With the decline in the prevalence of many infectious or Communicable Diseases, there has been a steady rise in the burden of Non-Communicable Diseases, also referred to as chronic diseases. Experts say NCDs are the leading causes of death worldwide.
They include heart/cardiovascular diseases, cancers, diabetes, chronic kidney and respiratory diseases and are responsible for the majority of NCD-related illnesses and deaths in Nigeria.
The National Cancer Prevention Programme reeled out a frightening statistics that indicates that no fewer than 80,000 Nigerians die from various forms of cancer annually.
The World Health Organisation and the International Diabetes Federation report of 2014, says there were 3.9 million Nigerians who were diabetic.
The recent report by Stephen James Stroke Centre of Excellence in Abuja indicates that 168 people die of stroke daily in Nigeria, while 18 stroke cases are recorded every hour.
It also indicates that Nigeria records 160,000 cases of stroke annually and that is indeed, worrisome. It underscores the seriousness of the problem of hypertension and the endemic nature of chronic diseases.
Dr. Ebun Bamgboye, the President-elect of the Nigeria Association of Nephrology and Chief Medical Director of St. Nicholas Hospital, Lagos, says 36.8 million Nigerians (23 per cent) are suffering from various stages of kidney/renal disease in Nigeria.
The low income earners or the poor in the society are also affected, but the wealthy or people perceived to be the rich in the society and can afford the best of medical check-up and treatment in the best of health facilities around the world are most hit.
Often times, they manage and live with these diseases or never return alive. One begins to wonder why this trend?
Dr. Emmanuel Eche, the Medical Director of Providence Clinic, Isheri-Osun in Lagos State, told the News Agency of Nigeria that rich Nigerians are more prone to heart attack than the poor.
According to Eche, these health conditions that can lead to sudden death are more common among the rich. He says that the rich can afford to eat foods that cause high blood pressure and high cholesterol every day. Obesity, related to diet, is one major issue why affluent Nigerians are dying.
Eche said: “The affluence that comes with political offices in Nigeria is alarming. For instance, a man who used to be slim will suddenly become fat after taking up a political appointment.”
“He will suddenly start drinking more alcohol and eating westernised foods that encourage weight gain. They have chefs, drivers and others employed to do everything for them. They are not tasking themselves physically and the result is weight gain and the accompanying heart attack and sudden death.”
In the same vein, Prof. Ignatius Onimawo, a Professor of Human Nutrition at the Ambrose Alli University, Ekpoma, Edo State, says almost half of all deaths attributable to NCDs have nutrition as the predominant risk factor. Nutrition is the process of providing food necessary for health, growth and wellbeing; it plays a significant role in the quality of life and longevity.
Onimawo, a former President of the Nutrition Society of Nigeria, explained that most chronic diseases experienced in adulthood originated from the kind of nutritional habit in the first 1,000 days of life.
The period, he said, was a unique window of opportunity to prevent these diseases. He said the first 1,000 days of life, from pregnancy to a child’s second birthday, if not properly taken care of, was irreversible and could lead to the development of chronic diseases later in life.
He said: “Seventy per cent of brain development and normal formation of the organs such as the heart, kidney, pancreas, liver, body tissues and cells, take place in the womb. And when a pregnant woman does not eat rightly to get adequate nutrients, the foetus will be compromised.
“It will result to low birth weight, which is below 2.5kg as against normal birth weight, which from 2.5 kg to 4 kg. The remaining 30 per cent of a normal development of a child takes place from when the child is born till his second birthday.
“If the mother does not breastfeed this baby exclusively for the first six months of life and later with timely and adequate complementary feeding till he is two, we have little or no control over what happens later in life.
“A good example is if the pancreas is not properly formed, it will not produce enough insulin to prevent diabetes.
“That is why when such individual has grown with all the riches, resources and knowledge to eat right with adequate nutritional habits, the organs that were not properly formed during the first 1,000 days of life will not be able to handle or cope with those nutrients and they begin to have problems and fail.
“So, once these diseases set in, no matter how wealthy you are, there is little or nothing that can be done to cure them, but such patients could manage and live with the disease throughout their lives.”
Onimawo harped on the need to better educate expectant and nursing mothers to make informed decisions regarding nutritional care in the first 1,000 days of their babies’ lives.
By the same token, Prof. Ngozi Nnam, the National President of the Nutrition Society of Nigeria, told NAN that six months exclusive breastfeeding can remedy some of the problems associated with low birth weight.
Nnam lamented the low rate of adherence to exclusive breastfeeding in the country.
Nnam, a Professor of Public Health Nutrition, Department of Home Science, Nutrition and Dietetics, University of Nigeria, Nsukka, noted that most nursing mothers preferred to feed their babies with animal milk instead of the human breast milk.
He said: “The protein content in the animal milk is higher than that of the human breast milk, which is why an animal will be delivered today and immediately it starts to walk.”
“When you feed a baby with animal milk, it will cause the cells in the baby’s body to increase in number and size, more than it should. This is why a young child will grow fat, become overweight or obese and even look older than his or her age.
“Obesity comes with increased risk of chronic diseases and causes death such as hypertension, stroke, coronary heart disease, Type-2 diabetes, mental illness such as depression, breakdown of cartilage and bone within the joint and some cancers.
“Even when that obese child becomes an adult and tries slimming mechanisms, they may not work because those cells are still there in the body. Therefore, mothers refusing to breastfeed are disservice to themselves, the baby and to humanity. And when you child is fat, don’t take it as being healthy, that child is obese.”
On what can be done when the 1,000 days window opportunity has passed, Dr. Kemi Odukoya, a Consultant Public Health Physician at the Lagos University Teaching Hospital, Idi-Araba, Lagos State, says that affluence and urbanisation mean new kinds of unhealthy lifestyles. It also implies new kind of diet, physical inactivity, alcohol consumption, tobacco use among others which can increase the risk of NCDs.
Odukoya says that Nigeria has witnessed a rise in the number of fast food restaurants serving meals with high salt and sugar content as well as preservatives, often containing saturated fat. She says that this goes hand in hand with an increase in the availability of bottled drinks, adding that canned fruit juices were becoming fashionable and replacing natural fruits. According to her, these eateries are patronised by people across all economic bands in the society.
Odukoya said: “The working class and the wealthy in Nigeria consider eating outside as trending and as such, people of limited resources also tend to follow the emerging trend. These trends cause overweight, which is a risk factor for diabetes mellitus, hypertension, coronary heart diseases, renal disease and cancer.”
“Thus, an increasingly obese population will bear the increased burden of these chronic diseases. But one-third of these diseases can be prevented through lifestyle modification by eating healthily, maintaining normal weight, and exercising throughout life. Also avoid tobacco use and consumption of alcohol to address disease prevention, control risk factors and sustain good health.”
Dr. Emmanuel Enabulele blamed the lack of nutritional care practice by pregnant women and mothers on the deteriorating state of the economy.
He said: “In Nigeria, where the environment and the economy have been unfriendly with unavailability of resources, how do you expect a pregnant woman to eat the required foods?
“Or what she does not have and cannot afford? This is because these good foods are very expensive. Government at all levels need to do something about this problem by ensuring a better and affordable life for all the citizens.
“They can begin by ensuring that the health and nutrition of women and children are given adequate attention. Specific actions such as enlightenment and education programmes geared towards quality of diet to protect, promote and support breastfeeding needs to be improved upon and sustained.”