This busy lady needs no introduction, but just in case – meet ADSA President for the term 2021 – 2023, Maria van der Merwe! She is one of those inspiring people who has the biggest passion for dietetics and public health! We are blessed to have her at the steer of ADSA!
Tell us a bit more of yourself?
I stay in beautiful White River, a fairly small town north of Nelspruit, with my husband and 17 year old daughter. We share our household with two dogs, two dwarf rabbits and two chickens.
Why did you become a Registered Dietitian?
When I was in standard 8 (grade 10), my father had to undergo cardiac bypass surgery. After the surgery, he made some self-imposed changes to his diet – mostly consisting of very unappetising foods. I was convinced that there would be better ways to support health through dietary intake, which led me to profession of dietetics.
What would you have wanted to do if not Dietetics?
Where did you study (degree and/ or postgrad)
B.Dietetics at the University of Pretori and M.Nutrition, Stellenbosch University.
Where do you work and what does your job entail?
I am self-employed, working as a public health and nutrition consultant. My current work mostly involve a combination of research (as co-investigator in a multi-national research project applying participatory action methods), teaching, technical advice and support to organisations, project management and managing a small private practice.
Walk us through a day in your life?
While no two days are the same, a lot of my time is spent behind a desk and computer. Attending meetings, doing presentations, writing reports, academic writing, etc. At the practice, my two colleagues, Hanna and Kylie, mostly handle all patient consultations and outreach activities; I add my two-cents-worth where required.
What do you enjoy most about the work you do? What are the most satisfying moments?
Research field days are my favourite, when I get to visit the local community members and health workers in our research area. I enjoy teaching and facilitating workshops – engaging with people and sharing experiences.
What has been your career highlight?
It is a privilege to serve as the president of ADSA.
What are the most challenging aspects of your career?
Unpredictability. Being self-employed comes with challenges and the most stressful one for me is the unpredictability with regards to work and income security.
What is something that people don’t know about you?
I carry my heart on my sleeve, so if you have met me you probably know everything about me. I’m a bit of a bore, actually.
What are your favourite foods?
Anything with good flavour! I love the combination of lemongrass, ginger and garlic – making Thai cuisine a sure favourite.
What are the three things that you think people should stop saying when they meet a dietitian?
Can you help me lose weight (mostly females) / build muscles (mostly males)?
Don’t look at what I am eating!
Not saying but doing: spelling dietitian with a ‘c’!
Hi fellow dietitians, our lovely Exec PR lady Mrs Retha Harmse has kindly requested that we share some information about the branches with you guys, what a pleasure. My name is Megan Clarke and I am the ADSA KZN secretary, as such I feel it is my duty to rise to the challenge here (the other branch committee members are all very busy and important and killing it in their fields to have enough time).
Let’s start by introducing ourselves, we are a smallish committee of six members (although I know we are lucky to have even this many) established in our current form in May 2019. I think we work well as a group because we are all so different and we work in such a variety of different areas within the Dietetic profession that we can relate to many Dietitians in our province and hopefully beyond. I believe we are all enthused about what we do in our own ways and we enjoy spreading that to others when we can. As a newbie to this committee, I have honestly enjoyed how it has challenged me in a personal and professional capacity and I am thrilled that I get to work with a very cool bunch of women from so many different walks of life, plus too we get to pay only half the annual ADSA fee (a lesser-known perk of being on the committee).
So, here we go, in no specific order, but maybe by rank, we have:
Julie Perks (Jules), our amazing Chairlady. Julie is lucky to have the best of both worlds and works in both the private and public sector and brings new meaning to the word passionate (she picked a good new Surname, haha!). She is perfect for her role on the Branch Committee and loves to challenge and push us to be better and better. She is a woman who knows how to get things done! Julie is also a newish mom to a beautiful little breastfed bundle called Hannah.
Joanne Lerwick (Jo), is our wise Treasurer (an under-appreciated job) and has been on the committee forever (since well before I got involved at least). Jo is really a ‘Jack of all Traits’; she does Food Service, tutoring at UKZN, private work and lactation consulting specifically. Amongst all this she has also managed to raise two beautiful daughters.
Kelly Francis (Kels), holds the PR and Communications position, and she is our private practise guru with more than a few projects on the side. If I could sum her up in a word it would be #Kind. 😊 Kelly is also our newest mom to beautiful baby Paige and she brings a good balance to our lot. Kelly is on the Exec committee too!
Jandri Barnard (or Jan3 as her number plate says) is our overachieving CPD portfolio holder, she does mostly private work and Food Service consulting AND is busy with a PHD! Jandri is a quieter soul so I’ve not yet discovered all there is to know, but I do know she has a passion for quilting and brings a bit of Afrikaans culture to our group. She has been an ADSA spokesperson since 2017 and does freelance writing in-between for publications such as Media24 and On Tap magazine, amongst others!
Laurencia Govender (Lau) is our ever-trusty Sponsorship and Student Liaison holder and she is so so good at this job! Sometimes she gets us too many sponsors and we need to reign her in! My word for her must be #enthusiastic! She also finds time to be a lecturer at UKZN and has a real passion and way with her students. AND she has recently just completed her PHD 😊 Plus she brings some awesome Indian culture to the table. PS: She’s about to have a modern Zoom wedding to her hubby to be and was generous enough to invite our Committee to share in her joy!
And lastly there’s me, Meg, the one who gets to write it all down. I work in public service at a little hospital that really gets a bad rap. I have only recently learned to appreciate the work I do, and it is an amazing feeling. I’ve completed my Master’s through Stellenbosch University (whom I can highly recommend, sorry UKZN fans!) and ADSA really helped me to achieve this goal, which is what brought me to this committee, to give back and pay it forward.
Being on the ADSA committee has given me the chance to interact with some amazing women and I have learned so much in such a little time. The only drawback I can think of, of working in KZN is that we truly are blessed with a great climate and we must work when we would rather be outside enjoying it all!
Now, what to say about ADSA… In a word #Inspiring. Thank you ADSA for inspiring me and so many other professionals to love, appreciate and enjoy what we do, because that truly is EVERYTHING. I was lucky enough to be on the committee last year when our talented President Mrs Christine Taljaard-Krugell gave a speech at the ADSA Exec Road Show about Leadership in Nutrition, and wow that really opened some new doors for me. One of the things that stuck with me was when she said: “Be willing to do the jobs that nobody else wants to do” (Even if it means emptying the filter of the ‘Moerkoffie’ machine haha!) So now, and especially after 2020 with Covid, I have nothing but love for ADSA.
AND at the risk of rambling: My advice to us Dietitians “Learn to Love what you do, Get Excited, Learn more, Do more, Be more! Don’t compete but Build Each Other Up! Challenge yourselves, our work really is so so important and it’s our job and duty to show people that through doing 😊”
Adaption has been the name of the game for 2020. The ADSA Gauteng South branch is doing their best to adapt to these strange times.
The year started off as usual with a live hosted event in February. We were fully booked with a variety of advertisers to discuss all things on weight loss.
Lock down started and many of our committee’s plans came to a holt. We had the unfortunate luck of planning our next live event to cover clinical nutrition. With these practitioners being in the thick of things on the COVID-19 front line, we postponed this event. We were exhausted, emotionally drained and in survival mode. A CPD event was not a priority or a possibility. We were ignorant then on how long COVID-19 would grip the health system and how long restrictions would be in place. Our initial 1-month event postponement turned into several new dates and an eventual cancellation.
Our committee jumped onto the Zoom bandwagon and offered 3 online webinars. We learnt more about emotional eating, gut health and neurological conditions. For most of us the biggest learning curve was adapting to using online platforms. The committee needed to host large numbers of attendees, arrange multiple speakers at different locations, record sessions, run polls, and fix technical issues. Our committee rose to the occasion and hosted three very successful webinars.
These adaptions were made easier with great support from the ADSA community. The ADSA CPD officer guided us on the new rules to provide points online. ADSA Exec guided us on Zoom usage, new advertisers guides and more.
The ADSA Gauteng South committee were privileged to assist in arranging a video to support dietitians during the strain of COVID-19. A psychologist provided insights into coping with the emotional stresses of COVID-19. We were grateful to play a small role in uplifting the spirits of dietitians during a very difficult year.
This term our committee has been a full house with twelve eager committee members. They have all worked hard in providing CPD events, monthly newsletters and support to the ADSA community. I am truly thankful for their dedication and giving up their spare time to give back to dietitians.
The six weeks after childbirth, known as the post-partum period, is a vulnerable time for women and their infants. The impacts of the ongoing pandemic have only heightened concerns that new mothers in South Africa are able to access the care and resources they need as they step into motherhood. It’s not unusual for the need for post-partum follow-ups to extend for four to six months, especially in cases where there are physical and emotional issues and health complications. In South Africa, primary health care provides free services to pregnant and lactating mothers, as well as children under six years. Given the severe economic impact of the global pandemic, this access to post-partum care has become particularly important to the country’s new mothers.
As with pregnancy, nutrition is a particular focus of post-partum care. New mothers need the support to recover from the rigours of pregnancy and childbirth so that they can cope well with the different challenges presented by infant care. Exclusive breastfeeding, which means providing only breastmilk to the exclusion of water, tea, juice or food, from birth for the first six months of life, is crucial and requires ongoing support within the family and through community and healthcare connections.
According to ADSA (The Association for Dietetics in South Africa) spokesperson, Professor Lisanne du Plessis breastfeeding is not only the best source of food for babies; it is also a major cost saver for food-insecure families and a major immune support for vulnerable children. Therefore, we have to make sure during this COVID-19 time that our new moms are healthy and well-nourished. She says, “Mothers should try and eat a healthy balance of fresh, whole foods including carbohydrates from unrefined, whole grain starches; proteins from meat, eggs, fish, chicken, beans and legumes; healthy fats; fruit and vegetables as well as dairy that
supplies vitamins and minerals. They should try to avoid fast foods and other ultra-processed foods that are high in salt, sugar, preservatives, and unhealthy fats. It is interesting to note that breastfeeding moms need around 500 additional calories daily, which equates to an extra snack such as a wholewheat bread sandwich with cheese or peanut butter; one to two glasses of milk, and an extra vegetable plus a fruit. What is most important is a focus on fresh and whole foods. New moms who are battling currently with household food insecurity need to raise this issue with their primary health care providers and get connected to a community-based or non-profit initiative which supports families through food parcel or other food security programmes.
When it comes to nutrition, post-partum care and breastfeeding, some of the same pregnancy restrictions should continue. Prof du Plessis says, “Limit coffee drinking to just one cup a day, avoid other drinks and snacks that contain caffeine, and keep avoiding cigarettes and alcohol.”
An issue for many new moms is managing the weight they gained through pregnancy. Another Registered Dietitian and ADSA spokesperson, Cath Day says, “Don’t rush it. Don’t worry about how much you weigh for at least the first six weeks after the birth of your baby. During this time, concentrate on eating fresh and minimally processed food. Focus on your support system and on getting enough rest. Once you have healed from childbirth and established a good breastmilk supply, you can begin to think about getting your body back. Go slow, do what you can, and be kind to yourself. If you are not back to your pre-pregnancy weight by six months, then you can start looking at your diet and exercise regime. Remember, it took you 9 months to gain the extra weight, so give yourself enough time.”
As disruptive as the pandemic has been, and how it has shaped many women’s experience of pregnancy, childbirth, and new motherhood, what’s important to remember is that COVID-19 has not changed the essentials of bringing a new life into the world. Moms need the same as they always have. They need support and encouragement from their families and friends. They need access to good, fresh foods. They need easy access to quality healthcare and professional support when needed. Day says, “There is currently no evidence to suggest that pregnant women and new mothers need to adapt their nutrition specifically in response to COVID-19. Pregnant mothers and new mothers should concentrate on eating a healthy and well-balanced diet made up of minimally processed and fresh foods such as wholegrains, legumes, nuts and seeds, plenty of fruit and vegetables, lean proteins, and plant-based oils. Combat stress with a healthy, balanced diet along with enough sleep and exercise. Consider stress management techniques such as walking, deep breathing, meditation, yoga or Pilates. It is really important that if mothers require nutrition and food support, there are various government, non-government and community-based programmes providing food parcels and other social relief.”
Prof du Plessis adds: “Although everyone is encouraged to stay at home with COVID-19 regulations in place, it is important that new mothers continue to go for their check-ups and take their babies for routine immunizations and follow-up clinic visits, according to the schedule in the Road to Health booklet. During these visits, mothers should ask questions about their health and their children’s growth, health, and nutrition. They should also request breastfeeding support if they are experiencing challenges to their goal of breastfeeding exclusively for the first six months. The pandemic has not changed the essentials of life, and post-partum maternal and infant health remains a high priority in our country.”
Nutrition and immune health has become a popular topic in 2020. Aside from Tiger King: Murder, Mayhem and Madness, another google search of interest was that of immunity and how one could stop themselves from contracting the virus. Terms such as ‘vitamin C’, ‘immune system boosters’, and ‘dietary supplements’ were searched on google up to 5000% more times in March 2020 than in previous months.1-3While this interest in nutrition and immune health is exciting to us, some information found on the internet may be rather misleading.
So, let’s try and clarify a few things!
Research has shown that a healthy, well-balanced diet can help strengthen the immune system. Does this mean that good nutrition can prevent you from contracting viruses like COVID-19? Not necessarily – viruses like these are incredibly infectious, meaning any one of us, well-nourished or malnourished, can contract it. But what it doesmean is that you can help prepare your immune system by maintaining a good nutritional status, thus potentially improving your outcomes should you contract an infection. And what better way to help strengthen the immune system than through food!
Certain nutrients have come under the limelight because of their abilities to improve immune health. These nutrients include: Vitamin C, Vitamin D, Vitamin A, Vitamin E, Zinc, Selenium, Omega-3 fatty aids and dietary fibre.
Vitamin C
Vitamin C has been shown to be protective against infectious diseases, particularly respiratory ones such as pneumonia and tuberculosis. It acts as an antioxidant, which helps protects our cells from oxidative damage, as well as an anti-histamine, which can help improve flu-like symptoms.4,5
Vitamin D
The vitamin that has created the most buzz in the scientific realm in recent months has been Vitamin D. It works as an anti-inflammatory and can reduce the severity of viral infections, particularly respiratory infections. Vitamin D is unique in that it can be synthesised by our skin when we are exposed to sunlight. 4,5,6 Fifteen to thirty minutes of sunshine everyday can do you wonders, just remember to protect your skin.
Vitamin A
Vitamin A deficiency has been associated with an increased risk of infection. Vitamin A helps with the growth of our immune cells, protecting us from illness and infection.5
Vitamin E
Vitamin E, like vitamin C, is an antioxidant and helps improve our bodies antibody response to infection.4,5
Zinc
Zinc is a mineral that acts as an anti-viral and helps recruit immune cells in the body to help fight infection.4,5 It is important for wound healing and can even improve the symptoms of a common cold.
Selenium
Selenium, also a mineral, help support the immune system as an antioxidant, which might provide protective effects against some types of cancer.7 Selenium deficiency has been associated with viral infections such as influenza.5
Omega-3 fatty acids
Omega-3 fatty acids are considered ‘healthy fats’ as they improve the healthy cholesterol levels in the blood. Omega-3 has both anti-inflammatory and antioxidant properties. 4,5
Dietary Fibre
Fibre is often overlooked. We always say, ‘less fat’ or ‘less sugar’, but sometimes we forget to say MORE FIBRE. Fibre gets fermented by the good bacteria in our gut, and the products of this fermentation have anti-inflammatory actions that can help improve our immune health.5,8 So not only does fibre help regulate our bowel movements, it also improves our immune health!
Nutrient
Benefit
Examples of Food Sources
Vitamin C
Antioxidant and antihistamine
Fruits and vegetables namely: Red and Green peppers Citrus fruits (oranges, grapefruit) Kiwi Tomato
Vitamin D
Anti-inflammatory
Fish Eggs Fortified milk Mushrooms
Vitamin A
Growth of immune cells and protection from illness and infection.
Carrots Spinach or kale Liver (beef and chicken) Eggs
Vitamin E
Antioxidant and improves immune response to infection
Nuts (almonds, hazelnuts, peanuts), Sunflower seeds Plant oils (sunflower, soya, corn, olive) Wheat germ found in cereal products Broccoli Blueberries
Zinc
Anti-viral and helps recruit immune cells to fight infection
Red meat and Poultry Oysters Dairy products Whole grains Beans Nuts
Selenium
Antioxidant
Nuts Whole grains Cereals Mushrooms Dairy products Poultry, Red meat and Seafood
Fermentation of fibre in the gut provides products that help strengthen the immune system
Whole grains Fruits Vegetables Legumes
Supplements: to buy or not to buy?
Our first choice of obtaining vitamins and minerals should be through food. A healthy and well-balanced diet will help you get the right nutrients that you need to help improve the functioning of your immune system. So no, you don’t have to sip on dissolved vitamin C effervescent tablets like they’re wine on a Friday night.
Vitamins and supplements are there for those who are deficient or are not meeting their nutritional demands. This could be for various reasons, such as disease, allergies, intolerances, or dietary preferences that cause you to avoid certain foods. Pregnant or lactating women, young children or the elderly may also need to use them. In these instances, the use of vitamins or supplements could be useful. If you are worried that you may need a nutritional supplement, you should discuss this with your doctor and dietitian first.9
The reasons for consulting your healthcare professional before choosing and purchasing supplements are five-fold9:
Vitamins may not be necessary as you may be able to meet your needs through food alone. Food has benefits that supplements do not have and should always be the first option.
Vitamins and supplements can be very expensive. Why put a dent in your budget if it is not necessary?
Some supplements on the market are advertised as doing magical things to boost your immune system, without scientific evidence to back their claims. A dietitian will be able to do the necessary research to help you identify which supplements to get – that is, if you even need them.
Taking vitamins in excess of what you need may be doing more harm than good.
Some vitamins or supplements may interfere with certain medications and may be unsafe for you if you suffer from a medical condition.
In a nutshell, to help strengthen your immune system enjoy a variety of whole foods (those that are not processed, high in fat or sugar), drink clean and safe water, practice healthy eating habits and get some well-deserved SLEEP.
The theme for this year’s National Nutrition and Obesity week was Good Nutrition for Good Immunity. For more information about nutrition and immune health, please visit https://www.nutritionweek.co.za
Fighting a virus is your bodies equivalent of going to war. So, make sure it has the right weapons to use, like a well-functioning immune system.
Shakoor, H., Feehan, J., Al Dhaheri, A., Ali, H., Platat, C., Ismail, L., Apostolopoulos, V. and Stojanovska, L., 2020. Immune-boosting role of vitamins D, C, E, zinc, selenium and omega-3 fatty acids: Could they help against COVID-19?. Maturitas, 143, pp.1-9.
Iddir, M., Brito, A., Dingeo, G., Fernandez Del Campo, S., Samouda, H., La Frano, M. and Bohn, T., 2020. Strengthening the Immune System and Reducing Inflammation and Oxidative Stress through Diet and Nutrition: Considerations during the COVID-19 Crisis. Nutrients, 12(6), p.1562.
Wu, D., Lewis, E., Pae, M. and Meydani, S., 2019. Nutritional Modulation of Immune Function: Analysis of Evidence, Mechanisms, and Clinical Relevance. Frontiers in Immunology, 9.
Mahan LK, Raymond JL. Food & the nutrition care process. 14th ed. Seattle, WA: Elsevier; 2017
Valdes, A., Walter, J., Segal, E. and Spector, T., 2018. Role of the gut microbiota in nutrition and health. BMJ, p.k2179.
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