Nutrition 'Normalised'

You just bought your daily newspaper, are you confident the nutrition advice you read is accurate? Do you watch television excerpts of ‘herbalists’ offering nutrition supplements and second guess their effectiveness? Are you that parent that ever wonders if those school meals are right for your child’s growth? Or do you think the food industry ought to fit within certain recommendations for your own health? Well, it is justified, you are only concerned about your health. Shouldn’t these service providers be too! How then should they ensure that the services offered promote healthy eating among the general public they serve?

The World Health Organisation provides guidelines that cater for specific categories within populations to promote healthy eating and lifestyles that prevent any form of malnutrition and chronic diseases. However, every country adapts guidelines that are used to help the general public make informed, healthy lifestyle and food choices that prevent malnutrition and chronic diseases.

So as expected, Uganda should have guidelines that are used by policymakers and health professionals including nutritionists to inform health and nutrition programs or even policies that help the general public adopt healthy eating patterns and live healthy lifestyles. Whereas these guidelines are meant for prevention of disease and not treatment of disease, health professionals may adapt these guidelines to encourage healthy eating patterns among their patients. These guidelines could ensure consistence with any publications of dietary guidance including the media.  

We do not have national dietary guidelines! Why? You ask. After all, non-communicable diseases are increasingly on the rise. A national survey conducted by the Ministry of Health in 2014 showed that 1 in 10 adults had more than three risk factors for non- communicable diseases. I couldn’t be more disappointed to inform you that, I do not know why either.

These risk factors are; a diet with less than five servings of fruit and/or vegetables a day, less or an equivalent of 150 minutes of moderate physical activity a week, a raised blood pressure, being overweight or obese and smoking. Yes people, smoking!

Now, sidebar, in East Africa, only Kenya has national dietary guidelines. These guidelines contribute to efforts of progress on the global nutrition targets (which include addressing diabetes among the adult populations, a non-communicable disease). Failure to have enacted dietary guidelines may revolve around reluctance to commit to nutrition as country. Whereas Uganda committed to the realisation of the right to adequate food, the country has not yet enacted into law any policy on nutrition. Not that we aren’t on our way there, it is a complicated issue to be discussed on another day, plus maybe it just is not a priority. End of side bar!

Nevertheless, a recently published Presidential Initiative on Healthy Eating and Healthy Lifestyle was released that provides the basics to a call for action of key messaging that would otherwise be included in a national dietary guide. It is important to note, this initiative was published to promote healthy eating and lifestyle practices in households and communities as one of its three key objectives. Although it cannot substitute the role of the national dietary guidelines, in the land of the blind, the one eyed man surely is king.

Lots of research will prove how having the dietary guidelines in place positively impact on the general health of populations. Maybe sometime soon, hopefully, you may comfortably sip from your favourite energy drink fully confident that the manufacturer put your health before business and conformed to consistence with the Uganda national dietary guidelines.

I peek into the mirror, look up to my torso and ‘behind’. I hold my waist, throw in a sway and turn sideways before I fake a smile or frown. I may nod in agreement or disagreement presumed on an unclear difference of the previous and present woman in the mirror. Well, we all fret the weight issue. For most of us, the weight gain.

How much should you not exceed? How do you even tell if you have increased weight or not? Please excuse the most obvious or sometimes even ridiculous ways we all do it. Have you ever stopped at the clinic to do it with a nutritionist present to explain your result? If not, you probably should. In any case, this is what you should know.

Measurements of weight and height when taken are aligned together to determine your Body Mass index (BMI) – a measure of body fat based on your weight in relation to your height. This index simple tells us if your weight is healthy for you. Everyone is categorized underweight, normal weight, overweight or obese. BMI can be calculated from the two measurements. This takes time. If a BMI wheel is used instead, it saves time, is simple to use and direct. In fact, it can easily tell the borders you should not exceed.

BMI however, will not apply to a pregnant mother, a mother breastfeeding for less than 6 months, an amputated person, or a child. Children should use BMI for age, the same wheel with age range. An estimated BMI for amputees may be calculated. Pregnant and breastfeeding mothers will use a Mid Upper Arm circumference.

There are rules to follow when taking your weight;

Take your measurement early in the morning before breakfast.

You may want to wear lighter clothing that day.

Use the same weight scale in case you are monitoring your weight.

This is an ideal scenario. Haidar goes to the clinic on a lovely Saturday morning and requests for a ‘weight’ measurement. The nutritionist requests him to empty his pockets, remove his copper watch and shoes. He steps onto the weight scale and a reading is taken (62kilograms). He then steps onto the height board a second reading is taken (1.6metres). Now these readings are aligned on the BMI wheel and a final reading (24kilgrams/metres2) is given to Haidar. The nutritionist explains the reading to Haidar. He is of normal weight. He however should not exceed a weight of 65kilograms otherwise, he would be overweight. If he lost weight, it is not healthy to exceed below 47kilograms because he would be underweight.

Remember, consulting with a nutritionist if you are outside your normal weight is wise. Being above or below your normal weight is unhealthy. An underweight person is at risk of falling ill easily and often, reduced fertility for both men and women, failing to grow and develop normally for children.

An overweight or obese person is at risk of diseases such as; high blood pressure, diabetes, heart disease and some cancers.

So find out if you have grown fat, it’s that simple!

Photo by Benardate A Okiria

So am excited, of course, along with many others about the recently launched National Integrated Early Childhood Development policy (NIECD). Naturally, because I argue the impeccable and irrefutable contribution of nutrition to the growth and development of children in their early years. This integration includes health, education, protection, water and sanitation, and family support apart from nutrition.

Uganda undoubtedly has several policies guiding development. NIECD is an addition uniquely calling for a multi-sector collaboration. Yes I have to give it to us, truly congratulations to all those behind this new baby on block. I have surely fallen for this one.

The NIECD policy aside from integration caters for children in the ages from conception to 8 years. Factually from minus, zero years to ‘not-Five’, but Eight! Its guiding principles and policy actions designed enable children to grow and develop to achieve better their full potential. Take for instance policy action 6.2,

‘Government of Uganda shall ensure that all households are food secure and have proper nutrition for proper child growth and development.’

It is one of the pillars and foundation for human development. A sure contribution to the Sustainable Development Goals without a doubt! In my opinion, a policy at the heart of the sustainable development agenda.

So, now that we have it around. How do we apply it to create the impact we all want to see? What does this policy mean to the average Ugandan citizen? Take for instances; an expecting mama Booyi in my village in Atiira or Katiini, the street kid at Clock tower on Entebbe road. What could this policy mean in their daily lives?

Yes, NIECD has an action plan just as any other policy to finally trickle-down effect to the very last young citizen in the country. Sources of funding to implement, who participates to implement, clear accountability lines, what to measure to ensure policy effectiveness, all mentioned in this plan.

Uganda will however have its challenges in implementing this astoundingly ingenious policy. Like any other of course, dawdling communication down to the average citizen is most likely. So let us embrace this one. I rally all of us to receive it with enthusiasm, advocate for it, take up and demand accountability. Let us give our children the best start in life.

Join the Campaign and advocate for #BestStartInLife #NutritionSavesLife on Social Media!