As Caribbean health experts fine-tune strategies for the imminent assault on chronic diseases, the spotlight has been turned on obesity (extreme overweight), the greatest underlying cause of sickness and death in the Region.

Obesity is recognised as a major contributor to cardiovascular diseases (high blood pressure, coronary heart diseases and stroke), diabetes and some forms of cancer. These diseases account for more than half of the deaths in the Region. The Caribbean Community (CARICOM) Heads of Government will therefore focus largely on obesity at their watershed summit conference on non-communicable chronic diseases (NCDs) in Port of Spain on September 15.

The summit will not only launch the campaign to galvanise the populations of CARICOM states to unite against NCDs but also identify public-policy measures that the Governments of the Region should urgently adopt to stem the rising tide of the epidemic of NCDs.

What is obesity?

According to the Caribbean Food & Nutrition Institute (CFNI), “Obesity is a condition of abnormal or excess fat accumulation to the extent that health may be impaired.”

The World Health Organisation (WHO) has demarcated overweight and its extreme state (obesity), using Body Mass Index (BMI). An individual’s BMI is his/her body weight in kilograms divided by the square of his/her height in metres. If, for example, a person weighs 80 kilograms and is 2 metres tall, his/her BMI would be 80 (the weight) divided by 4, the square of the height. That BMI of 20 would be within the acceptable range of 18-24. The WHO reckons that anyone with a BMI of 25 or more is overweight. At 30 or more, obesity, the very dangerous level of overweight, has set in. Indeed, the CFNI reports that there is evidence that the risk of chronic disease increases progressively from a BMI of 21.

What causes obesity?

The basic cause of obesity or overweight is simply over-consumption of energy in food and drink – that is, consistent eating of foods and drinking of fluids with high energy content and lower expenditure of energy in terms of inadequate physical activity. Fatty and sugary foods, soft drinks and high-energy foods and drinks are implicated. So also are sedentary habits such as excessive viewing of television and playing of video games and being transported in private automobiles instead of walking or cycling for even a part of the journey.

The answer to overweight/obesity is self-evident: consume less, especially of high-energy, fatty and sugary foods and drinks and engage in more physical activity, like walking, swimming, cycling, dancing, outdoor games, gardening or other forms of physical work or recreation.

Health-conscious persons should eat less foods from animals (meat, milk, milk products, and eggs) and the high-energy fatty and sugary snacks and drinks that are heavily advertised on the mass media. They should choose in preference foods from plants, especially whole grains, peas, beans and nuts, ground provisions and other cholesterol-busting high-fibre foods; and fruits and vegetables, which are rich in protective vitamins, minerals and other micronutrients. They should know their height, monitor their weight, and do regular routine checks with health professionals to maintain their biochemical integrity.

Public policy

As for the Governments of the Region, they proclaimed at the end of a CARICOM summit in the Bahamas in 2001 that “the Health of the Region is the Wealth of the Region” and committed their countries to treating health as a vital input into development as well as an output of development. They are mindful of the burden of chronic diseases in terms of human suffering, expensive treatment and loss of production and are ready to put in place measures to modulate the environment and thus facilitate individual and community efforts to bring about a dramatic reduction in the incidence of chronic non-communicable lifestyle diseases.

Measures advocated by the Caribbean Commission on Health and Development (CCHD), established by the Heads of Government themselves, include closer regulation of food imports and licensing laws to ensure that consumers know the contents of the foods they eat and that food security is pursued in the context of incentives for local production of the fruits, vegetables and whole grains required for a healthy diet.

An issue of particular concern is the alarming growth in the incidence of obesity among young children and adolescents, which the CCHD addressed with a recommendation that weight reduction should begin in schools, focusing on nutrition and “the absolute necessity’ to include physical education as a critical aspect of the curriculum, and to recognise it as important as the academic subjects.