When most people hear the word ‘malnutrition’, they often think, undernutrition. But malnutrition, in all its forms includes undernutrition (wasting, stunting, underweight), inadequate vitamins or minerals, overweight, obesity, and resulting diet-related non communicable diseases. Every country is affected by one or more forms of malnutrition. Tackling malnutrition in all these forms is one of the world’s greatest health challenges.
It is no secret that Nigeria’s poor nutritional statistics are of an epidemic proportion. In Nigeria, nearly 2 in 5 (37%) children under five are stunted, or too short for their age. Also, 7% of children under five are wasted or too thin for their height. In addition, 22% of children under five are underweight or too thin for their age. Rural children have higher levels of stunting, wasting, and underweight, compared to urban children.
Once seen as a health concern more prevalent in high-income countries, low- and middle-income countries (LMICs) are now reporting a record rise in obesity. About 70 percent of the globally overweight or obese people — nearly 2 billion people — live in LMICs. In many of these LMICs, undernutrition still prevails, and they are now experiencing the double burden of malnutrition. Indonesia is the largest country with a severe double burden, but many other Asian and sub-Saharan African countries also face this problem.
Is obesity in Nigeria a myth?
Obesity is abnormal or excessive fat accumulation that presents a risk to health. In the 2021 Global Nutrition report, data from Nigeria shows how much progress the country has made towards achieving the global nutrition targets. Of the 13 targets, Nigeria has made ‘some progress’ in achieving four targets while the country is reported to be ‘off-course’ on seven targets. It is estimated that 15.7% of adult women (aged 18 years and over) and 5.9% of adult men are obese. However, the prevalence of obesity in Nigeria is lower than the regional average of 20.7% for women and 9.2% for men.
Hajiya Jummai Hassan Abdul, clinical nutritionist/dietitian at Karshi General Hospital, Abuja, said, “Obesity can affect anybody, whether child or adult. But, in some cases, the most affected group are adults, due to their sedentary lifestyle.” She added that some people believe that it’s impossible to become obese in Nigeria, “but it’s easy for one to become obese because our diets are changing. We have poor dietary habits which cause us to consume refined sugars and fizzy drinks. In addition, we have lifestyles that stress our bodies”. Consuming calorie-dense, low-nutrient food and beverages is a contributing factor to obesity. Consumption of sugar-sweetened beverages (SSBs), particularly carbonated soft drinks, is also a key contributor to obesity as the beverages are high in sugar content and have no nutritional value.
It has been predicted that by 2025, the global obesity prevalence will reach 18% in men and surpass 21% in women. Left untreated it increases the risk of non-communicable diseases NCDs, including diabetes, cardiovascular disease, liver disease and certain cancers, needing more extensive and costly interventions. At least 2.8 million people die each year as a result of being overweight or obese.
Tackling the obesity crisis
Obesity is a chronic disease and a driver of other diseases, with serious implications for individuals, families, societies and economies.
In 2018, Nigeria Health Watch organised a policy dialogue that brought together stakeholders, discussing the need for our diets to include local foods. Interventions need to tackle the root causes of malnutrition which often requires looking into the home environment the children come from and their general family circumstances.
The Nigerian government has instituted various policies and strategies to enhance positive nutrition outcomes in the country, with particular attention to the nutritional status of women and children. In 2016, the government launched an updated National Policy on Food and Nutrition to provide the framework for addressing food and nutrition insecurity problems in Nigeria together with a holistic approach for its implementation.
Sugar tax to address poor nutrition
In December 2021, the Federal Government introduced an excise duty of N10 per liter on non-alcoholic, carbonated, and sugar-sweetened beverages (SSBs) as contained in the Finance Act of 2021. While a sugar tax might not be a silver bullet for addressing poor nutrition, it is expected that this tax will foster a decrease in the consumption of SSBs and ultimately address diet related NCDs.
In 2011, the Hungarian government put a levy on food products containing unhealthy levels of sugar, salt and other ingredients in an effort to reduce their consumption, promote healthy eating and create an additional mechanism for financing public health services. Four years after the tax was introduced, consumption of unhealthy foods in Hungary decreased; many food manufacturers reduced or eliminated unhealthy ingredients in their products; population awareness of healthy eating increased, and approximately US$ 219 million in revenue was raised and earmarked for health spending.
A notable impact of the levy in Hungary was improved nutrition literacy. Indirectly, the tax and the public discourse around its introduction began to change population attitudes to unhealthy foods. Improved nutrition literacy is a welcome outcome as it ultimately leads to citizens making healthy food choices. It is important that consumers understand the adverse health consequences resulting from the consumption of SSBs.
As the consequences of a modern lifestyle become more apparent, governments have begun to adapt policy to fight against the knock-on effects of obesity on public health systems including the increased susceptibility to chronic illnesses like diabetes and high blood pressure.
Childhood obesity is a strong risk factor for adult obesity, and it has significant health and economic implications due to the cost of managing NCDs and the loss in productivity due to ill health. Though policies like the sugar tax are a step in the right direction, it is important that individuals are aware of the damaging effects of consuming foods that are high in fat and sugar.
Behavioural change communications about the impact of poor nutrition and continuing nutrition educational is also key. This would ensure that, empowered with more information, people would be better able to make more informed decisions about the food they eat.
Have you heard about the newly introduced Sugar Tax? What are your thoughts about its introduction? Share your thoughts in the comment section.