Rainbow-coloured drinks with tropical names and fruit-inspired flavours are the beverage of choice for many children in the Caribbean. But happy neon tongues and adorable food dyed lips disguise a public health crisis that is anything but cute. With a single serving of sugar sweetened beverages (SSBs) exceeding the World Health Organisations daily-recommended maximum sugar intake, and in a region where there are more soft drinks consumed than anywhere else in the world, SSBs have been linked to the Caribbeans deadly childhood obesity epidemic.
The Caribbean exhibits some of the highest rates of childhood obesity globally, says Maisha Hutton, Executive Director of the Healthy Caribbean Coalition, a Caribbean Non-Communicable Diseases alliance of over 100 organisations. One in every three Caribbean children is obese and at risk for developing non-communicable diseases including diabetes, hypertension and heart disease.
"Happy neon tongues and adorable food dyed lips disguise a public health crisis that is anything but ... [+] cute."
Excessive consumption of sweet beverages is one the major drivers of obesity, yet most Caribbean children are still consuming carbonated drinks loaded with sugars on a daily basis, continues Hutton.
It has been found that the odds of obesity in children increase by approximately 60% with each additional serving of a sugary drink per day. (Francis et. al, 2009)
Fizzy, sugary drinks on a supermarket shelf. (Photo by Matthew Horwood/Getty Images)
According to the Healthy Caribbean Coalition, approximately 75% of Trinidadian students between the ages of 13 and 15 consume carbonated sugar sweetened beverages every day. In Barbados, it is more than 73%. In Jamaica, it is almost 70%. In the Bahamas, it is 69% and in St. Kitts and Nevis, it is 62%.
The typical 12-ounce can of soda or any sugar sweetened beverage has around 40 grams of added sugar which adds calories with no essential nutrients and accounts for at least 40% of the added sugar in Caribbean childrens diets. (Pan American Health Organisation)
Children aged 2-18 years are advised to consume less than 25 grams of sugar daily (WHO), yet popular beverages from the region, such as Canada Dry Ginger Ale (35g sugar/container), Fanta Orange (48g sugar/container), Pinehill Passion fruit (32g sugar/container), Vita Malt (46g sugar/container), Frutee Red (68g sugar/ container), Angostura Lemon Lime Bitters (37g sugar/ container) and Tiger Malt (31g sugar/ container) all exceed the maximum recommended amount in just one serving.
It is no wonder that, according to the Global Atlas on Childhood Obesity, three Caribbean nations (Dominica, the Bahamas and St. Vincent and the Grenadines) are among the top twenty countries in the world with the highest risk of having a significant childhood obesity problem in the coming decade.
The Healthy Caribbean Coalition and its regional member civil society organisations have been working collaboratively across the Caribbean since 2017 to advocate for healthy nutrition policies which tackle unhealthy diets and in particular the unacceptably high levels of overweight and obese Caribbean children.
Urgent action is needed to ban the sale and promotion of sweet beverages in schools, tax sweet beverages and make front of package nutrition warning labels mandatory. Strong public education is needed to inform the general public about the dangers of excess consumption of sugar and the levels of sugar in the beverages commonly consumed, says Hutton.
Taxation has proven to be a successful strategy in curbing the consumption of sweet drinks. According to the Pan American Health Organisation, Price elasticity models for SSB sales estimate a 6-16% reduction with a tax rate of 10%. These measures have already been put in place in Barbados, Dominica and St. Lucia and the rest of the region appears to be supportive of the tax.
A 2019 Jamaican survey found that 82% of Jamaicans support the sugary drinks tax if the proceeds go towards funding obesity prevention programmes, particularly for children, while 71% are supportive of a sugary drinks tax in general.
In 2015, Barbados imposed taxes on carbonated soft drinks, juice drinks, sports drinks and fruit juices, with mixed findings. While there was a 4.3% decline in SSB sales and an increase of 7.5% in bottled water sales during the first year of implementation, a recent study found evidence suggesting that consumers responded to the price increase by purchasing cheaper sugary drinks that are typically associated with higher levels of sugar.
One of the most critical policy priorities is the restriction of sugar sweetened beverage sales in schools. Regulation banning or restricting the sale and marketing of SSBs already exists in the Bahamas, Belize, Grenada (from January, 2020), Jamaica and Trinidad and Tobago.
Despite regulatory impediments to consumption, at an average of 1.9 eight-ounce servings per day, the Caribbean continues to have the highest recorded consumption levels of sugar sweetened beverages in the world (Singh et al. 2015). This has lead to weight gain, increasing the risk of obesity, with direct links to cancers, cardiovascular disease and diabetes.
Latin America and the Caribbean has the highest absolute mortality related to SSB consumption in the world and among the 20 countries with highest SSB-related deaths, at least 8 of them are in Latin America and the Caribbean. (Singh et al. 2015)
Given that childrens health and nutritional choices are guided by adults, childhood obesity is a social justice issue and should be addressed as such by policy makers, parents and schools. Allowing children to consume sugary drinks on a regular basis is a violation of Article 24 of the United Nations Convention on the Rights of the Child that provides for the right of the child to the enjoyment of the highest attainable standard of health.
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