Today’s blog post comes from Mariana Ndrio. Mariana is a second-year medical student at the University of Medicine & Health Sciences (UMHS) in St. Kitts and is currently serving as the President of the American Medical Student Association (AMSA) on campus.

Mariana has recently started volunteering with us as a research assistant and is supporting us as we conduct our fibroids qualitative study. She is also creating a fibroids and COVID-19 infographic which will be published shortly.  

Today, Mariana discusses the challenges that fibroids patients may be experiencing during this COVID-19 pandemic and shares some evidence-based self-care and stress management tips to help women with fibroids manage during this difficult period.

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As the COVID-19 pandemic continues to prompt stressful changes to our daily routine and lifestyle, health-related worries regarding ourselves and loved ones have undoubtedly intensified. While the growing uncertainties stemming from financial difficulties and social isolation impact the health and personal decision-making of everyone across the globe, women suffering from uterine fibroids are facing unprecedented challenges in their attempts to preserve their mental and physical wellbeing.

Uterine fibroids are the most common benign tumours among women. While some cases of fibroids are accompanied by no side effects, other cases contain patterns of heavy menstrual bleeding, long and irregular periods, pelvic pressure and pain, constipation, frequent urination, and in rare occasions, infertility.

Treatment for fibroids can range from no treatment at all to surgery, depending on the severity of symptoms. Aside from apparent physical symptoms, the psychological impact of fibroids should not be disregarded. In a 2013 national survey of 968 women suffering from fibroids, 79% of the surveyed women expressed fear that their fibroids will grow or experience further health complications. According to a 2014 study assessing the emotional impact of fibroids half of the participating women reported feeling helpless and that they had no control over their fibroids, because of the difficulty managing and predicting the heavy menstrual flow.

Black women are 3 times more likely to become diagnosed with fibroids than white women, just as they are more likely to develop fibroids at a younger age; moreover, their fibroid size, frequency, and symptom severity are much greater.

As a medical student that remains generally impressed by the increasing amount of existing medical and scientific knowledge, researching gynaecological diseases such as fibroids have led me to a stark realization: that despite the high prevalence of uterine fibroids among women, not enough high-quality data is available to formulate evidence-based guidelines that address patients’ needs adequately. This points to a larger, unforgiving gap in medical knowledge pertaining to common diseases affecting women, and when combined with the gap in medical knowledge regarding COVID-19, a mixture of increased emotional stress and confusion is to follow. Such stress can hinder overall physical health and may exacerbate fibroid symptoms by influencing cycle length, vaginal bleeding patterns, and painful periods. If you are feeling uncertain or anxious, know that you are not alone; your worries and feelings are valid.

For that matter, we compiled some scientifically-backed tips that could be helpful in restoring a sense of control and ease in these difficult and unprecedented times.

First, don’t hesitate to reach out.

While staying home and self-isolating is the best way to stay protected from COVID-19 and prevent the spread of the virus, this should not halt or compromise access to necessary medical care for women suffering from fibroids.

If you need to see a healthcare provider for a gynaecological reason, reach out to your medical provider and try to see if they are able to set up a virtual appointment or address non-urgent concerns over the phone (such as prescription refills). 

While it is true that a lot of non-urgent appointments and elective surgeries are cancelled, many medical professionals and medical facilities are encouraged to use and have already embraced telehealth services which allow long-distance patient and clinician care via remote and virtual appointments, intervention, education, and monitoring. Telehealth services vary based on your location and medical provider. But even if you are having difficulties accessing gynaecological telehealth services locally, you might be able to reach out to service providers in other countries such as the U.K, U.S, or Canada. For example, USA Fibroid Centers provide virtual appointments you can schedule online. Women to Women OB GYN Care, located in Florida, states in their website that they welcome appointments from women internationally and the Caribbean. The Pan American Health Organization (PAHO) has also attempted to establish or expand telehealth services in a lot of Caribbean countries.

Keep up to date with your prescribed medications.

Keeping up to date with your prescribed medications can be confusing during a pandemic. You might feel like your regular access to your medical provider or pharmacy is compromised, you might worry that your current medications might be making you vulnerable to the COVID-19 or you might be feeling uncertain regarding the continuation of your current prescribed medications or supplements.

Nonetheless, it is important that you continue taking your prescribed medications and/or supplements unless otherwise advised by your physician.  If you are receiving preoperative therapy (Zoladex, Lupron, etc.) but your surgery is cancelled, ask your physician regarding the course of your current prescribed therapy. If you have been prescribed a drug called Esmya (Ulipristal Acetate), you must consult with your physician regarding its discontinuation; as of 2020, Esmya’s license has been suspended due to the risk of serious liver injury. As mentioned previously, do not hesitate to discuss any concerns you might have regarding your current medications and supplements with your medical provider.

Plan ahead.

Studies show that women with fibroids might present heavier, prolonged bleeding and frequent, irregular periods. While everyone during a pandemic is worrying and trying to secure produce and disinfecting supplies, women suffering from fibroids have to also think about stocking up on female hygiene products. Especially, since frequent trips to the stores must be limited due to social distancing/quarantine rules.

Ensure that you have enough gynaecological hygiene products at home, to eliminate frequent trips to the store and avoid exposure to the virus. This by no means should be considered as the green light to go into a buying frenzy. Try to remain conscientious of the needs of others.

If buying hygiene products in bulk is not an option due to financial difficulty or store availability, reach out to local non-governmental organizations (NGOs) or philanthropic entities, that might be willing to donate hygiene products such as the Days for Girls International Organization or even by reaching out directly to product manufacturers. Local grassroots organizations or associations in your region might also be able to donate hygiene items. Moreover, the governmental departments of public health or genders affairs might be willing to assist women in need of hygiene products.

This pandemic could also be a good time to consider reusable, more economical and environmentally friendly menstruation products such as washable pads, menstruation caps, or absorbent underwear.  Check Days for Girls .org and learn how to make sanitary washable period pads during the COVD-19 pandemic, diligently following sanitary safety precautions.

Maintain healthy eating habits. 

Research has shown that following a healthy balanced diet, filled with fruits and vegetables, could lower the risk of developing fibroids and may help to alleviate symptoms.

While access to your usual healthy foods might be compromised at the moment, try to make healthy dietary choices while in quarantine. More specifically, dieticians recommend an increase in the consumption of cruciferous vegetables such as cabbage, broccoli, and kale. This category of food contains a phytochemical called indole-3-carbinol which recent research has suggested may prevent the cellular proliferation of fibroids and consequently prevent exacerbation of fibroid symptoms.

For many years, there has been a significant amount of scientific evidence that vitamin D may inhibit fibroid growth. Get your serum vitamin D levels tested and supplement (with medical supervision) as needed to correct a deficiency. A few recently published studies assessing the role of vitamin D against COVID-19, suggested that there is a possible link between the two and that vitamin D can have a protective effect against COVID-19.

Stay hydrated by consuming adequate amounts of water during the day and eliminate alcohol and caffeine. Researchers are advising women to avoid alcohol and caffeine because these substances are metabolized by the liver adding more stress on it and making it work less effectively at metabolizing oestrogen in the body.  Additionally, amidst the COVD-19 pandemic, the World Health Organization (WHO) urged the public to reduce alcohol consumption because alcohol compromises the body’s immune system and increases the risk of adverse health outcomes, making people more vulnerable to COVID-19. In other words, by cutting out alcoholic beverages, you are protecting yourself from adverse outcomes from both the COVID-19 and fibroids.

In addition, researchers believe that endocrine-disrupting chemicals (EDCs) which mimic oestrogen activity, may fuel fibroid growth. Examples include processed foods which contain various oestrogen-like preservatives; bisphenol A in water bottles, canned foods and plastic containers; various pesticides, herbicides, insecticides; and additive hormones and steroids used in meats and dairy products.

Try to choose organic, locally grown and in-season foods that are hormone and pesticide-free. Attentively wash any produce and peel fruits and vegetables. Reduce the use of plastics whenever possible and avoid reusing plastic water bottles or microwave food in plastic containers.

Stay active.

Research shows that a higher BMI – body mass index – is linked to the development of fibroids. By exercising you can reduce your BMI and prevent the fibroids’ growth. It may also help alleviate symptoms caused by fibroids. At the same time, exercise improves mental health by reducing anxiety, depression, and negative mood and by improving self-esteem.

Continue performing simple or recreational household chores and find an indoor workout routine such as yoga or aerobic exercises that you can perform at home while keeping up with the rules of quarantine. Choose what works best for you, based on your physical fitness and medical advice.

Be gentle to yourself—your body & your mind

On days that you are feeling pain and other fibroid symptoms, rest up and give your body time to heal. Try to soothe cramps by applying heat and wear comfortable clothes.

It’s okay to spend a whole day in bed recovering. Be gentle with yourself and do not undermine what your body is trying to tell you.

We live in a society where time and productivity are precious and synonyms for money and self-worth. Yet, nothing is more precious than your physical and emotional well-being. Do not feel guilty for taking some time to rest and recover.

Although self-care looks different for everyone and should be based on your personal needs and situation, there are a few suggestions that could work for you and help you boost your mental well-being:

• Try to meditate and practice mindfulness. You can find a lot of free guided meditations online or on YouTube.
• Monitor your thoughts and feelings in a journal.
• Practice good sleep hygiene. Maintain a sufficient sleep schedule, stay away from electronic devices while in bed, and start a regular bedtime routine—such as drinking a soothing tea, taking a warm bath or shower, reading, etc.
• Limit the amount of media you ingest daily.
• If you live alone reach out to family and friends via phone or video. If you live with family, roommates, or a partner use this time to connect and nurture your relationships.

And remember, during these confusing and unprecedented times and while you are feeling that this pandemic is affecting you, in particular, a bit harder than the rest, there is always a community of women who are feeling exactly like you—you are not alone.

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Sources

1. Mayo Clinic website: “Uterine Fibroids.” – http://www.mayoclinic.com/health/uterine-fibroids/DS00078.
2. Seminars in reproductive medicine: “Uterine Fibroids: Burden and Unmet Medical Need.” – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6193285/
3. CARE About Fibroids: “Uterine Fibroids: The Emotional, Physical, and Economic Toll.” – http://www.careaboutfibroids.org/toll-of-fibroids.html
4. The BMJ, British Medical Journal Publishing Group:  “Uterine Fibroid Drug Is Recalled after Case of Liver Failure Requiring Transplant Prompts EU Review.” www.bmj.com/content/368/bmj.m1112.
5. American Journal of Clinical Nutrition: “Dietary glycemic index and load in relation to risk of uterine leiomyomata in the Black Women’s Health Study.” – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2854903/
6. Journal of Obstetrics and Gynaecology: “Vegetarian diet and reduced uterine fibroids risk: A case-control study in Nanjing, China.” https://www.ncbi.nlm.nih.gov/pubmed/26458740
7. Reproductive Biomedicine Online Journal: “Quercetin and indole-3-carbinol inhibit extracellular matrix expression in human primary uterine leiomyoma cells” – https://www.sciencedirect.com/science/article/abs/pii/S1472648320300249
8. Fertility and Sterility Journal:  “Endocrine-disrupting chemicals and uterine fibroids.”- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5051569/
9. Healthline Magazine: “How Alcohol Can Affect your Immune System.”- https://www.healthline.com/health-news/can-alcohol-hurt-your-immune-system-during-covid-19-outbreak
10. The Elusive Magical Solution: The Relationship between Vitamin D and Fibroids- https://scholars.direct/Articles/gynecology-and-obstetrics/ago-3-008.php?jid=gynecology-and-obstetrics
11. The role of Vitamin D in the prevention of Coronavirus Disease 2019 infection and mortality- (https://www.researchsquare.com/article/rs-21211/v1)
12. American Journal of Epidemiology: “Association of Physical Activity with Development of Uterine Leiomyoma.”                – https://academic.oup.com/aje/article/165/2/157/97971
13. Mayo Clinic: “ COVID-19 and Your Mental Health”- https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/mental-health-covid-19/art-20482731
14. Lake Health and Wellbeing: “Fibroids and your Mental Health.”- https://lakehealthandwellbeing.com/newsite/wp-content/uploads/2019/05/FibroidsANDEmotionalWellbeingVersion2.pdf

To contain the spread of COVID-19, the government of St Kitts and Nevis declared a State of Emergency on 28^th March 2020. Since that declaration, we’ve had a combination on 24-hour and partial curfew days and our borders have been closed.  This quick action by the government has been effective and the number of COVID-19 cases has remained fairly low. We have had 15 cases, 8 of those cases have recovered and we haven’t had a new case in over 10 days.

Whilst this is all good news in terms of the pandemic, the closure of our borders and the lock-downs have been devastating to our economy which is heavily dependent on tourism. This has led to many businesses shutting their doors, school closures, and people being laid-off or placed on reduced hours. This has created a lot of anxiety and uncertainty about the future which the government has tried to address through a number of support programmes such as the COVID-19 Relief Fund, the expansion of the Poverty Alleviation Programme, moratoriums on utility bill payments, a range of social services to support the vulnerable and psychological support to address the mental health impact of the pandemic.

One service, which we have been delighted to be assisting with is the COVID-19 Helpline. This is a service established by the Ministry of Health and the National Emergency Management Agency  (NEMA) to give the public someone to easily reach out to if they have a COVID-19 related question, need support during this time and are concerned that they may have COVID-19 symptoms. When the public calls 311, their concerns are discussed with a friendly helpline operator (like us 😊) and then they are signposted to the relevant government department or an NGO for their issue to be addressed.

It has been very fulfilling volunteering with the helpline and being able to help those who are experiencing a number of challenges during this time. We’re just so happy that the support available in the Federation is comprehensive and holistic. So far, there has been a programme to address all the concerns we have had from callers and many have ended the call feeling happier and more at peace.

If you are based in St Kitts and Nevis and have a question about COVID-19, curfew timings, the COVID-19 relief fund, then please don’t’ hesitate to call 311 (it’s a free call). To find out more about the helpline, you can view the video below and for general information about COVID-19 in St Kitts and Nevis, you can visit https://www.covid19.gov.kn/

Today, we’re delighted to share a guest blog post from the team at Mesothelioma Guide.  Mesothelioma Guide connects mesothelioma patients and their loved ones to top doctors, cancer centres and treatment options, plus legal resources. In today’s feature, they dispel the myth that the asbestos-related cancer, mesothelioma, has been eradicated since the introduction of legislation restricting the use of asbestos.

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In the latter half of the 20th century, the general public learned of asbestos’ dangers. They learned the substance is, in fact, a carcinogen, one which can lead to aggressive diseases such as mesothelioma.

The awareness of asbestos’ harm led to increased regulations worldwide and scrutiny of businesses which used the mineral. Most people expected asbestos-related diseases like mesothelioma to level off early in the 21st century and eventually fade into obscurity.

This has not happened — nor will it any time soon.

According to the World Journal of Surgery, pleural mesothelioma cases in the United States increased from 2004 to 2014. The World Health Organization revealed that around 43,000 people worldwide die from this cancer. Despite more than 60 countries banning the commercial use of asbestos, the mesothelioma mortality rate has increased worldwide since the 1990s. This is proof that mesothelioma isn’t going anywhere.

National Cancer Database on Mesothelioma

In 2004, there were 1,783 pleural mesothelioma cases in the United States. In 2014, there were 1,961 reported cases. That’s an increase of around 10%.

Pleural mesothelioma accounts for between 70% and 80% of all U.S. mesothelioma cases and the same is true globally. Peritoneal mesothelioma and pericardial mesothelioma comprise the other 20-30% of cases.

According to numerous sources, including the Centers for Disease Control and Prevention, there are usually between 3,000 and 3,300 new mesothelioma cases in the U.S. each year. From 2012-2016, there were on average 3,253 new cases each year. In 2016 alone, 3,096 mesothelioma cases were reported.

The World Health Organization estimates that 10,000 new mesothelioma cases each year are diagnosed collectively in Australia, Japan, North America and western Europe.

In the United Kingdom, the incidence of mesothelioma has increased steadily each year from the 1950s (153 cases) to 2010 (2,360 cases). Like we said earlier, this disease isn’t going away.

But…

Mesothelioma Treatment Is Improving

 Science continually evolves, which means treatment for diseases continuously improves. Mesothelioma treatment is getting better, which is good news for patients and their loved ones.

Earlier in 2019, The U.S. Food and Drug Administration approved the Novo TTF-100L medical device for pleural mesothelioma treatment. It is limited to humanitarian use device distinction, but this approval was a significant moment for mesothelioma patients and doctors.

Peritoneal mesothelioma treatment is expanding as well. Many patients receive cytoreductive surgery, plus heated intraperitoneal chemotherapy (HIPEC) immediately after the operation. In a study published by the Annals of Surgical Oncology, around 55% of participants who underwent this treatment combination survived for at least three years. Roughly 37% survived for at least five years.

This study only included a few peritoneal mesothelioma patients, and other studies have reported different percentages:

• Between 50% and 65% for three-year survival
• Between 35% and 47% for five-year survival

Mesothelioma Patients Undergoing Treatment More Often

The best route to healing from mesothelioma is undergoing treatment. Surgery is the first choice followed by chemotherapy and radiation. If more patients receive medical help, then more of them will survive longer.

In 2004, treatment and survival rates in the U.S. were as follows:

• Approximately 34% of pleural mesothelioma patients underwent treatment.
• Around 37% of them survived for at least one year after diagnosis.
• Roughly 9% survived for at least three years.

In 2014, the rates were better:

• Around 54% of mesothelioma patients received treatment.
• Roughly 47% survived for at least one year after diagnosis.
• Approximately 15% survived for at least three years.

So, more people are getting treatment for their mesothelioma, and more people are surviving for longer after diagnosis.

How to Find Mesothelioma Treatment

We at Mesothelioma Guide can help patients find quality treatment and potentially extend their lives. Our patient advocate and registered nurse, Jenna Campagna, has connections to the top cancer centres in the USA.

If you or a loved one has mesothelioma, remember that treatment now is better than ever before. Jenna works with patients every day to improve their quality of life and prognosis. Email her at jenna@mesotheliomaguide.com if you wish to explore your treatment options.

More Information

If you have any questions on mesothelioma or would like any further information, you can leave your question for Mesothelioma Guide in the comments section below. Alternatively,  you can visit Mesothelioma Guide’s website here,  like their Facebook Page or follow them on Twitter.

Sources

1. Largely Unchanged Annual Incidence and Overall Survival of Pleural Mesothelioma in the USA. World Journal of Surgery. Retrieved from: https://link.springer.com/article/10.1007s00268-019-05132-6. Accessed: 08/23/2019.
2. Global mesothelioma deaths reported to the World Health Organization between 1994 and World Health Organization. Retrieved from: https://www.who.int/bulletin/volumes/89/10/11-086678/en/. Accessed: 04/22/2020.
3. Global mesothelioma epidemic: Trend and features. Indian Journal of Occupational and Environmental Medicine. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4280782/. Accessed: 04/22/2020.
4. Update on the management of malignant peritoneal mesothelioma. Translational Lung Cancer Research. Retrieved from: http://tlcr.amegroups.com/article/view/23788/18535. Accessed: 08/23/2019.
5. Effect of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy on Quality of Life in Patients with Peritoneal Mesothelioma. Annals of Surgical Oncology. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/31069554. Accessed: 05/16/2019.
6. Survival prognostic factors in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy treatment: analysis from a single oncological center. WorldJournal of Surgical Oncology. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4815060/. Accessed: 04/12/2019.

The COVID-19 pandemic has left many of us feeling anxious and uncertain about the future and with this in mind, we are delighted to share some tips from NJC Therapy Practice to help you find some inner peace during this difficult time.

Six Principles to Nurture Balance and Peace in Your Life

1. Find your calm before you start anything (e.g. deep, slow breaths; visualization; whatever works for you)
2. Know you control your thoughts (limitless possibilities)
3. Know you control your actions (pause and decide how you’re going to act)
4. Everything is neutral (until you give it meaning i.e. how you look at it e.g. cup half full or empty)
5. Each day, find the joy in simple things (do what makes you laugh out loud/grin)
6. Begin and end your day with gratitude (appreciate someone or something)

About NJC Therapy Practice

NJC Therapy Practice aims to help their clients use their unique inner strengths and passion to take control of their lives. They offer a variety of life-enhancing and holistic programmes that are tailored to your individual needs incorporating the following approaches:

• Life coaching
• Hypnotherapy
• Educational Performance Programme
• Self Help Publications and Audio Recordings
• Hypnosis Meets Sports
• Specialisms: Stress management, weight control and performance management

To find out more about NJC Therapy Practice, you can visit their website, follow them on Twitter or send them an email

Photo Credit

Ian Kiragu

As part of our My Healthy Heroes pilot project, we worked with two fourth grade classes in St Kitts to highlight the importance of healthy eating.

As part of this project, we sought to use creative ways to consolidate what students learnt in our sessions. Therefore, one of the tasks we gave students was to write either a short story, rap or poem featuring one of our My Healthy Heroes characters.

Today, we’re delighted to share a few of the short stories with you. We hope you enjoy them.

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A Mangolicious Dream

By: Rainier Martin

In the night, Amelia ate her dinner. Afterwards, she went to sleep, to wake up the next morning.

When Amelia was finally asleep, she had a great dream. There were characters, Miss Mangolicious and her healthy fruit and vegetable friends.

Miss Mangolicious and her friends, Tommy Tomato and Potato Head Jed were on a great mission.

“We have to save Amelia!” exclaimed Miss Mangolicious.

“Amelia is suffering from a severe case of Lack-of-Healthy-Eating-itis” said Tommy Tomato.

“We need to meet Ameilia at her usual eating spot right now. Quick, to my Mangolicious Carriage!” exclaimed Miss Mangolicious.

“There she is, sitting under the shady trees,” said Potato Head Jed.

“Amelia!” shouted Miss Mangolicious.

“You need to eat healthy foods,” said Tommy Tomato.

“Let us teach you the importance of healthy eating,” they all said.

“It is good to eat fruits and vegetables because you get a lot of vitamins and your bones become stronger,” said Potato Head Jed.

After all that Amelia learned in her dream, she started eating healthy from then on. Every day, Amelia eats fruits, vegetables and of course, mangoes!

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The Adventures of Professor Cornilious Cob

By: Kailynn Browne

 One day, the Sugary Drink Assassins and the Junk Food Villains were trying to take over Healthy Land.

Professor Cornilius Cob said, “Stop right there!”

The Sugary Drink Assassins and Junk Food Villains exclaimed, “We’re not going to listen to you!”

Professor Cornilius Cob needed some help from his friends. He called Miss Mangolicious, Captain Splash, Potato Head Jed and Mama Elegant.

Professor Cornilius Cob said, “We are going to fight them with facts.”

They all thought this was a great idea.

Professor Cornilious Cob said, “I am rich in vitamin B12, folic acid and iron.”

With that said, Frenchy the Frier disappeared into thin air.

“I have vitamins A, C, B6 and potassium,” said Miss Mangolicious. Donutter Dennis turned into dust.

Captain Splash exclaimed, “I am very important.” Juicer Jones turned into a puddle.

Mama Elegant exclaimed, “I have a beautiful colour which makes people want to eat me,” Greasy Greg Chicken Led turned raw.

After that day, the Junk Food Villains and Sugary Drinks Assassins went back to Unhealthy Land and never came back.

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We hope you enjoyed these two stories. Please do give our young writers a bit of encouragement by leaving a comment below and we’ll share more in our next blog post.

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).

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.

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.

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!

COVID-19 is starting to make its way over to the shores of the Caribbean. We are sure you’ve been bombarded with a lot of information so we won’t add too much more but simply share some useful information from the Pan American Health Organisation (PAHO) and Jamaica’s Ministry of Health and Wellness.

As of 11^th March 2020,  PAHO reported the following number of confirmed COVID-19 cases in the Caribbean

• The Dominican Republic: 5
• Jamaica: 1
• Martinique: 3
• Saint Barts: 1
• Saint Martin:2

What is COVID-19 and what you can do at work, home and in public to prevent infection

Jamaica’s Ministry of Health and Wellness has prepared some very useful resources to help the public understand what COVID-19 is and how you can protect yourself, your family and your colleagues. You can read these below:

What is COVID -19?

Measures You Can Take to Protect Your Home

Protecting Your Workplace

Protecting Yourself When You’re in Public

Conclusion

Before we go, we just wanted to stress the importance of seeking information from reputable sources which would be WHO, PAHO and your countries’ Ministries of Health, to remain calm and to pay special attention to your elderly family members (those who are over 60) and those with non-communicable diseases such as diabetes, cancer, cardiovascular disease and chronic respiratory disease as these two groups of people are at a higher risk of developing severe COVID-19 disease if exposed.

We are absolutely delighted to inform you that our fibroids research study has now begun after receiving ethics approval from the Ministry of Health last month. Our research project will explore the experiences of women residing in St Kitts and Nevis, who have been affected by fibroids.

The reason for trying to understand these experiences is because it has become clear that fibroids are a common health issue affecting women in St Kitts and Nevis. It is therefore important to explore if fibroids are affecting the quality of life of women in the Federation and understand what challenges women may be facing so we can provide effective and appropriate support, advocate on behalf of women, and ensure that women receive the best medical care possible.

We’re Looking For Volunteers

If you live in St Kitts and Nevis, are between the ages of 18 and 55 and have been diagnosed with fibroids within the last 5 years (any time between January 2015 and January 2020), you can take part in this research.

As a participant, you will be asked to take part in a 90-minute interview and in exchange for your time, you will receive $50EC.

 More Information

If you’re interested in taking part in this study or have any questions, please contact Abi Begho by emailing research@lakehealthandwellbeing.com or calling  1 869 765 8702.

Ethics Approval Details

This research study was granted ethics approval by St Kitts Ministry of Health’s Interim Ethics Review Committee on 12^th December 2019 (our ethics approval number is IERC-2019-12-035)

Research Partners

                                                 

This project is a partnership between Lake Health and Wellbeing, Serrette Brown Research and Consulting and Soca Girls Rock!

Today, we are delighted to share with you a guest blog post from Dyna Criss.

Dyna holds a degree in health and fitness, has worked as a health instructor for over a decade with a number of prominent health-related organizations and is a writer at heart.

 In this guest blog post, Dyna discusses how you can maintain a healthy weight by practising mindful eating.

People who want to maintain the right body weight can try mindful eating. Often, while eating, we can become preoccupied, distracted by our thoughts and others around us. Mindful eaters stay in the present moment and truly focus on the task at hand. Mindful eating requires that we eat slowly and reflect on why we’re eating, savour the taste of our food and listen to our body so that we pick up on our body’s signal of when we’re full, to avoid overeating.

Research suggests that mindful eating can help improve our eating habits and address binge eating, as well as eating for comfort.

Mindful eating can be challenging so below are some tips and tricks to help you get started

Reflect

Before eating try pausing for a moment. Now, think about how you are feeling. Are you stressed? Hungry? Bored? Happy? Ask yourself, what you want and what your body needs? After getting the answer to these questions, you can then choose the right food, at the right time and in the right quantity.

Take A Seat

 You should never eat in a rush. First, take a seat, get comfortable and then start eating. You will not be able to enjoy your meal or track your food intake if you are in a hurry or multitasking.

Turn off the TV and Put Away Your Phone

 Many people watch TV or interact with their phone while eating. These are significant distractions, that prevent us from being aware of the taste and quantity of what we are eating.

Be Aware of Your Portion Size

If you have purchased something to eat from a food vendor, eating it directly from the package can lead to overeating as we feel obligated to eat everything in one sitting.  It is better to place a small portion on a plate and tackle that, let it digest and if you’re still hungry, add another small portion. If there is any leftover, you can save the rest for another time.  If you’re cooking at home, be aware of what a serving size is and then make sure you adjust your portion size accordingly, so you don’t consume more than you realise.

Use Smaller Plates

If you see less than your stomach will crave less. Try using a smaller plate that will help you to eat adequately, but not excessively. A small plate size is a simple way to control the quantity of food you eat.

Be Thankful

Before having your meal, take a break for a minute and acknowledge and appreciate what it has taken to get every piece of food on to your plate. From farmers and factory workers to the chefs and your dining companions as well as your job that provides the resources to buy what you eat, there is much to be thankful for. When you pause to acknowledge this, you will develop a deeper appreciation and respect for the food you eat and this can positively affect your eating habits.

Chew At Least 30 times

 After having each bite, try to chew at least 30 times.  Not only does this enable you to enjoy the flavour and texture of your food, but it prevents overeating by giving your gut time to send a signal telling your brain you are full before you overindulge.

Put down Your Knife and Fork

 Many times, when we eat, we’re in a rush so we are ready to take our next bite before finishing what’s already in our mouth. Try putting down your knife and fork, sitting back, relaxing and enjoying what you’re currently eating. Try to refrain from picking up your knife and fork until you have swallowed what’s in your mouth.

You Can Leave Something On Your Plate

As kids, we were taught to finish all the food that was on our plate. We were not allowed to leave the table until our plate was empty. This has led to many of us overeating and not recognizing when we’re really full. It’s better to take your time, listen to your body and when you start to feel full, stop. To avoid waste, simply pack what is left for another time.

Try Solitude and Silence 

Every now and again, try eating in a quiet, tranquil environment. Silence can be challenging as our minds can wander so try to acknowledge any thoughts you may have and then swiftly return to the present moment and enjoy your meal.

Also, most of us like to eat with friends, family or colleagues which is nice but can be distracting. Mealtimes can be a good opportunity to have some me-time, a break from chores, work or the busyness of the day. Try eating alone sometimes and use this time to truly appreciate your mealtime, it may be the only time you get to relax especially during the working week. It also gives you the opportunity to be more food-conscious and really enjoy what you’re eating.

Final Words

Mindful eating offers various benefits. It is helpful for those who want to lose weight and stay fit, makes us more aware of the types of food we are consuming and encourages us to make better food choices.  Through mindful eating, we can improve our eating style and habits, stay healthy and maintain our optimum weight.

Let us know what you think about mindful eating in the comments section below and if you try mindful eating, please share your experience with us, we’d love to hear how it went.

Sources

1. https://www.wikihow.com/Practice-Mindful-Eating
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5556586/https://www.ucsf.edu/news/2016/03/402171/mindful-eating-meditation-may-lead-better-metabolic-health
3. https://scholar.google.com/scholar?hl=en&as_sdt=05&q=mindful+eating+researches&btnG=
4. https://careactive.com/

Picture Credits

Tobias Nii Kwatei Quartey

Pablo Merchán Montes

Happy New Year everyone and welcome to 2020!

As usual, as one year ends and the other begins, we like to look back and reflect on our achievements. It’s important for our morale to take some time out to focus on the positive as we don’t have a lot of time during the year to fully appreciate our successes.

This year, we focused our attention on two main areas – childhood obesity and women’s health with our overall objective being to tackle non-communicable diseases in St Kitts and Nevis.

We are delighted to share our 2019 achievements:

1. We continued our work on fibroids, a women’s health issue that is often neglected. We teamed up with organizations from across the world in July for a global fibroids awareness campaign; continued with our fibroids self-care webinar series and formed a partnership with Soca Girls Rock and Serrette Brown Research and Consulting to initiate a qualitative research study on fibroids and received ethics approval from the Ministry of Health, this project will start officially in January 2020. We also held our first fibroids educational event in St Kitts which was attended by over 40 women.

2. We received funding from the ICDF to start our My Healthy Heroes project which aims to encourage a healthy lifestyle in children.

3. We conducted three 6-week chronic disease self-management courses reaching 43 people who either had a chronic health condition, were caring for someone with a chronic disease or were at a high risk of developing a chronic disease.

4. We continued as an active member of the Healthy Caribbean Coalition’s Childhood Obesity Prevention Action Team and assisted in collecting data for the team’s recently published sugary drinks infographic, advocated for front-of-pack (FOP) nutrition labels in the Caribbean and a sugar-sweetened beverage tax.

5. We became members of the St Kitts and Nevis Bureau of Standards Technical Committee for Labelling as part of our work to advocate for FOP nutrition labels. We also became a member of the St Kitts Ministry of Health’s Elimination of Mother-to-Child Transmission (EMTCT) of HIV and Syphilis Committee (EMTCT Committee).

6. We launched our Healthy Kids SKN campaign and a campaign for World Cancer Day.

7. We attended or participated in a number of events including the ICDF’s Chronic Disease Prevention and Control Forum, the Ministry of Health’s SSB Focus Group, discussed stress management at the Verchilds High School and raised awareness of the importance of a healthy lifestyle and attended the HCC’s NCDs and Conflict of Interest meeting in Barbados.

8. Finally, we expanded our consultancy services from working with one client in 2018 to six clients in 2019 and this included both grant writing and research support. This branch of our work has helped us raise much-needed funding to cover the cost of some of our work.

And that, my friends, is it. It was indeed a productive year.

We would like to say a big thank you to all our funders, clients, collaborators and supporters for your encouragement, kind words and support. We really appreciate it and look forward to a fantastic year ahead. We are truly excited about 2020 and can’t wait to get started.