Nutrition
PUTTING OUT THE FIRE IN YOUR CHEST
| William Shakespeare is one person in history that I would love to meet and Much Ado About Nothing is his first work that I really dug into probably because I was “forced” to and I bet you it was worth it. Shakespeare is a master wordsmith and he seems to have so much knowledge as well, hear him in Much Ado- “How tartly that gentleman looks! I never can see him but I am heart burned an hour after.” Once again he hit the nail right on the head; anxiety or simply stress from meeting someone can actually cause heart burn. Sometimes the acidic contents of the stomach go back into the oesophagus probably because the sphincter or band that should prevent this return is not doing its work well. The acidic contents may cause a painful burning sensation behind the breastbone and this is referred to as heart burn. The whole process of stomach contents returning into the oesophagus is referred to as Gastroesophageal Reflux Disease (GERD). I have met many people who live with this burning pain in their chest; some take medication daily but fail to modify their lifestyles appropriately to prevent sleepless nights and panic attack when its meal time. Though heartburn is the commonest symptom of GERD, one may also experience; nausea, sour or bitter taste in mouth, stomach contents in mouth, sore throat, coughing or wheezing or repeatedly needing to clear throat or a hoarse voice especially in the morning. Causes of Heartburn 1. Certain foods a. Caffeine containing products such as coffee and tea have been named and so has cocoa, chocolate, mints, fizzy drinks, citrus fruits, spicy foods- kelewele, khebab and pizza. Fried and/or Fatty foods are also known to ask questions of our oesophagus. 2. Certain medication a. This is no ticket to avoid your medication, only discuss this with your doctor or pharmacist if you suspect your medication may be causing that burning sensation in your chest. Drugs that may cause this include some painkillers, some medication for treating osteoporosis (thinning of bones), medications for managing high blood pressure and asthma. Others are drugs for treating depression and anxiety. 3. Overweight or obesity a. Any extra pounds that you carry will increase your risk of reflux and the reason is quite clear; extra pressure on the stomach. Obesity seems to rear its head in every condition and remains the only disease that never requires a second opinion. 4. Smoking a. This evil will irritate the lining of the gut and also cause you to swallow air as you inhale leading to increase in stomach pressure. 5. Eating pattern a. What you eat, timing of your meals and what you do soon after may all keep you awake all night. Make sure you wait for about three hours after meals before you lie down. Skipping breakfast and lunch and making it all up with a heavy dinner may be a recipe for disaster. Spread your meals through the day. 6. Other conditions a. Heart burns appear to be more frequent in pregnant women and this may be triggered by hormonal changes as well as the increased pressure on the stomach by the foetus. b. Asthma and heartburns appear to be “bedfellows” and it has been found in some instances that treating or controlling heartburns also reduces the episodes of asthmatic attacks. Some medication for managing asthma have also been associated with increased reflux. c. Stress is also known to worsen heartburn and this probably was what Shakespeare was referring to. Lifestyle Modifications You may need a doctor’s help to diagnose and manage the discomfort but you will have to live smart to remain pain-free. Our aim is to keep the contents of the stomach where they belong and the following are helpful hints: 1. Eat smaller meals a. Large meals make us uncomfortable and may also stay in the stomach for a longer time, increasing the risk of acid seeping back into the oesophagus. Reduce your food portions; you are better off with five small meals spread throughout the day than having only two heavy giant-sized “heartburn-inducing” meals. 2. Relax when you eat a. Do not rush through your meals; sit down, chew properly and enjoy your meal. Fortunately for you no one is going to take that meal away from you. 3. Relax between meals a. Deep breathing, massage and various relaxation techniques may help to relieve anxiety and stress and reduce the incidence of heart burn. 4. Remain upright after eating a. Do not lie down or bend over less than three hours after a meal and don’t strain to lift heavy objects soon after a meal. 5. Do not eat close to bed time 6. Lose weight if needed 7. Loosen up a. Tight belts and waist bands may be worsening your nightmare simply from extra pressure on the stomach. 8. Avoid foods that burn – spices etc. 9. Stop smoking and do not be a passive smoker 10. Chew gum a. The increase in saliva will not only soothe the oesophagus, it will also wash down the acid. 11. Check your medication 12. Raise the head of your bed a. Do not use pillows to achieve this since it may worsen the condition. You may put a block on the floor at the head of your bed to elevate it. 13. Exercise wisely a. Wait at least 2 hours after a meal before you exercise Dear reader if you are being tormented by heartburn or other forms of peptic ulcer disease the above modifications together with the medication prescribed by your doctor may be your winning formula. AS ALWAYS LAUGH OFTEN, ENSURE HYGIENE, WALK AND PRAY EVERYDAY AND REMEMBER IT’S A PRICELESS GIFT TO KNOW YOUR NUMBERS (blood sugar, blood pressure, blood cholesterol, BMI) Dr. Kojo Cobba Essel Health Essentials Ltd/Mobissel/St. Andrews Clinic (www.healthessentialsgh.com) *Dr. Essel is a Medical Doctor, holds an MBA and is ISSA certified in exercise therapy, fitness nutrition and corrective exercise. Thought for the week – “If you plan to live to a ripe old age, make those golden years healthy ones and not bedridden years.” Reference: 1. www.patienteducationcenter.org 2. Much Ado About Nothing – William Shakespeare |
Ingredients
-One full cabbage
– Five large tomatoes
-Two large onion
-Five large pepper
-Garlic
-3 large fresh salmon
-1 tin of mackerel
-Salt to taste
-Coconut oil
Seasoning
Preparation
- Wash and chop cabbage under running water and put in a large pot with water
- Wash it for the second time and pour vinegar on it to remove unwanted particles.
- Blend onion, garlic, ginger, pepper and tomatoes
- Heat coconut oil in a saucepan over medium heat
- Add blended mixture and stir. (Allow it to cook for 10 minutes)
- Wash fresh salmon and add to stew
- Add mackerel, seasoning and salt to taste
- Add cabbage, stir and cover to cook for five to seven- minutes
- Allow to simmer when it is soft and serve with rice
- By Linda Abrefi Wadie
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Malnutrition remains one of the most significant barriers to Ghana’s long-term development. While its effects are most visible in childhood illness and mortality, its consequences extend far beyond the health sector, affecting education outcomes, labor productivity, and economic growth.
Severe Acute Malnutrition (SAM), in particular, demands urgent policy attention due to its direct link to preventable child deaths. At the center of the solution lies Ready-to-Use Therapeutic Food (RUTF) and the need for its inclusion in the National Health Insurance Scheme (NHIS).
NHIS has played a critical role in expanding access to healthcare by reducing out-of-pocket expenditures and improving utilization of services. However, the exclusion of RUTF exposes a structural weakness in the system.
When families cannot access treatment for SAM through NHIS, the burden of care shifts back to households already struggling with poverty and food insecurity.
RUTF is not a luxury commodity; it is an essential medicine for malnutrition. Its formulation allows children to be treated at home, reducing hospitalization costs and improving adherence. Evidence from Ghana and other countries shows that community-based management of acute malnutrition is both effective and scalable when adequately financed.
Failure to integrate RUTF into NHIS creates inefficiencies across the health system. Facilities cannot plan effectively, health workers face ethical dilemmas, and monitoring of outcomes becomes fragmented. By contrast, NHIS coverage would allow for standardized protocols, better data collection, and improved quality of care.
Importantly, integrating RUTF into NHIS would reduce Ghana’s dependence on donor funding for a core child survival intervention.
While development partners play a valuable role, reliance on external funding for essential services poses sustainability risks. National ownership through NHIS financing would ensure continuity of care and long-term impact.
The economic case is equally compelling. Studies consistently show that investments in nutrition yield some of the highest returns in development, often exceeding returns from infrastructure projects. Children who receive timely treatment for malnutrition are more likely to complete school, earn higher incomes, and contribute to national growth.
As Ghana advances its Universal Health Coverage agenda, it is imperative that nutrition interventions are fully integrated into health financing decisions.
Leaving RUTF outside NHIS sends the message that malnutrition is a peripheral issue rather than a core determinant of health and development.
Policymakers have the opportunity to correct this imbalance. Integrating RUTF into NHIS would strengthen the health system, protect vulnerable children, and safeguard Ghana’s future workforce. It is a policy decision grounded in evidence, equity, and national interest.
Key Policy Recommendations: The Ministry of Health and NHIA should immediately commission a costing study to integrate RUTF into the NHIS benefits package by 2027. Parliament’s Health Committee should prioritize oversight of this integration, with quarterly progress reports.
The National Health Insurance Authority must allocate 2-3% of its annual budget to nutrition interventions, including RUTF coverage for all diagnosed SAM cases. District health directorates should establish standardized RUTF distribution protocols, with digital tracking systems to monitor utilization and outcomes.
Finally, the Ghana Health Service should launch a nationwide training programme for health workers on community-based management of acute malnutrition, ensuring quality service delivery from hospital to household level.
Feature article by Women, Media and Change under its Nourish Ghana: Advocating for Increased Leadership to Combat Malnutrition project
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