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How poor nutrition, sedentary lifestyle fuel Nigeria’s diabetic burden

By Kemi Olatunde

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Diabetes is a disease that occurs when your body doesn’t make or use the hormone insulin properly. It causes too much blood glucose (sugar) to build up in the blood. There are two main types of diabetes.

Type 1 diabetes occurs when your body doesn’t produce any insulin. It’s sometimes called juvenile diabetes because it’s usually discovered in children and teenagers, but it may appear in adults, too.

Type 2 diabetes occurs when your body doesn’t produce enough insulin or doesn’t use the insulin as it should. In the past, doctors thought only adults were at risk of developing type 2 diabetes. However, an increasing number of children in the United States are now being diagnosed with the disease. Doctors think this increase is mostly because more children are overweight or have obesity and are less physically active.

The overall pooled prevalence of Diabetes Mellitus was 5.77 percent (95 percent CI 4.3-7.1). The pooled prevalences of Diabetes Mellitus in the six geopolitical zones of Nigeria were 3.0 percent (95 percent CI 1.7-4.3) in the north-west, 5.9 percent (95 percent CI 2.4-9.4) in the north-east, 3.8 percent (95 percent CI 2.9-4.7) in the north-central zone, 5.5 percent (95 percent CI 4.0-7.1) in the south-west, 4.6 percent (95 percent CI 3.4-5.9) in the south-east, and 9.8 percent (95 percent CI 7.2-12.4) in the south-south zone. Risk factors for the pooled prevalence of Diabetes Mellitus were a family history of Diabetes Mellitus (4.6 percent; 95 percent CI 3.5-5.6); urban dwelling (6.0 percent; 95 percent CI 4.3-7.8); unhealthy dietary habits (8.0 percent; 95 percent CI 5.4-10.5); cigarette smoking (4.4 percent; 95 percent CI 1.3-10.2); older age (6.6 percent; 95 percent CI 4.5-8.7); physical inactivity (4.8 percent; 95 percent CI 3.2-6.4); and obesity (5.3 percent; 95 percent CI 3.8-6.9).

Findings revealed that there has been an increase in the prevalence of diabetes mellitus  in Nigeria. All regions of the country have been affected, with the highest prevalence seen in the south-south geopolitical zone. Sedentary lifestyle or physical inactivity, and unhealthy diet ( poor nutrition) among others are important risk factors for Diabetes Mellitus among Nigerians.

It is a norm to see Nigerians spend time to engage in sedentary activities. It is glaring that during leisure time, people are often seen sitting: while using a computer or other device, watching TV, or playing video games. Many of our jobs have become more sedentary, with long days sitting at a desk. And the way most of us get around involves sitting that is in our vehicles either private or public and even on bikes. Many people feel relaxed being on a spot especially in work places, some can never receive phone calls while standing, some cannot do without making use of the elevator and also, some people don’t stretch their legs all through their work hour. All these have been said to contribute negatively to our overall well-being

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According to a Nigerian tabloid, “sedentary behaviour is consistently linked to more than 30 chronic diseases and conditions. This includes a 112 percent increase in the risk of type 2 diabetes, and a 147 percent increase in heart disease risk.

“Insulin resistance -a key driver of type 2 diabetes -has been a particular area of interest for those researching sedentary behaviour.

“Studies have shown that walking fewer than 1,500 steps per day, or sitting for long periods without reducing calorie intake, can cause a major increase in insulin resistance.

“Researchers believe that being sedentary has a direct effect on insulin resistance, and this can happen in as little as one day. While regular exercise is always recommended, it can’t completely offset all the health risks of sitting too much.

“One study tested this theory by measuring metabolic markers in 18 people following different exercise protocols.

“When the entire day is spent sitting, one hour of intense exercise cannot make up for the negative effects of inactivity.

“Additionally, a recent review of 47 studies found that prolonged sitting was strongly linked to negative health outcomes, regardless of exercise levels. As expe­­­­­cted, the negative effects were even greater for people who rarely exercised.”

Another crucial factor is poor nutrition and this put people at risk of developing type 2 diabetes. In is observed that adults who experience poor nutrition are 2 to 3 times more likely to have diabetes.

Nutritious foods may be too expensive for some people, which limits healthy food choices. Foods that are cheaper and easier to get tend to be lower-quality foods that are high in added sugars, saturated fat, and sodium (salt). While these foods can provide plenty of calories to get someone through the day, they can also increase the risk of developing type 2 diabetes.

For people who already have diabetes, food and nutrition insecurity can affect how well they manage their diabetes. Experiencing food and nutrition insecurity while having diabetes can lead to higher A1c levels, diabetes-related complications, hospitalizations, and poor mental health.

A diet that includes plenty of vegetables, fruits, and lean proteins is important for diabetes management. But some of these foods can cost more than foods that are high in calories but low in nutrition. While lower nutritional foods can cost less and provide plenty of calories, they can cause frequent spikes in blood sugar levels (hyperglycemia), which can increase the risk of diabetes-related complications like nerve damage or vision loss.

Some people with diabetes may only be able to afford enough food to eat once a day, which can also make it hard to manage their diabetes. Skipping meals can increase the risk of hypoglycemia (low blood sugar) and can be dangerous.

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Health care costs twice as much for people with diabetes as those who don’t have diabetes. As a result, some people with diabetes often have to choose whether to treat their diabetes or put food on the table (sometimes called “treat or eat”). To save money, people may find themselves putting off filling prescriptions, reusing needles, and checking their blood sugar less often than recommended. This can be dangerous and can lead to serious diabetes-related complications.

According to medscape.com,  Poor diets account for most newly diagnosed type 2 diabetes cases worldwide, a new analysis has found.

More specifically, the modeling study showed that roughly 14 million cases of type 2 diabetes — or 70 percent of total type 2 diabetes diagnoses in 2018 — were linked with a poor diet, Meghan O’Hearn, a doctoral student at the Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, and colleagues. The study was published online April 17 in Nature Medicine.

The results also indicate that the greatest burdens of type 2 diabetes were accounted for by excess wheat intake and refined rice (24.6 percent), excess processed meat consumption (20.3percent), and inadequate whole-grain consumption (26.1percent). Factors such as drinking too much fruit juice and not eating enough non starchy vegetables, nuts, or seeds, had less of an impact on new cases of the disease, the researchers determined.

“These findings can help inform nutritional priorities for clinicians, policymakers, and private sector actors as they encourage healthier dietary choices that address this global epidemic,” O’Hearn said in a press release.

Prior research has suggested that poor diet contributes to about 40% of type 2 diabetes cases worldwide, the researchers note.

The team attributes their finding of a 70 percent contribution to the new information in their analysis, such as the first-ever inclusion of refined grains, which was one of the top contributors to diabetes burden; and updated data on dietary habits based on national individual-level dietary surveys, rather than agricultural estimates.

“Our study suggests poor carbohydrate quality is a leading driver of diet-attributable type 2 diabetes globally, and with important variation by nation and over time,” said senior author Dariush Mozaffarian, MD, DrPh, MPH, who is the Jean Mayer Professor of Nutrition at the Friedman School of Nutrition Science and Policy.

“These new findings reveal critical areas for national and global focus to improve nutrition and reduce devastating burdens of diabetes,” he noted.

“Left unchecked and with incidence only projected to rise, type 2 diabetes will continue to impact population health, economic productivity, healthcare system capacity, and drive health inequities worldwide,” O’Hearn said.

Speaking with The Hope, Medical Director of a private clinic in Akure, Dr. Victor Adefesoye while describing nutrition as the process of provision of food, processing, storing AMD consumption of food and water, explained that it is important that food are consumed in their right proportion for age and sex.

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According to him, all food components must be present in a diet to avoid the development of Diabetes Mellitus.

He said; “There are six classes of food; carbohydrates, protein, fat and oil, water, minerals and vitamins. All the components of food must be present in their adequate or recommended proportion for age and sex in order to have balanced diet.

“In Nigeria today, large proportion of the population do not have the means of income to make adequate/balance diet, hence, there is development of Diabetes Mellitus which is also known as metabolic disorder or disease of carbohydrate. Some people eat whatever they see which is commonly carbohydrate in nature, then people are prone to develop the disease.

“Some people, after consuming carbohydrate loaded food, engage themselves in taking sugar loaded drink. Some will also add cigarettes smoking to the food they eat. All these constitute the injurious eating lifestyle which eventually cumulate into the development of the disease.”

Speaking further, he revealed that people with sedentary lifestyle store large quantity of carbohydrate and fats in their body system much more than the daily requirement for daily activities saying”they hence develop Hyperglycemia (High Blood Sugar) than normal.

He stressed the need for people to take food in adequate proportion, avoid drinking of sugar labelled drink and alcohol, avoid smoking and engage in physical and mental activities that will burn out fat from the body system.

Chairman, Association of Public Health Physicians of Nigeria, Lagos chapter, Oladoyin Odubanjo at recent function said that it is essential to reduce the amount of time spent being sedentary in addition to engaging in more exercise.

“A more active lifestyle can significantly reduce the chances of chronic health conditions, mental health disorders and premature death

“We have to be very careful with our living condition, many people are exposed to sedentary lifestyle and this is unhealthy.” He cautioned.

A male nurse who craved anonymity said that elites are in most cases patients of the disease saying “the have all it takes to enjoy life at its fullness at the expense of their health.

According to him; “they sit in a place and send other people on errand, they buy chemicalised food and eat. After the close of work majorly on daily basis, they hang out with friends and take all manner of alcohol, carbonated drink etc. The poor on the other hand cannot afford these things and as such go for what is within their reach.”

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