Friday 17^th November was the second annual Caribbean Alcohol Reduction Day. This year’s theme was: Drink Less, Reduce Cancer and to mark the day the Healthy Caribbean Coalition, in collaboration with PAHO, CARPHA and CARICOM, hosted a webinar on Alcohol and Cancer in the Caribbean.  This was a very informative and interesting webinar which featured three speakers:

• Dr Kevin Shield – Alcohol Consumption and Cancer in the Caribbean
• Dr Maristela Monteiro – Alcohol Policies in the Caribbean
• Dr Rohan Maharaj – Alcohol use among the elderly in the Eastern Caribbean: Associations with NCDs and psycho-social issues

Alcohol Consumption and Cancer in the Caribbean

The first presentation was delivered by Dr Kevin Shield. He started by providing some background into cancer in the Caribbean explaining that the latest data, from 2012, shows that in the Caribbean about 21,000 new cancer cases are diagnosed every year and just over 13,000 deaths per year in the region are due to cancer.  When we look at the number of cancers in the Caribbean caused by alcohol, it is estimated to be 650 cancer cases per year or put another way 3.1% of all cancers diagnosed in the Caribbean are due to alcohol consumption. Looking at the number of cancer deaths in the Caribbean due to alcohol, 2.9% of all cancer deaths are due to alcohol consumption or 387 deaths per year.

Dr Shield  stated that in the Caribbean, on average, an adult consumes 1.2 alcoholic drinks per day, but there is a difference amongst countries with some countries drinking less and other drinking significantly more.

Dr Shield explained the  link between cancer and drinking stating that numerous studies have been conducted that have determined how drinking causes cancer. Data suggests that alcohol causes cancer in the following ways:

• By our bodies converting alcohol into a cancer-causing chemical (i.e. a chemical that can damage our DNA)
• By affecting our hormone levels and various pathways in the body

Through research links have been found between alcohol and cancers of the mouth, upper throat, food pipe, voice box, breast, bowel and liver.  The number one cancer impacted by alcohol is breast cancer.

Based on all of these factors the  International Agency for Research on Cancer  has classified alcohol as a type 1 carcinogen, which means there is the highest level of evidence to suggest that it does cause cancer. So drinking is a major problem.

The question then is: how can we prevent the cancers that are caused by alcohol? The solution is to reduce alcohol consumption and Dr Shield stated that there are three cost effective and feasible approaches that can be taken:

• Restrictions on access
• Banning advertising
• Increasing excise taxes

This presentation ended on a fairly positive note highlighting that many Caribbean countries have not fully introduced these three measures which means that there is potential to make a huge difference in tackling alcohol and cancer in the Caribbean.

Alcohol Policies in the Caribbean

We then heard from Dr Maristela Monteiro who gave an overview of alcohol policies in the Caribbean. She started by explaining that as part of the voluntary global non-communicable diseases target for 2025 there is a goal to reduce harmful use of alcohol by 10%.  WHO and PAHO, in consultation with a number of organisations, developed a global strategy to reduce harmful use of alcohol and they provided recommendations on 10 policy areas and countries are to try to implement as many as possible. They describe particular recommendations as “best buys” especially for low to middle income countries and these were the three areas mentioned by the previous speaker (restrict access to alcohol, enforce bans on advertising and raise taxes on alcohol).

Dr Monterio then went through each of these three policy areas giving an assessment of how successful Caribbean countries have been with their implementation. She started first with whether countries have a national alcohol policy in place.  Out of the 14 Caribbean countries that they looked at only three had some form of national policy.

Dr Monterio then looked at policies to restrict access to alcohol:

• Licensing: most Caribbean countries have a licensing system, 12 out of the 14 countries. Licensing systems restrict access by imposing rules and penalties to those who wish to sell alcohol such as not selling to minors, the license also has a fee and this may limit the number of businesses who choose to sell alcohol.
• Restrictions on hours, locations and days of sale of alcohol: only three Caribbean countries were fully compliant in this area.
• Minimum drinking age: most Caribbean countries have a minimum drinking age, only three don’t.  The majority of countries in the Caribbean with a minimum drinking age have set this at 18, some have set this at 16.  It was felt that 18 was a relatively low age restriction and this could be increased to 21 to have more of an impact.

Dr Monteiro then discussed taxation. She stated that in the Caribbean most countries have some taxation of alcohol, but these taxes were introduced many years ago and have not been adjusted for inflation. This means that taxation is not having the impact that it should as taxes are fairly low and are not acting as a deterrent.

Finally Dr Monteiro discussed restrictions on advertising and explained that this was the least developed area of policy in the Caribbean.  She explained that this is a major problem as 20% of students are exposed to alcohol advertising daily and research has shown that this is associated with an increase in alcohol consumption. She explained how persuasive these advertising campaigns are and some of the tactics used to encourage people to drink –  companies focus on alcohol as an antioxidant, that consuming alcohol causes weight loss and improves your mood (this communicates the message that alcohol is healthy)  and equating drinking alcohol to business success.

Action needs to be taken to address advertising as research as shown that youths are more exposed to advertising than adults so there is a concerted effort by the alcohol industry to reach young people and make them life-long drinkers.

Alcohol Use and the Elderly

Finally we heard from Dr Rohan Maharaj who summarised a very interesting piece of research carried out across four Caribbean countries on alcohol use and the elderly.  The research consisted of participants from Puerto Rico, Barbados, the US Virgin Islands and Trinidad. The data was collected from April 2013 to May 2015 and they determined whether people were ever-drinkers, current drinkers, problem drinkers or heavy drinkers and related this to various psycho-social and health issues.  Their main conclusions were:

• Generally there was wide use of alcohol across all participants
• 5-6% of participants were involved in potentially harmful alcohol use
• Males were more likely to be problem or heavy drinkers
• There was an association between alcohol use and stage 1 hypertension
• There was an association between alcohol use in ever-drinkers and cancer
• A higher proportion of those with lower educational achievement admitted to alcohol use
• Those who were employed were more likely to be drinkers (thought to be because they had more disposable income)
• Those who reported earlier initiation of sexual activity reported heavy drinking
• Those who had issues with domestic violence (current or past) had reports of problem drinking
• Heavy and problem drinkers tended to be lower educated males, living in Trinidad, married, physically active and employed with high rates of hypertension and being diabetic.

Dr Maharaj and his team will be doing a follow up study with participants in the next 2 to 3 years and this will give them the opportunity to further explore the link between alcohol use, cancer and other non-communicable diseases.

Conclusion

This was a very informative webinar  and it’s so important that we get some of this information out to the public as we know that many people are not aware of the link between cancer and alcohol consumption.

For more information you can listen to a recording of the webinar here

Yesterday, we attended the CARICOM Marijuana Commission’s public consultation in Basseterre, St Kitts. This was an interesting, and at times heated, discussion which aimed to inform their report on marijuana use in the Caribbean.

The commission has been tasked with examining the health, social, economic  and legal issues surrounding the use of marijuana and to make recommendations to heads of government on whether the drug classification of marijuana should be changed. They will also make recommendations on, if marijuana is to be re-classified, what legal and administrative conditions should apply.

Yesterday’s consultation was one of many that the Commission has conducted throughout the Caribbean enabling them to reach a wide and diverse audience. In addition,  the Commission itself represents a range of stakeholders including commissioners from the fields of law, social work,  medicine, science, religion, law enforcement and psychology,  and they have youth representation.

Introduction by the Commission

In this public consultation we first heard from Prof Rose Marie Belle-Antoine who gave a brief introduction and provided some background into their work. She explained that the information obtained from the consultation would be combined with the information from other consultations, the St Kitts National Marijuana Commission and their own research on the medical, economic, social and legal implications to provide recommendations for policy changes to heads government in the Caribbean. She also mentioned that there was a need for public education on some of these issues as there are many people who are not informed about marijuana.  She explained the importance of looking at social justice issues (e.g. who gets arrested), gender issues (we hear a lot about the men but what happens to women and what is the impact on families), law enforcement (do they turn a blind eye to some marijuana use), the impact on productivity and addiction issues.

Prof Belle-Antoine also explained that internationally marijuana is classed as a narcotic so if the Caribbean re-classifies marijuana they would need to understand the implications for the Caribbean internationally – would we become a “rouge state.” Here she said we can learn some lessons from Jamaica who have already decriminalised marijuana.

Prof Belle-Antoine also touched on research being conducted in Barbados with prisons to understand if there is any real link between marijuana and crime.  She ended by stating that another important aspect of their work is understanding the  risks of marijuana use and what safeguards can be implemented.

The Public’s View

After Prof Belle-Antoine’s introduction the floor was then opened up to the public for comments and feedback. Overall the audience was in favour of legalising marijuana or decriminalising it. There was a feeling that it shouldn’t be illegal to use a plant  and that an adult should have the right to make an informed decision as to whether they use marijuana or not.  There was an overwhelming feeling that  vast amounts of data on marijuana already exists that give a clear picture of the  benefits and harms showing the benefits do outweigh the harms. Therefore many felt that a decision could already be made on whether we should reclassify marijuana, a report would delay things further. There was frustration about the consultation itself with a few people stating that it felt like “just talk.”

Several members of the public were able to give concrete examples of the use of marijuana for therapeutic purposes – chronic pain, nausea, cancer, liver disease etc. Many mentioned the historic and religious use of marijuana. One participant was able to provide a comparison between alcohol and marijuana showing that alcohol was significantly more harmful than marijuana – alcohol causes 1 million deaths a year and there has been no known death caused from marijuana itself.

The audience raised the huge economic potential in developing a safe marijuana industry in the Caribbean. It  was felt it could help to diversify our economies as many islands are heavily dependent on the tourism industry. It was highlighted how versatile marijuana is with one attendant showing the panel a book made from marijuana.  There was concern that if a marijuana industry is developed, large foreign companies would find a way to exploit our resource and no financial benefit would be reaped by Caribbean islands.

Conclusion

The evening ended with the commissioners answering some questions on the time-frame for the report and how much influence they would have on governments to implement their recommendations. The Commission explained that they are working as hard as they can to collate all the information and will produce a comprehensive report.  They stated that their report won’t be binding but they hope it would be influential and lead to change, but change does take time.

This was an interesting discussion and we do hope that the report published by the Commission will lead to change in the laws on marijuana and that we can develop a thriving industry that creates wealth for our nations.

Further Information

The CARICOM Marijuana Commission is still keen to hear from the public on this issue and is inviting anybody with an interest in this topic to submit their views to them in writing at marijuana@caricom.org

For more information on the work of the Commission, please visit their website http://caricom.org/marijuana-commission

Let us know what you think about this issue by leaving a comment below.

Every year, on 14^th November, the world comes together to recognise World Diabetes Day.  Created by the International Diabetes Federation and the World Health Organisation in 1991 to address the escalating threat that diabetes poses, this is a day that aims to raise awareness by reaching a global audience. This year’s theme is: ‘Women and Diabetes – Our Right to a Healthy Future.’  ‘Why the focus on women?’  You may ask. The stats say it all.

Women and Diabetes

Currently there are over 199 million women living with diabetes throughout the world and research suggests that this could rise to a staggering 313 million women by 2040. Diabetes is the ninth leading cause of death in women with 2.1 million deaths per year being due to this condition.  Forty per cent of women with diabetes, around 60 million women, are of reproductive age. The complication here is that women with diabetes are more likely to have fertility problems and without access to pre-conception planning there is a higher risk of death and illness for both mother and child during pregnancy.

Additionally, one in seven pregnant women develop gestational diabetes. This is a type of diabetes that only develops during pregnancy. If it is not managed properly it can negatively affect both the expectant mother‘s and baby’s health.  In most cases, after pregnancy, gestational diabetes resolves on its own, but the mother is then at a higher risk of developing type two diabetes.

Finally, women with type 2 diabetes are ten times more likely to have coronary heart disease than  women who don’t have diabetes.

Due to these facts and figures there is a need to focus on women, raise awareness and ensure that health services are equipped to address the specific needs of women with regards to diabetes.

Black Women and Diabetes

Black women are at a significantly higher risk of developing diabetes than their white counterparts. In the US, diabetes affects 25% of black women in the 55 and over age group and it is the fourth leading cause of death in black American women of all ages.

Black women in the UK are also at increased risk of developing diabetes  and diabetes rates in the Caribbean and Africa are also high.

It is thought that the increased risk in black women is due to multiple factors including genetics and black women being more likely to have high blood pressure,  to be obese and be physically inactive.

What Can We Do?

Diabetes can be prevented by adopting a healthy lifestyle. We should endeavour to:

• Maintain a healthy weight
• Eat a healthy diet
• Get active: it doesn’t have to be structured exercise, just anything that increases your heart rate such as gardening, brisk walking, dancing, cycling, playing with the kids

Let’s all spread the word about the prevention of diabetes so that we can stop more women, especially black women, from developing this condition.

---

References

International Diabetes Federation

American Diabetes Association. Diabetes in African American Communities Advocacy Fact Sheet.

With 1 in 4 people in the UK suffering from a mental health issue, there is a need to find experienced counsellors who provide an effective and high quality service, OH Services does just that.

Founded in 2010 by counsellor Olivia Haltman, OH Services aims to support people through the difficult periods of their life. They are committed to providing a safe, confidential and non-judgemental environment where people can open up and get the support they need.

They provide one-to-one counselling, EMDR therapy, group therapy, workshops and seminars for adults and young people from all walks of life. They understand that people have different needs and deal with traumatic experiences in different ways, and therefore provide a tailored programme of support that ensures the right approach for each individual.

Founder, Olivia Haltman, is an accredited Integrative Humanistic Counsellor and an Eye Movement Desensitization Reprocessing (EMDR) Therapist.  She is also a member of British Association for Counselling and Psychotherapy (BACP), EMDR UK & Ireland and BAATN (Black and Asian Therapist Network). Ms Haltman has over 10 years experience working in the mental health sector having worked for organisations like Mind and established her organisation to support people who want to develop their lives on a personal level and reach their best potential. Of her approach to tackling mental health issues she says:

“I believe everyone is different, with unique needs and aspirations so I use an integrative approach to apply and integrate the most suitable solutions for my clients. Within my practice, I also apply (where necessary) a holistic approach to help clients enjoy the essential benefits of wellbeing and healing processes.”

OH Services works with a range of clients and issues, and if you’re experiencing some form of anxiety or trauma, or just need someone to talk you through an issue then please contact OH services. You can find their contact details here and for more information visit their website.

We recently came across this really interesting video on TED and thought we’d share it with you.  In this video you’ll hear from Dr Elizabeth Wayne, a biomedical engineer, who discusses the work her lab is undertaking to explore a more effective method to treat cancer. They researching  how they can develop “a mean killing machine on wheels” by using cells in our immune system to target cancer cells.

Climate change has been a controversial topic since Al Gore’s 2006 documentary, an Inconvenient Truth, with people passionately defending both sides of the debate – climate change deniers and climate change believers.  Over the past year climate change has become very topical due to the United States pulling out of the Paris Agreement. This is an agreement that aims to facilitate a global response to climate change by “keeping a global temperature rise this century well below 2 degrees Celsius above pre-industrial levels and to pursue efforts to limit the temperature increase even further to 1.5 degrees Celsius.” Countries throughout the world have committed to working towards this aim and will report regularly on their emissions.

Why are we so concerned about climate change? Researchers have been able to demonstrate that climate change will have a significant impact on the weather, agriculture and a range of other areas. This week, The Lancet Countdown report has demonstrated the impact of climate change on our health.

What is the Lancet Countdown?

The Lancet Countdown is an international research collaboration consisting of 26 institutions tracking the world’s response to climate change and in so doing have been able to reveal the impact that climate change has on the public’s health.

Some of the research findings

In this week’s report, researchers stated that climate change is “already a significant public health issue and a looming global health emergency.”

Some of their key findings were:

• Between 2000 and 2016, the number of vulnerable people exposed to heatwave events had increased by around 125 million.
• Annual weather-related disasters increased by 46% from 2000 to 2013.
• Vectorial capacity for the transmission of dengue increased by 9.4% (Aedes aegypti) and 11.1% (Aedes albopictus) due to climate trends since the 1950s.
• The number of undernourished people in 30 countries vulnerable to climate change and highly dependent on regional food production has increased from 398 million in 1990 to 422 million in 2016.
• Over 803,000 premature and avoidable deaths in 2015 as a result of air pollution across 21 Asian countries, attributable to just one type of air pollution from coal power, transport and use of fossil fuels in the home.

The report highlights the progress that has been made to tackle climate change and this includes:

• Many countries now have a climate change risk assessment in place
• Over a third of countries in the study have developed plans to increase the climate resilience of their health infrastructure
• The total primary energy supply of coal peaked in 2013 and has been rapidly declining, showing a movement towards cleaner energy supplies

Prof. Anthony Costello, Co-Chair of the Lancet Countdown and a Director at the World Health Organization concluded that:

 “Climate change is happening and it’s a health issue today for millions worldwide. The outlook is challenging, but we still have an opportunity to turn a looming medical emergency into the most significant advance for public health this century.”

The Lancet Countdown will continue to report on climate change annually with the aim of ensuring that governments continue to pursue efforts to prevent climate change.

Our Thoughts

The Lake Foundation was happy to see this report published which provided an update on the progress being made to tackle climate change and clearly explained the impact on our health. It was sad to read that climate change is disproportionately affecting communities least responsible for climate change and those most vulnerable in society. We need to understand how we can encourage those that are most responsible for climate change to take responsibility and act now.  There is work to be done to discuss climate change with those who believe it doesn’t exist, many people with this view are very influential and there needs to be some form of compromise so that progress can be made.  The take home message should be that regardless of your view, we need to respect and take care of the planet.  Reducing pollution and preserving our wildlife is the right thing to do, you can’t really argue with that.

---

For more information on the Lancet Countdown report please visit their website here

A couple of weeks ago government representatives from across  the world met in Montevideo, Uruguay for the World Health Organisation’s Global Conference on NCDs (Non-communicable diseases, e.g: cancer, diabetes,  cardiovascular disease etc).  The objectives of the conference were: to guide countries on how to reach sustainable development goal target 3.4 by 2030; to launch a new set of global initiatives to help countries accelerate progress in tackling NCDs; to share and exchange experiences; and to discuss how the health sector can be a key example of the benefit of enhancing policy coherence to achieve the sustainable development goals.

Making A Commitment to Tackle NCDs

At this conference governments endorsed the Montevideo Roadmap 2018-2030 on NCDs as a Sustainable Development Priority. By endorsing this roadmap they have made a commitment to take significant steps towards reducing the premature deaths due to NCDs by a third. They recognised that NCDs are one of the major challenges of the 21^st century and that progress to tackle them has been uneven and insufficient. The roadmap states that 15 million 30 to 69 year olds per year die from a NCD and 80% of these premature deaths occur in developing countries.  There are a number of challenges associated with tackling NCDs and with this is mind they committed to the following actions:

• Reinvigorate political action
• Enable health systems to respond more effectively to NCDs
• Increase significantly the financing of national NCD responses and international cooperation
• Increase efforts to engage sectors beyond health
• Reinforce the role of non-State actors
• Seeks measures to address the negative impact of products and environmental factors harmful for health and strengthen the contribution and accountability of the private sector and other non-State actors
• Continue relying on WHO’s leadership and key role in the global response to NCDs
• Act in unity

Our Thoughts

We were delighted to see world leaders come together and make this commitment and look forward to seeing these actions being taken forward.

We’re particularly happy to see that efforts will be made to engage with a variety of stakeholders. As a small organisation that is passionate about improving the health and well-being of our community we do get frustrated at the lack of engagement with grassroots organisations. We have many times reached out to local and national governments with our enthusiasm and ideas, ready to play a role but have received lukewarm responses or no responses at all. We hope that governments will see the value of working with small organisations and we have been grateful for the funding provided by Croydon Council, Sports England, Macmillan and Eli Lilly for some of the work we’ve conducted on NCDs. We look forward to continuing to work in this area and making our own small contribution.

---

You can read the complete Montevideo Roadmap below.

Today is World Stroke Day giving us the perfect opportunity to put the spotlight on this condition.  The organisers of World Stroke Day, the World Stroke Organisation, as part of this year’s campaign are asking the question: what’s your reason for preventing stroke? Our reason is because strokes are more common in the black community and we would like to prevent this condition from affecting so many people in our community. This is achievable as 90% of strokes are linked to avoidable risks.

Stroke is the second leading cause of death in the world with 6.2 million deaths per year being due to stroke. It is also the leading cause of disability with 5 million people being permanently disabled every year after suffering a stroke.

What is a Stroke?

A stroke occurs when the blood supply to part of the brain is cut off resulting in damage to or death of brain cells. You can think of a stroke as a similar to a heart attack, but it takes place in the brain, people sometimes refer to it as a brain attack.

There are two types of stroke:

Ischaemic strokes – this is where something blocks an artery to the brain. The blockage can be caused by a blood clot, air bubble or fat globule.

Haemorrhagic strokes – these occur when a blood vessel bursts and bleeds into the brain.

It is estimated that members of the black community are twice as likely to suffer from a stroke as the white population. This is thought to be related to the fact that stroke is a complication of diabetes, high blood pressure and sickle cell; these are all common conditions in the black community.

You can watch the video below to find out more about what a stroke is.

Warning Signs of a Stroke

When someone has a stroke it is very important that they get medical care quickly to ensure that any damage to the brain is kept to a minimum. Strokes happen suddenly so the person who has the stroke or those around him/her may not recognise what is happening until it is too late.  There may be warning signs just before  a stroke occurs so it is very important that everyone is aware of what these are so that you can get help immediately from the emergency services.

The warning signs of a stroke are:

• Numbness or weakness in your face, arm, or leg, especially on one side
• Confusion or trouble understanding other people
• Trouble speaking
• Trouble seeing with one or both eyes
• Trouble walking or staying balanced or coordinated
• Dizziness
• Severe headache that comes on for no known reason

Who is at risk of having a stroke?

• Older people – most strokes occur in people over the age of 65 but younger people have strokes too with 25% of strokes being in younger people
• People with a family history–if a close family member has had a stroke your risk of having a stroke is higher
• Particular ethnic groups – South Asians, Africans and Caribbeans are more likely to have a stroke
• People with a medical history – if you’ve already had a stroke, heart attack or a mini-stroke you are more likely to have a stroke. Also if you have diabetes, high blood pressure and sickle cell.
• Smokers – smoking doubles your risk of having a stroke
• Drinkers – alcohol can increase your risk of having a stroke

Prevention of Strokes

You can reduce your risk of having a stroke by:

• Eating a healthy diet – a low fat, high fibre diet is recommended including plenty of fruits and vegetables
• Regular exercise – this will make your heart and blood circulation more efficient
• Not smoking
• Reducing your alcohol intake

Think FAST

If you or someone you know are ever worried that you may be having a stroke it is important to think FAST:

Face: weakness of the face. Can you or the person smile? Has your face fallen on one side?

Arms: weakness in the arms. Can you or the person lift their arms?

Speech: has your speech been affected. Are you experiencing slurred speech?

Time: if any of the above are experienced then call 999/911 immediately

 More information

This World Stroke Day let’s all make a commitment to work towards preventing stroke by changing our lifestyle and being aware of the symptoms. This is so important for the black community as we are twice as likely to develop stroke.

For more information on stroke you can visit the following websites:

• World Stroke Day
• Stroke Association
• Centres for Disease Prevention

Last week Monday was World Food Day. This day is recognised every year on 16^th October and aims to highlight the on-going issue of hunger and food scarcity globally. It gives us the opportunity to reflect on the world’s efforts to ensure food security and that everyone has access to healthy food.

This year’s theme was “Change the future of migration. Invest in food security and rural development.” The idea behind this theme was to raise awareness of the fact that addressing the reasons why people migrate will enable us to tackle hunger and food scarcity.

People migrate for many reasons such as political instability or conflict in a country, but many more people migrate due to hunger, poverty and extreme weather conditions. A lot of migration occurs in developing countries where people move within their country, for example from the countryside to the city. This puts a huge strain on already meagre resources and further exacerbates the problem of hunger and food scarcity in these countries.

Research has shown that 763 million people migrate within their borders which, contrary to popular beliefs, means there is more internal migration then external migration in the world.  When we look at the people who migrate internally a third of them are young adults aged 15-34 and almost half of them are women. The question is: what is going on? Why are young adults and women migrating in such large numbers? As previously stated people migrate for many reasons, and hunger and poverty is one of them.

What World Food Day is encouraging people to understand is why people are hungry and poor in the first place. Can we tackle those reasons? If we can get to the root of the problem and address these reasons, it will prevent hunger and poverty. This will stop people from migrating in such large numbers and then putting a strain on food resources in the cities they migrate to.

When we look at people that migrate internally, the majority come from rural areas where people depend on a limited number of sectors to survive. There tends to be a lack of job opportunities, a lack of opportunity for further education and no access to healthcare; pairing this with other issues like a natural disaster leads to migration. Therefore, this World Food Day, the Food and Agriculture Organisation of the United Nations encouraged governments to focus on rural development.

Through rural development business, job and educational opportunities can be developed making communities stronger financially. Whilst providing access to good healthcare can improve their health and wellbeing. This means rural communities can become stronger so that when disaster strikes they are better equipped to overcome any natural or man-made disaster.  They can stand strong without the need for mass migration.

The key to rural development is balance.  We know that aspects of rural life are better for our health and well-being – people are more physically active, consume less processed foods, are less dependent on technology and have better social interactions. Therefore there is a need to preserve what is good about rural living and turn away from just converting rural areas into urban cities. We need a creative approach to rural development that delivers the development that is needed to strengthen communities, but doesn’t create the problems associated with urban living.  This can only be achieved by a totally understanding the communities, their interests and what they would want from urban development.

We hope that the message from World Food Day resonated with people throughout the world so that we can eradicate hunger and poverty. There is certainly enough food and resources in the world to feed everyone so let us spread that around by strengthening all communities.

---

References

Food and Agriculture Organisation of the United Nations

Last week was World Obesity Day and to mark the occasion researchers released global estimates of childhood and adolescent obesity levels. The publication of this data aimed to give a flavour of where we are with the health of children throughout the world and initiate action on tackling childhood obesity. The study pulled together data from 2,416 sources and this covered information on the height and weight of 128.9 million people aged 5 and over from 1975 to 2016.

Overall the data showed that globally the number of obese children increased by a factor of 10 from 1975 to 2016. If we put that into numbers the number of obese girls (aged 5 to 19) rose from 5 million in 1975 to 50 million in 2016, whilst the number of obese boys increased from 6 million to 74 million.

Interestingly, when we look at specific regions across the world, we see that Polynesia and Micronesia have the highest childhood obesity levels and the lowest levels are seen in south Asia and east Africa.

It was also noted that whilst there are high levels of obesity amongst children worldwide a significant number of children are moderately or severely underweight – 75 million girls and 117 million boys. The majority of these children are in South Asia, specifically India.

What’s happening in the Caribbean?

The Caribbean is also included in this study with 18 countries explored. This included Antigua & Barbuda, the Bahamas, Belize, Barbados, Bermuda, Cuba, Dominica, Dominican Republic, Grenada, Guyana, Haiti, Jamaica, Puerto Rico, St Kitts and Nevis, St Lucia,  St Vincent and the Grenadines, Trinidad and Tobago and Suriname.

When all the data for the Caribbean was pooled together, the data was somewhat promising in 5-9 year olds with the average BMI (Body Mass Index) for Caribbean boys and girls being on the lower end when compared to other countries. For example, the average BMI for girls aged 5-9 in the Caribbean was found to be about 16kg/m². This was the 6^th lowest out of 21 countries. The highest being about 20 kg/m² in Polynesia and Micronesia, the lowest being 14.5kg/m² in East Africa and South Asia.

When looking at the older age group of 10-19 year olds, the data is not so promising with Caribbean children being on the higher end of the scale. For example, the average BMI for Caribbean boys aged 10-19 was about 21.5 kg/m², the 6^th highest out of 21 countries. The highest being almost 24 kg/m² in Polynesia and Micronesia, the lowest being 18 kg/m2 in South Asia

As well as looking at the average BMI, the researchers explored the prevalence of obesity in different countries and again some countries in the Caribbean are ranked amongst the highest with countries like Bermuda and Puerto Rico having an obesity prevalence in girls of over 20%.

Conclusion

This work confirms what is widely known in the Caribbean and other countries, childhood obesity is a problem and needs to be tackled with some urgency. On paper the solution is easy: get children active and improve their diet, but in reality due to a number of factors such as culture, income, motivation and opportunity the solution is difficult and complex.

We all need to work together to determine how best we can address this problem by encouraging the Caribbean to see the benefits of their traditional way of life before Western culture and food were embraced. We have to make physical activity a part of life and turn back to home-grown, unrefined, home-made food.