Objective: Trinidad and Tobago has experienced an epidemiological transition over recent decades characterised by reduced rates of communicable diseases but rapidly increasing rates of obesity and non-communicable chronic diseases. The objective of the present study was to investigate the changes in energy and nutrient supply that have taken place in Trinidad and Tobago between 1961 and 2007. Design: Food balance sheets for each year between 1961 and 2007 were downloaded from the FAOSTAT database and daily per capita supply for seventeen food commodity groupings was calculated. After appropriate coding, energy and nutrient supply were determined using dietary analysis software. Conclusions: Nutritional imbalances in the Trinidadian food supply need to be addressed to combat the rise in nutrition-related chronic disease that is projected to cause increased disability and premature death in the country in the coming years.
Keywords
Food balance sheets Nutrition transition Nutrient supply Trinidad and TobagoTrinidad and Tobago is a Caribbean nation (population 1?3 million) situated off the north-east coast of Venezuela. The country is dominated by two major cultural traditions: Creole and East Indian. Creole is a mixture of African elements with Spanish, French and British colonial influences, while the East Indian tradition originated with the arrival of indentured servants from India to work on the sugar plantations after the abolition of slavery in 1833 (1) . Today, the country's multi-ethnic population consists of people of East Indian descent 40?3 %, African descent 39?5 %, mixed descent 18?4 %, Europeans 0?6 %, and Chinese and others 1?2 % (2) . From 1960 to 2009 the average life expectancy of Trinidadians at birth rose from 63?5 to 69?6 years (3) . During the same time period, however, the country has experienced an epidemiological transition characterised by a shift in leading causes of death from communicable to noncommunicable chronic diseases, including heart disease, cancers, cerebrovascular diseases, diabetes mellitus and hypertensive diseases (4)(5)(6) . In 2004 Trinidad and Tobago ranked 4th highest in the Americas for mortality from non-communicable diseases (7) . Estimated age-standardised mortality rates from CVD, diabetes mellitus and cancers in that year were 364, 128 and 123 per 100 000 population, respectively, compared with 179, 17 and 133 per 100 000 in the USA (7) . Diabetes has become a major public health burden (8) with prevalence rates having increased from 1?3 % in the 1950s to more than 12 % in the 1990s (9) . Total direct and indirect costs attributed to diabetes in Latin America and the Caribbean were estimated at $US 284?5 million in 2000 (10) . This escalating economic burden due to noncommunicable chronic disease is set to continue with the increasing prevalence of metabolic syndrome components such as obesity, dyslipidaemia and insulin resistance (11) . The WHO Global InfoBase Obesity Comparison Tool (7) predicted that by 2010 some 81 % of women and 65 % of men in Trinid...