Children ages two to eight years across 11 Pacific jurisdictions (Alaska, American Samoa, Commonwealth of the Northern Mariana Islands, Federated States of Micronesia, Guam, Hawai'i, Marshall Islands, and Palau) are not meeting daily recommended intakes for key micronutrients, either consuming too much or too little. That discovery was published recently in a study led by scientists at the University of Hawai'i (UH) at Mānoa. The research team also found associations between children's micronutrient intake, obesity, and presence of acanthosis nigricans, a skin condition that is linked to insulin resistance.
"Nutritional intake during childhood can shape health and well-being throughout life," said Lucia Seale, associate professor at the Pacific Biosciences Research Center in the UH Mānoa School of Ocean and Earth Science and Technology and co-lead author of the study along with Ashley Yamanaka, assistant director and assistant researcher at the Children's Healthy Living Center of Excellence (CHL Center) based in the UH Mānoa College of Tropical Agriculture and Human Resources (CTAHR). "Although excess intake of macronutrients, such as carbohydrates and fats, is considered the main driver of obesity development, micronutrients, such as minerals and vitamins, can positively or negatively affect the processes that lead to obesity. So, understanding the micronutrient intake relationship to childhood obesity can guide precision interventions to address nutritional needs throughout the United States–Affiliated Pacific (USAP) region."
Digging into the data
Micronutrient intake of adults living in the USAP region, has been investigated in previous studies. However, the association between micronutrient intake with nutritional status markers, such as obesity, among USAP children had not previously been evaluated, despite the crucial role of vitamins and minerals in health and the potential risks of both deficiency and excess.
Seale, Yamanaka, and co-authors from the UH Manoa Cancer Center , and John A. Burns School of Medicine ; University of Alaska Fairbanks; Northern Marianas College; University of Guam; and American Samoa Community College analyzed food intake data collected by the CHL Center, a long-standing collaborative initiative dedicated to research, training, and dissemination of critical nutrition and health information across the Pacific. The CHL Center, which has operated for over a decade, is funded by the U.S. Department of Agriculture and the National Institutes of Health and led by study co-author Rachel Novotny, professor in CTAHR and Director of the CHL Center.
The research team focused their analyses on data about how much vitamins and minerals children consumed and markers of nutritional status and health. Their investigation revealed low intake of calcium, potassium, vitamin D, and vitamin E; while sodium, folate (vitamin B9), vitamin A, and niacin (vitamin B3) were consumed in excess. They also found associations between children's micronutrient intake, obesity, and presence of acanthosis nigricans, which is a hallmark of type 2 diabetes development.
"Our analysis revealed that Pacific children with obesity had higher intake of thiamin (vitamin B1) and lower intake of selenium compared to children without obesity, however, their selenium intake was high compared to daily intake recommendations from the dietary reference intakes for the US," Seale shared. "Additionally, Pacific children with acanthosis nigricans had lower intake of calcium, copper, iron, phosphorus, potassium, riboflavin, vitamin B6, vitamin D, and vitamin E, while consuming higher amounts of selenium and pantothenic acid (vitamin B5) compared to children without the skin condition."
Seale expected selenium intake to be high in Hawai'i, due to the high consumption of seafood and derived products, and the selenium in the soil where vegetables grow in the islands. But this study provides confirmation. The analysis showed that 13% of the children living in high income areas of the Pacific, which includes Hawai'i, consumed excessive amounts of selenium, which could be harmful. Worse, 95% of the children in the high income areas of the Pacific consumed excessive amounts of sodium and 97% consumed lower amounts of vitamin D than is needed for their health.
Guiding future recommendations
By analyzing nutrient intake data along with jurisdiction World Bank income levels, the researchers also examined micronutrient intake across the different Pacific jurisdictions based on their economies.
"This breakdown provides a foundation for more tailored micronutrient recommendations, which can serve as a starting point for future program and policy discussions such as those related to school meal programs and trade priorities," Seale said.
Their findings also highlight specific concerns that require targeted intervention. For example, excessive sodium intake is a widespread issue across the region, posing risks to cardiovascular health. While previous studies have primarily focused on adults, the new research underscores the need to include children in sodium reduction efforts through education and policy initiatives. These insights can help shape strategies to improve childhood nutrition and long-term health outcomes in Pacific communities.
"To advance nutritional programs, policies, and improve children's health in Hawai'i and the USAP, we need data-driven strategies that are socio-economically and culturally relevant," said Seale. "This study plays a crucial role in generating scientific evidence necessary to inform these targeted approaches. It represents an essential first step in shaping policies and interventions that reflect the unique needs of our communities, reinforcing UH's commitment to serving the people of Hawaii and the USAP through research that drives meaningful change."
