It’s official. For the first time in the history of the world, there are more overnourished children than undernourished. Sounds good? Less undernourished? Less starving? Despite the fight for food that children face in the Sudan, in Gaza and in Haiti, the fact is that there are more fat children in the world today than there are starving children.
The thing is, both are malnourished but in opposite ways. Parents, grandparents and public health officials do not understand this. An overweight child is just as poorly nourished as an underweight one. The underweight is much more dramatic. Those shrunken babies! Those thin arms and wasted thighs and bottoms! The apathy! The lack of energy as they slowly die before our eyes, as their parents are bombed out of existence in Somalia or try to flee the overhead jets in Gaza by donkey cart.
Both malnourished. One from not enough food. The other from too much.
There are more overweight children than starving children in the world.
Both are sick. Both are going to die before their time. The undernourished living less time, the over nourished longer. They die from different things. The undernourished from weakness, diarrhoea, dehydration, anaemia, pneumonia. The overweight, later on in life, from NCDs, heart attacks, high blood pressure, diabetes, stroke and the like.
Overweight and obese children invariably grow up to be overweight and obese adults. In May 2000, in the T&T Guardian, I wrote: “Nowadays, these children constitute one of the more common reasons for paediatric consultation. A major problem is the parents’ perception of what a healthy child should look like. What most parents think is a healthy son or daughter is really an overweight child. The skinny, active little boy who eats nothing, sleeps like a log and is never sick, is considered abnormal. Fat babies, nicknamed “milkalcoholics” win all the baby prizes. People compare their healthy, slender girl-child with some plump social media image and think something must be wrong. It’s time to change this idea.”
Twenty-five years later, that hasn’t changed. What has happened to those unfortunate children?
They’ve grown up to be sick, fat adults.
Last year the Ministry of Health STEPS survey showed that 60 per cent of Trinidadian adults are overweight and 30% of those are actually obese.
One in three adults suffer from high blood pressure. Fifteen per cent are diabetics and 41% have raised cholesterol. One third of the adult population have three or more risk factors for cardiovascular disease.
Obviously, paediatricians and public health officials have not done an adequate job.
Prevention is better than cure and nowhere is this better illustrated than in the treatment of overweight children. Obesity is a lifestyle disease. In the overwhelming majority of cases, it’s due to an abnormal lifestyle, to bad habits taught to the child in the first two years of life. It starts off with mothers forcing babies to swallow bottle after bottle of cow’s milk in the mistaken belief that this is good for the baby. On the other hand, breastfeeding protection, as recommended by the International Code of Marketing of Breast-milk Substitutes, is the strongest preventive measure of early childhood obesity in the world. Protection means giving mothers at least six months of paid maternity leave so they can breastfeed.
When solids are started, the infant is introduced to the wrong foods, sweet cereals, sweet drinks and bottled fast food rather than local fruits, vegetables and ground provisions. A lifetime problem with food has commenced, made worse by the false advertising of the food industry.
To quote the Lancet editorial of September 20, 2025, “First, the problem lies with the food and beverage industries whose pervasive influence has created harmful food environments. For example, unhealthy foods and beverages, including ultra-processed foods, are highly accessible and aggressively marketed in the places where children live, learn, and play. Despite many countries having implemented legal measures to protect families and children from exposure to unhealthy food environments, many industries use unethical practices to undermine government action and exploit children.”
The rise in the Caribbean of so-called “parent’s groups” supported by the food industry is one such example.
In the face of such opposition, public health interventions fail to reduce obesity in children and interventions that focus solely on family behaviour are insufficient.
What’s needed is strong political commitment to prevent babies from becoming obese by increasing maternity leave, encouraging breastfeeding, controlling junk advertising, and quality nutritional education, including measures to decrease the annual TT$7 billion imported food bill, at schools, antenatal units, maternity hospitals, health centres and private doctors.
This will not be done easily. But as happened with tobacco, the price of taking care of NCDS (TT$8.7 billion) will ultimately push governments towards prevention.
