Outcome results for the Ma'alahi Youth Project, a Tongan community-based obesity prevention programme for adolescents

K. F. Fotu*, L. Millar, H. Mavoa, P. Kremer, M. Moodie, W. Snowdon, J. Utter, P. Vivili, J. T. Schultz, M. Malakellis, M. P. McCabe, G. Roberts, B. A. Swinburn

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

51 Citations (Scopus)


Tonga has a very high prevalence of obesity with steep increases during youth, making adolescence a critical time for obesity prevention. The Ma'alahi Youth Project, the Tongan arm of the Pacific Obesity Prevention in Communities project, was a 3-year, quasi-experimental study of community-based interventions among adolescents in three districts on Tonga's main island (Tongatapu) compared to the island of Vava'u. Interventions focused mainly on capacity building, social marketing, education and activities promoting physical activity and local fruit and vegetables. The evaluation used a longitudinal design (mean follow-up duration 2.4 years). Both intervention and comparison groups showed similar large increases in overweight and obesity prevalence (10.1% points, n=815; 12.6% points, n=897 respectively). Apart from a small relative decrease in percentage body fat in the intervention group (-1.5%, P<0.0001), there were no differences in outcomes for any anthropometric variables between groups and behavioural changes did not follow a clear positive pattern. In conclusion, the Ma'alahi Youth Project had no impact on the large increase in prevalence of overweight and obesity among Tongan adolescents. Community-based interventions in such populations with high obesity prevalence may require more intensive or longer interventions, as well as specific strategies targeting the substantial socio-cultural barriers to achieving a healthy weight.

Original languageEnglish
Pages (from-to)41-50
Number of pages10
JournalObesity Reviews
Issue numbers2
Publication statusPublished - Nov 2011
Externally publishedYes


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