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Wednesday, November 30, 2022

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Why Protein Deficiency Persists in Nigeria

Professor Henrietta Ene-Obong of the University of Calabar says protein deficiency persists in Nigeria due to entrenched behavioural, socio-economic, political and environmental decay which failed to address the many multi-factorial causes of malnutrition in the country.

Delivering a paper on: Protein Deficiency: Bridging the Knowledge Gap at The Protein Challenge Webinar Series 5, Ene-Obong listed some of the factors for persistent protein deficiency in Nigeria to include poor infant and young child feeding in terms of exclusive breastfeeding, inadequate complementary foods; poor utilisation of available food resources, poor uptake/adoption of technology and low dietary diversity (monotonous diets, mono-staples).

Others are:

  • Poverty and low level of education, including nutrition education
  • Household food insecurity
  • Failure to pay attention to ethnic differences in food habits and choices as well as lack of access to culturally acceptable food
  • Lack of safe water and proper hygiene
  • Political instability and insecurity

She lamented the lack of nation-wide quantitative studies on the nutrient intake of Nigerians just as available data are qualitative, limited in scope/sample size or outdated.

“The adequacy of protein intake among Nigerian infants, children, adolescents and women was reviewed by de Vries-ten Have et al. [2020] and it showed that apart from adolescent girls, pregnant and lactating women, the Nigerian population had mostly adequate protein intake when compared with the most recent protein recommendation by FAO (2003) and WHO/FAO/UNU (2007).  This is contrary to a recent study by the Japan International Cooperation Agency (JICA, 2017) which showed that about 76 percent of children in the Study sites (Federal Capital Territory) did not meet their requirement for protein and most key nutrients, even though the sample size was small. From available data, we still record high prevalence of acute malnutrition and stunting among infants and young children.  Is this a matter of quality? “

Ene-Obong stated that protein deficiency could manifest in Protein-Energy Malnutrition (PEM), which is very common in children of less than five years old just as it is the 10th leading cause of cause of death in the Nigerian population, accounting for 2.5 percent of total deaths.

“According to the most recent 2018 NDHS report, 37 percent and seven percent of children less than five years are stunted and wasted, respectively. Although wasting seems to have decreased from 18 percent in 2013 to seven percent in 2018, stunting has not really changed.”

To effectively curtail the problem of protein deficiency in the country, the don called for adequate nutrition in the first 1000 days of life, adequate adolescent and maternal nutrition, promotion and support of exclusive breastfeeding and continued breastfeeding for two years, and promotion of adequate complementary food: Plant protein alone cannot be adequate to support maximum growth and development in infants and children. Plant proteins should be supplemented with ASFs (fish, eggs, milk, etc.).

Other critical measures she suggested include:

  • Dietary diversification: ensuring that infants and young children consume foods from at least four food groups. These groups include) Grains, roots & tubers) Legumes & nuts;) Dairy products) Flesh foods; Eggs) Vitamin A-rich fruits and vegetables; 6) Other fruits & vegetables. This will ensure that some ASF will be included in the diet.
  • Aggressive promotion of high-quality protein sources (Soybean and other indigenous legumes like the African yam bean, cowpea, etc.)
  • Production of low-cost, affordable soybean-based products
  • Protein complementation (called mutual supplementation), e.g., “rice and beans” dish. One exception is combination of milk with legume.
  • Increased food production even at household level
  • Nutrition education; nutritional benefit of soybean, usage pattern, preparation and storage
  • Empowering women
  • Good governance
  • Treatment strategies

In conclusion, Ene-Obong affirmed that the prevention of malnutrition using the food-based approach is and has been recognised as the most cost-effective development strategy.

“There are many therapeutic means to solve the malnutrition challenges, and a lot of resources have been devoted to them. It is my humble opinion that we need knowledge and the capacity to apply what we know in order to face challenges and overcome them. Bridging this knowledge gap and providing the capacity to bridge it, puts the knowledge into action, which should be focused on the right decisions. More focus should also be given to prevention strategies by appropriately utilising indigenous food resources, which Nigeria is naturally endowed with.”

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