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Improper dieting is believed to be behind the large number of lifestyle related illnesses or non-communicable diseases that continue to affect thousands of Jamaicans.
This therefore begs the question: Are we sacrificing our health and by extension our lives to satisfy the yearning of our taste buds? Quite frequently our food choices are loaded with cholesterol and trans-fats, two of the major risk factors for diabetes and hypertension, two killer diseases that claim the lives of thousands of Jamaicans each year.
Washington Representative of the Pan American Health Organisation, Dr. Alafia Samuels, in a recent National Policy Dialogue on Non-Communicable Diseases (NCD) workshop said diabetes and high blood pressure cost five percent of Jamaica’s Gross Domestic Product (GDP). High blood pressure, she said, is causing about 22 per cent of deaths in Jamaica.
Medical dietician at the Spanish Town Hospital in St. Catherine, Cordell Dallas, laments the disheartening fact that many Jamaicans are indeed sacrificing their health for food.
“Even more daunting,” she says, “is the fact that many individuals are not cognisant of the effects of excess cholesterol and trans-fats on the body,” pointing out that, “it becomes even more frightening when one realises that many of the people who don’t know are suffering from these illnesses.”
If the response of one diabetes patient David Simms, is anything to go by, then there is much more to be done to increase the awareness of Jamaicans about these chemicals in the body. When questioned about his knowledge of cholesterol, he responded, “mi don’t know anything you know, as mi say before, I don’t stick to any diet.” He then asked: “is it when your body have too much of one thing?
A similar response by one other interviewee was, “Is it too much oil, or too much sugar, mi nuh know but when too much grease deh pon mi stomach it burn mi.”
An understandably disconcerted Cordell Dallas, was more than willing to shed some light on this matter of cholesterol, so that Jamaicans can become better informed about this health issue.
Cholesterol
Cholesterol, she explains, is a soft fat-like substance manufactured by the liver from fatty foods. It plays a vital part in building and regulating cells and can be found in certain animal-based products.
She mentions two types of cholesterol, one good and the other bad. High Density Lipoprotein (HDL), is thought to prevent arterial disease, by taking cholesterol away from the cells and back to the liver, where it is either broken down, or is passed from the body as a waste product.
Meanwhile, bad cholesterol known as Low Density Lipoprotein (LDL), does the exact opposite, by carrying cholesterol from the liver to the cells, which can cause a harmful build-up if there is too much for the cells to use.
So, for those with notions that all cholesterol is bad, Ms. Dallas hastily dispels such myths, as she highlights the role that this chemical plays in the overall body function.
“Cholesterol performs some enzymatic function and the good one is transported to the liver and protects against heart disease. It’s not that we are saying do not take in any cholesterol, we are only asking that you reduce it, as it does have its place in the body,” she says.
And, for persons like the interviewee, who tends to eat everything, Ms. Dallas is appealing to them to sever that love affair with unhealthy foods and become selective in their choice of food and methods of meal preparation.
“Eat less animal based foods such as meats, milk and cheese and more fruits and vegetables,” she recommends. Although she does suggest the use of monounsaturated and polyunsaturated fats such as olives, olive oil, nuts and nut oil, she still cautions individuals to temper their use of oil, margarine and butter.
“Even if the oil you are using is a good oil, for example corn oil and canola oil, we still say to you, restrict the amount of oil that you are using because too much of one thing is bad, so though you may be using a good oil, you run the risk of increasing the bad cholesterol which is what we call the LDH if you use too much,” the Dietician informs.
Most of cholesterol, she says, is derived from animal-based foods. These include organ meats such as liver, kidney, egg yolks, cheese, whole milk, and solid shortening, among others.
What Your Cholesterol Level Means
It should therefore, come as little surprise, that the two diabetics had no knowledge of cholesterol measurement and what the readings indicate. In fact, when both were asked if they had ever gone to get their cholesterol level checked, the female, who is in her mid 60s responded, “no sah, and all of this year, I have not gone to the doctor and the year soon done. It is too expensive.”
Even more astounding and disheartening was the advice that Mr. Simms offered to this lady. He stated, “don’t worry yu self man; from you not feeling any pain you don’t have to go no where. Every day the doctor them jus a look more money.”
Ms. Dallas has sought to provide information on how cholesterol is measured in the blood. She explained that cholesterol levels are reported in milligrams per decilitre of blood (mg/dl).
“The desired total cholesterol score should be 200 mg/dl. If under 200mg per decilitre or 5.1, this is a good level,” she informed, adding, “a score between 200 to 239 mg/dl is considered borderline and if someone’s blood cholesterol level is 240 mg or more, their blood cholesterol is high and they are at a higher risk for a heart attack.”
However, she continues, many doctors recommend a total cholesterol level of 150 to180 mg/dl. To maintain this level, she suggests diet modification and regular exercise, and changes in meal preparation methods.
What are the possible effects of high cholesterol? “Too much LDL can line the walls of the arteries with plaque, making them narrower and hence decreasing the flow of blood around the body. When that happens, you either get the heart attack or you possibly will have chest pains that might indicate that a heart attack is not too far off,” informs Ms. Dallas.
Dietary Advice
She advises those who are trying to decrease their blood cholesterol levels to make a few dietary changes at a time, starting with the choice of grocery and meal preparation methods.
She recommends that individuals significantly reduce their intake of fatty foods. “If you are going to prepare your chicken, do so without the skin. For red meat, strip off the fat as that fat is the cholesterol,” she urges, while encouraging increased consumption of fruits and vegetables, particularly peas and beans and oats.
“These are what we call soluble fibres and help to lower the amount of cholesterol in your body,” she notes.
The Spanish Town Hospital medical dietician also recommends replacing frying, a popular method of cooking in Jamaica, with low fat methods such as broiling, baking, boiling or steaming. She cautions against the common practice in Jamaica of adding fat to food while steaming. “We need to cut down on the amount of fat that we are using,” she emphasises.
The Ministry of Health and Environment, is cognisant of the devastating impact that chronic diseases are having on the region. Last September, CARICOM Heads of Government met in Trinidad at a Chronic Disease Summit, to discuss these and other issues. One result of the conference was the declaration of the second Saturday in September, as Caribbean Wellness Day, a symbol of the binding partnership by the Heads of Government to reduce the chronic disease burden in the sub-region.
Chief Medical Officer (CMO), of the Ministry of Health and Environment, Dr. Sheila Campbell-Forrester, in her recent delivery of the Caribbean Wellness Day Message, urges Jamaicans to begin to take responsibility for their health.
Chronic non-communicable diseases, she says, are preventable and are chiefly the outcome of harmful food choices, low levels of physical activity, and smoking.