Wednesday, February 21, 2018


-Findings highlight need for national surveillance, urgent interventions

One in five school-age children in southern 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, which aims to improve population health in that country 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 a 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., senior author on the report, an associate professor at the Johns Hopkins University School of Medicine and the 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. 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 researchers say, there are a variety 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, 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., and 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 the West Indies and a research assistant for the Trinidad and Tobago Health Sciences Initiative.