How serious is this threat ofNCDs and what can be done to prevent the looming pandemic? 

The threat is even more imminent than we are expecting because of the fact that we don't have enough information. You must have noticed that a lot of people are on hypertension pills now. That is the first signal. Once you are hypertensive and it is a condition that you may not even know that you have it except you are the type who will present with headache or some-thing. When you have headache and you take Panadol you think it is all over whereas the main cause of that headache is high blood pressure. 

So a lot of Nigerians are hypertensive, a lot of Nigerians are diabetic. In fact the increase is on the high side. About ten years ago it was about two per cent. Today it is more than u per cent that is the prevalence of diabetes in Nilgeria. So if we don't change our lifestyle, we don t change our dietary habits, then it will be on the increase. A lot of people eat a lot of these junk foods; we have a lot of fast foods around. 

One of the issues on hypertension is the amount of salt. You see all these foods you get at fast foods are very salty. You don't even know the source of the oil they are using because they will go for the cheapest oil to make maximum gain. Nobody controls the kind of oil they use, nobody controls how they produce their food and all they want is gain. A lot of Nigerians are getting interested. Any gathering you see whether is government or private they will serve maybe doughnut, meat pie or fish pie or egg roll, which oil did they use in producing these things? We consume them with relish. 

Until we change our snacks to native snacks. 

What do I mean by native snacks? Moi Moi is snacks; Akara made from good oil is a good snack, mangoes, oranges, guavas and all the fruits available within the season because every season has the fruits that are available. Serve these kinds of 

things in a conference, and then you will find that in the course of doing these things you prevent your heart from getting a lot of some these cholesterol building up in our system. One thing about cholesterol is that if it is from saturated fatty acids or from trans fats. As the . arteries carrying blood to the brain when they, get into the brain they get into arterioles it becomes smaller and smaller. If you have high blood pressure what it means is that the pressure the heart use to carry the blood to all parts of the body has increased either because the lumen of the artery has become narrower in which case the pressure increases. Just like if you open a tap and you try to block one side you see the pressure increases. That is the kind of thing that happens. 

So because of the pressure the heart has to exert, those little arteries at the end that supplies the brain can burst as the pressure comes. When it bursts the blood begins to flow into the brain and you will not know it. You may just have a small 

headache and then stroke. 

So it is something that is really very serious. It is big. Look at the other angle, increase in body weight. For those of you who can eat what you want to eat. We always indulge ourselves, eat what we want to eat and before you know it your bodyweight increases and if you are not aware of what you are doing, once you get beyond Body Mass Index (BMI) of 24.9 you go into overweight and from overweight to obesity. 

" Obesity predisposes to hypertension and to all kinds of cardiovascular diseases even diabetes. So overweight is another problem. Nigerians have become progressively heavy. When I go to any town especially big towns just watch our ladies are very robust, rounded and rolling and they think they are enjoying. It is a signal of bad things to come. 

How do we address it? 

Firstly, physical activity and exercise. You must not have to jog all the time. Increase your walking distance; minimize automation in your house. Do some physical activity even jogging or try to do some press ups in your room. You don't need to go to a sports centre. I do press-ups in my room. I do some of those exercises we were taught in Primary school. I do them right inside my room before I take my bath. It helps. Before you know it your muscle tone is up. 

There is this bad thing people do because they want to lower their weight they skip breakfast. It is a very wrong method. When you skip your breakfast you lower down your body metabolism. When you lower that your body metabolism, anytime you eat that food your body will adjust to that lower body metabolism. Instead of the body burning up that food it will use it to store. You should have noticed that once you eat breakfast you become hungrier around Ham and 12 noon. It shows that your body has rewed up your metabolism. So if there is any food you must skip it must be dinner. There something everybody here must do which will guide you. You need to know your Body Mass Index (BMI). Once you know your BMI it can serve as a guide. All you need to do is very simple, know your body weight, and know your body height. You divide your weight in kilogrammes bysquare of your height in metres it will give you a figure. If that figure is between lS.5 and 24.9 is norma!. If it is 

below lS.5 you are underweight and therefore you need to beef up because that one is also a dangerous situation. If you fall sick you can just travel to heaven or hell immediately. If you go on the other side that is from 25 to 29, your are overweight. When it gets to 30, which is grade-one obesity. From 35 and above is grade 2 obesity and from 40 and above is morbid obesity. So you can easily calculate that and it will help to bring you to a very healthy situation. 

How true is this reported association between reuse of cooking oil and NCDs. How bad is the situation? 

 We have not carried out a survey to find out the impact it has on Nigerians. But since we know the content of that overused oil which is trans fat and any food you use it to fry whether Dodo (fried plantain), egg at whatever it carries it along wit it and you take it into your system. Trans fat is more deadly than saturated fat because what those ones do is that they go 

straight to deposit fats inside the lumen of the artery and will block it. So it is more dangerous than the one that will deposit outside and make it hardened that atherosclerosis. Atherosclerosis or hardening of 'the arteries is the leading cause of heart attacks, stroke, and peripheral vascular disease. That is what saturated fats do but this trans fats go inside the lumen and deposit it there. As it continues to deposit it there it becomes narrower and narrower and at a stage it will block. 

One important thing is use oil once at most twice and discard. Don't allow poverty to carry you to a horrible disease that you will spend more money. I want to make this thing clear because people are beginning to ask how can people who are poor be coming down with NCDs? Italso comes from the way we use our oil and the kind of oil we use. 

What about this issue about gluten intolerance? 

Sometime ago we were tall<ing about cassava bread and I told Nigerians then that cassava bread was better than wheat bread. When you increase the level of cassava flour in bread you are reducing the gluten in wheat flour by level of dilution. So gluten level becomes very minimal. There is a level you can take it and your body will not react. But if you prefer 100 per cent wheat flour that means you are taking all the gluten. Some people react to it and some people may not react to it. 

What is the danger of this gluten? 

It is an allergy. Some people when they eat groundnut either they have cramps, stomach cramps. Just like lactose intolerance. But is not everybody that has problem with gluten. Because of those few people that are allergic to gluten we advocate just like the Federal Ministry of Agriculture has been talking about that is 40 per cent inclusion of cassava flour in wheat flourwill reduce to a very Significant level the problem of gluten. If it is well diluted people can tolerate it better. 

Some studies have linked soft drinks such as Cola Cola to NCDs such as diabetes. How true is this? 

It is miSinformation. Diabetes is caused by either lack of insulin or insulin insensitivity. The pancreas produces insulin, which is a hormone that helps to metabolise glucose. Glucose can come from yam, cassava, or anywhere. It can come from Coke, it can come from fruit juice, and it can come from any food that contains carbohydrate. , So if your body has enough insulin, even if you pack a packet of sugar put it in water and drinks it. If your body insulin is sensitive and good, nothing will happen, there will be no dia- betes. But if you are already having a problem, if you are having a health situation then you avoid food that will give you a dramatic increase in sugar level. That is what Coca Cola will give you or any of these processed drinks that contain sugar. It is already digested, once you drink it, it goes straight into your blood stream and it shoots up the glucose level especially those who have issues with diabetes already. If don't have issues with diabetes there is nothing about Coca Cola or any soft drink for that matter. What is important is that every carbohydrate food when digested will produce glucose. It is the same glucose that the sugar from Cola Cola will give you. So why blame it on a particular source. But for those who already issues because of the dramatic increase insugar they are supposed to avoid it. That is why Coca Cola has come to realize that and they have produced zero Coke. There is no sugar at all in zero Coke and so if you are diabetic you can still take that one. You have zero Coke with no sugar at all. You can that zero Coke, lite Coke or the regular Coke depending on the calories you need. So all these things are there to guide us. I think information is very important in all these things 

 

By Prof. Ignatius Onimawo