METHODS: Adolescents aged 10.5-16 years (n = 182) in New Caledonia completed the survey and wore an accelerometer for seven consecutive days. Accelerometry was used to determine sleep onset and wake-up time using validated algorithms. Based on response comparison, Bland-Altman plots provided agreement between subjective answers and objective measures. We categorized participants' answers to the survey into underestimated, aligned and overestimated categories based on time discrepancies with accelerometry data. Multinomial regressions highlighted the sociocultural factors associated with discrepancies. RESULTS: Concordance between the accelerometer and self-reported assessments was low particularly during weekends (18%, 26% and 19% aligned for onset sleep time, wake-up time and sleep duration respectively) compared with weekdays (36%, 53% and 31% aligned, respectively). This means that the overall concordance was less than 30%. When considering the sociocultural factors, only place of living was associated with discrepancies in onset sleep time and wake-up time primarily on weekdays. Rural adolescents were more likely to overestimate both onset sleep time (B = -1.97, p < 0.001) and wake-up time (B = -1.69, p = 0.003). CONCLUSIONS: The study found low concordance between self-assessment and accelerometry outputs for sleep components. This was particularly low for weekend days and for participants living in rural areas. While the adapted four-item questionnaire was useful and easy to complete, caution should be taken when making conclusions about sleep habits based solely on this measurement.

Prevalence, causes and contexts of childhood overweight and obesity in the Pacific region: a scoping review.

Background: Non-communicable diseases (NCDs) are a major threat to health and development and account for 75% of deaths in the Pacific Islands Countries and Territories (PICTs). Childhood obesity has been identified as a main risk factor for NCDs later in life. This review compiled overweight and obesity (OWOB) prevalence (anthropometric data) for children aged six to 12 years old living in the Pacific region and identified possible related causes. Methods: We conducted a systematic search using PubMed, Google Scholar and ScienceDirect for articles published between January 1980 and August 2022. We also searched for technical reports from Ministries of Health. Guided by the eligibility criteria, two authors independently read the selected articles and reports to extract and summarise relevant information related to overweight and obesity. Results: We selected 25 articles, two worldwide analyses of population-based studies and four national reports. Information revealed that childhood OWOB prevalence reached 55% in some PICTs. This review also indicated that age, gender and ethnicity were linked to children's weight status, while dietary practices, sleep time and level of physical activity played a role in OWOB development, as well as the living environment (socio-economic status and food availability), parenting practices and education level. Conclusion: This review highlighted that anthropometric data are limited and that comparisons are difficult due to the paucity of surveys and non-standardized methodology. Main causes of overweight and obesity are attributed to individual characteristics of children and behavioural patterns, children's socio-economic environment, parenting practices and educational level. Reinforcement of surveillance with standardised tools and metrics adapted to the Pacific region is crucial and further research is warranted to better understand root causes of childhood OWOB in the Pacific islands. More robust and standardized anthropometric data would enable improvements in national strategies, multisectoral responses and innovative interventions to prevent and control NCDs.

In the Pacific region, populations have gained faster access to modern lifestyles in the past few decades, causing fundamental changes in the way people move about and eat (including food choices, physical activity, and sedentary time) and a dramatic increase in noncommunicable diseases. This is mainly the case in young generations since they are particularly exposed to an environment that can drive to overweight and obesity. This scoping review aims to summarize the prevalence and known causes of overweight and obesity for children aged six to 12 years old living in the Pacific region and identified possible related factors. This work highlighted that causes of overweight and obesity are mainly attributed to individual characteristics of children and behavioural patterns, children's socio-economic environment, parenting practices and educational level.

Adolescent screen time and unhealthy food consumption in the context of the digital development in New Caledonia.

OBJECTIVE: For several years, the Pacific Island Countries and Territories (PICTs) have been undergoing digital developments that have had an impact on the time adolescents spend in front of screens. The association between screen time and the overconsumption of unhealthy foods has been observed but little studied in New Caledonia. The twofold aim of this research was to analyze adolescent screen time based on the number of screens at home, gender, place of living, ethnic community and family socio-professional category and determine the link with the consumption of unhealthy food and drinks. METHODS: Self-report questionnaires on time spent in front of tablets, computers and mobile phones, as well as the consumption of unhealthy food and drinks, were administered between July 2018 and April 2019 to 867 adolescents from 11 to 15 years old during school hours in eight schools across the three provinces of New Caledonia. RESULTS: Adolescents in rural areas had fewer screens than their urban counterparts, and the number of screens determined the amount of screen time, which was significantly higher among the adolescents living in urban areas (3.05 h/day weekdays vs rural 2.33 h/day). Screen time was not related to gender, socio-professional category or ethnic community, but correlations were found between screen time and consumption of unhealthy food and drinks. Those who consumed less than 1 u/day of unhealthy drinks watched screens for 3.30 h/day, whereas those who consumed more than 1 u/day watched screens for 4.13 h/day. Also, those who consumed less than 1 u/day of unhealthy food watched screens for 2.82 h/day and those consuming more than 1 u/day did so for 3.62 h/day. Melanesians and Polynesians consumed greater quantities of unhealthy food and drinks than Europeans. As the consumption of unhealthy products is linked to screen time in the context of digital development, there is an urgent need to address the excessive consumption of unhealthy foods in Oceanian populations, particularly among young people.

An examination of procrastination in a multi-ethnic population of adolescents from New Caledonia.

BACKGROUND: Although procrastination has been widely studied in adults, comparatively little work has focused on adolescent procrastination, especially in the Pacific region. As a contribution to knowledge and diversification of population sampling, therefore, we examined procrastination in a multi-ethnic sample of adolescents from New Caledonia. Specifically, we examined gender and ethnic differences in procrastination, as well as sociodemographic and ethnic identity predictors of procrastination. METHODS: 927 adolescents (474 boys, 453 girls; age M = 13.2 years) completed measures of procrastination and ethnic identity, and reported their ethnicity (Kanak vs. Polynesian vs. European). Sociodemographic data (sex, age, area of residence and socioeconomic status) were also collected. RESULTS: An analysis of variance indicated significant ethnic (Kanak and Polynesian adolescents had higher procrastination than European adolescents) and sex differences (girls had higher procrastination than boys), but no significant interaction. Regression analysis showed that higher procrastination was significantly associated with sex, ethnicity, age, and the interaction between ethnicity and ethnic identity. Moderation analysis showed that ethnic identity moderated the relationship between ethnicity and procrastination, but only in Kanak adolescents. CONCLUSION: Relatively high levels of procrastination were observed in Kanak and Polynesian adolescents, and in girls. These findings, while preliminary, may have important implications for academic attainment in the New Caledonian context.

Physical Activity in Adolescents Living in Rural and Urban New Caledonia: The Role of Socioenvironmental Factors and the Association With Weight Status.

Physical activity (PA) is an important factor for the prevention of overweight and obesity, particularly during adolescence. This study focuses on the understudied adolescent population of New Caledonia with the aim to (1) determine the daily PA levels and estimate the sedentary time through out-of-school sitting time; (2) highlight the influence of sociodemographic and environmental factors, and (3) assess the associations of PA and sitting time with overweight and obesity. A sample of 508 school-going adolescents living in New Caledonia was surveyed about their PA habits using the International Physical Activity Questionnaire-Short Form, as well as about the context in which they usually engage in PA. The influences of the place of living and ethnic community were also investigated. Results indicated that about 66% of the adolescents performed an average of at least 60 min of PA daily. Both Melanesian adolescent boys and girls were more active than Caucasian adolescents but only when they lived in rural areas (females: 115 vs. 93 min/day, p = 0.018; males: 133 vs. 97 min/day, p = 0.018). Indeed, PA was reduced in an urban environment (females: 88 min/day; males: 95 min/day, p = 0.028; rural vs. urban in Melanesian adolescents). Melanesian adolescents also spent less time in out-of-school sitting than Caucasian adolescents independently of where they lived (females: 164 vs. 295 min/day, p < 0.001; males: 167 vs. 239 min/day, p = 0.001). Feeling safe was positively associated with PA levels (females: ORadj = 2.85, p < 0.001; males: ORadj = 4.45, p < 0.001). In the adolescent boys, accessibility to a suitable place was also an important factor (ORadj = 2.94, p = 0.002). Finally, while PA and sitting time were negatively associated with overweight in male adolescents (ORadj = 0.28, p = 0.044 and ORadj = 0.39, p = 0.004), they were not in females. Living in a rural area allowed the Melanesian adolescents to maintain a more active lifestyle with more physical activities and less sitting time. Our results also indicated that safety was an important driver for engagement in PA. The urban environment in New Caledonia appears to be a contributor of a less active lifestyle in adolescents.

Associations between weight status, body satisfaction, ethnic identity and self-esteem in Oceanian adolescents.

BACKGROUND: Self-esteem has consistently been observed to be relatively low in adolescents with obesity. In the Pacific region, the prevalence of obesity in adolescence is high, but few studies have considered issues of self-esteem in this population. OBJECTIVE: To examine associations between weight status, body dissatisfaction and self-esteem in a sample of New Caledonian adolescents and to test for moderation effects of ethnicity on predictors of self-esteem. METHODS: Objective anthropometric measures (height, weight, waist circumference and thickness of skinfolds) were obtained in a multi-ethnic sample of New Caledonian adolescents. Body mass index (BMI), waist-to-height ratio and the sum of four skinfolds thickness were used as proxies of weight status. Indices of ethnic identity, self-esteem, socio-demographic data (socioeconomic status, ethnicity, gender, urbanicity of residence) and body dissatisfaction were obtained using survey methods. RESULTS: Between-group analyses indicated that adolescents of European/white origin had significantly higher self-esteem than adolescents with Oceanian Non-European Non-Asian ancestry (ONENA). However, low self-esteem was significantly associated with weight status and body dissatisfactions in European/white adolescents but not ONENA adolescents. Ethnicity moderated the relationships of predictors (BMI z-score, body dissatisfaction, age, urbanicity and ethnic identity) on self-esteem, and the strongest predictors of self-esteem were ethnicity and ethnic identity. CONCLUSIONS: While self-esteem has important consequences for adolescent well-being and health outcomes, these results highlight the importance of applying different steps to develop and maintain healthy self-esteem in the Pacific region.

'Eating well' in Pacific Islands countries and territories: A qualitative and normative approach to food cultures in New Caledonia.

In recent decades, the food cultures of the Pacific populations have undergone a profound transition, particularly because the increasing trade exchanges with Western countries have facilitated access to a wide range of processed foods. Essentially, a new normative model of eating is now taking the place of the traditional models. The aims of this qualitative study were to explore what 'eating well', 'good food' and 'bad food' now mean in the New Caledonian family context and, more broadly, to categorise the current food practices and representations in adolescents' families. A double qualitative methodology was applied: 59 face-to-face interviews with 30 parents and 29 adolescents in both rural and urban areas and 15 collective structured discussions with middle-school classes (11- to 16-year-olds) of almost 25 students each. The main results showed various normative frames for nutrition, food quantities, local provenance, and personal taste. Food practices were related to food availability (having a home garden or involvement in family farming), socioeconomic status and community. In addition, access to nutritional information, temporal and financial constraints mostly in the urban area, and the role of food socialisation between parents and children had an impact on food practices and perceptions. The permanence of food cultures, mainly observed in families in rural areas, and the social inequalities in urban areas regarding food availability are highlighted. The positive perception of 'local food' as 'cultural', 'organic' and 'healthy' may help policymakers communicate clear messages to reach a sustainable food system.

Generational issues in linking family farming production, traditional food in diet, physical activity and obesity in Pacific Islands countries and territories: the case of the Melanesian population on Lifou Island.

In the Melanesian culture, traditional activities are organized around family farming, although the lifestyle transition taking place over the last several decades has led to imbalances in diet and physical activity, with both leading to obesity. The aim of this interdisciplinary study was to understand the links between family farming (produced, exchanged, sold, and consumed food), diet (focused on produced, hunted, and caught food), physical activity (sedentary, light, and moderate-to-vigorous physical activity) and obesity in Melanesian Lifou Island families (parents and children). Forty families, including 142 adults and children, completed individual food frequency questionnaires, wore tri-axial accelerometers for seven continuous days, and had weight and height measured with a bio-impedance device. A family farming questionnaire was conducted at the household level concerning family farming practices and sociodemographic variables. Multinomial regression analyses and logistic regression models were used to analyze the data. Results showed that family farming production brings a modest contribution to diet and active lifestyles for the family farmers of Lifou Island. The drivers for obesity in these tribal communities were linked to diet in the adults, whereas parental socioeconomic status and moderate-to-vigorous physical activity were the main factors associated to being overweight and obesity in children. These differences in lifestyle behaviors within families suggest a transition in cultural practices at the intergenerational level. Future directions should consider seasonality and a more in-depth analysis of diet including macro- and micro- nutrients to acquire more accurate information on the intergenerational transition in cultural practices and its consequences on health outcomes in the Pacific region.

Living in Rural and Urban Areas of New Caledonia: Impact on Food Consumption, Sleep Duration and Anthropometric Parameters Among Melanesian Adolescents.

BACKGROUND: Food consumption, sleep duration and overweight were assessed in rural and urban Melanesian adolescents. METHODS: A cross-sectional survey of 312 rural and 104 urban adolescents (11-16 years old) was conducted. Food intakes were assessed by a 26-item food frequency questionnaire and then categorised into the number of serves from each of the three recommended Pacific food groups (energy foods, protective foods, bodybuilding foods), with two additional categories for foods and drinks to be avoided i.e., processed foods and sugary drinks. Number of food serves were compared with the guidelines of 50% serves from energy foods, 35% serves from protective foods and 15% serves from bodybuilding foods. Sleep duration as hours per day was self-reported and body mass index (BMI) was calculated from measured weight and height. RESULTS: Approximately 17.9% of rural and 26.9% of urban adolescents met the guidelines for energy foods; 61.5% rural and 69.2% urban met the serves for protective foods and 88.5% and 94.2% met the serves for bodybuilding foods. Less than 6.4% rural and 1.9% urban adolescents avoided processed foods but 61.5% rural and 56.7% urban avoided sugary beverages. Sleep duration for school days was below the international recommendations and did not significantly differ between rural and urban groups: respectively, 8.16 ± 1.10 and 8.31 ± 1.29 h. Overweight/obesity percentage was 38.1% for rural and 31.7% for urban adolescents. CONCLUSIONS: Although traditional foods, including protective food, are still part of the adolescents' diet, low consumption of the energy food group and high consumption of processed food occurs regardless of location. As poor eating habits and insufficient sleep may contribute to overweight/obesity, educational nutrition programs should target these lifestyle variables.

Overweight in the pluri-ethnic adolescent population of New Caledonia: Dietary patterns, sleep duration and screen time.

BACKGROUND: A high prevalence of overweight and obesity has been found in adolescents of New Caledonia and other Pacific Island Countries and Territories. Although Westernization may contribute to the weight gain in populations of Oceanian, Non-European, Non-Asian ancestry (ONENA), little is known about the sociodemographic and lifestyle factors associated with overweight in the Melanesian and Polynesian adolescents of New Caledonia. METHODS: In this cross-sectional study, a pluri-ethnic sample of New Caledonian adolescents (N = 954; age M = 13.2 years) completed a survey to estimate sleep duration, screen time, and dietary pattern using a food frequency questionnaire. Demographic data (gender, ethnicity, socioeconomic status: SES, area of residence) were collected, and anthropometric measures were used to compute weight status. FINDINGS: We found a higher risk for being overweight in Melanesian (OR = 1.67) and Polynesian (OR = 5.40) adolescents compared with European adolescents, even after controlling for age, SES, area of residence, dietary pattern, sleep duration and screen time. We also found that low SES (OR = 3.43) and sleep duration (OR = 0.65 per hour) were independently associated with overweight status in the European but not in ONENA adolescents. INTERPRETATION: In this study, the main contribution to being overweight was ethnic background, i.e. being Melanesian or Polynesian. The hypothesis of a genetic influence thus seems attractive and merits further analyses. FUNDING: This project was funded by the University of New Caledonia and the Fondation Nestlé France.

Body image, body dissatisfaction and weight status of Pacific adolescents from different ethnic communities: a cross-sectional study in New Caledonia.

Objective(s): The prevalence of adolescent obesity is high among the various ethnic groups native to the Pacific region (European, Melanesian and Polynesian). An important factor of weight gain or loss is body size satisfaction; however, little is known about adolescent body self-perception in the Pacific region.Design: Body dissatisfaction was evaluated using the Stunkard Figure Rating Scale in a sample of 699 adolescents from rural and urban areas of New Caledonia. The socio-demographic factors associated with higher body dissatisfaction were determined by multiple linear regression modeling.Results: Our results showed a high rate of body dissatisfaction (over 70%) in the adolescents. Body dissatisfaction was strongly related to the body mass index z-score. Melanesians boys had higher body dissatisfaction scores when they felt 'too thin' while Melanesian girls showed lower body dissatisfaction when they felt 'too fat.'.Conclusion: These results showed that social pressure for thinness or musculature may be different among adolescents living in New Caledonia. These results should be taken into account in education overweight prevention programs.

Too big or too thin? New Caledonian adolescents' perceptions of overweight and underweight.

OBJECTIVES: The first aim was to examine New Caledonian adolescents' views of what constitutes an overweight or underweight person. The second aim was to assess whether an environment with a high prevalence of overweight is associated with different norms of overweight or underweight in this population. METHODS: The Stunkard Figure Rating Scale was used for a sample of 699 pluriethnic adolescents in New Caledonia. Body mass index (BMI) was assessed for each participant and weight status was determined. The factors associated with higher figure ratings were determined by linear regression modeling. RESULTS: Multilinear regression analysis indicated that gender (being male) and BMI were associated with higher rating scores to designate overweight. Moreover, higher BMI z-scores were associated with higher underweight figure ratings. Ethnicity, area of residence, age, and socioeconomic status were not associated with higher ratings of body image. CONCLUSIONS: These findings show that an environment with a high prevalence of overweight does not necessarily shift adolescent "norms," contrary to visual normalization theory. These results should be taken into account in educational overweight prevention programs.

Energy drink consumption in a pluri-ethnic population of adolescents in the Pacific.

OBJECTIVE: Energy drinks are very popular among teenagers but may cause health problems. Energy drink consumption is partly associated with energy drink perception, but little is known about this in the Pacific Island Countries and Territories. The aim of this cross-sectional study was to identify the relationships between energy drink consumption, energy drink perception, weight status and sociodemographic characteristics in a school-going sample of Pacific adolescents. DESIGN: A cross-sectional study carried out in the schools during school hours between July 2015 and April 2016. SETTING: Sociodemographic characteristics, weight status, energy drink perception, and quantity of energy drinks consumed were obtained. Chi-square tests of independence, independent t tests, multivariate logistic regressions and multiple linear regressions were used. SUBJECTS: A representative sample of 678 New Caledonian adolescents (11-16 years). RESULTS: We found that one third of New Caledonian adolescents consume energy drinks. Boys are more likely to drink them than girls and Polynesians drink significantly more than European and Melanesian adolescents. Higher energy drink consumption in the New Caledonian adolescents is associated with good or neutral perceptions of the energy drink impact on health. Moreover, sex (being male) significantly influences the total energy drink consumption per week. Energy drink consumers have a tendency toward better perceptions of energy drinks than non-consumers. CONCLUSIONS: Nutritional education targeting energy drink consumers should take these results into account by providing (community-based) educational programs, especially for adolescents from low socioeconomic backgrounds, boys, or those living in rural areas.

Sugar-Sweetened Beverage Consumption and Associated Factors in School-Going Adolescents of New Caledonia.

This cross-sectional study assessed sugar-sweetened beverage (SSB) consumption and its associations with the sociodemographic and physical characteristics, behavior and knowledge of New Caledonian adolescents. The survey data of 447 adolescents from ages 11 to 16 years were collected in five secondary public schools of New Caledonia between July 2015 and April 2016. These data included measured height and weight, SSB consumption, sociodemographic characteristics, body weight perception, physical activity, and knowledge (sugar quantity/SSB unit; energy expenditure required to eliminate a unit) and opinions about the SSB‒weight gain relationship. Ninety percent of these adolescents declared regularly drinking SSBs. Quantities were associated with living environment (1.94 L·week-1 in urban environment vs. 4.49 L·week-1 in rural environment, p = 0.001), ethnic community (4.77 L·week-1 in Melanesians vs. 2.46 L·week-1 in Caucasians, p < 0.001) and knowledge about energy expenditure (6.22 L·week-1 in unknowledgeable adolescents vs. 4.26 L·week-1 in adolescents who underestimated, 3.73 L·week-1 in adolescents who overestimated, and 3.64 L·week-1 in adolescents who correctly responded on the energy expenditure required to eliminate an SSB unit, p = 0.033). To conclude, community-based health promotion strategies should (1) focus on the physical effort needed to negate SSB consumption rather than the nutritional energy from SSB units and (2) highlight how to achieve sustainable lifestyles and provide tools for greater understanding and positive action.

Nutrition behaviors and sociodemographic factors associated with overweight in the multi-ethnic adolescents of New Caledonia.

Objectives: New Caledonia is a multi-ethnic French territory in the Pacific, characterized by communities with widely varying nutritional habits. Little is currently known about adolescent food behaviors and habits and their association with overweight. This study therefore determined the sociodemographic factors and food behaviors associated with overweight and underweight in this population, as well as the factors associated with skipping breakfast. Methods: A cross-sectional survey was conducted among New Caledonian adolescents using a self-administered questionnaire; anthropometric measurements were also taken. Weight status was determined using international cutoffs, and the factors associated with overweight and underweight were identified with multiple logistic regression analysis. The factors associated with breakfast skipping were also determined. Results: Skipping breakfast, being Melanesian, living in a rural area and having low economic status were positively associated with overweight in these adolescents. Skipping breakfast was relatively infrequent, reported by 18% and 13% of the males and females, respectively. Logistic regression models found that the main factors associated with breakfast consumption habits were gender, weight status and ethnicity. Conclusions: Several factors are associated with overweight status in New Caledonian adolescents. Breakfast education should be improved for adolescents living in rural areas and from low socioeconomic status.

Tackling the Consumption of High Sugar Products among Children and Adolescents in the Pacific Islands: Implications for Future Research.

The Pacific Islands are experiencing an obesity epidemic with a rate of overweight and obesity as high as 80% among adults in some Pacific Island nations. Children and adolescents in the region are also affected by overweight and obesity, which is alarming due to the increased likelihood of remaining overweight as an adult. Research supports an association between poor diet and an increased risk of obesity and development of non-communicable diseases (NCDs). Excess consumption of free sugars is associated with poorer overall diet quality and increased risk of weight gain, chronic inflammation and dental caries. Traditional diets in the Pacific Islands are being supplemented with processed, high-sugar foods and beverages; thus, there is a clear need for effective interventions promoting positive dietary behaviors in the region. School and community based interventions offer an opportunity to promote positive behavior change among children and adolescents. This review aims to evaluate interventions targeting the consumption of high-sugar products in this population in the Pacific Islands.

Potential for waist-to-height ratio to detect overfat adolescents from a Pacific Island, even those within the normal BMI range.

INTRODUCTION: Waist-to-height ratio (WHtR) is a simple anthropometric proxy for central body fat; it is easy to use from a health education perspective. A WHtR value >0.5 has been proposed as a first level indicator of health risk. The first aim of this study was to compare WHtR with values based on body mass index (BMI) in their prediction of the percentage of body fat (%BF) in a multi-ethnic population of adolescents from New-Caledonia (age 11-16year). Secondly, to see whether WHtR >0.5 could be used to detect overfat subjects whose BMI was in the normal range. MATERIALS AND METHODS: Body fat percentage (%BF, based on skinfold measurements), BMI and WHtR were calculated for New Caledonian adolescents from different ethnic backgrounds. The relationship between %BF, BMI and WHtR was determined using quadratic models and from linear regression equations. The sensitivity and specificity of WHtR for detecting overfat adolescents (%BF >25% in boys and >30% in girls) were assessed and compared with those from the BMI-based classification. RESULTS: WHtR showed better correlation with %BF than BMI-based measurements. WHtR >0.5 was also more accurate than BMI in detecting overfat adolescents. Moreover, using this boundary value, 8% of adolescents in the normal BMI range were shown to be over-fat. CONCLUSIONS: WHtR is a good anthropometric proxy to detect overfat adolescents. Detecting overfat adolescents within the normal BMI range is particularly important for preventing non communicable diseases. We therefore recommend using WHtR for health education programs in the Pacific area and more generally.

Anthropometric Characteristics and Physical Fitness in Rural and Urban 11- to 16-Year-Old Melanesian Adolescents: A Cross-sectional Study in New Caledonian Schools.

We evaluated anthropometric characteristics and physical fitness in 556 Melanesian adolescents from rural and urban New Caledonia to build health education programs focused on physical activity. In 2013, body weight, height, skinfold thickness, lean body mass (LBM), percentage fat body mass (%FBM), physical fitness (power, agility, speed, maximal aerobic speed [MAS], estimated VO2max), and self-reported physical activity were assessed. Rural adolescents were significantly shorter and faster, had lower weight, %FBM, LBM, and power output and similar MAS and VO2max, and were more active than urban adolescents. Rural girls were significantly shorter, had higher MAS and VO2max, and were faster and significantly more active than urban girls while similar %BFM was observed in both groups of girls. Rural boys showed significantly lower height, weight, %FBM, and power and were significantly faster and more active than urban boys. In conclusion, rural Melanesian adolescents are more active, with good physical fitness (especially boys), although high %FBM was noted (especially in girls).

Self-Reported Height and Weight in Oceanian School-Going Adolescents and Factors Associated With Errors.

We examined the accuracy of self-reported weight and height in New Caledonian school-going adolescents. Self-reported and measured height and weight data were collected from 665 adolescents of New Caledonia and were then compared. Multivariable logistic regressions identified the factors associated with inaccurate self-reports. Sensitivity and specificity of self-reported body mass index values to detect overweight or obesity were evaluated. Self-reported weight was significantly lower than measured weight (boys, -3.56 kg; girls, -3.13 kg). Similar results were found for height (boys, -2.51 cm; girls, -3.23 cm). Multiple regression analyses indicated that the difference between self-reported and measured height was significantly associated with ethnicity and pubertal status. Inaccurate self-reported weight was associated with socioeconomic status, place of residence, body-size perception and weight status. Screening accuracy of self-reported body mass index was low, particularly in the Melanesian subgroup. These findings should be considered when overweight is estimated in the Melanesian adolescent population at individual scale.

Misperception of weight status in the pacific: preliminary findings in rural and urban 11- to 16-year-olds of New Caledonia.

BACKGROUND: Adolescent obesity is prevalent in Pacific region ethnic groups (European, Melanesian and Polynesian) living in both urban and rural areas. Although body perception is an important factor of weight gain or loss, little is known about the body self-perceptions of Pacific region adolescents. This study therefore evaluated adolescent perceptions of body weight according to ethnicity (European, Melanesian or Polynesian), socioeconomic status (low, intermediate or high) and living area (rural or urban) in New Caledonia. METHODS: Sociodemographic and anthropomorphic data from 737 adolescents (351 boys and 386 girls) with ages ranging from 11 to 16 years were collected and analysed. The International Obesity Task Force (IOTF) standards were used to define weight status as normal-weight, underweight or overweight/obese. Weight perception was assessed from detailed questionnaires, with adolescents rating their own weight with the following descriptors: 'about the right weight', 'too heavy', or 'too light'. RESULTS: Results showed that only 8.5% of normal-weight adolescents (7% boys and 10% girls) identifying themselves as 'too heavy'. Normal-weight Melanesian adolescents were less likely than their European counterparts to assess themselves as too heavy (OR = 0.357). However, half the overweight/obese adolescents underestimated their weight status (53% boys and 48% girls). Weight misperception was associated with ethnicity, socioeconomic status and living area, with gender-specific differences. CONCLUSIONS: The results of this study suggest that these sociodemographic factors should be taken into account when designing public health policies and health education school programmes in New Caledonia and, more broadly, the Pacific region.