Alex Johnson | School nutritionists are needed now more than ever

In May 2022, public health organisations and advocates across Jamaica welcomed the announcement of the Green Paper for the National School Nutrition Policy (SNP). Developed by the Government of Jamaica through the Ministry of Education and Youth (MOEY) in collaboration with the Ministry of Health and Wellness (MOHW) and partner agencies, this policy seeks to guide the provision of proper nutrition alongside overall wellness for our nation’s students.

Since its unveiling, numerous public consultations have been held involving school administrators, concessionaires, vendors, parents, and students – offering each group the opportunity to share concerns and provide feedback on the proposed policy. Among these sessions, the youth consultation stood out, bringing together bold, well-informed students from across the country and leaving many with their eyes wide open.

In May, the policy was approved by the Jamaican Cabinet. We are in the stage of implementation. A key concern raised was the critical need for school nutritionists. This call, though echoed most loudly by students, has long existed as a silent cry from many school administrators who are tasked with implementing various school nutrition initiatives without adequate support.

Appointing trained school nutritionists would ensure that meals provided align with students’ nutritional needs and activity levels. While we continue to encourage healthy eating and promote wholesome school food environments, it is crucial to remember that such policies, like all public health interventions, require ongoing monitoring and evaluation.

A pertinent question was raised on October 9, by the president of the Paediatric Association of Jamaica during the Heart Foundation of Jamaica’s “Let’s Implement the National School Nutrition Policy!” mass media campaign.

The question highlighted a crucial gap – how will the nutritional needs of students with neurodivergent and special-needs challenges be adequately planned and supported under the policy? This concern underscores the pressing need for trained school nutritionists within educational institutions, to ensure that every child, regardless of ability, receives individualised nutritional care that promotes learning, inclusion, and overall well-being.

OVERWEIGHT OR OBESE

According to the World Health Organization (WHO), over 340 million children and adolescents ages 5-19 were overweight or obese in 2016, while 40 million children under five fell into this category in 2018. Jamaica’s own 2017 Global School-Based Student Health Survey (GSHS) paints a worrying picture:

• Obesity among boys nearly doubled between 2010 and 2017, from 5.3 per cent to 10.3 per cent – a 94 per cent increase.

• Among girls, the rate rose from 6.7 per cent to 9.9 per cent – a 47 per cent increase.

In total, 23 per cent of Jamaican students ages 13-17 are now overweight or obese, while over 66 per cent of adolescents ages 15-19 consume fast food on most days – a key focus in the ongoing campaign led by the Heart Foundation of Jamaica and its partners.

A position paper published by the Jamaica Youth Advocacy Network recommends: “Guidelines for the monitoring and evaluation aspect of the programme by nutritionists, trained school administrators, and students.”

While school administrators may understand various elements of the school environment, the monitoring and regulation of nutrition programmes should be led by registered nutrition professionals. Nutrition is a science, and a dietitian or nutritionist is a licensed medical expert in that field.

Think of it this way: if you had a dental issue, you wouldn’t visit a dermatologist, you’d go to a dentist. The same logic applies when addressing nutrition. This is a crucial appeal for both the MOEY and MOHW to prioritise the involvement of school nutritionists to enhance the efficiency and effectiveness of the SNP’s implementation.

MAY NOT BE FEASIBLE

Realistically, it may not be feasible to place one nutritionist in every school. However, a zonal approach could be adopted. For instance, a single nutritionist could be assigned to a group of 10 schools within a zone, providing oversight, training, and support. A referral system could be established wherein school nurses conduct basic screenings and refer students or staff for further assessment with the nutritionist. This would ensure that nutrition-related concerns are addressed promptly and professionally.

Sceptics may ask, “Is this really a priority? Aren’t there more pressing issues?”

A 2017 investment case by the Pan American Health Organization (PAHO) estimates that Jamaica could lose approximately J$77 billion between 2017 and 2032 if it fails to implement a comprehensive package of interventions for non-communicable diseases (NCDs). We are already seeing the health and economic consequences of rising NCDs such as diabetes, hypertension, and heart disease – not just among older adults, but increasingly among children.

A 2017 study revealed that 30,000 Jamaican students ages 10–19 had been diagnosed with hypertension. This is alarming.

If the government overlooks the urgent need for nutrition professionals in schools, we must ask ourselves whether we are truly committed to safeguarding the health of our children. As we observe National Nutrition Month, we should reflect on whether we’re doing enough to prioritise children’s nutrition.

We often say that children are the future. But, with their future threatened by rising obesity and NCDs, our inaction could lead to massive, avoidable burdens on our healthcare system.

Let us evaluate and improve our current system, and, above all, remember to let food be our medicine, and medicine our food – because there’s nothing sweeter than a healthy lifestyle.

Alex Johnson is a clinical dietitian. Send feedback to columns@gleanerjm.com