Abstract
The nutrition transition in Small Island Developing States like Kiribati has led to a significant shift from traditional diets to processed, imported foods, resulting in a double burden of malnutrition. This study provides the first comprehensive assessment of nutrition-related health issues in Kiribati, analyzing data from a nationally representative household survey conducted in 2019-2020 (with over 12,000 participants). We examined anthropometric measures and biomarkers related to both under- and overnutrition across 21 islands, including obesity, anemia, hypertension, diabetes, and dyslipidemia. Results reveal high prevalence of overweight and obesity (78.6% in adults), alongside persistent undernutrition in children (23.9% stunting, 6.9% wasting in under-fives). Non-communicable disease indicators were alarmingly high, with 38.5% of adults having hypertension (i.e., stage 2 or hypertensive crisis), 16.5% diabetes, and 87.1% at risk for high cholesterol. Anemia affected 13.8% of the population. Age and sex were significant factors, with older individuals and women generally at higher risk for obesity and related conditions. Geographic analysis showed that total cholesterol and diabetes varied most across islands, while obesity and other markers varied more at the household level. These patterns suggest the need for both island-specific and household-level interventions. Our findings highlight the urgent need for targeted public health strategies and interventions to address the double burden of malnutrition in Kiribati. By providing baseline data on nutritional status and its geographic and demographic variations, this study informs evidence-based policies to improve food security, nutrition, and health outcomes in the face of ongoing environmental and socioeconomic challenges in this vulnerable island nation.