Caribbean Paediatricians Call to Action on Obesity – 5 Years Later

Key Takeaway Messages

Childhood obesity in the Caribbean is a current public health crisis. Nearly one in three Caribbean children are overweight or obese, signaling an urgent need for action.

Challenges

1. Caribbean diets have undergone major structural changes
Over the past six decades, dietary patterns have shifted toward:

• more sugars
• more fats and oils
• more ultra-processed foods

This transformation is closely linked to changes in agri-food systems and food supply chains.

2. Healthy diets are significantly more expensive
The cost of healthy diets is a major barrier. The Caribbean has some of the highest costs of healthy diets globally, making nutrient-poor, energy-dense foods the most accessible option for many families.

3. Ultra-processed products are part of the problem
Research shows a rapid shift away from traditional foods toward ultra-processed products across countries. Higher consumption of ultra-processed products is linked to more sugar, fat, and calories, and lower fiber and essential nutrients. These products are designed with additives, flavors, and formulations that promote excessive intake. Studies show associations with obesity, diabetes, cardiovascular disease, depression, and increased mortality. Between 2017 and 2023, ultra-processed food sales grew 4–13% annually across several Caribbean countries.
Drivers include:

• aggressive marketing
• expansion of modern retail systems
• global food corporations
• changing lifestyles.

4. The Caribbean imports most of its food

5. Physical activity opportunities are also limited
Barriers include:

• lack of safe community spaces
• insufficient school physical activity programs
• declining movement opportunities for adolescents.

6. Commercial determinants of health can be a major barrier to policy progress to address obesity and other NCDS. Some Food and beverage industry actors may attempt to delay policies, weaken regulations and influence policy discussions.

Successes and Opportunities:

Tackling obesity requires a whole-of-society approach.

1. Policy interventions are essential to reversing the trend

Actions such as front-of-package warning labels, fiscal policies and comprehensive school nutrition policies that address the sale and marketing of ultra-processed products are critical tools.

2. Safeguards against conflicts of interest are essential

Public health policymaking must be protected from undue industry influence. The Bahamas Health Promotion and Wellness Act is a landmark example. The Act includes specific conflict-of-interest protections to prevent regulated industries from influencing policymaking. In the Bahamas example, industry input was allowed only after a draft policy was completed to avoid shaping the initial legislation.

3. Early life interventions remain powerful solutions to address childhood obesity.

Key strategies include breastfeeding promotion, baby-friendly hospital initiatives and early childhood nutrition support.

4. Agricultural policy must be part of obesity prevention

Solutions must include strengthening local food production, prioritizing whole and minimally processed foods and aligning agriculture, trade, and health policies. This represents a whole food-system approach to public health.

5. Governments should prioritize cultivating and sourcing specific healthy foods

Priority foods should include:

• high-fiber vegetables and fruits
• complex carbohydrates
• minimally processed foods
• omega-3 rich foods
• low- or no-calorie beverages.

6. Media plays a critical role in driving change

Effective health journalism can:

1. humanize health issues
2. hold policymakers accountable
3. influence policy development
4. combat misinformation.

7. Economic policies can improve access to healthy foods

Potential strategies include:

• subsidies or tax exemptions for healthy foods
• incentives for farmers to produce priority foods
• targeted food assistance programs
• vouchers for nutritious foods for vulnerable households.

8. Healthcare systems must shift from treatment to prevention

Traditional healthcare models focus on managing disease after it occurs. The new model should focus on:

• early prevention
• nutrition counseling
• lifestyle medicine
• multidisciplinary care.

9. Youth and civil society are driving a people-powered movement to tackle childhood obesity.

10. The pediatricians’ call to action remains relevant five years later.

Despite some policy progress, accelerated action is needed to protect Caribbean children’s health.

The challenge is no longer knowledge — it is action

The closing message of the webinar was clear The Caribbean already has:

• evidence
• policy options
• proven interventions

The remaining challenge is political will and collective action.