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The survey: objectives and methods

The Barbados Food Consumption and Anthropometric Survey was carried out in 2000/2001 by the National Nutrition Centre (NNC) of the Ministry of Health, in collaboration with the Barbados Statistical Service (BSS) and the Ministry of Agriculture and Rural Development. It received funding and technical assistance from FAO and the Ministry of Health, and technical assistance from the Caribbean Food and Nutrition Institute (CFNI).

The main purpose of the survey was to provide a basis for policy and programme planning by determining the food intake and dietary patterns of the adult population aged 18 years and over, the prevalence of obesity and diagnosed nutrition-related chronic non-communicable diseases (CNCDs), and the relationship of these to dietary patterns.

The specific objectives of the survey were to:

The survey gathered information on:

Main findings

Key findings of the survey are presented as highlighted text in this section.


A total of 1 051 households were represented in the sample. Some important findings were that:

Nearly a quarter of the households failed to provide information on income. The following findings are based on those households that provided such information:

A total of 1 704 individuals (945 women and 759 men) from the survey households completed questionnaires. The following is a profile of those respondents:


Respondents were asked whether they had been diagnosed with one or more of the CNCDs - diabetes, high blood pressure, heart disease or cancer - and whether either parent had suffered from any of these diseases. Respondents were also asked whether they were on any form of diet.

Weights and heights were measured in order to calculate BMI as an indicator of nutritional status. Respondents were asked whether they considered themselves to be underweight, overweight or of the correct weight, and whether they took planned exercise.


Food production

Food purchasing practices


Valid dietary intake data were obtained from 1 600 respondents. Healthy eating guidelines (for nutrients and foods) broadly include:

The survey identified the best food sources of energy and of the nutrients investigated, both in Barbados' food supply and as consumed by the survey respondents. This is essential information to guide the design of programmes that promote healthy eating.

Intakes of energy and macronutrients (fats, protein and carbohydrates)

Vitamins and minerals (micronutrients)

Owing to incomplete food composition data, intakes of some micronutrients may be underestimated. This applies especially to zinc, and to a lesser extent folate.


Most Barbadians enjoy a high standard of living. Nonetheless, the basic analyses of survey data suggest that economic and demographic factors (often interrelated) may influence food and nutrient intakes and health status.

Lower-income households

In comparison with respondents from wealthier households, respondents from households in the lowest third of the income per capita range are:

Single-sex households

In comparison with their counterparts living in households composed of both sexes:

Female-headed households

Despite significantly lower per capita incomes, households headed by women appear to be coping well nutritionally, compared with households headed by men. In fact, the main nutritional difference to emerge was that older (³ 45 years) men and women living in female-headed households achieved greater dietary diversity than their counterparts in male-headed households.

Older people

Barbados, as most other countries, is experiencing a major demographic shift towards an ageing population. In general, nutrient adequacy was good in older Barbadians (³ 65 years), and better than that of younger Barbadians (and that of older people in the United Kingdom). There are significant differences in dietary patterns compared with younger (< 65 years) people: older people consume more starchy roots and tubers, but less sugar, carbonated beverages, cereals, legumes and fruits. CNCDs are more prevalent in older people, who are therefore more likely to be on diets, which may restrict dietary diversity. The poorest dietary diversity was found among older people living alone.


Three special issues were examined in detail: iron-deficiency anaemia, healthy lifestyles, and the situation of young Barbadians. Based on the points already mentioned, the survey concluded the following:

Policies and programmes: issues and actions

Achieving good nutrition is a crucial step towards achieving a healthy population. Research repeatedly highlights the links between diet and health. Both obesity and low intakes of antioxidants are established risk factors for a range of CNCDs, while recent studies have shown that the increased consumption of fruits and vegetables can reduce blood pressure and heart disease rates, the latter by as much as 15 to 20 percent. Whether such dietary effects work through increased antioxidant levels, changes in fat profiles or other means is not clear. There are also indications now that higher than normal intakes of some micronutrients may delay the onset of AIDS in HIV-positive individuals. Other links between diet and disease include calcium with osteoporosis, salt with hypertension, and folate with birth defects.

The cost of diet-related disease is high both to a country's health system and economy and to its people, in human and financial terms. In common with many of its Caribbean neighbours, Barbados has experienced changes that may have had a negative impact on lifestyles and health: socio economic development, changed patterns of food acquisition and consumption, and increasingly sedentary lifestyles. The survey results highlight a number of key nutritional and nutrition-related problems that merit urgent attention. The survey report contains a wealth of information to guide the choice and design of appropriate policies and programmes. The following are some proposed areas for action, in the context of an overall nutrition strategy, and the operational strategies needed to achieve successful programmes. The overarching goal of such a nutrition strategy is clear, and reflects the goals of Barbados' National Plan of Action on Nutrition (approved by Cabinet in 1998) and the mission of NNC: the improvement of the nutrition and health of all sections of the population - and the maintenance of such improvement - through information, access to a safe, affordable food supply, and the promotion of healthy lifestyles.


Creating an informed consumer is an essential first step towards achieving lifestyle change. Barbados has clear advantages in this regard: its food supply is plentiful, it has an educated population, and most Barbadians enjoy a high standard of living. To make informed choices, the consumer needs:


While the dietary management of CNCDs receives commendable attention from NNC, the survey found that prevention of obesity and CNCDs appear not to be adequately addressed. Preventive action could include the following elements:


Current practices in the dietary management of CNCDs should be examined to find ways of increasing the diversity of foods in diet plans. When providing dietary counselling, health professionals need to stress foods that the client can eat, or should eat more of, and not just those to be avoided. Moreover, every effort should be made to reach overweight clients who are not suffering from a CNCD, in order to encourage weight reduction before a chronic disorder such as diabetes or hypertension develops. Individual weight reduction plans, including those for CNCD sufferers, should be comprehensive and include all aspects of a healthy lifestyle, especially an exercise programme.


Women of child-bearing age

Using the survey results and other information, nutritionists need to find ways of improving dietary folate and iron intakes and the bioavailability of the latter, without increasing the intake of energy.


The finding that substantial obesity exists among young adults highlights the need for starting action at an early age. Imaginative approaches are needed to make nutrition exciting to schoolchildren, and to further strengthen the existing food, nutrition and home economics programmes in schools.

Young adults

Most of the actions recommended for the previous two categories will also have an impact on young adults. However, young adults greatest need is for an awareness of their own nutritional status, of the risks associated with obesity, and of the importance of early action.

Older people

The survey found that, on the whole, older Barbadians were coping well, nutritionally. Moreover, many of the actions described for the previous three categories can be designed to encourage active older people to participate. However, special attention should be paid to older people's dietary: meals with high fibre content and high micronutrient density, more frequent, smaller meals, and improved dietary diversity that accommodates food preferences. The emphasis must be on improving quality of life, and on enabling the older person to remain independent and living at home for as long as possible.


Political commitment

An essential precondition for all action is demonstrated political commitment, which translates into financial support and a willingness to engage all relevant sectors to address the problems. NNC alone cannot undertake the necessary actions.

Strategic use of NNC resources

It is recommended that NNC re-examine its approach to addressing the nutrition problems that are prevalent in Barbados. The individual dietary counselling that is currently offered by the technical staff of NNC can be carried out in collaboration with other health professionals with suitable training. In addition, the community nutrition programmes should be targeted, not only to the traditional vulnerable groups, but also to specific groups such as young people. The data that have been collected provide community-based nutrition programmes with the tools to develop effectively targeted interventions at the community level.

Strategic alliances

Virtually all the proposed actions require strategic alliances and often unconventional partnerships. At the very least, the collaboration of other government departments and ministries (such as those of agriculture and education) and the cooperation of the private sector (especially the food sector) are crucial to the success of an overall nutrition strategy.

Monitoring the food and nutrition situation

A simple, cost-effective system should be established to monitor progress in the implementation of a nutrition strategy and the achievement of its goals. Frequent food consumption surveys are costly and unrealistic. What is needed instead is the routine gathering of simple data on food patterns, nutritional status and CNCDs. There are a number of possible ways of achieving this.

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