Nutrition and Wellbeing

Food and disease  –  what  is  the  weakest link


Early origins of diseases

Scientists are exploring links between what we eat, the way we live and effect of our environment on some of the diseases we suffer. These effects of environment have been traced right from before our conception through our life course and increases our risk of suffering certain diseases such as obesity, type 2 diabetes, cardiovascular diseases and certain cancers.
In this presentation, Prof. Paul Haggarty, from Rowlett Institute of Nutrition and Health at the University of Aberdeen explains further:
A along  and  healthy  life.  Most  of  us  want  that and  we have a  good idea of  the things  we need to do to  achieve it  -  eat  a  good diet,  don't  put  on too  much weight,  and  avoid  smoking.  But  there is  an emerging area of  research that  suggest  that  events  even before  birth  may  be  influencing our  health  and wellbeing  throughout  life,  from  obesity,  heart  disease,  diabetes, and cancer, to cognitive function.  Interest  in this  possibility  started when researchers  looking  at  historical  birth records  noticed  that  the risk  of  some diseases  in later  life  were related to birth weight  decades  earlier.  These  observations  led researchers  in  Southampton to suggest  that  the  mother's  nutrition in  pregnancy  could impact  on the  health of their  offspring.  Subsequent  research  suggests  that  the period of  sensitivity  may extend beyond pregnancy into breastfeeding and back even before fertilisation.  Birth weight  has  been linked to the risk  of  breast  cancer,  cardiovascular  disease, and  a number  of  other  health outcomes  in adult  life,  and  even intelligence. These  statistical  associations  suggest  that  a fundamental  biological phenomenon  may  be  linking  something  in  the  early  environment  to later  health. Someone suggested that  the cause could be  factors  like stress  in  the mothers during  pregnancy.  But  most  interest  is  focused on  mother's  nutrition and  specific studies  have been carried out  on the effects  of  mother's  consumption of  nutrients such as polyunsaturated fatty acids, folic acid, and others.  However,  researchers  are only  beginning  to  understand  how  this  process  works. A  particular  challenge  has  been  how  to  explain the delay  of  decades  between those  early  life influences  and the chronic  diseases  that  they  appear  to give rise to in later  life.  In recent  years,  a new  understanding  of  the  biology  of  the  human genome  has  emerged  that  can  help  explain this  time  delay  and the transgenerational  transmission  of  health and  disease  risk  from  parents  to children.  That  new  idea is  something  called  epigenetics.  The word comes  from  the Greek "epi,"  which means  upon or  over.  And it  refers  to information  in the  human genome over  and above the normal  genetic  information.  This  provides  a mechanism  by  which our  genome  may  be  modifiable  by  the environment  on our experiences  throughout  life.  Epigenetic  changes  can  accumulate  over  our lifetime  and may  explain how  the  environment  before birth  and even  the environment  experienced by  our  parents  before they  were born can  affect  our health.  We know that  one  of  the most  important  ways  in which the  environment  can affect  our  DNA  through  this  epigenetic  process  is  by  something  called methylation.  Developments  in  technology  mean that  we can now  measure  these changes  very  accurately.  In this  process,  the  DNA  is  modified in  a way  that changes  the  function  of  the  human genome.  It  alters  the genes  that  are switched on and off, and ultimately, it influences our biology.  We now know  that  a  wide range  of  nutrients  can change these  epigenetic  states in  ways  that  can impact  our  health and it  could also  be influenced  by  factors such as  social  status,  infertility  treatment,  and  even the emotional  environment. This  emerging  understanding  also  helps  to  explain how  completely  different aspects  of  life,  from  diet  to  physical  activity,  to emotional  health,  and our  ability to cope with stress, can interact at the fundamental level of the genome.  Epigenetic  marks  are known to change over  the life course.  And this  trajectory has  been  linked  to longevity.  Well,  particular  patterns  have been linked to specific  diseases  such  as  cancer.  The concept  is  these changes  accumulate until  they  reach a  stage where they  tip the genome into an unhealthy  state.  And that  when  enough of  these transitions  occur,  it  can give rise to  disease.  New insights emerging from this field are already changing the way we look at health.  When  it  comes  to  things  like pregnancy  advice,  it's  usually  assumed  that  this  is all  the  mum's  responsibility.  She's  the one that  has  to  eat  well,  avoid alcohol,  and smoking,  and keep to  a healthy  weight.  But  this  new  concept  of  epigenetics brings  dad into the  frame  too.  We've known  for  a long  time  that  the  age of  the father  can  affect  the  health in  the  offspring,  particularly  in relation to  psychiatric illnesses  like schizophrenia.  And  we now  understand  that  the  father's  diet  and lifestyle can  influence  the epigenetic  marks  in  the sperm  that  provide half  the genetic makeup of the offspring.  So  maybe it's  time  for  dads  to look  after  their  health too  for  the  sake of  baby. This  emerging  field  of  epigenetics  shows  us  that  what  happens  before birth can influence the way  the human genome works  through the rest  of  our  life,  with potentially  important  consequences  for  our  health  and  wellbeing.  We're only  now beginning  to  understand that  how  we live may  influence the  health of  our children and grandchildren.  The  hope is  that  this  new  understanding  will  help us to develop effective strategies  to  improve the  life chances  for  all  babies  in the future.

Source: Future learn

Breastfeeding: Nutritionist advises employers to provide crèches

A nutritionist, Prof. Ignatius Onimawo, has advised employers to provide crèches in their work places to support nursing mothers to practise exclusive breastfeeding for six months.

Onimawo, the Vice Chancellor of Ambrose Alli University, Ekpoma, Edo state, gave the advice in an interview with the News Agency of Nigeria (NAN) in Abuja on Wednesday.

He said employers should look at the international policy on crèches and implement same in the country.

“The international policy says any employer that has more than 50 people should provide a crèche where a woman can always take care of the child and breastfeed him or her on demand.

“All these come to play if we want to improve breastfeeding rate in the country,’’ the expert said.

Onimawo, who is also a former President of the Nutrition Society of Nigeria, said awareness on breastfeeding was not enough in the country.

He advised medical workers to educate nursing mothers on the need to embrace exclusive breastfeeding for their babies.

“Some nursing mothers give excuse that they are career women but that should not be an excuse for not breastfeeding because there are ways of doing it.

“Breast milk can be expressed even if it is not stored in the fridge; it is healthy, so people need to know that breast milk can be expressed while the mother is at work.

“Mothers need to know that breast milk contains more than 80 per cent water. The child doesn’t need water while being breastfed,’’ he said.

Onimawo said there were a lot of advantages of practising exclusive breastfeeding for the baby and the mother.

“Exclusive breastfeeding will make the child to be healthy and he or she will be more intelligent.

“ The mother of the child will visit clinic less because the health of the mother will improve and the mother is not likely to develop loop that can lead to breast cancer.

“So, there are so many advantages and when the mother knows about this; on her own, she will begin to practise it,’’ he said.

In addition, Onimawo urged Nigerians to eat balanced diet.

“Our diets are heavily carbohydrate and too much of it is not good for human nutrition.

“We should include vegetables and fruits in our diets to increase our nutrients,’’ he said.

Source: The Nation Newspaper

Appeal for Nigeria

GPEI appeals for support to respond to a polio outbreak in north-eastern Nigeria as part of the broader humanitarian response effort

© WHO Nigeria

Nigeria & Lake Chad Polio Outbreak Appeal

Nigeria has been experiencing insurgency in the north-eastern part of the country since 2009 which led the Nigerian President to declare the state of emergency in the 3 worst affected states of Borno, Yobe and Adamawa states in May 2014.

The Global Polio Eradication Initiative (GPEI) aims to deliver polio vaccine alongside broader life-saving health interventions to some of the most marginalized populations globally in order to fulfil the goals of the Endgame plan. As part of the humanitarian response to the current crisis in Nigeria, a holistic approach to tackling polio underpins the current outbreak response efforts.

A deteriorating humanitarian situation

Against a backdrop of long-term crisis, the humanitarian situation in northern Nigeria has worsened substantially in recent weeks.  Over seven million people are in urgent need of humanitarian assistance across the country, with limited access to basic health and other essential services, with the main areas impacted by the crisis situated in the north-east.  Access to health services has been drastically compromised, with half of the population not having access to any basic health services. As a result on-going public health risks are very high, with low baseline vaccination coverage rates, populations housed in overcrowded and unsanitary camps and severe food insecurity. The crisis also has broader regional implications, with approximately 155,000 refugees in Chad, Cameroon and Niger.

Challenges to polio eradication

This difficult situation was made more complicated by the detection in August in Borno of two new cases of polio - the first cases detected in Africa since 2014. As many as 600,000 children across north eastern Nigeria remain inaccessible to polio vaccinators, presenting a very real obstacle to polio eradication efforts. Concrete strategies are in place to tackle such obstacles, including through close collaboration with key community stakeholders.   Similar approaches have been used by the GPEI in other parts of the world beset by complex humanitarian emergencies or insecurity. Most recently in the Middle East, the polio outbreak response was conducted within the broader humanitarian response effort, to ensure that as communities are reached, they are not just reached with polio vaccine but with a host of other lifesaving health interventions.

An effective outbreak response

Following the recent cases of polio in Nigeria, a major vaccination campaign in Nigeria and the surrounding region has been launched in collaboration with the Ministry of Health and UNICEF, with subsequent rounds to follow.  Vaccination efforts form part of the broader response to the current humanitarian crisis in Borno and the surrounding states, and across the Lake Chad basin countries. The focus is on coordinating the delivery of basic health services including vaccinations, enhancing surveillance for epidemic-prone diseases, providing life-saving interventions to manage common ailments among children, adult and the elderly, improving maternal and child health services at the community and facility level including mentoring of health workers, conducting ongoing evaluations of the evolving situation, and improving readiness response for any new disease outbreaks. The GPEI is committed to integrating within a broader humanitarian framework in order to secure a polio-free world.

Source: Global Polio Eradication Initiative

Tetanus shots: Is it risky to receive 'extra' boosters?

What happens if you get tetanus shots too close together — within a few years instead of the recommended 10 years?

Answers from James M. Steckelberg, M.D.

It's usually OK to receive an extra booster of the tetanus vaccine. This is especially true if you're being treated for an acute injury, such as a deep cut or puncture wound.

Vaccination is the best way to prevent tetanus — a serious disease caused by a bacterial toxin that affects the nervous system. Tetanus bacterial spores can enter your body through any cut or scratch. But deep puncture wounds, such as from stepping on a nail, are most susceptible to tetanus infection.

An adult who's never been immunized against tetanus should complete the initial tetanus series of three tetanus shots. The first two shots are given at least four weeks apart, and the third shot is given six to 12 months after the second shot. After the initial tetanus series, booster shots are recommended every 10 years.

If you experience a puncture wound, it's best to get the booster shot regardless of when you had your last tetanus shot.

Source: Mayo Clinic

Oral polio vaccine (OPV)

The oral polio vaccine (OPV) was developed in 1961 by Albert Sabin. Also called “trivalent oral polio vaccine” or “Sabin vaccine”, OPV consists of a mixture of live, attenuated (weakened) poliovirus strains of all three poliovirus types.

OPV produces antibodies in the blood to all three types of poliovirus. In the event of infection, these antibodies protect against paralysis by preventing the spread of wild poliovirus to the nervous system. 

OPV also produces a local, mucosal immune response in the mucous membrane of the intestines. In the event of infection, these mucosal antibodies limit the replication of the wild poliovirus inside the intestine. This intestinal immune response to OPV is thought to be the main reason why mass campaigns with OPV can rapidly stop person-to-person transmission of wild poliovirus.

Advantages

• OPV is administered orally. It can be given by volunteers and does not require trained health workers or sterile injection equipment.
• The vaccine is relatively inexpensive. In 2011, the cost of a single dose for public health programmes in developing countries was between 11 and 14 US cents. 
• OPV is safe, effective, and induces long-lasting immunity to all three types of poliovirus.
• For several weeks after vaccination, the vaccine virus replicates in the intestine, is excreted in the faeces, and can be spread to others in close contact. This means that in areas where hygiene and sanitation are poor, immunization with OPV can result in the “passive” immunization of people who have not been directly vaccinated.

Disadvantages

Although OPV is safe and effective, in extremely rare cases (approx. 1 in every 2.7 million first doses of the vaccine) the live attenuated vaccine virus in OPV can cause paralysis. In some cases it is believed that this vaccine-associated paralytic polio (VAPP) may be triggered by immune deficiency. 

The extremely low risk of VAPP is well known and accepted by most public health programmes in the world because without OPV, hundreds of thousands of children would be crippled every year. 

A second disadvantage is that very rarely the virus in the vaccine may genetically change and start to circulate among a population. These viruses are known as circulating vaccine-derived polioviruses (cVDPV).

Safety

OPV is an extremely safe vaccine. All OPV used in supplementary immunization activities for the Global Polio Eradication Initiative is pre-qualified by WHO and procured through UNICEF. In 2006, WHO issued a statement to affirm the quality and safety of OPV.

Efficacy

OPV is highly effective against all three types of wild poliovirus. When this vaccine is used however, there is competition among the three viruses to cause immunity, which results in protection but not with equal efficiency for each type: it is most effective against type 2.

One dose of OPV produces immunity to all three poliovirus serotypes in approximately 50% of recipients. Three doses produce immunity in more than 95% of recipients. Immunity is long-lasting and probably life-long.

Recommended use

In most countries, OPV remains the vaccine of choice in routine immunization schedules and supplementary immunization activities. 

Where more than one type of wild poliovirus is circulating, OPV is epidemiologically and operationally the best vaccine to use because protection develops to each of the three types of polio virus.

Related links

WHO position statement: safety and pre-qualification of oral polio vaccine (OPV)

For further information visithttp://www.polioeradication.org/Polioandprevention/Thevaccines/Oralpoliovaccine(OPV).aspx

HIGH INFANT MORTALITY RATE IN NIGERIA

UNICEF’s Chief of Field Office in charge of Katsina and Kano States, Padmavathi Yedla, has explained that the solutions to high infant mortality rate in Nigeria are not expensive but they are not properly observed because social norms are opposed to them.

Yedla, who stated this at the weekend while speaking at her maiden meeting with Katsina newsmen, was disturbed by the high rate of infant mortality, particularly in the North.

She expressed that even in the North with the highest rate of infant mortality; many women do not practice exclusive breast feeding.

“The reason they give is that their mothers – in – law or their mothers say when a child is not given water, the child will not be healthy. What happens is that the water they often give to the children is not pure; it is already contaminated.”

Yedla said another major reason for high infant mortality is malnutrition, saying “if you look at the cycle of malnutrition, many children (girls) are married at the age when they are not completely ready for marriage and these girls themselves are very malnourished; they are not very healthy by the time they get married.”

According to her, a child born to a malnourished mother doesn’t have adequate resistance against ailment caused by bacteria contamination.

“So, the solutions are there but the social norms prevent us because we believe that a child needs more than breast milk. That’s not true. The child’s stomach is very small and when the child is given water, the child’s stomach is filled up but water does not contain any nutrient.”

She also said it is unfortunate that lack of access to safe water and sanitation procedures remain the major source of diarrhea; a one of the killer diseases of children who are under five years.

She was confident that the proactive role of media on immunisation and malnutrition among others would no doubt improve the health condition of the populace at the grassroots.

By: Andy Asemota
Leadership News

Polio Eradication End Game and Certification Programme

These activities were part of the training workshop on polio eradication organized by FCT health administration in collaboration with WHO for Guild of Medical Director (GMD) and private health sector practitioners.
This was held in response to the recent outbreak of polio in North East Nigeria. The training dwelt on how to tackle polio and contain its further spread. Issues on urgent large-scale immunization of the affected areas and effective surveillance measures to detect any threat of further spread were discussed.

Case was also made for sustained efforts at checking reemergence of other communicable diseases that have largely been controlled/eradicated, such as measles, neonatal tetanus, yellow fever, cholera, meningitis, guinea worm disease and Ebola virus disease.