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 |

Nutrition
The NHIS Opportunity: Leveraging Ghana’s uncapped health levy for nutrition services
Ghana’s decision to uncap the National Health Insurance Levy in 2025 marks an important shift in health financing. By removing limits on how much revenue the National Health Insurance Scheme (NHIS) can receive, government has created room to strengthen and expand essential health services.
This change comes at a crucial time for maternal and child nutrition, where effective solutions already exist but are yet to reach everyone who needs them.
Two such interventions are Ready-to-Use Therapeutic Food (RUTF) for children with severe acute malnutrition and Multiple Micronutrient Supplements (MMS) for pregnant women. Both are included in Ghana’s Essential Medicines List and Standard Treatment Guidelines, confirming their safety and effectiveness. Yet neither is currently covered under NHIS, leaving access dependent largely on donor-supported programmes.
The consequences are visible. An estimated 68,517 children in Ghana need treatment for severe acute malnutrition, but only about 15 per cent receive RUTF. For pregnant women, iron–folic acid supplements remain the standard, even though they address only two of the 15 essential micronutrients required during pregnancy. As a result, maternal anaemia remains widespread, affecting between 37 and 63 per cent of pregnant women depending on the trimester.
What makes this moment different is that Ghana already has the systems needed to deliver these services at scale. NHIS enrollment among mothers of children under five stands at about 84 per cent. National guidelines for the use of RUTF and MMS are finalised and in use, and more than 600 health workers have been trained on updated protocols. Supply chain structures are in place. The missing link has been sustainable, predictable financing.
Cost should not be a barrier. A full course of MMS costs about USD 2.50 per pregnancy and has been shown to reduce low birth weight by 12 per cent and preterm births by 11 per cent. This represents a small share of current spending on undernutrition. RUTF, while more resource-intensive, reduces the need for expensive hospital admissions by enabling effective community-based care, with recovery rates of 75 to 90 per cent. Ongoing Health Technology Assessments will provide Ghana-specific evidence to guide NHIS reimbursement decisions.
Including RUTF and MMS in the NHIS benefits package would change how nutrition services are delivered. Coverage would no longer depend on where donor programmes operate. Families would be protected from out-of-pocket costs, and services would be delivered as part of routine maternal and child healthcare. Importantly, data on coverage and outcomes would flow through national systems, strengthening monitoring, accountability, and planning.
Ghana has committed to achieving 80 per cent coverage of essential health services by 2030 under its Universal Health Coverage agenda. Nutrition is central to this goal, as it underpins child survival, maternal health, and long-term human development. The uncapping of the National Health Insurance Levy offers a rare chance to close long-standing nutrition financing gaps using domestic resources.
The opportunity is clear. The systems are ready. The evidence is established. What remains is a deliberate policy choice to use this expanded fiscal space to ensure that lifesaving nutrition services reach mothers and children across the country, consistently, equitably, and sustainably. The levy uncapping opens the door; leadership must walk through it.
Feature article by Women, Media and Change under its Nourish Ghana: Advocating for Increased Leadership to Combat Malnutrition project
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Nutrition
Benefits of chocolate

Chocolate is made from tropical Theobroma cacao tree seeds. It has since become a popular food product that millions enjoy every day. It has a unique, rich, and sweet taste.
-Cholesterol
A researcher revealed that chocolate consumption help to reduce low density lipoprotein.
Regular consumption of chocolate bars with low-fat diet supports cardiovascular health by lowering cholesterol and improves blood pressure.
- Keeps brain healthy
Researchers have suggested that drinking two cups of hot chocolate a day could keep the brain healthy and reduce memory decline in older people.
The researchers found that hot chocolate helped improve blood flow to parts of the brain where it was needed.
- Heart disease
Consuming chocolate could help lower the risk of developing heart disease and also lower risk of cardiometabolic disorders.
-Stroke
Canadian scientists, in a study involving 44,489 individuals, found that people who ate one chocolate were 22 per cent less likely to experience a stroke than those who did not.
Also, those who had about two ounces of chocolate a week were 46 per cent less likely to die from a stroke.
-Fetal growth and development
Eating chocolate every day during pregnancy might benefit fetal growth and development, according to a study presented at the 2016 Pregnancy Meeting of the Society for Maternal-Fetal Medicine in Atlanta, GA.
The flavonoids in dark chocolate can stimulate the endothelium (lining of arteries) to produce nitric oxide (NO).
One of the functions of nitric oxide is to send signals to the arteries to relax, which lowers the resistance to blood flow and therefore reduces blood pressure.
Dark chocolate may also improve the function of your brain.
Studies show that eating high flavanol cocoa could help improve blood flow to the brain in young adults.
Cocoa flavonoids may also help maintain brain health and the ability to think in older adults with mild cognitive impairment and reduce the chance of progressing to dementia. But more research is needed.
-medicalnewstoday.com



