Changes in mediators of inflammation and pro-thrombosis after 12 months of dietary modification in adults with metabolic syndrome.

OBJECTIVE: This study evaluated the effects of a 12-month dietary modification on indices of inflammation and pro-thrombosis in adults with metabolic syndrome (MS). MATERIALS AND METHODS: This longitudinal study involved 252 adults with MS recruited from the Bodija market, Ibadan and its environs. Participants were placed on 20%, 30% and 50% calories obtained from protein, total fat and carbohydrate respectively and were followed up monthly for 12 months. Anthropometry and blood pressure were measured using standard methods. Fasting plasma glucose (FPG), total cholesterol (TC), triglycerides (TG), high density lipoprotein-cholesterol (HDL-C), fibrinogen, plasminogen activator inhibitor-1 (PAI-1)], interleukin-6 (IL-6) and interleukin-10 (IL-10) were measured using spectrophotometric methods and ELISA as appropriate. Data was analysed using ANCOVA, Student's t-test, Mann-Whitney U and Wilcoxon signed-rank tests. P-values less than 0.05 were considered significant. RESULTS: After 6 months of dietary modification, there was a significant reduction in waist circumference (WC), while the levels of HDL-C, fibrinogen and PAI-1 were significantly increased when compared with the corresponding baseline values. However, WC and fibrinogen reduced significantly, while HDL-C and IL-10 significantly increased after 12 months of dietary modification as compared with the respective baseline values. CONCLUSION: Long-term regular dietary modification may be beneficial in ameliorating inflammation and pro-thrombosis in metabolic syndrome.

Knowledge and practices of nutritional care among day care staff in selected preschools in Ibadan North Local Government Area, Oyo State, Nigeria.

BACKGROUND: Studies have established that growth of children usually falters during the preschool age when the child is usually left in the hands of other care givers; as parents go to work. Feeding of the preschool children is sometimes solely under the care of Day Care Staff (DCS) whoselevel of knowledge and practice of nutritional care is unknown. Knowledge and practices of nutritional care among DCS in selected preschools were investigated. METHOD: A descriptive cross-sectional study design was used and 400 DCS were randomly selected for interview. A validated questionnaire with 50-point knowledge scale was used to collect information from the target population and this was complemented with observational checklist to assess the level of practice of nutritional care and environmental hygiene. Data obtained were analysed using both univariate and bivariate analyses including Chi-square test at p=0.05 level of significance. RESULTS: Most of the DCS were female (97.5%) and 47.5% specialised in child education. Few (28.8% and 25.0%) of the DCS had ever received training on child nutritional care during pre-service and in- service training, respectively. Only 20.0% of DCS had good knowledge of nutritional care, which reflected in the activities observed. Age was significantly associated with knowledge of preschool nutritional care.. CONCLUSION: Knowledge of day care staff on nutritional care of preschool children was found to be poorer as the age of staff increases. This may also contribute to the poor practices observed. Training on nutritional care among day care staff, especially the older ones is suggested.

Experiences and perceptions of menopause among women in Ibadan South East Local Government Area, Nigeria

Menopausal experiences and perceptions of menopausal women in Ibadan South East Local Government Area were determined. A three-stage sampling technique was used to select the LGA, wards, and participants for the study. Eight Focus Group Discussions (FGDs) were conducted and a validated questionnaire was used to interview 240 participants aged between 46 to 69 years. Five questions were used to assess participants' knowledge with each question attracting 1 point thus culminating to a maximum of 5 points. Data from the FGD were recorded on audio-tapes, transcribed and subjected to content analysis. Descriptive and Chi-square test statistics were used to analyze the quantitative data. The mean age of participants was 56.9 ± 6.2 years. The mean age at menopause was 46.1 ± 2.5 years. Eighty-five percent of participants had ever heard about menopause and the participants' major source of information included close relatives (75.5%). The mean knowledge score for menopause using a 5-point scale was 2.8 ±1.0. Only 28.0% of the participants could state at least one symptom of menopause and 4.1% could list the risks associated with it. Fifty-four percent who scored above the mean knowledge score had positive attitude towards menopause regarding it as a natural occurrence. Seventy percent had the belief that sexual intercourse causes sickness for menopausal women. The belief of 60.8% of the participants was that women should not tell anyone about their menopausal experiences. Eighty-three percent had experienced at least one out of the 19 common symptoms of menopause. Discomforting experiences attributed to menopause included dryness of the vagina (81.3%), pain during intercourse (76.7%) and joint pains (74.2%). Only 32.9% took action to alleviate the discomforts. Actions taken included self-medication (47.4%), adoption of sexual abstinence (13.0%) among others. Illnesses perceived to be associated with menopause included: fibroid (34.4%), weakness of the body (30.0%) and protruding stomach (18.0%). FGD revealed that many of the participants were of the opinion that sex should be avoided by menopausal women in order to prevent adverse effects associated with menopause. There are gaps in knowledge, wrong perceptions and use of inappropriate palliative measures regarding menopause among the participants. Public enlightenment and community-based patient education interventions are needed to address these challenges

Nutrition transition and chronic diseases in Nigeria.

Nutrition transition goes with industrialisation that fosters human development which is usually desirable, especially in developing nations. However, the health consequences of this development include high rates of preventable non-communicable diseases which are usually undermined in the quest for industrialisation. The goal of the present paper is to provide evidence-based information that will promote healthy lifestyle including healthy consumption pattern among urban dwellers. Relevant local and international literature was accessed and reviewed to harvest evidence-based information through the use of validated review guide in addition to observation from the field experience. Industrialisation promotes creation of more job opportunities and this facilitates proliferation of fast-food eateries in the cities. However, it was also observed that many of the available workplaces in urban areas are not health-promoting because employees have poor access to preventive health information and sensitisation to healthy lifestyle has been poorly considered. Ironically, weight gain among urban workers which may be linked with increased intake of high-energy foods and low participation in physical activities as a result of accessibility to many energy saving devices have been highlighted as some of the pull-pull factors that attract many people to the cities. Using the concept of health promoting workplace, the workforce in urban areas can be trained as agent of change in health-promoting lifestyle. Consumption of healthy indigenous foods through aggressive promotion of its health potentials should be seriously advocated through the use of existing structure of urban fast-food vendors who constitute a strong stakeholder in nutrition transition.

Metabolic alterations in different stages of hypertension in an apparently healthy nigerian population.

Metabolic syndrome (MS) amplifies hypertension (HTN) associated with increased risk of cardiovascular disease (CVD). MS components and other CVD risk measures were investigated in different stages of hypertension. 534 apparently healthy Nigerian traders aged 18-105 years were participants of a cohort study. The International Diabetes Federation (2005) and the National High Blood Pressure Education Program Coordinating Committee criteria were used for MS and HTN classifications, respectively. Anthropometric indices were obtained by standard methods. Levels of fasting plasma glucose (FPG), total cholesterol (TC), triglyceride (TG), and high-density lipoprotein cholesterol (HDLC) were determined by enzymatic methods, while low-density lipoprotein cholesterol (LDLC) was calculated. Data analysed statistically were significant at P < 0.05. 143 (26.8%), 197 (36.9%), and 194 (36.3%) of the traders had normotension, pre-HTN and HTN (stages 1 and 2), respectively. All indices tested except HDLC were significantly different among BP groups (P < 0.05). Waist to hip (WHR) and waist to height (WHT) ratios were significantly different between HTN groups (P < 0.05). HTN was associated with MS and female gender (P < 0.05). Metabolic alterations and significant HTN were observed. Treatment of the individual components of the syndrome and improvement of modifiable metabolic factors may be necessary to reduce MS and high BP.

Public health nutrition concerns on consumption of red palm-oil (RPO): the scientific facts from literature.

There appears to be a state of uncertainty as far as the health benefits of consumption of Red Palm Oil (RPO) is concerned from public health point of view globally. Literatures are replete with conflicting information on saturated fatty acid content of palm-oil, with caution on the possibility of increasing low density lipoprotein (LDL) in the blood. The implication of this may be subsequent elevation of serum cholesterol when the oil is consumed. This review paper is aimed at providing scientific facts from well referenced journal articles on public health nutrition benefits of RPO. It considers findings from animal and human experiments, to arrive at conclusion based on scientific evidence on the potential health benefits associated with consumption of RPO. Although, the level of saturated fatty acids content may suggest health risk, the presence of carotenoids and other powerful anti-oxidants in RPO makes it one of the best cooking vegetable oils with health promoting properties.

Nutrition education in medical training: the need to reconsider the sacrosanctity of medical education in Nigeria.

The "no controversy" status of the important role of nutrition in maintaining good health and disease management is becoming a gold standard in medical practice. Medical schools in developed countries and some in developing countries are beginning to renew interest in nutrition education for medical professionals. Despite difficulties envisaged in modifying the medical school curricula, it is inevitable that medical professionals need some basic nutrition knowledge appropriate for medical counselling in disease prevention and management. Cost effectiveness in providing health care services is now an important policy tool, which emphasizes preventive medical care. This is dependent on good nutrition education, which informs not only on food but healthcare and good environment. This article examines the need for nutrition education in medical schools, approaches that can be used to introduce nutrition education, using the available information from medical schools that have already integrated nutrition into their medical education curricula. It also identifies some of the barriers and strategies to overcome including specific actions for nutrition educators or whoever may be saddled with the responsibilities for initiating the development of nutrition curriculum for medical education.