You are what you eat

Are Egyptians eating right? On the occasion of World Food Day, Reham El-Adawi opens the file on Egypt's nutrition problems
Eight-hundred million people in the world don't have enough to eat to supply their basic energy needs; about two billion people can't afford to eat the variety of foods necessary to meet their vitamin and mineral needs.
-- FAO statement on the occasion of World Food Day
World Food Day, on 16 October, commemorates the founding of the United Nations' Food and Agriculture Organisation (FAO) in 1945, but it has also taken on further meaning. This Tuesday, people and organisations around the world remembered the millions of people who live in poverty and without access to even their most basic food requirements.
"No one in Egypt goes to bed hungry," the popular saying goes. But recent reports on the nutritional status of Egyptians show that it is the quality, not the quantity, of the food people ingest that defines Egypt's nutritional problems.
In the first study of its kind, the Food Technology Research Institute (FTRI), in collaboration with California University, looked into the state of nutrition in Egypt today. The study, initiated in 1993, is continuing and ranges over the gamut of regions, classes and age. According to Ibrahim Youssef, head of the food economics sector at the FTRI, the first stage of the study covered some 7,000 families in five governorates: Greater Cairo, Daqahliya, Ismalia, Aswan and the New Valley. The second stage, completed in 1999, included 3,200 families in four governorates: Alexandria, Beheira, Assiut and the New Valley. Currently 3,800 families are taking part in the third stage of the study.
The governorates were selected to represent Upper and Lower Egypt, urban and rural areas. Participants depict a broad cross-section of society, representing the low, middle and upper classes and taking into consideration a variety of educational levels. The results to date show that across social levels nationwide, Egyptians are stocking up on their proteins and energy requirements (many people, it seems, are ingesting more than 125 per cent of their needs in this department), but most suffer from a lack of vitamins and minerals -- in particular, vitamins E, B6, B12, calcium, iron and zinc.
Health ramifications of these shortages include congenital deformities of the fetus in pregnant women with vitamin B6 and B12 deficiencies and widespread osteoporosis, weakness of the bones, among those whose diet lacks calcium. Zahra Saleh, a nutrition researcher at the National Research Centre, told Al-Ahram Weekly that such ailments and many others are common among the majority of Egyptians and are directly linked to poor eating habits and ignorance of essential nutrition requirements.
Bad habits are further entrenched when they are passed on from parent to child. Soft drinks, for instance, are given freely to children despite the fact that they contain phosphoric acids, which damage the teeth, stomach and kidneys while filling them up on "empty calories." Also, drinking tea right after a meal -- an old and popular tradition -- actually destroys the iron in the food just eaten.
Saleh is keen to warn Egyptians about the dangers of "multi-nutrition deficiency" -- failure to gain one's nutritional needs from a variety of sources. Stressing the importance of dietary diversification, Saleh noted that the human body needs approximately 40 different sources of nutrients to be suitably "fit and alert." She bemoaned that Egyptians prefer to overuse the three "white poisons": sugar, salt and fats. "As long as there are several colours on the table, like orange, red and dark green, you can acquire balanced and nutritious food," suggested Saleh.
At the "Lose Weight, Gain Health" obesity workshop organised this month by the Nutrition Institute (NI), an affiliate of the Ministry of Health, NI food safety expert Atef Hussein told listeners that concentrating on staple and cheap dishes increases the risk of obesity. Foods such as rice, bread, pasta and koshari, which make up the bulk of many Egyptians' diets, particularly among inhabitants of poorer areas, have the advantage of making people feel full, but do not provide all the nutrition people need.
Anaemia, which is on the increase, was singled out by Saleh as a topic worthy of close attention. In Egypt, data on the prevalence of anaemia shows that it is most common among women of childbearing age, nursing mothers and young children, from newborns to two years old. It is also prevalent among school children and is known to inhibit the normal growth and development of children as well as limit learning capacity. Ninety-five per cent of the cases of anaemia documented by the Ministry of Health were due to iron deficiency.
Food consumption patterns are further endangered by safety concerns, adds Saleh. For instance, vegetables and fruits can be contaminated by polluted irrigation water. Meat is avoided, when people can afford it, because of fears of mad cow disease and concerns about Egypt's safety regulations. Specialists also stress the role played by television advertisements, which repeatedly promote foods high in calories and sugar, such as soft drinks and junk food saturated with fats.
Emtethal Sweifi, an NI nutrition consultant, notes that Egyptians from various social and educational levels are uninformed about how to best combine foods to produce the most positive effect on their health. For example, green tea can help break down fats in the body, and its potency is enhanced by the active ingredients in grapefruit. Almonds, like all nuts, have alkaline properties and will neutralise the acidity of a spicy dish. The sulphur in the garlic helps to deactivate any possible yeast activity in bread. Too much calcium can affect magnesium levels and magnesium, in turn, is important for the absorption of calcium. Sugar, coffee, fish, chicken, olives, noodles, eggs are all acid-forming foods.
In the same vein, Samir Miladi, a nutrition consultant at the FAO regional office for the Near East, which is based in Cairo, argues that many of the nutrition problems suffered in Egypt are not necessarily due to lack of food or a limited budget, but to a lack of nutritional awareness. FAO figures indicate that the average Egyptian takes in 3,340 calories and around 80 grammes of fat. The FAO estimates that intake should not exceed 2,400 calories and that the amount of fat consumed should make up no more than 30 per cent of the total calories.
But excessive calorie and fat intake is pervasive throughout the region. Syrians average 3,000 calories and 80g of fat and Tunisians take in an average of 3,000 calories and roughly 85g of fat. In Saudi Arabia, the average is 2,900 calories and 82g of fat and in Kuwait it is 3,200 calories for 100g of fat. Consequently, most of these countries suffer a high level of obesity.
Miladi explained that within a family, small children may suffer from malnutrition because they eat only sweets and too few vegetables, meat and fruits. The parents, on the other hand, are likely to be "over-nutritioned" when it comes to fats and carbohydrates. "A national campaign to promote better food habits and proper dietary practices is highly recommended, with intensive television programming," Miladi told the Weekly. Television, Miladi stresses, is a powerful means of mass media and, directed at the ordinary person, it can have a strong effect. Re-orienting the school curriculum will also contribute to more nutritional awareness, he added.
Another problem is the availability of relevant and up-to-date nutrition information. In an attempt to redress this shortage, the NI, in cooperation with UNICEF, began publishing The Guide to Healthy Food for the Egyptian Family in 1995, which was updated in 2000. The book is available to the general public for free and is provided as a comprehensive source of information about nutritional needs and is illustrated with photos, tables and diagrams. It also provides low-cost recipes for nutritious food.
Further, the FAO is celebrating this year's World Food Day by launching a nutrition education campaign under the slogan "Feeding Minds, Fighting Hunger." The initiative, which will officially launch next week, provides model lesson plans and resource materials on such topics as hunger and malnutrition. "There is no health without nutrition and there is no nutrition without food. The health status of any population is the best indicator of their present and future development," concludes Miladi. Yes, but good nutrition comes at a cost -- and who will pay?
For more information on Feeding Minds, Fighting Hunger visit the Web site: www.feedingminds.org
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