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FOOD AND AGRICULTURE ORGANIZATION

OF THE UNITED NATIONS

FAO - NUTRITION COUNTRY PROFILES

ANTIGUA AND BARBUDA

ANTIGUA AND BARBUDA

Nutrition Country Profiles – ANTIGUA AND BARBUDA August, 2003

Nutrition Country Profiles – ANTIGUA AND BARBUDA 1

Note for the reader

The objective of the Nutrition Country Profiles (NCP) is to provide concise analytical summaries describing the food and nutrition situation in individual countries with background statistics on food-related factors. The profiles present consistent and comparable statistics in a standard format. This pre-defined format combines a set of graphics, tables and maps each supported by a short explanatory text. Information regarding the agricultural production, demography and socio-economic level of the country are also presented. In general, data presented in the NCP are derived from national sources as well as from international databases (FAO, WHO...). Technical notes giving detailed information on the definition and use of the indicators provided in the profile can be obtained from ESNA upon request. An information note describing the objectives of the NCP is also available. Useful suggestions or observations to improve the quality of this product are welcome. The data used to prepare the maps are available in Excel upon request at:

E-mail: [email protected]

Nutrition Country Profile of Antigua and Barbuda

prepared by Caribbean Food and Nutrition Institute (CFNI), Ms. Juanita James (Antigua and Barbuda) and Mr. Michael Ennis for the Food and Agriculture Organization of the United Nations (ESNA).

The designations employed and the presentation of material in this publication do not imply the expression of any opinion whatsoever on the part of the Food and Agriculture Organization of the United Nations concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers .

FAO, 2003

mailto:[email protected]


Table of contents

SUMMARY----------------------------------------------------------------------------------------------- 3

TABLE 1: GENERAL STATISTICS OF ANTIGUA AND BARBUDA--------------------- 4

I. OVERVIEW ------------------------------------------------------------------------------------------- 5

1. Geography ..........................................................................................................5 2. Population ...........................................................................................................5 3. Level of development: poverty, education and health .........................................6 4. Agricultural production, land use and food security.............................................6 5. Economy .............................................................................................................8

II. THE FOOD AND NUTRITION SITUATION -------------------------------------------------- 9

1. Trends in energy requirements and energy supplies ..........................................9 2. Trends in food supplies .....................................................................................90 3. Food consumption...........................................................................................133 4. Anthropometric data........................................................................................135 5. Micronutrient deficiencies..................................................................................19

REFERENCES--------------------------------------------------------------------------------------- 161

MAPS are presented after the <REFERENCES> General Map of Antigua and Barbuda Graphs, tables and maps can be visualised by clicking on the words in bold and underline, only in the “Full profile” pdf file.


SUMMARY

Very little recent national information is available on anthropometric measurements for children in Antigua and Barbuda. The latest available figures show that the level of undernutrition (weight for age) among children less than one year old was 1.4% in 1995, a decrease from the 1993 level of 2.3%. For children 1-4 years old, the level remained almost constant, 0.6% - 0.8% over the period 1993-1995, while among the wider age group, 0-5 years, there was a decline of 0.3% between 1996 and 1999. The prevalence of overweight (weight for age) among children, less than one year old, was higher than that for underweight. It fluctuated during the period 1993-1995, increasing overall from 7.4% to 8.5%. Among children 1-4 years, there was a slight decline between 1993 and 1995 (from 2.8% to 2.5%). Between 1997 and 1998 the prevalence of overweight decreased among children 0-5 years from 6.6% t0 5.8 % (Table 4a). A 1993 Ministry of Health survey found that the national prevalence of obesity (BMI: > 30) was 4.6%. Among persons 40 years and over, 60% men and 25% women were obese. No recent anthropometric data were available on adolescents in Antigua and Barbuda.

Iron deficiency anaemia is the most common micronutrient deficiency in Antigua and Barbuda. The prevalence, in 1996, among children 1-4 years was 49.4% (Table 5) (PAHO/CFNI,1997), with the highest prevalence among children 2 years old. No data were available on the prevalence of anaemia among older children or for other population groups, including pregnant women. Given the common consumption of non-haeme foods (cereals, pulses, vegetables and fruits) coupled with the relatively low level of haeme-iron foods consumed by children in particular, the level of iron deficiency present may have dietary origins. The micronutrient study also showed that, although marginal levels of vitamin A deficiency exist, vitamin A deficiency is not a public health concern (1.1% of children 1-4 years were deficient).

No national surveys on food consumption have been carried out in Antigua and Barbuda that could explain the nutritional status of the adults and children. The increase in the contribution of fat to the dietary energy supply (DES) along with the general increase in DES between 1980 and 1997 may provide a part of the explanation.

The extent to which the nutritional problems facing the country can be attributed to the economic situation is not certain. The high per capita GNP relative to most other Caribbean countries may be resulting in increased spending per capita on food, and may be contributing to the level of obesity. No data are available on the level of poverty in the country, and hence the proportion of the population that is vulnerable to insufficient nutrient intake cannot be accurately determined. Those that are unemployed are likely to be at risk for undernutrition, especially the children in these households.

Last updated: 26/08/2003Indicator (§) Year Unit Indicator (§) Year Unit

A. Land in use for agriculture G. Average Food Supply1. Agricultural land 1995 ha per person 0.1822. Arable and permanent crop land 1995 ha per person 0.121 1. Dietary Energy Supply (DES) 1998-2000 kcal/caput/day 2388

B. Livestock1. Cattle 1996-98 thousands 162. Sheep & goats 1996-98 thousands 243. Pigs 1996-98 thousands 24. Chickens 1996-98 millions 0

C. Population1. Total population 2000 thousands 650002. 0-5 years 2000 % of total pop. …3. 6-17 years 2000 % of total pop. …4. 18-59 years 2000 % of total pop. …5. >= 60 years 2000 % of total pop. …6. Rural population 2000 % of total pop. 63.17. Annual population growth rate, Total 2000-2005 % of total pop. …8. Annual population growth rate, Rural 2000-2005 % of rural pop. …9. Projected total population in 2030 2030 thousands 70000

10. Agricultural population 2000 % of total pop. ...11. Population density 1995 pop. per km2 150.0

D. Level of Development1. GNP per capita, Atlas Method 2001 current US$ …2. Human Development Index rating (new) 2000 min[0] - max[1] 0.8003. Incidence of poverty, Total ... % of population …4. Incidence of poverty, Rural or Urban ... % of population … % Energy from:5. Life expectancy at birth (both sexes) 2000 years … 2. Protein 1998-2000 % of total energy 13.66. Under-five mortality rate 2000 per 1,000 live births 15 3. Fat 1998-2000 % of total energy 33.7

E. Food Trade 4. Proteins 1998-2000 g/caput/day 80.91. Food Imports (US $) 1996-98 % of total imports 9.9 5. Vegetable products 1998-2000 % of total proteins 33.02. Food Exports (US $) 1996-98 % of total exports 2.3 6. Animal products 1998-2000 % of total proteins 67.03. Cereal Food Aid (100 t) 1996-98 % of cereals imports ...

H. Food Inadequacy

F. Indices of Food Production 1. Total population "undernourished" 1995-97 millions…

1. Food Production Index 1996-98 1989-91=100 98.9 2. % population "undernourished" 1995-97 % of total pop. …2. Food Production Index Per Capita 1996-98 1989-91=100 95.0

TABLE 1: GENERAL STATISTICS OF ANTIGUA & BARBUDA

... no data available § see References for data sources used See Technical Notes for definitions used.

Percentage of DES by major food groups

26.8%

13.6%

1.6%8.3%

10.7%

11.9%

4.6%

15.5%

3.3%

Cereals (excl. beer)Starchy rootsSweetenersPulses, nuts, oilcropsFruits & VegetablesVegetable oils

Animal FatsMeat & offalsFish & seafoodMilk & EggsOther

Note: Value not indicated if below 1%


ANTIGUA

I. OVERVIEW

1. Geography The nation of Antigua and Barbuda comprises three islands: Antigua, Barbuda and the

uninhabited island of Redonda. Located at the centre of the Eastern Caribbean’s Leeward Islands group, the country is 440 km2 in area, with Antigua occupying 64% of the land mass and containing 98% of the population (General Map).

Antigua has relatively flat topography characterised by central plains and volcanic hills rising in the southwest (the highest point, Boggy Peak, reaching an altitude of 400 m), all of which strongly influence the island’s hydrology. Approximately 90 Km2 of the country is considered to be forest area (World Bank, 2001). To the north and east, the soil is mainly calcareous limestone. Annual rainfall is low, averaging 40 inches, and droughts occur every 3 to 7 years. The islands have a tropical marine climate with little seasonal temperature variation. In addition, these islands face natural hazards of hurricanes and tropical storms. There are no rivers and very few streams. A desalination plant supplies approximately 50% of the water needs of the island.

Antigua and Barbuda (capital – St. John’s) became independent in November 1981. It is governed by an elected parliament representing majority and opposition parties, with elections occurring at least every five years. The country is divided into 17 administrative constituencies, which include Barbuda. Executive authority is vested in a cabinet that is headed by a Prime Minister.

2. Population The last national housing and population census was conducted in 1991. The 2000

mid-year population of Antigua and Barbuda was estimated at 65,000 (UN, 2002). This represented a 1.6% increase over 1995, when the population was 64,000. In 2000, 36.9% of the residents lived in rural areas, marginally higher than the proportion seen in 1965 (36.6%). However, the proportion of urban residents is projected to reach 52.9% by the year 2000. The population density was 158 persons/km2 in 1999, compared with 150 in 1995, 141 in 1985, and 134 in 1975 (Table 1).

The crude birth and death rates for 1997 were 21.6 and 6.4 per 1,000 population respectively. Over the period 1996-1999, there were 5, 602 live births, averaging 1,400 annually. The average birth rate for this period was 19.8 per 1,000 population.

According to the 1991 census, approximately 91% of the population were of African origin, 3.7% of mixed race, and 2.4% white. Persons of Syrian, Lebanese, Chinese, East Indian, and Portuguese ancestry made up the remainder of the population.

Antigua and Barbuda attracts immigrants from many countries in the region. Foreign-born residents came primarily from Dominica, the Dominican Republic, Guyana, Jamaica, Montserrat, Saint Kitts and Nevis, Saint Lucia, and Saint Vincent and the Grenadines. There was a noted increase in Spanish-speaking residents, which had an impact on the delivery of health and education services. In addition, a number of expatriate retirees and their offspring returned from the United Kingdom and the United States of America. The number of work


permits granted to foreign workers in 1993 was 2,278 compared to 3,417 in 1994, and 3,657 in 1995. CARICOM citizens accounted for 68.6% of these permits in 1993, 74.7% in 1994, and 77.7% in 1995 (PAHO/WHO, 1999).

3. Level of development: poverty, education and health No data were available on poverty. However, the human development index (HDI) (a

composite measure of life expectancy, health, knowledge and standard of living) was 0.8 (among the highest in the English-speaking Caribbean) in 2000 (UNDP, 2002). The GNP per capita (Atlas method) was estimated at US$ 9,070 in 2001, up from US$ 7,900 in 1996 (World Bank, 2002).

Since 1973, Antigua and Barbuda has had a free and compulsory system of education for children 5–16 years old. In 1999–2000, there were 13,079 students enrolled in 30 public and 26 private primary schools. Additionally, 5,318 children were enrolled in 9 public and 5 private secondary schools. In the period 1996-2000, more than half (52%) of the students at the primary level were males. However, this proportion decreased to 45% at the secondary level (PAHO,2002). A survey done in 1993 by the Antigua Literacy Program found that 15.6% of the adult population was illiterate (PAHO/WHO, 1999). However, in 1998, the adult literacy rate was estimated at 88% (PAHO,2002).

In 1995, the education system’s infrastructure was badly damaged by Hurricane Luis, and intensive effort has been concentrated on repairs. The quality of both academic and technical tertiary level education at the State College continues to improve. The local centre for the University of the West Indies (an institution jointly operated by the English-speaking Caribbean Governments) provided continuing education through the distance teaching system that links the University’s centres in different Caribbean locations through satellite. Private institutions provide technical and secretarial education courses.

Life expectancy at birth in 1999 was 71.4 years for males and 76.8 years for females (WHO, 2000). The infant mortality rate was 13 per 1000 live births in 2000, which an improvement on the 1995-1998 period (17 per 1,000 live births). The mortality rate for children under 5 years declined from 20 per 1000 live births in 1998 to 15 in 2000. In 1995, this rate was 57.7 per 1000 live births. The maternal mortality ratio was 149 per 100,000 live births in 1995 (PAHO/WHO, 1999; UNICEF, 2002).

Antigua and Barbuda, like most of the other Caribbean countries, has experienced a shift in the pattern of diseases affecting its population. Noncommunicable diseases have replaced communicable diseases as the leading cause of morbidity and mortality. Between 1996 and 1999, neoplasms, diseases of the circulatory system were among the leading causes of death (PAHO, 2002). In 1995 malignant neoplasm was the number one cause of death; diseases of the circulatory system (including heart disease, cerebrovascular disease, and hypertensive disease) accounted 37.7% of all deaths. The leading causes of death among the age group 15 - 64 years were diseases of the circulatory system and neoplasm. The elderly, 60 years and older, are mostly affected by chronic non-communicable disease; hypertension and diabetes formed the majority of cases seen at the clinics in 1995. The prevalence of obesity/overweight is a significant contributor to this burden of chronic nutrition related diseases (PAHO/WHO, 1999). A 1993 Ministry of Health survey recorded national prevalence for obesity of 4.6% (> 120% median weight). Further, 60% of women over 40 years were obese, 33% of whom were grossly obese (>140% median weight), and 25% of men over 40 years were obese (PAHO/WHO, 1999). Among the school-aged children, respiratory illness accounted for 80% of the first-time cases seen at the clinics in 1995. Accidents and injuries, and respiratory infections also affect persons in the age group 20-59 years, in substantial numbers. AIDS, along with other sexually transmitted diseases including


gonorrhoea and syphilis, affect a relatively small section of the population (PAHO/WHO, 1999).

Antigua is divided into seven geographically determined medical districts. A government-appointed district medical officer serves each district, and is responsible for providing medical services to district residents. Primary health care services in the districts include: maternal and child health, health education, management of common health problems, environmental sanitation, community mental health care, nutrition, diabetic and hypertensive care, communicable disease control and surveillance, home visitation, and referral services. The Ministry of Health provides leadership in public health-care, regulation, and the delivery of services. The system is financed through public taxation or levies in support of the medical benefit scheme; participation of private insurance in health financing is minimal. Holberton Hospital is central to the health system, being the only public acute health care institution. Community health services are provided through a network of nine health centres and 18 satellite clinics or subcentres linked to the health centres. These facilities are evenly distributed across the country. Teams that include the district medical officers (physicians), family nurse practitioners, public health nurses, district nurse-midwives, community health aides, and clinic aides provide services in the health centres. District nurse-midwives and clinic aides provide services at the subcentres with support from health centre teams. In general, there was an adequate supply of health personnel; 309 worked in the public sector and 58 in the private sector in 1995. In addition to the local health personnel, Caribbean and other nationals as well as returning residents supplemented the cadre of health workers (PAHO/WHO, 1999).

4. Agricultural production, land use and food security In 1999, agriculture contributed only 3.9% to GDP, which remained essentially at the

same level since 1989 (4%). The agricultural land available was 0.182 hectare per person in 1995 (down from 0.193 hectare in 1970), and included 0.121 hectare per person (down from 0.14 hectare in 1970) of arable and permanent crop/meadow land. This, in part, may account for the over 50% decrease in contribution of agriculture to GDP (FAOSTAT, 1999; World Bank, 2000).

The major food export of Antigua and Barbuda up to 1971 was sugar (sweeteners), but since then has been non-existent or extremely low. Only 4.8 metric tonnes (Mt) were exported in 1984-86 compared with 12261 Mt in 1964-66 and 6438.5 Mt in 1969-71. Fish and seafood along with alcoholic beverages are the other major food exports both of which have increased significantly since 1964/1971 (FAOSTAT, 1999).


5. Economy The country’s economy depends primarily on tourism, which, with related services,

accounts for 65% of the GDP. Other major contributors were government services, wholesale and retail trade, construction, communications, real estate, and housing. The Government continues to focus on further developing the tourist industry and diversifying the economy through expansion of the financial and information sectors (PAHO/WHO, 1999; PAHO, 2002).

In 2001, Antigua and Barbuda recorded a GDP (current) of US$ 682.2 million, up from US$ 580.4 million in 1997 (World Bank, 2003 ). Between 1992 and 1995 GDP averaged US$ 403 million. In 1995, tourism, finance and information sector activities, and agriculture contributed US$ 59.2 million, US$ 30.5 million, and US$ 13.6 million, respectively. Contributions from agriculture showed only slight increases, with an average of US$ 14 million, while banks and financial institutions averaged US$ 28 million over the period. Per capita GDP in constant prices was US$ 2,399.1 in 1994 and US$ 2,288.1 in 1995, compared to US$ 2,192.0 in 1991.

The external debt was approximately US$ 348 million in 1999, an increase from US$ 246 million in 1996. At the end of fiscal year 2000, the outstanding debt of the consolidated public sector was approximately US$ 0.5 billion, consisting of US$ 0.4 billion in external obligations and US$ 0.1 billion in domestic debt. Inflation rate has trended downwards over the last decade. The inflation rate in 1999 was 1.1% (according to the International Monetary Fund’s Interim Index), down from 3.4.0% in 1998, dropping further to near zero in 2000 (PAHO, 2002). The inflation rate in 1994 was 3.5%, down from 7.0% in 1990. In 1993, the Government imposed a home-grown structural adjustment program that includes the satisfaction of Government debt obligations and other financial commitments. Debt repayment (domestic and external) totalled 19.2% of actual expenditure in 1995 (PAHO/WHO, 1999).


II. THE FOOD AND NUTRITION SITUATION

1. Trends in energy requirements and energy supplies

As shown in (Table 2), the population of Antigua and Barbuda increased by 16% between 1965 and 2000 (UN, 2002). The percentage urban population experienced a marginal (0.3%) increase over the same period. The per caput dietary energy supply (DES) increased by 2.5% between 1965 and 2000. However, no data were found on the per caput dietary energy requirements for 1965 through 2000, nor any projected figures for 2030. Table 2: Total population, urbanisation, energy requirements and dietary energy supplies (DES) per person and per day in 1965, 2000 and 2030

Year 1965 2000 2030

Total population (thousands) 56000 65000 70000

Percentage urban (%) 36.6 36.9 52.9

Per caput energy requirements (kcal/day) ... ... ...

Per caput DES (kcal/day) * 2330 2388 …

*Three-year average calculated for 1964-66 and 1998-2000 (Source: FAOSTAT)

Figure 1: Share of protein, fat and carbohydrate in Dietary Energy Supply Trends from 1964-66 to

1998-2000

52.750.552.656.761.562.465.8

10.8 10.411.5 12.7 14.2 14.5 13.6

23.4 27.326.9 30.6 33.2 35.0 33.7

0

500

1000

1500

2000

2500

3000

3500

1964-66 1969-71 1974-76 1979-81 1984-86 1989-91 1998-2000

DES

kca

l/cap

ut/d

ay

Carbohydrates Protein Fat Source: FAOSTATAntigua & Barbuda

The contribution of carbohydrate as a percentage of DES, declined from 65.8% in

1964-66 to 50.5% in 1989-91, then increased slightly to 52.7% in 1998-2000. The contributions of protein and fat have increased by 2.8 and 10.3 percentage points respectively between 1964-66 and 1998-2000 (Figure 1).

2. Trends in food supplies Quantity: Fruits and vegetables, meat and offals, and milk and eggs experienced

significant growth in terms of supplies (Kg/caput/year), but the first two groups showed more striking growth during the period 1964-66 to 1998-2000 (especially between 1974-76 and 1989-91) mainly due to significant increases in imports and domestic production. Between 1974-76 and 1998-2000, local vegetable production increased by approximately 447% and


that of fruits by 114%. Over the same period, vegetable and fruit imports grew by 278% and 226%, respectively. Between 1974-76 and 1996-98, imports of meat and offals increased by 456% (FAOSTAT, 1999, 2002). Cereal, starchy roots and sweeteners all showed a slight reduction over the period 1964-66 to 1998-2000, whereas vegetable oils and animal fats remained almost constant over the same period (Figure 2).

Figure 2: Supplies of major food groups (in kg/caput/year)Trends from 1964-66 to 1998-2000

0

25

50

75

100

125

150

175

200

225

250

275

1964-66 1969-71 1974-76 1979-81 1984-86 1989-91 1998-2000

kg/c

aput

/yea

r

Cereals (excl. beer)

Starchy roots

Sweeteners

Pulses, nuts, oilcrops

Fruits & Vegetables

Vegetable oils

Animal Fats

Meat & offals

Fish & seafood

Milk & Eggs

Other

Antigua & Barbuda Source: FAOSTAT

Energy: As shown in Figure 3, over the period 1964-66 to 1998-2000 cereals

accounted for the major share in DES. This was followed by sweeteners (which has seen a decrease in its contribution to DES over the period) until 1984-86 through to 1998-2000 when meat and offals moved from being the fourth to the second largest share in DES. The meat and offals group increased sharply between 1974-76 and 1989-91, declining slightly thereafter. Similarly, vegetable oils moved from being the third largest share in DES between 1964-66 and 1974-76 to the fourth largest share between 1979-81 and 1998-2000, being replaced by sweeteners. Fruits and vegetables, animal fats, milk and eggs, and pulses, nuts and oilcrop all experienced an increase in quantity between 1964 and 2000, while fish, seafood, and to a lesser other foods experienced a decrease over the same period. The total food supply available in terms of Kg/caput/day fluctuated over the period, but the food supply per caput in 1964-66 (2340 kcal) was only marginally lower than that seen in 1998-2000 (2388 kcal) (Figure 3).


Figure 3: Share of major food groups in Dietary Energy SupplyTrends from 1964-66 to 1998-2000

0

500

1000

1500

2000

2500

3000

1964-66 1969-71 1974-76 1979-81 1984-86 1989-91 1998-2000

kcal

/cap

ut/d

ay

Cereals (excl. beer)

Starchy roots

Sweeteners

Pulses, nuts, oilcrops

Fruits & Vegetables

Vegetable oils

Animal Fats

Meat & offals

Fish & seafood

Milk & Eggs

Other


Major food imports and exports: Figure 4 shows the overall movement in food

imports as a percentage of DES between 1964-66 and 1996-98, moving from about 75% in 1964-66 to approximately 90% in 1996-98 (remaining virtually constant between 1969-71 and 1996-98). This indicates a high dependence on international trade to earn foreign currency and to supply the population with approximately 90% of its food. Cereal imports fluctuated throughout the period, but saw an overall decrease from 1964 to 1998. Milk and milk products, sweeteners and meat and offals experienced a significant increase in their imports over the period (animal fats increasing slightly), while vegetable oils imports remained fairly constant throughout the same period.


Figure 4: Major food imports as a percentage of Dietary Energy SupplyTrends from 1964-66 to 1996-98

0

25

50

75

100

1964-66 1969-71 1974-76 1979-81 1984-86 1989-91 1996-98

% o

f DES

Cereals (ex cl. beer)

Sw eeteners

Oilcrops

Vegetable oils

Animal Fats

Meat & offals

Milk & products

Alcoholic Bev erages


Figure 5: Major food exports as a percentage of Dietary Energy Supply

Trends from 1964-66 to 1996-98

0

20

40

60

80

100

1964-66 1969-71 1974-76 1979-81 1984-86 1989-91 1996-98

% o

f DES

Sw eeteners


The primary food export of Antigua and Barbuda between 1964 and 1971 was the sweeteners, but as a percentage of DES has decreased from 44.9% in 1969-71 to 0.1% in 1974-76 and has remained at that level since (Figure 5; FAOSTAT, 1999). Fruit exports, as a percentage of DES, has remained consistently low at 0.1%, while alcoholic beverages have seen an overall increase from 0.1% in 1964-66 to 0.6% in1996-98 (FAOSTAT, 1999).


3. Food consumption No national food consumption survey data were found, and in fact very little

information on the food habits of Antiguans is available. Locally they produce some fruits, vegetables and animal products, but the majority of the foods they consume are imported (cereals, meats, dairy and sugar products). Information gathered from two parishes in 1985, indicated that the staple foods were rice along with red beans, plantain, dumplings and fungee or funchi (a stiff pudding of seasoned cornmeal and okra). Saltfish, egg, beef, chicken and fresh fish were the principal protein sources. Popular vegetables were carrots and antrobers (eggplant) (PAHO/ CFNI, 1997).

While no information on the actual meal pattern in Antigua and Barbuda was found, like most other Caribbean countries one would expect a tendency towards adults in Antigua and Barbuda consuming three meals per day. The bulk of at least two of these meals would be expected to be comprised of small amounts of starchy fruits, roots and tubers, yams and lots of cereals such as rice and wheat flour in its many forms. The other components of the meal vary in quantity and type according to economic status. Some of the special dishes of Antigua include: Fish Soup, Pepper Pot Soup, Stuffed Crab Back, Saltfish with Pear (avocado) or Aubergine (garden egg) and Funchi (CFNI, 1983.a, b & c ).

4. Anthropometric data Very little recent national information is available on anthropometric measurements

for children in Antigua and Barbuda. Data from health clinics across the country indicated that the level of undernutrition (defined as < 80% standard weight for age) among children less than one year old decreased from 2.3% in 1993 to 1.4% in 1995. Among those 1-4 years, the level decreased only marginally from 0.8% to 0.6% over the same period, while among the wider age group, 0-5 years, there was a decline of 0.3% (from 1.8% to 1.5%) between 1996 and 1999. Overweight (defined as >120% standard weight for age) levels among children less than one year old fluctuated over the period 1993-1995, increasing overall from 7.4% to 8.5%. Among children 1-4 years old, there was a slight decline between 1993 and 1995. Similarly, for the group 0-5 years old, overweight decreased between 1997 and 1998 (Table 4a ; CFNI, 2000). Parish level data were not available.

A 1993 Ministry of Health survey (PAHO/WHO, 1999) found that the national prevalence of obesity was 4.6% (> 120% of standard weight). In addition, 60% of the women over 40 years old were obese, of which 33% were grossly obese (> 140% of standard weight). Twenty-five percent of the men in the same age group were also obese (PAHO/WHO, 1999). However, the actual survey report was not available, and hence details such as sample size could not be determined.

The prevalence of low birth weight babies in 1995 was reported at 4.9% (PAHO/WHO, 1999). No other figures were available, hence no comparison could be made with other years. Further, no data are available on adolescents.


Table 4a: Anthropometric data on children

Source/ Location Sample Percentage of malnutrition Year

of surveySize

NumberSex Age

Years

Underweight% Weight/Age % Weight/Age

>120% median

CFNI, 2000 Clinic Data

Obesity Prevention 1993 … M/F < 1 7.4

and Control 1994 … " " 11.3

Strategies in the 1995 … " " 8.5

Caribbean, 1990-2000

" Clinic Data1993 … M/F 1.0-4.0 2.81994 … " " 2.71995 … " " 2.5

" Clinic Data1996 … M/F 0-5.0 …1997 … " " 6.61998 … " " 5.81999 … " " …

< 80% median

2.32.11.4

0.80.70.6

1.82.01.61.5

Notes: ... no data available

5. Micronutrient deficiencies A micronutrient study carried out by CFNI in 1996 found that among children 1-4

years old, 49.4% were iron deficient based on WHO standard (cut-off: <11 g/dl) (Table 5). The mean haemoglobin level was 10.99, with a standard deviation of 0.9. Slightly more girls than boys were anaemic. The highest level of anaemia was among 2-year old children (77%) although there was no significant difference in haemoglobin levels by age (PAHO/CFNI, 1997). When a haemoglobin level of less than 10 g/dl was used as the cut-off, 14.5% of the children were anaemic (Table 5).

No proper correlation can be made between dietary patterns and this level of iron deficiency as no national food consumption data are available. However, given the common consumption of non-haem foods (cereals, pulses, vegetables and fruits) coupled with the relatively low level of haem-iron foods consumed by children, the level of iron deficiency present may have dietary origins (PAHO/CFNI, 1997).

The micronutrient study did not address the prevalence of anaemia in pregnant or lactating women, and no data were found elsewhere. However, the PAHO/WHO publication referred to earlier reported a Ministry of Health estimated prevalence of 6.3% among pregnant women for 1993 (PAHO/WHO, 1999).

The CFNI study also indicated that vitamin A deficiency is not a public health concern, with only 1.1% of the children 1-4 years were deficient (< 10 µg/L), while another 10.6% showed marginal deficiency (10-25 µg/L) (PAHO/CFNI, 1997).


Table 5: Surveys on micronutrient deficiencies

Source/ Deficiency Location Sample PercentageYear

of surveySize

NumberSex Age

Years

Iron

CFNI/PAHO, 1997 Hb < 11 g/dL National 83 M&F 1.0-4.0 49.4Micronutrient " " 44 M " 47.7Study, A Three " " 39 F " 51.3Country Survey,1996

Hb < 10 g/dL National 83 M&F 1.0-4.0 14.5" 44 M " 15.4" 39 F " 13.6

Notes: ... data not available


REFERENCES CFNI. 1983.A. What's Cooking Around the Caribbean for the Festive Season. Caribbean

Foodways - Part 2. Nyam News. The Caribbean Food and Nutrition Institute. November, 1983. Kingston, Jamaica

CFNI. 1983.b. Dietary Practices in the Caribbean. Caribbean Foodways - Part 3. Nyam News.

The Caribbean Food and Nutrition Institute. November, 1983. Kingston, Jamaica CFNI. 1983.c. Dietary Practices in the Caribbean. Caribbean Foodways - Part 4. Nyam News.

The Caribbean Food and Nutrition Institute. November, 1983. Kingston, Jamaica CFNI. 2000. Obesity Prevention and Control Strategies in the Caribbean, 1990-2000.

Caribbean Food and Nutrition Institute (PAHO/WHO) in Collaboration with International Obesity Task Force. CFNI, Jamaica.

FAOSTAT. 1999. FAO Web page. Statistics database . FAO, Rome CFNI. 2002. FAO Web page. Statistics database . FAO, Rome FAO/WFS (World Food Summit). 1996. Mapping Undernutrition - an ongoing process-.

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Publication No. 587. Pan American Organization. Washington, D.C. PAHO/CFNI. 1997. Micronutrient Study Report - A Three Country Survey. Vitamin A, E,

Beta-Carotene and Iron Status in the Caribbean. Caribbean Food and Nutrition Institute (PAHO/WHO) in Collaboration with the Ministries of Health and Education of Antigua and Barbuda, Dominica, and St. Vincent and the Grenadines. CFNI, Kingston, Jamaica

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PAHO/WHO Web page. Country Health Profiles (http://www.paho.org). UN. 2001. World Population Prospects Database 1950-2050. 2000 Revision. United Nations

Population Division. New York. CFNI. 2002. World Urbanisation Prospects. 2001 Revision. United Nations Population

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FAOSTAT. 1999/2002 A.1-2, B, C.10-11, E.1-3, F, G

UN. 1999/2000/2001 rev. C.1-9, D.5

World Bank. 2002. D.1

UNDP. 2002. D.2

Tabatabai H. 1996. D.3-4

UNICEF. 2002. D.6

FAO/WFS. 2002. H


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