High prevalence of childhood overweight and obesity in ten Caribbean countries: 2018 cross-sectional data and a narrative review of trends in Trinidad and Tobago

Predictors of obesity among school-age children in Debre Berhan City, Ethiopia

BACKGROUND

Obesity causes a serious diet-related chronic disease, including type-2 diabetes, cardiovascular disease, hypertension, osteoarthritis, and certain forms of cancer. In Sub- Saharan Africa including Ethiopia, most nutritional interventions mainly focused on a child undernutrition and ignored the impacts of obesity among children. In Ethiopia, the magnitude and associated factors of obesity among school-age children were not clearly described. Therefore this study assesses the predictors of obesity among school- age children in Debre Berhan City, Ethiopia, 2022.

METHODS

A cross-sectional study design was conducted from June to July, 2022. Participants were selected by using multistage sampling method. Data were collected using pre-tested and structured questions. Data were coded and entered in Epi-data version 4.6 and exported and analyzed using SPSS version 25.

RESULT

A total of 600 children were participating in the study. The prevalence of obesity was 10.7% (95% CI: 8.3, 13.2). In this study, attending at private school (AOR = 4.24, 95% CI: 1.58, 11.32), children aged between 10-12years (AOR = 2.67, 95% CI: 1.30, 5.48), soft drink available in home (AOR = 2.27, 95% CI: 1.25,18.13), Loneliness (AOR = 1.67 95% CI: 1.12, 3.15) and mothers with occupational status of daily labour (AOR = 8.54 95% CI: 1.12, 65.39) were significantly associated with childhood obesity.

CONCLUSION

In this study, the overall magnitude of childhood obesity was (10.7%) which means one in eleven children and relatively high as compare to the EDHS survey. Therefore, more attention should be given to strengthening physical activities, providing nutritional education, and creating community awareness about healthy diets as well as other preventive measures.

Maternal feeding styles in infancy predict child body mass index z-scores at 72 months: findings from a cohort of Jamaican children

Objective

To explore whether maternal feeding styles at 12 months predict child Body Mass Index (BMI) z-scores at 72 months and evaluate whether BMI z-scores at 18 months mediates the association.

Methods

Data from 239 mother-child pairs participating in a parenting intervention were analyzed. Feeding information was ascertained at 12 months by questionnaire with feeding styles identified using factor analysis. Children's weight and length/height were measured at 18 and 72 months and BMI z-scores computed. Maternal sociodemographic data, depressive symptoms and language skills were obtained by questionnaire. Multilevel linear regression analysis was used to examine whether feeding styles predicted 72 month BMI z-scores. Complete case analysis was conducted and multiple imputation used to treat missing values of explanatory and outcome variables at 18 and 72 months. Mediational analysis was performed to assess the indirect effects of feeding styles on 72 month BMI z-scores via 18 month BMI z-scores.

Results

Restrictive feeding at age 12 months predicted higher 72 month BMI z-scores in both complete case analysis [β (95%CI): 0.19 (0.02, 0.37)] and multiple imputation [β (95%CI): 0.20 (0.02, 0.39)]. Uninvolved, forceful, indulgent and responsive feeding styles were not significant predictors of 72 month BMI z-scores. A significant indirect effect was observed between restrictive feeding and child BMI z-scores at 72 months via 18 month BMI z-scores [β (95% CI) 0.12 (0.03, 0.22)].

Conclusion

Restrictive feeding at 12 months was associated with higher BMI z-scores at 72 months and appeared to be mediated by BMI z-scores at 18 months.

Review: Evaluating existing policies to address overweight and obesity in the Anglophone Caribbean: A narrative review of Barbados, Grenada, St. Lucia, and Trinidad & Tobago

Overweight and obesity continues to be a burden to the health and well-being of Caribbean residents. The rise of childhood obesity and non-communicable diseases within the Caribbean is a major public health challenge for policymakers, educators and health professionals. These alarming rates of obesity also pose a threat to the sustainability of existing health systems particularly in small island developing states like the Caribbean. Therefore, it is crucial to evaluate existing policies and create policy solutions to address these problems and reduce the potential impact later on. This systematic review explored existing policies among countries within the Anglophone Caribbean to identify trends within the region. The literature search focused on the following themes: (i) national policies (ii) school nutrition policies and programs (iii) physical activity among youth, and (iv) food import bill and food security. An analysis was conducted on literature from national, regional and international institutions including but not limited to the World Health Organization, Ministries of Health and the Healthy Caribbean Coalition. Countries throughout the region has acknowledged the challenges with overweight and obesity in the region. Collectively decisions have been made to address food insecurity and promote healthy lifestyle behaviours through policy changes. There's still a need for Caribbean countries to work together to create effective policy solutions in collaboration with community service organizations and other stakeholders. As small island developing states grappling with the same issues, pooling resources to create effective regional policies can help to address this public health crisis.

Increasing incidence of slipped capital femoral epiphysis in Trinidad and Tobago: A 50-year review

Slipped Capital Femoral Epiphysis (SCFE) is a physeal disorder of the proximal femur. Misdiagnosis and late treatment are associated with poorer outcomes. The epidemiology and delays in treatment of the disease between 1968 and 2018 were investigated in North Trinidad. The number of cases presenting annually has increased over the decades and the incidence between 2008-2018 was 2.2 cases per 100 000 per year. Almost 70% of cases were above the 95^th percentile for body weight. Delay in treatment from onset of symptoms was 278 ± 258 days. Awareness of the risk factors and clinical presentation of SCFE may facilitate early diagnosis and treatment, and prevent severe hip disability in adulthood.

A Combined Theory of Change-Group Model Building Approach to Evaluating “Farm to Fork” Models for School Feeding in the Caribbean

There is a scarcity of research on building nutrition-sensitive value chains (NSVCs) to improve diets and nutrition outcomes of populations in the Caribbean. This study contributes to filling this research gap by outlining a participatory approach to evaluating a NSVC model for “farm to fork” (F2F) school feeding in the Eastern Caribbean Island of St. Kitts. Using a combined group model building (GMB) and theory of change (ToC) approach, policy actors and other stakeholders (n = 37) across the school feeding value chain were guided through a facilitated process to evaluate the ToC underlying a series of F2F interventions designed to enhance childhood nutrition. Stakeholders at the workshop engaged collaboratively to create a causal map of interconnected “system factors” that help explain behaviors contributing to unhealthy eating among children that extended well-beyond the original F2F project ToC that had been used to inform interventions. Through this facilitated GMB process, stakeholders proposed additional food system interventions, and identified multiple “impact pathways” and “mediating influences” underlying local availability and consumption of nutritious foods in local school environments. Workshop participants were also able to identify leverage points where community-level efforts, alongside research interventions, may ensure that initiatives for building local NSVCs are ultimately institutionalized. Results of this study suggest that developing NSVCs for school feeding and food systems in the Caribbean requires both locally driven innovation and the leveraging of system-wide resources, with lessons for project intervention strategies.