Childhood Obesity in Cayman

What is Obesity?

Although terms like 'overweight' and 'obese' are often used interchangeably, there are some significant differences between the two. Overweight describes people who have an excess of fat deposits, but obesity is a chronic disease that is often much more complex.

To help determine which category people fall into, medical professionals use something called the Body Mass Index or BMI. Every person is unique, which means everybody carries weight differently. Therefore, we can’t simply use a number on a scale to determine where a person nets out. What might be a healthy weight for one person could be dangerous for another. BMI uses a combination of someone's weight and height to calculate a distinct measurement: BMI = weight/height².

That being said, additional factors should always be considered when it comes to determining a person’s health. For example, muscle is actually denser than fat, which can add a lot of weight to one’s body. A very athletic person may have a BMI categorised as 'obese' but still be healthy. While BMI isn’t a perfect system, it’s still an essential tool when it comes to tracking obesity levels.

The World Health Organisation (WHO) defines overweight as someone with a BMI equal to or greater than 25. For obesity, it’s a number equal to or greater than 30. The exception to this rule is children. Because of the different rates at which they grow, other factors need to be considered, like age and gender.

Why is Obesity Dangerous?

While all overweight people have excess fat deposits, those categorised as obese have an amount that can seriously impair health. From an increased risk of type 2 diabetes to higher rates of heart disease, there are many ways obesity can harm the body. Even reproduction rates can be affected, and the chance of developing cancer also rises.

For example, a report by the International Agency for Research on Cancer (IARC) found consistent evidence of a link between higher amounts of body fat and an increased risk of cancer. In one study, they found that endometrial cancer was seven times as likely in people with severe obesity, and esophageal cancer was 4.8 times as likely.

Their research also revealed that people who have a higher BMI at the time their cancer is diagnosed have an increased chance of developing a second, unrelated cancer. This also includes people who have survived cancer before but have a high BMI post-recovery.

Obesity is something that must be taken seriously and research has proven that there are genuine risks. From premature death to life-altering chronic conditions, obesity needs to be understood and recognised as the global epidemic that it is.

Obesity in the Cayman Islands

In 2023, the STEPS survey was conducted in Cayman. The goal of this survey was to obtain clearer data on how the Cayman Islands is affected by obesity. Across all three islands, a sample of 3,300 individuals were randomly selected and invited to take part in this research project. The people polled were a mix of residents aged 18-69 years old.

The survey, which you can see below, revealed that an estimated 69.7% of Cayman’s population is overweight; almost seven in every ten people. Within that range, 32.7% were classified as obese. Interestingly, although men were more likely to be overweight (41% compared to 32.7% in women), women were much more likely to be obese (41.1% versus 24.6% in men).

Because the data collected came from a sample of the overall population, the results have been adjusted to indicate what the true prevalence of obesity is in the Cayman Islands. This is shown as the '95% CI' or '95% Confidence Interval', which is a range with an upper and lower number calculated from a sample. In this case it indicates a high likelihood of the statistic being accurate.

For comparison purposes, an obesity estimation of 32.7% puts the Cayman Islands above Canada (30%) and the UK (25.9%), but below the US (42.4%).

Childhood Obesity in the Cayman Islands

To get a better understanding of obesity in the Cayman Islands, it’s also important to look at where it begins.

As mentioned previously, the Cayman Islands School Health Programme includes a health screening at the time that all children enter primary school and again in Year 6. These screenings are important because they can provide early detection and treatment for a number of health problems. Assessments cover growth and development, vision and hearing, and a dental check is done.

During these health screenings, the BMI of the student is recorded. As mentioned, BMI is tracked a little differently in children. A child’s age and gender are considered, along with the standard height and weight measurements. From this information, a percentile result is calculated, which reveals how a child’s BMI compares to other children of their respective age and sex. These percentiles represent different BMI categories, which have been recommended by the Centre for Disease Control and Prevention (CDC).

The latest results from the 2023-2024 School Entry Screening show that 70% of the children entering Reception were of healthy weight, 8% were underweight, 9% were classified as overweight and 13% were obese.

In comparison, older children (7-18 years) who entered school after Reception had slightly higher percentiles, with 14% defined as overweight and another 20% defined as obese. The BMI results are laid out in the table below.

While the BMI of children entering Reception has remained relatively consistent over the years, childhood obesity in primary school students has fluctuated in Cayman. Although new data has shown a small decrease in recent years, we also experienced a large peak between 2021 and 2022. During this school year, the number of children entering Reception with obesity increased from 14% to 22%.

It’s too early to say whether obesity levels will continue to decrease or ramp upwards again, but there are many things we can do now to manage the situation.

Ways to Combat Obesity

Eat Healthier Foods

A balanced diet will help your body feel happy and healthy. Some examples of wholesome and nutritious foods are:

Whole grains: Steel cut oats, brown rice and quinoa have more fibre than refined grains and can help lower risks of heart disease and type 2 diabetes.

Vegetables: Asparagus, Brussels sprouts and spinach are all low in calories and great for gut health.

Fruit: When it comes to fruit, try to stick with fresh or frozen varieties. Many dried or canned fruits contain added sugars or syrups.

Lean proteins: White-fleshed fish like cod, haddock and bass are excellent low-fat high-protein sources. Skinless chicken and turkey breasts are also great options.

Legumes: Chickpeas and lentils are another fantastic source of protein. They are a perfect vehicle for 'meatless Mondays' or other vegetarian/vegan meals.

Nuts: Nuts contain an abundance of heart-healthy fats, vitamins and minerals. Studies show that the antioxidants in almonds may even protect against chronic diseases like obesity and diabetes.

Everyone has their favourite comfort foods, but consider trying healthier variations. For example, making chicken noodle soup from scratch is much more nutritious than buying the tins!

Move Your Body

In Cayman, we’re surrounded by beautiful spaces to move our bodies. From walking on the beach to swimming in the sea, it’s easy and inexpensive to be active.

For kids struggling with weight gain, getting out as a family can inspire a more active lifestyle. If you have a pet, go on long dog walks together or invest in some bikes and ride around the neighbourhood. Reducing screen time and getting outside is crucial.

In general, the NHS recommends some type of physical activity every day, but exercising just once or twice a week can have a big impact on your health. At least 150 minutes of moderate-intensity activity each week is suggested, and for kids, the CDC recommends at least 60 minutes of physical activity per day. Enrolling your little ones in sports leagues or other after-school activities can help.

Team Up

Changing your lifestyle can be challenging, but an accountability buddy will help keep you motivated! Find a friend or family member with similar goals and team up.

Go for walks, especially in the cool of the day and at the weekends, or try a new sport; not only will it be sociable but you may find it is great fun! Support and encourage each other, and enjoy the journey together.

Speak to a Professional

When it comes to combatting obesity, so much of the work starts at home. Making changes to our routines and listening to our bodies is so important. That being said, obesity can lead to serious medical issues, and talking to a doctor can help those struggling with chronic issues.

Healthcare professionals can perform physical exams that will help gather more information about your current condition. They may recommend a dietician, behavioural counsellor or obesity specialist to help with treatment.

To get back to a healthy weight, reducing calories is often an essential part of the process. However, you should speak with a dietician or medical professional that specialises in obesity to determine the best way to do so for your body and your health.

Patience & Perseverance

Overcoming obesity can take time, but people struggling should try not to get discouraged. Progress isn’t always linear, and it’s important to treat yourself with kindness. Build new habits, make lifestyle changes and consider chatting with a medical professional about next steps. Many say that 'health is wealth', and investing time and care into our bodies will help us live longer and happier lives.

The statistics for this article were provided by Rachel Corbett, National Epidemiologist at the Ministry of Health & Wellness.