Feeding smart from the start

The 16^th of October was World Food Day and I wonder what this means to most members of the public in South Africa. In prosperous societies, nutrition is so often just regarded in terms of weight loss with the odd thought given to diets for certain illnesses such as diabetes and cardiovascular disease.



But for the millions of people who face starvation, World Food Day and food security have very different meanings. Decisions taken around World Food Day can mean the difference between life and death for those in need of adequate nutrition.

More than just slimming diets

Human nutrition encompasses much more than just diets for weight reduction or the treatment of existing diseases. The prime objective of what is known as community nutrition is the provision of an adequate diet for a given population and the long-term prevention of diseases by means of dietary measures.

NCDs

In recent years, the burden of ill-health in the majority of countries has shifted from so-called "communicable diseases" (infections, all childhood infectious diseases, TB, rabies, hepatitis, etc) to "non-communicable diseases or NCDs" which include obesity, diabetes, heart disease and cancer. Deficiencies, particularly micronutrient deficiencies (a lack of vitamins and minerals), increase susceptibility to disease and are also linked to undernutrition and NCDs.

It has been estimated that by 2030, NCDs will be responsible for more than 75% of all deaths in the world (Badham & Kraemer, 2011). Whereas in the past, vulnerable populations used to succumb to epidemics caused by pathogens (plague, smallpox, etc), in future NCDs will most probably be the prime causes of death and disability. Balanced nutrition that provides healthy food choices rich in protective nutrients, can help to lighten this burden and to prevent the development of NCDs.

Disadvantaged women and children

According to Badham and Kraemer (2011), women and children are the most vulnerable in terms of nutrition in our modern word. While women worldwide make up less than 50% of the population, 60% of people suffering from daily hunger are women. Ironically it is these undernourished, deprived women who produce up to 80% of the food in developing countries, despite the fact that they have less access to arable land and financial support than their male counterparts. And it is these disadvantaged, underfed women who give birth to the next generation of children. This is indeed a situation that clouds the future of the world.

Double burden

People in developing countries and this includes South Africa, are faced with a double burden of nutritional deficiencies coupled with communicable and non-communicable diseases. Many families in such populations contain members who suffer from undernutrition and stunting (mainly children and young women), while other members of the same family may be obese and diabetic or prone to hypertension and heart disease or cancer.

Early malnutrition predicts future ill health

About 20 years ago, Dr David Barker already showed that low birth weight babies were more likely to develop heart disease in later life than babies with normal birth weights. According to what has now become known as the "Barker Hypothesis", undernutrition and malnutrition before birth and during the first two vital years of life, can predict the risk of future vulnerability to NCDs. In other words, the body structure, physiology and metabolism of babies that have been exposed to undernutrition in the womb and during infancy, are changed permanently by these nutritional insults (Badham & Kraemer, 2011).

At present 17 million underweight babies are born annually and it is probable that this statistic will increase sharply due to the current worldwide economic crisis and the effects of global warming.

So being undernourished in your mother’s womb and for the next two years can doom you to obesity, diabetes, heart disease, hypertension and/or cancer in later life. According to Badham and Kraemer (2011), “Disease susceptibility [is] determined in the first 1 000 days of our lives".

Factors that put individuals at risk

The following nutrition-related factors can predispose an individual to developing NCDs:

• the mother’s body composition and diet at conception and during pregnancy
• a low weight at birth
• poor weight gain after birth leading to underweight and stunting in infancy
• weight gain after birth that is too rapid, especially during childhood and adolescence

(Badham & Kraemer, 2011)

What can be done?

On national and international levels, it is vital that governments play an active role in promoting balanced nutrition and take active steps to ensure that even the poorest of the poor have access to adequate nutrition. Particular emphasis must be placed on maternal and childhood nutrition.

The Millennium Development Goals which include poverty reduction, reduced child mortality, improved maternal health, and combatting HIV/Aids, malaria and TB, cannot be achieved if nutrition is not prioritised. Badham and Kraemer (2011), point out that despite the billions of dollars that are spent each year on aid and development globally, insufficient funds are allocated to ensure food security (i.e. providing enough food for the energy needs of the population), and nutrition security (nutrition of good quality). By shifting the emphasis to good nutrition many of the other problems that absorb so much financial aid at present, could be prevented and vast amounts of money and manpower, as well as human suffering could be saved.

National Nutrition Week 2011

Nutrition education is probably one of the most powerful tools at the disposal of governments to improve health outcomes, but it is also often the most underused resource.

The message which the Association for Dietetics in South Africa (Adsa), and their partners the Department of Health and other role players such as the Consumer Goods Council of SA, the SA Milk Producer’s Organisation, Unicef and USAID, promoted during National Nutrition Week 2011 (9-13 October 2011), concentrated on the importance of breastfeeding and complementary feeding.

Under the headline "Feeding Smart from the Start", the message is as follows:

“From six months of age your baby needs breastmilk and solid foods, to promote health, support growth and enhance development.

This is called complementary feeding:

• After six months introduce new foods to your baby every few days.
• At six months start with 2 meals a day, with regular breastfeeding. Increase to 5 small meals (including snacks) a day, with continued breastfeeding by 10 months. Continue with these regular meals and breastfeeding until your baby is two years old.
• Wash your hands with soap and water before feeding your baby.
• Keep everything clean when preparing food for your baby.”

(Adsa, 2011)

This message may sound simple, but if it is put into practice by every mother in South Africa, our future population will be less likely to develop NCDs and everyone in this country will benefit.

National Nutrition Week and World Food Day are vital for the future of our country, so give them and the above mentioned message some thought this year.

- (Dr IV van Heerden, DietDoc, October 2011)                                                                                   

References

(Adsa, 2011. National Nutrition Week 2011. http://www.adsa.org.za; Badham J, Kraemer K, 2011. The Link between nutrition, disease and prosperity: Preventing non-communicable diseases among women and children by tackling malnutrition. Sight & Life, Vol 25(2): 32-36.)

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