Chronic diseases are usually associated with weight loss (cachexia) which can be adduced to various reasons. Of interest in this issue of the journal is the article by Ogunkunle and others
highlighting an unusually high frequency of stunting and malnutrition in over 70% of the 151 children diagnosed with acyanotic and cyanotic congenital heart diseases based on echocardiography with Doppler and color flow mapping. Almost two thirds of the children were underweight with 57% stunted and 37.7% had wasting.
When such children develop heart failure, the reasons for stunting include: abdominal distension resulting in early satiety, fatigue associated with feeding, liver congestion with impaired metabolism and nutrient absorption. It thus becomes important that nutritional assessment should be included in the management of children with congenital heart diseases even before they decompensate and present in heart failure followed by counseling to ensure early corrective interventions as advocated by the authors. An appropriate next step would be to determine changes in muscle mass in these individuals and relate this to stunting to either sarcopenia which is more commonly associated with aging  or loss of subcutaneous fat. This would be an interesting line of research as well as a search for other biomarkers.
Dietary advice is an essential component in the prevention and management of chronic diseases including cerebrovascular diseases, hypertension, chronic kidney disease and diabetes
mellitus. In this issue of the journal, Akinlade and others reported that the consumption of wheat meal was associated with low glycaemic and insulin index when compared with yam flour paste
(amala) and cooked cowpea. This has translational implication because whole, unprocessed wheat is available as staple meal in many homes and it would seem to be an appropriate choice
in the prevention and management of diabetes mellitus. The time is right for us to have a table of the glycaemic indices, insulin indices and glycaemic load of most of the traditional meals available in Nigeria so that patients can make informed choices on what to eat to prevent chronic diseases.
Di Tano G, Fulle S, Pietrangelo T, Bellomo R and Fanò G. Sarcopenia: characteristics, genesis, remedies. Sport Sci Health. 2005;1(2): 69–74.