Chronic lifestyle diseases, particularly diabetes and hypertension, continue their menace on the health sector, racking up medical expenditure and leaving many families in mourning. Yet many Jamaicans are still clinging to unhealthy food choices, the healthy alternative unknown or too expensive, some say.
And health experts believe it will only get worse this Christmas – the first free of restrictions after two years of tight COVID-19 measures that devastated the country’s economy, plunging scores into unemployment and worrying fiscal strain.
According to the World Bank, domestic food price inflation remains high globally, with low- and middle-income countries feeling the tightest pinch after the pandemic.
Jamaica, it states, is regarded as an upper-middle income country, struggling with low growth, high public debt and exposure to public shock, such as the Russia-Ukraine war.
“Information between July and October shows high inflation in almost all low-income and middle-income countries,” the World Bank underscored in its Food Security Update/World Bank Response to Rising Food Insecurity earlier this month.
“Eighty-three point three per cent of low-income countries, 90.7 per cent of lower-middle income countries, and 95 per cent of upper-middle income countries have seen inflation levels above five per cent, with many experiencing double inflation,” it added, noting that, “the share of high income countries with high food price inflation has risen to 86.8 per cent.”
Additionally, a probe by the World Food Programme (WFP) that surveyed 6,000 households across 22 countries and territories earlier this year suggested that four in every 10 Jamaicans have reduced their food consumption, while 98 per cent of Jamaicans who participated in the study said there has been an increase in food prices.
Probably the hardest hit by the food crisis locally are persons living with chronic illnesses, which, according to statistics from the National Health Fund (NHF), account for the biggest spend annually for public medication.
Then, there are those Jamaicans who, while willing to eat healthier, do not know how to or cannot afford to do so.
“Our biggest problem is that we don’t know how to eat healthy,” Dr Alfred Dawes, a general laparoscopic and weight-loss surgeon, told The Sunday Gleaner.
“Nutritionists are saying you can’t eat rice, cut out bread and flour, and eat protein with each meal. But the cheapest protein out there is chicken back, which is the worst part with the lowest protein content and highest fat content.”
“We need to have a complete change in our dietary patterns where ground provisions are cheaper alternatives to rice and flour,” Dawes posited. “The will may be there, and some people will try to eat healthy a little bit, but financially, it is challenging for many. In terms of availability of ground provisions, when the crops come in, you get good prices, but what happens after? The prices jump drastically, putting it out of reach for many.”
Dawes is of the view that many Jamaicans suffering from chronic illnesses are from lower-income communities where at corner shops, it is much easier to access unhealthy starchy foods such as rice and flour than healthier fruits and vegetables.
“It is easier for them to fry some dumplings with butter or stretch a tin of corned beef or mackerel,” the CEO of Windsor Wellness Centre said.
‘MUTTON AND OXTAIL DON’T SELL AGAIN’
If used only for food, Jamaica’s current minimum wage of $9,000 weekly equates to $1,286 daily, and that is breakfast, lunch and dinner.
At two supermarkets, two wholesales and two corner shops visited by The Sunday Gleaner in Stony Hill, St Andrew; Cross Roads, Kingston; and in Portmore, St Catherine, last week, the cost of two pounds of flour ranged from $160 to $190. A ‘big gil’ of oil in the corner store was for $200 and a stick of butter for $120. That is a minimal total of $420.
Across the locations, the cost of two pounds of rice ranged from $150 to $170.
As for protein, a large corned beef ranged from $459 to $485 between the supermarkets and wholesales, while at one corner shop in Bridgeport the price was $535.
Roughly $10 cheaper at the larger outlets, a tin of sardine at that corner shop was for $225, while a large tin of the cheapest brand of mackerel was sold for $370. The same brand was sold for more than $100 less in the bigger establishments.
One pound of chicken back was roughly $160 at wholesales, while at one corner store, the same amount was being sold for $180. Kidney, liver, and chicken foot, which are also favourites among the poorest, were going for $220, $220 and $230, respectively, per pound.
Eggs, frankfurters and bread are the most common breakfast items for the poorest Jamaicans. At a corner shop, one egg cost $50, and so did a single sausage. Breads were sold for $240 for a ‘shorty’, and $500 for a whole hardough bread.
“Mutton and oxtail don’t sell again; only one and two people will buy them something there,” Bridgeport shopkeeper Kerry told The Sunday Gleaner.
“People come and buy even half stick of butter and return two, three times for the day; it’s almost as if they are working on a Cash Pot basis,” she said, referencing a popular lottery game.
“Some people want you to sell them half of the things and I sell them because the need is there and I can assist. But certain things like the bread, I don’t get into like that,” she admitted. “I don’t know how long the other half of bread is going to take to sell and I don’t want it to stale on me.”
HEALTHY LIFESTYLE ON $1,200 PER DAY
Rosalee Brown, a consultant dietician and certified diabetes educator, told The Sunday Gleaner that while it would be a challenge, it is still possible for Jamaicans to live a healthy lifestyle on $1,200 per day.
Still, she said, food prices will vary with location, especially in the rural areas, where there is greater access to ground provisions like breadfruit, banana, fruits and vegetables.
“Proteins seem to be the concern; that persons are not getting adequate amounts. But we do not need large amounts of protein. What we need is food which is nutrient dense, which is in our backyards and often goes to waste,” Brown pointed out. “We should encourage our population to eat whole unprocessed foods, which have all the nutrients and health-promoting fibre.”
She cited that vegetables of all colours cooked down lightly with fresh seasoning are excellent choices.
“We can eat healthy and economically. Let us not confuse healthy foods with artistically marketed processed foods,” she stated. “Whole foods fill us up more and provide more health-promoting nutrients and not calories per ounce. How can we be poor when breadfruit, callaloo and beans are not being consumed?”
At the island’s largest and most vibrant market, the Coronation Market in downtown Kingston, broccoli was on sale for $900 per pound, and cauliflower was $500 for the same amount on Saturday. Okra cost $200 per pound, pumpkin was $180, and cabbage was $250 per pound.
Other foods such as sweet potato was $150 per pound, pak choi could be had for $100 per pound, lettuce was $200 per pound, and yam for $150 per pound.
As opposed to unhealthy sodas, Jamaicans have the choice to make freshly squeezed natural juices, with pineapple costing $250 per pound, papaya at $150 per pound, ginger at $250 per pound, carrot $180 per pound and $50 per pound for cucumber.
Sorrel this year was $250 per pound at one stall, while red peas was $400 per quart.
There seems to be a growing tomato shortage, as a pound now costs roughly $300 in the market, “but you better buy it now ‘cause last week it was $500”, warned a female shopper, suggesting that the price could once again climb.
Professor Denise Eldemire-Shearer, a medical doctor and one of the island’s foremost ageing experts, said Jamaica’s food dilemma is almost a double-edged sword.
“I don’t think that the elderly are affording as much fruit and vegetables as I, personally as a clinician, would like to see. But there is the other thing that when you go to the supermarket there aren’t that many fruit and vegetable options. So I think supply is an issue,” she reasoned.
“I think affordability is one component, but I also think that there is a lack of education and understanding of what you should eat, especially with the older persons. We should also think about those who live alone who don’t have large families. It is so much easier for them to eat a piece of bread,” Eldemire-Shearer told The Sunday Gleaner.
• Include beans/peas in at least one or two meals throughout the day, such as in soups, stews, balls, burgers, spreads or dips.
• Aim for an abundance of edible goods that can be easily planted and consumed green or dried.
• Including small amounts of nuts and seeds, like pumpkin seeds, in the diet also add proteins.
• Canned meat/fish are high in fats, salts and other additives that promote chronic non-communicable diseases, so aim for fresh sources instead.
HEALTHY MEALS FOR FOUR ON A BUDGET
All meal plans are adequate in all nutrients and high in fibre.
Cornmeal or peanut porridge
with nutmeg or cinnamon leaf
Add a small amount sugar (optional)
Pumpkin or callaloo rice
Meatless stew peas
Curried pak choi and cabbage chop suey
Whole wheat flour/pumpkin dumpling
Fruit in season
Curry broad beans (home-grown and precooked)
Loaded rice and peas
Brown-stewed chicken (optional)
Sunday salad: cabbage, carrot, tomato (oil and vinegar dressing)
June plum drink with ginger (light sugar optional)
Turn cornmeal stove top pudding with fresh coconut milk
June plum drink
MEAL IDEAS FOR A WEEK
Cornmeal or whole wheat flour porridge with peanut and sugar
School canteen lunch for children (government subsidised)
Leftover dinner for adults
Fruits in season
Seasoned rice (with greens, legumes; minimal fish/chicken optimal)
Peas soup (with breadfruit, pumpkin, and dumplings)
Local economical vegetable chop suey and dumplings
Meatless stew peas and rice
• Shop at the produce markets in the evenings when prices tend to be lower.
• Do home gardening where possible, planting herbs and spices, tomato, thyme, pepper, mint, etc.
• Consume less expensive vegetables from same group, for example, callaloo and pak choi, instead of lettuce and broccoli.
• Use local herbs and spices
PREPARED BY: Dr Rosalee M. Brown, registered dietitian, integrated health and lifestyle medicine professional, certified health and well-being coach; Integrated Nutrition and Health Services. Email: email@example.com.