Cultural Food Preferences and Non-Communicable Diseases: a case study of cultural values assigned to food in Kiribati

The global burden of non-communicable diseases (NCDs) is increasing. This has significant implications for Pacific Island Countries and Territories (PICTs) including Kiribati, whose struggles with food security have led to an increased burden of chronic, metabolic, and lifestyle-related NCDs, particularly diabetes and cardiovascular diseases. While past studies have explored consumption patterns, no studies have examined actual cultural food preferences in Kiribati. Through freelist data collected from 399 fixed-question household surveys, this study aims to explore this gap in cultural food narratives and see if there is an association with NCD prevalence. The study used Smith’s S salience analysis to assess significance, finding food items such as fish, rice, breadfruit, chicken, and coconut as culturally important in Kiribati. Participants were also categorised into sociodemographic regions, finding nuanced differences between urban and rural communities. The analysis revealed focus foods for tailored interventions that align with cultural narratives and ‘healthy’ foods ensuring effective food security interventions that address the escalating prevalence of NCDs. Limitations were identified, such as the temporal aspect of the data collected just before the COVID-19 pandemic, potential social desirability bias, unequal sample sizes between sociodemographic regions, and disparities between reported food consumption and actual consumption patterns. The study also suggests future implications, including a comprehensive dietary investigation of Kiribati, particularly in examining food additives like sugar and salt, and the applicability of similar methodologies in exploring cultural food narratives in other PICTs.