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Childhood obesity is one of the “wicked issues” facing the Region examined by participants in the CLP Leadership Development Program.
In discussing the issue, questions were posed about the significance of cultural views about weight and body types and the biological features of different ethnic groups:
Childhood obesity was placed on the Region’s priority agenda by the CARICOM Heads of Government. Obesity in all age groups is now the most important underlying cause of death in the region and contributes to chronic non-communicable diseases such as heart disease, stroke, hypertension, diabetes and cancer. CARPHA notes that the trend among Caribbean children is worrisome. From 2001–2010, the prevalence of overweight children less than 5 years old rose from 6% to 14%. For boys 11–13 years old, combined overweight and obesity prevalence was 27% while for girls it was 33%. This trend will result in higher lifetime health costs for individuals and countries.
According to the World Health Organization (WHO), the standard measure of weight is the Body Mass Index (BMI)—a person's weight in kilograms divided by the square of his/her height in meters (kg/m2). BMI provides a standard population-level measure as it is the same for both sexes and for all ages of adults. A BMI greater than or equal to 25 is deemed overweight, and a BMI greater than or equal to 30 is obese.
An interesting study of body image in Trinidad and Tobago examined the body image and satisfaction with body size of 1,100 male and female adolescents (age 14–17). The study identified noteworthy ethnic differences in perceptions of body size. According to the study:
Most important was probably the finding that overweight Africans were more likely to be satisfied with their size than the other overweight adolescents while thin South Asians were more likely to be satisfied with being thin than the other thin persons. In addition, the African girls were also less inclined to want to lose weight than the other girls. This may have great significance for the occurrence of obesity when they become adults.
Another study conducted in England used BMI and other tools to compare body fat. Weight, height, waist circumference, and skinfold thickness values were measured, while fat mass was derived from bioelectrical impedance analysis (BIA) (a method for estimating body composition, and in particular body fat). The results found that BMI systematically underestimates adiposity (fat) or obesity in South Asians, and it overestimates adiposity in black African–Caribbean people. The study raised doubts about the use of BMI as a standard measure suggesting that it may not be the most reliable measure of body fat for all racial groups.
It is noted that heredity, hormonal content, metabolic rate, body shape and other factors have correlations with body weight of individuals, not only food intake and the level of physical exercise. This must be balanced, though, with the recognition that health and well-being, and indeed fitness, are crucial for improving quality of life and reducing risk of chronic ailments. Therefore, maintaining a healthy lifestyle requires having a suitable body weight.
What messages are we sending male and female children and youth about health, wellness and body size? What are the messages about “ideal” body size conveyed by media?
How do these messages affect their self-concept? How is one’s image of himself or herself impacted by the “gold standard” that has been developed or portrayed about the ideal body?
How do these messages about weight and body vary in different cultures?
Has there been discrimination against persons who do not fit within the image of an ideal body weight?
D T Simeon, R D Rattan, K Panchoo, K V Kungeesingh, A C Ali and P S Abdool. “Body image of adolescents in a multi-ethnic Caribbean population”. European Journal of Clinical Nutrition (2003) 57, 157–162. http://www.nature.com/ejcn/journal/v57/n1/abs/1601515a.html
 C. M. Nightingale, A. R. Rudnicka, C. G. Owen, D. G. Cook, P. H. Whincup. “Patterns of body size and adiposity among UK children of South Asian, black African-Caribbean and white European origin: Child Heart And health Study in England (CHASE Study)”. International Journal of Epidemiology, 2010; DOI: 10.1093/ije/dyq180; http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3043281/
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