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Khan addressed the Ministry of Health’s consultation event on school nutrition held at the Hyatt Regency Hotel, Dock Road, Port-of-Spain. He began his presentation with a personal aside. He said earlier this year when he saw a photograph of himself in the press it caused him to take stock.
“I really and truly had to look at my own self,” the Minister of Health said. “I had ballooned....I like roti, I like doubles, I like bread. I am a bread addict.” He continued, “But I have lost 29 pounds. I am now an authority on obesity because I was there and I am now here.” He said on becoming Minister of Health he noticed a trend.
“Our people were becoming fat,” Khan said. “At Carnival time the majority of young women were looking fat. Why were they having all that jiggling and why were there all those bellies?” He said patterns of consumption have to change and have to start from young.
“Obesity is a disease we have to be attacking,” Khan said. He said consumption must change, warning that items like a single soft-drink have as much as 20 to 50 teaspoons of sugar. He said changes have to occur at the school level as the patterns there are linked to problems later in life, including chronic non-communicable diseases like diabetes.
The minister said in 1999, the overweight or obese category among primary school children was approximately 11 percent. Ten years later, in 2009, the level was 23 percent, representing a 100 percent increase. The breakdown of this showed the class of the obese moved from two percent to 13 percent of the total respectively.
This, according to data collected by the University of the West Indies and by Guillford et al in 1999 and similar data collected by the Caribbean Food and Nutrition Institute (CFNI). Both studies are cited in the “Interim Nutrition Standard for Food Offered for Sale in Schools in Trinidad and Tobago” report, dated October 2014, prepared by the Ministry of Health.
The Ministry report also quoted the “Evaluation of School Meals Options and Survey of Body Mass Indexes (BMIs) in Schools” which was conducted by CFNI for the Ministry of Health in 2010 in with 5,305 students in 27 primary and 14 secondary schools. That report stated the survey of BMIs of children five to eight years old revealed: 24 percent of children in that group were obese or overweight; 14 percent were assessed as thin.
“The trend in overweight and obesity among school aged children is that of increasing prevalence,” the Ministry’s report stated. “The survey of BMI also revealed pockets of underweight (persons) within the school-aged population, which is equally important to address alongside the issue.
Khan said he was working to get a dietician in every school as an expansion of the physical education staff into primary and early childhood centres. The research findings showed secondary school students frequently consumed foods high in fats, sugar and salt, with the most common foods being: hot dogs, pelau, chicken sandwiches, peas, cheese sandwiches, stew chicken, pizza, curry chicken, fries, phoulourie, buss-up-shot/roti, bread and sausage, burgers, plain rice and vegetables with rice. Favourite snacks included chips, corn curls, biscuits, cakes, muffins. Soft drinks and juices topped the list of beverages.
The compilers stated there was an over-abundance of staples and scarcity of fresh fruit. Cafeteria options were not balanced, too many starchy and greasy foods were offered, children – as expected – picked out vegetables from school nutrition lunches.
“In Trinidad and Tobago and other countries in the Caribbean, there is a nutrition transition where traditional diets are being replaced by diets which are high in fats, refined sugars and salt. This creates a dual problem as under-nutrition and deficiencies have not been eradicated, but instead have been joined by over-nutrition and the development of associated chronic diseases. Both of these need to be addressed in order to improve the outlook for future generations.
“Although there is no national data regarding the incidence of chronic diseases like Type II Diabetes and hypertension in children five to 18 years old, data collected by nurses in St George East in 2011 and followed up by Paediatricians at the Wendy Fitzwilliam Children Hospital revealed a trend of increased risk of chronic diseases among obese children. The report stated children who are under-nourished are also exposed to the consumption of foods high in refined sugars, oil and fats. This was linked to increased risk of micronutrient deficiency-related diseases (anemia, osteoporosis) as well as other chronic diseases.