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Fast food, slow demise

Thursday, August 10, 2017
Senior doctor at the Ministry of Health Rohit Doon holds a copy of the National Strategic Plan for the Prevention and control of Non Communicable Diseases, Trinidad and Tobago 2017-2021

A doubles and a red soft drink.

A two-piece with fries.

Not to be left out as well would be the variety of burgers, sandwiches, oriental cuisine, gyros and tasty deserts that come in all shapes, sizes and combinations.

The reality is: while as a nation we feast on ever increasing volumes of these delectable delights, what we are consuming is killing us.

Every year billions of dollars flow through the public and private health sector in T&T to cover the costs associated with non-communicable (lifestyle) diseases (NCDs).

In fact, money spent on treating NCDs makes up a significant portion of the funds allocated to the health ministry in the annual budget. A walk through any of the wards of the nation’s public hospitals provides ample evidence that as a country, our lifestyle, diet and work habits are pushing us closer to the tipping point of a local healthcare catastrophe.

Undoubtedly, the experience in private hospitals would closely mirror that of the public ones as well. Putting the quality of service provided by our local health institutions aside, few can argue that certain lifestyle choices —particularly in what we as a nation choose to consume—are responsible for the scores of patients populating T&T’s hospitals with diseases such as diabetes, hypertension, cancer, heart disease and cerebrovascular (strokes).

Sitting at the centre of this growing epidemic—and trying to prevent its spread—is Dr Rohit Doon.

As an adviser in public health to the ministry of health, Doon has witnessed first-hand the damaging effects of poor lifestyle practices on the country generally, and within the labour force specifically.

“Sixty two per cent of all deaths in T&T are attributable to lifestyle diseases,” Doon said, speaking from his third floor office at the Ministry of Health, Park Street, Port-of-Spain.

A former chief medical officer, Doon pointed out that among the major lifestyle disease categories, heart disease was the most prevalent.

“In 2015, 25 per cent of all deaths were from heart disease,” a stone-faced Doon said.

Breaking down the categories further, he added: “Fourteen per cent were from diabetes, 13 per cent from cancer, and 10 per cent from cerebrovascular diseases.”

Questioned about the impact of these diseases on the population, Doon noted that the vast majority of these diseases were affecting members within the labour force.

“These diseases in the main are occurring in the adult working population and what we’ve observed is that the diseases are affecting people at a younger and younger age. So there is a shift taking place where diseases that one would expect to manifest themselves later on in a person’s life are showing up much earlier.”

Doon added that the impact of picking up lifestyle diseases earlier on in life, directly compromises an individuals ability to be a fully productive member of society.

“Productivity is linked to health, so a healthy population is a productive population. When someone who is a member of the working population becomes ill, he or she has to go to the doctor or the hospital, most times during working hours. When a worker takes sick leave, he or she is off from work and productivity is lost. If the person were to pick up a disability associated with an NCD, his ability to contribute as a member of the labour force is potentially compromised,” he said.

The financial burden to T&T is significant. Commenting on the economic cost borne by the country as a result of poor dietary and lifestyle choices, Doon described it as horrendous.

“The overall estimated economic cost to society of diabetes, hypertension and cancer directly and indirectly is $8.7 billion annually in T&T. This represents close to five per cent of our current GDP. Diabetes alone has an economic cost to society of about $3.5 billion annually in terms of productivity losses. The growing incidence of diabetes, in particular, is having a profound negative effect on our population.”

Referring to money spent on treating NCDs by the government, Doon added that the figures were rising.

“Treatment for diabetes costs the government $1.2 billion annually. Hypertension costs the government $1.3 billion dollars while cancer costs $190 million. These aren’t insignificant figures at all,” he said.

Probed about whether a link between income and diet existed, Doon noted that lower income earners had tougher dietary decisions to make.

“The lower income earners tend to have poorer diets. Essentially, they’re making unhealthy choices because economically, healthier foods are more expensive foods. For example, we recommend that a person should have about five to six servings of fruits and vegetables each day. How can someone in the lower income brackets afford this?”

Doon added that 91 per cent of Trinidadians surveyed in 2011 by the health ministry said they were not consuming fruits and vegetables in such quantities on a daily basis and currently, approximately 55.7 per cent of the population is classified as overweight and obese.

“People seldom recognise the cumulative effect of poor dietary choices until it’s too late. It’s the cumulative effect that crushes you. When you have more than half the population being overweight and obese, developing diabetes is almost a certainty.”

The health adviser added that tobacco use and heavy alcohol consumption were additional risk factors that were taking a toll on the population.

As a first step in remedying T&T’s addiction to fast food and the consequent impact on health and productivity, Doon stated the simple act of preparing meals at home went a long way in preventing the onset of diseases such as diabetes and hypertension.

“By cooking our own meals, we can control portions, salt, sugar and so on. So, in essence, simply cooking our own meals makes us healthier.”

He noted that employers also had a critical role to play in ensuring their workforce remained healthy and productive.

“Employers should engage in health promotion by providing their workers with general advice on healthy living and healthy eating. Instead of the many vending machines you see around offices today filled with processed, sugary foods, the move should be towards a more healthy range of options for employees. It’s about promoting a healthy working environment as well.”

Doon also encouraged individuals to adopt more active lifestyle.

“One thing I tell people all the time is to simply keep moving. The act of walking around the office instead of sitting all day, or walking instead of taking a car or taxi or even taking the stairs instead of the elevator promotes some sort of psychical activity and moves people out of a sedentary state that does them no good.”

The overall estimated economic cost

to society of diabetes, hypertension and cancer directly and indirectly

is $8.7 billion annually in T&T.

This represents close to five per cent

of our current GDP.


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