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. 2023 Sep 1:13:04097.
doi: 10.7189/jogh.13.04097.

Exploring the link between home garden use and severe obesity: Insights from a nationwide survey in Tuvalu

Po-Jen Lin  1   2   3 , Tai-Lin I Lee  4 , Maria Soledad Hershey  5 , Chih-Wei Shih  1   6 , Selotia Tausi  7 , Vine Sosene  8 , Pauke P Maani  8 , Malo Tupulaga  8 , Stephanie M Wu  9 , José Francisco López-Gil  5   10   11 , Yuan-Hung Lo  1   6 , Shi-Chian Shiau  1   6 , Yu-Tien Hsu  12 , Chia-Rui Chang  9 , Chih-Fu Wei  5   6
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Exploring the link between home garden use and severe obesity: Insights from a nationwide survey in Tuvalu

Po-Jen Lin et al. J Glob Health. .

Abstract

Background: Obesity is prevalent and increasing but understudied across Pacific Islanders. Tuvalu is a South Pacific country with a high obesity rate and faces multiple threats of food insecurity. Home garden serves as a sustainable food source and can be a possible intervention for the obesity pandemic in Tuvalu. This study investigated Tuvaluans' home garden use and obesity, and explored factors associated with increased use of home gardens.

Methods: We conducted a nationwide, cross-sectional study in Tuvalu during 2022. Structured questionnaires were administered during the in-person interviews, and trained interviewers measured the height and weight of each participant. The association between home garden use, obesity and severe obesity were tested with univariate and multivariable logistic regression. We also applied overlapping weights to balance the distribution of baseline demographic factors.

Results: The average body mass index was 34.87 kilogrammes (kg) / square metre (m2) among the study population of 1024 adults (630 from Funafuti and 394 from other islands in Tuvalu). Overall, people having home gardens was associated lower odds for severe obesity compared to those without a home garden in overlap weighting models (odds ratio (OR) = 0.946, 95% CI = 0.897-0.997, P = 0.039) and the association was stronger in Funafuti (OR = 0.927, 95% CI = 0.866-0.991, P = 0.027) than in the outlying islands (OR = 0.967, 95% CI = 0.889-1.052, P = 0.435). Furthermore, increased age was positively associated with having a home garden in Funafuti, and smoking showed an inverse association.

Conclusions: Having a home garden is associated with lower odds of severe obesity in Tuvalu, and the association is stronger in Funafuti. Smokers are less likely to have home gardens, and increased age is positively associated with having home gardens. These findings promote more home garden utilisation and provide evidence for targeted interventions in Tuvalu.

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Conflict of interest statement

Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and declare the following activities and relationships: PJL and CFW received consulting fees from Taiwan Technical Mission in Tuvalu; PJL received reimbursement from Taiwan Technical Mission in Tuvalu for attending the Planetary Health Annual Meeting 2022 in Boston, Maryland, USA.

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