Meet the Dietitian: Philna Eksteen
Philna Eksteen serves on the ADSA Executive Committee 2021 – 2023 in the Portfolio CPD (Continuous Professional Development). Read on to get to know her better!
- Tell us a bit more of yourself?
I was born, raised and went school and university (North West University – NWU) in Potchefstroom. Having a father as a lecturer at the university and a mother as a school teacher, I know very early in my life that would like to be ‘some form of teacher’, later it became clear to me that I would like to work with students at a university. I am therefore very fortunate to have been involved in academics as a registered dietitian in the training of dietetic students for the last 25 years, at first at SMU (Pretoria) and the last 10 years at NWU (Potchefstroom).
- Why did you become a Registered Dietitian?
As a student, I first enrolled for Home Economics (now known as Consumer Sciences). I did ballet and modern dance for many years and continued with it into my student years. This created a natural interest in general health and fitness and triggered as much bigger passion for evidence-based nutrition, leading to me changing my studies to Dietetics already early in my 1st years at the university. With more studies, I learnt that general health & fitness and weight management are only very small components of the scope of dietetic practice. Since I also seriously considered studying medicine at a point in time, medical nutrition therapy and the difference we a registered dietitians can make in the life of patients and clients, made a big impact on me.
- What would you have wanted to do if not Dietetics?
Becoming a medical doctor or an accountant.
- Where did you study (degree and/ or postgraduate)?
- BSc Dietetics (1992) and BSc Honours (Dietetics) (1993) degrees – North West University (NWU), Potchefstroom Campus
- Post-graduate Diploma in Hospital Dietetics (1995) – at University of Pretoria (UP)
- MSc (Dietetics) degree (2014) – NWU (Potchefstroom Campus)
- Where do you work and what does your job entail?
From 2010, I have been working at the NWU, Potchefstroom in the Dietetics department, mainly as a lecturer & the internship coordinator of the 4th year Dietetics students, travelling to students at training facilities, evaluating and supporting them and ensuring quality control of the internship training.
- Walk us through a day in your life?
Not one day is the same, depending on where I need to do visits to and evaluate my students in the internship – hospitals, various community settings or foodservice units. A day when visits are not required will be typically spent at the office, managing admin and other academic duties.
- What do you enjoy most about the work you do? What are the most satisfying moments?
Working with my students and encouraging them to do their best and becoming the best young dietitian they can be. Nothing is more satisfying when students improve on their performance with hard work and dedication, and receiving positive reports from training personnel.
- What has been your career highlight?
- Every year bring highlights, especially when the 4th year Dietetic students graduate
- Obtaining my MSc in Dietetics and publishing my 1st article
- Serving my profession by serving on ADSA branch committees (NW and Pretoria) in several portfolios and also several terms as chairlady
- Serving my profession by serving on the ADSA executive committee (terms 2009 – 2011 and 2011 – 2013 in the membership portfolio and also, the current term 2021 – 2023 in the CPD portfolio)
- What are the most challenging aspects of your career?
Act as a go-between my students and dietetic internship training personnel, always having to have an open ear, mind and heart for both parties, not judging either side too quickly and facilitating good communication between the parties involved to ensure quality training of the students. And also, not getting angry too quickly about incompetent individuals in my profession.
- What is something that people don’t know about you?
I am a dancer in my heart, doing ballet for most of my young life as a child, young girl and student. I love music and also want to dance when I hear good music.
- What are your favourite foods?
Salads, eggs, pasta, pizza and seafood dishes
- What are the three things that you think people should stop saying when they meet a dietitian?
“Hey, maybe you should work out a diet for me, then I will lose weight!”
“I should actually not eat this in front of you”
“Have you heard about this …….. (newest fad) diet? It really works!!”
Meet the Dietitian: Alta Kloppers
You might have heard the name Alta Kloppers. She serves on the ADSA Executive Committee from 2019 – 2023 in the Private Practicing Dietitian portfolio. Do yourself a favour and get to know them better!
- Tell us a bit more of yourself?
I was born more than a half century ago at one of the hospitals where I currently run a practice, at that time known as the Glynnwood Nursing Home in Benoni. I was also schooled and lived on the East Rand all my life. I obtained a B Dietetics degree as well as Post Graduate Diploma in Hospital Dietetics from the University of Pretoria and recently completed a M Sc Dietetics degree from the University of the Free State. I have been a PPD for 27year.
In December, I will be married for 33 years. We have a beautiful 23year old son that makes us very proud.
- Why did you become a Registered Dietitian?
I wanted to become a pharmacist all my life. When I was not accepted to study pharmacology, (those years there were no 2nd and 3rd choices) – I paged through possible courses and noted that a certain course included pharmacology as subject in the third year. I paged back and saw that it was the B Dietetics course and immediately decided that this is what I want to do.
- What would you have wanted to do if not Dietetics?
30 years ago, a pharmacist, now… I can’t imagine being anything other than a dietitian.
- Where did you study (degree and/ or postgrad)
UP
- Where do you work and what does your job entail?
My practice is based in Alberton and Benoni. My personal special interest is critical care, food allergies as well renal. I work with a team of passionate dietitians. Besides consulting my own patients, I love mentoring and teaching the younger dietitians in my practice. I also enjoy running my own business and the challenges that it entails.
- What do you enjoy most about the work you do? What are the most satisfying moments?
I love teaching. I enjoy most to be able to “connect” with a patient during a session and observing the “aha moments” in their eyes, regardless, if it is explaining to a weak ICU patient why they need additional supplementation or an insulin resistant patient grasping that they actually do need carbohydrates. I also love it when young dietitians show a true passion for the profession and being able to mentor them to the best of my ability.
- What has been your career highlight?
I know it sounds boring but obtaining my Masters.
- What are the most challenging aspects of your career?
Running my practice like a business.
- What is something that people don’t know about you?
I am determined to learn how to ride a horse at my mature age. I can’t ride a horse but I am determined to learn how to do it and do it well when I can make the time to do so!
- What are your favourite foods?
“Skaaptjoppie met n stukkie vet aan”
- What are the three things that you think people should stop saying when they meet a dietitian?
Start telling me what they eat
Telling me they “don’t do carbs” without even knowing what carbohydrates are
Changing “people” to “nursing staff” – what is for lunch today?
Meet the Dietitian: Cindy Chin
Get to know Cindy Chin, who serves on the ADSA Executive Committee 2021 – 2023 in the Communications portfolio (and she is the Woolworths dietitian)!
- Tell us a bit more of yourself?
I live in Cape Town, I have two beautiful daughters (almost both teens) and an amazing husband. I enjoy experimenting in the kitchen with new recipes and ingredients, and gardening when I have the time!
- Why did you become a Registered Dietitian?
I’m passionate about helping people to improve their diet and lifestyle.
I love the science of nutrition and the psychology of eating.
I love food (most types).
- What would you have wanted to do if not Dietetics?
Accounting, but I can’t imagine myself doing that today!
- Where did you study (degree and/ or postgrad)
Wits (BSc undergrad), UCT (BSc Hons Nutr & Diet), Stellenbosch (MSc Ther Nutr) (almost finished!)
- Where do you work and what does your job entail?
Woolworths Foods. As the Nutrition manager, my role is to inform, direct and enable the delivery of the nutrition strategy across the foods business, through science-based nutritional expertise, strategic partnerships and thought leadership.
- Walk us through a day in your life?
No day is the same but it usually entails a mixture of responding to emails and attending virtual meetings that are comprised of giving guidance to product teams, providing strategic input into various initiatives, presenting nutrition insights and training, signing off marketing comms, writing/reviewing nutritional guidelines, scanning research and attending webinars to stay up-skilled.
- What do you enjoy most about the work you do? What are the most satisfying moments?
Making a difference to the nutritional quality of the foods people purchase, challenging better product development, the privilege of setting and driving nutritional standards for a major food retailer
- What has been your career highlight?
I would have to say that travelling internationally with colleagues has probably been a career highlight. Experiencing good food with foodie fanatics is highly recommended!
- What are the most challenging aspects of your career?
Influencing and negotiating in a commercial environment; translating complex scientific information into a retail-specific context; dispelling pseudoscience
- What is something that people don’t know about you?
I like imagining a futuristic world so enjoy science fiction/fantasy books and movies like Lord of the Rings, Marvel, and reading the classics like Charles Dickens and Jane Austen.
- What are your favourite foods?
I love almost all types of foods, but Cantonese cuisine is my favourite.
- What are the three things that you think people should stop saying when they meet a dietitian?
- Is this healthy? (points at their plate of food)
- What do you think about *insert latest fad diet name*?
- I hope the dietitian approves.
Meet the Dietitian: Fatima Hoosen
We had a chat with Fatima Hoosen, who serves on the ADSA Executive Committee 2021 – 2023 in the Ad Hoc portfolio. Read on to get to know her better!
- Tell us a bit more of yourself?
My name is Fatima Hoosen, I am from Cape Town, married and a mom of 4 with ages ranging from 16 to 4 years old.
- Why did you become a Registered Dietitian?
I met a dietitian when I was about 16 years old. She told me about dietetics and I was immediately interested in the career. I then researched the profession and where to study the course. My dad was not keen on this course and encouraged me to study something else – I did one year of BSc (general) and then secretly applied for the course for the following year…and the rest is history!
- What would you have wanted to do if not Dietetics?
I think teaching may have appealed to me – I enjoy working with young people.
- Where did you study (degree and/ or postgrad)
I did my undergrad at the University of the Western Cape, my masters at Stellenbosch University and currently completing my PhD at the University of Cape Town.
- Where do you work and what does your job entail?
At present I am a full-time PhD candidate, however I was clinical educator at UCT prior to this.
- What do you enjoy most about the work you do? What are the most satisfying moments?
I enjoy working with people and being of assistance. When working with patients it is very satisfying when the desired outcomes for the patient are achieved. When I am working with students – it is extremely satisfying to see them grow and develop into qualified dietitians and later into leaders in the field.
- What has been your career highlight?
Working in the UK has always been special to me. I initially worked as a clinical dietitian but when I went abroad for the second time I worked as a community dietitian working in various multidisciplinary teams. Another highlight was when I was awarded an internship at the South African Medical Research Council to focus on my PhD.
- What are the most challenging aspects of your career?
My PhD is focused on behaviour change and I think understanding human behaviour and successfully implementing behaviour change can be extremely challenging for any dietitian. The trick is to make small changes which are easy to implement.
- What is something that people don’t know about you?
I enjoy large scale cooking and have done so on a few occasions for people – like family weddings. I also recently discovered that I enjoy gardening. I have successfully planted quite a few rose trees and now I am trying my hand at some fruit trees.
- What are your favourite foods?
I enjoy most foods but really enjoy seafood and pasta the most and any dish that my mom has made.
- What are the three things that you think people should stop saying when they meet a dietitian?
‘You know I have been trying to lose weight but …’
‘I don’t usually eat this but this is a treat today’
‘I am sure that you would never eat chocolate’
ROAST RED PEPPER PASTA
By Megan Clarke
Serves 4
Ingredients:
- 400g cooked fusilli pasta
- 2 red peppers
- 2 cloves garlic
- 1 brown onion
- 1 block (350g) tofu
- 1 tin (450g) chopped tomato/ tomato puree
- 2 Tbsp Olive oil
- 1 tsp chilli flakes (optional)
- Salt and pepper to taste
Method:
- Cut the red peppers in half length-ways and deseed. Place on an oven tray and drizzle with olive oil. Roast at 180°C until skins are blistering.
- Chop garlic and onion and sauté in a frying pan until onions are translucent.
- Place the roasted peppers, onions and garlic, block of tofu, tinned tomatoes and seasoning in a blender or food processor and blend until pureed.
- Serve with whole wheat pasta of choice.
Nutrient analysis per serving:
1358kJ energy, 45g carbohydrate (of which 7.5g sugar), 16g protein, 10g fat (of which 1.2g saturated fat), 8g fibre, 236mg sodium.
We love it!
This recipe is plant based, high in fibre, low in fat and salt and a good source of vitamin C.
Dietitians say:
Fibre promotes gut health, aids in blood sugar control, and helps prevent certain cancers.
Top tip: red peppers are packed with Vitamin C to support the immune system.
Meet the Dietitian: Nireshnee Reddy
Nireshnee Reddy is a registered dietitian and serves on the ADSA Executive Committee 2021 – 2023 in the portfolio Public Sector. We thought it well to meet up with her and get to know her a bit better.
- Tell us a bit more of yourself?
I’m 39 years old, wife to my high school sweetheart, Prean and mum to 2 amazing kids (Kiara and Kaelen). We have a dog, and 2 chickens J I love spending time with my family and am passionate about Indian classical dance and music. I enjoy doing social work that involves children. I love birthdays as I feel it a great opportunity to celebrate a person’s uniqueness and contribution to this world!
- Why did you become a Registered Dietitian?
In high school, I had to do a research project and chose to do the impact of the Indian diet on blood glucose control in diabetics compared to the impact of Western diet on blood glucose control in support of my mum who was diabetic for 15 odd years at that time. It was then that I met dietitians (Phumelele Mthembu and Chantell Witten) for the first time, and they inspired me to do dietetics.
- What would you have wanted to do if not Dietetics?
Medical Doctor
- Where did you study (degree and/ or postgrad)
Proudly UKZN (Undergrad and Masters)
- Where do you work and what does your job entail?
KZN Department of Health – Assistant Director Nutrition at the Provincial Office
We provide technical support to other government departments, districts in KZN, and health facilities. We develop guidelines and policies that support the implementation of the Integrated Nutrition Programme.
- Walk us through a day in your life?
It really does vary and could start at 5am (when travelling to far away districts) and end at 11pm completing reports or driving back home. There are amazing days of working with clinics and outreach staff to deliver nutrition services, and there are long board room days strategizing and planning. There are then office days of admin, and reviewing reports, and hospital days of clinical audits and monitoring. In summary no 2 days are the same.
- What do you enjoy most about the work you do? What are the most satisfying moments?
Developing and implementing interventions that brings about positive change gives me gratitude and appreciation for being in the field of nutrition. Dietetics is dynamic and vast and there is so much we can do, even with little. Having the opportunity to support and mentor younger dietitians also gives me joy, for as much as they develop I also learn from them along the way.
- What has been your career highlight?
Completing my Master’s degree whilst working full time in a demanding job, taking care of my family and living life. It felt impossible at times and I felt like giving up.
- What are the most challenging aspects of your career?
At times the fruits of your labour are also dependent on bigger systems and challenges beyond your control.
- What is something that people don’t know about you?
I am able to read, write and speak in my mother tongue (Tamil – a South Indian tamil language) and
I’m also a qualified Bharatha Natyam (South Indian classical) dancer, although a bit rusty now.
- What are your favourite foods?
Sushi & crab curry
- What are the three things that you think people should stop saying when they meet a dietitian?
Can I have a diet sheet?
Don’t look at what I’m eating.
You must cook very healthy things at home
SWEET POTATO AND OAT MUFFINS
By Kelly Francis
Ingredients:
- 1 cup mashed sweet potato (roasted)
- 1/2 cup canola oil
- 2 whole eggs, large
- 1/2 cup plain, fat free yoghurt
- 1 teaspoon vanilla essence
- 1/3 cup brown sugar
- 2 cups oat flour
- 1 teaspoon baking powder
- 1/2 teaspoon baking soda
- 1/4 teaspoon salt
- 1 teaspoon cinnamon
Method:
- Preheat the oven to 180°C and line a muffin tray with paper cups
- Make oat flour by grinding rolled oats until fine. Measure 2 cups after grinding.
- Add the sweet potato, the oil, eggs, yoghurt and vanilla into a large bowl and whisk to combine
- In a separate bowl, mix the sugar, oat flour, baking powder, baking soda, salt and cinnamon
- Add the dry ingredient mixture to the wet mixture and stir until combined
- Spoon the mixture into 12 paper muffin cups and bake for 20 – 25 minutes until a skewer comes out clean.
Nutrient analysis per serving
Energy: 287kJ | CHO: 21.7g (of which sugar 4.5g) | Prot: 3.95g | Fat: 21.3g (of which sat fat 3.8g) | Fibre: 2.5g | Sodium: 257.4mg
We love it:
This recipe is easy to prepare, stores well and is perfect for on-the-go, one-handed snacking while breastfeeding or carrying a baby!
Dietitians say:
Both sweet potato and oats are nutrient dense sources of fibre which make them a perfect substitute for white flour. Nutrient density is important for busy moms.
Top tip: The mixture is stickier than a traditional muffin recipe
MELANZANE
By: Mico Price
Serves: 4 people
Ingredients:
- 3 – 4 aubergines
- 2 tins chopped pureed tomatoes
- 1 tsp crushed garlic or 2 garlic cloves, crushed
- 2 tsp dried oregano
- 1 tablespoon balsamic vinegar
- 2 tsp sugar
- Salt & pepper to taste
- 15 ml olive oil
- 1/4 cup breadcrumbs or Parmesan cheese
White sauce
- 2 tbsp margarine
- 2 tbsp flour
- 400 ml low fat milk
- Salt & pepper to taste
Method:
- Slice the aubergines into 1cm discs, place on a tray and sprinkle with coarse salt. Leave to stand for 30 minutes. Rinse and pat dry with paper towel.
- Combine the tinned tomatoes, garlic, oregano, balsamic vinegar and sugar in a saucepan and simmer for 20-30 minutes until sweet. Season with salt and pepper to taste.
- Heat the olive oil in a pan and lightly cook the aubergines on each side. Set aside.
- Prepare the white sauce. Melt the margarine in a saucepan. Add the flour to make a paste. Whisk in the milk a little at a time until the sauce thickens. Flavour with salt and pepper to taste.
- This dish can be made on a stove top or in the oven. Select an oven proof casserole dish or a large frying pan.
- Place a small amount of the tomato sauce in the bottom of the dish. Place a layer of the aubergine slices on the sauce.
- Alternate layers of tomato sauce and aubergine, finishing off with a tomato sauce layer.
- Pour the white sauce over and sprinkle with the breadcrumbs or parmesan.
- Bake in the oven at 180°C for 30-40 minutes or simmer lightly on the stove top for 40 – 50 minutes.
Nutrient analysis per serving:
Energy: 1449kJ | CHO: 53.7g (of which 19.8sugar) | Prot: 12.1g | Fat: 12g (of which 5 mg cholesterol) | Fibre: 18.7g
We love it:
People are often nervous to try aubergines but this is a delicious way to serve it. It can be served as a main dish or used as a side dish
Dietitians say:
This recipe is a delicious vegetarian dish which is suitable for diabetics as it has a low glycaemic index and contains small amounts of added sugar.
Top tip: This recipe can be made on the stovetop or in the oven, choose an oven proof dish or large frying pan.
STRAWBERRY CHICKEN SALAD
By: Mariska Barnard
Serves: 2 portions
Ingredients:
Chicken:
- 120 g Chicken breast fillet
- 1 tsp Olive oil
- Chicken spice to taste
Salad:
- 1 cup Baby spinach
- ½ cup Cucumber
- ¼ medium Avocado
- ¾ cup Strawberries
- ¼ cup Mozzarella cheese
- 10 g Cashews, unsalted
- 1 tsp Balsamic vinegar
- Salt and pepper to taste
Method:
- Grill chicken in oven with olive oil and chicken spice until cooked.
- Cut cucumber into quarter circles, dice up the avocado in blocks and slice up the strawberries into quarters.
- Cut the mozzarella cheese into blocks.
- Wash baby spinach if needed.
- After chicken has cooled down, slice into pieces as well.
- Put all ingredients together and drizzle some Balsamic vinegar over the salad.
We love it!
This recipe can be easily changed into a side dish by removing the chicken and dividing it into smaller servings.
Dietitians say:
Cashews contains Omega 3 fatty acids, a heart healthy fat, which has been shown to lower blood pressure, reduce chances of stroke and heart attack and is anti-inflammatory.
Top tip: To check if chicken is cooked through, cut into it and make sure the juice is clear!
Nutrient analysis per serving:
Energy: 1009 kJ | Carbohydrates: 5.3 g (of which 4.3 g sugar) | Protein: 24.3 g |
Fat: 12.9 g | Fibre: 3 g | Sodium: 389 mg
VEGETABLE PASTA
By: Mico Price
Serves: 4-6 people
Ingredients:
- 1 punnet or 250g mushrooms, quartered
- ½ – 1 pepper, chopped
- 6 cups chopped spinach or baby spinach leaves
- Olives, pitted
- Sundried tomatoes (in olive oil/rehydrate in warm water for 30 minutes or until soft)
- 1 aubergine
- 1 tsp crushed garlic or 2 garlic cloves, chopped finely
- 1 tbsp olive oil
- Salt and pepper to taste
- Any pasta of your preference.
Method:
- Slice the aubergine into 1cm thick discs.
- Place on a tray and sprinkle with coarse salt. Set for 30 minutes. Rinse and pat dry with a paper towel. Cut into cubes.
- In a large frying pan, heat the olive oil and add the crushed garlic, chopped aubergine, mushrooms and pepper and fry until soft and cooked.
- Add salt and pepper to taste.
- Add the spinach and cover with a lid until the spinach is soft. About 5-10 minutes.
- Stir in the sundried tomatoes and olives and allow to cook for 5 minutes.
- Boil the pasta. Retain some of the pasta water.
- Add the pasta to the cooked veggies and cook for a further 5 minutes. If you prefer your pasta to be saucier add some of the pasta water that was retained.
- Season as needed.
Nutrient analysis per serving:
Energy: 1239kJ | CHO: 50.2g (of which 0.8 g sugar) | Prot: 11.8 g | Fat: 5g(of which 61 mg cholesterol) | Fibre: 2.6g
We love it:
This is a very versatile plant based recipe and you can add a lean protein source of your choice. Kids love it too!
Dietitians say:
This recipe is very low in total fat, which makes it suitable for people with chronic lifestyle diseases such as heart disease, diabetes and hypertension.
COCONUT CHICKEN CURRY
By Tharien Bezuidenhout
Serves 6
Ingredients:
- ½ Onion – finely chopped
- 1 Garlic clove – finely minced
- 2 tsp Olive oil
- 2 tsp Curry masala
- 2 tsp Turmeric
- 1 tsp Cumin
- 1 tsp Coriander
- ½ tsp Cinnamon
- 1 tsp Mustard seeds
- 1 Thumbnail fresh ginger – finely grated
- 2 Red chillies – deseeded (optional)
- 2 Tbsp Chutney
- 1 Tbsp Lemon juice
- 600g Skinless Chicken Breasts – cut into small strips
- ¼ cup Lentils – dried
- ½ tin (120g) drained Chickpeas
- ½ tin (200ml) Coconut milk
- 5-6 Carrots – julienne strips
- ½ tsp Salt and Pepper to taste
Method
- Sauté onion and garlic in olive oil until soft and translucent over medium heat.
- Add all spices to onion mix and sauté for another 3-4 minutes. The mix will be dry.
- Add fresh ginger and chilies.
- Add chutney and lemon juice. Deglaze pot with ¼ cup water.
- Add chicken strips and cook through.
- Add dried lentils, chickpeas and coconut milk.
- Season with salt and pepper.
- Add carrots and simmer for 60 minutes over medium heat for the best flavour.
- Serve with ½ cup brown rice or ½ cup whole-wheat couscous.
- Garnish with fresh tomato and desiccated coconut.
Nutrient analysis per serving:
Energy: 311 Kcal | CHO: 14.9g (of which sugar 7.4g) | Prot: 34g | Fat: 9.2g (of which sat fat 4.8) | Fibre: 3.9g | Sodium: 297mg
We love it:
This recipe is delicious, packed with flavour, healthy with many benefits from all the spices. Keep a couple of portions in your deep freeze for an easy meal.
Dietitians say:
Capsaicin – the component that gives chillies their heat has anti-inflammatory, antioxidant, anti-cancer and blood glucose regulating effects.
Top tip: Legumes are high in Fibre and can significantly lower the risk of heart disease
Meet the Dietitian: Michelle Zietsman
Michelle Zietsman serves on the ADSA Executive Committee 2021 – 2023 in the Representation portfolio (and she serves as chair of our ADSA Pretoria branch). We thought it well to meet up with her and get to know her a bit better.
Tell us a bit more of yourself?
My name is Michelle Zietsman and I am 27 years young. I live in Pretoria with my amazing husband Mauritz, who is a Youth Pastor at Every Nation Hennopspark. We have two fur babies (pugs), Britney and Bruno. Bruno was named after my husband’s favourite Manchester United soccer player, Bruno Fernandez. I have one older sister who is an engineer and always helps me with my excel spreadsheets as I just cannot get the hang of it. My sister and I are extremely close, although she is moving to the Netherlands at the end of the year so I will miss her dearly. But luckily, we will get to visit them and get to explore the beautiful country. We are a very close family. My parents live in Cape Town so we try to visit them as often as we can.
I have been a Registered Dietitian for almost 6 years now and I still feel like I am just scratching the surface of all the amazing things we can do and be as dietitians. I love growing in the dietetic field and as a person, and I love how being a dietitian has contributed to shaping and molding me into the person I am today.
Why did you become a Registered Dietitian?
I have known without a doubt since I was 15 that I wanted to be a dietitian. I developed an interest in nutrition and I was so intrigued with how food choices can affect our physical, emotional and spiritual well-being in either a positive or not-so-positive way.
What would you have wanted to do if not Dietetics?
This is a tough question for me because it has always been dietetics. But I think I would still choose to be a health care professional, maybe a nurse, speech therapist or occupational therapist? And if not a healthcare professional, then definitely a chef with a restaurant that provided unique culinary experiences!
Where did you study (degree and/ or postgrad)
I obtained my BSc Degree in Dietetics at the North-West University. I also completed a Higher Certificate in Christian Counselling at the South Africa Theological Seminary and I am currently studying towards becoming a South African Certified Lactation consultant.
Where do you work and what does your job entail?
I work at En Bonne Santé Dieticians, which is a dietetic private practice. En Bonne Santé is French for “In Good Health”. I provide nutrition counselling, support and guidance for individuals to achieve their lifestyle goals, no matter where you are in your health journey. I have a special interest in women’s health and nutritional intervention for chronic diseases. I also consult with those who wish to follow a vegan or vegetarian lifestyle, or those interested in eating more plant-based. I aim to promote eating patterns that emphasize whole plant foods not only for health and well-being but also for sustainable and compassionate living.
What do you enjoy most about the work you do? What are the most satisfying moments?
I love when my clients rediscover that even though food is about health, it is also about culture, fun, family and relationship. And when they break free from the restrict-binge cycle.
What has been your career highlight?
That is still a work in progress 😉
What are the most challenging aspects of your career?
At the moment, I feel like the biggest challenge for me is that many well-meaning individuals, without a degree in Dietetics, are claiming to be nutrition experts and are promoting extreme diets or they want to sell weight-loss products. In most cases, people’s beliefs regarding health and weight are affected negatively and this can lead to an unhealthy relationship with food. These restrictive health beliefs are challenging for clients to release. But as I mentioned earlier, the most satisfying moments are when people break free from restrictive diets and realize that a real healthy lifestyle is much more abundant.
What is something that people don’t know about you?
I follow a Vegan lifestyle 😊
What are your favourite foods?
I love tropical fruits OR Mexican style dishes with beans, guacamole and salsa OR a Curry.
What are the three things that you think people should stop saying when they meet a dietitian?
“Please don’t look at the food I dish up” OR “oh you must put me/my spouse on a diet” when you are at a Braai OR “what do you think about the Blood Group diet?”
Meet the Dietitian: Janke Draper
We caught up with Janke Draper, who serves on the ADSA Executive Committee in the Membership portfolio for the term 2021 – 2023. We met up with her to get to know her a bit better!
Tell us a bit more of yourself?
I am a wife of the best husband in the world and a mother of three lovely boys. My favourite place to be is at home and I like to spend time outside with my family.
Why did you become a Registered Dietitian?
I am not exactly sure about how exactly I decided to become a dietitian, it always feels as if the profession chooses me…and not the other “expected” way around.
What would you have wanted to do if not Dietetics?
When I was a little girl I wanted to become a teacher. But now since I have my own children I think it is better that I did not become a teacher, even though I do teach patients on a daily basis, so it is a win-win!
Where did you study (degree and/ or postgrad)
I completed my B.Sc. Dietetics degree at the University of the Free State and then I obtained my Master’s degree in dietetics also at the UFS.
Where do you work and what does your job entail?
I am a proud public servant. I am the sole dietitian at a TB Specialist Hospital in the province of the rising sun in a small town, Standerton and I also act as the food service manager.
Walk us through a day in your life?
Loads of administration, ward rounds, kitchen visits, training at clinics and lots of meetings. I used to travel a lot, but since the COVID-19 pandemic, we travel less and attend more online meetings and training. And then of course, when I get home after work, my “real” work starts (the job to keep three little busy boys alive).
What do you enjoy most about the work you do? What are the most satisfying moments?
The best part of my work is when I get the opportunity to teach and interact with patients. And the most satisfying moments are when we notice some positive change.
What has been your career highlight?
I think over the period of nine years there have been many significant highlights, but a personal highlight was when I was nominated and selected as one of the top three public service dietitians in Mpumalanga Province in 2018.
What are the most challenging aspects of your career?
The world of dietetics is unlimited and the research is forever changing, so for me the biggest challenge is to stay up to date with the newest findings in as many nutrition aspects as possible.
What is something that people don’t know about you?
I am a cat lover and I dream of adopting my own Maine Coon cat one day.
What are your favourite foods?
I like a big variety of foods, but I can’t resist a good pasta, soup in the winter, salad and fruit in the summer and chocolate.
What are the three things that you think people should stop saying when they meet a dietitian?
- Are carbs bad for you?
- What do you do in a hospital?
- What is the best weight loss trick?
MEET THE DIETITIAN: COMMUNITY SERVICE SERIES
By Marcelle Zahn Kruger
Hi, I’m Marcelle.
I will try to keep this as short as possible.
A few facts about me; I grew up in Centurion where I matriculated from Hoërskool Zwartkop. Thereafter I moved to Potchefstroom to study at North West University and graduated in 2019. I am currently serving my community service year in Harrismith.
When you get to know me, you will realize that I am a very ambitious, hardworking, fast learner who has a passion and love for dietetics. I have always had an interest in nutrition, cooking, baking, health, diseases, science and an urge to help people. I am highly allergic to peanuts and nuts. All these factors contributed to why I became a dietitian.
As a community service dietitian, I have the wonderful opportunity to practice both as a therapeutic and community dietitian. My job entails quite a lot of different tasks; ward rounds, follow-ups with outpatients, outreaches to the surrounding clinics, planning and organising health and wellness events as well as information days, to name a few. Basically, what a day as a community service dietitian looks like, with the added bonus of coffee with colleagues. With that said, 2020 is not an accurate representation as to what a community service year should look like.
Being so young and new to the field, I don’t think that I have experienced my career highlight, as yet, and I am looking forward to what it may be. But I can say that the most rewarding aspect of my job is when you see the changes and improvements in your patients, especially paediatric patients, they just show results much faster. As a dietitian we have the privilege to work within a wide field of practice and different types of circumstances as well as work settings. This I enjoy thoroughly, because we are not confined to a limited field of work. But with that said, I also think this contributes to the challenges of being a dietitian, practicing in such a wide scope and that there are always new guidelines or information to stay on top of. Without a challenge, how can you grow?
I find that when people hear I am a dietitian, they make a lot of assumptions and prepare a list of questions to ask. I just want to set the record straight with one of the common assumptions: Yes, I do eat chocolates, some will say it is my favourite food. To those asking about what I think about fad diets, what I suggest they should do regarding weight loss and if I also did a four-week course to become a dietitian, make an appointment and we can discuss all these questions further.
Thank you.
Meet the Dietitian: Community Service Series
By Danisa le Roux
My community service story looks a little different to most newly graduated community service dietitians. As my graduation drew near, the fear around the reality of my future started to become overwhelming. I started to have countless doubts about the path that I decided to take. Not because I didn’t love what I studied, but because reality hit me that this is what I will be doing for the rest of my working life, and uncertainty started to creep in. The fear of being placed away from my family and friends also gripped me. I graduated in the year 2019 and ended up being placed at a clinic that ended up being, as I feared, far away from my family and friends. Far away from everything I knew.
Out of fear, I decided to decline the position and take a year to regroup and find out if this is really what I wanted to do with my life. Sometimes it’s important to be 100% sure. Long story short, I ended up being excited to apply for my community service year (round 2) for 2021, and no matter where I was to be placed, I knew this time I was certain, even if the distance was scary. I ended up being placed at Red Cross War Memorial Children’s Hospital, which is a dream come true, seeing that my passion is paediatrics.
I decided to become a dietitian because I knew that this is where my passion lies. I have a heart for maternal and child nutrition and working with children has always been a dream of mine (second to having my own children one day). I also have a passion for food and health, as well as for people in general. Dietetics covers all these passions and was therefore the ideal career path for me.
I studied at Stellenbosch University, and am so grateful for the incredible friends, and now colleagues, that I made during my 4 years of studying.
At Red Cross Hospital my main focus is optimizing nutrition within the first 1000 days of life. I work in the short stay ward, gastro ward as well as trauma ward. I, therefore, see many patients who present with malnutrition in all its forms (Failure to thrive, underweight babies, SAM/MAM, micronutrient deficiencies, etc.) I have also (nearly) mastered the effective management of acute and chronic gastroenteritis through the guidance of my incredible colleagues. On occasion, I will also cover the longer stay wards where I will see various patients who need feeding prescriptions and nutritional support either orally or via tube feeding. I also run our obesity, general, infectious disease and Cerebral Palsy clinics. And my favourite part of it all is providing breastfeeding support and education to mothers who need it.
My main challenge when stepping into my community service year was the extra hours I needed to put in to refresh my theory after being out of practice and studies for just over a year. The knowledge came back quickly, however, and with practice and guidance from my colleagues, my confidence in patient care and management improved tremendously.
If I could encourage any future community service dietitians/fellow community dietitians with anything it would be the following:
- Follow your passion no matter how scary it might be.
- Put in the extra study/research time. Continued learning is good and helps a lot.
- Don’t be afraid to ask questions. Everyone was once where you are.
- If you make mistakes, it’s not the end of the world. You will grow and learn from them. I had to, and still constantly have to remind myself of this.
Meet the Dietitian: Community Service Series
By Elske Rich
When it came to choosing a career path I knew one thing: I want to help people. This combined with my passion for Biology at school led me to find dietetics. At the University of the Free State, I met the most amazing group of ladies and lecturers who made me fall in love with all aspects of Dietetics. Now I adore this profession and its neverending possibilities.
I completed my Community Service year at the fairly new and very small Albert Nzula District Hospital in Trompsburg, about 120km from Bloemfontein. Situated next to the N1 right in the heart of the Free State this hospital was sometimes the only option for a higher level of medical care for up to seventeen small surrounding towns. This means that I spent half of my time driving to surrounding clinics and the other half in the hospital treating in- and out-patients or managing the food service unit along with the other Dietitians.
This hospital was my first choice as I worked in Trombsburg as a student. I knew the area and the type of patient that was to be expected but I never expected to gain so much happiness. Albert Nzula only opened its doors for the first time about four years ago. This meant that the Dietetics department had so much room for growth which excited me a lot. I spent my spare time developing educational material and organising wellness events as far as COVID-19 allowed in order to promote the profession.
Challenges included limited staff during the pandemic but this allowed me to feed patients and help them with sip feeds when there were not enough hands available. There was also no parenteral nutrition or a theatre but luckily Bloemfontein was not too far away. It became a part of the job to get creative with feeds in the hospital setting and spend long hours on the road driving to clinics that were far away. During the pandemic, it also became our job to supervise the food service aspect of the quarantine and isolation sites in the district. So not one day was the same.
If you know me, you know I love public speaking. As a result, all the health talks at the clinics were memorable to me. Especially when I got the patients to interact and start holding each other accountable as a community for their individual health goals. In addition, what I adored most was just really talking to people and seeing the impact of very small but significant changes in their life. I also really enjoyed visiting the clinics and having an excuse to hold and weigh all the babies!
I encourage you to make the best of every situation by looking at what service you offer from a patient’s point of view. If your approach is one filled with compassion and determination you can help every single person around you. I always say: “Everyone eats so there must be something I can help with.”
PROTECTING BREASTFEEDING IS A SHARED RESPONSIBILITY
Breastfeeding is the recommended ideal, a natural and sustainable food for the healthy growth and development of infants and young children. Yet, South Africa’s breastfeeding rates, at all ages, are low. The recommendation for infants 0 – six months is exclusive breastfeeding (feeding breastmilk only). The rate of exclusive breastfeeding in the first six months of life was reported at just 32% at the last national survey in 2016. While that figure falls far short of the World Health Organisation (WHO) global target of 50% by 2025, it signals a slight improvement over the past years for the country.
The effort to improve breastfeeding rates has shifted from focusing on mostly mothers and health care workers, to look across our society and identify all the contact points with mothers and ways that mothers may be discouraged and or even persuaded to give up on breastfeeding their babies. This has led to efforts to include all sectors throughout the healthcare system, the non-profit and community-based organisations, workplace settings and families to unite in protecting breastfeeding and creating a culture where the whole society fully supports breastfeeding mums.
We often don’t realise that we may be discouraging breastfeeding and may have little idea of the health impacts on both mothers and babies if exclusive breastfeeding for the first six months of life doesn’t happen. It’s quite another thing though, to answer a call to become a protector of breastfeeding. How do we do this? It starts with understanding the barriers to breastfeeding that many mothers face. Breastfeeding education in South Africa is insufficient and there is often not enough skilled healthcare support for new mothers to help them overcome early challenges. The answer to any sign of a struggle is too often a recommendation to abandon breastfeeding and switch to infant formula products. In a upper-middle income country, this is a move that not only compromises the health of mom and baby but adds a significant household expense impacting on the entire family.
However, the challenges of breastfeeding exclusively for six months, and ongoing breastfeeding on demand are not limited to our healthcare facilities and services. Key to successful breastfeeding is that moms are empowered to feed their babies anytime and anywhere, which means they need broad-based support across society. Dr Chantell Witten, a Registered Dietitian and spokesperson for ADSA, (The Association for Dietetics in South Africa), points out that moms can face significant roadblocks to breastfeeding their babies even when this delicate process went well for them after the birth of their baby. She says, “Given the many stressors on households, sometimes mothers find themselves in hostile home environments and social circles negative towards breastfeeding. Often influential women in their lives second-guess them or encourage that they feed other foods before their baby is six months old. The need to earn and return to work, puts pressure on moms to give up on breastfeeding. That’s why protecting breastfeeding needs to be a “whole of society” effort to ensure that we have work and social environments that are breastfeeding-friendly.”
In essence, what we all have to remember is the simple truism that ‘breastfeeding is best’ – for both babies and moms. The straightforward health benefits are all the reasons we need to become protectors of breastfeeding. Breastfeeding from birth supports the healthy development of babies and plays an important role in prevention of all forms of childhood malnutrition including undernutrition, obesity and micronutrient deficiencies. Breast milk contains antibodies which help protect against many childhood illnesses. The risk of breast and ovarian cancers can also be reduced in women who breastfeed.
Professor Lisanne du Plessis, a fellow ADSA spokesperson and Registered Dietitian and Nutritionist, makes it easy to understand how we can be a protector of breastfeeding:
- Partners can help mothers with the domestic workload as well as the caring of the baby. Getting hands-on with baby bathing, burping, talking, singing and playing is a great support. Doing grocery shopping, helping with food preparation and cleaning of the house creates a supportive environment. Raising children was never supposed to be a one-woman job and partners have a major impact on creating a home environment conducive to breastfeeding for optimum mom and baby health.
- Family and friends should be cheerleaders for breastfeeding. It makes such a difference to encourage mothers on their journey to provide their babies with the best nutrition. Be aware of supporting breastfeeding moms anytime and anywhere. Even if you didn’t have a positive breastfeeding experience with your baby, make sure you fully encourage the new moms in your social circle.
- Workplace support can make a real difference when it comes to maintaining breastfeeding after the end of maternity leave. In South Africa, we have few workplace policies that are designed to create an enabling environment to support breastfeeding mothers, and you can be part of ensuring this happens in your company. Breastfeeding moms who have returned to work are entitled to two 30- minute breaks to express breastmilk. A private room and refrigeration facilities for safely storing their breastmilk can provide further support.
- SA society needs to be aware of attitudes that discourage breastfeeding, and even shame breastfeeding mothers. Breastfeeding is perfectly natural and should be normalised and championed across SA communities. Do your part to support, promote and protect breastfeeding as a national asset. It makes sense for us to ensure that our breastfeeding moms feel valued for the great choice they are making.
World Breastfeeding Week runs from 1 to 7 August 2021. In the midst of the global pandemic with our heightened awareness of the importance of health and robust immunity, it is vital to remember that breastmilk is the optimum food for our babies. Nothing compares, it is priceless. Let’s support and encourage moms in those critical hours after birth, continue the support for the first six months of the baby’s life and also over the longer term as they strive to do their best for their children.
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:
- Pre-heat the oven to 180 °C.
- 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.
- 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.
- Blend with a hand blender until smooth.
- 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.
- Serve with some black pepper, chilli flakes and fresh basil leaves.
- 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:
- Blend the oats in the food processor until it becomes oat flour.
- Add the dates and chickpeas and blend until smooth. Gradually add some water if the mixture is very stiff.
- Add the salt, coconut flakes and cocoa powder and blend until smooth.
- Roll into balls and let it set in the fridge.
- Melt the chocolate in the microwave and then add the coconut oil and combine.
- Coat your date balls with the melted chocolate by dipping it into the chocolate, covering it and removing it with a spoon.
- Place on a cutting board or large oven dish with wax paper.
- 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
Meet the Dietitian: Community Service Series
By Santi Turner
Hello, my name is Santi Turner and I’m currently 1 year post-comserve
I’ve always had a big passion and interest in health, food and people. Dietetics is a combination of all 3 of these elements and that’s why I chose it!
My aunt is a dietitian in Namibia and she definitely sparked my interest in this field. I’m so glad that I chose to study dietetics and I can’t see myself in any other job.
I studied at the University of Stellenbosch on Tygerberg campus and graduated at the end of 2019 after 4 hard-working years. I was blessed with the most incredible friends that helped me get through the course! I might be biased, but I believe that we had the best lectures and got the best practical experience on Tygerberg Campus!
I completed my community service year at Rob Ferreira Hospital in Nelspruit, Mpumalanga. It’s a tertiary hospital and we rotated wards every 2 months. I had the best year and made a lot of new friends! My biggest advice to final years would be to choose a tertiary hospital if you want the most clinical/practical experience. Some of my friends in rural clinics never worked with parenteral or enteral feeds, but they still had great health promotion opportunities.
I currently work for a private practice in Nelspruit and I see out-patients at our practice as well as in-patients at two private hospitals in the area. Private is a lot different than government in terms of the environment that you work in, but you still get very good practical experience! The private sector was a big adjustment for me as I wasn’t the only dietitian in a hospital ward anymore. All of a sudden I was being surrounded by several other dietitians.
What I love most about my job is seeing the progress that my patients make. It could be someone progressing from a tube feed to oral feeding or a pt coming in for a weight-loss consultation and gradually shedding off the weight to reach her end goal!
My biggest advice to future dietitians would be to work hard and be like a sponge. Embrace all the new learning curves that come your way! Absorb new information and learn from the mistakes that other health professionals make. Be the best version of yourself!
RECOVERING FROM COVID-19? HERE’S WHAT YOU NEED TO KNOW ABOUT NUTRITION
COVID-19 has impacted infected people in different ways. Some have been asymptomatic; many have had mild cases; some have had to be hospitalised but didn’t need ventilation and others have endured long stays in ICU. There are those who have recovered quickly, but a number of people are suffering from ‘long-COVID’ and experience symptoms that go on for months. As with any other illness, nutrition will play an important role in recovery. Whatever you eat and drink on a daily basis will either be supporting and advancing your return to health or making it more challenging for your body to fully heal. Importantly, good nutrition can help to avoid risks of complications and shorten your recovery time.
According to ADSA (The Association for Dietetics in South Africa) people recovering from COVID-19 who also suffer from diabetes and cardiovascular disease need to take special care when it comes to their nutrition during post-COVID recovery. Registered Dietitian and ADSA spokesperson, Andiswa Ngqaka says, “Pregnant women who are recovering from COVID also have questions around nutrition. They feel anxious to return to health as quickly as possible, and of course, want to make sure their bodies are supporting the development of their unborn babies as they recover. In addition, family members who are supporting loved ones who are recuperating at home after a stay in ICU may be facing challenges when it comes to nutrition.”
Omy Naidoo, another ADSA spokesperson and Registered Dietitian points out that people recovering from COVID may still be experiencing health issues. He says, “COVID symptoms such as the loss of taste and smell can persist for quite some time, and these senses have a major impact on appetite. Chronic fatigue, weight loss, loss of muscle mass and general weakness are common too. The main goal of recovery nutrition is to provide enough of the nutrients that support healing, and therefore a loss of appetite is a challenge that needs to be addressed.”
The general nutrition tips for post-COVID recovery include:
- When fighting an infection, the body needs more energy and more fluids. Eat a variety of foods every day to ensure balanced nutrition
- Eat plenty of vegetables and fruit, and include plant-based meals to ensure optimal intake of immune-supporting vitamins and minerals
- Make whole grains and high fibre foods (which includes veg, fruit and salads) part of most meals
- Drink plenty of clean safe water as adequate hydration is essential to recovery, and focus on hydration particularly if you are still experiencing symptoms such as fever, vomiting and diarrhoea
- In the case of muscle mass loss, focus on a high protein diet to support muscle recovery. Good sources of protein include lean chicken, eggs, dairy and fish, as well as legumes and pulses such as beans, lentils and chickpeas
- Limit sugary foods and drinks, highly processed and fast foods
Naidoo points out that different strategies may be necessary if you or your recovering family member is experiencing a chronic loss of appetite. He says, “Oral nutrition supplement drinks may be necessary if the person is unable to consume enough protein and calories each day. Good quality oral nutrition supplement drinks are easy to consume, and they contain a balance of protein, carbohydrates, fat and necessary micronutrients.”
In addition to general nutrition guidelines, people living with other health conditions and recovering from COVID-19, should take note of Andiswa Ngqaka’s advice:
Additional nutritional advice for people with diabetes or heart disease recovering from COVID-19
- Pay attention to your glucose control. Regular control will manage complications caused by low and high glucose levels
- It is important to eat small frequent meals, for instance 3 meals a day and healthy snacks like nuts in between, to avoid any fluctuations of glucose levels. Fluctuations in blood glucose predisposes to serious complications and most commonly diabetes ketoacidosis.
- An ideal diet is high in fibre, whole grains, legumes, with plenty of vegetables and fruits
- Avoid sugar and unhealthy fats, reduce salt intake and reduce high fat and processed meat products
- Foods that support immunity and reduce inflammation are important for the heart. Focus on vegetables and fruits of different colours to provide a spectrum of vitamins and minerals to support the immune system.
- Infections such as COVID-19 contribute to a rise in blood sugar therefore you must ensure you drink sufficient fluids – clean safe water is best
- It is important not to overwork and to get a good night’s sleep
Additional nutritional advice for people recovering from COVID-19 after being in ICU
- Address loss of appetite by encouraging small, frequent meals and encourage a variety of foods to provide different nutrients
- Focus on foods that are rich are vitamins and minerals, such as vegetables and fruit, high fibre and wholegrain foods
- Aim to have a high protein food at each meal, to help replace muscle loss and regain your strength
- A dietitian can recommend oral nutritional supplement drinks that may be necessary
Additional nutritional advice for pregnant women recovering from COVID-19
- Include foods rich in iron, such as spinach, asparagus, broccoli, dried apricots, lentils, beans, eggs, fish, chicken and lean red meat
- Include foods rich in folate, such as brussels sprout, mushrooms, green leafy vegetables, peas, chickpeas, kidney beans, lentils, butter beans and soya beans
- If you’re feeling a loss of appetite, focus on healthy snacks and creating more frequent healthy mini meals
- It is important to rest well and take it easy during recovery
What’s most important is that if you or a recovering loved one are experiencing difficulty following these guidelines, then you should get help. Nutrition is too important to recovery to struggle on alone with an inadequate intake of nutrients. Your dietitian can help you with an individualised plan to meet your unique post-COVID recovery nutrition challenges and provide ongoing patient support. They can provide expert guidance and recommendations when it comes nutrient-rich, fortified, tasty foods and special supplements that will support rehabilitation, reduce risks of complications and shorten your recovery time.
To find a registered dietitian in your area, please visit www.adsa.org.za
The Importance Of Nutrition In Fighting Cancer
As many of us know all too well, a cancer diagnosis for you or a loved one is a sea change. While day-to-day life goes on, cancer symptoms and the ongoing effects of treatments usher in a myriad of adjustments. Typically, our food preferences and eating habits are deeply entrenched, and therefore, getting optimally supportive nutrition can be challenging, but it is vitally important.
As a Registered Dietitian and spokesperson for ADSA, (The Association for Dietetics in South Africa), Omy Naidoo points out, “Cancer propels the body into a catabolic state where both muscle mass and fat are breaking down, therefore the nutritional needs of cancer patients increases. To meet this, there needs to be a careful focus on protein, calorie, and vitamin intake.
Unfortunately, this need for increased nutrition comes at a time when it’s highly common to experience a general loss of appetite and the side effects of treatment that can seriously impair a patient’s interest in eating. This makes a focus on nutrition a critical part of a patient’s cancer journey.”
Revealing a cancer diagnosis in your circle often opens the floodgates to well-meaning nutritional advice that can lead to going down unhelpful ‘rabbit-holes’. There’s a mass of information and promotion around ‘alternative’ or ‘natural’ cancer nutritional support, even cancer ‘nutritional cures’. This can be overwhelming, confusing, and frustrating during a vulnerable time. It is important to note that there is currently no scientific evidence that any particular food, food supplement, or diet can cure cancer.
Cancer patients in both the private and the public healthcare systems do have access to the support of a dietitian, who is the only health professional that has specifically qualified in evidence-based nutrition. If you’re feeling uncertain about what you or your loved one should be eating and drinking, it’s time to ask your doctor to help bring a dietitian onboard. It’s important to discuss any natural remedy you want to introduce with your doctor or dietitian to ensure that there are no unintended interactions with the treatment you are undergoing.
While nutritional support for cancer patients focuses on avoiding malnutrition, some foods are allies, and some are to be avoided. Another ADSA spokesperson, Registered Dietitian, Faaizah Laher puts it in a nutshell:
Foods to avoid during cancer treatment and recovery:
- Avoid or limit alcohol
- Avoid or limit highly refined, highly processed foods
- Limit foods high in sugar, including sweets, cakes and sugary drinks
- Limit foods that are high in salt
- Limit foods that are high in animal fats
- Avoid or limit cured meats such as bacon, ham and sausages
Focus instead on
- Eating lots of fresh vegetables and fruits every day
- Enjoying lean animal protein such as chicken breast and fish
- Including more plant-based foods high in protein such as beans, lentils, peas, chickpeas, quinoa and soy-based foods
- Choosing whole-grain options such as brown bread, brown rice and wholewheat pasta
- Increasing your intake of nuts and seeds
- Focusing on sources of healthy fats such as olive oil, avocados and fatty fish like sardines
Tips for bypassing the typical nutritional roadblocks
Omy Naidoo says, “Cancer patients undergoing treatment often experience a severe loss of appetite, nausea, vomiting, diarrhea, as well as dysgeusia which is taste alterations. Very often these patients need high protein, vitamin-containing supplements which they drink 2-3 times per day. Some patients need tailored diets to help them get through spells of nausea and vomiting, and this is exactly how your dietitian can help you.
It’s important to remember that cancer patients need more nutrition, however, they typically end up taking in much less than usual due to these symptoms. The nett effect of this is that patients can lose muscle mass and become malnourished. This is precisely what you want to avoid as malnutrition then becomes an independent risk factor for poorer outcomes.”
If you or a loved one are dealing with these challenges, then you need to reset your daily nutritional regime:
- Focus on smaller, lighter meals eaten more frequently than the standard three meals a day
- Experiment with healthy snack foods that are always on hand such as wholewheat crackers, nuts, seeds, fruits and vegetables
- Try out delicious nutrient-rich smoothies
- Add nuts and seeds to yoghurt, cereals, smoothies, and even casseroles
- Make frozen lolly treats from fresh fruit juices, fruit, yoghurt and smoothies
- Use nutritional supplements prescribed by your health professional
Most important is to remember that combatting malnutrition is your goal. Take action and get professional nutritional advice to help the cancer patient maintain their weight as best as possible.
Healthy nutrition also reduces your risk of cancer
While some risk factors for cancer cannot be changed, research shows that 30 to 50% of major cancers can be prevented by following a healthy lifestyle. Faaizah Laher says, “While there is no guaranteed way to prevent cancer, a healthy lifestyle can help reduce your risk of developing many cancers and positively support treatment and recovery if you are diagnosed with cancer.
Think of eating the colours of a rainbow and lots of variety of nutritious foods (such as fruits and vegetables, whole grains, nuts, seeds, and legumes). Along with healthy eating, an active lifestyle and maintaining a healthy weight play important roles in reducing risk and boosting your resilience.”
Meet the Dietitian: Community Service Series
My Unexpected Journey
Written by JéJéan du Plessis
As a little girl walking around the grocery store, it was the norm for me to turn around the pretty pictures of products and focus on the more ‘boring’ nutritional information.
This was to ensure that I stay clear from any allergens that could lead to an eventful trip to the hospital. Being surrounded by all of the knowledge of food as a child (and now adult) with severe allergies, it was quite inevitable for me to find a passion for nutrition, thus leading me to study dietetics at the NWU Potchefstroom Campus.
Like most of us, while studying for my degree at Potchefstroom, I quickly developed a love for therapeutic nutrition. Any form of Hospital assignments or practicals were written in my diary with the most beautiful washi tapes and highlighters, and during my last year, I was completely fascinated by all hepatic- and liver-related diseases.
This led me to be deeply disappointed, as I was not placed at either of my five options for my Community Service Year. I was placed in the District Office in Ekurhuleni, which is Clinic-based work. Yet, and to my surprise, I am enjoying it tremendously! I mostly see outpatients throughout my day; do in-service training with the clinic staff members; are responsible for health campaigns; visit surrounding ECD centres; Old Age Homes; and Mental Health Institutions.
In the past few months, my love for Community Nutrition grew overwhelmingly, and I was never aware of just how rewarding this spectrum of dietetics can be! You walk a close path with each of your patients, struggle with them to find a suitable diet, and try different approaches to see which will fit their lifestyle best. Through this process, you really get to know the person sitting on the other side of the table, which truly spoke to me, as you can really feel the difference you make in most lives.
A new field of interest for me is definitely Diabetes and the nutritional management thereof, since I quickly realised that these people’s way of living is changing drastically within a few weeks from diagnoses, and giving them the best possible support will make the worlds difference to them, but that can also be said about any patient seen in the clinic setting.
The moral of my story is the following:
- The biggest curveballs in life can be full of opportunities and self-exploration experiences that will ensure huge growth within you as an individual, and newly graduated dietitian.
- Always remember that you are making a difference, no matter if you are calculating a TPN feed in an ICU setting, or if you are working at the local clinic with patients who really need your expert advice to live the best possible quality of life.
Meet the Dietitian: Community Service Series
By Ilse Gravett
At the end of every stage in our lives, we find ourselves in a tricky position where we need to decide what our next step is. For a 17/18-year-old, it is quite daunting, well it was for me. I had so many different ideas of where I wanted to be and what I wanted to become. Eventually, I applied to study medicine at the University of Pretoria, and dietetics at the North West University. I got accepted for both medicine and dietetics, but I chose dietetics. Deep inside me, I knew that I wanted to do more and be more. Please don’t get me wrong; all doctors are real superheroes and I have a huge amount of respect for each one of them! There were times that I even wanted to be one of them. But it was not until my final year that I realised the honour and privilege of being a dietitian. Being a dietitian, you get to really make a difference in a person’s every-day life. Essentially, everyone needs to eat, and you get to be the expert. You get to work with the sick and the healthy, the individual and the community. So here I am, already in the last week of my community service year.
I got placed in a hospital I have never heard of in a town I didn’t even know existed. St Patrick’s Hospital, Bizana, Eastern Cape. What a blessing! Looking back, I know that I have learned so much – some might even help you on your journey:
- Share your knowledge. We forget that information that seems like common sense to us, might prevent severe acute malnutrition in a toddler or help the sweet old lady gain control of her blood pressure.
- Be extra… Okay, not annoyingly extra, but be extra kind and go the extra mile. You have no idea what battle your patient or even colleagues are fighting, so never underestimate the power of that.
- Don’t settle for the “lack of resources” excuse. Rural hospitals are challenging on a whole different level. In most cases, you don’t have all the fancy feeds or even a feeding pump. This means you really need to think outside the box and get creative. You are the expert; you can do it!
- Focus less on yourself. With this I don’t mean let yourself burn out – please take your break when necessary. But you are doing this year to serve the community. So, don’t always think about how much you can get out of a situation but how much you can give. Once you do that, you will feel how you automatically grow.
- Look on the bright side. One of the biggest challenges I had to face this year, was to accept the fact that I will only see “basic” cases. And wow, how my perception of “basic” cases changed. Every case has so much detail to it and a lot that you can master.
- Give it time. This is probably the most cliché of them all, but really – give it time. It doesn’t all happen overnight, and that’s okay. Be open to growth and to learn from those who have been there longer. They have a different kind of knowledge that books don’t have.
- Enjoy! Make friends with anyone, have inside jokes with the cleaners, get to know all the different cultures, and make every day an adventure.
In the end, it’s all up to you and the choices you make each day. I hope you choose to make it the best 365 days of your life!
WHY ‘EAT LESS, MOVE MORE’ IS NOT OBESITY’S SILVER BULLET
We would like to believe there may be small, simple solutions to big problems, but when is that actually true? The answer is probably, never. Intractable, extreme issues arise out of complexity, and nothing less than a host of multi-dimensional, cross-functional countermeasures issued at the right time and the right place can bring about sustainable transformation.
Obesity, a disease characterized by the interaction of genetic, behavioural, metabolic and environmental factors, embodies a complex matter requiring a comprehensive approach. A quick glance at the South African context (marked with more than 41% of women being obese) highlights that combatting obesity in South Africa will require more than a one size fits all approach.
This is why advising people who are obese to just consume fewer calories while burning more energy is not just doomed to fail but damaging to vulnerable people.
Obesity is a health condition beyond overweight that soars past trite platitudes. Research has shown that restricting calories while boosting exercise only makes a paltry 3 to 5% difference to sustainable weight loss and weight management. This is staggering, and it points out that the roots of obesity run deep – in the unseen details of our DNA; in the shadowy intricacies of our individual psychology, and day-to-day, in the banality of our homes, workplaces and communities where bias and shame are uncontested.
World Obesity Day, the 4th of March, is a time to acknowledge the global increase of obesity and its long-term impacts, while providing hope through awareness and education. Having a loved one on the brink, or all the way down the road, causes all involved parties to grapple with bona fide existential fear. Obesity puts one at risk for a host of other medical conditions such as non-communicable diseases, and it is too complex to solve with simple calorie restrictions plus exercise.
Dr Christine Taljaard-Krugell, President for ADSA (The Association for Dietetics in South Africa) says, “Simplifying obesity to one cause could prevent effective treatment. It ignores the various root causes such as biology, food, genetic risk, healthcare access, life events, marketing and sleep. Hence, when tackling obesity as a chronic disease, an evidence-based approach should be followed. Holistic patient care is critical. While cutting back on calories and increasing exercise is a relevant start and lays a foundation for healthy living at a healthy weight, it’s not the be all and end all when you’re aiming for sustainable change. This is a misconception that needs to shift.”
In recognition of World Obesity Day, the National Department of Health has stated that “it welcomes a broader view when it comes to dealing with obesity in South Africa, which is at an all-time high. Obesity is defined as a prevalent, chronic condition that impairs health, increases morbidity, and renders people prone to relapsing.”
Obesity care cannot simply be about diet and exercise advice; it should include intensive nutritional therapy led by registered dietitians, physical activity programmes, pharmacotherapy, as well as psychological, and even surgical interventions. For sustainability, the root drivers of obesity must be dealt with. These may be genetic and/or psychological drivers that will inevitably scupper calorie-restriction and exercise efforts if they persist as underlying causes.
People living with obesity also face bias and stigma that have major impacts on their life goals and aspirations, and therefore, their well-being. Here’s a way that we can all help counter the increasing obesity among SA adults and children: understand the complexity of the issue; don’t assume; don’t judge and don’t give off-the-cuff advice. Interrogate your own explicit and implicit biases. Promote and support holistic, professional patient care. There is a better way.
To find a registered dietitian in your area that can assist in the management of obesity, visit: http://www.adsa.org.za
The National Department of Health is inviting people to join the World Obesity Day webinar under the global theme “EveryBODY needs Everybody” on 4 March 2020 from 11am to 12pm. Follow this link to register for the webinar.
ADSA Kwazulu-natal: Who we are
Hi! We are ADSA KZN! 😊
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 😊”
Happy 2021 y’all (as we say in Durbs).
ADSA Gauteng South: Pivoting in the Pandemic
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.
MEET THE DIETITIAN: COMMUNITY SERVICE SERIES
By Nicoli Haasbroek
“Trust the process!”
No one would ever really know what a dietitian does until they are on the receiving end of our services. I remember another health professional saying to me that she never really knew what a dietitian does until her mother was hospitalised and treated by a. That is when she realised the impact that our profession has on all our patients.
Becoming a dietitian never crossed my mind, until I went to the open day at Kovsies – because even I was not sure about what dietetics encompasses. Afterwards, I went home and immediately applied for this four-year BSc degree not knowing what I was getting myself into. When I received the message from the University of the Free State notifying me of my acceptance I was ecstatic! Before I knew it, this city girl loaded her car to start her dietetics journey in Bloemfontein. After the first week, I knew that dietetics chose me.
At the end of the year, I found out that I was placed at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH), formerly known as Joburg Gen, which was my first choice (#blessed). Cut to, I have just started my last month of the community service year at CMJAH and what a year it has been! I remember in my first few days asking “is it normal to feel like I don’t know ANYTHING?!”. That feeling only lasted until the end of that week as I remembered that I possess a lot of knowledge. Another thing that scared me, in the beginning, was that out of my whole fourth-year class which consisted of a total of seven girls, yes, seven, I was the only one placed in Gauteng. I felt lost, alone, nervous and only slightly excited. Now I wouldn’t trade the people who walked through this year with me.
Currently, I am doing my final block in the orthopaedic and vascular wards, but previously I was in infectious diseases, GIT surgery, neurology, radiation oncology, paediatrics, neonatal and obstetrics & gynaecology. I was also responsible for various outpatient clinics (slimming, general clinic, new-born clinic, lipid clinic and supplementation). Through these wards and with all the patients I have treated, it was once again made clear to me that paediatrics is my passion. What a beautiful thing when passion and purpose collide!
To future Comm Serves:
- Take it all in! This year goes by very fast and before you know it it’s time to start looking for a new job.
- If you feel clueless during the first few weeks – it’s okay because you are not alone!
- Don’t be scared to ask questions and learn from your colleagues including the multidisciplinary team, seniors and peers.
- Don’t forget that you are treating a person and not just a disease condition.
- Make a difference where and when you can.
- Take care of yourself.
- Spend your hard-earned money wisely 😉
Most important; the experience you have this year, what you learn & what you make of this year ALL DEPENDS ON YOU!
MEET THE DIETITIAN: COMMUNITY SERVICE SERIES
By Dur-e-nayab Burki
As the name Solanum Lycopersicum is not commonly said, neither is mine.
Hello everyone, my name is Dur-e-nayab Burki and like the word mentioned before, not everyone calls me by it, instead, they call me Nayab or Nabi for short as it is easy, the same way we call Solanum Lycopersicum a tomato. Simple really!
I am currently a community service dietitian, working at Witbank Provincial Hospital, which is located in Mpumalanga. It’s an hour from home, but still a little distant. To be honest, I never saw myself becoming a dietitian, All I knew after graduating from matric was I wanted to study in Varsity and the fact that my Dad is a doctor, I leaned more towards health sciences.
I applied for BSc Dietetics at Sefako Makgatho Health Sciences University (SMU), previously known as MEDUNSA. In my 4th year of studying, I did my internship for Therapeutic nutrition in Dr George Mukhari Hospital, as well as my Foodservice training, where I learned more theoretically. Later, I was transferred to Jubilee Hospital, where I learned more practically. I did my Community block in Phedisong, a clinic in Ga-Rankuwa.
Yes, it was overwhelming, but asking for help when needing it was the step needed to overcome the fear of the unknown and extremely emotional rollercoaster ride. But in the end, when I look back – with all the support from my classmates, supervisors, lecturers, friends and family, I said ‘that was worth it!’ and ‘I made it!’- the most satisfying feeling ever.
My Community service year has thought me that you are in control of what you decide to do with this year. Yes, new experiences are part of It, but working alongside other medical professions, such as OT’s, SLT’s, PT’s, Nurses and other medical staff actually showed me how important my role as a dietitian is. What’s even more important is educating them about my role as a dietitian for a patient. To give a patient the correct NF feed is Crucial in their treatment, however to others, any feed is fine!
I’ve also learned from a nurse, when working in neo-natal ICU, about how to do continuous feeds of EBM, when resources are limited, to use an IV bag – interesting right?
One major thing I’m excited to report is the amount of emphasis I have put on referring patients with any nutritionally affected conditions, to the doctors I know, my dad and sister. And I have seen changes to their mindset when working with patients because they always ask ‘ hey Nabi do we refer patients with renal dysfunction & HPT with low appetite to Dietitians?’ and I reply ‘ Yes. Please!’. Changing one doctor’s perspective at a time is a small step to making a big change.
Also use the opportunity to ask your colleagues as well – learn from their experiences, because by the time you start enjoying this year with all you learn, it has already gone by. (To Esme and Loren – thank you for this year).
MEET THE DIETITIAN: ANNETTE WEAVER
- Tell us a bit more of yourself?
2020 marks my 35th year of being a registered dietitian! Most of my career has been as a food service dietitian. I am married to wonderful man, whose work took us to Germany, Qatar and Egypt. We have a beautiful daughter who is now the doctor in the house. We are looking for that perfect place to retire and do more travelling.
- Why did you become a Registered Dietitian?
It was second choice but no regrets.
- What would you have wanted to do if not Dietetics?
Physiotherapist
- Where did you study (degree and/ or postgrad)
BSc Dietetics – UKZN Postgraduate diploma – UP
- Where do you work and what does your job entail?
The last nine years I have been working on the National Youth Chef Training Programme and teaching nutrition and food safety to hospitality and chef students.
- Walk us through a day in your life?
My day has to include a walk with my husband. Lesson preparation, lessons marking and admin. Thinking of new ways to get nutrition messages across. Cooking dinner, experimenting with flavours in nutritious dishes.
- What do you enjoy most about the work you do? What are the most satisfying moments?
The challenge of working with young adults. Being able to pass on knowledge and give people an opportunity to improve their lives.
- What has been your career highlight?
Working in a renal unit was the most rewarding time in my career. My career has been varied and never boring.
- What are the most challenging aspects of your career?
Dietetics was a relatively new profession when I started my career, so promoting what dietitians can do was important. Getting away from the dietitians are just kitchen supervisors label was a challenge. Today’s challenge is motivating people to adopt healthier lifestyles and choose more nutritious foods in a world that promotes unhealthy choices. My hope is that my students will remember their nutrition lessons and make a small positive change in their or someone else’s eating habits.
- What is something that people don’t know about you?
Mmm – no secrets.
- What are your favourite foods?
At the moment homemade bean & vegetable soup and Irish soda bread. I do enjoy a glass of wine, red of course.
- What are the three things that you think people should stop saying when they meet a dietitian?
Oh, you work with fat people!
Can you give me a diet, I need to lose weight?
What do you think about, (the latest fad diet), should I try it?
It is great to see how the profession has grown and developed over the years. We need to focus on better nutrition for all in South Africa and have a common message based on sound principles.
NUTRITION AND IMMUNE HEALTH
By Natasha de Almeida
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 |
| Omega-3 fatty acids | Anti-inflammatory | Walnuts Flaxseed Canola oil Avocado Eggs Fish (salmon, sardine, tuna, mackerel) |
| Dietary Fibre | 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.
References
- Google Trends. 2020. Google Trends. [online] Available at: <https://trends.google.com/trends/explore?date=2020-03-01%202020-03-31&geo=ZA&q=vitamin%20c> [Accessed 27 September 2020].
- Google Trends. 2020. Google Trends. [online] Available at: <https://trends.google.com/trends/explore?q=%2Fm%2F025sjz4&date=2020-03-01%202020-03-31&geo=ZA> [Accessed 27 September 2020].
- Google Trends. 2020. Google Trends. [online] Available at: <https://trends.google.com/trends/explore?q=%2Fm%2F0q593&date=2020-03-01%202020-03-31&geo=ZA> [Accessed 27 September 2020].
- 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.
- Bda.uk.com. 2020. Supplements. [online] Available at: <https://www.bda.uk.com/resource/supplements.html> [Accessed 13 October 2020].
FESTIVE SEASON & FOOD IN A PANDEMIC YEAR
We’ve had a year like no other, and while the shadow of the pandemic still looms over the world, South Africans can breathe a sigh of some relief, that it is, at least, the summer holiday season. A good dose of festive cheer has rarely felt so crucial. The pandemic will inevitably mute our celebrations in various ways. Some of us are feeling the effects of the economic impacts and will have to scale down or forego the treats and luxuries. Others, especially those with vulnerable loved ones, will opt for smaller, home-based gatherings and would rather skip the holiday crowds this year. However we choose to make the most that we can of the festive season, our hearts will be pulled towards those struggling to put food on the table this December, as well as those who have an empty chair at their family table.
If a global pandemic can have a silver lining it is that it has immersed us far more than usual in home life. We’ve had more concentrated time with our loved ones and closest friends, and that’s heightened our appreciation of the really important things in our life. As families, we’ve cooked more together, and shared more meals. Food is at the centre of our social lives, and the festive season brings with it particular food traditions and long-established favourite holiday food habits. This brings challenges to starting up or maintaining healthy eating, and to how we can still enjoy special food occasions on tighter budgets this year.
Three registered dietitians, all spokespeople for ADSA (Association for Dietetics in South Africa) share their advice for a happy, healthy 2020 holiday season for all South Africans:
Omy Naidoo, registered dietitian from KZN on beating the budget:
- Opt for much more cooking in rather than eating out; the savings are significant, especially when it comes to larger families
- Add beans, peas and lentils to dishes for a punch of affordable, quality protein so that you can use less meat
- Include more vegetables at every meal to ensure you get a boost of vitamins and minerals without breaking the budget. Start your own summer veggie garden at home
- Cook large meals from inexpensive ingredients, and use your leftovers over the following days
- Every meal doesn’t have to have meat which can be swopped out for beans, legumes, eggs or canned fish, which are all cheap, nutritious and delicious sources of protein
Zitandile Mfono, registered dietitian from Eastern Cape on healthy balance:
- Every day and every meal won’t be the same, and you should strive for balance over time. For instance, a sweet treat at lunch can be balanced by plenty of vegetables at dinner
- Plan ahead for your ‘must-have’ favourite celebration meals; make the shopping list for those ingredients and then stick to it. Because you will enjoy getting what you most want out of festive eating, you won’t miss those less healthy extras you slipped into your trolley
- Put the tips for healthier alternatives into action so that you can reduce sugar and saturated fats at most meal times
- Have fun with family workouts and long family walks to balance out the long hours sitting down to bigger meals
- Balance is also about the mind; so enjoy your festive meals and holiday time with your loved ones. Despite the difficulties of this year, we are still going to be thankful for the festive cheer
Rosanne Lombard, registered dietitian from Gauteng on keeping it simple:
- Don’t overcomplicate your nutrition. Try not to restrict yourself and deprive yourself of treats as this tends to lead to a binge. If you can eat the healthier foods most of the time, in portion-controlled amounts, then it is okay to enjoy festive season treats
- Fill at least half your plate with vegetables and salad for an easy way to control your portions
- Drink lots and lots of water, and limit alcohol, which is expensive. This is an easy way to save money and keep healthy
- Make simple breakfasts like oat, banana and egg flapjacks, high fibre cereal cereal and yoghurt, poached eggs and toast and delicious smoothies. For lunches, you can do snack platters with crudité veggies, homemade wraps and filled brown or seeded rolls with a big salad. All of these ideas are super easy and affordable, plus healthy too
- Buy fewer treats and energy-dense snacks. We tend to stock-pile these items during the festive season, and because we have them, we eat them. Rather don’t have them in the house. If you really want a treat every now and then, then you can rather go and buy one treat such as an ice cream at the beach or a slice of cake with a friend
A last word from Zitandile:
“It’s the giving season and the holidays are a time to make extra or pack your leftovers to share with neighbours, friends or your local shelter. In these tough economic times, sharing food can prevent food waste and bring festive cheer to someone else.”
MEET THE DIETITIAN: COMMUNITY SERVICE SERIES
By Mariska Barnard
I started my studies enrolled in the BPharm course, but realised it wasn’t what I wanted to do. I wanted to journey with my patients and help them achieve health through nutrition. I have a passion for prevention of disease as I don’t want anyone to go through long, tiresome treatments for any disease/illness. Thus I decided to study dietetics, a way of treating patients with no side effects!
I studied dietetics at the wonderful North West University on the Potchefstroom campus and then completed my Master’s degree at Nelson Mandela University. And finally it was time for my community service year. I work in Bloemhof, a small town in North West, as a sub-district dietitian. We are responsible for all the clinics in the sub-district. We consult chronic patients, audit Road-to-Health booklets, do health talks, organise Vitamin A and deworming campaigns and much more. Working in a sub-district setting you learn a lot about other programmes as well.
When I first arrived, I was nervous, I didn’t know if I was going to be able to do the work and I was in a little town with my family 800 km away and I knew no one – probably the feeling of everyone on their first day. The first challenge I experienced was thus a mental one, I was not prepared to do community work, I expected to be placed in a hospital as I just applied to hospitals, and wasn’t placed at one of my options. I was negative about my placement and I felt lost. But I was welcomed with open arms, everyone in our team is friendly and I have an amazing supervisor that is passionate about community dietetics. I instantly admired her passion and my eyes opened up to all the possibilities of community work. My mindset changed quickly!
This year I have learnt about the set-up of community dietetics, about the way in which our community lives and how to adapt in unsuspected circumstances.
Tips for others walking the same path:
Help where you can: This year we helped other programmes with their campaigns and then COVID-19 happened. Now we screen the community and do contact tracing. This not only teaches you a lot, but it also builds your character.
Always be ready to learn: I once asked my supervisor to sit in while I counselled a newly diagnosed diabetic, and it was the best thing I could have done! When I was done counselling I asked her if I missed something, and she started talking to the patient, using some Tswana words that I did not know yet, and describing some practices in different ways, using easier words. I learnt so much in just five minutes!
Never stop fighting for your profession: Sometimes you won’t understand why staff members don’t listen when you ask them to do the right thing. Accepting that behaviour can’t be changed instantly will save you a lot of frustration. Rather go back and ask again or do training. Showing them that you won’t back down makes the difference!
I want to encourage you to be open to the journey ahead and to accept the challenges. We are all stronger than we think and capable of extraordinary things!
LOADED BAKED POTATO
Look at this wonderful recipe for loaded baked potatoes, from registered dietitian, Cheryl Meyer. Give this delicious recipe a try!
We Love:
- That loaded baked potatoes are so easy to make. Both oven and airfryer methods provide beautifully crispy and flavourful on the outside, whilst soft and fluffy on the inside baked potatoes.
What the dietitian says:
- Draining and rinsing tinned beans reduces the sodium content by as much as 40%, what a win!
Serves 4
INGREDIENTS:
- 4 small-medium sized potatoes (approx 150g each)
- 3 teaspoons olive oil, divided
- 1 x 400g tin of black beans, drained and rinsed
- 1 teaspoon crushed garlic
- ½ teaspoon ground cumin
- 1 small onion
- ⅔ cup low fat plain yoghurt
- 1 cup grated cheddar cheese
- 4 spring onions, finely diced
- salt & pepper, to season
METHOD:
- Rinse, scrub and dry your potatoes. Using a fork, thoroughly prick the skins, brush or rub with olive oil and season with salt.
Oven bake: place on a baking sheet and bake at 200℃ for 1 hour until fork tender.
Airfryer: spread out within the basket, set to 180℃ and roast for 30 – 40 minutes until for tender.
- Just before the potatoes are ready, saute the diced onion, drained and rinsed black beans, crushed garlic and ground cumin in olive oil to soften the onion and warm through the beans.
- Slice the potatoes lengthwise down the middle (not all the way through), gently squeeze open and top each one with yoghurt (about ½ a small tub), ¼ cup grated cheese, ¼ of the bean mixture and a diced spring onion.
NOTES:
- The 2-3 cloves of fresh minced garlic can be substituted with 1 teaspoon crushed garlic.
- To cut down the baking time, microwave the potatoes for 3 to 4 minutes before baking.
Nutrition Information: Per serving
Energy: 1448 kJ
Protein: 16.2 g
Carbohydrate: 46.3 g Of which, total sugars: 3.2 g
Fat: 3.2 g
Fibre: 10.7 g
Sodium: 267 mg
Meet the dietitian: Blog series
By Darinka Theron:
I was born in Port Elizabeth (also known as the friendly city). I have lived in Port Elizabeth, Cape Town, Cradock, Beaufort West and Knysna. The last 9 years I have worked in the government sector at 7 hospitals and 39 health clinics in two of South Africa’s most beautiful provinces. I love meeting people from different cultures and learning new things in life. I have gained experience in various areas of being a dietitian, from enteral home feeding, vegetable gardens, therapeutic nutrition, food service management and private practice consultations.
During my high school years, I loved learning about biology and the body’s functions. I still remember my first biology terms like osmosis, amoeba, chloroplast, extracellular matrix etc. I became a dietitian because I have always loved the feeling I get when I walk into any hospital environment and I knew I wanted to help people and make a difference in the community and world! If I didn’t study dietetics, I would have studied any degree working in the hospital environment. Through my younger years I have wanted to be a dentist, occupational therapist, dermatologist, pharmacist etc… and the list continues.
I’m a Matie at heart. I studied at Stellenbosch University for 4 years while I stayed in Huis Francie and Meerhoff residences. My favourite modules included anatomy, physiology and therapeutic nutrition. I am currently busy with my master’s degree in Therapeutic Nutrition. I find ICU nutrition, perioperative nutrition and gastrointestinal nutrition fascinating.
At the moment I work at Knysna Provincial Hospital as part of the Eden District in the Garden Route. I work in the hospital wards as well as at the surrounding clinics.
My main responsibilities include: nutrition support treatment and counselling, growth monitoring, nutrition therapeutic programme management, MBFI management, malnutrition control, nutrition education, promotion and advocacy, and food service management.
A day in my work life consists of:
A big cup of coffee in the morning (without sugar!) > ward: nutritional screening or some mornings a meeting > clinic visits: 10-30 patients a day administration (emails, etc.) > patient nutrition counselling and education/In-service training as needed.
I enjoy seeing patients’ results, growth, change in behaviour and knowledge, and helping to make a difference in people’s lives. I am thankful for the patients who give positive feedback or a small gift to show their appreciation. I also enjoy organizing Health Days, World Breastfeeding Week and Nutrition Week. My career highlights include helping Murraysburg hospital get the Mother & Baby Health Initiative accreditation, helping Knysna Provincial Hospital food service unit achieve silver status, helping Cradock health clinics with their vegetable gardens and celebrating World Breastfeeding Week yearly… Breast is truly the best!
Generally being a dietitian has many challenges. Challenging aspects of being a government dietitian includes time management, high workload (especially at the clinics), language barriers, less resources, poverty and poor social circumstances and the community’s lack of knowledge on proper nutrition. During my career I have also found that some health care workers are uninformed about what nutrition really can do for a patient’s health and wellbeing.
When I’m not being a dietitian, ‘Event planner’ should have been my second name. I love doing theme parties, including the food and décor. Party themes I have done include Mexican, Asian, kindergarten and Halloween themed parties. I also love dancing; I did Ballet, Modern, Horton and Contemporary Dancing for 13 years. Dancing teaches a person determination, discipline, teamwork and never giving up in life.
Favourite foods, mmm… nothing like avocado and scrambled eggs on rye toast with a cup of filter coffee or rooibos tea, yes please! I also enjoy eating a variety of colourful fruit and vegetables daily. When I have time to dine out, I always choose between steak, sushi, pizza or a creamy pasta dish. I believe in having a balance in my diet and enjoying different foods.
The things that people should stop saying when they meet a dietitian: “Do these pills/shakes work for weight-loss?” or “Do you only eat salad and fruit?” & “Please don’t look at what I’m eating right now.”
I’m sure other dietitians know what I’m talking about.
WHAT YOU NEED TO KNOW ABOUT MANAGING DIABETES IN THE FAMILY
As the rates of Type 2 diabetes continue to rise in South Africa, more and more South African families are meeting the challenges of living with the condition. A diagnosis of diabetes in the family is a life-changing event, but it is important to remember that diabetes can be managed. If you, or a family member has been diagnosed with diabetes, the first step is for you to completely understand the condition and how it impacts the body. You are empowered to take charge of the condition by diabetes education. So if you feel that you don’t fully understand diabetes, you must ask your local clinic or a community dietitian or a healthcare practitioner to give you more information and help you understand the condition fully.
Diabetes can be managed by medication combined with healthy eating, exercise and monitoring your blood sugar. Registered dietitian and Association for Dietetics in South Africa (ADSA) spokesperson, Neo Mongoegi says, “You need to understand the symptoms of high blood sugars, which is hyperglycaemia, and the symptoms of low blood sugars, which is hypoglycaemia. You also need to understand the impact that food has on blood sugar levels. This awareness enables you to identify any symptoms and then manage them.” Neo is the Head of the Dietetics department at Chris Hani Baragwanath Hospital. She explains, “It is important to know that diabetes is a manageable condition and not a death sentence. However, it is a progressive disease and has to be managed properly through a lifestyle change and compliance to medication. This lifestyle change is essential, and it involves the whole family, not just the person who has been diagnosed. We know that compliance with your healthier lifestyle and new medication routine is improved when the whole family adopts healthy eating and exercise habits.”
Type 2 diabetes disproportionately effects people living in lower income communities where making the necessary lifestyle changes can be challenging due to harder access to healthcare services and diabetes education. Sometimes, access to fresh fruit and vegetables is less easy, and in neighbourhoods with high crime and less recreational space it can be more challenging to develop sustainable exercise habits. No matter the challenges you face, it is important to know that solutions can still be found. This is the advice from another registered dietitian and ADSA spokesperson, Carla Boshoff who works in low income rural communities. She says, “Some small lifestyle changes can be made immediately. Don’t start with what you don’t have, but with what you do have available. Start adding less sugar to foods and drinks, and work towards avoiding it completely. Swop sugary cold drinks for water. Stop adding unnecessary fats or spreads to food and start eating a smaller portion of the carbohydrates that form part of your current daily diet. Start harvesting seeds from available vegetables like tomatoes, pumpkins and peppers, and start planting. Invest in planting spinach, whether you have a garden, an old bucket or old car tyres, so that you always have access to green leafy vegetables. Many people discover that they love food gardening and that there’s great satisfaction in growing your own healthy food. Ask your neighbours and friends to share the costs of seeds with you, and you can all start planting. Join others in community food gardening so that you can share resources, trade vegetables and even sell some for extra income.”
These are Carla’s top 6 tips for people affected by diabetes who live in low-income communities:
- Enjoy a variety of fresh, wholesome food and ensure a variety of vegetables form part of your everyday meal plan
- Ensure that you enjoy a healthy breakfast and never skip a meal which is very important when taking medication for diabetes
- Choose foods and drinks with little or no sugar. Drink lots of clean, safe water
- Work with what you have and focus on portion control. A healthy diet doesn’t need to be expensive and even the smallest changes such as adhering to portion sizes can make a difference. If there is a dietitian or nutrition expert in your area, consult with them for an eating plan that suits you and your family
- Follow up at your local clinic to have your blood sugar levels monitored and take your medication as prescribed
- Invite your friends or loved ones to join you in exercise to make it more enjoyable and take a brisk walk at least two or three times a week. Get gardening – this is not only good exercise by working physically in the garden; it contributes to food production, improves food security; helps you eat a variety of fresh and wholesome food every day. Food gardening is also encouragement, and setting a good example for your children and the children of the community. Perhaps you can also get involved in local food gardening projects at your hospital, clinic or school – and if there is no such project, then start one!
Raising awareness of diabetes is not only important to help people living with diabetes and their families, but also to help prevent diabetes in your community. November is Diabetes Month in South Africa, and World Diabetes Day is on the 14th of November 2020. Neo concludes, “There are dietitians at most hospitals and local clinics that can assist you. If the doctor does not refer you to a dietitian, you can still refer yourself to the dietitian at your local clinic or nearest public hospital. If you are struggling with accepting your diagnosis, there are also social workers at local health facilities for counselling after diagnosis.”
You can also find a dietitian in your area by visiting https://www.adsa.org.za/find-a-registered-dietitian.
Meet the dietitian: Natasha de Almeida
Hi everyone! My name is Natasha de Almeida, I am a 26-year-old Registered Dietitian from Johannesburg, and I absolutely love food. I spend a lot of my time eating, or thinking about eating, or cooking food, or watching people cook food on TV. Food brings people together, when we’re happy or sad, and there are so many different cuisines to enjoy from all around the world.
My food journey has been a bumpy one. I went from being an incredibly fussy child, teenager and young adult to someone who tries to taste and enjoy different types of foods. Before all of this, the look of ANY vegetable got me shifting uncomfortably in my chair. If there were vegetables on the menu for supper, I’d try to switch plates with my sister while my parents weren’t looking. Anything to avoid the absolute torture that it was to eat a single pea. That has changed now, but one thing that has always been with me is my sweet tooth. Anything chocolate and I’ll be happy. If I could cover everything in bar-one sauce, trust me, I would.
I studied Dietetics at the University of Pretoria. A health-related degree appealed to me as it would allow me to help people improve their lives. I’ve always wanted to help anyone or anything, and when I was younger, it was animals. I aspired to be a veterinarian, that is until a 7-year-old me shadowed one performing surgery on a dog. I left that room with a face toned deep purple and a broken dream. Though now, if I look back, I might have studied veterinary science if I hadn’t studied dietetics.
I am half-Mozambican and grew up there, where my whole school, pre-school through to high school, had seven hundred students. So, going from that to a giant, seven-campus university with tens of thousands of students was intimidating to say the least. My university years were incredibly challenging but also rewarding in many ways. When starting at university they recommend that you partake in the ‘three pillars of university life’: academics, social events, and exercise. So that’s what I tried to do, even though it seemed pretty unrealistic at times. Balancing all three was not easy, but I managed to make good friends, pass my degree timeously, and become a first team varsity soccer player in those four years.
I think I only truly realised that health was important to me during my studies. When I started learning about nutrition and health, I was able to reflect, and think about how many lives are affected by nutrition related problems, which I feel like I was very ignorant about before. Studying dietetics opened my eyes to how nutrition can truly affect your health, and that there is more to my interests than just a love of food.
Last year, I completed my one year of community service at a community clinic. Throughout the year I learned a lot about myself and the dietetic profession. I experienced the triumphs and the pitfalls of working as a dietitian. The most challenging aspect of the job being a lack of resources, both in the environment in which we work, and those of the individuals we counsel. The highlight of my job so far has been helping the most disadvantaged improve, even in the smallest of ways, such as helping a child with severe cerebral palsy gain that little bit of weight. My career has just begun, there is much room for growth and experience, and I look forward to many more highlights and learning curves. At the moment, in between completing short courses to improve my knowledge, I am slowly looking at starting my own practice. I also have a keen interest in clinical dietetics and look forward to getting back into a hospital setting.
Being a dietitian comes with many stereotypes, and since I qualified, I have noticed a few misconceptions that people have about the profession, the worst being that we are incredibly judgemental about what others eat. It is sad to hear a friend try to defend their eating when you sit down with them at the dinner table. We do not watch your every bite and dissect every meal you eat. When you season your food, we don’t picture little salt monsters dancing in circles above your head, chanting and waving blood pressure cuffs in the air. We are just like you in that we enjoy food as well, and it is okay to have preferences or dislikes. Some people do not know this about me, but I have texture issues when it comes to certain foods, one example being strawberries. I love the smell, taste and look of them, but I can’t eat them because of their texture. This is something my friends and family joke about with me on a regular basis! We are all different.
Another frustration is the immediate mention of a meal plan when the word ‘dietitian’ pops up in conversation. Yes, we can definitely help you with weight management, but there is so much more that dietitians can do. A dietitian may have helped your uncle with diabetes control his blood sugar by educating him about carbohydrates and insulin use. They may have helped your premature baby gain weight while in the NICU through careful calculation of their nutrient requirements, and they may have analysed that very menu that you choose from at your favourite restaurant. There’s so much more!
One last thing that I do not like hearing as a dietitian, is the idea that eating healthy involves a boring diet that gets rid of your favourite foods. There are so many ways to make a healthy diet enjoyable, including using some of your favourite foods, but in different ways and amounts. Everything in moderation.
With all that being said, the biggest thing I look forward to is helping people from all walks of life, educating those in need, and myself in the process. I am proud to be a Dietitian.
Blueberry Breakfast Bars
This month’s wonderful and nutritious Nutrition Confidence breakfast recipe was formulated by registered dietitian, Julie Perks. See how creatively Julie combined these ingredients for a delicious “on the run” breakfast but also an ideal snack.
As much as I wanted to create a lovely crunchy breakfast bar, I kept making granola as nothing was sticking together so in the interest of ensuring success, I created this version which is both delicious and healthy and utterly fool proof! These can be made with store (and freezer) ingredients. They are then perfect to keep in the fridge or freezer for a quick breakfast on the run. Ideally obviously we would prefer you to be mindful of your meals and not eat “on the run” but also, we know life happens and these then help to ensure you don’t skip breakfast. Ideally enjoyed with some plain yoghurt for added protein where possible.
Serves 8
Ingredients:
- 1 ¾ cup rolled oats (210g)
- 2 TBSP ground flaxseed (10g)
- 1 TBSP cinnamon (7g)
- ½ tsp nutmeg (1g)
- ½ tsp ginger (1g)
- ½ tsp salt (2.5g)
- ½ cup mixed unsalted nuts (70g)
- ¼ cup pumpkin seeds (35g)
- ¼ cup honey
- 1 ¼ cup milk
- 2 cups blueberries (245g)
Instructions:
- Preheat the oven to 180 degrees Celsius.
- Mix the dry ingredients (oats, flaxseed, spices, salt, nuts, pumpkin seeds) in a large mixing
bowl. - Then add in the honey and milk and mix well.
- Allow to soak for 10-15 minutes.
- Line a 20 x 20cm baking dish with baking paper (I used 2 pieces of baking paper going in
opposing directions so it made it easier to remove after it has cooled). - Stir in the blueberries and pour into the baking dish.
- Cook in the oven for 40 – 50 minutes until set.
- Allow to cool completely then cut into 8 bars.
EXTRA: You can make this bar vegan by swapping the milk for plant based milk of your choice (soya milk will be most aligned with the protein content as shown in the nutritional analysis) and then substituting the honey for maple syrup or rice malt syrup.
Nutrition Information: Per serving
Energy: 1100 kJ Protein: 7,5g Carbohydrate: 34,7g of which, total sugars: 2,7g Fat: 11,6g, unsaturated fats 9,23g, Saturated fats 2,4g, Fibre: 5,4g Sodium: 171mg
*note, if you chose to cut into squares to make it a snack portion, then make 16 squares and it will halve the nutritional analysis.
MEET THE DIETITIAN: COMMUNITY SERVICE SERIES
By Jemima Meyer
As a dietitian especially enthusiastic about community health development and digitalising healthcare, I can’t wait to harness the potential of digital technologies to improve our food and nutrition systems. But first I’ll have to complete my community service year.
After graduating from the University of the Free State, I was placed at the South African Military Health Service in Bloemfontein. At the military clinic, I spend most of my time treating patients with lifestyle diseases (obesity, diabetes, high blood pressure, and high cholesterol levels) and other conditions (e.g. HIV, TB, allergies and IBS). I am responsible for promoting health by launching community projects. I also pay monthly surprise visits to military messes to evaluate hygiene and the nutritional adequacy of their menus.
Though I have considered studying a wide range of disciplines (data science, genetics, physiotherapy, music, sound engineering, journalism, you name it), I don’t regret choosing Dietetics. The impact that simple dietary changes can have on a person’s emotions and quality of life is astounding. I also love the controversy in nutrition science. As dietitians, we have to analyse research findings and methodology and compare it to other available studies. In that way, we constantly challenge and update our views. Nutrition science is a tricky research field because researchers cannot simply perform RCTs (randomised clinical trials) to establish the effect of food on health. Usually, we have to make do with looking at the relationship between food intake (actually, what people report eating) and health outcomes. We also have to account for the effect that other variables may have on health. For example, if a population group that drinks a glass of red wine every day has a lower risk for developing cardiovascular diseases, can we assume that wine has some sort of preventative effect? Or is this positive outcome rather because of something else (e.g. financial or lifestyle factors)?
The most frustrating aspect of this occupation is that few people understand why dietitians work in hospitals or clinics. It is common for people, upon meeting a dietitian, to ask about weight loss, banting, veganism, intermittent fasting … Hopefully, in time, it will become general knowledge that dietitians are also responsible for tube feeding and intravenous feeding; and that nutrition plays a pivotal role in preventing and treating gastrointestinal disorders, cancer, HIV, TB, kidney disease, liver disease, burns, etc.
When I’m not busy being a dietitian, I like to meet new people, play the piano, and compose songs. I also enjoy writing and am currently busy with my debut poetry anthology.
MEET THE DIETITIAN: BLOG SERIES
Meet the contributing dietitian
Hi. My name is Rendani Ratshibvumo. I am currently working as a clinical dietitian in the public sector. My function as a dietitian is predominantly clinical nutrition, 20% community-based nutrition, and 20% foodservice management.
I have been a clinical dietitian for the past 8 plus years. My role in the hospital entails management of medical conditions through the application of the clinically approved medical nutrition therapy approach. It is the responsibility of the hospital to provide nutritionally adequate meals daily to hospitalized patients and therefore the foodservice unit and dietetics work hand in glove. I am currently the supervising dietitian in the foodservice unit.
As a dietitian, I reach community members outside the hospital through community outreach programmes targeted at vulnerable groups, which includes people living with chronic diseases, infants, young children and pregnant women. During outreach, I am able to identify nutritional gaps and come up with strategies to remedy those gaps in conjunction with other stakeholders in the community, such as primary health care nurses, school teacher, social development social workers, and others. These outreach programmes provide an opportunity to practice preventative nutrition strategies.
I’ve acquired my degree in dietetics from MEDUNSA, currently known as Sefako Makgatho Health Science University (now you know my age).
The best part about being a dietitian, despite rehabilitating a child from severe acute malnutrition, and seeing a patient go home after a long hospital stay after identifying the sweet spot where their blood glucose can be controlled, is that the field of dietetics is revolving faster than the speed of light. I have a duty to provide the best evidence-based approach to my patients and anyone who might trust me enough to ask dietetics related questions, thus I am continuously learning. Readership is at the heart of being a dietitian.
My best achievement thus far was being part of the protocol review committee in Limpopo 2018, becoming a mother and baby-friendly national assessor, and heading the dietetics department in my institution from 2018. I am currently in the process of editing my first cookbook.
My day as a dietitian starts at 4 am – that’s my time to read up on new articles, news, books on self-development, social sciences and have my breakfast. Work starts at 07h30, with reviewing of patients to be fed for the day and adjustment to be made on the menu with the food service manager. Ward rounds start at 09h00 until 11h00, then I assist outpatients until lunchtime. For the rest of the day I do administrative work and attend to calls from the wards. Officially as a dietitian my day ends at 16h30. Depending on the day I might go to clinics, schools, or ECD.
After work I exercise for 30-60 minutes, currently, I exercise at home due to the COVID 19 restrictions. After the gym, I get to spend time with my family before I can get my beauty rest.
My favourite foods are indigenous vegetables and meat (I’ve yet to meet meat that I didn’t eat)!
The most challenging aspect of my career is the fact that access to food is a basic right but when people are living in poverty, unemployment, and inequality even the best innovative approach can be fruitless without access to food.
One thing that people don’t know about me is that I do not like broccoli.
If I was not a dietitian, I would be a food scientist. Nutrients excited me ever since high school.
Three things that people must stop saying when they meet a dietitian:
- What can I do to get a flat stomach?
- I am healthy nowadays, I don’t even use normal salt anymore, I use the pink one.
- I don’t eat that much so I don’t understand why I am overweight.
That’s just a little bit about me.
MEET THE DIETITIAN: COMMUNITY SERVICE SERIES
ONCE A FUSSY EATER, NOW A REGISTERED DIETITIAN
By Jessica Botes
I was unsure of what I wanted to study but one thing I did know was that I wanted to help people on a daily basis – yes, I know its cliché.
So when the time came to apply for university I chose anything and everything – audiology, physiotherapy, emergency care practitioner, etc.
On a whim I applied to study Dietetics at the North-West University in Potchefstroom after chatting with a friend of the family who is a dietitian and has spent her career in the therapeutic and research fields. I was fascinated. We spoke about ongoing studies involving genetics and nutrition, the integral part nutrition plays in healing a sick body, the role dietitians play in a hospital setting and much more. This awakened a new interest in me and so my journey began.
We got the email that I was accepted- as if it were fate.
Ironically to everyone’s surprise I was now going to be a Dietitian even though throughout my life I have been the fussiest eater ever! I lived off Pronutro/Cornflakes and my scope of vegetables were carrots (only raw) and mealies. I can now proudly say I am in love with all foods and the way they benefit our bodies.
Fast forward to 2020, I am doing my community service at Tembisa Provincial Tertiary Hospital. Every day I get to encounter so many new and interesting patients in the wards as well as educate outpatients in our clinic, who are faced with extreme socioeconomic circumstances.
Although I’ve been taught to use the ideal products specific for our patients, in government settings you will be challenged by limited resources. Another difficulty is communication, whether it be with patients or staff. This includes language barriers and ensuring my prescriptions/recommendations are followed. Yet these challenges all mounts up to experience and can only enrich me for the better!
I love interacting with patients, getting to know them, being that person who shows a little extra care that they may need and always trying to put a smile on their face. This has been especially important during lockdown as all my patients do not have their loved ones visiting – I can’t even imagine being unwell and isolated.
Their progress and healing is so rewarding to witness. Whilst working in the burns and surgery unit, the amazing transformations I experienced there will forever remain with me. My patients have taught me how a positive attitude in dark times can always get you through.
Walking into community service, remember:
- Each day that you get up for work, go in with a positive mind set. You may be tired, you might be struggling to adjust but being negative will hinder your learning experience.
- Never be afraid to ask. You are still learning and are not expected to know everything.
- Ask to do extra work, ask to help fellow colleagues, every opportunity that presents to learn – grab it.
- Don’t be afraid of fellow healthcare professionals. You are an expert in your field. Be confident in your knowledge.
- Go on ward rounds and interact with your allied health professionals.
- What you see in the hospital can be emotionally exhausting- lean on your fellow colleagues for comfort, they see what you do every day too.
- AND ENJOY!
Seafood & stirfry Paella
This month’s recipe is by registered dietitian, Retha Harmse.
A classic Spanish rice dish with a healthier twist. We used wholegrain brown rice, added extra veggies but kept the delicious prawns, calamari, mussels, clams and shrimp and loaded with flavour.
This delicious recipe is very filling, has a low glycaemic index and is high in Omega 3 and unsaturated fatty acids.
Serves: 4
Preparation & Cooking: 40 min
Ingredients:
• 1 tbsp olive oil
• 1 large onion, chopped
• 1 clove garlic, minced
• 1 cup wholegrain brown rice
• 1 can chopped tomatoes
• 2 cups low-sodium vegetable stock
• 1 tbsp hot sauce (eg Tabasco or Sriracha sauce)
• 2 tsp paprika
• 1 tsp saffron (optional)
• 500g mixed seafood mix
• 300g chopped cabbage (red and white cabbage), spinach, carrots or any other veggie of choice
• Salt and pepper to taste
• Spring onions, chopped (for garnish)
Instructions:
- To a paella pan, add the oil and onion and cook for 2 minutes until the onion becomes translucent and soft. Add the garlic and cook for another minute.
- Add the uncooked rice and can of tomatoes to the pan and stir well. Let the rice cook in the sauce from the tomatoes for about 5 minutes.
- Add the vegetable stock, hot sauce, paprika, saffron and season with salt and pepper if needed. Stir everything together and cover with the lid.
- Cook for roughly 15 minutes or until most of the liquid has been absorbed by the rice. The rice will not be cooked through at this time.
- Meanwhile, roughly chop your vegetables of choice to resemble a shredded stir-fry.
- Turn down the heat and stir the rice around a bit. Add the vegetables and seafood mix and gently fold it in. Cover with a lid again and cook for another 10 minutes (if using mussels or clams in the shell, this cooking time will be until the mussels and clams open).
- Turn off the heat and garnish with chopped spring onions.
Nutrition information per serving:
• Energy 1685 kJ
• Protein 26.7
• Carbohydrate 52g
• Of which total sugar 11.1g
• Total fat 6.8 g
• Of which saturated fat 0.9 g
• Dietary fibre 7.6 g
• Total sodium 970 mg
• GI (estimated) 52
Meet the Dietitians: Rosey Lombard & Jenna Spooner
We spoke with ‘softie’ Rosey and ‘ants-in-her-pants’ Jenna as they referred to themselves. These best friends are not only dietitians, but also triathletes and they both competed in IronMan. We had a chat with them to get to know them a bit better:
- Tell us a bit more of yourselves?
Rosey: My name is Rosanne (everyone calls me Rosey) and I was born and raised in Stellenbosch. I went to primary school, high school and varsity in Stellenbosch and then moved to Cape Town to study Dietetics. I got placed in Johannesburg for my commserv year (2017) and have been here ever since. I am a fitness addict, nature lover and a big “softie”.
Jenna: I am a very energetic person who absolutely loves and family, friends, outdoors and adventures. I tend to have ants in my pants and seriously lack the ability to sit still. I love understanding how things work and I am more inclined to watch a documentary or read an article than get stuck into a good book. I am not scared of some alone time doing the things I love, including; cooking, baking, getting outdoors and simply soaking up some sun.
- Why did you become a Registered Dietitian?
Rosey: Sport has always been a massive part of my life, which I think sparked the interest in food, nutrition and the impact on performance. I got to know Jenna at Stellenbosch (we played Maties Hockey together). We instantly became friends. She was 2 years ahead of me, went on to UCT to study Dietetics and that is when I started learning even more about what it entails. This made me even more curious and I then decided to follow this route as well (thanks Jen)!
Jenna: I have had a love for food and sport for as long as I can remember. I saw a dietitian in high school when my academic load and sporting commitments became extremely taxing. I was constantly exhausted, falling asleep in class and no longer achieving on the sports field. Counting the number of grapes and almonds I could eat to achieve portion control still haunts me but wow, what a difference. The role that food played in my energy levels and ultimately performance was amazing.
- What would you have wanted to do if not Dietetics?
Rosey: I would have studied to be a Doctor.
Jenna: I find the human body fascinating so it would have to be medicine.
- Where did you study (degree and/ or postgrad)
Rosey: BSc Sport Science (Stellenbosch) | BSc Honours in Kinderkinetics (Stellenbosch) | BSc (Med) (Sci) Honours in Nutrition and Dietetics (UCT)
Jenna: I started my studies at the University of Stellenbosch where I completed a BSc Sport Science followed by an BSc Hons. in Human Physiology. I furthered my studies at the University of Cape Town where I completed a BSc Med. Hons. in Nutrition and Dietetics.
- Where do you work and what does your job entail?
Rosey: I work at Nutritional Solutions which is a private practice in Johannesburg (I am based at the Bryanston branch). My passion is paediatrics, gut health, general weight loss and sports nutrition. So I often see clients/patients related to those things specifically. But private practice definitely requires a lot more than just “making people skinny”. There is a lot of work for corporate clients, writing articles on nutrition, doing nutrition education for companies/corporate, recipe development and analysis. There really is a lot of variety.
Jenna: I work in a beautiful wellness centre in Bryanston where I have my private practice. I am part of a multidisciplinary team made up of biokineticist, chiropractors, physiotherapist, psychologists, and beauticians. I also work in the RMB Wellness Centres and occasionally get the opportunity to locum in Morningside and Milpark hospitals. I consult with the media on a regular basis; writing articles, analysing recipes and occasionally appearing on a television channel, radio show or health promotive podcast.
- Walk us through a day in your life?
Rosey: It really depends what I am training for. I prefer morning exercise, so on most days I would wake up at 04h45 to get to exercise by 05h20/05h30 for 1h-1h30 mins. I will get to work by 07h20/07h30 for the first patients (depends if there are early birds or not, but I will always be there by about 08h00). I will then be at work until 17h00ish (sometimes stay later if there is a need from patients) and then may go an do another exercise session for the day. It all actually depends on the races ahead. At the moment, Jenna and I have full ironman coming up, so weeks are full on with training. 1-2 sessions per day and then long sessions of 4-6 hours on the weekend. This doesn’t always happen, but in the 4-6 weeks leading up to full ironman, it gets pretty hectic. We love it though. It definitely is my drug and my coping mechanism. When I can’t exercise = MOODY Rosey.
Jenna: Training is a huge part of my life and always has been. It is often (if not always) how I start my day. I may start with a run, a cycle, a swim or even a combination of the three. This is followed by a very quick shower-change-blow-dry routine which I have mastered over time. My day starts with breakfast followed by patients at 340 on Main Health & Wellness Centre. Most of the time breakfast is eaten at work and is by far my favourite meal of the day. My day is spent consulting, calculating, and updating meal plans, developing content for social media or for my patients to use. I also spend a fair amount of time on admin and keeping up to date with all that needs to go on behind the scenes of running a private practice. Some days, not every day, I may get in a second training session. This all depends on upcoming races or what my coach has set out for me. From there it is home time and supper time before I complete the final bits of work that I need to do to make sure I am on track for the following day. Before bed I always pack my bag to avoid rushing in the morning and forgetting to put in a set of underwear which has happened more often than I would like to admit. I aim to get into bed by 21:00/21:30 which isn’t always possible and a daily goal I set myself.
- What do you enjoy most about the work you do? What are the most satisfying moments?
Rosey: I enjoy the people aspect, that I get to meet a lot of different people from all walks of life. I REALLY love when patients are successful and finally come to the realisation that the weight loss/health journey doesn’t need to involve an “all or nothing” approach. I really enjoy when they reach their goals and when their lives have been transformed through this process.
Jenna: I love teaching and empowering my patients with knowledge and skills. Losing weight, overcoming their fear of food, breaking binge eating cycles, achieving blood glucose control, no matter what the goal or outcome is, the journey requires trust, patience and a special bond between a patient and a practitioner which honestly is something I cherish.
- What has been your career highlight?
Rosey: In terms of work or sport?
- Work: I think getting the job at Nutritional Solutions has been the biggest blessing. I am able to work with and learn from the best dietitians in the business.
- Sport: Qualifying for Ironman 70.3 World Champs which is in New Zealand in November 2020. Although the race to qualify (East London 70.3) was VERY tough and not that enjoyable, I am still very grateful for what I went through and how it all turned out.
Jenna: I had the opportunity to be a guest judge on a Disney children’s cooking show which was quite exciting and very different to my normal day-to-day activities.
- What are the most challenging aspects of your career?
Rosey: Work: the most challenging is dealing with the public/media. But, if you are up to date with knowledge and research then this becomes a lot easier to deal with.
Jenna: Private practice is tough. Staying up to date with literature, keeping patients on track with their goals as well as running a business is hugely time consuming and stressful.
- What is something that people don’t know about you?
Rosey: I LOOOOOOOVE Carrot Cake and I eat it almost every Sunday. I know all the spots in Joburg with the best carrot cake 😉
Jenna: I think that sleeping is a waste of time. I know how important it is and hence why I set a daily goal of 7-8 hours a night for myself, but I feel like I can achieve so much more when days are longer and nights are shorter.
- What are your favourite foods?
Rosey: Sushi, Mexican and Carrot Cake
Jenna: I am mad about Thai food but It would have to be my mom’s (or actually my great grandmother’s) carrot cake.
- What are the three things that you think people should stop saying when they meet a dietitian?
Rosey: “Oh my gosh, I better watch what I eat because the Dietitian is here” | “What do you think of Banting?” | “What do you reckon about this whole Game Changers thing?”
Jenna: I only cheat on my diet over weekends. | Wine and chocolate are the reasons I do not lose weight. | What do you think about “this” diet – aka the latest diet fad.
Apple Flapjacks
The latest NutritionConfidence recipe from the authors of Food for Sensitive Tummies, registered dietitians Cath Day and Gabi Steenkamp!
Makes 15 flapjacks
(3 per serving – 175 g)
Ingredients:
- 1 large egg
- 10 mL (2 tsp) sugar
- 2.5 mL (½ tsp) salt
- 1 ripe banana (80 g)
- 5 mL (1 tsp) vanilla essence
- 250 mL (1 cup) skim milk (0.5% fat)
- 5 mL (1 tsp) olive/ canola oil
- 180 mL (¾ cup) cake flour
- 5 mL (1 tsp) bicarbonate of soda
- 5 mL (1 tsp) baking powder
- 60 mL (¼ cup) wheat bran (digestive bran)
- 125 mL (½ cup) oat bran
- 4 medium apples (320 g), preferably green as they are lower GI
- 5 mL (1 tsp) ground cinnamon
- 125 mL (½ cup) full cream plain yoghurt (3% fat)
- 30 g nuts, chopped
Instructions:
- Place the egg, sugar, salt, ripe banana and vanilla essence in a mixing bowl and beat with a fork.
- Add half the milk to the egg mixture.
- Sift the flour, bicarbonate of soda and baking powder into the egg mixture, without stirring just yet.
- Add the wheat bran and then stir gradually using a wooden spoon, until smooth and lump-free.
- Add the rest of the milk and oat bran and mix in carefully.
- Core the apples and cut into thin round slices. Sprinkle the cinnamon over both sides of the slices.
- Add a teaspoon of canola / olive oil to a non-stick frying pan and spread the oil around the base of the pan with some paper towel, to coat the pan evenly, ensuring the crumpets go a wonderful golden brown colour.
- Place the four to five (depending on the size of your pan) apple slices onto the non-stick frying pan, allowing the apple slice to cook for 1-2 minutes.
- Using a tablespoon, spoon one tablespoon of flapjack mixture onto each apple slice.
- Cook the crumpets over medium heat until they start to bubble on the top. Place another apple slice on top of the bubbles then turn over the crumpet using an egg lifter. The crumpet should be golden brown in colour on the cooked side. Repeat the process until you have used up all the batter and apple slices.
- Serve three crumpets per person topped with full cream yoghurt and chopped nuts.
Nutritional Analysis per 175 g serving
Energy 1210 kJ (290 Cal) | Protein 9.8 g | Carbohydrate 39.9 g | Added Sugar 1.6 g | Total Fat 8.4 g | Saturated Fat 1.6 g | Monounsaturated Fat 4.0 g | Polyunsaturated Fat 1.9 g | Cholesterol 51 mg | Dietary Fibre 5.6 g | Sodium 607 mg | Glycemic Index 46 | Glycemic Load 19
Dietitians Notes:
These high fibre crumpets are easy to make and do not require the batter to stand before cooking. They contain both soluble fibre (oat bran) and insoluble fibre (wheat bran), as well as one fruit portion per 3 crumpet serving, making these a healthier alternative to regular crumpets.
Because of the flavour and natural sweetness of the banana and apple slices, very little sugar is added to this recipe, resulting in a good low GI breakfast of delicious crumpets.
These crumpets can also be served as a delightful snack for mid-morning or afternoon tea with the family.
BREASTFEEDING & COVID-19: BUSTING THE MYTHS
We’ve had an overload of fake news over the past pandemic months. One of the most damaging falsehoods to emerge has been that COVID-19 + moms can transmit the virus through breastmilk to their little ones, and should stop breastfeeding. Spokesperson for ADSA (The Association for Dietetics in South Africa), Andiswa Ngqaka, a registered dietitian says, “There are anecdotes from various countries indicating that this misinformation is causing moms to avoid breastfeeding during the pandemic. While some may see infant formula as a ‘safer alternative’ during this time, this is not the case. Breastmilk is the safest and most nutritious food for babies, and COVID-19 does not change that.”
There is no evidence of COVID-19 transmission through breastmilk
As the medical profession’s foremost experts in nutrition, registered dietitians are constantly keeping up to date with the latest scientific evidence. Worldwide, there is currently no evidence that breastfed babies have been infected by mothers who have tested positive to COVID-19. Andiswa explains, “The WHO cites one study where there was a detection of non-infectious COVID-19 viral RNA in breastmilk, and this is definitely not the same thing as finding viable and infective virus. Therefore, there is unanimous agreement across international health organisations that moms can have complete peace of mind breastfeeding their children through the pandemic, even if they are COVID-19 + or suspect they might be infected. The benefits of skin-to-skin contact with your baby and breastfeeding as normal are overwhelmingly immune-boosting and protective of your baby’s health.”
Lisanne du Plessis, Associate Professor at Stellenbosch University and ADSA spokesperson, gives her top 5 tips for breastfeeding moms during the pandemic:
- Mothers should breastfeed on demand, whenever baby wants to breastfeed, day and night.
- Breastfeed exclusively for 6 months. Breastmilk provides all the food and water that babies need during this time. Breastmilk also protects babies against sickness or infection.
- Do not give any other food or liquids to babies, not even water, during the first 6 months of life. Even during very hot weather, breastmilk will satisfy babies’ thirst.
- Giving babies under 6 months anything other than breastmilk will cause them to suckle less, will reduce the amount of breastmilk that a mother produces and may make babies sick.
- Practice hygienic measures to protect moms and babies against COVID-19 and other harmful bacteria and viruses in our environments.
Breastfeeding is food security for babies
Breastfeeding from birth supports the healthy development of babies and plays an important role in prevention of all forms of childhood malnutrition including wasting, stunting, obesity and underweight and micronutrient deficiencies. Breastmilk protects against many infections including COVID-19. At a time when many South African families are facing serious food shortages, breastmilk provides complete food security for babies under 6 months, and boosts nutrition and health for other young ones. Breastfeeding saves on the food budget, making more money available to feed the family. When it comes to food, you can’t get anything safer, more convenient and more economical than breastmilk. “It would make good sense to see a boost in breastfeeding across South Africa at this time,” says Lisanne.
What precautions should a COVID-19 + mom take?
The WHO provides the following breastfeeding guidelines if you suspect or know you have COVID-19:
- Wash hands frequently with soap and water for at least 20 seconds or use alcohol-based hand rub and especially before touching the baby;
- Wear a medical mask during any contact with the baby, including while feeding;
- Sneeze or cough into a tissue. Then dispose of it immediately and wash hands for at least 20 seconds again;
- Routinely clean and disinfect surfaces that you have touched.
It is vital that partners, family and friends support breastfeeding moms who may be COVID-19 infected. They need to understand that there is no evidence that the virus is transmitted through breastmilk, and that by continuing breastfeeding, the mother is doing the best she can do to protect her baby from COVID-19.
What should happen if you’re just too ill to breastfeed?
Andiswa says, “If you’re too ill to breastfeed, try to express your milk for your baby and give it with a clean cup or spoon and cup. Expressing breastmilk is important to sustain your milk production so that you can carry on breastfeeding when you recover. If you can’t express your breastmilk, you can consider donor human milk. Wet nursing is another option if culturally acceptable to you. Your last option would be to provide a breastmilk substitute. Reunite with your baby as soon as your recover. Get support if you need help re-lactating and bonding with your baby.”
Get Messages for Mothers – M4M
A global pandemic is certainly not the easiest time to be a new mom and the mom of young children. Mothering babies and small children is often an isolating experience at the best of times, so now, with social distancing and staying-at-home, you may need to make some extra efforts to ensure you are well-supported at this critical parenting time. Grow Great, a campaign to prevent stunting by 2030, partnered with other NGOs Embrace, ilifa labantwana and the Perinatal Mental Health Project, to launch Messages4Mothers, a new digital platform to connect with South African moms during the pandemic. Messages for Mothers can be accessed at M4M or you can connect with Grow Great on social media @GrowGreatza on both Twitter and Facebook. Grow Great Communications Specialist, Duduzile Mkhize says, “Some of the biggest concerns for mothers are around how they can safely continue to breastfeed their children while dealing with COVID-19. Some mothers are essential workers and they worry about how they can continue to keep their families safe. Mothers of small children worry about taking them for immunisations as they fear clinics might not be safe. Pregnant mothers who have to go for checks ups also worry about this. COVID-19 lockdown has caused a lot of anxiety for many people, so many mothers ask questions about how to cope with anxiety and depression.”
You’re not alone
On a daily basis, the M4M platform provides accurate and reliable information for mothers by answering frequently asked questions. These questions are gathered from social media platforms of all the partners and the Grow Great WhatsApp groups and campaigns. You will find reliable updated COVID-19 information as well as support for breastfeeding and practical advice for coping with the challenges of motherhood during the pandemic.
World Breastfeeding Week takes place from Saturday, 1st August to Friday, 7th August. The local 2020 campaign theme is Support breastfeeding for a healthier South Africa. The Department of Health and its partners, including ADSA, appeal to the country to fully support and encourage breastfeeding mothers who are protecting their babies against many infections, including COVID-19. Through breastfeeding on demand, mothers also protect their baby’s vital source of immune-boosting breastmilk and help their babies thrive through close mother-and-child contact.
Nutrient-Dense ‘Lockdown’ Recipes
67 minutes for Mandela
Today is Mandela Day, but how we approach it and which activities we engage in will no doubt look different than it did in previous years due to the pandemic.
But to quote the inspirational Nelson Mandela himself: “What counts in life is not the mere fact that we have lived. It is what difference we have made to the lives of others that will determine the significance of the life we lead.”
ADSA and NSSA collectively launched this booklet on Mandela Day (18 July 2020), in the spirit of goodwill and to support and guide the prolonged humanitarian response to fight hunger and malnutrition. The recip-e book will be shared with regional and national food relief organisations, for use and further distribution.
We encourage every follower of this page to share this recip-e booklet widely (aim for at least 67 people), including to local organisations involved with food relief and humanitarian efforts, soup kitchens, households and individuals.
Link for download below:
GREEK STYLE CHICKEN FOIL PACKET DINNER
This delicious Greek style Chicken foil packet dinner was formulated by Registered Dietitian Cheryl Meyer from Dish & Delite.
@dishanddelite
Serves 4
INGREDIENTS
- 500 g skinless, deboned chicken breasts, cubed (3-4 chicken breasts)
- 250 g baby potatoes, skins on, quartered
- 2 large or 3 medium-sized peppers (any colour), sliced
- 1 onion, sliced
- 1 lemon, sliced
- 2-3 cloves garlic, minced
- 2 tablespoons olive oil
- 2 tablespoons red wine vinegar
- 1 tablespoon fresh rosemary, roughly chopped
- 1 tablespoon fresh oreganum, roughly chopped
- ⅓ cup pitted kalamata olives, sliced
- 1 round of feta cheese, crumbled
- salt & pepper, to season
METHOD:
- Stir together garlic, olive oil, red wine vinegar, rosemary and oreganum to make a herb vinaigrette.
- In a large bowl combine baby potatoes, peppers, onion and lemon. Stir through the vinaigrette to coat the vegetables.
- Take a long piece of heavy duty foil or fold light-weight foil in half for a double layer.
- Center a quarter of the chicken mixture on each sheet.
- Top your chicken with the vegetable mixture. Divide and pour over any herb vinaigrette remaining in the bowl.
- To make packets: Fold over one side, fold the edges together and press to seal. Double fold the remaining 2 edges to make a small packet, leaving room for steam to circulate inside the packet.
- Transfer the packets to a baking sheet and oven bake at 200°C for 30-45 minutes until chicken is cooked through and potatoes are fork tender. Cut slits in the foil to release steam before opening. Top with olives and feta and enjoy.
NOTES:
The 2-3 cloves of fresh minced garlic can be substituted with 1 teaspoon crushed garlic.
If you don’t have fresh herbs on hand, substitute 1 teaspoon dried for 1 tablespoon fresh.
We Love:
The fresh herbs and bright lemon flavour of this simple recipe. Foil packet cooking allows the flavours inside to intensify as the food cooks in its own steam.
What the dietitian says:
You need 1-2 tablespoons of liquid per packet to create the steaming effect and to infuse the other ingredients with flavour. Alternative liquids to the vinaigrette listed in the recipe that you could try: wine, stock, vegetable juice, soy sauce, your favourite sauce or marinade.
Nutrition Information: Per serving
Energy: 1299 kJ Protein: 32.9 g Carbohydrate: 16.4 g Of which, total sugars: 1.7 g Fat: 1.7 g Fibre: 3.1 g Sodium: 455 mg
SOUTH AFRICA’S SUPERHERO DIETITIANS
Superheroes are dedicated to making the world a better place and protecting the public. They stand up to threats and use their superpowers to ensure people’s well-being and safety. As COVID-19 has spread across the world, we have seen dietitians at the frontlines of the health response supervising life-sustaining nutrition in hospitals and care homes. Many have also been working remotely, helping patients manage their health and nutrition under lockdown. Those in public health have been contributing their expertise to emergency food relief efforts as South Africa faces a sharp crisis in food security. These are just some of the vital roles that registered dietitians play across a range of fields.
“The need for latest nutrition knowledge and science-based advice is far more widespread than most people realise,” says Logesh Govender, registered dietitian and council member of SASPEN, the South African Society for Parenteral and Enteral Nutrition. “There is considerable dietetic diversity, from food product innovation in the corporate sector to patient care in government hospitals; from the policy level of public health disease prevention to practically improving nutritional access in communities. Food is a basic essential of life, and the need for expert nutrition-related services impacts every one of us.”
At a time, when most countries around the world are emerging from hard COVID-19 lockdowns, the health of our families has come sharply into focus on a daily basis. With the closure of food takeaways and restaurants and confinement to our homes, many of us are experiencing changes to our habits and relationships with food. “For the individual and the family, the community and the country, we are experiencing a unique opportunity to examine our thoughts, beliefs and actions around food,” says Association for Dietetics in South Africa (ADSA) President, Christine Taljaard-Krugell. “If there is good that can emerge from this global crisis, it is to see where we can use science-based evidence and advice to make positive changes that will improve our lives now, and once the threat of COVID-19 has subsided. When it comes to nutrition knowledge, it is our dietitians who are the superheroes that can lead the way in recommending sustainable changes to ensure healthier lifestyles.”
These South African Dietetic Superheroes represent their colleagues in diverse and critical health sectors:
Dietetic Superhero in ICU/COVID-19, Anna-Lena Du Toit is currently the dietitian responsible for the nutritional management of patients in the intestinal failure unit, colo-rectal surgery, hepatobiliary surgery, upper gastro-intestinal surgery and surgical ICU at Groote Schuur hospital. In light of the pandemic she has been re-assigned to a 12-bed COVID-19 ICU unit as well as two COVID-19 wards. She also works part-time at UCT Private Academic hospital with mostly surgical in-patients. Anna-Lena serves as the scientific secretary and president-elect of SASPEN.
Your Superpower: To be a valued member of the multi-disciplinary healthcare team I think is the most vital tool if you want to influence patient care and ensure that your patients receive optimal nutrition support. Your relationship with the various players in the team have a direct impact on the nutritional management of your patient. Building relationships with various members of the team ensures early referral of patients for nutritional input all the way through to nursing staff valuing your input and ensuring accurate delivery of the nutrition prescription. Regular training and education within the multi-disciplinary team ensures their buy-in into the important role nutrition plays and ultimately translates into better nutrition for your patient. Being up to date and able to translate evidence into practice ensures that you are regarded as the expert in your field and gives you the opportunity to advocate for your patient.
When patients are in hospital and unable to eat by themselves the dietitian has the super power to still ensure that patients receive all the nutrition they need for their various conditions. This is achieved either through feeding the patient directly into the stomach or by feeding into the veins. This requires the use of very specific nutritional products that should only be prescribed and used under supervision of a registered dietitian.
Is there a positive health lesson we can take out of our experience of COVID-19? What a time to be alive! In my 13 years in clinical dietetics, I have not seen protocols and plans being put in place as quickly as it has been happening in the past three months. The innovation, drive and commitment on all levels that has gone into ensuring safe working conditions and optimal facilities for patient care has been phenomenal. In the community, the way in which people have adapted to a ‘new normal’ and the realisation of what is truly important in our lives has been incredible. It has been positive to see the amount of good that there is in this world, and how willing people are to help and give. If we can come out of this pandemic and continue doing these things we can truly change the world.
Dietetic Superhero in breastfeeding advocacy, Chantal Whitten recently completed her PhD at the North West University and is currently a lecturer at the University of the Free State. Chantell serves as the Nutrition Lead for the coalition network the South African Civil Society for Women’s, Adolescents’ and Children’s Health, and as a member of the National Department of Health Ministerial Committee for the Morbidity and Mortality of Children under 5 years.
Winning the challenge: For all my years of experience in the field of breastfeeding, my greatest moment of contribution was in facilitating the legislating of Regulations R991, which are the regulations that control the marketing of breastmilk substitutes. These latest regulations protect breastfeeding for generations to come and help to foster a supportive environment for mothers to choose breastfeeding without undue pressure from the infant formula industry.
Is there a positive health lesson we can take out of our experience of COVID-19? We know that mothers who are breastfeeding through the pandemic have less stress trying to source food for their young infants and children, while mothers who are not breastfeeding have an additional burden to find food for their young children. We can now see first-hand the protection that breastfeeding offers both children and mothers during a time of crisis. This will remain important as we enter an economic depression. For children, food security starts at the breast.
Dietetic Superhero in reducing obesity, Kelly Francis serves on the executive committee of ADSA where she is currently assisting with a COVID-19 hunger relief campaign and a strategy to support the prevention and reduction of obesity in South Africa. She has a passion for nutrition education and the prevention of nutrition-related diseases and her special areas of interest include obesity.
Greatest challenge: The culture of dieting is the greatest threat to winning the battle against obesity. Many people are resistant to long term lifestyle and behaviour modification and would rather be very restrictive for short bursts of time than work at developing a healthy and mindful relationship with food. Not only is this not a sustainable treatment for obesity, but the family’s opportunity to develop a healthy relationship with food is ultimately disrupted by family members following a different diet.
As a Dietetic Superhero what one sweeping change would you like to see that would improve nutrition and health in SA? I would like to see that no nutritious food goes to waste in South Africa, especially ‘ugly’ vegetables not accepted by retailers. I feel that there is much room for work in this particular area of safe food waste to improve access to nutrient-dense food.
Dietetic Superhero in public health, Lenore Spies has more than 35 years’ experience in the public health sector. She is currently a Senior Technical Advisor in Nutrition for the Maternal, Adolescent and Child Health Institute. Lenore is an expert in nutrition leadership, strategy and policy development, and she is passionate about mentoring the next generation of nutrition leaders.
Greatest challenge: The single greatest challenge in public health nutrition is the underestimation of the contribution that dietitians and nutritionists can make to the public health agenda. You are always having to explain and motivate the contribution that dietitians and nutritionists can make. We can do so much more. We need to move to a place where the expertise of public health nutritionists is an integral part of any public health agenda item. In the current COVID-19 context, with hunger and malnutrition as well as hospitalizations and quarantine, we should be central to the discussions. I was very impressed with the
Governor of New York, the hardest hit state in USA, when he specifically listed Public Health Personnel and Dietitians and Nutritionists as essential front line workers.
Your Superpower: Over the years, I have worked relentlessly to develop my leadership and
advocacy skills to the extent that I am often consulted on my views and opinions. I have become particularly adept at being able to navigate the balance between the political and social contexts, take a high level view of its relevance and translating that to the nutrition policy environment.
Dietetic Superhero in public health, Gilbert Tshitaudzi is a Nutrition Specialist at the UNICEF South Africa Country Office. He has many years’ experience in the public health sector and has specialised in infant and young child nutrition, clinical nutrition, HIV and nutrition programming. Gilbert served for four years as a board member of the Professional Board for Dietetics and Nutrition of the HPCSA (Health Professions Council of South Africa).
Winning the challenge: My contributions have been in advocating for public health nutrition interventions through public health policies, nutrition-specific, nutrition-sensitive policies and strategies. Having advocated for the mainstreaming of nutrition into HIV/AIDS care when South Africa started with ARV rollout is one of the major contributions I have made in the nutrition landscape in South Africa.
Is there a positive health lesson we can take out of our experience of COVID-19? COVID-19 could be a springboard for our healthcare system in South Africa in strengthening our public health interventions, with prevention of diseases as a cornerstone. It is also an opportunity to bring all South Africans around to one health system for all in order to deal with the inequalities that have been highlighted by this pandemic. This is an opportunity to interrogate our food systems and play a meaningful role as a profession in those debates.
Dietetic Superhero in private practice, Monique Piderit serves private practice patients through Nutritional Solutions in Bryanston, Johannesburg and consults to corporate and food industry clients. She is currently a PhD Dietetics candidate at the University of Pretoria.
Greatest challenge: Dietitians are dedicated to sharing evidenced-based nutrition information and advice. Today, everyone has vast amounts of information, and misinformation, at their fingertips. There are high levels of consumer confusion which, unfortunately, can lead to distrust of professionals. This confusion may be fuelled by non-experts like bloggers, influencers, health coaches, and the like, who often have large social media followings vulnerable to misinformation. It’s particularly challenging when such non-experts create fear-mongering related to healthy eating and nutrition.
Winning the challenge: The best for me is when a patient, who starts out resistant, reluctant and unwilling to change, realises the huge power that they hold in improving their nutritional status. It’s fascinating to watch this transformation to one of confidence and positivity as they choose to take control of their health and turn it all around. Actually, my patients and clients are the real superheroes. I am just their sidekick!
ADSA has joined forces with SASPEN in the upcoming celebration of Dietitian’s Week, which runs from 1 to 5 June 2020, focussing on #WhatDietitiansDo.
Dietitian’s Week highlights the diverse and important roles that these science-based nutrition experts play in our health care system.
9-Veg Lasagne
This month’s Nutrition Confidence recipe is a nutrient-dense veggie-packed lasagne formulated by Registered Dietitian Julie Perks.
While this recipe uses a lot of ingredients and take more than average steps it is SO worth it. It makes a large serving dish and freezes well for use when you’re too busy to cook. This also uses so many vegetables that really packs a nutrition punch. They aren’t hidden and aren’t meant to be to trick children into eating more veg (well, except the cauliflower but that can’t be helped). This meal provides over half of the daily fibre requirements for an adult and is a really tasty nutrient rich dish.
I have used dried lentils to make this option but you are welcome to use tinned. I am using my slow cooker and steamer a lot more these days during lock down. I use my slow cooker to cook up legumes that I freeze for various other dishes.
I hope you will make it and enjoy finding new ways to incorporate more vegetables into your lasagne and enjoy this delicious meat free meal!
Serves 8
INGREDIENTS:
Cauli-sauce
- 2 medium heads cauliflower, broken into florets (900g)
- Nutmeg – pinch
- ½ cup full cream milk
Lentil Bolognaise
- 2 TBSP oil
- 3 tins lentils (rinsed) OR alternatively you can cook your own lentils – 345g dried lentils cooked with 900ml water (I did this in the slow cooker and freeze in “tin” amounts to use at my convenience).
- 1 large onion, finely chopped
- 2 carrots, finely chopped
- 2 large sticks of celery finely chopped
- 2 cloves garlic
- 250g button mushrooms
- 6 large tomatoes, skinned and chopped (900g)
- 50g sachet tomato paste
- 2 sprigs of Rosemary (roughly 1 tbsp)
- 2 bay leaves
- 2 tsp vegetable stock powder
- 1 cup water
- 100ml red wine (optional)
Other
- 600g butternut
- Pinch nutmeg
- ¼ tsp salt
- 2 bunches of spinach
- 2 large Baby marrow (300g)
- 10 Dried Lasagne sheets
- 120g cheddar cheese, grated.
METHOD:
- Dice onions finely and fry in a large pot using 2 tbsp olive oil for approximately 5 minutes until soft.
- Add the diced carrots, celery and garlic to the pot.
- While these are cooking boil the kettle and cut a cross into the tomatoes and place into a large bowl and pour over the hot water. Leave for a few minutes until the skins are easily removed. Then chop and keep aside.
- Add the mushrooms to the pot, stir regularly.
- While the vegetables continue to cook, destalk the spinach and chop roughly. Place in a steamer for 5 minutes then rinse under cold water and squeeze dry.
- To the bolognaise pot add the chopped tomatoes, bay leaves, rosemary and cook for 5 minutes. Then add the vegetable stock, water and the wine (optional). Cover for 15 minutes, stirring occasionally.
- While this is cooking peel the butternut, chop and add to a steamer.
- Place the chopped cauliflower into another small pot with 2 cups of water and cook until tender.
- Now preheat the oven to 180 degrees Celsius.
- To make the Cauli-sauce put ¼ cup of the water from the pot then add the milk and nutmeg into a blender. Add the drained cauliflower and blend until smooth.
- Mash the butternut once it is cooked. Stir in a sprinkle of nutmeg and ¼ tsp salt.
- Using a peeler, peel the baby marrow into long ribbons and set aside.
- Remove the bay leaves from the bolognaise.
- Spray a large serving dish with a non-stick spray (the one I used had the following dimensions: 33 x 24.5cm).
- Now it is time to put all the layers together – Start by layering your lasagne with cauli sauce first (use 1/3 of the amount you made), then lasagne sheets (I used 5 per layer and broke into shapes I required where necessary), then layer in all the spinach, another layer of cauli sauce (1/3), then generously overlap half the portion of baby marrow slices, then pour in half of the lentil bolognaise, then layer in the remainder of the baby marrow slices, then top off with the last of the bolognaise, layer in 5 more lasagne sheets, and finally pour over the remaining 1/3 of cauli sauce and finish off with grated cheese.
- Bake in the preheated oven for 50 minutes and ENJOY!
Nutrition Information: Per serving
- Energy: 1657 kJ
- Protein: 21g
- Carbohydrate: 60,3g
- Of which, total sugars: 1,0 g
- Fat: 10,7g
- Fibre: 17,6g
- Sodium: 497 mg
Good Nutrition, a priority during COVID-19
The global pandemic has stripped daily life down to the essentials, and we find ourselves under lockdown restrictions with our thoughts and actions around food set in a very different context to anything we have known before. As it grows ever clearer that the threat of COVID-19 will be with us for quite some time and restrictions will be ongoing, optimising our family’s health now is top of mind for many. Generally, South African families are now home together for an extended period of time. There’s more opportunity to shift into healthy habits like cooking nutritious meals together, making healthy snacks and drinks available in the home and being physically active as a family on a daily basis.
“If it’s not already a focus of family life, this is actually an ideal time to prioritise nutrition and health,” says Retha Harmse, a Registered Dietitian and spokesperson for ADSA (Association for Dietetics in South Africa). “As lockdown restriction levels fluctuate; we will have more freedom of movement, but also more risks of contracting COVID-19. Eating a balanced diet plays an important role in maintaining health and supporting the immune system, as well as all the body’s vital systems.”
A balanced diet is the best immune support
The media, especially social media, are rife at the moment with information-sharing about COVID-19, and there’s a lot of ‘advice’ and recommendations that are not evidence-based. A feature of the COVID-19 fake news has been the touting of various foods, medicinally-used plants or nutritional supplements as ‘immune-boosters’, treatments or even ‘cures’. Retha says, “Of course, everyone would like to minimise their risk for contracting COVID-19, however, there is no simple quick fix to boost our immune system to guarantee that we won’t be infected. Simply put, you cannot ‘boost’ your immune system through diet, and no specific food or supplement will prevent you contracting COVID-19. Good hygiene practice and social distancing remains the best means of avoiding infection.”
There are many nutrients involved with the normal functioning of the immune system. This is why maintaining a healthy balanced diet made up of different foods that provide a spectrum of nutrients that include copper, folate, iron, selenium, zinc and vitamins A, B6, B12, C and D is the very best way to support immune function. “In addition to a healthy balanced diet, a general healthy lifestyle is also important to support your immune system,” says Retha, “This means not smoking, exercising regularly, getting adequate sleep and very importantly, minimizing stress, which is very intense at this time.”
How do we achieve a balanced diet for optimum immune support?
A well-balanced, healthy diet will provide you with all the nutrients you require to support immune functioning. Retha suggests going back to the basics of good nutrition. Here, she takes the South African Food Based Dietary Guidelines and shows where you can make some creative adjustments to fit the lockdown restrictions you might experience:
- Enjoy a variety of foods – Although certain foods might be a bit harder to come by, don’t fall in the trap of eating only certain foods. Variety also means including foods from two or more food groups at each meal.
- Be active – Regular, moderate exercise is very beneficial for getting outdoors (if you can), stress relief and improved immune function. Try some of these lockdown ideas:
– You don’t need big spaces for cardiovascular exercise – running up and down stairs is great; as is skipping, and skipping ropes are inexpensive cardio tools
– download exercise apps for daily workouts
– Similarly, there are many physical activity videos, including dance, martial arts and yoga, available on YouTube and other websites
– If you have a closed in garden or courtyard-type space, play physical games such as handball, bat and ball, mini-cricket or mini-soccer as a family or couple, combining fun, bonding and exercise - Make starchy foods part of most meals – Choose whole grain, unrefined foods to add more fibre, vitamins and minerals to your diet. Good options to choose are whole-wheat pasta, multigrain provitas or cracker breads, brown rice and bulgur wheat. Combine whole grains with other tasty, nutritious foods in mixed dishes.
- Eat plenty of vegetables and fruit every day– This can be challenging while we are under lockdown and want to avoid frequent shopping. Here are some tips:
– Choose fresh, whole fruit that is naturally longer lasting such as apples, pineapple and citrus fruits
– Eat fruits as snacks and desserts. Add sliced fruit or dried fruit to your cereal, muesli or yoghurt
– As some fresh vegetables don’t last long, blanche or cook them on the day of purchase and then freeze for later use
– Root and bulb veg options such as carrots and turnips, onions, garlic and ginger are longer lasting
– Frozen and canned vegetables are also good options - Eat dry beans, split peas, lentils and soya regularly – Dried legumes are not only good substitutes for meat, fish, eggs or cheese, but can also be used as affordable ‘meat extenders’ to make meals go further. If you use canned legumes rinse them well after they have been drained to reduce the sodium content.
- Mash and heat up tinned cannelloni beans as the creamy base for a pasta sauce.
- Save on your budget and make your own humus from canned chickpeas.
- Peanut butter can be used as a sandwich filling and can be stirred into porridge.
- Have milk, maas or yoghurt every day – Maas and yoghurt will last longer in the fridge than fresh milk. For more long-term milk options buy long-life milk, skim milk powder or evaporated milk. Fresh dairy products can also be frozen. Eat yoghurt, with added fruit, as a snack between meals instead of a packet of chips as this contributes to the day’s nutrient intake and does not contain excess fat and salt.
- Fish, chicken, lean meat or eggs can be eaten daily –
- Stock up on tinned fish options such as tuna, pilchards, sardines
- Quiches and omelettes are an easy and tasty way to use up vegetables that might spoil soon
- Drink lots of clean, safe water – This is perhaps the easiest time to get into the habit of drinking enough water because you are confined to one space. If water is readily available during the day, it increases consumption. Keep a water bottle on hand or a jug nearby.
- Use fats sparingly – Choose vegetable oils rather than hard fats, and always use only a little, as fats are high in energy but provide relatively few nutrients.
Even for those who are still earning under the lockdown restrictions, the economic downturn is going to have an impact on the vast majority of South African households. Retha emphasises the importance of getting your household food budget under control, as this can relieve some stress. “Prioritise nutrient-dense foods that you know your family enjoys, and limit your purchases of treats, drinks and snacks that are high in calories but low in nutrients,” she says. “Meal planning, and keeping dishes simple yet nutritious, helps to reduce your food waste and gives you the peace of mind that you’re doing the best you can so that your family can maintain their health. Always remember that the best ways to stay safe are through regular, proper washing of hands, social distancing and limiting movement outside of your home.”
Green salad: Green beans, courgettes , tarragon, capers and peppercorns
Our new NutritionConfidence recipe created by dietitian, Mpho Tshukudu, is a flavour powerhouse and oh-so nutrient rich everything green salad. This is a great in between seasons – not completely cold, but also not a warm salad, for those in-between days.
Courgettes are indigenous to South Africa. They make beautiful salads, soups, stir-fries and can also be used in baking to add moisture and fibre to the dish. They are a relatively low kilojoule vegetable and are a source of fibre and vitamin C.
Serves 4 – 6
Ingredients:
- 500 g Green beans, stems removed
- 2 Courgettes, julienned and cut into 4 cm length
- 3 Tbsp baobab mayonnaise OR 3 Tbsp or plain yoghurt dressing, mixed with 1 tbs cold-pressed oil (olive, avocado, sesame, marula)
- 1 tsp dried tarragon OR 1 Tbsp fresh, chopped tarragon
- 1/2 teaspoon green peppercorns, finely crushed
- 3 teaspoon capers, drained and roughly chopped
- Pinch of salt, or more to taste
Method:
- Prepare ice water bath
- Blanching: Using a big pot, bring about 2 cm water to boil. Add beans for 1-2
minutes until bright green but still crisp. - Drain and soak in an ice water bath for about 2 min bath, to stop cooking process
- Once cool, drain in cut into 4 cm lengths
- Add beans and courgette to a bowl
- Add baobab mayonnaise or yoghurt dressing and oil. Mix well
- Add capers, tarragon and peppercorn
- Add salt if needed
Baobab mayonnaise
- ⅓ cup baobab powder
- ¼ cup water
- ⅓ cup oil
Put all ingredients in a high speed blender for 2 minutes until thick.
OR
Yoghurt Dressing
- 3 Tbsp plain yoghurt
- 1 tsp lemon juice
- Whisk together
Notes:
- The everything green salad.
- The green beans are slightly blanched and the courgettes (baby marrow) are raw, giving the recipe a fresh and crisp texture. Baobab mayo is an alternative to the regular mayonnaise, it gives a slight tart taste with a creamy mouth-feel. Baobab is indigenous to Southern Africa and other tropical areas in Africa. The fruit is rich in insoluble fibre, vitamin C and calcium.
- Capers are edible flower buds that add colour and build up the tangy taste.
- Tarragon adds a slight liquorice flavor.
Nutritional analysis per serving of 4:
Energy: 570 kJ
Carbohydrates: 6
Protein: 3,2
Fat: 4,4 g
Fibre: 4,7 g
Plant-based Breakfast: Sweet potato rosti with sautéed vegetables
We love the latest NutritionConfidence recipe from registered dietitian, Retha Harmse.
This recipe is a delicious twist for those who want to embrace plant-based eating but don’t know where to start. It is also an interesting way to incorporate more veggies into your breakfasts.
The kilojoule content is greatly reduced by making basil-and-pea pesto instead of normal basil pesto. The high fibre content is good for glycaemic control and reducing cholesterol.
This breakfast is packed with nutrients, flavours and fibre. Because of the versatility of sweet potatoes, the rosti can easily also be used for a sweet breakfast with fruit, nuts and cottage cheese.
Recipe served 4 (2 rosti per person)
Ingredients:
Sweet potato rosti
- 2 medium sized sweet potatoes, washed
- 1 small onion, peeled
- 1 Tbsp (15 mL) olive oil
- 1 Tbsp (7 g) flour
- 1 tsp (4 g) garlic powder
- 1 tsp (4 g) cumin powder
- ½ tsp salt and ½ tsp ground pepper
Basil-and-pea pesto
- 2 cloves garlic, minced
- ½ cup (68 g) roasted pine nuts
- 1 ½ cup (225 g) cooked green peas
- 1 lemon, juiced
- 1 heaping cup (30 g) fresh basil, chopped
- 2 Tbsp (30 ml) olive oil
- Black pepper and salt to taste
Toppings
- Rocket leaves
- 250g mushrooms
- 1 x red pepper
- 1 x avocado
Instructions:
- Pre-heat the oven to 200 °C and prepare a baking tray with non-stick spray.
- Grate the sweet potato and place into a bowl filled with water. Soak for 5-10 minutes, to reduce the starchiness, while you prepare the rest of your rosti.
- In the meantime: Roast pine nuts in a pan on high heat for 2 minutes, stirring throughout. Remove the pine nuts from the heat and add to a food processor (or pestle and mortar). Add the peas, garlic, lemon juice, basil, olive oil, salt and pepper. Blend until creamy. Set aside and keep for serving.
- Grate the onion into a bowl. Add the oil, flour, garlic powder, cumin powder, salt, and ground pepper.
- Drain the sweet potatoes, place in a clean dry cloth and squeeze to get rid of excess water. Add to the onion and stir to combine.
- To form the rosti: Use a ½ cup measure to scoop the mixture onto the baking tray and press them flat (no higher than 2cm). Bake in the oven for 15 minutes, flip over and bake for another 10-15 minutes, or until the edges are golden and crispy.
- While they are baking, sauté the mushrooms and red pepper until fragrant.
- Once ready; assemble the rosti, spreading with basil-and-pea pesto, rocket, mushrooms and peppers.
- Serve with sliced avocado.
Note:
- Other veggies that can easily be used as toppings are:
- Wilted spinach / kale
- Cherry tomatoes
- Mielies
- Baby marrows / courgettes
Dietitian Tips for COVID-19 Food Shopping and Preparation
No take-away foods. No home deliveries. No hot counter meals. No restaurant fare. For now, and the foreseeable future, COVID-19 has us all cooking from home, 7 days a week. Lockdown rules and the need for social distancing also mean that we need to do our best to reduce the amount of times we are leaving home for essential food shopping. But mindless panic buying and frightened hoarding aren’t actually going to help when it comes to ensuring we’ve got balanced, nutrient-dense foods at home that will help to support our families’ immune systems.
Here’s some advice from Registered Dietitians and ADSA (Association for Dietetics in South Africa) spokespeople, Jessica Byrne and Retha Harmse:
First, get organised – Take note of what you already have at home. Many of us will now have time on our hands to make an inventory, tidy up and declutter our storage spaces. Look at the use-by dates of foods in your pantry and freezer and discard anything that is no longer safe to eat or won’t be eaten, recycling whatever you can. Make a proper assessment of your food storage spaces, so that you can be sure not to buy more than you can properly and safely store. “Aim to use your fridge and freezer space optimally; for instance, fresh produce such as whole butternuts, potatoes, sweet potatoes, onions, garlic and tomatoes should rather be stored in a cool, dry place,” Retha says.
Plan your meals – Keep in mind easy recipes using a variety of simple ingredients; and focus on healthy, nutrient-dense foods. Lockdown is not the best time to get experimental with your family meals, even if you do have more time for cooking. Jessica says, “Rather prioritise the foods you know your family enjoys and will eat so that you can minimise food waste and make the best use of your resources.” Plan for opportunities to cook in bulk soon after you shop so that you can freeze for later, especially when it comes to meals that require perishable ingredients.
Make your shopping list – Maybe it’s not something you usually do – but a list can really help to keep you on track when you’re under the stress of lockdown shopping.
Here are some foods to consider:
- Grains: Aim for higher fibre grains such as brown rice, barley, bulgur wheat, oats, whole-wheat pasta, whole-wheat noodles, high fibre crackers, quinoa and cous cous. Whole-wheat wraps can be stored in the freezer to extend their shelf-life.
- Fruit: Fresh fruit for a week or two – choose fruits that last longer such as apples, pears, unripe bananas and citrus fruits. If you have the freezer space, you can also look for frozen fruits. If you include dried fruits and canned fruits, these should only be eaten in small amounts.
- Vegetables: Quite a lot of the fresh vegetables that you buy such as spinach, peppers, brinjals and marrows will have to be consumed or used for home-prepared frozen meals in the first few days after you shop. However, you should also shop for fresh produce that lasts longer, such as potatoes, sweet potatoes, onions, carrots and other root vegetables, whole butternut, gem squash, ginger and garlic. Frozen and canned vegetables can be stored to use once the fresh items have been used up.
- Dairy and protein sources: These include canned fish such as salmon, tuna or sardines; canned or dried beans, lentils, chickpeas or split peas; nuts and seeds, including nut butters; eggs; cottage cheese; yoghurt or maas, and long-life milk. Store chicken pieces in the freezer, and lean mince which can be turned into bolognaise sauce and then, portioned and frozen.
- Herbs and spices: Having a range of herbs and spices on hand provides more variety in your meals and can help boost the flavour of foods without needing to add extra salt.
Retha adds: “In case you do fall ill, it is worth having a few easy to cook and prepare foods in the house on standby. Frozen soups, microwavable rice and frozen ready meals are easy options that you can keep in stock in reasonable quantities if you don’t have the energy to prepare more complex recipes. Just remember that canned foods are high in salt, so be sure to drain and rinse before using to remove the extra salt.”
Stocking up well during the nationwide lockdown is all about thinking clearly and planning well as there is no need to panic buy and stockpile foods. “Our President has confirmed that food stores will remain open during the lockdown, and we are seeing this happening all over South Africa,” points out Jessica. “We all need to act sensibly and to exercise restraint when it comes to the bulk purchasing of foods at supermarkets, as panic buying places greater strain on the poorest and most vulnerable members of our community.”
Nutrition for Women – should it be different?
When it comes to the basics of healthy eating, there’s no doubt that what’s good for the goose is also good for the gander. No matter your gender, you can’t go wrong with eating a variety of healthy foods including lots of fresh vegetables and fruit; legumes and pulses, nuts and seeds; lean proteins and dairy; healthy fats and wholegrains. Combine those healthy eating guidelines with regular physical activity plus the awareness that we require less calories than men, and women can do a lot to safeguard their health. Inevitably though, finely etched into the fabric of women’s lives are the details of our difference, and we do have some unique needs when it comes to certain micronutrients, which shift in focus during our changing life stages.
Maryke Bronkhorst, a Registered Dietitian and spokesperson for ADSA (Association for Dietetics in South Africa) points out that our reproductive years represent the major portion of our lives. “Women and girls of reproductive age, who are not pregnant or breastfeeding, should strive for optimal nutritional status for their own health and for the health of any future children,” Maryke says. “Good nutrition during the reproductive years helps set the foundation for health in years to come. It helps ensure proper growth during adolescence, adequate nutrient stores for a healthy pregnancy, and a good nutritional status to help maintain bone health during the menopausal and postmenopausal time of life. Many women’s health issues are related to the hormonal shifts in oestrogen and progesterone associated with the menstrual cycle. These include higher risk of anaemia, weakened bones, and osteoporosis. Malnutrition, as either under- or over-nutrition, can also have adverse effects on women’s health and fertility.”
Top tips for your reproductive years are:
- Achieve and maintain a healthy body weight. Underweight is related to poor nutritional status; heart irregularities; osteoporosis; amenorrhea (absent menstruation); and infertility in women. Obesity is associated with increased risk of chronic disease and obesity-related anovulation (ovulation does not occur during the menstrual cycle) which affects fertility
- Consume a healthy, balanced diet. Women should enjoy a variety of foods across all food groups. Include wholegrains, plenty of vegetables and fruit, healthy fats, dairy and lean protein sources. Limit processed foods, salt, saturated and trans-fats, refined carbohydrates and sugar. Remember that supplementation cannot compensate for an unhealthy or unbalanced diet
- Exercise regularly. Research shows that women are less physically active than men. Find sports and activities that get you moving that you enjoy and try to ensure a minimum of three hours of physical activity every week
- Avoid harmful substances including tobacco and vaping products, alcohol, recreational drugs and environmental toxins
- Include iron-rich protein food in your diet like lean meat, eggs and fish or plant sources such as spinach, beans and lentils, and eat these in combination with Vitamin C rich foods to help improve iron absorption. Iron deficiency is one of the most common nutrient deficiencies that results from losing more iron than one takes in. Menstruation depletes a woman’s iron stores. Iron deficiency reduces the ability to complete any work, lowering productivity and performance. We know that worldwide, women do more unpaid work in the household than men. If you are diagnosed with iron deficiency anaemia, make sure to take your iron supplement daily as prescribed.
What about pregnancy?
This incredibly special time in a women’s life can become a minefield when it comes to everyone’s opinions about pregnancy do’s and don’ts. What is critical for pregnant women is to turn a blind eye to old wives’ tales and the latest fads and to rather follow professional, evidenced-based nutritional advice.
Pregnant women and breastfeeding moms do have important nutritional requirements that support both their health and the health of their precious baby. Maryke highlights the importance of healthy weight gain: “Ideally, a healthy weight should be achieved prior to conception but, of course, this can only be worked on in the case of planned pregnancy. What mums-to-be need to understand is that obese pregnant women have increased rates of pregnancy related hypertension, gestational diabetes, large babies, C-section, perinatal morbidity and mortality. Conversely, underweight pregnant women have greater risks when it comes to preterm delivery, low birth weight, and foetal growth restrictions. Healthy weight gain during pregnancy is important for the health of both the mother and the foetus, and it has a positive impact both during and after pregnancy. However, weight loss during pregnancy should be avoided.”
Top tips for pregnancy and breastfeeding are:
- Focus on the basics of a healthy, balanced diet every day
- Avoid harmful substances including tobacco and vaping products, alcohol, recreational drugs and environmental toxins
- Reduce your caffeine intake to no more than 200mg or two coffees daily and remember caffeine is also present in teas, hot chocolate and sodas
- Exercise up to 30 minutes daily as approved by your health care professional
- Take prenatal supplements as prescribed by your health care professional
- Avoid certain foods to prevent the chance of foodborne illness such as soft cheeses, sushi and deli meats. Also, avoid fish that may contain high levels of mercury such as albacore tuna, swordfish, tilefish and king mackerel. And limit excessive liver consumption.
During and after menopause
While the basics of a healthy, balanced diet stay the same, your post-reproductive years herald some slight changes in your healthy eating regime. Maryke notes that a common concern for women during and post- menopause is ‘unexplained’ weight gain, especially around the abdomen. “This is attributed to many factors, “she says, “such as changes in hormones affecting metabolism; the loss of lean body mass which is part of the ageing process; reduced basal metabolic rate; lifestyle changes and changes in physical activity.” It is important to note that your calorie requirements are reduced post-menopause due to a natural metabolic ‘slow down’. Focus on consuming nutrient-dense foods in smaller portions, cutting down on processed foods and foods that are high in fat and sugar, as well as maintaining (or increasing) regular physical activity. Due to the cessation of menstruation, iron requirements are reduced.
Top Nutritional Tips:
- Consume a healthy, balanced diet – Menopausal women should also consider including more plant-based foods in their diet
- Be physically active – During and post-menopause, women should engage in regular physical activities that they enjoy – this should include aerobic, resistance, and weight bearing exercises that are protective of bone, heart and emotional health
- Manage your weight – As we age, excessive weight gain is a risk factor for other health conditions. If you find yourself struggling to maintain a healthy weight, get the help of a registered dietitian, who will take all aspects of your lifestyle into account to assist you in reaching a healthy weight
- Protect your heart health – Menopausal women often experience changes in blood lipid levels (for example raised cholesterol levels), therefore it is important to include healthy fats in your diet. The focus should be on plant-based sources of unsaturated fats, such as nuts and seeds and their oils, avocado, and especially sources of omega-3, such as sardines, pilchards or salmon. Limit saturated and trans-fats.
- Include phytoestrogens in your diet – These plant-based oestrogens may mimic the oestrogen produced in the body. Some studies show that the intake of soy may help to manage menopausal symptoms such as hot flashes. Sources include soy, soymilk, tofu, tempeh, and soybeans
- Avoid fad diets- These are unsustainable in the long-term; they often don’t meet your nutrient requirements, and they can adversely affect metabolism
Maintaining a healthy weight for a lifetime
From girlhood through to old age, we benefit greatly from maintaining a healthy weight. Another ADSA spokesperson and Registered Dietitian, Nathalie Mat makes the point that South African women tend to weigh more than our male counterparts, which puts us at greater risk of a number of health conditions including Type 2 diabetes, cancer and high blood pressure. “One of the key identified reasons is physical inactivity, says Nathalie. “South African women tend to exercise less than men do and this increases the likelihood that they will gain weight.” Nathalie also warns against unregulated portion size, especially when eating out: “Chefs have no idea whether the food they are dishing up in the kitchen is going to a woman or a man. As women, we need to be acutely aware that the portions we are eating when out are most probably more food than we need. This means we need to stop eating when we have had enough, instead of eating mindlessly until we finish the plate.”
COVID-19: KEEPING SAFE AT WORK
With the arrival of COVID-19 in South Africa, our focus is on the health and safety of our members and the clients and communities you serve. We have put together a list of action points that can be implemented by our dietitians across various industries. Primary prevention measures include washing your hands frequently with soap and water or sanitizer, social distancing, covering your mouth when coughing or sneezing, and avoiding touching your face.
Wherever possible move face-to-face consultations / meetings / interactions into the virtual space. We understand that this can be a challenge for both the dietitian and client, but there are various options available including Skype, Zoom and WhatsApp. Many of the online meeting options currently have special offers to try and support people to do their work online. Many private-practising dietitians already do virtual consulting with patients abroad and have had equally successful results with their patients using this format of nutrition intervention.
For any face-to-face interactions stick to the following guidelines for yourself and your clients:
- If you have recently travelled to a country identified as a high risk or have been in contact with someone who has travelled to these countries, please change your consultation / meeting to a virtual one.
- If you or your patients are immune compromised, rather book virtual consultations.
- If your clients are coming into your office / work space, please put in place the following hygiene practises:
- Ask all clients to wash or sanitize their hands on arrival at your office.
- Frequently clean your reception and office counter surfaces, as well as door handles, flushing mechanisms and taps, because contamination on surfaces touched by employees and customers is one of the main ways that COVID-19 spreads.
- Don’t shake hands, maintain a reasonable distance between you and your client.
- Regularly (between each use) clean equipment such as credit card machines and all clinical equipment with alcohol swabs. Refrain from handling cash, rather opt for contactless transactions (EFT, Snapscan or Zapper)
- If you are feeling ill, do not implement a face-to-face consult.
Please at all times follow the advice and guidelines from WHO and the South African National Institute for Communicable Diseases (NICD):
- If anyone of your clients or their immediate family, have been travelling overseas, please do not have face-to-face meetings for a period of 14 days.
- Ask your clients to inform you immediately if they are diagnosed with COVID-19 and inform your clients and close contacts immediately if you are diagnosed with COVID-19
- Do not meet with clients if you are experiencing symptoms such a fever, runny nose, cough, shortness of breath or a sore throat and vice versa.
- Ask clients to arrive on time for appointments and not early.
- Don’t allow any accompanying persons into the waiting area, rather ask them to wait in the car.
- Do not allow any eating or drinking in the waiting area.
- Do not allow the use of cellphones, laptops, tablets or any other electrical devices in the waiting area.
Hand-Washing
- Please wash or sanitize your hands regularly and thoroughly, no matter where you work.
- Display posters in your workplace promoting hand-washing
- Make sure clients and staff have access to places where they can wash their hands with soap and water or sanitizer, because washing kills the virus on your hands and prevents the spread of COVID-19
Meetings
- Consider whether a face-to-face meeting or event is needed. Rather move all meetings online, using existing meeting platforms or WhatsApp.
- If you have to meet ensure that as few people as possible are in the meeting and follow the hygiene guidelines above.
To learn more about COVID-19 and to access the latest information and advice, we further recommend that members refer to the following resources:
- COVID-19 Corona Virus South African Resource Portal: https://sacoronavirus.co.za/
- South African Coronavirus Disease 2019 Public and Emergency Hotline: 0800 029 999
- South African Coronavirus Disease 2019 WhatsApp Support Line: 0600- 123456
- The National Institute for Communicable Diseases (NICD): nicd.ac.za
- The World Health Organisation (WHO): http://www.who.int/health-topics/coronavirus
Meet the Dietitian: Wenda Nel
We spoke to Registered Dietitian and Olympic 400m hurdler Wenda Nel. We got to know her a bit better; from the deep things, to her secrets and even the silly things like her favourite foods. She is truly an inspirational woman and amazing RD flying our profession-flag high!
Read on and be inspired.
Tell us a bit more of yourself?
I grew up in Worcester in the Boland and matriculated there. I’ve moved to Pretoria thereafter and started my studies at Tuks. Throughout my life I’ve always had a big interest in sport, participated in athletics, netball, tennis and swimming. As the years passed, my passion for athletics grew bigger and I’ve pursued a career in track and field.
Although athletics has always been a big part of my life, I’ve also made an effort to not let it define who I am and form my identity. I am a follower of Jesus Christ (Christian) and my faith is the thing that I base all the values of life and I seek my identity in Christ. It brings me a lot of joy if I can help anyone in need. I like celebrating life and believe no matter your circumstances, we all have a story to tell that will inspire people.
I have a huge passion and love for this sport, but there are many other interests in my life I like spending time on to celebrate life.
I am part of a big family and like spending time with them. A lovely weekend ‘braai’ might make the top of my list 😊. I treasure the small things in life. Having a nice cup of coffee with my husband is the best example of how I like to spend some quality time together.
I like to read books, watch movies, bake and experimenting with new recipes. Even when I’m not on the track training, I like any other form of exercise and spending time in nature.
Why did you become a Registered Dietitian?
Sport has always been a big part of my life and what I enjoy spending my time on. I’ve also always had a big interest in food 😊. Being an athlete myself, the curiosity grew over the years of how different foods can play a role in sports performance. Becoming a dietitian gives me the opportunity to give guidance to fellow athletes to help them to look better after their nutrition to aid in better performance. I like to help people in one way or another, but believe I can somehow make a difference in the sports world being a dietitian.
What would you have wanted to do if not Dietetics?
In high school I thought I would like to be a physiotherapist as it is also something I could have combined with my sport. Looking back, I am happy I’ve landed in the dietetics field.
Where did you study (degree and/ or postgrad)
Univeristy of Pretoria (TUKS)
Where do you work and what does your job entail?
Currently I am not working as a full time dietitian. I am a professional track athlete, preparing for the Olympic Games in Japan, Tokyo.
Walk us through a day in your life?
A typical day in my life will be planned around my training sessions. The main track session will mostly take place during the morning at Tuks with a gym/technique session in the afternoon. In between sessions I will usually schedule appointments such as physiotherapy, recovery massage, sport psychologist and the occasional catch up with friends😊. There is also always general admin on a daily basis to give attention to.
📷: Reg Caldecott
📷: Reg Caldecott
What do you enjoy most about the work you do? What are the most satisfying moments?
I am fortunate to use my sport as a platform where I can get in contact with young athletes to not only help them with advice directly sport specific, but also try and make a positive impact in their lives in how I live my life on and off the sports field.
It brings me great joy to see how my life choices, how I react on setbacks as well as achieving my goals, can influence the people around me in a positive way.
What has been your career highlight?
I’ve had the opportunity to compete at the 2016 Olympic Games in Rio, that was an amazing experience which many competitive sports people dream of and work towards in their sporting careers. Although becoming an Olympian will always be a special memory to treasure, my biggest career highlight will be achieving a bronze medal at the 2018 Commonwealth Games in Australia. The medal will not define me, but I treasure the journey I have taken to get to the Games.
What are the most challenging aspects of your career?
Being a professional athlete requires a lot of patience on different levels and I had to learn to be adaptable as things can change on a daily basis. It can range from travel, accommodation, food and also competition challenges.
It is also challenging to give up family time and being away from home for long periods of time during a year.
What is something that people don’t know about you?
If they don’t know it, I guess it is a secret😉…
Being a dietitian amongst professional athletes, many of the people assume that I am on a strict diet…so I guess what most people don’t know, I basically eat anything, and yes, that includes ice cream and chocolates…a lot of chocolates😊. I think I am fortunate to have a better idea of how to manage my nutrition with my sport in a way that works to my benefit. So I can say, being a dietitian helps me to understand the nutritional needs of my body better to assist me in better sports performance and to also know that a treat can occasionally fit into my diet.
What are your favourite foods?
I am a huge foodie, just to gather with family and friends having a nice meal together is always a celebration.
Some of my favourites will have to include most dishes with chicken, pasta dishes (my favourite being my mom’s lasagne😉. Pizza, nacho’s and sushi are always a treat!
I am a fan of having a variety and colour on my plate for example a fresh Mediterranean bowl with quinoa, falafel, peppers, olives, feta, cherry tomatoes, avo, cucumber is always a winner in my eyes😃. I also have a soft spot for eggs.
I am also crazy about dairy products…milk (great recovery drink), yogurt and cheese!
I guess in summary, my favourite will have to be food😃.
- What are the three things that you think people should stop saying when they meet a dietitian?
- What can I eat to lose fat?
- You probably don’t eat any sweets
- Give me your diet
Meet the Dietitian: Community service series
By Danielle Smith
I studied dietetics at Stellenbosch University and Mia was at University of Cape Town, after her undergrad and an honours degree at SU. Both of us ended up graduating as dietitians at the same time last year.
To our surprise, we both ended up being placed together at Themba Hospital for our community service!
I decided to study dietetics because I have always been fascinated by the impact that a well-balanced diet can have on your well-being. I have a special interest in eating disorders and how to achieve holistic health. I thoroughly enjoy working in clinical and community settings. Mia is very passionate about paediatrics and loves both the community and clinical aspects of it. She hopes to study further regarding the first one thousand days and has a special interest in breastfeeding.
What surprised us was how much the Western Cape province differs from Mpumalanga! It was challenging to suddenly have such a big responsibility. Both Mia and I had to become used to the freedom that we suddenly had, without constant supervision or guidance.
One of my favourite things from this year was having the opportunity to get to know my patients. It was also a lot of fun to be able to work alongside other allied health professionals with patients who required a multisectoral approach. Mia and I have been able to grow as dietitians, and have become confident with our role in a patient’s road to recovery.
Mia and I have summarised a few points for any dietitian doing their community service in the near future:
- Thoroughly enjoy your time where you are placed! A year goes by so quickly, therefore be able to enjoy your time while your there.
- Remember to challenge yourself out of your comfort zone!
- It’s so important to motivate yourself to constantly educate and update yourself with the latest research for our profession. You won’t be exposed to everything in your community service year, therefore it’s essential to participate in as many educational courses in the year as possible.
- Lastly, always promote our profession! Sometimes doctors and other health professionals do not understand or acknowledge the need for a dietitian. It is so important to advocate for the profession and to constantly show them what our role as dietitians are in the medical field. To this end, we started our own Instagram page: @ournutritionmission. We share case studies and really try to explain in easy terms what a dietitian’s role is in all settings.
Enjoy your time as a community service dietitian; soak in every moment, learn and grow as much as you can as both a dietitian and an individual. And most importantly, enjoy the journey!
-Danielle & Mia
Meet the Dietitian: Community service series
“You care capable of anything”
By Bianca Lawrie
Why dietetics?
Throughout school I had a ‘love – hate’ relationship with food. I felt like I never truly understood nutrition messages and how I could nourish my body without causing more damage to my disastrous relationship with food. Should I skip breakfast? Should I only eat fruits and vegetables? The diet says I need to eat eight carrots a day – side effects: your hands might turn orange (wait, what? I don’t want to look orange?). I wanted to understand the nuances around nutrition, what it truly meant to nourish my body and how to heal my relationship with food. I attended my first lecture at the Nelson Mandela University in February of 2014 and I was hooked. I wanted the answers to the questions I so fiercely tried to seek.
All about my current job:
I work as a clinical community service dietitian in Zeerust, a small farming town near the border of Botswana in the North West. Our case load mostly consists of malnutrition, diabetes, hypertension, TB and anemia but we’ve seen an array of different cases. I am also involved in a lot of outreach work which I love. We are running a nutrition programme at the local primary school at the moment which has been so fun. We do a lot of work with the crèches in the nearby villages, clinics and community health centers. Throughout my university career I worked as a swim coach, so I was thrilled when we started working with the crèches and schools.
My biggest challenge and what I love:
My biggest challenge was tackling the idea that I will be 1100 km’s away from home. A new department, new people, getting used to a much hotter climate and limited resources to work with – I was nervous. However after a month of finally understanding the ropes and getting settled, the idea of being so far away from home wasn’t so daunting.
Being able to apply the knowledge I’ve gained in order to help others is what I love the most. Irrespective of my placement, I can help make some else’s life better. You can be placed at a tertiary hospital or a small 80 bed hospital like mine, either way – you have the opportunity to help someone every single day. You are no longer in practice mode; your job now is to serve your patients and community every day.
To the community service dietitians of 2020, remember you are capable of anything. Whether you’re close to home or 1100 km’s away, this year is yours. Explore and don’t be scared to be uncomfortable. Get used to the idea of working with few resources – soon you will figure out how to make it work. Use this year to learn from your allieds and teach where you can. Make friends with the other comm. servs because they’ll soon become family.
Before you know it, you’ll be packing your bags to move back home.
Meet the Dietitian: Jodie Mouton
Meet Registered Dietitian Jodie Mouton, that is more than your average dietitian – she is also a personal trainer!
Why did you become a Registered Dietitian?
From a very young age I knew I always wanted to work within the health sector, but never knew which route was intended for me. My aunt studied to be a Dietitian and after she told me stories about her work, I knew that was what I wanted to do!
Where did you study (degree and/ or postgrad)?
I moved from Port Elizabeth to Cape Town to study my undergraduate degree, then moved to Queenstown for my community service year before moving back to PE, that would always be home for me. I am currently studying my Masters degree at Nelson Mandela University, they have such an incredible Dietetics department.
Where do you work and what does your job entail?
At the moment I work predominantly in the sports sector, I work as the in-house Dietitian and Personal Trainer at a gym and absolutely love it. I see patients for weight loss, diabetics, patients with IBS and hypertension, among others. I make up super individualized and easy-to-follow meal plans and information pamphlets. I also provide personal training that accompanies healthy eating so well.
What do you enjoy most about the work you do? What are the most satisfying moments?
The types of patients I see are really relatable and generally I am able to connect well with them, I think the most satisfying thing is seeing how exercise, great nutrition and determination can completely change a person’s life.
What has been your career highlight?
I have been recruited to work at a few corporate wellness events and also be on the radio, those definitely are some of the highlights of my career.
What are the most challenging aspects of your career?
I must admit that this career is more challenging than I expected, at least speaking as a private practicing dietitian, marketing and finding patients is a big task if you work alone – but I am so proud of the progress I have made and I am learning all the time.
What are the three things that you think people should stop saying when they meet a dietitian?
I wish people wouldn’t be so afraid to talk to a dietitian, we don’t bite! I think people are scared of the truth and dietitians are all about speaking truth, but I wish that people embraced it and take the advice (if any) as a helping hand.
I also wish people stopped asking “So what do you think about banting”, and then expect a short concise answer.
And finally, I wish people stopped asking about weight loss pills or shakes. Eating healthy isn’t difficult at all, and your health should never be taken for granted. You only have one body, treat it as best as you can!
Meet the Dietitian: Community service series
By Kinza Hussain
I always say the profession of dietetics chose me. After completing a 3-year B.Sc degree in Biochemistry, I attended the Honors evening at the University of Cape Town to figure out what my next step would be. I was always intrigued by the medical field but when I heard what an honours degree in nutrition and dietetics could offer me, it was love at first sound!
I loved the idea of working in a hospital setting and more so, I was fascinated by the role nutrition plays in health and disease in both critical and stable phases. For this reason, I completed a rather stressful (to say the least) two-year honours degree and graduated as a dietitian in 2017.
It took a year before I got a post to do my community service and during this year, I explored the other branches of dietetics, namely fitness, research and healthy cooking. Instead of losing hope of one day practising as a clinical dietitian, I grew even fonder of the field and was convinced more than ever that this path was for me.
February 2019, I finally got placed at Kopanong Hospital in Vereeniging, Gauteng. I am responsible for part of the pediatric ward where I overlook a spread of diagnoses. From Severely Acute Malnourished babies to obese children to lactation consulting. I am also responsible for the female medical ward and the surgical ward. Here I see to the management of non-communicable diseases as well as the numerous indications that lead to nasogastric feeding in adults.
Although it is not my responsibility, I sometimes get given the opportunity to manage infectious diseases such as HIV/TB to remind me of how broad this field really is.
Being placed in an Afrikaans speaking community, the initial stages of my job was quite challenging due to the fact that I do not speak or understand the language at all (originally being from Zimbabwe). My other challenge was mastering the art of doing all that I can with all that I have. Once I overcame these two main challenges, I really found myself truly enjoying my work. The grand pediatric ward round which includes the entire multidisciplinary team kicks off my week every Monday morning.
Not only does nutrition play an ample role in the patient’s management, but how it ties in with other spheres of treatment such as the rehab input from occupational therapists and physiotherapists really fascinates me. I also love the fact that I am still learning. From my fellow dietitians in my field and from the doctors as I nutritionally manage a patient.
More than halfway into my community service year, do I have any words of encouragement? Definitely!
- Getting into this year, know that your experience is going to be similar but different. You may face the same challenges as everyone else but how you handle them is what will make your journey unique. I would say don’t let these challenges dim your sparkle.
- Continue and complete this year with the same enthusiasm as you started it. There may be days you’ll feel otherwise but you will be making a difference in lives as you hoped to.
- Don’t underestimate the small but valuable extra effort you make for your patient. It goes a long way for them and their recovery.
- Always respond to your gut feeling. If something bothers you while managing a patient, speak up. And speak again. And again.
- Ninety-nine percent of the time, you will pick up on missed ques which can literally save a life!
- Develop and maintain a good working relationship with the nursing staff of your hospital. They run the hospital and if you want to successfully manage a patient, their support will help you achieve that.
- Lastly, while you enjoy what will most probably be one of the best years of your life in terms of personal and professional growth, be sure to let it all out. When your first patient passes on, you may think you’re alright but it has a way of surfacing way later. Be sure to allow yourself to heal so that you can continue improving lives…with your nutritional and dietetic powers!
All my best wishes ☺
Meet the Dietitian: Nadine van Niekerk
Inspirational Dietitians Nadine van Niekerk and Stefanie du Plessis make a huge impact in their area (Bethlehem, Free State) by going above and beyond their job description of Dietitians. They empower, encourage and equip their patients and colleagues and frequently reach the papers for the impact they are having.
We spoke to them both and decided to launch both their ‘Meet the Dietitians’ on the same day! Read on and be inspired.
Why did you become a Registered Dietitian?
I had thought a lot about what career path to choose in school, and after shadowing a lot of different careers I ended up choosing dietetics. I love the science and research behind it and I was fascinated by the physiological effect of food on the human body. And I just love eating!
Where did you study (degree and/ or postgrad)?
I studied at North-West University, Potchefstroom campus and completed my B.Sc. Dietetics degree in 2010.
Where do you work and what does your job entail?
I am a dietitian for the department of health, stationed at Dihlabeng Regional Hospital in Bethlehem in the Free State.
The Hospital is Regional and caters to a large community. It offers all specialised fields of medicine, from intensive care, surgical, orthopaedic, gynaecological, paediatric, obstetric, medical and outpatient services. As the dietitian, I tend all wards rotationally and ensure all nutritional needs are met, especially in critical care, surgical and paediatric wards. I am also responsible for product selection and prescription.
What do you enjoy most about the work you do? What are the most satisfying moments?
What I enjoy most is really feeding the patients that cannot feed themselves. Critical care is my passion and I love ensuring those that cannot speak for themselves are taken care of. Ensuring our ICU discharges survivors, not victims is basically our focus and what we strive for, focusing on early effective nutrition and ensuring better outcomes.
I also love working with the premature unit and being involved in breastmilk banking and striving for a formula free unit. Breastfeeding advocate is an understatement! We make a very big deal of breastfeeding week and always try to go the extra mile when promoting. Debunking all the terrible myths around breastfeeding is a very high priority.
We also organise a big event each year to ensure more people are aware of the benefits of breastfeeding and why we are so obsessed with it. We usually use all proceeds from sales for our own lodger mothers and NICU, as the unit is so close to our hearts. This year we raised over R 5000 in the breastfeeding event, which really focused on the empowering role breastfeeding plays.
We used the proceeds for toiletry packs to improve the personal hygiene in the unit and also just to treat the moms to something nice, as we are expecting so much of them. The toiletry project is ongoing, so we also encourage anyone interested to contact us for more details with regards to donating.
My most satisfying moments are seeing patients leave the hospital in better condition than they arrived, helping mothers reach breastfeeding goals and making a difference in people’s lives that would otherwise be unable to afford your services.
At this year’s breastfeeding event we also let mothers get the opportunity to take professional portraits of themselves in a professional studio setting by an accomplished photographer. The point was to remind all women of how beautiful they are and just to boost their confidence. The photos came out more beautiful than we ever imagined. Giving opportunities to people that would maybe otherwise not have been able to have them, is I think, by far the most satisfying aspect of my job. Government work is really what I love to do and I am so thankful that I have the opportunity to work for the Department.
What has been your career highlight?
That’s a hard one! I think this year’s breastfeeding event and all that was achieved and all the money raised is something I am very proud of. But also each year offers a new highlight, we have really also made our mark in the Hospital and are at an all-time high when looking at in-hospital referrals and ensuring no patients fall through the cracks.
What are the most challenging aspects of your career?
Working in Government you sometimes have to make difficult choices with regards to stock availability and you have to be flexible due to budget restrictions. I also find the Intern doctors very challenging, hahaha 😉. Having to go through the same routine each year to ensure proper referrals is often exhausting.
- What are the three things that you think people should stop saying when they meet a dietitian?
Oh my word don’t look at what I am eating!
Can I quickly ask you something?
What do you do all day in a hospital?
Meet the Dietitian: Stefanie du Plessis
Inspirational Dietitians Stefanie du Plessis and Nadine van Niekerk make a huge impact in their area (Bethlehem, Free State) by going above and beyond their job description of Dietitians. They empower, encourage and equip their patients and colleagues and frequently reach the papers for the impact they are having.
We spoke to them both and decided to launch both their ‘Meet the Dietitians’ on the same day! Read on and be inspired.
Why did you become a Registered Dietitian?
I was interested in a career in health and dietetics was brought under my attention and I immediately knew that was what I wanted to do, especially the type of work that a hospital dietitian did.
Where did you study?
I studied at the University of the Free State in Bloemfontein and completed my degree in 2008.
Where do you work and what does your job entail?
I work at Dihlabeng Regional Hospital in Bethlehem. It’s a level 2 hospital which serves a very large community and offers a variety of services which includes intensive care for adults and neonates, surgery, medical, orthopaedics, paediatrics, obstetrics, renal as well as an outpatient department. We are 2 permanent dieticians at the hospital and we rotate between all the departments on a weekly or monthly basis. We are very fortunate to gain experience in all the different specialised fields that the hospital offers.
I am also responsible for managing the budgets for the Dietetic Department, monitoring stock levels and placing orders to ensure that sufficient stock is always available.
I also attend all management related meetings and I am responsible for all Quality improvement programs involving the Dietetic Department.
What do you enjoy most about the work you do? What are the most satisfying moments?
The part that I enjoy the most is definitely feeding the critically ill patients, doing a thorough assessment of their condition, calculating their nutritional requirements and choosing a suitable product. Working in the paediatric ward is also a part of my work that I enjoy a lot, especially tending to the severely malnourished babies and children. With both of these scopes of patients, it’s very gratifying to see the big difference that proper nutrition can make in a short while and see my patients going home in a better condition.
Dihlabeng is a Mother and Baby Friendly hospital so I also have a lot of passion for breastfeeding and everything that goes with it. We really strive towards enabling all mothers to breastfeed successfully before they leave our hospital. We recently had a big event for World Breastfeeding Week where the aim was to empower parents and this then leads to a mother being able to successfully breastfeed her baby and to continue at home.
All the proceeds made on the day was used for our newly established Toiletry Project for the lodger mothers in the Neonatal Intensive Care Unit. The aim of the project is to supply all the mothers with basic necessities for their stay in NICU.
These mothers do so much for their tiny babies and sometimes stay there for up to 3 months (sometimes longer). We recognised the need to do something special for the mothers and that’s when the Project was born. We would like this to be an ongoing project, so anyone who is interested in donating or becoming involved in any way is more than welcome to contact us.
Furthermore, I also enjoy and appreciate the fact that we, at Dihlabeng Hospital, are able to work very well together as a multi-disciplinary team. This really makes all our jobs much easier. Especially me and my colleague, Nadine van Niekerk, we really work well together as a team to ensure that the Dietetics Department is run as smoothly and well as possible!
What has been your career highlight?
Wow, there are so many! But one of the highlights is definitely being accredited as a Mother and Baby Friendly Hospital in 2016. All of our staff put in a lot of effort and hard work to achieve this, so this was a very proud moment for us all.
And then, of course, our Breastfeeding Empowerment Day that we held for World Breastfeeding this year. It was a very gratifying experience for us as the dieticians and staff of DRH to be able to do this to show our support and dedication to breastfeeding!
What are the most challenging aspects of your career?
It can be challenging to plan and decide which nutritional products to order due to dealing with budget constraints, but this also keeps our work interesting.
What are the three things that you think people should stop saying when they meet a dietitian?
- You’re a dietitian and you are eating that???
- Can you give me a diet?
- Asking about detox diets.
Diabetes in the family – It’s All for One, and One for All
A diagnosis of diabetes in the family comes as a shock and sets in motion a range of emotional and practical lifestyle changes. How well you come together as a family to master those changes, not only restores peace in the home, but also positively impacts on the ongoing well-being of your loved one with diabetes. Diabetes is a chronic lifelong condition but with good medical care and through education to empower more effective self-management of the condition, the potential complications can be prevented or delayed. According to the World Diabetes Day campaign which is featured on the 14th of November, it is the world’s leading cause of blindness, amputation, heart disease, kidney failure and early death. However, maintaining healthy blood glucose, blood pressure and cholesterol levels can help delay or prevent such diabetes complications.
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ADSA (Association for Dietetics in South Africa) spokesperson, Liana Grobbelaar, who works at the Centre for Diabetes & Endocrinology, points out that knowing what to eat, and how much to eat is one of the most challenging parts of managing the treatment plan of a family member. “Getting the whole family on board makes it easier for the person with diabetes to stay healthy,” she says. “It breaks the isolation that comes with being the sole member whose plate looks different, for one thing. But there’s another positive effect – everyone else can get healthier, too.”
The reason for this, Liana points out, is that there is actually no ‘diabetic diet’. Instead, the person living with diabetes and their family, find themselves on a journey of understanding the impact of different foods on blood glucose levels and health. “Healthy eating should be for everyone, with or without diabetes,” says Liana. “It’s actually an ideal opportunity to take positive steps to adopting a healthy family lifestyle. You can transform the negative into positive by educating your whole family to help them understand the importance of making the necessary changes, healthy choices and to be more supportive.”
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Psychologist, Rosemary Flynn also emphasises the importance of family-wide support. “The way each member of the family responds to the necessary changes influences how well the person with diabetes will accept and manage their condition,” she says. “If they feel criticised and devalued because of their condition, they can feel alienated and resentful. If they feel empathy and support from the family, they will have the encouragement to embrace their treatment management in an effective way.”
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Knowledge is power
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Understanding diabetes, its symptoms, treatment and lifestyle impacts is key for the whole family. All people with diabetes should be offered a referral for individualised nutritional education provided by a registered dietitian with experience in diabetes management.
Registered dietitians are uniquely skilled in equipping people living with diabetes with the knowledge to better understand the impact of food choices on blood glucose levels and overall health, which can lead to improvements in quality of life. A registered dietitian will take into account factors like culture, religion, age, other health conditions, medications and your finances, food preferences and family dynamics which will influence the approach that will work best for you and your family.
Practical tips for families with a loved one with diabetes include:
- Choose healthier carbohydrates – All carbohydrates tend to raise blood glucose levels, but some carbohydrate sources provide nutrients important for health. Focus on high fibre carbohydrate sources such as vegetables, fruits, whole grains, unsweetened dairy products and legumes such as chickpeas, beans, peas and lentils instead of refined carbohydrates with added sugar, fat and salt. From a blood glucose perspective, the portion size of these foods is critical.
- Eat a rainbow of vegetables and fruit – Vegetables, particularly non-starchy vegetables, contain much bulk relative to the amount of energy they provide. They also contain phytonutrients or plant chemicals that play many vital roles in the body including behaving as antioxidants (repairing the body from daily damage) and stimulating a good immune system response. Although fruits also contain these properties, they do contain natural sugars which can affect your blood glucose management, so, don’t eat fruit to excess.
- Swop out red fatty and processed meat with healthier alternatives – Replace red, fatty and processed meat with protein-rich legumes such as beans and lentils, as well as eggs, fish and poultry.
- Choose heart healthy fats – Fats are an essential component of one’s daily food intake. But, the type and quality of the fats you consume is vital. Eat foods rich in long chain omega-3 fatty acids or anti-inflammatory fats found in naturally fatty-fleshed fish like mackerel, pilchards, sardines, salmon, trout and herring, at least twice a week. Reduce your intake of saturated fats such as animal fats, coconut and palm kernel oils. Rather choose mono-unsaturated fats like olive or canola oils, avocado, olives and nuts. Remember that fats are a concentrated source of energy and should only be used in small amounts.
- Treat any new foods as an experiment – test your blood glucose before and after trying out something new to understand the effect of your food choices on blood glucose levels.
Meet the Dietitian: Community service edition
By Marlize Erasmus
Every 4th-year Dietetics student experience feelings of stress, anxiety and excitement when making the decision of where to do their community service year. I googled every hospital on the list, trying to figure out where to go. I got my first choice (believe it or not) – a rural hospital (Connie Vorster Memorial District Hospital) in a small town called Hartswater in the Northern-Cape. This is where driving past cows and chickens on your way to the clinic is a daily norm.
The first time I heard about dietetics was from my grade 9 teacher when I had to do an assignment on what career to follow. I decided to shadow a clinical Dietitian in grade 11 and got intrigued by the profession. It wasn’t until my first year while studying dietetics at the Potchefstroom Campus of the North-West University that I knew I made the right choice. I realised that dietetics is my passion.
I did not really know what to expect when I started. I quickly realised that this was nothing like that perfect picture of dietetics that you have while studying. Especially when you are working in a place with severely limited funding and resources with communities in extreme poverty. This makes both spectrums of under-and-over nutrition (Obesity and Non-Communicable Diseases as well as a high prevalence of Severe Acute Malnutrition) major problems in the communities in the area.
I originally felt estranged to dietetics because working in rural is nothing like the bigger hospitals I was used to when I did my internship. Something important to know is that working in a rural hospital means there is no such thing as parenteral nutrition, fancy surgeries or certain wards like ICU or Renal. You are working with the basics.
I was not enthusiastic about community nutrition at varsity so I felt a bit discouraged when I found out that half of my time this year would entail working in the clinics. I developed a new kind of appreciation and love for working in the community. Community nutrition started to change me. It is especially in rural communities where dietitians are extremely needed. Working in the community can be challenging but the reward is sweet when you can see you’ve made a difference. I came to love going out into the community to fetch a SAM kiddie, to do outreaches and health talks and to work at a hospital alongside people who make the hard days better. I believe it was God’s plan that I got placed in Hartswater. This has shaped me into a better Dietitian and a better version of myself.
No matter at what hospital you are or what type of dietetics work you do, it is always important to realise that at the end of the day your happiness as a human being is a necessity. This is not only a year for practical experience in the dietetic profession but a year of personal growth and new adventures. Be open-minded as you step into the unknown.
Meet the Dietitian: Karla Pretorius
Not only is Karla Pretorius a Dietitian; she is also a Protea netball player, vice-captain and announced as the Player of the Tournament at the Netball World Champs earlier this year! Thank you Karla for flying the Dietetic flag high.
Karla Pretorius:
My participation as an elite netball athlete in the professional world of sports has increased my awareness and understanding of the indispensable importance of nutrition in the lives of both individuals and communities. The effective implementation of nutrition knowledge can drastically enhance the quality of every individual’s life, including athletes performance and overall wellbeing.
My path first crossed with nutrition as a science during my undergraduate studies at the University of the Free State (Kovsies) in Bloemfontein. I would later also complete my masters in dietetics and nutrition at the institution. This quaint city, located in the wide-open gold plains of the Free State proved to be a great learning experience, both on and of the court.
Balancing full-time studies with the close to year-round netball season, both domestically for Kovsies and the Free State Crinums and nationally for the Proteas proved challenging at times. Although challenging, the opportunities presented by netball could not be turned down. With support from various stakeholders and determination, I was able to manage both. I strongly encourage all athletes to pursue further studies whilst working towards their personal sporting goals. With hard work, a good balancing act and support it can be done. Also, do not be ashamed to ask for help and assistance along the way. I am most grateful for the time spent at Kovsies, playing for the university team in the Varsity Cup Netball league and at the University Sport South Africa Games.
At the end of 2016, I was approached to join the Sunshine Coast Lightning netball club in their inaugural season in the Australian premier league, the Suncorp Super Netball League. This marked my entry into the sport as a Professional Netballer. The club managed to secure two consecutive wins in the premier league in 2017 and 2018. We are currently continuing our campaign for the 2019 season, after a month-long break for the 2019 INF World Cup in Liverpool. The Spar Proteas, which I am honoured to vice-captain, excelled in the tournament by managing a win over number 2 ranked Jamaica and achieving an overall 4th place.
Noting that Netball is not a professional sport in South Africa, many athletes wanting to pursue a career as a professional netballer are necessitated to look abroad for opportunities in professional leagues, most notably in Australia, England and New
Zealand.
And that is what I did, firstly with a move to England to represent Team Bath, and later on the Sunshine Coast Lightning in Australia. The move abroad also meant that I had to temporarily sacrifice my professional career as a full-time dietician.
Remaining informed of developments in the field of dietetics and adding to my skills and knowledge compelled me to read towards my masters, enrol for online courses, and to do community volunteer work abroad.
Dietetics and nutrition should be incorporated in every high-performance sport and environment, including netball. From my experience, I found that the importance thereof is underestimated and valued in South African netball. There is a clear difference in the value-added to the role and profession of a dietician in the amateur league of netball in South Africa compared to the professional league in Australia.
The main objective for our team dietician, and myself, is to ensure that I am ‘nutritionally healthy’, whereby my performance is maximised. This is achieved by the development and implementation of practical nutrition strategies, guidelines and policies. The rewards of effective use and implementation of nutrition strategy have ensured that I reach my goals, enhance my performance and recovery and minimise
injury risk.
Meet the Dietitian: Community service series
Dietetics might have been my plan B, but it turned out to be the (B)est plan yet!
By Carmyn Gast
Nutrition has been known to play a key part in good health since the time of ancient Greeks, with Hippocrates famously writing “Let thy food be thy medicine, thy medicine be thy food” in the 5th century BC. However, the profession of dietetics itself is relatively young, having only been put in the forefront of patient care by Florence Nightingale and Alexis Soyer during the Crimean War in the 19th century. And it was only in 1974 in South Africa that the Health Professions Act officialised Dietetics as a profession.
So being a dietitian means that you’re also a pioneer in this profession – an exciting but sometimes frightening experience. Which is exactly what I felt like when I walked into the very rural district hospital in KwaZulu Natal on the first day of my community service year. As the only dietitian in the hospital, I was immediately given all of the responsibilities of running an entire Dietetics Department. From consulting with and managing all the in-patients and out-patients, to budgeting and controlling all the nutritional feed stock, to auditing the hospital kitchen and the surrounding clinics, to supervising and assisting the Nutrition Advisors (something unique to KwaZulu Natal), to doing seemingly never-ending administration tasks and statistics, to training fellow health care professionals on nutrition, to advocating for patients’ nutritional health at meetings, to learning the local isiZulu language to be able to communicate with patients – there was (and still is) always something more to do and something more to learn.
The most important thing I have learned thus far is to always remember your heart. The nature of our job is to deal with people, and people are extremely complex and they often only encounter us when they’re not feeling well. Unfortunately the public healthcare system is under immense pressure in our country so most health care professionals only spend a handful of minutes with each patient before moving on to the next patient. So I consider it a privilege that, as a dietitian, I get to spend more time with patients. It gives me great joy to be able to sit down, talk with and really get to know my patients. After all, food and nutrition is such a personal thing – it gives you a real understanding of a person and their life. And this enables you to meaningfully and effectively help a patient to reach and maintain their optimal nutritional status. And a healthy happy patient makes for a very happy heart.
Sometimes the importance of dietitians is undermined and poorly understood, but as pioneers, it is up to us to continually show and prove our worth as a profession. And hopefully sometime in the near future the rest of the world will catch up and wake up to the most important fact that we already know – that food is life. In the meantime, let’s show them how it’s done!
Carmyn had the wonderful initiative to take a photo and add a caption each day of her Community Service Year to document the real and ‘unfiltered’ journey. See more on Intstagram @BecomingAnRD.
First day out to the clinics #Day10 #BecomingAnRD #scenicroute #roadtrip #longroad #landscape #blueskies #mountains #Drakensberg
Some days I forget how lucky I am to be working in such a beautiful setting… Yes, it’s rural and in the middle of nowhere. Yes, the resources are limited and the circumstances are trying. Yes, there is sadness and heartbreak when patients pass away/ you can’t help them in more ways. Yes, I can barely understand/ speak the local Zulu language. BUT the people are friendly and welcoming, and the natural environment is breath-taking. Each and every day has beauty in it, you just have to find it. This aloe is flowering just outside my office and is proof that something beautiful can still emerge from harsh circumstances. #Day78 #BecomingAnRD #dietitian #dietitiansofig #nutritionexpert #rurallife #nature #aloe #naturalbeauty #outdoors #flowers #hope #indigenousflowers #hardyflowers
Make Eating Whole Foods a Way of Life
Despite what we know about the impact of food choices on our health, overweight and obesity are still on the rise in South Africa, alongside a host of preventable diseases that can be attributed to unhealthy lifestyles. Thanks to our industrialised food system, and far greater, ultra-processed and fast food choices aimed at our ‘convenience’, we’ve got further away from eating the whole foods that are really good for us. This is the message that a coalition of health professional associations, including the Department of Health, is highlighting in October across both National Nutrition Week and National Obesity Week.
The 2019 theme, ‘Make eating whole foods a way of life’ aims to focus the country’s attention on the importance of consuming a mostly plant-based diet of mainly unprocessed and minimally processed foods. Whole grains, fresh vegetables and fruits, legumes, nuts and seeds are health-promoting foods that are nutrient-dense, high in fibre, and free from food additives, added sugar, fat and salt. Whole foods offer a wide range of choice and enable a family lifestyle centred around healthy eating choices, that for children, can help cement these healthy lifestyle habits for years to come.
Carol Browne of the Nutrition Society of South Africa (NSSA) points out that the risks of unhealthy diets and lifestyles start in childhood and build up over our lives. She says, “Approximately 13.3% of South African children under 5 years of age are overweight or obese; and according to the 2012 South African Health and Nutrition Examination Survey (SANHANES), 14.2% children aged 6 to 14 years are overweight or obese. The situation amongst adults is even worse, with the 2016 South Africa Demographic and Health Survey finding that 68% of women and 31% of men in South Africa are overweight or obese. Severe obesity which is life-threatening affects around 20% of women and 3% of men. Unhealthy diets and a lack of physical activity are contributing to a considerable burden of disease in our country.”
These concerns are shared by the Heart and Stroke Foundation South Africa (HSFSA) which reports that every day 225 South Africans die of cardiovascular disease (CVD). Only a small proportion of the deaths are age-related. HSFSA’s CEO, Professor Pamela Naidoo says, “South Africa has one of the highest rates of overweight and obesity in the world, a major contributor to diabetes which in turn is a risk factor for CVD. We have to understand the link between making poor food choices on a daily basis, being at an unhealthy weight and the risks of disease and early death”. Bianca Tromp, registered dietitian at the HSFSA states: “Many South Africans don’t think twice about consuming large amounts of sugary drinks, salted snacks and ultra-processed fast food meals. This constitutes a daily diet that while overly dense in energy is actually dangerously nutrient-deficient.”
President of ADSA (Association for Dietetics in South Africa), Dr Christine Taljaard-Krugell points out that prevention of overweight and obesity in South Africa is urgent and requires multi-disciplinary collaboration. She says: “As national government departments, industries, academia, non-governmental organisations, health professionals, communities, households and individuals we have to urgently, actively and collectively turn towards the actions that are needed in order to address obesity, to ensure better health for all South Africans. Many of these actions can be linked to what we do – physical activity – and what we eat. As this week’s message focuses on the consumption of whole foods, it is important that each and every role-player, from government level to the individual level, re-think and creatively contribute to enable households to truly make eating whole foods a way of life.”
The campaign is also supported by MaTCH, the Maternal, Adolescent and Child Health Institute, an indigenous non-profit organisation providing a broad range of HIV and TB-focused assistance. Lenore Spies, the technical advisor of MaTCH says: “Limiting the intake of ultra-processed foods and rather eating mainly whole foods plays an important role in a healthy pregnancy as well as ensuring good nutrition for children, families and those whose immune functioning may be compromised. A diet based on a variety of whole foods; which are foods in, or close to, their natural state, provides us with a broad spectrum of nutrients we need to safeguard our health.”
Another important aspect of healthy eating is getting into the habit of reading the ingredient lists on the labels of the prepared food and drinks that you buy. An ultra-processed food or drink is one that usually has five or more ingredients listed on the label, and typically a number of these are not recognisable as foods you would use in home cooking. Rebone Ntsie, Director of Nutrition at the National Department of Health says, “Ultra-processed foods typically contain a wide range of food additives such as stabilisers, emulsifiers, preservatives, flavourings and colourings. These are the opposite of whole foods, which are unprocessed like fresh vegetables or minimally processed such as brown rice. We should make our drink of choice clean water instead of sugary drinks. In addition, we should plan and prepare more home cooked suppers so we have extra for our lunches and snacks the next day.”
Strategies to make eating whole foods a way of life include:
• Enjoy a variety of unprocessed and minimally processed food choices – Make sure that the vegetables, fruit, whole grains and legumes make up around 80 percent of your daily food intake. Make at least one day a week all meat-free with plant-based meals.
• Eat plenty of vegetables and fruit every day – Eating a variety of vegetables and fruit every day can help prevent chronic diseases, including heart disease, high blood pressure, strokes, some types of cancer, aging related eye diseases and type-2 diabetes. These foods also contribute to a strong immune system.
• Eat dry beans, peas, lentils and soya regularly – Naturally high in plant proteins, micronutrients and dietary fibre, soya and legumes such as beans, split peas and lentils make excellent substitutes for meat or can stretch a meat dish further. They can also be used to make soups, salads and side dishes.
• Plan and prepare healthy home meals rather than buying ready-to-eat meals and snacks or eating out frequently – Eating healthy home-cooked meals ensures that you are in control of the ingredients that go into your family’s meals. It helps save money spent on ultra-processed and fast foods.
• Always check food and beverage labels to read what is in your food and drink – Knowing how to read labels is very important in making the healthier choice when choosing foods. Product ingredients are listed by quantity, from the highest to lowest amount, so watch out for foods that have sugar, salt or fats listed in the first three ingredients.
By focusing on whole foods as a way of life, we can ensure that our families are eating the vegetables and fruits, legumes, seeds, nuts and whole grains that are essential to build and sustain healthy bodies.
National Nutrition Week and National Obesity Week Partners are:
• National and Provincial Departments of Health http://www.health.gov.za
• Department of Basic Education (DBE)www.education.gov.za
• SA Military Health Services (SAMHS)
• Maternal, Adolescent and Child Health (MaTCH) http://www.match.org.za
• The Association for Dietetics in South Africa (ADSA) http://www.adsa.org.za
• The Cancer Association of South Africa (CANSA) http://www.cansa.org.za
• The Nutrition Society of South Africa (NSSA) http://www.nutritionsociety.co.za
• The Heart and Stroke Foundation SA (HSFSA) http://www.heartfoundation.co.za
• Consumer Education Project (CEP) of Milk South Africa http://www.rediscoverdairy.co.za
• Consumer Goods Council of South Africa (CGC-SA) http://www.cgcsa.co.za
• Humane Society International (HSI) http://www.hsi.org
For additional information on how to make eating whole foods a way of life, including tips and recipes, visit http://www.nutritionweek.co.za
Thai Meatballs with Green Salad and Corn
Serves 4 – Makes 16 mini meatballs
Ingredients:
- ½ small onion, very finely chopped or grated
- 5 ml fresh crushed garlic and ginger mix (1 t)
- freshly ground mixed peppercorns to taste
- 10 ml fish sauce or soya sauce (2 t)
- 10 ml soft brown sugar (2 t)
- 90 ml fresh coriander leaves, chopped (6 T)
- 400 g extra lean beef mince or ostrich mince, or a mix of both
- 60 ml oats (4 T)
- 1 egg, beaten
- 100 g washed mixed lettuce leaves
- 30 g fresh rocket leaves (3 handfuls)
- ¼ English cucumber
- 150 g baby tomatoes
- 250 g tinned sweetcorn, drained (1 x 410g tin, drained)
- 15 ml sweet chilli sauce (1T) (optional)
Instructions:
- Place the grated onion, garlic and ginger, ground peppercorns, fish / soya sauce, sugar and chopped coriander leaves in a bowl. Mix all the ingredients.
- Add the mince, oats and beaten egg, and mix well, ensuring that all the ingredients are well mixed into the meat. If the mix does not stick together add another tablespoon of oats.
- Using 1 tablespoon of mixture at a time, roll the mix into 16 small balls.
- Gently heat a frying pan that has been sprayed with aerosol non-stick cooking oil.
- Place the mini meatballs side by side into the lightly greased pan.
- Cover with a lid or aluminium foil.
- Cook on low heat for 7 minutes until the underside of the meatballs are brown.
- Turn all meatballs and cover again. Cook for 5 minutes until the other side of the meatballs is browned.
- Remove the meatballs from the pan and leave to cool while assembling the salad.
- To make the salad, divide the salad leaves, sliced cucumber, tomatoes and rocket onto 4 dinner plates, add the drained sweetcorn and the cooked meatballs and serve with a drizzle of sweet chilli sauce.
NUTRIENTS PER SERVING
Energy 1372 kJ
Protein 25.1 g
Carbohydrates 18.5 g
Total sugars 6.3 g
added sugar 3.7 g (chili sauce (optional) & sugar)
Total fat 17.5 g
Saturated fat 6.7 g
Fibre 4.8 g
Sodium 429 mg
One serving is equivalent to 1 carbohydrate, 3 protein and ½ vegetable.
Dietitian notes:
Remember that red meat immediately increases the fat content of any dish, even if you use the extra lean beef mince as we recommend in this recipe. Only four mini meatballs made with lean beef mince contain 17.5 g fat per serving. Using ostrich mince, however, reduces the fat content to 6 g per serving for 4 mini meatballs. So it is important to “dilute” red meat with lots of vegetables (salad) and a little starch (sweetcorn).
We would not suggest that you especially buy sweet chilli sauce for this recipe as this may tempt you to use it in other recipes or on food which will only add to the added sugar content. If you don’t have sweet chilli sauce then feel welcome to omit this ingredient or use ½ diced kiwi fruit or ½ grated apple for a little sweetness instead. Alternatively, you could also use light chutney.
A wonderful tasty recipe from Cath Day from her recipe book alongside Gabi Steenkamp – Food for Sensitive Tummies.
#foodforsensitivetummies
@cathsday
@dietitian_cathD
Meet the Dietitian: Robyn Duarte
We spoke to Registered Dietitian, Robyn Duarte, working in the interesting field of Molecular Diagnostic Services (MDS).
Why did you become a Registered Dietitian?
I’ve always had an interest in food; the effect different nutrition has on our bodies and the psychology behind eating. In school there were many girls with eating disorders and helping individuals with these disorders was the avenue down which I wanted to go after my studies. This changed however as different opportunities presented themselves.
Where did you study (degree and/ or postgrad)
I studied my BSC Degree and PG Diploma in Dietetics at the UKZN in Pietermaritzburg, completing my community service at Appelsbosch hospital in 2010.
Where do you work and what does your job entail?
I am a Wellness Consultant/Dietician/Marketing HOD at Molecular Diagnostic Services (MDS). MDS is a private specialist molecular (DNA) diagnostic laboratory focusing on genetic and veterinary diseases, DNA paternity, identity and wellness tests. I have worked at MDS for 8 years, within the WellPro Wellness division liaising with practitioners and clients interested in exploring various tests to try and identify possible causes of adverse symptoms experienced. I believe that personalised testing – knowing about your own genes and about the foods that you react to – help to optimize your well-being.
What do you enjoy most about the work you do? What are the most satisfying moments?
I am excited to be at the forefront of this rapidly developing field with the use of the most advanced technology used for testing. The most satisfying moments are when clients contact me, emotional and grateful that they have finally found symptom relief or improved health after many years of struggling with various adverse symptoms.
What has been your career highlight?
Being able to travel to Poland and Germany for international conferences as well as hosting our very own in Cape Town and being able to share experiences with, and learn from, intelligent, like minded individuals who offer similar tests in their countries.
What are the most challenging aspects of your career?
Science and technology is continuously improving. What I do now is completely different from the content included in our standard dietetics degree. Thus many aspects of the job require research in order to try to stay abreast of this rapidly developing field. Sometimes, also, the technology can be ahead of the routine adoption of certain tests in current practice and we have to wait for more clinical trials to be conducted to make the findings more valuable to a practitioner.
What are the three things that you think people should stop saying when they meet a dietitian?
“Oh, I never knew that dietitians drank wine/ate dessert!”
“What do you think about xxx diet?”
“I don’t like eating around you because I feel like you’re watching everything I put in my mouth”.
Meet the Dietitian: Community service series
Take the journey!
By Colette Dreyer
Are you ready for your journey in Dietetics? My journey started from a young age having a passion for delicious food and a healthy, active lifestyle. Cycling competitively made me realise that proper nutrition was essential to sustain performance. I realised how big the impact of food is on our health, energy levels, performance, overall well-being and daily lives when a close family member was diagnosed with Idiopathic Pulmonary Fibrosis and had to lose weight in order to be added to the lung transplantation list. This encouraged me even more to become involved in changing lifestyles of individuals.
I started off by completing a BSc. Human Movement Sciences degree followed by BSc. Honours in Nutrition. This was a great combination, but my aim was to provide individualized meal plans for individual goals and specific disease related conditions. The best decision I finally made was to study BSc. Dietetics at the North West University, Potchefstroom.
And so, my journey as a community service dietitian, and the only dietitian placed at this specific community health centre in Johannesburg began. This came with uncertainties at first as I am responsible for all dietetic services at the facility. Although I was placed out of my comfort zone, as this was not one of my five placement options, and I’m only the third dietitian placed at this facility, I realised the lack of education in this community and the opportunity to contribute to the dietetic department. I gain a lot of experience in various aspects such as malnutrition, cerebral palsy, tuberculosis, brain injury, percutaneous endoscopic gastrostomy, pregnancies, hypertensive and diabetic patients as well as patients living with HIV.
Everyone has a unique nutritional composition and individual goals to attain. When patients progress towards, or reach their goal, their gratefulness is very rewarding. I developed skills to explain complex ideas simply, and to use different techniques when a communication barrier occurs. Creative methods were developed to improve patient’s lifestyle and nutritional status with their available food and resources. Attending monthly district meetings held at different facilities provide the opportunity to meet other dietitians and to become familiar with surrounding facilities. This is truly a great year to improve your practical skills and to gain more knowledge.
Tips:
Say yes to the journey – Life do not always go according to your plan. Sometimes an unexpected opportunity arises. Be open minded, say yes to the opportunity and climb out of your comfort zone. That is the only way to grow and learn.
Be friendly & have respect – It can be difficult to obtain cooperation from colleagues and patients but being friendly and treating them with respect will assist you in doing your job more efficiently.
Promote our profession – Amongst staff and patients.
Do not leave the facility unchanged – You have a big opportunity to make a difference wherever you are placed. Identify a gap and fill it or bring something new to the facility.
Lastly, remember that the community service year is what you make of it. Make sure your journey count!
SPRING CLEANING YOUR LIFESTYLE
Finally! It’s time to emerge from the heft and sluggishness of Winter, and tune into the bright, clean energy of Spring. It is the season for clearing out the old and slow and kicking up our heels to livelier, sunnier rhythms. Springtime brings the perfect opportunities to reboot our immune systems after the cold-and-flu blues; use the extra daylight hours to boost our Vitamin D and swop stodgy comfort food for the juicy buoyancy of the new season’s bounty.
There are many potential benefits to responding to the effervescent energy of Spring; however, specialist healthcare professionals such as Registered Dietitian and ADSA (The Association for Dietetics in South Africa) spokesperson, Retha Harmse cautions against getting caught up in making lifestyle changes that are too sweeping. “Trying to make too many changes, or really big changes overnight doesn’t always stick,” she says. “A great approach to the new season is to just aim to be the better person than you were the day before. When you begin with small steps, it is far easier for the changes you make to improve your health and well-being to be sustainable.”
Go with the season
Keeping your focus on the in-season fruit and vegetables is an easy way to usher in small daily changes that can make a big difference. Swopping out soups and stews for fresh and delicious salads and plant-based bowls helps you to increase both the amount and variety of fruit and veg you eat. Jade Seeliger, also a Registered Dietitian and ADSA spokesperson points out that Spring produce can have a restorative effect on the body. “After a long, cold winter, our immune systems take a knock and many of us turn to antibiotics to help us recover. Antibiotics wipe out both the bad and good microbiota living in our gut. Certain fruit and vegetables are known as prebiotics provide food for your gut bacteria and help them to flourish once more. Prebiotic-containing fruit and vegetables in season in Spring include artichokes, apples and asparagus.” Keep your attention also on the versatile cruciferous veg such as broccoli and cauliflower; and stock up on the Spring avocados, tomatoes and berries.
Experience an awakening
Much of our less than healthy eating is rooted in being on auto-pilot when it comes to choosing what we eat and how we eat it. Spring invites us to wake up to our habits, and there’s no better way to do this than by exercising our mindfulness.
“Mindful eating is an ancient, mindfulness-based practice with profound implications and applications for resolving problematic eating behaviours and troubled relationships with food,” says Retha. “It also fosters the development of self-care practices that support optimal health.
Here are five ideas to you get started with mindful eating:
- Start with a favourite: Choose a favourite food or a dish you really enjoy and have eaten often.
- Sense it: Observe the look, touch, texture, and smell. Appreciate the appearance and scent of your food and begin to perceive any sensations happening in your body, particularly stomach and mouth.
- Observe before you chew: Once you take a bite, observe the sensation of food in your mouth without chewing. Carefully think about the taste of the food.
- Go slow and think: Chew slowly and pause briefly. Think about the location of the food in your mouth, as well as the taste and texture. Concentrate on how the taste and texture change as you continue chewing.
- Pause: Before you swallow, pay attention to the urge to swallow. Do so consciously and notice the sensation of the food travelling down the oesophagus to the stomach. Pay attention to any physical sensation.”
Lighten up!
More sunshine and warmth, new green shoots and coloured blossoms all give Spring its quintessential lightness that lifts the spirits and invigorates the body. It’s an ideal time to choose a few new habits that feel good. Jade suggests:
Cut the Cuppa’s! – “Caffeine has always created a buzz, and cappuccinos are always a perennial favourite. Unfortunately, when it comes to kilojoules, these milky drinks come at a cost. A ‘short’, ‘tall’ or ‘grande’ cappuccino is approximately 500, 700 and 900 kilojoules respectively (based on low-fat milk and no sugar), which are kilojoule equivalents to 1.7, 2.7 and 3.7 slices of bread.” If you find it too difficult to cut out your daily caffeine-fix, replace your cappuccino with an Americano or filter coffee with a splash of milk, which will help reduce the energy to approximately 150 kilojoules per serving.
Eat your water – “Thankfully, this does not mean crunching away on ice cubes to help shut down the hunger, rather pile your plate high with vegetables and salad. Most vegetables are between 90 – 95% water, this paired with fibre, vitamins, minerals and anti-oxidants makes them the perfect accompaniment for every meal. Try to ensure that at least half of your plate is vegetables and/or salad and that they represent all colours of the rainbow, from purple eggplants, yellow peppers, red radishes, orange butternut to green spinach.”
Bring back balance – “Extremes have always held so much appeal, from fasting to carb-free to fat-full to fun-less. Diets seem to be a collection of short-term restrictions that never reach the pot of gold at the end of that ‘goal weight’ rainbow. When it comes to meals and snacks, and eating in general, it is worth bringing back some balance which will help you to not only achieving those health goals but also being happy at the same time.”
Get an energy boost
Take inspiration from all the joys of Spring to boost both your physical and mental well-being.
Get outside and get more Vitamin D – Find your Instagram moments outside. Nature has a calming effect on us and spending time outdoors is so good for that extra Vitamin D. Embrace walks in the park and picnics; think about taking up gardening, especially growing your own salad leaves and edible flowers, Spring veg and herbs.
Find the ways to make healthy fun – Spring offers an opportunity of starting a-fresh; it’s worth using this new season to approach your health journey differently. Embark on a healthy cooking class or actually use the recipe books that adorn your shelves; ditch the gym if you don’t like it and find a new exercise you actually enjoy. Make health your new wellness goal, not deprivation and dieting, which is often the case leading up to summer holidays
Spring clean your sleep – Our bodies and minds need enough sleep to recover and be sharp for the next day. Sleep hygiene refers to your pre- and bedtime habits that help you to get the rest you really need. Ensure that you remove distractions close to bedtime to fully wind down and fall asleep quicker and more easily.
Meet the Dietitian: Leanne Katzenellenbogen
Meet Dietitian, Leanne Katzenellenbogen, that dispels the myth that “diet” food is boring.
My name is Leanne Katzenellenbogen and I am a dietitian.
I originally decided to study to become a dietitian because I love helping people and I believe that good nutrition is integral to good health. I did my undergraduate BSc degree at WITS and then went on to do my Honours in Human Nutrition at UCT and my Masters after that through Stellenbosch University.
I currently work in the Northern suburbs of Johannesburg in a private practice. I see people daily for various dietary issues. These may entail clients wanting some knowledge of how to eat healthily or people wanting lose weight. I also counsel many people who have either type 1 or type 2 diabetes on how to eat appropriately for their condition and how to manage their food and insulin.
The most satisfying part of my job is being able to help people achieve their dietary goals; whether it’s to achieve a certain weight, eat healthier or get their blood sugars under control. There are several client success stories that I could tell but my favourite is of a client who lost 50kg. It was such an enormous sense of achievement for him and brought great joy to him.
The most challenging aspect of my career would have to be keeping people motivated. In theory, to set a goal and stick to it seems simple. But… then real life gets in the way
and the task is way more challenging than it initially appears. Often goals are set and then not achieved and it can be very frustrating.
Having said that, there are still many people who do achieve their goals and it is very rewarding. There is a great misconception that the diets that dietitians give out are too strict, are boring and are unachievable. People often don’t realise that we are able to make meal plans exciting, fun and delicious.
I have written two books called “simple fabulous lunchbox ideas” and “Delicious Modern healthy Recipes for Diabetes” for just this reason. To try and dispel the myth that “diet” food is boring. The books highlight how delicious, creative and modern food can be even if you have certain dietary constraints.
So I would suggest that if you have any dietary issues that need sorting out, to go and visit a dietitian to help you maximise your chances of success on your nutrition journey.
Twitter: @LeanneDiet
FB: www.facebook.com/sandtondiet
Instagram: @sandtondiet
Pinterest: www.pinterest.com/sandtondiet
My website/ blog: www.sandtondiet.co.za
Meet the Dietitian: Community service series
“DIETITIANS ARE ADAPTABLE!”
By Yuri Bhaga
I am a community service dietitian currently working at a hospital in Witbank, which places me very far from where I got my dietetics training at UCT . But a lot closer to home in Pretoria where I completed my BSc degree 3 years ago.
When I got accepted to study dietetics I had no idea what I was getting myself into. Much like everyone else who hasn’t gotten the formal training, I had a very narrow understanding of what the title “Dietitian” stood for. Now 3 years later it has become a great passion of mine and I make sure to promote the profession and spread awareness of the role that nutrition has in all areas of our health.
Being familiar with the Western Cape health system, Mpumalanga was new to me. The province had its own set of unique challenges and demands that I had to learn to adapt to. The system is under immense pressure with far less than adequate resources and it would be a lie to say it doesn’t get frustrating at times. Some days will go smoothly and you will be able to implement a plan within the hour, thanks to a great multidisciplinary effort. Other days you will receive the wrong referrals and it will take up to 2-3 days just to start a feeding plan. It’s not always easy but it does provide hands on experience and a great opportunity for learning – and the feeling when you see an improvement in a patient’s condition or receive sincere thanks from a patient post counselling can really put things into perspective. Sometimes it’s not even about the clinical work or education you give but simply chatting to the patients and seeing how they feel that can make a world of difference to their stay.
I have been very fortunate to have arrived to an established and supportive department with members of staff who have years of experience and are always open to lending input and giving help should I need it. The hospital offers the majority of the services of a tertiary hospital which means I will have been exposed to a diverse patient population by year-end which is both a wonderful thing and a little daunting. That said, not everyone will have the same experience of community service, but if you are willing to work with what you have and find opportunity to improve and make good of what’s at your disposal you will come out having grown as both a person and as a professional.
Community service year is a great opportunity to gain independence and to be a fresh pair of eyes to fill gaps that are missing. Personally, it has put meaning to a phrase that I heard from an educator in my internship year: “Dietitians are adaptable!”. This year is all about what you are willing to put into it and the attitude you have going into the year will determine what you get out– as cliché as it sounds.
That’s not to say you MUST be busy day in and day out with no chance to breathe. Rest is equally important. I have found it has been of great benefit to find a support group. I am lucky to have been warmly adopted into the Speech and Audiology department where I go to spend most of my lunch breaks, or to vent about something that’s on my mind and have made new friends with their comm-serves. Working in a hospital is different for everyone and can be very taxing so it’s always good to have something other than work to help destress. If time allows it, find a new hobby or continue engaging in activities you enjoy – I have decided to try my hand at sign language classes.
To conclude :
- You won’t know everything (and that’s fine, you have plenty of time to learn and read-up)
- Ask as many questions as you need (granted you have tried to come up with the answers yourself first)
- Speak up and be firm – but polite.
- Get to know your surroundings and the people you work with.
- Have confidence, you likely know much more than you think! 😊
- And lastly , enjoy it and take it all in!!
Meet the Dietitian: Community service series
Read more about her love-at-first-sight story with Dietetics.
By Rhodene Oberholzer
A little over seven months ago I moved into a tiny apartment in Johannesburg, nervous about starting my community service year at Charlotte Maxeke Johannesburg Academic Hospital. Suddenly, I felt as if I forgot everything I learned in my four years studying at the North-West University of Potchefstroom. I could feel my heart making 20 000 jumping jacks per minute as I walked through the hallway on my way to the dietetics department, my very first day as a dietitian. I honestly did not think I would be able to do this, but fast-forward seven months later and I cannot believe how much I have learned and grown as a person so far.
The reason why I decided to become a dietitian is quite simple, it is like a love-at-first-sight kind of story. I always knew I wanted to work with people, but being a dietitian never really crossed my mind as something I wanted to pursue. It was only in my matric year that I decided to shadow a clinical dietitian. The profession fascinated me, and I soon realised that my idea of what I thought a dietitian did was only a drop in the ocean. So, I instantly knew I found my calling.
Now this year has probably been the most challenging, but rewarding time of my life. I feel so blessed to be able to work in a place where I get to see and learn so much.
Working in a clinical environment, we as dietitians are responsible for all the dietary needs of patients, whether it is total parenteral nutrition (TPN), enteral nutrition, dietary education, supplementing a patient’s diet or prescribing a special diet meeting the requirements for their specific disease condition. At first, this was very intimidating for me, but after a while, you can see how your interventions pay off, and it gets so much easier. Nothing is more rewarding than seeing the premature baby gain weight, the severe acute malnourished child gaining his appetite again, to hear the patient with muscle wasting say that she feels much stronger after drinking the supplements you provided, or even just getting a smile from a patient because you ordered him some extra jelly and custard.
I also have the opportunity to work in various clinics this year (such as Paediatric Diabetics; Orthopaedic Slimming; Neonatal; as well as a General clinic) where we assess and counsel out-patients with a specific nutrition related health problems.
For any future community service dietitian that feels nervous about starting this next chapter: I understand how you feel. I don’t think starting your first job is supposed to be a walk in the park, so be kind to yourself if you feel anxious and unsure. I did not believe it at first, but I promise you it will get better. Take your December holiday to rest, and have peace about where you are placed as it is only for 12 months and time goes by so fast. I think the biggest mistake you can make as a community service dietitian is to finish your 12 months, feeling like you did not learn much and made no difference where you were placed. Enjoy being a dietitian, fall in love with your work, as it really is such a fun and exciting profession to be in!
Meet the Dietitian: Raeesa Seedat
We spoke to Registered Dietitian, Raeesa Seedat, creative and passionate about the field of nutrition.
Why did you become a Registered Dietitian?
Being a Dietitian is like being the Terminator, except that you’re analysing food instead of potential threats (even though some may be treated as such). So you get to see each food with special vision and all the constituents are flagged.
What do you enjoy most about the work you do? What are the most satisfying moments?
I enjoy being involved in nutrition education and promotion. I am passionate about writing and communicating science and evidence into nutrition advice with tangible benefits to an audience. I also enjoy working with paediatric patients and mums who are very appreciative for managing various conditions in infancy and childhood.
What has been your career highlight?
I think I still have a long way to go to achieve all my career goals. For now the highlight would be graduating with my Masters of Science degree in Dietetics.
What are the most challenging aspects of your career?
It is sometimes a challenge to convince patients that even though they have been eating a certain way for a number of years the effect on one’s health is cumulative. The value of one’s health cannot be taken for granted and preventing disease is easier than treating it.
How do you cope after a day of nutrition disaster and bad eating choices?
Dietitians are mere mortals and we all enjoy a treat every now and again. However, I try not to let it get to a point where I am wallowing in guilt over what I have eaten. I try to balance the energy I have taken in with energy expended through physical activity.
What are the three things that you think people should stop saying when they meet a dietitian?
- I need a diet a plan
- Will eating this make me gain weight?
- How do I get shredded?
What should clients look out for when deciding which dietitian to work with?
It often narrows down to who you feel comfortable opening up to. Also, some Dietitians may have a special interest in specific areas such as food allergy or sports nutrition and if you require such expertise you can contact one of these Dietitians.
What is your favourite dish and your favourite treat food?
My favourite dish at present is homemade nachos (you can play around with healthier variations) and my favourite treat food is chocolate ice cream (yum!)
EMPOWERING PARENTS TO ENABLE BREASTFEEDING: COMMUNITY
Breastfeeding is one of the most crucial strategies to boost mother and child health. While South Africa has made some gains over the years, we still have one of the world’s lowest rates of exclusive breastfeeding for the first six months of life. Instead of being revered as the ‘superfood’ that it is for babies, a mother’s breastmilk is still often doubted as enough nutrition for her growing infant. Often, close family members and friends are the ones who undermine exclusive breastfeeding by suggesting to the vulnerable mother that her breastmilk is ‘not enough’ and wrongly pressure her to introduce solid foods.
Another major barrier to exclusive breastfeeding for the first six months of life, and ongoing breastfeeding for two years, is society’s attitude towards this most natural nurturing of babies, especially in public. Breastfeeding in public is protected by law; yet so often women are shamed and humiliated if they dare feed their babies, when and where they are hungry.
With its 2019 theme for World Breastfeeding Week, from 1 to 7 August, ‘Empower Parents, Enable Breastfeeding’ the World Alliance for Breastfeeding Action (WABA) is resolutely focusing on how we shift public and private attitudes to be appropriately supportive of the optimal nutrition for babies. This is a theme that cuts across all sectors of society and applies to breastfeeding moms across the board.
In celebration of World Breastfeeding Week 2019, we asked ADSA (The Association for Dietetics in South Africa) spokesperson and lecturer in the Division of Human Nutrition at Stellenbosch University, Thembekile Dhlamini, who also happens to have breastfed her child, to answer two burning questions about how we can empower parents to best enable breastfeeding.
#BurningquestionbreastfeedingNo1 – Empowering Parents – What do you wish you had known before you started breastfeeding?
- Due to my work, I was involved in breastfeeding training and advice for many years before I gave birth to my first son. Little did I know that the theoretical experience doesn’t equate to the actual experience. I wish I had known that.
- I wish I had known more about Lactorrhea, the continued discharge of milk between nursing, as one of the challenges that I could face. As dietitians our experience is often about dealing with the perceptions of ‘Not Enough Milk’, so as a mother, I was caught off guard by ‘too much milk’. Lactorrhea means you need to know about breast shells versus breast pads, because you need different solutions, especially when you are going back to work.
- I also wish I had known that hand expression of breastmilk is a hassle. I quickly understood why mothers struggle to do it at the beginning.
- I wish someone had told me that I would not want to go back to work at the end of my maternity leave because I wanted to breastfeed all the time. I thought I would be ready when time came, but the pain of separation cannot be forgotten. My little one is now 20-months old and I still struggle with separation.
- I wish I had known that breastfeeding goes deeper than most human bonds. It’s true love at its best. Breastfeeding moments are like meditation; nothing exists except you and the little one.
#BurningquestionbreastfeedingNo2 – Enabling Breastfeeding – How do you think family, friends, businesses, shops, corporates, public spaces can enable mothers to breastfeed?
- Family: I want my family to support exclusive breastfeeding without their interference. My baby does not need gripe water, Phipps, etc. They should allow me to experience breastfeeding the best way I know how and understand that my baby does not cry because he’s hungry. Families should understand that breastmilk is food like any other; it does not make anyone sick. I would like my family members to be there to feed my baby when I’m separated from him.
- Friends: I need my friends to respect my space and choice to breastfeed. They should not bring dummies, bottles and formulas to my baby shower. My friends should respect that my baby’s container is my breast. Also, they should not come along with teething biscuits, or anything else that contributes to mixed feeding.
- Workplaces: Businesses and big corporates need to adhere to the laws that ensure time and space for breastfeeding moms. They should take pride in promoting and enabling breastfeeding. Facilities for breastfeeding moms to feed or express should be enabling, safe and comfortable.
- Shops: We need to get breastfeeding out of the shopping centre toilets and parking lots. Why should bottle-feeding babies be allowed anywhere, anytime but breastfeeding is an issue? Shops and restaurants can really be a part of the solution by putting up signs that communicate their support that breastfeeding is the best and is welcomed in their establishments.
- Public spaces: There should be an emphasis on safe public spaces where mothers and babies will be comfortable and free from harm, such as tobacco. Mothers should not be expected to hide the natural beauty of breastfeeding. Our South African public needs to learn to appreciate breastfeeding.
Essentially, while breastfeeding is a deeply intimate time-bound bond shared between mom and baby, it remains a team-supported effort. As the WABA states: “Breastfeeding is in the mother’s domain and when fathers, partners, families, workplaces, and communities support her, breastfeeding improves.”
We can all play our part in enabling breastfeeding for the greater good by protecting, promoting and supporting it.
For information on World Breastfeeding Week 2019 visit www.worldbreastfeedingweek.org
EMPOWERING PARENTS TO ENABLE BREASTFEEDING
Snickering, disparaging, denigrating and casting aspersions on breastfeeding; shaming moms who breastfeed; who breastfeed in public or who excuse themselves to express breastmilk at work; raising doubts that a breastfeeding mom is producing enough milk to meet her baby’s needs; expecting a breastfeeding mom to place other priorities above her baby’s hunger – these are some of the insidious ways that we, as society, routinely disempower parents and ultimately discourage the very best way to feed a baby for the first six months of its life, and beyond.
You may think: ‘It’s not my baby, it’s not my problem’; or ‘I am so uncomfortable, I have a right not to have a breastfeeding mom near me!’ You would be wrong on both accounts. As part of society, we all have a moral obligation as to how we collectively foster the care for our most vulnerable children; as well as a vested interest in them turning into healthy, well-adjusted, contributing citizens. Also, breastfeeding wherever, whenever a baby gets hungry is perfectly legal, and deserves to be fully supported. Shaming moms into desperately breastfeeding their babies, or expressing breastmilk, in cold toilet cubicles and cramped cars in parking lots is the real problem.
With its 2019 theme for World Breastfeeding Week, from 1 to 7 August, ‘Empower Parents, Enable Breastfeeding’ the World Alliance for Breastfeeding Action (WABA) is resolutely focusing how we shift public and private attitudes to be appropriately supportive of the optimal nutrition for babies. This is a theme that cuts across all sectors of society and applies to breastfeeding moms across the board. In celebration of World Breastfeeding Week 2019, ADSA (The Association for Dietetics in South Africa) has brought together a panel of Registered Dietitians, who also happen to be past and current breastfeeding moms, to answer two burning questions about how we can empower parents to best enable breastfeeding.
#BurningquestionbreastfeedingNo1 – Empowering Parents – What do you wish you had known before you started breastfeeding?
NASREEN JAFFER: “I wish I knew that breastfeeding is a learned skill for mom and baby. As first-time moms, we are expected to know exactly what to do. No matter how much you read, the practical experience of breastfeeding is learned, so expect it to be something new and not something you have to master from Day 1.”
VANESSA CLARKE: “As with everything in life, everyone’s story is different. From my university days I was very aware of the theory regarding breastfeeding. However, I didn’t have any idea of the variables that existed. I really struggled to breastfeed my children and what made it even harder was seeing other mothers whose children latched beautifully, or they didn’t struggle with pain. I wish I had known that sometimes breastfeeding doesn’t come naturally and that everyone’s story is different – and that is okay to struggle.”
MARYKE GALLAGHER: “I never knew how much I would enjoy it and how much I would miss it once I stopped! Being able to breastfeed your baby is such a great privilege and the wonderful quality time you have with your baby is priceless. I also learnt that just because it was easy first time around, doesn’t mean it is going to be easy the second or third time. Feeding my first and second child was relatively easy as they both loved breastfeeding. When my third child arrived I just assumed she would latch easily and feed easily like the other two did. But this wasn’t the case, although with perseverance I’m still breastfeeding 15 months later. My advice to new moms is to get help from a lactation consultant if you are struggling with breastfeeding. They are able to assess each situation individually and provide you with sound advice and support.”
LISANNE DU PLESSIS: “Before I had my children, I had completed most training available on breastfeeding in the public sector at the time; so I had a good knowledge base. However, what training cannot instil is the VASBYT-factor; the perseverance required to make breastfeeding work for you and your baby. I believe that perseverance to breastfeed exclusively and to continue breastfeeding stems from the deep belief that it is the right thing to do and the very best nutrition and nurture I could provide my children. When times were tough, I reminded myself of this truth.”
THEMBEKILE DHLAMINI: “I wish someone had warned me that I would not want to go to work at the end of my maternity leave because I wanted to keep breastfeeding. The pain of separation that I thought I would be ready for; well, when the time comes, it cannot be forgotten. 20 months later with my little one, I still struggle to separate.”
CHANTELL WITTEN: “I never knew how important my mind-set would have to be, to truly engage and enjoy my breastfeeding journey. I learnt as a mom that breastfeeding is not a job or a task to complete. It is relationship you build and invest in; therefore it takes time.”
MONIQUE PIDERIT: “Before I started breastfeeding, I wish I’d known just how much of a team effort this journey would be. I went in with the idea that breastfeeding was solely my responsibility and put a lot of pressure on myself. However, I, unknowingly, had a great support team, each contributing in their unique way. Friends and close colleagues shared their real-life mom stories and lactation consultants guided me on choosing the right pump as working mom. Within minutes of my baby being born I had the hands-on, practical support of great midwives in hospital, and by the time I got home, I underestimated the encouragement and support I would get from my husband. He kept motivating me to keep positive and took care of things like stocking up the breastfeeding station with water, tea and healthy snacks, and bringing baby to me when I was utterly exhausted. As Helen Keller said: ‘Alone we can do so little. Together we can do so much.’”
#BurningquestionbreastfeedingNo2 – Enabling Breastfeeding – How do you think family, friends, businesses, shops, corporates, public spaces can enable mothers to breastfeed?
We asked our ADSA Dietitian moms. Here’s what they say:
NAZEEIA SAYED: “More shops, restaurants and other public spaces need to declare their support for breastfeeding mums to normalise breastfeeding. All work places need to have a policy around support for breastfeeding mothers and take action to support breastfeeding mums returning to work.”
THEMBEKILE DHLAMINI: “My friends need to respect my space and choice of breastfeeding. They should not bring baby dummies and formulas to my baby shower. I want my friends to respect that I choose to give my baby the breast, not milk from containers. Also, I do not want friends bringing teething biscuits as they contribute to mixed feeding. Breast is best exclusively for six months, and that’s an important goal for breastfeeding moms.”
LISANNE DU PLESSIS: “Family is so important. My mother, sister, husband and extended family were all on my side. They fed me while I fed my babies! They also cuddled, winded, bathed and changed nappies so that I could shower, eat, sleep. There is power in the family circle!”
NATHALIE MAT: “Breastfeeding takes a lot of time and energy; and only a mom can do it. Please support mothers by helping take other tasks off her plate that anyone can do. At home, this can mean tidying the kitchen or doing the laundry. At work, this can mean delegating tasks that are easily transferable so that the overall load on a new mom doesn’t become overbearing.”
NASREEN JAFFER: “Family members need to be careful about not telling a first-time Mom what to do, what to feel and what not to do. Each person will find their way. When it comes to public spaces, we definitely need to have many more public environments in which mom can breastfeed comfortably, and these need to be welcoming, clean and attractive spaces.”
CHANTELL WITTEN: “Breastfeeding needs to be openly welcomed. Salute to Spur Restaurants which has a public pro-breastfeeding policy. We need many more corporates to normalize and encourage breastfeeding.”
MARYKE GALLAGHER: “Business needs to look at longer maternity leave so that they give moms a bit more time for breastfeeding to be well established. Providing breastfeeding mothers with flexi time that enable them to breastfeed when they need to can make a big difference. Having childcare facilities at businesses could benefit both the business and the mom as the mother can continue breastfeeding while at work. Providing dedicated, private and relaxing areas for moms to feed and express breast milk is vital.”
Essentially, while breastfeeding is a deeply intimate time-bound bond shared between mom and baby, it remains a team-supported effort. As the WABA states: “Breastfeeding is in the mother’s domain and when fathers, partners, families, workplaces, and communities support her, breastfeeding improves.”
We can all play our part in enabling breastfeeding for the greater good by protecting, promoting and supporting it.
For information on World Breastfeeding Week 2019 visit www.worldbreastfeedingweek.org
Meet the Dietitian: Community Service series
Meet Community Service Dietitian, Iman Gierdien! She is passionate about forming relationships with patients, remembering faces and seeing the impact she is making on, not only the patients, but on their families too.
Written by Iman Gierdien
The thought of becoming a dietitian never crossed my mind. I didn’t know much about the profession until I came across it when applying for university. After researching, the then unfamiliar occupation showed to be a perfect combination of my interests and hobbies: the human body and food. The more I researched, the more I became excited even though the ‘’mighty’’ google couldn’t fully describe what, and how much, you do as a dietitian.
So, I started my roller-coaster journey at Stellenbosch University. Four years blinked away, and I was halfway through final year applying for community service. Being married and never having been away from home I naturally chose options close home or big cities. To me family and being close to those who love and support me was more important than the type of facility, the type of work I would do or the state of the working environment.
My greatest fears then came true; I was only placed after swops and appeals were closed. When I read the name I thought, wow, where is that? I had never heard of it, never even seen it on the list and it was definitely not one of my ‘’many’’ (5) options. Again, I relied on google and google maps to help me along.
Making the decision to accept the post was difficult. I would be 14hours away from home and family, 7 hours away from my husband and in rural Eastern Cape, deep deep rural. After much deliberation and many tears, I accepted. However, it is nothing close to what I was expecting both socially and emotionally. I have made friends that feel like family and I’m in an environment that is so uplifting and positive even though I came with such a pessimistic attitude.
I am one of two dietitians at the hospital and together we conquer the challenges thrown at us. We are working with a community riddled with non-communicable disease, TB, HIV, teenage pregnancies and severe malnutrition in its children. We are working with a community that is set in their ways and beliefs and that is crippled by their economic status.
However, the best part of work is the people. Being a primary, small, hospital you’re able to form relationships with patients, remember faces and you’re able to see the impact you’re making on, not only the patients, but on their families too with such limited resources and little contact sessions.
Community service shouldn’t be a year for you to think about how much academic experience you gain. It’s an opportunity to go outside your comfort zone and develop soft skills. It should be about gaining understanding and empathy for the determinants of health and actions so that it allows you to grow into a holistic healthcare practitioner and human.
So, the greatest advice I could give is to use your community service as a year for you to cultivate the skills that cannot be taught.
AGEING AND ITS NUTRITIONAL CHALLENGES
Around the age of thirty years, the strength and vigour of the human body naturally begins to decline. There are gradual losses we have to accept as we make our way into our older adult years; less elasticity, less muscle and bone mass, less energy and physical efficiencies. Decades later, we reach a time when our health is simply much more vulnerable than younger adults and it takes a different effort to take good care of our health.
We cannot avoid the natural consequences of ageing, but embracing a healthy lifestyle does a lot to help us enjoy our senior years. Older adults have unique nutritional needs and challenges, and this often demands changing lifelong eating habits. While overweight can be an issue for some seniors, malnourishment is much more common and the causes of this are variable. The diminishment of senses, such as smell and taste can lead to a disinterest in food. Living alone; preparing most of your meals just for one and eating all by oneself can similarly lead to a lack of concern about nutrition that the elderly cannot afford. Chronic health issues associated with ageing can lead to a poor appetite or an avoidance of eating.
In general, seniors do need fewer calories, but more nutrients. The body’s ability to efficiently absorb vitamins and minerals declines, and therefore nutrient-rich meals become even more important. According to Cath Day, a registered dietitian and spokesperson for ADSA, the Association for Dietetics in South Africa, ageing healthily requires greater intake of calcium, magnesium and folate, as well as of Vitamins B12, D, E and K. She says, “These needs can be met with a varied diet of healthy foods. However, good nutrition exists in the context of a healthy lifestyle. Interestingly, meals that promote social interactions for older adults in a variety of settings are associated with improved food and nutrient intake or nutritional status.” There are no guidelines for the elderly to take nutritional supplements as a matter of course, but Day adds, ”If deficiencies are noted, supplementation becomes imperative as these need to be corrected through therapeutic supplementation and under the supervision of the medical team.”
Another nutritional priority for seniors is to focus on their protein intake. Sarcopenia is, most commonly, age-related muscle degeneration which leads to weakness, frailty, delayed wound healing and other vulnerabilities in seniors. Even if it cannot be prevented, you want to decelerate sarcopenia. Day says, “As dietitians, we often find that older people – over 70 years of age – are less efficient at using the protein in the food they eat. This means that they may not be getting enough. Seniors who suffer from a loss of appetite should monitor their protein consumption strictly. Tips include eating protein at each meal instead of only at lunch or dinner. Add yoghurt, cheese or egg for breakfast instead of only eating marmalade on toast. Include protein in your snacks by switching from sugary biscuits or a packet of crisps to peanut butter and banana on toast, whole-wheat crackers topped with cottage cheese and fruit or veggies, beans or sardines on a whole-wheat cracker.”
The loss of muscle mass also leads to a lower fluid requirement; but despite less need, the elderly still have a much higher risk of dehydration. The reasons for this are variable – it could be a side-effect of medication, a fear of incontinence or simply the diminishment of thirst as the self-regulatory mechanism against dehydration. Seniors need to be aware of the risk; monitor their hydration and adjust their fluid intake accordingly.
While a healthy old-age demands this kind of focus on nutrition and, the adoption of different eating habits, Day reminds that diet alone cannot make people live well for longer. She says, “A varied diet made up of good quality protein, lots of fresh vegetables and fruits, beans and legumes, whole-wheat breads and brown rice, healthy fats such as olive oil is vital. However, seniors need to embrace other healthy living habits as well.”
Healthy lifestyle habits also include:
- Maintaining a normal weight
- Getting regular physical exercise.
- Drinking alcohol sensibly
- Not smoking.
- Finding your purpose in life as a senior and interacting socially often, such as sharing meals with family and friends; going on outings; pursuing interests and hobbies; learning something new
- Assessing your stress levels and managing your stress if necessary through meditation or yoga or mindful techniques such as deep breathing
Meet the Dietitian – Estée van Lingen
We chatted to Estée van Lingen, a dietitian who is passionate about growth and evolving in her field. And is willing to share a chocolate brownie or cheesecake!
Why did you become a Registered Dietitian?
I have always been passionate about food as well as helping others achieve their goals. With Dietetics I get to work with both! Nutrition is also a field that is consistently growing it is also nice to keep on evolving with it and keep on learning and not just a set of rules that we learn in University and stick with for the rest of our careers.
What do you enjoy most about the work you do? What are the most satisfying moments?
Clients that are actually motivated and come to you for help. When they then leave your office feeling like they have learned a lot and you have made everything so clear and easy for them and then they go home eager to start implementing it.
Its always satisfying when clients achieve their goals following the advice you gave them but not just that. The fact that they also believe you made a difference in their lives and that you played a key role. Even if it was just for clearing bloating or improving energy levels.
What has been your career highlight?
Being able to start my own private practice without working in a private practice setting before. I would never have though that I could actually achieve it and now to just keep on seeing my practice growing on a daily basis. It has been a true blessing that I would never have been able to achieve without help from my heavenly Father and the support of family & friends.
What are the most challenging aspects of your career?
Convincing clients that a healthy balanced diet is the way to go especially if they have been following other diet trends with success.
How do you cope after a day of nutrition disaster and bad eating choices?
We all make mistakes, and yes dietitians also have bad days, believe it or not ☺
I just tell myself its ok and it’s not a train smash so I just have to get back on the wagon tomorrow or with the next meal and start afresh. We can’t keep on getting stuck in the past, then we will never be able to move forward.
What are the three things that you think people should stop saying when they meet a dietitian?
- I know I am fat. Do you think I am obese?
- What do you think about the banting diet?
- I want to lose the weight quickly, how can we speed weight loss up with supplements?
Tell us about what work you have done in the past as well as what work you are currently involved in?
I have finished my community service in a government hospital where after I went into a corporate company doing catering. I was responsible for compilation of meal plans for special diets eg Diabetes, high cholesterol, IBS, soft diets etc for in a hospital set up as well as healthy meal alternatives in canteens. I also did training with the chefs and staff on what healthy meals consist of as well as special dietary needs for patients in hospital. I then started my private practise where I still consult with clients to assist them with weight loss as well as special dietary needs.
Where did you study your undergraduate degree and where did you do your community service?
I studied at NWU (Potchefstroom campus) for my 4 year Dietetics degree (incl honours) and then completed my community service in Tambo Memorial hospital in Boksburg.
Tell us about your community service experience.
It was great to learn from other dietitians in the government setup as well as see what things are like in a public setting as well as the different needs there is for patients. I also enjoyed helping people that was not able to afford Dietetic services otherwise and it made my heart melt when you could see the difference you made in their lives. It also was frustrating at times when you really wanted to assist people but did not have the right resources due to unpaid accounts or lack of funds. But overall it was a life-changing experience
Have you continued studying and what do you do to keep up to date on nutrition?
I have not continued studying a degree but have done a few shorter courses/ diplomas in Sports as well as Advanced sports nutrition. I also keep up to date with the latest research through CPD activities/ events/ articles as well as attend congresses
What should clients look out for when deciding which dietitian to work with?
Have a look at the Dietitians website/ Facebook profile and have a look at what their passions are, what clients they see and compare it to your goals you want to achieve.
If a close friend or doctor refers you they are normally doing it after seeing great results themselves or with their clients so trust their judgement.
What is your favourite dish and your favourite treat food?
My favourite dish is any form of seafood including sushi. I normally enjoy a treat of a nice dessert such as a chocolate brownie or cheesecake which I normally would share with someone.
Media release: Stress, digestion & nutrition
Stress, as an appropriate response to a real danger, is an evolutionary life-saver. Thanks to the fight-flight responses in our ancestors’ bodies, we, the descendants have made it through to the 21st Century. It’s ironic that in this modern age with extraordinary technologies devoted to eliminating hazards and increasing our ease in life, our stress is off the charts. We’ve become aware that our bodies, almost perpetually flooded with the stress hormones, adrenalin and cortisol, are now at risk from their own, age-old, protective ingenuity.
Our bodies are well-designed to cope with short bursts of life-saving stress, but it is sustained stress, resulting from a barrage of perceived threats, that takes its toll. Flowing adrenalin and cortisol from our activated endocrine system ignite both visceral and cerebral reactions; and they do so by drawing the body’s energy away from other systems, such as our digestion and immunity.
Registered dietitian and spokesperson for ADSA (Association for Dietetics in South Africa), Maryke Gallagher explains that it is our autonomic nervous system (ANS), comprising of sympathetic, parasympathetic and enteric nervous systems, that controls our involuntary responses. “Stress hormones switch on the sympathetic nervous system to increase your heartbeat and send blood to the areas to cope with the emergency,” she explains. “In the process, the effects of the parasympathetic system in charge of other functions, such as digestion, are dampened. This can lead to unwanted digestive symptoms such as constipation, diarrhoea, nausea, stomach cramps, malabsorption and irritable bowel symptoms. Stress may also exasperated symptoms of heartburn and acid reflux in susceptible individuals and those suffering from stomach ulcers.”
How stress can undermine our nutrition
Apart from raising the risks of digestive ailments, chronic stress can influence how and what we eat, to the detriment of our healthy eating plans. Gallagher says, “Research has shown that in susceptible individuals chronic stress can lead to overeating especially highly palatable, less nutritious foods that are high in highly processed carbohydrates, sugar, salt and unhealthy fats. High cortisol levels, in combination with high insulin levels, may be responsible. The hormone ghrelin that regulates hunger, may also play a role. The happy hormone serotonin may have an impact as the consumption of carbohydrate-rich foods may trigger its release, which can have a momentary calming effect on stressed individuals. Unfortunately, the consumption of these foods can have a negative effect on blood sugar levels, causing spikes and drops in blood sugar that then make one feel agitated, fatigued and hungry and grabbing for the same sugary, highly-processed foods that initiated this process, leading to a vicious circle of poorer dietary choices.
The impact of stress on our weight
Sustained stress might well impact on our weight management. While some individuals may lose weight because of their stressed state, those who are inclined towards emotional eating can go the opposite way. Mpho Tshukudu, also a Registered Dietitian and ADSA spokesperson says, “Adrenalin can trigger overeating or eating unhealthy foods to calm the response after the body has used up glucose for the stressful situation. One may eat mindlessly whilst thinking about the problem at hand and not even focus on the taste of foods, portions and your satiety level. Elevated cortisol creates physiological changes that help to replenish the body’s energy stores that are used and depleted during the stress response. It makes you want to eat more to obtain more energy. This leads to increased appetite and cravings for sweet and fatty foods, which can lead to fat gain particularly around the belly.”
Nutrition’s role in stress management
Just like physical activity and mindfulness, nutrition has an important role to play in managing our stress and caring for ourselves well during a difficult time. Keeping your healthy eating regime on track, or changing to one during times of prolonged stress can have positive physical and emotional impacts. The experts recommend:
- Eat regular meals to avoid blood glucose dips, which helps to keep hunger and hormones such as insulin in check. Skipping meals on the other hand can exacerbate symptoms of stress and erode your stress response.
- Focus on a diet rich in plant-based, high fibre foods such as vegetables, fruit, legumes, nuts and whole grains, as well as lean proteins and healthy fats. This will assist in better blood sugar regulation to better manage the short term effects of stress, while protecting the body against chronic disease in the long run.
- Avoid highly-processed carbohydrate rich and sugary
- Be careful of regularly eating treat foods, such as chocolate in order to make you ‘feel better’. Likewise be aware of not increasing your intake of caffeine or alcohol during stressful times.
- Consider including fermented foods in your diet, or taking a probiotic supplement to keep your gut microbiome healthy. Research has shown that stress affects the amount and type of healthy bacteria in the gut, which in turn can affect our immunity that may be suppressed due to stress. Tshukudu points out: “There is a complex two way connection between the digestive system and the brain, called the brain-gut axis. A troubled intestine can send signals to the brain, just as a stressed brain can send signals to the gut. This system is sensitive to our emotional state and affects digestive illnesses such as irritable bowel syndrome, indigestion and heartburn. It also affects the whole body function.”
ABOUT ADSA
ADSA, the Association for Dietetics in South Africa, is one of the country’s professional organisations for registered dietitians. It is a registered non-profit organisation served by qualified volunteers. The Association represents, and plays a vital role in developing the dietetic profession so as to contribute towards the goal of achieving optimal nutrition for all South Africans. Through its network of ten branches ADSA provides dietitians with the opportunity to meet and network with other professionals in their provinces. Through its comprehensive Continuing Professional Development (CPD) system, ADSA supports dietitians in meeting their mandatory on-going learning, which is essential to maintain their registration status with the Health Professions Council of South Africa (HPCSA). Visit: http://www.adsa.org.za