Much ado about traditional African foods

I write this just after attending a research seminar that finally reinforced what I long suspected. I am in no way an anthropologist but I am a rational scientist and will start by stating that researchers have long suspected that the type of foods we eat play a significant role in disease causation. However, while some evidence has been clearly established, there are still a lot of missing pieces to the puzzle. The key points in this article are highlighted in green.

There is increasing data that the food we eat impacts our bacteria population and diversity (a.k.a. microbiome) and that this may indirectly have an effect on disease development. For instance, why are certain diseases like celiac disease, multiple sclerosis, Crohn’s disease, and ulcerative colitis, prevalent in certain parts of the world, especially the West, and less so in most parts of Africa?

Why are certain cancers very common in some countries yet uncommon in others? The answer to these questions will definitely not be straightforward and it may take many more years (possibly decades) to get the full explanation.

Lifestyle changes in Africa

It is very concerning to me that if you walk down the streets of Lagos, Accra, Nairobi, Dar es Salaam, or Johannesburg, you can’t help but notice a Domino’s pizza or Macdonald’s restaurant. In addition, these fast-food restaurants are increasing in number suggesting that there is indeed a demand for them. Many fast-food restaurants including the two listed above have healthy food options, but also have foods that are unhealthy.

Africans have long admired the lifestyle of the West – not just in dressing, culture and lifestyle but also in food. I am certainly not innocent of this action. However, growing up in Africa, I didn’t eat a slice of pizza until my late 20s but now pizza is almost a weekly meal.

My sister visited me recently, and I ordered a pizza pie for her only to return home to see it largely untouched. Her response to me was that “the pizza back home is much better than this.”

Growing up in Lagos, my mother would prepare up to 10 different soups with various vegetables which we would eat with “eba” (garri- a complex starch, or pounded yam, or Semovita).

Our diet was also predominantly rich in beans, rice, and yams. However, over the past 10 years, there has been a transformation in the diet of many Africans. Many may be ignorant of the impact of this lifestyle, the goal of this article is to bring attention to the ills that this transition may have in the future.

The traditional African diet, intestines, and the microbiome 101

As introduced above, the traditional African diet is rich in complex carbohydrates like yams, beans, and plantains. There are even many types of tubers including regular yams, cocoyams, water yams. Complex carbohydrates are rich in fibre and may have a beneficial effect on the type of bacteria that colonizes our digestive tract (gut).

The bacteria in our gut constitute the microbiome. The microbiome has been implicated in various disease states including obesity, liver disease, cancer, and other chronic medical diseases. It has thus become a hot topic for researchers in an attempt to understand how our gut and its bacterial content affects our health and wellness.

How may traditional African foods affect gut bacteria and prevent disease?

The upper part of the intestines have bacteria that like to consume simple sugars. Examples of simple carbohydrates include glucose, high-fructose corn syrup, juices, and carbohydrates in pastries, and sugars found in sodas. Many breakfast cereals also contain have simple carbohydrates.

However, the African diet is rich in complex carbohydrates that are not completely digested in the upper intestine, the remnant nutrients from the breakdown of these complex carbohydrates go further down the bowel to supply nutrition to the bacteria in the lower intestines.

There is some evidence that if bacteria in the lower intestines do not receive sufficient nutrients (which can be seen with a diet that is low in complex carbohydrates, and rich in simple carbohydrates, as is seen in some Western diets), the bacteria start to invade the mucous layer of the digestive tract.

This mucous layer has a protective effect in keeping certain pathogens (bad stuff) in the bowels from crossing into the bloodstream. There is also evidence that a diet low in complex carbohydrates may lead to an increased selection of these mucous-loving, potentially problem-causing, bacteria in the gut.

If the above holds true, you can imagine that the chronic consumption of a diet low in complex carbohydrates may allow continual exposure of the human immune system to pathogens that may directly or indirectly lead to certain diseases. Once again, this is just a simplistic explanation of what is likely a more complex and dynamic interaction.

This leads many curious individuals such as myself to wonder why Africans (particularly in SubSaharan Africa) have lower rates of these autoimmune diseases and certain cancers compared to people in Europe and the United States.

Are the impaired interactions of a gut that receives mostly low carbohydrate foods and its bacteria a gateway for certain pathogens to lead to specific disease? Does this help in understanding why early man, who ate a diet predominantly of complex vegetables and carbohydrates, had lower rates of the diseases listed above, and lower rates of obesity?

Can these complex carbohydrates be manipulated to offer potential targets for preventing and treating disease?

It is important to note that the Western diet also has foods that are rich in complex carbohydrates such as broccoli and other cruciferous vegetables. In fact, the American Cancer Society suggests that eating broccoli may be beneficial in reducing the risk of cancer.

So, the problem may be in the balance and proportion of the diet that is simple vs. complex carbohydrates, and the benefit of traditional African foods may lie in the fact that they are almost exclusively complex in carbohydrates (of note, similar foods are also seen in parts of Asia and South America).

Examples of foods in the Western diet that have complex carbohydrates:

Potatoes

Tomatoes

Onions

Okra

Dill pickles

Carrots

Yams

Strawberries

Peas

Radishes

Beans

Broccoli

Spinach

Green beans

Zucchini

Apples

Pears

Cucumbers

Asparagus

Grapefruit

Prunes

Just reviewing the list above, I can recognize certain foods that are prevalent in Africa. Depending on where you are in Africa, there are many different types of foods rich in complex carbohydrates that you can incorporate into your diet.

Africa, antibiotics and gut bacterial diversity

Another major problem is that in many African countries access to antibiotics is very easy. You walk down a street in Lagos and you find numerous “chemists” where you can buy antibiotics without a prescription. As such, people take antibiotics inappropriately without realising how they affect their gut bacteria in the short and long term.

While there is new evidence that giving children antibiotics reduces childhood deaths in Africa, which is a good thing, we don’t know the long-term deleterious effect of administrating these antibiotics so early in life, particularly the impact on the gut, the microbiome, and disease risk.

We should approach this issue of early antibiotic administration in our children very cautiously. The Gates Foundation is supporting research on the benefits of administering antibiotics in African children to reduce deaths and has plans to fund research to study the impact of this strategy on the microbiome in Africans, which is laudable.

So why should we care so much about our traditional African foods?

Well, we need to think ahead. While a lot of work is going on to eradicate communicable diseases, attention has to be paid towards preventing a future epidemic of noncommunicable diseases.

In a separate article, we at Qwenu! discussed the increasing trends in obesity in Africa which is rapidly becoming a significant public health problem. Eaten in moderation, the risk of obesity with traditional African foods may be lower, however, it is also unclear if there is direct or indirect modulation of the microbiome.

However, if the ongoing transition continues, and our lifestyles completely transform into the Western lifestyle, we may lose these protective gut bacteria and their benefits in disease prevention. This is because as your lifestyle changes towards a Western one, your microbiome (bacterial diversity) also changes to mirror those of people in Europe and the United States on a typical Western diet.

If we (Africans) and our kids eat less of our traditional African foods that are rich in beneficial complex carbohydrates, we may get to a point when previously uncommon diseases become prevalent, and these may be challenging to manage in low-resource settings that are already burdened with communicable and infectious diseases like malaria.

For this reason, I am a strong proponent of feeding our kids traditional African foods as much as possible. This is particularly important for Africans and their children in the diaspora. In certain countries outside Africa, traditional African foods are expensive. However, it is important for African parents to provide their kids adequate exposure to traditional African foods, and teach them how to cook these foods so that they, in turn, can do the same for their children.

This last point is particularly important because of the possibility of an extinction-level effect on gut bacteria diversity. To simplify this, it may be possible that if you eat foods low in complex carbohydrates for a long period of time, that you may lose the beneficial bacteria permanently, possibly to a point where you cannot transfer these “good” bacteria to your children, depriving them of the disease-preventing benefits.

So my fellow Africans, keep eating your yams, beans, plantains, and traditional vegetables, in healthy proportions. Slow down on the fast-foods as our traditional African foods are very beneficial, and may one day become treatment options (almost like drugs) for certain diseases other parts of the world.

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