Malnutrition harming nine out of ten people in Kenya

Malnutrition isn’t always caused by starvation. The reality is that up to 90 per cent of Kenyans are suffering from some form of malnutrition - because they are eating the wrong foods.

The result is micronutrient deficiencies that are stunting growth and intelligence, suppressing immune systems, and causing multiple diseases and deaths.

In fact, micronutrient deficiency is Kenya’s biggest killer, at levels that are way higher than most other developing nations: because the Kenyan diet is worse.

With children the most studied and the worst affected, some 35.2 per cent of under 5 year old Kenyans are malnourished, according to the World Bank. But the overall figure hides a more severe mix of micronutrient deficiencies.

“Most child deaths are caused by malnutrition,” said Maanan Mumma, a nutritionist. Moreover, the country’s levels of malnutrition are rising, not falling, driven by the near absence of fruit and vegetables in many Kenyan diets.

Says Huyen Tran, Action Against Hunger’s country programme co-ordinator in Kenya, the cause is “the consumption of foods low in fibre and high in fats and sugars”.

Specifically, the emphasis on staple foods, such as Ugali, with almost zero nutritional content, and the heavy loading of sugar into drinks, is making for a disease cocktail.

At base, Kenya is suffering some of the highest levels in the world of Vitamin A Deficiency (VAD), which is affecting 85 per cent of Kenyan children under 5 years, according to a recent World Bank report.

VAD is the leading cause of preventable blindness in children, causes child and maternal deaths, and night blindness among pregnant women. Unicef reports that VAD is causing tens of thousands of deaths a year in Kenya, and affecting the vast majority of Kenyan children.

A direct consequence of VAD and associated nutrient deficiencies is stunting, which is defined as low height for age and is caused by insufficient nutrients over a long period of time, coupled with frequent infections.

A stunted child is usually inches shorter than a well nourished child. They also have a weaker immune system and are therefore more vulnerable to disease.

According to Unicef, a stunted child is five times more likely to die from diarrhoea. Other effects include delayed motor development, impaired cognitive function, and poor school performance.

The fact that nutrient deficiency can permanently reduce intelligence, as well as growth and immunity, has drawn little attention in public debate, but the problem is both severe and widespread across Kenya.

Globally, stunting affects about 180m under the age of five years. In Kenya, as of 2009, 35 per cent of Kenyan children under five years were stunted, with the then Eastern province reigning supreme at 42 per cent.

Stunting is more common in rural areas, at 37 per cent, than in urban areas, where the prevalence is 26 per cent. Altogether, Kenya accounts for almost one twelfth of the world’s stunted children.

Iron Deficiency Anaemia (IDA) is also a severe problem in Kenya. According to the World Health Organisation, in developing countries, every second woman and 40 per cent of pre-school children are anaemic.

But a 1999 survey in Kenya, conducted by Unicef and the government, found that 89 per cent of children under six years, 56 per cent of women of child-bearing age, and 46 per cent of men were anaemic in Kenya.

Anaemia causes impaired physical and cognitive development, increased levels of disease in children, a reduction of work productivity among adults, and contributes to 20 per cent of all maternal deaths.

The overall scale of malnutrition is now driving a raft of initiatives, including campaigns to encourage the consumption of orange-fleshed sweet potatoes, which contain high levels of vitamin A and beta carotene, both of which help reduce child blindness and child mortality.

According to a Nutrition Action Health Letter’s study of 58 vegetables in which the percentages of six nutrients including vitamin A and C, folate, iron, copper and calcium and fibre were analysed, sweet potatoes topped the list with 582 points, with raw carrots following with 434 points.

Food fortification has been another way of curbing micronutrient deficiencies, with the 2012 launch of a food fortification programme in Kenya set to benefit some 27m people.

The aim is to nutritionally fortify wheat flour, vegetable oil and maize meal thereby reducing the widespread prevalence of vitamin and mineral deficiencies by inserting Vitamin A.

And other fortification into the foods that Kenyans do eat. Large scale maize meal, wheat flour and vegetable oil producers are now committed to fortifying their food products.

READ: Processors ignore directive to fortify basic food products

But obesity and poor diet are also driving other conditions, with diabetes one of the most devastating.

Type 1 diabetes is hereditary, but Type 2 can be brought on as the insulin produced by the body becomes insufficient or the body is unable to respond to sugar intake, leading to a build-up of glucose in the body. It used to be a condition that generally struck in old age, but is now becoming more prevalent in children and young adults, and once developed, is permanent.

As it is, obesity is twice as high in urban areas than in rural areas, and increases with age, education and wealth. As of 2009, 41 per cent of Nairobi women were found to be overweight or obese.

This is especially troubling for pregnant overweight women with impaired glucose tolerance, a category of higher than normal blood glucose that is normally below the threshold for diagnosing diabetes.

To stabilise glucose levels, which can cause high blood pressure, kidney failure, foot ulcers and many other conditions, a typical diabetes food program recommends small portions of meat, meat substitutes and other proteins. With meat not easily affordable for everyone, protein maize also can provide an alternative.

The maize, known as Quality Protein Maize (QPM), is biofortified and non-transgenic, made from a naturally occurring mutant maize gene that increases the amount of two amino acids, lysine and tryptophan, necessary for the synthesis of proteins in humans.

QPM does not increase the total amount of protein but rather contains enhanced protein which is more beneficial to humans on consumption. Having 90 per cent the nutritional value of milk, this type of maize is also great for malnourished children.

While much remains to be done to stop the explosion in Kenya’s diet-related diseases, measures are being taken to improve, which can only signify a step in the right direction.

-African Laughter