Nutritional adequacy and dietary disparities in an adult Caribbean population of African descent with a high burden of diabetes and cardiovascular disease.

Rachel M Harris,Nigel Unwin,Angela M C Rose,Nita G Forouhi

doi:10.1002/fsn3.1363

Abstract

The Caribbean island of Barbados has a high burden of diabetes and cardiovascular disease. Dietary habits were last described in 2005. A representative population‐based sample (n = 363, aged 25–64 years) provided two nonconsecutive 24‐hr dietary recalls in this cross‐sectional study. Mean daily nutrient intakes were compared with the Dietary Guidelines for Americans. Subgroup differences by age, sex, and educational level were examined using logistic regression. High sugar intakes exist for both sexes with 24% (95% CIs 18.9, 30.0) consuming less than the recommended <10% of energy from added sugars (men 22%; 15.0, 31.6; women 26%; 18.9, 33.7). Sugar‐sweetened beverages provide 43% (42.2%, 44.4%) of total sugar intake. Inadequate dietary fiber intakes (men 21 g, 18.2, 22.8; women 18 g, 16.7, 18.9) exist across all age groups. Inadequate micronutrient intake was found in women for calcium, folate, thiamine, zinc, and iron. Older persons (aged 45–64 years) were more likely to report adequacy of dietary fiber (OR = 2.7, 1.5, 4.8) and iron (OR = 3.0, 1.7, 5.3) than younger persons (aged 25–44). Older persons (aged 45–64 years) were less likely to have an adequate supply of riboflavin (OR = 0.4, 0.2, 0.6) than younger persons. Men were more likely to have adequate intakes of iron (OR = 13.0, 6.1, 28.2), folate (OR = 2.4, 1.3, 4.6), and thiamine (OR = 3.0, 1.5, 5.0) than women. Education was not associated with nutrient intake. The Barbadian diet is characterized by high sugar intakes and inadequate dietary fiber; a nutrient profile associated with an increased risk of obesity, type 2 diabetes, and related noncommunicable diseases.

Highlights

Barbados is a small island developing state and the most easterly island of the Caribbean chain
The nutrient profile for Barbadians is characterized by high sugar intakes, with half of total sugar intake coming from added sugars and half of added sugars coming from SSBs
We focus our discussion around those results which we consider to be of public health importance

Summary

| INTRODUCTION

Barbados is a small island developing state and the most easterly island of the Caribbean chain. The Global Burden of Disease (GBD) Study estimates that a suboptimal diet contributes approximately 15% of total disability-adjusted life years (DALYs) among adults worldwide (GBD 2017 Diet Collaborators, 2019). For the Caribbean, the GBD study estimated suboptimal intakes of fruits, vegetables, whole grains, nuts, and seeds, with inadequate levels of fiber and calcium (GBD 2017 Diet Collaborators, 2019). In 2012–2013, we conducted the population-based Barbados Salt Study in adults aged 25–64 years, which included 24-hr dietary recalls and urine collection. We anticipate that this work will add to an area with the current paucity of dietary data for the Caribbean region These findings will be of importance for the formulation of effective public health policy and culturally appropriate nutritional interventions, targeting those groups at greatest risk, for the Barbadian population

| MATERIALS AND METHODS

| Procedures

Findings

| DISCUSSION