Many Small Island Developing States (SIDS) are experiencing a nutrition transition, wherein high prevalence of malnutrition co-occurs with growing rates of diet-related non-communicable diseases. Sustainably managed and accessible aquatic foods can serve as a rich and bioavailable source of nutrients, helping communities achieve healthy diets and meet key sustainable development goals (e.g., SDG 1 No Poverty, SDG 2 Zero Hunger, and SDG 14 Life Below Water). However, to properly harness aquatic food systems in nutrition interventions, we must first understand aquatic food's role in nutrient intake and adequacy. Here, using a nationally representative survey from Kiribati, we quantify the contribution of aquatic foods to nutrient intake and adequacy, and examine the spatial variability in nutrient intake adequacies. We find aquatic foods are the main contributors of most nutrients we examined, providing > 75% of vitamin B12, retinol, and heme iron, > 50% of niacin and total vitamin A, and > 25% of protein, vitamin E, potassium, and total iron consumed. Consumption of aquatic foods contributes to meeting key nutrient adequacies (e.g., niacin) and provides complete adequacy for vitamin B12 and protein. However, despite high aquatic food consumption, we find high levels of nutrient inadequacies (11 of the 17 nutrients with dietary reference intakes). Overall, our study quantifies the nutritional importance of aquatic foods in an emblematic SIDS, emphasizing their vulnerability to declining aquatic resources. We also highlight the need for cross-scale context-specific targeted nutrition interventions, even when aquatic food consumption is high, to enable SIDS to meet key SDGs.

Ensuring healthy and sustainable food systems in increasing social, economic, and ecological change is a key global priority to protect human and environmental health. Seafood is an essential component of these food systems and a critical source of nutrients, especially in coastal communities. However, despite rapid transformations in aquatic food systems, and our urgent need to understand them, there is a dearth of data connecting harvested food production to actualized food consumption. Many analyses suggest institutional, legal, or technological innovations to improve food systems, but few have analyzed the pathways through which people already gain access to nutritious food. Here, using a random forest model and cluster analysis of a nationally representative data set from Kiribati, we operationalize access theory to trace the flows of consumptive benefit in a fisheries-based food system. We demonstrate that the market access mechanism is the key mechanism mediating seafood access in Kiribati, but importantly, the highest seafood consumption households showed lower market access, pointing to the importance of non-market acquisition (e.g., home production and gifting). We reveal six distinct household strategies that employ different sets of access mechanisms to ensure high levels of local seafood consumption in different contexts. We demonstrate the impacts of these strategies on the composition of household seafoods consumed, stressing the need to support these existing successful strategies. Finally, we point to key policy and management insights (e.g., improved infrastructure, shifts in species management) that may be more effective in reinforcing these existing pathways than commonly proposed food system interventions.

Research on food system framework development has increased substantially in recent years to better understand how we can best transform food systems. However, these frameworks generally take a one-size-fits-all approach, with food system indicators lacking relevance in many countries and territories. This research, centred on the Solomon Islands as a case study, employed a participatory approach involving stakeholders to identify context-specific indicators across three food systems pathways. These pathways, reflecting context-specific goals and a collective vision, encompassed strengthening and connecting rural food systems, enhancing the national policy environment, and advocating for food environments supporting healthy food accessibility, affordability, and convenience. The research identified a range of context-specific indicators and evaluated their alignment with existing data sources. Results underscored the need for data collection and analysis efforts to inform evidence-based decision-making. The study also emphasised the importance of engaging diverse stakeholders to ensure a comprehensive and representative set of indicators, aligning with regional and global efforts to advance food system resilience and sustainability. This research lays the foundation for future endeavours to enhance food system monitoring and assessment, acknowledging nuances and complexities specific to the Solomon Islands and similar contexts.

The Pacific Guidelines for Healthy Living recommend consuming a minimum of five servings of fruit and/or non-starchy vegetables each day, however, diets in Solomon Islands stray from the regional and global trend of healthy diets high in fresh fruit and vegetables. Our study drew on multiple sources of data and a food systems framework to show a country-wide picture of the role and benefits offered by fruit and non-starchy vegetables in Solomon Islands. First, we analysed data on fruit and non-starchy vegetable consumption and matched this to the data on supply. Second, we used a policy documentary analysis to highlight opportunities for the roles of fruit and non-starchy vegetables in the Solomon Island food system to advance progress in multiple Sustainable Development Goals. Key findings related to supply were the findings that domestic production of fruit and non-starchy vegetables is insufficient to meet per capita requirements, which coupled with our finding that per capita national level supply through imports is inconsequential, thus highlighting important undersupply issues for the nation. The food environment analysis indicated multiple further challenges hampering fruit and non-starchy vegetable consumption. Integrated with our analysis of policy, these revealed several opportunities, including improving affordability of this healthy commodity, enhancing livelihood equitability of supply chains, and strengthening environmentally sustainable agricultural practices that support increased production.

The Kiribati 2019 Integrated Household Income and Expenditure Survey (Integrated HIES) embeds novel ecological and human health research into an ongoing social and economic survey infrastructure implemented by the Pacific Community in partnership with national governments. This study seeks to describe the health status of a large, nationally representative sample of a geographically and socially diverse I-Kiribati population through multiple clinical measurements and detailed socio-economic surveys, while also conducting supporting food systems research on ecological, social, and institutional drivers of change. The specific hypotheses within this research relate to access to seafood and the potential nutritional and health benefits of these foods. We conducted this research in 21 of the 23 inhabited islands of Kiribati, excluding the two inhabited islands—Kanton Islands in the Phoenix Islands group with a population of 41 persons (2020 census) and Banaba Island in the Gilbert Islands group with a population of 333 persons (2020 census)—and focusing exclusively on the remaining islands in the Gilbert and Line Islands groups. Within this sample, we focused our intensive human health and ecological research in 10 of the 21 selected islands to examine the relationship between ecological conditions, resource governance, food system dynamics, and dietary patterns. Ultimately, this research has created a baseline for future Integrated HIES assessments to simultaneously monitor change in ecological, social, economic, and human health conditions and how they co-vary over time.

The Pacific food system has become progressively more integrated into global food regimes. This integration has had impacts on availability and consumption of food, population health, and vulnerability to external drivers. We describe major elements of the contemporary food system to provide a foundation for analysis of food system transitions and public health outcomes. Although crop production has doubled in the last fifty years, it has not kept pace with population growth. This deficit is increasingly filled by imported foods, particularly staples, meat and sugar. The burden of malnutrition and poor health outcomes are increasingly apparent. We propose seeds for transitioning the Pacific food system to a hybrid form that supports historical continuity with healthy regionally-produced food.

Extensive literature describes the importance of food environments (FEs) as a driver of food choices and nutrition outcomes; yet existing FE frameworks do not adequately capture the diversity of FEs relevant to the Pacific Region. This limits identification of opportunities in food systems to reduce the multiple burden of malnutrition. We present a conceptual typology of FEs including six primary FEs relevant in the Pacific; wild; cultivated; kin and community; informal retail; formal retail; and food aid and services. We then apply this typology to food acquisition data from Solomon Islands 2012/13 Household Income and Expenditure Survey and analyse the relationship between FEs and diet quality. The cultivated FE accounts for 60% of the quantity of food acquired nationally, followed by wild (15%), kin and community (9%), and formal and informal retail FEs (8% each), with wide variation between urban and rural households, provinces and wealth groups. Reliance on different FEs is a significant predictor of diet quality and affirms the importance of subsistence fisheries and agriculture, and community and kinship networks. Integration of a FE typology such as the one presented here in commonly conducted household expenditure surveys offers significant opportunity to advance our understanding of food system leverage points to improve nutrition and health.

Recognized as an emerging global crisis in the mid-1990s, the "nutrition transition" is marked by a shift to Western diets, dominated by highly processed, sugar-sweetened, and high caloric foods. Occurring in parallel to these health transitions are dramatic shifts in the natural systems that underlie food availability and access. Traditionally, environmental degradation and ecosystem change, and processes of nutritional transition, though often collinear and potentially causally linked, have been addressed in isolation. Food systems represent an emblematic social-ecological system, as both cultivated and wild foods are directly reliant on natural ecosystems and their processes. While healthy ecosystems are a necessary precondition of food production, they are not themselves sufficient to ensure continued benefits from local food systems. Mediating between food production and nutritional security are myriad governance and market institutions that shape differential access to food resources. Moreover, globalization and urbanization may shift communities from non-market to market-based economies, with profound implications for local environments and food systems. Specifically, we argue that it is this feedback between coupled socioeconomic and natural dynamics within food systems that reinforces specific nutritional outcomes, and may result in a social-ecological trap. Here, we use the case of reef-based food systems globally, paying particular attention to the Pacific to showcase social-ecological traps present in global food systems, and to illustrate how such traps lead to the acceleration of the nutrition transition. Improving both nutritional and environmental outcomes of food systems requires understanding the underlying drivers of each, and how they interact and reinforce each other. Only in recognizing these interactions and coupled dynamics will economic, governance, and environmental policies be positioned to address these food system challenges in an integrated fashion.

National rates of aquatic food consumption in Pacific Island Countries and Territories are among the highest in the world, yet the region is suffering from extensive levels of diet-related ill health. The aim of this paper is to examine the variation in consumption patterns and in nutrient composition of aquatic foods in the Pacific, to help improve understanding of their contribution to food and nutrition security. For this examination we analysed nutrient composition data and trade data from two novel region-specific databases, as well as consumption data from national and village level surveys for two Melanesian case studies, Vanuatu and Solomon Islands. Results demonstrated that consumption depends on availability and the amount and type of aquatic food consumed, and its contribution to nutrition security varies within different geographic and socio-demographic contexts. More data is needed on locally relevant species and consumption patterns, to better inform dietary guidelines and improve public health both now and into the future. Advice on aquatic food consumption must consider the nutrient composition and quantity of products consumed, as well as accessibility through local food systems, to ensure they contribute to diverse and healthy diets.

Canned fish is a healthy alternative to the poor-quality, imported, processed foods implicated in the rise of non-communicable diseases in Pacific Island countries. Increased availability and consumption of canned fish also promises to help fill the gap between sustainable coastal fish production and recommended intake of fish for good nutrition. This study estimates the recent contribution of canned products to fish supply in Fiji, Papua New Guinea (PNG) and Solomon Islands, based on the quantities of imported and locally-produced canned fish sold on domestic markets. The greatest quantities of canned fish were sold in PNG, however, average annual consumption of canned fish per capita was highest in Fiji (8.8 +/- 1.3 kg) and Solomon Islands (5.9 +/- 0.6 kg), where it supplied an average of 25 +/- 4% and 17 +/- 2% of recommended dietary fish intake, respectively. Canned tuna comprised an average of 53 +/- 2% of the canned fish consumption in Fiji and 92 +/- 1% in Solomon Islands. Key actions needed to maintain/increase per capita consumption of canned fish in Pacific Island countries include promoting the health benefits of canned tuna to help combat non-communicable diseases, and facilitating distribution of locally-canned products, especially to the inland population of PNG. Increasing the market share of locally-canned tuna by assisting national canneries to obtain sufficient supplies of tuna to achieve economies of scale and compete effectively in both domestic and infra-regional canned fish trade, could create more employment and contribute indirectly to local food security.

It is widely recognised that anchored, nearshore fish aggregating devices (FADs) are one of the few practical 'vehicles' for increasing access to tuna to help feed the rapidly growing rural and urban populations in many Pacific Island countries and territories (PICTs). However, considerable planning, monitoring and research is still needed to understand and fulfil the potential of nearshore FADs. Investments are required to (1) identify the locations where FADs are likely to make the greatest contributions to the food security of rural (coastal) communities, and yield good catches near urban centres; (2) integrate the use of FADs with other livelihood options available to rural communities and remove any blockages preventing such communities from harnessing the full range of benefits from FADs; (3) assess whether exclusion zones for industrial fishing provide adequate access to tuna for small-scale-fishers; (4) determine if small-scale fishers are able to catch sufficient tuna to meet the protein needs of rural communities; (5) evaluate whether FADs add value to coral reef management initiatives; and (6) improve the design and placement of nearshore FADs. This paper describes these investments and outlines other steps that governments and their development partners need to take to establish and maintain nearshore FADs as part of national infrastructure for food security of PICTs.

The large tuna resources of the Western and Central Pacific Ocean are delivering great economic benefits to Pacific Island countries and territories (PICTs) through sale of licences to distant water fishing nations and employment in fish processing. However, tuna needs to contribute to Pacific Island societies in another important way—by increasing local access to the fish required for good nutrition to help combat the world’s highest levels of diabetes and obesity. Analyses reported here demonstrate that coastal fisheries in 16 of the 22 PICTs will not provide the fish recommended for good nutrition of growing Pacific Island populations, and that by 2020 tuna will need to supply 12% of the fish required by PICTs for food security, increasing to 25% by 2035. In relative terms, the percentages of the region’s tuna catch that will be needed in 2020 and 2035 to fill the gap in domestic fish supply are small, i.e., 2.1% and 5.9% of the average present-day industrial catch, respectively. Interventions based on expanding the use of nearshore fish aggregating devices (FADs) to assist small-scale fishers catch tuna, distributing small tuna and bycatch offloaded by industrial fleets at regional ports, and improving access to canned tuna for inland populations, promise to increase access to fish for sustaining the health of the region’s growing populations. The actions, research and policies required to implement these interventions effectively, and the investments needed to maintain the stocks underpinning the considerable socio-economic benefits that flow from tuna, are described.