Category

Nutrition

Nutrition

Autism Spectrum Disorder

In my book – Differently Abled Nutrition (will soon be on your bookshelves), I mention that disability in childhood can have lifelong impact on a child’s physical, mental and emotional health, and their social situation when they become adults. Some children will be born with a disabling health condition because of illness, injury or poor nutrition. Differently Abled children include those with health conditions such as cerebral palsy, spina bifida, muscular dystrophy, traumatic spinal cord injury, Downs syndrome and children with hearing, visual, physical, communication and intellectual impairments. Today I will dedicate it to Autism Spectrum Disorder or simply autism.

It will soon be on your book shelves.

Arguably one of the most confusing disabilities, there is often nothing physically obvious about a child with autism setting them apart from other children. Autism is however a serious developmental disorder that impairs the ability to communicate and interact. It impacts the nervous system with a range and severity of symptoms. The common symptoms include difficulty with communication, difficulty with social interactions, obsessive interests and repetitive behaviours. Autism begins in early childhood and eventually causes problems of functioning in society and although there is no cure, early recognition, as well as behavioural, educational and family therapies may reduce symptoms and support development and learning.

Among many of the things that children with autism struggle with is feeding and because sometimes parents are not aware of the condition their child is struggling with or are frustrated with the burden of care, they end up beating these children or shoving the food down their throats during mealtimes which unfortunately does more harm than good. Feeding problems can range from mild to severe. They are often mild at the onset, but sometimes become severe because parents have difficulty managing their children’s challenging behaviour and end up enabling them. These children may also have preferences, refuse some foods now and then, and throw an occasional tantrum, but in other instances, they try different foods. “Children with autism, however, take selective eating to another level. For example, a child may want to only eat one type of food and if the parents don’t give that to him, he may respond with a burst of tantrums.”

Children with autism may often repeat behaviours or have narrow, restricted interests. These types of behaviour can affect eating habits and food choices, which can lead to the following health concerns:

  1. Limited food selection or strong food dislikes: 

A child or anyone with autism may be sensitive to the taste, smell, colour and/or texture of foods. They may limit or totally avoid some foods and even whole food groups. Dislikes may include strong flavoured foods, fruits and vegetables or certain textures such as slippery or soft foods.

2. Not eating enough (Low food intake): 

Children with autism may have difficulty focusing on one task for an extended period of time. It may be hard for a child to sit down and eat a meal from start to finish and you will have to monitor their eating habits to ensure that they have eaten.

3. Constipation: 

A child’s limited food choices, low physical activity levels, or medications can cause this. It can typically be remedied by gradually increasing sources of dietary fibre, such as bran cereals and fruits and vegetables, along with plenty of fluids and regular physical activity.

4. Drug interactions: 

Some stimulant medications used with autism can lower appetite. This can reduce the food intake of the child, which may affect growth. Other medications may increase appetite or affect the absorption of certain vitamins and minerals.

Caring for a child with autism can be challenging on so many levels, and healthful eating is no exception. A nutritious, balanced eating plan can make a world of difference in the child’s ability to learn how they manage their emotions and how they process information. Because children with autism often avoid certain foods or have restrictions on what they eat, and have difficulty sitting through mealtimes, they may not be getting all the nutrients they need. This calls for careful attention to their behaviour in order to correct the deficiency as well journeying with a nutritionist/dietician to design a meal plan tailored for your child. One thing to note however is every autistic is unique and requires an individualised plan based on their autistic symptoms.

Early recognition, behavioural, educational and family therapies may reduce symptoms and support development and learning.


Nutrition

We all are potential refugees

Some nights I love to stay up late and watch Straight talk Africa. Lately, I was following a series they were airing called a day in the life of a refugee. The stories were very mind-boggling and it dawned on me that each one of us wherever we are, is just an insurgency away from being a refugee. I watched in a mixture of emotions the plight of these men and women with their families just trying to make it to safety and try to forge a living. A life once perfect, snatched away by a group of selfish people who could be fighting from the effects of their ego, who knows? But like an African proverb reads, “When elephants fight, it is the grass that suffers

A day in the life of refugees

According to Wikipedia, A refugee is a displaced person who has crossed national boundaries and who cannot or is unwilling to return home due to well-founded fear of persecution. In other words, a person who has been forced to leave their country to escape war, persecution, or natural disaster.

As of the end of 2020, the refugee statistics were at 82.4 million people compared to 79.5 million people who were forcibly displaced worldwide by the end of 2019 according to The UN Refugee Agency (UNHCR) all this being as a result of persecution, conflict, violence, human rights violations or events seriously disturbing public order. More than two-thirds of all refugees (68%) were from five countries [ Syrian Arab Republic – 6.7 million, Venezuela – 4.0 million, Afghanistan – 2.6 million, South Sudan – 2.2 million, and Myanmar – 1.1 million]. 39% of these were being hosted in five countries including Turkey hosting the largest number of refugees with nearly 3.7 million people, Colombia – 1.7 million, Pakistan – 1.4 million, Uganda – 1.4 million, and Germany – 1.2 million. 35 million (42%) of these were children below the age of 18 years and a whole 1 million children were born as refugees between 2018 and 2020, an average of between 290,000 and 340,000 children being born into a refugee life per year.

The reason I labor to put out these statistics is to show you that the burden of not only being a refugee but also being a refugee host country seeing that my country (Uganda) is one of the five countries hosting the highest number of refugees in the world. Refugees face a plethora of challenges including cultural barriers, access to basic needs like shelter, health care, clothing, a livelihood to mention but a few. The malnutrition burden alone among refugees leaves you teary. On the other hand, countries that host refugees grapple with several endless challenges as a result of opening their borders for these people including environmental degradation during the process of setting up camps, insecurity spillovers from the conflict in the country of origin, high economic and social costs to mention but a few. Now in this Covid era, one can only imagine what the refugees and refugee host countries are going through.

Much as opening borders is the right thing to do, many a time this influx often impacts the politics and governance of the host countries. Some people often ask why refugees are ‘prioritized’ over the citizens, arguing that many people are also in worse situations than the refugees in the country but more often than not they are not thought of, or maybe not enough. The issue of refugees has for a long time also been one of contention even within the European Union (EU), with some member countries divided over the matter. Countries like Hungary, for example, refused to take in their quarter share of refugees entering Europe, arguing that it would strain her economy. This leaves me wondering what the best approach to handling this refugee influx should be given the fact that we are all potential refugees. You do not want to be caught in a situation where you close your borders to refugees only to face the same fate years later and you are left with nowhere to run to for safety.

I was following a Twitter thread for Straight Talk Africa, where we were being asked “Can those (refugees) who have escaped conflict return home?” This would have been the answer to all those questions or say concerns I point out above I suppose, right? No, unfortunately, it is not as easy as I may want to think; a friend of mine Musanjufu Benjamin said, ” These crises that make our brothers and sisters flee are caused by those same countries, that produce the guns; they control the plunder of natural resources that lead to disorder.” I couldn’t agree more. What he was essentially saying was that we keep burying our heads in the sand seeming to find solutions to the problem yet overlooking the root cause.

The Bigger question –
Are we burying our heads in the sand?

Could this be the answer to reducing the influx of refugees in host countries and reducing the burden on them or is there somewhere we are not looking?

Tomorrow we are going to look at the sickening plight of refugees with a focus on the malnutrition burden.

Culture, Nutrition

Food taboos, do you they work for us or against us?

Taboos are a part of every culture and among these are food taboos. Anything that is taboo is strictly forbidden, for cultural or spiritual reasons. Those known to have transgressed taboo are punished, and may be cast out of their society. In the days of old, these taboos served a purpose of enforcing discipline and control in society although many of these were many a time affecting only a section of society who were the children and women. These days however, a taboo is usually seen as a magic concept with no real basis although there often is reason for it, at least within systems of belief, some of which are now termed ‘religions’, others ‘philosophies’, and others ‘superstitions’. Food taboos are deeply entrenched and their rationale may be religious, cultural, hygienic, historic or economic.

Reggie Annan, a lecturer/Public Health Nutritionist at Kwame Nkurumah University of Science and Technology says ” In Africa, as in many other parts of the world, what people say and do is strongly influenced by age-old supernatural beliefs, which Christian missionaries downgraded as ‘superstition’. In Africa, as in Asia, older and country people still may live as much in the realms of the supernatural and the afterlife, as in the physically living realm”

In Africa, many cultures forbade children and women from eating most of the protein rich foods from animal sources like chicken, eggs, pork, goats milk to mention but a few. But like we said many of these had a super natural belief attached however behind closed curtains, a justifiable reason was given. For example in Ghana, children were not allowed to eat eggs for it was believed that if the child was fed on eggs, they would end up thieves. This practice has faded in current times although some areas still hold onto this practice and children themselves will refuse eggs when they are offered to protect themselves from becoming thieves. Trying to understand why this supernatural belief existed, this is the explanation that I was given which turns out to be for economic reasons, “it was feared that when children were fed very well or were brought up luxuriously, they would resort to stealing to maintain opulent ways of living when their parents can longer afford or when they grew up. And so to avoid this situation, children were not allowed foods considered to be luxuries.” Whilst this made alot of sense and I believe it was done in the best interest of the children, it served more harm than good. You see, children need eggs more than anyone as they are growing because eggs are a very good source of proteins that is most required yet here they are worrying about not becoming thieves. It is even more unfortunate that some superstitions found their way to breastfeeding in some cultures and some of these will shock you. In some cultures, it was believed that milk given to babies in the night would be sour their stomach so teas were given instead. Lactating mothers who had sexual intercourse with a man who was not the father of the child, were at risk of giving the baby ‘bad’ milk or the baby picking germs. The most surprising of them all I came across was that unless a drop of breastmilk is squeezed into the rectum of the baby, milk from the breast of a woman who has been working in the sun and sweating would make the baby sick. All these worked against the baby who would end up losing out all the benefits of breastmilk and end up malnourished.

Food taboos have an impact on dietary intake and nutritional status of the affected persons. In Uganda like other parts of Africa, tribal food taboos, especially as applied to women and female children, have been one of the main causes of malnutrition. Kwashiorkor which is a form of severe acute malnutrition has been one of the common occurrences here in Africa and food taboos together with poverty have played a big role in this. In addition to the examples I have pointed above, I will give you another case in point to drive the point home. For so long here in Uganda among many cultures, it was a taboo for a pregnant woman to continue breastfeeding even when the older child was less than six months. It was believed that continuing to breastfeed would harm the growing child therefore such mothers stopped breastfeeding as soon as they found out that they were pregnant. On top of stopping to breastfeed, these children were often neglected because mothers turned all their attention on the pregnancy and preparation for the coming child. Hence the older child became malnourished. The indigenous people in those days did not realise that these children were suffering from malnutrition because they had been prematurely weaned, were being inadequately fed, and receiving poor care.

This leaves me with the question that where do we draw the line between respecting culture by upholding the taboos and violating them to preseve life.

What food taboos exist in your culture? What superstitions accompany them and have you found out the reason behind the closed curtains. Also have you ever wondered why there is almost no food taboo that affects the men?

Culture, Nutrition

Uganda’s native foods

You have probably heard people talk about a staple food and maybe or maybe not you have wondered what in the world a staple food is. A staple food is a food that is eaten routinely and in such quantities that it constitutes a dominant portion of a standard diet for a given person, supplying a large fraction of energy needs and generally forming a significant proportion of the intake of other nutrients as well. It is eaten regularly or even daily. We have about 41 tribes here in Uganda and each of these have a staple food that has been handed over generations down since time memorial although many tribes share in the regions where they are. These staple foods are mostly shaped by the geographical conditions of the area where these people hail.

Uganda is generally an equatorial country although the climate is not uniform as temperatures and rainfall vary with altitude across regions. The southern part of Uganda is more rainy, and the rainfall is generally spread throughout the year. On the northern shore of Lake Victoria, the rain falls from March to June and from November to December. In the southwest, on the border with the Democratic Republic of the Congo, it rains heavily all year round. The northeastern region has the driest climate and is prone to droughts in some years. Annual rainfall ranges between 500 mm in the northeast and 1300 mm in the southwest. However today let us look at the different staples and native foods that shape our cultures in Uganda

Overall, plantains (also commonly known as matooke here in Uganda) and cassava are the most common staple foods in Uganda. Plantains or simply matooke are starchy bananas that are cooked and consumed as a staple which you will find as a part of most household diets here. Plantains are common in the central, western, and southern regions whereas cassava is very in eastern, northern, and northwestern Uganda. The other staple foods we have in Uganda include sweet potatoes, Maize, wheat, rice, millet, groundnuts, sorghum, to mention but a few. Food staples vary from place to place like earlier said, depending on the food sources available. Most food staples are inexpensive, plant-based foods and usually full of calories for energy. From the examples given above you can see that cereal grains and tubers are the most common food staples. Although staple foods are nutritious, they do not provide the full, healthy range of nutrients. People must add other foods to their diets to avoid malnutrition.

You maybe wondering the ‘other foods’ I am referring to that ought to be added to get the rest of the nutrients. These ‘other foods’ are called complementary foods and just as their name suggests, these complement the staples. They may not be routinely eaten and not in large quantities as the staples but the serve an essential role in meeting nutritional requirements. They are also more expensive compared to the staples. They include protein sources like meat, poultry, fish, legumes and milk products; energy sources like fats, oils and sugars; and vitamin and mineral sources – fruits, vegetables and animal products. Just like the staples they are varied in regions depending on their way of living, for example fish will be found common in the Albertine region and Lake Victoria basin while milk products will be found among regions that herd cattle.

That being said, I will leave you with Uganda’s must trys when it comes to native foods. These comprise of most of Uganda’s staple foods in all regions that we have.

Matooke

Being the most common staple food is Uganda I will start here. It is a type of plantain belonging to the East African Highland Banana group that can be peeled and be boiled in water, steamed in banana leaves then squeezed to make a golden yellow mash or else boiled together with ground nuts, beans or meat, offal to make the delicious meal commonly known as akatogo. Another type of plantain that is enjoyed by many is Gonja which can either be steamed or fried. Matooke can also be cooked without being peeled to make a dish known as mpogola or roasted in hot ash which is a very tasty meal accompanied with a complementary dish of choice. Probably what makes it even more common is the various options of preparation that it has.

Luwombo

This is a very common dish that has spread to almost all parts of the country with it’s roots in Buganda. History tells us that it was invented by Kabaka Mwanga’s personal chef in the 19th century, in 1887and was meant to be eaten by the royal family. Over the centuries, this opened up to his subjects and is now popular in most parts of the country. Because of it’s length of preparation, it is preserved for special days like Christmas, Easter, Eid, weddings, introduction ceremonies, business meetings and also when one has important visitors at home. There are restaurants however that have made it part and parcel of their daily menu and one does not have to wait for a special day to enjoy it. Luwombo can be prepared using chicken, smoked fish, beef, goat meat, mushrooms and ground nut (peanut) sauce. The ingredients are put in smoked banana leaves to give the luwombo the best aroma. Note that smoked beef or goat meat also make very delicious luwombo. Recently I found out that there is pork luwombo which I am yet to try.

Akaro

I have decided to use my native language for this but this is a mixture of millet or sorghum flour and cassava that is mingled with boiling water until it stiffens and becomes solid. The mixture of the ingredients differs as some tribes prepare it with less proportions of cassava and others with more cassava flour while others prefer it with no cassava. For instance the Bakonjo enjoy just mingling cassava flour known as Obundwe whereas people in eastern Uganda enjoy Atapa where more cassava flour is mingled with less millet flour. In Western Uganda it is millet with less cassava, they do not use sorghum and it is known as Akaro

Malewa

I got the privilege for tasting this for the first time in my life just a few weeks ago and if I had not seen it before preparation, I would have sworn that it was fish. This is a popular meal in Eastern Uganda where soft bamboo shoots are harvested, dried, cut into smaller pieces and boiled. Groundnut or peanut sauce is added and boiled together with the shoots until it is ready to be eaten. It is commonly enjoyed by the Bagisu, they serve it with Matooke and will leave you biting at your fingers.

Eshabwe

Have you ever imagined fat and salt making a delicacy? This is a traditional meal for the Banyankole, one of the tribes in western Uganda, although just like luwombo, it has gained popularity in other parts of the country too. It is prepared by using mature ghee of about 2 or 3 weeks, salt, cold boiled water and rock salt. For a variety and enhanced taste, some go ahead and add smoked meat.

Malakwang

Originally, this dish was reserved for dry seasons when food was scarce. Originating from the northern region, it is prepared using sour vegetables together with groundnuts and can be served with sweet potatoes and millet bread. Gone are the days when the dish was reserved for dry seasons, it is now eaten almost everyday given its affordability and it is also gaining prominence in other parts of the country.

Firinda

Growing I dreaded the day we had this on the menu. The work that went into un-shelling of the beans was exhausting especially those last 5 beans that would take forever. Firinda is a traditional meal popular among the Banyoro and Batooro in Western Uganda and is prepared by soaking the beans for a night and then they remove the husks. They are then boiled until they are soft and mashed into a porridge like consistency (puree); tomatoes, onions, ghee or smoked meat are added to make the firinda get the perfect taste and aroma. Other ingredients that can be put are vegetable eggs, pumpkin leaves, eggplants. The Bagisu and Acholi also enjoy this sauce and it is served with Akaro, sweet potatoes, cassava.

Removing the testa from beans to make firinda

This is not all of the native foods, I have sampled just some of the most common ones in all the regions. Food shapes any culture or society and it would be interesting for you to try out all these if you happen to come to Uganda.

Faith, Nutrition

Food culture and religion

We got to see yesterday that culture dictates the type of food eaten by a particular set of people of the same ethnic grouping and we also said that we cannot talk culture without talking about food. Interesting the angle that we are looking at today is line with food now being a sole factor in the identification of a group or an entire nation with emphasis on religion. I am a Christian, and in particular a catholic and the one thing that is widely known in connection to food is that we consume alot of beer and pork. That in itself is an identification.

The role of food in cultural practices and religious beliefs is one that is complex and is very varied among communities. Understanding the role of food in cultural and religious practices is important as a sign of respect and response to the needs of that community. If you happen to be in a profession like mine where we attend to people’s dietary needs, you don’t want to be caught off guard recommending a type of food that is a taboo in one’s culture however nutritious it maybe. For example, pork is a good source of high biological proteins that are very beneficial for someone’s health, but according to the religious cultural practices of Muslims this cannot be consumed. Recommending this will certainly be an insult to someone practicing that faith. People practicing the Hindu religion do not eat meat or anything that involves taking life, so it is important that you do not assume someone’s religious practices and beliefs, if in doubt, it does not hurt to ask. You may find that the restrictions could go as far as the utensils used. Detailed below are some of the dietary practices of some religions;

Christianity

The various faiths of Christianity include Roman Catholic, Orthodox and Protestant. The regulations governing food and drink differ from one to the next, including some faiths that don’t advocate any restrictions. Individuals may choose to forgo alcohol and may choose whether or not to eat meat.

Some of the food beliefs and practices may include:

  • Some Catholic and Orthodox Christians observe several feasts and fast days during the year. For example, during lent, the practice is that the faithful fast or avoid red meat on Fridays, if one must eat meat then it should be white meat like fish.
  • Most Protestants observe only Easter and Christmas as feast days and don’t follow ritualised fasting.
  • The ritual of communion is regularly celebrated by many Christians and this involves eating bread and drinking wine (or substitutes) to represent the body and blood of Jesus Christ.
  • Some Christians don’t drink alcohol at all. These include many members of the Salvation Army and other Protestant churches like the Pentecostals.
  • Mormons and Seventh Day Adventists also avoid caffeinated and alcoholic beverages. Many Seventh Day Adventists don’t eat meat or dairy products. Those that do eat meat don’t eat pork.
  • Self-denial (of food), or fasting, is sometimes considered to be ‘praying with the body’. It is believed to improve spiritual discipline by overcoming the sensations of the physical world and focusing on prayer and spiritual growth. It may also be used by some Christians as a way of connecting with those people around the world who regularly face starvation or malnutrition.

Islam

Moderation in all things (including eating and dietary habits) is central in Islam. When done according to the way of Allah, daily acts like eating are considered a form of worship.

Muslims eat halal (lawful) foods, which include fruit, vegetables and eggs. Any meat and meat products they consume must be from a halal slaughtered animal, this includes the person who has done the slaughtering too. Milk and dairy foods are halal, cheese may be halal depending on ingredients. Haram (prohibited) foods on the other hand include pork, crustaceans, blood, non-halal animal-derived additives such as gelatin or suet, alcohol and any foods containing alcohol as an ingredient.

Fasting is required during Ramadan, the ninth month of the Islamic calendar, when Muslims must refrain from consuming food, liquids between sunrise and sunset. However some individuals are exempt from fasting, like the pregnant, breastfeeding or menstruating women, children under 12 years, older people and chronically or acutely ill people.

Judaism

Food forms such an integral part of a practicing Jew with Jewish ‘food laws’ dating as back as more than 3000 years. These laws contribute to a formal code of behaviour that reinforces the identity of this community. Judaism requires that food is kosher, meaning the food must meet the standards of kashrut. Kashrut refers to the laws pertaining to food in the Jewish religion, and Kosher means that a food is ‘fit’ or permitted.

The only types of meats acceptable are cattle and game that have cloven hooves and chews curd. Sheep, cattle and goats may be eaten as they meet the requirement, whereas pigs cannot be eaten as, although they have cloven hooves, they do not chew curd. After slaughter, forbidden blood, veins and certain fats must be removed.

Chicken, turkey, goose and duck can be eaten, but other birds are forbidden. Eggs from kosher birds can be eaten as long as they do not contain blood.

Dairy products from kosher animals may be eaten, although meat and dairy cannot be eaten together. There are rules forbidding the mixing and consumption of dairy products with meats. The law requiring the separation of meat and dairy products is strict that it includes the need for separation of utensils used and bread should not contain dairy products. Only fish with scales may be eaten and shellfish is forbidden. Fruit and vegetables may be eaten.

Buddhism

Buddhists avoid harming any living thing therefore killing animals for food is wrong. As a result, many  Buddhists are vegetarians. It is believed that Buddha cycled through various animal forms before attaining the form of a human being in his multiple lives on Earth so killing of animals is forbidden. Buddhism proposes that violence or pain inflicted
on others will rebound on you, hence some Buddhists believe that a contributing cause of human aggression is violence against animals.

Hinduism

Hindu dietary customs are based in the belief that the body is composed of fire, water, air and earth, and that the food you eat can either balance these elements or throw them out of balance. Hindus believe that all living things have a soul, and strongly believe in the concept of reincarnation, making Hindus reluctant to kill any living creature, therefore majority of Hindus are lacto-vegetarian (avoiding meat and eggs), although some may eat lamb, chicken or fish. Beef is always avoided because the cow is considered a holy animal, but dairy products are eaten. Animal-derived fats like lard and dripping are not permitted.

I do not know what religious affiliation you belong to but you will be surprised that there are dietary laws that are pertained in there, each having a significance in the upholding of your faith. You may want to find out.