Thursday, 21 October 2021

Nutrition in the First 1000 days of Life


Every child has a right to optimal cognitive, emotional and social behavioral development. These parts of the brain continue to develop across lifespan. A great deal of brain’s ultimate structure and capacity is shaped between 0-2 years of life.

 The first 1000 days of life, which includes gestation and the first two years of life, are a vulnerable period in human development when poor nutrition can have short- and long-lasting consequences on human health and function. This a window of opportunity because it is when improvements in nutrition can have the greatest impact in individual’s growth and development. Maternal prenatal nutrition and the child's nutrition in the first 2 years of life (1000 days) are crucial factors in a child’s neurodevelopment and lifelong mental health. Child and adult health risks, including obesity, hypertension, and diabetes, may be programmed by nutritional status during this period. Calories are essential for growth of both fetus and child but are not sufficient for normal brain development. key nutrients that support neurodevelopment include protein; zinc; iron; choline; folate; iodine; vitamins A, D, B6, and B12; and long-chain polyunsaturated fatty acids. Failure to provide key nutrients during this critical period of brain development may result in lifelong deficits in brain function despite subsequent nutrient repletion.

The best way to meet the nutritional needs of this crucial stage is to:

  • diversify your diet 
  • take your pre-pregnancy supplements judiciously
  • cut down on the use of junks 
  • minimize/reduce or avoid pica eating
  • exclusively breastfeeding your infant in the first 4-6 months of life
  • introduce adequate complementary feeding after the first 6 months while introducing one food item at a time

These  provide the ideal nutrients for optimum growth and development and protection against illness. Not meeting the nutrients is difficult to reverse any deficiency effect after this stage and it has both financial and social implications.

Wednesday, 13 October 2021

NUTRIENT-DRUG INTERACTIONS


Medications both the prescription and over-the counter can interfere the way body uses nutrients in food. They interact with nutrients in several ways such that, it can increase or decrease appetite, or change the way a nutrient is absorbed, metabolized or even excreted.

Dietary nutrients can also affect medications by altering their absorption or metabolism. The kind of food eaten can make a medication work faster, slower or even prevent it from working. This may result to different responses leading to loss of therapeutic efficacy or disease control, compromised nutritional status, drug toxicity or even a life-threatening condition.

Types of interactions

· Drug-nutrient (effect on nutritional status)

·        Food-drug interactions (effect of efficacy of drugs)

Some drugs and their nutrients interactions

1.     Contraceptives and folate: oral contraceptives interfere with and impairs the body’s metabolism of folic acid. Inadequate folate status is linked to impaired gene synthesis and insufficient production of Red Blood Cells which in severe cases can lead to fetal Neural Tube Defect. Women who are planning pregnancy shortly after stopping oral contraceptives are at a higher risk of complications as a consequence.

2.     Antibiotics and calcium: dietary calcium binds to antibiotics, reducing the body’s ability to absorb the amount of antibiotic intended. Calcium is found in milk, dark-green leafy vegetables etc.

3.     Antimalarial drugs and vitamin C: taking antimalarial medication with any vitamin C containing supplement or fruits compromise the rates of the parasites clearance. Grape fruit juice, orange juice or any vitamin C concomitant diminishes the efficacy and potency of widely used antimalarial drugs. Vitamin C favours the development of young malaria parasites.

4.     Antibiotics and iron supplements: iron supplements should not be taken with antibiotics or during fever because the body’s defense mechanisms have pulled all the reserves out and will only add strain to the body.

5.     Diuretics and potassium: diuretics (anti-hypertensive drugs) increases the loss of potassium along with fluids. Potassium is important for the proper functioning of the heart and other muscles.

6.     Antidiabetic drugs and vitamin B12: antidiabetic drugs interfere with vitamin B12 absorption and if left untreated, the deficiency can lead to anaemia, dementia, and neurological damage.

 

Monday, 4 October 2021

ATTAINING GOOD NUTRITIONAL STATUS IN SPITE OF THE ECONOMIC CHALLENGES IN NIGERIA

 

It is not news that the cost of living in Nigeria has skyrocketed. The Covid-19 pandemic, inflation, and rising insecurity are among the factors being blamed for that. The fact is, good nutrition may be a huge challenge in some homes at this point. At The Informed Mum, we understand that nutrition plays a vital role in overall health thus we think sharing the following tips would help us attain good nutrition inspite of the cost of food items.

1.       Focus on locally produced foods and buy from local markets. Most Nigerians believe (sometimes rightly) that the quality of foods from the supermarkets is higher than those in the open markets. The poor regulatory conditions in the country make this belief debatable. But one thing we should be able to do at this point is to ditch the foreign foods for local ones. We wouldn’t only be growing our economy; we would also be saving our money. Buy the Nigerian rice, swap Semo for Amala, tuwo or garri. For babies, ditch the packaged baby foods and produce your own cereals-based food like akamu/pap. You can choose to fortify the baby meals with fruits, nuts, and proteins sourced from our locally produced foods. We have some links to explorable baby food options Mango puree, Avocado and egg puree, Sweet potato and spinach puree and many others by clicking Baby meal ideas . “Good quality” doesn’t necessarily mean “imported”. I may actually trust akamu made from the corn I bought in a local market than some of the baby foods bought in supermarkets.

2.       For babies under 6 months of age, exclusive breastfeeding cannot be overemphasized. It is free, cheap and the healthiest option for most babies.

3.       Eat foods in season. Our lack of steady electricity for food storage often means that foods and fruits that are in season are as cheap as dirt, then become as expensive as diamonds when their seasons start to go. One way of feeding fine is to stick to foods that are in season. Season of yams; eat yams. Do the same with beans, fruits and even vegetables. Nigeria is so blessed with arable land that there are foods in season all year round. During the rainy seasons, we get the vegetables like Ugu, spinach and so on, abundant in the Southern parts of Nigeria. When the dry season comes, vegetables from the Northern parts of Nigeria where they practice a lot of irrigation farming start to bloom. There is food for every season, we just need to make our taste buds adapt to our pockets. We would end up both healthy and able to save some money for our other needs

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.