Use of food expenditure data to estimate household nutrient accessibility

The nutritional status of at-risk groups is usually monitored using health statistics. This approach has limitations as individuals are identified only after they have been afflicted by morbidity. In Jamaica, national surveys are carried out in which expenditure data on all consumption items are collected. We used these data to monitor food accessibility in at-risk groups. The identification of decreases in accessibility levels relative to requirements would enable timely intervention before there is a deterioration in nutritional status. We analysed the data from the survey of 3861 households conducted by Statistical and Planning Institutes of Jamaica in 1989. Using the food expenditure data, per capita energy and protein accessibility levels were determined. The mean energy and protein accessibility levels for the sample were 2170 Cals and 64 g, respectively. The results showed that the per capita accessibility levels of 20 percent and 9 percent of the households were less than half of requirments for energy and protein, respectively. The situation was worse in rural areas than in urban centres. However, the accessibility levels may have been underestimated as the data did not include meals bought and consumed away from the home, which may be significant to some households. We believe that the use of data from these surveys is a cost-effective way to monitor nutrient accessibility in Jamaica (AU)

Use of food expenditure data to estimate household nutrient accessibity

The nutritional status of at-risk groups is usually monitored using health statistics. This approach has limitations as individuals are identified only after they have been afflicted by morbidity. In Jamaica, national surveys are carried out in which expenditure data on all consumption items are collected. We used these data to monitor food accessibility in at-risk groups. The identification of decreases in accessibility levels relative to requirements would enable timely intervention before there is a deterioration in nutritional status. We analysed the data from the survey of 3861 households conducted by Statistical and Planning Institutes of Jamaica in 1989. Using the food expenditure data, per capita energy and protein accessibility levels were determined. The mean energy and protein accessibility levels for the sample were 2170 Cals and 64 g, respectively. The results showed that the per capita accessibility levels of 20 percent and 9 percent of the households were less than half of requirments for energy and protein, respectively. The situation was worse in rural areas than in urban centres. However, the accessibility levels may have been underestimated as the data did not include meals bought and consumed away from the home, which may be significant to some households. We believe that the use of data from these surveys is a cost-effective way to monitor nutrient accessibility in Jamaica

KAP study of secondary school students towards obesity in Jamaica

A series of focus groups was used to study the knowledge, attitudes and practices of students (ages 11-18 years) towards obesity in Jamaica. Specifically the study sought to: Understand whether obesity is considered a nutritional disorder or disease among secondary school students in Jamaica. Understand whether obseity is accepte, and if so what are the specific cultural influences? Describe any difficulties between urban and rural atitudes towards obesity. Provide information to assist the development of public health messages that may be most beneficial for health programmes to utilize, for secondary school students in combatting the problems of obesity. Fifteen focus groups with a total of 180 students were drawn form a total of one thousand and twenty-two (1,022) students, from two schools: one located in the urban area of Kingston, St. Andrew; and the other located in the rural area of Ewarton, in the parish of St. Catherine. Samples of students from the two schoos were divided into three categories: Young-for-Grade; Average-for-Grade and Old-for-Grade. Students were further grouped into all boys, all girls, and mixed groups of boya and girls. Group interviews were tape recorded, and all recordings were transcribed verbatim. Notes were also made during each session. Following the standard procedures outlined in grounded methods of groupd interviews, open coding of the transcriptions was done. Concepts were identified and developed in terms of their properties and dimensions. Similar questions werelabelled and grouped to form categories relating to each research question. Analysis of the sessions showed that there was no significant difference in the knowledge of causes of obesity among students in diffferent grades. The majority of male students showed a negative attitude or feeling toward being obese. Yet many preferred women who were heavier or had a lower body distribution of adipose tissue which was referred to as a "coca-cola bottle shape" (gynoid obesity), rather than women with an upper-body or abdominal distribution of adipose tissue (android obesity). The majority of female students expressed a positive attitude toward gynoid obesity, but disliked android obesity. In addition, many of the female students expressed their dislike for obese men. Studnts' knowledge about the causes of obesity and prevention measures was not very consistent with their dietary patterns. Most of the students who participated in the focus group sessions did not think of obesity as a nutritional disease, but rather regarded it as a sign of wealth, good living, or access to an abundance of food (AU)

KAP study of secondary school students towards obesity in Jamaica

A series of focus groups was used to study the knowledge, attitudes and practices of students (ages 11-18 years) towards obesity in Jamaica. Fifteen focus groups with a total of 180 students were drawn from a total of one thousand and twenty-two (1.022) students, from two school: one located in the urban area of Kingston, St. Andrew; and the other located in the rural area of Ewarton, in the parish of St. Catherine. Samples of students from the two schools were divided into three categories: 1. young-for-grade 2. average-for-grade 3. old-for-grade. Students were further grouped into all boys, all girls, and mixed groups of both boys and girls. Group interviews were taped recorded, and all recordings were transcribed verbatim. Notes were also made during each session. Following the standard procedure outlined in grounded method of group interviews open coding of the transcriptions was done. Concepts were identified and developed in terms of their properties and dimensions. Similar questions were labelled and grouped to form categories relating to each research question. Analysis of the sessions showed that there was no significant difference in the knowledge of causes of obesity among students in different grades. The majority of male students showed a negative attitude or feeling toward being obese. Yet many prefered women who were heavier or had a lower body distribution of adipose tissue which was refered to as the a "coca-cola bottle shape" (gynoid obesity, rather than women with an upper-body of abdominal distribution of adipose tissue (android obesity). The majority of female students expressed a positive attitude towards gynoid obesity, but disliked android obesity. In addition many of the females student expressed their dislike for obese men. Students' knowledge about the causes of obesity and prevention measures was not very consistent with their dietary patterns. Most of the students who participated in the focus group sessions did not think of obesity as a nutritional disease, but rather regarded it as a sign of wealth, good living, or access to an abundance of food.

Evaluation of a gastric delivery system for iron supplementation in pregnancy

The present investigation was undertaken to assess the efficacy of oral iron supplementation during pregnancy by using a gastric delivery system (GDS). Three hundred seventy-six pregnant women between 16 and 35 years of age and 14 and 22 weeks gestation were selected if mild anemia was present (hemoglobin concentration 80-110 g/l). The participants were randomly assigned to one of three study groups given no iron, two FeSO4 tablets (100 mg FE) daily, or one GDS capsule (50 mg Fe) daily. Blood was obtained initially and after 6 and 12 weeks for measurement of red blood cell and iron indexes, including serum transferrin receptor. There was a significant and comparable improvement in hematologic and iron-status measurements in the two group of women given iron whereas iron deficiency evolved in women given no iron supplement. We conclude that by elimating gastrointestinal side effects and reducing the administration frequency of an iron supplement to once daily, a GDS offers significant advantages for iron supplementation of pregnant women. (AU)

Energy and protein accessibility at the household level in Jamaica: results from a national survey - abstract

Patterns of food consumption in Jamaica are of interest not only because of the increase in the food prices relative to the national minimum wage but also because the increased mortality rates from cardiovascular diseases in Jamaica may be related to dietary intakes. Data on household food expenditure were collected in the Jamaica Survey of Living Conditions and these were used to determine household energy and protein accessibility. The survey comprised a national representative sample of 3,861 households. The mean per capita daily energy and protein accessibility levels were 2,170 calories and 64 gm, respectively. This can be compared to reference requirements of 2,250 calories and 43 gm protein. The sample was divided into quintiles of total consumption with the top comprising the richest 20 per cent of the sample and the bottom quintile the poorest 20 per cent. The mean accessibility levels from the poorest quintiles were 909 calories and 24 gm protein while those of richest were 3,356 calories and 102 gm protein. The deficit in energy and protein in the poorest individuals may not be as dramatic as these figures indicate. The total energy and protein accessibility levels do not include meals consumed outside of the home, whether these were bought or received as gifts or as wages. This source of nutrients may be important to this group. In addition, the poorest households have more children which will decrease their per capita nutrient received. However, the indication is that the poorest individuals may be having intakes below those required. This would not only result in poor development of children but also may affect productivity levels in adults and hence national development (AU)

Overview of the food and nutrition situation in the Caricom Region.

The majority of the population enjoys a good nutritional status. For the remainder an uneven situation exists where there is wasting and stunting as well as obesity and the chronic non-communicable nutrition related diseases. The causes of malnutrition are complex and multifactorial. In the Caribbean, poverty and inadequate knowledge are seen as being the major underlying causes. An adequacy of available foods is essential, and has been achieved in all Caribbean countries. However, in identifiable communities in most countries there is a deficiency of food security in the poorest households, due to a disadvantageous relationship between food prices and household incomes. In definable communities too, there is a significant amount of undernutrition particularly among young children. There is need to investigate further intra-familial food distribution. The persistence of low birth weight - a phenomenon most prevalent among teen-aged mothers - points to the need to target nutrition interventions to adolescent girls. A large percentage of the food eaten is imported. In some cases food choices have aggravated health risk. Most of the CARICOM region consumes too much sugar and salt, too much fat and too little complex carbohydrates, fruits and vegetables. This consumption pattern is associated with an increase in heart disease, cerebro-vascular accidents, diabetes and some cancers. The way food is prepared is also vitally important. Infections and lifestyles are critical to nutritional status. Good nutrition is an input as well as a result of positive development. (Summary)

An analysis of the food and nutrition situation in the Commonwealth Caribbean and the role of the Caribbean Food and Nutrition Institute in this nutritional environment

The paper analyses the nutritional environment in the Commonwealth Caribbean. The differences in economic growth and the detrimental social consequences of those countries experiencing negative growth, are used to demonstrate the differing scenarios existing in the area. All the countries under review have for a prolonged period showed low domestic food production, and incurred large food import bills. Within this environment, household food security is unstable and very vulnerable especially for the poorer segments of society. Coping mechanisms employed by the government and the people have maintained an adequate supply of energy-rich foods so that energy-protein analysis of the available foods(using the most recent FAO data) point to a deficiency of complex carbohydrates, an overabundance of simple sugars and animal foods. From observation, the animal products tend to be very fatty. Coincidentally, the countries are experiencing an epidemic of the chronic nutrition-related diseases,e.g. cerebrovascular and ischemic heart diseases and diabetes mellitus of adult onset. The role and mission of the Caribbean food and Nutrition Institute in this nutritional environment is stated, as are its priority programme activities. As regards future directions, new targes to 1995 to be based on the situational analysis are presented. A shift in the work of the Institute to focus on chronic nutrition related diseases and health promotion and to emphasize health for development, is the major consideration for the 1990's

Knowledge, attitudes, and practices of Jamaican secondary school students regarding health and fitness - abstract

Improvements in lifestyles, particularly weight control, dietary practices, exercise habits and self esteem in youth have been found to lessen the probability of obesity, diabetes mellitus, hypertension and heart attack in adulthood. A school-based project is being implemented to test this in the Caribbean. Baseline data on knowledge, attitudes, and practice of 2,910 students were collected from 2 intervention and 2 Secondary/High Schools. Sixteen (16) percent of the children thought that they were too thin while 13 percent thought they were too fat. Only 44 percent said that they knew how to accurately measure their weight and height. However, 82 percent wanted to know how to maintain desirable weights. Seventy-one (71) percent thought that weighing was related to health. Forty-nine (49) percent believed that weighing right is healthy while 51 percent and 36 percent thought that being too fat and too thin, respectively, can lead to ill health. Sixty-one (61) percent of the sample thought that eating right meant having the right type and amount of food. Fifty (50) percent usually had three (3) meals per day while 32 percent ate as many times as possible. Sixty-seven (67) percent, 62 percent and 53 percent of the students said that sweet, greasy and salty foods, respectively, are unhealthy. Thirty (30) percent of the sample usually add salt ot prepared food while 33 percent did so occasionally. Ninety-one (91) percent of the sample thought it important for everyone to exercise. However, only 28 percent exercised regularly. Sixty-three (63) percent of the students belonged to groups either at school or in their communities. Ninety-five (95) percent thought it was all right to feel good about themselves, and 71 percent considered themselves worthwhile. These results are useful not only in determining the nature of the intervention needed to facilitate the desired changes in lifestyles, but also in identifying variables which may serve as bases for future evaluations (AU)