In Guyana, one or more of the multiple forms of malnutrition remain significant public health concerns and a threat to human and national development. Protein-energy malnutrition (PEM), anaemia, and overweight/ obesity are the most common nutrition-related disorders. PEM primarily affects young children. Although there has been an overall declining trend in prevalence levels over the last 2-3 decades, survey data indicate no discernable improvements in nutritional status of children in the last 5 years.
The critical features relating to the nutritional status of the Guyanese population are as follows:
1. A significant proportion of children under five years of age suffer from malnutrition (survey data indicate that 14% were underweight for age; 11% had low height for age and 11% had a low weight for height (UNICEF, 2000).
2. Persistently high levels of iron-deficiency anaemia affecting about 48% of young children, 57% of school age children, 41% of adults and 52% of pregnant women (PAHO/CFNI, 1997).
3. About 40% of adults are overweight, with the prevalence of obesity increasing with age. Significantly more women are obese compared to men.
4. Nutrition and obesity-related diseases - diabetes, hypertension, and heart disease - are among the ten leading causes of death. Survey data indicate that persons with these chronic conditions were more likely to be obese (PAHO/CFNI, 2000.)
A micronutrient study conducted in 1996-97 revealed that, among children 0-4 years old, the level of undernutrition (weight for age, Z-score) was 11.8% and the level of overweight was only 1.0%. Among children 5-9 years old, 8.5% were undernourished and a higher proportion of females were undernourished compared to males. However, a larger proportion of males suffered from overweight. According to data collected by the Ministry of Health relating to children 0-5 years old, moderate to severe undernutrition (weight for age) stood at 21.7% in 1995 up from 16.0% in 1994. Severe undernutrition was reported at 0.5% in 1999 declining from 0.9% in 1996. Among this same age group the level of overweight (weight for age) was reported at 4.3% in 1999, declining from 5.6% in 1995.
The latest available data indicate that among the adolescents in the age group 10-14 years, 5.1% are overweight of which significantly more females are overweight. Among this group, 17.9% are underweight, with a significantly larger proportion of males being underweight.
A national study on physical activity conducted in 2000 (results not yet officially available), found that 22.4% of the population 20 years and older are obese and that an additional 29.0% are overweight. Significantly more females are obese compared with males. Compared to a previous survey (1996-97) these values indicate an increase in the prevalence of excess weight over the period 1996-97 to 2000. According to the 1996-97 survey there were marked variations with respect to the prevalence of overweight and obesity at the regional level.
Iodine and iron are the micronutrient deficiencies of public health concern in Guyana. According to the findings of a 1996 survey, the national prevalence of severe iodine deficiency was 3.2% among children 5-14 years and 2.1% among pregnant women. However, among the children and pregnant women an additional 23.7% and 40.7%, respectively, were mildly to moderately deficient.
With regards to iron deficiency, over 40% of all the groups targeted in the 1996 study were deficient according to the WHO standard. Vulnerable groups, such as pregnant women (52.0%) and pre-school children (47.9%), had particularly high levels of deficiency. The deficiency level seen in the pregnant women shows a significant decrease from the 1982 level of 73.7% and a marginal decease from the 1971 level of 55.0%. On the other hand the prevalence of iron deficiency among the pre-school children has seen a steady increase since 1971.
No recent national surveys on food consumption, among adults, have been conducted in Guyana that could help explain the current nutritional status. The prevalence of moderate undernutrition among the pre-school children may be related to the low level of exclusive breast- feeding occurring during the first 4-6 months. The current levels of iodine and iron deficiencies suggest that insufficient quantities of the foods rich in these nutrients are being consumed or other factors may be inhibiting the proper absorption of these nutrients, or a combination of both.
Economic access to food may be a major cause of the nutritional problems in the country. The percentage of the population living below the poverty line up to 1996 was approximately 40%. Therefore a significant number of persons, especially among the Amerindians are likely to be vulnerable to insufficient nutrient intake and hence malnutrition.