High prevalence of childhood overweight and obesity in ten Caribbean countries: 2018 cross-sectional data and a narrative review of trends in Trinidad and Tobago

ABSTRACT Background: There is an increasing prevalence of obesity among school-children globally, including the Caribbean region. Aim: To obtain cross-sectional data on childhood obesity in the Caribbean, and to explore trends in prevalence of childhood overweight and obesity over the past two decades in Trinidad and Tobago. Methods: The 2018 Caribbean Island Urinary Iodine Survey (CRUISE) was a multi-site, cross-sectional, primary school-based study in ten Caribbean countries, in which healthy school-children aged 6–12 years (n = 3040) from urban and rural clusters were selected to complete a questionnaire and obtain anthropometric data using standardised methods. Additionally, all reported studies among school-children (aged 5–18 years) in Trinidad and Tobago within the last 20 years were utilised in a narrative review of the trends in prevalence of childhood obesity and associated risk factors. Results: All 10 Caribbean territories had a high prevalence of overweight (28 · 0–44 · 5%) and obesity (14 · 3–19 · 8%). The highest cumulative overweight and obesity percentage were in Dominica (60 · 1%) and the lowest in Grenada (43 · 0%). Trinidad and Tobago ranked fifth, but in this territory the combined percentage of overweight and obese school-children has been steadily increasing from 12% in 2001 to 51 · 5% in 2018. This corresponds with a notable decline in physical activity (29 · 2% to 20 · 5%) and increase in sedentary time (47 · 3% to 49 · 0%) from 2011 to 2017. Conclusion: There is an alarmingly high prevalence of childhood obesity across the Caribbean. Within the last two decades, the percentage of overweight and obese school-children in Trinidad and Tobago has increased four-fold, likely reflecting a decline in physical activity and rise in sedentary behaviour.