Hello all and welcome back to our gardening and health blog series. We’ve had a fantastic year exploring the great outdoors and the health benefits of gardening. This blog post is the second of our two-part blog on fruit trees. Our final blog in this series, coming up next month (hopefully!), will focus on herbs.

Last time, we discussed our mango and sour orange trees and today we’re going to  discuss  two more trees that we have growing in our (Abi Begho’s) garden in St Kitts – soursop and guava. These are trees that we inherited from the previous owner of our house and we were so pleased to have these growing nicely on our property. They have given us much joy allowing us an easy and fun way to introduce a few more fruits into our diet.

Soursop

Some background

Soursop is a fruit known by a few names – custard apple, guanabana and Brazilian paw paw. It is a green, prickly fruit with a white flesh that forms on the graviola tree. It can be used to make a juice, ice-cream, sorbet, syrups and sweets.

It contains vitamin C, dietary fibre, iron, vitamin B, B2, magnesium and potassium.

Soursop has received a lot of attention over the past few years due to its anti-cancer properties in laboratory settings. Studies have shown that either soursop extract or pulp can inhibit the growth or cause the death of some cancer cell lines. Whilst this is promising a lot more work is needed to determine if the extract can be used as a cancer treatment. Studies haven’t been conducted in humans and a recent review explained that “further studies are required to verify the exact properties and mechanisms of action” (i.e. we need to completely understand how the extract affects cancer cells). Therefore, patients should not use soursop capsules, at this time, as a treatment for cancer, as these have not been validated through research.

In addition, studies have found that soursop has a number of health benefits: anti-convulsant, anti-parasitic, anti-arthritic, anti-malarial, anti-diabetic and hepatoprotective (protects the liver). Historically the leaves, pulp and juice have been used in the Caribbean, South America and Africa  for a number of ailments.

Our Soursop Experience

Soursop is a fruit that really grew on us; the more we ate it, the more we liked it.

We eat the white flesh, but we mostly make a lovely juice with it and tend to keep our juice recipe very simple. You can find lots of recipes online, so we won’t go into detail, but our juice just contains soursop, water and a bit of nutmeg, this is how we make it most of the time. For a more creamy, sweet and indulgent version we add some condensed milk and serve it with ice.

In terms of caring for the tree, it’s pretty low maintenance, our tree produces a lot of soursop and after a certain point the fruits start to ripen really quickly so if we don’t pay attention and check on the tree regularly the soursops spoil (I threw away 4 today ☹), and sometimes birds and bugs get to them before we get a chance to pick them. So you definitely have to keep an eye on them.

Guava

Guava is a lovely, fragrant fruit that is found in the tropical regions of the Americas and in the Caribbean. There are many variations including the Redland, Supreme and Red Indian. We haven’t yet been able to identify what variation our guava tree is, but ours has a strong sweet fragrance, white flesh and many small seeds.

Guavas can be eaten in a variety of ways. It can be eaten as is (skin and all), cooked to form stewed guavas and it can be used to make jam, pies, cakes, ice-cream and more.

We haven’t been very creative yet with our guavas and simply just pick them from the tree and eat them as they are. We mostly slice them up and have them with breakfast. Once we get a large number of guavas, we keep losing most of them to the birds, we are going to experiment and try making guava tart (BVI style), guava jam and guava juice.

Guava is high in vitamin C and contains potassium, vitamin B-6, vitamin A and dietary fibre, making it a healthy, tasty addition to our diet.

Conclusion

Having lived in London for over 10 years and not being able to appreciate the joy of having a garden,  being in the Caribbean and being able to explore the great outdoors has been such a pleasant change for us. Being able to spend more time outdoors and have access to fresh untainted fruits has been a blessing enabling us to change our lifestyle and have a more plant-based diet.  We love it!

Previous Blogs

If you missed the previous blogs in this series you can read through them here:

1. Improving Our Health and Wellbeing Through Gardening: An Introduction
2. How I Got Started
3. Growing Tomatoes
4. Growing Okra
5. Growing Peppers
6. Sour Oranges and Mangoes

References

1. Deep, G. et al. (2016). Graviola inhibits hypoxia-induced NADPH oxidase activity in prostate cancer cells reducing their proliferation and clonogenicity. Scientific Reports, 16 (6).
2. Ioannis, P. et al. (2015). Graviola: A Systematic Review on Its Anticancer Properties. American Journal of Cancer Prevention. 3 (6), pp 128-131.
3. Morton, J. 1987. Guava. p. 356–363. In: Fruits of warm climates. Julia F. Morton, Miami, FL.
4. Paul, J. et al. (2013). Anti cancer activity on Graviola, an exciting medicinal plant extract vs various cancer cell lines and a detailed computational study on its potent anti-cancerous leads. Current Topics In Medicinal Chemistry, 13 (14).

In October, we started a new consultancy project with our client being the FIT Wellness Centre in Nevis. This piece of work has involved us assisting the FIT Wellness Centre in developing their non-communicable disease (NCD) action plan and with the implementation of their National Weight Loss Campaign, a key part of their action plan.

In November, we took part in a press conference to discuss FIT’s NCD Prevention Action Plan and the National Weight Loss Campaign and were delighted to be featured on the NNC News.

We’re really happy to share the news clip with you. You can check it out below.

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If you’re based in Nevis and would like to take part in the National Weight Loss Campaign, please email us and if you’re creative and would like the chance to win $500EC, then you can enter the slogan competition for the campaign. You can find out more here.

CARE About Fibroids is a Washington, DC-based non-profit whose mission is to elevate uterine fibroids as a women’s health issue and drive change. Bringing together many of US’s most respected women’s health advocacy and policy-focused organizations to advance solutions, CARE About Fibroids is a catalyst for increased awareness, research and education about uterine fibroids, leading to earlier diagnosis and improved treatment.

As part of their mission to raise awareness of fibroids, they recently published a white paper entitled: ‘Uterine Fibroids: A Report on the Condition and its Impact on Women in the U.S. Their white paper provides some good background information on what fibroids are, how they are diagnosed and treatment options. They also discuss the challenges that women encounter with respect to diagnosis and the health system. As part of their discussion on the diagnosis challenges it was useful that the authors included a section exploring what is normal with regards to menstrual cycle. The confusion around this question means that many women are unable to recognise the symptoms of fibroids because they see their symptoms as being a normal part of their menstrual cycle.

We were also happy to see that the mental health challenges were discussed in this report, as this is an area that is often overlooked, and were pleased to see that the importance of family awareness was highlighted.

This was an interesting report which can be downloaded below.

The Healthy Caribbean Coalition and the Heart and Stroke Foundation of Barbados have released a new short video raising awareness of childhood obesity in the Caribbean. The clip informs the public of the negative consequences of childhood obesity and what needs to be done to address this issue.

Please view and share this video with your friends, family and associates and help get the message out there about how we can all improve the health and wellbeing of our children.

To find out more about childhood obesity in the Caribbean and for some useful resources you can visit the Healthy Caribbean Coalition’s Childhood Obesity Portal

Are you good with words? Are you creative? Then we want to hear from you!

We’re inviting residents of Nevis to take part in our tagline/slogan competition for the National Weight Loss Campaign.

The competition is open to all residents of Nevis. Entries should be clear, concise, catchy and easy to understand. They must also appeal to a wide audience and follow the basic guidelines below:

• Convey the sentiment of the public coming together, taking a stance and making a change to get healthy and lose weight.
• The slogan must be seven words or less
• The slogan must rhyme
• The slogan must be submitted by 5pm on  21st December 2018

You can submit your entry in any of the following ways:

• Via a video on social media tagging @fitgames_inc on Instagram or @fitwellnessnevis on Facebook
• Emailing the slogan to info@lakehealthandwellbeing.com
• Sending the slogan via a WhatsApp message to 667 0079

A winner will be selected, and this slogan will be used for the National Weight Loss Campaign.  Three runners up will also be selected, and these slogans will be used throughout the campaign on social media.

There will also be a cash prize of $500EC, sponsored by the FIT Wellness Centre, for the winner.

More Information

For further information please contact Abi Begho by calling 667 0079 or emailing info@lakehealthandwellbeing.com

About the National Weight Loss Campaign

The National Weight Loss Campaign starts in January 2019 and aims to help residents of Nevis lose weight through a fun six-month weight loss challenge that will support participants in getting active and eating a healthier diet. Participants will be guided through the six-month period with advice, tips, healthy recipes, fun events and one-to-one support. There will also be prizes for the person who loses the most weight in their category, recognition of those who have succeeded in losing their target weight and we’ll be following specific people on their weight loss journey.

We are so happy to announce that registration for the F.I.T. National Weight Loss Campaign in Nevis is open!

The National Weight Loss Campaign starts in January 2019 and aims to help residents of Nevis lose weight through a fun six-month weight loss challenge that will support participants in getting active and eating a healthier diet. Participants will be guided through the six-month period with advice, tips, healthy recipes, fun events and one-to-one support. There will also be prizes for the person who loses the most weight in their category, recognition of those who have succeeded in losing their target weight and we’ll be following specific people on their weight loss journey.

Technology will play an important role in the campaign and we’ll be creating a web-based health portal where participants can come together, support each other, ask questions, share pictures and videos and receive tips and advice from experts in health and fitness. The health portal will consist of a forum and a chat facility, so we can keep in touch with all participants and provide them with support every step of the way.

How To Register for the National Weight Loss Campaign

The National Weight Loss Campaign is open to everyone in Nevis – old, young, male and female. If an individual would like to lose weight or would like some support in adopting a healthier lifestyle then they are welcome to take part.

The public can register for the campaign by emailing admin@fitwellnesscenter.com or calling (869)-662-8749

Businesses Can Get Involved Too

Businesses are strongly encouraged to take part in the National Weight Loss Campaign by either registering a team of their staff to get involved in the six-month weight loss challenge or they can play an instrumental role in improving the health and wellbeing of our community by becoming a corporate partner or sponsor.

For more information about this, businesses in Nevis can contact David Walwyn by email  or phone (869)-662-8749

On 20^th November 2018, we were on the beautiful island of Barbados for the Healthy Caribbean Coalition’s ‘Beyond the Call to Action Event: Towards School Policies in Support of Childhood Obesity Prevention.’

This event marked the end of the HCC’s childhood obesity prevention campaign. One of the key parts of this campaign was the HCC’s childhood obesity prevention petition (Call to Action) which called on Heads of Government to enact any of the following policies and legislation which have been demonstrated as effective measures to combat childhood  obesity:

• Imposition of a tax of not less than 20% on Sugar Sweetened Beverages (SSBs) and use tax revenue for NCD prevention and control.
• Banning the sale, promotion and marketing of SSBs, and unhealthy foods and beverages in and around schools.
• Mandatory physical activity in all primary and secondary schools
• Adoption and application of regional standards for nutritional and front of package labelling of foods and beverages.
• Banning the marketing of unhealthy foods and beverages to children (includes non-school environments)
• Enacting legislation related to The International Code of Marketing of Breast-milk Substitutes.

This event brought together a wide cross section of national and regional stakeholders to celebrate the achievements of the campaign and to showcase all the great work being conducted across the Caribbean to tackle childhood obesity. We heard from speakers from the Bahamas, Bermuda, Jamaica and Trinidad. It was particularly interesting listening to Dr Simone Spence’s presentation explaining Jamaica Moves’ new initiative targeting schools.

Youth Involvement

It was also very nice to see young people actively participating in this event. Young people took part in a parallel youth session led by Krystal Boyea, the HCC’s Youth Advocate. In this session young people discussed the solutions and barriers to creating a healthy school environment and also explored the types of products sold in schools and how the school environment influences behaviour and health.

We Took Part in a Panel Discussion

We had the pleasure of taking part in a panel discussion with other CSOs including the Antigua and Barbuda Diabetes Association,  the Heart and Stroke Foundation of Barbados,  the Grenada NCD Commission, the St Lucia Diabetes and Hypertension Association and the Heart Foundation of Jamaica about the importance of coalitions and collaborations in addressing critical issues such as childhood obesity. We had an interesting discussion, facilitated by Sir Trevor Hassell.

We really enjoyed this event and would like to thank the HCC for inviting us to take part in the panel discussion. We look forward to hearing more about the work being conducted across the Caribbean to tackle childhood obesity and making our own small contribution to this effort.

In October 2018,  we began consulting with the F.I.T. Wellness Center in Nevis to assist with the development and implementation of their NCD Prevention Action Plan, part of their NCD Prevention Programme.

On 27^th November 2018, we were delighted to join F.I.T. in the launch of their NCD Prevention Action Plan and  the announcement of their upcoming National Weight Loss Campaign.

The launch took the form of a press conference and was attended by the major media outlets in Nevis. The event was chaired by Mr David Walwyn, Director of the F.I.T Wellness Center and featured on the panel were:

• Hon. Hazel Brandy-Williams, Junior Minister for Health, who provided an overview of NCDs in Nevis
• Dr Judy Nisbett, Chief Medical Officer for Nevis, who discussed the cost of NCDs, this included direct and indirect costs as well as the impact NCDs have on families
• Nadine Carty-Caines, Programme Coordinator, Health Promotion Unit, Ministry of Health, who took the press through all the statistics on NCDs in Nevis
• Dr Raymond Moving, Internal Medicine, Alexandra Hospital, who explained the complications of NCDs focusing particularly on diabetes
• Dr Samir Anadkat, Obesity and Diabetes Specialist, Professor (Neuroscience & Anatomy), Medical University of Americas, Nevis, who explored prevention and addressed some of the myths around weight loss
• David Walwyn, Director, F.I.T. Wellness Centre, who spoke about F.I.T’s approach to tackling NCDs in Nevis
• Abi Begho, Public Health Project Manager, Lake Health and Wellbeing, who discussed the upcoming National Weight Loss Campaign and also announced the slogan competition for the campaign

Why Focus on NCDs?

Non-communicable diseases (NCDs) such as diabetes, hypertension, heart disease and cancer are a major health challenge in St Kitts and Nevis with 83% of deaths in the Federation being due to these conditions.

One of the key factors driving NCDs in St Kitts and Nevis is the high rate of obesity. In 2012, PAHO reported that 32.5% of secondary school children in St Kitts and Nevis were overweight and 14.4% were obese and a more recent report published by UNICEF in 2017 stated that 26% of children in St Kitts and Nevis were obese. We know that children who are overweight or obese are more likely to become overweight or obese adults and this puts them at a high risk of developing NCDs like diabetes, heart disease and cancer. Obesity rates in St Kitts and Nevis in adults aged 25 to 64 is high with a 2008 study stating that 33.5% of adults in this age group were overweight and 45% were obese.

F.I.T. has developed its answer to NCDs by developing its NCD Prevention Action Plan which will focus on supporting residents of Nevis to get fit, healthy and lose weight, and thus reduce their risk of developing an NCD. A core part of the action plan is the National Weight Loss Campaign which will start in January 2019.

The National Weight Loss Campaign

The National Weight Loss Campaign aims to help residents of Nevis lose weight through a fun six-month weight loss challenge that will support participants in getting active and eating a healthier diet. Participants will be guided through the six-month period with advice, tips, healthy recipes, fun events and one-to-one support. There will also be prizes for the person who loses the most weight in their category, recognition of those who have succeeded in losing their target weight and we’ll be following specific people on their weight loss journey.

Technology will play an important role in the campaign and we’ll be creating a web-based health portal where participants can come together, support each other, ask questions, share pictures and videos and receive tips and advice from experts in health and fitness. The health portal will consist of a forum and a chat facility, so we can keep in touch with all participants and provide them with support every step of the way.

How The Public Can Get Involved in the National Weight Loss Campaign

The National Weight Loss Campaign is open to everyone in Nevis – old, young, male and female. If an individual would like to lose weight or would like some support in adopting a healthier lifestyle then they are welcome to take part.

The public can register for the campaign by emailing admin@fitwellnesscenter.com or calling (869)-662-8749

Businesses Can Get Involved Too

Businesses are strongly encouraged to take part in the National Weight Loss Campaign by either registering a team of their staff to get involved in the six-month weight loss challenge or they can play an instrumental role in improving the health and wellbeing of our community by becoming a corporate partner or sponsor.

For more information about this, businesses in Nevis can contact David Walwyn by email  or phone (869)-662-8749.

Who is Behind this Initiative?

The National Weight Loss Campaign is an initiative of the FIT Wellness Center led by Mr David Walwyn with support from the Ministry of Health and Lake Health and Wellbeing

More Information

F.I.T. Wellness Center 
Website www.fitwellnesscenter.com
Phone number: 9869) 469-3481 or (869) 662-8749
Email: admin@fitwellnesscenter.com

Ministry of Health, Health Promotion Unit
Phone: (869) 469-5521, (869) 469-8010, (869) 469-7470
Email: healthpromotion@niagov.com

Lake Health and Wellbeing
Website: www.lakehealthandwellbeing.com
Phone: (869) 667 0079
Email: info@lakehealthandwellbeing.com

In April 2018, the UK Government introduced their sugar sweetened beverage (SSB) tax. Drinks containing 5-8g per 100 ml of sugar are now taxed at a rate of 18p per litre and drinks containing over 8g per 100 ml are taxed at a higher rate of 24p per litre. The tax is applied to all manufacturers and to date 457 companies are registered to pay this tax.

The tax has been successful in two regards. Firstly, in the run-up to the introduction of the tax many manufacturers reformulated their drinks to reduce the amount of sugar they contain to avoid paying the tax. This included supermarket giant Tesco’s who, in 2016, reduced the sugar content of their soft drinks to below 5g per 100ml. Other brands who have reduced the sugar content of their products include Ribena, Fanta and Lucozade.  Some brands, such as Coca Cola have decided not to reformulate their products as they are concerned about losing their customers. This means that in the UK the price of a can of coke has increased by 8p and a large bottle of coke by 50p.

The second success of the sugar tax is the revenue that has been raised. In the first six months of the tax being introduced £154m was raised. The money raised from the sugar tax will be used to double the funding available to primary schools for PE and sports programmes to support healthier, more active, lifestyles in children. The funding will not only go towards expanding PE and sports programmes but to also expand breakfast clubs in primary schools ensuring that children have access to a healthy breakfast every week day.

Islands states throughout the Caribbean are considering introducing a SSB tax and it is hoped that the recent success of the UK and other countries like Mexico will provide Governments with the evidence of the impact of a SSB tax.

On 1st November 2018, the Ministry of Health in St Kitts held a public consultation on SSB taxation. During this consultation they provided information on their proposed approach to sugar sweetened beverage (SSB) taxation. Lake Health and Wellbeing supports the government’s plans to tax SSBs and has published a position statement outlining our views on this topic.

SSB Taxation

The taxation of SSBs has been utilised as a method of tackling obesity by creating a deterrent which leads to a reduction in the purchase and consumption of SSBs.

Taxation of SSBs has three important aims. The first it to incentivise manufacturers to reformulate or replace their products to create healthier options, the second is to deter the public from purchasing and consuming SSBs by making them unaffordable and the third is to raise funds from the tax revenue that can be used to support initiatives aimed at improving the health of the public.

Caribbean Children’s SSB Consumption

Children in the Caribbean drink large quantities of SSBs putting them at risk of becoming obese or overweight.  Caribbean children’s frequency of consuming SSBs was found to be amongst the highest out of 187 countries. Furthermore, teenagers (12 to 15-year olds) in Barbados, Jamaica, the Bahamas and Trinidad and Tobago reported drinking SSBs three times or more a day, and in St Kitts and Nevis it was found that children consumed at least one carbonated soft drink a day.

SSB Consumption and Obesity

This high consumption of SSBs has been linked to weight gain and obesity in adults and children, and obesity or being overweight increases a person’s risk of developing a number of non-communicable diseases such as type 2 diabetes, stroke, heart disease and cancer.

Obesity is a significant challenge in St Kitts and Nevis. A PAHO report revealed that 33% of secondary school children in the twin island state were overweight and 14% were  obese. More recently, in 2017, a UNICEF report published that 26% of children in  St Kitts and Nevis are obese. When looking at adults in St Kitts and Nevis, the  PAHO study reported that 34% of adults were overweight and 45% were obese.

Tackling Obesity

In order to address the high rate of obesity in St Kitts and Nevis, a number of strategies are required and reducing the public’s consumption of SSBs by introducing a tax is just one of many approaches.

Our Position Statement

To find out more about the St Kitts Ministry of Health’s approach to SSB taxation and our position on this approach. You can download our position statement below.

Document: Taxing SSBs in St Kitts: A Position Statement

Published by: Lake Health and Wellbeing

Date: 15th November 2018

Download here: SSB Taxation Position Statement

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References

1. UNICEF, Situation Analysis of Children in the Federation of St Kitts and Nevis, UNICEF Office for the Eastern Caribbean Area and the Government of St Kitts and Nevis, Christ Church, Barbados, 2017
2. PAHO, Health in the Americas, 2012: St Kitts and Nevis, PAHO, 2012
3. Xuereb, G. (2017). Sugar Sweetened Beverages Taxes in the Caribbean – Progress and Challenges.
4. Yang, L. et al. (2017). Consumption of Carbonated Soft Drinks Among Young Adolescents Aged 12 to 15 Years in 53 Low- and Middle-Income Countries.  American journal of public health, 107(7), pp 1095-1100.