Community, Diet, Pacific
Health Promotion Forum’s Senior Health Promotion Strategist Dr Viliami Puloka presented his thoughts home grown solutions to the Pacific’s obesity problem at a recent conference in Wallis and Futuna.  
Gardening and Health: Let your garden be your health and your health be your garden
Dr. Viliami PULOKA, Senior Health Promotion Strategist, New Zealand Health Promotion Forum   Abstract When Hippocrates, the father of medicine some 2,500 years ago said “Let food be thy medicine and medicine be thy food”, I can assure you he was not talking about fast food like Cheese burgers, Fizzy drinks and French fries. He was talking about fresh produce from people’s home gardens. Being the top physician of his time and a leading scientist in the field of medicine, he knew the importance of good healthy food in providing proper fuel for healthy living. Consumption of foods that are highly processed but empty of proper nutrients is one of the key drivers of the obesity and diabetes pandemic the world is facing today, including Wallis and Futuna.   The Wallis & Futuna Chronic Diseases Risk Factor Study in 2009 showed a 17% prevalence of diabetes, and an 87% prevalence of overweight and obesity among the study population. Eating fresh food, locally grown in home gardens is a very good way to prevent and control chronic diseases including diabetes and obesity.   The health benefits of growing your own food are well documented. You are in control and decide what to grow. You are not dependent on food produced by someone you do not know, whose interest is your money not your health. Growing your own garden provides opportunities for physical activity which goes hand in hand with good nutrition giving you good health. One can also enjoy fresh air and sunshine, which is good medicine for the whole person.   Wallis and Futuna are very fortunate to have such fertile soil, and many people still grow food in their own gardens. The challenge is the ever-increasing amount of readily available imported processed food that competes with traditional local cuisines.   I like to suggest that the way forward to good health through home gardening is to ‘return to nature’ and re-claim the socio-cultural and economic value of home gardening and… “Let your garden be your Health and your Health be your garden”.   “If I had the same life expectancy as a Tongan man, I’d only have one year and three months left to live.” Statistics show that life expectancy for men in Tonga is 65 years, mainly due to the rise in NCDs[1].   A child born in the Pacific today is more likely to die before their grandparents and parents, largely due to the Obesogenic environments. It does not matter whether we are in Samoa, Tonga Vanuatu or Wallis and Futuna our story is one and the same. A healthy baby is born, fully immunized, is well cared for and loved. We invest in their education and they get good qualification, good job and they may earn good money.   The food environment however makes it very easy for us to eat ourselves to death. Young Pacific persons develop diabetes as early as age 30 and many develops complications by age 40 requiring amputation at 50 followed by kidney failure  at 55 paving the way for “early preventable death” the plight of Pacifica today.   What a loss! Financial/economic investments as well as social and cultural loss that have direct impacts on families and the country as a whole.   The presentation discusses NCD issues as related to how we look after our health as “a garden for our food security, health is for our everyday living.” Health isn’t everything, but without health, nothing else matters. Your health is the only resource we have to do life and to contribute to life.  Doctors and nurses have known for many years now that health deteriorates when people don’t eat healthy food. Everyone knows that as a fact but knowledge is not enough to make us do what we know we should be doing.  In the Pacific, NCDs cause up to 40% of sickness and up to 70% of deaths. Over 20% of countries’ budgets are allocated to NCD control in hospitals. Much more resources is needed for prevention and to address the many social cultural determinants outside the hospitals. Some 2500 years ago, Hippocrates said, “Let food be thy medicine and medicine be thy food”. The NCD issue is directly related to what we eat or do not eat. It is therefore important to look at the food we eat with the same respect we give to any medicine we take for any illness.   From the food we eat our body have fuel or energy to carry out daily activities. To be healthy, the energy gain from food we eat should be proportional to the energy required for daily activity.   This is the problem in the Pacific, we eat and gain way too much energy but spent too little doing minimal physical activity. We drives to the supermarket, buy processed energy rich food instead of working in our gardens.   People in the Pacific don’t walk to the hospital, because when they do decide to go, they are too sick to walk. A 2009 study in Wallis and Futuna revealed high rates of factors causing NCDs.  Not enough fruit and vegetables consumed, inadequate physical activity, high rate of high blood pressure and high rates of obesity.   Specifically regarding obesity in Wallis and Futuna, the risk factors are visible as early as age 18. In the 18-24 age group, 51% of men and37 % of women are already obese. Many people are obese very early in life.   In Wallis and Futuna, diabetes prevalence was three times higher in 2009 than 1986. High blood pressure was twice as prevalent and obesity remained high. If the various NCD risk factors in Wallis and Futuna and are compared with American Samoa (the Pacific NCD champions), the figures for both territories are quite similar.   With regard to food security, the issue is access to and the availability and use of food. In Wallis and Futuna, these issues do not really apply, as food is available. The problem is related to the choices local people make in terms of food. We eat what we do not grow, we grow what we do not eat.   Geoff Lawton said that all these issues can be solved by gardening. Gardening can really feed both body and mind.   When people garden, they know exactly what they are growing, unlike shop items produced in unknown places by unknown people whose interest is more in our wallets than our good health. So it is best to grow our own food. Gardening should be medically prescribed.   Uvea is a garden with a few houses dotted around it. Most homes have gardens and gardening has many benefits:  
  • Stress relief – A study in the Netherlands indicated that gardening is better at relieving stress than other relaxing leisure activities.
  • Brain health – A study that followed people in their 60s and 70s for up to 16 years found that those who gardened regularly had a 36% lower risk of dementia than non-gardeners
  • Nutrition – Studies have shown that gardeners eat more fruits and vegetables than other people. The freshest food you can eat is the food you grow,
  • Healing – Interacting with nature also helps our bodies heal. A landmark study by Roger S. ULRICH, published in the April 27, 1984, issue of Science magazine, found strong evidence that nature helps heal.
  • Immunity – In 2007, University of Colorado neuroscientist Christopher LOWRY, then working at Bristol University in England, made a startling discovery. He found that certain strains of harmless soil-borne Mycobacterium vaccae sharply stimulated the human immune system. It’s quite likely that exposure to soil bacteria plays an important role in developing a strong immune system [7].[m1] [VP2]
Nature is the key to health. We have a certain affinity with nature, because we are part of it and would rather look at a flowery lawn than concrete and steel. We are one with the fenua. Plants and animals must not be simply seen as useful things, but given the same respect we would expect from them.   A big challenge and real issue is the war between economic development and health. More than 60% of food consumed locally in many of the Pacific islands are imported from outside. The driving force is economic growth and often done in the expense of good health. By nature, imported food are not fresh, processed and high in sugar, salt and fat. Wallis and Futuna need healthy economy but it can only happens when people are healthy themselves to grow the economy and to enjoy the benefits it produces.   A discussion followed Dr Puloka’s presentation, comments were made by participants.  Here is a summary    Pierre CAMI, nurse in Wallis A lot has been said about preventing, but little about treating these non-communicable diseases. Too often in the Pacific, we tend to try making methods from mainland France fit our situation when they are not necessarily suited to Pacific-island cultural notions about disease.   With regard to soda, it’s 15% sweeter in the Overseas Territories than Europe. Individual preventive measures have been mentioned, but the political and traditional authorities should also be used to reduce soda consumption. It has been done in New Caledonia for alcohol. Individual initiative is not enough to win the struggle between business and health. The government and traditional authorities should do their duty and at least start a genuine discussion on these issues.    Viliami PULOKA Human beings are very strange creatures. As soon as someone advises us to do something, we decide not to listen. My experience has taught me that Pacific islanders are hard to convince. We don’t like listening to reason. To overcome the problem, we need to speak to Polynesians’ hearts and win them over. Pacific people are “heart people” Speak to the hearts not the minds. “We think with our hearts and feel with our minds”   We tell people they chose to be the way they are, but how many really did have a choice? People’s choices are limited to what they can afford and can easily do. The campaign must be politically driven for healthy lifestyles and to make healthy choices, easy choices.   Pesamino TAPUTAI It is high time to start asking our political leaders and elected representatives a few tough questions. We need to startle people and ring alarm bells, as the doctor said. I’m grateful to the traditional leaders who are here, because they are the ones who need to get the ball rolling by holding village meetings.   In Wallis and Futuna, people sometimes feel that health is something to be ashamed about. The territory’s leaders must set an example. The Catholic mission should also be involved in agricultural, land and health issues. These people still wield some influence and are respected by the community.   We shouldn’t be bashful about being healthy. There’s nothing wrong with walking. It is nothing to be ashamed of. Nicolas SIMUTOGA   Banning was mentioned. Smoking is prohibited in public areas. Unfortunately there are advertisements everywhere that tempt people. It’s Big Food that invented these diseases. Politicians are also to blame.