Trinidad cuts sugar from school meals

In Trinidad recently Health Minister, Dr. Fuad Khan moved to ban soft drinks in schools. The move came four days after an article published in the Daily Mail in the United Kingdom ranked T&T the third-fattest country in the world behind Kuwait and the United States, which are in first and second places. Khan called for a total “lockdown” on all unhealthy foods in schools because “we have to protect the children.”

After a discussion with Education Minister Dr. Tim Gopeesingh it was felt that soft drinks were the main offenders in obesity, which can trigger a tsunami of health complications. The two were putting things in place to ban soft-drinks in schools as well as snack foods loaded with sugar and salt. Meals high in carbohydrates will also be a no-no. They will ramp up the students’ protein and fibre intake instead. Khan said owners of school cafeterias will also have to sign an agreement on what they sell, which “must be consistent with a formula we are adopting.”

Told that students were picky when it comes to eating vegetables, Khan said, “We have to give it to them. If they don’t eat it, what you go do?” It was hard to change one’s cultural taste, he said, but the children will acquire it over time. “After a while they will eat it. If you keep giving them sugars, sweets and soft drinks they will never change.”

The US, Khan said, changed its school menus from unhealthy to healthy foods, which the students did not eat for three to six months. “But they are eating the food now.”

President of the Diabetes Association of T&T Zobida Ragbir-Singh has endorsed Khan’s plan, saying it was a step in the right direction. Ragbir-Singh has taken the School Feeding Programme (SFP) to task for not serving well-balanced meals to students. A retired nurse, she said she observed that caterers in the SFP were serving primary school children a thick-crust pizza slice, covered with cheese, along with a soft drink, for lunch. For breakfast, she said, children were given an iced bun and juice containing 28 grams of sugar.

The observation was made while the association undertook glucose testing on Standard Three pupils. T&T has 559 primary schools. The SFP provides 58,000 breakfasts and 98,000 lunches to primary, secondary and special-schools students. Breakfast for each student costs $6, while lunch is $8.15. The meals cost taxpayers $1.2 million monthly.

“We are going into the schools to show them about eating a healthy breakfast, lunch and dinner—and this is what the caterers are serving. In a few years these children will die and leave their parents if we continue this way.”

Approximately 175,000 citizens have diabetes and the numbers are growing, with 1,000 new cases every year.

“But there is a cadre of people called pre-diabetics who can go into full-blown diabetes and they don’t know it because of the silent nature of the disease. It is frightening and alarming.” The age group most prevalent with diabetes is over 40, but Ragbir-Singh pointed out that diabetes is increasing in the under-40s. In Penal, Ragbir-Singh said, diabetes was most prevalent .

“Some parents are too damn lazy. It is easier to fill their lunch kits with snacks rather than preparing something that is attractive, tasty and healthy.

In January all menus in school cafeterias were changed to local foods and the juices now have 20 per cent less sugar. “We have taken off a lot of sweet items that we would have had before. We have always tried to keep our fat down.” A spinach and cheese pie which had a high fat content was removed. “We are now doing wholewheat sandwiches.”

Caribbean Community (CARICOM) countries are being urged to establish regional standards for “clear, consistent, food labeling” while also banning, or at least limiting, the marketing of energy dense, high-salt foods and beverages to children.

The recommendations are contained in an 80 page report released at the Second International Conference on Non-Communicable Diseases (NCDs) of Children and Adolescents earlier this year.

Professor Nigel Unwin, one of the authors of the report titled “Responses to NCDs in the Caribbean Community,” said that it outlines the response of governments and regional organisations, such as CARICOM and the Caribbean Public Health Agency (CARPHA), to the NCD epidemic that’s taking place in the Caribbean.

He told the Caribbean Media Corporation (CMC) that the report looks at the success stories of which there are many but also looks at the considerable challenges that still exist to address this epidemic.

“An example of one of the big gaps that currently exist is that there is no–within any of the countries that we looked at –policy around the marketing of energy-dense, often called ‘fast foods’ and sugar-sweetened drinks to children for example; and that’s now recognized world over as a very important step to be taken to decrease childhood obesity.

“Another one for the Caribbean is the issue of alcohol and harm caused by alcohol; and again there’s . . . a real lack of policy here and initiatives to address problem drinking around the Caribbean,” said Unwin, a professor of public health and epidemiology at the University of the West Indies (UWI).

Professor Sir Trevor Hassell, president of the Health Caribbean Coalition (HCC), which sponsored the report, said “what we have done is to assess actions that have been taken since the heads of government of CARICOM met in a seminal meeting here in Port of Spain in 2007 and issued the declaration of Port of Spain, uniting to stop the epidemic of NCD and since the UN High Level Meeting on chronic diseases in 2011.

“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,” he said.

The report urges regional governments to ban, or “at the very least limiting” the marketing of energy dense, high salt, foods and beverages to children, as well as promote the reduction in salt consumption and reduction in consumption of sugar sweetened beverages including fruit juices.

Moreover, the authors of the report are also calling for the establishment of regional standards for clear, consistent, food labeling as well as the development, implementation and monitoring of national strategies on the reduction in harm from alcohol.

The report also calls for NCDs “to be fully addressed within national development plans” and the “use of up to date regionally derived evidence based guidelines for the treatment and management of chronic diseases”.

Dr. T. Lafiah Samuels, UWI senior lecturer on epidemiology and public Health, who also co-authored the report, told CMC that in Trinidad and Tobago, for example, there is a lot of fast food that’s being sold, there’re lots of people sitting in their cars in traffic, not exercising, drinking a little too much alcohol…(and) although reports are written, the environment and the lifestyles of persons still continue”.

She said she hopes now that the report has been released action would be taken on different fronts.