Hardship: Kwashiorkor back in Nigeria, experts raise alarm

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Dr Foluso Balogun, a paediatrician at the University College Hospital (UCH), Ibadan, has said that for the first time in many years, children with kwashiorkor are seen in his part of the country.

Kwashiorkor is a severe form of protein malnutrition. Children who eat diets low in caloric and protein are most likely to suffer from kwashiorkor. Infants and children are typically affected, usually from the time of weaning until age five. The illness is prevalent in areas of the world that are impoverished and have extremely high rates of starvation.

Dr Balogun who stressed that the occurrence is evidence that something is wrong told Saturday Tribune, “Last year, my paediatrician colleagues in the north were complaining that children were coming down with malnutrition. The implication of the economic reform is real; people are starving. It’s been a long time since we saw cases of Kwashiorkor; we are seeing it again.”

Dr Balogun said that malnutrition has long-term implications also for the girl child since it will cause stunting, therefore a delay in puberty since the adolescent girl is unable to attain the right weight at the appropriate time.

A child is said to be stunted if they are too short for their age, which is typically the result of starvation. It suggested that their development and progress have been impeded.

The United Nations International Children Emergency Funds (UNICEF) said Nigeria has the second highest burden of stunted children in the world, with a national prevalence rate of 32 percent of children under five.

As of last year, 35 million children under five years of age suffered from malnourishment. Also, 12 million children had stunted growth, 3 million were wasting from excessive and rapid weight loss, and 23.5 million were anaemic.

A global hunger index ranked Nigeria 109th out of the 125th countries after scoring 28.3% in 2023. The Global Index rate is based on 4 indicators, namely, undernourishment, child wasting, child stunting, and child mortality.

Dr Balogun claimed that with the hunger situation in Nigeria, the high proportion of children that are stunted has further worsened, imparting them for life.

She added, “The majority of brain development occurs within the first five years of life. Children who suffer from malnutrition have lower IQs. As adults, they will inevitably be less productive.

“Malnutrition is like the masquerade that is behind the five common infections that you see in children, including malaria, measles, pneumonia, and diarrhoea.  So, they are more susceptible to these infections since it lowers their body’s immunity. Additionally, a child who is malnourished has an increased risk of dying from these diseases.”

Furthermore, Dr. Balogun warned that if children continue to suffer from inadequate nutrition, Nigeria could not be able to meet the SDGs by 2030.

“SDG 3 addresses educational access. Right now, a lot of children are dropping out since schools resumed classes in September. School fees have gone up in practically every school. People’s resources are already stretched, even for survival. How many families are able to handle it? Thus, a lot of kids are quitting school at the moment.

“Health access is SDG 4. Nearly N4,000 is needed to cure malaria at this time. How many families can afford it? The cost of the insecticide we use to repel mosquitoes is about N6,000. So mosquitoes will be having a field day. Health is, therefore, compromised.

“The role that nutrition plays in a child’s survival is under threat. Additionally, their education is in danger. It is establishing the groundwork for other epidemics, such as those caused by poor brain development, low IQ, and starvation,” he said.

Dr Olutosin Awolude, a consultant gynaecologist at the UCH, Ibadan, declared that despite the biting economic situation in Nigeria, pregnant women still need to eat adequate and balanced meals for their health and their unborn baby.

For pregnant women, sufficient protein intake supports the development of the baby and maintains the mother’s health.

He stated that in order to ensure that their meals are adequate, they need to be more inventive in their meal preparation and take into account the abundance of local foods and vegetables in their surroundings.

Economic disparities contributing to change in dietary preferences

Fish and meat are essential parts of a healthy diet and are considered the biggest sources of protein. They contribute to human growth and health by supplying nutrients such as protein, lipids, minerals, and other essential chemicals.

Meat and fish contain high levels of vital minerals like iron, iodine, and omega-3 fatty acids, which lower the risk of cancer, heart disease, stroke, abnormal brain development, and other fatal illnesses.

The average Nigerian diet is moderate in fat and oil intake, rich in carbohydrates and fiber, and relatively low in protein. Usually, the protein source is either a piece of meat, fish, pieces of eggs, dairy, or plant-based proteins like beans, melon, and groundnut.

In recent times, the Naira has depreciated to over N1000 to $1, and the level of inflation has deeply affected the daily lives of many Nigerians, particularly in terms of their buying power and the cost of living.

Economic disparities are contributing to a change in dietary preferences, with less focus on eating meat and fish. It is making animal protein sources like meat, fish, and chicken-less popular in the diets of many people.

In October, dealers in cattle businesses in Nigeria lamented low patronage following the rise in prices of cows. The traders said that the removal of fuel subsidies has been having negative impacts on the prices of cows.

Numerous factors, such as inflation, the rising cost of transportation, and the ongoing insecurity that disrupts the flow of cattle from the northern part of the country to the markets, have been cited by cattle dealers as the reasons for the sharp increase in cattle prices in the market over the years.

Amid rising food costs, the Nigeria Bureau of Statistics reported in March 2024 that items derived from animals, including meat, fish, and eggs, were the most costly food group.

In reality, the cost of a healthy adult diet in March nearly reached N1,000 due to the price of fish, meat, and eggs, which increased more quickly than both general and food inflation.

The report added, “Nigerians required N982 on average in March to access essential nutrient requirements in their diet, a 4.7 percent increase from N938 in February. The most expensive food group in March was animal-source foods such as fish, meat, and eggs, making up 37 percent of the total cost but only providing 13 percent of the calories.

“Fruits and vegetables were most expensive per calorie, accounting for a combined 26 percent of the cost but providing only 12 percent of the calories in the Healthy Diet Basket. Legumes, nuts, and seeds were the least expensive at 6 percent of the total cost.”

The way out

Diran Oyewole, a professor of health promotion and education at the College of Medicine of the University of Ibadan, said due to the high prices of meat and fish, Nigerians should consider novel protein sources such as crickets and termites as well as rely more on plant proteins to meet their body’s protein and micronutrient requirements.

“When you prepare rice, please add beans to it so that rice and beans can complement each other and meet the basic needs of the child,” he declared.

He declared that it is a common practice in many societies to enrich their meals with different plant-based food items and condiments.

“For a household of four, a cup of beans might not be sufficient. However, it can be made into gbegiri, a bean stew. This is the time when you can make a legume-based stew that you serve to the children every time.

“Instead of making a plain okra soup, you can stir in ground melon and locust beans. If you can afford it, you can add some crayfish to that egusi to make it richer. Additionally, groundnuts can be used in any of our stews. It enriches it as well. The children will still gain from it, and they won’t truly miss the meat or fish component.

He suggested people also go into backyard farming, including rearing animals to support their nutritional needs.

Professor Oyewole, however, stated that more people are eating out than ever before due to the expense of cooking and the cost of food items. He called on the government to tighten regulations on the safety of food from vendors in order to stop the rise in unhealthy practices such as boiling meat with paracetamol tablets, cooking meals with rotten or unwholesome peppers, and mixing alums into yam flour.

“They target the least significant nutrients. Additionally, they only add ingredients that enhance the food’s flavour. In the meantime, that contains no nutrition. Therefore, the government must set up procedures to guarantee that all food vendors are closely watched, including what they use to prepare their food and if the area where they do so is sanitized,” he added.

At the household level, he recommended that parents look for ways to enhance meals for kids without spending a lot of money on their surroundings by learning about the foods that may be combined or used.

Eating foods from both plant and animal categories generally improves the likelihood of fulfilling nutrient requirements.

Maintaining dietary diversity by including new protein sources and locally grown veggies is crucial to ensuring that Nigerians are getting enough of the important nutrients they need, especially at this time, regardless of the economic crisis.

These indigenous vegetables include African nightshade (odu in Yoruba), eggplant (Igbagba in Yoruba), scarlet eggplant, local celery, fireweed (Ebolo in Yoruba), fluted pumpkin, snake tomato (tomato elejo), and local amaranth (Tete a tetedaye in Yoruba).

In addition to their nutritious value, these foods are affordable and easily accessible and have the potential to prevent and manage a number of illnesses.

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