Weighty matters

Monday January 31 2011

Manuel Uribe sits on his reinforced bed outside his house in the suburb of San Nicolas de los Garza in the northern city of Monterrey, Mexico in this file picture taken in 2008. While the distance between Kenya and Mexico is enormous, Uribe’s condition illustrates the direction many in Kenya are headed, with authorities warning that it is only a matter of time before lifestyle diseases start taking the largest portion of government expenditure on health care. Photo/FILE

Manuel Uribe sits on his reinforced bed outside his house in the suburb of San Nicolas de los Garza in the northern city of Monterrey, Mexico in this file picture taken in 2008. While the distance between Kenya and Mexico is enormous, Uribe’s condition illustrates the direction many in Kenya are headed, with authorities warning that it is only a matter of time before lifestyle diseases start taking the largest portion of government expenditure on health care. Photo/FILE 

By GATONYE GATHURA [email protected]

In the next few days, thousands of teenagers will be leaving home to start a new life in boarding school.

Between them, they will be hauling several tonnes of sweetened juices and heavily salted and greasy confectioneries to supplement their diet in the new life.

In their admission letters, some boarding schools say students ‘must bring’ up to three litres of juice, a kilogramme of biscuits, 1,000 grammes of crisps and other processed foods.

To satisfy this artificially created demand, manufacturers and distributors are not blind to the opportunity to sell today, and recruit regular customers among these easily impressionable minds.

Already, sweetened deals are on offer through highly targeted marketing and advertising that has coincided with the last-minute buys for Form One students.

And health professionals want immediate action to protect these children against heavy exposure to marketing messages that promote foods high in saturated fats, trans-fatty acids, free sugars and salt.

After taking on tobacco and the alcohol industries for their unhealthy contributions to our wellbeing, now the attention is being focused on manufacturers and distributors of processed foods and non-alcoholic drinks.

In May, Kenya joined a global World Health Initiative to reduce exposure of children to the powerful marketing of foods high in fat, sugar or salt. These have been found to increase the potential of younger generations developing non-communicable diseases during their lives.

“Non-communicable ailments, such as cardiovascular diseases, cancers and diabetes, represent a leading threat to human health and socio-economic development,” says Dr Ala Alwan, WHO’s Assistant Director-General for non-communicable diseases.

Kenyans may start seeing a more active role being taken by the ministries of health to ensure that schools, parks and playgrounds are free from all forms of marketing of junk food.

The World Health Organisation has already released a set of recommendations on how to protect children against powerful marketing gimmicks for junk food, and implored its members to adopt them.

Launching the first national diabetes strategy in the country in June last year, the Minister for Public Health and Sanitation, Ms Beth Mugo, hinted on a food policy that would put a limit on the content of salt and sugar in packed foods, and the advertising of unhealthy foods.

Ms Mugo also wants schools to teach nutrition and emphasize the dangers of unhealthy foods. These poor diets could cause a calorie imbalance in the body, resulting in either obesity or unhealthy weight gain.

Overweight conditions and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health. Such risks may include heart disease and stroke, some cancers, arthritis and diabetes. And these have been described as a growing epidemic in Kenya.

Dr Vincent Onywera, a lecturer at Kenyatta University’s Exercise, Recreation and Sports Science department, says youth obesity is a major problem in Kenya, and that it is already affecting career choice and progression.

“We could be facing a career and health crisis in just about five years because of lifestyle diseases,” Dr Onywera, whose recent research indicated that 16.7 per cent of town girls and 6.8 per cent of boys are overweight, says.

Such teenagers would have a problem in securing careers demanding high physical fitness levels like the armed forces and sports. It is estimated that 12 per cent of all Kenyans are overweight, and more than half of hospital admissions in Nairobi are due to non-communicable diseases.

Healthy diets and physical activities are essential in keeping away the extra fat. However, to others, obesity is inevitable because it is in their genes, meaning they will inevitably need medicines help to control weight.

Called slimming or diet pills, gels, lotions, patches or belts, their use was embraced in the past decade, especially the herbal alternatives which claim huge returns with no side effects.

“Initially, this was a girl thing in the process of searching for a beautiful body, but now we are seeing more mature women and men wanting to lose weight for health reasons,” says Dr Peter Murugu, who runs a nature and nutritional clinic in Nairobi.

Do they work? Dr Murugu argues that some of these herbal cures, although lacking in published peer- reviewed studies, are based on years of use in Africa and experience in practical application.

He gives the example of Hoodia mint pills, which, paradoxically, are an African invention that is currently helping to shed fat in Europe and America.

The pills are made from Hoodia Gordonii, a shrub known to grow naturally in the Kalahari Desert in Southern Africa and used by Khoisans to stifle hunger in the food-scarce environment.

Many Kenyans may be able to relate to N!xau, the star actor in the movie Gods Must Be Crazy, acted across the Kalahari.

It is not easy to understand how N!xau and his sons managed to crisscross the unforgiving desert (apparently) with no food stores. But theirs is a feat the Bushmen have managed for thousands of years.

The secret, however, has since been unravelled by South African scientists. On a routine investigation, they identified that a cactus-like plant, Hoodia Gordonii, which is eaten by Khoisans, has a special molecule that fools the brain into believing you are full.

The license to the molecule, then named P57, was sold to a UK bio-pharmaceutical company, Phytopharm, which, in turn, sold the development and marketing rights to the giant Pfizer Corporation.

By this time, word of the wonder slimming herb had leaked out widely, and many products have since hit the market, some genuine, others fake. A check for Hoodia in the Internet will give an indication how widespread the Bushman’s invention is.

“In the human brain, there are nerves which sense glucose sugar. After eating, the nerves fire a message telling the body you are full. This molecule in Hoodia seems to trigger a false message telling the body you are full even when you have not eaten,” explains Dr Murugu.

Although reluctant to detail how one of his popular slimming packs works — for fear of copy cats, he explains — Dr Murugu says it employs a mechanism that de-triggers the hunger reporting mechanism.

“This, like the Bushman’s herb, allows somebody to go on with business as usual without either eating or feeling the urge. But it also allows for elemental nutrients supplementation.”

Nature, he explains, has provided for situations where there is scarcity of food, allowing the body to dip into the savings from days of plenty and consume the fat or the adipose tissue.

The extract in his product, he says, works on the brain pathway that regulates food intake, body weight and glucose — called the melanocortin system.

“It works by limiting the production of the hormone MSH, whose action can either increase or decrease appetite and prevents existing hormone from signalling for food.”

Like the N!xau of the movie, the body is cheated that these are times of scarcity and the stomach will constrict, naturally expecting less food. Shortly, one is weaned off the product.

This is unlike the procedure used in gastric bypass surgery, a surgical operation to make the stomach smaller and shorten the small intestine. This means you eat less ,and that some of the food you eat won’t be fully digested. It is does bring down weight, but it may leave behind a sagging skin.

Other products in the market are called fat burners, which work by turning the accumulated fats into energy and then revving up the body’s metabolism.

Usually used in combination under the direction of a medical expert, fat burners — such as green tea, bitter orange and dandelion — are widely available locally.

However, the wrong combination of some of these burners, such as the ephedrine and caffeine, can lead to serious health problems, especially to people with high blood pressure or diabetes.

Ephedrine is an extract from the plant ephedra, commonly known as Marmon Tea, which grows in Asia. The extract is a stimulant.
A few years ago, slimming pills containing a banned ingredient called Fenfluramine found their way into the country. The products, imported from China, had killed some people there.

And, recently, Australia warned its citizens against the use of another slimming pill from China said to contain a banned compound called Sibutramine, which has been medically found to increase the risk of heart attacks and strokes.

“We are excited that finally the government has given nature’s medicine the thumbs up, indicating that herbal products are based on knowledge and not ignorance,” says Dr Murugu, referring to the release of a new study on herbal trees in Kenya.

Although Kenyans are said to have one of the highest usages of alternative medicine in the world, with 80 per cent of them seeking such services, they are the net losers on the global scale.

Last month, the World Health Organisation started creating the first ever Web-based global data on traditional medicine, citing terminologies and classifications for diagnoses and interventions.

“This will allow users from all countries to document the terms and concepts used in traditional medicine,” says Dr Marie-Paule Kieny, Assistant Director-General of Innovation, Information, Evidence and Research at WHO.

Unfortunately, for Kenya, the classification will initially focus on traditional medicine practices from China, Japan and the Republic of Korea that have evolved and spread worldwide.