Work highlight – “Being able to witness how positively nutrition changes affect clients’ every day lives!” – Meet The Dietitian

Leave a comment June 24, 2015 nutritionadsa

As part of our ‘Meet the Dietitian’ series, we chatted to Lila Bruk about why she became registered dietitian, what she loves about her work, how she copes after a day of nutrition disaster and bad eating choices, and what people should look out for when choosing a dietitian.

Meet Lila Bruk a registered dietitian (RD) in private practice (Lila Bruk & Associates)

Why did you become a registered dietitian?

I have always been passionate about health, but I was particularly interested in the nutrition side and liked how dietetics allowed for creativity as well as interaction with people.

What do you enjoy most about the work you do? What are the most satisfying moments?

I love meeting new people, guiding them on their journeys and seeing them achieve their goals along the way. Without a doubt, the most satisfying moments are when people start to feel a significant difference in their health, energy and wellbeing and being able to witness how positively these changes affect their every day lives.

What has been your career highlight?

There have been so many, so it’s hard to pick, but I would have to say being involved with many high-profile projects and companies is definitely a highlight. Having said that, every day is filled with highlights and seeing my clients’ progress and being there when they achieve their goals is always so rewarding.

What are the most challenging aspects of your career?

This would definitely be managing the different sources of misguided nutrition information out there. Unfortunately the public gets so many conflicting nutrition messages from so many different sources that it can lead to them being extremely confused. This is especially difficult when the source of the nutrition information is seemingly reputable websites, health professionals, celebrities or other media. A lot of my time is then taken up trying to debunk many of the myths and misconceptions that these sources have put forward.

How do you cope after a day of nutrition disaster and bad eating choices?

I think the best thing is to try to get back on track as soon as possible. Trying to cut out food from the next day will only backfire and you will land up overeating at a later stage. Getting back on your plan is the best strategy.

What are the three things that you think people should stop saying when they meet a dietitian?

• “Do you eat like this?” – dietitians are people too. Sometimes we have good days and sometimes bad, but ultimately most of the time we do our best and make good choices.
• “I don’t like the taste of healthy food” – healthy eating is not all about boiled chicken and steamed broccoli! Healthy food can also be delicious, vibrant, tasty and exciting. It’s all about preparing it right.
• “I hate exercise” – being more active is all about finding something you enjoy. If you hate running and love dancing, then by all means do the dancing!

What should clients look out for when deciding which dietitian to work with?

Try to find out whether the dietitian has dealt with similar situations to yours, but also see how you feel about them, whether they inspire confidence and whether they have a good reputation and the right qualifications.

What is your favourite dish and your favourite treat food?

My favourite dish is grilled teriyaki salmon with steamed veggies. My favourite treat would be frozen yoghurt or liquorice 🙂

Lila Bruk is a registered dietitian and nutritional consultant in private practice in Illovo, Johannesburg. 

She graduated from UCT with a Bachelor of Science degree in Microbiology and Biochemistry in 2002, followed by a Bachelor of Science Medical (Honours) degree in Nutrition and Dietetics in 2004 also from UCT. In 2010 she completed a Masters in Nutritional Sciences through the University of Stellenbosch in the fields of body image in pre-adolescent girls, digestive disorders (e.g. IBS), sports nutrition and food allergies.

Lila is passionate about promoting health and good nutrition and thus has written for various general and health-related publications such as O Magazine, FairLady, COSMOPOLITAN, Women’s Health, Men’s Health and Longevity. She also gives regular lectures on nutrition-related topics around the country, and appears regularly on television and radio. 

Her main areas of interest include nutritional management of lifestyle diseases (including diabetes, insulin resistance and heart disease), glycaemic index, food allergies, post-operative nutrition, sports nutrition, adolescent body image and digestive and gastrointestinal disorders (e.g. Crohn’s disease, Irritable Bowel Syndrome).

Lila is registered on the Discovery Vitality Dietician Network and thus is accredited to perform Discovery Vitality Nutrition assessments. Lila is registered with the HPCSA (Health Professionals Council of South Africa) and the Association for Dietetics in South Africa (ADSA). She holds the Sponsorship portfolio on the ADSA Executive Committee for the July 2013 to June 2015 term of office. She was also the chairperson for the ADSA Gauteng South branch from July 2009 to June 2013.

New NutritionConfidence recipe – Stuffed chicken breast wrapped in proscuitto

Leave a comment June 22, 2015 nutritionadsa

We love our latest NutritionConfidence recipe because it is the perfect easy-to-prepare option for a dinner party and is sure to wow guests.

This recipe is for special occasions and can be served with beautiful, seasonal vegetables, which at this time of the year include: asparagus, beetroot, broad beans, broccoli, brussel sprouts, fennel, Jerusalem artichokes, Kale spinach, parsnips, pumpkin, radishes, turnips and watercress.

Our dietitians say:

This is the lower fat version of bacon wrapped chicken breast stuffed with creamy feta and spinach. Leaner or lower fat protein options are used in this recipe – skinless chicken breasts instead of thighs; prosciutto ham instead of bacon; and Danish feta instead of Greek feta. To lower the saturated fat content of this recipe further, use reduced fat soft feta and remove excess visible fat from the prosciutto before cooking. Unfortunately the sodium content of this dish is high – the feta cheese and prosciutto ham being the main contributors. So rather keep this meal for special occasions!

Stuffed chicken breast wrapped in prosciutto

Makes 2 portions

Ingredients

2 free-range chicken breast fillets

100 g soft Danish style feta

100 g baby spinach

10 ml olive oil

4 long slices of prosciutto ham

Pepper

2 tablespoons chopped parsley

Zest of half a lemon

How to make it

1. Heat a medium pan on a high heat.
2. Add the olive oil and the baby spinach. Season the spinach with a pinch of pepper, and sauté the spinach until just wilted.
3. Remove the spinach from the pan and put into a mixing bowl to cool. Once cooled, squeeze any excess liquid from the spinach and crumble the feta into the spinach. Add the lemon zest and parsley and mix to combine.4
4. Preheat the oven to 180 deg C.
5. Lay two slices of prosciutto onto a chopping board, slightly over lapping.
6. Place the chicken breast on top of the prosciutto slices. Make a lengthways slit down the middle of each chicken breast, to butterfly it. Split the feta and spinach mix into two and stuff one half of the mixture into the chicken breast. Repeat the same process with the other chicken breast and stuff with the other half of the spinach mixture.
7. Roll the chicken breast up, wrapping it in the prosciutto.
8. Use a toothpick to pin and seal the ends of the chicken roll.
9. Put a non stick pan on medium heat.
10. Brown the chicken breasts for about 2 minutes until golden brown, turning them every couple of seconds for an even colour.
11. Transfer the breasts into an oven proof dish and bake in the oven for 12 minutes.
12. Remove from the oven and remember to remove the toothpicks.
13. Serve with a fresh seasonal salad or side dish of your choice.

Nutritional Value (per portion)

Energy: 1063 kJ

Protein: 35.2 g

Carbohydrate: 2.1 g

Total Fat: 11.6 g

Dietary Fibre: 2.3 g

Sodium: 1082 mg

To download the recipe card, visit http://www.adsa.org.za

Next week we start with our new series of NutritionConfidence recipes that will be perfect for the coming Winter months.

Dietitians and consumers deserve more credit

Leave a comment June 19, 2015 nutritionadsa

ADSA Executive Member, Maryke Gallagher, has responded to a recent article by Sonia Mountford, published on the BizNews website, entitled “Dietitians dishing you up a daily menu of unhealthy eating advice”

http://www.biznews.com/health/age-well/2015/05/25/are-dietitians-dishing-up-a-daily-menu-of-unhealthy-advice/

DIETITIANS AND CONSUMERS DESERVE MORE CREDIT

By Maryke Gallagher (van Zyl)

The recent article by Sonia Mountford in BizNews titled “Dietitians dishing you up a daily menu of unhealthy advice?” makes several allegations against the Association for Dietetics in South Africa (ADSA) and, regrettably, also brings an honourable profession into disrepute.

I would like to address some of the concerns and provide a more balanced view on the issues raised.

Ms Mountford’s arguments are not new and she quotes several international studies to justify her arguments but references no credible empirical research locally that finds an “unhealthy”, compromising and complicit relationship between big foods and dietitians, which she claims.

ADSA is not the only body that raises funds from the sector in which it operates. It’s a common practice and there is nothing sinister about it. That is exactly why ADSA is open and transparent about who our sponsors are and our sponsorship policy is readily available on ADSA’s website. Sponsors should never be allowed to dictate an organisation’s messaging and content, especially in the health sector where all information should be evidence-based and ‘first do no harm’. We firmly believe that, as health professionals, we follow this mantra and that our members have sufficient training to be able to assess evidence-based, peer reviewed literature and are aware of possible undue influence.

The independence of ADSA is not compromised by the support it receives from the food industry. While, in a perfect world, professional associations should be completely independently funded, we, like many other associations, don’t have the resources or benefactors to support the work we do to promote the profession and provide ongoing professional training to members. We are proud that we raise 66% of our funds from members’ fees, but this is insufficient to sustain the organisation. Only 34% of our funds are raised from sponsors, with their full understanding of our sponsorship policy.

Many of our sponsors are retail competitors which in itself mediates unfair advantage of one product or company over another. The most we get from any one sponsor annually is about R60 000. Ms Mounford’s concern creates the impression that we are cash flush and powerful enough to dictate a nation’s diet. Far from it. An operating budget of less than R500 000 annually to serve roughly 1 350 dietitians nationally is hardly the resources required to conduct the work we do let alone indulge in the antics we’re accused of.

Dietitians themselves have a code of conduct that specifies that they are committed to providing systematically assembled, evidence-based advice after careful assessment and diagnosis based on the individuals nutritional and health status, and must take the necessary steps to avoid bias and commercial interests.

ADSA does not recommend or endorse brands, products or services. Our donors are not permitted to publicise their support nor use our logo on their websites or on their products. Anyone who has recently consulted a dietitian would know that, rather than promoting a brand or products, dietitians advise patients to read the labels of products and consume foods that address their particular health needs, whether it’s no sugar, low fat, low salt, high fibre or reduced carbohydrates, for example. Dietitians are trained as experts in nutrition and that training includes being able to interpret scientific evidence and separate fact from marketing hype. Ultimately, we educate our patients by providing sufficient information to empower them to make informed food and purchasing choices. Patients can choose to shop at large retailers, eat organic foods or support local farmers markets. It’s their choice.

ADSA does contribute to related draft legislation as do many NGOs, industry bodies and even members of the public. This is not unusual and ADSA does not unfairly influence legislation in the interest of big foods. ADSA has often submitted comments that might be considered unpopular by some food companies. We comment on legislation to benefit the health of all South Africans based on current best practice. To craft legislation in the absence of such evidence would be ill advised. Ultimatley Government drafts regulations based on its own policy considerations which, at present, is guided by the fight against Non Communicable Diseases (NCD’s) such as hypertension and obesity. ADSA strongly supports the policy of reducing such NCD’s through diet.

Finally, South African consumers can take comfort that the local food industry is highly regulated. Food labelling regulations, for example, include permitted and/or prohibited nutrition and health claims, endorsement and the presence and levels of additives.

Making sustainable lifestyle changes and creating new habits – Michael’s success story

Leave a comment June 9, 2015 nutritionadsa

This week we chat to Michael North, as part of the series of success stories we will be sharing over the next couple of months. Michael started seeing Registered Dietitian, Elienne Horwitz, when he started gaining weight and feeling unhealthy:

Why did you decide to see a dietitian? (Michael’s before story)

The short answer is I was getting fat and feeling and unhealthy and all my attempts at watching what I ate and drank were short lived and unsuccessful. I was exercising a bit, mountain biking on the weekend and playing the odd game of squash, but these were usually followed by reward lunches with my friends.

Combined with this was that some friends who I would generally beat up the hills and round the trails started beating me! I also started noticing how slow I was getting and how steep and more difficult the hills were becoming. I guess when the lunches were getting longer and more taxing than the mountain biking, I knew I needed some help.

Tell us about your journey with the dietitian?

My first visit to Elienne was for a Discovery Vitality assessment that a friend from work said I should do to get points on my card to qualify for the discounts. After doing this and realising that the dietitian was not a scary food nazi intent on making me feel useless unless I weighed the same as I did in primary school and only ate salad and tofu, I knew that I needed to step up if I wanted to make any changes. Elienne was really friendly, honestly wanted to help and also had a nice, but slightly strict way about her.

She made me aware of what I ate but also explained why things were good or bad. If I didn’t like some of the food items she suggested, she always had several alternative options and by explaining why I needed those food choices I was, over time and with some practice, quite easily able to choose my own alternatives.

Elienne started out by giving me a breakdown of the number of carb, protein, dairy and fat portions I should eat a day and when and how I should eat them; breakfast, mid-morning snack, lunch, mid-afternoon and dinner.

I started swimming with a group at my local gym and was still mountain biking a bit so she showed me how I should adjust my diet during exercise and for recovery after.

The basic principle was not a quick weight loss scheme but more of a healthier living choice, which facilitated weight loss until reaching a weight appropriate for my height and age, etc. So my journey was not a very quick one but my weight loss and fitness levels gradually but consistently went in the right direction.

Tell us about your results / successes?

I think it took me about a year but I lost 18 kg and quite a few centimeters. I also started cycling more, doing events like the Argus and several open water swims. Most importantly, I just felt better.

After a while I started looking for other challenges to help keep me active and on track with my plan instead of back to the pub everyday! I joined a group called Embark, in Sea Point to train for the Ironman 70.3 event in East London and not only completed the triathalon, but also won the Embark “Most Improved Over All” award at the club after party. I was quite proud of that, considering that I had sworn to never run more than 5km in my life!

The following year I joined another triathlon group (My Training Day) and in April 2014 completed the full Ironman. Now the bug has bitten and this year I improved by time by about 30 minutes.

I still keep pretty much to the same eating plan that Elienne put me on in the beginning but am able to eat a bit more now with all the training I am doing. What is great though is that I now know that when I go off track a bit and maybe pick up a kilo or two and it doesn’t take much to fall back into the routine of eating properly and losing the excess again.

What was the hardest part of the journey?

Avoiding beer, red wine and pizza!

In the beginning, the hardest part was eating 5 times a day. Generally in the past I would not eat breakfast or eat very little, then be so hungry by lunch that I would eat a big, junk food lunch and would justify it by saying that I hadn’t eaten all day “so it was ok”. Then I did the same for dinner.

What are the top three tips you can share?

• If you want to eat more, exercise more and substitute some of the bad stuff for good stuff.
• If you want to lose weight, don’t make excuses, you know that pies and chips are not going to help.
• If you can, go to a dietitian or someone like that to help get you started on your way and explain the ins and outs of the process. Being held responsible for your progress with regular weigh-ins can be a real help and motivation to say no to the extra beer or second helpings.

What the dietitian says

Michael lost 18kg, 13% body fat and 15cm around the waist over 16 months. He slowly changed his habits and started putting more energy into planning and preparing his meals and increasing his levels of exercise. He maintained his weight even a year later.

The most important reason Michael managed to lose the weight and keep it off was because because he did not diet – he made sustainable lifestyle changes and slowly created new habits.

HPCSA inquiry

20 Comments June 4, 2015 nutritionadsa

A concern was lodged with the Health Professionals Council of South Africa (HPCSA) as a matter of public interest after a tweet from Professor Tim Noakes advising a mother to “wean” her baby on to a low carbohydrate high fat (LCHF) diet.

The concern was referred to the HPCSA to adjudicate in February 2014 on behalf of members of the Association for Dietetics in South Africa (ADSA). Following a preliminary hearing last year, the HPCSA has decided to convene an inquiry into the conduct of Professor Tim Noakes. They will then rule on the matter.

The advice, via Twitter, is not considered to be in accordance with both international (WHO Guiding principles for complementary feeding of the breastfed child) and national (South African Paediatric Food Based Dietary Guidelines) feeding guidelines for infant and young child nutrition. Furthermore giving one on one nutrition advice on social media to a patient who has not been assessed, as well as providing information outside of the scope of practice for which you are registered with the council is in contravention of the HPCSA ethical guidelines.

“I look forward to a resolution of this matter that will provide clarity on complementary feeding recommendations for infants and young children. It should also set a precedent on how social media should be used by health professionals. Clarity on these issues will help to advance health care in South Africa in the interest of the public. It should also clear any public and professional confusion on these issues,” said Claire Julsing Strydom, President of the ADSA.

World Milk Day

Leave a comment June 1, 2015 nutritionadsa

Today, 1 June, South Africa joins a number of other countries around the world in celebrating World Milk Day.

Why?

Because milk is an important source of nutrients we all need to survive. These include calcium, vitamin A, vitamin B12, vitamin B2, potassium, phosphorus, zinc, magnesium and protein.

The South African Department of Health’s daily dietary guidelines stipulate we should all have milk, maas or yoghurt every day as part of a healthy, balanced diet.

Thought we would share four excellent reasons why you should include dairy in your daily diet:

1. As an adult you need 1000mg of calcium per day. One serving of dairy (that’s 250ml of milk or 40g of cheese or 200ml yoghurt or maas) provides 300mg of calcium. In other words, just three servings of dairy give your body almost all the calcium it needs every day.
2. Milk, maas and yoghurt have low sodium-to-potassium ratios and contain bioactive peptides. This composition may help to protect against the development of non-communicable diseases such as hypertension, diabetes and metabolic syndrome.
3. The calcium in dairy products is highly bio-available, contributing significantly to your bone-mineral content.
4. The calcium in milk, maas and yoghurt could play an important role in the regulation of body weight and metabolic syndrome.

World Milk Day aims to celebrate milk as a nutritionally important, global food. Find out all you need to know about the health and nutritional benefits of dairy by visiting http://www.rediscoverdairy.co.za – an online portal, brought to you by the Consumer Education Project of Milk SA, featuring up-to-date and scientifically sound information on the health and nutritional value of all dairy products.