One of the most challenging things to achieve in today’s technology-driven world is maintaining a reasonable balance between a busy work schedule and a healthy active lifestyle. We may be paying more for a lack of sleep than we know.
Poor sleep, failing nutrition and excess weight are chief results of working life and modern lifestyle patterns worldwide. Individuals and families are heavily affected by current trends which sometimes translate into various avoidable ailments.
Several studies have shown that reduced sleep time is associated with higher energy intake. In fact, one study showed that lack of sleep has led to the intake of 385 additional kilocalories per day, without energy expenditure compensation.
Many characteristics of the modern lifestyle may be the reason for frenetic sleeping patterns. Our bodies are armed with a so called ‘internal clock’ that, among others things, regulates the wake-sleep daily cycle. With light being one of the main external stimuli for this clock, our bodies are prepared to rest during night-time and be active during daylight. Excessive use of electronic media, altered exposure to light, and repeated changes in your daily lifestyle routine are some of the reasons for issues with sleep. In addition, some habits like smoking, alcohol consumption, excess of caﬀeine intake (especially late at night), or even exercising at the wrong time might worsen sleep duration and sleep quality. An average adult should get between 7 to 9 hours of sleep per day.
Science suggests that the relationship between sleep quality and excess weight might be bidirectional, which means that insufficient sleep is causing weight gain which means that obesity is causing impaired sleep. Here are a few reasons why.
In comparison with people that have normal sleep duration, those ones with shorter sleep duration do not only consume more calories in total, but they also consume more calories at night. Higher food intake late at night may be a reason behind lack of sleep. Food intake and nutritional status have also been linked to sleep reduction and daytime sleepiness. Currently, the evidence suggests a bidirectional relationship between sleep quality, duration and diet.
Four years into the adoption of the Ghana Nutrition Policy of 2013, it is still strapped with challenges that are limiting its implementation at the decentralized level.
Many programmes and strategies have been put in place to end malnutrition and hunger, but the results have been slow and cases continue to persist in many parts of the country with the three northern regions, the worst hit.
This has been so because no benchmarks are set to track results of interventions introduced to deal with issues bothering on nutrition among different segments of the society.
Despite reports of growing cases of under-nutrition in Ghana and the rest of Africa, strategies and interventions are not backed by strong political will and funding.
The result is that about 165 million children in the African continent suffer conditions related to nutrition.
Linked to this are the bad road infrastructure, the difficulty of transporting food from the farming communities and the high rates of post-harvest that tend to impact on food prices – unstable food markets.
A study by the World Food Programme and the Ministry of Food and Agriculture on Emergency food security and market systems in Ghana, in 2016, showed that 15.6 per cent of assessed households in the northern regions, Brong Ahafo and Volta Regions were food insecure. Of these, 15 per cent were moderately food insecure while less than one percent was severely food insecure.
The report said most of the food insecure households were found in the Talensi-Nabdam, Garu-Tempane, Bongo, Lambussie-Karni, Jirapa, Central Gonja, Savelugu-Nanton, Nanumba North and Tain.
Meanwhile three out of the 10 most food insecure districts were in the Upper East Region and this was consistent with the findings of the 2012 Comprehensive Food Security and Vulnerability Analysis that identified the Upper East Region as the most food insecure.
These at least provide facts and figures upon which any planned intervention should be based. This, however, has not been the case, regarding strategies employed in various interventions and policies aimed at promoting optimal nutrition in communities.
CARING FOR THE MALNOURISHED CHILD
A visit to one year old Kelvin’s house in Shega and Gideon, 15 months old, in Zubeong, near Tongo in the Talensi District exposed the difficulties their mothers faced in caring for their babies who weighed below the average weight at their ages and had mid upper arm circumference (MOAC) measurement ranging between 10.3 and 11.0cm.
These are living testimonies of the malnutrition cases some families have had to contend with.
Talata, one of the mothers told this reporter the ordeal she had to go through caring for her children, a difficult task for someone with no income source.
Dietary supplements to enhance the conditions of the malnourished children such as plumpy nuts have not been supplied to them because they are in short supply in the district.
The malnutrition situation in the Talensi District is disturbing as the Health Directorate has had virtually no budgetary support from the District Assembly to support any nutrition-related activity since 2015.
Speaking with the Talensi District Director of Health Services in Tongo, Ms. Estella Abazesi, said agriculture and health could not be separated. The implications of poor feeding of pregnant women and the effect on their babies should not be underestimated. She expressed worry at the increasing rate of cases of anaemia among pregnant women in the district, who have been visiting the health centre in Tongo and surrounding CHPS compounds.
STAKEHOLDERS WORKING FOR CHANGE
It is heart-warming that Organizations such as the Netherlands Development Organization – Ghana (SNV) in partnership with the International Food and Policy Research Institute (IFPRI), with funding from the Dutch Ministry of Foreign Affairs under the Voice for Change (V4C) Partnership programme, are working hard towards strengthening the capacity of Civil Society Organizations (CSOs)s to advocate for increased budgetary allocations and expenditure, increased private sector investment, improved coordination and effective implementation of the nutrition policies in Ghana.
Mr Eric Banye, Country Programme Coordinator of the V4C programme, identified the main challenges in the implementation of the Nutrition policy as the limited coordination and weak relationship within the stipulated implementation structures of the policy from the national, district and community levels of the nutrition committees.
Although a number of sectors including the Ministries of Finance, Agriculture, Health and Gender among others were key players in the structures, clear ownership of the implementation was lacking.
He added that not until the government and for that matter the National Development Planning Commission accepted to lead the implementation of the policy, stakeholders would continue to work in isolation, something unhelpful to delivering the expected outcomes.
Mr Ibrahim Akalbila, the Coordinator of the Ghana Trade Livelihoods Coalition, noted at a just ended Regional Policy Dialogue on the Planting for Foods and Jobs (PFJs) that the government’s agricultural interventions were still bedevilled with difficulties of accessing agricultural services.
He underlined that good nutrition was a pointer to real development.
Lamenting on the high rates of malnutrition, stunting and wasting among Ghanaian adults, Mr Akalbila said more was needed to be done.
His organization was passionate about monitoring the implementation of some government policy interventions and to advocate for better services.
“If we produce and don’t eat right, it is a problem.” Households should be able to produce enough, buy enough and be able to feed well with nutritious food.
“When every Ghanaian child has access to nutritious food from first day of birth to adulthood and when we are able to report severe cases of malnutrition in our communities and finally when agriculture inure to better livelihoods then I can say we have arrived”
The Goal Two (2) of the Sustainable Development Goals (SDGs), places emphasis on ending hunger, achieving food security, improving nutrition and promoting sustainable agriculture.
It further employs all countries to end all forms of malnutrition by 2030, including achieving, by 2025, the internationally agreed targets on stunting and wasting in children less than 5 years of age, address the nutritional needs of adolescent girls, pregnant and lactating women and older persons.
As the clock ticks there is need to focus more investment and priority attention on nutrition.
It is important to have targets and consumption indicators to address malnutrition on annual basis especially in the District Assemblies Annual Programme of Actions.
The Government of President Nana Addo Dankwa Akufo-Addo’s flagship “Planting for Food and Jobs” policy is a welcome intervention – promoting agriculture, food security and job creation. It also shows how the international community is eager to assist improve livelihoods and fight hunger as exemplified by the 125 million Canadian dollars support.
Ghana must deliver the PFJs well and endeavour to remove any gaps in the distribution of inputs so that it will be equitable, to avoid fertilizer smuggling and also ensure its availability at the right time for the farmers.
Roads leading to the farms to cart food to the markets should be made accessible to prevent post-harvest losses.
The intervention should also be gender sensitive to make sure that women who bear the crux of caring for the families have enough to eat, earn income and remain healthy.
When faced with a crisis, our natural reaction is to deal with its immediate threats. Ateka* came to the make-shift clinic with profuse diarrhoea: they diagnosed cholera. The urgent concern in the midst of that humanitarian crisis was to treat the infection and send her home as quickly as possible.
But she came back to the treatment centre a few days later – not for cholera, but because she was suffering from severe acute malnutrition. Doctors had saved her life but not restored her health. And there were others too, who like Ateka eventually succumbed to severe malnutrition.
This scene could have taken place in any of the dozen or so African countries that have suffered a cholera outbreak this year alone. Experience from managing epidemics has shown that when the population’s baseline nutritional status is poor, the loss of life is high. Beyond malnutrition’s damaging impact on bodily health, it weakens the immune system, reducing the body’s resistance to infection and resilience in illness.
On the flipside, integrating the treatment of malnutrition in the response to humanitarian crises assures survival and recovery better than an exclusive focus on treating diseases.
As countries across the continent commit themselves to Universal Health Coverage (UHC), the same lessons need to apply. UHC is ultimately about achieving health and wellbeing for all by 2030, a goal that is inextricably linked with that of ending hunger and all forms of malnutrition.
With 11 million Africans falling into poverty every year due to catastrophic out-of-pocket payments for healthcare, no one can question the need to ensure that everyone, everywhere, can obtain the health services they need, when and where they need them, without facing financial hardship.
As wealth patterns and consumption habits change, the African region is now faced with the triple burden of malnutrition – undernutrition coupled with micronutrient deficiencies and increasing levels of obesity and diet-related non-communicable diseases.
In 2016, an estimated 59 million children in Africa were stunted (a 17 percent increase since 2000) and 14 million suffered from wasting – a strong predictor of death among children under five. That same year, 10 million were overweight; almost double the figure from 2000. It’s estimated that by 2020, non-communicable diseases will cause around 3.9 million deaths annually in the African region alone.
Yet most of the diseases that entail catastrophic costs to individuals, households and national healthcare systems in Africa could be avoided if everyone was living actively and consuming adequate, diverse, safe and nutritious food. After all, a healthy diet not only allows us to grow, develop and prosper, it also protects against obesity, diabetes, raised blood pressure, cardiovascular disease and some cancers.
To tackle malnutrition, achieve UHC and ultimately reach the goal of health and wellbeing for all, governments need to put in place the right investments, policies and incentives.
As a starting point, governments need to assure the basic necessities of food security, clean water and improved sanitation to prevent and reduce undernutrition among poor rural communities and urban slum populations in Africa. For example, reduction in open defecation has been successful in reducing undernutrition in Ethiopia, parts of the Democratic Republic of Congo, Mali and Tanzania.
Then, to influence what people eat, we need to do a better job at improving food environments and at educating them about what constitutes a healthy diet. Hippocrates asserted that “all disease begins in the gut,” with the related counsel to “let food be thy medicine.”
Current research on chronic diseases is reasserting the health benefits of consuming minimally-processed staple foods which formed the basis of traditional African diets. This information needs to be communicated to the public through the health and education sectors and complemented by agricultural innovation to increase production of the nutrient-rich grains, crickets, herbs, roots, fruits and vegetables that were the medicine for longevity among our hardy ancestors.
But until that awareness is in place, policies and programmes are urgently needed to protect and promote healthy diets right from birth. This includes regulating the marketing of breast milk substitutes and foods that help establish unhealthy food preferences and eating habits from early childhood.
In South Africa, for example, the country with the highest obesity rate in Sub-Saharan Africa, the government has introduced a ‘sugar tax’ that is expected to increase the price of sugary soft drinks. The hope is that this will encourage consumers to make healthier choices and manufacturers to reduce the amount of sugar in their products.
Finally, governments must create incentives – and apply adequately dissuasive sanctions when necessary – to help food manufacturers collaborate in promoting healthy diets through reformulation and informative labelling, for example. In cases of food contamination, we are very quick to take products off the shelves. Yet we are much slower to react to the illnesses caused by processed foods containing high quantities of salt, sugars, saturated fats and trans fats.
A shortcut to achieving Universal Health Coverage is to reduce the need for costly treatments. And there is no better way to do that than to ensure that everyone, everywhere, preserves their health and has access to safe and nutritious food: let food be thy medicine.