Taro, breadfruit, reef fish, coconut: for centuries this was the diet of American Samoa, one of 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 epidemic of obesity, Type 2 diabetes or hypertensive cardiovascular disease.
Today, about 77 percent of American Samoan adults are classified as obese, the highest rate on earth. On an ordinary morning a household might open a can of Spam, fry it alongside white rice, and serve sweet rolls from a packet with instant noodles on the side. Unlike the Spam that occasionally turns up as retro camp in Western food culture, this can is unremarkable: it has been a staple for decades, since before today’s parents were children.
All ten of the most obese countries and territories on earth are Pacific islands. The usual explanation is globalization: fast food and processed calories reaching island populations too small and too economically marginal to resist them. It is not entirely wrong. Corporations did enter Pacific markets, and ultra-processed food is 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, and France for longer, yet neither country appears in the top ten. What the Pacific islands carry in addition is a structural vulnerability that preceded any corporate arrival by several decades.
The conventional epidemiological account of 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, urbanization accelerated, and cheap oils and sweeteners began displacing traditional fats and starches around the world. The account is accurate about what happened from that point. What it gets wrong is the condition of the populations before those forces arrived, a starting point it treats as intact.
In the Pacific, that starting point has a history that can be traced with unusual precision and is rarely examined. The standard narrative has no adequate answer to why these islands are affected more severely than almost anywhere else on earth.
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 and in a specific direction, and that window opened before 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. His original model traces dietary patterns across the whole of human history, but the recent shift toward diets high in refined carbohydrates, added sweeteners and ultra-processed foods in low- and middle-income countries is the part that policy work draws on, and that story begins in the 1970s, tied to economic development, urbanization and the aggressive marketing of transnational food corporations. It is a well-evidenced account of how diets deteriorate. What it leaves unexamined about the starting conditions, though, is not true for most formerly colonized nations: the policy narrative built on it takes for granted that the food cultures being displaced were intact before the corporations arrived.
They were not, and the sharpest evidence for this is also the most precise natural comparison anywhere in the epidemiology of obesity: American Samoa and the independent nation of Samoa.
The two share the same ancestry, the same traditional Polynesian food culture and the same ethnic and linguistic heritage, and both have comparable access to global processed-food markets, from supermarkets and fast food chains to canned and packaged goods. They lie about 80 miles apart in the South Pacific.
American Samoa has been a US territory since 1900; independent Samoa gained independence in 1962. By every available metabolic measure, American Samoa is dramatically worse off.
Its adult obesity rate, estimated at about 77 percent, is the highest on earth. Independent Samoa, at about 66 percent, ranks eighth in the world, itself among the highest national rates anywhere but more than ten percentage points lower. Fan and Le’au, setting the two polities side by side, found about 94 percent of American Samoan adults overweight or obese in 2007, compared with 85 percent in independent Samoa in 2002, and argued that the islands’ divergent political histories were likely a major factor in their different health trajectories. Colonial powers pressed Westernized institutions on both, but American Samoa, more urbanized and more tightly bound to the United States, went further and faster in adopting Westernized diets and lifestyles. The comparison is not a controlled experiment: the survey years differ, both populations are severely affected, and many variables differ beyond food policy. Still, a gap of this size between two halves of one archipelago, with a shared ancestry and a shared food culture, does not emerge by accident.
The standard narrative also fails to explain the specific disease cluster in formerly colonized Pacific populations: obesity together with Type 2 diabetes, hypertension and metabolic syndrome. These are the diseases that result specifically from rapid, structurally forced dietary shift, the replacement of a nutritionally varied diet with a refined-calorie, low-fiber one at speed. In the Pacific, that shift was accelerated by a specific historical event and locked in by specific policy arrangements. Neither features in the standard account, because both precede the decade its clock starts.
The thrifty gene
For decades, the dominant biological explanation for high 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. James V. Neel first proposed the theory, in general terms, in 1962, and it was soon applied to Pacific Islanders more readily than to almost any other population. 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 examined the Pacific evidence in 2015 and found that the hypothesis had never been explicitly tested, and that most of the archaeological and anthropological data from the region do not support it. The timing argues against it too: US Navy health surveys in Micronesia in the late 1940s found almost no obesity, hypertension or diabetes, yet within a few decades the region led the world, far faster than genes can change.
Gosling's research group has since argued that, where Pacific populations do carry metabolic risk variants, selection for resistance to infectious disease is a more plausible driver than famine. That mechanism 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.What colonialism did to the land
Long before the corporations, the marketing campaigns and the trade liberalization agreements of the 1980s and 1990s, and before any of the modern mechanisms the standard narrative names, colonial administration had already changed the land itself.
Colonial agricultural policy reshaped food environments through several mechanisms operating at once, each compounding the others, and their effects outlasted the colonial period by generations.
The most visible was land conversion, as export monocrops displaced subsistence food production: sugar in the Caribbean, groundnuts in West Africa, cotton across much of South Asia and the Levant, indigo and then jute in Bengal. In the Caribbean the conversion was fast. 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 largely 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. None of it was written down: which crops grew where, which wild plants were edible, which cultivation practices maintained soil productivity through polyculture rotation. It was passed on through practice, and it could not survive intact on land converted to monoculture. In the Caribbean, where the conversion was most absolute, Taino and Kalinago agricultural knowledge survived only in fragments. Enslaved Africans learned to grow and process bitter manioc from the islands’ Indigenous peoples, and cassava flour became a ration staple. Some of the wider system survived too: the provision grounds enslaved workers farmed on the margins of the plantations became sites of real crop diversity, the ancestors of today’s “creole gardens”, and Indigenous techniques such as seine fishing are still practiced around the Caribbean. But the hunting and fishing that had anchored Taino and Kalinago subsistence could not be fitted into a slave-plantation economy, and enslaved communities lived with a chronic shortage of protein. Forced relocation, imposed land-tenure regimes, and the structural impossibility of maintaining mixed food production alongside export agriculture stripped much of 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: on finite land, export agriculture competed with food production, and the export crop did not feed local people. Colonial rule across Africa, the Caribbean and Asia pushed farmers into a handful of export crops, and the result, as the Catholic development agency CAFOD notes, was serious food shortages. The pattern outlived the empires: in Ghana, Kenya and Senegal, export crops are still grown on more than half of all arable land.
The Caribbean sugar plantation shows this displacement in its most brutal form. By the mid-eighteenth century, Barbados, Jamaica and Saint-Domingue were among the most intensively planted sugar colonies on earth, and Barbados, where nearly every acre went to cane, could not feed itself at all. The enslaved African labor force lived on salt fish from the North Atlantic cod fisheries, often grades rejected for sale in Europe, along with salt beef, rations of corn or manioc flour, and whatever they could grow on provision grounds on marginal land during their few free hours. The diet the plantation imposed on the enslaved was built to maintain labor capacity at minimum cost rather than to support their nutritional health.
Later generations inherited a caloric delivery system engineered for one purpose and passed down as if it had always been there. What it left behind was dietary impoverishment rather than simple caloric poverty: 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 starvation. The plantation diet produced caloric sufficiency and nutritional devastation at the same time, 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.
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. The dual burden turns up at every level throughout low- and middle-income countries, most of them former colonies: across communities, within households, and even within a single child who is both stunted and overweight.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. These foods were delivered, 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 such as salt fish from the North Atlantic and salt beef, and starchy carbohydrates in the form of corn and manioc flour. These foods became the dietary baseline for several generations, because there was no alternative baseline available on a plantation that had destroyed the prior food system and replaced it with monoculture.
These foods outlasted emancipation and independence, and not for lack of known alternatives. The taste for salt fish, for white-flour preparation and for sweetness had been installed across generations in everyday ideas of cooking and of what a meal looks like, deeper than any change of government could reach. Sidney Mintz showed how the plantation system turned sugar from a luxury into a cheap everyday calorie for the working poor of the Atlantic world. On the plantations themselves the logic was the same: the cheapest calories were the ones handed out, and children grew up with them as the given.
The contemporary Caribbean diet, high in sugar and refined starches, low in fiber, and associated with high 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. In Jamaica, 12 percent of adults had diabetes in 2018, and researchers modeling the island’s future project that share reaching about 21 percent by 2050 without substantial intervention.
The direct epidemiological chain from Caribbean plantation diet history to contemporary disease burden remains incompletely documented. Mintz establishes how plantation sugar became a mass calorie, but no single prospective study has fully established the forward causal connection to contemporary nutritional epidemiology.
In the Pacific, the mechanism was the military. During and after World War II, the US military poured men, money and shelf-stable food into these islands at a scale and speed that had no precedent in their histories.
American Samoa never saw a land battle: a single Japanese submarine shelling in January 1942 was its only brush with enemy fire. But Tutuila took in a Marine brigade of 5,600 men and became the largest jungle training center in the South Pacific. On Guam, in Palau and across Micronesia, the war itself wrecked coastlines, gardens and fishing grounds and displaced whole communities. Spam, corned beef, canned fish, sugar and white rice, the standard shelf-stable foods of a Pacific war, flowed in, and military surplus found its way onto island tables. When the war ended, the traditional food systems did not fully recover, and the canned food did not leave.
In Kosrae, one of the Federated States of Micronesia, 88 percent of adults aged 20 or older were overweight by 2000 and 59 percent were obese, in a region where US Navy health surveys in the late 1940s had found almost no obesity at all. US subsidies to Micronesia, then a UN Trust Territory under American administration, grew more than twentyfold between 1962 and 1978, creating a cash economy in which imported processed food was affordable and accessible. Fishing technique, taro cultivation, fermentation and preservation, the traditional means of producing food, atrophied from disuse. A USDA feeding program launched in the 1960s served school lunches made up mostly of rice and tinned food. By 1986, food and beverages made up 40 percent of the value of all imports to Micronesia. In Guam, which eats more Spam per person than anywhere else in the world, Spam became, and remains, a culinary staple, present as a default rather than a novelty.
The cash economy the subsidies created did not supplement traditional food production. In the short term it removed the need for it, and in the medium term it made it structurally impossible. The skills required to work a reef fishery, to ferment taro for preservation, or to judge which crops would yield well in which soils are learned by doing. Once the import economy made traditional food production economically unnecessary, fewer people kept those skills up, the knowledge decayed, and communities that might have needed it in any disruption were left dependent on the import system that had replaced it.
Underneath the wartime mechanism ran a third channel of dietary suppression across the Pacific colonial period. Colonial administrators and missionaries actively discouraged traditional food practices as part of broader civilizing projects, framed as hygiene, as progress, as the behavior of people who had left primitivism behind. On Nauru, a missionary’s wife proudly recorded her success in teaching islanders to fry fish rather than eat it raw. Changes like this led over time to lost skills and a growing dependence on imported foods. Across the region, preservation skills such as drying and fermenting breadfruit and pandanus, once a vital insurance against drought and storms, were lost along with the habits that sustained them.
Palau shows the accumulated metabolic consequence. In a survey from 2011 to 2013, 40 percent of Palauan men and 45 percent of women aged 25 to 64 were obese, and 68 percent of men and 85 percent of women had abdominal obesity. Palau’s traditional diet had supported a stable population for millennia.
Two Samoas
American Samoa has been under US rule since 1900; independent Samoa has followed its own path since 1962. The two share an archipelago and an ancestral food culture, and Fan and Le'au argued that their different political arrangements were likely a major factor in the gap between their obesity rates, with American Samoa more urbanized and more Westernized under US rule.
That is meaningful evidence, though not proof in the experimental sense: both populations are severely affected, and variables beyond food policy differ.When the empire built your food system
The Caribbean and Pacific cases share a mechanism: colonial administrations and military 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, and it shows that colonial food-system disruption did not require direct food provision: there the administration built the infrastructure that determined what grew, and left the rest to economics.
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 crops were the nutritional foundation of a civilization, adapted to local soil, climate and human metabolism over millennia, and together they provided the micronutrient range that refined-grain monocultures cannot match.
From the 1880s to 1940, the British colonial administration built a chain of great canal colonies in western Punjab, in what is now Pakistan. The project was vast: rivers redirected, arid land broken for cultivation, entire communities relocated into new agricultural settlements. The colonial state, Imran Ali argues, subordinated development to its political and military imperatives, rewarding loyal collaborators with land and securing the army’s recruiting grounds, while the new wheatlands fed imperial revenue and the grain trade. In his account, feeding the people of the subcontinent was never the organizing goal.
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, with barely 1.5 percent of India’s land area, became the country’s breadbasket, eventually growing more than a fifth of its wheat. India achieved food self-sufficiency, but the definition of food had narrowed to wheat and rice.
The monoculture logic had a cost. Wheat and rice output doubled while millets and traditional rice varieties were pushed out of cultivation, some of them to extinction, and the per capita availability of millets fell. Within a few decades, a diverse grain ecology built over millennia had given way to 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 of wheat, scale and volume over diversity, 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. Keeping them distinct matters, because collapsing them into a single causal claim would let the colonial administration off the hook for the foundation it laid.
The health consequence sits at the intersection of that dietary shift and a metabolic characteristic that is clinically well-established. C.S. Yajnik 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 can persist into adulthood. The higher susceptibility of South Asian populations to Type 2 diabetes, at BMI levels lower than those at which Europeans develop the disease, is well documented, and Yajnik’s work ties it partly to the mother’s nutrition before and during pregnancy shaping babies in the womb, not to genes alone. What colonialism and the Green Revolution together installed was a dietary environment mismatched to that susceptibility: high in refined carbohydrates, low in micronutrient diversity, and built on a monocrop wheat infrastructure that an empire constructed for its own purposes.
India now bears one of the world’s heaviest burdens of diabetes: by International Diabetes Federation estimates, about 90 million adults in 2024, second only to China, a number projected to reach about 157 million by 2050.
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 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 grain agriculture had been tilted toward wheat by colonial canal infrastructure and Green Revolution reinforcement.
The markets they found were 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, positioned their products as modern and aspirational in societies that had been explicitly taught to associate indigenous foods with backwardness, and exploited distribution infrastructure that colonial and post-colonial administrations had built.
Barry Popkin and colleagues documented the resulting shift toward ultra-processed, energy-dense, nutrient-poor foods in low-income countries. Monteiro and colleagues 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. In formerly colonized nations, the nutrition transition began from a food culture that colonialism had already disrupted.
The colonial history does not exculpate the corporations, which understood the markets they were entering. Monteiro and Cannon, writing about transnational food companies in Brazil, described the tactics: “popularly positioned” products aimed squarely at low-income consumers, door-to-door sales networks in the urban periphery, branded ice creams displacing the fruit lollies of local vendors, and product reformulation that, in their view, may head off legislation limiting marketing to children.
Nestlé, Coca-Cola and PepsiCo accelerated what would have happened more slowly without them, and they bear real accountability for that acceleration. But speeding up the epidemic is not the same as causing it. The structural vulnerability preexisted their arrival, and attributing the epidemic primarily to corporate behavior, as the dominant public narrative does, leaves out the colonial history that came before.
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 just when transnational food corporations were most aggressively seeking new territory. None of this required a conspiracy; the pressures were built into the arrangement.
By 2035, the World Obesity Federation forecasts, 79 percent of the world’s adults living with overweight or obesity will be in low- and middle-income countries, and so will 88 percent of such children. Those countries already account for 78 percent of global deaths attributed to high BMI. Market access, corporate marketing and the dietary choices of these populations do not explain that distribution on their own. It is what results when populations enter the global processed-food era from a starting point that a century of colonial agricultural policy created.
By 2004, three in four adults in American Samoa were obese and nearly half had raised fasting blood sugar. A territory of about 50,000 people, under US administration since 1900, it has 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 post-war economy kept it cheap, the administration built no alternative infrastructure, and the corporations found the rest.
Hormel’s marketing department did not put the can of Spam in the American Samoan pantry, or not primarily. The US military did, as part of the wartime provisioning of America’s Pacific bases and garrisons, and it remained because the post-war administrative and economic structures that followed kept it cheap, available and culturally embedded. By the time Hormel was promoting Spam breakfasts through fast-food chains in Guam, Saipan and Hawaii, Spam was already what breakfast looked like.
The two accountability claims are not in competition. Naming the colonial foundation makes the corporate complicity sharper: 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.
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 systematically removes from the story the century that preceded the moment it starts, and treats what colonial administration constructed as if it were the weather, something no one is answerable for.
The populations now living with the metabolic consequences inherited those conditions from administrations that built them through policies serving their own economic interests.
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