Maintaining a healthy body weight in Nigeria

Obesity and overweight are increasingly causing global health concerns as a result of the myriad of health problems associated with them. For persons resident in Nigeria, it seems almost impossible to keep tabs on weight gain without frequent visits to gyms or buying and consuming certain exotic food products; which are known to be quite pricey in Nigeria. The Nigerian diet as it is today, coupled with increasingly sedentary lifestyles are responsible for the reported large population of overweight Nigerians. Maintaining a healthy body weight or shedding excess body weight need not be expensive or impossible, all one needs to do is put a conscious and consistent effort into maintaining a healthy lifestyle that involves dietary modifications and moderate physical activity. Rapid weight loss programs and weight loss supplements are usually not recommended by dieticians and nutritionists.

The Nigerian cuisine is based largely on carbohydrate-rich foods like yams, cassava, rice, beans and grains such as millet and sorghum. The Nigerian forebears who cultivated and ate a lot of those foods were involved in a lot of physical activities that helped them burn the carbs from their diets. They were mainly involved in farming; the most common modes of transportation then were the use of bicycles or feet (trekking) so somehow the intensity of their physical activities ensured they were within a healthy weight range.

Increasing westernization in Nigeria like in other developing countries meant a shift towards more sedentary lifestyles; fewer people did physically exacting jobs. But westernization has not changed so much of the Nigerian cuisine. As a result, most Nigerians of today eat the same foods at almost the same rations their forebears who did more physically exacting jobs ate, causing a sharp increase in the number of overweight Nigerians as reported by several researchers. An increase in overweight or obesity cases meant an increase in related diseases like high blood pressure, diabetes and several cardiovascular diseases.

It is, therefore, necessary that Nigerians who intend maintaining healthy body weights make lifestyle adjustments that should include dietary modifications and increased physical activity. To achieve a healthy body weight we recommend you do the following.

1. Decide to maintain a healthy weight. Making certain decisions often translates into conscious decisions to achieve one's objectives. This also applies to maintaining a healthy body weight. There are no wrong reasons for wanting to shed excess body weight, but health-related reasons trump fashion and confidence. So no matter your reason, deciding to maintain a healthy body weight is a beautiful decision.
2. Invest in a body weight/bathroom scale. You need to know your present body weight to determine if it is within the healthy range or not. This will help you know how much body weight you should work towards shedding or adding as the case may be. Also, you will need to monitor how effective the modifications you adopt are. Owning a body scale  helps everyone in the home keep tabs on their weight gain. Luckily, bathroom scales are not usually expensive. A bathroom scale will also help make it easy for you to periodically calculate your Body Mass Index (BMI) using the formula in the image below.

After calculating your BMI, check the range to which the figure falls in to determine if your weight is within the healthy range or not. 

Since adults do not usually record changes in height as they do in weight, all one may need to do is check his/her height at a health or fitness center and use the figure obtained in calculating one's BMI periodically.

 3.Get involved in a targeted body weight-control program. All weight control programs are not the same. Weight-control programs are often designed for certain people in mind. There are several apps downloadable on most phones and computers designed for body weight control. They usually include diet  as well as body workout  suggestions. Some include animations to put you through the processes. The beauty is that most of these apps are free and workout sessions are adapted to suit both beginners and persons already experienced in workouts. Workout sessions usually last for 5 to 10 minutes and can be done in the comfort of one's home making them especially suitable when the hustles and bustles of life in Nigeria is put into perspective.  Like our Facebook page and send us a message for recommended apps that may be suitable for you.

4. Dietary modifications!Dietary modifications!!Dietary modifications!!!. Effective weight control programs involve both dietary modifications and physical activity. There should be a suitable balance between your calorie intake and expenditure. You may need to reduce your starchy foods portion, increase your intake of fruits and vegetables, cut down on processed foods and increase water intake. The particular regimen you follow depends on your present health and fitness status. Weight loss programs are not necessarily expensive and do not always demand special foods not obtainable in the Nigerian market. Most times portion control can do the job. Weight-control programs are easier in more developed countries where foods carry nutritional information. Nutritional information when found on made-in-Nigeria products are not always reliable. 

If you would like to know more about targeted weight-control programs and suitable apps, you could chat us up on our Facebook page  or send us an email on the address displayed on the blog.


Author: Atukpawu Onyinyechi; A volunteer nutritionist at The Informed Mum. 

Shedding the excess pregnancy and postpartum weight

Pregnancy and the postpartum period are associated with increased weight gain often as a result of the reduced physical activity and increased food consumption associated with those periods in a woman's life. When one adds the hustles and bustles of life in the Nigerian society to the equation, one would most likely find a woman working round-the-clock to attend to the increasing demands for her time and attention with little attention to weight issues. Mothers in Nigeria understand that the struggle to shed pregnancy and postpartum weight is real. Many mothers find themselves losing hope of getting fit and trim again; they just relax and watch themselves climb up the body weight ladder.

The topic of healthy weight gain/loss is important given the increased prevalence of overweight and obesity in the Nigerian society and a reported rise in health conditions linked to them. There are no wrong reasons for wanting to shed excess body weight, but health-related reasons trump fashion and confidence in ranking. Evidence-based research links being overweight/obese to an increased risk of several health issues like diabetes, high blood pressure, and cardiovascular diseases. A mother, therefore, needs to understand the need for her to keep fit and trim. Recognising why she needs to shed the excess weight is often linked to a woman's ability to sustain a weight loss program.

Sometimes, keeping gestational weight gain in check makes it easier to keep tabs on postpartum weight gain. Nutrition in pregnancy can make a lot of difference. Physical exercises like walking are usually recommended for pregnant women who need to keep weight gain in check. The intensity at which an individual walks determines the person's caloric expenditure. As such, brisk walking at about 12 minutes per kilometer is often recommended for healthy, pregnant woman to achieve moderate caloric expenditure.  Before a pregnant woman gets involved in more intense physical exercises, she needs to consult her healthcare provider to determine which ones are safe for her.
Pregnancy and postpartum periods are not times to indulge in some quick-fix weight regimens as they could lead to increased risk to mother and baby. Weight loss supplements are also discouraged during these periods. Healthy behaviors are rather encouraged.

The postpartum period with its attendant demands increases a woman's risk of being overweight. However, it also provides a window of opportunity to initiate lifestyle modifications such as increased physical activity and nutritious eating, that encourage healthy behaviors.  There is said to be an inverse correlation between obesity during the postpartum period and breastfeeding as well as obesity during pregnancy and exercise. Postpartum obese women require targeted programs that use evidence-based interventions for weight loss. Gradual weight loss of about 0.5kg per week (that is 2kg per month) is reported safe for postpartum women. Quick-fix or rapid weight-loss regimens are usually not recommended during this period as they can have negative outcomes. Moderate exercise during postpartum periods have been shown to have no adverse effect on breastmilk, infant weight gain or maternal prolactin level (which help sustain breastmilk supply). Interventions that combine exercise and dietary changes and monitoring, result in great postpartum weight loss.


Recommended steps towards shedding the excess pregnancy and postpartum weight

1. Keep gestational weight in check during pregnancy. A pregnant woman needs to take note of her weight gain at each antenatal check-up. A healthy goal for total pregnancy weight gain for women of normal weight ( based on Body Mass Index((BMI) 18.6 to 24.9) averages about 11.5kg to 16kg ). Women carrying more than one baby gain between 15kg to 23kg. Keeping tabs on your diet during pregnancy as well as moderate physical exercise helps you keep tabs on gestational weight gain. Women who maintain healthy weights during pregnancy stand better chances of maintaining healthy weights during postpartum periods. 
2. Keep postpartum weight gain in check. It is completely normal to not lose any weight or even gain some during the first 3 months after birth in breastfeeding mothers. Due to hormonal changes in her body, a new mother may have a bigger appetite and be more prone to holding on to body fat. Restricting calories too much, especially during the first few months of breastfeeding, may decrease both a mother's milk supply and her much-needed energy level. However, after 3 months, the new mum may get involved in targeted weight-loss programs that involve moderate exercises and dietary adjustments.

The recommendations are easy to adapt to if a woman

• Knows her Body Mass Index (BMI)
• Determines how much weight she needs to lose
• Gets involved in targeted weight loss programs. There are several free apps available that help towards achieving your target weight. Many involve dietary recommendations and exercises you can do in the comfort of your home for about 5 to 10 minutes every day. Weight loss need not be so difficult, all it needs is a conscious and consistent effort. One small step every day can result in a giant leap. Research suggests that technology-based weight loss programs are very effective in shedding excess weight. Like our Facebook page and send us a message or an email for recommended apps with targeted weight-loss programs to suit your lifestyle. 

Credit to Millicent Onyinyechi, A graduate of Human Nutrition. 

Irrational use of medicines/drugs in Nigeria

 According to the World Health Organization (WHO), Rational use of medicines require that "patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their community". Any usage of medicine that is not rational can be said to be irrational and therefore tantamount to abuse.

The Nigerian Healthcare system is bedevilled by so many problems amongst which is the irrational use of medicines. The ease of access to medicines in Nigeria makes it so easy to use medicines inappropriately. Almost everyone in Nigeria has at one point been involved in irrational medicine use. It is such an easy thing to do because almost every drug can be gotten without prescription.

Medicines play an important role in healthcare delivery. When used right, medicines can help cure diseases, but the wrong usage can harm the user.

Source: slideplayer.com. 

You guilty of irrational use of medicine if you have done any of the following

1. You have bought and/or taken any prescription-only medicine without a prescription from a licensed medical practitioner. Prescription-only medicines as the name suggest should only be taken when prescribed by a medical practitioner. Antibiotics are probably the most irrationally used medicines in Nigeria. Irrational use of antibiotics is said to be the leading cause of Antibiotic resistance and it's attendant risk of a post-antibiotic era.
2.  You have taken antimalarials without running malaria test. Certain malaria drugs are allowed over-the-counter in malaria-endemic regions of the world like Nigeria. That does not mean we should self-medicate and randomly take malaria drugs when we so desire.  The presence of malarial parasites in a person's blood should be confirmed before taking malarial drugs. Failure to do so is tantamount to irrational use of antimalarials.  Most health facilities have Malaria Rapid Diagnostic Test (RDT) kits that can detect the presence of malaria parasites in blood within few minutes. It is necessary to confirm the identity of a disease before commencing treatment lest time and money be wasted on a wrong treatment course. 
3.  You have taken more or less than the recommended dosage of a medicine. Paracetamol is one drug type commonly misused in this manner. People have been known to swallow more or less than the recommended dosage of paracetamol, citing the excuse that the recommended dose has no effect on them. If the recommended dose of a particular medicine produces no effect when you consume it, report to your practitioner who would be in a better position to review your dosage if necessary.
4.  You have divided a drug meant for an adult and given a child. There are specific medicines meant for kids, formulated with them in mind. Do not divide an adult's tablet to give a child, doing so could expose the child to harm's way.  
5. You have taken or caused someone else to take medicines prescribed for another person. A patient's medical history is put into perspective before drug prescriptions. What is medicine for one person could be poison for another. Medicines should not be transferable.
6. You have stopped a medication too soon or taken the medication beyond the recommended length of time

Medicines are chemical compounds, and like all chemicals, they have the potential to cause harm. In fact, medicines should only be taken when absolutely necessary. Some diseases can run their course and therefore have no need for the intervention of drugs. Example cold. Most colds are caused by viruses so one may just be wasting one's time by taking antibiotics.


Every medicine carries the risk of side effects. Every medicine can be toxic.  Doctors take this, as well as a patient's medical history into account when making drug prescriptions. Different patients can be given different doses of same medicine because their different medical histories demand so.

While we pray and hope that the Nigerian Healthcare system improves, we need to make personal efforts to stay alive and healthy by completely avoiding the irrational use of drugs. Always bear in mind that the medicine in your hand could as well be poison so you need to be guided by medical professionals on how and when to take the medicine. 

Memoirs of a Nigerian mum:I am a good mother

Last week Thursday something interesting happened.
It was a work day at African Founders.
I rushed home to be there when the children are dropped off.
I got in earlier and reposted the graphics for the promo posts for the Content Creation Challenge on my Instagram and Facebook accounts.

Then it was time to put on the mommy hat.
The boys came back from school.

I gave them (snacks) yoghurt and peanuts.

We then spent the next hour or so doing homework.

Then it was playtime for them and dinner preps for me.

In my haste to quickly get food ready, I cut my finger. Ouch.

Every wash was added pain.

Seasoning the food added salt to my injury.

My legs were already tired.

Then while the food was on fire, I quickly bathed them.

I had the choice of giving them cereal for dinner but since it was a long time since they had eaten pepper soup, I decided to give them as well.
But it was still cooking.
Treasure was already hungry and clingy.

I had shooed him gently and he wasn't going.

He came back while I was slicing the scent leaves. I then raised my voice and told him to stay away from the kitchen.
He sulked away.
Finally!
I could get the food ready.
Minutes later, my glorious pepper soup was ready.
Come and eat, guys!

I entered the living room and what I saw stopped me dead in my tracks.
My boys were ASLEEP.
After all my efforts.
I then heard that ever-familiar voice of condemnation whisper, "you are a bad mother".
So this was how my children would go to sleep hungry.
Feeling the tears well up behind my eyelids, I retorted, "I'm not a bad mother. I'm doing the best I can".
I don't know how many times I said that to myself till I was in control again.

There are times when things would spiral out of control and you would be faced with the unexpected.
Drown the voice of condemnation faster than you can say your name.
Because if you wallow in self-pity and shame, you won't be able to produce anything positive.

When those voices come, just say to yourself, "I'm not a bad person. I'm not a failure. I'm doing the best I can".

But don't say this unless you are truly doing the best you can.

Keep your head up!

Yes You Can.

Love, RZ

PS: I later made the cereal and fed them half-asleep. They slept with food in their lil tummies. 😍 #goodmother

Culled from the Facebook group called BABES REDEFINED. 

Written by Ruth Zubairu

Sleep position in late pregnancy linked to a mother's risk of having a stillbirth

Stillbirth; the death of a baby before birth,  almost always causes heartbreak to the hitherto expectant parents and often leaves them wondering what they may have done or avoided doing that led to the loss of their unborn baby. The babies lost before birth, just like those lost after birth are hardly ever forgotten. 

To contribute towards reducing incidences of stillbirths, risk factors are often studied to identify women at increased risk, with the aim of possibly reducing the risk factors.  Some researchers in the UK looked at the association between maternal sleep practices and stillbirths. 


They found out that 'mothers who went to sleep on their back had at least twice the risk of stillbirth compared with mothers who went to sleep on their left-hand side'. The study suggested that 3.7% of stillbirths after 28 weeks of pregnancy in the UK was linked with going to sleep lying on the back. The report as presented in the International Journal of Obstetrics and Gynecology posited that the maternal supine position (a position where the pregnant woman lies horizontally with her face and torso facing up) is associated with compression of the inferior vena cava and reduced venous return, which in turn decreases the amount of blood pumped by the heart per minute and ultimately leads to reduced blood flow to the uterus. The study further reported the maternal supine position as a contributor to abnormalities in fetal heart rate traces in labor. 

Physiological studies had before now reported that unborn babies frequently adopt the quiet sleep position which is an oxygen sparing position whenever their mothers are in the supine position. 
Although women regularly change their sleep positions when sleeping, the report stated that the going-to-sleep position is very important as it is the one that is held longest and may have the greatest impact on the baby.The study suggests that incidences of late stillbirth will decrease if no pregnant mother goes to sleep on her back. 

Based on the reports of the study and other similar ones, pregnant women are recommended to as much as possible avoid the supine position, especially during the last trimester. 
While a pregnant mother may not be able to do anything about the position she wakes up in, she can do something about that which she goes to sleep in. Putting a pillow behind her back would help encourage side-sleeping.  It is best if she can afford a maternity pillow which can help her remain in the side-sleeping position. 

Source; www.vkool.com. A maternity pillow

MALNUTRITION IN CHILDREN

Malnutrition is a serious health condition that occurs when a person's diet does not contain the right amount of nutrients to meet the person's nutritional needs. It often occurs as a result of deficiency, excess or imbalance of food nutrients. Malnutrition includes both undernutrition and overnutrition; that is, both obese and starving persons are described as malnourished but this write-up is focused on undernutrition as that is the most prevalent type of malnutrition in Nigeria.

Source:www.slideshare.net

   
The problem of malnutrition should not be taken lightly as it can cripple a child's entire life. Almost half of all deaths in under five children in developing parts of the world  are attributed to malnutrition (undernutrition). Malnutrition is said to be the underlying cause of morbidity and mortality of a large proportion of children under five years old in Nigeria. 

 Malnourished children are prone to continuous bouts of  diseases which can affect their growth and development. They are exposed to common infections, the severity and frequency of which  contribute to delayed recovery or even death. Poor nutrition in the First 1000 days of a child’s life can also lead to wasting and  stunted growth, which is irreversible and associated with impaired cognitive abilities and reduced school and work performance.

   
 Infants and pre-school children depend on adults around them for their nutritional needs and if the selection of foods for them is incorrect, they may suffer from malnutrition. The process of weaning a child off breast milk increases the risk of malnutrition in that child as complementary foods offered may be deficient in certain nutrients. In Nigeria, the most common food offered to infants for complementary feeding is pap (akamu in Igbo, Ogi in Yoruba).   Pap supplies carbohydrates with little or no proteins,  and lack of proteins in the diet may result to severe wasting of body tissues. This can be fatal, or may lead to impaired or delayed cognitive development. It is therefore necessary that an infant's pap be enriched with some protein-rich foods like milk, egg yoke, crayfish, soybeans, deboned and mashed fish etc, as well as with fruits and vegetables. From birth to 6 months, exclusive breastfeeding is recommended to take care of the infant's nutritional needs.  Beyond then,  an infant's meals should be carefully planned with a balanced diet in mind. 

Source:Www.unicef.ca

Measures used in dictating malnutrition

The three commonly used measures for detecting malnutrition in children are:

1. Stunting (extremely low height for age): Stunting  usually results from  chronic undernutrition;  it is  increasingly used  as  the key  measure of nutritional status  in under two  year olds. Stunting can lead  to irreversible cognitive damage. 

2. Underweight (extremely low weight for age).

3. Wasting (extremely low weight for height): Wasting usually results from an acute, significant shortage of food and/or disease.  It a strong predictor of mortality among children below five years old.

Source:www.interactivealjazeera.com

  

      CAUSES OF MALNUTRITION

The UNICEF conceptual framework on malnutrition takes into account three major causes of malnutrition which include 

1. Basic causes: such as human and environmental resources, economic systems, political and ideological factors. Basic causes of malnutrition often affects an entire community or nation.

2. Underlying causes: insufficient household food, inadequate maternal and Child care, and insufficient health services and unhealthy environments result to household malnutrition.

3. Immediate causes: inadequate dietary intake and diseases like diarrhea, infections etc are the immediate causes of malnutrition in children.  

     PREVENTION OF MALNUTRITION

Malnutrition if not checkmated  can not only affect the affected persons but also influence the economic growth of the nation. The immediate causes of malnutrition can be prevented starting from the first 1000 days of a child's life, which is from the start of a pregnancy to a child's second birthday.The first 1000 days offer an opportunity for preventing undernutrition and it's consequences. 

Read baby meal ideas for suggestions on healthy homemade foods you can offer your baby

Nutrition for a healthy pregnancy

      

Pregnancy is a very crucial period in a woman's life during which good nutrition is very important to ensure that mother and baby are healthy. The calorie needs of a pregnant woman is said to increase by about 150kcals per day during the first trimester. This figure is said to further increase to about  350 to 450 kcals per day during the second and third trimesters respectively. The increased need is necessitated by the increased metabolism during pregnancy which often leads to hunger pangs and food cravings.  Pregnancy increases the need for micro-nutrients  such as Iron, Folate, Calcium etc. by up to 50%  hence many medical practitioners recommend dietary supplements during pregnancy; where as the need for macro-nutrients  (protein, carbohydrates and fat) increases by about 20% during the second and third trimesters. All these needs can be met by choosing a diet full of healthy foods.The "eating for two" concept does not refer to doubling the food and calorie intakes, rather it refers to the increased need for several vitamins and minerals.

Rather than binge on sugary or fat filled snacks, increasing the serving size of foods should be sufficient to satisfy the increased calorie needs . The extra calories needed should come from  foods like whole grains, fruits, vegetables, lean meat, yogurt, snails, fish etc. Lucky enough, Nigeria is blessed with an abundance of nutrient-dense foods such as meat, beans, different sea foods, many varieties of vegetables and fruits most of which are easily accessible . Pregnant women should strive to maintain good nutrition during pregnancy and avoid both too little and too much food intake.Sadly, there are many Myths surrounding nutrition in our part of the world, most of which are baseless. 

  

 Gradual weight gain during pregnancy is necessary, with most of the weight gained in the last trimester. Pregnancy diet should allow  for approximately 0.9kg to 1.8kg(2 to 4 pounds) of weight gain during the first trimester and then subsequent weight gain of 0.3kg to 0.5kg (0.75lbs to 1lbs) weekly during the second and last trimesters.
  

 A healthy goal for total weight gain for women of normal weight ( based on Body Mass Index((BMI) 18.6 to 24.9) averages about 11.5kg to 16kg (25lbs to 35lbs). Women carrying more than one baby gain between 15kg to 23kg (35lb to 50lbs). For women who begin pregnancy with low BMI,  the goal increases to 12.5kg to 18kg (28lbs to 40lbs). It decreases to 7kg to 11.5kg for women who begin pregnancy with high BMI  .

   

To calculate your BMI,  measure your weight in kg and divide it by your height in meters square as shown in the image below.  

   

The chart below gives an idea of the range of a healthy BMI. 

Suggested reads;

Myths surrounding nutrition we need to discard

Promoting the first 1000 days cause