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Ten Fattest Countries

How are the top two... islands? I don't know if my reasoning makes any sense but I figure on an island with limited technological convenience the population would be slimmer.

Apparently, they have all of the technological conveniences necessary to promote obesity.

www.ncbi.nlm.nih.gov/pubmed/19588607

"... Before the end of the century, imported white rice had replaced plantation crops as the chief source of carbohydrate. In September 2000 the first fast food franchise opened in American Samoa with enthusiastic fanfare. By 2008 six nationally known fast food restaurants were catering to a population of over 57,794 (July 2006 est.). With more meals eaten at fast-food restaurants, fewer families tending plantations or gardens as their main source of food and regular exercise, and a greater reliance on video games and television to occupy children because of both parents working outside the home..."
 
Kiribati and American Samoa just have big people. As Capsandwich noted, a whole lot of NFL players come out of Samoa. Polynesians also turn out a bunch of Rugby players and Sumo wrestlers too.

Sometimes it's genes. Other times, it's culture. No condemnation on either end. Everyone's got to eat and everyone's got to die. How much they eat compared to how they die all depends on where they're from.
 
Kiribati and American Samoa just have big people. As Capsandwich noted, a whole lot of NFL players come out of Samoa. Polynesians also turn out a bunch of Rugby players and Sumo wrestlers too.

It's possible that Samoa has big people and an obesity epidemic. Here is one snippet that I came across:

http://www.rnzi.com/pages/news.php?op=read&id=37550

Now, I am somewhat suspicious about conclusions drawn from "leading causes of death," and I'd want to see more data than just one quote from one doctor.

At the same time, I wonder if it's the same in the US, that a whole lot of NFL players come out of communities that also have higher rates of obesity and obesity related disease.