Meet the Dietitian: Community service series

By Leandré Piek


“Flexibility is key”

I remember doing a “personality test” during my dietetics studies that pointed out that I’m as flexible as a rock, not having the ability to eagerly adapt to new and unexpected environments and changes. This was true of me since I absolutely love structure, or so I thought.


As I entered my last year in high school, I still had no idea what I wanted to do with my life – but I knew it would be something in medicine and health sciences. It was thus appropriate to go to the open day at the Tygerberg Campus of Stellenbosch University, hoping that I would find some clarity!

Thank you to the 4th years at the dietetics stall who convinced me to choose dietetics as my future profession. With no plan B, I applied for the 4-year course, and by grace, I got accepted. With lots of grace, I got through the 4 years to where I am now!


Where am I now? Not in the Western Cape where I was hoping to be placed (I think a few can relate to this). No, I was placed at Kakamas Hospital in the Northern Cape, and can I just say how grateful I am for being Afrikaans!

During my comserve year I am getting the best of both worlds – a mixture of all there is to dietetics. I work in the hospital, at clinics, see out-patients, work in the food service unit, do training and health talks and manage a Severe Acute Malnutrition Project in the district. I absolutely love the variety, although it took me some time to get used to everything. It is not all textbook work, and it is normal to swim a bit before finding solid ground.

One thing that I can encourage is, to ASK QUESTIONS! Don’t be afraid to learn from others or to show vulnerability. After 4 years of studying, you know a lot, but you don’t know everything. After the anxiety and uncertainty of my comserve placement, I am extremely grateful for the journey so far.

In a rural setting, you must work with what you have, and this has improved my ability to be flexible and think out of the box! But it is absolutely what you make of it – how you see every opportunity, how you build relationships, how you treat other people, and how you keep on trying to do better.


Don’t be afraid to be flexible – it opens new doors that you didn’t know you needed.


OPTIMISING HEALTHY EATING HABITS

There’s nothing quite like a (hopefully) once-in-a-lifetime experience of a global pandemic to focus our attention on the status of our health, and the preventative benefits of a healthy lifestyle.  As rolling lockdowns have restricted our movements and options, and tightened our belts, we’ve had little choice but to adapt our shopping and exercise habits; and shift our cooking and eating patterns to meet the moment.  Now, in the midst of a third wave, many South Africans across economic spectrums are thinking more about how and what we eat; and wondering if our eating habits can help to protect our health in the face of COVID.


As Registered Dietitian and President of ADSA, (The Association for Dietetics in South Africa), Maria van der Merwe points out when it comes to preventative health, nutrition plays a bigger role than just immune support. “Good nutrition is essential for optimal health across our lifespans.  Meeting our changing nutritional needs from infancy through childhood and the teen years, through our adulthood into older age can not only help to increase resilience but helps us to manage our weight, prevent nutritional deficiencies and the development of a range of chronic health conditions.  If we do become ill, a balanced diet can help us fight acute health problems and aid in our recovery.”

So, how is the pandemic shaping our views and habits when it comes to daily eating?

Registered Dietitian, Dr. Nazeeia Sayed says, “Many South Africans are feeling the economic impacts of the pandemic such as rising food prices and reduced household incomes threatening their household’s food security.  With tighter budgets, you can still find affordable, healthy foods and achieve balanced meals.  Focusing on increasing your family’s intake of seasonal veg and fruits, whole-grain options like oats, as well as shifting to more plant protein sources such as beans and lentils in place of meat, will save money.  Healthy eating is within reach.  For instance, traditional foods such as samp and beans, or dahl and rice are tasty, affordable meals that can be supercharged with some extra veg or a salad.”

Many middle-income South Africans have increased their focus on nutritional supplements and so-called ‘functional foods’.  Nazeeia points out that, “With vitamins and minerals flying off the shelves, it’s important to note that’s there’s no scientific evidence that any particular food or nutritional supplement or diet that can prevent COVID or any other infections. Your best move is to stick with the healthy eating guidelines and ensure your family is enjoying a variety of foods every day.”

But what are functional foods?

Maria explains, “Also known as nutraceuticals, functional foods contain particular ingredients that offer health benefits that extend beyond their nutritional value. For example, these ingredients may protect against disease, prevent nutrient deficiencies, and promote proper growth and development. Some examples of functional foods include products enriched with vitamins, minerals, probiotics, or fibre; with each of these ingredients having a specific function. However, by their nature, nutrient-rich whole-foods like fruits, vegetables, nuts, seeds, and wholegrains can also be considered functional foods. For instance, whole-grains like oats and barley contain a type of fibre called beta glucan, which has been shown to reduce inflammation, enhance immune function, and improve heart health. Similarly, fruits and vegetables are packed with antioxidants, which are beneficial compounds that help protect against disease.  So, increasing your family’s access to functional foods in an affordable way is as simple as including more fresh vegetables and fruit, legumes and whole-grains in our daily meals.”


Should we make more home-cooking a keeper in this COVID world?

Most South Africans have cooked more at home over the past 18 months than ever before.  Nazeeia says, “Home cooking is great for many different reasons! If you involve the family, especially your children, it is a time to learn more about the food you eat – where it comes from and what it contains.  Home cooking inspires us to try new recipes, talk about healthy eating, and explore different global cuisines.  This is important modelling for the younger generation and assists in them establishing better eating habits that can last a lifetime. Many of us have access to the internet and you can learn to cook from watching videos, even if you have not done so before.”


Maria agrees, “Cooking at home, from scratch, allows us to use unprocessed or minimally processed foods – foods in their natural state – as the basis of our meals. When we cook our own meals, we can determine how much fat, salt and sugar, if any, are added during meal preparation. Unprocessed foods are more often than not, affordable ‘functional foods’ – nutrient dense and good sources of vitamins, minerals and fibre.”

What are the top dietitian tips for getting more preventative nutrition benefits on a tighter budget?

  • Focus on eating a variety of affordable foods so that you consume a wider spectrum of beneficial nutrients
  • Prioritise unprocessed foods, including seasonal vegetables and fruits, wholegrains, dried beans and lentils
  • Eat less take-out meals which are often high in salt and fats, and allocate this budget to whole-foods you can prepare at home
  • Replace drinks with added sugar including sodas, fruit, sports and energy drinks with lots of clean, safe water – you will be amazed at how much you will save on your food budget
  • Reduce your meat intake by focusing on more plant-based eating.  Inexpensive dried beans and lentils are tasty replacements in meat dishes, or they can be added as an extra ingredient to stretch out your meat-based meals
  • If meat options are becoming too expensive, shift to other more affordable animal-based protein sources such as eggs, maas and yoghurt
  • Plan your meals and plan your food shopping.  Look out for price specials and discounts.  Collaborate with your family, friends and neighbours so that you can collectively shop for cheaper bulk buying options. 
  • Grow your own – start a home or community veggie garden and increase your daily access to easy-to-grow veg such as spinach, kale and traditional greens such as marog, as well as onions, beans, beetroot, carrots and tomatoes

Meet the Dietitian: Community service series

By Chené Vorster


“Stay positive by staying negative.” – The main joke of 2020

I stumbled upon dietetics by accident and I have never looked back. A friend of mine stated that she wanted to become a dietitian and she was going to shadow them in the upcoming holidays. Curious about this unknown career and unsure about what I wanted to study, I decided to do the same. The moment I entered the ICU, I fell in love with dietetics. As the university years progressed along, I realised how big this field was and I was amazed by all the areas we work in. I studied at the University of Pretoria, the “Jakarandastad” gave me fond memories and the opportunity to work from Stanza Bopape CHC to Chris Hani Baragwanath Academic Hospital.

During the year 2020, I was busy completing my community service year at Thelle Mogoerane Regional Hospital – a 760-bed hospital in Vosloorus, Gauteng. The first three months of the year went well, I was fortunate enough to have another comserve walk this daunting road with me. I ran the medical and surgical wards and occasionally a paediatric ward – everything was going well. I will never forget when a colleague sent me the post with the caption “It’s here”. We had been following this covid-19 but was told it’s too hot in SA. On the 23rd of March, everything started to change. We tried not to panic but the lack of knowledge on this virus and protocols on its treatment, the implication of the lockdown and all the new rules were overwhelming. We can no longer eat together, we had to rotate offices to prevent overcrowding, insufficient PPE and the emotions were running high. We had to close down the OPD and ‘sneak’ out some packages to patients that were being turned away. The importance of a dietitian became very clear during the pandemic and our services were needed all around.

My wards shifted and I was now in charge of the covid PUI ward, medical wards and occasionally the covid wards. I was terrified to go in there, terrified to walk out – “What if I contracted it?”. The kangaroo pumps ran out and I was feeding patients myself from time to time. The pandemic wasn’t all bad though, I built fond relationships, learned how to dance to Jerusalema, gained so much knowledge and love what I do. I am forever grateful that I could fight on the frontlines.

My advice to those who are still fighting on the frontlines:
MDTs are very important. Befriend everyone – they are an excellent support structure!
Don’t be intimidated – you have a lot more knowledge than you think. If the opportunity arises, write a protocol or volunteer to assist in a difficult case. Your hard work will not go unnoticed.
Be kind, but don’t allow anyone to walk over you – if there’s a problem, sort it out immediately.
Stay positive by staying negative – wear your PPE, wash your hands and sanitize everything. Practice social distancing and be a role model in your community.


Roasted Tomato Soup

By Rhodene Oberholzer

Serves 4

Ingredients:

  • 6 Medium Tomatoes
  • 2 Small onions
  • 1 Green pepper
  • 2 Garlic cloves
  • 1 Cup cooked split red lentils
  • 500 ml Boiled water
  • 1 Tomato and onion stock cube
  • 1 Cup plain low-fat yoghurt
  • 1 Tablespoon tomato paste
  • 1 Teaspoon ground Cumin
  • 1 Teaspoon Turmeric
  • ½ Teaspoon Cayenne pepper
  • 1 Tablespoon Olive oil / Canola oil

Method:

  1. Pre-heat the oven to 180 °C.
  2. Chop the tomatoes, onions and green peppers into chunks and place, along with the garlic cloves, in an ovenproof dish. Drizzle with olive oil and place in the oven to roast for about 30 minutes until cooked.
  3. Place the tomatoes, peppers and onions in a pot and add the stock, tomato paste, cooked lentils, and spices. Heat the mixture and allow to simmer for about 10 minutes. Remove from heat.
  4. Blend with a hand blender until smooth.
  5. Add a small amount of the soup in a separate bowl and mix with yoghurt. Add the mixture to the rest of the soup and mix well. Allow to simmer for another 10-15 minutes.
  6. Serve with some black pepper, chilli flakes and fresh basil leaves.
  7. Enjoy!

Top tip:

Serve with a slice of 100% rye or seeded bread for that extra bit fibre.

We love it!

This recipe is packed with nutrients that can help to support your immune system and bursts with flavour. A perfect pick-me-up when appetite is low and you’re feeling a bit under the weather.

Dietitians say:

One serving of soup provides about 102% of the recommended intake for Vitamin C. It is also high in fibre to support gut health, as well as flavonoids that have antioxidant properties to help and protect our body against damage.

Nutrient analysis per serving

Energy: 940 kJ | CHO: 28 g (of which 18 g sugar) | Prot: 9.8 g | Fat: 4.9 g (of which 1 g sat fat) | Fibre: 7.2 g | Sodium: 480 mg


Date And Chickpea brownie bites

By Michelle Zietsman

Serves: Makes 14 date balls

Ingredients:

For the date balls

  • 1 cup dried dates, soaked in boiling water for 20 minutes and then drained
  • 1/2 cup rolled oats
  • 1 cup tinned chickpeas, rinsed well and drained
  • pinch of salt
  • 1 tablespoon shredded coconut
  • 1/2 cup cocoa powder

For the chocolate coating

  • 80 g dark chocolate slab
  • 1 teaspoon coconut oil


Method:

  1. Blend the oats in the food processor until it becomes oat flour.
  2. Add the dates and chickpeas and blend until smooth. Gradually add some water if the mixture is very stiff.
  3. Add the salt, coconut flakes and cocoa powder and blend until smooth.
  4. Roll into balls and let it set in the fridge.
  5. Melt the chocolate in the microwave and then add the coconut oil and combine.
  6. Coat your date balls with the melted chocolate by dipping it into the chocolate, covering it and removing it with a spoon.
  7. Place on a cutting board or large oven dish with wax paper.
  8. Let it set in the fridge and keep it stored in the fridge.

Top tip:

Sweet treats can definitely be part of a healthy diet and can be consumed on occasion and in moderation!

We love it!

Legumes, like chickpeas, are some of the most versatile, nutrient-dense and affordable foods to add to your meals and even treats!

This recipe is vegan friendly if vegan chocolate is used!

Dietitians say:

Legumes are concentrated sources of fibre and provide us with protein, iron and zinc without the saturated fat and cholesterol.

Nutrient analysis per serving

Energy: 465kJ | CHO: 15g (of which sugar 10.1g) | Prot: 2.9g | Fat:  3.5g (of which sat fat 1.9g) | Fibre: 3.2g | Sodium: 2mg