Reflections On The 1st International Confab On Nutrition

“The doctor of the future will no longer treat the human frame with drugs, but rather will cure and prevent disease with nutrition” (Thomas Edision). This quotation from the famous American inventor and businessman, brings to the fore the significance of not only the availability of food, but nutritious foods that will nourish the body, keep us alive, healthy and strong to go about our duties.

Very often, we hear statements like “I am very hungry, I will eat plenty when I get food,” “My belly is now full, I am now satisfied,” “There is plenty to eat and drink, so enjoy yourselves.” These statements give indications that people eat to satisfy one thing-to make the belly full. The nutrient in the food usually is not the concern!

Nutrition is concerned with how the food is produced, processed, handled, sold, prepared, shared and eaten and what happens to food in the body- how it is digested, absorbed and used, according to Kings and Borges, 1993.

Nutritional status, therefore, refers to the nutritional state of the body as expressed according to scientifically tested parameters such as weight, height, age or combination of these variables.

One will need to know his or her Body Mass Index (BMI) to ensure that one is within the weight limit to avoid becoming obese, a situation that can lead one to contract cardiovascular diseases like hypertension, stroke, arthritis, and cancers.

The consumption of healthy diet throughout life is expected to help prevent malnutrition in all forms as well as a wide range of Non Communicable Diseases (NCD) and conditions. Increasing production of processed and industrial food, rapid urbanization and changing lifestyles have led to a situation where people are consuming more food high in energy, saturated fats, trans fat, free sugar or salt/sodium, at the expense of fruits, vegetables and dietary fibre such as grains.

The consequence is that, NCDs are fast becoming the leading cause of death in developing countries like Ghana. Most developing countries are facing what is described as “double burden of disease”- infectious diseases and NCD. Historically, in December 1992 in Rome, Ministers, Plenipotentiaries representing 159 states and the European Economic Community at the first international conference on nutrition made a – 21 point declaration to eliminate hunger and reduce all forms of malnutrition, and noted that hunger and malnutrition are unacceptable in a world that has both the knowledge and resources to end this human catastrophe.

Two decades on, the international community is hosting the first global intergovernmental conference to address the world’s nutrition problems in the 21st century between November 9 and 21, under the auspices of the Food and Agriculture Organisation (FAO) and the World Health Organisation at the FAO Headquarters in Rome.

It will review the progress made in the years intervening, focusing specifically on country level achievements and proven interventions in scaling up and will identify new challenges and opportunities for improving nutrition policies and coordination across multiple sectors.

The first Rome Declaration in 1992 on nutrition was a political outcome document identifying public policy priorities in addressing malnutrition, and committing signatories to a list of concrete goals towards achieving the global nutrition targets by 2025.

Consequently, the second ICN will serve to reinvigorate the international community and key stakeholders by developing specific nutrition related targets and accountability mechanism and committing resources to promote nutrition-enhancing food system.

Additionally, it is also expected to contribute to the post 2015 UN Development agenda and re-inforce the Secretary General’s call to leaders to take the “Zero Hunger Challenge.” The FAO Director General, Jose Graziano da Silva noted that “Nutrition is a public issue that governments need to take responsibility for.”

Statistics from the FAO show that today 805 million people are chronically malnourished, down more than 209 million since 1990/2. According to the FAO, investing in nutrition, therefore, is not only a moral imperative, but an economic one; as it improves productivity and economic growth, reduces health care cost and promotes education, intellectual capacity and social development.

It has been proven by medical science that the first two years of a child’s life are vital as optimal nutrition during this period reduces the risk of dying and developing NCDs and also fosters better development and healthy growth and overall development.

The cost of malnutrition to the global economy is estimated at US 3.5 trillion per year while the cost of under nutrition and micronutrient deficiencies is estimated at US1.4-2.1 trillion, obesity and underweight related NCDs estimated at US 1.4 trillion in 2010, and child and maternal malnutrition impose by far the largest nutrition related health burden at the global level.

It is also estimated that 805 million people suffer from chronic hunger, 162 million children under the age of five are stunted, 99 million children are underweight and 51 million children are wasted due to acute malnutrition. Moreover, two billion people suffer from one or more micronutrient deficiencies, 1.4 billion people are overweight with 500 million adults being obese, and 3.4 million people die each year due to overweight and obesity, as about 465 per cent of 6.9 million child deaths are linked to malnutrition.

Significantly, it is also estimated that child and maternal malnutrition and underweight remain the leading nutrition related health burdens in the world, with 167 million children under the age of five chronically malnourished.

Startlingly, the cost of undernutrition and micronutrient is estimated at 2.3 per cent of global Gross Domestic Product due to its impact on human development, productivity and economic growth. Also it is also estimated that undernutrition is a major pathway of intergenerational poverty.

Maternal stunting is estimated at being the strongest predictor for giving birth to an underweight child, who will in turn have a higher risk of physical and cognitive impairment, and will suffer the resulting economic burden.

It is noted that the economic cost of overweight and obesity, which are occasioned by unhealthy eating habit, arises from increased spending on health care and reduced economic productivity.

Ghana is going into the conference against the backdrop of nutrition challenges facing the population. Available statistics as reported in the 2012 Annual Progress Report of the Implementation of the Ghana Shared Growth and Development Agenda (2010-2013), indicate that almost one in seven children(13.4 per cent ) under the age of five years in Ghana is underweight, and the proportion has remained relatively unchanged since 2008.

At the regional level, malnutrition among children under five years was more prevalent in the Northern Region, 24.4 per cent; Upper East Region, 20 per cent and Upper West Region 15 per cent. And compared to other regions, Greater Accra region has relatively lower proportion (8.3 per cent) of children who are underweight for their ages.

Iron deficiency anemia constitutes a major threat to the health and survival of children. Results from the 2011 Multi Indicator Cluster Survey as reported in the report indicate that the prevalence among children aged between 6 and 59 months was estimated at 57 per cent in 2011, compared with 78 per cent estimated in 2008 Demographic and Health Survey.

At the regional level, Upper West Region had the highest proportion, of 81.5 per cent, of children aged 6-59 months who had anemia, followed by the Northern Region, 81.2 per cent, and the Upper East Region, 77.5 per cent. Eastern and Greater Accra regions recorded least proportion of children with anemia of 46 per cent and 47.8 per cent respectively.

While efforts have been stepped up to ensure food security and good nutrition in the population, climate change with its associated drought and floodings is a threat to food security and for that matter nutrition, among the population especially in the Northern, Upper East and Upper West Regions.

It is hoped that the Ghana Food Security and Nutrition Monitoring System will continue to monitor events in the food and agricultural sector for the necessary interventions and that the outcome of the second ICN will offer groundbreaking strategies and policy choices to address the nutritional challenges facing the world population, especially in the population of developing countries who are most vulnerable.

The statement by Ann Wigmore, the Lithuanian holistic health practitioner that “The food you eat can be either the safest and most powerful forms of medicine or the slowest form of poison,” is very significant to Ghana as the country is struggling to cope with cholera outbreak, the worse of its kind in the country.

It should also serve as food for thought, as the debate on the post 2015 sustainable development agenda continues.

By Salifu Abdul-Rahaman

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