CASE study: Maria presented with obesity at six years old being 21 pounds over ideal weight for age. Yet she seemed to be eating 'healthy food'.
Her mother ensured a 'balanced' breakfast before school, she carried cooked lunch from home to avoid the fried chicken at school, and returned home to a proper dinner at 5:00pm. She received 'lots of vegetables and fresh juice'.
Her mother, being overly concerned that her only child should eat properly, did not allow her sweets, soft drinks, snack foods, and anything 'bad,' so the child started to feel deprived and left out from parties and friendships. However, the food portions of 'healthy food' offered were just too large relative to the child's calorie needs. This is one form of food abuse.
Case study: Stael, at 23 years old, was 15 pounds underweight and was teased of being 'mawga'. She wanted to gain weight. Her referring doctor gave her clearance for any health cause, but her nutrition assessment indicated low nutrient intakes and anaemia. She had a hectic job, often leaving home without eating breakfast, but would catch a bite at 10:00 am from the office tray of plantain tart, doughnut or bun.
She tried to have a 'heavy lunch' but had little time for it and most times just had a patty and box juice. Right after working late, she had church or other activities and grabbed a 'coconut drops' or other snack 'to hold her till dinner time'. By the time she got home, she was too tired to eat and went straight to bed. Although underweight, she exhibited 'skinny fat' — higher body fat than expected. This is another form of food abuse.
Should we now ban all these foods to protect people from eating and getting fat?
No single food will cause or prevent obesity, but what is required is proper eating practices and a balanced approach to nutrition among the populace.
As seen from the case studies, obesity is a complex disorder with many manifestations and underlying factors along a continuum of food abuse that can range from food aversion to food addiction. Effective treatment requires thorough evaluation and intervention from qualified nutrition professionals specially trained to understand the issues.
Yet the government system has failed to recognise the need for and to utilise this valuable human resource to forestall the problem emerging years ago at the community level and in our schools. Many nutrition professionals trained by our universities since 2005 to meet the projected need cannot even receive a professional title to practice, and they have become a wasted resource while society is deprived of their expertise. This has resulted in a burgeoning obesity incidence as a public health problem, along with other diet-related disorders of diabetes, hypertension and heart diseases in children and the young and which now costs the country billions in health care dollars.
Instead, a number of stop gap measures are being proposed by many such as “to ban and tax various foods”. Such measures have been applied to alcohol addiction, drug abuse and cigarettes with little success in eliminating the problems.
Some foods are undoubtedly of low-nutrient density, but they have a role in providing cheap sources of energy for the masses. When GCT was applied to various items, many foods were exempt such as white flour, cooking oil, sugar and the like since, if properly included in the diet, can still allow for balanced nutrition. Nutrition professionals can impart the guidance and skills for all foods to be properly incorporated in the overall diet for good nutrition.
Rather than merely banning single food items, why not use the holistic approach and instead fix the flawed registration system to allow the suitably trained professionals to practise? The professional council of the Ministry of Health should implement a system to recognise and utilise the expertise of the new type of highly trained nutrition graduate from our universities. Many have already migrated to join our nurses, doctors and other health care professionals to work in more accommodating countries. Failing to act with alacrity will only result in more severe consequences.
Patricia Thompson MSc is a consultant registered nutritionist and the executive director of Jamaica Island Nutrition Network (JINN)