Tag Archives: Health

Maryam Babangida, The End of a Chapter

By Adeola Aderounmu

Maryam was 61 when she finally succumbed to the cold hands of death. She battled with ovarian cancer for several years.

Maryam for the record was the wife of one of Nigeria’s former evil ruler-Ibrahim Badamosi Babangida. Babangida is famous for plotting coups and he ruled Nigeria for 8 wasteful years (1986-1993).

Babangida stole more than 12 billion dollars during the gulf war alone. It is not known how much he stole in 8 years of tyranny. Maryam Babangida was obviously part of the evil reign of her husband.

Babangida could probably learn a lesson from the death of his wife and give us back our money. Life is transient and nobody will leave this world alive!

The money stolen by the Babangidas was meant for millions of Nigerians who are now living in extreme poverty and hopelessness. Meanwhile the Babangidas have been living large and far beyond the means of their military father.

There are a lots of online responses to the death of Maryam and many of them have not shown any sort of sympathy to the Babangida family. This ia largely because they consider Maryam to just be one person like anyone of us. Therefore her death is a childs’play compared to the effects that the rule of her husband had on the nation.

Babangida is reputed to have institutionalise corruption in Nigeria. his greatest evil against Nigeria and Nigerians was that he oversaw the annulment of the June 12 1993 elections. That election remained the only peaceful, free and fair election in the history of Nigeria.

But Babangida annulled that election that would have brought MKO Abiola to power as the president. MKO was killed later in detention by the Nigerian military and probably with the help of some American collaboration. Abiola died while receiving visitors sent by Bill Clinton. One question the US has not been able to address…what roles did the American entourage play in the death of Nigeria’s legitimate president?

Anyway, Babangida annulled the election/ results and created confusion that resulted to the deaths of hundreds of Nigerians in the aftermath as riots broke out nationwide.

It is not uncommon for Nigerian politicians to pay homage to Babangida. This is because the man stole Nigeria’s money like no other; he allowed corrupt people like him to occupy key offices and indeed many useless politicians in Nigeria owe their wealth and breakthroughs to Babangida. This is why the Minna home of the Babangida has become a point of rally for evil and political absurdities.

So don’t be surprise by the eulogies that will come from the political circle to honour Maryam and don’t be surprised that in the next few months from today-all roads lead to Minna.
This is Nigeria, the land of bad politics and tyranny.

Maryam is dead. Is there anything that she would have changed if we could turn back the hand of time? What were her last wishes? Definitely nothing close to evil desire of looting money!

Are there any lessons for our greedy politicians about the essence of life? Is Babangida going to give back to the Nigerian people the money he stole or would he continue to live above the law?

What will happen in Nigeria or to Nigerians that will lead to the re-emergence of good?

Judgment is coming to town and those who have eyes, let them see. Those who have ears let them hear. Yar Adua is wasting away in Saudi Arabia. There will be no greater judgment than the “feedback-evil” befalling those who knew the right thing but ended up doing the wrong thing.

Those who are still looting and doing one little thing or the other that adds up to destroy Nigeria will be rewarded accordingly while they are alive and before our very eyes.

As I close this blog entry I am completely indifferent to the passage of Maryam. If her husband and the rest of the evil rulers in Nigeria have done what they ought to do, she would have been in a Nigerian hospital rather than an American hospital. Now that Yar Adua is in Saudi Arabian hospital, let it be known that judgement may have come to town.

Death is certain, life and power are transient.

Live and let’s live..!

Nigerians, free yourselves from Bondage, Seek Change Now!

By Adeola Aderounmu

Nigeria’s illegal president Mr. Yar Adua has gone (again) to Saudi Arabia for another medical check up. The man is extremely sick and very weak. His physical appearance speaks volumes. He is not fit for the post of a councillor how much more the (illegal) president of Nigeria. He was fraudulently imposed on Nigerians by the machinery of the evil PDP government largely assisted by Mr. Obasanjo and the fraudster called Maurice Iwu who is still the head of the useless Electoral Commission in Nigeria.

Mr. Yar Adua

Mr. Yar Adua since his illegal ascension to Nigeria’s top post has visited hospitals in Germany, Brazil and more recently and frequently Saudi Arabia. This is the shame of Africa and Nigeria. For 8 years this man ruled over Katsina State and could not build any hospital that would be able to manage his health and that of the citizens of Katsina. For an additional 2 years of recklessness, absolute waste and meaningless governance he has been unable to design or build or update any hospital in Nigeria to take care of his failing health. And his health is failing rapidly! Not to my joy but to our collective shame that this is the type of nonentity that rules the most populous black nation on earth.

Yar Adua

There are so many problems in Nigeria and an incapable leader is the last thing we desire at this point of our history. We are already battling with many issues including fraudulent elections, poverty, lack of infrastructure, decay in education, low standard of living, internal rife, high cost of living, hopelessness, crime, kidnapping, environmental pollution, lack of electricity and extreme lack of both social and national orientation. We are also battling with politicians who continue to loot the treasury and persistently remain neck deep in the deep rooted corruption. We are becoming a failed country.

Some fools are suggesting a second term for Mr. Yar Adua. In the 2 years of his first term, he has spent more time in health institutions than in the office. He has done almost nothing and he is extremely weak and probably depressed. There is a huge doubt he will make any impact in the 2 years remaining of his illegal reign. The present government in Nigeria needs total FLUSHING. They have to be bundled out one way or the other. With the likes of Aondoakaa, Ibori and Iwu, Nigeria remains in a deep mess. Ogbulafor the PDP chairman heads a network of undemocratic hell angels who will for eternity suppress the will of the people. Under the PDP state of affairs, Nigeria will not rise. It is doomed for calamity.

Nigeria and Nigerians need public institutions that will bring back the glory that is long lost. We must be able to choose and remove public officers as the situation or conditions demand. We must be able to account for our positions in public. All the corrupt people and politicians since 1999 and before remain free. The prosecution of Bode George is 0.0001% of the job that should be done in the fight against corruption.

The 2010 and 2011 elections are already reaping casualties with assassinations. This is the madness of Nigerian politics. This is where social and national orientation is a missing gap. The spirit of live and let’s live is completely absence as successive governments have made jungle of our existence. We live like it’s a rat race.

Nigerians must begin to reflect on recents developments in the country. Bode George was prosecuted-no condition is permanent. Mariam Babangida is terminally ill in an American hospital-her husband could have build hospitals in Nigeria instead of the mansions he built in Minna. The Babangidas could have done more for the good of all. Babangida cancelled the most peaceful and the fairest election in the history of Nigeria and he is reputed to have stolen more than 12 billions dollars of Nigeria’s oil money. Nothing last forever you see. 12 billion dollars cannot buy life.

In one of my articles, I have written that life is a passage. It will always be. The best way to go through life is to live and let others live. What is the outcome of evil acquisition? It is absolute vanity.

Yar Adua squandered 8 years as a governor and 2 years as an illegal president. That he lacks the mentality required to build a state of the art hospital in Nigeria speaks volume about his fate. The good and evil that men do now follows them and live with them.

To all those who are waiting in line for their turn to loot the treasury in Nigeria and to those who are shielding corrupt politicians and other evil people systematically destroying the country, look around you and seek wisdom. Good life is good, but it is evil and wicked to gain that status at the expense of millions of others. More than 70m Nigerians are living on less than 1 dollar per day whereas someone has the guts to steal 12 billions dollars and nothing has been done about that.

The life of all men is not different from those of the flowers that boom at one time and are weak or dead at another time. Everybody deserves a good life especially in a country like Nigeria where the oil wealth from the Niger Delta can cater for the needs of all Africans. Why is poverty so widespread in Nigeria? it boils down to not only corruption but the greed of the leadership/rulership.

WHAT IS THE WAY FORWARD FOR NIGERIA?

Nigeria must go through a new period of genuine transition. Honestly I don’t have the formula but I think there is a need to recall all the thieves who called themselves senators or lawmakers. There is a need to send home all the ministers and public officers who are there just to loot and serve their personal interests. Nigeria needs a period of say 6 months to one year to build up fundamental institutions especially the electoral commission and the anticorruption agencies.

A new reawakening is needed in Nigeria whereby a sense of collective social responsibility is created in the mainstream but starting with responsible leadership. We need a few men and women of honour to steer Nigeria under this transitional period so that we can achieve concrete goals and development in the nearest future.
As mentioned above it is difficult but it requires a great deal of sense and sacrifice. Some people must give way especially as they got into our lives through questionable means. The damage is far too extensive and the earlier we make this needed transition the better. I am no longer worried about my generation, I’m 37 and I can see the
absurd mentality pervading my generation. It appears we have been indoctrinated or absorbed into the wasted generation of Soyinka and Obasanjo. My worries are now towards my children, our children and the future of this blessed nation.

We must set out now, it is no longer dawn, but it is not too late. We can start by sending Mr. Yar Adua back to Katsina when he returns from Saudi Arabia. To do nothing now will confine the largest concentration of black people on earth into the doldrums, FOREVER!

Nigeria 2009 BC?

By Adeola Aderounmu

There is almost 100% complete darkness in Nigeria. The other day women in Abuja were rejoicing over the promise by NEPA that they will be supplied electricity from 7am to 10am daily.

Almost every household in Nigeria now has 1, 2 or 3 power generator sets. From small sizes making loud noises to the very big making deafening noises they come in different shapes and makes. There are even custom-built power generators with minimum price of N150, 000. Nigeria in my opinion is probably the most polluted country in the world. The noise and chemical substances release from the combustion of fuel may have severe consequences now and in the future.

So where does this leave Nigeria because she Nigeria prides herself as the giant of Africa. I hope every Nigerian knows that this total absence of public power supply is a big ridicule. It is a very serious shame and catastrophe.

I do not need to re-evaluate the impact on the cost of business and the subsequent high rate of unemployment. What about the inconvenience and the unhappiness knowing that after a hard day at work, you are going back to the heat or the noise that surrounds you. Nerves can break down!

Darkness poses a huge security risk. Bad intentions and armed robberies are made easy under the shade of darkness.

But this lazy government in Nigeria is not even doing anything positive in ensuring that power generation is improved. After 10 useless years of democracy power generation has dropped sharply, the cost of living has increased and the standard of living is extremely poor. Violence, riots, strike and civil unrest is commonplace. Almost all the important public institutions are experiencing one form of unrest or the other.

Education is completely paralyzed and the health care industry is zero. Yar Adua is on his way to The Middle East where he will receive Medical attention. Nigeria’s fake president for you! How else do you want to describe the state of health in Nigeria when the one who claims to be number one citizen goes abroad to receive treatment?

This is why I was visibly shaken by statements made by Jack Warner FIFA’s vice president as he praised Nigeria and our health institutions preparatory to the U-17 World cup. I am wondering why Yar Adua did not go to one of those hospitals that Jack Warner was describing at the draws in Abuja on Friday 7th of August 2009. What is wrong with Jack Warner?

Seriously what will it take?
To have education back on course?
To have our health care up to standard, available and affordable?
To have good roads and basic infrastructure?
To have 24 hour constant power supply all year all life?
To improve the standard of living?
To reduce the cost of living?
To ensure that we practice democracy?
To ensure that life is worth living in Nigeria?

I am very confused, sad and disappointed in Nigeria where “be corrupt” is the first law of survival…

THE ROLE OF NUTRITION IN THE PREVENTION AND TREATMENT OF OBESITY

A review by Adeola Aderounmu (Written in May 2005)

Introduction
Obesity is a worldwide chronic disease affecting over 300 million adults. Excess body fat is the largest nutritionally related problem in the United States and many other affluent countries (Willet and Leibel, 2002). The prevelance of obesity in the United States continues to rise dramatically (Flegal et al., 2002) and the situation may represent an epidemic in such a society because of its widespread and prevalence (Kottke et al., 2003).Over the past decade, the obesity rate among French children has doubled, from 6% to 12%, and between 1997 and 2003 the percentage of overweight and obese adults jumped from 37% to 42%. That growth curve parallels the one in the US about 10 years ago (TIME Magazine, May 23 2005). This disease is not limited to industrialised countries as over 115 million people in developing countries suffer from obesity-related problems (Whitney et al., 2005).

Quite naturally, excess intake of food (carbohydrate, protein and fat) can lead to obesity or at least the maintenance of an overweight body. To a reasonable extent, body weight regulation depends on the balance between energy intake and energy expenditure (Jequier and Bray 2002). It is not clear if high-fat diets are in part responsible for the increased prevalence of obesity in several countries. Some questions are of interest, for example (1) why are several epidemiological studies in the United States showing that the prevalence of obesity is increasing at the same time that fat consumption is decreasing? (Willet, 1998); (2) why is the prevalence of overweight worldwide directly related to percent of fat in the diet? (Bray and Popkin, 1998). What is known however is that the ability of the different macronutrients to stimulate satiety and to suppress subsequent food intake is not equal. There is a hierarchy such that protein intake has the most potent satiating effect, carbohydrate has a less pronounced effect, and fat has the lowest capacity to stimulate satiety and to decrease the amount of food energy ingested at the next meal (Rolls et al., 1994 Stubbs et al., 1997 and Prentice 1998). Additionally, glucose is the preferentially oxidisable food nutrient in the cells and the processes involved in the storage of fats seems to consume less energy and therefore fats are easily stored.

High-fat diets are more energy dense than high-carbohydrate diets, and the former favor hyperphagia (increased food intake) (Jequier and Bray, 2002). With high-fat diets, which are energy dense, more calories are passively ingested than with high-carbohydrate foods. High-fat diets favor passive overconsumption and body weight gain (Blundell and Macdiarmid, 1997). It is difficult to correlate the known effects of food substances on the prevalence or incidence of obesity in various epidemiological settings. Nevertheless obesity remains one of the several chronic diseases that have been implicated or linked to dietary and lifestyle factors. Those who are obese are more likely to suffer from life-threathening diseases such as diabetes and heart disease.

On the other hand, positive energy balance is not always undesirable. For instance, a growing youth (or pregnant woman) should be in postive energy balance, i.e consume more energy than expended, since they are growing / increasing in body tissues.

Etiology
There are controversies over the factors that lead to obesity. The major factors can be discussed under 3 major headings viz: total energy intake, lifestyle factor and genetics.

Total energy intake
There has been an inverse relation between dietary fat intake and obesity in the US over the last several decades: as the prevalence of obesity has increased, the percentage of calories from dietary fat intake has decreased, (Willet and Leibel, 2002). Despite the lower fat percentage in diets, there has been an increase in total calorie intake. The total energy intake is the primary contributor to obesity, [Bray and Popkin (1998), Jequier and Bray (2002) and (Forrety and Poston,(2002)].

Some investigators attribute part of this problem to the greater frequency of eating outside the home, particularly in fast-food restaurants (McCrory et al., 2000). Significant associations have been demonstrated between eating fast food and body weight (Binkley et al., 2000) and between consuming restaurant food and body fatness. For example, after controlling for age, sex, education, smoking, alcohol intake and physical activity, restaurant food consumption was significantly correlated with the total daily intakes of energy and fat; most importantly, it also was significantly related to body fatness (McCrory et al., 1999). Many full-service and fast-food restaurants and convenience stores offer “super-size” portions that contain 2 to 3 times more calories than regular-size portions.

Dietary fats as well as carbohydrates are probably important contributors to the excessive caloric consumption (Poston and Foreyt, 1999) and evidence has accumulated recently showing that high-fat, energy-dense meals favor passive overconsumption, a mechanism that very likely helps to explain the increasing prevalence of obesity in many countries ( WHO, 1998).

Lifestyle Factor. Physical Activity
There also is a consensus that high prevalence of a sedentary lifestyle in the United States plays a central role in the development of obesity (Barlow et al., 1995). Generally, the lack of physical activity can be an important contributor to positive fat balance and weight gain. Crespo et al., (1996) reported that the prevalence of little or no physical activity is 54% in the general American population and nearly 70% in African American and Mexican American women, a particularly disturbing figure because minority women also experience the highest prevalence of obesity (WHO 1998). Inactivity contributes to weight gain and poor health.

Genetics
Genetic influences do seems to be involved in some cases of obesity; at least researchers have identified an obesity gene called ob which codes for the protein leptin (Whitney and Rolfes, 2005). Even if these suspected genes do not cause obesity, genetic factors may influence the food intake and activity patterns that lead to it and the metabolic pathways that maintain it (Froguel and Boutin, 2001). Genetic factors may influence which individuals within a population will develop excessive adiposity but the rise in obesity observed in recent years cannot be down to genes, the environment is paramount.

As a sequel, in a very recent study University of Glasgow and Bristol researchers reported some findings that support the theory that early life environment could determine obesity:

• Birth weight
• Parental obesity
• Over 8 hours of TV a week at age 3
• Short sleep duration less than 10.5 hours per night at age 3
• Size in early life-measured at 8 and 18 months
• Rapid weight gain in the first couple of years
• Rapid catch-up growth up to 2 years of age
• Early development of body fatness in pre-school years-before the age at which body fat should be increasing
(Source, BBC News, May 19 2005)

Prevention
People with clinically severe obesity may need aggressive treatment options such as drugs or surgery (Yanovski and Yanovski, 2002). There are 2 drugs used to treat obesity: Sibutramine suppresses appetite while Orlistat inhibits pancreatic lipase activity in the GI tract. However, these drugs are side effects and some shortcomings. The challenge for obesity is to develop an effective drug that can be used over time without adverse effects or the potential for abuse. No such drug currently exist (Halsted 1999).

Surgical procedures effectively limit food intake by reducing the capacity of the stomach and suppress hunger by reducing production of the hormone, Ghrelin. This protein is secreted primarily by the stomach cells and act in the hypothalamus. It promotes a positive energy balance by stimulating appetite and promoting efficient energy storage (Kojima and Kangawa, 2002). Surgery to treat obesity involves very risky procedures.

Role of Nutrition
The important question for the prevention and treatment of obesity is to assess whether low-fat diets promote long-term weight loss or slow weight regain (Willet, 1998). Low-fat diets have been consistently shown to promote moderate weight loss over 1 year, and no study has reported an increased incidence of cardiovascular diseases with low-fat diets (Mensink and Katan, 1992). It has not been justified that low-fat, high carbohydrate diets lack the efficacy to elicit weight loss or that they have adverse effect in cardiovascular disease prevention. Instead, low-fat diets with more fruits, vegetables and fibres have also been shown to promote regression of atherosclerosis (Gould et al., 1995) and reduction in blood pressure (Appel et al., 1997).

Although low-fat diets have a significant effect on body weight of overweight individuals (Jeffrey et al., 1995), their long-term effect from a public health perspective is limited in the treatment of obesity (Prentice 1998). Nevertheless, promoting low-fat diet should be a priority in any programme for the prevention of obesity. The concept of a weight-maintaining diet is important and may be a realistic approach even in obese individuals, particularly after a successful weight loss after a hypocaloric diet or after gastric surgery in obese patients (Jequier and Bray, 2002).

Some researchers used a new simplified method to assess meal pattern among 2 groups of women in Sweden. Their findings revealed that the number of reported intake occasions across a usual day was higher in obese women compared with controls and the timing was shifted to later in the day. They suggested that these findings should be considered in the treatment of obesity (Forslund et al., 2002). Therefore, it is appropriate from a public health perspective to promote a reduction in total fat intake as an important goal for the prevention of obesity and obesity-induced diabetes because modest weight loss in obese subjects is usually accompanied by an improved insulin sensitivity and a decrease in impaired glucose tolerance (Appel et al., 1997; Ferrannini and Camastra 1998).

It will be reasonable that obesity treatment-related dietary modifications include suggestions to reduce total calories by reducing fat intake, particularly saturated fats and reducing intake of high-carbohydrate foods. In furtherance to this for example, the European Dietary Guidelines stipulated that the specified goal for dietary fat content as percent total energy is for the primary prevention of obesity (EURO DIET). Similarly, the current US incidence of overweight and obesity, and the chronic diseases to which they are precursors, will be mitigated and prevented only with major changes in national dietary policies and programs based on successful experiences and models (Gifford, 2002).

Finally, Physical activity is a necessary component of nutritional health. People must be physically active if they are to eat enough food to deliver all the nutrients they need without unhealthy weight gain (Whitney and Rolfes, 2005). A low level of daily physical activity is a factor that contributes to the positive energy balance, which leads to obesity. Exercise of moderate intensity will stimulate oxidation of fat (Smith et al., 2000). It seems considerable to compensate for the low-fat oxidation by not only promoting low-fat diets but also by promoting adequate daily physical activity.

This review paper was submitted to the Department of Bioscience at NOVUM, Unit of Preventive Medicine, Karolinksa Institure, Huddinge-Stockholm in 2005.

REFERENCES
References
Appel, L.J., Moore, T. J., Obarzanek, E et al., (1997). A clinical trial of the effects of dietary patterns on blood pressure. N Eng J Med 336, 1117-1124.
Barlow, C. E., Kohl, H. W., Gibbons, L. W et al., (1995). Physical fitness, mortality and obesity. Int J Obes Relat Metab Disord 19, S41-S44.
BBC News. TV ‘increases child obesity risk. http://www.bbc.co.uk/health. Published 2005/05/19.
Binkley, J. K., Eales, J and Jekanowski, M (2000). The relation between dietary change and rising US obesity. Int J Obes Relat Metab Disord 24, 1032-1039
Blundell, J. E and Macdiarmid, J. I (1997). Passive overconsumption. Fat intake and short-term energy balance. Ann NY Acad Sci. 827, 392-407.
Bray, G. A and Popkin, B.M (1998). Dietary fat intake does affect obesity! Am J Clin Nut 68, 1157-1173.
Crespo, C. J., Keteyian, S. J., Heath, G. W et al., (1996). Leisure-time physical activity among US adults. Results from the 3rd National Health and Nutrition Examination Survey. Arch Intern Med 156, 93-98.
EURO DIET (2001). Core Report. Nutrition and Diet For Healthy Lifestyles in Europe.
Ferrannini, E and Camastra, S (1998). Relationship between impaired glucose tolerance, non-insulin-dependent diabetes mellitus and obesity. Eur J Clin Invest 28, 3-7.
Flegal K. M and coauthors (2002). Prevalence and trends in obesity among US adults. J Am Med Ass 288, 1723-1727
Foreyt, J. P., Poston, W.S.C (2002). Consensus View on the Role of Dietary Fat and Obesity. The Am J Med 113, 60S-62S.
Forslund, H.B., Lindroos, A. K., Sjöström, L and Lissner, L. Meal patterns and obesity in Swedish women; a simple instrument describing usual meal types, frequency and temporal distribution. Eur J Clin Nut 56, 740-747.
Froguel, P and Boutin, P (2001). Genetics of pathways regulating body weight in the development of obesity in humans. Exp Bio Med 226, 991-996.
Gifford, K. D (2002). Dietary Fats, Eating Guides and Public Policy: History, Critique and Recommendations. The Am J Med 113, 89S-106S.
Gould, K. L., Ornish, D., Scherwitz, L et al., (1995). Changes in pyocardial perfusion abnormalities by positron emission tomography after long-term, intense risk factor modification. J Am Med Ass 274, 894-901.
Halsted, C. H (1999). Is blockade of pancreatic lipase the answer? Am J Clin Nutr 69, 1059-1060.
Jeffrey, R. W., Hellerstedt, W. L., French, S. A and Baxter, J. E (1995). A randomised evaluation of a low fat ad libitum carbohydrate diet for weight reduction. Int J Obes 17, 623-629.
Jequier E and Bray, G. A (2002). Low-Fats Diets Are Preferred. The Am J Med 113, 41S-46S.
Kojima, M and Kangawa, K (2002). Ghrelin, an orexigenic signalling molecule from the gastrointestinal tract, Curr Opin Pharmacol 2, 665-668.
Kottke, T. E., Wu, L. Aand Hoffman, R.S (2003). Economic and psychological implications of the obesity epidemic. Mayo Clinic Proceedings 78, 92-94.

McCrory, M. A., Fuss, P. J., Hays, N. P., Vinken, A. G., Greenberg, A. S and Roberts S. B (1999). Overeating in America: association between restaurant food consumption and body fatness in healthy adult men and women ages 19-80. Obes Res 7, 564-571.
McCrory, M. A., Fuss, P. J., Saltzman, E and Roberts, S. S (2000). Dietary determinants of energy intake and weight regulation in healthy adults. J Nut 130, 276S-279S.
Mensink, R. P and Katan, M. B (1992). Effects of dietary fatty acids on serum lipids and lipoproteins. A meta-analysis of 27 trials. Arterioscler Thromb 12, 911-919.
Poston, W. S. C and Foreyt, J. P (1999). Obesity is an environmental issue. Atherosclerosis 146, 201-209.
Prentice, A. M (1998). Manipulation of dietary fat and energy density and subsequent effects on substrate flux and food intake. Am J Clin Nutr 67, 535S-541S.
Rolls, B. J., Kim-Harris, S., Fischman, M. W et al., (1994). Satiety after preloads with different amounts of fat and carbohydrates: implication for obesity. Am J Clin Nutr 60, 476-487.
Smith, S. R., de Jonge, L., Zachwieja J. J et al., (2000). Concurrent physical activity increases fat oxidation during the shift to a high fat diet. Am J Clin Nutr 72, 131-138
Stubbs, R. J., Prentice, A. M and James, W. P (1997). Carbohydrates and energy balance. Ann NY Acad Sci 819, 44-69.
TIME Magazine, May 23 2005. Mon dieu! The French Get Fat. p14
Whitney, E and Sharon, R. E (2005). Understanding Nutrition. 10th edition. Thomson Wadsworth.
Willet, W. C (1998). Is dietary fat a major determinant of body fat? Am J Clin Nutr 67, 556S-262S.
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Confronting the rot in LUTH By Hope Eghagha

Culled from the Nigerian Guardian August 5 2008

AS we try to define ourselves as a nation, there are certain institutions that ought to stand firmly and serve as centres of excellence. No nation worth its salt ought to toy with the health of the people. One of the institutions I grew up to meet as an excellent health centre is Lagos University Teaching Hospital (LUTH) Idi Araba. Its name was a dread, as the final arbiter on health matters. I remember the first time my General physician referred me to LUTH, the question that cropped to my lips was: ‘Am I in such a terrible shape? This was back in the 1990s. I reluctantly went, endured the slow pace, incompetence but eventually went home smiling. Since then I have had cause to go to LUTH on visits on several occasions. My ears had always tingled with stories of gross and criminal inefficiency in that ‘centre of excellence’. I was a distant observer until the events of June 23, 2008.

A husband and his wife, Israel and Viviane Emuophe, vibrant and hopeful in the abundance of life offered by life were knocked down by a drunk driver on Sunday the 22nd of June right in front of a house along Lekki/Ajah road where they had gone visiting. Good Samaritans rushed them to a clinic nearby. The wife, a Youth Corps member serving in Lagos State and eight months pregnant was badly wounded on her lower limb. As for the man, we found out later that he was fractured on both legs. The doctor in the temporary hospital in Ajah advised that the limb be amputated immediately. Instead of referring the patients to LUTH or Igbobi for specialist intervention, he kept them there throughout the night. He was more interested in his hefty fees (over a hundred thousand naira for stabilising them overnight!). Friends and relations on the ground advised against outright amputation. In their view, such a decision should be taken at Igbobi. The patients were moved to Igbobi early the next morning. Igbobi advised that the lady be taken to LUTH. That was where we encountered criminal inefficiency and neglect of the first order.

The lady arrived at LUTH at about 10 in the morning. It took the intervention of a retired Matron in LUTH for the victim to receive minimal attention in the Emergency Unit. We were asked to buy almost everything that was needed to treat an emergency case. We patiently did. The decision was announced that there would be surgery. The patient was moved to the theatre. As at 4p.m., nothing concrete had been done. That was when we decided (Dr. Clement Edokpayi and I) to call up some of our colleagues who work in LUTH. We also called up people in town who had some influence in the health sector to reach people in the management of LUTH. A matron on duty gave a false report to one of our contacts that the lady was already in the theatre. I countered that immediately. We found out that as at that time, there had been no official communication with any of the consultants to handle the job. Our intervention worked. The doctors showed up.

We started the process of getting this and getting that. At about 9.30p.m. when all was set for the surgery, we were told that an x-ray had not been done. She was wheeled back to the x-ray room where I confronted the Professor in charge. His explanation was plausible. Except cases are referred to him, he cannot do an x-ray. Finally, the x-ray was done and at this time we were only interested in saving the life of the lady. Her baby we suspected was gone. Her little cries of ‘I want my life’, made it imperative for some action to take place. Surgery intervention finally took place at about 12 midnight. My little Christian sister lost both her right limb and her eight month pregnancy.

My position is that in LUTH the simple routines and procedures expected have been compromised. Nobody is in charge. No doubt, the consultants and doctors are efficient. In their private clinics, they do very well. LUTH is currently a carcass of itself. This is not the LUTH that the wife of a Head of State patronised when she was going to have her baby in the 1970s. The equipment is obsolete. LUTH is a danger to health care. The entire institution is a mortuary. Death smells around the wards. In the Modular Theatre, referred to as one of the best in the country, surgery could not take place there because there was no back up to power supply. Most of our colleagues we discussed the matter with simply agreed that the place needs to be overhauled. The concept of management currently in place should go. Who will overhaul LUTH?

Indeed LUTH is a victim of the corruption which has steadily crept into the country. The Obasanjo administration announced and launched new equipment for LUTH with fanfare. As we have found out, it was a fluke. None of those items deserves to be called modern. They were second hand, or Tokunboh bought for the purpose of making money for the boys.

LUTH needs to be thoroughly reorganised, re-structured, re-ordered. A new management that can enforce its rules should be put in place. If a patient comes in at 10 a.m. and does not receive attention until 4p.m., somebody should be penalised for it. This should be routine as it is in the medical profession. We do not need to report to SERVICOM for nurses and doctors to do their jobs. Most of the nurses are so indifferent to patients that I wonder where they were trained. During my last visit to the female surgical ward there was a breast cancer patient who kept howling for the duration of my visit. The nurse kept passing her by. I was told that she had been in that condition for three days. Where has the human spirit gone in LUTH?

The Minister of Health or the Federal Executive Council ought to intervene directly in LUTH. Management is practically dead in the place. Most of the consultants are first rate when they have to work outside LUTH. However, they work in an environment that lacks the basic tools. They cannot perform magic. Sadly, the available equipment is not efficiently utilised. This is the crux of the matter. There is too much indifference in the place. Too many patients die from lack of care and attention. Too many people are dissatisfied with working conditions.

It is very easy to give explanations and rationalise our inadequacies. I expect that LUTH would soon issue a rejoinder claming that its facilities are excellent and that staff are doing their best. But the truth is that no one who has the means takes his relation to LUTH. They simply go abroad. Perhaps this is at the core of the problem. The people who are in power do not patronise the hospital. German and American hospitals wait for them. Even our President has no faith in LUTH. But is a turn-around of LUTH not possible that would make the First Citizen of the country patronise it when next he is ill? With the necessary will, it is possible. This is all I ask for so that another young lady or man would not lose precious life or limb or both.