Garth Rattray | Don’t flop on FOPL

Dr Christopher Tufton, Jamaica’s minister of health and wellness, wrote an excellent article titled ‘Clarifying issues on front-of-package labels’ ( The Sunday Gleaner, In Focus, Sunday, July 4). He cited the crisis and dangers of the lifestyle-modifiable, chronic non-communicable diseases (NCDs) and the need to “… clearly communicate the risks of consuming certain foods to consumers who might not be aware of the excess salts, sugars, and fats that are in their foods”.

The minister rightfully admonished the “… pushback from processed-food manufacturers who are far more well-resourced than any coalition. The coalition’s efforts and resources expended on consumers’ right to know what they are consuming is in no way comparable to the significant budgets assigned by private brands to promote their products, as is their right in a free market economy”.

VARIOUS DESIGNS

There are several designs for the front-of-package label (FOPL). They help shoppers make healthier food choices, and, most commonly, reveal saturated fat, sugar, and sodium (or salt). Some are outright warning labels, others are nutrient-specific labels. I vividly recall visiting my father (of blessed memory) who was about to drink a colourful liquid. He did not believe that it was sweetened. However, the label was in Spanish and of very fine print. I peered at the label and saw azúcar, which is ‘sugar’ in Spanish. A clear FOPL, in any language, would have saved him from making the mistake of drinking that sugary drink for weeks until I caught on to it.

We have a pandemic of NCDs. They include hypertension, cardiovascular diseases, cancers, diabetes, obesity, chronic respiratory diseases, musculoskeletal diseases and mental disorders. Some are modifiable and, as a group, they are the leading cause of death in today’s society. Our diet plays a significant role in the management of several NCDs, and because modern society relies heavily on processed foods, they require proper labelling that can be easily seen and understood by all, no matter their literacy status or language skills.

Obesity (a word that I abhor because it is outdated, judgemental and demeaning, yet remains a socially accepted epithet) puts people at risk for other NCDs. It is defined as a body mass index (BMI) greater than or equal to 30. The BMI is calculated by dividing your weight (in kilogrammes) by your height (in metres) squared. It is inaccurate in muscular individuals. A BMI of 18.5 to below 25 is considered normal. A BMI of 25 to below 30 is considered overweight, and 30 and above is obese.

Being overweight or obese are not simple to control; if that were so, we would all be slim and trim. Weight problems are caused by genetics, conditions within the womb, conditions outside the womb (nutrition, like the lack of adequate breastfeeding), social conditioning, habits, hormones secreted by the stomach and intestines and even the gut bacteria. Physical activity is also a modulator.

Diabetes and hypertension have genetic and environmental components, but they are also heavily influenced by diet, weight and physical activity. Diabetes is extremely diet- dependent. The Ministry of Health and Wellness advises that, generally, about 11.9 per cent of Jamaicans are diabetic, but of those who are aware of it and on treatment, only 27.5 per cent are controlled. And 34 per cent of Jamaicans, 15 years and older, are hypertensive; but 40 per cent don’t know that they are. Only 70 per cent are on medication, but a mere 30 per cent are controlled. These are major incapacitating and very deadly NCDs, and those staggering figures prove that we need all the help that we can get in controlling them.

Low-income countries like ours must reduce the health and economic burden of modifiable NCDs. FOPLs are essential for all processed/manufactured foods and drinks. In-depth research revealed that FOPLs clearly help consumers identify healthier options. It goes without saying that we need them.

Garth A. Rattray is a medical doctor with a family practice. Email feedback to columns@gleanerjm.com and garthrattray@gmail.com.