-Findings highlight need for national surveillance, urgent interventions
One in five school-age children in South Trinidad are overweight or obese, a condition that sets them on a lifelong path for a range of chronic health problems, including heart disease, stroke and diabetes.
These are the findings of a newly published report by a team of experts from the Trinidad and Tobago Health Sciences Initiative, a collaboration among Johns Hopkins Medicine, The University of Trinidad and Tobago and the Trinidad and Tobago Ministry of Health, among other institutions, aimed at improving population health in Trinidad and Tobago through education and research. The study was conducted on behalf of the Trinidad and Tobago Olympic Committee, the Ministry of Education and the Ministry of Health.
The results, the research team says, underscore the urgent need to make childhood obesity a top national priority. The experts recommend a swift analysis that quantifies the prevalence of childhood overweight and obesity on national scale, followed by the development of relevant strategies to prevent and reverse the condition in youngsters affected by it.
“These are decidedly sobering findings that highlight a critical need to reverse a trend that, if uncorrected, can have far-reaching consequences for the health of this nation,” says Felicia Hill-Briggs, Ph.D., ABPP, senior author on the report, associate professor at the Johns Hopkins University School of Medicine, director of diabetes research for the Trinidad and Tobago Health Sciences Initiative.
A growing body of evidence shows that many chronic conditions typically deemed “adult” are, in fact, rooted in childhood, the experts say. Obesity is believed to fuel a range of cardiovascular and metabolic disorders and even some cancers, research shows. In addition, early weight problems can speed up the onset of disease at a younger age. For example, type 2 diabetes, which was virtually unseen in children 20 years ago, is now increasingly diagnosed in teens and younger children, a trend fueled by growing childhood obesity, scientists believe. In addition to immeasurable human suffering, the experts note, obesity-fueled disease can cause a serious financial drain on a nation’s health care system to the tune of billions of dollars.
Fortunately, the experts say, there are a range of lifestyle and behavior-modification programs that have proven successful in the treatment of childhood overweight and obesity.
“We have a wide range of interventions, and the time to act is now, before the trend reaches a tipping point,” says report co-author Larry Romany, B.Sc., M.S., former president of the Trinidad and Tobago Olympic Committee.
The analysis, based on data collected in 2012, involved more than 3,300 children, ages 5 through 12, from 14 primary schools in the Point Fortin and Mayaro regions of the country. Less than two-thirds of children had normal body mass index. More than one-fifth were overweight or obese, while 13 percent of youngsters were underweight, the study showed. The relatively high proportion of underweight children is another alarming finding, the experts say, highlighting the range of pathologies stemming from poor nutrition. Children in standard 5, or 12 to 13-year-olds, on average, had the highest body-mass index, a finding suggesting that weight troubles that start in early childhood are generally progressive and difficult to reverse, the research team says.
The researchers say that even though the results come from data collected from two Southern regions of the country, the findings may very well reflect a national trend.
Nearly three-quarters of deaths among Trinidadian men stem from chronic diseases, such as cardiovascular disease, diabetes, cancer and respiratory ailments, according to estimates from the World Health Organization published in 2004. Such conditions claim the lives of more than 80 percent of women in Trinidad and Tobago, according to the World Health Organization.
Co-investigators on the report included Mariana Lazo, M.D., Ph.D., Sc.M.; Gary Gerstenblith, M.D.; both of Johns Hopkins. The other co-authors on the study were Troy Romany, former director of the Trinidad and Tobago Olympic Committee Shape the Community Programme; and Andrew Dhanoo, B.Sc., of the University of West Indies and a research assistant for TTHSI.
Johns Hopkins Medicine (JHM)
Headquartered in Baltimore, Maryland, Johns Hopkins Medicine is a $6.7 billion integrated global health enterprise and one of the leading academic health care systems in the United States. JHM unites physicians and scientists of the Johns Hopkins University School of Medicine with the organizations, health professionals and facilities of The Johns Hopkins Hospital and Health System. JHM's vision, “Together, we will deliver the promise of medicine,” is supported by its mission to improve the health of the community and the world by setting the standard of excellence in medical education, research and clinical care. Diverse and inclusive, JHM educates medical students, scientists, health care professionals and the public; conducts biomedical research; and provides patient-centered medicine to prevent, diagnose and treat human illness. JHM operates six academic and community hospitals, four suburban health care and surgery centers, and more than 35 Johns Hopkins Community Physicians sites. The Johns Hopkins Hospital, opened in 1889, was ranked number one in the nation for 21 years in a row by U.S.
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Trinidad and Tobago Health Sciences Initiative
TTHSI began as an umbrella program representing a collaboration among the Ministry of Science,
Technology and Tertiary Education (MSTTE), the University of Trinidad and Tobago (UTT), Ministry of Health (MOH), and Johns Hopkins Medicine International (JHI), with the goal to advance medicine and health sciences in Trinidad and Tobago and the wider Caribbean. Since then, the collaboration has expanded to include other significant stakeholders in the country including, but not limited to, the University of the West Indies (UWI) and the Trinidad and Tobago Medical Association (TTMA). TTHSI includes three programs: the Diabetes Outreach Program (DOP), the Cardiovascular Services Initiative (CSI), and the Masters of Health Administration (MHA).