Sub-Saharan African (SSA) countries are currently experiencing one of the most rapid epidemiological transitions characterized by increasing urbanization and changing lifestyle factors. This has resulted in an increase in the incidence of non-communicable diseases, especially cardiovascular disease (CVD). This double burden of communicable and chronic non-communicable diseases has long-term public health impact as it undermines healthcare systems. The purpose of this paper is to explore the socio-cultural context of CVD risk prevention and treatment in sub-Saharan Africa. We discuss risk factors specific to the SSA context, including poverty, urbanization, developing healthcare systems, traditional healing, lifestyle and socio-cultural factors. We conducted a search on African Journals On-Line, Medline, PubMed, and PsycINFO databases using combinations of the key country/geographic terms, disease and risk factor specific terms such as "diabetes and Congo" and "hypertension and Nigeria". Research articles on clinical trials were excluded from this overview. Contrarily, articles that reported prevalence and incidence data on CVD risk and/or articles that report on CVD risk-related beliefs and behaviors were included. Both qualitative and quantitative articles were included. The epidemic of CVD in SSA is driven by multiple factors working collectively. Lifestyle factors such as diet, exercise and smoking contribute to the increasing rates of CVD in SSA. Some lifestyle factors are considered gendered in that some are salient for women and others for men. For instance, obesity is a predominant risk factor for women compared to men, but smoking still remains mostly a risk factor for men. Additionally, structural and system level issues such as lack of infrastructure for healthcare, urbanization, poverty and lack of government programs also drive this epidemic and hampers proper prevention, surveillance and treatment efforts. Using an African-centered cultural framework, the PEN3 model, we explore future directions and efforts to address the epidemic of CVD risk in SSA.

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An overview of cardiovascular risk factor burden in sub-Saharan African countries: A socio-cultural perspective

High sodium intake increases the risk of hypertension and cardiovascular diseases. For this reason the World Health Organization recommends a maximum intake of 2 g per day and a 30 % reduction in population sodium intake by 2025. However, in global reviews, data on sodium intake in sub-Saharan Africa have been limited. A systematic review was conducted to identify studies reporting sodium intake in sub-Saharan African populations. Meta-regression analyses were used to test the effect of year of data collection and method of data collection (urinary/dietary), as well as any association between sex, urban/rural status or a country’s economic development, and population sodium intake. We identified 42 papers reporting 67 estimates of adult population sodium intakes and 12 estimates of child population sodium intakes since 1967. Of the 67 adult populations, 54 (81 %) consumed more than 2 g sodium/day, as did four of the 12 (33 %) child populations. Sixty-five adult estimates were included in the meta-regression, which found that urban populations consumed higher amounts of salt than rural populations and that urine collection gave lower estimates of sodium intake than dietary data. Sodium intake in much of sub-Saharan Africa is above the World Health Organization’s recommended maximum intake and may be set to increase as the continent undergoes considerable urbanization. Few identified studies used stringent measurement criteria or representative population samples. High quality studies will be required to identify where and with whom to intervene, in order to meet the World Health Organization’s target of a 30 % reduction in population sodium intake and to demonstrate progress towards this target.

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Salt intakes in sub-Saharan Africa : a systematic review and meta-regression

Effect of germination time and temperature on the functionality and protein solubility of sorghum flour

The present study was conducted to prepare the gluten-free cookies from raw and germinated Chenopodium album flours. The physico-chemical, functional, pasting and morphological properties of raw and germinated C. album flour were studied. The gluten free cookies developed from both flours were compared with wheat flour cookies. Germination increased protein content of flour from 13.12 g to 15.45 g/100 g, total dietary fibre from 35.50 g to 38.61 g/100 g, antioxidant activity from 14.10% to 18.20% and total phenolic from 241 mg/100 g to 565 mg/100 g while fat content was decreased from 6.5 g to 4.13 g/100 g and carbohydrate from 54.61 g to 50.66 g/100 g, respectively. Germination improved functional properties and decreased pasting properties of C. album flour. Scanning electron micrographs of flour revealed the presence of polygonal and angular starch granules. The raw flour showed continuous composite structure of starch embedded in dense protein matrix. However germination caused destruction of this continuous structure. Germinated C. album flour cookies revealed highest antioxidant activity (23.97 g/100 g), total phenolic (671 mg/100 g) and total dietary fibre (38.77 g/100 g) as compared to raw C. album and wheat flour cookies.

Physico-chemical, textural, sensory and antioxidant characteristics of gluten – Free cookies made from raw and germinated Chenopodium (Chenopodium album) flour

Enzymatic modification of sesame seed protein, sourced from waste resource for nutraceutical application

The aim of this present study was to produce and evaluate the nutritional quality of complementary foods from popcorn, African locust bean and Bambara groundnut. The popcorn, bambara groundnut and African locust beans were obtained locally in Akure, Nigeria. The seeds were germinated, oven dried, milled and sieved into flours. The flours were mixed as follows: GPA (70% popcorn, 30% African locust bean), GPB (70% popcorn, 30% bambara groundnut) and GPAB (70% popcorn, 20% bambara groundnut, 10% African locust bean). The chemical composition, functional properties, sensory attributes and nutritional qualities of the food samples were determined using standard methods. The protein content of the food samples range between 23.85±1.54 – 28.84±1.02 g/100g, energy values, 434.47±2.04 444.11±2.47 and appreciable amount of minerals. The total essential amino acid (TEAA) composition range from 27.63 to 31.09 g/100g. The calculated biological value range from 29.84 to 42.01 % . The oxalate, tannin, phytate and trypsin concentration of the food samples were reduced; while the choking property of the popcorn-based diets was eliminated with respect to the survival of experimental animals. The calculated molar ratios for [Ca][Phytate]/[Zn], phytate:calcium and phytate:iron were less than the critical values For sensory attribute, the GPB was rated highest in terms of overall acceptability over the JMBFS / Ijarotimi and Keshinro 2012 : 1 (6) 1358-1388 1359 GPA and GPAB, but rated less when compared with ogi and cerelac. It could be concluded that GPB had a better nutritional quality based on the overall ranking using protein, energy, Ca/P ratio, TEAA, biological value and sensory attributes indices.

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Formulation and nutritional quality of infant formula produced from germinated popcorn, Bambara groundnut and African locust bean flour.

Background The most popular form of utilization of African locust bean (ALB) is in its traditional fermentation food condiment (iru/dawadawa), which adds protein to a protein-poor diet and also as medicine. In view of the nutritive values of ALB, the present study therefore aimed at investigating the effect of germination and fermentation on the nutritional quality of ALB flour. Material and methods The ALB was obtained from a local market in Akure, Nigeria. The seeds were divided into three portions, and treated as raw African locust bean (RALB), germinated African locust bean (GALB) and fermented African locust bean (FALB) respectively. Each of the samples was milled, sieved and analysed for chemical, functional properties and nutritional qualities using standard methods. Results Some most important results of the chemical analysis were as follows: protein content range between 33.64 ±0.41 - 41.49 ±1.89 g/100 g, while the energy value was between 442.79 ±2.32 - 457.20 ±2.15 kcal. The P/Ca and Na/K ratio of the RALB were higher than other fl our samples respectively. Total essential amino acid was between 29.960-27.514 mg/100 g. Protein efficiency ratio (PER) was between 1.78-1.87; essential amino acid index 31.43-34.75%; while biological values were 22.56-26.18%. The dominant fatty acid (FA) composition of the samples was linoleic with 33.687%, 31.578% and 28.7% for RALB, GALB and FALB respectively; while the least was lauric acid. The polyunsaturated/saturated FA ratio ranges between 0.589-0.718. The antinutrient concentration of fermented flour sample was significantly reduced than other food samples. Conclusion The present study investigated the effect of germination and fermentation on the nutritional quality of ALB flour. The finding showed that fermentation technique significantly reduced antinutrient concentration and also improved the nutrient composition, particularly amino acid profile of ALB flour.

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Comparison between the amino acid, fatty acid, mineral and nutritional quality of raw, germinated and fermented African locust bean (Parkia biglobosa) flour.

This study aimed at assessing the anthropometry, dietary intake and micronutrient status of hypertensive pa- tients attending specialist hospitals in Ondo State, Nigeria. A descriptive case control study was conducted among subjects attending two specialist hospitals located in Akure and Ondo towns. A total of 452 subjects (44.9% males and 55.1% females), was purposely selected from the study centres. A structured questionnaire was designed to collect information on demographic characteristics, socio-economic parameters, nutrition knowledge and dietary intakes of the subjects. The quantities of subjects' dietary intakes were measured using household measurements. Weight, height, systolic (SBP) and diastolic (DBP) blood pressures were measured using electronic bathroom scale, standiometer and sphygmomanometer, respectively. The subject's urine was collected; and vitamin C, sodium, potassium, calcium, zinc and magnesium were determined using standard procedures. The results showed the following means: age 52.4±2.38 years, weight 66.4±1.63 kg, height 1.64±0.01m, body mass index (BMI) 24.13±0.69kg/m 2 , SBP 124.86±2.3mmHg and DBP 76.22±1.86 mmHg. Blood pressure (BP) of the subjects showed that 46.9% had optimal BP, 14.2% normal BP, 11.5% high normal BP, 12.8% mild hypertension, 9.7% moderate hypertension and 4.9% severe hypertension. For BMI, 8.8% were underweight, 47.1% normal, 30.3% overweight, 6.0% obesity class I, 6.0% obesity class II and 1.8% obesity class III. The proportion of hy- pertensive subjects that were obese was signifi cantly (P=0.0001) higher than control subjects. Three-fi fth of the control subjects had good nutrition knowledge compared to one-fi fth of hypertensive subjects. The estimated mean energy intake was 8.46 MJ, protein 93.1g, carbohydrate 314.5g, fat 42.9g, fi bres 5.6g and appreciable amount of vitamin C, calcium, zinc, magnesium, sodium and potassium. The subjects' urinary vitamin C concentration was 32.49±2.53mg; calcium 0.41±0.06mg, zinc 0.04±0.01mg; magnesium 4.57±0.37mg, sodium 8.33±0.37mg) and potassium 7.45±0.21mg. Statisti- cally, there were signifi cant differences (P<0.05) between urinary vitamin C, sodium and potassium concentration (except zinc) of hypertensive patients and the control subjects. Weak correlations were observed between the subjects' systolic (P<0.05) and diastolic (P<0.01) BP and age, BMI and magnesium; with inverse correlations between vitamin C, sodium and potassium. The study concluded that hypertension was signifi cantly infl uenced by BMI of the subjects, which may be an indication of high intake of calories. Therefore, calorie intake should be controlled among the hypertensives.

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Nutritional knowledge, nutrients intake and nutritional status of hypertensive patients in Ondo State, Nigeria

The objective of this study was to determine protein quality and hematological properties of infant diets formulated from local food materials The food materials were obtained locally, fermented, and milled into flour The flours were mixed as 70% popcorn and 30% African locust bean (FPA), 70% popcorn and 30% bambara groundnut (FPB), and 70% popcorn, 20% bambara groundnut, and 10% African locust bean (FPAB) Proximate analysis, protein quality, hematological properties, and anthropometric measurements of the animals fed with the formulations were investigated The protein contents of the formulated diets were significantly higher than that of Cerelac (a commercial preparation) (1575 ± 001 g/100 g) and ogi (traditional complementary food) (652 ± 031 g/100 g) The energy value of FPAB (46494 ± 122 kcal) was higher than those of FPA (44141 ± 305 kcal) and FPB (44148 ± 305 kcal) The biological value (BV) of FPAB (6020%) was the highest followed by FPB (4424%) and FPA (4115%); however, BV of the diets was higher than that of ogi (1003%) but lower than that of Cerelac (7043%) Net protein utilization (NPU) of the formulations was 4116-6020%, whereas true protein digestibility was 4105-6005% Metabolizable energy (23298 kcal) and digestible energy (8369 kcal) of FPAB were the highest, whereas that of FPA had the lowest values The protein digestibility values corrected for amino acid score of the diets (022-044) were lower than that of Cerelac (052), but higher than that of ogi (021) The growth patterns and hematological properties (packed cell volume, red blood cells, hemoglobin, mean corpuscular hemoglobin concentration, mean corpuscular hemoglobin, and mean corpuscular volume) of the formulated diets were higher than those of ogi, but lower than those of Cerelac In conclusion, we established that the FPAB food sample was rated best in terms of protein quality over the other formulated diets Therefore, a FPAB blend may be used as a substitute for ogi

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Protein quality, hematological properties and nutritional status of albino rats fed complementary foods with fermented popcorn, African locust bean, and bambara groundnut flour blends

Objectives: This study evaluated the glycaemic response of three commonly consumed meals, and the resultant effect on postprandial plasma glucose response in type 2 diabetes mellitus patients at the University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria.Design: This was an experimental study on 100 consenting type 2 diabetes mellitus patients who were on medical nutrition therapy only, attending the University of Nigeria Teaching Hospital medical outpatient clinic between May 2012 and March 2013.Subjects and setting: One hundred non-diabetic healthy University of Nigeria Teaching Hospital workers served as the control. Participants consumed served portions of each meal containing 50 g of glycaemic carbohydrate. Only the control consumed 50 g glucose to establish glycaemic response. The three test meals comprised pap and bambara nut pudding; meat and okro soup with fermented cassava dough; and meat, beans and corn pottage with spinach.Outcome measures: Plasma glucose was measur...

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The effect of the glycaemic response of three commonly consumed meals on postprandial plasma glucose in type 2 diabetics at the University of Nigeria Teaching Hospital, Enugu

Oluremi Olufunke Keshinro

Papers

Formulation and nutritional quality of infant formula produced from germinated popcorn, Bambara groundnut and African locust bean flour.

Comparison between the amino acid, fatty acid, mineral and nutritional quality of raw, germinated and fermented African locust bean (Parkia biglobosa) flour.

Nutritional knowledge, nutrients intake and nutritional status of hypertensive patients in Ondo State, Nigeria

Protein quality, hematological properties and nutritional status of albino rats fed complementary foods with fermented popcorn, African locust bean, and bambara groundnut flour blends

The effect of the glycaemic response of three commonly consumed meals on postprandial plasma glucose in type 2 diabetics at the University of Nigeria Teaching Hospital, Enugu