Obesity among Cayman’s children needs to be tackled in schools and at home to prevent skyrocketing medical costs stemming from weight-related illnesses in the future, a seminar attended by many of the territories’ medical professionals heard.
At a symposium on obesity held at the St. Matthew’s University medical school campus on Friday, 9 November, speakers outlined some shocking statistics about the rate of obesity among children and adults in the Cayman Islands and the United States.
In his opening comments, Health Minister Mark Scotland described obesity as “one of the biggest threats to our country and we need to do all we can to end this epidemic”, pointing out that 22 per cent of Cayman’s school children were overweight and 15 per cent at risk of becoming overweight.
Dr. Ana Viamonte Ros, medical director of Clinical Staff Development for Baptist Health International and the former surgeon general of Florida, said 1.8 billion people worldwide are obese or overweight – the equivalent of more than one in five people – and that it is estimated that three in four Americans will be obese by 2020, she said.
Fighting weight issues was not just about appearances as children who are overweight are more likely to develop asthma, gall stones, diabetes and chronic back pain.
She pointed out that today’s children will be the first generation in history to have a lower life expectancy than their parents, describing this likelihood as “staggering”.
Dr. Viamonte Ros said the Cayman Islands government spent 17.5 per cent of its national budget on healthcare costs in 2009 – similar to the percentage spent on healthcare in the United States. Although there are no statistics available on the cost of healthcare related to obesity, the doctor said that if one extrapolates from the US numbers, that would mean that in Cayman, $8.87 million had been spent in Cayman in 2009 on obesity-related health costs.
That figure is likely even higher, the doctor said, once obesity-associated illnesses such as diabetes, high blood pressure and cardiovascular disease are factored in. She said it was probable that more than half of public health spending in Cayman was related to obesity, a cost which she described as “unsustainable”.
Citing a report by the Trust for America’s Health, released in 2010, Dr. Viamonte Ros said investing just $10 per person in proven community-based obesity prevention programmes would lead to $18 billion in annual savings on healthcare costs.
“Obesity is not just a medical issue, it’s a complete social issue. Obesity will not be solved unless we solve it in all our arenas – in our homes, in our schools, in our restaurants, in our doctors’ and in our government buildings,” she said.
An analysis of 64 obesity programmes in the US showed that only 21 per cent were effective. Those that were successful were short and simple and predominantly targeted children and adolescents, Dr. Viamonte Ros said.
“Obese children are more likely to become obese adults,” she said, citing a startling statistic that one in three children born in the US after the year 2000 will develop diabetes.
The most successful school-based programmes adopt multiple approaches, with the best programmes focusing on physical activity rather than body weight and teaching children to choose healthy foods, which is available at the schools.
“Activities should be play-based, not sport-based or competitive-based because that can dissuade children from taking part,” Dr. Viamonte Ros said.
Children should be discouraged from eating while watching television or playing video games, she said, adding that adults need to set good examples and praise their children’s good choices.
Local endocrinologist Diane Hislop Chestnut agreed with Dr. Viamonte Ros and the health minister, saying obesity was one of the most important public health issues facing Cayman.
She highlighted the importance of identifying children who were overweight and at risk of being overweight from an early age, citing statistics that showed that pre-schoolers who are overweight have a 25 per cent chance of being obese as adults and that kids who are obese at the age of six have a 50 per cent likelihood of being obese grown-ups. Once a child hits the age of 10 and is overweight, there is an 80 per cent chance of that child becoming an overweight adult.
“The earlier we start, the more impact we can make on these kids,” Dr. Hislop-Chestnut said.
According to local statistics, of the 533 children entering schools in the Cayman Islands in 2010, 16 per cent were overweight and 13 per cent were obese. The following year, the figures were similar with 16 per cent overweight and 14 per cent obese.
Statistics for children already in school were even worse. Screenings of children ages 10 to 14 in 2009 and 2010 showed 34 per cent and 35 per cent, respectively, were overweight or obese.
And while many consider heart disease to be an illness that only affects adults, young obese children have been shown to have cardiovascular disease risk factors. Dr. Hislop-Chestnut said that data from the US shows that 39 per cent of overweight children have at least two risk factors for heart disease. Again, when that statistic is extrapolated to Cayman, this means that 30 of Cayman’s 4 year olds have two or more cardiovascular risk factors – a statistic Dr. Hislop-Chestnut, as a mother of a 4 year old, found alarming.
As well as the inherent physical issues that come with obesity, children also have psychological and social fallout from being overweight, with some becoming isolated and depressed. Research shows, Dr. Hislop-Chestnut explained, that people who are overweight are also less likely to finish college and more likely to live in poverty.
The life expectancy of obese people is also shorter. For example, an obese adolescent’s risk of dying by middle age is two to three times higher than a non-obese adolescent.
To forestall these future medical problems, introducing healthy eating habits and daily physical exercise for children is vital.
“It is really everyone’s problem. It’s something we all have to partake in – medical personnel, parents, children and teachers,” said Dr. Hislop-Chestnut.
She supports the introduction in Cayman of a programme used in Trinidad and Tobago that inserts healthy eating and wellness education into the school curriculum, not just in health education classes, but in all classes.