Too many fat children

In an interview with Sunday Newsday at its Chacon Street, Port-of-Spain office, she discussed the child obesity epidemic and provided some statistics both at the world and country level.

According to the World Health Organisation (WHO), in 2014 an estimated 41 million children under five years of age were affected by overweight or obesity worldwide.

A 2003 study that included Body Mass Index (BMI) tracking of children at seven to eight years and then at 11 to 12 years in Jamaica, revealed obesity rates for study participants increasing from 3.5 percent to 9.5 percent after follow-up (Gaskin and Walker 2003). In Trinidad and Tobago, separate studies conducted in 2001, and in 2010 also showed a disturbing increase in prevalence from five percent in 2001 to 26 percent in 2010 (Batson et al.

2013).

In Trinidad and Tobago, obese and overweight students at schools have doubled in the last decade.

According to research done in 2009/2011, 23 percent of primary school children were overweight and 25 percent of students at secondary school were overweight.

Health Minister Terrence Deyalsingh has expressed concern about the levels of obesity and diabetes among the nation’s children and announced that a national policy on non-communicable diseases (NCDs) would be launched.

John, a registered dietician who joined TTANDi this year, reported that the organisation has been in existence for 33 years but has not done enough to promote its visibility.

She reported that the organisation is working on re-branding to accomplish its mission to promote professional excellence among members, and increase public awareness of the role of nutrition in good health. “We are trying to be more effective to be more visible to the population.” THE WHY John noted that childhood obesity is a concern for TTANDi, which has partnered with other organisations and the Ministry of Health to contribute ideas to combat the “epidemic” of childhood obesity. She said there are NCDs among children and there are even children with hypertension, which she describes as “incredible”.

She suggested that for a good picture of the state of the children would be to look at adults.

“One quarter of the children are either overweight or obese. If you are overweight as a child you will be overweight as an adult,” she explained.

Asked about the factors causing the high levels of child obesity locally, John explained that for adults there is occupational transition with a moving away from manual labour to more sedentary office jobs and more technology.

There has also been a nutrition transition where dietary habits have shifted from things like peas, beans, vegetables and fruits to more fast food-oriented convenience food. She said before these things were just an occasional treat, and explained the reliance on fast food was partly because people do not have the time to prepare healthy meals.

She stressed, though, that nutrition was not the only factor causing the obesity epidemic and advised that we have to look at environmental factors, including food marketing, pricing in supermarkets and availability. She pointed out, for example, that it is cheaper to get imported fruits so people will buy apples over local fruits like chennet and sapodilla.

THE RESPONSE On what can be done to address the issue, John advised that at the State level there needs to be a focus on labelling of products. She explained that in some countries certain companies had to change their product labelling to comply with the importing country’s standards, and Trinidad and Tobago should not have to wait for someone from outside to instruct us before we put similar standards in place.

Referring to a recent controversy over the labelling of a “coconut water” drink, John said there needs to be a watchdog group for these products, and consumers with limited nutrition information would see products marketed as healthy because “you would assume they (producers) have your best interest at heart when is only dollars and cents”.

She stressed that different ingredients may be potentially harmful and these could affect the metabolism of children causing things like growth spurts. She pointed out that obesity itself is a dysfunction, highlighting that some fast foods are marketed towards children with toys or discounts.

“Fast food restaurants need to take responsibility for the way they market to children,” she said.

“Fast food chains have to do their part to combat childhood obesity.” John believes the infrastructure of some communities is another factor that should be addressed, as there are some without recreation facilities, open air spaces to exercise or even sidewalks. She suggested the Health Ministry should work with the Ministry of Works and Transport and Local Government bodies to put things in place or utilise what they already have like churches, temples, mosques and schools.

She said the issue of the unavailability of sufficient dieticians and nutritionists at health centres was another contributing factor to the obesity problem. Two dieticians to 12 health centres when there is a NCD epidemic is just “not enough”.

But children depend on adults to take care of them, and John said targeting adults so they will be nutritionally aware and ensuring their children have: adequate sleep, limited screen time, and increased physical activity is one of TTANDi’s strategy.

She stressed children should not become tied to video games and television.

Additionally, she said, parents of children in childcare centres should ensure they are being given healthy meals both at home and at the centres. Too much juice and sweetened drinks, she insisted, is not healthy because they contain too many calories. She suggested giving children water at meal times.

When it comes to battling childhood obesity, she said a multifaceted approach that includes parents, schools and government needs to be adopted.

“If (obesity) has reached the children we are at an alarming state,” she stressed.

For more information you can contact the TTANDi secretary at 468-8465, PRO 462-6583 or email ttandi@gmail.com.