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Is fried chicken setting back development in the Caribbean?

Carmen Carpio's picture

The Caribbean: Are people getting sick from eating fried chicken?

We've all been there... it's lunch time, we're hungry, we don't have much time to wait, don't want to spend too much money, but want to make healthy choices. So, what are our options? Well, on a recent mission in the Caribbean the choices were fried chicken or stew with fried chicken, not many other choices.

We felt guilty because we were the health team on mission in the Caribbean conducting studies on the impact of non-communicable diseases (NCDs) and we are extremely conscious that fried chicken contains a lot of saturated fat --a contributing factor in obesity, heart disease and diabetes, which top the list of NCDs. 

We ended up swallowing our guilt and snacking on the crispy morsels of chicken anyway.

This simple encounter brought to light the challenges countries and individuals face in addressing NCDs which as a group represent the leading causes of morbidity and mortality worldwide --two thirds of global deaths are the result of chronic diseases. In the Caribbean, the burden of NCDs has escalated to the point that five times as many people are dying from chronic diseases than from all other illnesses combined.

Much of the rise in NCDs in the Caribbean can be traced to individual risk factors such as unhealthy diets (the fried chicken experience), lack of physical activity, smoking and excessive alcohol consumption. Particularly at risk are women who are more overweight or obese and more inactive than men; young adults who begin smoking and consuming alcohol as early as 12 years of age; and the poor who find themselves paying a larger proportion of their out-of-pocket expenditures on NCD care than the better off population.

One of the most stunning facts is that more than 60 percent of women aged 35-54 years in Jamaica are either overweight or obese. The trend is very similar in other Caribbean countries. Is this related to what we put in our mouths? While it may seem that the risk factors driving NCDs are largely under the control of each individual --eating healthier, getting more exercise, making better choices-, is this really the case? Just look at our experience in trying to eat healthy. Much like our team, many people, not only in the Caribbean, but across the world face similar dilemmas. People are busy, want something to eat quickly, and don’t want to spend too much money.

So what are the choices? Fast food, fast food, and fast food! So, how do we address this fried chicken epidemic? Challenges always present opportunities. Can we make the food industry provide food with less trans-fat and less salt through regulations and monitoring? Can we give farmers the incentives to produce more veggies and fruit? What is evident is that we need to work closely with the private sector to reduce the risk factors fueling NCDs.

In our consultation meeting for risk factors, we were told one of the reasons why Jamaican women are likely to be overweight or obese is that full figures are considered beautiful in the Caribbean.

So, it appears we also have to work on cultural norms and habits too. In the twin reports that our team just completed, Non-Communicable Diseases in Jamaica: Moving from Prescription to Prevention and The Growing Burden of Non-Communicable Diseases in the Eastern Caribbean, we document the situation in selected countries in the Caribbean, analyzed countries response to non-communicable diseases and provide policy recommendations for moving forward in controlling them.

Some of the recommendations include: 

  • Prevention as an integral part of any initiative to address the NCD epidemic, such as policies that encourage physical activity, promote a healthy diet and reduce the harmful use of alcohol and tobacco.
  • Engaging actors outside the public realm such as non-health ministries, NGOs and the private sector in NCD prevention and control. Actions can include encouraging the food industry to manufacture, distribute, and market healthier products.
  • Boost surveillance, monitoring and data collection for NCDs so policymakers can more accurately target high risk groups.
  • Introduce legislation of tobacco, alcohol, food and essential medicines to better coordinate pricing and taxation initiatives, establish smoke-free work and public environments, and restrict the sale of alcohol to appropriate age groups.


Only this comprehensive approach could break the “fried chicken curse” and help people in the Caribbean make healthy choices as the best response to beat non-communicable diseases.

Comments

Submitted by celine Hobson-Garcia RN on
The World Health Organization identified 5 Global Targets "Health for all by year 2000. identified in the Ottawa charter signed in 1986 for countries and islands to implement programmes to assist in the choices of the people. Health Promotion became another tool, Health Promotion another tool, Patient Education, Specialist training for nurses, doctors and other medical personnel. Almost 25 years later we are faced globally with obesity, diabetes, coronary heart disease, Hiv/Aids, Cancers, Mental Health,Road Traffic death from alcohol, Nurses and doctors are overweight and they tell the clients... loose weight. Eat Healthy. Who are the role models here? attitudes and cultures have not been measure in the real sense of education. We have healthy choices but we still lack the willpower to make the right choice to eliminate disease. One area that Governments seen to pay little attention to is Our Environment. Government has an obligation to look after the citizen welfare by putting the systems in place to avoid epidemics,promote health abide by the Global targets Heath for all by year 2000, but few politicians know that these Targets will promote a healthier, longer living nation. Instead we are faced with crime (not on the list of the WHO), incest, global disasters, murders, drugs and the narco trade. We have lost the true meaning of Health is Wealth. My ambition is to become an International Health Promoter and assist with the WHO global targets. Celine Hobson-Garcia

Submitted by Carmen on
Dear Celine, Thanks for your comment and for emphasizing the importance of the overall environment. A key challenge to addressing NCDs, as you point out, is the need for not only providing the right choices, but taking the next step so that the right choices are made. I congratulate you on your goal to become an international health promoter to assist with addressing health challenges such as these and the WHO global targets. Kind regards... Carmen

I think it worthwhile to examine other counties' experiences, specifically Finland and Poland. Finland is the home of the North Karelia Project, which used a combination of national policy (including changes in agricultural subsidies, tobacco taxes, food pricing), communications campaigns, community mobilization, and careful surveillance to turn their CVD statistics completely around. It is worth a visit there to really appreciate the comprehensive approaches used so successfully. In Poland, combined tobacco control policies (taxation, media advocacy, professional education, etc), and pricing policies for animal vs vegetable fats reduced CVD mortality significantly. The Caribbean nations are seemingly more manageable policy environments, as long as high level commitments are made. These commitments will be influenced by good data and analyses of mortality, morbidity, and economic costs of NCDs. Human behavior is hard to change by itself; it depends on a policy environment in which positive individual health behaviors can be supported. It is simply not enough to advise individuals on healthy diets, smoking, and exercise; NCD disease interventions require comprehensive trade policies, pricing policies, denormalization strategies for tobacco use, communications campaigns, and strong commitments from health care systems in order to make a difference. The key word here is comprehensive.

Submitted by Rylan Mede on
I don’t think that this culture can be changed with a program much like in Africa, the image of a curvy woman is considered attractive and healthy and the eating habits of those societies are not that healthy. But the way I think about it, You cannot change people that’s a fact and the food culture there must had been for ages but in every society there is the bad eating habits and the good ones so if we just focus on promoting the healthy life style like for example fish is popular in the Caribbean and other topical fruits. So producing new products based on those traditional healthy plants could really direct the public to healthier choices because fried chicken is not just a recipe for how to gain weight (unhealthy of course) it is a recipe for a heart disease. Also encouraging small business for importing nuts and other un-saturated fats products could introduce the public of the Caribbean to a whole new healthy food choice, along with promoting healthy meals especially for launch time via TV shows and educational programs and documentaries could really open the mind of the public on how to look at food that makes you gain weight in healthy way (therefore still preserving the image of a curvy woman as attractive but this time healthier) and what foods that make you lose weight or avoid obesity to be exact.

Submitted by Kia on

This is a subject that really needs discussion in the region and this report will be a great start.

Old photographs of the Caribbean from the late 19th through the first half of the 20th century show little obesity among the lower-income population. They were eating a diet that was suited to long days of physical labor, and that diet, except for the addition of American-style fast food, has not essentially changed: meat (or fish) rice plus yams and some other starch, a very little bit of vegetables on the side. Also for the first half of the 20th century most country people walked everywhere. This change in the physical nature of work can be made very quickly--as quickly as a move into town. But the body does not adapt to the change with the same speed. (In some of the smaller islands in the Eastern Caribbean remittances from relatives who had emigrated had the same effect by two means: 1)it became a status marker to eat processed imported food rather than food that you had grown on your own land (there's a whole cultural history associated with this too); and 2) it became possible to afford cars.)Poverty is a psychological factor as well, as can be seen right here in DC: in Northeast DC where I live all these cheap carry-out places have basically the same offerings: fried chicken, fried fish, fried "Chinese" food,and some version of cheese steak sandwiches or Italian subs. If you live in a state of food insecurity, these are about the cheapest source of protein, fat, and salt that you can get all in one package, and, bolstered up with some starchy sides, make a feeling of satiety that satisfies not only the nutritional need but the pressure of the insecurity--till you get hungry again, that is. Obviously we can't and shouldn't wish people back to the days when they had to walk for miles carrying water on their heads and so on, and there was no doubt still hunger among the very poor.

Promoting better choices also means creating the conditions in which better choices are feasible in terms of cost, time, availability of ingredients, taste, and, of course, sustainability.

Enormous dietary changes have occurred in the US just over the past 30 years, much of this driven by an expansion of the palette, of what people consider to be good food, as well as by a concern for health. The people who contributed to this transformation of the American diet were chefs and food critics, who made the quest for interesting new flavors interesting. Moreover that transformation was accelerated by consumers' social aspirations and disposable income. Some credit for it is also owed to the counterculture movement. This was a pretty major cultural shift in food terms. Caribbean cooking could certainly benefit from similar kinds of exploration adn the time to do it has never probably been better, now that there is so much wider exposure to media there. But the availability and cost of ingredients are constraints. When you live in the Caribbean and try to cook from, say, some healthy Mediterranean or Asian recipes, many are just basically out of the question. And all this of course presupposes people having enough leisure (and spare cash) to experiment on their families with new flavors. Nor are the people selling chicken on the street in a position to do try things out on their customers at the risk of their slim profit margins.

Eating more fish would be healthy but I'm not sure it is sustainable. Fish stocks in the Caribbean are already severely depleted, so unless there's some vision of maybe tilapia farming to go with the recommendation to eat more fish even the current level of consumption there is basically unsustainable.

I'm assuming that there, as here, the healthy and environmentally sound thing to do would be to grow a wider repertoire of vegetables and fruit locally rather than import them. People want to do it but for many reasons (praedial larceny, for example) have found it very difficult. Farming is a hard living anyway--which is why people move into the cities. But it would be great to solve this.

One interesting development in the Caribbean is the emergence of I-Tal food, which is like the Caribbean version of vegan food. . It is tasty and healthy (the flavors are not an extreme departure from the customary (English-speaking) Caribbean palette--and people there tend to be rather conservative about their food) and really deserves wider recognition in the region as an effective indigenous approach to nutritious and healthy cooking.

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