Poverty, rising prices have made Nigerians’ food choices poor, worsened common diseases – Sodipo, Chairman, Lagos Medical Guild
Dr Oluwajimi Sodipo, the Chairman, Medical Guild, Lagos state, is also the Head of Department, Family Medicine, Lagos State University. He speaks to DAYO OJERINDE on food choices, healthy and unhealthy spreads and their impact on consumers
What are your views on food choices and their effects on health?
My approach to food choices is based on a number of factors, including the nutritional value, availability, cost and ensuring moderation. There is also a need to apply the concept of an individualistic approach based on the medical history and comorbid conditions of individuals such as obesity, diabetes mellitus or hypertension etc. Of course, the spectrum also includes those that are malnourished especially in an era of increasing food prices.
Nigerians generally consume an unbalanced diet based on lots of carbohydrates such as pounded yam, eba, rice etc, which can worsen common diseases like diabetes mellitus and also leads to stunting of growth in children, though a pattern of fast food consumption is also contributing to obesity. A culture of eating vegetables and salads and even beans is a positive approach gradually becoming impressively imbibed by many in Nigeria now and this may just be the lifestyle we need to turn to in order to lead healthy lives.
How critical is it for people to reconsider their choices of meals in view of the recurring global and regional health hazard trends?
The International Diabetes Federation has projected an increase in the number of diabetic patients in Africa from 14.2 million persons in 2015 to 34.2 million in 2040 with a large percentage in Nigeria and this is largely driven by increasing obesity rates. Similarly, the prevalence of cardiovascular diseases is increasing and is projected to conservatively account for about 30 per cent of all deaths in Nigeria. In Nigeria, we are seeing a new culture of increased fried and fast food consumption, especially in the urban areas, as they are largely cheaper and easier to prepare.
Combined with our traditional high carbohydrate diet, it is truly a cause for concern and could be responsible for increasing cardiovascular challenges like hypertension, stroke etc. Of course, as breakfast, we consume lots of bread and also use butter and margarine, which have saturated fats and hence high cholesterol levels. We, therefore, need to consider adding healthy varieties to our diet profile, while reducing consumption of unhealthy options
With the controversies around saturated and unsaturated fats in foods, how can families make healthy meal choices?
The rise in cardiovascular diseases in Nigeria is largely driven by diet and our changing, more sedentary lifestyle. To this end, there are varying data, mostly from urban studies in reviewed journals citing prevalent rates of hypertension, diabetes and obesity as 40 per cent, eight per cent and 20 per cent, respectively with attendant complications of increased stroke, heart failure, cancers and ischemic heart disease. This basically shows us that there is a dearth of nutritional compositions in the majority of our food choices. As such it has become imperative that we re-examine and address our food choices. Beyond this, we must place a premium on our health by making healthier food choices that can turn our lifestyle around for good.
In 2018, the United States Food and Drug Administration placed a ban on margarine containing trans-fat. What is the difference between this and the unsaturated fats contained in spreads like mayonnaise for example?
Spreads are an important part of our diet and recently we have found out that we can’t do without popular spreads like margarine, butter and mayonnaise on our staple foods. However, the trans-fats contained in margarine increase bad cholesterol (i.e. low-density lipoprotein and triglycerides), whilst reducing the good cholesterol (high-density lipoprotein). As a result of this, there is an increase in the incidence of atherosclerosis and overall cardiovascular risk in individuals. The unsaturated fats as seen in spreads like mayonnaise, on the other hand, increase the good cholesterol and reduce the bad cholesterol, thereby reducing the risk of atherosclerosis and cardiovascular risk.
Currently, our regulatory agencies are concerned with overall food safety and consumption for Nigerians. However, we must acknowledge their role in ensuring that we do not consume meals that are totally harmful to our health. After all, as has been said, there is still a lot of work to be done by regulatory agencies with the increasing consumption of foods concentrated in saturated fats and trans-fats. We need to look beyond the gain made from looking the other way to actively prioritising the health of Nigerians and increasing longevity.
In addition to ensuring better health consciousness, manufacturers of condiments are already introducing low-fat and organic variants in the market. How will this be beneficial to health and how should Nigerians take advantage of this opportunity for leading a healthy lifestyle?
It is wonderful news that low-fat alternatives and organic variants of mayonnaise are being considered as they will help broaden the healthy food options for Nigerians. It is similar to efforts to reduce the salt in ketchup and moves in other climes to seek alternatives to beef consumption by providing synthetic healthy options with less animal fat content or eating more unprocessed rice or basmati rice as against processed rice. There must, however, be a synergy in terms of cost and taste so that Nigerians can adopt it as a healthier option.
For people who choose to use mayonnaise, is there a medically backed position on the appropriate quantity of consumption, especially considering its ingredient makeup of healthier fats?
Mayonnaise is largely made up of soybean oil, which is an unsaturated fat with benefits in improving cholesterol and helps in the skin, bone and also vision. This is because soya beans also contain Vitamin E and Omega 3 fatty acid. Mayonnaise also contains eggs, which are a good source of protein such as homocysteine and vitamins (Vitamin A, C, Selenium); it is particularly important in the growing and middle-aged population as it helps with muscle and bone development, brain, immune system and vision. It is also useful in the elderly population as nutrition becomes a challenge as people age due to a reduction in food choices. In all, moderation in consumption is important as for all healthy food.
What contributions can the nutrition society make to help consumers’ stay ‘sane’ when it comes to making decisions on food choices?
There are challenges with nutrition advice as medical guidelines vary on the consumption of various food choices and the ability to ascertain the quantity and also availability. This is always a cause for debate as patients complain that the list of healthy options keeps narrowing and there is a worry about the quality of life. The good news is that a lot of research is ongoing by various medical bodies in Nigeria to come up with local guidelines on healthy food options.
Recently, the Society of Family Physicians of Nigeria carried out extensive work on egg and its benefits/risks and came out with recommendations on the amount of eggs to be consumed in a healthy manner. Such research has to be supported by the government, regulatory bodies and even food companies, which produce or market various food options. Similarly, there must be constant engagement with the public on these healthy options in order to help them focus on a linear approach to maintaining a healthy lifestyle, rather than being pushed in different directions by a variety of authorities.
With the rate at which poverty is rising, don’t you think the rate of malnutrition will also increase?
Poverty is a critical challenge, especially in present day Nigeria with increasing prices of food. It has affected food security, which is defined as the state of having reliable access to a sufficient quantity of affordable and nutritious food. In Nigeria, about 3.7 million people across 16 states are food insecure, hence prone to malnutrition. There is a need to explore and utilise available cheap food options such as beans, millet and eggs. Mayonnaise is also a spread with good nutritional value as many Nigerians consume bread and salad. The spread is not expensive and keeps you healthy due to its strong nutritious composition.
Is there a relationship between longevity and nutrition?
Longevity is synonymous with vitality and, of course, nutrition is a critical component of achieving that. There is a need to adopt healthy food choices, whilst keeping in mind the need for moderation, no matter how healthy a food option is. Adopting this approach will allow for healthy ageing, especially when combined with other healthy choices like exercise, not smoking, reducing salt intake and consuming minimal amounts of alcohol ( if at all).
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