Awareness: Stop Breast Cancer Through Early Detection

According to WHO-2021 Breast cancer (BC) is the most common cancer globally, accounting for 12% of all new annual cancer cases worldwide? In Kenya, it is the second leading cause of death among cancers, with increasing incidences and mortality rates as years unfold. In 2020, GLOBOCAN highlighted that BC accounted for 7% of overall mortality, with 42,116 new cases and 27,092 deaths in Kenya.

Late detection and treatment of breast cancer (BC) remains the big obstacle to the fight against this overwhelming epidemic. Across sub-Saharan Africa, BC is mostly detected in the advanced stages, because most patients with symptoms delay to seek healthcare early enough. In an article published by Lancet global health in 2018, more than 40% cases of BC in Eastern Africa have delayed diagnosis by more than 12 months from symptomatic presentation to diagnosis. Preliminary data from the Kenya National Cancer Registry (KNCR) show that 7 out of 10 cancers are diagnosed at advanced stages (stage III and stage IV).

Breast cancer is killing thousands of Kenyans and millions in the world every year, not because it cannot be treated, but because it is detected too late. Early detection and treatment of breast cancer has shown tremendous results in reducing its morbidity and mortality. A survey published by Lancet showed a decrease of BC deaths by 36% between 1989 and 2012 in the US due to the combined improvement in early detection and adjuvant systemic therapy. With early detection and right treatment, there is a likelihood of beating the disease. However, what could be causing the delays? An article published in 2020 in the European Journal of Health highlighted a strong link of delays to patient psychology and behavior. The article notes that shorter delays attribute to patient fear of BC outcomes, practicing self-examination, higher education levels and support from family and friends.

The critical component of breast health awareness is “Knowing your normal”, WHO. Know the risk factors, signs and symptoms, and how to practice self-examination. The belief that breasts disfigure during diagnosis, and that BC is an incurable disease is a lie.  Early detection and diagnosis of breast cancer allows for less invasive treatments and the majority of patients recover after treatment to live healthy and productive lives. Advanced cancer demands more extensive therapies that are more likely to metastasize to other organs at which point they no longer can be cured.

Health Column

Include men in household nutrition practices

“Good Nutrition is Everyone’s Responsibility”

What are men’s roles in the household? Do you think it is appropriate for a man to learn how to prepare food, feed the baby, or go shopping?  Overtime, men have not fully embraced household nutrition practices. Most often, a majority of men have exercised superiority to women when it comes to the normal household nutrition practices. This has been influenced by peer pressure from other men, cultural beliefs, fear of stigma, and most men conform because of the indwelling fear of being labelled ‘Weaklings’. Men consider themselves responsible for food provision at the household. They believe good health and nutrition are essential to being strong and productive. Most consider that they play a pivotal role in supporting their children’s education and development. Some men are however rarely interested in food preparation or the intricacies of food distribution, supporting expectant and lactating mothers since they view these activities as a woman’s domain.

 In a study to assess the determinants of dietary diversity and the potential role of men in improving household nutrition in Kenya, it was found that men benefit more than women and children in diet diversity. This was because men often eat lunch and sometimes dinner away from home, increasing their chances of consuming other food items not usually available in their household. Other project based observations show that men rarely participate in household nutrition decisions leaving this task to their wives, leaving most women and children with smaller food portions and less nutritious meals compared. Paradoxically, most interventions still focus on women neglecting the role of men in improving the household nutrition status.

Including men in nutrition activities and discussions has helped them recognize the importance of providing nutritious food to their families and increasing their participation in household chores related to childcare and feeding. A study done in rural Uganda to determine effects of male involvement on the Nutritional Status of Children under 5 Years showed that families, whose husband took the baby to the clinic, and participated in purchasing family food had babies with a normal weight. It is important to move beyond interventions that focus on individual responsibility for securing nutritious food because men are ingrained in wider structures that condition their behavior. Men need tremendous support and inclusion as they confront and question the cultures at home, in the community, at work, and those presented by the media, which shape their psychological and social identities.

Nutritional Jabs For COVID 19; Improving The Efficacy Of Vaccines Through Good Nutrition

Cov Shield

Have you gotten the Jab yet? If not, you ought to decide quickly because Covid 19 might stay longer. Vaccination helps one achieve herd immunity lowering the spread of the virus. However, a vaccine only provides the antigenic stimulus, and how the body reacts is influenced by the nutritional status and will vary among individuals. Healthy eating helps build the immune system, and conversely, lack of a healthy diet leads to weakening of both the innate and acquired immunity, making one susceptible to infections, whether they are vaccinated or not. Immune system dysfunction is considered to increase the risk of viral infections, such as SARS-CoV-2.

Some vitamins and trace elements such as zinc, iron, selenium and copper play a critical role in the functioning of the immune system. A review of micronutrients and their impact on the immune system suggests the role of vitamins C and D and zinc in strengthening immune support and reducing the risk of infections. Consuming a nutrient-rich diet is prudent to support the immune system and deal with pathogens. Normally, nutrient intake and incidence of disease impact the nutritional status of an individual, and a lack of it can lead to severe malnutrition. Malnutrition affects the quality of immune response to vaccination. A balanced and healthy diet ensures a robust immune system and a lower incidence of chronic diseases and infections.

Studies indicate a better response to vaccines and antibody stores in the elderly who consumed five or more servings of fruits and vegetables and/or Vitamin E supplements. Polyphenols, micronutrients naturally occurring in plants act as dietary antioxidants. Long-term consumption of polyphenols offer protection against cardiovascular diseases and diabetes due to their anti-inflammatory properties. Another study elicits the role of zinc and selenium in immunomodulatory effects in the management of COVID-19. A rapid review of vitamin D and COVID-19, suggests a possible role in the body’s immune response to respiratory viruses. And consuming diets rich in nutrients to improve immune responses As the world regroups and covid 19 relapses, it is increasingly important to have a nutrition-rich intake of food to reduce acquisition and the long-term complications from COVID-19. Whether or not you got the jab, it is important to eat healthily, and improve your lifestyle in order to ensure vaccine efficacy and that you are well cushioned from infections.

Mental Health; A glimpse at eating disorders

An eating disorder (ED) is a mental disorder defined by abnormal eating behaviours that negatively affect a person’s physical or mental health. There are three main types that include anorexia nervosa, bulimia nervosa and binge eating. Other EDs include pica, rumination, avoidant/restrictive food intake disorders, and night eating syndrome. Having an ED and being on a diet is not the same thing, but frequent dieting can be a curtain-raiser in developing an eating disorder. EDs are often associated with preoccupations with food, weight or shape, eating anxiety or consequences of eating certain foods. Behaviours associated with eating disorders include restrictive eating, avoidance of certain foods, binge eating, purging by vomiting or laxative misuse or compulsive exercise. These behaviours are often driven in ways that resemble an addiction. Common risk factors include gastrointestinal disorders, a history of sexual abuse, and being a dancer or gymnast.

EDs are highly prevalent globally. They affect several million people at any given time, most often women between the ages of 12 and 35. Anorexia and bulimia occur nearly ten times more often in females than males.  Research published in May 2019 on PubMed showed an increase in prevalence rates of eating disorders escalating from 3.5 % between 200-2006 to 7.8% for the 2018-2018 period. Many factors can influence the development of an eating disorder. These factors can be biological, psychological, and social. Individuals who are struggling with their identity and self-image can be at risk, as can those who have experienced trauma. EDs and mental illness are stigmatized hence some people with EDs are secretive or ashamed and often conceal them.

Assessing for an ED is simple. If the way you eat and think about food interferes with your life and keeps you from enjoying life and moving forward, you may be experiencing disordered eating. EDs impose severe health complications such as anxiety, depression, acid reflux, low blood pressure, organ failure, amenorrhea and infertility, and stroke on. Individual. Both anorexia and bulimia increase the risk of death. Recovery from an ED is guaranteed when professional help is sought. Seeking help soonest is paramount, as prolonged suffering may delay recovery from treatment.  EDs are mostly diagnosed by a physician and help sought from a therapist for counselling, a registered dietitian on healthy eating strategies and healthy weight management, and sometimes taking medications (e.g., antidepressants). Recovery from EDs may take time (about 5 years), and therefore requires patience and consistency.

Market Inflation Cripples Kenyan’s Food Security

Many Kenyans are currently caught in the grip of heightened food prices engendered by the currently market inflations that have steadily been escalating. Kenyans have protested on social media about the high cost of living using the #LowerFoodPrices in vain. They criticize the government for failing to stem the rise in the prices of everyday items. In March, the Kenya National Bureau of Statistics (KNBS) reported a 9.2% food inflation rate, which is predicted to increase further with the increase in fuel cost. This means a greater majority of Kenyans are and will be unable to put food on the table.

In 2021 Kenya was ranked 87/116 qualifying countries on the 2021 Global Hunger Index. In the same year, 2.6 million Kenyans were said to be in a food insecurity crisis. This is termed a ‘serious’ food and nutrition insecurity situation. Food and nutrition security means that all people, at all times, have physical, social, and economic access to sufficient, safe, and nutritious food that meets their food preferences and dietary needs for an active and healthy life. In the whole country, prices of basic food items like milk, bread, sugar, and maize flour have spiked sharply in recent months, making it difficult for Kenyans to afford the recommended three meals per day. While these frustrations on social media are collective, the financial squeeze is more painful on a personal level.

Those hit hardest by these increased costs are the vulnerable. The pressure to shift to cheaper, sugary, salty and fatty food alternatives in order to have enough to eat may be enormous. Those who need to manage their diets to control diabetes, heart conditions and so on may face the prospect of worsening health. If, as expected, these food price rises become the ‘new normal’, even fit, healthy people would risk developing chronic disease as a result. Moreover, there can be poor educational attainment, poor mental health and social isolation, or increased mortality rates. Both short-term and long-term policies that have been enacted by the government should be implemented. Some households might require emergency food assistance by the government and donors, food subsidies, cash transfers, food for work and school feeding programs, adjustment of trade and tax measures, enhancement of agricultural production by providing agricultural input subsidies etcetera. At a household level, families need to budget, cut on junks, enrich foods and preserve the leftovers, and invest in kitchen gardening. 

Nutrition Awareness Month: “Eat right with a Nutritionist’s advice”

A long time ago, Hippocrates, the father of modern medicine said, “Let thy food be thy medicine, and thy medicine be thy food.” This sentiment still rings true in our modern day. Every year in March, the Academy of Nutrition and Dietetics observe a “Nutrition Month” that stresses the importance of a balanced diet and exercise. It promotes the transformative powers of healthy food choices, by encouraging using a registered dietitian (RD) to develop and stick with a healthy eating plan.

Between what you hear on TV and read in the news, eating well can seem like a real challenge that doesn’t have to be. A RD will partner with you to develop a safe and realistic eating plan that you can stick with for the long haul. To guide and motivate you, dietitians use creative and out-of-the-box strategies to help with meal planning, grocery shopping and mindful eating.

What an ophthalmologist does for your eyes, a dietitian does to keep your digestive system and body running smoothly, making sure you’re getting the proper nutrients and helping you tailor an eating plan that works best for you. Whether your goal is weight loss, healthy eating, or boosting iron intake. Dietitians work in a range of fields including patient care; mostly in hospitals to offer disease-specific therapeutic interventions, community and public health, and national level to influence policy making, private sector to offer consultancy to groups and individuals, food industry, sports, and research and teaching.  

Anyone can call themselves a nutritionist. However, only an RD has completed multiple layers of education and training established by the Kenya Nutritionist and Dietitians Institute. All RDs must have gotten a four-year degree; a specially designed, accredited nutrition curriculum, completed an extensive supervised program of practice at a health care facility, foodservice organization or community agency, passed a rigorous licensure exam, and maintained continued education credits throughout their career. In addition, some RDs may have certifications in specialized fields, such as sports, pediatric, renal, oncology or gerontological nutrition. 

Do you want to lose or gain weight? Are you pregnant, looking to become pregnant or just had a child? Are you looking for ways to maintain your health in your older years? Are you an athlete looking to boost performance? Do you have a health condition such as diabetes, high blood pressure, stroke, any allergies etcetera? Then you need to seek the expert, science-based advice of an RD.

Don’t Buy Deceits And Sabotage Your Weight Loss Plans

Have you been sipping green tea, lemon tea, been on fad diets, skipped some meals, or been practicing intermediate fasting in an attempt to cut down your weight? As mentioned previously, the basic premise to healthy living is eating a balanced diet while remaining physically active, and burning more calories than those consumed. The seemingly “simple” and healthy road to weight loss is actually an arduous and long-term process. Therefore, it becomes enticing to substitute sensible diets and exercise regimens with unhelpful ideologies such as fad, Paleo, Atkins, etcetera, that promise quick results, but have deleterious outcomes.

A popular myth on weight loss is taking hot or warm water mixed with lemon. Some believe that the water temperature will help burn body fats. This is not biologically possible. Water is important for our Hydration, and Healthy Kidneys, but no matter its temperature, it cannot burn body fats. Skipping meals and taking less than the recommended 3 meals a day can actually result to an increase in weight rather than the expected weight loss. The body needs energy for daily use. When denied, it switches to a coping mechanism. Taking the regular 3 meals a day ensures enough supply of energy from the carbohydrates we take while skipping meals makes the body preserve as much as it can from what we take in order to use it through gluconeogenesis as a source of energy. This facilitates weight gain.

Fad diets are clearly extreme and often irrational plans that lack valid evidence and scientific research. Aside from being unhealthy, they are ineffective. High-fat diets promote short term weight-loss, but most of the loss is caused by dehydration. As the kidneys try to destroy the excess waste products of fats and proteins, water is lost. High-fat diets are low in calories, causing the depletion of lean body mass with little fat loss. Drastic reduction in carbohydrates causes the body to believe that it is being starved. Continued practice of these extreme diets risks one to CVDs and may cause irrevocable damage to the liver and kidneys.

Seeking hotkey weight loss aids is ineffective however long you’ll persist. A proper diet should place long-term health before immediate results. Reducing caloric intake enables one to maintain the body weight, whilst physical activity enables one to burn the excess body fat and therefore, weight loss. This is a long-term journey that requires discipline. Don’t buy deceits!

Why you need to maintain a healthy weight.

Have you ever been told “you look thin” or “you look fat?” how did you feel about it? What is a healthy weight and why is it important to maintain it?

What does a healthy weight mean?

Research has attempted to define healthy weight based of parameters that measure body fat composition. In this article, we will use two parameters: the Basal Metabolic index (BMI) and the Waist Circumference (WC).

BMI is determined by your weight and height. It doesn’t measure body fat but correlates with direct measures of body fat. A higher BMI tends to indicate higher body fat, and a lower BMI indicates lower body fat. BMI is calculated by taking your weight in (kgs) divided by height in M2 and interpreted based on standard values. BMI <18.5Kg/m2 indicates Underweight, 18.5- 24.9Kg/m2 is a healthy weight, 25- 29.9 Kg/m2 shows one is overweight and obesity correlates a BMI>30kg/m2.

BMI is however a screening method rather than a definitive measure of a person’s body fat. Moreover, it doesn’t work in isolation nor replace guidance from a medical professional. It gives a general idea of a person’s body fat, but it is not a diagnostic tool for disease risk. Being within a healthy weight range doesn’t necessarily mean that you’re healthy. Being underweight or overweight doesn’t necessarily mean that you’re unhealthy either.

Waist circumference (WC) screens for health risks associated with carrying excess body weight. Fat tends to settle around the waist rather than the hips. This indicates an elevated risk of developing heart disease and type 2 diabetes. The risk level increases for women with WC >35 inches, and for men with WC >40 inches.

Why it’s important to maintain a healthy weight.

It’s not safe to be underweight or overweight. Underweight is associated with mineral and vitamin deficiencies, immunodeficiency, vitamin D deficiency, osteoporosis, and anemia. On the flip side, being overweight or obese is linked to most lifestyle diseases such as sleep apnea, cardiovascular diseases, stroke, hypertension, type 2 diabetes, osteoarthritis, lower quality of life etcetera.

Many weight management experts have over the years focused on the outward goal of measurable weight gain or weight loss. Whereas this has been quite beneficial, research proves it unsustainable. Focusing on individual behavior change proves beneficial and sustainable, than just losing kilo over a period of months. Whatever size you are, you need to appreciate you can be healthy at that. You need to modify your health behavior(s) to achieve good metabolic fitness i.e. blood pressure control, increase physical activity levels and have a better psychological status in pursuit of maintaining weight.

Behavior Change: A Catalyst for Weight Management

Have you ever been told “you look thin” or “you look fat?” how did you feel about it? What is a healthy weight and why is it important to maintain it?

What does a healthy weight mean?

Research has attempted to define healthy weight based of parameters that measure body fat composition. In this article, we will use two parameters: the Basal Metabolic index (BMI) and the Waist Circumference (WC).

BMI is determined by your weight and height. It doesn’t measure body fat but correlates with direct measures of body fat. A higher BMI tends to indicate higher body fat, and a lower BMI indicates lower body fat. BMI is calculated by taking your weight in (kgs) divided by height in M2 and interpreted based on standard values. BMI <18.5Kg/m2 indicates Underweight, 18.5- 24.9Kg/m2 is a healthy weight, 25- 29.9 Kg/m2 shows one is overweight and obesity correlates a BMI>30kg/m2.

BMI is however a screening method rather than a definitive measure of a person’s body fat. Moreover, it doesn’t work in isolation nor replace guidance from a medical professional. It gives a general idea of a person’s body fat, but it is not a diagnostic tool for disease risk. Being within a healthy weight range doesn’t necessarily mean that you’re healthy. Being underweight or overweight doesn’t necessarily mean that you’re unhealthy either.

Waist circumference (WC) screens for health risks associated with carrying excess body weight. Fat tends to settle around the waist rather than the hips. This indicates an elevated risk of developing heart disease and type 2 diabetes. The risk level increases for women with WC >35 inches, and for men with WC >40 inches.

Why it’s important to maintain a healthy weight.

It’s not safe to be underweight or overweight. Underweight is associated with mineral and vitamin deficiencies, immunodeficiency, vitamin D deficiency, osteoporosis, and anemia. On the flip side, being overweight or obese is linked to most lifestyle diseases such as sleep apnea, cardiovascular diseases, stroke, hypertension, type 2 diabetes, osteoarthritis, lower quality of life etcetera.

Many weight management experts have over the years focused on the outward goal of measurable weight gain or weight loss. Whereas this has been quite beneficial, research proves it unsustainable. Focusing on individual behavior change proves beneficial and sustainable, then just losing kilo over a period of months. Whatever size you are, you need to appreciate you can be healthy at that. You need to modify your health behavior(s) to achieve good metabolic fitness i.e., blood pressure control, increase physical activity levels and have a better psychological status in pursuit of maintaining weight.

Behavior change -The Nutrition Approach to weight management

The principle of weight gain is simple, Energy intake exceeds energy expenditure. Energy intake is measured by the amount one takes in food, whereas expenditure is determined by the amount the body utilizes and physical activity levels.

The majority of the Kenyan urban population is obese. Studies relate 60.3% of urban residents and about 19.5 % of rural to be obese. Overweight and obesity are a result of complex set of interactions among genetic, behavioral, and environmental factors. Hundreds and thousands of weight-loss strategies, diets, portions, and devices being offered to the overweight public, prove ineffective. The percentage of individuals who lose weight and successfully maintain the loss is 1-3%.

Physical Activity, Dieting and Weight management: Some eating habits such as eating few meals at home, increased intake of high fats, skipping breakfast, and snacking junk promote weight gain. Following a diet can help lose weight and maintain a healthy weight over time. However, not all diets are equal, and many fad diets and extreme calorie restriction plans can have a negative impact on your health, and lead to more weight gain in the future. Making healthy food choices, like eating more fruits and vegetables, food portioning by adhering to serving sizes for meals and adding activity to your daily are behavior modifications that can help in weight control. Any diet plan should build on these habits, and it’s key to choose a lifelong plan.

One of the best predictors of a comprehensive long-term weight reduction strategy is physical activity. How one develops and sustains an exercise program determines their weight management outcome. For any given individual, the intensity, duration, frequency and type of physical activity is determined by their health condition. Among other benefits, it ensures maintenance of lost weight, preserves the lean body mass, improves cardiovascular, respiratory and musculoskeletal fitness, and improves psychological profile and self-esteem. People become or remain overweight as the result of modifiable habits. By changing those habits, weight can be lost and the loss can be maintained. Behavior change in weight control primarily focuses on increasing physical activity levels and reducing caloric intake by altering eating habits. I encourage anyone on a weight loss management program to keep a food diary that records what and how much you have eaten, and a record of your daily physical activity. Self-monitoring is a sense of accountability and it’s associated with immediate reduction of food intake and consequent weight loss.