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adequate food supplies, bounteous climaLe and soil, and limited demands for zustained daily
exercise have allowed obesity to be common in areas such as Hawaii, Kinqdom of Tonga and
parts of French Polynesia. Those m atolls with more limited tesources and different
iifestyles sueh as on Pukapuka have not had the resources to allow them to become obese.
Early explorers described some obese people in different part of the Pacific but no dala is
available about their health status.
The emergence of diebetes in Tokelau migrants in New Zealand compared with non
migrants in Tolielau is providing valuable insights . into the risk factors associated with
deielopment of diabetes and the part played by diet (Stanhope and Prior, f980). Tte duration
of time in New Zealand and the emergence of new or incident cases can be compared in the
two groups and with results from long term studies carried out smong New Zealand Maoris.
The BMI differences between Tokelau migrants and Tokelau non-migrants are clearly
shown in Figure 5 and Figure 6 for males and females respectively. The prevalence of
diabetes ar6ng TokelauanJ in Tokelau, in New Zealand and among New Zealand Maori are
shown in Table l.
Table I :
Age slandardised* prevalence (per hundred) of definite diabetesr by sex'
in Tokelauans (in Tokelau and in New Zealand) and New Zealand Maoris'
Male
Female
Tokelauans
in Tokelau
in New Zealand
al two points in time
aged 24 and over.
New Zealand
Maoris
1968l7L 1975 r972174 L975177 re68l5e r974
1.0
t.t
J.7
8.5
5.6
8.0
5.4
rt,6
+ lndirect standardisation using pooled groups as reference population.
The increasing rate, particularly in Tokelau women in New Zealand can be seen' while
those in men are not significantly different. The notably higher rates in the Maoris can be
seen.
The relationship with bodymass using the BMI can be examined furLher by studying the
rates of diabetes in zubjects by sex and ethnic group in different tertiles of BMI. These are
set out in Table 4.
The rates in the women increase in the second tertile in both Maoris and Tokelauans
white the increases are most marked in the third tertile in the males. Tl-e overall rates
amonq Maoris are notably higher in both men and women than in Tokelauans in the same
tertile. The question whether further increases will take place in the N.Z. Tokelau groups
will be examined in the prospective surveys.
The development of incidence cases, that is cases who did not have diabetes when first
examined, have been estimaled in three groups, the non-migrants, those in Tokelaur the
migrants, those seen in Tokelau and Lhen in N.Z. and the post-migrants, those first seen in
N.Z. and lhen followed in N.Z. A rumber of bhe latter had spent time in Samoa en route to
N.2., or were in N.Z. prior to first examinations by the Epidemiology Unit.
Among females, post-migrants had the highest incidence, 2I.8 per.l0p0 per yearr and
non-migrants tne lowest, 5.1, while migrants were intermediate, 14.f (X- = Lt.l{86 p =
0.00.1.). Arnong males, the ineidences wefe: pos!-migrants II.0' non migrants 4.5 and migrants
5.2r.but the dlfferences were not significant (X'= 4.L7, p = 0.I24).
10.7
II. I
L2.4
L6.4