Obesity in Women and Children: Caribbean Perspectives

1
Obesity in Women and Children Caribbean
Perspectives

• Maria Jackson PhD
• Dept. of Community Health and Psychiatry,
• UWI, Mona

2
Introduction

• Obesity - increasingly important problem in the
  Caribbean especially among females.
• Social, economic and demographic transformations
  in Caribbean - accompanied by
• changes in dietary and nutrition patterns and
• superimposed onto a susceptible genotype

3
Introduction

• Developing countries (recent past) - children
  with low anthropometric values in need of
  rehabilitative care.
• Little attention to over-nutrition especially
  among young children.
• Paucity of information on the determinants of
  obesity in children and adolescents.
• Obesity in adulthood - investigated as an
  explanatory variable in studies of chronic
  diseases.

4
Obesity - Caribbean Problem

• Females () Males ()
• Jamaican Adults
• (Wilks et al, 1999)
• BMI gt 30 34.0 9.0
• Jamaican Adolescents
• (Jackson et al, 2000)
• BMI gt 85th 20.3 18.6

5
Recent studies and Interventions

• Focused on lifestyle patterns weight control.
• Few studies on
• Perception and lay understanding of obesity
• Social or cultural meanings
• Relative inattention to health services and
  prevention measures.

6
Policy

• Caribbean countries - have political will to make
  obesity a priority health care issue.
• CARICOM Conference of Ministers (Health) -
• stated the need to reduce the prevalence of
  obesity in adults and adolescents (CCH Phase II,
  1999)
• Inter-ministerial and multi-sectoral planning and
  implementation
• Dietary guideline for the Caribbean

7
Jamaica (MOH) - Health Promotion Strategy for the
Prevention and Control of CV Disease (extract)
Policy

• Strategy on Changing Lifestyles to
• Prevent and control obesity through
• Increased physical activity (schools,
  communities, workplace, etc.)
• Promoting consumption of a health diet
• Lifestyle survey
• to document extent of problem
• evaluation of intervention

8
Family History and Obesity
9
Perceptions of Familial Associations and Obesity
10
Environmental FactorsDiet
Diet did not predict obesity
11
Obesity SES Status in the Caribbean
12
Parity and Obesity
13
Knowledge of Obesity

• Barbados (Hoyas Clarke, 1987)
• Overeating - as a cause of obesity
• reported by more men (53) than women (40)
• more non-obese (51) than obese (31)
• Lack of exercise - as a cause of obesity
• no gender differences
• reported by 12 of subjects

14
Knowledge of Obesity

• Jamaica (Bockarie et al, 1994)
• Lack of exercise - as a cause of obesity
• reported by 2/180
• Associated with Chronic Diseases
• Fairly well recognized by both genders

15
Attitudes Towards Obesity

• Barbados (Hoyas Clarke, 1987)
• Attitude Health, Wealth Happiness
• no gender differences
• 19 obese healthier than non-obese
• 30 obese wealthier than non-obese
• 36 obese happier than non-obese
• Attitude Female Fatness
• 41 preferred women to be fat or a little fat
• Significantly more men (44) than women (25)
  were of this view and primarily among 15-44 yr
  olds.

16
Attitudes Towards Obesity

• Jamaica (Bockarie et al, 1994)
• Attitude Female Fatness
• Girls men like fat women (50)
• fat men are ugly (40)
• Boys girls dont like fat men (20),
• men like fat women (20)
• Attitude Obesity as ill-health
• not seen as ill-health by girls (40), boys (8)

17
Perceptions of Body-size
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Implications for Prevention

• Multiple approaches with greater emphasis on
  education and training
• Policy initiatives need to address the barriers
  to effective implementation of obesity prevention
  and treatment programmes
• Need for further elucidation of the social and
  cultural factors - to be incorporated into
  preventive programmes