Leslene Gordon, PhD, RDN, LDN
Similar to world-wide trends, chronic diseases contribute to high mortality and morbidity in Caribbean populations. Recent data estimates that greater than 75 percent of deaths in the English-speaking Caribbean were due to chronic diseases. Cardiovascular diseases, cancer, and diabetes account for the highest proportion of those deaths, respectively. These deaths are mostly preventable if attention is given to four important risk factors, smoking, diet, physical activity, and alcohol.
As a nutrition professional you have a critical part to play beyond your role as a provider of MNT.
Smoking
Recommend that your patients who smoke make a plan to quit. Many national and state resources exist to assist with tobacco prevention and reduction. Make appropriate referrals to medical and community prevention specialists.
Diet
It is recommended that adults include a variety of fruits, vegetables, whole grains, lean protein, and low-fat dairy products and limit added sugars, saturated fats, and sodium. For all Americans including Caribbean immigrants, encourage them to:
- Choose water to replace sugar sweetened beverages.
- Increase intake of whole fruits. They can be fresh, frozen, canned, or dried.
- Eat a variety of vegetables and add them to mixed dishes like casseroles, and soups.
- Choose whole-grain versions of common foods, such as bread.
- Eat a variety of protein foods, such as beans, soy, seafood, lean meats, poultry, and unsalted nuts and seeds.
- Choose low-fat (1%) or fat-free (skim) dairy.
- Reduce fat intake, especially saturated fats.
- Reduce daily sodium intake. When possible, use fresh poultry, fish, pork, and lean meat, rather than cured, salted, smoked, and other processed meats. In general, select low sodium alternatives for purchases.
More detailed nutrition recommendations for English-speaking Caribbeans and the relevant cultural concerns may be found in https://culturecompetenceandcare.com/continuing-professional-education-cpe/. This presentation provides 1 CPEU for nutrition professionals. To ensure the best quality service we need to be aware of the foodways, cultural nuances and perceptions of individuals and communities that are different from our own.
Physical Activity
Adults need to include both aerobic physical activities such as brisk walking, biking, dancing, or yard work and muscle-strengthening physical activity that works all major muscle groups, such as lifting weights, or working with resistance bands. At least 150 minutes a week of moderate intensity activity and at least 2 days a week of activities that strengthen muscles.
Alcohol
The 2020–2025 Dietary Guidelines for Americans recommends that adults of legal drinking age can choose not to drink or to drink in moderation by limiting intake to two drinks or less in a day for men or one drink or less in a day for women. Pregnant women should avoid any alcohol consumption.
Prevention is Key
This old classic poem remains relevant in drawing our attention to the benefit of prevention.
The Ambulance Down in the Valley by Joseph Malins (1895)
‘Twas a dangerous cliff, as they freely confessed,
Though to walk near its crest was so pleasant;
But over its terrible edge there had slipped
A duke and full many a peasant.
So the people said something would have to be done,
But their projects did not at all tally;
Some said, “Put a fence ’round the edge of the cliff,”
Some, “An ambulance down in the valley.”
But the cry for the ambulance carried the day,
For it spread through the neighboring city;
A fence may be useful or not, it is true,
But each heart became full of pity
For those who slipped over the dangerous cliff;
And the dwellers in highway and alley
Gave pounds and gave pence, not to put up a fence,
But an ambulance down in the valley.
“For the cliff is all right, if you’re careful,” they said,
“And, if folks even slip and are dropping,
It isn’t the slipping that hurts them so much
As the shock down below when they’re stopping.”
So day after day, as these mishaps occurred,
Quick forth would those rescuers sally
To pick up the victims who fell off the cliff,
With their ambulance down in the valley.
Then an old sage remarked: “It’s a marvel to me
That people give far more attention
To repairing results than to stopping the cause,
When they’d much better aim at prevention.
Let us stop at its source all this mischief,” cried he,
“Come, neighbors and friends, let us rally;
If the cliff we will fence, we might almost dispense
With the ambulance down in the valley.”
Nutrition professionals are in an ideal position to assist in the treatment of cardiovascular disease, diabetes, various cancers, and other non-communicable diseases. However, “stopping the cause”, through education and behavior changes remains the best approach for reducing deaths and disabilities.