Lutgard Musiime - Page 6 of 31

Childhood obesity, the ticking time bomb

July 13, 2022

According to the Global Nutrition Report of 2021, Globally, we are off course to meet five out of six global maternal, infant and young children nutrition (MIYCN) targets, on stunting, wasting, low birth weight, anemia and childhood overweight. We are also off course for meeting all diet-related non-communicable disease (NCD) targets, on salt intake, raised blood pressure, adult obesity and diabetes.

Worldwide 38.9 million (5.7%) children are overweight. Child overweight is on the rise, as is the prevalence of adult obesity (12.3% among men and 16.2% among women, compared with 9.2% and 13.2% in 2010). The prevalence of overweight (including obesity) in children and adolescents has increased worldwide, from 17.0% among boys and 15.5% among girls aged 5–9 years, and 14.4% and 13.8% respectively among adolescents (aged 10–19 years) in 2010 to 24.5% (male) and 21.4% (female) among children and 20.2% (male) and 18.4% (female) among adolescents in 2019.

If the numbers do not move you, try going into the supermarkets on a Saturday in Kampala, the sight is worrying. The number of visibly overweight children is disturbing.

Childhood Obesity also known as pediatric obesity is a condition in which a child is significantly overweight for his or her age and height. Obesity in a young age creates a serious risk of type two diabetes, high blood pressure and high cholesterol. I once read a quote that said “If we stuff our children with fast food and cans of soda, do they become ticking timebombs of poor health? Ready to explode at any moment into fully-fledged type two diabetes?“

Lifestyle issues as well as eating habits is most to blame for this. There is need for public health prevention. I like to say we can never speak enough until we see a desirable change. From the moment a child is born parents need to be guided more since it is them who decide what’s eaten in the house. We live in an era where parents have ‘little time’ to prepare healthier meals and opt for convenient foods which are mostly fast foods and highly refined there by increasing the risk of these children to obesity.

Preventing Childhood Obesity - HealthScopeHealthScope

Tips on preventing childhood obesity

Promote a healthy lifestyle

This is the first stop in fighting this battle. Nutrition is such a big determinant of how a child lives and thrives in life. Matter of fact, a compromised nutrition status of a child has long term effects in a child’s life and we emphasize good nutrition for children especially those under the age of five because they are at the peak of their growth. Healthy meals and snacks are important for provision of nutrients for their growing bodies while modeling healthy eating behavior and attitudes.

Children even at a tender age can be given nutrition education and ought to be involved in the process of getting their food onto their plates such that they develop and adopt a healthy lifestyle that they will carry on through out their lives. Include regular age appropriate physical activity in the lives of these children and reduce sedentary activity such as watching television.

Next time when you are packing your child’s lunch box, think better the foods you are choosing to include.

Be a role model

Walk the talk dear parent. Children learn the most be observation. Having healthy meals, participating in regular physical activities will set the stage for your child. Gradually work to change the family’s eating habits and activity levels if you are not doing that already.

If your child is already overweight, refrain from the temptation of putting your child on a diet, they will miss out on key nutrients they require for their growth. Instead of focusing on their weight, turn your attention to changing the undesirable behaviour and the weight will even out as their height increases.

Do not use food as a reward or withhold food as a punishment

The relationship with food just like any relationship is important. Children need to learn how to respect their hunger and fullness cues. They need to learn that people eat when they are hungry and stop eating when they are satisfied. Whenever these cues are overrun, children tend to over eat thus promoting overweight.

Using food as a reward may be a problem as children will fail to eat once a reward is not in view.

Reduce sugar and fat

Refrain from giving children beverages with added sugars and reduce processed foods as these have alot of fat. In addition to increasing the risk of being overweight when children consume beverages with a high sugar content and foods with high fats, they also lose appetite for healthier meals which they need anyway.

Seek medical intervention early

It is important that if you have concerns about your child’s weight, you speak to a physician early. Ensure that your child’s growth in regularly monitored and implement all the things that you are advised to do knowing that it is in the best interest of your child and your wallet.

Share with me some of the ways you using to avoid your child from becoming overweight or if your child is already overweight what are you doing to make the situation better.

See you next Wednesday

Nutrition

Maternal mortality

July 6, 2022

Yesterday I woke up to a disturbing story in the New-vision newspaper of Tuesday, 5th July 2022 and this is what it read. “16 mothers die everyday due to negligence, extortion” A story is told of a mother, 23 years of age from Kiboga district who loses her life and that of her new born baby because of lack of platelets at the hospital as well as where she was transferred (Hoima Hospital). The different accounts given of what took place that day are even more disturbing. This is one of the many stories you will hear about maternal mortality in Uganda.

SDG 3-Target 1

Sustainable Development Goal (SDG) 3 target 1 is to reduce the global maternal mortality ratio to less than 70 per 100,000 live births by 2030. According to the Uganda Demographic Health Survey (UDHS), maternal mortality rates refer to the number of maternal deaths per 1,000 women age 15-49. The number of deaths is the number of sisters reported as having died in the 7 years preceding the survey either during pregnancy or delivery, or in the 42 days following the delivery, by their age group at the time of death. Deaths due to accident or violence are excluded. The maternal mortality ratio for the 7-year period before the 2016 UDHS is estimated at 336 maternal deaths per 100,000 live births. We have only 8 years to reduce this number if we meet our SDG 3 target goal 1. (With our current situation I cannot tell you that I am very confident).

This not only grieves my heart but also freaks me out because that can be me or anyone I know. No one deserves to die giving life for goodness sake neither does a child deserve to die coming to life. Some of the reasons given for these number of deaths in the newspaper article include; lack of infrastructure, gaps in human resources, inadequate supplies and commodities, knowledge and skills gap among health workers to mention but a few. The question for you and I is what can we do?

According to a report on Reducing maternal mortality by UNFPA, almost all cases of maternal mortality are preventable but if this is so, what is failing us and causing so much grief to you and I? A lack of information among many is one of the reasons sighted and if just 2 sentences in this blog will help prevent just 1 mother from dying at their next child birth, my life is more than complete.

Where to start

Teenage Pregnancy | Plan International

Teenage pregnancies

An old saying goes ” Prevention is better than cure”. According to World Health Organisation, The risk of maternal mortality is highest for adolescent girls under 15 years old and complications in pregnancy and childbirth are higher among adolescent girls age 10-19 (compared to women aged 20-24). Teenage pregnancy and motherhood has been a major health and social concern in Uganda for some time.
The 2016 UDHS results showed that 25% of women age 15-19 have begun childbearing; 19% have had alive birth, and 5% are pregnant with their first child. The health, social and economic consequences that come with teenage pregnancies are too undesirable therefore better to prevent than to deal with the consequences. The next you are drawn to a teenager, think about the many things at stake especially for the girl. Do not let the wig and booty fool you. It could be your sister someone is messing with. It can surely wait.

Pregnancy related complications

These may not be completely done away with but something can still be done. Many of these develop during pregnancy and most are preventable or treatable. Other complications may exist before pregnancy but are worsened during pregnancy, especially if not managed as part of the woman’s care. These pregnancy related complications include but are not limited to severe bleeding (mostly bleeding after childbirth), infections (usually after childbirth), high blood pressure during pregnancy (pre-eclampsia and eclampsia) to mention but a few.

First and fore most the onus is on you to care for your own life. No one will like or love your life more than your self thus the need to choose you first. Your mother, man or pastor will not do that for you. Dear lady don’t wait to conceive to start on the healthy journey. Some of these complications like severe bleeding, pre-eclampsia can be avoided or at-least their severity reduced if you prepared your body early enough. Pregnancy is an intense period that requires all hands on deck for you to go through it and bring forth healthy life. Take care of your body if you have plans of creating life so that we can avoid or reduce the risk of maternal mortality.

I cannot over emphasize the need for antenatal care. I know of some people who go only to find out the sex of their child and that is it. Why do you do yourself a disservice to this extent? It is in routine antenatal care visits that unwanted pregnancy and other post pregnancy complications can be prevented. Going back to the story I began with, low platelets in the blood can be detected early enough during these visits and early preparations can be done. Yes! I know our hospitals are not doing the best but atleast let us do our part. Remember no one will love your life more than you do. Do not give up the fight. Ask as many questions as you can, even those you consider silly or obvious. It could be the one to save your life and the unborn child.

Kolhapur illegal abortion

Unsafe abortion

According to World Health Organisation, nearly 8 % of maternal deaths worldwide are abortion-related and 99.5% of these occurring in developing regions. In Africa, 99% of abortions are unsafe resulting in one maternal death per 150 cases. It is high time we embraced comprehensive sexuality education to avoid having our girls finding themselves at cross roads that may warranty abortions. Culprits who defile, rape girls and women ought to be seriously apprehended and let us save the mothers of this nation.

These are some of the things I could point out for now, what do you have in mind? Please share with me in the comment section. If you think this is worthy information to pass on to someone for whom it can benefit, the pleasure is all mine.

Thank you for always coming back

See you next Wednesday.

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Nutrition

Why no salt and sugar for babies until they turn one

June 15, 2022

When babies are ushered into this world, they are very dependent on us for literally everything including what goes into their bellies as food. Children are supposed to be exclusively breastfeed for the first six months of their lives and there after introduce solid foods alongside breastmilk, what we call complementary feeding.

When we introduce solid foods to our children, there is no doubt that we want to make their food as ‘tasty’ and enjoyable as we would want to taste it so we figure we can always add some sugar and salt to their food so that it is not as bland but your child DOES NOT need the sugar and the salt until they are one year. I know you are wondering why, and I will tell you.

Why No Salt and Sugar for babies till 1 year?

Why you should avoid adding salt to your child’s food

Compromised kidney function

Babies have just made an entry into the world and development is still ongoing. They have a delicate system and salt may effect their kidneys. Their kidneys are unable to process a high amount of added salt. As a matter of fact children below the age of one are supposed to have less than 1g of sodium per day according the Scientific Advisory Committee report on Nutrition (SCAN).

Kidney stones

Excess sodium from salt can cause the body to excrete more calcium in the urine. This calcium can form kidney stones that carries with it severe pain in the body, fever and chills, nausea and vomiting, burning sensation while urinating, and blood in the urine. I am not sure you want that for your baby.

Brittle bones

An increase in sodium levels in the body, in turn, causes excretion of too much calcium. We all know how important calcium is for a growing child, they need for the development of strong bones and teeth. Calcium depletion can lead to a condition called osteoporosis which makes the bones thin and brittle.

Hypertension

Did you know that just like in adults, babies too can develop hypertension also known as high blood pressure and high salt intake can cause it.

Dehydration

Last but not least, unlike adults, babies are not be able to indicate that they are thirsty, d until serious symptoms show up. Babies who have excess salt in their bodies are in danger of dehydration, as salt causes the body to lose water in the form of urine and sweat thus increasing their risk of getting kidney stones, joint and muscle damage, constipation, and liver damage.

Why you should avoid adding sugar to your babies food

Sugar lacks protein, fat, and nutrient density which babies need the most at this point in their life and when the sugar is in excess, can lead to an increased risk of obesity, high blood pressure, and dental caries.

It is also important to mention that babies have an innate preference for sweetness, so it’s important to give them ample time to develop a palate for healthy foods that do not contain added sugar. If this not done, the struggle to consume healthier options of food will be an uphill task.

Have you noticed that when toddlers are given sugar or foods with high sugar content they become hyperactive? The same will happen to your baby and the reason is that since sugar is absorbed into the blood very quickly, high sugar consumption causes the blood sugar levels to shoot up. This leads to higher adrenaline levels and causes hyperactivity in children.

Why should You Avoid Sugar and Salt in Your Infant's Diet

In conclusion

Babies’ sugar and sodium (salt) needs can be met in the breastmilk and the natural foods that they are consuming. The reason your baby could be resisting breastmilk could be that they were introduced to salt and sugar early and they are now missing out on the immense advantages of breastmilk.

Increase the variety of foods prepared for your baby as a way of adding flavor to your child’s diet and carefully read the nutrition labelling of manufactured foods for babies that you opt to buy taking into consideration that sodium and sugar content therein. Fruits like bananas are a good source of natural sugars so there is no need for added sugars.

I will end by saying DO NOT give honey to babies either.

See you next Wednesday

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Nutrition

Weight is not an indicator for health

June 8, 2022

Someone once asked me if I could tell whether someone is healthy by just looking at their size. The short answer is no. Weight is not an absolute indicator of health although it is an important factor for health. Weight has to be combined with other measures to fully assess well being.

It is common for us to associate small bodied persons with being healthy and having normal weight compared to the bigger bodied persons. I want to tell you that this can be misleading for many.

There are studies that indicate that weight is not an accurate measure for health. In one study researchers found that almost one-quarter of adults who were classified as “normal” weight, or approximately 16.3 million people nationwide, have indicators for one or more of the risks usually associated with being overweight such as elevated blood pressure or higher levels of triglycerides, blood sugar and cholesterol.

In another study researchers at UCLA and the University of Minnesota evaluated nearly two dozen studies and concluded that there was “no clear relationship between weight loss and health outcomes.” In other words, shedding pounds didn’t meaningfully lower blood pressure, diabetes risk, or cholesterol. In other words equating being heavier with having poor cardiometabolic health and being thin with the opposite is way off the mark.

Health

What should we consider?

Adopt healthy behaviors

Weight is very important in this journey of health and should never be ignored however it alone is not indicative of health, so nobody can tell whether or not a person is healthy based on their weight solely. Healthy behaviors are more important than the number on the scale. I have seen people who are relatively big but have better fitness levels and lower cholesterol levels than their smaller counterparts. Being physically active, eating nutritious foods, and quitting smoking, socializing enough to avoid isolation, minimizing stress, and managing depression are some of the healthy behaviors that will get you thriving and living longer and not necessarily fitting in those skinny jeans.

Before you run for the slimming teas hear this

Who is guilty for looking at a big bodied person and scoffing, “She/He is so unhealthy.” and you are there feeling sorry or concerned for them? Fitness in most cases is not equal to the shape. There are many big bodied people who are very fit and the numbers that are seen on the scale do not only indicate fat. Muscle too contributes to weight therefore before you go running for the slimming teas, find out what your weight is composed of and adjust accordingly. Talk to a professional and adjust from an informed point of view.

Weight is not just the calories you take in and the ones you lose, it is more complex

Weight is so complex with so many variables involved; genes, ethnicity, medication taken, the environment where you live, mental stability, financial state, how much you sleep all play a role. Concentrating on only the caloric intake can be very misleading if the rest of the factors are not put into consideration.

Together with your healthcare provider you may want to explore all these factors before you ‘kill’ yourself.

Stay away from extremes

Much as I have emphasized that weight in itself is not an indicator for health, extremes either are not good. Being underweight or overweight will land you in a place you would rather not be. Your Body Mass Index (BMI) is a good indicator for health and your weight together with your height will be used. Watch your weight and talk to a professional whenever you catch something off or anything gets concerning.

Health

In Conclusion

Weight is a contributing factor to health and cannot be ignored but we cannot use it in itself as an indicator for health. It’s no secret that both thin and fat people can develop heart-related problems but also there is a likelihood for a thin person to develop a heart related disease and a fat person does not.

Watch out for your weight but do not get depressed over it, there is more to life than the number on the scale.

See you next Wednesday.

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Nutrition

Prenatal nutrition

June 1, 2022

We have always talked about the importance of prenatal nutrition but we still do not appreciate the magnitude of the effects as we should and it is my goal to help us understand in the easiest way. Listen to this.

If a pregnant woman found herself in a situation where her nutrition conditions are poor for example in times of famine, war or simply food scarcity, a pregnant woman can modify the development of her unborn child such that it will be prepared for survival in an environment in which resources are likely to be short. Whereas this may sound like a good or let us say reasonable thing nature allows so that in whatever situation, life can be brought forth, it has a downside to it.

In 1992, Nick Hales and David Barker proposed a hypothesis that an undernourished fetus becomes thrifty which explains the situation I described above. Fetal undernutrition leads to impaired development of the pancreas, liver, and other tissues (e.g., muscle), leading to low insulin secretion and insulin resistance, which maintains high levels of sugar in the fetal bloodstream to preserve brain development, but may trade-off muscle development. Once adopted, this thrifty behaviour becomes permanent and, combined with adiposity in later life, leads to type 2 diabetes.

To put it in simple terms when this child comes into the world and is now able to afford better nutrition conditions, and get nutrients in the right amounts, they are at risk of several chronic conditions later in life, including coronary heart disease, stroke, diabetes, and hypertension resulting from adaptations made by the fetus in an environment limited in its supply of nutrients.

In the American journal of clinical nutrition, it is noted that in developing countries, the health and nutrition of females throughout their entire life is affected by complex and highly interrelated biological, social, cultural, and health service-related factors. Good maternal nutrition is important for the health and reproductive performance of women and the health, survival, and development of their children.

Over 200 million women become pregnant each year with many of these at risk of suffering from both ongoing nutritional deficiencies and the long-term cumulative consequences of undernutrition during childhood. Pregnancy-related health and nutritional problems affect a woman’s quality of life, that of her newborn infant well beyond delivery, and that of her family and community.

The effect of women’s prenatal health and nutritional status on child growth, health, survival, and development occurs both through reproductive performance and survival and through fetal growth and development.

Prenatal nutrition

Strategies to improve prenatal nutrition

Promotion of optimal nutrition

This needs to be emphasized right from childhood especially among girls because it can result in a buildup of the nutritional reserves needed during periods of increased nutritional demand, including the adolescent growth spurt, pregnancy, and lactation. This can be done by all players in the field like myself (nutritionists) to make nutrition information as common and accessible as silver in the times of Solomon’s reign of Israel. Community- and facility-based health and nutritional care can be combined just like we have been doing for malaria eradication programs.

Invest in female education

I know this has been a song that has been singing for so long but before you come at me about the increasing imbalance that is being caused by over pushing for investment in female education hear me out. There is strong evidence that associates higher levels of maternal education with improved child survival and nutritional status. Educating women means they will make better-informed decisions in terms of their nutrition and health for both themselves and their families. For those in school, how can we include nutrition education in the curriculum right from primary school? We continue to witness teenage pregnancies and we cannot afford to wait until they are in tertiary school for them to know about nutrition in its totality.

Increase access to quality nutrition services

Much as nutrition is a vital component of antennal visits, the reality is that it is not held in high regard and is often missed or talked about in passing yet it determines a lot in the development of a growing child. This can begin with expectant mothers demanding these services because they need them. This way stakeholders will strengthen the healthcare delivery infrastructure; improve the quality of services for women including nutritional services and increase the number of healthcare providers for women. This will make monitoring the nutrition status of pregnant women easy and we can avert many of these negative consequences when it is still early.

In a bid not to write a thesis, I will stop here and hope this can be a trigger for us to think about the nutrition health of our women whose health and nutrition status directly affects the health of a child and consequently a whole generation.

Prenatal nutrition

Do not hesitate to share with me your thoughts in the comments.

See you next Wednesday

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