The Just Dance Crew is our new innovative Public Health Tech project that uses 3D animation to promote physical activity and exercise in children by teaching them to perform short dancercise (dance + exercise) routines. We’re using animation because research has shown that children engage more with animated characters and we’re focusing on dance because it is a fun way to get children active.  Additionally, research shows that dance has a number of health benefits: it’s an excellent form of exercise, improves fitness, leads to weight loss, strengthens bones and muscles, is beneficial to mental health and improves social skills.

The routines will be 1-5 minutes long and will focus on cardiovascular exercise; muscle and bone strengthening; and flexibility and relaxation exercises.  The routines can fit into both the school and home environment. At school, the videos can be used during devotional, at breaks and over lunchtime. While at home, children and parents can use the videos during their leisure time and the whole family can get involved creating a fun, family experience.

Current Progress and Next Steps

So far we have created two demo animations focusing on a simple muscle strengthening exercise – squats – as a proof of concept and towards the end of 2020, we’ll be working with the Ministry of Education to develop more animations as part of a pilot project to test the effectiveness of this approach.

After the pilot, we will conduct a thorough analysis of the project and our plan is to then use the evaluation of the pilot to inform our next phase which will be to create a comprehensive collection of animations and develop an online learning platform to disseminate the videos.

We will also create educational material, guides and lesson plans for both teachers and parents to ensure the videos are used effectively. The videos will be easily accessed by teachers, to use in the classroom, or parents, through the internet or they can be downloaded and saved on to any device. Through the learning platform teachers, parents and guardians will be able to evaluate children’s progress with respect to their technique, consistency and their recall of the benefits of different types of exercise.

The Impact of Our Project

We hope that through this project, we can tackle childhood obesity in our local (St Kitts and Nevis) and regional (the Caribbean) area.

Childhood obesity is a challenge in the Caribbean with 1 in 3 children being overweight or obese.  The rate of childhood obesity in the Caribbean is higher than the global average and is on the rise. Being obese and overweight in childhood is linked to several conditions such as diabetes and hypertension, and it negatively impacts a child’s mental health.

Childhood obesity is also 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. In 2017, a UNICEF report published that 26% of children in St Kitts and Nevis are obese.  Being overweight and obese puts children at an increased risk of developing NCDs which are becoming an epidemic in the Federation with 83% of deaths being due to NCDs.

To combat childhood obesity, we must ensure that children adopt a healthy lifestyle and one approach is to get more children participating in exercise or physical activity. This is a priority as the Ministry of Health has reported that 58.4% of teenagers in St Kitts and Nevis are physically inactive.

We believe our project offers a simple, inexpensive and fun option for schools to get children active and teach important aspects of PE.

More Information

You can view the demo videos below and you can download our PowerPoint presentation below which provides more details about this project.

If you have any questions, about this new initiative, please don’t hesitate to send us an email

The squat challenge: How many squats can you do, properly,  in 60 seconds? Let us know 🙂

On 21^st February 2020, we were delighted to start the pilot for our My Healthy Heroes program with over thirty wonderful, enthusiastic fourth-graders from the Immaculate Conception Catholic School (ICCS) in St Kitts.

Our My Healthy Heroes program aims to educate and empower children to make healthy choices by tapping into their creativity to highlight the importance of a healthy lifestyle in a fun and engaging way.

This pilot project with the ICCS aimed to test our resources and characters (Healthy Heroes, Sugary Drinks Assassins and Junk Food Villains) and determine whether our approach would be effective at educating children about healthy eating and more importantly facilitate a change in their behaviour.

Getting Ready for the Pilot

For six months, we worked closely with the Taiwan International Cooperation and Development Fund and teachers at the ICCS to develop a collection of resources that would align with the school curriculum, particularly with the healthy eating classes currently being delivered to fourth graders as part of Health and Family Life Education (HFLE).

One of our My Healthy Heroes planning meetings

The resources we developed were based on three types of characters.

My Healthy Heroes. A group of characters that represent fruits and vegetables, for example, Miss Mangolicious and Professor Cornelius Cob.

Sugary Drinks Assassins. A collection of characters that raise awareness of the dangers of sweet drinks such as the Soda Pop Sniper and Juicer Jones.

Junk Food Villains. A set of characters that educate children about the impact that junk food has on their health (Greasy Grey Chicken Leg, Zerger the Harmburger etc.)

Using these characters, we then went on to develop a lesson plan for teachers, a set of information cards, badges, fridge magnets, activity sheets (food trackers, drinks trackers, food groups, word searches, mazes etc.) and a series of data collection sheets (questionnaires for teachers, students and parents).

We also explored ideas for how we could make classes engaging, encourage children to critically analyse the importance of a healthy lifestyle and introduce creative ways for children to demonstrate what they have learnt.

Through a series of brainstorming meetings, we decided on introducing two creative assignments.  The first would be to ask students to write a rap, poem or adventure story based on our characters and what they have learnt about healthy eating. Their creative writing would then be used to create a healthy eating anthology which students can have as a keepsake but most importantly can be used to educate other children about healthy eating.

The second assignment would be to bring their creative writing to life using stop motion animation. In this activity, students will develop a short animation that will communicate a healthy eating message.

Delivering the Pilot

After months of planning, we were really happy to implement our ideas and began on a sunny Friday in February with two fourth grade classes. Our first session with fourth-graders was what we called week 0, a pre-assessment session.  During this session, we introduced students to our project and were thrilled at their response. They were excited, enthusiastic and very keen to learn more about My Healthy Heroes – a great start. We also took some basic measurements – height, weight, body fat and waist circumference – of each child and asked each student to complete a questionnaire to find out more about their eating preferences and what they knew about healthy eating. We also gave students a food tracker and asked them to make a note of everything they ate over the following seven days.

Taking some measurements

Prior to this session we sent students home with a questionnaire for their parents to further explore their eating habits and identify any challenges that parents may have in introducing healthy eating practices at home.

Right now, we’re still analyzing this information, but so far this data has been very insightful. We’ll report back on this in a future blog when all the data has been analysed.

After our pre-assessment session, we visited the school for a further four sessions where we used our resources to discuss the following with students

• Food groups and healthy eating
• Healthy vs. unhealthy eating
• Fruits and vegetables
• Colour categories of fruits and vegetables
• Healthy drinking
• The dangers of sweet drinks

We also gave students their assignment of writing a story, rap or poem based on their selected character (either a Healthy Hero, Sugary Drinks Assassin or Junk Food Villain) and were very impressed at the quality of the work they submitted. The raps were excellent, the stories were creative and the poems were engaging whilst maintaining a healthy eating message as the foundation of their work.

Students getting ready to read their My Healthy Hero stories

They also had to present their piece to the class and all we can say is ‘wow!’  Our fourth graders came prepared. Some students had memorized their raps and had carefully planned how they would recite their piece so that it was engaging and fun. They really did a great job.

Due to the coronavirus, the school the term ended early, so we’ll be continuing our work with fourth graders in the next month or so.

Next, they’ll be working on bringing their assignments to life with stop motion animation and we’ll be doing a post-project assessment to get their feedback on the project.

What We Have Learnt So Far

So far, we have been extremely impressed with fourth graders retention of the information that we have taught them over the past few weeks. They remember a lot and every week they have been able to recall the information they learnt the previous week.

Our characters have been extremely important in getting children excited about learning about healthy eating and improving their retention of the information. They love the characters and were excited to receive the information cards, badges and fridge magnets, and many of them wore the badges to class every week and wanted to be associated with a Healthy Hero and not a Junk Food Villain or Sugary Drinks Assassin. This suggests that if healthy foods are made cool, we can entice children to gravitate towards healthy options.

An issue that we identified was the need to properly explain the harms of unhealthy eating and in a way that resonates with them. There didn’t seem to be an appreciation of the long-term effect of unhealthy eating and through our discussions with them, we felt that because of this they didn’t see unhealthy eating as something that would impact them significantly. So, we tried to strike a balance of being honest and informative without causing any unnecessary fear, the aim was to be empowering.

Children are honest and overall they did say that they would try to make healthy choices but if they had to choose between certain foods, they would still choose the unhealthy option only because they felt it tastes better – so trying to explore tastier ways of preparing healthy food is a must if we are to change children’s eating habits.

Children were also very perceptive, they realized that they tend to make unhealthy choices because it’s easy in terms of it being accessible and they see it on TV all the time. One student said to us, if he had a food tracker all the time, it would remind him to eat healthily. He genuinely just forgets and doesn’t think about the choices he makes during the day when he buys snacks.

A project like ours needs to be long-term, children need constant reminders and nudges to make healthy choices or else the high volume of marketing of unhealthy foods will capture their attention and influence their behaviour.

We have a lot of work to do in the field of Public Health to compete with the food industry and by expanding this work, we hope that we can make a small contribution to getting children excited about healthy food and therefore encourage them to make healthier choices.

Coming up Next

In our next blog, we’ll be sharing fourth-graders stories, raps and poems with you. They did a great job!

Non-communicable diseases (NCDS) like cancer, diabetes and heart disease are a major challenge in St Kitts and Nevis. Data has demonstrated that NCDs are becoming an epidemic in the Federation with 83% of deaths being due to NCDs. We must do something about this to prevent our citizens from dying prematurely.

One approach to tackling NCDs is to focus on the next generation and ensure that children adopt a healthy lifestyle. We have to create a healthy environment at schools, in homes and within society so that children can make healthy choices.

Our Healthy Kids SKN campaign aims to raise awareness of the changes that children need to make in order to reduce their risk of developing an NCD later in life. We’re encouraging children, parents and teachers to focus on three main areas – eating healthily, drinking healthily and physical activity.

Eating Healthily

Junk food is everywhere so we must make a concerted effort to help children resist temptation and eat healthily. Children should eat a variety of foods to ensure they are getting enough nutrients to develop and grow. This includes consuming foods from all food types. In particular, parents should ensure that their children cut down on foods that are high in sugar, salt and saturated fat and introduce more fruits and vegetables into their diet.

Children should eat 5-7 portions of fruits and vegetables every day, and eat colourfully, and aim to eat different colours of fruit and vegetables.

Drinking Healthily

Children in the Caribbean drink large quantities of sugary drinks putting them at risk of becoming obese or overweight.  Caribbean children’s frequency of consuming sugary drinks 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 sugary drinks 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.

Soft drinks are very high in sugar, for example, a can of coke contains 9.75 teaspoons (39g) of sugar and even juices contain high levels of sugar, a 330ml box of Rica Orange Juice contains 10.6 teaspoons of (42.2g) sugar – that’s more than coke!

We’re encouraging children to cut out the sugary drinks and drink water instead.

Physical Activity

For children to get healthy, they need to be active every day. The World Health Organisation recommends that children accumulate 60 minutes of moderate to vigorous-intensity physical activity every day.

We must get creative about physical activity as in St Kitts and Nevis, children are not active enough, over half of children, 58.4%, are physically inactive. We need fun approaches that don’t feel like work.

Working With Young People

We’re delighted to have worked with a young designer, Hadiya Lewis, to create the three graphics for this campaign. This is a great example of the talent and creativity that exists and how young people can contribute to communicating important health messages.

SKN Moves Support

We’re delighted that this initiative has been endorsed by SKN Moves and we’d like to thank the SKN Moves team for their support.

You can find out more about SKN Moves here

In May, the team behind the HENRY (Health, Exercise and Nutrition for the Really Young) project announced that as a result of their work, Leeds has become the first UK city to see a reduction in childhood obesity (although this has been disputed)

If this is true, this is a great achievement. As we’re embarking on a childhood obesity prevention project, we read this news with great interest because we wanted to identify the secret to HENRY’s success and what we can learn from this project as we enter this arena.

What is the HENRY Project?

The HENRY project started 10 years ago, in 2009, with the aim of giving babies and young children the best start possible. They achieve this by working with parents to provide them with the support and skills they require to improve their families’ overall health by focusing on:

• Nutrition;
• Emotional wellbeing;
• Exercise and physical activity;
• Parenting skills; and
• Breastfeeding

The programme offers workshops, programmes, resources and online help and one of their core services is their eight-week Healthy Families Programme. This programme covers five areas:

• Parenting confidence
• Physical activity for young children
• What children and families eat
• Family lifestyle habits
• Enjoying life as a family

What Has the HENRY Project Achieved?

The HENRY Project reported that over a four-year period they observed the following:

• An overall reduction in childhood obesity in Leeds from 9.4% to 8.8%
• A reduction in obesity in children from deprived backgrounds from 11.5% to 10.5%
• A reduction in obesity in children from affluent backgrounds from 6.8% to 6%
• The highest decline in childhood obesity in the four-year-old age group of 6.4%

What Can We Learn From This Project?

As we’re beginning to plan for our own childhood obesity pilot project, we are keen to understand what specifically led to HENRY’s success. Helpfully, the HENRY team have been very open about their project and have explained that some of their success can be attributed to the following:

• Focusing on early years – they based their work on the premise that it is more effective to target younger children when they are in the habit-forming stage of development. By intervening at this point, obesity interventions are more likely to have an impact with regards to preventing and reversing childhood obesity because of the focus on the period in a child’s life before their habits and food preferences have fully formed.
• Providing high quality, practical information and support to parents – in the HENRY project parents are not just simply given evidence-based healthy lifestyle information, they work closely with the HENRY team and form a close relationship; a relationship where parents are comfortable enough to explore what changes need to be made in their family’s lives and what is right and convenient for them. Parents are not told what to do but work with the HENRY team to develop a healthy lifestyle plan that works for them.
• Exploring parenting style – the project worked with parents to evaluate their parenting style and encouraged parents to use an authoritative rather than an authoritarian style. An authoritative style is where parents set clear rules and boundaries but respond to their children’s thoughts and opinions through open discussion and reasoning. This style also includes parents being affectionate, supportive and encouraging of independence. The HENRY project guided parents on how to implement this parenting style, which research has shown to be the most effective parenting style in terms of producing the best outcomes in children.

In Conclusion

The above points are very helpful in demonstrating that for any childhood obesity programme,  there are two important considerations: ensuring your programme targets children at the right age and that it engages parents in a meaningful way. As we begin our work in this area, we will bear this mind so that we give our project the best chance of succeeding.

Sources

1. Four Parenting Styles – Characteristics and Effects by Parenting for Brain
2. What is Authoritative Parenting, With Examples by Parenting for Brain
3. Leeds Becomes the First UK City to Lower its Childhood Obesity Rate – The Guardian
4. My Organisation Helped Leeds Lower Child Obesity. Here’s How to Do it Nationwide – The Guardian

From 29^th April to 3^rd May 2019, the counselling department at Verschilds High School hosted their Health and Wellness Week and we were delighted to have been invited to take part in two of their planned events.

On 29^th April, we spoke, bright and early, at the school’s assembly on the topic of stress management. During our 15 minute presentation, we talked about what stress is, what types of situations cause stress, the impact of stress and how we can manage stress.

We encouraged students to think about their own personal situations, especially during this exam period, to see how they can address any stressors that may be affecting their wellbeing and provided tips on managing these, which included – identifying stressors, elimination/delay of stressors, preparation, stress relief techniques, building resilience and getting support.

We had a great session with the student body and therefore were very happy to return on the 3^rd May for their health and wellness fair.

During their health and wellness fair, we set up a stall and promoted living a healthy lifestyle. We spoke to students and staff about the importance of children and teenagers getting enough exercise and physical activity (WHO recommends 60 minutes per day), drinking more water, eating 5-7 portions of fruit and vegetables per day and cutting down on sugary drinks.

We had information showing how much sugar is in many popular soft drinks and students and teachers were shocked to learn that one can of coke contains 8 teaspoons of sugar.

To encourage children to swap their unhealthy snacks for healthier snacks, we had some lovely mangoes for staff and students to sample and this included some dried mangoes. Dried mango is a great alternative to candy and chocolate and it tastes great –  the students (well…most of them) loved it.

We also held a competition where we asked students how many minutes of physical activity children and teenagers should take part in every day and three lucky students won a comic book – congratulations.

Finally, it was great to connect with the other stallholders, some of whom were familiar faces, such as the team behind Mother Becky Bush Tea and Sugar Town Organics. It was nice meeting the Gideon  Force Organic Agriculture  Cooperative, Close to Nature and the Drugs and Substance Misuse Team and learning about the great work they are all doing.

We had a great time at Verchilds High School and would like to thank the staff for their kind invitation and both staff and students for their warm welcome, visiting our stall and asking some great questions.

On 26^th April, we attended the Ministry of Health’s focus group on sugar-sweetened beverages (SSBs). This event was part of the Ministry’s consultation process to get feedback as well as inform the public and key stakeholders on the progress being made to develop a national SSB policy.

This event was a follow-up to the Ministry’s SSB National Consultation which took place in November 2018 and provided an update on the policy imperatives that were presented last year.

From the focus group we learnt that the updated policy recommendations are:

• A 32% excise only tax on SSBs
• The tax will apply to calorically sweetened beverages including carbonated drinks (sodas), sweetened carbonated water, sugar-sweetened juices, sports drinks, energy drinks, tea and coffee drinks, sweetened milk/milk alternatives, milk powdered blended drinks, powdered drink mixes and drink mix syrups
• Excluded from taxation would be fresh fruit juice (no sugar added), unsweetened milk/milk alternatives, infused water, unsweetened carbonated drinks and non-caloric sweetened drinks
• Alternatives to SSBs will be suggested to the public. These would include: fruit/vegetable infused water, plain water, unsweetened carbonated water, unsweetened herbal (bush) tea and fresh-poured coconut water (unsweetened coconut water)
• The tax revenue will be used to provide: a water infrastructure, water fountains in schools, reusable water bottles in schools, healthier school meals, public health campaigns, National Health Insurance, implementing a marketing ban to children, policy development for safe school zones and to improve agriculture education especially in primary schools

What About Artificially Sweetened Beverages?

One area still to consider, which is an interesting one, is whether to tax artificially sweetened beverages (ASBs).

ASBs are drinks that have been sweetened with non-nutritive sweeteners which include saccharin, acesulfame, aspartame, neotame, sucralose and stevia.

The field of ASBs is a confusing one. It has been hard to answer the simple question of whether they are beneficial or not. Therefore  WHO funded a large global study to answer this question, but this still didn’t answer the question with health officials stating the following:

“The inconclusive results of the review of the evidence suggest that we need to see better, bigger and longer-term studies of non-sugar sweetener use, to find out for sure their benefits and risks. The review suggests that there could be some benefits in terms of preventing weight gain, but the evidence so far is not strong and does not show consistent enough results to be sure.”

Whenever there is doubt, we recommend that the public keeps things simple and uses products where there are clear health benefits and there is no doubt. The best option at the moment is to consume unsweetened beverages.

In the meantime, the Ministry will evaluate whether ASBs should be taxed as part of their SSB policy.

 Why Tax SSBs?

Childhood obesity is a significant challenge here 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.

SSBs have been linked to weight gain and obesity. Therefore, the taxation of SSBs has been utilised throughout the world 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.

Next Steps

The Ministry of Health will now take all the feedback from their consultation, focus group and other engagement activities to draft a policy which will be circulated to stakeholders for any final comments before it is sent to Cabinet for approval.

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

At the end of last year, we started developing our two-year strategy after a year of exploring the public health landscape in St Kitts and Nevis, and the wider Caribbean region.

After careful consideration, we settled on focusing on women’s health and the prevention of childhood obesity.  In a previous blog we explained why we decided to focus on women’s health and today we’ll discuss why we’re also going to focus on childhood obesity.

 Why Childhood Obesity?

Childhood obesity is a major health issue in the Caribbean with 1 in 3 children being overweight or obese.  The rate of childhood obesity in the Caribbean is higher than the global average and is reported to be on the rise.

Being obese and overweight in childhood is linked to the development of several health issues such as type 2 diabetes and hypertension, and it also negatively impacts a child’s mental health. These health issues can follow children into adulthood with children affected by obesity, or who are overweight, having an increased risk of becoming overweight or obese adults and developing non-communicable diseases (NCDs) such as cancer and heart disease in later life.

Childhood Obesity in St Kitts and Nevis

Childhood obesity is a significant challenge here 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.

Data has demonstrated that NCDs are becoming an epidemic in the Federation with 83% of deaths in St Kitts and Nevis being due to NCDs. We must do something about this to prevent our citizens from dying prematurely and one approach is to tackle childhood obesity.

To combat childhood obesity, we have to ensure that children adopt a healthy lifestyle and we also have to create a healthy environment at schools, in homes and within society so that children can make healthy choices.

Tackling Childhood Obesity in the Caribbean

The Healthy Caribbean Coalition (HCC) is a civil society member organisation that was established to combat NCDs and their associated risk factors.

One of their key focus areas is childhood obesity prevention and as part of their work, they published their Civil Society Action Plan for Preventing Childhood Obesity in the Caribbean. This plan provides guidance on how HCC members (we are a member) can strategically address this significant health challenge in their specific island states.

Lake Health and Wellbeing is thus aiming to align its strategy for childhood obesity prevention in St Kitts and Nevis with the following HCC priority areas:

• Trade and fiscal policy (taxation of unhealthy foods)
• Nutrition literacy (mandatory front-of-pack-labelling of foods)
• Early childhood nutrition (enacting legislation related to the International Code of Marketing of Breast Milk Substitutes)
• Marketing of healthy and unhealthy foods to children (Banning the marketing of unhealthy foods and beverages to children)
• School and community-based interventions (Banning the marketing and sale of unhealthy foods and beverages in and around schools, mandatory physical activity in schools)

What We’ve Done So Far

We’ll be taking our time and starting slowly with the implementation of our childhood obesity prevention strategy. We’re delighted to say that we have started making some progress and have achieved the following:

• We took part in the HCC’s regional campaign which aimed to raise awareness of childhood obesity in the Caribbean and influence the region’s leaders to champion and implement critical policies that will improve the health of our children and reduce childhood obesity. One of the key parts of this campaign was their childhood obesity prevention petition (call-to-action) which called on our Heads of Government to enact key policies and legislation which have been demonstrated as effective measures to combat childhood obesity. We got involved by gaining support for the HCC’s petition in St Kitts and raising awareness of this issue through a four-part podcast series. You can find out more about this here

• We’ve started advocating for front-of-pack nutrition labelling as this is an easy way for parents to assess the health of the foods they purchase. We submitted a response to the CARICOM Regional Organisation for Standards and Quality‘s consultation on pre-packaged food labelling which included front-of-pack food labelling and are now a member of the SKNBS Technical Committee for Labelling.

• We have also started advocating for the introduction of a sugar-sweetened beverage tax in St Kitts and Nevis. As part of this process, we attended the Ministry of Health’s National SSB Consultation, have prepared a position statement of SSB taxation in St Kitts and will be attending an SSB focus group, at the end of April 2019, organised by the Ministry of Health.

• We launched a childhood obesity social media campaign for World Cancer Day

Next Steps

We’ll be continuing with the above and exploring the development of resources to encourage children to get active.

We’re really excited about this work and are looking forward to making a difference in this area.

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

Childhood obesity is a major health issue in the Caribbean with 1 in 3 children being overweight or obese. Being obese and overweight in childhood is linked to the development of a number of health issues such as diabetes and hypertension, and it also negatively impacts a child’s mental health. These health issues can follow children into adulthood with children affected by obesity, or who are overweight, having an increased risk of becoming overweight or obese adults and developing non-communicable diseases such as cancer and heart disease in later life.

Childhood obesity is a significant challenge here 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.

Childhood Obesity Solutions

To combat childhood obesity we have to ensure that children adopt a healthy lifestyle and one approach is to explore how we can reduce the consumption of products that are high in sugar, salt and saturated fat. One strategy is to focus on nutrition education and making it easier for to parents identify which foods are high in these components, so they can easily make healthy choices when they purchase groceries.

Front-of-Pack Nutrition Labelling

Front-of-pack nutrition labelling has been introduced in many countries to provide a quick and easy way for consumers to assess the health of the foods they purchase. Currently there are several front-of-pack nutrition labelling systems with the main options being:

Summary indicators. These include the Health Star Rating developed by Food Standards Australia New Zealand which gives foods a 1 to 5-star rating based on their healthfulness and France’s Nutri-score which puts foods into five categories, A to E, based on how healthy they are deemed to be.

The traffic light system. This uses the colour code green, amber and red to communicate whether products have a low, medium or high level of salt, sugar and saturated fat based on daily intake references.

Warning labels. This uses a ‘high-in’ label to inform consumers that foods are high in certain nutrients

Front-of-Pack Nutrition Labelling Consultation in the Caribbean

Caribbean countries are starting to explore the introduction of front-of-pack nutrition labels. The CARICOM Regional Organisation for Standards and Quality held a consultation from 15^th October 2018 to 31^st January 2019 on pre-packaged food labelling which included front-of-pack food labelling. The labelling system being explored is warning labels and we were pleased to have been able to submit a response to their consultation.

Our Views

• We support the introduction of front-of-pack nutrition labels in the Caribbean
• We believe that front-of-pack nutrition labels present a quick, easy and useful way of communicating the healthiness of pre-packaged foods
• We believe that front-of-pack labelling provides information in a way that is easier to understand, with respect to healthiness, than back-of-pack nutrition labelling
• We believe more work is needed to determine which front-of pack  labelling system would be most effective in the Caribbean
• We believe that a full assessment is required to determine if front-of-pack food labels will influence consumer behaviour in the Caribbean and if not, why not
• We feel that if the ‘high-in’ labels are to be used, the colour of the labels should be reconsidered, from black to red. This is important so that we begin to steer dialogue away from black always being seen as a negative, which has a wider societal context with regards to race and ethnicity
• We believe a standard international front-of-pack nutrition label is required to ensure consistency and to prevent confusion

Next Steps

CARICOM Regional Organisation for Standards and Quality will review all the comments it has received from throughout the region and decide on a way forward with respect to nutrition labelling of pre-packaged foods.

We look forward to seeing how the strategy for FOP labelling in the Caribbean develops and are pleased to see this action being taken on this matter.

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. Kanter, R., Vanderlee, L., & Vandevijvere, S. (2018). Front-of-package nutrition labelling policy: Global progress and future directions. Public Health Nutrition, 21(8), 1399-1408. doi:10.1017/S1368980018000010