Mexico Joins US, Canada and Denmark To Ban Trans Fats In Food, Beverages

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.

NHF, experts advocate national guidelines for food production

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

Concerns over rising cases of cardiovascular diseases

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

How to address spike in heart disease cases, deaths, by NHF

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

Heart Failure now growing threat to health in Africa, Middle East -Experts

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

World Heart Day: How to avoid 80% of heart-related diseases – NHF

The Nigerian Heart Foundation (NHF) says 80 percent of premature deaths from heart diseases can be addressed if tobacco use, unhealthy diet, physical inactivity, harmful use of alcohol and air pollution are controlled.

Addressing a news conference in Lagos on behalf of the NHF, Mrs Dolapo Coker, Member, Nutrition Committee of the foundation, stressed the need to address carbon emissions by the government to reduce cardiovascular diseases.

She said that the World Heart Foundation (WHF) was calling for urgent action on climate change and health inequity, saying millions more lives now at risk from cardiovascular disease, “which is still the world’s biggest killer.”

“The year 2022 has seen historic heat waves and, with climate change disproportionately affecting the most vulnerable populations, we can expect a further widening of the gap in global cardiovascular healthcare equity.

“Climate change and related air pollution is already responsible for 25% of all deaths from cardiovascular disease, killing 7 million people annually.

Quoting Prof. Fausto Pinto, President of WHF, Coker said: “Millions of already vulnerable people are doubly exposed to extreme weather events and limited access to healthcare.

“World leaders must step up efforts on the two biggest threats of our time – climate change and global health inequity.”

Coker said that working hand in hand with the World Health Organisation (WHO), WHF was calling on governments, civil society, and global industry to meet net-zero targets, to tackle global warming and curb air pollution, and to deliver healthcare access for all .

“A new global survey by WHF 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 issues in relation to cardiovascular health among the respondents.

“The survey also revealed that awareness of healthcare inequality is growing: in reply to a question about which global issues affected cardiovascular disease the most the second.

“The second most common answer was social inequality and access to healthcare.

“WHF is also urging healthcare providers to help improve cardiovascular health and prevent CVD mortality by issuing regular reminders to at-risk groups about the dangers of extreme weather events, including tips on managing excessive heat events.”

She commended all partner in the fight against heart diseases and promotion of healthy lifestyles in Nigeria.

In his goodwill message, Mr Foluso Ogunwale, the Chief Executive Officer, I Fitness, who described heart as most important organ in the body, decried prevalence of harmful lifestyles and physical inactivity among many Nigerians.

“If the heart is that much important, it means that at one point we need to match the brake and examine how we live over lives so that we can perhaps live a happy and healthier life.

“The issue of physical health, physical exercise and the issue of nutrition and harmful lifestyles that potentially cause heart diseases can be addressed,” Ogunwale said.

Another NHF’s partner, Quest Oil Group, said that the issue of heart health was a concern to the firm, hence the commitment to address carbon emissions to reduce heart risks.

Its Corporate Communications and Branding Manager, Mr Gerald Moore, said: “For us at Quest Oil, we believe that good health is good business and that is why we innovatively changed the energy mix that we provide our customers.

“We now have different systems that can change from fuel to gas. We have gas as our transition fuel. We also provide LPG which is cleaner fuel.

“We also started something innovative in our stations, which is to replace the existing fuel generators with the solar power system.

“We believe that will significantly reduce the carbon emissions and give out stakeholders the opportunity for a better health,’ Moore said.

In her remarks, wife of Lagos State Governor, Dr Ibijoke Sanwo-Olu, said it was extremely important that people desist from unhealthy lifestyles to build heathy population which in turn would enhance productivity in the state.

Sanwo-Olu, who was represented by Mrs Patience Ogunnubi, Member, Committee of Wives of Lagos State Officials, said that the increase in the statistics of cardiovascular disease called for comprehensive approach and strategy.

“This is to ensure that people are aware of the serious threat that the disease posed.”

She advised people to embrace deliberate lifestyles and choice that can help to address the trend.

Recall that the NHF has outlined a month long activities to mark the 2022 World Heart Day which include bike a Heart Route (cycling rides), medical health talks and check, walks, mini health exhibitions, distribution of fliers and i Fitness exercise.

More older adults should be checking blood pressure at home, study suggests

Only 48% of people age 50 to 80 who take blood pressure medications or have a health condition that’s affected by hypertension regularly check their blood pressure at home or other places, a new study finds.

A somewhat higher number – but still only 62% – say a health care provider encouraged them to perform such checks. Poll respondents whose providers had recommended they check their blood pressure at home were three and a half times more likely to do so than those who didn’t recall getting such a recommendation.

The findings underscore the importance of exploring the reasons why at-risk patients aren’t checking their blood pressure, and why providers aren’t recommending they check — as well as finding ways to prompt more people with these health conditions to check their blood pressure regularly. This could play an important role in helping patients live longer and maintain heart and brain health, the study’s authors say.

Past research has shown that regular home monitoring can help with blood pressure control, and that better control can mean reduced risk of death; of cardiovascular events including strokes and heart attacks; and of cognitive impairment and dementia.

The findings are published in JAMA Network Open by a team from Michigan Medicine, the University of Michigan’s academic medical center. The data come from the National Poll on Healthy Aging and build on a report issued last year.

The poll, based at the U-M Institute for Healthcare Policy and Innovation and supported by Michigan Medicine and AARP, asked adults aged 50 to 80 about their chronic health conditions, blood pressure monitoring outside of clinic settings, and interactions with health providers about blood pressure. Study authors Mellanie V. Springer, M.D., M.S., of the Michigan Medicine Department of Neurology, and Deborah Levine, M.D., M.P.H., of the Department of Internal Medicine, worked with the NPHA team to develop the poll questions and analyze the findings.

The data in the new paper come from the 1,247 respondents who said they were either taking a medication to control their blood pressure or had a chronic health condition that requires blood pressure control — specifically, a history of stroke, coronary heart disease, congestive heart failure, diabetes, chronic kidney disease or hypertension.

Of them, 55% said they own a blood pressure monitor, though some said they don’t ever use it. Among those who do use it, there was wide variation in how often they checked their pressure — and only about half said they share their readings with a health provider. But those who own a monitor were more than 10 times more likely to check their blood pressure outside of health care settings than those who don’t own one.

The authors note that blood pressure monitoring is associated with lower blood pressure and is cost-effective. They say that the results suggest that protocols should be developed to educate patients about the importance of self blood pressure monitoring and sharing readings with clinicians.

Source: Science Daily

World Heart Day: Experts alert to steep rise in heart attacks, stroke in Nigeria

THURSDAY, September 29th was World Heart Day (WHD) and cardiologists have alerted to a steep rise in cases of heart attack, stroke and kidney failure in the country.

Heart diseases, also called cardiovascular diseases, are heart conditions that include diseased vessels, structural problems and blood clots. Most common types are coronary heart disease, high blood pressure (hypertension), cardiac arrest, heart failure, arrhythmia, peripheral artery disease, stroke and congenital heart disease.

The theme of WHD 2022 is ‘Use Heart For Every Heart.’ The World Heart Federation has created this day to raise awareness about cardiovascular disease.

Cardiologists in interviews with The Guardian and in recent publications said cases of hypertension rose by about 700 per cent in 25 years, from 4 million people in 1995 to 27 million in 2020 in the country.

They said over 11 million Nigerians are living with diabetes, obesity and high cholesterol levels. They blamed hypertension and diabetes for the increased prevalence of stroke, heart failure, heart attack and kidney failure.
They insisted that diabetes, obesity, smoking, socioeconomic transition, marked by a sedentary lifestyle, lack of physical activity and high consumption of fatty foods, are the main contributors to the higher prevalence of heart failure.

The cardiologists also identified a lack of community-level awareness, and 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.

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

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

The experts include Consultant Cardiologist with the Lagos University Teaching Hospital (LUTH), Dr. Akinsanya Olusegun-Joseph; Executive Director, Nigerian Heart Foundation (NHF), Dr Kingsley K. Akinroye; and Consultant Cardiologist, the University of Port Harcourt and Chairman, Hypertension Working Group, NHF, Prof. Osarentin James Odia.

Others are Professor of Cardiology, Department of Cardiology in Casablanca, Morocco, Dr. Ahmed Bennis, and Professor of Cardiology at the University of the Witwatersrand in South Africa, Dr. Eric Klug, in their study published Tuesday in the Journal of the Saudi Heart Association.

Meanwhile, to address the steep spike in heart diseases and the implications, the experts recommended massive awareness campaigns about heart diseases, causes and prevention with lifestyle changes that can keep the menace away.

They said energy drinks could predispose one to abnormal heartbeat, hypertension, heart attack and sudden death.

The cardiologists said palm oil is very good for the heart, but overheating or bleaching it can alter the property, convert it to bad oil, with increased chances of causing heart disease.

Olusegun-Joseph said: “The burden of cardiovascular disease (CVD) is on the increase in Nigeria. CVD accounts for a sizeable number of admissions in our hospitals, with over 30 per cent of CVD-related deaths yearly. Several studies from every region of the nation show this increasing trend of CVD morbidity and mortality.

“There is a significant increase of hypertension in the country with about one-third of the population hypertensive. The prevalence varies from one region of the country to the other, however, ranging from 20 per cent to over 45 per cent in some communities.

Studies show that the prevalence of hypertension has increased astronomically among Nigerians, from around 4 million in 1995 to over 27 million of the population as of 2020, and it is still increasing. Worse still awareness of hypertension is very low among our people, though slightly better than before. The same increasing trend is noted for diabetes mellitus with over 11 million Nigerians living with diabetes; obesity, and high cholesterol levels.

“The result of all these is an increase in the prevalence of stroke, heart failure, heart attack, and kidney failure which are now very common cases in our hospitals. There is hardly any day in the hospital that we don’t have more than four new admissions of people with stroke and heart failure, and more than two cases of kidney failure. On some occasions, we can have more than seven admissions of these diseases. Unfortunately, this is the trend in most of our secondary and tertiary hospitals.”

On the reason for the rise in heart diseases, Olusegun-Joseph said: “The reason for the increase in CVD that we are experiencing are multifactorial, mainly due to behavioral and lifestyle changes. There is an increase in poor lifestyle choices. People eat more processed food, increased salt intake, increased patronage of fast food establishments, increased sedentary lifestyle, increased poverty, increased stress (emotional, financial, mental, social etc), cigarette smoking, and increased obesity, including childhood and early adolescent obesity, polluted environment (increased dirty environment, increased noise pollution, increased fumes from generator set etc).”

On recommendations on how to address the situation, the LUTH cardiologist said: “The first and most important is what you are doing now- education and enlightenment of the populace. We must educate our people. There must be a massive campaign to drive awareness among our people about heart diseases, the causes and prevention with lifestyle changes that can keep it away!

“We must cut down on salt and high cholesterol intake. Exercise often, weight loss for those who are obese, intake more fruits and vegetables, smoking cessation, stop or reduction in alcohol intake, maintain a cleaner environment with no or very minimal air pollution, healthy drinks like smoothies, hibiscus drink, green tea, instead of sodas and refined, processed drinks.”

Olusegun-Joseph said trans fats predispose to heart disease by causing inflammation, predisposing to atherosclerosis, and causing endothelial damage. He said trans fat will cause an increase in bad cholesterol, and low-density lipoprotein (LDL), which can predispose to obesity, stroke, heart attack, and peripheral arterial disease.

The cardiologist said energy drink is a double barrel: firstly, it has very high caffeine content which can predispose to the abnormal heartbeat (arrhythmia), hypertension, heart attack, sudden death etc. “All of these have been reported in people following energy drink intake. Secondly, the excessive refined sugar in it will cause subclinical inflammation, predispose to atherosclerosis, obesity and diabetes to mention a few,” he said.

Does palm oil cause heart disease? Olusegun-Joseph said: “Palm oil is used to cook without excessively heating it is very good for the heart. It has tocotrienol, a very potent antioxidant. It also contains tocopherol, palm olein and other substances that promote heart health. However, overheating or bleaching of the oil can alter the property of the oil and convert it to a bad oil making it more atherogenic with increased chances of causing heart disease.”

Akinroye said Low and Middle-Income Countries (LMICs) such as Nigeria Nigeria bear almost 90 percent of the burden of premature deaths due to CVDs, as most individuals affected are between the ages of 45 – 74 years, resulting in low life expectancy rates.

Akinroye said, in Nigeria, the economic burden of CVDs on individuals and families is enormous. “Since post-COVID-19 era, the cost of treatment of CVDs has risen sporadically since payment is mostly by out-of-pocket spending,” he said.

Akinroye said hypertension is the commonest CVD affecting not less than 33 percent of the adult population. He said the main CVDs burdens are- hypertensive heart disease 48.9 percent, stroke 24.4 percent, heart attack ( coronary heart disease) 8.9percent, arrhythmias (irregular heartbeats), heart failure, cardiomyopathy and valvular heart disease from the remaining 17.8 per cent.

Odia said about one-third of deaths and disabilities from NCDs are due to heart diseases. He said this is borne out from hospital-based studies and a few population-based studies.

Odia recommended: “Public health advocacy, improved primary health care services. Funding for research and development in our tertiary hospitals. Assessable health insurance.”

Bennis said: “Heart failure is a serious and growing threat to health in the Middle East and Africa, but it does not have to be this way. Policymakers across the region must act now to prioritise heart failure and associated diseases, through better training for health workers, and national registries to ensure the collection of quality data and improved access to novel therapies.”

Klug said: “Whilst local guidelines are available in South Africa (click), too many lives are being cut short in this part of the world due to gaps in how we identify and treat heart failure. This problem also places a huge economic burden on already over-stretched health systems. This paper clearly lays out what needs to be done to avert further suffering. In honour of World Heart Day, we are calling on policymakers to turn words into action.”

The study urged 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
•Create local data registries on heart failure
•Train health workers in the early identification of high-risk patients
•Improve access to advanced diagnostics and train primary care health workers to use the available technology
•Enhance access and insurance for novel therapies

Source: The Guardian