The use of plants in the traditional management of diabetes in Nigeria: Pharmacological and toxicological considerations

Ethnopharmacological relevance: The prevalence of diabetes is on a steady increase worldwide and it is now identified as one of the main threats to human health in the 21st century. In Nigeria, the use of herbal medicine alone or alongside prescription drugs for its management is quite common. We hereby carry out a review of medicinal plants traditionally used for diabetes management in Nigeria. Based on the available evidence on the species׳ pharmacology and safety, we highlight ways in which their therapeutic potential can be properly harnessed for possible integration into the country׳s healthcare system. Materials and methods: Ethnobotanical information was obtained from a literature search of electronic databases such as Google Scholar, Pubmed and Scopus up to 2013 for publications on medicinal plants used in diabetes management, in which the place of use and/or sample collection was identified as Nigeria. ‘Diabetes’ and ‘Nigeria’ were used as keywords for the primary searches; and then ‘Plant name – accepted or synonyms’, ‘Constituents’, ‘Drug interaction’ and/or ‘Toxicity’ for the secondary searches. Results: The hypoglycemic effect of over a hundred out of the 115 plants reviewed in this paper is backed by preclinical experimental evidence, either in vivo or in vitro. One-third of the plants have been studied for their mechanism of action, while isolation of the bioactive constituent(s) has been accomplished for twenty three plants. Some plants showed specific organ toxicity, mostly nephrotoxic or hepatotoxic, with direct effects on the levels of some liver function enzymes. Twenty eight plants have been identified as in vitro modulators of P-glycoprotein and/or one or more of the cytochrome P450 enzymes, while eleven plants altered the levels of phase 2 metabolic enzymes, chiefly glutathione, with the potential to alter the pharmacokinetics of co-administered drugs. Conclusion: This review, therefore, provides a useful resource to enable a thorough assessment of the profile of plants used in diabetes management so as to ensure a more rational use. By anticipating potential toxicities or possible herb–drug interactions, significant risks which would otherwise represent a burden on the country׳s healthcare system can be avoided

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Mycotoxins : Food Safety, Consumer Health and Africa’s Food Security

Mycotoxins are among the major food contaminants, especially in Africa and in many developing countries. Contamination by mycotoxins has greater consequences in terms of both human and animal health as well as economics of these countries. This phenomenon may impact negatively Africa’s food availability and food security scenarios. This review evaluated mycotoxins in foods, safety of foods, consumer health and Africa’s food security. This review also gave comprehensive information on socio-economic implications of mycotoxins of foods and the effects on food security in Africa. In Africa, information concerning food contamination by mycotoxins is very scanty and the problem of storing agricultural produce under poor storage conditions that may predispose food to fungal infestation and subsequent mycotoxin contamination are common in African countries. Consumption of moldy produce or food contaminated with mycotoxins and the dangers of mycotoxicoses as well as the impact on public health necessitated a comprehensive approach to reduce the impact on public health and consumer safety. The challenges of food shortages, wars and conflicts, poor governance and planning in African countries have increased the problems of mycotoxins in Africa. In order to improve food safety, consumer health and availability of needed food by the teeming African population, education and enlightenment of Africans on the economic and health implications of mycotoxins are very crucial. The major techniques for control and mitigation of mycotoxins need to be explained to consumers. A robust regulatory control and effective analyses and detection of mycotoxins as well as good produce handling and storage are important to stem the tides of effects of mycotoxins in foods in Africa countries to improve consumer health and food security

Quality characteristics and consumer acceptance of bread from wheat and rice composite flour

The quality characteristics and consumer acceptance of wheat-rice composite flour bread were evaluated. Substitution of rice flour was done in wheat flour from 0 to 100% and the composite flour was used to produce bread. The bread samples were subjected to proximate, physical, and sensory analyses. The results showed significant differences (p ≤ 0.05) between the proximate compositions of bread samples studied. Bread from control (100% wheat flour) had moisture content of 28.61±0.28%. Bread from 10-50% wheat-rice composite flour had moisture contents ranged from 28.04±0.41 - 24.81±0.40%. The oven spring of the samples from control (100% wheat flour) had the highest value of 1.12±0.28 cm. The oven spring of wheat-rice composite bread ranged between 1.00±0.22 and 0.82±0.38 cm. There was inverse relationship between loaf weight (g), loaf volume and specific volume and the quantities of rice flour added to the wheat flour. The results of consumer acceptance showed that bread with 70:30 wheat: Rice flour ratio was acceptable to the consumers. In conclusion, bread of good quality and good consumer acceptance could be made from wheat-rice composite flour.</p

Effect of natural fermentation on nutritional composition and anti-nutrients in soy-wara (A Nigerian fried soy-cheese)

This study was carried to evaluate the effect of natural fermentation on nutritional composition and anti-nutrients in soy-wara. A total of 100 samples consisting of five treatments of 20 samples per each treatment were studied. Yellow soybeans were soaked and fermented for 24 hrs, 48 hrs, 72 hrs and 96 hrs respectively at 27±2°C with 0 hr as control. Fermented soybeans were used for soy-wara production and soy-wara samples were evaluated for nutritional (amino acid, vitamin and mineral profile) and anti-nutritional (phytate, tannin and trypsin inhibitor activity) qualities. Results of amino acids analysis showed that tryptophan, isoleucine, methionine, phenylalanine, leucine and lysine contents in the fermented soy-wara ranged from 3.49 to 6.75, 21.94 to 24.41, 20.60 to 23.98, 22.11 to 27.15, 33.16 to 36.51 and 24.16 to 26.27 mg/100 g respectively. The values of thiamine, riboflavin and niacin contents in the fermented soy-wara ranged from 1.60 to 1.87, 1.44 to 1.71 and 2.21 to 2.78 mg/100 g respectively. The mineral elements calcium, iron, potassium, sodium, phosphorus and magnesium contents in the fermented soy-wara ranged from 17.65 to 19.08, 6.94 to 8.41, 29.76 to 30.69, 8.31 to 9.42, 27.52 to 28.55 and 21.02 to 24.83 mg/100 g respectively. Soaking and fermentation reduced the tannin content from 115.64 to 43.26 mg/100 g; phytate content from 153.81 to 47.16 mg/100 g, trypsin inhibitor from 96.56 to 1.10 mg/100 g and protease inhibitor from 98.11 to 1.2 mg/100 g respectively. In conclusion, natural fermentation of the legume reduced anti-nutritional factors and improved the nutrient composition of the product.</p

Evaluation of nutritional composition, physico-chemical and sensory properties of ‘Robo’ (A Nigerian traditional snack) produced from watermelon (Citrullus lanatus (Thunb.) seeds

This study evaluated the nutritional composition, physico-chemical and sensory properties of ‘Robo’ (a Nigerian traditional snack) produced from watermelon seeds in order to improve the utilization of watermelon seeds in producing value-added products, acceptable to the consumers. Watermelon seeds were dehulled, dried and used to prepared ‘Robo’ in the laboratory and control samples were prepared from melon seeds. The proximate analysis, amino acid profile, vitamin, mineral and heavy metal profile and consumer acceptance of the ‘Robo’ samples were determined using standard methods. The results showed that there were no significant differences (p≥0.05) in the proximate composition of the ‘Robo’ samples from watermelon and melon seeds. There were significant differences (p≤0.05) in amino acid, vitamin and mineral profile of ‘Robo’ samples from watermelon and melon seeds. The amino acid concentration in g/100 g crude protein of ‘Robo’ for lysine, arginine and leucine were 4.58±0.01, 1.82±0.00 and 4.92±0.01 respectively for ‘Robo’ produced from watermelon seeds while 4.91±0.01, 2.01±0.00 and 5.16±0.01 respectively were recorded for ‘Robo’ produced from melon seeds. The study showed that the ‘Robo’ samples contained high amounts of vitamin B-complex and minerals and low amounts of heavy metals. In conclusion, the ‘Robo’ samples from watermelon seeds and control samples had high sensory scores and were well acceptable to the consumers. With these research findings, watermelon seeds could be used for the production of ‘Robo’ as a promising raw material. This will create ready-made market for the underutilized watermelon seeds and as well as creating more income to watermelon farmers.</p

Nutritional assessment of instant poundo yam from yellow yam (Dioscorea cayenensis) supplemented with yellow cassava (manihot esculenta) flour

The major objective of this study was to investigate the nutritional properties of yellow yam flour supplemented with yellow cassava flour. Specifically, the study dertermined functional properties of the yellow yam and yellow cassava flour blends, pasting properties of the yellow yam and yellow cassava flour blends, effect of supplementation on the sensory properties of the instant pound yam paste produced from yellow yam flour supplemented with yellow cassava flour. Good quality yellow yam (Dioscorea cayenensis), tubers and yellow cassava (Manihot esculenta) and UMUCASS38 roots were obtained from International Institute for Tropical Agriculture (IITA), Ibadan, Oyo State, Nigeria. Samples were prepared by appropriate methods. The flour blends were formulated and instant pounded yam flour prepared. Functional analysis and sensony evaluation were carried out. Results of the analysis show the following ranges; oil absorption capacity 70.25-85.63%; water absorption capacity 73.89-78.69%; bulk density 0.76-1.59g/m3; peak viscosity 158.36-210.43 RVU; final viscosity 178.53-277.15RVU; setback viscosity of cooked paste 51.53-72.54 RVU; pasting time 5.95-8.65 min; breakdown viscosity of the cooked paste 8.75-9.53RVU; pasting temperature 62.55-67.130C; trough 152.46-180.16 RVU. The general acceptability of all the supplemented samples were highly rated (8.00 each) as compared to control sample which had the lowest (6.05) value. Commercial production of instant poundo yam from yellow yam and yellow cassava flours will serve as a strategy of alleviating the challenge of food insecurity in Nigeria