Combating Nutritional Diseases

Diet has an immense impact on human life; it plays a vital role in our health and wellbeing. The consensus is that nutritional diseases are a direct result of a poor diet. Research has also identified these diseases to include hereditary metabolic disorders that respond to dietary treatment, the interaction of foods and nutrients with drugs, food allergies and intolerances, and developmental abnormalities that can be prevented with diet.

Nutritional diseases, known as non-communicable diseases (NCDs), include deficiencies or excesses within a diet, obesity and eating disorders, and chronic diseases such as cardiovascular disease, hypertension, cancer, and diabetes mellitus. NCDs lead to deaths at a younger age in low- and middle-income countries, where 29% of NCD deaths occur among people under 60 compared to high-income countries at 18%.

The primary risk factors for these diseases are similar in almost all countries and have been noted for decades. An unhealthy diet consisting of foods high in saturated and trans fats, salt and sugar (especially in sweetened drinks), physical inactivity, and excessive alcohol consumption causes more than two-thirds of all new cases of these diseases. Studies show that at least 80% of heart disease, stroke and type 2 diabetes, and 40% of cancer cases, could be avoided by following a healthy diet and regular physical activity.

How did we get here?

• The desire for a more varied and tasty diet has led to incorporating dietary fats and sugars into many foods.

• The connection between increased income and consumption preferences is evident. Several studies indicate that income is increasing, and consumption is shifting towards more foods with higher fat content.

• The centralisation of the mass media with strong campaigns to promote selected dietary patterns.

• Technology has reduced domestic efforts resulting in consumers preferring to order food online rather than cooking.

Perhaps the most significant nutrition-related disease is chronic undernutrition, which plagues more than 925 million people worldwide. Undernutrition occurs when there is insufficient food to meet energy requirements. Low birth weight in infants, inadequate growth and development in children, diminished mental function, and increased susceptibility to disease are among the many consequences of chronic persistent hunger. Poverty, famine, war, floods, and droughts are among the reasons for catastrophic food shortages, leading to starvation.

Additionally, malnutrition is a weakened function resulting from a prolonged deficiency or excess of total energy needs or specific nutrients such as protein, essential fatty acids, vitamins, or minerals. This condition can also result from fasting, anorexia nervosa, bulimia nervosa, impaired digestion and intestinal malabsorption, or chronic illnesses that result in a loss of appetite (e.g., cancer, AIDS). Malnutrition can also result from limited food availability, unwise food choices, or the overzealous use of dietary supplements.

Food allergies and intolerances

A genuine food allergy causes an immune system reaction affecting numerous organs in the body. It involves an abnormal immunologic response to an otherwise harmless food component, in most cases, a protein. In immediate hypersensitivity food allergy cases, the body produces specific immunoglobulin E antibodies within minutes or hours of exposure to the allergen. Chemical mediators such as histamine are released, resulting in gastrointestinal, skin, or respiratory symptoms ranging from mild to life-threatening. On the contrary, much less common delayed hypersensitivity food allergies, in which a localised inflammatory process and other symptoms may only start showing up to a day later.

Adverse food reactions that do not involve the immune system, aside from foodborne infection or poisoning, are referred to as food intolerances or sensitivities. The most common is lactose intolerance, a genetically determined deficiency of the enzyme lactase needed to digest the milk sugar, lactose.

Other intolerances include

• Celiac disease, also known as celiac sprue, non-tropical sprue, or gluten-sensitive enteropathy, is a hereditary disorder in which wheat gluten and related proteins from rye and barley are not tolerated.

• Foods that most commonly cause antibody-mediated allergic reactions are cow’s milk, eggs, wheat, fish, shellfish, soybeans, peanuts, and tree nuts (such as almonds, walnuts, and cashews).

• Foods or beverages with drug-like effects, such as those caused by caffeine or alcohol. Studies show that ripened cheese, chocolate, red wine, and even ice cream can trigger headaches in some individuals. Food additives that can cause reactions in susceptible people include sulphite preservatives used in some wines, dried fruits, nitrate and nitrite preservatives, certain food colourants, particularly tartrazine, and the flavour enhancer monosodium glutamate (MSG).

Foodborne illnesses

More than 250 different foodborne hazards have been recognised, including infectious bacteria, viruses and parasites, and non-infectious chemicals and toxins. Many of these agents commonly cause diarrhoea and vomiting, but there is no single clinical syndrome grouping all foodborne diseases.

Foodborne diseases can cause short-term symptoms, such as nausea, vomiting, and diarrhoea (commonly referred to as food poisoning). Still, they can also cause longer-term illnesses, such as cancer, kidney or liver failure and brain and neural disorders. These may more seriously affect children, pregnant women, the elderly and those with weakened immune systems.

Children who survive more serious foodborne diseases may suffer from delayed physical and mental development, impacting their quality of life permanently. Therefore, food safety should be the shared responsibility of all stakeholders within the food chain. There is a significant need for better education and training among food producers, suppliers, handlers, and the general public on preventing foodborne diseases.

Nutritional diseases have become part of our daily lives and affect us in numerous ways—with technological advancements aiding in identifying them promptly. Thanks to much research over the past decades and significant diagnoses and treatments, there are many ways of overcoming these ailments.