Belizeans: Overweight And Unaware

Belize has a high prevalence of overweight and obese citizens, with 34.6% of adult women and 19% of adult men living with obesity. Belize's obesity prevalence is higher than the regional average for women but lower than the average for men. UNICEF supports nutrition programmes in Belize because the factors that contribute to the problem of overweight and obesity are environmental, biological and behavioural.

In Belize, 11% of children under 5 are overweight or obese, with the highest percentage found in Belize City, where poverty is highest. UNICEF data shows that Belizean infants are not always exclusively breastfed between the ages of 0-5 months, and that many Belizean homes do not have sufficient space for children to play and move around. Families may also lack knowledge about healthy diets, instead purchasing unhealthy foods and beverages they see advertised in the media.

Healthy food is often more expensive than unhealthy items, and food labelling can be incomplete. The food supply is often low in fruits and vegetables but high in sugar and salt. Social norms and beliefs about large body size as an indicator of health may also play a role in the high prevalence of overweight and obese citizens in Belize.

Lack of physical activity

Belize has a high prevalence of childhood and adult obesity, with 11% of children under 5 years old being overweight or obese, and 18% of children and teens aged 5-19 being overweight in 2018. In Belize City, the majority of overweight and obese children under 5 years old are found in Southside, where poverty is highest.

Many Belizean homes do not have sufficient space for children to play and move around. Families may lack knowledge about healthy diets, purchasing unhealthy foods and beverages they see advertised in the media. When it is available, healthy food is more expensive than unhealthy items, and food labelling can be incomplete. The food supply is often low in fruits and vegetables, but high in sugar and salt.

Belizeans are dying prematurely due to non-communicable diseases such as heart disease, diabetes, and cancer, which are largely linked to unhealthy lifestyle habits. A third of Belizeans die prematurely due to these diseases.

Belize has an economic policy of supporting sugar, and the country's GDP has been bolstered by high sugar production. Asking the country to reduce its use of sugar could also mean a reduction in economic activity, which represents a clash of objectives.

Dr. Ramirez, coordinator of the Research Center of INCAP for the Prevention of Chronic Diseases, pointed out that food and recreation are major contributors to the problem of overweight and obesity in Belize. He also noted that a significant portion of the media's revenue comes from the food industry, and a lot of those ads are targeted at children.

Belize faces a "double burden" of nutrition crises: despite a decrease in the number of children whose growth is either moderately or severely stunted, the country is still among the top 8 Latin American and Caribbean countries with the highest stunting prevalence.

Belizean children are already being given information on nutrition literacy and encouraged to get enough exercise. Adolescents are encouraged to access nutrition information and share this on social media and among their peers.

Physical activity and health

Physical inactivity is a primary cause of most chronic diseases. Physical activity is rehabilitative treatment from the inactivity-caused dysfunctions.

Physical inactivity causes decreases in capacities of functional systems, leading to premature deterioration of health in humans. The body rapidly maladapts to insufficient physical activity, and if continued, results in substantial decreases in both total and quality years of life.

Physical inactivity is an actual cause of most chronic diseases. In addition, physical activity primarily prevents, or delays, chronic diseases, implying that chronic disease need not be an inevitable outcome during life.

Physical inactivity is a primary cause of loss of functional capacities.

Physical inactivity is an actual cause of chronic diseases.

Physical inactivity is an actual cause of insulin resistance and of prediabetes, and therefore, according to disease progression of type 2 diabetes, itself.

Physical inactivity is a primary cause of VAT and whole-body obesities.

Physical inactivity is an actual cause of some obesity co-morbidities. Thus, even if primary prevention for the loss in body fat fails, primary prevention of some, but not all, of obesity's co-morbidities is possible with physical activity.

Physical inactivity is a cause of at least 1 of 3 deaths from CHD.

Physical inactivity is a cause of some osteoporosis.

Physical inactivity is a cause of up to 1/3rd of depression. Physical activity can primarily prevent 20–30% of depression.

Physical inactivity is a primary cause of NAFLD.

Physical inactivity is a primary cause of all major CVDs.

Physical inactivity is a cause of at least 10–30% of stroke, depending on the volume of activity.

Physical inactivity is a cause of CHF.

Physical inactivity is a cause of endothelial dysfunction.

Physical inactivity is an actual cause of dyslipidemia.

Physical inactivity is a cause of deep vein thrombosis.

Physical inactivity is a cause of gallbladder disease.

Physical inactivity is a cause of diverticulitis.

Physical inactivity is a cause of constipation.

Physical inactivity is a cause of gallbladder diseases.

Physical inactivity is a cause of gastrointestinal hemorrhage and inflammatory bowel disease.

Physical inactivity is a cause of CKD.

Physical inactivity is a cause of LBP.

Physical inactivity is a cause of ED.

Physical inactivity is a cause of PCa.

Physical inactivity is a cause of cognitive function.

Physical inactivity is a major cause of chronic diseases and conditions in Belize. It is a primary, upstream event that causes substantial increases in risk factors for 30 chronic diseases/conditions.

Unhealthy diets

Firstly, many Belizean families lack knowledge about healthy eating and often purchase unhealthy, highly processed foods that are heavily advertised in the media. These unhealthy options are typically more affordable than nutritious alternatives, making them more accessible to lower-income households. Additionally, food labelling can be incomplete, making it challenging for consumers to make informed choices.

Secondly, the food supply in Belize is often low in fruits and vegetables and high in sugar and salt. This imbalance contributes to a diet that is deficient in essential nutrients and excessive in empty calories. Belize's history of sugar production and the economic importance of the sugar industry further perpetuate the high sugar consumption among Belizeans.

Thirdly, social norms and beliefs about body image play a role in dietary choices. There is a perception that a larger body size is an indicator of health or a preference for "chunky" individuals. These cultural attitudes influence the types of food consumed and can normalise unhealthy eating patterns.

Lastly, physical inactivity is also a contributing factor. Many Belizean homes do not have sufficient space for children to play and move around, leading to a sedentary lifestyle that, when combined with unhealthy dietary choices, increases the risk of overweight and obesity.

Addressing these issues requires a multifaceted approach, including nutritional education, improving access to healthy and affordable food options, regulating the food industry, and promoting physical activity. By implementing interventions that target these factors, Belize can improve the dietary habits of its population and reduce the prevalence of overweight and obesity.

Poverty

Belize faces a double burden of nutrition crises, with a high prevalence of both malnutrition and obesity. In 2019, the annual report of UNICEF Belize revealed that 49% of Belizean children lived in multidimensional poverty, which directly affects their health status. Poverty is a key factor contributing to the high rates of overweight and obese children in Belize.

In Belize, the highest percentage of children under 5 who are overweight or obese (11%) is found in Belize City, with the majority (9%) in the Southside, where poverty is highest. In comparison, other districts such as Cayo, Orange Walk, and Toledo have around 7% early childhood obesity. This disparity highlights the impact of poverty on nutritional outcomes.

The link between poverty and obesity is complex and multifaceted. Firstly, poverty limits access to healthy food options. In Belize, healthy food tends to be more expensive than unhealthy alternatives, creating a financial barrier for low-income families. The availability of healthy options is also an issue, as the food supply is often low in fruits and vegetables and high in sugar and salt. This is particularly challenging for families in poverty who may rely on cheaper, highly processed foods to feed their children.

Secondly, poverty can restrict access to education and health services, which are crucial for promoting healthy lifestyles and nutritional literacy. UNICEF's Strategic Plan aims to address this issue by providing support and education to women before and during pregnancy, as well as offering nutrition counselling and education on maternal energy and healthy fetal growth. The plan also includes Infant and Young Child Feeding practices (IYCF) to improve early childhood nutrition.

Additionally, poverty can limit physical activity opportunities. In Belize, many homes lack sufficient space for children to play and move around, which can contribute to a sedentary lifestyle. This is exacerbated by social norms and beliefs that associate large body size with health or prefer "chunky" children, potentially discouraging families from prioritizing physical activity.

Finally, poverty can lead to increased stress and limited time for self-care, which can contribute to unhealthy coping mechanisms, such as comfort eating or a lack of physical activity. This can have long-term impacts on both physical and mental health, increasing the risk of obesity and related complications.

Addressing the root causes of poverty is essential to tackling the issue of obesity in Belize. By improving access to nutritious food, education, and health services, as well as promoting physical activity and healthy lifestyles, Belize can make significant strides in reducing the impact of poverty on the weight status of its citizens.

Healthcare access

Healthcare in Belize is provided through both public and private healthcare systems. The public healthcare system is available to everyone in Belize, offering free or low-cost healthcare services. However, it is often underfunded, understaffed, and undersupplied, resulting in long waiting times. The private healthcare system, though more expensive, provides comprehensive coverage and a range of secondary and tertiary healthcare facilities.

Belize has taken significant steps towards ensuring universal health access by removing all fees in public hospitals as of November 2023. This move eliminates the financial barrier to healthcare for all citizens, especially those from low-income families. Previously, patients were required to pay fees for health services, but revenue arrears for hospital bills reached approximately 50% over the past three years. The removal of fees will allow the Ministry of Health to focus on delivering quality care instead of monetary concerns.

The Ministry of Health (MoH) is the government agency responsible for overseeing the entire health sector and is the largest provider of public health services. The MoH offers affordable care to the majority of Belizeans with a strong focus on quality. It launched a National Health Plan, "Quest for Equity", which included an analysis of the major health conditions and determinants of health impacting Belize. The plan identified key policy areas and priorities for improving the healthcare system, including increasing access to care and improving the quality and efficiency of delivery.

Belize has eight major public hospitals and around 60 public clinics, with the highest level of care offered in Belize City. The public system often struggles to meet demand, leading those who can afford it to opt for the private system. The private health sector has grown in recent years, particularly in urban areas, and while costly, it offers more comprehensive services.

The Belize Health Information System (BHIS) is an integrated comprehensive health information system that allows for the collection and dissemination of population-based and record-based health data to improve health outcomes and performance. The BHIS was expanded to various hospitals and clinics across four health regions (northern, central, western, and southern) by 2009.

While the healthcare system in Belize has been subjected to several reforms and improvements, it still faces challenges. There is a shortage of medical professionals, with many being foreign nationals working as volunteers. Additionally, the limited medical supplies and equipment hinder the delivery of quality health services, especially in rural areas. Emergency services are largely limited to urban areas, and the country lacks a Level I trauma centre equivalent.

Social norms

In Belize, social norms around food and exercise play a role in the country's nutrition crisis. UNICEF reports that social norms and beliefs about large body size as an indicator of health or a preference for "chunky" children and adults may contribute to the problem of overweight and obesity.

The social norms around body size in Belize may be influenced by the country's history of colonialism and the resulting social hierarchy. Belize's social structure is marked by enduring differences in the distribution of wealth, power, and prestige, with political and economic power vested in the hands of a relatively small local elite, most of whom are white, light-skinned Creole, or Mestizo. This elite group controls the institutions that mediate relations between Belize and the outside world and has close connections with North America.

The middle sector of Belizean society, which is largely the product of the expansion of educational opportunities and the growth of the modern sector of the economy, is more diverse and less cohesive. It includes members of all Belizean ethnic groups but is disproportionately made up of Creoles, Mestizos, and Garifuna. This group is unified by a shared belief system that emphasises cultural respectability, upward social mobility, and the importance of education.

The lower sector of Belizean society, also stratified by ethnicity and occupation, consists of unskilled or semi-skilled urban workers, subsistence farmers, agricultural labourers, and the unemployed. This group has severely limited access to land, higher education, and opportunities for social mobility.

While there is some fluidity between these social sectors, with intermarriage and political mobilisation helping to cut across ethnic boundaries, overall, the social norms around body size and health in Belize are influenced by the country's social structure and its history of colonialism.

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