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DiBello JR et al. – The neo–traditional dietary pattern, similar across both polities, was characterized by high intake of local foods, including crab/lobster, coconut products, and taro, and low intake of processed foods, including potato chips and soda. The modern pattern, also similar across both polities, was characterized by high intake of processed foods such as rice, potato chips, cake, and pancakes and low intake of local foods. The neo–traditional dietary pattern was associated with significantly higher serum HDL–cholesterol in American Samoa and a decrease in abdominal circumference in American Samoa and Samoa. An inverse association was found with metabolic syndrome, although it did not reach significance. The modern pattern was significantly positively associated with metabolic syndrome in Samoa and with increased serum triglyceride levels in both polities. Reduced intake of processed foods high in refined grains and adherence to a neo–traditional eating pattern characterized by plant–based fiber, seafood, and coconut products may help to prevent growth in the prevalence of metabolic syndrome in the Samoan islands.

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