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:

  1. 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.  
  2. 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.
  3. 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!
  4. 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.
  5. 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.
  6. 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.
  7. 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!

NutrientBenefitExamples of Food Sources
Vitamin CAntioxidant and antihistamineFruits and vegetables namely: Red and Green peppers Citrus fruits (oranges, grapefruit) Kiwi Tomato
Vitamin DAnti-inflammatoryFish Eggs Fortified milk Mushrooms
Vitamin AGrowth of immune cells and protection from illness and infection.Carrots Spinach or kale Liver (beef and chicken) Eggs
Vitamin EAntioxidant and improves immune response to infectionNuts (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 infectionRed meat and Poultry Oysters Dairy products Whole grains Beans Nuts
SeleniumAntioxidantNuts Whole grains Cereals Mushrooms Dairy products Poultry, Red meat and Seafood
Omega-3 fatty acidsAnti-inflammatoryWalnuts Flaxseed Canola oil Avocado Eggs Fish (salmon, sardine, tuna, mackerel)
Dietary FibreFermentation of fibre in the gut provides products that help strengthen the immune systemWhole 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:

  1. 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.
  2. Vitamins and supplements can be very expensive. Why put a dent in your budget if it is not necessary?
  3. 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.
  4. Taking vitamins in excess of what you need may be doing more harm than good.
  5. 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


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:

  1. 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:

  1. Preheat the oven to 180 degrees Celsius.
  2. Mix the dry ingredients (oats, flaxseed, spices, salt, nuts, pumpkin seeds) in a large mixing
    bowl.
  3. Then add in the honey and milk and mix well.
  4. Allow to soak for 10-15 minutes.
  5. 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).
  6. Stir in the blueberries and pour into the baking dish.
  7. Cook in the oven for 40 – 50 minutes until set.
  8. 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:

  1. What can I do to get a flat stomach?
  2. I am healthy nowadays, I don’t even use normal salt anymore, I use the pink one.
  3. 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:

  1. 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.
  2. 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.
  3. Add the vegetable stock, hot sauce, paprika, saffron and season with salt and pepper if needed. Stir everything together and cover with the lid.
  4. 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.
  5. Meanwhile, roughly chop your vegetables of choice to resemble a shredded stir-fry.
  6. 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).
  7. 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:

 

Jen_Rosey 1

 

  • 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:

  1. Place the egg, sugar, salt, ripe banana and vanilla essence in a mixing bowl and beat with a fork.
  2. Add half the milk to the egg mixture.
  3. Sift the flour, bicarbonate of soda and baking powder into the egg mixture, without stirring just yet.
  4. Add the wheat bran and then stir gradually using a wooden spoon, until smooth and lump-free.
  5. Add the rest of the milk and oat bran and mix in carefully.
  6. Core the apples and cut into thin round slices. Sprinkle the cinnamon over both sides of the slices.
  7. 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.
  8. 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.
  9. Using a tablespoon, spoon one tablespoon of flapjack mixture onto each apple slice.
  10. 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.
  11. 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:

  1. Mothers should breastfeed on demand, whenever baby wants to breastfeed, day and night.
  2. 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.
  3. 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.
  4. 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.
  5. 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.

 

Breastfeeding pamphlet

Breastfeeding Q&A Booklet


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:

 

Nutrient Dense Lockdown Recipes (Mandela Day) with cards


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:

  1. Stir together garlic, olive oil, red wine vinegar, rosemary and oreganum to make a herb vinaigrette.
  2. In a large bowl combine baby potatoes, peppers, onion and lemon. Stir through the vinaigrette to coat the vegetables.
  3. Take a long piece of heavy duty foil or fold light-weight foil in half for a double layer.
  4. Center a quarter of the chicken mixture on each sheet.
  5. Top your chicken with the vegetable mixture. Divide and pour over any herb vinaigrette remaining in the bowl.
  6. 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.
  7. 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.

ADSA_NutritionConfidence_Cheryl Meyer1_July2020

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!

 

Veg Lasagne_Image1

 

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:

 

  1. Dice onions finely and fry in a large pot using 2 tbsp olive oil for approximately 5 minutes until soft.
  2. Add the diced carrots, celery and garlic to the pot.
  3. 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.
  4. Add the mushrooms to the pot, stir regularly.
  5. 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.
  6. 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.
  7. While this is cooking peel the butternut, chop and add to a steamer.
  8. Place the chopped cauliflower into another small pot with 2 cups of water and cook until tender.
  9. Now preheat the oven to 180 degrees Celsius.
  10. 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.
  11. Mash the butternut once it is cooked. Stir in a sprinkle of nutmeg and ¼ tsp salt.
  12. Using a peeler, peel the baby marrow into long ribbons and set aside.
  13. Remove the bay leaves from the bolognaise.
  14. Spray a large serving dish with a non-stick spray (the one I used had the following dimensions: 33 x 24.5cm).
  15. 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.
  16. 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:

  1. 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.
  2. 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
  3. 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.
  4. 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
  5. 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. ​
  1. 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.
  2. 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
  1. 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.
  2. 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:

  1. Prepare ice water bath
  2. Blanching: Using a big pot, bring about 2 cm water to boil. Add beans for 1-2
    minutes until bright green but still crisp.
  3. Drain and soak in an ice water bath for about 2 min bath, to stop cooking process
  4. Once cool, drain in cut into 4 cm lengths
  5. Add beans and courgette to a bowl
  6. Add baobab mayonnaise or yoghurt dressing and oil. Mix well
  7. Add capers, tarragon and peppercorn
  8. 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.

 

20200331_090315

 

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:

  1. Pre-heat the oven to 200 °C and prepare a baking tray with non-stick spray.
  2. 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.
  3. 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.
  4. Grate the onion into a bowl. Add the oil, flour, garlic powder, cumin powder, salt, and ground pepper.
  5. 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.
  6. 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.
  7. While they are baking, sauté the mushrooms and red pepper until fragrant.
  8. Once ready; assemble the rosti, spreading with basil-and-pea pesto, rocket, mushrooms and peppers.
  9. 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.

 

Young black mom running errands at the supermarket smiling at camera

 

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.

 

Multiracial females with different size and ethnicity stand together and smile. 

 

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:

 

  1. Ask all clients to wash or sanitize their hands on arrival at your office.
  2. 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.
  3. Don’t shake hands, maintain a reasonable distance between you and your client.
  4. 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)
  5. 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):

  1. 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.
  2. 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
  3. 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.
  4. Ask clients to arrive on time for appointments and not early.
  5. Don’t allow any accompanying persons into the waiting area, rather ask them to wait in the car.
  6. Do not allow any eating or drinking in the waiting area.
  7. 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:

 


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.  

 

wenda2

📷: Reg Caldecott

 

wenda3

📷: 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😃.

 

wenda1

 

  • What are the three things that you think people should stop saying when they meet a dietitian?
  1. What can I eat to lose fat? 
  2. You probably don’t eat any sweets
  3. 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.

 

67933672_748043588946475_8333155960709185536_n.jpg

 

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.

69252530_774400693010787_7423836780564054016_n

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.

68611928_774387959678727_855888348168847360_n

 

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.

Toiletry packs containing all the goodies for both mother and the baby

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.

.
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.”

.
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.”

.
Knowledge is power

.
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 2.jpg

 

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.

 

Vitality Netball World Cup: SPAR Proteas v Trinidad and Tobago


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.

 

day10

First day out to the clinics #Day10 #BecomingAnRD #scenicroute #roadtrip #longroad #landscape #blueskies #mountains #Drakensberg

day 78

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

NNOW2019_Logo_17Sept19 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:

  1. Place the grated onion, garlic and ginger, ground peppercorns, fish / soya sauce, sugar and chopped coriander leaves in a bowl. Mix all the ingredients.
  2. 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.
  3. Using 1 tablespoon of mixture at a time, roll the mix into 16 small balls.
  4. Gently heat a frying pan that has been sprayed with aerosol non-stick cooking oil.
  5. Place the mini meatballs side by side into the lightly greased pan.
  6. Cover with a lid or aluminium foil.
  7. Cook on low heat for 7 minutes until the underside of the meatballs are brown.
  8. Turn all meatballs and cover again. Cook for 5 minutes until the other side of the meatballs is browned.
  9. Remove the meatballs from the pan and leave to cool while assembling the salad.
  10. 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.

delcious-FB-post.png

Screenshot-2014-06-21-18.31.40.png

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

20140510_121150

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


Dietitian’s week 2019

Dietitians do much more than you think!

The careers of dietitians are way more diverse than many think.  The typical assumption is that a dietitian is a nutritional health professional available through private practice to those who need and can afford weight loss expertise.  The reality couldn’t be more different.  Dietitians are employed across private practice and public healthcare; academia and research; corporate, government and non-government sectors.  While they all have the expertise to deal with weight loss and weight management, which can be critical health issues, their expertise in science-based nutrition means that they work far more widely on a myriad of nutrition-related issues.

Our relationships with food are so complex that it is not uncommon for a community-based dietitian to be dealing with both issues of obesity and malnutrition not just in the same day, but even within the same family.  If you are in hospital recovering from cancer surgery or a debilitating stroke; how do you take in the nutrition you need?  If you are a consumer goods company wanting to offer healthier food products; who will you turn to?  If we want to understand the latest claims about Omega 3 fats; who will help us sort the fact from fiction?  If a school needs to revamp its tuck shop and find healthier, popular alternatives; what are the best, proven recommendations?

In support of Dietitian’s Week, which runs from the 3rd to the 7th of June, ADSA, the Association for Dietetics in South Africa, is highlighting the wide range of services dietitians are specifically trained to deliver. SASPEN, the South African Society for Parenteral and Enteral Nutrition; ENASA, the Enteral Nutrition Association of South Africa and HDIG, the Hospital Dietitian Interest Group have all joined forces with ADSA to raise awareness that there’s much more to the work of a dietitian than is commonly assumed.

Registered Dietitian and ADSA spokesperson Abby Courtenay says, “At the core of every dietitian’s work is evidenced-based nutrition science and the ability to interpret this to meet an endless variety of demands for sound and expert nutrition advice.  Worldwide, nutrition research is ongoing, and Registered Dietitians are required by regulatory bodies to keep studying after they have qualified in order to ensure that they are at the forefront of the latest nutrition science, no matter what field or industry they work in.”

SASPEN spokesperson, Logesh Govender, further explains: “In South Africa, dietitians must be registered with the HPCSA which regulates the professional titles of Dietitians, Supplementary Dietitians, and Student Dietitians, as well as Nutritionists, Supplementary Nutritionists, and Student nutritionists. Requirements for eligibility for registration include a recognized bachelor’s degree in dietetics or nutrition from an accredited educational institution. The undergraduate training should include the three practice areas of therapeutic nutrition, community nutrition, and food service management. Dietitians can then select any of these areas to practice. Even in these different areas there are dietitians who may develop a keen interest in specific components.”

These are some of things that Registered Dietitians do:

Christine Taljaard-Krugel: “As a Registered Dietitian researcher and consultant, I make nutrition evidence useful for different sectors, including government, the private sector and the public.  I also invest in developing leadership capabilities in nutrition professionals across the continent to move the nutrition agenda forward.”

Linda Drummond: “My role at the Consumer Goods Council of South Africa (CGCSA) is to be the Nutrition Consultant to the Food Safety Initiative (FSI).  The CGCSA is a non-profit organization representing more than 12000 member companies engaged in the manufacture, retail, wholesale and distribution of consumer goods in South Africa and internationally. The FSI advocates for sustainable initiatives, forums, projects and programmes related to food safety, nutrition, quality and sustainability. My work focuses on helping members achieve compliance to food and nutrition regulations and I am responsible for driving the Healthy Food Options Industry Initiatives programme. The work in this programme aims to make healthier food options available and accessible to South Africans, as a means of curbing non-communicable diseases and promoting good health.”

Nazeeia Sayed: “I am a Consultant Registered Dietitian. I have over 20 years’ experience spanning food composition, research, lecturing dietetic students, supporting food industry research and development, regulatory and marketing teams in product development (in particular salt reduction, healthy recipe development and fortification), and developing nutrition communication.”

Bianca Tromp: “As a Registered Dietitian at the Heart and Stroke Foundation South Africa (HSFSA) which is a non-governmental and non-profit organisation, I am responsible for creating public awareness of cardiovascular disease and stroke in order to reduce the prevalence in South Africa. With this aim in mind, I provide scientifically accurate information to healthcare professionals and the general public in the form of research updates newsletters, television, radio and written media. The Nutrition Science team at the HSFSA also play a fundamental role in the Heart Mark endorsement programme where we endorse products that meet our strict nutritional criteria.”

Gaby Sidelsky: “I am a private hospital Clinical Registered Dietitian which means I work in a hospital. On a daily basis I work with doctors, mainly surgeons, who perform procedures on patients who require nutritional counselling on discharge. This is usually a gut surgery which requires a long term change in diet. I also work in ICU where I calculate a patients nutritional requirements and provide nutritional support if they cannot eat orally such as feeding through a tube from the nose directly into the stomach or through a vein. I also provide extra nutrients for patients who can’t get enough through their food or have a poor appetite due to side effects of medication, such as cancer patients on chemotherapy.”

Qudsiyah Kassim:  “As a public service Clinical Registered Dietitian I play a role in the public sector by providing therapeutic nutrition to both in and outpatients. I am part of the hospital’s multidisciplinary team and engage in ward rounds in my allocated wards. I provide therapeutic nutrition through assessing patients and prescribing the appropriate nutrition intervention as per the patient’s medical condition, as well as delivering nutrition intervention for in-patients through the prescription of a hospital diet/enteral nutrition/parenteral nutrition/dietary education and providing a meal plan on discharge.  For outpatients, I conduct a nutrition assessment and provide relevant dietary education (with appropriate meal plan and/ or supplementation if needed).”

Cindy van Rooyen: “As a Registered Dietitian I am also qualified to work in the food service industry. I currently work at a school hostel as their food service manager. In this role, I am responsible for menu planning, which includes making sure that the meals are nutritionally appropriate for our students (13-18 years). I am responsible for doing stock take and stock control to ensure the products are fresh, nutritious and safe to consume.  I also have to ensure that we comply with the health and safety act and that the appropriate hygiene practices are followed.”

ABOUT ADSA
ADSA, the Association for Dietetics in South Africa, is one of the country’s professional
organizations for registered dietitians. It is a registered non-profit organization 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


Meet the Dietitian: Community service series

An unforgettable community service experience in the ‘forgotten province’…

By Inarie Jacobs

Health should not be taken for granted – a lesson I learned as a child whilst being very ill due to my poor lifestyle and dietary habits. After this experience, I decided to study dietetics at the North-West University of Potchefstroom to share this lesson as far and wide as possible.

I started my community service journey in December 2018 at a small rural hospital in the beautiful Transkei area of the Eastern Cape – a.k.a. “the forgotten province”. The challenges seemed a bit overwhelming at first as I had to trade my luxurious lifestyle habits for much simpler ones. Not only was the hospital an hour away from where I lived but it also never had a dietitian or a dietetic department before. No equipment and no supplements together with a huge language barrier made counseling with patients nearly impossible. To be honest, the tunnel did not seem to have light at the end.

However, after a few weeks of feeling really sorry for myself, I noticed how heavily the burden of wasting, obesity and poverty weighed on this community. The effects of the nutrition transition were clearly visible in this rural area which made me realized how badly nutrition intervention was needed. This led me to change my perspective and strategy towards this year and soon my challenges transformed into endless opportunities.

I get to build and establish a whole new dietetic department to promote our profession – an opportunity few community service dietitians have. I’m forced to improvise and to be more creative with cost-effective tools and methods to educate and treat patients – a skill I would have never developed if things were easy. I’m forced to reach out to the surrounding dietitians for help – a network of professional colleagues I would have otherwise not built.  I’m also trying to learn the beautiful isiXhosa language to interact with patients – a privilege I would have otherwise not had.

In short, comfort does not enhance growth! I’m grateful to be pushed beyond my comfortable limits as it is teaching me more than any book ever will!

I encourage all future and current community service dietitians to rise to the opportunity to lead, to influence and to inspire others with your attitude, deeds, and knowledge. To Quote Anne Frank: “You don’t always know how great you are, how much you can accomplish and what your potential is”. Dare more boldly, walk that extra mile and give it all you have!

A few rural survival tools:

  • Breathe…
  • Rural is never a textbook case.
  • Be culture sensitive and respect different views/religions.
  • Get to know local indigenous foods, what traditional foods are and how they are prepared.
  • Ask for help as much as possible. You don’t have to know everything, just be willing to learn.
  • Know that change doesn’t happen overnight and that some may be very resistant towards it.
  • Be kind and treat people with respect, no matter their background, title or position.
  • Be gentle and patient with yourself, your progress and setbacks.

 

ABOUT ADSA
ADSA, the Association for Dietetics in South Africa, is one of the country’s professional
organizations for registered dietitians. It is a registered non-profit organization 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


Meet the Dietitian: Community service series

“The best decision I’ve made in my life…”

By Bonnie Evert

“TPN? Food in arteries?” These were my thoughts, as a very inexperienced 17- year- old girl, when the Registered Dietitian (RD), who was assisting a very close family member of mine in the ICU, explained what all the little bags hanging above the bed were in aid of.

My perception that RDs only help fat people lose weight was destroyed and the profession fascinated me. I canceled my application for the air force and immediately applied to study B.Sc. Dietetics at the NWU Potchefstroom Campus – which has been the best decision I’ve made in my life, thus far.

Five years later, I am working at a psychiatric hospital to complete my community service year. It is not quite the same as the acute setting we became familiar with in our 4th-year internship. This psychiatric hospital specializes in patient-care for the intellectually disabled patient, rehab for mood disorders, substance abuse or both, and a rehab unit that accommodates patients with spinal cord as well as brain injuries.

When starting anything new, there are a few challenges and opportunities. Here are a few of mine as a new Comm-serve.

  1. Opportunity

Working in a psychiatric hospital is very interesting and different to an acute hospital. Not a day goes by where an opportunity doesn’t arise to learn something new, read up on a rare condition or have a heart-warming encounter with a patient.

  1. Multi-professional team

I have realized the importance of working together in a multi-professional team, including the occupational-, speech- and physiotherapists, and how important each unique role is regarding nutritional management and overall patient care. I have come to understand that one cannot be a one-dimensional dietitian: yes, we are the nutrition experts, but it won’t hurt to learn more about all the complex medical aspects of different patients. In fact, it will improve your nutritional decision-making.

  1. To err is human – it’s okay to make mistakes

This is only relevant IF we use our unintended mistakes as learning curves and IF they do not harm anyone, of course. I have often felt as though my opinion is not worthy or helpful until I realized that if I don’t speak up immediately and take a stand for my patients (who often cannot speak for themselves), a greater risk is imposed on their healing and well-being. However, it is our responsibility to be updated with the latest evidence-based guidelines and medical nutritional therapy to support our opinions.

  1. Separate your work from your private life

In our line of work, it is our job to be empathetic towards patients and to remain professional. I learned that to keep my emotions from getting the better of me at work, I will have to find a way to debrief – and believe me – it is important to talk about your feelings. Thankfully, I have the best support system at work and an absolute role model as my supervisor who taught me this: It is important to be empathetic towards patients, but so is protecting yourself and ensuring the quality of your work.

Some of the highlights I have enjoyed about this year include the opportunity and privilege to help others and actually make a difference. The possibility of improving my knowledge as well as my work ethic – which includes earning a salary – has been outstanding.

My heartfelt message to anyone reading this article is NEVER to underestimate yourself, treat others the way you would like to be treated, stay up to date with the latest research, be positive and most of all enjoy the journey, it passes all too quickly!

ABOUT ADSA
ADSA, the Association for Dietetics in South Africa, is one of the country’s professional
organizations for registered dietitians. It is a registered non-profit organization 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


Making the best food choices for HIV & TB

Human Immunodeficiency Virus (HIV)/ Acquired Immunodeficiency Syndrome (AIDS) and Tuberculosis (TB) are two of the most prevalent infections in South Africa, and both conditions present nutritional challenges that must be met to effectively treat these diseases.

“HIV/AIDS and TB patients are not just eating to maintain their normal bodily functions, like moving their muscles and the pumping of their hearts,” says Chantell Witten, a registered dietitian and spokesperson for ADSA (Association for Dietetics in South Africa). “When you have a disease, it becomes even more important to  maintain good nutrition because you often need additional energy and nutrients to effectively treat the disease, maintain a healthy weight, help the medication work optimally and support the body to repair damaged cells.”

According to Yzelle Watermeyer, a clinical dietitian working at the coal-face at the Kopanong Hospital in Vereeniging, one of the most serious challenges many patients face is the danger of getting caught up in a vicious cycle of malnutrition and an impaired immune system.

“Sickness and some medications can cause loss of appetite, malabsorption and an altered metabolism (increased nutrient needs).  This, together with a lack of access to quality food may result in a vicious cycle of weight loss, decreased immunity and worsening of the chronic infection (HIV and/ or TB).”

The significant link between healthy eating and wellness is at the heart of an ongoing Department of Health (DoH) message to broadly increase awareness that what we choose to eat and drink really matters.  “South Africans needs to be empowered with the knowledge of how nutrition impacts on their health, and their lives,” says DoH Director of Nutrition, Rebone Ntsie.  “With information and understanding, people can take responsibility for their wellness by making small lifestyle changes that can have a big impact. For instance, if you have money to buy a packet of chips as a snack; this money would be more wisely spent on fresh fruits which are packed with vitamins, minerals and fibre. If you have money to buy a fizzy, sugary drink; again you can make a better choice by choosing to drink life-giving water instead. You can reduce intake of unhealthy fat (saturated fats and trans fats) by buying a good quality piece of meat with no visible fat, grilled chicken or fish rather than fried ones.  This is how every South African can make better food choices and improve their wellness, and it is particularly important to people living with HIV/AIDS and TB.”

So, what should South Africans infected with HIV or TB eat?

The experts are unanimous that basic healthy eating guidelines as per our South African Food Based Dietary Guidelines apply to all, regardless of your HIV or TB status. Whilst, some medications may present challenges due to malabsorption and/ or nutrition-related symptoms, sticking to the rule of following a healthy diet made up of a variety of foods goes a long way.

“As we would advise healthy individuals, it is equally important for those affected with HIV/ TB to eat a variety of foods that will supply their body’s with much-needed nutrients,” points out Witten.  “Eat foods that are minimally processed which will provide you with a good dose of micronutrients (vitamins and minerals), as well as a  good quality macro-nutrients (protein, carbohydrates and fats).  We encourage everyone to eat plenty of fresh vegetables and fruits; wholegrains and legumes (such as beans and lentils); good quality meat, chicken or fish as well as eggs and unsweetened dairy products. These whole foods will help you  manage the disease and build and repair damaged cells.”

Watermeyer emphasises that eating fermented, probiotic-rich products like yoghurt or maas every day helps to support gut health, which is often compromised by HIV and TB. “Try to stick to the unsweetened/ plain dairy products because, with infections like HIV and TB, patients have a propensity towards developing thrush. Adding excessive amounts of sugar to the diet may worsen this. So whilst sugar is energy dense and may help you gain weight, it should be consumed in moderation as it may worsen side effects and is considered a nutrient-poor choice as it does not contain any additional vitamins and minerals to support the body,” she says.


What foods should HIV and TB Patients avoid?

Watermeyer says:

  • Avoid unpasteurised dairy products such as milk, yoghurt and cheese (always check the label if unsure, almost all dairy products sold in supermarkets are pasteurised, but milk bought directly from the farm, although more cost effective is not always pasteurised, so rather be safe than sorry!)
  • Alcohol (increases risk-taking behaviour and can exasperate malabsorption)
  • Raw or partially cooked animal products (can be a source of potentially harmful bacteria like Listeriosis)
  • Do not use anything past its expiry date
  • Limit tea and coffee as they affect some nutrient absorption and are not beneficial to the body (for example iron)
  • Avoid sugary coldrinks and energy drinks (these are high in sugar and low in nutrients a.k.a nutrient poor.)

Witten adds: “Avoid processed meats like polonies, viennas and corned tinned meats.  Although you may think these taste good, they are often high in salt and saturated/ trans fats which is not ideal for your health.) If you can’t afford fresh meat, chicken or fish every day, rather than buying processed meats daily, save up for a piece of good quality piece of meat once or twice a week and remember that legumes such as beans and lentils, eggs and tinned fish like sardine’s and pilchards are wonderful and healthy alternatives.” 

Top tips to help patients access safe, healthy foods that are more affordable include:

  • Make a vegetable garden at home and grow your own fresh vegetables
  • Legumes (like beans and lentils), soya mince, eggs and tinned fish are fantastic sources of good quality protein
  • Shop at the most affordable stores, be price-aware and look out for the specials
  • Buying in bulk is often cheaper, share the cost and produce with family, friends and neighbours
  • Do not buy and eat cracked eggs (check them before you buy them)
  • Be vigilant about keeping your hands and food preparation surfaces clean at all times.

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


Meet the Dietitian: Community Service Series

Challenge… Accepted!

By Liezel Engelbrecht

I am probably not your typical community service dietitian: I am 37 years old. At 32, after nearly a decade in the media industry, I gave up my career as a content editor in order to pursue a new goal: to make a contribution in the field of preventative healthcare.

I was probably a little less apprehensive than first-time careerists going into my community service year (I am currently placed at a provincial hospital in Cape Town). It thus came as somewhat of a surprise when I found it challenging to adjust to the new routine, my new role and establishing new goals.

Let me start with the routine. Initially, I was thrilled to be able to start at 6:30 if I preferred. Getting up early in exchange for a more leisurely afternoon sounded like a good deal. I didn’t, however, take into account how emotionally taxing being a hospital dietitian would be. Even though I now technically had a large chunk of the afternoon to myself, I was so tired from the adrenalin of the day that I didn’t feel like my usual gym class or an afternoon run. Almost four months in, I have now adjusted my working times slightly, but I’m still working on striking the right balance to optimize my energy levels while building in some much needed “me”-time.

Secondly, the new role was an adjustment. A month before I started at the hospital, the chief dietitian contacted me to share that she’s had a major health setback, and would only be coming in intermittently for the first three months. Needless to say, I was a bit anxious, as this meant I wouldn’t have a supervisor or mentor. Luckily, this angst soon dissipated. She had arranged for the previous (very competent) community service dietitian to help out in her absence, who was extremely patient in showing me the ropes and guiding me through the hospital systems. Now that my supervisor is back, I am using the opportunity to soak up as much of her 25 years of experience as possible.

Which brings me to the next challenge I experienced: setting new goals for myself. It’s not called “community service” for nothing. In my final (internship year) studying at Stellenbosch University, we got a taste of working in various practical settings, such as hospitals, clinics and in rural areas. The hospital environment did thus not feel uncomfortable. However, in the community service year, your focus shifts from being a good student to being 100% focused on serving patients eight hours a day, every day. And serving takes up a lot of mental and physical energy! My goals thus changed from expecting results and feedback following projects, assignments, and exams, to attempt giving quality service to each patient, every day. Though this goal sounds obvious, it really is challenging to be fully present and equally enthusiastic and thorough with every patient you see, especially since you might do counseling for the same type of conditions and work out requirements for similar types of patients repeatedly. The end result will however only be rewarding if you manage your own expectations.

In conclusion, I encourage all prospective community service dietitians to see this year for what it is: an opportunity to get a better understanding of how the public health system works; an opportunity to become really good at something (you can become an expert at diabetes education, breastfeeding counseling, or any other area where you have an interest in), and, most importantly, the opportunity to serve.

Whether you love or hate this year, one thing is certain: you will grow.

More tools that work for me:

  • Respect the system, but don’t lose your enthusiasm. Fresh eyes are great for spotting areas of possible improvement. And if you have an open-minded chief dietitian (like I have), your ideas or suggestions might just get used and have a long-lasting positive effect.
  • Smile (even if you’re in a terrible mood). This makes you appear friendly. And if someone smiles back, you’ll instantly feel better.
  • Ask for help. It’s okay not to know how everything works initially, or what all the diagnoses and abbreviations mean. You’ll get better.
  • Accept (and face) your mistakes. I had many (I lost a scale, measuring tape and calipers in the wards, all in my second month!). You can only learn from them.
  • It’s okay to be affected if you lose a patient. Make sure you can talk to someone. It also helped me to talk to more experienced health professionals about their coping mechanisms.
  • Don’t neglect yourself. If you’re not in a good space mentally, chances are this negative energy will follow you around.

If you are a community service dietitian and would like to share your story, pop Abby Courtenay an email at adsapublicrelations@gmail.com with the subject line ‘Meet the Dietitian- Community Service Series’.

ABOUT ADSA
ADSA, the Association for Dietetics in South Africa, is one of the country’s professional
organizations for registered dietitians. It is a registered non-profit organization 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


Red Lentil Veg Curry

Our latest NutritionConfidence recipe, created by registered dietitian Alex Royal, is a delicious Red Lentil Veg Curry, filled with veggies, herbs and aromatic spices.

We love lentils. Not only are they a great plant protein (containing the third highest levels of protein of all legumes and nuts) but they are also a great source of soluble and insoluble fibre, folate and magnesium, which all contribute to a healthy heart!

This recipe is super easy and quick, so ideal for weeknight dinners and the leftovers are great for a work lunch the next day. 

INGREDIENTS (serves 1)

1/2 cup red lentils, raw, making 1 cup cooked

2 handfuls baby spinach

1/2 small onion

1 large tomato

1 clove garlic

Salt and pepper

1/2 tsp turmeric

1/2 tbsp coriander

1 tsp cumin

Fresh chopped chilli (to your taste)

1 tbsp olive oil

Fresh coriander

PREPARATION

Boil the lentils until tender.

Finely chop the garlic & fry in the olive oil, at medium heat, in a large pot. 

Add the spices, salt, pepper and chilli and fry for about 5 minutes.

Chop the baby spinach, onion and tomato. Add into the pot and fry on low for 5-10 minutes.

Mix the lentils into the mixture.

Top with coriander.

NUTRITIONAL VALUES

Per serving:

Energy: 245 kCal

Carbohydrates: 23g

Protein: 10g

Fat: 14g

 


The planetary health diet: what, why and how…

For the first time in human history there is a proposal on the table that all the world’s people follow the same diet.  The EAT-Lancet Commission brought together more than 30 world-leading experts to figure out if we can feed a future population of 10 billion people a healthy diet within sustainable planetary boundaries.  According to the report’s authors, food is “the single strongest lever to optimise health and environmental sustainability on earth.”

The healthy eating plan that they have subsequently developed, and are now promoting to governments and other agencies around the world, is closely aligned to the World Health Organisation (WHO) guidelines for healthy diets and the current trend of prioritising plant-based foods.  Lecturer at North-West University and spokesperson for ADSA (Association for Dietetics in South Africa) Dr Mariaan Wicks describes the planetary health diet as: “…rich in plant-based foods, with fewer animal source foods and limited amounts of added sugars. The planetary health plate consists of approximately half a plate of non-starchy vegetables and fruits, preferably locally produced, fresh and in season.  The other half of the plate should primarily consist of whole grains, plant protein sources such as legumes and nuts, with only modest amounts of unsaturated plant oils and animal sources of proteins.”

Why is the planetary health diet good for the earth?

The world’s food systems are grappling with the issues of needing to produce more food for a growing population on a planet where the sustainable boundaries have already been breached.  The EAT-Lancet researchers looked at how to feed more people while reducing greenhouse gas emissions, preventing further species extinction, curbing the expansion of farmland and conserving water.  Their recommendation to reduce our consumption of animal protein is because its production has the highest detrimental impact on the environment.  Similarly, the limitations on eating highly processed foods are in line with reducing the negative consequences of food manufacturing and distribution.  According to Dr Wicks our will to create a more sustainable world for our future generations makes changing our diets inevitable.  “The composition of our diets determines the impact of food on the environment, and the food system is where the domains of our health and the health of the environment meet,” she says. “Earth is our home, and it is the only one we have.  The responsibility to take care of the planet falls on each one of us, and therefore, dietary adaptions are essential.”

How do we change to the planetary health diet?

Following the planetary health diet will demand different changes for different peoples and different countries.  In South Africa, the biggest impacts would be the reduced intakes of animal proteins, added sugars and starchy vegetables.  Globally, the eating plan aims to halve the world’s consumption of red meat, and to achieve that goal, the world’s top red meat-eating countries, such as the USA, need to reduce their consumption by 80% which equates to eating one hamburger a week, or a big steak once a month.  Dr Wicks advises that South Africans can take small steps towards eating more sustainably rather than making sweeping changes.  The planetary health diet offers an incredible variety of plant-based foods, and there are excellent sources of plant proteins that provide complete amino acid requirements.  Getting used to eating less meat, eggs and dairy doesn’t mean we won’t be eating delicious meals.  “Every little change can make a big difference,” says Dr Wicks.  “Start with little easy changes, and then as you become more comfortable and familiar add new changes.”

Dr Wicks points out that eating more sustainably is not just about food choices but also includes food packaging issues and how we reduce food waste.  Her examples of simple changes that we as South Africans can make to eat more sustainably include:

  • Rethink the amount of meat you consume in your regular diet. Little changes such as reducing your portion size and the amount of times in a specific day or week that you consume meat, especially red meat, can contribute greatly in reducing your carbon footprint.
  • Try to include at least one meat-free day in your week, breakfast, lunch, snacks and dinner. Experiment with beans, lentils and chickpeas in the place of meat. There are fantastic recipes available online that are easy and affordable. My personal favourites are tomato-based whole-wheat pasta dishes and a chickpea, black bean and cauliflower curry with brown rice.
  • Exchange your breakfast of eggs, bacon and sausages for a delicious vegetarian omelette with onions, tomatoes, mushrooms and peppers.
  • Develop a week menu and plan your meals and food shopping for the week. By having a clear plan for what you want to buy, you will not only save money and time but will also limit your food waste.
  • Limit the amount of meat included in your weekend braai to only one meat option. You can always add other braai items such as black mushrooms with a garlic butter filling, brinjals in barbeque sauce and vegetable sosaties made with onions, peppers, cherry tomatoes and baby marrows.
  • To reduce dependence on refined starches, experiment with other starchy foods such as brown rice, couscous and whole-wheat pasta. You can replace your starchy vegetables and maize meal side-dishes by creating other fantastic side-dishes simply by adding these starchy foods to your salads and vegetables. Include some lentils or chickpeas and then you have a complete meal.
  • Rethink what you do with food waste. Using leftovers for the next day’s lunchboxes or freezing the remaining sauces for a base for a next meal is a good start.
  • Buy fresh, seasonal, locally-produced fruit and vegetables, and limit pre-cut and packaged fruits and vegetables. By doing this you will not only save money but will also dramatically reduce your plastic use.
  • Choose water instead of sugar-sweetened beverages. Use re-usable bottles to limit your single- use plastic items.”

While the planetary health diet focuses on a sustainable global food system that is better for the environment, we mustn’t forget that it has also been specifically designed to be beneficial to human health.  The EAT-Lancet researchers believe that the planetary health diet can save 11 million human lives by reducing overweight, obesity and other diet-related health issues.  In the sense that all life is connected and interdependent, what is good for the planet is also good for us.

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


‘Stay consistent’ – success story: Simone de Pinho

ADSA_Success Story_Simone de Pinho.pngWe chatted to Simone de Pinho about her journey with registered dietitian Michelle McDermott.

Why did you decide to see a dietitian? (the before story)

I have been a yo-yo dieter all my life. I struggled with my weight from the time that I became aware that weight means something in the world. I have lost a considerable amount of weight often but always put it back on as I failed to stay consistent.

The reason that I went to Michelle, which is the reason that I always start, is because I became so uncomfortably large that my only option was to lose weight. Sometimes I wished that I had a medical reason to lose weight (it might have pushed me to be more motivated) but my health has generally not been a factor.

Tell us about your journey with the dietitian?

Michelle is not like other dietitians. Her approach is one of realism, when all I strived for was perfection.

Michelle helped me realise that my excess weight was a result of emotional eating – although this could sound obvious to someone else, I only realised this when I would go to weekly sessions, see weight gain on the scale and then cry while Michelle tried to console me and give me the motivation I needed. How Michelle didn’t fire me during those weeks, months, years, I have no idea!

I think Michelle now knows me so well that she can see when I am motivated and when I am slipping. Michelle also gives the most amazing advice just when I need it. 

I also want to mention that my boyfriend and I see Michelle together. I can see how Michelle’s approach to a man differs to that of a woman and that is a testament to her experience and the wealth of knowledge that she holds! Our sessions are always fun (especially when we know we have stuck to our plan) and Michelle always gives us great feedback and measures all sorts of other things (such as body fat, water retention and metabolic calorie rate).

Tell us about your results / successes?

Most (if not all) of my over eating stems from emotional eating. This is something that I have researched over and over in an effort to understand it. I am successful with my plan when I remember to focus on eating healthily and within my plan. I am unsuccessful when I let me emotions overwhelm me and my brain literally doesn’t engage. Binge eating cannot be stopped no matter how much my brain tries to see the logic!!

I first started seeing Michelle in October 2014 and lost about 30kg’s from October 2014 to September 2015. I then started falling off the wagon and during 2016 and 2017 put all the weight that I had lost (plus an additional 10 kg) back on. In January 2018 Michelle put me on a strict medical weight loss program using meal replacements and I have lost 18.4kg’s in approximately 3 months. 

What was the hardest part of the journey?

Definitely maintaining the weight loss! The hardest part of the weight loss journey is not losing the weight, it’s about maintaining a healthy lifestyle and being consistent, after you have reached your “goal weight”.

The other difficult part is to actually start – for me it’s all about getting my mind right. Learning how to self-motivate has been a journey and is still a journey.

What are the top three tips you can share?

• Stay consistent

• Have treats but make sure you get back on your plan immediately afterwards

• Exercise is key to ensuring that your mindset is correct

What the dietitian says

Simone has been a dedicated patient and is a true example of how you can do things when your mind is in the right place. We have worked together to find a plan that works for her and all I did was provide the tools and the guidance – Simone did all the hard work after that and is achieving wonderful results. Starting on any new plan needs clear guidance,  goal setting and tools to make it work within your lifestyle so that the changes made can be sustained long term.

This is what a dietitian would aim to achieve with a patient as well as offer encouragement and  ways to make easy sustained changes to reach the health and nutrition goals of the patient.

Congratulations and well done to Simone – a few more steps to go!

 

To find a registered dietitian in your area, visit the ADSA website.


‘Notice and appreciate the smallest changes in yourself and body’ – success Story: Kim Gunnell

ADSA_Success Story_Jade Seeliger_KimKim Gunnell struggled with her weight her entire life. Her gran’s passing was her turning point, which resulted in her meeting registered dietitian Jade Seeliger and kicking off her weight loss journey and a whole new way of seeing herself:

Why did you decide to see a dietitian? (the before story)

I’ve struggled with my weight throughout my life. No matter what I tried, things didn’t work and neither did my motivation to stick it out when the going got tough.

After my gran past away in March 2017, I decided to get rid of my comfort blanket (my hair) and I donated over 35cm to CANSA. This was the surprising start of my journey and the start of the investment in myself. 

Tell us about your journey with the dietitian?

Jade has become a part of my life, from when I stand in the queue at Woolworths and am tempted by sweets to when I am having a bad day and am not wanting to go to the gym. 

It’s so important to have a honest relationship with your dietitian, you can only BS your way to a certain extent as they honestly become a part of your life as you cover everything from bowel movements to menstrual cycles.  

Jade has shown me that my relationship with food was they way it was because of my home environment, no concept of portions and a lack exposure to variety. This was all that I knew for 25 years of my life. However the past 365 days have opened my mind and mouth up to new foods, recipes and cooking methods. 

Our relationship has well surpassed that of client and patient as she has not only guided me throughout the process but when I had stumbling blocks, she was able to recommend the next steps that were beyond her expertise. 

Tell us about your results / successes? 

To date, I have lost just short of 20kg’s in less than a year – with ups and downs along the way and with Jade being on maternity leave. 

I hated running since I was a child. I used to dread having do it from both a physical and mental perspective and was never been able to wrapped my head around it. In 2016 I attempted the 10km Soweto Marathon race and it was one of the most eye opening experiences of my life at nearly 130kg (I cried all the way to the finish). However, this has changed since I decided to start running at gym and to enter the Spar Series, JP Morgan and my nemesis Soweto again. Needless to say, I finished my 10km in 1h19min which was 2 minutes faster than the time I set myself as a goal and I am now hooked. I’m participating in Park Runs every weekend and clocking a minimum of 10km a week at gym. Further to this, I have a goal of doing at least 10 x 10km races before the end of the year.

I’ve always put off things which have a predetermined weight restriction or will make me look ‘silly’ for trying, but I have now gone for a wake boarding lesson and learnt to ride a scooter. To some this may seem like small, but for me those were a big deal and something I’d always put off. 

What was the hardest part of the journey? 

There were two parts of my journey that were really hard and I still work on them daily: 

1 – Loving the Scale (well trying to) – The scale was avoided for years prior to my choice to confront it. I had to learn to love and understand it far beyond the numbers that are displayed. 

2 – Self Love – I’ve had to learn to love myself and recognize the change that I have undergone, past the numbers on the scale. This has been my biggest challenge as I have always done everything for everyone else, except myself and have been the size that I am for as long as I can remember. It has affected me from clothes shopping to getting in a aeroplane and feeling as if there is now more space. I am a work in progress as 25 years of negativity cannot be undone overnight or in a few months. 

This is still a challenge for me, as I have to completely adapt my mindset and way I perceive myself and the world around me on a daily basis. 

What are the top three tips you can share?

  • You aren’t going to lose weight every time you get on the scale – make peace with it 
  • Notice and appreciate the smallest changes in yourself and body
  • Stick to it, but don’t be too hard on yourself – even wheels fall of wagons

What the dietitian says

Some clients have the ability to not only to motivate themselves in their health journey, but in fact everyone they come into contact with.  Kim was such an inspiration to me, to see someone turn their entire life around through the lessons they learnt in health made the journey a deeply fulfilling one for me as a dietitian. 

To find a dietitian in  your area, visit www.adsa.org.za

 


Banking Your Breastmilk Saves Lives

The breastmilk bank is probably the most altruistic banking system in the world. Healthy, lactating moms express and donate their excess breastmilk. The milk is tested and pasteurised, and then distributed to neo-natal intensive care units around the country, where it is used to feed the most vulnerable babies.

Every year, donated breastmilk saves the lives of thousands of vulnerable babies in South Africa. Eight out of one hundred babies in the country are born prematurely and, every year, approximately 11 000 premature babies die from preventable infections and complications.

“All babies have immature immune systems,” says Abby Courtenay, a Registered Dietitian and spokesperson for ADSA (The Association for Dietetics in South Africa), “Breastfeeding plays a vital role in transferring not just nutrients but antibodies and other immune-boosting properties to an infant to strengthen the immune system and protect them against infections. This is why breastmilk is the perfect first food, and why the World Health Organisation recommends exclusive breastfeeding for the first six months of life.”

Many mothers giving birth to premature babies in neo-natal intensive care units don’t produce milk immediately, or enough of it. Some mothers experience health complications and cannot breastfeed. If their babies can be fed donated breastmilk instead of formula, it dramatically increases the baby’s chance of survival and offers greater protection against life-threatening infections such as the intestinal infection – necrotising enterocolitis. Donated breastmilk also helps premmies to gain weight and grow faster. This is why donated breastmilk is the next best option when the mother’s own milk is not available.

Breastmilk banking was pioneered in South Africa sixteen years ago by the South African Breastmilk Reserve (SABR) and, today, they have a network of 27 banking facilities across the country. The breastmilk movement in South Africa has since grown to include several other initiatives such as ithemba Lethu milk bank and children’s home in Durban, the KZN Breastmilk Bank Initiative and Milk Matters in the Western Cape.

Every year, more than a thousand South African moms help save lives by donating their milk. “What we would like to see is breastmilk banking being used far more frequently,” says Executive Director and SABR founder, Stasha Jordan. “Expressing breastmilk has become the norm for many new moms who have to return to work while still breastfeeding. Some women have an abundant supply of breastmilk and can easily express more than their baby needs. That surplus can literally save the life of another child. Our donor moms are real heroes helping the most vulnerable in our society to survive.”

SABR and ADSA have partnered to raise awareness of breastmilk banking, which is supported worldwide by both the World Health Organisation and UNICEF.

Who can bank their breastmilk?

A healthy, lactating mom with an excess of breastmilk can make donations. It’s important that you have not received a blood donation in the past year; that you are a non-smoker; that you do not consume alcohol regularly and that you are not on any medication. Donor mothers do need to undergo blood tests to be screened for HIV and hepatitis B.

How does banking my breastmilk work?

  • Donor moms complete an online screening questionnaire
  • SABR contacts you telephonically to refer you to your nearest sign-up facility.
  • Arrangements will be made for the necessary blood tests.
  • You will receive all the information you need for the safe storage of your expressed milk, which will be collected from you.
  • Your breastmilk will be screened, pasteurised and distributed to help save the lives of premature babies in neo-natal intensive care units.

 

Every drop counts and small donations can also be used, so don’t be put off from donating if you don’t have a particularly excessive supply. To find out more visit https://www.sabr.org.za


‘Be dedicated and committed to your journey’ – success story: Bongi Ncube

We chatted to Bongi Ncube, who has been seeing registered dietitian Monique Piederit, to find out more about her health and fitness journey:

Why did you decide to see a dietitian? (The before story)

In January 2017 I started on the fitness journey – due to work pressure and the amount of stress I endured, I needed an outlet to release the pressure; gym became that outlet. The initial intent was to keep fit, but I soon realised that I was not happy with how I looked and thus wanted to lose weight.

I procured the services of a personal trainer who later recommended that I consider consulting with a dietitian as diet plays a key role in weight loss. 

 Tell us about your journey with the dietitian?

The first consultation was an eye-opener! I realised that approximately 50% of my weight comprised body fat – the task at hand was to work on reducing the body fat %.

The first week was very tough as the portions I had to eat were far smaller than what I used to eat, but with time I got used to the eating plan.

What I appreciated the most is that the eating plan that was recommended for me was easy to follow – no food types were cut out, instead the portions were reduced.

My dietitian was been very supportive and encouraged me on this weight-loss journey and the eating plan complemented the training schedule I had with my personal trainer.

Tell us about your results / successes? 

I have successfully managed to loose 17.5kg (from 88.6kg in July 2017 to 71.1kg in September 2018). This has been a consistent gradual reduction of my weight over the months.

What was the hardest part of the journey? 

Taking the first step to consult with a dietitian was certainly not easy. I was not sure of what to expect and was very nervous at my first consultation.

Getting used to the smaller portions was not easy. It took me at least 1.5weeks to get used to the eating plan. Over the period October 2017 to January 2018, my weight remained stagnant at 81.6kg – this was very difficult to accept as I was doing everything that was recommended and still there was no change. It took a lot of courage to press on through this period.

What are the top three tips you can share?

  • You need to have a good relationship with food – do not be scared to eat, but eat right.
  • Don’t view the eating plan as a diet, view it as an eating plan (a guide to follow to ensure that you consume the right amount of micronutrients).
  • Be dedicated and committed to your journey; it pays off. It does not matter how long it takes, as long as the weight keeps coming down.  

I never thought that I would ever be able to reach my 2012 pre-baby body weight, but through the help of both my dietitian and personal trainer, I have been able to achieve this goal. My family’s support has been a huge contributor and enabler to my weight loss.

My fitness level have reached new heights – over and above the 10kms runs, I have managed to run 7 X 21.1kms with PB of 2:46. I am now working on toning my body and maintaining the weight.

What the dietitian says

Bongi is the perfect example of how you can do anything you put your mind to. She started seeing another dietitian, Kezia Kent, after a wellness challenge at work inspired the start of her journey, starting at 88kg and moving down to 81kg. When Kezia immigrated, I continued working with Bongi who in total has lost over 20kg. Apart from making daily and sustained changes to her diet, Bongi’s new found love of running has supported her weight loss even further where she regularly challenges herself to 21km half marathons.


Spicy Tofu Bowl

Our first NutritionConfidence recipe for 2019 is a delicious  bowl of food that is high in fibre, low in saturated fats but full of heart healthy fats. The ‘Spicy Tofu Bowl’ created by registered dietitian Julie Perks is dairy, wheat and gluten free and is also vegan with a lovely source of protein. People often  don’t include tofu in their diet as they don’t know how to cook it or flavour it. We love how the spicy chilli sauce in this recipe lends a wonderful taste to the tofu that makes the bowl really delicious as a lunch or light dinner.

INGREDIENTS (Serves 1)

Marinade:

1 tablespoon chilli sauce (I used sriracha)

½ teaspoon olive oil

1 tablespoon soya sauce (or Tamari for Gluten Free)

Salad Ingredients:

100g Tofu

1 cup spinach

½ medium avocado

½ cup black beans

1 small carrot, spiralized

5 baby tomatoes

1 tsp sesame seeds

Picked Radish & Onion:

¼ red onion

2 radishes

2 tablespoons white wine vinegar

1 tablespoon water

½ tsp sugar

Pinch of salt 

METHOD

Slice radish and onion finely and place in a small container with the other pickling ingredients and leave to stand until serving. The longer the onion and radishes pickle for, the softer they will become.

  1. Preheat the oven to 180 degrees Celsius.
  2. Make the marinade with the chilli sauce, olive oil and soya sauce by combining all the ingredients in a small bowl.
  3. Add the tofu to the marinade and once covered well, place onto a baking sheet.
  4. Place the tofu in a preheated oven for 10 minutes.
  5. While the tofu is cooking, start preparing the salad bowl by placing the spinach at the bottom of the bowl, followed by the spiralized carrots, tomatoes, black beans, pickled radish and onions and avocado.
  6. After the tofu has been in the oven for 10 minutes, turn and cook for a further 10 minutes. Once cooked, remove from the oven and add to the tofu bowl.
  7. Garnish with lemon juice.

Nutrition Information: Per serving

Energy: 1225 kJ Protein: 14g Carbohydrate: 25g Of which, total sugars: 2,2 g Fat: 17g Fibre: 11g Sodium: 200,4 mg


Healthy Eating for a Healthy Pregnancy

There’s nothing else quite like pregnancy to sharpen your focus on your health and well-being. The journey of carrying and nurturing new life within your body is an exceptionally special time, and moms-to-be are deeply invested in doing it as well as they can. Advice will inevitably come from all quarters, and it is important to tap into expert sources that will give you peace of mind that you are on the right track.

The aim of Pregnancy Awareness Week this month is to help moms access the information they need to support a healthy pregnancy and safe motherhood. The Department of Health urges pregnant South African women to access antenatal care as early as possible in their pregnancies. This provides the opportunity to understand and manage any health issues, as well as get information on important factors such as self-care and nutrition. Once the pregnancy is confirmed by a nurse at a health facility, the mother can register for MomConnect, a free cell phone-based resource for accessing pregnancy-related health information.

Nazeeia Sayed, a registered dietitian and spokesperson for ADSA (Association for Dietetics in South Africa), points out that good nutrition is vital as it supports a healthier pregnancy and a healthier baby. “Pregnancy is a great opportunity to get yourself and the family into the habit of healthy eating before the new baby arrives,” she says. “You don’t need special or expensive foods. A healthy diet during pregnancy is made up of foods that we commonly encounter when grocery shopping. A variety of fruit and veg, whole grains, legumes and lentils, dairy, plant fats and lean meats, fish and eggs can all be enjoyed while you are pregnant and will provide the nutrients you need.”

What nutrients should moms-to-be focus on?

Following a balanced diet according to the accepted healthy eating guidelines is the optimum nutritional route to support a healthy pregnancy. Pregnancy is definitely not the time for weight loss or fad diets that focus on particular nutrients at the expense of others. Registered dietitian and ADSA spokesperson, Cath Day says, “Energy (kilojoule) restriction during pregnancy is not recommended! High protein diets which increase ketone production are also not recommended as the foetus has a limited ability to metabolize ketones. It is much healthier for you to adopt a balanced diet with a good variety.”

Nutrients such as folic acid, calcium, iron and protein are all important to the developing baby; however a balanced diet will, in most cases, meet these needs. Women enrolled in the government’s antenatal care programme will receive supplements of the essential micro-nutrients; and many women choose to supplement with folic acid to prevent the risks of Spina Bifida and cleft palate.

Day points out that meeting protein requirements during pregnancy is as simple as ensuring that you eat roughly six servings or between 180 g- 210 g of protein each day (size of two palms or two decks of cards). One serving equates to 30 g lean meat or fish, 1/2 cup of legumes, 15 g nuts or one egg. “These are also the best sources of iron which is needed to prevent anaemia,” she says. “By eating fruit and vegetables high in vitamin C at the same time as eggs, nuts and pulses, you can enhance iron absorption from these foods.”

Focusing on a variety of healthy foods for each meal or snack, rather than the particular nutrients, is what helps to ensure you and baby get what you need. Sayed says, “Some examples of this are choosing nutrient-dense meals or snacks like an omelette with veg, a fruit and yoghurt smoothie, a salad with raw veg, nuts or lean meat; or a cooked lentil dish with green leafy veg and rice.”

What should moms-to-be avoid?

Smoking tops the list of what shouldn’t be going into a pregnant body. While there’s debate about whether drinking one glass of wine is safe for a growing baby, many experts and governments around the world advise a complete avoidance of alcohol during pregnancy. Pregnant women should avoid foods with a greater risk for contamination with Listeria or other bacteria or parasites, including under-cooked meat and eggs, raw fish, processed meats and unpasteurised dairy and soft cheeses. Dietitians also advise avoiding fish that may contain high levels of mercury such as swordfish, shark, tuna steaks and canned fish brands that are not tested. Caffeine intake should be limited, and rather swopped out for decaf options, with water as your best beverage of choice. Foods that are high in salt, sugar and other refined carbohydrates should be limited as they crowd out the opportunity for you to eat healthy foods which provide for your vitamin, mineral and fibre needs. They can also lead to excessive weight gain which increases your risks of developing high blood pressure issues and gestational diabetes.

Reach out and get help when you need it

Healthy eating during pregnancy does not have to be complicated or a minefield. It might be more challenging for moms-to-be who need to make big changes; or who are overweight or managing other health conditions. A registered dietitian can be an important ally to come up with a healthy eating plan that suits your food preferences, your budget and your lifestyle. “The big advantage of using your pregnancy as the inspiration to eat well is that you can go on to become a healthy eating role model for your precious child, instilling healthy eating habits that can last them a lifetime,” Sayed concludes.

To find a registered dietitian in your area visit www.adsa.org.za.


Success Story: Zandra Sissing

ADSA_Success Story_Zandra DixonHaving been a runner from a young age, Zandra always thought “I can eat what I like” and just run it off …. until she couldn’t.  She met up with registered dietitian Maryke Gallagher to help her develop better eating habits that would complement her training and recently completed her first ever Half Ironman triathlon. Here is her story:

Why did you decide to see a dietitian? (The Before Story)

At the age of 38 I hurt my knee while running, and three months later had surgery.  I was off exercise for over six months, and during that time I ate: depression from a difficult relationship, depression from not being able to get out there and run, poor eating habits within the household.  My blood sugar and cortisol levels had gotten so disrupted I used to keep a glucose monitor with me.

Fast forward some time and I started training again, but was struggling to shake the weight.  Nothing I did helped, and if I wanted to keep the knee and joints healthy, I needed to do something.  I was referred to Maryke by my coach and that’s when my life changed.

Tell us about your journey with the dietitian

Firstly, I have an unpredictable schedule and she was so accommodating. Most of our communication was Skype, telephonic or whatsapp. Maryke took all this in her stride.

I have always thought I ate correctly, and had tried banting with no great success. Maryke taught me balance, how to realise when I was emotionally eating (and how to fix that).  She taught me how to include that one (or two) glasses of wine a week. Best of all, she taught me how to adapt my meals to meet my ever-changing schedule.  She did not give me an eating plan, she taught me which choices to make to suit MY body.  This sounds strange but even for my pre-run snack we went back and forth on options until I knew BOTH what worked for me and what I liked.

Tell us about your results / successes

My results were the things a runner dreams of: steady and consistent.  From a start of 74 kg I lost 6 kg to reach my goal of 68kgs.  I remember sending her the picture of the scale at 67.9kgs with great excitement.

I stopped looking at the scale but in my head I wondered if I could reach 66kgs, which my run coach had advised would be a good weight for me. It was a month later when I got on the scale and there it was: 66kgs!

I had lost almost 10% of my original weight, and a total of 9% body fat.  All the while enjoying life.

Since then, I have got married, moved home and changed jobs, changed countries and damaged a ligament in my foot. All these things combined have meant I could once again not run for a while.  The best part about having all the skills taught to me by Maryke is that I didn’t pick up the weight again.  I was able to deal with anything and still be healthy and happy.

What was the hardest part of the journey?

Starting out is the hardest part. The first weeks as you are learning and adapting. If you are consistent in the first few weeks, you see results and that really motivated me to keep going.  Think long term and not short term, because you want these results to last.  Changing my mindset to one that includes better carbs and fats.  Learning to remember that I need to eat for my body, and not for what works for someone else.

What are the top three tips you can share?

  • Don’t design your eating from what you read on Google/social media/books. A dietitian takes years of study and trains to put this learning into something unique for you.  Different bodies, different solutions.  Do not be caught up thinking you need to do your eating in a “specific way”.
  • Make sure you like what you are eating. You should not resent the food but enjoy a meal. Slow down your eating, enjoy the flavours and you will find yourself eating less.
  • If you  need that 5pm snack, plan it in.  Many a time the snack suggested by Maryke has prevented a ‘carb’ craving dinner (you know that one where you walk in the door and open the cupboard, ready to consume anything ).  I now carry snacks with me every day to work.

What the dietitian says

I met Zandra for the first time through a Triathlon club meeting and noticed her bubbly and determined personality. A few months later she contacted me to assist her with her diet and weight loss goals – for health reasons and to achieve her training goals. She was motivated and questioning, willing to work through the main areas in her diet and lifestyle that were hindering her to achieve her goals. She was willing to let go of the ‘all or nothing’ approach of certain food groups and foods being ‘bad’ or ‘good’, to eating habits that are best for her personal needs. Seeing her achieve her weight loss goals slowly but surely, and most of all being able to make the necessary changes and develop a healthy relationship with food and her body was very rewarding! Thank you Zandra for choosing me to help you in this journey.

To find a dietitian in your area visit http://www.adsa.org.za

 

 


Ride For Hope

ADSA_Ride for Hope 3Our dietetic students are often involved in awesome projects and we love the Ride For Hope campaign that Bernadine Blom, a third-year student studying Dietetics at the North-West University (NWU), started with her father. Here is her story:

 

 

Bernadine Blom

I’m a third-year student studying Dietetics at the North-West University (NWU). My passion for dietetics started when I learned about the impact that food can have on your health. Cliché I know, but once you read my story you will understand.

When I was 9 years of age my mom became ill and was diagnosed with kidney failure. It was something we didn’t know much about, just that my mom had to get treatment every 4 hours at home. This treatment is known as peritoneal dialysis. The peritoneal treatment wasn’t very successful; my mom then switched to haemodialysis, meaning 4 hours of treatment 3 times a week. During this time my mom was referred to a dietitian who helped her make important lifestyle changes. She changed her diet to reduce her potassium and phosphate levels. I kept asking why she should prepare food differently or why she isn’t allowed to eat her favourite fruit anymore? Then I started to understand the effect of different food choices on my mother’s health. It soon became part of my life but never really affected my food choices. I was still allowed to eat things my mother was not allowed to have like chocolate (Sorry Mom!)

My mother was in and out of hospitals during my school years. In 2012 we received the good news that my father  was a match and could donate a kidney to my mom! The transplant was performed on the 31st November 2012. Life was back to normal for almost a year. Then in October 2013 she got an infection and became very ill again. The kidney was damaged and my mother returned to dialysis in July 2014.

This was my Grade 11 year, the year of many decisions with matric approaching rapidly. With no idea of what exactly I wanted to study after finishing school, I had developed a passion for baking, food and helping people. I attended NWU’s open day and discovered what dietetics really entails and decided to study dietetics – the perfect way to help people while doing something I love.

I went off to university and for the next two years both my brother and I were out of the house studying at NWU. My mom’s health was like a roller coaster. She continued the haemodialysis, which was essential for her survival.

2018 became a year that really shaped me. I was chairperson of the Academic Student council for Dietetic and Occupational Hygiene students. I was also on the ADSA North West Branch as the student representative. I really learned a lot! I waited 3 years once I started studying to learn more about nutrition therapy in renal patients. 2018 was also the year I could finally ask all the questions I had as to why certain things can and can’t be eaten by someone with kidney disease! I now know the importance of healthy dietary intake in renal patients, as we are training to become nutrition experts, but with my history I also better understand the emotional part of making drastic changes to one’s diet.

My passion for organ donation grew strongly during the years of personally seeing the effect of it on a person’s life as well as the family. My mother is currently still on dialysis as the waiting list for a kidney transplant is between 10 – 12 years.

Ride for Hope

My father and I are currently busy with a campaign called Ride for Hope. It started one night when he told me about his idea and I immediately say YES! So, the scheming and planning started. Our aim is to get as many new registered organ donors as possible. Our wish is also to give hope to those who are waiting for a transplant.

There are currently 4 300 adults and children in South Africa waiting for an organ or cornea transplant. Less than 600 will get the gift of life this year, because of the shockingly low rate of organ donors in South Africa. It’s estimated that only 0.2% of all South Africans are registered organ donors. We discovered that lots of people have little to no knowledge about organ donation as they have never been affected by it. For others the fact of organ donations is just too scary. With this journey we hope to inspire and motivate people to take action! To register is really as easy as 1, 2, 3. It only takes 5 minutes of your life and has no hidden costs or any medical tests required. All that is required is your commitment to do 1 final act of kindness after you have passed away.

My father, Braam Blom, is currently travelling from Pretoria to Cape Town on the bicycle with the aim to create awareness around organ donation. The journey started on the 17th of November 2018 from Netcare Jacaranda Hospital in Pretoria. Our goal is to reach the 10 000 mark in new registered organ donors during the 1700km of cycling. Reaching 10 000 may sound like a lot and not possible for 2 people to achieve but with the help of other people it can be possible. Anyone can be a possible registered organ donor including YOU!

We have a few more days left on the journey, so please visit our Facebook page @ Ride for Hope for more information. Ride for Hope is endorsed by the Organ Donor Foundation & has a dedicated link to register. https://www.odf.org.za/ride-for-hope.

We currently have 305 new organ donors successfully registered.

 


Meet registered dietitian, Jessica Oosthuizen

ADSA_Jessica Oosthuizen.jpgWe chatted to registered dietitian Jessica Oosthuizen to find out why she became a dietitian, what being a dietitian means to her, the challenges she faces in her profession and her views on healthy nutrition:

Why did you become a registered dietitian?

I was diagnosed with Type 1 Diabetes when I was just 13 years old. I had always been a competitive swimmer and sportsman at school so healthy eating was always a way of life (although I did have the ultimate sweet tooth as well). After being diagnosed with diabetes, nutrition just became that much more important. Juggling diabetes with school, swimming and being a teenager had it’s up and downs. I became a dietitian because I am passionate about helping children and adults understand diabetes and the role that nutrition plays and I felt that having the personal experience and empathy can make such a difference.

How do you promote a healthy lifestyle as a registered dietitian from day-to-day?

I feel that a healthy lifestyle incorporates more than just nutrition and it includes aspects such as being physically active, practicing mindfulness, decreasing stress as much as possible, smoking cessation and of course following healthy eating principles. I feel very strongly about not being able to blanket the same message to all my patients because everyone is a unique individual and this always needs to be taken in to account. I also try to promote a healthy way of life on social media using my Instagram account dietitian_with_diabetes.

What does being a registered dietitian mean to you?

I like to think that this means that I am respected as a trusted healthcare practitioner. That I am someone who my patients trust to provide them with evidence based scientific information that I am able to translate into easy-to-understand language for the general population.

What in your opinion are some of the biggest nutrition-related health issues South Africa is faced with?

Overweight and obesity is definitely up there and something that I see on a daily basis. This of course increases the risk for a host of diseases such as Type 2 Diabetes, cardiovascular disease, certain cancers, non-alcoholic fatty liver disease and stroke.

If you only had 30 seconds to convince someone to eat healthier, what would you say?

Start with a focus on quality, quantity and frequency!

  • Eat not too much, mostly plants
  • Include whole grains to ensure adequate fibre to maintain a healthy gut
  • Include lean protein sources with a focus on fatty fish to get in your omega 3’s
  • Include healthy fats daily such as olives, avocados, nuts, seeds and olive oil
  • Don’t forget to drink water – the specific amount will depend on the person but 8 glasses (2 litres) per day is a good goal to aim for

What is your biggest challenge as a dietitian?

Dr Google is definitely right at the top! The general population can find an answer to anything in a matter of seconds on the internet so why would they believe me? Convincing patients that the latest fad diet is not the healthiest way to lose weight, or in fact is just not heathy at all, can sometimes be quite challenging.

What do you think are some of the most important skills or personal traits a dietitian should have?

A dietitian should be non-judgemental, a very good listener and they should not be too quick to give advice without getting all the information from the patient first. We need to have good time management and organisational skills. I also feel that a dietitian should be passionate about the work that they are doing.

How do you handle difficult clients/patients?

I put the ball in their court and try get them to understand the situation. I focus on trying to educate the patient because I often felt that a lack of education is the problem when they’re so set in their ways. I try to negotiate and come to a happy medium where both parties are able to understand and communicate openly and freely.

What is your opinion on fad diets?

There are so many fad diets around and if they are so successful then why are there so many different ones? Yes, of course fad diets will cause weight loss for most people at the beginning because you are creating a severe calorie deficit and often cutting out complete food groups. However the weight regain after stopping the diet is generally more than the weight that has been lost. This is because fad diets:

  • Are completely restrictive
  • Are unsustainable for most people
  • Can be anti-social
  • Are unhealthy and unbalanced
  • Do not teach you healthy eating habits around food
  • Are not individualised

 

ABOUT 

Jessica Oosthuizen RD (SA) obtained a degree in Sport Science from Stellenbosch University and furthered her studies at the University of Cape Town where she graduated with a Bachelor of Sciences Medical Honours Degree in Nutrition and Dietetics.

Jessica is registered with the Health Professions Council of South Africa (HPCSA) and the Health and Care Professions Council (HCPC) in the UK. She is a member of the Association for Dietetics in South Africa and a Vitality Wellness accredited dietitian.

She has experience working in the clinical hospital setting as well as experience with a variety of chronic diseases of lifestyle such as obesity, hypertension and type 2 diabetes.

Being a Type 1 Diabetic herself since the age of 13, Jessica has a special interest in the nutritional management of children and adults with diabetes. She also has a key interest in weight management and eating disorders.

Jessica is passionate about the ever-changing profession of dietetics. She enjoys helping individuals achieve optimal health through nutrition to live their best life as a healthy and happy individual.

To find a dietitian in your area, visit http://www.adsa.org.za/Public/FindARegisteredDietitian.aspx

 

 


Diabetes in the Family, How to Cope

More often than not a diabetes diagnosis is experienced as devastating; not just to the patient but to their loved ones as well. Even though the condition is manageable, and it is possible to live a life full of well-being, a diabetes diagnosis comes as a shock and ushers in all sorts of changes. Association for Dietetics in South Africa (ADSA) spokesperson and registered dietitian, Jessica Oosthuizen describes it as a ‘rollercoaster ride of a diagnosis’, full of stress and anxiety for the whole family – and she should know, she was diagnosed herself with Type 1 diabetes when she was thirteen years of age.

A host of challenges faces the family when a member is diagnosed with diabetes. With more than 1.8 million cases of Type 2 diabetes in South Africa in 2017, the wider impact is significant in our country. “I think for most families shock is the first feeling,” Jessica says. “Family members are also faced with the emotional, financial and physical adjustments that need to be made with a diagnosis. These feelings can weigh on family members, and stress and anxiety are common challenges faced by parents, siblings and other family members who are involved. One of the biggest challenges is the confusion and uncertainty. It is very daunting being diagnosed with a condition that you don’t know very much about. Even though patients and family members should get a good explanation of what diabetes is and how it can be managed, this amount of information may be very overwhelming and often very little is taken in initially.”

Today is World Diabetes Day the focus is ‘The Family and Diabetes’. Jessica points out that the impact of a diabetes diagnosis is typically more acute when the patient is a child. “The challenges faced with the diagnosis of diabetes in a child is different,” she says. “The parent or caregiver will probably be much more involved with their day to day care as it may take some time for children to comfortably be able to measure their own blood glucose and inject themselves with daily insulin injections. For children who are of school going age, there generally has to be a third party helper involved which can cause added stress and anxiety for a parent or caregiver as they can’t have control over the situation at all times in the day. Parents may also feel frustration, guilt and anger, as their child’s hurt and pain is something that they are not able to fix.”

Young or old, Type 1 or Type 2, what diabetes does bring about are lifestyle changes. As Jessica points out: “With Type 1 Diabetes once you’ve had the diagnosis, there is never a holiday or break from it.” While the treatment regimens do differ between Type 1 and Type 2 Diabetes, both kinds of diabetes demand discipline, constant thinking, planning and control. The patient and the family need to understand a number of things including how the medication works; how many carbohydrates they can consume, and how often. For some, these lifestyle changes can be completely overwhelming. In addition, having a chronic illness like diabetes is expensive and the family may well suffer from financial stresses, which brings a different dimension to the anxiety experienced.

Ideally, a team approach can deliver vital support to the family. Overtime diabetes patients may need access to various diabetes experts including an endocrinologist, a diabetes educator, a psychologist, a dietitian, a biokineticist, a podiatrist and an opthalmologist. As the family moves from shock to acceptance, regular touching base with the different members of their team helps them to gain a holistic view of diabetes care.  “If it is possible, regular follow ups with your doctor or diabetic educator are essential to fix any problems that the patient or family are facing in a timeous manner instead of trying to fix a problem months or years down the line. There are also diabetic support groups such as Diabetes South Africa and Youth with Diabetes, and social media platforms that patients and family members can join,” Jessica advises.

Perhaps, the biggest challenge is that of normalising life after the diagnosis, so that the chronic condition is well managed and does not get in the way of day-to-day life. “It is important for patients and families to know that while diabetes is a chronic condition that requires daily discipline, control and organisation; it is possible to still live a completely normal life,” Jessica says. “After diagnosis and implementing treatment, it is useful to note that everyday can be completely different as blood glucose readings can be influenced by a number of factors such as exercise, illness, sleep, stress, caffeine, alcohol, types of food and the timing of medication. By taking every day as it comes, you will learn something new that can be used to improve your control and become adept and efficient at managing your condition.”

Jessica advises those who are newly diagnosed to keep a diary recording blood glucose readings, the amount of insulin used and the timing of insulin doses, as well as all food intake and exercise. While it is time-consuming, this journaling doesn’t have to be done forever and it does help to provide a clear and accurate picture, as well as insights into what is working well for you, and what isn’t. This is important because every diabetic’s experience is completely individual. There are also mobile apps available such as FatSecret, Carbs & Cals, mySugr and MyFitnessPal. Strategies such as these empower the person with diabetes to set targets and chart their progress towards managing their condition in the most optimal way. Family support for gaining control over the treatment is vital for the person with diabetes, and helps them to get on the road to wellness and enjoy their life to the full.

For those who are newly diagnosed or who have family members that have recently been diagnosed with diabetes, you can get support from a registered dietitian in your area by visiting www.adsa.org.za.


BUSTING THE BREAKFAST MYTHS

Starting the day with a healthy breakfast is the opening act for a healthy lifestyle, and lays the foundation of our future health over the longer term. Yet, if there’s a meal to be skipped, it is most likely to be breakfast.

This year, National Nutrition Week from 9 – 15 October and National Obesity Week (NNOW) from 15 – 19 October 2018 have united a coalition of health partners, including the National and Provincial Departments of Health, the Association for Dietetics in South Africa (ADSA), The Nutrition Society of South Africa (NSSA) and The Heart and Stroke Foundation SA (HSFSA) amongst others to promote a shared and very important message that breakfast is the best way to start the day.

“There are a number of key reasons why people skip breakfast,” says ADSA spokesperson and Registered Dietitian, Abby Courtenay. ”This is why it is so important to bust the myths around breakfast and give South Africans from all walks of life the information and help they need to make a healthy breakfast a happy, lifetime habit.”

Myth #1 I am skipping breakfast to lose weight

There is a host of studies that show that people who have a healthy breakfast habit have better weight outcomes than those that skip. Not eating breakfast puts you at risk of grabbing convenience foods with low nutritional value to help you make it through to lunchtime. Feeling starving by lunchtime also causes you to blow out proportions and overeat. “It’s a common belief that if you want to lose weight you should skip breakfast,” points out Kim Rutgers, also a Registered Dietitian and ADSA spokesperson. “This is far from the truth. Skipping any meal will mean important nutrients like vitamins and minerals will be missed.” Effective, and sustainable weight loss and management is instead achieved through healthy food choices, which includes breakfast.

Myth #2 I don’t have time in the morning for breakfast

Healthy avocado, egg open sandwiches on a plate with cherry tomaIt is true, that for most of us, the morning is far more time-stressed in comparison to supper. However, planning, preparation and smart food choices will result in being able to either sit down and eat breakfast with your family or eat your breakfast over the two to three hours after waking.  Abby advises: “From a time perspective, drinking is often quicker than sitting down to a full meal and so my suggestion is a nutritious smoothie. I encourage my patients to blend together a small banana, oats, sugar-free peanut butter and low fat milk. Baby spinach is an optional extra. Not only is this the quickest meal, but it contains balanced portions of fruit, vegetables, minimally processed grains and healthy plant fats. What a way to start your day!” With some planning, preparations for breakfast can be made the night before. Beat the clock by soaking your oats, cutting fruit and boiling eggs during your supper preparation so that it is as easy as possible to make breakfast a quick, enjoyable family meal.

Myth #3 I can’t eat breakfast, I don’t wake up hungry

Many people question the advice to eat when they don’t yet feel hungry, but breakfast doesn’t have to be immediate or done all in one go. It can take place during the two or three hours after waking. Abby says: “Swap your smaller mid-morning snack and breakfast around. For example, eat a fruit when you are getting ready for work or school and then enjoy a bigger, more complete meal at around 10h00. This way you are getting in all the food and nutrients you need whilst still honouring your body’s natural hunger cues.”

Myth #4 I can’t eat breakfast, I don’t like cereals or eggs

A healthy breakfast doesn’t have to be traditional or contemporary breakfast foods. If you don’t like them, don’t eat them; other healthy food choices make a great breakfast. It’s also important to keep in mind that many processed foods marketed as breakfast foods can be laden with sugar and are nutrient poor, and are not the healthy options. “Use up your leftovers for breakfast,” says Abby. “Breakfast food doesn’t always have to be cereal and eggs. Why not have leftover mince on toast with fresh tomato slices or use your leftover pumpkin to make pumpkin fritters?”

When it comes to what a healthy breakfast should consist of, Kim agrees: “The 3 main nutrient groups are carbohydrates, proteins and fats. When all three of these macronutrients, in the right proportions are included in one meal, then you are getting in a balanced, nutritious meal.”

Myth #5 Not eating breakfast saves us money

In the short term, reducing your food bill by skipping breakfast is a folly that will play out in your future and cause unforeseen health expenses. Studies have shown that people who regularly eat healthy breakfasts are at lower risk for expensive conditions such as overweight and obesity; hypertension and heart disease. The issue is rather about how to make breakfast more affordable. According to Abby, healthy eating does not have to expensive. “It may take a little extra planning but when you are in the routine of eating well, you will actually save money. Consider how much you can save with less store bought convenience foods, takeaways and eating out.”

 Top tips for affordable, healthy breakfasts include:

  • Shop around for bargains
  • Buy bulk where possible; share bulk purchases with family and friends
  • Buy seasonal fruits and vegetables; not only will you save money but you will get fresher, tastier produce and contribute to the reduction of your carbon footprint.
  • Use your leftovers
  • Draw up meal plans and budgets; proper planning reduces costs
  • Single portion items, for instance single serving tubs of fruit or yoghurt is often more expensive than buying a large tub of yoghurt. Decant the yoghurt into reusable containers if you need to travel with it.
  • Ready-to-eat cereals cost more than double the price of maize meal, oats and mabele porridge. Save money by making your own muesli instead of store-bought options.

For more information on how breakfast is the best way to start your day, visit the National Nutrition & Obesity Week 2018 website for more tips and recipes: http://www.nutritionweek.co.za/

To find a dietitian in your area, visit www.adsa.org.za


Meet the ADSA President!

We sat down and had a chat with the new ADSA President, Christine Taljaard-Krugell, who has taken over from Nicole Lubasinski, following her relocation to the UK.

Christine brings along a wealth of experience as the general manager of the African Nutrition Leadership Programme. “With ADSA turning 30 this year, I am truly humbled for the opportunity to contribute in my new role as ADSA president.”

 Why did you become a Registered Dietitian?

My sister had DM type 1 from a young age. The way that her disease impacted not only her own life but also our family’s as a whole made me realize just how big the potential impact of optimal nutrition can be. I have the utmost respect and deepest empathy for any family who is faced with chronic illness. It was only later in life, in my fourth year that I was exposed to what I now enjoy the most, public health nutrition related research.

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

Being a researcher I love the diversity that my work brings. Research is challenging in the sense that you have to invest for a very long period of time before you get the reward. It is when one’s research is usable, when it reaches the target audience that I think the satisfying moments emerge. I am also very privileged to have been involved in the African Nutrition Leadership Programme for the past 6 years. Investing in individuals in the field of nutrition, and to experience the change within such a person, must be some of the most satisfying things one can do.

What has been your career highlight?

In 2016 I was chosen by the International Agency for Research in Cancer to partake in their “50 for 50” initiative to be held in Lyon, France. The initiative entailed that 50 young leaders from around the world were selected to participate in their initiative called “Empowering future cancer research leaders”. It was an absolute wonderful opportunity where I have met great mentors and made new colleagues and friends.

What are the major nutrition-related health issues that South Africa is faced with?

South Africa remains to be utterly complex. South African households are faced with significant challenges that include high levels of poverty, unequal distribution of income and wealth and inequality in health outcomes. In addition to the above malnutrition, including both under and over nutrition prevail. While one fifth of households do not have enough money to buy food for the household till the end of the month, two thirds of women are either overweight or obese. Dietitians needs to provide a health service to the population that is evidence informed as well as attainable.

What are the positive side to the relative dark picture painted above?

Malnutrition is preventable. In the words of Lawrence Haddad, the executive director of the Global Alliance for Improved Nutrition (GAIN):

Despite the challenges, malnutrition is not inevitable, where leaders in government, civil society, academia and business are committed… anything is possible.

How do you see a nutrition champion?

The nutrition champions in my life are men and women who have an inextinguishable passion for their work. They invest unlimited time, resources and knowledge into young (nutrition/dietetic) professionals. They have the highest work ethic that they choose to stand by.

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

I think a good routine (even if a bit boring) helps in preventing a day of total nutrition disaster. However, if that day happens, I hope it was in good company, under the blue sky and enjoyed with friends and family.

What is your favourite dish and your favourite treat food?

I have to stick to my Dad’s braaivleis and for my favourite treat food it has to be Clover Vanilla Milk.

 

More about Christine

Christine Taljaard-Krugell is a registered dietitian and currently a part-time researcher and lecturere at the Centre of Excellence for Nutrition at the North-West University, Potchefstroom Campus.  She holds a PhD in Nutrition and a MSc in Dietetics with her research area being Public Health Nutrition.  She is the general manager of the African Nutrition Leadership Programme (www.africanutritionleadership.org) and the Editor and founding member of The Leader  the official newsletter of the African Nutrition Leadership Programme which is published quarterly.

Her research career started with clinical trials investigating the effect of a multi-micronutrient fortified beverage on cognitive growth in primary school children.  Since 2014 she has been actively involved in the South African Breast Cancer study.  This population based case-control study of breast cancer aims to clarify the role of body size, diet and physical activity in the African female population. In 2016 she was invited as part of the prestigious “50 for 50 initiative” where the International Agency for Research on Cancer (IARC) identified 50 future cancer research leaders from low-and middle income countries to attend a specialised workshop entitled Fostering Leadership in Cancer Research. 

Christine has an interest in evidence informed decision making and was the project lead for the South African leg of the EVIDENT (Evidence informed decision making for nutrition and health) project.  This multi-country project included other African countries such as Benin, Morocco, Ghana and Ethiopie.  The aim of the South African study was to document decision-making processes for public health nutrition programming.


Weight loss – a journey, not a destination

Today we meet Debbie de Coning who after many years of trying to improve her health and loose weight unsuccessfully, reached out to registered dietitian Monique Piderit.

She shares her journey with us, as well as some great tips for anyone embarking on a journey to better health:

Why did you decide to see a dietitian?

I had been on a quest to improve my overall health for many years and as a result had developed an interest in nutrition and healthy eating. I had already eliminated several food groups in my efforts to reduce inflammation, sinus and increase my energy levels. I had cut out sugar and refined carbs; wheat; as well as dairy – and while I did feel some benefits from significantly reducing all these – my energy levels remained low and the weight refused to move.

I had got to the point where I felt there must be a missing link somewhere and that if I could find out what it was, I was sure that I would be able to lose weight. I had tried so many approaches – and even although my health improved – the weight did not budge. Quite simply, I was tired of all the guesswork.

I kept researching, and after reading about DNAlysis, decided that I was going to invest in my health and get my weight sorted out once and for all.

Tell us about your journey with the dietitian?

I put a request out on Facebook asking for recommendations of dietitians who worked with DNAlysis. Someone tagged Monique in that post, and Monique reached out and offered to assist me on my weight loss journey.

What I really loved about working with Monique was the holistic way in which she approached this ‘project’. While we waited for the DNAlysis results, we had an in-depth consultation about relationships with food, family and friends. We also spoke about lifestyle. She found out which foods I liked and which I didn’t. We did a comprehensive set of blood tests and adjusted my supplement intake. By the time we had the DNAlysis results, we had a sound scientific platform from which to work.

The test showed that my body does not metabolize fat well. So, I went onto a low-fat eating plan. When I received my eating plan from Monique, it was scientifically worked out. There was nothing on it that I didn’t like and so it all felt pretty normal and do-able.

I now knew, that if I put something fat (good or bad) into my mouth, it wasn’t going anywhere anytime soon! I drastically reduced my red meat and chicken intake. I had to learn to use different sources of protein that were lower in fat, and had to make decisions to cut back on foods though they were healthy fats, such as peanut butter, almonds and avocados, and watch portions. No more guesswork: we had an informed strategy. Having the scientific knowledge has really helped me to rationalise making the right choices.

I really recommend working with a dietitian. Healthy living and good nutrition is a science. You need someone with the knowledge and skills to assist you, and it’s a real plus to find someone who is your champion as well.

 Tell us about your results / successes? 

In a relatively short time (8 months) and with what felt like minimal effort I lost 20kg. My waist and hips reduced by 14cm each. I also reduced my insulin by half and reduced my cholesterol count. My energy levels have also increased.

I went to see a biokineticist to get the appropriate exercises to tone and strengthen my muscles. My fitness is the next leg of the journey that I need to work on. Before losing weight, I wouldn’t have been able to complete even half of the exercises, but after the weight loss, I was able to complete all the sets of repetitions, albeit slowly.

When I first picked up the 2 x 2kg weights, I could hardly lift the 4kg. It was a shock to realise that I had been carrying five times that weight all day and every day. No wonder I had no energy!

What was the hardest part of the journey? 

Being a people pleaser, it was often hard for me to say no when being offered well-intentioned albeit wrong food choices. I had to become firm in making decisions to decline food without being apologetic and feeling the need to explain myself to others. Drinking enough water is always a challenge. And of course, who wants to offend a Lindt chocolate on offer?

What are the top three tips you can share?

  1. Be pedantic about portion sizes. Have a good food scale and measuring cups to make sure you stick to your portion sizes. If it’s 80g of chicken, then it’s 80g and not 95 or 100g. Also, split portions to allow for variety and texture. Instead of a full starch portion of mealies, have half mealies and half couscous. This helps to make food interesting with a variety of colour and texture. The minute food becomes boring, you are sabotaging yourself and feel hard done by.
  2. Embrace the new normal. I only told a few people about my weight loss journey while I was in the trenches, those I knew would support me. I did not want people watching me, watching what I was eating and passing judgement. There will always be pessimists and naysayers. Limit your exposure to them. It was a personal journey and I just wanted to get on with it. Sometimes the downside of setting a goal is thinking that when you’ve reached it the journey is over. Embracing the new normal means exactly that. When you’ve reach your goal weight, your healthy lifestyle continues.
  3. Celebrate a range of milestones. It’s not just about the weight. Celebrate reducing your insulin or centimetres lost. I celebrated cleansing my wardrobe and adopting a minimalistic capsule wardrobe approach. It’s not about buying things to reward yourself necessarily. You are making a conscious lifestyle change, so why do you need to be rewarded for that? Celebrate mindshifts and lifestyle choices. They are rewards in themselves.

What the dietitian says 

Monique says: “A key lesson is how Debbie approached this change in her life as a journey and not a destination. Right from the beginning, she chose to embrace the process of change by eating healthier, controlling portions, and making better food choices every day and at every meal, consciously avoiding dieting and the deprivation that it entails. Debbie’s dedication to her health is a great inspiration to other women. I am so proud of you, Debbie!”

To find a registered dietitian in your area, visit the ADSA website!


Why Breastfeeding is the Foundation of Life

 

This  year’s World Breastfeeding campaign celebrates breastfeeding as the foundation of life for the good health of mothers and children. Co-ordinated by the World Alliance for Breastfeeding Action (WABA), the campaign identifies breastfeeding as an essential strategy to prevent malnutrition in all its forms, combat inequality, crises and poverty – all major issues in many South African communities.

ADSA (Associations for Dietetics in South Africa) spokesperson and Registered Dietitian Mbali Mapholi, points out how important it is that women in South African communities – where hunger, poverty and inequality are rife; where crises such as fires, floods and social unrest are frequent – realise that breastfeeding their babies can provide many vitals benefits.

“Breastfeeding provides babies with the best source of highest quality nutrition possible, at the very small cost of just ensuring that the mother’s nutritional needs are met,” says Mbali. “Malnutrition is the third highest cause of infant death in South Africa, and breastfeeding can prevent malnutrition in all its forms. Breastfeeding also provides complete food security for infants, even in times of crisis.”

 Breastfeeding saves you time

  • Breastmilk is always available
  • Breastfeeding requires no preparation

Breastfeeding saves you money

  • No need to buy infant formula
  • No need to buy bottles, teats and sterilising products
  • No need to use electricity

Breastfeeding boosts your baby’s health. A breastfed baby is likely to get sick less often. This means there are fewer clinic visits, and fewer days off absent for Mom.

  • Lower risk of death
  • Lower risk of diarrhoea
  • Lower risk of chest infections
  • Lower risk of ear infections
  • Lower risk of overweight and obesity

Breastfeeding boosts mom’s health

  • Lower risk of breast cancer
  • Lower risk of ovarian cancer
  • Lower risk of high blood pressure

“There are so many incredible advantages to breastfeeding,” says Mbali, who is currently breastfeeding her 14-week old twins. “Moms need to feel confident that it is the natural, perfect food for their infants under six months; and it continues to be a vital source of nutrition as a baby grows into a toddler and their immune systems continue to develop. Some Moms may need to return to work, but because breastmilk is best for baby, they should consider expressing and storing their milk so their children continue to receive the benefits for longer.”

Tips for expressing breastmilk

  • Allow 20 to 40 minutes of relaxed private time
  • Gently massage and squeeze around the nipple area and your milk will start to flow
  • Collect your breastmilk in a wide-rimmed container that has been sterilised with boiling water
  • Transfer the breastmilk to sealable bottles, food containers or food bags that have been sterilised with boiling water. You can even get pre-sterilised, resealable food bags.
  • Breastmilk can be safely stored in the fridge for one to two days or in the freezer for up to six months
  • If you are expressing and storing a lot of breastmilk, date the storage containers so you can keep track of the milk that needs to be used first

“World Breastfeeding Week reminds us that breastfeeding is a universal solution that gives everyone a fair start in life and lays the foundation for good health and survival of children and women”, concludes Mbali. “Moms need to be fully supported by their families, friends and employers because breastfeeding is a major strategy to fight poverty and boost food security in our communities, and we hope to see a significant increase in breastfeeding across South African communities.”

For information on World Breastfeeding Week 2018 visit www.worldbreastfeedingweek.org


BREASTFEEDING, NOT JUST BEST FOR BABY, BUT BEST FOR SA!

Today is the start of the 2018 World Breastfeeding Week, which runs from the 1st to the 7th of August. This year the emphasis is on breastfeeding as ‘the foundation of life’ and highlighting the advantages of improving breastfeeding for communities and countries. The campaign, co-ordinated by the World Alliance for Breastfeeding Action (WABA), identifies breastfeeding as an essential strategy to combat the impacts of inequality, crises and poverty – all major issues across South Africa. Yet, we remain one of the countries with the lowest rates of breastfeeding in the world.

In an attempt to turn this around, South African organisations, which promote and support breastfeeding, such as ADSA (Association for Dietetics in South Africa) are driving conversations around the 2018 World Breastfeeding Week themes. On the individual level, breastfeeding significantly boosts the health of children and mothers, while saving family income. Amplified at the country level, breastfeeding contributes to breaking the cycle of poverty, reduces the burden of health costs by preventing all forms of malnutrition and ensures food security for babies and young children in times of crisis. It is a universal solution that gives everyone a fair start in life and lays the foundation for good health and survival of children and women.

Optimal infant nutrition is defined by the World Health Organisation (WHO), as exclusive breastfeeding for the first six months of life, and continued breastfeeding until the age of two years and beyond, whilst complementary foods are introduced. One of the key Sustainable Development Goals of the United Nations is that by 2025 at least 50% of infants aged 0-6 months in every country will be exclusively breastfed. At just 32% currently, South Africa has a long way to go in the next seven years if we are to reach this goal.

ADSA spokesperson, Registered Dietitian/Nutritionist, lecturer and researcher at Stellenbosch University, Associate Professor Lisanne du Plessis, explains that breastmilk and breastfeeding are referred to as ‘the economic choice’ because mothers produce custom-made breastmilk for their children at no additional expense to their households. She points out that the high costs of not breastfeeding include the impacts on nutrition, healthcare and the environment. It is essential that the barriers to mothers providing their children with the most natural, nutritious and health-boosting free option need to be overcome. Lisanne points out that: “On average, 20 kilogrammes of formula is needed to feed a baby for the first six months of life. At an average price of R190 per kilogramme, the formula bill adds up to almost R4000. Add to this, the cost of bottles and teats as well as fuel to boil water and clean utensils, and families face a staggering expense of thousands of rands to feed their babies.”

There are also substantial environmental costs associated with not breastfeeding. According to the widely cited Lancet Breastfeeding series, breastmilk is ‘a natural, renewable food that is environmentally safe’. It is produced and delivered to the consumer without fuel inputs, pollution, packaging or waste. By contrast, breastmilk substitutes have a substantial ecological footprint, which includes agricultural production, manufacturing, packaging and transport just to get to the consumer. In the home, it requires water, fuel and cleaning agents for daily preparation and use. A host of pollutants and significant waste are generated along the way. It is estimated that more than 4000 litres of water is needed to produce just 1 kilogramme of infant formula. “It is clear that from the household to the country level, breastfeeding can significantly reduce costs and contribute to breaking the poverty cycle,” Lisanne concludes.

A nation of breastfeeding mothers can also reduce the burden of their country’s healthcare costs. Registered Dietitian and ADSA spokesperson, Chantell Witten, who is also a researcher at North West University says, “It is well-proven that breastfeeding reduces disease risk. Breastfeeding substantially protects infants against death, diarrhoea, chest and ear infections. Breastfeeding also helps to prevent malnutrition in all its forms. It protects against overweight, obesity, diabetes as well as the various health consequences of under-nutrition. For mothers, breastfeeding reduces the risk of breast and ovarian cancers, and of high blood pressure.” As pointed out by Chantell, infants who are not exclusively breastfed; who are given food earlier than age six months and who are not following a varied diet, are at higher risk of malnutrition and death. Globally, if higher rates of optimal breastfeeding were practiced, 823 000 annual deaths in children under the age of five years and 20 000 deaths from breast cancer could be averted.

The third key message of the 2018 World Breastfeeding Week is concerned with the role of breastfeeding in a world of upheaval. Breastfeeding has the power to ensure food security for infants and children in times of crisis. This is highly relevant to disadvantaged communities in South Africa, which bear the brunt of disasters such as fires and floods, but are also increasingly thrown into crisis due to protest action.

University of the Western Cape lecturer, Registered Dietitian and ADSA spokesperson, Catherine Pereira points out that breastfeeding provides complete food security for babies up to six months of age. “Furthermore, from 6-24 months, breastmilk still provides a substantial contribution to a child’s nutrient and energy needs. Breastmilk is accessible, sufficient, safe and nutritious and it is therefore quite clear that breastfeeding can contribute directly to ensuring food security during emergencies.”

Catherine emphasizes the need for us to think carefully about the ways in which we respond and give help as a crisis unfolds: “When it comes to making sure that babies are fed in a crisis, for many people, the first thought is to donate infant formula. Infant formula is expensive, and so there’s an assumption that it is something valuable that could help. Unfortunately, this is not the case. Rather, providing support to mothers to continue breastfeeding, especially during a crisis, is a much more important priority. The WHO and UNICEF have issued a very recent brief on breastfeeding during a crisis which includes suggestions consistent with what has been mentioned by Catherine.

In addition to this, many women struggle to continue breastfeeding when they return to work and research shows that breastfeeding rates go down when women go back to work. It is therefore important for South Africa to focus on improving comprehensive maternity protection for women, which is defined by the International Labour Organisation (ILO) as: health protection in the workplace, a minimum period of maternity leave, some form of cash and medical benefits while on maternity leave, job security, non-discrimination and support to breastfeed or express milk upon return to work.

In South Africa, we have a far way to go to support breastfeeding mothers in the workplace. Current law indicates that women should receive four months of maternity leave, however paid leave is not mandatory (although government departments and some companies do provide paid leave). It would be very important for all stakeholders to advocate for longer maternity leave (up to 6 months) and that paid leave is mandatory. Non-standard employees (employees placed by temporary employment services, employees on temporary or fixed-term contracts and part-time employees such as domestic workers or farm workers) are a particularly vulnerable group. This group of women often have to claim pay for their maternity leave from the Unemployment Insurance Fund (UIF) and this can be an extremely time-consuming and complex process for some women.

Once back at work, women should be informed that they are entitled to two 30-minute breaks during their work day to breastfeed or express breastmilk until their infant is six months old. This enables mothers to return to work and earn an income whilst still providing their infants breastmilk, the best feeding option. All stakeholders should work together in an attempt to improve the support of women to be able to continue breastfeeding when they return to work.

It’s clear that South Africa has much to gain in turning around its low rates of exclusive breastfeeding and actively striving to reach the 2025 target of 50% of mothers’ breastfeeding exclusively for the first six months of life. Developing a national culture that supports the truism that ‘breast is best’ can have far-reaching positive impacts for our children, mothers and country.

For information on World Breastfeeding Week 2018 visit www.worldbreastfeedingweek.org

 


Meet Registered Dietitian, Nazeeia Sayed

dav

We chatted to registered dietitian Nazeeia Sayed, who is the Branch Liaison on the current ADSA Executive committee, acting as the communication link between ADSA branch chairpersons and the national Executive Committee to ensure consistency in operations. She also manages the mentorship programme. We wanted to find out why she became a registered dietitian, what she loves about her work and what the challenges are:

Why did you become a Registered Dietitian?

I love food and cooking and was all set to study Consumer Sciences – but I stumbled into Dietetics at UKZN when I received a bursary. 

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

I most enjoy the variety in the work that I do: teaching dietetic students, supporting new mums on breastfeeding, or technical R&D support to food companies.  Every day is different!  I also enjoy the flexibility my work as a consultant dietitian allows me so I have time for other things I enjoy and value.  The most satisfying moments are being able to see the positive impact I can make and the feedback I receive from the people I interact with.

What has been your career highlight?

I have been a dietitian for over 20 years now with lots of exciting times.  My career highlight would undoubtedly have to be working on my own the last 3 years as a consultant dietitian.  It has been tremendously challenging and rewarding.

What are the most challenging aspects of your career?

Trying to stay abreast of all the nutrition research and information!  I have embraced the fact that I cannot be a Jack of all trades but I need to focus and build my expertise in a few areas of nutrition.  This also allows me to market myself to potential clients more strongly.  

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

A hot cup of tea can resolve most things!  There will be periods when we all find it difficult to have a healthy eating day – I don’t focus on that – I move on and make better decisions the next day!  If I do overindulge then I make the extra effort to have lighter meals the next day.

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

I didn’t know dietitians ate cake.”

“Do you have a diet sheet for me about xyz?”

“But I was not breastfed and I turned out ok.”

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

All dietitians are equally qualified but their special interests and experiences vary.  A client (individual or company) can ask the dietitian about his/her experience, and ask him/her for a brief proposal. 

What is your favourite dish and your favourite treat food?

Lamb biryani with cucumber raita is my favourite! I am easy to please – chocolate would be my favourite treat!

 

To find a dietitian in your area visit: http://www.adsa.org.za/Public/FindARegisteredDietitian.aspx


Nutrition at the centre of sustainable corporate wellness

We live in an era when many of us, not just aspire to, but have an expectation that living well for longer is a real possibility. Increased awareness of the impact of lifestyle on health has made it clear we can’t just rely on medical industries to reach this goal – we play the most important part. It is a part that is played not at all in sweeps of grandeur, but in the small details of our daily choices – What will we eat? When we will exercise? How will we get sufficient rest and sleep? What do we need to do to actively manage our stress today?

Corporate Wellness Week, from 2 to 6 July, emphasises the need to properly consider our time spent at work when we answer these questions. We’re the master of our own universe at home – we are able to muster up great salads and fresh food inspired dishes; take yoga classes, mountain bike, meditate and walk the dog along the beach in our free time. But what happens when we go to work?

If you are a corporate employee, chances are that you eat nearly half of your daily meals and snacks at work, and your physical activity is low. Typically, home is the haven of well-deserved respite, relaxation and free choice; while the workplace, driven by the demand for efficiencies, is stressful, demanding and limiting. This is why we like weekends.

But two days a week of healthy living is not enough. We need workplaces that also support our wellness, simply because that is where we spend most of our time. This is not just an agenda from the employee perspective. As ADSA spokesperson and Registered Dietitian, Lerato Radebe points out: “Wellness in the workplace is not only a means to keep employees happy, but has tremendous effects on absenteeism, presenteeism and productivity.”

Lerato explains that wellness is an active process of becoming aware of and making choices towards a healthy and fulfilling life. “Wellness is more than being free from illness, it is a dynamic process of change and growth. WHO, the World Health Organisation, describes it as: “a state of complete physical, mental and social wellbeing, and not merely the absence of disease or infirmity.”

Nathalie Mat, another Registered Dietitian and ADSA spokesperson, weighs in: “Nutrition is one of the easiest modifiable factors that controls a person’s energy levels and productivity. A company’s culture can perpetuate or inhibit healthy eating. I have experience of many companies where health is still not prioritized, leading to poor nutrition and health overall.”

So, what can South African business do to promote a sustainable culture of wellness in the workplace?

With nutrition at the centre of wellness, ADSA experts offer these guidelines:

  • Create and maintain higher levels of wellness awareness through ongoing advocacy, engaging a Registered Dietitian and other wellness professionals through a dedicated wellness programme;
  • Make wellness exciting by avoiding tick-box exercises or initiatives that are punitive in spirit. Wellness programmes need to be dynamic and up to date with latest trends that are interesting, value-added and that inspire employees to make lifestyle changes;
  • Combat rising healthcare costs by rewarding employees’ participation in your corporate wellness programme through rebates on health insurance;
  • Make healthy eating the workplace norm with healthy meeting snacks, healthy options in the canteen, water as the primary drink and bowls of fresh fruit;
  • Have a dietitian available on site and facilitate dietitian-led support groups as a great way to foster healthy eating without forcing programmes on employees.

 

To find a Registered Dietitian in your area visit http://www.adsa.org.za/Public/


All the ways that Dietitians do Prevention

Across the world, health and social care services are under stress; and in South Africa, the inaccessibility of quality health care for many people remains one of the country’s intractable problems. These pressures have intensified the focus on the prevention of disease as the key driver of public health. At the forefront of prevention is food. As one of the only healthcare professionals trained and qualified to interpret the latest nutrition science and dietary guidelines, dietitians play multiple roles in the prevention of diseases.

Dietitians Do Prevention is the theme of the 2018 Dietitians Week which starts today and runs until 8th of June. To create awareness, ADSA (Association for Dietetics in South Africa) joined SASPEN (South African Society for Parenteral and Enteral Nutrition), ENASA (Enteral Nutrition Association of South African) and HDIG (Hospital Dietitian Interest Group) in highlighting the six major ways that Dietitians Do Prevention and help to reduce the burden of disease in South Africa through their vital work.

ADSA spokesperson Jessica Byrne points out that: “Not many people are aware that dietitians, who must be registered with the HPCSA (Health Professions Council of South Africa) in order to practice their profession, are employed across many different sectors from industry to communities; as well as in health, research and educational institutions. Across the board, they play a key role in disease prevention.”

ADSA_Dietitians Do Prevention_JPG

 

The Six Ways that SA Dietitians Do Prevention, are:

Guidance during first 1 000 days – Dietitians support expecting mothers to promote healthy pregnancies and prevent complications, but their work doesn’t end there. Jessica Byrne says: “Due to the country’s suboptimal rates of breastfeeding, the dietitian’s promotion of breastfeeding, monitoring of infant growth and ongoing guidance as a baby starts to also consume solids has become critical prevention work. Breastfeeding not only provides the best source of nutrition for a baby but also promotes growth and enhances the vulnerable immune systems of babies to help prevent disease.”

Public Health and Primary Prevention – Healthy eating and hydration is essential for health. Dietitians work to educate the general public on good food choices to maintain their health, which helps prevent illnesses and avoid diet-related conditions such as diabetes, malnutrition or obesity. Dietitians do prevention at community level through the promotion of house hold food security and the drive to eliminate hunger. Various community projects involve the services of a dietitian.

Mental Health and Addiction Recovery – Good nutrition and a healthy diet can impact positively on both the prevention and management of mental health conditions, including helping to support recovery and prevent relapse in the case of addictions.

Hospital, rehab and home-based care – “You will find dietitians working right across the health care system,” says Alta Kloppers, spokesperson for HDIG. “This is because nutrition plays such an important role in survival, recovery, rehabilitation and symptom relief, as well as reducing the risks of further illnesses and preventing more admissions to hospital and other health care services.” Dietitians do prevention through screening of hospitalised patients to identify patients at risk of developing malnutrition, and providing specialised nutrition interventions to manage specific diseases and conditions.

Optimising Health and Secondary Prevention – Dietitians do prevention by helping people with existing conditions such as diabetes, kidney failure or dementia to optimise their nutrition in order to get relief from symptoms, prevent complications and enhance their quality of life. This will include individualised dietary advice and appropriate follow-up and monitoring.

Making Every Contact Count through Healthy Conversations – Dietitians don’t just advise on diet and nutrition when they do prevention. Instead they engage also with clients on the other issues related to good health such as the importance of physical activity and not smoking. They also take into account the social and emotional factors that can easily contribute to a client’s need for a healthier lifestyle. Conversations with dietitians can then easily direct people to where they can also access professional help for the non-dietary issues that also impact on disease prevention.

“The important message of this year’s Dietitian’s Week,” says Lizl Veldsman SASPEN’s spokesperson, “is that it is impossible to separate disease prevention from nutrition and therefore, from the work of a dietitian.”

Lynne Mincher, ENASA spokesperson agrees: “Good nutrition is the foundation of prevention and recovery. Whether you are talking about supporting breastfeeding tube-feeding or oral nutritional supplements, a person recovering from an operation or guiding someone with a chronic condition such as diabetes, we need that expertise of the dietitian right at the frontlines of prevention.”

A collection of “Dietitians Do Prevention” recipes by South African dietitians has been published and includes 39 recipes, covering breakfast, lunch, dinner and snacks. Each recipe comes with a prevention message. It can be downloaded here: http://www.adsa.org.za/Public/DietitiansWeek2018.aspx

You can also download the Dietitian’s Week infographic here: http://www.adsa.org/za/Public/DietitiansWeek2018.aspx