Wednesday, January 17, 2018

Health minister tells of ‘worrying’ school statistics in obesity, diabetes


T&T had been warned: Health Minister Dr Fuad Khan

Mark Fraser

 Health Minister Dr Fuad Khan has told a two-day conference in Port of Spain that the Global Health School survey completed in 2011 showed 30 per cent of teenagers between the ages of 13 and 15 were overweight.

He said in this country, the figure was 17 per cent with 15 per cent obese and more than 40 per cent having at least one risk factor of developing diabetes.

Khan said these were “worrying statistics” and that 40 years ago, Trinidad and Tobago had been warned that diabetes would be a problem and that many affected people were undiagnosed.

“At that time, diabetes was rare in those younger than 20 years old, but this trend has changed markedly in the past decade,” Khan said, noting that Trinidad and Tobago now has a diabetes prevalence of more than 12 per cent in those under 20 and growing numbers of young people being diagnosed with Type 2 diabetes and pre diabetes.

He was speaking at the Second International Conference on Non-Communicable Diseases of Children and Adolescents in Port of Spain earlier this month.

In June 2012, the International Diabetes Federation (IDF) launched a report on the links between diabetes and climate change.

The report noted that the two are urgent challenges in the 21st century that were rapidly accelerating, fuelled by changes in the way people live and work, predicting they will have intergenerational effects on health, wellbeing and security.

The report noted that the human and financial costs of diabetes and climate change were staggering and that as many as half a billion people will suffer from the disease by 2030.

“Many of the drivers of the non-communicable disease (NCD) epidemic are very much linked to what’s causing and driving climate change,” said Katie Dain, executive director of the Geneva-based NCD Alliance, a global network of civil society organisations working collectively to transform the fight against NCD.

Dain, who was in Trinidad attending the conference said things such as urbanisation, transportation and huge increases in population demographics “are increasing the risks of climate change and climate change emissions and also increasing the risks of NCDs”.

“The two are very much interlinked,” she said, noting that the IDF report “really provides some of the win-win solutions you can implement which has an impact on climate change and a reduction in the NCD epidemic as well”.

One of the authors of the IDF report, Sir George Alleyne, who is also Director Emeritus of the Pan American Health Organization (PAHO), told the conference that it may not be enough for voices to speak to the bald data on mortality and morbidity on the issue of NCDs.

“I believe that not enough importance in advocacy terms has been attached to the social and human aspects of NCDs in children-the consequences of diabetes on schooling, the social isolation and discrimination against the obese child and the ineffable tragedy of childhood cancer- a tragedy made starker by the inequities in terms of access to adequate treatment and palliative care when it is needed.

Society tends to block out the images of the wheezing child who is prevented from taking part in the sports the young enjoy because of asthma,” said Alleyne, who is also Chancellor of The University of the West Indies (UWI).

One of the highlights of the conference that was attended by delegates from Africa, Europe, Asia as well as Latin America, was the launch of the “Regional Status Report on NCDs in the Caribbean”.

The report urged Caribbean governments to ban,“or at the very least” limit the marketing of energy dense, high salt foods and beverages to children, as well as banning the use and sale of transfats.

The 80-page report also urged the reduction in consumption of sugar sweetened beverages including fruit drinks.

The report also noted that no Caricom country has national policies or major initiatives aimed at reducing the salt intake of the population which has shown to reduce blood pressure which is a major problem among Caribbean people and a major cause of heart attack.

“All but one Caricom country have ratified the WHO (World Health Organisation) international treaty known as the Framework Convention on Tobacco Control and some countries have enacted legislation in support of mandates of the treaty,” the report noted, while making a plea for the development of policies on physical activity and the promotion of green spaces.

The Healthy Caribbean Coalition (HCC), which sponsored the report, said it was intended to assess actions taken by regional governments in 2007 when they met here and adopted the Port of Spain Declaration on NCDs.

“As far as we know this is the first occasion that a review has been undertaken regionally by a civil society organisation to determine the response to chronic diseases in the Caribbean,” said HCC president Prof Trevor Hassell, an honorary consultant physician and cardiologist at the Queen Elizabeth Hospital in Barbados.

In their 2007 declaration the regional governments had promised to “promote policies and actions aimed at increasing physical activity in the entire population” as well as committing themselves “to increasing adequate public facilities such as parks and other recreational spaces to encourage physical activity by the widest cross-section of our citizens”.

One of the authors of the report, Nigel Unwin, a professor of public health and epidemiology atThe UWI, said the region needs to be part of what is recognised the world over as “the whole of society approach” to NCDs.

“It is not just an issue for the health sector or the Ministry of Health. It needs to transfer into policy around transport, urban planning such as provisions of green spaces around agriculture and provisions of healthy and affordable food.”

The former medical officer in the Diabetes Group at the WHO, said climate change does have relevance particularly to small vulnerable countries like many of the Caribbean countries because it can have negative impacts upon agriculture for example.

“Most modern societies have an obesigeneric environment and over the past ten years you will see obesity tends to go up. This is a global challenge and it is a challenge where the solutions are similar the world over in terms of having to make changes to make it easier to eat healthier and to be physically active,” he added.

Jamaica recently indicated it was revising its Green Paper on the Climate Change Policy Framework and Action Plan and that feedback from recent public consultations on the document is being analysed to determine the recommendations that can be included in the document.

The Green Paper, which was approved by Cabinet and tabled in Parliament last year, outlines strategies expected to be implemented in Jamaica to effectively respond to the impacts and challenges associated with climate change.

It is intended, primarily, to support the goals of the country’s national development lan, “Vision 2030 Jamaica” by reducing the associated risks posed for sectors, such as: water, energy, agriculture, fisheries, coastal and marine resources, health, mining, tourism, planning, and disaster risk reduction and response management.