The Pacific region is an ideal place for studying human evolution, variation, and adaptation. It has a complex history of both ancient and recent human migrations, variable levels of population interactions and a range of potential source populations. There are an array of different physical environments and associated pathogen loads which may have shaped Pacific genomes. Of particular significance is the distribution of malaria, one of the strongest known selective forces impacting human genomes. Pacific communities have distinct histories and impacts of European contact, including introductions of new infectious diseases and differing levels of population integration. Pacific peoples therefore likely adapted (both genetically and culturally) in unique ways. Despite these differences, some Pacific populations share a propensity for unusually high rates of metabolic disease – including type 2 diabetes (T2D), obesity, gout, heart, and renal disease. We know that there is a genetic predisposition to these diseases in Polynesians, but we do not know how, when or why this evolved or if there is a consistent pattern across the Pacific. We are currently developing a multidisciplinary, international research project to investigate these questions which Professor Matisoo-Smith will present in this talk.