How colonialism created the conditions for today’s global obesity epidemic

Taro, breadfruit, reef fish, coconut. For centuries, this was the diet of American Samoa — one that the nutritional anthropology and ethnobotanical literature describes as among the most nutritionally complete in the pre-industrial Pacific. It was calorie-dense but varied, shaped by the sea and volcanic soil rather than by any external supply chain. There was no obesity epidemic. There was no epidemic of Type 2 diabetes or hypertensive cardiovascular disease. The islands that supported these food systems were not producing nutritional poverty.

Today, roughly 75 to 80 percent of American Samoan adults are classified as obese. The World Obesity Federation’s Global Obesity Observatory ranks the territory first on earth by that measure. On an ordinary morning in American Samoa, a household might open a can of Spam, fry it alongside white rice, and serve sweet rolls from a packet with instant noodles as a side. The Spam is not there ironically, in the way it occasionally appears in Western food culture as retro camp. It is unremarkably present because it has been unremarkably present for decades — there in the way a staple is there when it was already there when your parents were children.

Nine of the ten most obese nations on earth are Pacific island territories. The conventional explanation is close enough to the surface to feel satisfying and insufficient enough to be wrong: globalization, fast food, the penetration of processed calories into island populations too small and too economically marginal to resist them. The explanation is not entirely wrong. Corporations did enter Pacific markets. Ultra-processed food is genuinely destructive to metabolic health at population scale. But the explanation does not account for the distribution. Japan has had dense market exposure to Western food corporations since at least the 1960s. France since before that. Neither country appears in the top ten. The Pacific islands’ position is not simply a product of exposure to the global food system — it reflects a structural vulnerability that preceded any corporate arrival by several decades.

The conventional epidemiological framework for understanding obesity in the developing world — the one that dominates policy discussions, public health curricula, and most journalism on the subject — starts its causal clock in the 1970s. That is when Western corporations began their serious expansion into low- and middle-income markets; when urbanization accelerated; when cheap oils and sweeteners began their global displacement of traditional fats and starches. The framework is accurate about what happened from that point. What it gets wrong is the condition of the populations before those forces arrived — the starting point it assumes was intact.

In the Pacific, that starting point has a specific history, and that history is unusually precise, unusually traceable, and unusually overlooked. The question of why these islands specifically, more severely than almost anywhere else on earth, is a question the standard narrative has no adequate answer to.

In these territories, the diet did not drift gradually into processed-food dependence the way European diets did over decades of rising prosperity and expanding consumer choice. It changed rapidly, within a specific historical window, in a specific direction. And the window did not open when the first fast food franchise arrived.

The standard narrative starts its clock too late

Barry Popkin, a nutritionist at the University of North Carolina, first described what he called the “nutrition transition” in 1993 and refined it across subsequent decades, most recently in a 2012 paper in Nutrition Reviews. The framework identifies the global shift toward diets high in refined carbohydrates, added sweeteners, and ultra-processed foods in low- and middle-income countries as a function of economic development, urbanization, and the aggressive marketing of transnational food corporations. As an account of the mechanism by which diets deteriorate, it is well-evidenced. As an account of starting conditions, it assumes something that is not true for most formerly colonized nations: that the food cultures being displaced were intact before the corporations arrived.

They were not.

The sharpest single piece of evidence for this is also the most precise natural comparison available anywhere in the epidemiological literature on obesity: American Samoa and the independent nation of Samoa.

Both territories share the same ancestry, the same traditional Polynesian food culture, the same ethnic and linguistic heritage. Both have comparable access to global processed-food markets — supermarkets, fast food chains, global supply chains of canned and packaged goods. They are ninety miles apart in the South Pacific. American Samoa has been a US territory since 1900. Independent Samoa gained independence in 1962. And by every available metabolic measure, American Samoa is dramatically worse off.

World Obesity Federation data from 2022 places American Samoa at approximately 75 to 80 percent adult obesity, first globally. Independent Samoa, by the same dataset, sits at roughly 61 percent — itself among the world’s highest national rates, but roughly 15 percentage points lower. Fan and Le’au, writing in the Hawaii Journal of Medicine and Public Health in 2015, examined this comparison directly. They found that 93.5 percent of American Samoan adults were either overweight or obese in 2007, compared with 85.2 percent of their counterparts in independent Samoa in 2002. They linked the differential explicitly to the two territories’ divergent colonial arrangements: American Samoa’s sustained US military presence, administered food distribution programs, and deep structural dependence on US commodity imports, versus independent Samoa’s post-1962 autonomy and less saturated food environment. The comparison does not constitute a controlled experiment — both populations are severely affected, and many variables differ beyond food policy — but a gap of this magnitude that persists despite equivalent ethnic background, equivalent market access, and equivalent geography does not emerge by accident.

What the standard narrative also fails to explain is the specific disease cluster in formerly colonized Pacific populations: not just obesity but Type 2 diabetes, hypertension, and metabolic syndrome. These are the diseases that result specifically from rapid, structurally forced dietary shift — from the replacement of a nutritionally varied diet with a refined-calorie, low-fiber one at speed. The shift from one to the other is what generates this profile. In the Pacific, that shift was not gradual. It was accelerated by a specific historical event and locked in by specific policy arrangements. Neither feature in Popkin’s framework, because both precede the decade his clock starts.

By 2035, the World Obesity Federation’s 2024 Atlas projects, 79 percent of the world’s adults living with overweight or obesity and 88 percent of children with overweight or obesity will be in low- and middle-income countries. Seventy-eight percent of global deaths attributed to high BMI already occur there. That is not a future projection about the next chapter of globalization. It is a pattern being produced by chapters that came before.

The gene that wasn't there

For decades, the dominant biological explanation for elevated obesity rates among Pacific Islander populations was genetic. Pacific Islanders, so the hypothesis went, had evolved a "thrifty genotype" — a predisposition to store fat efficiently as an evolutionary adaptation to historical cycles of famine and feast. The theory was first proposed by James V. Neel in a 1962 paper in the American Journal of Human Genetics. It offered something politically convenient: a cause located in biology rather than in policy, meaning no administration needed to answer for anything.
The archaeological and anthropological record does not support it. Anna Gosling and colleagues, in a 2015 paper in Annals of Human Genetics, examined the Pacific evidence and found no credible history of recurrent, severe famine in tropical equatorial Pacific island populations — the precondition the hypothesis requires. They also showed that the rapid onset of obesity in Pacific populations after World War II, in communities that had not been obese before the twentieth century, cannot be explained by a stable genetic predisposition that was somehow latent for millennia. Genes don't switch on in a decade because of a war.

Gosling's team proposed a more plausible genetic explanation: selection pressure from the infectious disease epidemics — measles, influenza — that devastated Pacific populations during the nineteenth century. This is a different mechanism entirely, and one that explains metabolic predisposition without rendering contemporary obesity rates inevitable or natural. The thrifty genotype hypothesis persists in popular writing because it is simple and because it removes the colonial period from the story. Neither is a scientific argument.

What colonialism did to the land

Before the corporations. Before the marketing campaigns and the trade liberalization agreements of the 1980s and 1990s. Before any of the modern mechanisms the standard narrative names. There was the land itself, and what colonial administration did to it.

Colonial agricultural policy worked on food environments through mechanisms that outlasted the colonial period by generations — not through a single instrument but through several operating simultaneously, each compounding the others.

The most visible was land conversion: subsistence food production displaced by export monocrops. Sugar in the Caribbean. Groundnuts in West Africa. Cotton across much of South Asia and the Levant. Indigo, then jute, in Bengal. In the Caribbean the conversion was not gradual — within decades of European settlement, the most productive islands were almost entirely given over to sugarcane for European markets. The indigenous food systems, the cassava cultivation and fishing and diverse horticulture that had sustained these islands, were destroyed along with the indigenous populations who practiced them, replaced by a monoculture serving a single commodity in a single direction.

What went with the land was the knowledge. Which crops grew where, which wild plants were edible, which cultivation practices maintained soil productivity through polyculture rotation — this knowledge was not written down. It was practiced, passed through practice, and it could not survive on land converted to monoculture. In the Caribbean, where the conversion was most absolute, the pre-colonial Arawak and Taino agricultural knowledge — manioc varieties, coastal fishing ecologies, cultivation practices adapted to island soils over generations — was erased before it could be transmitted to the enslaved African populations who replaced the decimated indigenous workforce. Those populations arrived into a landscape already stripped of its nutritional complexity. Forced relocation, imposed land-tenure regimes, and the structural impossibility of maintaining mixed food production alongside export agriculture stripped this knowledge from communities across generations. Once lost, it did not recover automatically when the colonial administration departed.

The third consequence is the one public health literature most consistently fails to register, and the most counterintuitive: in Africa, increased export production under colonial regimes coincided with a decline in per capita food production. Not a trade-off. A direct displacement. Research drawing on FAO data — synthesized by the Catholic Agency for Overseas Development — has documented Africa as the only world region in which more export production meant less food for local populations, with export crops occupying more than half of arable land in Ghana, Kenya, and Senegal at the peak of colonial exploitation. The export crop and the food crop were not additive on finite land. One displaced the other, and it was not the export crop that fed local people.

The Caribbean sugar plantation makes this displacement visible in its most brutal form. By the mid-eighteenth century, Barbados, Jamaica, and Saint-Domingue had been so thoroughly converted to monoculture that they could not feed themselves. The enslaved African labor force was provisioned rather than fed: salt cod shipped from Newfoundland, hardtack biscuit, molasses as a waste product of the sugar production they performed, and the minimal produce from the provision grounds they were permitted to cultivate on marginal land during their few free hours. Sidney Mintz, in Sweetness and Power (1985), documented how the plantation system assembled this dietary baseline — built not to support nutritional health but to maintain labor capacity at minimum cost. Richard Sheridan’s Sugar and Slavery (1974) traces the economics of that provisioning in detail.

Not a food culture that emerged organically. A caloric delivery system engineered for one purpose and inherited by every subsequent generation as if it had always been there.

What the plantation system left behind was not simple caloric poverty — an absence of food — but dietary impoverishment: cheap refined calories available, nutritional variety gone. That distinction matters when explaining why the metabolic consequences of colonial food history look like obesity and metabolic syndrome rather than the acute undernutrition of simple starvation. The plantation diet produced caloric sufficiency and nutritional devastation simultaneously. It is a combination the contemporary global food system has proved very effective at reproducing.

Obese and malnourished

In sub-Saharan Africa and parts of South Asia, the same household can contain an overweight adult and a stunted, micronutrient-deficient child. Public health researchers call this the "double burden of malnutrition," and it consistently confounds observers who assume obesity must mean caloric surplus.

What colonial agriculture left behind was not food poverty in the conventional sense — absence of calories — but dietary impoverishment: cheap starchy calories in relative abundance, nutritional variety depleted. An overweight adult and a malnourished child can both be produced by the same dietary environment, one dominated by refined carbohydrates and stripped of micronutrients; the difference is often in how much each person consumes, not in what is available. Tzioumis and Adair, in the Food and Nutrition Bulletin in 2014, documented the double burden's emergence and geographic concentration in the developing world. Its geographic distribution follows closely the footprint of colonial agricultural disruption.

The food of occupation

Two mechanisms, operating through different geographies and different institutions, produced the same result: specific processed and refined foods became culturally embedded in local diets during the colonial period, long before any corporate marketing campaign told anyone to want them. The embedding was active. Not drift, not influence, not the gradual seduction of the market. Delivery — through provisioning systems and military supply chains, by administrators with no interest in nutritional outcomes.

In the Caribbean, the mechanism was the plantation itself. The diet that enslaved and, later, indentured populations received was not the food culture of West Africa or the Indian subcontinent. It was assembled by plantation economics for caloric sufficiency at minimum cost: heavily salted preserved protein — salt cod from Newfoundland, corned beef, dried salt fish — starchy carbohydrates in the form of hardtack and eventually white wheat flour, and sugar products in the form of molasses and raw cane from the plantation’s own production. These foods became the dietary baseline not of one generation but of several, because there was no alternative baseline available on a plantation that had destroyed the prior food system and replaced it with monoculture.

After emancipation, after independence, these foods remained. Not because no one knew about alternatives, but because cultures do not shed their diets the way governments shed their constitutions. The taste for salt fish, for white-flour preparation, for sweetness: this had been installed across generations at the level of what food means, what cooking requires, what a meal looks like. Mintz, in Sweetness and Power, traced this precisely: the sugar that Caribbean workers produced for European tables became embedded in their own food culture not through market seduction but through the provision system — they were given it because it was cheapest, and their children grew up with it as the given.

The contemporary Caribbean dietary profile — high in sugar and refined starches, low in fiber, associated with elevated rates of Type 2 diabetes and cardiovascular disease — is not a natural evolution of traditional African food cultures. It is the dietary inheritance of the plantation, passed through post-emancipation poverty and post-independence food environments that had no particular structural incentive to change it. Jamaica’s diabetes prevalence stood at 12 percent of adults in 2018. A 2022 system-dynamics modeling study in PLOS Global Public Health projects that figure reaching 20.9 percent by 2050, absent substantial intervention. That projection does not describe a country that chose this trajectory.

The direct epidemiological chain from Caribbean plantation diet history to contemporary disease burden remains incompletely documented — Mintz establishes the cultural embedding mechanism with precision, but the forward causal connection to contemporary nutritional epidemiology has not been fully established in a single prospective study. The historical argument is sound. The epidemiological documentation of what came after it is not — and naming that limitation is more useful than papering over it.

In the Pacific, the mechanism was military occupation.

During and after World War II, the US military distributed food throughout Guam, American Samoa, Palau, and across Micronesia at a scale and speed that had no precedent in these islands’ histories. Spam, corned beef, canned fish, powdered sugar, white rice — standard shelf-stable military rations, distributed to populations whose traditional food-gathering capacity had been physically disrupted: coastlines and fishing grounds damaged by war, agricultural land destroyed, communities displaced from the specific places they had farmed and fished for generations. When the war ended, the traditional food systems did not fully recover. The canned food did not leave.

Susan Cassels, in a 2006 study in Globalization and Health, documented what this produced in Kosrae, one of the Federated States of Micronesia: 88 percent of adults aged 20 or older were overweight by BMI measure; 59 percent were obese; 24 percent were extremely obese. US subsidies to the FSM grew from $6 million annually in 1962 to $130 million by 1978, creating a cash economy in which imported processed food was affordable and accessible while the traditional infrastructure for food production — fishing technique, taro cultivation, fermentation and preservation — atrophied from disuse. By 1986, food imports represented 40 percent of the FSM’s total import value. In Guam and American Samoa, Spam became and remains a genuine culinary staple with no real parallel in mainland American food culture — present not as a novelty but as a default, in the way a staple is present when it has been present for eighty years.

The cash economy the subsidies created did not supplement traditional food production. It replaced the need for it in the short term, and made it structurally impossible in the medium term. The skills required to navigate a reef fishing system, to ferment taro for preservation, to judge which crops would yield well in which soils — these are not written down anywhere. They live in practice and die with the generation that stops practicing them. Once the import economy made traditional food production economically unnecessary, the knowledge required to practice it decayed from disuse. The communities that might have needed those skills in any disruption were now structurally dependent on the import system that had replaced them.

Underneath the wartime mechanism ran a third channel of dietary suppression that McLennan and Ulijaszek, in a 2015 paper in Public Health Nutrition, document across the Pacific colonial period. Colonial administrators and missionaries actively discouraged traditional food practices as part of broader civilizing projects. Colonial records describe officials instructing Pacific islanders to fry fish rather than eat it raw or prepare it through fermentation and drying — techniques that preserved fish nutritionally and required no imported cooking fats. These were not casual recommendations. They were framed as hygiene, as progress, as the behavior of people who had left primitivism behind. Once suppressed and allowed to atrophy through disuse, these techniques did not recover. The knowledge went with the generation that last practiced it.

The Palau case illustrates the accumulated metabolic consequence. WHO STEPS survey data from 2011 to 2013 found 40 to 45 percent obesity among Palauan adults aged 25 to 64, with 84 to 86 percent of the adult population classified as overweight or obese. Global Nutrition Report modeled estimates place obesity at 55 to 62 percent depending on gender. It is a territory whose traditional diet supported a stable population for millennia. What its diet now is did not happen because its people chose it.

Two Samoas

American Samoa has been a US territory since 1900. Independent Samoa gained independence in 1962. They share the same ancestral food culture, the same ethnic background, and comparable access to global processed-food markets.

World Obesity Federation 2022 data places American Samoa at approximately 75 to 80 percent adult obesity, highest in the world. Independent Samoa sits at roughly 61 percent, eighth globally. Both figures are extreme. The comparison is not between crisis and health. But Fan and Le'au, in the Hawaii Journal of Medicine and Public Health in 2015, found 93.5 percent of American Samoans overweight or obese in 2007 versus 85.2 percent of independent Samoans in 2002 — and linked the gap explicitly to American Samoa's sustained US military presence, administered food distribution programs, and structural commodity import dependency, compared with independent Samoa's post-independence food environment.

The gap correlates with colonial structural exposure more closely than with general market access. That is meaningful evidence. It is not proof in the experimental sense — both populations are severely affected, and variables beyond food policy differ. But a 15-percentage-point differential between two territories sharing the same culture and the same degree of access to processed-food markets does not emerge from nothing.

When the empire built your food system

The Caribbean and Pacific cases share a mechanism: colonial administrations and occupying forces placed specific foods in the daily lives of subject populations and the result became a diet. The South Asian case operates through a different pathway, worth naming explicitly because it shows that colonial food-system disruption did not require direct food provision. Sometimes the administration didn’t hand out the food. It built the infrastructure that determined what grew, and let economics do the rest.

Before British colonial rule, the agricultural regions of the Punjab and the Indus Valley supported a diverse multi-grain ecology: millet, sorghum, barley, amaranth, chickpea, varieties of lentil. These were not poverty foods. They were the nutritional foundation of a civilization, adapted to local soil, climate, and human metabolism over millennia, and collectively providing the micronutrient range that refined-grain monocultures cannot match. The Punjab was not a region awaiting improvement.

Between 1886 and 1940, the British colonial administration built nine major canal colonies in western Punjab — in what is now Pakistan. Imran Ali, in The Punjab Under Imperialism (Princeton University Press, 1988), documents this as one of the largest hydraulic engineering projects in colonial history: rivers redirected, arid land broken for cultivation, entire communities relocated into new agricultural settlements. The purpose was not to feed Indians. It was to produce exportable wheat for the imperial market. Railway networks were built to move grain to the port at Karachi, not to connect Indian populations to each other’s food supplies. The infrastructure was built as an extraction mechanism and functioned as one.

Colonial administrators positioned white flour products as markers of civilization and progress. Maida — finely milled white wheat flour — spread through urban food culture in association with British baking practices and the aspirations of those seeking proximity to colonial status. Indigenous coarse grains were positioned, in colonial agricultural discourse and through missionary education, as the food of the backward, the pre-civilized, the not-yet-modern. The ideological work was part of the economic project.

The canal system just described sits in what is now Pakistan’s Punjab — a distinct region from the Indian Punjab and Haryana where the Green Revolution would unfold after partition. The two geographies have separate post-independence trajectories; collapsing them would obscure how the colonial agricultural logic propagated across the partition line and through subsequent decades. What connects them is the same wheat logic, operating at different times and through different instruments.

After partition and independence, the Green Revolution reinforced what colonialism had begun. Using high-yield wheat varieties developed with US agricultural aid and Rockefeller Foundation funding, centered on Indian Punjab and Haryana, it drove India’s national wheat production from 12 million tons in 1965 to 20 million tons by 1970. Punjab alone produced 70 percent of India’s total food grain output by that year. India achieved food self-sufficiency — but the definition of food had narrowed to wheat and rice.

Research on the Green Revolution’s impact on India’s indigenous crops, published in the Journal of Ethnic Foods, documents what the monoculture logic cost: the area under coarse cereals declined from 37.67 million to 25.67 million hectares in the decades following the revolution’s introduction; sorghum cultivation fell from 15.57 million to 5.82 million hectares. A diverse grain ecology built over millennia was replaced, within a few decades, with a commercial food system dominated by two crops.

The Green Revolution was not a colonial policy. But it operated within the agricultural infrastructure colonialism had built, deployed the same crop logic — wheat, scale, export orientation — and extended the monoculture rather than reversing it. The colonial administration initiated the wheat shift; post-independence food security priorities reinforced it. Both phases contributed to the contemporary dietary baseline. The distinction between the two matters: collapsing them into a single causal claim would let the colonial administration off the hook for the foundation, and the foundation is the argument.

The health consequence sits at the intersection of that dietary shift and a metabolic characteristic that is clinically well-established. C.S. Yajnik, in a 2003 paper in the International Journal of Obesity drawing on the Pune Maternal Nutrition Study, described what he called the “thin-fat Indian” phenotype: South Asian neonates with lower overall body size but preserved body fat, creating insulin-resistant metabolic profiles that persist into adulthood. The documented higher susceptibility of South Asian populations to Type 2 diabetes at BMI thresholds lower than those at which European populations develop the disease reflects a real biological reality — one that existed before colonialism. What colonialism and the Green Revolution together installed was a dietary environment precisely mismatched to that susceptibility: high refined-carbohydrate, low micronutrient diversity, built on a monocrop wheat infrastructure that an empire constructed for its own supply needs.

India now bears one of the world’s heaviest burdens of Type 2 diabetes — 74.2 million adults as of 2021, by International Diabetes Federation estimates, with projections suggesting that number will reach 124.9 million by 2045. The metabolic susceptibility was pre-existing. The dietary environment that triggered it was built by someone else, for other purposes.

The door was already open

By the 1970s, when transnational food corporations began their serious expansion into low- and middle-income markets, the terrain had been prepared for them. Thoroughly, and across three geographies that together represent a substantial fraction of the global obesity epidemic.

They were not entering pristine food cultures, seducing populations with the novel pleasures of refined sugar and cheap fat. In the Caribbean, they were selling to populations whose dietary baseline for two or three centuries had been built around imported starchy calories and cheap processed protein — because that was the plantation diet, installed by the plantation, practiced through emancipation and into independence. In the Pacific, they were entering markets where Spam and canned corned beef were already cultural staples, placed there by the US military and locked in by US subsidy structures and the post-war cash economies they created. In South Asia, they were selling refined wheat snack products to populations whose entire agricultural system had been restructured around wheat by colonial canal infrastructure and Green Revolution reinforcement.

They found markets that had been prepared for them.

The nutritional landscape they entered was not neutral territory. It was already tilted by a century of policies that had reduced food diversity, embedded specific caloric profiles in local cultures, and created cash economies in which imported processed food was the path of least resistance. Corporations recognized this and built on it: they competed aggressively on price, they positioned their products as modern and aspirational in societies that had been explicitly taught to associate indigenous foods with backwardness, and they exploited distribution infrastructure that colonial and post-colonial administrations had built. The alignment between what they were selling and the dietary baselines that colonial provisioning had created was not accidental. It was a match.

Barry Popkin and colleagues, in the 2012 Nutrition Reviews paper, documented the resulting shift toward ultra-processed, energy-dense, nutrient-poor foods in low-income countries. Monteiro and colleagues, in Obesity Reviews in 2013, showed how ultra-processed products had moved from dominance in high-income countries to rapid expansion in middle-income ones, driven by the same transnational corporations now entering markets where the traditional dietary defenses had already been largely dismantled. The mechanisms both frameworks describe are real. What neither addresses is the starting point — the condition of the populations before the corporations arrived. The nutrition transition in formerly colonized nations did not begin from traditional food culture. It began from already-disrupted colonial food culture.

This matters for attribution, which matters for accountability.

The corporations are not exculpated by the colonial history — not remotely. They understood the markets they were entering. Research published in PLOS Medicine in 2012, by Monteiro and Cannon, examining transnational food companies in Brazil, documented the tactics: targeting children, undercutting local food vendors on price, leveraging post-colonial aspirations toward Western lifestyle as a premium brand signal. Nestlé, Coca-Cola, PepsiCo, Indofood: they accelerated what would have happened more slowly without them, and they bear real accountability for that acceleration. But the acceleration is not the cause. The structural vulnerability preexisted their arrival, and attributing the epidemic primarily to corporate behavior — which is the dominant public narrative — tells a last-chapter story while omitting the first three.

Post-colonial governments compounded the structural inheritance. Many were advised by the same Western agricultural institutions that had promoted Green Revolution monocultures; they inherited food policy frameworks oriented toward caloric production rather than nutritional diversity. World Bank and IMF structural adjustment programs in the 1980s and 1990s required trade liberalization as a condition of lending, opening markets further to cheap processed imports at precisely the moment when transnational food corporations were most aggressively seeking new expansion territories. The mechanism was not conspiratorial. It was structural, which in some respects is worse — no one had to decide to do it.

By 2035, the World Obesity Federation’s 2024 Atlas forecasts that 79 percent of the world’s adults living with overweight or obesity and 88 percent of children with overweight or obesity will be concentrated in low- and middle-income countries. Seventy-eight percent of global deaths attributed to high BMI already occur there. This is not a distribution produced by market access alone, or by corporate marketing sophistication, or by the dietary choices of populations that knew better. It is the distribution that results when populations enter the global processed-food era from a starting point that a century of colonial agricultural policy created.

American Samoa’s diabetes rate stood at 21.5 percent of adults in 2002 — itself among the highest in any US-administered territory. Territory health surveys from subsequent years indicate the figure has continued to climb. A territory of 55,000 people, under US administration since 1900, with some of the highest rates of diet-related chronic disease anywhere in the US-administered world. Each phase of the food environment that produced it was built for purposes that had nothing to do with Samoan health. The military brought the Spam. The subsidies kept it cheap. The administration built no alternative infrastructure. The corporations found the rest.

The can of Spam in the American Samoan pantry was not put there by Hormel’s marketing department. Or not primarily. It was put there by the US military, as part of the wartime provisioning of occupied Pacific territories, and it remained because the post-war administrative and economic structures that replaced direct occupation continued making it cheap, available, and culturally embedded. By the time Hormel was running advertising campaigns in the Pacific, Spam was already what breakfast looked like. The corporations found the preference. They didn’t build it.

The two accountability claims are not in competition. Naming the colonial foundation makes the corporate complicity sharper, not less: corporations entered markets whose vulnerability had been constructed by colonial policy, exploited that vulnerability with deliberate commercial aggression, and in doing so both accelerated the epidemic and deepened the structural dependencies that make it so difficult to address. One did the groundwork. The other moved in.

When the next wave of public health reporting describes an obesity crisis in the Pacific, or rising diabetes rates in the Caribbean, or the scale of metabolic disease in South Asia, the frame of choice will be lifestyle, market penetration, the seductions of the modern food system. That frame is not neutral. It systematically removes from the story the century that preceded the moment it starts. It treats what colonial administration constructed as if it were simply the weather — unfortunate, present, nobody’s fault.

These conditions were not natural. They were not the result of cultural drift or biological fate or the undifferentiated forces of modernity. They were constructed, by specific administrations, through specific policies, in service of specific economic interests. The populations living with the metabolic consequences did not design those policies. They inherited them.

Avis de non-responsabilité de Gen AI

Certains contenus de cette page ont été générés et/ou édités à l'aide d'une IA générative.

Les médias

Towfiqu barbhuiya – Pexels

Principales sources et références

Barry Popkin, Linda S. Adair, Shu Wen Ng. “Global nutrition transition and the pandemic of obesity in developing countries.” Nutrition Reviews 70(1):3–21, 2012. PubMed ID: 22221213. https://pubmed.ncbi.nlm.nih.gov/22221213/

Fan, Victoria Y. and Le’au, Ruth Faioso. “A Tale of Two Polities: Health in Independent and American Samoa.” Hawaii J Med Public Health 74(5):179–184, 2015. PMC4443619. https://pmc.ncbi.nlm.nih.gov/articles/PMC4443619/

World Obesity Federation Global Obesity Observatory. American Samoa country data, 2022. https://data.worldobesity.org/country/american-samoa-249/

World Obesity Federation Global Obesity Observatory. Samoa country data, 2022. https://data.worldobesity.org/country/samoa-184/

World Obesity Federation. World Obesity Atlas 2024. World Obesity Federation, March 2024. https://www.worldobesity.org/resources/resource-library/world-obesity-atlas-2024

Gosling, Anna L., et al. “Pacific Populations, Metabolic Disease and ‘Just-So Stories’: A Critique of the ‘Thrifty Genotype’ Hypothesis in Oceania.” Annals of Human Genetics 79(6):470–480, 2015. PubMed ID: 26420513. https://pubmed.ncbi.nlm.nih.gov/26420513/

Neel, James V. “Diabetes Mellitus: A ‘Thrifty’ Genotype Rendered Detrimental by ‘Progress’?” American Journal of Human Genetics 14(4):353–362, 1962.

Mintz, Sidney W. Sweetness and Power: The Place of Sugar in Modern History. Viking, 1985.

Sheridan, Richard B. Sugar and Slavery: An Economic History of the British West Indies 1623–1775. Caribbean Universities Press, 1974.

Tzioumis, Emma and Adair, Linda S. “Childhood dual burden of under- and overnutrition in low- and middle-income countries: a critical review.” Food and Nutrition Bulletin 35(2):230–243, 2014. PubMed ID: 25076771. https://pmc.ncbi.nlm.nih.gov/articles/PMC4313560/

Cassels, Susan. “Overweight in the Pacific: links between foreign dependence, global food trade, and obesity in the Federated States of Micronesia.” Globalization and Health 2(10), 2006. PMC1533815. https://pmc.ncbi.nlm.nih.gov/articles/PMC1533815/

McLennan, Amy K. and Ulijaszek, Stanley J. “Obesity emergence in the Pacific islands: why understanding colonial history and social change is important.” Public Health Nutrition 18(8):1499–1505, 2015. PMC10271720. https://pmc.ncbi.nlm.nih.gov/articles/PMC10271720/

Ali, Imran. The Punjab Under Imperialism, 1885–1947. Princeton University Press, 1988.

Nelson, A.R.L. Eliazer, Ravichandran, K., and Antony, U. “The impact of the Green Revolution on indigenous crops of India.” Journal of Ethnic Foods 6:8, 2019. https://link.springer.com/article/10.1186/s42779-019-0011-9

Yajnik, Chittaranjan S., et al. “Neonatal anthropometry: the thin-fat Indian baby. The Pune Maternal Nutrition Study.” International Journal of Obesity 27(2):173–180, 2003. PubMed ID: 12586996. https://pubmed.ncbi.nlm.nih.gov/12586996/

Vaidyanathan, N., et al. “Exploring ways to respond to rising obesity and diabetes in the Caribbean using a system dynamics model.” PLOS Global Public Health 2(5):e0000436, 2022. PubMed ID: 36962372. https://pubmed.ncbi.nlm.nih.gov/36962372/

Monteiro, Carlos A., Moubarac, Jean-Claude, Cannon, Geoffrey, Ng, Shu Wen, and Popkin, Barry. “Ultra-processed products are becoming dominant in the global food system.” Obesity Reviews 14(S2):21–28, 2013. PubMed ID: 24102801. https://pubmed.ncbi.nlm.nih.gov/24102801/

Monteiro, Carlos A. and Cannon, Geoffrey. “The impact of transnational ‘Big Food’ companies on the South: a view from Brazil.” PLOS Medicine 9(7):e1001252, 2012. PMC3389019. https://pmc.ncbi.nlm.nih.gov/articles/PMC3389019/

International Diabetes Federation. IDF Diabetes Atlas, 10th edition. Brussels: IDF, 2021. India country data table (Table 3.4). https://www.ncbi.nlm.nih.gov/books/NBK581940/table/ch3.t4/

WHO STEPS Survey Data. Palau Adult NCD Risk Factor Survey 2011–2013. As reported in: PMC10330999. https://pmc.ncbi.nlm.nih.gov/articles/PMC10330999/

Development Initiatives. 2022 Global Nutrition Report: Stronger Commitments for Greater Action. Development Initiatives, 2022. Palau country nutrition profile: https://globalnutritionreport.org/resources/nutrition-profiles/oceania/micronesia/palau/

Gordon, Graham. “Why colonialism contributed to the breakdown of our food system.” CAFOD, 29 September 2022. https://cafod.org.uk/news/international-news/three-ways-colonialism-contributed-breakdown-food-system