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Battling against obesity

By George Alleyne From Barbados Today

The extra pounds that Barbadians will be carrying into the New Year will add to a national battle of the bulge that begins in children. Samuels has warned that some 2,500 children here are currently suffering from hypertension stemming from obesity.

Medical findings point to obese children growing into adults with the same condition, and Samuels has been waging a campaign against practices across the island that instill in the youngsters tastes for fatty foods.

Her entreaties for Barbadians and other people in the Caribbean to resist fatty temptations by eating healthier and leaner caught the attention of international renowned medical journal, The Lancet, which hailed her as “a leading figure in the fight against obesity in the Caribbean”.

Among the reasons why last month’s edition of The Lancet stacked praises on the Director of the Barbados Chronic Diseases Research Institute is because, “in 2016, Samuels appeared in various Caribbean newspapers calling for taxes on sugar-sweetened beverages and fried foods such as chips. In July, the heads of government of CARICOM mandated taxes on sugar, salt, and trans fats, although this mandate is not binding and Samuels is not hopeful that all of these taxes will be implemented region-wide any time soon”.

But despite her doubts on the willingness of regional governments to act, and do so quickly, Samuels stated in the acclaimed Journal, that, “the only hope would be using fiscal measures to make unhealthy foods more expensive and cross-subsidising healthy foods to make them cheaper”.

Samuels has made clear in many presentations in Barbados this year that her battle is against fat, and not fat people.

Justification for that struggle can be found in the World Health Organization’s 2014 Global Status Report on
Non-communicable Diseases (NCDs) that placed Barbados squat in the middle of a region with a severe fat problem.

The Bahamas leads with the highest rate of adult obesity in the Americas, at 36.2 per cent; followed by the United States of America, at 33.7 per cent; and Barbados, at 31.3 per cent; Trinidad and Tobago, at 31.1 per cent; Antigua and Barbuda, at 30.9 per cent; and Saint Kitts and Nevis, at 28.3 per cent.

Obesity can be regarded as the gateway condition to a number of chronic non-communicable diseases that plague Barbadians, frequently resulting in premature death from cancer, diabetes, and cardiovascular problems.

But in a recent lecture, Dr Samuels, who is also the deputy dean of graduate studies and research at the University of the West Indies, Faculty of Medical Sciences, Cave Hill Campus, said that the battle against obesity that leads to NCDs must not be waged only in the dining plate.

“We need to get away from the perception that chronic disease is just personal responsibility, and understand that the environment is also very important.”

In this regard, she extended kudos to Government for providing walkways such as the Richard Haynes Boardwalk in Hastings, but said there is need for more similar facilities spread across the island as an inducement to healthy and lifesaving practices, like taking regular strolls.

“A lot of people walk on that boardwalk. That’s because it’s there. If it wasn’t there, a lot of people wouldn’t be walking on an evening. So we have to create the environment where people are comfortable and happy to go and do physical activity. And promote that.”

The holder of a PhD in Chronic Diseases Epidemiology said her medical colleagues also need widen their focus and include educating the patient. “We also need to improve NCD quality of care by promoting the use of clinical guidelines.”

She spoke of a Barbados 2016 hypertension control project aimed at training doctors and patients to get best results by setting and achieving targets. “Some people are going to the doctors but the guidelines around care sometimes are not being adhered completely”.

She noted that unlike illnesses resulting from injuries due to bodily malfunctions or accidents, NCDs require patient participation in the treatment.

“If you get a ruptured appendix, the only thing you have to do is sign the medical consent form. That is all the participation you are going to have in the process,” she said, pointing out that after giving consent, the patient is prepared, wheeled into the theatre, operated upon, given nursing care, and then discharged.

“Chronic diseases, it’s all about you. You spend five per cent, or half an hour with the doctor every month. The rest of the time you have to manage it yourself. And so empowering patients to understand their disease, to take their medication, to live correctly, hopefully to have an environment that supports them.”

IMAGE: Dr Alafia Samuels

For more on this story go to: https://www.barbadostoday.bb/2016/12/31/battling-against-obesity/

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