Reversing Barbados’ NCD crisis warrants more aggressive action, says doctor

By Marlon Madden

One of the island’s leading epidemiology researchers is warning that unless firm actions are taken now Barbados faces an uphill battle reducing incidence of obesity, much less stopping it.

This caution has come from Dr Natasha Sobers, Senior Lecturer in Epidemiology at the University of the West Indies (UWI), Cave Hill Campus, who suggested that the increased tax on sugar-sweetened beverages from 10 to 20 per cent was not enough of a deterrent.

Her comments came against the background of recent announcements by Government to roll out a National School Nutrition Policy and remove trans fatty acids from industrially-produced foods in Barbados in the next two years.

During an exclusive interview with Barbados TODAY, Dr Sobers lauded Government’s latest policy decisions, saying they indicated a level of seriousness.

“They are doing the right thing in terms of the National School Nutrition Policy. They did the right thing with the sugar-sweetened beverage tax. That is getting serious. And they did the right thing when it comes to the trans fat they are talking about regulating. Those are the strong regulatory frameworks that are needed from a government in order to change. They are putting these things in place and I applaud them for it,” said Sobers.

However, noting that estimates indicated that obesity was on the increase and there was perhaps only a one per cent chance of Barbados meeting its 2030 target of stopping the increase if it continues on its current trajectory, Dr Sobers is encouraging Government to be more aggressive.

“In my opinion, sometimes we talk a bit too much. You know as much as we talk about our sugar-sweetened beverage tax, what really works is an increase of at least 20 per cent. So in my opinion we really should have increased our tax to 30 per cent. Bermuda has a 75 per cent tax on sugar-sweetened beverages. If we are serious, those are the types of things we are going to do.

“If we are serious about this and really want to increase our chances, we are going to have policies that support that seriousness – we are going to have front-of-package labelling. It doesn’t happen with one policy. It has to be all of the policies working together, plus education . . . and it also has to be aggressive,” said Sobers.

Reports in recent years have indicated that more than 33 per cent of Barbadian children aged nine to 10 are overweight.

According to the Barbados National Registry 2019 cardiovascular disease report, in 2019 the country registered some 547 cases of myocardial infarction (MI or heart attack), representing a 28 per cent increase from the 2014 to 2016 period. The case fatality rate was about 32 per cent, compared to between three and 12 per cent internationally.

There were 758 strokes recorded for the 2019 review period, representing a steady increase from 631 in 2014. The in-hospital case fatality rate for stroke in 2019 was 37 per cent, up from 28 per cent the prior year.

Sobers told Barbados TODAY it is time that Barbadians recognise the seriousness of non-communicable diseases (NCDs) and the tremendous burden these were having on families and the country in terms of death, costs and disabilities.

“We are talking about persons who are having strokes when they are 40 years old. We are talking about heart attacks in men 50 years old and that is young,” said Sobers.

“We are already seeing the impact. That is why we are in such a dire situation,” she said.

However, noting that change was possible though not easy, the researcher said most NCDs were preventable “by shaping our behaviours in childhood”.

“Most of it can be prevented by changing our behaviours then as an adult, but it is easier to shape the behaviour as children,” she said.

“It really starts in childhood. It starts with what we are eating as children. We know that persons who are obese as a child are twice as likely to be obese as an adult. When you are obese as an adolescent you are about almost 14 times more likely to be obese as an adult,” said Sobers.

Describing the planned policies as “completely necessary”, Sobers added: “I think that creating a healthy environment, an environment that makes it easier for people to choose healthy food is really important.”

A part of the planned National School Nutrition Policy is to regulate and control food vending around schools through the issuance of licences or permits, which would specify the types of food and beverages, based on nutritional standards, which are permitted to be sold to children.

Some vendors argued that children still preferred sugary snacks even when they included healthier options in their offerings and that they could go out of business if they are forced to sell only “healthier” options.

However, Sobers gave the assurance that presenting children with choices was critical.

“Once we train their palates to enjoy healthy foods they will enjoy them.”

In response to concern that some parents may find it difficult to afford healthier options, which may be more expensive, Dr Sobers said avoiding certain items was a start.

“I don’t buy drinks. I drink water. We don’t have to have chicken on our food every single day for example . . . and there are cheap options if we look for them,” she added.

The Heart and Stroke Foundation has come up with a document highlighting some of the affordable, healthier alternatives from which parents and children could choose their snacks and beverages. This document is expected to be released with the roll-out of the National School Nutrition Policy. 

marlonmadden@barbadostoday.bb