Food-consumption and anthropometric surveys are much needed analytical tools to assist policy decisions at this conjuncture of Caribbean reality when chronic nutrition-related diseases are serious public health problems and significant pockets of undernutrition and micronutrient deficiencies persist in several countries. Moreover, there is relatively little empirical evidence available on food consumption patterns and specific nutrient intakes and how these relate to the health, nutritional and socio-economic status of individuals and households. The data and information that these surveys provide are critical to any attempt to assess the health and nutritional situation and to formulate policies and implement programmes to address health and nutrition problems. With a view to building demand by decision-makers for such surveys and to promote the application of the data in food and nutrition policy and programme design, targeting, and monitoring of nutritional goals, this document evaluates and analyses past experiences in planning and implementing food consumption and anthropometric surveys in the region. In this regard, the study provides insights into how data from food consumption and anthropometric surveys can be transformed into information critical for effective policy-making and programme interventions. The general objective is to improve household food and nutrition security through an understanding of the quality and adequacy of the diet of the Caribbean people.
Chapters 1 and 2 discuss the uses, scope and objectives of food consumption and anthropometric surveys. They show that consumption survey data can provide information on nutrient intakes and consumption patterns of both individuals and groups in the population. It will be shown that the data can be used for:
identifying, predicting and detecting chronic or acute food and nutritional problems;
targeting population groups for short-term relief efforts and longer-term policy and programme development;
planning and implementing food and nutrition programmes and interventions;
monitoring changes and evaluating the impact of interventions and programmes.
Likewise, anthropometric surveys can be used for:
assessing the overall nutritional status of population groups;
monitoring trends in nutritional status;
evaluating the impact of changing socio-economic conditions on health and well-being;
assessing the impact of intervention programmes.
Combining anthropometric data with food consumption data can clarify the nature of food and nutrition problems identified within a population.
Several preconditions are required in the planning and implementation processes of these surveys and the application of the results. These include:
convening a multisectoral team;
formulating relevant research questions and priorities;
ensuring commitment and a sense of ownership by users and funders;
guaranteeing that the research design is appropriate to the objectives and resource availability.
In addition, sampling, pre-testing and selecting and training survey personnel can affect the quality of the data generated significantly. Experiences from Belize, Cuba and Jamaica are used to demonstrate how the data and information derived from these surveys have been applied successfully to plan, formulate and evaluate domestic food-production and distribution policies, regulate food imports and exports, establish priorities in food and nutrition, enhance overall food security, design food and nutrition educational programmes, and implement dietary guidelines aimed at reducing the risk of disease.
Since diet is multidimensional and is influenced by biological, psychological, social and cultural factors, the diet-disease relationship requires methods that provide adequate specificity for describing food and quantifying nutrient intakes. It also requires methods that will minimize systematic error and provide reasonably accurate estimates of the variability between individuals and/or groups. These issues are examined in Chapter 3, which shows that quantitative and qualitative methodologies can be used to collect data on:
amounts of various foods consumed by individuals and/or populations;
the kinds of food consumed;
food preparation procedures, food preferences;
cultural influences and attitudes towards foods.
Chapter 3 emphasizes that no single method of dietary assessment is entirely satisfactory: hence, a combination of methods is recommended. Qualitative research enables investigators to better understand underlying beliefs, perceptions and behaviours, thereby providing a meaningful complement to the quantitative approaches.
Chapter 4 focuses on the use and application of findings from anthropometric assessments. Anthropometric studies assist in identifying nutrition problems, such as under-nutrition, and overweight, among individuals and population groups. Anthropometric indicators such as height-for-age, weight-for-age, and weight-for-height can be used to classify population groups by need, thereby guiding the targeting of appropriate interventions and informing decisions on resource allocation. Where interventions are expected to influence nutrition directly or indirectly, anthropometric measures can be used to evaluate the progress and outcome of the intervention. Although anthropometric studies have traditionally been conducted to investigate the relationship between malnutrition and mortality of children, increasingly attention is being directed to the use of anthropometry for assessing overweight, obesity and body fat distribution and the risk of chronic diseases.
Chapter 5 shows how food consumption and anthropometric data can be transformed into useful information: the raw data that are found in food consumption and anthropometric surveys must be packaged and presented so that the information can be used by planners and programme managers. Attention must be given to the choice of indicators, which must be based on the prevailing nutrition problems in the country. These indicators facilitate national and regional planning and monitoring of food and nutrition goals and targets.
Computers and appropriate software are also essential to the task of transforming data. In this regard, Chapter 5 discusses how statistical applications are easily facilitated with computer packages such as SPSS, SAS or STATA. Additionally, it shows how the computer application, CERES, provides a useful platform for evaluating and processing data from food consumption surveys.
The final chapter, Chapter 6, stresses the importance of food consumption and anthropometric information in decision-making. The chapter highlights the potential policy applications of this information to different sectors of government, NGOs and other stakeholders in the Caribbean, and discusses how the results from food consumption and anthropometric surveys can be applied effectively. Several areas for application - all relevant to current Caribbean reality - are identified:
assessment of current dietary intake;
trend analysis in eating patterns;
development of dietary guidelines;
assessment of food safety.
The document concludes by identifying several factors that play key roles in enhancing the use and application of survey data. These include:
the need to demonstrate to policy makers the relevance of the surveys in improving nutrition and health care;
appropriate rigour in conducting research so that the results are credible and without controversy;
the need for participation and inputs of policy makers from different sectors throughout the research process;
the presentation and dissemination of survey recommendations in a timely manner and in ways that policy makers can understand and use effectively
