Building mental Health Resilience in health care teams.

Dr. C.V. Alert MB BS, DM, FCCFP.

Family Physician.

 

The term ‘resilience’ primarily reflects the capabilities of a system to absorb and recover from disturbances. Mental health resilience is crucial for effective teamwork in healthcare, and mentally strong doctors are essential for success of any health care system. Mental health resilience is a cornerstone of effective teamwork. Doctors must be able to discuss difficult issues, such as difficult diagnoses, without fear of repercussions. Inaccurate information or hesitation in these areas can have serious consequences. This requires an appropriate health environment, which is not a hypothetical construct but must be created.

Healthcare systems need to focus on both individual coping mechanisms, as well as creating a supportive work environment. Personal wellness means being physically, mentally and spiritually healthy. A healthy lifestyle helps balance all these aspects to achieve wellness. This includes activities like getting adequate sleep, eating healthy, avoiding drinking and smoking, and engaging in physical activity. To cultivate resilience in your life, it's important to apply the principles of the 7 Cs:  competence, confidence, connection, character, contribution coping and control.

On the other hand, lower resilience often stems from taking on (or being forced to take on) too much too fast. If you don't have faith in yourself or your abilities, or faced with an overwhelming situation, you’re less likely to adapt to stressful situations.

Here lies the catch-22 situation, for Caribbean Health professionals. Facing large workloads in under-resources clinics, many health care professionals are forced to take on too many patients, often with little or no support.  Mental health support? Just a rumor, as in many cases there is little recognition of the need to have supportive services, especially mental health services, available to health care professionals. ‘Only the strong survive, the weak fall by the wayside” : if individuals don’t develop personal coping mechanisms, then historically health care systems in the Caribbean are not designed to provide any assistance.

Violence, unfortunately in a prominent feature in many Caribbean islands- in two islands violence appears in the top 5 leading causes of death, and in most Caribbean islands the frequency and severity of violent acts is increasing; local health care providers are often called on to become involved, whether the involvement involves the perpetrator, the victim, family members, or even the security services. In rarer circumstances, the health care provider is himself/herself the victim of a violent act. But where is the support for the health care provider?

Dealing with dying patients and their families is another area of great mental challenge for physicians.

Associations such as the Caribbean College of Family Physicians (CCFP), and other groupings of health care providers, should not only consider advising its members to attend resilience training seminars, but to actually organize such seminars, even inviting other groups of health care professionals to participate.

Resilience training aims to teach how to adapt to stressful or dangerous events. It gives you tools to handle problems that arise on a daily basis. Being more resilient can improve quality of life, increase emotional strength, and lessen stress and worry. Teaching and prioritizing self-care to all family physicians should be also standard practice and supported throughout their careers.

Support must also go beyond workshops. There should be policies that specify adequate staffing targets to minimize exhaustion and burnout. Access to mental health services is also mandatory where family doctors can voluntarily seek psychological support.

Lastly creating a culture of psychological safety and support among peers will also help.

Psychological Safety?

 

Psychological safety is defined as the belief that one can take interpersonal risks without fear of being ridiculed or penalized. It allows team members to:

·         Ask questions without being seen as incompetent

·         Admit mistakes without fearing punishment

·         Raise concerns without being labeled as disruptive

·         Seek help without feeling embarrassed.

 

Psychological Safety benefits.

 

·         Better clinical decisions: Teams where junior doctors and nurses can express concerns without fear of negative consequences make more accurate diagnoses and prevent errors early.

·         Stronger team dynamics: A leader who sees themselves as a listener fosters trust within the team. Those open to feedback often receive critical information in time, preventing undesirable events.

·         Role modeling and sustainable leadership: Leaders who admit their own mistakes create a culture of mutual respect and foster a transparent, learning organization.

·         Error management as an opportunity: Errors are inevitable. What matters is how they are handled. A culture that views mistakes as learning opportunities improves both safety and team innovation. Experienced doctors and leaders who consciously strengthen psychological safety in their teams benefit in the long run through higher employee satisfaction, and improved patient safety.

 

Implementation in Clinical Practice.

 

Implementing psychological safety in healthcare requires action at multiple levels:

 

·         Individual level:

Personal communication skills development

Training in emotional regulation and conflict resolution

Feedback competency building

 

·         Team level:

Daily team reflection huddles

Leadership training at all levels.

Structured handovers with communication standards

Regular team reflection rounds

“Closed-loop communication” to reduce misunderstandings

Anonymous reporting systems for safety issues

 

·         Organizational level:

Regular interdisciplinary case discussions

Standardized communication processes

Speak-up protocols for critical situations

Cross-hierarchy meeting formats

Simulation training to improve error communication

Call to action.

 

Development of psychological safety is a continuous process that requires time, commitment, and resources. A lived culture of mistakes, where employees can communicate openly and without fear, is the key success factor for resilient high-performance teams in medicine and aviation.

 

 

Stress and Mindfulness.

Dr. C.V Alert, MB BS, DM. FCCFP.

Family Physician.

 

“The truth is that stress doesn’t come from your boss, your kids, your spouse, traffic jams, health challenges, or other circumstances. It comes from your thoughts about your circumstances.”
Andrew Bernstein, American Philosopher.

 

Stress is your body and mind’s way of mobilizing you to help you respond successfully to challenges in your environment.  This stress response evolved to keep us safe and healthy. When our cave-dwelling ancestors encountered a tiger, their bodies readied for action to meet the threat. Stress hormones such as cortisol and epinephrine ramp up to provide energy. Breathing quickens, the heart pumps harder, the immune system gears up to be ready to respond to injury. Once the tiger is vanquished and the threat is over, the body returns to a state of rest and restoration.

 

Our fight-or-flight response is still protective today. There are times you must act quickly, for example when a driver cuts in front of you in traffic suddenly. If we didn’t have that system kick on when it needed to, we wouldn’t be here.

 

Chronic Stress.

 

Chronic stress results when what was meant as an occasional emergency response becomes a day-to-day occurrence. Modern life can feel like an endless stream of emergencies: daily bad news, increasing violence in your neighborhood, constantly rising prices, or concern that a hurricane(s) may decide to do a Caribbean island tour, while God is busy with Ukraine and Gaza. Today, many of our stressors often are not life-threatening, like a face to face encounter with a tiger. But it’s still that same biological response. We weren’t designed to be stressed constantly. Biologically, stress a very energy intensive state, and it’s very hard on the body and mind to maintain this high intensity on an ongoing basis.

 

A state of chronic stress takes a heavy toll on the body’s systems. Research has linked chronic stress to a host of physical and mental conditions from high blood pressure to weight gain to digestive problems. In fact, chronic stress is believed to be a major factor in the global (and local) rise in hypertension and its complications, and hypertension is the most prevalent chronic illness. When someone’s hypertension is triggered by chronic stress, in most cases unless we can reduce/eliminate the stress, we won’t be able to control the blood pressure.   Chronic stress actually makes us age faster and shortening our life spans.

 

Chronic stress also has profound consequences for our emotional health.  It can precipitate anxiety, panic attacks, insomnia, and depression. Many adults are aware that stress causes them trouble concentrating, forgetfulness, headaches, or difficulty making decisions.  Your thoughts can become a stressor even in the absence of an outside threat.  In other words, just thinking about ‘something’ can cause you to be ‘stressed out’, and your heart starts to race and your stomach starts to churn.

 

Compounding the problem, we often turn to unhealthy ways of coping. Some people start seeking quick relief by eating more or drinking more or smoking more. These strategies may feel good in the moment, but can cause further damage to our physical and mental health in the immediate to long term.

 

Why doctors can’t diagnose stress?

 

Although stress contributes to various medical issues, diagnosing it is challenging because individuals respond to events in unique ways. For example, imagine a cricket match between Team A and Team B. If the best batsman on Team A gets out quickly, supporters of Team A may feel disappointed, while supporters of Team B may feel elated. The same event—the dismissal of Team A’s best batsman—triggers entirely different reactions among different groups of supporters. This variability in emotional responses makes stress difficult to diagnose, as it is highly subjective and influenced by personal perspectives.

 

 Successful Strategies for Coping with Stress.

 

Escaping forever to a hideaway with no telephones may sound like a tempting solution. But there are other strategies one can employ.  The stress may be here to stay, there is much you can do to boost your resilience.   

 

1.    Take stock of your situation.

 

Press pause and take an honest look at your day-to-day life. If you keep going 24/7/365 at 120 miles an hour, you're never going to get a handle on stress.  Reflect on how you are feeling physically and mentally and identifying the stressors that may be contributing, such as being on your phone constantly or skimping on sleep. Some people don’t want to take stock in this way as it increases their feelings of stress or anxiety. But recognizing your stressors is the first step to being able to do something about them. While you may not be able to eliminate your life’s stressors entirely, reflecting on those aspects you can control and doing something about them can be very helpful. If you are caregiving for an ill loved one, for example, you could ask a friend to do a supermarket run.

 

Taking a hard look at your priorities and then cut back. You may be thinking, ‘I’m doing these 100 things. I’m so important!’ We just take it as a part of modern life. But it’s not sustainable. Ask yourself, if today was the last day of your life, how would you spend your time?”

 

2.    Lean on Others.

 

Make spending time with family and friends a priority. People who have social support cope better Being around people you trust can calm your body and mind, but unfortunately, loneliness is another health crisis that is partially self-inflicted. During the pandemic, rates of anxiety and depression went through the roof and isolation played a huge role.

 

‘Mindfulness’ is a type of meditation in which you focus on being intensely aware of what you're sensing and feeling in a particular moment, without interpretation or judgment. Practicing mindfulness involves breathing methods, guided imagery, and other practices to relax the body and mind and help reduce stress. Mindfulness meditation has been shown to offer a host of stress-busting benefits, from lowering blood pressure to easing anxiety. With regular practice, you can become less reactive. You’re able to sit back a bit, take a breath, and contemplate before you shoot back a reply to that distressing email. Another effective go-to: deep breaths. Simply closing your eyes and inhaling and exhaling five deep breaths can have an immediate stress-relieving effect.

To see benefits from meditation, experts suggest you aim for at least 10 minutes each day. However, each person responds differently, so try longer meditation periods if 10 minutes don't seem to make any difference for you. If you find this difficult, try meditating several shorter times throughout the day.

4. Practice Good Self-Care.

 

Stress saps your mental and physical resources, so good self-care can help you be more resilient. Prioritize sleep. Turn off your phone, listen to relaxing music, and take a bath, so your body knows it's time to rest.

 

Make regular exercise a priority. That doesn’t mean you have to have a full-out sweat session every day. Walking can be great exercise. Some of my patients use a step counter (pedometer), often on their smart phones. You can slowly increase your goal by 500 steps every few days. Other exercises that are particularly restorative for body and mind include swimming, yoga and tai chi, and there’s support for spending time in nature – stop and smell the roses- to reduce stress as well.

 

A healthy diet can also help you combat the toll of stress. That can start with eating more mindfully. Eat with a focused mind. Chew their food down to a liquid before they swallow. Once you really connect with your food, you tend to want to eat more nutritiously.

 

5.    Seek Help.

 

Sometimes, despite such efforts, we reach a state of complete overwhelm. Seeking professional help from your doctor or a mental health specialist can be an empowering step toward coping better.

 

“Doing what matters in times of stress. An illustrated guide. Adapted for the Caribbean” is a booklet produces by WHO/PAHO, is available for free on line, and offers simple advice about dealing with stress, and is particularly useful for persons who fear the stigma of being labeled ‘mental case’.

 

6.     Laugh more.

A good sense of humor can't cure all ailments. But it can help you feel better. When you laugh, it lightens your mental load. It also causes positive physical changes in the body. Laughter fires up and then cools down your stress response. So read some jokes, tell some jokes, watch a comedy or hang out with your funny friends. Did you hear about the man who walked into a bar and said “Ouch”? Well, it was an iron bar.

 

Minimizing the chronic stress of daily life as much as possible can support your overall health. Engaging in activities that support self-care may help reduce stress and anxiety. These can include getting more exercise, mindfulness practices, getting adequate sleep. and eating a well-balanced diet. By prioritizing mindfulness and self-care, we create space for calm, growth, and resilience.

 

 

Artificial Intelligence (AI) in Medicine. Many positives, some negatives, but can we benefit?

Dr. C.V. Alert, MB BS, DM. FCCFP.

Family Physician.

Artificial Intelligence (AI) is a rapidly evolving field of computer science that aims to create machines that can perform tasks that typically require human intelligence. AI in medicine and healthcare is rapidly transforming the field by enhancing diagnostics, treatment plans, and patient care. AI algorithms can analyze medical data to identify patterns and insights that may be missed by humans, leading to earlier and more accurate diagnoses, personalized treatment strategies, and improved patient outcomes. 

 

Here are some areas in which AI is being used to improve healthcare:

 

1.    Diagnosis of complex cases.

 

Very recently, it was announced that a new AI tool (from Microsoft) can diagnose complex illnesses more accurately than most doctors. This AI tool blends the strengths of both generalists and specialists. Most doctors either have a broad base of knowledge (e.g. family physicians) or deep expertise in a particular field (e.g. specialists), but this AI combines both. In testing, this new tool correctly solved over 80 percent of the specifically selected challenging cases, compared to just 20 percent by human doctors. Even more impressive, it managed to do so while ordering fewer tests, suggesting a more efficient and cost-effective approach to diagnosis.

 

The system’s ability to update its diagnosis in real time, as more data is added, means it can adapt quickly and provide up-to-date recommendations. This is a big deal, especially in complex cases where every detail counts. Researchers say the AI’s clinical reasoning skills are beyond what any single doctor can offer, thanks to its ability to process vast amounts of information from different medical fields at once.

 

Despite these promising results, Microsoft is claiming that this is a pathway to ‘medical superintelligence’, but is not positioning this AI tool as a replacement for doctors, at least, not yet. The tool is still being tested in real clinical settings to see how it performs outside of controlled experiments. Safety checks and clinical validation are ongoing, and the company says it will only move forward with broader use once these hurdles are cleared. Stay tuned.

 

 

 

2.    Personalized Treatment Plans:

 

AI can analyze patient data to predict individual responses to different treatments, allowing for the development of more targeted and effective treatment plans. AI-powered tools can also help optimize medication dosages, minimizing side effects and maximizing therapeutic benefits. 

 

On the other hand, many of the ‘newer’ classes of medications, like the monoclonal antibody treatments for a wide variety of diseases, many newer anti-cancer drugs, and the new classes of anti-obesity medications, are outside the price range of many Caribbean patients and most Caribbean National Drug Formularies, so we are unlikely to see any of these medications in the near future, or at least until patents run out, and/or effective and affordable generics become available.

 

3.    Disease Prevention and Management:

 

AI can analyze population health data to identify individuals at risk for certain diseases, enabling proactive interventions and preventive measures. AI can also help manage chronic diseases by providing personalized recommendations for lifestyle changes and medication adherence. 

 

On the other hand, there seems to be limited ability and enthusiasm, if not resources, for Caribbean Ministries of Health (+ Wellness) to generate and analyze data on local populations, At a regional level, the World Health Organization (WHO) and the Pan American Health Organization (PAHO) Caribbean countries are linked with Latin American countries, but the populations of tiny islands are dwarfed by the millions of persons in Central and South America with whom we share little apart for geographic closeness. It seems likely that Caribbean islands will need to develop Caribbean-specific AI algorithms, but it is unknown whether any concrete steps have been taken or contemplated in this regard.

 

4.    Ethical Considerations and Challenges:

 

While AI offers tremendous potential, it is crucial to address ethical considerations related to data privacy, bias in algorithms, and the potential for job displacement. It is also important to ensure that AI is used responsibly and ethically in healthcare, with proper oversight and regulation. Again this is an area in which Caribbean specific algorithms may be needed. Clear oversight and regulations would be needed to ensure ethical use of AI in healthcare.

 

To most independent observers, it would seem that many Caribbean islands are experiencing a mental health pandemic, although this has not been officially recognized. The triggers for this include both violence and drugs, often interconnected, and harsh financial conditions which impact on employment opportunities and even education. While AI is being used to develop tools to assist in mental health diagnosis, treatment and ongoing support, and can assist in scenarios where mental health professionals are in short supply, as we have here, again Caribbean specific (or even island specific?) algorithms will need to be developed before we can use these technology advances to improve health care.

 

AI companions that combine conversational AI, cognitive behavioral therapy (CBT), and mood tracking are used to support users’ mental wellness. The best of them simulate real conversations, prioritize user privacy, and deliver interventions grounded in psychological research. However, they are not a substitute for a mental health therapist, especially in severe cases.

 

But there is a possible downside to all of this new technology. AI programs can be configured to routinely answer health queries with false information that appears authoritative, complete with fake citations from real medical journals. Without better internal safeguards, widely used AI tools can be easily deployed to churn out dangerous health misinformation at high volumes. If a technology is vulnerable to misuse, malicious actors will inevitably attempt to exploit it - whether for financial gain or to cause harm,

There are many areas in medicine where AI is likely to make, and is already making, significant valuable contributions.  These include areas like the development of new drugs, where AI can analyze vast amounts of data at record speeds. The discovery and production of a variety of vaccines against Covid-19, for example, fall in this category. AI will be here when the next infectious disease pandemic arises. AI can automate some tasks, potentially alleviating the burden on healthcare professionals and helping to address workforce shortages. Robotic systems can assist surgeons with complex procedures, improving precision and minimizing invasiveness. AI can analyze medical images (like X-rays, CT Scans and MRIs) with greater accuracy and speed than humans, aiding in earlier disease detection. By automating tasks and analyzing data, AI can minimize human errors in diagnosis and treatment, leading to safer and more effective care. By improving accuracy, efficiency, and resource allocation, AI can help reduce healthcare costs and address workforce shortages 

Finally, AI can be used to train healthcare professionals and enhance patient education.

 

Like any other tool, whether AI can be a blessing, or a curse, depends on the use to which it is put, or if it is put to use at all.  There is no doubt that, in the ‘real world’, AI is being increasingly used to improve global health. The question is, do we wish to advance Caribbean health care services, and the health of our people? In the Caribbean we have rapidly rising health costs, yet decreasing population health.  The gap between the population’s need for health care, and the ability of the health services to supply this care, seems to be widening.  At least AI seems to provide one avenue for us to adopt a new business model: ‘business as usual’ is not working. AI should be used to complement human intelligence, but is not likely to be useful in situations where human intelligence seems to have run out of ideas.

 

 

 

 

WORLD FAMILY DOCTOR DAY 2025 - MENTAL WELLNESS

 World Family Doctor Day 2025. - Dr. C.V.Alert MB BS, DM., Family Physician.

“We are all just prisoners here, or our own device”. - The Eagles, from”Hotel California”, 1972.

World Family Doctor Day is on May 19 every year. Founded by the World Organization of Family Doctors (WONCA) in 2010, World Family Doctor Day has grown into a global celebration of the importance of family doctors in health care. World Family Doctor Day 2025 will highlight the vital role family doctors play in mental wellness, emphasizing our ability to care for our patients.

The rise in mental illnesses today has many possible explanations. Modern stressors such as economic pressures, social isolation, and the pervasive influence of technology have also contributed to the growing prevalence of mental health challenges. Global events like the COVID-19 pandemic have further exacerbated these issues, highlighting the urgent need for accessible mental health care. While advancements in diagnosis and treatment have improved, the demand for mental health services often outpaces availability, emphasizing the importance of continued efforts to address this global concern.

Mental illness can affect some ‘normal’ persons, who are overwhelmed by everyday situations that push them into anxiety or depression. Today, people have fewer friends and less time for interacting and are less likely to engage in activities that bring them into contact with other people. “You are not alone, but you may be lonely”. Recent research has linked chronic loneliness/social isolation to depression, dementia and even early death.  Mental illness can affect some persons who choose to use and abuse drugs like alcohol, marijuana and cocaine.  And mental illness can affect some individuals who, perhaps because of a genetic predilection, develop diseases like schizophrenia or a bipolar disorder. Sometimes symptoms of mental health appear as a physical problem, such as stomach pain, back pain, headaches, or other unexplained aches and pains.

Family doctors provide many areas of patient care, including routine examinations such as well-baby and child care, vaccines, screening for the multitude of ‘silent killers’ that have infiltrated Caribbean populations, healthy lifestyle counseling, and treatment of common chronic illnesses. Importantly, the family physician can also be the point of first contact with the health services for persons with stress related and other mental health issues, especially in an environment of a shortage of mental health professionals. The family physician can function in other roles too, such as sports medicine, as well as public health and public health education. These doctors provide general care and, when necessary, consult with other specialists.

Benefits of having a Family Physician.

A doctor is not just a person you think of when you are sick. It is equally important to focus on staying healthy, and this includes both physical and mental health. Patients who see their family physicians regularly and over a long period are better taken care of than those who don’t. A long-term relationship with a family doctor means that he or she gets to know you, your family, and your health care needs. Because your family doctor keeps your medical records, he or she can better organize your care.

 Family doctors are dedicated to long-term care.

·    Family doctors are dedicated to providing long-term care for you and your family. They identify and treat you as a whole person. They are your initial point of contact with the health care system. Patients can receive care from their family doctors not only in their offices, nursing homes, but even the patients’ homes.

·       They can handle many a health issue. The family doctor may be the only doctor who offers preventive care. To keep you from getting sick, they give importance to your efforts to stay healthy.

·    Having a family physician is beneficial to your well-being. Studies have shown that individuals who have a good relationship with their family doctors are more likely to have better health outcomes.

·       Family doctors collaborate or consult with specialists and other health care providers, when necessary.

·  Family doctors, along with mental health professionals like psychologists and psychiatrists, have the training to improve the quality of mental health care for patients and increase patients' access to behavioral health services. Further, the stigma associated with mental illnesses discourages many persons (or their families) from seeking help from some types of mental health specialist, but may feel more comfortable visiting a family doctor.

• Family medicine fosters mental wellness through trust and continuity of care. Family doctors are uniquely positioned to promote mental wellness due to its emphasis on long-term relationships, continuity of care, and patient-centered approaches. Through early intervention, lifestyle medicine, and a holistic understanding of patients' lives, we family doctors can identify and manage mental health challenges before they become crises.

·         The most profound impact a family doctor can have for a struggling patient is to listen, deeply and without judgment. Acknowledging suffering is the first step towards healing, followed by exploration of meaning. By offering compassionate support and realistic hope, family doctors help their patients navigate difficult times and move toward recovery.

• Mental health is about resilience and adaptability. The goal of family doctors is to equip our patients with the ability to navigate life's challenges.

 World Family Doctor Day 2025 will highlight the vital role family doctors play in mental wellness.  Family doctors are encouraged to improve the quality of mental health care for patients and increase patients' access to behavioral health services.

Promoting Health through Nutrition.

Promoting Health through Nutrition.   

Dr. C.V. Alert, MB BS, DM.

Family Physician. 

YouTube Link: YOUTUBE VIDEO

First we eat, and then we do anything else.

Nutrition plays a significant role in health promotion and in disease prevention and management. To avoid various disease states, advising persons on variety, balance, and moderation of foods, is important in promoting a healthy lifestyle. [Unfortunately, the price of food items is not the focus of this article, although for many persons cost is the most significant factor.] A nutritious diet not only helps decrease the likelihood of chronic illnesses but also boosts mood and enhances overall quality of life.

Chronic inflammation is a key factor in many of today's health issues. These include rheumatoid arthritis, cancers, heart disease, diabetes, asthma, and Alzheimer’s. A weapon against chronic inflammation can be found not only in a pharmacy or a medical clinic but also in your local supermarket. Certain foods and beverages possess anti-inflammatory properties. Selecting the right anti-inflammatory foods might lower your chances of developing health issues. Leafy greens, legumes, fruits and vegetables are rich in plant-derived nutrients that combat inflammation for improved health. On the other hand, consistently choosing the wrong options could speed up the progression of many inflammatory diseases. Unhealthy foods may also contribute to weight gain, a known risk factor for inflammation.

Focus on adopting a nutritious diet to lower inflammation. A diet, rich in fruits, vegetables, nuts, whole grains, fish, and healthy fats, is an excellent meal plan that aligns with anti-inflammatory principles.

Steer Clear of Simple Sugars.

• Refined, simple sugars are found in products ranging from breakfast cereals to countless convenience foods. These offer short term energy but can lead to sugar spikes. 

• Sugar sweetened beverages, particularly in Caribbean children, lead to obesity. In turn, obesity leads to the non-communicable diseases, the ncds, and a variety of cancers.

• Choose complex carbohydrates which are found in peas, beans, vegetables and bananas, which are rich in fiber and vitamins. 

Fruits and Vegetables.

• According to the 2015 Health of the Nation (HotN) study in Barbados, 90% of adult Barbadians do not consume the recommended amount of fruits and vegetables. These facts, in addition to the large numbers of persons who fail to exercise, are major contributors to our NCD picture.

• Aim for half of your meal to consist of vegetables, with lean protein and whole grains making up the rest.

• A plant-based diet, prioritizing fruits, vegetables, nuts, seeds, and legumes, reduces animal product consumption while providing essential nutrients.[Scientists have also noted that plant-based dies are better for a sustainable environment, than animal based diets]

• The benefits include reducing the risk of chronic diseases such as obesity, heart disease, diabetes, and certain cancers.

• Foods such as lentils, peas and beans, nuts, and green leafy vegetables (like spinach, okras, kale and cabbage) are good sources of both protein and fiber.

• Colorful fruits, like tomatoes, grapes, oranges; vegetables like avocadoes, sweet potatoes, carrots and turmeric are all recommended.

Protein.

• The World Health Organization (WHO) recommends limiting red meat and avoiding processed meats. Heavy consumption of meat (“meat mouths”), including processed meats (like sausages, luncheon meat, corned beef) has been linked to a variety of cancers.

• Incorporate protein-rich foods, such as eggs, nuts, seeds, and lentils, into your diet to curb cravings and manage weight.

• Choose poultry and fish over red and processed meats, which are linked to certain cancers.

• Oily fish, such as tuna, mackerel, sardines and salmon are recommended

• Overemphasizing protein can lead to insufficient consumption of fruits, vegetables, and whole grains.

Increasing protein intake for most meals can help persons keep their nutrition in check. Protein takes longer to digest, helps curb cravings, and keeps you fuller longer. You can first try to incorporate protein-rich foods, like eggs, into your breakfast. Protein in the morning can help you avoid unhealthy snacking and improve appetite control throughout the day.

Ultra-processed foods (UPFs).

• UPFs are those that have added chemicals, colorings and sweeteners used to improve the food appearance or taste and to help it last longer. In fact, the chemicals are designed to stimulate the satiety center in the brain, and can lead to food addiction.

• Most supermarket snacks and foods such as pasta sauces, stir fry sauces and ready-made meals are classed as UPFs because they contain a lot of fat, sugar and salt.

• UPFs include foods that have been packaged, such as baked goods, snacks, fizzy drinks, sugary cereals, and ready-to-eat products.

• UPFs have been linked to over 30 different health issues, including obesity, cardiovascular disease, diabetes, depression, certain cancers, sleep problems and many more.

When you eating, you eating only.

• Avoid distractions like smartphones or TV while eating to prevent overeating.

• Listening to hunger cues: Eat only when hungry, and stop when full.

• Pay attention to portion sizes:

o For example, limit yourself to one slice of pizza instead of two.

o Use smaller plates to manage portion control.

• Avoid emotional eating: Recognizing patterns and finding healthy coping mechanisms.

• Chew thoroughly: Digestion begins in the mouth; eating slowly prevents overeating.

Meal planning tips.

• When shopping, don’t only look at the price tags, but look at the ‘front of package’ labelling to help identify healthy foods.

• Prepping in batches: Cooking meals in advance saves time.

• Balancing nutrients: Each meal should contain lean protein, healthy fats, and complex carbs.

• Portion control strategies: Measure servings.

Healthy snacking.

• Nut-based snacks: Almonds, nuts, or mixed seeds.

• Yogurt and fruit: A protein-packed, satisfying option.

• Vegetable sticks with a dip: A fiber-rich choice

Dietary myths vs snacks.

• Myth: Carbs are always bad.

Fact: Whole grains and complex carbs are essential for energy.

• Myth: Eating fat makes you gain weight.

Fact: Healthy fats, like avocado and olive oil, support metabolism.

• Myth: Skipping meals aids weight loss.

Fact: It leads to overeating later and slows metabolism.

Beware the SEE Food diet (“see food I eat “) diet.

When trying to lose weight, it’s normal for patients to feel overwhelmed, particularly if they’re aiming to lose a significant amount of weight. The idea of losing 30 pounds can feel like staring up at a mountain to some, Break the journey down into small, achievable goals, like focusing on losing one to two pounds per week for a period of time. Drinking an extra glass of water each day, incorporating protein into every meal, and even walking around the block after dinner are all great goals that will add up over time. 

Each step becomes a habit that can be built upon. Achieving each small goal gives you that boost of encouragement that is needed to keep going and working toward the next goal,

In summary, don’t only think about a bellyful, the cost of the meal, or the taste.  Your health should also be considered. Healthy eating means taking in a variety of foods you need to maintain health, feel good, and provide energy. These nutrients include protein, carbohydrates, fat, water, vitamins, and minerals.

World Hypertension Day 2025

 

                                                                          World Hypertension Day 2025.

Dr. C.V. Alert, MB, BS, DM.

Retiring Director, Heart and Stroke Foundation of Barbados.
Family Physician.

World Hypertension Day falls on Saturday, May 17, 2025. This year’s theme, "Measure Your Blood Pressure Accurately, Control It, Live Longer," highlights the importance of regular, precise blood pressure checks and management.

Watch video here: YouTube Link

How You should Get Involved:

• Check Your Blood Pressure: Visit a clinic or use a reliable home monitor to check your numbers. An ideal blood pressure for most adults is 130/80 mmHg or lower.
• Attend Screening Events: Encourage community participation in public blood pressure screenings.
• Adopt a Heart-Healthy Lifestyle: Reduce salt intake, exercise regularly, maintain a healthy weight, limit alcohol consumption, get adequate sleep, and quit smoking.
• Seek professional assistance:  If your blood pressure is persistently above 130/80 mmHg, then seek medical advice. A physician should be able to advise on appropriate blood pressure lowering therapies, of working out your chances of developing a severe complication of hypertension, and on avoiding further cardiovascular disease.

The Silent Killer.

Hypertension is often referred to as the "silent killer or sometimes the silent enemy" because it presents no symptoms yet can lead to severe complications such as heart attacks, strokes, kidney disease, and vision loss. Research conducted in Barbados and across the Caribbean consistently indicates:

• A rising number of individuals are affected by hypertension, with prevalence increasing over time.
• Many persons with hypertension are not even aware that they have the disease.
• Many suffer and die from hypertension-related complications, including heart attacks, strokes, heart failure, and chronic kidney disease.
• Significant numbers of hypertensive individuals neglect treatment, fail to adopt healthy lifestyle changes, or do not follow up with their doctors to ensure their blood pressure is within safe limits.

The Challenges of Hypertension Management.

Several factors contribute to poor blood pressure control across the Caribbean:

• Because they have no symptoms, many people don’t take the disease seriously.
• Some individuals rely on free anti-hypertensive medications from National Drug Formularies, making them vulnerable when pharmacies run out of stock.
• Clinical inertia, where some doctors fail to recognize or aggressively treat borderline high blood pressure in high-risk patients.
• Studies indicate persistent gaps in hypertension management over the years. For example, the ICSHIB study in Barbados (1995) found that 42% of treated patients had uncontrolled blood pressure. Twenty years later, the Health of the Nation Study (2015) reported the same figure: 42% of treated patients still had uncontrolled hypertension. There is a strong chance that in 2025 (this year) things have not changed.
• Many persons only visit their doctors when they are sick. With this “silent killer”, this visit may be too late. Routine medical visits can detect potential critical problems early, and intervene before it is too late. If you wait for symptoms of high blood pressure, the first symptom might well be a heart attack, a stroke or kidney failure. Or even (heaven-forbid) death. It can even lead to long term problems like dementia.

While public health clinics face immense pressure in caring for large patient populations, individuals can and must take charge of their health.

A Call to Action.

This World Hypertension Day, let’s shift the focus from treatment to prevention. By embracing the theme "Measure Your Blood Pressure Accurately, Control It, Live Longer," individuals must take control of their cardiovascular health through early detection and healthy lifestyle changes.