Background: Obesity has been increasing in adolescents in Fiji and obesogenic dietary patterns need to be
assessed to inform health promotion. The objective of this study was to identify the dietary patterns of adolescents
in peri-urban Fiji and determine their relationships with standardized body mass index (BMI-z).
Methods: This study analysed baseline measurements from the Pacific Obesity Prevention In Communities (OPIC)
Project. The sample comprised 6,871 adolescents aged 13–18 years from 18 secondary schools on the main island
of Viti Levu, Fiji. Adolescents completed a questionnaire that included diet-related variables; height and weight
were measured. Descriptive statistics and regression analyses were conducted to examine the associations between
dietary patterns and BMI-z, while controlling for confounders and cluster effect by school.
Results: Of the total sample, 24% of adolescents were overweight or obese, with a higher prevalence among
Indigenous Fijians and females. Almost all adolescents reported frequent consumption of sugar sweetened
beverages (SSB) (90%) and low intake of fruit and vegetables (74%). Over 25% of participants were frequent
consumers of takeaways for dinner, and either high fat/salt snacks, or confectionery after school. Nearly one quarter
reported irregular breakfast (24%) and lunch (24%) consumption on school days, while fewer adolescents (13%) ate
fried foods after school. IndoFijians were more likely than Indigenous Fijians to regularly consume breakfast, but
had a high unhealthy SSB and snack consumption.
Regular breakfast (p<0.05), morning snack (p<0.05) and lunch (p<0.05) consumption were significantly associated
with lower BMI-z. Consumption of high fat/salt snacks, fried foods and confectionery was lower among participants
with higher BMI-z.
Conclusions: This study provides important information about Fijian adolescents’ dietary patterns and associations
with BMI-z. Health promotion should target reducing SSB, increasing fruit and vegetables consumption, and
increasing regularity of meals among adolescents. Future research is needed to investigate moderator(s) of inverse
associations found between BMI-z and consumption of snacks, fried foods and confectionery to assess for potential
reverse causality