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Why Over 200,000 Nigerians Will Die of Cardiovascular Diseases By 2023

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By Sunday Elom

When Gift Okoye, a food seller in Awka, Anambra State capital, ventured into the food selling business, unbeknown to her, some of her actions could lead to health crises in the lives of her customers. Okoye is well known in Ifite Awka, for her delicious akara (bean cake), fried yam, potatoes and plantain – a delicacy for all and sundry. She fries the food  with vegetable oil. 

Orient Daily paid an early morning visit to Okoye before she settled into her business for the day. She picked up a transparent 20 litres gallon from inside her small shop and began pouring a blackish brown liquid from it into the large frying pan. It was not until it began to sizzle and she started frying sliced yam in it that it became apparent that the liquid was vegetable oil which had clearly been repeatedly used numerous times. Next, she fried sliced potatoes and plantain before the akara. She repeated the process for another two hours until she fried everything. By this time the oil was visibly black.

This was clearly nothing out of place because rather than throw it away, she simply poured what was left into the container it had come out of, to be re-topped for use the next day. For her, the oil turning black does nothing to the taste of her cooking. Frying fish with the same oil is the only thing that affects the taste of her food. 

“The only thing is that when I use it until it goes down very well [quantity reduces], I will add more to it,” she quipped.

Okoye, who has been in this business for five years, has never heard of trans fat. She also does not know that her thriving business is a death trap for her cheerful customers, including her children and her who also all eat from her fried foods. 

“I don’t know anything about trans fat because nobody has ever told me about it. 

“In fact, Nigeria’s problem cannot make you know that one [trans fat] because if you change the oil every time like that, at the end of the day, you will borrow money and start your business again because you will not make profit. Even your capital, you can’t get it,” she laments.

Okoye, one of many Nigerians trading in fried food business across the country, based on findings carried out by our reporter in Awka, Anambra State and Enugu, Enugu State, are oblivious of the gravity of their actions and the attendant consequences.

Trans fats according to Wikipedia are unsaturated fatty acids found in processed foods, in fried foods, and in margarine and any food prepared with partially hydrogenated oil. Trans fat is formed when hydrogen is added to vegetable oil through overheating, thereby converting it from liquid into a solid form, resulting in “partially hydrogenated” oil (PHO).

Research carried out by our reporter on fried meats and packaged foods like bread, chicken strips, crumbed chicken, potato chips, gold fingers, fried fish, egg rolls, sauce, amongst others from popular stores, malls and roadside sellers like Okoye in Anambra State and neighboring Enugu State, revealed that Nigerians, regardless of class, consume large quantities of foods prepared with partially hydrogenated oils.

The Vice President, Northern Region of the Nutrition Society of Nigeria, Dr. Salisu Abubakar, explains the reason for the alarming rate of trans fat related diseases in the country.

Facts and Figures

Since February 27, 2020, when Nigeria recorded its first case of COVID-19 infection until June 16, 2022, Nigeria has recorded only 3,144 deaths from the pandemic. A breakdown of this figure shows that the annual distribution of COVID-19 death rate is about 1,572.

In 2019, however, a former National Coordinator for Non Communicable Diseases (NCDs) at the Federal Ministry of Health (FMoH ), Dr. Nnenna Ezeigwe, in Abuja, said that cardiovascular diseases have become a significant public health concern, being responsible for 11% of over 2 million NCD deaths in Nigeria annually.

Although, there are no official exact figures of trans fat mortality rate in Nigeria, the Minister of Health, Dr. Osagie Ehanire, while commissioning a privately established specialised cardiac care hospital in Abuja on November 26, 2020, posited that, over 2 million Nigerians died of non-communicable related disease annually, out of which, cardiovascular diseases account for 11 percent.

While giving a breakdown of the death figures, Dr. Salisu Abubakar, said trans fat is the major risk factor of cardiovascular diseases.

According to him, analysis of the 11 percent of the over 2 million mortality figure of cardiovascular diseases annually showed that an estimated 220,000 Nigerians die of trans fat related diseases annually; while COVID-19 death rate of three African countries, Nigeria, South Africa and Kenya combined for the past two years stood at 110,795 as at June 16; leaving trans fat related diseases mortality rate in the country at a margin of 109,205.     

Globally, the World Health Organisation (WHO) said that about 540,000 people die every year due to intake of industrially produced trans-fatty acids.

The WHO trans fat free programme

Over 10 years ago, WHO called for the global elimination of industrially produced trans fat by 2023. The organisation launched a REPLACE campaign and recommended countries to “develop and implement best-practice policies to set mandatory limits for industrially produced Trans Fats to 2% of oils and fats in all foods or to ban partially hydrogenated oils (PHO).”

REPLACE campaign by WHO required countries to review dietary sources of industrially-produced trans fat and the landscape for required policy change. Promote the replacement of industrially-produced trans fat with healthier fats and oils. Legislate or enact regulatory actions to eliminate industrially-produced trans fat.

It also required them to assess and monitor trans fat content in the food supply and changes in trans fat consumption in the population; create awareness of the negative health impact of trans fat among policy-makers, producers, suppliers, and the public and Enforce compliance with policies and regulations, by 2023.

According to the WHO’s third annual report published on December 7, 2021, on the global progress on elimination of industrially produced trans fats by 2023, 57 countries already have mandatory TFA policies, out of which, 40 countries have best-practice policies in effect. 

Unfortunately, seven months to 2023, Nigeria is neither among the 57 countries nor among the 40 as the country is yet to gazette the Fats, Oils, and Foods Containing Fats and Oils Regulations 2022 drafted by NAFDAC and submitted to the Federal Ministry of Health (FMOH). 

What has Nigeria done?

The National Agency for Food and Drugs Administration and Control (NAFDAC), in collaboration with the Federal Ministry of Health, recently updated two existing regulations, namely, the Fats and Oils, and Pre-packaged Ice and Water Labelling Regulations. The Nigerian Government through the Federal Ministry of Health has made an effort to reduce dangers associated with the consumption of trans fats by drafting the fat and oils regulations.

Towards the efforts to contain the Covid-19 pandemic, Federal Government of Nigeria, without further ado, made a litany of regulations and policies within a short period of time; declared countless number of national lockdowns and closed down many event and worship centres. Meanwhile, no regulation, policy or regulatory actions has been put in place to eliminate industrially produced Trans Fat in the Nigerian food chain to save the lives of the dying populace.

The Nigeria’s National Agency for Food and Drug Administration and Control (NAFDAC) drafted the Fats and Oils Regulations in 2014 and updated the regulations in 2020, but till date, the draft is yet to be approved and gazetted by the Nigerian government.

Sequel to the Food and Agriculture Organization’s (FAO) warning that COVID-19 pandemic poses a substantial risk to agricultural input, and the overall food supply chain, the federal government quickly set up an advisory for food business on safe food practices. Yet, the policy draft by NAFDAC and the Standard Organization of Nigeria (SON) to regulate and eliminate Trans-fatty acid in the Nigerian food supply chain over a decade has not been gazetted till date.

Recall, the federal and state governments distributed some industrially packaged foods including noodles to Nigerians as support to cushion the effects of Covid-19. Ironically, some of the foods were prepared and preserved with hydrogenated oils; thus, putting the beneficiaries into higher health risks.

Due to low attention, publicity and actions given to trans fat in the country, a greater number of Nigerians are ignorant of the silent killer. Unfortunately, this population consumes fast foods, fried foods, deep-fried foods, packaged and pre-packaged foods that contain high level of industrially produced trans fat acids.

In her presentation at a training programme organised for journalists in Enugu State on May 6th and 7th, 2022 by the Corporate Accountability and Public Participation Africa (CAPPA) and partners, NAFDAC’s Director of Food Safety and Applied Nutrition Directorate, Dr. Eva Edwards, said the agency transmitted the final draft of the regulations back to FMOH in April this year.

The National Policy on food and nutrition made and gazetted in 2005 did not acknowledge trans fat as a public health issue on Nigeria’s radar at the time. But the document was reviewed in 2019/2020 after the WHO launched the REPLACE campaign during which, trans fat was included. However, till date, the ministry of health is yet to get the Minister of Justice and the Attorney General of the Federation to gazette it.

The National Coordinator of Food Safety & Quality Programme in the Federal Ministry of Health, Mr. John O. Atanda, who, during the training, confirmed that the ministry has received the draft regulation, said it would go through many stages of review before it could be gazetted.

Atanda, said that the ministry has “reviewed and made inputs to the regulations developed by NAFDAC to ensure it meets the required standard.”

“Advised the Honourable Minister of Health on the impact and merit of the regulation and seek his approval” and sent “Advocacy to the Honourable Minister of Justice and the Attorney General of the Federation on the national importance of gazetting the reviewed Fats and Oils regulations and other accompanying regulations and engaged with the leadership of key departments of the Federal Ministry of Justice to initiate internal processes for speedy gazetting of the regulations.”

While some Non-Governmental Organisations (NGOs) like CAPPA and NHED, have launched Public Service Announcement (PSA) and other programmes to create Trans Fats awareness, if the government continue to neglect and delay the regulations on industrially produced Trans Fatty foods, research by our reporter revealed that the number of Nigerians that will die of trans fat related diseases by 2023 will be more than the Nigeria, South Africa and Kenya COVID-19 death figures combine.

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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