How paradise became the fattest place in the world

Vital Signs is a monthly program bringing viewers health stories from around the world

(CNN)They're remote and beautiful. A place many long to escape to for sun, sea and serenity. But the Pacific islands have another reality for the residents living there -- a life based on imported food, little exercise and remote access to healthcare.

The result? The most obese nations in the world.

'A deadly epidemic'

"One third of the world is either overweight or obese right now," says Emmanuela Gakidou, professor of Global Health at the Institute for Health Metrics and Evaluation. Gakidou's recent paper used data from countries across the world to identify the global burden of obesity and trends seen in different populations. "The Pacific islands have a lot of countries with very high levels of obesity," she adds.
    Among the top 10 most obese countries or territories globally, nine are Pacific islands, according to the World Health Organization (WHO), making this paradise the fattest region of the world.
    "Up to 95% of the adult population are overweight or obese in some countries," says Temo Waqanivalu, program officer with the WHO's Prevention of Non-communicable Diseases department. As a Fijian Native, Waqanivalu has worked on the issue for over a decade and seen the epidemic evolve first-hand, aided by the cultural acceptance of bigger bodies as beautiful. "In Polynesia the perception of 'big is beautiful' does exist," he says. "[But] big is beautiful, fat is not. That needs to get through."
    Percentages for obesity range from 35% to 50% throughout the islands, according to the WHO. The Cook Islands top the ranks with just over 50% of its population classified as obese.
    "It's a deadly epidemic," says Waqanivalu.

    Measuring up

    Obesity is measured through an individual's body mass index (BMI) and a measurement above 30kg/m² is defined as clinically obese.
    Pacific islanders tend to have a naturally big build, says Jonathan Shaw, associate director of Baker IDI Heart and Diabetes Institute, Australia. "With Pacific islanders, their frame is typically bigger," he explains, "but that still doesn't account for the obesity we see."
    Poor diets and reduced exercise have become a major public health concern for the region as they are not only a cause of obesity -- associated diseases are also rife, such as heart disease, stroke and diabetes, the latter of which has a known genetic basis among locals.