Samhuka Medical

21/10/2022

Link between traditional beer, storage of maize and oesophageal cancer in the Eastern Cape revealed

A combination of inappropriately stored maize coupled with traditionally brewed beer has been linked
Researchers at Walter Sisulu University have found a link between the high incidence of oesophageal cancer in the province and the consumption of umqombothi/ 7 days (traditional beer). They say the risk of this type of cancer is increased by the consumption of umqombothi, coupled with a fungus found in inappropriately stored maize.

Umqombothi traditional beer, coupled with a maize-based diet — where maize is not stored properly — may be the leading cause of oesophageal cancer in the Eastern Cape. This is according to the latest findings of researchers at Walter Sisulu University.

Previous research has linked the consumption of traditionally brewed beer, often made with maize, to the high incidence of the disease, specifically among black men in the province.

The study, led by the department of human biology’s Prof Eugene Ndebia, continued previous work to find out why the Eastern Cape had an exceptionally high number of oesophageal cancer cases compared with other provinces.

“There are a lot of causes that have been brought forward for oesophageal cancer in the province,” Ndebia said, explaining that they had looked at the industrial pollution of the soil by factories and the possible contamination of vegetables with carcinogens.

“The other causes brought forward were to***co and alcohol, but now the main reason we have found is that people with this type of cancer have a diet with a higher level of carbohydrates [in the form] of maize.

“Because the Eastern Cape has the highest percentage of people living below the poverty line, especially on the rural outskirts, people have found ways to preserve food by buying it in bulk and storing it.

“Maize on its own is not harmful as long as you buy it and use it within a reasonable time period. The problem is when you have stored it for a while that it starts to develop carcinogenic agents which become harmful to the oesophagus.

“It’s those chemicals that cause cancer, not the maize itself.

“You can buy maize meal and cook it today and that will be fine, but when you cook from the same bag of maize meal after a few weeks, it is no longer the same maize,” Ndebia added.

He said they had shown that fumonisins, a fungal toxin which is carcinogenic, is found in maize stored in poor conditions for up to four weeks.

“The way we store maize is also an important factor — when humidity and temperature [are] not controlled, this leads to the maize becoming contaminated with carcinogens. In rural areas the storage of food is usually not in a controlled environment,” he said.

“In the making of traditional beer, they are adding a lot of artificial components and those components can be carcinogenic… even the containers they use for beer during the fermentation and storage process have an impact. So, the problem is not the maize meal, but how you store it, how long you store it and what you add to it when you are cooking,” he said.

Ndebia concluded his hypothesis on how the cancer occurs, saying that if one’s diet is high in carbohydrates, this can increase reflux.

“Our research has led us to monitor a rare type of reflux which is not acid, also known as alkaline reflux,” he said.

He said a surprisingly high number of patients seen by them had alkaline reflux, and they had linked this to patients with a diet high in maize.

“Research has shown that alkaline refluxes are very carcinogenic compared to acid refluxes. This may be why oesophageal cancer patients are usually diagnosed at an advanced stage of the disease, because nothing warns them to seek help early,” Ndebia said.

Research published in the South African Medical Journal in 2015 pointed to a possible link between oesophageal cancer and maize when researchers found that cases of this disease started increasing when traditional beer brewers switched from sorghum to corn.

Back then, researchers said studies were needed to link fumonisins to the increased incidence of oesophageal cancer in the province. #

03/06/2022

Addressing the Increased Risk of Postpartum Depression for Black Women

Postpartum depression (PPD), also known as perinatal depression, is a mood disorder that occurs during pregnancy or after a recent birth. The condition can create bonding issues between a mother and her baby, contribute to sleep and feeding problems, and cause mental, emotional, developmental and verbal complications in children. PPD affects one in eight new mothers, but the risk is significantly higher for new mothers of color. Notably, while Black women are more likely to have PPD, they are less likely to receive help.

There are a number of factors that may contribute to increased rates of PPD among Black women and low levels of treatment, including lifestyle and living conditions.

Identifying and understanding these factors may be a lifesaving measure. Ultimately, accessing treatment that includes cultural understanding is critical in improving the health outcomes for expecting Black women and those that have recently given birth.


Symptoms Of Postpartum Depression
According to the CDC, symptoms of PPD include:

Guilt
Fears of harming the baby
Feeling angry
Isolating from family
Feeling disconnected from their baby
Crying more than normal
While symptoms of postpartum depression have been widely documented, much of the research conducted and screening tools developed have been focused on white women. As a result, doctors may miss somatic symptoms that tend to present in nonwhite women, such as high blood pressure or unexplained body aches, pain and nausea. If a new mother is experiencing these symptoms, it’s important to discuss them with a provider.


Why Black Women Have A Higher Risk
Black women are three times more likely to have a maternal death than white women in the U.S. Awareness of this risk can heighten stress and anxiety during pregnancy, potentially placing women of color at risk for PPD. Many researchers suggest providers prioritize examining social factors to further understand and address these health disparities. Social factors that can place Black women at increased risk for PPD include:

Low income or education
High stress living environments
Exposure to trauma
Food insecurity
Lack of access to quality care or health coverage

Obstacles To Receiving Mental Health Care

Many Black women experiencing PPD are silenced by shame and stigma. In the Black community, seeking help is often viewed as a sign of weakness. Additionally, when someone makes the decision to seek guidance, they are likely to turn to family, friends or religious leaders rather than trained personnel.

Reasons many do not seek professional help can include:

Stigma and perceptions of mental illness in the Black community
Experience with inaccurate diagnoses
Lack of representation or diversity in health care
Distrust of the health care system
Perceived racial discrimination
One common symptom of PPD is feeling hopeless. If such feelings become severe, a new mother could threaten her life and or die by su***de. It is important that Black mothers receive help as soon as possible to prevent symptoms from escalating.


Resources For Culturally Supportive Care
Below is a list of resources to assist women with finding providers and other sources of support.

Therapy Resources
Therapy has been shown to be effective in treating depression and reducing depression symptoms in women with PPD — when mental health providers are culturally sensitive and appropriately

Nutritional Resources
PPD has been linked with lacking affordable and nutritious food. The Women, Infants and Children (WIC) program provides families with healthy food and nutritional education for mothers and their children. Mothers can contact their local WIC site online or by phone to complete an application. Name and birthdates of parent and child is required for application.


Moving Forward
PPD is a debilitating illness that can produce detrimental outcomes for mothers, families and communities. Education at the provider and community level is essential in combating the disparities in black maternal mental health. Many pediatric physicians observe PPD in mothers at baby wellness visits. Thus, training physicians to do screens that are inclusive of symptoms specific to African American women could help with early detection and treatment of PPD. Equipping providers with culturally appropriate resources can ensure mothers are receiving adequate care. Many women in underserved communities do not seek assistance simply because they are unaware it exists.
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