Eating to beat COVID-19, others

Dr. Bartholomew I. C. Brai is the President, Nutrition Society of Nigeria (NSN), and a consultant nutritionist at the Federal University Oye-Ekiti, Ekiti State. Brai, in this exclusive interview with The Guardian, made recommendations on what local foods to eat to beat the novel coronavirus (COVID-19) and other chronic diseases. CHUKWUMA MUANYA writes.

Hippocrates was quoted as saying, “Let food be thy medicine, and medicine be thy food.” So what local foods do we have that can satisfy this position? Or rather what food materials do we have in Nigeria that can also serve as our medicine in the fight against coronavirus?
This statement is used to emphasise the importance of nutrition to prevent or cure diseases. Nutrition is the foundation for a healthy living and this means that consumption of nutritious and healthy diets is key to staying healthy. Nigeria is blessed with diverse foods such that when they are consumed in appropriate quantities and quality, and with proper hygiene, individuals could stay healthy.

These foods include: tubers/roots – yam, cocoyam, potato, cassava; cereals – maize, millet, sorghum; legumes – beans, meat, poultry, fish, milk and milk products; fruits and vegetables – available in different seasons; and nuts and seeds – ground nuts, cashew nuts and walnuts.

Is there any particular food, supplement or herb that has been identified to help prevent or treat COVID-19?
Although there are widespread claims on social media inaccurately asserting that certain foods and supplements can prevent or cure COVID-19, there is no evidence that any food/supplement or herb can prevent or cure COVID-19.

Current treatment is targeted at the symptoms not the virus. Eating certain foods or following certain diets will not prevent any individual from being infected by coronavirus. That is why it is important that people adhere strictly to rules and guidelines issued by World Health Organisation (WHO), Federal and state ministries of Health and the Nigeria Centre for Disease Control (NCDC).

What are your recommendations to governments at all levels on how best to contain COVID-19 especially using nutrition as a tool?
The COVID-19 pandemic has brought social and economic crisis that is rapidly exacerbating ongoing nutrition insecurity in Nigeria. The country has taken the first step of putting in place a multi-sectoral Nigeria Nutrition Response Plan for COVID-19.

The Federal Government should: ensure the nutrition sector is adequately represented in the Presidential Task Force by including Nutrition Officers on the teams; increase food and nutrition awareness among the state governors on the need to support access to input and services to enable farmers to engage in farming activities, access the markets to sell their produce in order to earn income to acquire enough food for their families during this farming season while maintaining all necessary prevention measures; and strengthen and support the health system to deliver by ensuring adequate procurement, supply and distribution of nutrition supplies for health facilities- ready-to-use therapeutic foods (RUTF), Mid-Upper Arm Circumference (MUAC) tapes for Family MUAC approach to screen; Micronutrient Powder (MNP) linked with

Infant and Young Child Feeding (IYCF) IYCF, Visual analog scales (VAS), therapeutic products and routine medicines – Iron and Folic Acid Supplementation (IFA), Zinc + LO- ORS) and also at community level. Zinc and Low-osmolarity Oral Rehydration Solutions (LO-ORS) are critical in the treatment of childhood diarrhoea.

MUAC is the circumference of the left upper arm, measured at the mid-point between the tip of the shoulder and the tip of the elbow (olecranon process and the acromium). MUAC is used for the assessment of nutritional status.

Others include: increase awareness of the general population on the importance of nutritionally diverse diet including animal source proteins (such as dried fish and dried meats), fruits and vegetables in food distribution to vulnerable groups in the Covid-19 pandemic period; promote appropriate Maternal Infant and Young Child Feeding (M&IYCF) practices including promotion of Exclusive Breastfeeding and Continued breastfeeding, Iron folate supplementation for pregnant mothers, monitoring of marketing of Codes of Breast Milk Substitute (BMS) in period during COVID-19 and post COVID-19 pandemic; develop/ adapt a minimum package of food groups that government and partners can use for palliatives; ensure that households identified for cash-transfer must include households with pre- school (zero- five years) and primary school children; and support the continuation of food assistance and social protection measures including school feeding programmes and increased household vulnerabilities beyond COVID-19.

Globally the thrust in treating coronavirus has been the issue of boosting the immune system to fight off the virus. What Nigerian foods could be used to improve the body’s defences?
Good diet and adequate nutrition is the bedrock of good immune system necessary to fight off infections and diseases. Nigeria foods are replete with necessary nutrients that could help boost the immune system. It must however be noted that no particular food or nutrient alone is sufficient to boost the immune system.

Foods available in Nigeria that can contribute required nutrient for boosting immunity include: legumes like beans, soybeans, and lentils are all nutrient-dense and known to contain a high amount of protein. Proteins (amino acids) are essential in production of antibodies that are needed to fight against infections. Fresh dark green leafy vegetables and fruits are rich in vitamins and minerals vitamins A, C, E, B6, B12, iron and zinc. Example fluted pumpkin leaves, African spinach, oranges, grapes, lemons, tangerines, lime etc. Vitamins and minerals aid in building and maintaining a healthy immune system. Seafoods: Eating seafoods regularly can strengthen the immune system. Seafood like oysters, shrimps, periwinkle, and crabs and are all excellent sources of selenium, a mineral, and an antioxidant that helps in boosting the immune system.

Eggs, liver, dairy products especially low-fat yogurt is healthy and can help you maintain a good immune system as it contains protein, calcium, vitamin B12, vitamin D, and vitamin B2 (riboflavin). The body requires adequate levels of vitamin D and other nutrients for optimal immune functioning. Yogurt is also rich in probiotics, such as Lactobacillus acidophilus, Lactobacillus casei, and Bifidus. These probiotics boost immune function and may even help reduce both the duration and severity of colds and enhance immune function to fight diseases. Spices: ginger and garlic both contain antioxidant compounds and have anti-inflammatory and immune-boosting properties. Consuming garlic regularly can help to boost your immune system to fight flu and viral diseases like common cold and COVID-19 but does not offer protection against it.

Why is NSN not part of Federal Government’s drive to contain COVID-19?
Considering the COVID-19 response committees formed in various countries of the world it is quite obvious that professionals in food and nutrition have been sidelined. Meanwhile, the COVID-19 patients require adequate nutrition support and counselling for fast and complete recovery.

NSN is not part of the Federal Government Presidential Task Force team for obvious reasons: low priority accorded to nutrition as a result of low governance at the policy making level; little knowledge of nutrition by medical practitioners who happen to champion the COVID-19 Team; and health and nutrition often misconstrued to mean the same thing.

However, the Head of Nutrition at the Federal Ministry of Health included NSN in the team that produced the Nigeria Nutrition Response Plan for COVID-19. Also, NCDC invited NSN to join the Nigeria COVID-19 Research Consortium.

Should mothers still breastfeed in the light of COVID-19? If yes or no, why?
A mother with COVID-19 should be supported to breastfeed her newborn. NSN hereby reiterates that breastmilk remains the safest and best meal for infants aged zero- six months. Therefore, exclusive breastfeeding and continued breastfeeding up to the age of 24 months should be sustained.

Currently, there is no evidence that coronavirus can be transmitted through breastmilk. It is therefore considered safe for mothers to breastfeed their infants. However, breastfeeding mothers in isolation should: practice respiratory hygiene; wash hands before and after touching the baby; and routinely clean and disinfect surfaces.

If a woman with COVID-19 is too unwell to breastfeed, she can be supported to safely provide her baby with breast milk in other ways, including expressing milk. Others are re-lactation and breastmilk donor where feasible and safe

What is Nigeria’s Nutrition Policy in situations like this?
The Federal Ministry of Health in collaboration with the relevant stakeholders, including Nutrition Society of Nigeria, has developed the Nigeria Nutrition Response Plan for COVID-19 to be used across the country.

What have been the challenges of the NSN in meeting its mandate in situations like this?
Nutrition Society of Nigeria is the largest umbrella body of nutritionists and allied professionals in Nigeria. Our members are spread across various tertiary institutions; government ministries, departments and agencies; research institutes; Non Governmental Organisations (NGOs) and food industries. We have human resources but lack the finances needed to carry out our programmes, which are aimed at addressing the nutritional needs of Nigerians.

Another major issue now is that people’s purchasing power has dropped due to the coronavirus COVID-19 induced lockdown. What are the cheap and available alternatives to achieve adequate nutrition at all ages and at breakfast, lunch and dinner?
It is true that purchasing power of the people has been adversely affected and usually this has compounded the issue of malnutrition and hunger. Since most Nigerians are poor living below poverty line the challenge would be huge and enormous. Fortunately, Nigeria foods are diverse as her culture. There is no community without cheap and affordable alternatives if the common food prices are beyond the reach of individuals.

Most of the foods vulnerable to rapid inflation are either processed foods or imported to which local alternative are available. Examples of such foods vulnerable to rapid inflation include but not limited to bread, rice and its derivatives, meat, noodles, canned foods, exotic fruits and vegetables etc.

Individual can substitute these with yam (different varieties) and their derivatives, cocoyam, plantain and its derivatives, potatoes, cassava and its derivatives, beans including local varieties, mushrooms, fish, crayfish, edible insects, local grains (maize, sorghum, millet), local vegetables and fruits in season etc.