The Tribune

There are a number of reasons most Bahamians do not smoke cigarettes. One reason is cultural: we frown on those who smoke. We do not like the smell of cigarettes, especially in our homes and vehicles.

Many of us have few relatives or colleagues who smoke. We often openly criticise those who smoke. Cultural acceptance makes a compelling difference when it comes to widespread cultural habits, whether positive or negative.

The Bahamas has topped the charts in two areas of public health. They are not rankings of which we should be proud. We have a high murder rate fuelled by a culture and normalisation of violence.

And we have an epidemic of obesity similarly fuelled by a culture which normalises being egregiously overweight. This includes an unhealthy diet. 

The Global Obesity Observatory numbers have been released for 2022. The Bahamas is number seven globally. Forty-seven percent of those of us 18 and over are obese.

A mother travelling overseas called her 26-year-old son who recalled the spate of murders last week. The mom responded: “You need to travel or live overseas for a while to appreciate that the high level of killings in Nassau is not normal.”

While obesity is a global problem, our levels of obesity including, childhood obesity are abnormal. Ask most Bahamians what is meant by obesity. Most could not tell you. Indeed, many would simply say they are big. Many are proud of being what the older people simply called “fat”.

Most people do not know what their optimum weight should be. Few know the distinction and relationship between obesity and being overweight. Many who believe they are overweight are medically obese.

“For adults, the World Health Organization defines overweight and obesity as follows: overweight is a Body Mass Index (BMI) greater than or equal to 25; and. obesity is a BMI greater than or equal to 30.”

It is not a matter of the proverbial fat shaming to recognize and to suggest to others that being obese is a doorway to myriad health problems, potentially high levels of physical pain, and early death.

Some, if not many women, view their high levels of fat as attractive. They wear tight clothes and other outfits highlighting their obesity as a sign of beauty. Because so many of their peers and others are obese, obesity is celebrated, normalised, and accepted by scores of Bahamians.

Even those women who may have a better understanding of the risks of obesity ignore admonitions to lose weight because being overweight is acceptable.

Many men who are obese are similarly comfortable with their weight, often fuelled by the high consumption of alcohol, carbohydrates, and processed food, exacerbated by physical inactivity. They literally revel in being “a big man”.

There are many who eat healthy and struggle with their weight. However, much of the obesity in The Bahamas, especially among young people and children, is the result of poor dietary and cultural habits.

The incidence of obesity has resulted in an explosive growth in non-communicable diseases including high blood pressure, heart disease and diabetes. Yet scores of Bahamians are largely unaware or significantly ill-informed about the risk factors involved in obesity and the onset of various diseases.

Many Bahamians do not appreciate that the consumption of large quantities of carbohydrates and the absence of fruits and vegetables in their diets significantly affect their health, mortality and quality of life.

God is not the cause of our ill-health or death because of our poor choices or obesity. Human beings have the free will to decide on healthier lifestyles which may prevent or help to regulate various diseases. This same Creator gave us fruit and vegetables.

It is near blasphemous to blame God for us getting sick and dying early as a result of eating fast foods and drinking alcohol and sugary drinks like water every week. This is not God’s will!

Behind the obesity statistics are personal stories of illness, disability and death, as well as loss and financial anxiety and woes. There is also the extraordinary economic burden on the country and on government finances.

In a 2016 report, the Food and Agriculture Organisation (FAO) and the Pan American Health Organisation (PAHO) estimated that an alarming nearly 70 per cent of Bahamians are overweight.

Equally alarming, according to PAHO, in a pamphlet entitled, The Burden of Childhood Obesity in The Bahamas: “21 percent of Bahamian youth between ages 13 and 15 are obese and 45 percent are overweight.”

Nearly half of all adolescents ages 13 to 15 are overweight, a time bomb that is exploding already with younger Bahamians presenting with myriad health problems that will only dramatically worsen as they grow older.

Rather than celebrating obesity or being overweight, we urgently need more healthy lifestyle initiatives dedicated to better nutrition, exercise and well-being, including meditation, such as transcendental meditation.

We exceed our Caricom neighbors in the prevalence and availability of American fast food chains, which are ubiquitous on New Providence, along with homegrown fast food businesses.

In a 2017 story reported in The Tribune, entitled, “Bahamas has ‘highest overweight rate’ in the Caribbean and Latin America”, dietitian and nutritionist Shandera Smith sounded the alarm on the obesity and public health crisis in the Bahamas that is leading to more early deaths.

Smith noted in the story: “Our diet for one is very different from that of other Caribbean islands. Culturally speaking, our idea of food has more fat, more sugar and salt. We eat a lot of things like peas and rice, macaroni, fried chicken and fast foods as well.

“We tend to drink a great deal of sweetened beverages and a lot of these beverages are marketed toward children. All of this contributes to obesity and overweight because these foods do very little for our bodies.”

In the document “Designing a Regional Advocacy Campaign Plan for Childhood Obesity Prevention Policies”, the Healthy Caribbean Coalition noted:

“In the Caribbean studies have shown that up to 30 percent or approximately one-third of children are overweight or obese. Childhood obesity has serious long-term effects both on the individual and regional levels.

“Individually, childhood obesity predicts adult obesity and foretells a plethora of comorbidities including diabetes, hypertension and cardiovascular diseases, which have already been seen in Caribbean children.

“On a broader level, childhood obesity affects the health of regional economies. The cost to the Caribbean economy of diseases linked to obesity, such as diabetes and hypertension, is over US$1 billion per year.”

Drs Christine Chin and Williamson Chea are part of a broader coalition to reduce the incidence of childhood obesity in the Bahamas. They are promoting education, physical activity and nutrition.

The risk factors for childhood obesity in The Bahamas include: salty food, sodas and sugary drinks, fast food, physical inactivity, insufficient fruits and vegetables and other factors.

There are other risk factors that will have to be addressed by parents, government, schools, businesses, unions, the religious community, civic groups and others.

Shandera Smith noted in The Tribune story: “We encourage people to eat native fruit as well. What we find is that a lot of children don’t consider the native fruits like the dilly a fruit. When you ask them what a fruit is, they say apples or oranges.

“Eating the native fruits benefits people because they are cheaper and the nutrients that they we get from them are better suited for the environment that we live in so we don’t have to worry.”

Smith also noted: “As for children, they are not as active as they should be. While in school, physical education is only offered once a week, so kids only have this time be active while in school. So our culture seems to feed the obesity problem we are currently faced with.”

The cultural shift needed to tackle obesity will be monumental. But small first steps may help such as innovative programs by community organisations like Hands for Hunger, which is dedicated to good nutrition and helping to tackle obesity, including childhood obesity.

To change our trajectory will first require key cultural change including the initial recognition by more Bahamians that we actually have an obesity problem. If someone does not recognize that they are obese and that there are ways to address this, little will change.

Just as most Bahamians believe that smoking cigarettes is bad for one’s health, we need to get to a place where more Bahamians recognising that the way they are eating is killing them and their children. More Bahamians are dying from our diet than the number of people dying from cigarettes.

Former Prime Minister Dr Hubert Minnis proposed a universal food program in the government-operated school system. Such a programme would include healthy meals and a learning component on healthy eating. Such broad scale initiatives will help to address cultural practices and mindsets.

If we do not address the cultural roots of obesity through a variety of comprehensive sociological and economic measures, we will remain unhealthy and in denial as more of us head to an early grave.