Author: Nigerian Heart Foundation

As the global community commemorated World Milk Day Thursday, the Nigerian Heart Foundation (NHF) in collaboration with Three Crowns Milk, has urged the newly inaugurated administration of President Bola Ahmed Tinubu, to prioritise local milk production, which offers better health to the populace than imported milk.

The stakeholders who emphasised the importance of milk consumption in boosting the nutritional needs of citizens, however, decried the low awareness of milk intake among Nigerian population.

They explained that milk is whole food, as it contains 13 essential nutrients that play an important role in growth and development for both adults and children.

The 13 essential nutrients in milk, according to them are: protein, calcium, phosphorus, vitamin A, vitamin D, riboflavin (B2), niacin (B3), pantothenic acid (B5) and cobalamin (B12), iodine, potassium, selenium and zinc.

Professor Tola Atinmo, nutrition director at the Nigerian Heart Foundation, in a world press conference noted the crucial functions of dairy products in maintaining healthy diets, responsible food production, and supporting livelihoods and communities. He pointed out that dairy has a vital role in global food systems, providing economic, nutritional, and social benefits to the populace.

He nonetheless bemoaned the burden of malnutrition in Nigerian children as available statistics show that 37 per cent of the 31 million children under five years are stunted due to lack of adequate milk consumption. He therefore called for the production of more dairy products locally for consumption and national economic growth.

“School feeding programmes have been identified as an important social protection mechanism as they provide good nutrition and education to children, and as well support local economies. The benefits of providing school children with milk are well-recognised. The well-known natural richness of dairy products makes them excellent sources of an abundant supply of high-quality protein, calcium phosphorus, potassium, iodine, vitamins B2 and B12.

“Evidence shows that a quality education combined with as a secure package of health and nutrition interventions at school, such as school feeding, can contribute to high cognitive children and adolescent development and build human capacity,” he stated.

The executive director, Nigerian Heart Foundation, Dr Kingsley Akinroye, dispelled the widespread notion that adults above 40 years should not take milk due to the risk of cardiovascular diseases, stressing that dairy products are essential for the maintenance of adults health.

He further explained that heart-healthy milk must be low in saturated fat, almost zero level of trans fat and must be low in sugar, which explains need for locally manufactured dairy products to meet the health needs of Nigerians .

Dr Akinroye urged the Tinubu-led government to formulate policies that will encourage local manufacturing of milk, lamenting at the present importation figure of dairy products, which is not less than 80 per cent.

“I will be glad to see in ten years time that milk local content has improved significantly, as dairy products low in sodium, saturated fat and sugar are heart-friendly”, he said.

In his contribution, Mr Victor Adeniran, brand manager, Three Crowns Milk, hinted on the activities of the company in promoting the importance of dairy in healthy diet, as they recently reached over 5000 consumers in Osogbo and Kano on healthy lifestyle.

“As a brand, we are not limited to milk promotion, but healthy lifestyle, which we have been doing for over 30 years. At Friesland Campina WAMCO, we delight in supporting our farmers to producing heart-healthy milk and we will continue to do that for the health of Nigerians”, he disclosed.

Source: www.pharmanewsonline.com

Deaths from cardiovascular disease (CVD) jumped globally from 12.1 million in 1990 to 20.5 million in 2021, according to a new report from the World Heart Federation (WHF). CVD was the leading cause of death worldwide in 2021, with four in five CVD deaths occurring in low and middle-income countries (LMICs).

The World Heart Report — launched at the 2023 World Heart Summit — provides the first in-depth analysis of CVD risk and mortality data worldwide, and unique analysis of country-level policy implementation to mitigate CVDs.

The highest CVD death rates occur in the Central Europe, Eastern Europe, and Central Asia region. Though the overall number of CVD deaths increased in the last three decades—largely due to an ageing and growing population—the CVD death rate fell globally from 354.5 deaths per 100,000 people in 1990 to 239.9 deaths per 100,000 people in 2019. This decline was however uneven across regions; the fastest decline in death rate was experienced in high-income countries.

Professor Fausto Pinto, co-author of the report and former WHF President, said: “The data doesn’t lie. This report confirms the serious threat that cardiovascular disease poses all over the world, particularly in low- and middle-income countries. Up to 80 per cent of premature heart attacks and strokes can be prevented. It’s vital that countries prioritise rolling out tools and policies to protect people from CVD.”

The report highlighted that high blood pressure, air pollution, tobacco use, and elevated LDL cholesterol were among the leading contributors to CVD deaths. Overall, a key finding is that risk factors vary across regions, making it vital that countries be aware of their risk profile. It also found that countries that invest more in healthcare as a percentage of gross domestic product (GDP) have lower CVD death rates, while CVD death rates are higher in countries where people pay more out-of-pocket for healthcare.

“Investing in healthcare saves lives. This evidence is indisputable. In line with WHO recommendations, countries must invest at least 5 per cent of their GDP to help bring down CVD death rates and morbidity,” said Professor Mariachiara Di Cesare of the Institute of Public Health and Wellbeing at the University of Essex, which compiled and analysed the data in collaboration with WHF.

In its analysis of country-level policies to improve CVD health, WHF found that 64 per cent of countries have implemented at least seven of eight recommended policies, including national tobacco control programmes, availability of CVD drug treatments, and operational units within Ministries of Health. The lowest level of policy implementation was found in Sub-Saharan Africa, where over 50 per cent of countries do not have availability of CVD drugs in primary care facilities, a CVD National Plan, or a Non-communicable diseases (NCD) Unit.

The report includes five recommendations to get progress on CVD health back on track. These recommendations cover implementing all key policies to combat CVD, ensuring CVD health interventions are adequately funded, and continuing efforts to improve data on CVDs and their risk factors, particularly in LMICs.

“Good data can help drive good policy – the report´s recommendations make clear that the opportunity is still there to accelerate action toward the goal of reducing premature mortality from NCDs by one-third by 2030,” said Pinto.

Courtesy: www.world-heart-federation.org

Image courtesy American Heart Association

Nigeria has become the second African country after South Africa to adopt a new best practice trans-fat elimination policy, that, according to estimates, will save almost 1,200 lives annually.

The country is seen to have set a powerful example for other African countries that seek to safeguard their citizens’ heart health and work toward a trans-fat-free continent.

Industrially produced trans fat (also called industrially produced trans-fatty acids) is commonly found in packaged foods, baked goods, cooking oils, and spreads.

Trans fat intake is responsible for up to 500 000 premature deaths from coronary heart disease each year around the world, according to the World Health Organization (WHO).

“Not only would passing best practice policies help to reduce the burden of heart disease throughout Africa, but it would inhibit the dumping of unhealthy foods into Africa as the rest of the world passes policies to ban the toxic food additive. Already, nearly half of the world’s population is covered by trans-fat-free policies,” Dr. Renu Garg, Senior Vice President of Cardiovascular Health at Resolve to Save Lives, who made the submission in a statement said.

He said that the regulation was the outcome of years of cooperation and work between the Federal Ministry of Health, the Nigerian National Agency for Food and Drug Administration and Control (NAFDAC), the Network for Health Equity and Development, Corporate Accountability and Public Participation Africa (CAPPA), the Global Health Advocacy Incubator (GHAI), and Resolve to Save Lives.

“We look forward to supporting the Ministry of Health and NAFDAC to implement the regulation and apply for the World Health Organisation’s validation programme which will recognize countries that have officially eliminated industrially-produced trans-fat from their food supply,” Garg stated.

WHO and the nonprofit organization Resolve to Save Lives have teamed up to promote the creation and execution of the REPLACE action package.

The WHO’s REPLACE action package, which was introduced in 2018, offers a tactical method of eliminating industrially produced trans-fat from national food sources.

With a prior elimination target set for 2023, population coverage of best-practice policies has expanded about six-fold since WHO initially advocated for the global eradication of industrially produced trans fat in 2018.

According to a status report released in January, 2.8 billion people are now safeguarded worldwide thanks to 43 nations that have adopted best-practice laws to combat trans fats in food.

However, despite significant progress, this still exposes 5 billion people to the devasting health effects of trans fat, making the global target for its complete eradication in 2023 now unachievable.

In Africa, only South Africa has had a best-practice regulation in place since 2011. Notably, none of the East African nations have best-practice TFA policies and are all in the red.

Kenya has a national strategy that calls for the elimination of TFA, but it has failed to implement the necessary procedures and set up a monitoring system for its restrictions.

As the year began, Egypt took steps to comply with the WHO’s advice on safer levels of trans fats by requiring manufacturers and importers to limit trans fats levels in all food to two grams per 100 grams of total fat within 12 months.

Over the next 25 years, the global ban on trans fats could save more than 17 million lives and avert at least twice as many heart attacks.

Courtesy: foodsafetyafrica.net

Worried by the high prevalence of hypertension in the Nigerian society, attributed to unhealthy lifestyles and shortage of medicines to manage the condition, medical experts have called for the inclusion of hypertension management in the Basic Health Care Provision Fund (BHCPF). They also canvassed the adoption of routine screening for hypertension and identification of risk factors at the Primary Healthcare (PHC) level; as well as involvement of people living with cardiovascular diseases in decision-making process on access to hypertensive care, screening and treatment.

The practitioners who spoke at a roundtable meeting organised by the World Heart Federation (WHF) in collaboration with Nigerian Heart Foundation (NHF) harped on the importance of increased access to medications and medical devices at PHC and community levels for hypertensive patients, arguing that patients’ inability to access medicines, especially non-affordability of monitoring devices by retirees has led to the untimely deaths of many.

In easing the bottleneck around hypertensive medication accessibility to the vulnerable at the grassroots level, the stakeholders urged governments at all levels to increase funding for the prevention and management of high blood pressure, while stressing the need for food manufacturers and individuals to reduce salt consumption, which is an identified risk factor in the development of the condition.

Speaking at the meeting, World Heart Federation Hypertension Programme Manager, Elisa Codato, highlighted the importance of communicating with the people in their local dialects, as that will enhance the assimilation of the awareness campaign messages on lesser salt consumption and more physical exercise, which are proven means of preventing cardiovascular diseases. She further corroborated the call for medicines availability, as she tasked officials at the helms of affairs at the Federal Ministry of Health, to place this on priority list in order to improve the health of the nation.

“Focus on availability of medicines is my first suggestion to Nigerian policymakers, while they are also to ensure that medicines are available to people at affordable rates, which will not adversely affect their already stressed finances. Of course, inclusion of people living with non-communicable diseases and cardiovascular diseases into relevant policymaking committees is crucial, for accurate and timely decisions to be made in impacting their health positively.

“And then I think there’s a lot of work to do on salt consumption. While there is a food policy in the country, it is need for concerted advocacy on lesser salt consumption and the need for people to embrace healthy eating habits, which should be the preference for the population compared to unhealthy food options that are available. I think this is common trend in most African countries, where healthy foods are more expensive than unhealthy ones. So I think the government should do a lot of work to resolve this challenge”, Codato said.

The World Heart Federation representative further raised the concern on the observed absence of nicotine replacement services in the country, adding that though there is no high prevalence of smoking in Nigeria, but since smoking is a major risk factor for developing high blood pressure, it is expected that nicotine replacement therapy are available in the country, to assist people smoking quit easily.

“So I think another recommendation for the government is to focus on how to strengthen availability of such services to help the population stop smoking. And once again, awareness campaigns can also support these policies”, she remarked.

In his contribution, Director, Hypertension, NHF, Prof. B.J.C. Onwubere, listed the various risk factors that predispose people to hypertension, as he suggested mitigating measures against them. He mentioned genetics, sedentary lifestyle, unhealthy eating habits, and obesity, as red flags to guard against.

While people with genetic risk factor have little or no control over the development of the condition according to him, he said it has been found that more males than females are hypertensive, but post-menopausal women are likely to be the in same group as men.

“Other risk factors are obesity due to inactivity; as a lot of people today just sit down to press their phones instead of taking a walk. Eating abnormal foods is another factor, as it has been discovered that when people consume a lot of cholesterol, it can block the blood vessels that supply the heart and the brain. Foods that make you gain much weight should also be avoided. It is advisable to eat more vegetables and fruits, but people with diabetics should regulate their fruits intake”, he advised.

Addressing the gathering on the resolution of the symposium, Executive Director, NHF, Dr Kingsley K. Akinroye, among other things mentioned the need for the provision of adequate and appropriate equipment, human and financial resources at the PHC centres; ensuring a two-way referral system between the PHC and secondary/tertiary healthcare facilities; as well as complete implementation of TSTS policy

Other recommendations presented at the various plenary sessions at the meeting according to him were: streamlining of guidelines for the management of hypertension; wide-spread advocacy for front of package labelling; standardised use of simple treatment protocols at the PHC and SHC levels; adoption of a simplified model of treatment for hypertension; training and re-training of healthcare workers at PHC level and increase access to medication and medical devices at PHC and community levels; strengthening of advocacy and support for hypertension at national, sub-national and community levels; improved hypertension data documentation on the national database and domestication of WHO-hearts strategies

Source: Pharmanews

Mexico has taken a major step in the fight against non-communicable diseases thanks to a bill that prohibits adding partially hydrogenated oils, commonly known as trans fats, to food and nonalcoholic beverages. Studies suggest that trans fats cause nearly 20,000 preventable deaths each year in Mexico, making it one of the most significant dietary risk factors for cardiovascular disease, according to the Government of Mexico.

The new law bans the use of trans fats in industrial products intended for human consumption, reads a press release by the Ministry of Health. The bill, which adds Article 216 Bis to the General Law of Health, was approved by the Chamber of Deputies with 472 votes in favor, zero against and zero abstentions.

Hugo López-Gatell, Deputy Minister of Health, praises the bill for its significance in reducing the prevalence of metabolic cardiovascular mortality, as most trans fats consumed by people are part of junk food. López-Gatell emphasizes the work of the Mexican government in addressing the major epidemic of non-communicable diseases in the country.

The addition to Article 216 Bis of the General Health Law reads that “Foods, non-alcoholic beverages, oils and fats may not exceed two parts of industrially produced trans fatty acids for every one hundred parts of total fatty acids. The Ministry of Health will establish the regulation bases for trans fatty acids of industrial production under the terms of this precept.”

With the addition of Article 216 bis, Mexico is in compliance with the recommendations from the Pan American Health Organization (PAHO) and the World Health Organization (WHO), which suggest to limit trans fats in food and prohibit the use of partially hydrogenated oils.

Ruy López Riadura, General Director, National Center for Preventive Programs and Disease Control (CENAPRECE), says that this achievement could not have been made without the coordinated work of Mexico’s Ministry of Health, civil society organizations and the correspondent Legislative Branch. This legislation was a “pending agenda that had been stuck or frozen since previous legislatures,” says López. The next step to eliminate industrial trans fatty acids is to work on the regulations, he adds, which is part of the administration’s strategy to reduce the consumption of harmful substances contained in some foods.

With this, Mexico joins countries such as the US, Canada and Denmark, which have already banned the use of partially hydrogenated oils and trans fats. López-Gatell says that this measure, combined with front labeling, will help to combat cardiovascular disease, one of the most prevalent causes for premature deaths across the world.

The Nigerian Heart Foundation (NHF) and nutritional experts have expressed worry over the increasing cardiovascular diseases and related death in Nigeria.

The experts, who spoke at the NHF’s “Stakeholders’ Meeting on Lipids and Cardiovascular Health: Global Status and the Nigerian Perspective” on Tuesday in Lagos, called for national guidelines on production and consumption of foods and beverages.

The scientists agreed that diet remained the commonest risk factor in the cardiovascular diseases.

Speaking, Prof. Rasak Sanusi, the Chairman of occasion, a former two-term Head of Department, Human Nutrition, University of Ibadan, stressed the importance of controlled and regulated diet to enhance cardiovascular health.

“There is a need for the development of a national guidelines for production and consumption of healthy foods with acceptable lipid concentration based on global standard and best practices.

“The quality of life cannot be described to what it was 10 or 15 years ago.

“There is a difference between feeding and eating. Eating is what human beings do, feeding is what animals do.

“The difference between them is choice. When we have choices of what we eat then we are eating.

“On the other hand, when choices are removed, we are only feeding. With this definition today, I wonder how many of us in Nigeria are actually eating,” Sanusi said.

Calling for the re-examining of the role of each of the stakeholders, Sanusi said that Nigerians should be informed about their cardiovascular health.

He pointed out the expectations for the meeting include examination of the increase in the cardiovascular diseases in Nigeria, the main risk factor, and to identify guidelines and focus on research agenda.

Dr Femi Mobolaji-Lawal, the Chairman, Executive Council, NHF said: “Ultimately, what we consume affect out health. What we consume has direct relationship with our cardiovascular system, especially our heart.

“We know that what we consume, especially the Lipid affect our heart.”

Mobolaji-Lawa said that the multi sectorial meeting had become necessary to review evidence of what was happening globally and experience Nigeria, to guide policy markets and activities.

He emphasised the need to disseminate information to the people especially consumers.

Also speaking, Dr Olorogun Sonny Kuku, the President, Non-Communicable Diseases (NCD) decried low life expectancy in Nigeria, saying cardiovascular diseases accounted for a lot of deaths in the country.

Describing the meeting as appropriate, Kuku said, “In this part of the country, we love lipids. Lipids need to be controlled and when controlled, life expectancy can be raised to 80 year.”

Doing an overview, Prof. Isaac Adeyemi, Director, Scientific Affairs, NHF said that the objective was for update on the current global and national status lipid concentration and profile in foods and beverages as well as the potential impacts of food on cardiovascular health.

Adeyemi said that the goal was to ensure that Nigerians live a healthy live, “that will ensure or reduce the increasing rate of cardiovascular diseases in this country.

Urging the consumers to select heart health options, the professor stressed the need to invest in monitoring and surveillance mechanism such as laboratory capacity to measure Trans Fatty Acids (TFA) content in foods.

On challenges, he said that foods and beverages being consumed must align with global health standards, saying, “it is important that food industry strives as much as possible to meet national, regional and global standards.

Adeyemi also stressed the need for early warning system that would involve scientist, academia, government agencies in curbing the rising incidence.

He added: “Consumers must read the nutrition facts on food products. Industry should replace trans fats in processed food as soon as possible and where feasible with healthy alternatives.

“The consumers must be stimulated should consume fish as part of healthy diet.”

Adeyemi emphasised the need for the experts to sensitise not only the public but also the government and industries about the important of having healthy foods devoid of trans fats and unhealthy fatty acids.

“Also, we must sensitise the public on the issue of point of package labeling.

“This is very important. As an individual and a country, consumers should be aware of the importance of point of package labeling.

“This will make them to identify the nutritional value of any food materials being purchased,” he added.

Dr Kingsley Akinroye, the Executive Director, NHF said: “We want Nigerians to live long, we wants Nigerians to live healthy and we want a productive population. In few years, quite a lot of our young executives have been dying suddenly.

“The commonest cause of sudden death is heart. We want everybody to be healthy. Right from the family to the policy makers., everybody has got responsibility.

“We know that the number factor in heart disease is diet and commonest culprit in the diet is fat. Although salt is also there but fat is key.”

According to him, in the last 15 years, the NHF has been working in Nigeria and has labelled some oils which were heart friendly.

He said that even though NHF was an international organisation, it ensure some flexibility in the contents to fit Nigeria content.

“We review what we do every four year, the last time we did this was 2016 and so, now this is high time we fall into global standard.

“Everybody here agreed that we need to live healthy and longer. To live longer, there are certain things we must do as individual, there are certain things government and industry must do.

“Individuals should go take care of themselves and ensure that they check contents of foods and beverages they buy. Is it friendly, does it carry the logo of Nigerian Heart Foundation.

“Government must invest in this cause, in. what we are doing and ensure more partnership with us.”

The participants were drawn from all the relevant agencies, academia, food industry, research scientists, university, government, regulatory agencies, organisations, consumers among others.

Courtesy: Shadanpama Repoters

Worried by the rising cases of cardiovascular diseases in the country, especially hypertension, the Nigerian Heart Foundation (NHF), cardiologists and nutritionists have advocated review of national guidelines for food production.

They expressed concerns over a World Health Organisations (WHO) report that 76.2 million Nigerians are living with hypertension, which poses the highest cardiovascular disease burden.

Cardiovascular diseases are the leading cause of deaths globally. An estimated 17.9 million people died from cardiovascular diseases in 2019, of which 85 per cent were due to heart attacks and strokes. Eliminating trans fat is seen as an easy way to reduce the numbers.

The experts led by the NHF have also bowed to pressure by the WHO, European Food Safety Authority (EFSA) and United States Food and Drugs Administration (FDA) to readjust safety limit for foods containing palm oil derivatives/Saturated Fatty Acids (SAFAs).

Consequently, the NHF has adopted new safety limit for palm oil derivatives in food products and set June 30, 2024 deadline for recertification of cooking oils as heart friendly. They also insist on zero limits for trans fat in foods.

They also decried association of added salt with hypertension, heart failure, stroke and heart attack, even as they explained how to detect cooked and packaged foods with high level of salt.

Cardiovascular diseases (CVDs) are a group of disorders of the heart and blood vessels. They include: coronary heart disease – a disease of the blood vessels supplying the heart muscle; cerebrovascular disease – a disease of the blood vessels supplying the brain; peripheral arterial disease – a disease of blood vessels supplying the arms and legs; rheumatic heart disease – damage to the heart muscle and heart valves from rheumatic fever, caused by streptococcal bacteria; congenital heart disease – birth defects that affect the normal development and functioning of the heart caused by malformations of the heart structure from birth; and deep vein thrombosis and pulmonary embolism – blood clots in the leg veins, which can dislodge and move to the heart and lungs.

According to WHO, heart attacks and strokes are usually acute events and are mainly caused by a blockage that prevents blood from flowing to the heart or brain. The most common reason for this is a build-up of fatty deposits on the inner walls of the blood vessels that supply the heart or brain. Bleeding from a blood vessel in the brain or from blood clots can cause strokes.

Trans fat, also called trans-unsaturated fatty acids, or trans fatty acids, is a type of unsaturated fat that occurs in foods. Trace concentrations of trans fats occur naturally, but large amounts are found in some processed foods.

A consultant cardiologist and Executive Director, NHF, Dr. Kingsley Akinroye, while speaking at a stakeholders meeting in Lagos, last week, with the theme, ‘Lipids and Cardiovascular Health,’ said: “We want Nigerians to live long, we wants Nigerians to live healthy and we want a productive population. In few years, quite a lot of our young executives have been dying suddenly.

“The commonest cause of sudden death is heart. We want everybody to be healthy. Right from the family to the policy makers, everybody has got responsibility.

“We know that the number one factor in heart disease is diet and commonest culprit in the diet is fat. Although salt is also there but fat is key.”

The participants at the stakeholders meeting were drawn from all the relevant agencies, academia, food industry, research scientists, university, government, regulatory agencies, organisations, and consumers among others.

According to Akinroye, in the last 15 years, the NHF has been working in Nigeria and has labelled some oils, which were heart friendly.

He said that even though NHF was an international organisation, it ensures some flexibility in the contents to fit Nigeria content.

The cardiologist said: “We review what we do every four years, the last time we did this was 2016 and so, now this is high time we fall into global standard.

“Most people here agreed they needed to live healthy and longer. To live longer, there are certain things we must do as individual and other things government and industry must do.

“Individuals should go take care of themselves and ensure that they check contents of foods and beverages they buy. Is it friendly, does it carry the logo of Nigerian Heart Foundation.

“Government must invest in this cause, in. what we are doing and ensure more partnership with us.”

Akinroye said Codex has the acceptable maximum limit for SAFA as 30g/100g of total fat in food products.

https://2907d9045475773dfa47aacfbb70581a.safeframe.googlesyndication.com/safeframe/1-0-40/html/container.html The Codex Alimentarius is a collection of internationally recognised standards, codes of practice, guidelines, and other recommendations published by the Food and Agriculture Organisation (FAO) and WHO of the United Nations relating to food, food production, food labeling, and food safety.

He, however, said American Heart Association, 50 years ago recommended the criteria of 30g/100g of total fat as acceptable in food products. This was recently reviewed.

The cardiologist said the World Heart Federation (WHF), the parent international body of NHF, recently released the criteria on SAFA in line with Codex and recommended SAFA maximum limit of 30mg/100 of total fat in foods.

Akinroye said all country members of WHF, including Nigeria are expected to comply with the recommendations. Akinroye said NHF, since inception of the NHF Front of Pack Labelling in 2003, in collaboration with the National Agency for Food and Drug Administration and Control (NAFDAC), adopted the upper limit of SAFA as 36g/100g of total fat acceptable to all products permitted to carry NHF Heart Mark Logo.

Akinroye, however, said there has not been clinical trials and supportive scientific evidence to back up the position of NHF over the last decade. “Unfortunately, research institutes, universities, oil manufacturing industries in Sub- Saharan Africa, where palm oil is majorly consumed daily have consequently not responded to scientific research to support the need to review the acceptable criteria,” he said.

The cardiologist said NHF has now made a position statement to adopt the acceptable level of SAFA of 30g/100g of total fat from June 30, 2024 for all food products to carry the NHF Heart Mark Logo, and total trans fat of zero (0.00) limit for certification or recertification.

https://2907d9045475773dfa47aacfbb70581a.safeframe.googlesyndication.com/safeframe/1-0-40/html/container.html On the implication of added salt in cardiovascular diseases, Akinroye said there are few studies in Nigeria that have shown high levels of salt consumption in homemade foods but not on fast foods.

The cardiologist said the implications of excess salt consumption is high level of mean blood pressure in individuals consuming high sodium content, and also leading to increased association with hypertension, heart failure, stroke and heart attack.

On how to check the level of salt in foods, Akinroye said: “For consumers it is advisable to check the content of sodium in all food items purchased. To promote easy identification of food with high contents of sodium; Nigerian Heart Foundation has been promoting the front- of – pack labelling programme in partnership with NAFDAC since 2003 in Nigeria. Products that participates in the programme and that fulfill the criteria carry NHF Heart – Check logo indicating the products fulfill the acceptable criteria.”

Akinroye said there are healthier alternatives like using herbs, and natural food products that could give the food a friendly taste.

Chairman Executive Council, NHF, Dr. Femi Mobolaji-Lawal, while speaking at a stakeholders meeting in Lagos, last week, said studies have shown that since the onset of COVID-19 in the country, people living with cardiovascular diseases, amongst other Non-Communicable Diseases (NCDs) were significantly affected and died from COVID-19.

Mobolaji-Lawal said statistics has shown that cardiovascular diseases pose a high burden on health systems; an increasing trend that can be controlled by making healthy food choices, among others.

Specifically, he disclosed that the Nigerian Policy and Strategic Plan of Action on NCDs, a Federal Ministry of Health document, proposes to look at different ways to manage NCDs, a rising cause of morbidly and mortality in the country.

To this end, he disclosed that in recognition of the rising prevalence of cardiovascular diseases in the country and the importance of prevention strategies is co-organising with World Heart Federation in March this year a “National Roundtable Discussion” on cardiovascular diseases, which is to focus on hypertension.

In her speech, Director General, NAFDAC, Prof. Christianah Mojisola Adeyeye, disclosed that coronary heart disease deaths in Nigeria reached 53,836 or 2.82 per cent of total deaths, and are responsible for the greatest proportion of the total mortality due to NCDs.

Represented by her Special Assistant, Dr. Gbenga Fajemirokun, Adeyeye said there is critical need to pay more attention to meeting global standards with a view to promoting cardiovascular health in the country.

According to her, “the development of socio-economic space and increasing disposable income of Nigerians giving them freedom to fund their healthier food choices is expected to influence the regulatory bodies in the long run. This would avoid adverse impact on widening of the socio-economic gaps and ensure closing of such gaps and lessening of diseases of public health concerns.”

Also, the experts expressed worry over the increasing cardiovascular diseases and related death in Nigeria.

The experts called for national guidelines on production and consumption of foods and beverages.

The scientists agreed that diet remained the commonest risk factor in the cardiovascular diseases.

Chairman of occasion and a former two-term Head of Department, Human Nutrition, University of Ibadan, Prof. Rasak Sanusi, stressed the importance of controlled and regulated diet to enhance cardiovascular health.

“There is a need for the development of a national guidelines for production and consumption of healthy foods with acceptable lipid concentration based on global standard and best practices.

“The quality of life cannot be described to what it was 10 or 15 years ago.

“There is a difference between feeding and eating. Eating is what human beings do and feeding is what animals do.

“The difference between them is choice. When we have choices of what we eat then we are eating.

“On the other hand, when choices are removed, we are only feeding. With this definition today, I wonder how many of us in Nigeria are actually eating,” Sanusi said.

Calling for the re-examining of the role of each of the stakeholders, Sanusi said that Nigerians should be informed about their cardiovascular health.

He pointed out the expectations for the meeting include examination of the increase in the cardiovascular diseases in Nigeria, the main risk factor, and to identify guidelines and focus on research agenda.

Mobolaji-Lawal added: “Ultimately, what we consume affect out health. What we consume has direct relationship with our cardiovascular system, especially our heart.

“We know that what we consume, especially the Lipid affect our heart.”

Mobolaji-Lawa said that the multi sectorial meeting had become necessary to review evidence of what was happening globally and experience Nigeria, to guide policy markets and activities.

He emphasised the need to disseminate information to the people especially consumers.

Also speaking, President of Non-Communicable Diseases (NCD) Committee, Dr. Olorogun Sonny Kuku, decried low life expectancy in Nigeria, saying cardiovascular diseases accounted for a lot of deaths in the country.

Describing the meeting as appropriate, Kuku said: “In this part of the country, we love lipids. Lipids need to be controlled and when controlled, life expectancy can be raised to 80 year.”

Doing an overview, Director, Scientific Affairs, NHF, Prof. Isaac Adeyemi, said that the objective was for update on the current global and national status lipid concentration and profile in foods and beverages as well as the potential impacts of food on cardiovascular health.

Adeyemi said that the goal was to ensure that Nigerians live a healthy live, “that will ensure or reduce the increasing rate of cardiovascular diseases in this country.”

Urging the consumers to select heart health options, the professor stressed the need to invest in monitoring and surveillance mechanism such as laboratory capacity to measure Trans Fatty Acids (TFA) content in foods.

On challenges, he said that foods and beverages being consumed must align with global health standards, saying, “It is important that food industry strives as much as possible to meet national, regional and global standards.

Adeyemi also stressed the need for early warning system that would involve scientist, academia, and government agencies in curbing the rising incidence.

He added: “Consumers must read the nutrition facts on food products. Industry should replace trans fats in processed food as soon as possible and where feasible with healthy alternatives.

“The consumers must be stimulated should consume fish as part of healthy diet.”

Adeyemi emphasised the need for the experts to sensitise not only the public but also the government and industries about the important of having healthy foods devoid of trans fats and unhealthy fatty acids.

“Also, we must sensitise the public on the issue of point of package labeling.

“This is very important. As an individual and a country, consumers should be aware of the importance of point of package labeling.

“This will make them to identify the nutritional value of any food materials being purchased,” he added.

Meanwhile, a professor of chemical engineering at the Tan Sri Omar Centre for Science, Technology and Innovation Policy Studies, UCSI University, Kuala Lumpur, Malaysia, Dr. Ahmad Ibrahim, said: “It was in the early 1990s when it became clear that trans fat was the real culprit behind the rise in cardiovascular diseases around the world. Prior to that, saturated fats were always the bad boy.

“When scientists found out that trans fat was more deleterious, the news shocked the world’s oils and fats trade.

“The United States Food and Drug Administration took some time before it came out with the necessary labelling rulings to warn consumers. There was hesitation in some countries, which fear the repercussions on the local edible fats business.

“The best practice on eliminating trans fat means either a mandatory national limit of 2g of industrially produced trans fat per 100g of total fat in all foods, or a national ban on the production or use of partially hydrogenated oils, which are a major source of trans fat.

“This is where palm oil offers clear benefits. Palm oil can be used in all such applications without undergoing partial hydrogenation. That piece of evidence alone sent world palm oil demand up beyond expectations.

“That also accounts for palm oil remaining as the leading edible oil in world trade. The WHO said nine of the 16 countries with the highest estimated proportion of coronary heart disease deaths caused by trans fat intake were not implementing best-practice policies.

“It was reported that 60 nations now have trans fat elimination policies, covering 3.4 billion people, or 43 per cent of the world’s population. The majority is largely in Europe and the Americas.

“Recently, WHO warned that five billion people are exposed to higher heart disease risks through trans fats. Back in 2018, WHO appealed for the unhealthy fats to be eliminated worldwide by 2023, amid evidence that it caused 500,000 premature deaths every year.”

Resolve to Save Lives president and former director of the United States Centers for Disease Control and Prevention (CDC), Tom Frieden, said: “There’s simply no excuse for any country not taking action to protect their people from this artificial toxic chemical. Only your heart will know the difference. You can eliminate artificial trans fat without changing the cost, taste or the availability of great food.”

Taking into account present developments, global elimination of trans fat is within reach, pointing to big countries like Nigeria and Mexico moving towards eliminating the use of trans fat. Experts are optimistic that the world can make trans fat history.

“And palm oil can play that saviour role. Who would have guessed that palm oil, which was heavily demonised before, is now a darling among consumers who want to avoid taking trans fat.

“Nature does work in mysterious ways, turning the table around in palm oil’s favour,” Ibrahim said.

Courtesy: The Guardian Nigeria

World Heart Day 2022 Commemoration in Lagos. Nigeria. The first ‘Bike a Heart Route ‘ event was held on 8th October 2022 at Lekki Phase 1, Lagos.

“Let’s use our hearts to make Nigeria Healthy.”

A Professor of Medicine, Consultant Cardiologist and Past Chairman of Nigerian Heart Foundation (NHF), Basden J. C. Onwubere, told The Guardian that the burden of heart diseases in Nigeria is significantly high, worrisome and appears to be steadily increasing. Onwubere said the diagnosis and treatment costs, as well as the medical effects of heart diseases, constitute a burden.

Onwubere, who is also the Past President, of the Nigerian Hypertension Society (NHS), Past Provost, of the College of Medicine, University of Nigeria/University of Nigeria Teaching Hospital, Enugu, said there are several reports from various parts of the country on the current statistics on heart diseases in Nigeria. “One report says that cardiovascular disease is responsible for 33 per cent or ‘one-third’ of nearly half a million non-communicable deaths in Nigeria yearly. More reports are emerging,” he said.

Why the rise in heart disease in Nigeria? Onwubere blamed current changes in lifestyle: more sedentary lifestyles, taking alcohol in more than recommended amounts, eating diets that are not heart-healthy, smoking cigarettes, and others.

On the connection between COVID-19 and air pollution, the cardiologist said: “Yes, COVID-19 particularly, and air pollution to a reasonable extent made the situation in Nigeria worse. Effect of COVID-19 on heart diseases was extensively discussed during a recent World Heart Day celebration.”

On causes of heart diseases in Nigeria, he said the most common cause of heart disease in Nigeria is high blood pressure, commonly called hypertension. Others, Onwubere said, are infections and other non-communicable diseases like diabetes.

On recommendations on how to address the situation, the cardiologist said the problems with hypertension are mainly the low awareness level and the current high cost of treatment in Nigeria. He said less than 20 per cent of Nigerians who are hypertensive in Nigeria are aware.

Onwubere said the World Hypertension League recommended World Hypertension Day to improve awareness globally, including in Nigeria in the month of May every year. He said most societies- NHF, Nigerian Cardiac Society, NHS and others- comply with this programme and other activities to address the problem.

On the association of trans-fats, energy drinks and palm oil with rise in heart diseases, Onwubere said: “Trans-fats and energy drinks should be taken in recommended amounts, otherwise they constitute great cardiovascular risks.

“Palm oil when taken in quantities greater than recommended amounts can cause heart disease.”

On the affordability of treatments for heart diseases, the cardiologist said treatment for most types of heart diseases is currently done with high out-of-pocket expenses and costs are out of reach by most Nigerians. He said the government needed to fund the health sector appropriately, as well as ensure effective health insurance programmes.

Also, in commemoration of World Heart Day 2022, a Member of the Nutrition Committee, NHF, Mrs Dolapo Coker, disclosed that globally, heart disease is the number one cause of death worldwide, claiming 18.6 million lives yearly.

Speaking at the World Heart Day 2022 in Lagos, last week, she disclosed that at least 80 per cent of premature death from heart disease could be avoided if five main risk factors—tobacco use, unhealthy diet, physical inactivity, harmful use of alcohol and air pollution are controlled.

Speaking further, she noted that a new survey by World Health Federation highlights the global concern surrounding the link between climate change and cardiovascular disease, with climate change and air pollution ranked as the third most serious issue in relation to cardiovascular health among the respondents.

She added that healthcare providers must help improve cardiovascular health and prevent cardiovascular death mortality by issuing regular reminders to at-risk groups about the dangers of extreme weather events, including tips on managing excessive heat events.

The first lady of Lagos, Mrs Ibijoke Sanwo-Olu, called for a comprehensive approach and strategy to ensure that people are aware of the threat that the disease poses.

Represented by a member, of the Committee of Wife of Lagos State Officials, Mrs Patience Ogunubi, said: “I’m excited to know that NHF is aligning with World Health Foundation to address the challenge.”

She added that The-bike-A Heart initiative is a good development on the importance of physical exercise.

She noted: “Cycling must be encouraged. Lagos is taking the lead to boost Non-Motorised Transportation. The state is working on infrastructure to ensure seamless implementation of Non-Motorised Transport plans.”

She also advised Nigerians, especially the youths to desist from an unhealthy lifestyle, such as drug abuse, lack of regular exercise, smoking excessively, alcohol, sugary foods and lack of regular check- up.

Communication Advisor, NHF, Mr. Abiola Awe, explained that Bike-A-Heart Route initiative, which would take place in Lagos Island and Mainland next month, is to encourage Nigerians to embrace healthy lifestyles through cycling.

Corporate Communications and Branding Manager, Quest Oil, Gerald More, disclosed that the organisation is embracing cleaner energy such as solar. He also stressed the need for improved health quality.

Chief Executive Officer (CEO), i-Fitness, Folusho Ogunwale, noted that due to harmful health lifestyle heart disease is found in older people. Nowadays, he said younger generations are victims of heart disease.

Meanwhile, in one of the first studies to examine the relationship between different types of grain intake and premature coronary artery disease in the Middle East, researchers found a higher intake of refined grain was associated with an increased risk of premature coronary artery disease in an Iranian population while eating whole grains was associated with reduced risk.

The study will be presented at the American College of Cardiology (ACC) Middle East and the 13th Emirates Cardiac Society Congress, taking place in Dubai, United Arab Emirates, October 7-9, 2022.

According to the researchers, previous epidemiological studies have reported an association between different types of grain intake with the risk of coronary artery disease. The current study evaluated the association between refined and whole grains consumption and the risk of PCAD in an Iranian population.

Premature coronary artery disease (PCAD) refers to an atherosclerotic narrowing of coronary arteries in males under 55 years old or in females under 65 years old. It is often asymptomatic early in the course of the disease but may lead to chest pain (angina) and/or heart attack with the progressive development of narrowing (stenosis) or plaque rupture of the arterial wall. Risk factors for PCAD include smoking, high cholesterol, high blood pressure and diabetes.

“There are many factors involved in why people may be consuming more refined grains as opposed to whole grains and these cases differ between people, but some of the most important factors to consider include the economy and income, job, education, culture, age and other similar factors,” said Mohammad Amin Khajavi Gaskarei, MD, of the Isfahan Cardiovascular Research Centre and Cardiovascular Research Institute at Isfahan University of Medical Sciences in Isfahan, Iran, and the study’s lead author.

“A diet that includes consuming a high amount of unhealthy and refined grains can be considered similar to consuming a diet containing a lot of unhealthy sugars and oils.”

Whole grains are defined as containing the entire grain, while refined grains have been milled—ground into flour or meal—to improve shelf life but they lose important nutrients in the process. The 2019 ACC/American Heart Association Guideline on the Primary Prevention of Cardiovascular Disease recommends a diet that emphasizes the intake of vegetables, fruits, legumes, whole grains and fish to decrease heart disease risk factors.

The study recruited 2099 individuals with PCAD from hospitals with catheterization labs in different cities and ethnicities throughout Iran who underwent coronary angiography (women aged ≤ 70 and men ≤ 60). In total, 1,168 patients with normal coronary arteries were included in the control group, while 1,369 patients with CAD with obstruction equal to or above 75 per cent in at least a single coronary artery or ≥ 50 per cent in the left main coronary artery made up the case group.

Participants were given a food frequency questionnaire for dietary assessments to evaluate dietary behaviours and evaluate the association between whole grain and refined grain intake and the risk of PCAD in individuals without a prior diagnosis of heart disease. After adjusting for confounders, a higher intake of refined grains was associated with an increased risk of PCAD, while whole grain intake was inversely related to a reduced risk of PCAD.

“As more studies demonstrate an increase in refined grains consumption globally, as well as the impact on overall health, it is important that we find ways to encourage and educate people on the benefits of whole grain consumption,” Khajavi Gadkari said. “Tactics to consider include teaching improved dietary choices in schools and other public places in simple language the general population can understand, as well as on television programs and by continuing to do high-level research that is presented at medical conferences and published in medical journals. Clinicians must also be having these conversations with each other and their patients.”

Courtesy: The Guardian

As Nigeria joins the rest of the world to mark the 2022 World Heart Day (WHD), researches have shown that the increasing rates of Cardiovascular Diseases (CVD) in Africa and the Middle East calls for concern.

Some regional experts in a report published in the Journal of the Saudi Heart Association have, therefore, called for urgent urgent action to stop and reverse the trend.

The report highlights that heart failure is associated with significant morbidity and mortality and considerably impacts patients’ quality of life, as well as incurring a substantial economic burden, with a total estimated cost of US $1.92 billion.

It notes that the average age a person will develop heart failure in the MEA region is significantly lower than elsewhere: Africa (53 years), Middle East (56.4 years), North Africa (58.79 years), Asia (60 years) and Europe (70 years).

The experts point to risk factors such as diabetes, obesity, smoking and socio-economic transition, marked by a sedentary lifestyle, lack of physical activity and high consumption of fatty foods, as the main contributors to the higher prevalence of heart failure in the region.

They also agreed that, in certain countries, high prevalence of existing infectious diseases such as tuberculosis shifts the focus and resources from non-communicable diseases like heart failure.
Global statistics

The experts said CVD, which remain the leading cause of death globally have continued to increase despite various preventive mechanisms.

CVDs are a group of disorders of the heart and blood vessels and include coronary heart disease, cerebral vascular disease, rheumatic heart disease, and other conditions.

According to statistics from the World Health Organisation (WHO), about 17.9 million individuals die from CVD every year, accounting for worldwide fatalities of 31 per cent.

More than four out of five CVD deaths are due to heart attacks and strokes, and one-third of these deaths occur prematurely in people under 70 years of age.

Various researches have identified unhealthy diet, physical inactivity, tobacco use and harmful use of alcohol as the most important behavioural risk factors of heart diseases and stroke.

At least 1.9 million people die from tobacco-induced heart disease yearly, the WHO said. It also indicates that smokeless tobacco is responsible for around 200,000 deaths from coronary heart disease per year.

However, health experts said Nigerians are still engaging in unsafe practices like tobacco usage and excess alcohol intake which are fueling increase in cases of heart diseases.
Situation in Nigeria

A cardiologist and Provost, College of Medicine of the University of Lagos, Idi-Araba, David Oke, said there is a paradigm shift in the CVD pattern in Nigeria and Africa generally.

Mr Oke said although CVD were less prevalent in the past, the number has increased in recent times due to unhealthy eating and lifestyles.

“In the past we used to have a lot of diseases with less prevalence, but now due to civilisation and what is happening in the so-called developed countries, we now have more of the non-communicable diseases,” he said.

He said heart failure is also getting on the increase due to the country’s failure to battle hypertension.

He said some persons suffer from heart failure as consequences of not treating hypertension.

“If we can’t battle hypertension because of the economic situation, if we can’t purchase the drugs that is neccessary, that is to say heart failure will get more prevalent,” he said.

Mr Oke said with the current economic crisis, Nigeria is heading to a point where each family will have someone with heart failure.
Risk factors

A Consultant Cardiologist at the Lagos State University Teaching Hospital (LASUTH), Ramon Moronkola, said there are many things that can affect the heart ranging from hypertension, diabetes, high cholesterol, obesity and some lifestyles.

Mr Moronkola said lifestyles like excess intake of alcohol and tobacco use which includes cigarette smoking, have a long-term negative effect on the heart.

“All these factors highlighted can affect the heart which then leads to heart failure, a condition where the heart is not working optimally to the level required to satisfy the body system,” he said.

He said the chances of survival of patient with heart failure can be compared to that of the deadliest cancer.

He said people must cultivate the habit of living healthy to prevent the killer disease.

Mr Moronkola also noted that the chances of survival for heart failure patients will be very low in the next five years except drastic action is taken now.

“In five years, the survival of patients that have heart failure, chances of survival is less than 50 per cent. In five years, more than half of such patients might likely die if there is no proper treatment,” he said.

The consultant cardiologist also said there are some non-modifiable risk factors that nothing can be done to prevent them. Some of them included race, age and heredity.

“An example is if one’s father, mother or relative has a heart condition, it is likely the person has inherited it.

“Age is another factor, the older you get, the higher the risk factor of becoming hypertensive or developing heart diseases,” he said.
Way Forward

According to a Professor of Cardiology, Department of Cardiology in Casablanca, Morocco, Ahmed Bennis, heart failure is a serious and growing threat to health in MEA, but it does not have to be this way.

Mr Ahmed said policymakers across the region must act now to prioritise heart failure and associated diseases, through better training for health workers, national registries to ensure the collection of quality data and improved access to novel therapies.

The report also points to the lack of community-level awareness and a high prevalence of associated conditions such as hypertension and diabetes, compounded by poor accessibility and affordability of healthcare, as major barriers to the prevention of heart failure in the region.

The report also urges policymakers to take the following steps to reverse current trajectories: Prioritise heart failure and its associated comorbidities alongside other infectious diseases; Develop and implement region-specific clinical guidelines on heart failure and create local data registries on heart failure.

It also calls for the training of health workers in early identification of high-risk patients, improved access to advanced diagnostics and training of primary care health workers to use the available technology and also enhancing access and insurance for novel therapies.
More awareness

A Consultant Cardiologist at the Nnamdi Azikiwe University Teaching Hospital, Nnewi, Gladys Ahaneku, said the awareness level on CVD is still very low in major parts of the country.

Ms Ahaneku said diseases like hypertension which used to be very rare in the 60s is now very high in the country.

“A lot of people that you see in the clinic are not even aware they have hypertension. Majority of them are only presented when there is an emergency,” she said.

She said some persons who are aware of their condition do not understand the severity.

She noted that education should be a part of the patient’s treatment procedure to keep them informed.

“If the patient is aware of the condition and the dos and don’ts, he/she will be better off for it and the society will also benefit from it at the long run,” she said.

Mr Oke, the cardiologist, said to end the menace of heart disease, more awareness is required especially in rural communities.

He said majority of NGOs focus on the urban areas hence neglecting rural communities where the message is most needed.

“Awareness is not at its depth, we need to pay more attention in providing awareness to those rural areas in the country then we will be good to go,” he said.
World Heart Day

The World heart day is marked on 29 September every year to raise awareness about Cardiovascular Diseases (CVD), their management, as well as their toll on the society.

The theme of the 2022 World Heart Day is ‘Use heart for every heart”.

The day which is founded by the World Heart Federation aims to draw attention to the behavior that can deter individuals from becoming predisposed to CVD, as well as to educate the masses on how to handle the potential risks associated with these diseases.

This includes an unbalanced diet, passive smoking, and lack of physical activity, which seem to be sufficient to stop 80 per cent of untimely deaths occurring from strokes and heart attacks.

The world heart federation noted that increased high blood pressure, increased blood sugar levels, being obese or overweight are all side effects of living a bad lifestyle that may harm the heart.

– Premium Times