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How ignorance about trans fat contribute to rise in chronic diseases in Nigeria




By Dare Akogun

Trans fats, according to medical practitioners, have no known health benefits and are a contributor to cardiovascular diseases worldwide. In Nigeria, efforts are being made to curb its use; however, the delay to gazette the laws to regulate the trans fat content in food has become worrisome, DARE AKOGUN reports.

“Had it been I knew how awful it is to have a stroke; I would have been more cautious and protective of my health and, most especially, what I eat. I have lost my job and have not been able to secure another one all because I don’t walk and look like I used to. I also get rejected everywhere I show up for an interview. My life has not been the same,” says Kemi Shuaib, a 37-year-old mother of two from Niger state who has been battling stroke for seven years now.

“It all started in 2015 when I woke up to ease myself around 3:00 am, and I just couldn’t move. I tried all possible ways, but it seemed impossible; the best I could do was to make a phone call to neighbours. I was rushed to the hospital, and after eight hours of running tests, the doctors confirmed I had a stroke due to high blood pressure, which I never knew I had,” she explained.

Kemi Shuaib
Kemi Shuaib

Just like Shuaib’s case, who was battling with stroke, partly due to many years of eating junk food, because of the nature of her work and ignorance about trans fat, non-communicable diseases, mainly cardiovascular diseases, cancers, and diabetes are leading causes of death globally.

The economic burden of non-communicable diseases on families in Nigeria is significant because the treatment cost is high, and it is usually paid out of pocket.

A report published in February 2021 in the European Journal of Preventive Cardiology,  a journal of the European Society of Cardiology, the number of patients with heart failure worldwide nearly doubled from 33.5 million in 1990 to 64.3 million in 2017.

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The authors said the rising rate of heart failure in low and middle-income countries such as Nigeria “is driven by risk factors such as hypertension, diabetes mellitus, obesity, smoking, and other unhealthy lifestyles.”

In 2018, as part of efforts to reduce the health crisis arising from the consumption of meals made with hydrogenated fat – industrial version of transfat –  the World Health Organization (WHO) called for a global elimination of industrially produced trans fatty acids by 2023 through an initiative called the REPLACE action framework which serves as a guide to all countries for a policy or regulatory enactment.

Replace has six areas of action, which are: Review dietary sources of industrially-produced trans fat;  Promote the replacement with healthier options; Legislate regulatory actions to eliminate industrially-produced trans fat; Assess and monitor trans fat content in the food supply; Create awareness of the negative health impact; and Enforce compliance with policies and regulations.

The WHO pointed out that cancer, cardiovascular diseases and diabetes were responsible for 37 per cent of fatalities in 2019, increasing from 24 per cent in 2000, largely due to weaknesses in the implementation of critical control measures, including prevention, diagnosis and care.

While speaking in April this year, the WHO Regional Director for Africa, Matshidiso Moeti, said the mounting burden of non-communicable diseases poses a grave threat to the health and lives of millions of people in the second largest continent in the world.

According to her, the growing burden of non-communicable diseases exerts pressure on treatment and care services. In the African region, the number of people living with diabetes, for example, is to hit 47 million by 2045, up from 19 million in 2019.

A woman serves small chops at an event.

She says findings from the 2022 non-communicable disease progress monitor showed that between 50 and 88 per cent of deaths in seven countries in Africa, mostly small island nations, are traceable to these ailments.

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The report also discovered that in seven other countries, the majority of them Africa’s most populous entities, the diseases claimed between 100,000 and 450,000 lives yearly.

The WHO describes industrial trans-fat as unhealthy fats produced when vegetable oils are heated or “hydrogenated”.

The organisation said food manufacturers use partially hydrogenated oils to improve food texture, flavour stability and keep some foods fresh for a long time. It is sold as ‘margarine’.

A consultant cardiologist at the University of Ilorin Teaching Hospital,  Ayo Ogunmodede, says foods rich in trans fat raise low-density lipoprotein known as ‘bad cholesterol.

The doctor said evidence has been mounting that even a small amount of trans fat increases bad cholesterol in the blood and decreases the amount of good cholesterol, raising the risk of coronary heart disease and heart attacks.

He says globally, high risks of heart disease are associated with industrially produced Trans Fatty Acids consumption.

Dr. Ogunmodede

He stated that partially hydrogenated oils were first introduced in the 20th century as a replacement for butter and became more popular in the 1950s through the 1970s with the discovery of the negative health effects of saturated fatty acids.

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According to him, the reasons for the popularity of the oil are simple: “The oils were relatively inexpensive to produce when compared to solid animal fat, which he also said increases the shelf life of food, tasted good, and at a time when saturated fats in butter were vilified, they were billed as a healthy alternative.

He adds that local foods with high industrially produced trans fatty acids and unhealthy fat content include biscuits, fried foods (like French fries, pizza, puff puff), deep-fried fast food (like akara, fried chicken), plantain chips, sauces and seasonings, ice cream, doughnuts, pastries, cakes, chin-chin, and pre-packaged snacks, microwave popcorn, margarine, and other confectionery.

He says diets high in trans-fat increase cardiovascular disease risk by 21 per cent and deaths by 28 per cent.

Talking about the relationship between trans-fat and heart attack, he says that Trans- fat increases levels of LDL- cholesterol, which is an established biomarker for cardiovascular disease risk, as well as decreasing the level of HDL- cholesterol, which transport cholesterol from arteries to the liver for excretion through bile.

“Replacing trans-fats with unsaturated fatty acids reduces the risk of heart disease, partly by ameliorating the negative impact of trans-fats in blood lipids. Additionally, evidence suggests that trans- fat may increase inflammation and endothelial dysfunction and also increase the tendency for platelet aggregations”.

NAFDAC DG Prof. Adeyeye
NAFDAC DG Prof. Adeyeye

The Director-General, National Agency for Food and Drug Administration and Control (NAFDAC), Mojisola Adeyeye, in an interview,  says to ensure Nigeria joins the rest of the world in limiting trans fatty acids in its food chain, the agency, in collaboration with the Federal Ministry of Health updated two existing regulations;  the Fats and Oil Regulations 2019 and the Pre-Packaged Food, Water and Ice (Labelling) Regulations 2019.

While progress has been made in putting together the regulations and getting the NAFDAC Council to approve them, she acknowledged the bureaucratic delays in getting the regulations gazetted and assured Nigerians that they are working as fast as possible with all the necessary departments to pass the bill.

She explains the delay has become costly as it allows manufacturers of foods high in trans-fats, interested only in profits, to continue the business of marketing lethal foods.

When passed into law, the first regulation will limit trans fat to 2g per 100g of total fat in all Fats, Oils, and Foods, while the latter will ensure proper labelling of food products in Nigeria in the context of industrially produced trans fats.

Kazeem Olaniyi, MK Small Chops and Grills CEO, is based in Ilorin. He has heard of trans fat but does not understand what it means.

Kazeem Olaniyi
Kazeem Olaniyi

Talking about using hydrogenated or reused oils to prepare food, he said he is aware that most caterers use it to prevent wastage and lack knowledge about the health hazard it can cause for their clients and families.

“Many people use the oil they used in frying to cook soup or make jollof rice and other edibles,” he said.

Although there is no safe level of trans fat consumption, the WHO recommends the total trans fat intake does not exceed one per cent of total energy intake, which translates to less than 2.2g per day for a 2,000-calorie diet.

Kazeem Olaniyi at work
Kazeem Olaniyi at work

When choosing fats and oils for domestic or commercial cooking, it is advisable to choose healthier options.

One major challenge, however, to the elimination of trans fat in foods in Nigeria that is not clearly addressed in the proposed Regulation is the sale of unbranded cooking oils.

Emphasis is focused more on packaged products or food containing fat and oils by the proposed law, but it does not specifically address unbranded-cooking oils, which are sold in the open market and easily accessible to so many Nigerians.

This Investigative Report was supported by Corporate Accountability and Public Participation Africa (CAPPA) and partner, Global Health Advocacy Incubator (GHAI) under her #TransfatFreeNigeria Project.

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