fao nutrition country profiles, the bahamas

8/2/2019 FAO Nutrition Country Profiles, The Bahamas

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FOOD AND AGRICULTURE ORGANIZATION

OF THE UNITED NATIONS

FAO - NUTRITION COUNTRY PROFILES

THE BAHAMASTHE BAHAMAS

Nutrition Country Profiles THE BAHAMAS August, 2003


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Nutrition Country Profiles THE BAHAMAS 1

Note for the reader

The objective of the Nutrition Country Profiles (NCP) is to provide concise analytical summaries describing the food andnutrition situation in individual countries with background statistics onfood-related factors. The profiles present consistent and comparablestatistics in a standard format. This pre-defined format combines aset of graphics, tables and maps each supported by a shortexplanatory 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 nationalsources as well as from international databases (FAO, WHO...).

Technical notes giving detailed information on the definition anduse of the indicators provided in the profile can be obtained fromESNA upon request. An information note describing the objectives ofthe NCP is also available.

Useful suggestions or observations to improve the quality ofthis product are welcome.

The data used to prepare the maps are available in Excel uponrequest at:

E-mail: [email protected]

Nutrition Country Profile of The Bahamas

prepared by the Caribbean Food and Nutrition Institute (CFNI), Mrs. Adelma

Penn (Bahamas) 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 ofthe 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]:[email protected]:[email protected]


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Table of contents

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

TABLE 1: GENERAL STATISTICS OF THE BAHAMAS ----------------------------------- 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.............................................7

5. Economy.............................................................................................................8

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

1. Trends in energy requirements and energy supplies ..........................................9

2. Trends in food supplies...................................................................................100

3. Food consumption...........................................................................................134

4. Anthropometric data........................................................................................146

5. Micronutrient deficiencies..................................................................................20

REFERENCES--------------------------------------------------------------------------------------- 172

MAPS are presented after the

General Map of The Bahamas

Graphs, tables and maps can be visualised by clicking on the words in bold and underline,

only in the Full profile pdf file.


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SUMMARY

Overweight and obesity have a greater effect on the nutritional status of the population in TheBahamas than underweight and nutritional deficiencies. Based on the 1994-95 Ministry of Health/CFNIreport, among children 4-9 years old, 6.6% were underweight, 12.9% were stunted (a greater

proportion of boys than girls) and 5.7% were wasting. In contrast, 14.9% of these children wereoverweight (the prevalence being the same for boys and girls) (Table 4a). It is not possible to say

whether these levels represent an improvement or deterioration in the nutritional status of thisparticular age group as no data are available for comparison. In the 1988-89 National Health andNutritional Survey (MOH, CFNI/PAHO, 1991), it was reported that the prevalence of undernutrition ( 5 years. The highest prevalence of undernutrition (< 3

thpercentile) was found on the

Family Islands (12.3%) among children 95th

percentile)among the 5-14 year old children, was 6.7%. However, the prevalence among females in NewProvidence was 16.0%. Among these 5-14 year olds, a relatively low prevalence was seen on Acklins(1.3%), while that seen on Crooked Island (15.8%) was relatively high. The prevalence of overweight(> 97

thpercentile) among children


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Indicator () Year Unit Indicator ()

Land in use for agriculture G. Average Food Supply

Agricultural land 1995 ha per person 0.043

Arable and permanent crop land 1995 ha per person 0.036 1. Dietary Energy Supply (DES)

Livestock

Cattle 1996-98 thousands 1Sheep & goats 1996-98 thousands 22

Pigs 1996-98 thousands 5

Chickens 1996-98 millions 4

Population

Total population 2000 thousands 307

0-5 years 2000 % of total pop.



>= 60 years 2000 % of total pop. 8.1

Rural population 2000 % of total pop. 11.5

Annual population growth rate, Total 2000-2005 % of total pop. 1.3

Annual population growth rate, Rural 2000-2005 % of rural pop.

Projected total population in 2030 2030 thousands 408

Agricultural population 2000 % of total pop. 3.6

Population density 1995 pop. per km2 20.2

Level of Development

GNP per capita, Atlas Method 2001 current US$ 14960

Human Development Index rating (new) 2000 min[0] - max[1] 0.826

Incidence of poverty, Total ... % of population ...

Incidence of poverty, Rural or Urban ... % of population ... % Energy from:

Life expectancy at birth (both sexes) 2000 years 2. Protein

Under-five mortality rate 2000 per 1,000 live births 17 3. Fat

Food Trade 4. ProteinsFood Imports (US $) 1996-98 % of total imports 9.7 5. Vegetable products

Food Exports (US $) 1996-98 % of total exports 0.6 6. Animal products

Cereal Food Aid (100 t) 1996-98 % of cereals imports ...

H. Food Inadequacy

Indices of Food Production 1. Total population "undernourished"

Food Production Index 1996-98 1989-91=100 138.3 2. % population "undernourished"

Food Production Index Per Capita 1996-98 1989-91=100 120.9

TABLE 1: GENERAL STATISTICS OF THE BAHAMAS

... no data available s

Percentage of D

19.0%

3.6%

5.7%

8.6%

18.3%

4.7%


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BAHAMAS

I. OVERVIEW

1. Geography

The commonwealth of the Bahamas is an archipelago of 700 Islands and Cays in theAtlantic Ocean between latitudes 20- 27north and longitude 72- 79 west, or southeast of

Florida, USA (General Map). Of these islands about 22 are inhabited, including NewProvidence where Nassau the capital is located, and Grand Bahama with Freeport, the secondlargest city. These two most populated islands are considered urban areas for statistical

purposes. The rest of the islands are commonly referred to as the Family Islands. The totalland area covers approximately 5,382 square miles scattered over 80,000 square miles.

The Bahamas is low and flat and the long and flat islands are mainly composed ofcalcareous sand derived from marine shells. The highest point (Mt. Alvernia) is about 207feet and is located at Cat Island. The Bahamas archipelago enjoys a moderate climate withtemperatures varying between 78F and 90F at nights in New Providence (Statistical

Abstract, 1997).

2. Population

In 2000, the population of The Bahamas was 307,000, of which 88.3% lived in urbanareas. Between 2000 and 2005, the population growth rate is expected to be 1.25%, and the

population is projected to reach 408, 000 in 2030 (UN, 200I; 2002). According to the lastpopulation census in 1990, The Bahamas had 255,049 inhabitants, with an annual populationgrowth rate of just under 2%. However according to the Department of Statistics (unpublished

data) the total population was 288,467 in 1997 which represents a growth of 13.1% over1990. In 2000, the crude birth rate was estimated at 21.7 per 1,000 persons, while the fertilityrate was estimated at 2.6 children per woman. The crude death rate recorded in 2002 was533.1 per 100,000 persons (PAHO, 2002).

Nearly 90% of the total population live on three of the 40 inhabited islands and cays(PAHO, 2002). The largest proportion of the population (67.5%) lives on New Providenceand mainly in the capital Nassau which has a population density of 2152.5 persons per squaremile. Grand Bahama (primarily Freeport) hosts 16.1% of the total population with a density

of 77.2 persons per square mile. The other islands and cays (collectively known as the FamilyIslands) are scarcely populated with a continuing migration flow from these Islands to NewProvidence and Grand Bahama (Statistical Abstract, 1997). An unknown number of Haitian

immigrants arrive in The Bahamas on a regular basis. The registered Haitian populationcomprised approximately 14,000 persons during the last census (Dept. of Statistics). The totalfertility rate was estimated at 2.4 for 1994 (Basic Health Information, 1996).

Approximately 30% of the population are under the age of 15 years and 5% are over65. More persons aged 65 years and older as well as children under 5 years live on the FamilyIslands, which are economically less developed compared with New Providence and GrandBahama. Tourists account for an extra 8% in population size per annum, with 3,690,613visitors in 1992 of which 1,398,895 were stop-over visitors (MOH, MAF, 1998).


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3. Level of development: poverty, education and health

In the Bahamas no data on the poverty situation have been collected. However, thehuman development index (a composite measure of life expectancy, health, knowledge andliving standard) rating in 2000 was 0.826, down from 0.851 in 1998, but still among thehighest in the Caribbean (UNDP, 2002). In 2001, the per capita GNP was B$14,960 (WorldBank, 2002). There are vast differences in average incomes between the various islands and

between households within the islands. The Family Islands are less developed and lesswealthy (average household income of B$ 14410.8) than the main economic centres of NewProvidence (average household income of B$ 31703.7) and Grand Bahama (averagehousehold income of B$ 27092.2). Unemployment was about 10% in 1997 (Dept. of Stat.,1997), but probably higher if the illegal immigrants are taken into account. This is the mostvulnerable group with respect to poverty. There is universal access to all essential socialservices, including health, education and housing (PAHO, 2002).

Education is compulsory between the ages of six and fourteen. Primary and secondaryeducation is provided by public and private institution. Technical and vocational schools andthe College of The Bahamas provide post-secondary education. Literacy rates have beenestimated at 96% for persons 15 years of age and older during the period 1993-1999 (World

Bank, 2000). However, according to the 1990 Population and Housing Census, 2% of personsover 15 years of age were without school education was 2.7%.The Bahamas experienced significant improvements in the health of its population

over the past two decades. This is reflected in the life expectancy at birth, which increasedfrom 72 years for females and 64 years for males in 1979-81 to 75 and 68 years respectivelyin 1989-90 (MOH, MAF, 1998). Life expectancy at birth was 71.0 years for males and 77.6years for in 2000 (PAHO, 2002).

Among the leading causes of death in The Bahamas are heart disease, HIV/AIDS,malignant neoplasm, accidents/violence and poisoning, and diabetes mellitus. The top fourleading causes of death vary according to age group and gender. Among males 20-59 yearsold, the four leading causes of death are (in descending order) HIV/AIDS, homicide, landtransport accident and ischemic heart disease. HIV/AIDS, breast cancer, diabetes mellitus

and hypertensive disease are the top four causes of death among women 20-59 years old. Inthe case of males 60 years and older, the leading causes are ischemic heart disease,hypertensive disease, cerebrovascular disease and prostate cancer. Women in this age groupdie mainly from hypertensive disease, ischemic heart disease, diabetes mellitus andcerebrovascular disease, in that order (PAHO, 2002).

Among the 15-64 year old population, a large percentage suffers from overweight(48.6% with BMI > 25) (MOH, PAHO/CFNI, 1991). Prevalence levels for chronic nutritionrelated diseases have not been, except for high blood pressure in adults, which was estimatedto be 13% in the 1988-89 (MOH, PAHO/CFNI, 1991). In that same survey 14 % of adultswere diagnosed with diabetes prior to the interview, and 50% were found to have abnormallevels for cholesterol (> 5.2 mmol/L) and/or HDL ( 3.4mmol/L). HIV/AIDS is a serious health threat in The Bahamas. The number of new AIDScases was growing until 1995, but seems to have stabilised since at 388 cases in total in 1997(Health Information Unit, MOH).

Child health improved significantly as well which is evident in the decline of theinfant mortality rate from 30.2 in 1986 to 19.0 in 1995 with Certain Conditions Originating inthe perinatal period as the main cause of infant death (PAHO, 1999). The mortality rate ofchildren under 5 years old was 17 per 1000 live births, while that of infants was 15 per 1000live births in 2000 (UNICEF, 2002), with accidents, violence and poisoning being the leadingcauses of death followed by HIV/AIDS and congenital anomalies (PAHO, 1999).


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Three public hospitals operate in The Bahamas, two in New Providence and one onGrand Bahama. On all the islands a total of 57 community clinics and 54 satellite clinics

provide Public Health Care services. Free pre-natal and post-natal care is provided to all

women who attend the government health centres. In addition, children enrolled in schoolsreceive free medical and preventive care up to the age of eighteen years (MOH, MAF, 1998).In the fiscal year 1999-2000, a total of US$ 132.5 million was allocated to health, which

represented 14.8% of the national budget. Annual health expenditure per capita increasedsteadily from US$ 362 in 1996 to US$ 420 in 2000 (PAHO, 2002).

4. Agricultural production, land use and food security

Agricultural production

In The Bahamas, most of the large commercial farms are located at Andros, Abacoand Grand Bahama and produce mainly vegetables and citrus crops for export to the NorthAmerican market. Diary and poultry farms in New Providence and Grand Bahama producefor the local market. Numerous small farmers scattered over the islands produce staple cropsfor private consumption as well as a limited volume for the Nassau market (Dept. of Stat.,1997).

In 1996 the contribution of Agriculture to GDP was only 1.4 %. Crops, especiallycitrus (grapefruit, Persian lime, lemon, sweet oranges), banana and avocado form about halfof this value followed by poultry (meat and eggs) and seasonal crops such as cucumber,tomato and pigeon peas. The agricultural population as a percentage of total population has

been on the decline, moving from 7.7% in 1969-71 to 3.6% in 2000 (FAOSTAT, 2002). Atotal of 6,695 people worked in agriculture in The Bahamas in 1994. This number includesland-owners, farm workers and family members that work on the farm and is 9.5 % of a totalof 70,380 registered employed persons in all sectors. While Bahamian nationals in theagricultural labour force is declining, the number of Haitian nationals employed in the sectoris expanding relatively. The Government is aiming at improving the self-sufficiency inagriculture (MAF, 1998).

Land UseApproximately 2.6% or 89,565 acres of the total land area was used for agricultural

holdings in 1978. According to the Second Census of Agriculture in 1994, agricultural landwas distributed as follows:

Permanent Crops: 9,684.08 Acres Pasture: 5506.64 AcresTemporary Crops: 3,443.26 Acres Pine/Coppice: 14,204.49 AcresMixed Crops: 493.66 Acres Other lands: 1,483.89 AcresOther arable land: 15,433.55 Acres

Average agricultural land holding in 1995 was 0.43 ha per person down from 0.052 in1985, while for arable and permanent cropland it was 0.036 ha per person down from 0.043 in1985 (FAOSTAT, 1999). The World Bank estimated that in the year 2000 the forest area ofthe whole country covered 8,420 Km2 (World Bank, 2002).

Food Security

No formal assessment of the level of food insecurity has been done in The Bahamas.

The country paper prepared for the World Food Summit indicated that 90% of the food itemsconsumed in The Bahamas are imported. These include most meats and all rice, wheat floursand other wheat and cereal products and sugar as well as the bulk of Irish potatoes.Interestingly, diary, fish and fish products are being imported even though they are producedin the country (MAF, 1996).


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Although food availability is not a problem in The Bahamas, high food prices makeaccess to food problematic for the poorer segments in the population. In November 1995 thecost of a well-balanced 2400 Kcal/day diet was estimated at B$ 1.81 compared with the

lowest wage per day of B$ 8.0. For a household with an average of 3.7 members and anaverage of 1.8 earners per household, food accounts for 62% of household earning potential,which implies an unfavourable access to food (MOH, MAF, 1998).

Social assistance in the form of food coupons, cash assistance and work assistance isavailable for the socio-economically disadvantaged, such as the unemployed, disabled, theelderly, single parents and orphans. Some basic food items are placed under price regulationin order to remain accessible for persons with low purchasing power (MOH, MAF, 1998).

5. Economy

The economy of The Bahamas is based on the Tourism Industry, which accounts for

approximately 50% of GDP and 60% of employment (PAHO, 1999). The Bahamas is a popular destination for mainly American visitors, and cruise ships frequently visit thecountry. The Financial Services as well as Real Estate and the Retail Trade contributeconsiderably to the country's GDP. Fisheries (mainly export of crawfish/spiny lobster) andAgriculture contribute to a lesser extent. In 1995, the GDP was B$ 3,069.34 million and GDP

per capita was B$ 10,692. Since 1972, the Bahamian dollar has been at par with the U.S.dollar.

Unemployment rates continue to decrease from about 15% in 1992 to about 10% in1997 (Dept. of Stat., 1997). In 1999, the overall unemployment rate was estimated at 7.8%(7.8% on New Providence and 9.5% on Grand Bahama). The service industries, including the

public sector, tourism, banking, insurance, fishing and agriculture employ approximately 80%of the labour force. In 1999, the labour force was 157,640, an increase of 7.5% over 1996.Women were the main contributors to the growth in the labour force over the period 1996-1999, as female participation grew by 8.3% and that of males by 6.7% (PAHO, 2002).

Inflation was 1.41 in New Providence in 1996 and peaked there at 7.29 in 1991 when it wasas high as 17.96 for Grand Bahama (Dept. of Stat., 1997).


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II. THE FOOD AND NUTRITION SITUATION

1. Trends in energy requirements and energy supplies

Table 2 shows that the population of the country increased by 119% between 1965and 2000 and is projected to increase by approximately 33% over the 2000 figure in 2030.Accompanying the increase in population, between 1965 and 2000, was a 15.5% increase in

the proportion of urban dwellers (Table 2).

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) 140 307 408

Percentage urban (%) 73.0 88.5 92.9

Per caput energy requirements (kcal/day) 2121 2195 2222

Per caput DES (kcal/day)* 2479 2486 __

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

The per caput DES (Dietary Energy Supply) has been consistently higher than theenergy requirements level over the period 1965-2000, although the former only increased by0.3% during the interval. This suggests that food availability is not a problem in the Bahamas.DES of 2301 Kcal/caput/day was projected for rural residents compared to 2179Kcal/caput/day for urban residents in the year 2000 (FAOSTAT,2002).

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

1998-2000

24.0 27.8 28.7 27.6 28.8 28.8 27.1

12.312.2 12.0 11.8

12.3 12.2 12.3

60.658.958.9

60.659.360.063.7

0

500

1000

1500

2000

2500

3000

3500

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

DESkcal/caput/da

Fat Protein CarbohydratesSource: FAOSTATThe Bahamas


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Figure 1 shows the contribution of three major food groups, fat, protein andcarbohydrates, to dietary energy supply (DES) over the period 1964-66 to 1998-2000. Thecontribution of carbohydrate to DES has decreased slightly over the period, while that of

protein (12.3%) has been relatively consistent over the period 1964-66 to1998-2000. Fat as a percentage of DES has increased from 24% to 27.1% over the period, peaking at 28.8%

between 1984 and1991 (Figure 1).

2. Trends in food supplies

Quantity: During the period 1964-66 to 1998-2000 the supplies (Kg/caput/year) offruits and vegetables increased significantly. The increase was interrupted in1969-71, butresumed in1979-81 and continued (although at a reduced rate since 1984-86), during the lastyears for which figures are available (1998-2000). The milk and eggs group, althoughdeclining slightly over the period, experienced some fluctuation peaking at 121 Kg/caput/yearin 1984-86. The supply of cereals decreased steadily between 1964 and 1981, but then

remained fairly constant thereafter at about 89 Kg/caput/year. All the other groups remained

relatively stable over the 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

300

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

kg/caput/year

Cereals (excl. beer)

Starchy roots

Sweeteners

Pulses, nuts, oilcrops

Fruits & Vegetables

Vegetable oils

Animal Fats

Meat & offals

Fish & seafood

Milk & Eggs

Other

The Bahamas Source: FAOSTAT


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Energy: As shown in Figure 3 cereals have maintained the major share in DES overthe period 1964 - 2000, although the quantity decreased from 801 Kcal/caput/day in 1964-66to 748 Kcal/caput/day in 1998-2000. This was followed by the meat and offals group (ranged370 - 458 Kcal/caput/day), which showed an increase in contribution over the period. There

may be an association between this increase and the increase in the percentage contribution offat to DES. The third largest contributor was sweeteners (334 - 445 Kcal/caput/day), which

has increased over the period. These three groups account for most of the energy supply percaput per day, constituting 64% of the total daily energy per caput in 1998-2000. Fruits and

vegetables increased slightly as a share of DES, as well as vegetable oils, partly at theexpense of animal fats. This may have positive effects on the health of the population,assuming a similar shift in consumption pattern. The contribution of starchy roots wasrelatively low over the period and shows a decreasing trend. Milk and eggs, fish and seafoodsall experienced a slight increase in contribution over the period, while pulses, nuts andoilcrops experienced a slight decrease.

Figure 3: Share of major food groups in Dietary Energy Supply

Trends 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/c

aput/day


Starchy roots

Sweeteners

Pulses, nuts, oilcrops

Fruits & Vegetables

Vegetable oils

Animal Fats

Meat & offals

Fish & seafood

Milk & Eggs

Other



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Major food imports and exports: Figure 4 shows the pattern of food imports as apercentage of DES since 1964-66,which was approximately 100% or more between 1964 and1998 (dominated by cereals, sweeteners, and meat and offals). Imports of animal fatsdecreased, while that of vegetable oils and fruits and vegetables increased slightly over the

period. Alcohol, although its levels fluctuated, comprises a significant proportion of DES.Given that imported foods supply nearly all the energy available, international trade is vital to

the Bahamas.

Figure 4: Major food imports as a percentage of Dietary Energy Supply

Trends from 1964-66 to 1996-98

0

20

40

60

80

100

120

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

%o

fDES


Sw eeteners

Fruit (excl. w ine)

Vegetable oils

Animal Fats

Meat & offals

Milk & products

Alcoholic Beverages


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

Trends from 1964-66 to 1996-98

0

5

10

15

20

25

30

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

%o

fDES Sweeteners

Fruit (excl. wine)

Alcoholic Beverages


Alcoholic beverages are the primary export food product from the Bahamas, and have been, in some years the only major component of food exports as a percentage of DES.Exports of this group have fluctuated, as a percentage of DES, during the period 1964-66(2,024Mt) to 1996-98 (9,319Mt) reaching a peak value of 7.6% (10,543Mt) in 1974-76. The1996-98 level reflects a 300% increase over the 1964-66 level. The export of sweetenersmade a significant contribution as a percentage of DES in 1969-71 (22.2%), but has remained

relatively low since then, the next highest contribution of 0.7% coming in 1986-86 (Figure

5). Other food groups that are exported by The Bahamas, but at relatively low levels (0.1-


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1.4% of DES), include fruits, vegetables, fish and seafood, and animal fats (FAOSTAT,1999).

3. Food consumption

Food consumption patterns in The Bahamas changed considerably during the last 20-30 years as a result of socio-economic development that allowed for an increase in purchasing

power in all sectors of the population. The patterns now closely resemble that ofcontemporary affluent societies and are far removed from the traditional diet. This isespecially with respect to the availability of food from animal origin which has increasedduring the last decades. The bulk of the food is imported and often low in fibre and high insalt. The current food consumption patterns in combination with sedentary lifestyles and alack of exercise predispose the population to obesity and the Nutrition-Related ChronicDiseases (MOH/MAF, 1998).

According to the National Health and Nutrition Survey (1988-89), unhealthy habits ofconsuming excessive amounts of sugar, sugar products and fatty foods, accompanied by smallintakes of fruits, vegetables and complex carbohydrates have been established very early inlife. These habits have been reported among school children, adolescents, and a large

percentage of adults.No national food consumption study has been carried out in The Bahamas. The closest

to such a study is the National Health and Nutrition Survey (1988-89). However, there areseveral reports of the dietary intakes of groups in the population. Symonette (1995) found thatthe intakes in protein and fat as a percentage of energy were on the upper side of therecommended range. In addition, the intake of saturated fat was over the recommended dailyintake (RDI) with 141% RDI among 13-17 year old girls. The survey was based on a 24hours recall and a Health Habits Questionnaire (Symonette, 1995).

Armstrong-Renwick (1997) reported on school children between the ages of 10-16 in New Providence for which a 24-hour food recall instrument was administered, using food

models and various measuring implements to assist the recall of food items and portion sizes.Less than half the children consumed a breakfast daily. Most frequently consumed foods were

low fibre cereals and bread. Ninety three per cent of the sample were consuming the RDA forenergy. The majority of the children (58%) had fat and saturated fat intakes equal to or inexcess of the recommended intake, while 52.5% consumed more than the recommendedintake of saturated fat mainly from poultry and meats. The majority of the children of childrenwere consuming less than the RDI for carbohydrates and vitamin A and E. Most children hada sufficient intake for iron.

The National Health and Nutrition Survey (1988-89) reported that very few mothers practised full breastfeeding and that solid foods were introduced very early, sometimes asearly as one month old. Fruit juice was introduced in the first month by 23.8% of mothers and55.4% of new-borns received cereal before the fourth month. The Primary Health CareMonthly Reports indicated that in 1995 18.7 % of mothers exclusively breastfed their new-

borns until at least 4 weeks. This is an increase from the 5.8% reported in 1992 (Health

Information and Research Unit). This increase was achieved through the LactationManagement project supported by UNICEF, which started in 1993.


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4. Anthropometric data

In general the nutritional status of the population in The Bahamas is more reflective ofoverweight and obesity than by underweight and nutritional deficiencies. The change in foodconsumption patterns described in the previous section, combined with a low level of exercisecontributes significantly to this problem of overweight and obesity. This increases the risk for

the Nutrition-Related Chronic Diseases which are indeed widespread in The Bahamas.Infants with low birth weights (< 2,500g) were estimated at approximately 10.2 % in

1993 and 8.7% in 1999 (PAHO, 1999). In 1997 13.4% of all births were among teen mothers(Dep. of Stat 1998, unpublished data). Of all the babies born at the Princess MargaretHospital in 1995, 9.8% had low birth weights (PAHO/WHO, 1999).

Existing data on over- or undernutrition among children < 5 years suggest very fewproblems, with the exception of a 12.3 % reported underweight in the Family Islands, and

higher prevalence of overweight among children in the Acklin and Crooked Islands. Amongthe school children 5-14 years, 16.7 % were reported to be underweight (BMI < 5th

percentile) (MOH, 1988-89. In the 1994-95 MOH/CFNI report, 15% overweight wasreported in children 4-9 years old and only 6.6% underweight. In that same sample the

prevalence of stunting was relatively high in boys (15.8%) (Table 4a).Female adolescents were especially at risk for overweight and obesity as shown in the

reports by Symonette (1995) and Armstrong-Renwick (1997). The female adolescents appear

to be at greater risk for overweight and obesity compared with males (Table 4b).Approximately 20% of the females 15-16 years had a BMI of 24.8 or higher, while 16.2% ofthe males in the same age group had a BMI of 24.3 or higher. Among females 10-14 years,17.9% had a BMI of 23.4 or higher, while among males at the same age 5.3% had a BMI of23.0 or higher. The risk appears greater in the older age group for both males and females.An earlier survey found that, among females 13-17 years, 9.0% were obese, and another16.7% were overweight.

The few studies that reported on adult and elderly nutritional status raise concerns

about overweight and obesity, especially in females (Table 4c). Among the adults 15-64

years, 21.3% were obese (significantly more females than males), while another 27.3% wereoverweight (29.1% males and 25.6% females). Among the elderly, over 65 years, 25.4% ofthe females and 15.2% of the males were obese.

Since 1981 a school-feeding Programme has been in place which aims to provideapproximately one third of energy, calcium and vitamin A and C requirements to schoolchildren in government schools where a need is established. School children are screened infirst, sixth and tenth grade for nutrition status (weight, height and haemoglobin) and blood

pressure and referred when necessary.The draft Food and Nutrition Policy recognises the Nutrition-Related Chronic

Diseases as the first priority area for action. Dietary counselling for weight reduction anddietary management is available. However, programmes addressing the total population for

the preventing overweight and obesity have not yet started.


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Table 4a: Anthropometric data on children

Source/ Location Sample Percentage of malnutrition

Year

of survey

Size

Number

Sex Age

Years

Underweight Stunting Wasting Overweight

% Weight/Age % Height/Age % Weight/Height % Weight/Height

< -2SD < +2SD < -2SD < +2SD < -3SD < -2SD > +2SD

MOH/CFNI, 1994-1995 National 2400 M/F 4.0-9.0 6.6 8.1 12.9 1.9 5.7 14.9

M 4.0-9.0 7.3 7.6 15.8 1.6 6.4 14.9

F 4.0-9.0 5.9 8.6 9.8 2.3 5.0 14.9

95th

MOH 1988-89 Nationala 773 M/F 5.0-14.0 16.7 76.6 6.7

National Health New Providencea M/F 5.0-14.0 16.0

and Nutri tion Acklinsa 155 M/F > 5 15.4 1.3

Survey, 1976-80 Crookeda 101 M/F > 5 11.9 15.8

Nationalb 950 M/F < 5 7.0

GBb 261 M/F < 5 2.7 8.5

New Providenceb 466 M/F < 5 6.8 10.1

FJb

223 M/F < 5 12.3 6.4Acklinsb 41 M/F < 5 2.6 15.4

Crookedb 37 M/F < 5 0.0 16.2

Notes: ... no data available aCentile of Reference Standard (Table 9 from BMI ). bCentile of Standard TableNCHS

Table 4b: Anthropometric data on adolescents

Source/ Location Sample

Year

of survey

Size

Number

Sex Age

Years

30

Symonette 1995 National 146 F 13-17 22.2 52.1 16.7 9.0

Armsrong-Renwick < 23.4 > 23.4

1997 New Providence 67 F 10-14 82.1 17.9

< 24.8 > 24.820 F 15-16 80.0 20.0

< 23.0 > 23.0

57 M 10-14 94.7 5.3

< 24.3 > 24.3

37 M 15-16 83.8 16.2

Body Mass Index

(kg/m2)

Notes:... data not available


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Table 4c: Anthropometric data on adults

Source/ Location Sample

Yearof survey

SizeNumber

Sex AgeYears

ChronicEnergy

Deficiency

% BMI

Overweight

% BMI

Obesity

% BMI

30.0

MOH

National Health National 1771 M/F 15-64 27.3 21.3

and Nutrition F 15-64 25.6 28.0

Survey 1988-89 M 15-64 29.1 13.9

309 M/F >65 11.5

F >65 25.4

M >65 15.2

Notes: ... data not available

5. Micronutrient deficiencies

The only micronutrient deficiency known to be a public health problem in TheBahamas is iron deficiency anaemia. This problem is prevalent in children < 5 years, in

adolescents of both sexes and in the elderly, especially in females. Mixed results wereavailable on school age children, for which the School Health Programme recorded a low

prevalence of 4.5% in 1994 (Hb < 12 g/dl) (MOH, MAF, 1998). This low level corroborateswith the observation that iron intake in school children was sufficient in the majority of thesample of Armstrong-Renwick in 1997.

Iron deficiency anaemia presents a more serious problem among pregnant women.Nineteen percent were found to be anaemic in 1994 with the low cut off point of 10 g/dl.Anaemia in pregnant women increases their risk of perinatal complications and death. Inaddition, this can result in low iron stores in the new-born. Anaemia is also prevalent in adultmales ranging from 14% to 20% on the different islands, according to the 1988-89 health andnutrition survey. Iron supplements are provided only to pregnant women visiting antenatalclinics.


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REFERENCES

Armstrong-Renwick A. 1997. Thesis:Risk Factors for Coronary Heart Disease HowardUniversity, Department of Nutrition Sciences

CFNI, MOH, ME, (Ministry of Health, Ministry of Education).1998.Nutritional Status ofSchool Children. Bahamas.

Department of Statistics. 1997. Common Wealth of The Bahamas Statistical Abstract.Department of Statistics, Ministry of Finance, Nassau, Bahamas

Department of Statistics. 1997. The Bahamas in Figures 1997. Department of Statistics,Ministry of Finance, Nassau, Bahamas.

Department of Statistics. 1998. Department of Statistics, Ministry of Finance, Nassau,Bahamas.

Symonette P. L. 1995. Dissertation: The relationships of dietary patterns and exercise habitsto risk factors for cardiovascular disease in Bahamian adolescent females. Howard

University.

MAF (Ministry of Agriculture and Fisheries). 1996. The Commonwealth of The BahamasCountry Paper Prepared for The World Food Summit.Nassau, The Bahamas.

MAF. 1998.Agricultural Sector Report, final draft.Nassau, The Bahamas.

MAF, Department of Statistics. 1996. Second Census of Agriculture 1994, Final Results.Nassau, The Bahamas.

MOH, CFNI/PAHO. 1991.National Health and Nutrition Survey 1988-89.

MOH, MAF. 1998.Draft Food and Nutrition Policy.

Ministry of Health and Environment. 1994.Nutritional Assessment of Children in Acklinsand Crooked Island.

PAHO. 1999.Health Conditions of the Americas (1998)- Bahamas Country Chapter. Pan-American Health Organization. Washington, D.C.

PAHO. 2002.Health in the Americas. Volume II, 2002 Edition. Pan-American HealthOrganization. Washington, D.C.

PAHO/WHO. 1999. The Bahamas: Basic Country Health Profiles, Summaries 1999.

PAHO/WHO Web page. Country Health Profiles (http://www.paho.org).

FAOSTAT. 2002. FAO Web page. Statistics database. FAO, Rome


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FAO/WFS (World Food Summit). 2002.Mapping Undernutrition five years later-. Posterfor the World Food Summit 10-13 June 2002. FAO, Rome

UN. 1999. World Population Prospects Database 1950-2050. The 1998. Revision. UnitedNations Population Division. New York.

UN. 2001. World Population Prospects Database 1950-2050. The 2000 Revision. UnitedNations Population Division. New York.

UN. 2002. World Urbanisation Prospects. 2001 Revision. United Nations PopulationDivision. New York.

UNDP (United Nations Development Programme). 2002. Human Development Report.Oxford University Press. New York.

UNICEF. 2002. The State of the Worlds Children 2002. United Nations Childrens Fund.Oxford University Press. New York.

World Bank. 2000. The Bahamas At A Glance. World Bank Country Data. World Bank,Washington, D.C.

World Bank. 2002. The World Development Indicators 2002 CD-ROM. Win*STARS SystemVersion 4.0. World Bank, Washington, D.C.

References of data presented in Table 1, unless otherwise stated:

Source: Indicator:

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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