Today, we are delighted to publish the report of our My Healthy Heroes pilot project. This project ran from February to March 2020 and aimed to test our approach to promoting healthy eating in children.

Through our My Healthy Heroes project, we aim to educate and empower children to make healthy choices by tapping into their creativity to highlight the importance of a healthy lifestyle.

Our pilot was important in helping us test our resources and characters (Healthy Heroes, Sugary Drinks Assassins and Junk Food Villains) with children and teachers to see if we could successfully engage children and educate them about healthy eating, and more importantly, facilitate a change in their behaviour.

Although our project ended slightly early because of the COVID-19 pandemic, it was very successful and demonstrated that with a little creativity, we can get children excited about healthy eating, to learn and retain important information about the harms of unhealthy eating, to reflect on their lifestyles,  to attempt to change behaviour and to rethink their food choices.

The main lessons learnt from this project were:

1. Children accept that they should be eating a healthy diet, but the depth of their knowledge of healthy eating, its benefits and the harms of unhealthy eating is low and therefore means this acceptance doesn’t translate into a change in behaviour or a motivation to eat a healthy diet.
2. The major factor that impacts children’s choice of what to eat, if they are given a choice, is taste, but children also recognise that some foods are more accessible and that the significant amount of marketing of unhealthy foods impacts their choices.
3. Students’ favourite foods vary. They selected both fast food and home-cooked meals as their favourite foods, and these were selected mostly based on taste. This means there is the opportunity to encourage more healthy eating if parents, schools and vendors explore creative ways to prepare healthy foods that children would deem to be tasty.
4. Children and parents overestimate how healthy children’s diets are; in reality, children are not eating a healthy balanced diet. Students are not eating the recommended 5-7 servings of fruits and vegetables, and students are eating more unhealthy foods than they realise.
5. Children need constant reminders and nudges to make healthy choices.
6. A comprehensive marketing strategy for healthy food is required to compete with the marketing of unhealthy foods.
7. Creative approaches are needed to engage children and educate them on healthy eating. Our project has shown characters that children can relate to and are considered ‘cool’ will be effective at reaching children and creating an intention to change their behaviour.
8. Parents need support regarding time, knowledge and ability with healthy food preparation, and schools can compensate by ensuring there is a healthy environment in schools—healthy breakfast, lunch and snacks available in and around schools.
9. Healthy eating should be a core part of the curriculum in school and go beyond conveying simple facts; the approach should be interactive to create a long-lasting change in attitudes and behaviours towards food.

You can download our full report below to find out more about this project. In the meantime, we will be using the learnings from this work to develop this project further.

We would like to thank the Taiwan ICDF for funding this work and providing invaluable advice and support throughout this project.

On Friday December 13th 2019, The Healthy Caribbean Coalition CSO Regional Action Team for Childhood Obesity Prevention released the 2019 Sweet Beverages in the Caribbean Infographic Series: How much sugar is in your beverage? This infographic series is an update of the 2016 HCC Sugar In The Caribbean Infographic Series which showed the sugar content of some sweet beverages available locally.

The consumption of sugar-sweetened beverages (SSBs) is one of the major contributors to the obesity epidemic among adults and children. In the Caribbean on average data shows that 1 in 3 children is overweight or obese. The sugar content of one serving of many popular carbonated beverages and juices far exceeds the entire daily healthy maximum sugar intake for adults and children as recommended by the WHO and the American Heart Association (AHA).

This infographic series is intended to be an educational, awareness-raising tool which provides a snapshot of the sugar content of some of the drinks available in eight Caribbean islands: Antigua and Barbuda, Bahamas, Barbados, Belize, Jamaica, Saint Kitts and Nevis, Saint Lucia and Trinidad and Tobago. HCC congratulates the members of the CSO Regional Action Team for the development of these advocacy tools. National supporters include the Ministry of Health and Wellness in Barbados, Barbados Moves, the Barbados National NCD Commission, Saint Kitts and Nevis Moves and Trinidad and Tobago Moves. The work of the HCC would not be possible without the support of Sagicor Life Inc.

You can download the infographics below and find out more about the HCC and their work on their website.

On 21^st June 2019, the Healthy Caribbean Coalition hosted their second webinar in their childhood obesity series. This webinar series aims to empower organisations in the Caribbean who are advocating for the introduction of policies to tackle childhood obesity.

This webinar focused on the Caribbean experience of implementing front-of package nutrition labels (FOPL), a key strategy in tackling childhood obesity by ensuring that consumers are provided with a quick and easy of way of assessing the nutritional content of the foods they purchase so they can make healthy choices.

Speakers included:

• Fulgence St Prix, the Technical Officer at the CARICOM Regional Organisation for Standards and Quality (CROSQ), who discussed the revision of the standard for the labelling of pre-packaged foods to include FOPL. He provided an overview of the consultation process, the timeline for the development of the standard, the next steps and recommendations for the standard’s successful implementation.
• Dr Fabio Da Silvia Gomes, Regional Advisor in Nutrition at PAHO, who gave an insightful presentation on the rationale behind the introduction of FOPL, the best strategy for assessing the most effective type of front-of-package label for Caribbean countries, compared different types of labels and summarised the evidence on the effectiveness of FOP.
• Dr E. Arthur Phillips, Senior Medical Officer of Health (NCDS), Ministry of Health and Wellness Barbados, who provided a health perspective
• Luis Galicia, Ministry of Health Uruguay, who summarised their experience of implementing FOPL explaining their strategy, the resources they developed, how they addressed imported products and the challenges they experienced
• Vonetta Nurse, Advocacy Officer at the Heart Foundation of Jamaica, discussed all the great work they’ve been doing to advocate for FOPL in Jamaica
• Lawyer, Nicole Foster,  who discussed the trade and practical considerations of FOPL as this is a major concern of industry who argue that FOPL may have trade implications. This presentation explored the WTO’s Technical Barriers to Trade agreement and how this agreement speaks to the balance between trade and protecting the health of a country’s population so that policies like FOPL are not more trade-restrictive than necessary.
• Maisha Hutton, the Executive Director of the Healthy Caribbean Coalition who summarised the work that the HCC has been doing to support the introduction of FOPL regionally

If you missed this very informative and insightful webinar, you can watch the recording below and for more information, please visit the HCC’s website.

We are absolutely delighted to have been invited to become a member of the St Kitts and Nevis Bureau of Standards Technical Committee for Labelling.

The St Kitts and Nevis Bureau of Standards has the responsibility of protecting the environment, health and safety of consumers. They focus on preparing, promoting and adopting standards on a national, regional and international basis with respect to the structures, commodities, materials, articles and other products and services offered to the public commercially. Through their work they promote standardization and quality assurance in industry and commerce.

One of the areas that the Bureau focuses on is ensuring the proper labelling of pre-packaged food items. Currently, the CARICOM Regional Organisation for Standards and Quality is updating the regional standard for the labelling of pre-packaged foods. The updated standard includes the introduction of front-of-pack labelling .

Front-of-pack (FOP) labels are just one of several strategies being used worldwide to tackle obesity and non-communicable diseases (NCDs). This type of labelling aims to provide the public with a quick way to assess the health of the foods they purchase and consume, making it easier to identify which foods are high in salt, saturated fat and sugar. It is also hoped that manufacturers will take notice of the labelling of their products and be encouraged to reformulate their products and reduce the amount of salt, sugar and saturated fat in them.

As part of our role in the SKNBS Technical Committee for Labelling we will be providing input on the need for FOP labels as a useful tool for the public to make healthier choices and for the government to tackle NCDs, a significant challenge in St Kitts and Nevis causing 83% of the islands’ deaths.

Last month we attended our first meeting of this committee and were delighted to have had the opportunity to have a productive discussion on FOP labels.

We’d like to thank the committee for inviting us to be a member of this group and are very much looking forward to making a positive contribution going forward.

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

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

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

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

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

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

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

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

SSB Taxation

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

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

Caribbean Children’s SSB Consumption

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

SSB Consumption and Obesity

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

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

Tackling Obesity

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

Our Position Statement

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

Document: Taxing SSBs in St Kitts: A Position Statement

Published by: Lake Health and Wellbeing

Date: 15th November 2018

Download here: SSB Taxation Position Statement

---

References

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

We’re so delighted to have been invited to take part in a panel discussion at the Healthy Caribbean Coalition and the Heart and Stroke Foundation of Barbados’ event on childhood obesity.

This event will take place at the beautiful Hilton Hotel in Barbados on 20th November in recognition of Universal Children’s Day and the official end of the HCC’s childhood obesity prevention campaign.

One of the key parts of this campaign was the HCC’s childhood obesity prevention petition which called on our Heads of Government to enact any of the following policies and legislation which have been demonstrated as effective measures to combat childhood  obesity:

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

This event will officially close the petition and campaign by bringing together a wide cross section of national and regional stakeholders to celebrate the achievements of the campaign and to chart the way forward.

The meeting will provide a unique opportunity for organizations across the Caribbean, who took part in the campaign, to discuss the progress made over the course of the campaign and share national and regional successes and lessons learned in childhood obesity prevention advocacy platforms.

This one-day forum will also serve to leverage the energy and momentum of the past seven months and redirect it towards focussed evidence-based advocacy in support of creating healthy school environments across the Caribbean.

Lake Health and Wellbeing, as participant of the campaign and a member of the campaign’s civil society action team has been invited to take part in a panel discussion on the importance of coalitions and CSO collaboration around critical issues such as childhood obesity.

We’re very much looking forward to taking part in this very important event and are honoured to have been invited to participate – a big thank you to the HCC and HSFB for the invitation.

We were delighted to e-attend the Healthy Caribbean Coalition’s Civil Society Action Team’s inaugural meeting on 20th April .  The main objective of the action team is to ensure that the Caribbean public becomes aware of the challenges of childhood obesity and supports the call for policy changes and other educational approaches that will create a supportive environment for the reduction of this growing problem which places children at risk of developing diabetes and hypertension as well as  cancer and heart disease in their adult life

During this inaugural meeting of the action team, the HCC shared its communication plan for their childhood obesity prevention petition and discussed ways in which organisations could play a part in their local area. This included liaising with the media and encouraging  members, corporate partners and other social and parenting groups to sign the petition at www.toomuchjunk.org.

This was a really interesting meeting and we were delighted to meet representatives from a number of Caribbean organisations and we look forward to implementing the ideas discussed in the meeting in our local area here in St Kitts.

The Healthy Caribbean Coalition has launched their Childhood Obesity Prevention Petition as part of their Civil Society Action Plan for 2017-2019.

The aim of the petition is to raise awareness of childhood obesity in the Caribbean and to influence the region’s leaders to champion and implement critical policies that will improve the health of our children, reduce childhood obesity and prevent the associated non-communicable diseases.

The Healthy Caribbean Coalition plans to present their petition at the CARICOM Heads of Governments Conference in Jamaica in July, which presents the perfect opportunity to raise this issue.

With 1 in 3 children in the Caribbean being overweight or obese urgent action is needed and therefore the HCC needs your help. Please add your voice to the HCC’s call for action to be taken on childhood obesity by signing their petition and encouraging your contacts to do so too.

We can all make a difference and improve our children’s health, and this petition is just the first step.

Thank you for your support. For more information on this campaign and to sign the petition, please visit: www.healthycaribbean.org/yourvoicematters