The alarming incidence of diabetes in the Solomon Islands and the need for proper dietary control measures

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THE Solomon Islands Broadcasting Corporation (SIBC) carried an alarming story this week on the occasion of World Diabetes Day.

This is what the SIBC reported.

“Diabetes cases at the National Referral Hospital (NRH) Diabetes Clinic are increasing every day, local health experts say.

“NRH medical consultant Dr Jones Ghabu revealed the alarming trend during World Diabetes day.

“ Ghabu said diabetes cases reported at the NRH were becoming more common, everyday.

“Most people come to the hospital with heart problems, kidney problems, high blood pressure and even infections,” he said.

“Currently we are normally receiving one case of heart attack and stroke a day.”

“The most common type of diabetes seen at the hospital was leg infection and there had been an increase in leg amputations at the hospital.

“Today, surgeons at the national referral hospital perform two to three amputations in a week,” he said.

“This means that is increasing and we don’t know whose legs they are going to amputatetomorrow, it might be one of us or one of our family members, and that is why we need to take serious actions against diabetes.”

Much of the blame for this increase in diabetes can be attributed to replacing traditional foods with imported, processed food which has contributed to the high prevalence of obesity and related health problems in the Pacific islands, according to a WHO report.

The report, from which I quote, says –

“Scattered across the Pacific Ocean are thousands of islands which make up three regions known as Melanesia, Micronesia and Polynesia. Beyond the image of white sandy beaches and carefree lifestyles, the Pacific islands are facing serious health problems, the prime culprit being imported foods.

“In at least 10 Pacific island countries, more than 50% (and in some, up to 90%) of the population is overweight according to World Health Organization (WHO) surveys.

“WHO defines overweight as having a body mass index (BMI) equal to or more than 25, and obesity as a BMI equal to or more than 30. Diabetes prevalence among adults in the Pacific region is among the highest in the world.

“About 40% of the Pacific island region’s population of 9.7 million has been diagnosed with a non communicable disease, notably cardiovascular disease, diabetes and hypertension. These diseases account for three quarters of all deaths across the Pacific archipelago and 40–60% of total health-care expenditure, according to a meeting on obesity prevention and control strategies in the Pacific held in Samoa.

“Dr Temo K Waqanivalu, technical officer for nutrition and physical activity at the Office of the WHO representative for the South Pacific in Suva, Fiji, partly blames poor diet for the region’s health problems. “Promotion of traditional foods has fallen by the wayside. They are unable to compete with the glamour and flashiness of imported foods,” he says.

“People in the Pacific islands may know what constitutes healthy eating but, as in many parts of the world, governments struggle to change people’s behaviour. In eight countries, less than 20% of people surveyed reported eating the recommended five or more portions of fruit and vegetables a day. The often calorie-rich and nutrient-poor imported foods have a stronger appeal.

“A major challenge for Pacific island countries is to reinforce nutrition education in schools by promoting healthy eating practices. “Even as kids we know what we are supposed to eat and not eat; there is a very good level of nutrition education in Fiji,” says Ateca Kama, senior nutritionist at Fiji’s National Food and Nutrition Centre. “The challenge is for us to translate knowledge into behaviour. For example, schools teach good nutrition as part of the curriculum, and then they sell junk food in the school canteen because they need to make a profit.”

“Historically, food was imported from Australia and New Zealand, but now it comes from much further afield: China, Malaysia and the Philippines. Nutrition labels are not only inconsistent but often not in English, the common language spoken in most Pacific island countries. Mandating clear, consistent labelling is crucial. The simpler, the better. Simple nutrition signposts can be useful and should be encouraged, and ingredient labels are really important for monitoring food safety and quality.

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“Increasing the proportion of locally grown, nutritious and less energy-dense traditional foods in the diets of Pacific islanders is also essential, says Waqanivalu.”

Turning to the Journal of Education and Health Promotion for general dietary guidelines for the people in the Solomon Islands in order to help reduce the incidence of diabetes I came across this information which I would earnestly request be followed

“Modern dietary management of diabetes essentially involves modifications of the quality and quantity of food to be taken by the diabetic patient. The following guidelines are applicable to diabetes irrespective of type, weight status, age, gender, or occupation. Most of the carbohydrate consumed should be in the form of starch (polysaccharides) such as maize, rice, beans, bread, potatoes etc.

“All refined sugars such as glucose, sucrose, and their products (soft drinks, sweets, toffees, etc.) and honey should be avoided, except during severe illness or episodes of hypoglycemia. These foods contain simple sugar, which is easily absorbed causing rapid rise in blood sugar.

“Non-nutritive sweeteners, e.g., Canderel, saccharine, NutraSweet, aspartame are suitable sugar substitutes for diabetic subjects.

“Animal fat such as butter, lard, egg yolk, and other foods high in saturated fatty acids and cholesterol should be reduced to a minimum and be replaced with vegetable oils, particularly polyunsaturated fats.

“Salt should be reduced whether hypertensive or not.

“Protein (fish, meat, beans, crab, crayfish, soyabean, chicken, etc.) and salt are restricted for those with diabetic nephropathy.

Cigarette smoking should be avoided by diabetic patients. Alcohol should be taken only in moderation.

“The items allowed for free consumption include: Water, green leafy vegetables, tomatoes, onions, cucumber, aubergine, peppers, and vegetable salad without cream. Any brand of tea, coffee, or drinks that contain very low or no calories.

“For patients too ill to eat solid food, a fluid or semi-solid diet should be substituted (papaya, soya bean, custard, etc.).

Patients treated with insulin or certain oral hypoglycemic agents, e.g., sulfonylureas must be advised to eat regularly and often to prevent hypoglycemia- 3 meals a day plus suitable snacks in between, e.g., fresh fruits.

“Small meals spaced over the day, rather than 1 or 2 big meals, are helpful in avoiding post-pyramidal peaks in blood sugar.

“Food can be powerful in preventing and reversing diabetes. However, dietary approaches have changed as we have learned more about the disease. The traditional approach to diabetes focuses on limiting refined sugars and foods that release sugars during digestion-starches, breads, fruits, etc. With carbohydrates reduced, the diet may contain an unhealthful amount of fat and protein. Therefore, diabetes experts have taken care to limit fats- especially saturated fats that can raise cholesterol levels, and to limit protein for people with impaired kidney function. The new approach focuses more attention on fat. Fat is a problem for people with diabetes. The more fat there is in the diet, the harder time insulin has in getting glucose into the cells

“EFFECTS OF THE FRUIT AND VEGETABLES ON THE HUMAN HEALTH

“Fruits constitute a commercially important and nutritionally indispensable food commodity. Being a part of a balanced diet, fruits play a vital role in human nutrition by supplying the necessary growth regulating factors essential for maintaining normal health.”

Yours sincerely

Frank Short

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