Role of proper diet in addressing Uganda’s burden of non-communicable diseases

Over recent decades, Uganda has experienced a notable shift in health burdens, transitioning from a predominant focus on infectious diseases like malaria, HIV/AIDS, and tuberculosis to an increasing prevalence of non-communicable diseases (NCDs).

This shift aligns with global trends where NCDs now lead in mortality rates and disability-adjusted life years. Factors such as urbanisation, lifestyle changes, and economic development have contributed to this epidemiological shift, marking NCDs as an urgent public health challenge.

Today, cardiovascular diseases, diabetes, chronic respiratory conditions, and cancers are no longer issues faced by wealthier nations alone but are now increasingly affecting populations in Uganda. Central to this growing health crisis is the role of diet, which has emerged as a major determinant in either mitigating or exacerbating the risk of NCDs.

As urbanisation accelerates, dietary patterns are undergoing significant changes. Traditional diets rich in vegetables, fruits, legumes, and whole grains are being replaced by diets high in processed foods, sugar, and unhealthy fats. This shift has contributed to the rising incidence of diet-related NCDs in Uganda.

Proper nutrition, on the other hand, can play a pivotal role in both the prevention and management of these conditions. Below, we delve into how diet contributes to each of the major NCDs and the benefits of maintaining a healthy dietary lifestyle.

1. Cardiovascular Diseases (CVD)

Cardiovascular diseases, including hypertension, stroke, and heart disease, are becoming increasingly prevalent among Ugandans, often linked to poor dietary habits. Factors such as excessive sodium intake, high cholesterol from processed foods, and low consumption of fiber-rich foods contribute to high blood pressure, a leading cause of heart disease. A diet high in fruits, vegetables, whole grains, and lean proteins can reduce the risk of heart disease. These foods provide essential nutrients and fiber, which help to manage cholesterol levels, reduce blood pressure, and maintain a healthy weight. Its therefore important to:

• Reduce salt intake: Limit sodium-rich foods and processed items.
• Increase intake of healthy fats: Incorporate sources of unsaturated fats, such as avocados, nuts, and olive oil, which can reduce bad cholesterol.
• Emphasize fiber-rich foods: Whole grains and legumes help lower cholesterol levels.

2. Diabetes

Diabetes, particularly type 2 diabetes, is rising among Ugandans, often linked to poor dietary choices and obesity. Diets high in refined sugars and carbohydrates increase blood sugar levels and insulin resistance over time, leading to diabetes. Proper dietary choices, including low-glycemic-index foods like whole grains, legumes, and vegetables, can help control blood sugar levels. Its therefore important to:

• Avoid processed sugars and refined carbs: Minimize sugary beverages, snacks, and refined grains that spike blood sugar.
• Increase fiber intake: Foods like oats, barley, and legumes slow down the absorption of sugar into the bloodstream.
• Choose low-glycemic foods: Foods such as whole grains and non-starchy vegetables help maintain steady blood sugar levels.

3. Obesity and related complications

As lifestyles become more sedentary and diets more calorie-dense, obesity is becoming a public health concern in Uganda. Obesity is a gateway condition, increasing the risk of other NCDs, including diabetes, CVD, and certain cancers. Reducing calorie intake and consuming a balanced diet with nutrient-dense foods can prevent weight gain and obesity. Its key to:

• Control portion sizes: Mindful eating helps prevent overconsumption of calories.
• Eat nutrient-dense foods: Foods high in nutrients but low in calories, like vegetables and lean proteins, help maintain a healthy weight.
• Limit sugary and fatty foods: Reducing intake of processed foods with added sugars and fats can curb weight gain.

4. Cancer

While many factors influence cancer risk, diet is recognized as a significant contributor. In Uganda, lifestyle shifts, including increased consumption of processed meats and a lack of dietary fiber, have been associated with a higher incidence of cancers, particularly colorectal cancer. A diet rich in antioxidants, vitamins, and minerals, particularly from fruits and vegetables, can help reduce cancer risk.

• Increase antioxidant intake: Antioxidant-rich foods like berries, tomatoes, and leafy greens protect cells from oxidative damage.
• Reduce red and processed meat consumption: Limiting these foods has been shown to reduce cancer risk.
• Consume fiber-rich foods: High-fiber diets are associated with a lower risk of colorectal cancer.

A nutritious diet not only aids in preventing NCDs but also supports mental health, boosts immune function, and enhances quality of life. Proper nutrition can reduce fatigue, improve cognitive function, and bolster resilience against other health conditions. For Uganda, where healthcare resources are often strained, a population-wide shift toward healthier dietary habits could alleviate the growing burden on the healthcare system and improve overall productivity.

Promoting healthy diets in Uganda involves addressing various structural and social barriers. Effective strategies could include:

1. Educational campaigns: Public health campaigns that educate people about the benefits of proper nutrition and the risks associated with poor dietary habits can encourage healthier food choices.
2. Subsidies for healthy foods: Reducing the cost of fruits, vegetables, and whole grains can make healthy diets more accessible to low-income families.
3. School-based nutrition programs: Introducing nutritional education and healthier food options in schools can instill good habits in children from a young age.
4. Proper halth behaviours: These include doing physical activities. These are key to ensure that it reduces on the risk factors for NCDs
5. Community involvement and agricultural policies: Encouraging local farming of nutritious crops can improve food security and reduce reliance on processed, imported foods.
6. Food labeling regulations: Implementing clear labeling on processed foods can help consumers make informed decisions about their diet.

Hence, adopting diets rich in whole foods and balanced nutrients, Ugandans can protect themselves against the life-altering impacts of NCDs and contribute to a healthier, more productive society.

The writer is a Master of Public Health student at Makerere University School of Public Health