Wednesday, 21 April 2021

Kidney diseases; what you may need to know


Image source: Livescience.com


 Kidney Diseases

The kidney is a pair of bean-shaped organs about the size of a fist and located on both sides of the spine. The kidneys carry out the critical function of maintaining the body’s chemical balance which helps ensure good health. If the kidneys fail to function, toxic compounds build up in the blood, causing a wide range of symptoms and life-threatening complications.

Kidney diseases are increasingly recognized as a global public health problem. Chukwunonye et al and Okwuonu et al suggest an increasing prevalence of chronic kidney diseases in Nigeria with treatment costs beyond the reach of the average Nigerian. This prevalence thus necessitates an increased awareness of the disease in Nigeria and possibly, the habits that may predispose one to it. 

                              How the kidneys function

The kidneys filter the blood removing excess water and toxins; the fluids that pass through end up in the bloodstream while those that don't are excreted out in the urine. The kidney is thus helpful in removing potentially harmful products from the body and in maintaining the chemical balance of the body. 

                                       Causes of kidney problems

Problems with the kidneys include health conditions such as kidney failure, kidney stones, and kidney cancer. These problems with the kidneys may be caused by:

Toxicity; The kidneys may be damaged by substances toxic to the body. These substances could be drugs, poisons or even plant extracts, which slowly cause the kidney to stop functioning

Aging. As humans age, changes in the structure of the kidneys can cause them to lose some of their ability to remove waste from the blood. Genetics can also predispose an individual to poor kidney function earlier than may be expected.

Illness or injury. The kidneys can be damaged by illness, inflammation, immune responses, or injuries that prevent them from filtering the blood properly or block the passage of urine. Diabetes and high blood pressure (hypertension) are leading causes of kidney disease.

                                     Types of Kidney Diseases

Chronic kidney disease: Chronic kidney disease is a long-term condition that usually does not improve over time. It’s commonly caused by high blood pressure and diabetes. Over time, the increased pressure and/ increased sugar levels damage these vessels and kidney function begins to decline. Kidney failure can occur when the body becomes overloaded with toxins.

Polycystic kidney disease: Polycystic kidney disease is a genetic disorder that causes numerous cysts (small sacs of fluid) to grow in the kidneys. These cysts can interfere with kidney function and cause kidney failure.

Kidney stones: Kidney stones are a common kidney problem. They occur when minerals and other substances in the blood crystallize in the kidneys, forming solid masses (stones). Kidney stones usually come out of the body during urination. Passing kidney stones can be extremely painful, but they rarely cause significant problems.

The Nephrotic Syndrome: The nephrotic syndrome is not a specific disease; rather, the term refers to kidney disorders that result in significant urinary protein losses (proteinuria) due to severe glomerular damage. The condition arises because damage to the glomeruli increases their permeability to plasma proteins, allowing the proteins to escape into the urine. Causes include diabetic nephropathy, immunological and hereditary diseases, infections (involving the kidneys or elsewhere in the body), chemical damage (from medications or illicit drugs), and some cancers.

Acute Kidney Injury: In acute kidney injury, kidney function deteriorates rapidly, over hours or days. The loss of kidney function reduces urine output and allows nitrogenous wastes to build up in the blood. The degree of renal dysfunction varies from mild to severe. With prompt treatment, acute kidney injury is often reversible, although mortality rates are high, ranging from 36 to 86 percent. Causes include severe illness, sepsis, or injury.

Urinary tract infections: Urinary tract infections (UTIs) are bacterial infections of any part of the urinary system. Untreated infections can spread to the kidneys and cause kidney failure.

                                                 What are the risk factors?

  • Smoking
  • Diseases such as diabetes and high blood pressure
  • Family history of kidney diseases
  • Dehydration
  • Poorly developed kidneys
  • Drug abuse 

It is pertinent to be careful with non-prescription medications, particularly painkillers. It is wise to discuss all over-the-counter medications with a doctor or pharmacist before they are taken. Certain other medications, toxins, pesticides and illegal drugs (such as heroin and cocaine) can also cause kidney damage. 

The use of non-approved traditional drugs and extracts can be a huge risk factor as most of those drugs have not gone through the necessary clinical trials. 

Drinking sufficient water daily prevents dehydration and can help remove the toxins from the body; toxins whose build-up can break down the kidney. 


                  What to do when diagnosed with a kidney disease

Stick to medical advice. If possible stick to the advice of a nephrologist. Get a second, and if possible a third medical opinion. For those with religious beliefs, it is important that prayers are made alongside medical treatments, not alone. 

It is also important that you consult a dietitian for diets that would not exacerbate the disease.


Contributor: Millicent O. Atukpawu (RDN)



Tuesday, 23 March 2021

Folate and pregnancy outcome



Folate is one of the vitamins famous for its roles in cell reproduction. It is needed in large amounts during pregnancy because new cells are laid down at a tremendous pace as the fetus grows and develops. At the same time, because the mother’s blood volume increases, the number of her red blood cells must rise, requiring more cell division and therefore more vitamins. Folate requirement increases during pregnancy in response to the fetal and placental growth and, maternal needs to produce Red Blood Cells (RBC), most importantly, for the prevention of Neural Tube Defects (NTDs).

Folic Acid Daily Allowance

The RDA for folic acid in pregnancy is 600 mcg, a 200 mcg increase over that for nonpregnant females.  The Institution of Medicine recommends that 400 mcg of the 600 mcg/day be provided by folate-fortified foods or supplements because it is better absorbed, with 200 mcg from food and beverages. To reduce the risk of neural tube defects for women capable of becoming pregnant, the recommendation is to take 400 µg of folic acid daily from fortified foods, supplements, or both in addition to consuming food folate from a varied diet because about 50% of pregnancies are unplanned and the neural tube closes by 28 days of gestation (before most women realize they are pregnant). Therefore supplementation with folic acid should begin before conception.

Folate Deficiency

A diet low in fresh fruits, vegetables, and fortified cereals is the main cause of folate deficiency. In addition, overcooking your food can sometimes destroy the vitamins.

Maternal folate deficiency is associated with an increased incidence of congenital malformations. Its deficiency can cause megaloblastic anemia - a condition in which you have too few RBCs. Megaloblastic anemia is the latest stage of folate deficienc and it may not present until the third trimester. Folate deficiency can also be caused by chronic alcohol abuse.

Symptoms of Folate Deficiency

Symptoms can vary from person to person. Common symptoms include:

  • Shortness of breath

  • Fast heartbeat

  • Abnormal paleness of the skin

  • Smooth or tender tongue (swollen tongue)

  • Loss of appetite/weight loss
  • Muscle weakness

  • Nausea

  • Diarrhea

  • Tingling in hands and feet


Dietary sources of folate

Sources include; spinach, fortified bread cereals, broccoli, cabbage, cauliflower, green beans,

lettuce, kidneys beans, peas, potatoes, most fruits, most nuts, brown rice, oats bran, some yoghurt, milk, eggs, salmon, beef, game(bush animals) etc.

 

Millicent Onyinyechi (RDN)

 

 

 

 

 

 

Monday, 15 March 2021

FAD DIETS-TIPS TO IDENTIFYING ONE


A fad diet is kind of plan with either macronutrients restricting or micronutrients depriving that are not physically or mentally sustainable. They advise that certain actions performed with the diet can maximize fat loss.  For example, taking a ’herbal supplement (green tea)' after eating or a hot bath to speed up your metabolism so that weight will drop off quickly. Fat burners and hot baths do not melt the fat of your body, rather could dehydrate and make you lose water weight, which is unhealthy and quickly added back on.

TIPS TO IDENTIFY A FAD DIET 

Ø Sounds too good to be true.

Ø Recommends using a single food consistently as the key to the program’s success.

Ø Promises quick and easy weight loss with no effort. “Lose weight while you sleep!”

Ø Eliminates an entire food group such as grains or milk and milk products.

Ø Guarantees an unrealistic outcome in an unreasonable time period. “Lose 5kg in 2 weeks!”

Ø Requires that you buy special products that are not readily available in the marketplace at affordable prices.

Ø Claims to alter your genetic code or reset your metabolism.

Ø Fails to mention potential risks or additional costs.

Ø Promotes the use of buzz words such as Fast, Low Carb, Cleansing, Detox dieting

Ø Promotes products or procedures that have not been proven safe and effective.

Ø Encourages a particular eating pattern such as skipping a certain meal of the day.

Ø Neglects plans for weight maintenance following weight loss.

 

The “magic feature” that best supports weight loss is to limit energy intake to less than energy expenditure. A healthy amount of weight loss is between 1/2 to 2 pounds per week. The scale should not be our only unit of measurement. Focus more on the habits you have changed, the quality of your diet, and strength.

Atukpawu, Millicent Onyinyechi RDN


Friday, 7 August 2020

CHILDHOOD FEEDING PROBLEMS





Feeding problems such as refusal to eat, disruptive meal time behavior and pickiness are common and part of the normal development of infants and toddlers. These feeding problems can lead to family stress with long-term negative consequences of children’s nutrition (under nutrition or over nutrition), behavior and growth. 
Early in life, children learn that refusal to eat is a powerful strategy that attracts the mother’s or caregiver’s attention and may lead to increased access to favorite fruits and snacks. Picky eating is usually just another method they use to express their strong desire for independence. Nagging, forcing, or bribing children to eat reinforces picky-eating behaviours because of the extra attention. Bribing children to eat a new food may achieve the parent’s immediate goal, but it often has negative results in the long run. In subsequent meals when the reward is removed, children eat less of the hurdle food. Bribing children to eat also teaches them that food is an appropriate reward.  

Feeding Guidelines

The nurturing of a young child involves more than nutrition, but also a safe, loving, secure environment in which the children may grow and develop.

  • Discourage unacceptable behaviour (such as standing at the table or throwing food). Be consistent and firm, not punitive.
  • Let young children explore and enjoy food. This may mean eating with fingers for a while. Learning to use a spoon will come in time. Children who are allowed to touch, mash, and smell their food while exploring it are more likely to accept it.
  • Meal presentation should be attractive: Color their plates with all kinds of great-tasting vegetables. Meals should include a variety of foods from each food group—in amounts suited to their appetites and needs.
  • Don’t force food on children. Rejecting new foods is normal, and acceptance is more likely as children become familiar with new foods through repeated opportunities to taste them.
  • Provide nutritious foods, and let children choose which ones, and how much, they will eat. Gradually, they will acquire a taste for different foods.
  • Limit sweets. Infants and young children have little room for empty calorie foods in their daily energy allowance. Do not use sweets as a reward for eating meals.
  • Don’t turn the dining table into a battleground. Make mealtimes enjoyable. Teach healthy food choices and eating habits in a pleasant environment. Mealtimes are not the time to fight, argue, or scold.


If a child fails to eat enough to support healthy growth and development, consult a registered dietitian-nutritionist.

Wednesday, 5 August 2020

WORLD BREASTFEEDING WEEK 2020





First week of August each year, the world celebrate World Breastfeeding Week (WBW). The team for the WBW 2020 is: Breastfeeding; the Foundation of Life. They so aim is  to give the people every knowledge about the positive effects of breastfeeding on the infants when they get a mother's milk.  Breastmilk is very important and necessary as it provides optimum nutrition for the infant and also has many non nutritional benefits for both mother and child. World Health Organization (WHO) and Paediatrics Society recommend that one should aim for exclusive breastfeeding for the first 4-6 months of life. WHO also recommends breastfeeding up to 2 years of life especially in countries/populations with high rates of infectious diseases as this will help in reducing morbidity and mortality rates.

Benefits of exclusive breastfeeding to the child includes;

  • It reduces the risk of developing non communicable diseases later in life. 
  • It positively influences the child’s immune system against infectious diseases such as diarrhea and respiratory tract infections.
  • It reduced a child chances of having immune related diseases such as diabetes, asthma, and inflammatory bowel diseases.
  • The relatively low protein content of breast milk compared to cow’s milk meets the infant’s needs without overloading the immature kidneys with nitrogen.
  • Minerals in breast milk are largely protein-bound and balanced to enhance their availability and meet infant needs with minimal demand on maternal reserves.
  • Breastfeeding influences the infantile growth especially during the few months of life.
  • Breastfed infants gain weight during the first months of life and grow leaner during the first year of life than formula fed infants. This explains the reason for lower risk of noncommunicable diseases such as obesity later in life.

Steps to a successful breastfeeding
  • Initiate breastfeeding within the first hour of birth.
  • Encourage breastfeeding on demand.
  • Breastfeed and maintain lactation even if you’re separated from your baby.
  • Give no teats or pacifier to breastfeeding infant.
  • Practice rooming in-that is, you and your infant should remain together 24 hours a day.


Promote, protect and support breastfeeding for a healthier planet.

Saturday, 22 February 2020

Colostrum.. Baby's First Milk



Colostrum isa milk-like liquid produced by the mammary glands of mammals immediately following delivery of the newborn. It looks thicker and more yellow than mature milk. It contains antibodies to protect the newborn against disease, but it is small in quantity . It’s very nutritious and contains high levels of antibodies, which are proteins that fight infections and bacteria. It’s an important source of nutrients that promotes growth and fights disease in infants. Newborns have very immature and small digestive systems, and colostrum delivers its nutrients in a very concentrated low-volume form. It has a mild laxative effect, encouraging the passing of the baby's first stool, which is called meconium. This clears excess bilirubin, a waste-product of dead red blood cells, which is produced in large quantities at birth due to blood volume reduction from the infant's body and helps prevent jaundice. Colostrum is known to contain immune cells (as lymphocytes) and many antibodies.
How long does colostrum last?
Colostrum secreted in the first few days (2-5days) after birth. After 2-3 days, mature breast milk called transitional milk starts to replace colostrum. During the next 10-14 days, the transitional milk increases in quantity and changes in appearance and composition to meet the increasing requirements of the baby. By day 10, the baby’s stomach grows to about 2 ounces. Mature milk being produced by this time; looks thinner than colostrum but is still full of nutrients for the baby. Mature milk will continue to change with your baby’s needs and tummy.

Quantity of colostrum a newborn needs

The amount of colostrum/breast milk produced varies, this is because, after delivery one can produce roughly 60-80ml of colostrum on the first day. The next day it is estimated that around 120ml and on the third day 180ml will be produced respectively. This amount is enough for the baby since the volume of a new born's stomach capacity is not much, and hence needs about 5-10mls of breastmilk per feed on a frequency of 8-12 times per day.

Importance of Colostrum

1.Colostrum fights infection:  Up to two-thirds of the cells in colostrum are white blood cells that guard against infections, as well as helping the baby start fighting infections for himself.

2. It supports the baby’s gut function: Colostrum is also rich in other immunologic components and growth factors that stimulate growth of protective mucus membranes in your baby’s intestines. And while that’s happening, the prebiotics in colostrum feed and build up the ‘good’ bacteria in the baby’s gut.

3. Your colostrum is especially rich in a crucial antibody called sIgA. This protects the baby against disease, not by passing into his bloodstream, but by lining his gastrointestinal tract. Antibodies and cells help in the immune mechanism which can last up to 6 months.

4. Prevents jaundice: This clears excess bilirubin, a waste product of dead red blood cells which is produced in large quantities at birth due to blood volume reduction, from the infant's body and helps prevent jaundice.

5. It contains complete nutrition (protein, salts, fats, carbohydrates, and vitamins) that the baby’s stomach can easily digest, and gives the baby’s brain, eyes and heart the right blend of nutrients and vitamins to grow.

6. Delivers its nutrients in a very concentrated low-volume form, suitable for newborn immature, small digestive system. Furthermore, learning to ‘suck and swallow’ is easier in small amounts.

Saturday, 8 February 2020

Overnutrition Malnutrition




While hunger is a tremendous global health concern that cannot be minimized, overnutrition should similarly be addressed as a top priority. Overnutrition is the form of malnutrition that happens when you take in more of a nutrient or nutrients than you need every day. It can develop into obesity, which increases the risk of serious health conditions, including cardiovascular disease, hypertension, cancer, and type-2 diabetes.
    Developing countries are facing a double burden caused by coexisting under- and over-nutrition, which causes a change in the disease profile from infectious diseases to a chronic degenerative pattern. The population moves from a traditional diet high in carbohydrates and fiber and low in fat and sugar, to a typical Westernized diet, characterized by a higher intake in energy, saturated fat, sodium, sugar, and low in fiber, and associated with physical inactivity and other unhealthy lifestyle behaviors (e.g., smoking), which increase the risk of obesity, hypertension, stroke, type 2 diabetes, and ischemic heart disease (IHD). According to the World Health Organization (WHO), Non-Communicable Disease (NCD)-related deaths are projected to increase by 15% globally until 2030, with most increases taking place in Africa.
    According to World Health Organization in 2014, more than 1.9 billion 18 years and older adults worldwide were overweight and more than 600 million adults were obese, while 42 million children under the age of five were overweight or obese.  In 2018, the WHO noted that childhood obesity is one of the most serious public health challenges, affecting people in every country in the world.

    Types Of Overnutrition
  • Overnutrition of energy nutrients: It happens when excess energy is consumed more than the body's daily requirements. Over time, it causes weight gain unless daily physical activity is increased. It doesn’t matter if those extra calories come from fat, carbohydrates or proteins, because the body can take whatever it doesn’t need and store it as fat leading to obesity and the many life-threatening conditions associated with it.
  • Overnutrition of micronutrients: It is possible to get too much of most vitamins or minerals, but usually, this happens when mega doses of dietary supplements are taken. Getting too much of micronutrients from food is rare. Micronutrients overnutrition can cause acute poising, like taking too many iron pills at once. The Institute of Medicine has established tolerable upper limits for most micronutrients, but the best way to avoid this type of overnutrition is to stay away from mega doses of dietary supplements unless directed by your healthcare provider.

Factors Contributing to Overnutrition

While many factors including genetics, drugs, and other medical conditions may contribute to obesity, behavior is perhaps the most common contributor. Individual level healthy weight is associated with a healthy diet and regular physical activity. 

Ways of Maintaining Optimum Nutrition

There is no best weight-loss diet. Choose one that includes healthy foods that you feel will work for you. Dietary changes to treat obesity include:
  • Cutting calories. The key to weight loss is reducing how many calories you take in. The first step is to review your typical eating and drinking habits to see how many calories you normally consume and where you can cut back. A typical amount is 1,500 to 1,800 calories for women and 2,000 to 2,400 for men. At the same time, increase physical activity and avoid junk foods, which are foods that are high in calories but have little nutritional value.
  • Dietary changes: Reducing calories and practicing healthier eating habits are vital to overcoming obesity. Although you may lose weight quickly at first, steady weight loss over the long term is considered the safest way to lose weight and the best way to keep it off permanently.
NB: Avoid drastic and unrealistic diet changes, such as crash diets, because they're unlikely to help you keep excess weight off for the long term.
  • Feeling full on less: Some foods —fruits and vegetables provide a larger portion size with fewer calories while foods like desserts, candies, fats and processed foods — contain a large amount of calories for a small portion.  By eating larger portions of foods that have fewer calories, you reduce hunger pangs, take in fewer calories and feel better about your meal, which contributes to how satisfied you feel overall.
NB: Drinking sugar-sweetened beverages is a sure way to consume more calories than you intended, and limiting these drinks or eliminating them altogether is a good place to start cutting calorMake
  • Make healthier choices. To make overall diet healthier, eat more plant-based foods, such as vegetables, fruits, legumes, and whole-grain carbohydrates. Also emphasize lean sources of protein — meat, skimmed milk, soy milk, fish etc. Limit salt and added sugar. Eat small amounts of fats, and make sure they come from heart-healthy sources, such as safflower oil,  olive oil, soy oil, canola and nut oils etc.