The health and economic burden associated with sugar-sweetened beverage consumption in Trinidad and Tobago.

BACKGROUND: In Trinidad and Tobago, non-communicable diseases (NCDs) are the leading cause of death. Unhealthy diet is one modifiable NCD risk factor, which contributes to the NCD burden. The consumption of sugar-sweetened beverages (SSBs) has been associated with an increased risk of NCDs. AIM: The aim of this paper is to estimate the burden of disease and economic costs associated with the consumption of SSBs in Trinidad and Tobago as evidence to support the implementation of health and fiscal policies on SSB consumption. METHODS: The results of this study were obtained through the use of a mathematical model which used a comparative risk assessment approach to estimate the health and economic burden associated with SSB intake, by sex and age. RESULTS: Estimates for one year showed that SSB consumption was associated with approximately 15,000 cases of overweight and obesity in adults and 11,700 cases in children, 28% of all the cases of diabetes and overall, an estimated 387 deaths and 9000 years of healthy life were lost due to premature death and disability. Approximately US$23.1 million was spent in the public healthcare system to treat diseases associated with consumption of sugary beverages. CONCLUSIONS: The consumption of SSBs is associated with increases in diseases, deaths and rising healthcare costs in Trinidad and Tobago. It is hoped that the results of this study will provide an added rationale and impetus for the implementation of policies to reduce the consumption of SSBs.

Sociodemographic and dietary influences on perceptions of eating habits in Jamaica.

Objective: To evaluate how sociodemographic factors and food intake affect survey respondents' perceptions of the quality of their diet. Methods: This cross-sectional analysis is based on a nonprobability sample of 374 participants in Jamaica aged ≥18 years. The three-stage process used a simple random sample to select three parishes; the main commercial areas of each parish were chosen for sampling. To ensure the inclusion of a cross-section that was as representative as possible, the sample included both public and private sector businesses, such as those in retail, hospitality and tourism as well as nongovernmental organizations. Employees and patrons completed a questionnaire regarding their food consumption and their perception of their own diet. Multiple correspondence analysis was used to evaluate the nonlinear relationships among the variables. The results of the analysis guided the specification of a multivariate logistic regression model that was used to estimate the relationship between sociodemographic factors, food intake and perceived eating patterns. Results: The average predicted probability of perceiving a diet as unhealthy was reduced when the respondent was male, economically active, in good health, and married or in a common-law relationship. The probability of perceiving a diet as unhealthy was increased for respondents with a college degree and those living in a household that had a male as the sole head. Consuming healthful food and drink reduced the perception of having a poor diet and vice versa, indicating there are possibly connections between food intake, the perception of diet quality and actual diet quality. Conclusions: This exploratory analysis established links between perceived diet quality, eating habits and sociodemographic factors. The impact on the perception of diet quality can be negative or positive, depending on the variable under consideration.

Assessing the determinants of unhealthy dietary habits among a sample of survey participants in Jamaica.

Objective: To identify and assess the determinants of unhealthy dietary habits among a sample of survey participants in Jamaica. Methods: Because of resource constraints, this cross-sectional assessment is based on a three-stage non-probability sample of 374 survey respondents in Jamaica aged ≥18 years. Firstly, three administrative areas (parishes) were randomly selected. Secondly, the main commercial areas within the selected parishes were identified, from which a non-probability sample of establishments was drawn. A broad selection of establishments covering public, private, and nongovernmental organizations was chosen. This array of establishments was selected to capture a sample of respondents that was as representative as possible. Patrons and employees in the selected establishments were asked to complete a questionnaire. Results: Respondents' self-assessment of their general consumption revealed that 48.4% were unhealthy eaters. Among these, the top reasons for generally unhealthy dietary choices were greater accessibility of unhealthy foods (63.5%) and limited time to prepare healthy meals (61.3%). Additionally, 52.5% indicated "unhealthy foods cost less," and 47.0% identified affordability as the main factor in the food choice equation. Findings revealed that the determinants of eating unhealthily tended to vary across income, age, and gender. Female, younger, and lower-income respondents have a higher likelihood of being impacted by the factors. Conclusions: The largest proportions of the sample identified limited time to prepare healthy meals and the ease of access to unhealthy foods as the foremost determinants of unhealthy eating habits. These barriers to healthy eating are more likely to impact survey participants in the 18-34 age group.

Health and economic burden of disease of sugar-sweetened beverage consumption in four Latin American and Caribbean countries: a modelling study.

OBJECTIVE: Overweight and obesity are important contributors to the non-communicable disease burden. The consumption of sugar-sweetened beverages (SSBs) has been associated with an increased risk of type 2 diabetes mellitus (T2DM), cardiovascular disease, cancer and other conditions. The objective of this study was to estimate the burden of disease attributable to the consumption of SSBs and the costs to the healthcare systems in Argentina, Brazil, El Salvador, and Trinidad and Tobago. DESIGN: Following a systematic review of models, a comparative risk assessment framework was developed to estimate the health and economic impact associated with the consumption of SSBs. SETTING: Argentina, Brazil, El Salvador, and Trinidad and Tobago. PARTICIPANTS: Overall population. PRIMARY AND SECONDARY OUTCOME MEASURES: The model estimated the effects of SSB consumption on health through two causal pathways: one mediated by body mass index (BMI) and health conditions associated with BMI and another that reflected the independent effects of SSB consumption on T2DM and cardiovascular diseases. RESULTS: The model results indicated that for all four countries, in 1 year, SSB consumption was associated with 18 000 deaths (3.2% of the total disease-related deaths), seven million disease events (3.3% of the total disease-related events), a half-million DALYs and US$2 billion in direct medical costs. This included 1.5 million cases of overweight and obesity in children/adolescents (12% of the excess weight cases) and 2.8 million cases in adults (2.8%); 2.2 million cases of type 2 diabetes (19%); 200 000 cases of heart disease (3.8%); 124 000 strokes (3.9%); 116 000 cases of musculoskeletal disease (0.2%); 102 000 cases of kidney disease (0.9%); and 45 000 episodes of asthma (0.4%). The Trinidad and Tobago population were the most affected by disease events. CONCLUSIONS: The study results indicate that the consumption of SSBs is associated with a significant burden of disease and death in Latin America and the Caribbean.

Sociodemographic and dietary influences on perceptions of eating habits in Jamaica

[ABSTRACT]. Objective. To evaluate how sociodemographic factors and food intake affect survey respondents’ perceptions of the quality of their diet. Methods. This cross-sectional analysis is based on a nonprobability sample of 374 participants in Jamaica aged ≥18 years. The three-stage process used a simple random sample to select three parishes; the main commercial areas of each parish were chosen for sampling. To ensure the inclusion of a cross-section that was as representative as possible, the sample included both public and private sector businesses, such as those in retail, hospitality and tourism as well as nongovernmental organizations. Employees and patrons completed a questionnaire regarding their food consumption and their perception of their own diet. Multiple correspondence analysis was used to evaluate the nonlinear relationships among the variables. The results of the analysis guided the specification of a multivariate logistic regression model that was used to estimate the relationship between sociodemographic factors, food intake and perceived eating patterns. Results. The average predicted probability of perceiving a diet as unhealthy was reduced when the respondent was male, economically active, in good health, and married or in a common-law relationship. The probability of perceiving a diet as unhealthy was increased for respondents with a college degree and those living in a household that had a male as the sole head. Consuming healthful food and drink reduced the perception of having a poor diet and vice versa, indicating there are possibly connections between food intake, the perception of diet quality and actual diet quality. Conclusions. This exploratory analysis established links between perceived diet quality, eating habits and sociodemographic factors. The impact on the perception of diet quality can be negative or positive, depending on the variable under consideration.

[RESUMEN]. Objetivo. Evaluar cómo los factores sociodemográficos y la ingesta de alimentos afectan las percepciones de las personas encuestadas sobre la calidad de su alimentación. Métodos. Este análisis transversal se basa en una muestra no probabilística de 374 participantes mayores de 18 años en Jamaica. En el proceso, de tres etapas, se utilizó una muestra aleatoria simple para seleccionar tres distritos; para el muestreo, se eligieron las principales áreas comerciales de cada distrito. Para garantizar la inclusión de una sección transversal lo más representativa posible, la muestra incluyó a empresas de los sectores público y privado, como las del comercio minorista, hotelería y turismo, así como a organizaciones no gubernamentales. Tanto empleados como clientes llenaron un cuestionario sobre su consumo de alimentos y su percepción sobre su alimentación. Para evaluar las relaciones no lineales entre las variables se utilizó el análisis de correspondencia múltiple. Los resultados del análisis se usaron como guía para las especificaciones de un modelo de regresión logística multivariante, utilizado para estimar la relación entre los factores sociodemográficos, la ingesta de alimentos y los patrones de alimentación percibidos. Resultados. La probabilidad promedio predicha de percibir que un régimen alimentario es poco saludable era menor cuando el encuestado era de sexo masculino y económicamente activo, tenía buena salud y estaba casado o en una unión de hecho. La probabilidad de percibir un régimen alimentario como poco saludable era mayor en el caso de los encuestados con título universitario y de los que vivían en un hogar con un hombre como único cabeza de familia. El consumo de alimentos y bebidas saludables redujo la percepción de tener una mala alimentación y viceversa, lo que indica la posible existencia de una relación entre la ingesta de alimentos, la percepción de la calidad del régimen alimentario y la calidad real del régimen alimentario. Conclusiones. En este análisis exploratorio se estableció una relación entre la percepción de la calidad del régimen alimentario, los hábitos alimentarios y los factores sociodemográficos. El impacto sobre la percepción de la calidad del régimen alimentario puede ser negativo o positivo, según la variable considerada.

[RESUMO]. Objetivo. Avaliar como fatores sociodemográficos e a ingestão de alimentos influenciam a percepção dos participantes da pesquisa sobre a qualidade de sua alimentação. Métodos. Trata-se de uma análise transversal realizada em uma amostra não probabilística com 374 participantes maiores de 18 anos na Jamaica. Três localidades no país foram selecionadas por meio de um processo de amostragem aleatória simples em três etapas, com amostragem da população nas áreas comerciais centrais de cada localidade. Para garantir uma boa amostra transversal representativa da população, foram incluídos estabelecimentos comerciais dos setores público e privado, como varejistas, hotelaria e turismo e organizações não governamentais. Clientes e empregados responderam um questionário sobre seu consumo de alimentos e percepção sobre a própria alimentação. Uma análise de correspondência múltipla foi realizada para avaliar as relações não lineares entre as variáveis e, a partir dos resultados desta análise, foi construído um modelo de regressão logística multivariada para estimar a relação entre fatores sociodemográficos, consumo de alimentos e padrões alimentares percebidos. Resultados. A probabilidade prevista média de perceber a alimentação como pouco saudável foi menor entre os participantes do sexo masculino, economicamente ativos, com boa saúde e casados ou em união estável. A probabilidade de perceber a alimentação como pouco saudável foi maior entre os participantes com nível superior de escolaridade e que residiam em um ambiente familiar com uma pessoa do sexo masculino como chefe de família. Consumir alimentos e bebidas saudáveis foi associado a uma percepção menor de má alimentação, e vice-versa, o que indica um possível vínculo entre o consumo de alimentos, a percepção da qualidade da alimentação e a qualidade efetiva da alimentação. Conclusões. Esta análise exploratória demonstrou existir um vínculo entre qualidade percebida da alimentação, hábitos alimentares e fatores sociodemográficos. A influência na percepção da qualidade da alimentação é negativa ou positiva dependendo da variável considerada.

Sociodemographic and dietary influences on perceptions of eating habits in Jamaica / Influencias sociodemográficas y alimentarias en las percepciones de los hábitos de alimentación en Jamaica / Influências sociodemográficas e dietéticas na percepção dos hábitos alimentares na Jamaica

ABSTRACT Objective. To evaluate how sociodemographic factors and food intake affect survey respondents' perceptions of the quality of their diet. Methods. This cross-sectional analysis is based on a nonprobability sample of 374 participants in Jamaica aged ≥18 years. The three-stage process used a simple random sample to select three parishes; the main commercial areas of each parish were chosen for sampling. To ensure the inclusion of a cross-section that was as representative as possible, the sample included both public and private sector businesses, such as those in retail, hospitality and tourism as well as nongovernmental organizations. Employees and patrons completed a questionnaire regarding their food consumption and their perception of their own diet. Multiple correspondence analysis was used to evaluate the nonlinear relationships among the variables. The results of the analysis guided the specification of a multivariate logistic regression model that was used to estimate the relationship between sociodemographic factors, food intake and perceived eating patterns. Results. The average predicted probability of perceiving a diet as unhealthy was reduced when the respondent was male, economically active, in good health, and married or in a common-law relationship. The probability of perceiving a diet as unhealthy was increased for respondents with a college degree and those living in a household that had a male as the sole head. Consuming healthful food and drink reduced the perception of having a poor diet and vice versa, indicating there are possibly connections between food intake, the perception of diet quality and actual diet quality. Conclusions. This exploratory analysis established links between perceived diet quality, eating habits and sociodemographic factors. The impact on the perception of diet quality can be negative or positive, depending on the variable under consideration.

RESUMEN Objetivo. Evaluar cómo los factores sociodemográficos y la ingesta de alimentos afectan las percepciones de las personas encuestadas sobre la calidad de su alimentación. Métodos. Este análisis transversal se basa en una muestra no probabilística de 374 participantes mayores de 18 años en Jamaica. En el proceso, de tres etapas, se utilizó una muestra aleatoria simple para seleccionar tres distritos; para el muestreo, se eligieron las principales áreas comerciales de cada distrito. Para garantizar la inclusión de una sección transversal lo más representativa posible, la muestra incluyó a empresas de los sectores público y privado, como las del comercio minorista, hotelería y turismo, así como a organizaciones no gubernamentales. Tanto empleados como clientes llenaron un cuestionario sobre su consumo de alimentos y su percepción sobre su alimentación. Para evaluar las relaciones no lineales entre las variables se utilizó el análisis de correspondencia múltiple. Los resultados del análisis se usaron como guía para las especificaciones de un modelo de regresión logística multivariante, utilizado para estimar la relación entre los factores sociodemográficos, la ingesta de alimentos y los patrones de alimentación percibidos. Resultados. La probabilidad promedio predicha de percibir que un régimen alimentario es poco saludable era menor cuando el encuestado era de sexo masculino y económicamente activo, tenía buena salud y estaba casado o en una unión de hecho. La probabilidad de percibir un régimen alimentario como poco saludable era mayor en el caso de los encuestados con título universitario y de los que vivían en un hogar con un hombre como único cabeza de familia. El consumo de alimentos y bebidas saludables redujo la percepción de tener una mala alimentación y viceversa, lo que indica la posible existencia de una relación entre la ingesta de alimentos, la percepción de la calidad del régimen alimentario y la calidad real del régimen alimentario. Conclusiones. En este análisis exploratorio se estableció una relación entre la percepción de la calidad del régimen alimentario, los hábitos alimentarios y los factores sociodemográficos. El impacto sobre la percepción de la calidad del régimen alimentario puede ser negativo o positivo, según la variable considerada.

RESUMO Objetivo. Avaliar como fatores sociodemográficos e a ingestão de alimentos influenciam a percepção dos participantes da pesquisa sobre a qualidade de sua alimentação. Métodos. Trata-se de uma análise transversal realizada em uma amostra não probabilística com 374 participantes maiores de 18 anos na Jamaica. Três localidades no país foram selecionadas por meio de um processo de amostragem aleatória simples em três etapas, com amostragem da população nas áreas comerciais centrais de cada localidade. Para garantir uma boa amostra transversal representativa da população, foram incluídos estabelecimentos comerciais dos setores público e privado, como varejistas, hotelaria e turismo e organizações não governamentais. Clientes e empregados responderam um questionário sobre seu consumo de alimentos e percepção sobre a própria alimentação. Uma análise de correspondência múltipla foi realizada para avaliar as relações não lineares entre as variáveis e, a partir dos resultados desta análise, foi construído um modelo de regressão logística multivariada para estimar a relação entre fatores sociodemográficos, consumo de alimentos e padrões alimentares percebidos. Resultados. A probabilidade prevista média de perceber a alimentação como pouco saudável foi menor entre os participantes do sexo masculino, economicamente ativos, com boa saúde e casados ou em união estável. A probabilidade de perceber a alimentação como pouco saudável foi maior entre os participantes com nível superior de escolaridade e que residiam em um ambiente familiar com uma pessoa do sexo masculino como chefe de família. Consumir alimentos e bebidas saudáveis foi associado a uma percepção menor de má alimentação, e vice-versa, o que indica um possível vínculo entre o consumo de alimentos, a percepção da qualidade da alimentação e a qualidade efetiva da alimentação. Conclusões. Esta análise exploratória demonstrou existir um vínculo entre qualidade percebida da alimentação, hábitos alimentares e fatores sociodemográficos. A influência na percepção da qualidade da alimentação é negativa ou positiva dependendo da variável considerada.

Assessing the determinants of unhealthy dietary habits among a sample of survey participants in Jamaica

[ABSTRACT]. Objective. To identify and assess the determinants of unhealthy dietary habits among a sample of survey participants in Jamaica. Methods. Because of resource constraints, this cross-sectional assessment is based on a three-stage non-probability sample of 374 survey respondents in Jamaica aged ≥18 years. Firstly, three administrative areas (parishes) were randomly selected. Secondly, the main commercial areas within the selected parishes were identified, from which a non-probability sample of establishments was drawn. A broad selection of establishments covering public, private, and nongovernmental organizations was chosen. This array of establishments was selected to capture a sample of respondents that was as representative as possible. Patrons and employees in the selected establishments were asked to complete a questionnaire. Results. Respondents’ self-assessment of their general consumption revealed that 48.4% were unhealthy eaters. Among these, the top reasons for generally unhealthy dietary choices were greater accessibility of unhealthy foods (63.5%) and limited time to prepare healthy meals (61.3%). Additionally, 52.5% indicated “unhealthy foods cost less,” and 47.0% identified affordability as the main factor in the food choice equation. Findings revealed that the determinants of eating unhealthily tended to vary across income, age, and gender. Female, younger, and lower-income respondents have a higher likelihood of being impacted by the factors. Conclusions. The largest proportions of the sample identified limited time to prepare healthy meals and the ease of access to unhealthy foods as the foremost determinants of unhealthy eating habits. These barriers to healthy eating are more likely to impact survey participants in the 18–34 age group.

[RESUMEN]. Objetivo. Identificar y evaluar los determinantes de los hábitos alimentarios poco saludables en una muestra de encuestados en Jamaica. Métodos. Debido a las limitaciones de recursos, esta evaluación transversal se basa en una muestra no probabilística de tres etapas de 374 encuestados en Jamaica de edad igual o superior a los 18 años. Primero, se seleccionaron al azar tres parroquias (áreas administrativas). Luego, se identificaron las principales áreas comerciales dentro de las parroquias seleccionadas, y se extrajo una muestra no probabilística de establecimientos de esas áreas comerciales. Se escogió una amplia selección de establecimientos que abarcaban organizaciones públicas, privadas y no gubernamentales. Se seleccionó este rango de establecimientos para reunir una muestra de encuestados que fuera lo más representativa posible. Se pidió a los clientes y empleados de los establecimientos seleccionados que llenaran un cuestionario. Resultados. La autoevaluación de los encuestados sobre su consumo general reveló que 48,4 % tenían una alimentación poco saludable. Entre estos, las principales razones tras estas decisiones alimentarias generalmente poco saludables fueron un mayor acceso a alimentos poco saludables (63,5 %) y limitaciones en el tiempo para preparar comidas saludables (61,3 %). Además, 52,5 % indicó que “los alimentos poco saludables cuestan menos”, y 47,0 % identificó la asequibilidad como el factor principal en la ecuación relativa a la selección de alimentos. Los resultados revelaron que los determinantes de una alimentación poco saludable tendían a variar según los ingresos, la edad y el sexo. Entre los encuestados, las mujeres más jóvenes y con menores ingresos tenían una mayor probabilidad de verse afectadas por los factores. Conclusiones. La mayoría de los encuestados identificó las limitaciones con el tiempo necesario para preparar comidas saludables y la facilidad de acceso a alimentos poco saludables como los principales determinantes de hábitos alimentarios poco saludables. Es más probable que estas barreras para una alimentación saludable afecten a los encuestados del grupo etario de 18 a 34 años.

[RESUMO]. Objetivo. Identificar e analisar os determinantes de hábitos alimentares não saudáveis em uma amostra de participantes de pesquisa na Jamaica. Métodos. Por limitação de recursos, esta análise transversal foi realizada a partir de uma amostra não probabilística com 374 participantes maiores de 18 anos na Jamaica. A amostragem seguiu um processo de três estágios. Primeiro, três áreas administrativas (localidades) foram selecionadas de forma aleatória e, em seguida, foram identificadas as áreas comerciais centrais em cada localidade selecionada. Para garantir a representatividade da população, uma amostra não probabilística de estabelecimentos comerciais em setores variados (público e privado e organizações não governamentais) foi obtida, com a aplicação do questionário da pesquisa aos seus clientes e funcionários. Resultados. Os participantes avaliaram o próprio consumo alimentar em geral, o que demonstrou que 48,4% consumiam alimentos não saudáveis. Os principais fatores para escolhas alimentares pouco saudáveis foram maior acesso a alimentos não saudáveis (63,5%) e falta de tempo para o preparo de refeições saudáveis (61,3%), sendo que 52,5% indicaram que “os alimentos pouco saudáveis são mais baratos” e 47,0% citaram os preços acessíveis como o principal fator na escolha dos alimentos. Os determinantes da alimentação pouco saudável tenderam a variar de acordo com o gênero, idade e o nível de renda, afetando mais as mulheres, os jovens e pessoas de baixa renda. Conclusões. Uma grande parcela da amostra estudada apontou a falta de tempo para o preparo de refeições saudáveis e a facilidade de acesso a alimentos pouco saudáveis como determinantes de hábitos alimentares não saudáveis. Os obstáculos à alimentação saudável repercutem mais entre os participantes jovens de 18 a 34 anos de idade.

Assessing the determinants of unhealthy dietary habits among a sample of survey participants in Jamaica / Evaluación de los determinantes de los hábitos alimentarios poco saludables en una muestra de encuestados en Jamaica / Uma análise dos determinantes de hábitos alimentares não saudáveis em uma amostra de participantes de pesquisa na Jamaica

ABSTRACT Objective. To identify and assess the determinants of unhealthy dietary habits among a sample of survey participants in Jamaica. Methods. Because of resource constraints, this cross-sectional assessment is based on a three-stage non-probability sample of 374 survey respondents in Jamaica aged ≥18 years. Firstly, three administrative areas (parishes) were randomly selected. Secondly, the main commercial areas within the selected parishes were identified, from which a non-probability sample of establishments was drawn. A broad selection of establishments covering public, private, and nongovernmental organizations was chosen. This array of establishments was selected to capture a sample of respondents that was as representative as possible. Patrons and employees in the selected establishments were asked to complete a questionnaire. Results. Respondents' self-assessment of their general consumption revealed that 48.4% were unhealthy eaters. Among these, the top reasons for generally unhealthy dietary choices were greater accessibility of unhealthy foods (63.5%) and limited time to prepare healthy meals (61.3%). Additionally, 52.5% indicated "unhealthy foods cost less," and 47.0% identified affordability as the main factor in the food choice equation. Findings revealed that the determinants of eating unhealthily tended to vary across income, age, and gender. Female, younger, and lower-income respondents have a higher likelihood of being impacted by the factors. Conclusions. The largest proportions of the sample identified limited time to prepare healthy meals and the ease of access to unhealthy foods as the foremost determinants of unhealthy eating habits. These barriers to healthy eating are more likely to impact survey participants in the 18-34 age group.

RESUMEN Objetivo. Identificar y evaluar los determinantes de los hábitos alimentarios poco saludables en una muestra de encuestados en Jamaica. Métodos. Debido a las limitaciones de recursos, esta evaluación transversal se basa en una muestra no probabilística de tres etapas de 374 encuestados en Jamaica de edad igual o superior a los 18 años. Primero, se seleccionaron al azar tres parroquias (áreas administrativas). Luego, se identificaron las principales áreas comerciales dentro de las parroquias seleccionadas, y se extrajo una muestra no probabilística de establecimientos de esas áreas comerciales. Se escogió una amplia selección de establecimientos que abarcaban organizaciones públicas, privadas y no gubernamentales. Se seleccionó este rango de establecimientos para reunir una muestra de encuestados que fuera lo más representativa posible. Se pidió a los clientes y empleados de los establecimientos seleccionados que llenaran un cuestionario. Resultados. La autoevaluación de los encuestados sobre su consumo general reveló que 48,4 % tenían una alimentación poco saludable. Entre estos, las principales razones tras estas decisiones alimentarias generalmente poco saludables fueron un mayor acceso a alimentos poco saludables (63,5 %) y limitaciones en el tiempo para preparar comidas saludables (61,3 %). Además, 52,5 % indicó que "los alimentos poco saludables cuestan menos", y 47,0 % identificó la asequibilidad como el factor principal en la ecuación relativa a la selección de alimentos. Los resultados revelaron que los determinantes de una alimentación poco saludable tendían a variar según los ingresos, la edad y el sexo. Entre los encuestados, las mujeres más jóvenes y con menores ingresos tenían una mayor probabilidad de verse afectadas por los factores. Conclusiones. La mayoría de los encuestados identificó las limitaciones con el tiempo necesario para preparar comidas saludables y la facilidad de acceso a alimentos poco saludables como los principales determinantes de hábitos alimentarios poco saludables. Es más probable que estas barreras para una alimentación saludable afecten a los encuestados del grupo etario de 18 a 34 años.

RESUMO Objetivo. Identificar e analisar os determinantes de hábitos alimentares não saudáveis em uma amostra de participantes de pesquisa na Jamaica. Métodos. Por limitação de recursos, esta análise transversal foi realizada a partir de uma amostra não probabilística com 374 participantes maiores de 18 anos na Jamaica. A amostragem seguiu um processo de três estágios. Primeiro, três áreas administrativas (localidades) foram selecionadas de forma aleatória e, em seguida, foram identificadas as áreas comerciais centrais em cada localidade selecionada. Para garantir a representatividade da população, uma amostra não probabilística de estabelecimentos comerciais em setores variados (público e privado e organizações não governamentais) foi obtida, com a aplicação do questionário da pesquisa aos seus clientes e funcionários. Resultados. Os participantes avaliaram o próprio consumo alimentar em geral, o que demonstrou que 48,4% consumiam alimentos não saudáveis. Os principais fatores para escolhas alimentares pouco saudáveis foram maior acesso a alimentos não saudáveis (63,5%) e falta de tempo para o preparo de refeições saudáveis (61,3%), sendo que 52,5% indicaram que "os alimentos pouco saudáveis são mais baratos" e 47,0% citaram os preços acessíveis como o principal fator na escolha dos alimentos. Os determinantes da alimentação pouco saudável tenderam a variar de acordo com o gênero, idade e o nível de renda, afetando mais as mulheres, os jovens e pessoas de baixa renda. Conclusões. Uma grande parcela da amostra estudada apontou a falta de tempo para o preparo de refeições saudáveis e a facilidade de acesso a alimentos pouco saudáveis como determinantes de hábitos alimentares não saudáveis. Os obstáculos à alimentação saudável repercutem mais entre os participantes jovens de 18 a 34 anos de idade.

A review of the response to HIV/AIDS in Trinidad and Tobago: 1983-2010.

This paper examines the character of the response to HIV/AIDS in Trinidad and Tobago and assesses the impact of the response on reducing the spread of the epidemic. The launch of the National HIV/AIDS Strategic Plan in 2004 signalled the intent of the government to take the response to HIV/AIDS to a different level. This is seen by the sheer increase in the volume of resources allocated to the response from the levels of the 1980s and 1990s. The expectation was that there would be increased cohesiveness, which would allow for targeted interventions to be more effective. Though in 2009, there was a slight increase in the HIV prevalence rate to 1.5%, this was due mainly to improvements in access to antiretrovirals and same-day testing as well as improvements in data collection and analysis. The annual number of new infections fell from a high of 1709 in 2003 to 1154 in 2010. Additionally, great strides have been made in the prevention of mother-to-child transmission programme with some regions reporting 100% coverage of antenatal attendees. The study indicates that the country has responded relatively well in the areas of Strategic Planning, Care and Support, and Prevention and there has been involvement by both the public and private sector (NGOs in particular), in the response. However, there are gaps in the provision of social services and the implementing legislation to protect the rights of persons living with HIV/AIDS. Of note is the fact that a successful response to the HIV/AIDS epidemic is one that embraces all social groups, all spheres of activity and all areas of the country.