COVID-19: KEEPING SAFE AT WORK

Chat Leave a comment March 18, 2020 nutritionadsa

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:

• COVID-19 Corona Virus South African Resource Portal: https://sacoronavirus.co.za/
• South African Coronavirus Disease 2019 Public and Emergency Hotline: 0800 029 999
• South African Coronavirus Disease 2019 WhatsApp Support Line: 0600- 123456
• The National Institute for Communicable Diseases (NICD): nicd.ac.za
• The World Health Organisation (WHO): http://www.who.int/health-topics/coronavirus

 

Make Eating Whole Foods a Way of Life

Chat 1 Comment October 9, 2019 nutritionadsa

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

Media release: Stress, digestion & nutrition

Chat Leave a comment June 11, 2019 nutritionadsa

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 21^st 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

Chat 1 Comment June 3, 2019 nutritionadsa

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 3^rd to the 7^th 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

The planetary health diet: what, why and how…

Chat 1 Comment March 20, 2019 nutritionadsa

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

Banking Your Breastmilk Saves Lives

Chat Leave a comment March 6, 2019 nutritionadsa

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

Healthy Eating for a Healthy Pregnancy

Chat 5 Comments February 11, 2019 nutritionadsa

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.

Ride For Hope

Chat 1 Comment December 7, 2018 nutritionadsa

Our 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.

 

Diabetes in the Family, How to Cope

Chat Leave a comment November 14, 2018 nutritionadsa

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

Chat 1 Comment October 8, 2018 nutritionadsa

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

It 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

Why Breastfeeding is the Foundation of Life

Chat Leave a comment August 6, 2018 nutritionadsa

 

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!

Chat Leave a comment August 1, 2018 nutritionadsa

Today is the start of the 2018 World Breastfeeding Week, which runs from the 1^st to the 7^th 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

 

Nutrition at the centre of sustainable corporate wellness

Chat Leave a comment July 2, 2018 nutritionadsa

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

Chat 1 Comment June 4, 2018 nutritionadsa

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 8^th 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.”

 

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

 

Busting the two biggest myths about your immune system

Chat Leave a comment May 16, 2018 nutritionadsa

Winter is here, and that gets us thinking about our immune system, and what we need to do to boost it, so that it helps us avoid colds and flu, or at least recover from them more quickly.

The immune system is one of the most complex networks in the body that is still far from being completely understood by the world’s scientific community. As pieces of research are added to the picture, myths about the immune system arise in the gaps, and they are often acted upon as truths.

Registered Dietitian and spokesperson for ADSA (Association for Dietetics in South Africa), Linda Drummond helps us sort fact from the fiction:

MYTH # 1 – ‘All I need for a winter immune boost is a multi-vitamin or more Vitamin C’ – “This is probably the most common misconception – that nutritional supplements, or greater doses of one particular vitamin, can be an effective protective solution,” says Linda. “While Vitamin C does play an important immune-boosting role, research has shown that supplementing with Vitamin C does not actually help you to avoid developing colds and flu. Studies have found that in some, but not all cases, Vitamin C, as an isolated strategy, may help to reduce the duration of the illness, but not protect you from it. Nutritional supplements can play an important role in supporting improved health for vulnerable people, such as children, the elderly, pregnant women and those with health conditions that compromise their immunity. However, others should rather aim to get their daily intake of immune-boosting micronutrients from their food. Eating a variety of healthy foods every day, including lots of vegetables and fruits, wholegrains, dairy, meat, chicken or fish, beans and lentils, and plant fats provides not just Vitamin C, but also the other immune-boosting nutrients such as Vitamins A, D and the B’s, as well as trace elements such as zinc and selenium. You cannot expect that if you eat poorly, but take a supplement, your immune system will still be highly effective. What you eat, not what you supplement with, is what is most important to build your defences against winter germs. Supplements are not the antidote to unhealthy eating. They can help to fill in gaps in an otherwise healthy eating plan, and you should get your dietitian’s advice on this. However, we should all be clear that when it comes to what we consume and our immune systems and our health, there is simply no substitute that we know of at this time that beats the effectiveness of eating a variety of quality, minimally processed foods, which are mostly plant-based, every day. It is the way to go.”

MYTH # 2 ‘To improve my immunity in winter all I have to do is focus on the food I eat and the supplements I consume.’ “This is false,” says Linda. “While healthy eating is a vital immune boosting strategy, and nutritional supplementation may be necessary for you if you have a compromised immune system, it remains one critical aspect of having an effective immune system during the challenging winter months. But, it is a complex system and other factors are at play.

Scientific research has shown that:

• Sufficient sleep is also important to support the immune system;
• Regular exercise is a powerful immune system booster;
• And, a positive mental and emotional state strengthens your resistance to disease.

What this means is that during winter, if we want to effectively develop our resistance to illnesses, we need to keep our focus on our whole body and our entire lifestyle, not only one part of it. We must get enough quality rest that is balanced by also getting daily physical exercise. We need to take regular action to manage stress, develop mindfulness and be in charge of our disruptive emotions. Sleepless nights; days of inaction and stress that is off the charts for most of the time will batter our immune system as surely as nutrient poor food and other poor eating habits.”

The bottom-line is that you should boost your immune system this winter, and, based on real evidence, you can do that each day by:

• Eating healthily by focusing on a variety of minimally processed quality foods from the different food groups to ensure your body gets all the nutrients it needs. Aim for at least five colourful vegetables and fruit daily;
• Saying no to high energy, sugar, salt and fat foods including take-aways, sweetened drinks, sweets, chips, cakes, biscuits and all the other highly-processed options;
• Enjoying tucking up warm at night and getting the sleep you need to wake up refreshed and strong;
• Keeping active every day and
• Letting go of your stress and anxieties.
• Washing your hands often with soap and water for at least 15 seconds. When you are not near a sink, use a hand sanitizer.

 

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

The Role of the Dietitian in Eating Disorder Treatment

Chat Leave a comment April 16, 2018 nutritionadsa

Eating disorders are complex illnesses with both psychological and physical aspects that require treatment. For this reason, over the past few decades, it has become more common for the treatment of people with eating disorders to be managed by multi-disciplinary teams which can deliver the necessary medical, psychological and nutritional help. As society’s foremost expert on nutrition, the dietitian has an important role on the treatment team for a person suffering from an eating disorder, and more opportunities are opening up for dietitians to develop as experts in this role.

Julie Deane-Williams, a registered dietitian and ADSA (Association for Dietetics in South Africa) spokesperson who has a special interest in treating people with eating disorders, points out that in some cases, the dietitian may also be the first port of call for help.

“Even though there are high levels of denial associated with disorders such as anorexia nervosa or bulimia nervosa, the dietitian is often the health care professional on call, especially when it comes to a person struggling with emotional/comfort eating or binge eating disorder. Typically, in the first session, a sufferer, usually female, confides that she is desperate to lose weight; reveals disgust at her body, even if she is within a healthy BMI (Body Mass Index) and feels shame that she has been unable to stick to a diet. The dietitian soon discovers that the emotional eater has tried many different diets. Patients commonly are keenly aware of the energy content of different foods but that doesn’t mean that they know much about nutrition. Often the patient hopes that the dietitian can provide a ‘miracle’ diet that is finally going to help her lose weight and keep it off.”

In combination, these are the warning signs for the dietitian who can recognise the symptoms of disordered eating. It is important that the dietitian doesn’t play into the patient’s scenario but instead helps them to acknowledge disordered eating and address it appropriately.

Deane-Williams makes it clear that the dietitian who works with people with eating disorders needs to acquire particular expertise and skills.

“It is important for the dietitian to understand how the different eating disorders develop and are maintained by patients, as well as to have sound knowledge of the medical, psychological and physiological aspects of the range of eating disorders. In order to play their role effectively on a multi-disciplinary team, they also need to have a general understanding of the mental health issues as well as the various psychological interventions and their applications. It would be an advantage to the dietitian to have expert communication, counselling and behaviour change skills. This is a relatively new role for dietitians, and the complexity of eating disorders demands education and training that goes beyond the minimum required to simply qualify as a registered dietitian.”

The dietitian who works with people with eating disorders plays an important role in the assessment, treatment, monitoring, support and education of the patient. As advocates of evidenced-based science, they serve as important resources of nutrition knowledge for the patient, the patient’s family and the other health care professionals on the treatment team. They need to be skilled at determining a patient’s nutritional status, eating patterns and behaviour, food rules and beliefs. It is the dietitian who takes into account the patient’s meal planning, food shopping and cooking skills. The dietitian works closely with other team members to understand how the patient’s underlying psychological and emotional issues impacts on their eating behaviours, as well as their motivation and capacity for behaviour change. The dietitian will work collaboratively with the patient to develop the nutrition aspect of the treatment plan, and to support the patient and the rest of the team throughout its implementation.

In the light of recent research in the UK that has attributed more deaths to eating disorders than any other psychiatric disease, Deane-Williams urges people with unhealthy relationships with food to seek help sooner rather than later.

“Using food, or the lack of it, to cope with distressing emotions and situations is a maladaptive way of managing life,” she says. “All eating disorders are addictions, and it is the nature of an addiction to further and further alienate a person from their own inner truth. Addictions also usually drastically stunt emotional growth. Once a person accepts that they have an eating disorder, and they seek good medical help, the healing journey is one that is difficult yet immensely rewarding. Not only can they recover, but they find out who they really are – bright and exceptionally intuitive people who had developed a coping mechanism to keep their ‘heads above water’ during extremely challenging times in their lives. Once they develop healthy ways of managing difficult emotions, they can go on to thrive, and create healthy and very happy lives.“

If you think you or a loved one might be struggling with an eating disorder, consider visiting a registered dietitian for expert guidance and advice. If you are looking for a dietitian in your area, please visit www.adsa.org.za

Pregnancy and Nutrition

Chat Leave a comment February 16, 2018 nutritionadsa

This Pregnancy Week a reminder that good nutrition before and during pregnancy may influence the pregnancy, the delivery and the health of mother and child later on. What you eat now will help your baby to grow healthily and give them the best start in life and help you to feel your best. We asked registered dietitians and ADSA (Association for Dietetics in South Africa) spokespeople to provide their top tips for healthy eating during pregnancy.

Does eating for two mean doubling up your portions?

“Additional energy is needed during pregnancy to support the growth demands of your baby, however the saying ‘eating for two’ has been taken out of context,” says Cath Day, Registered Dietitian. “During the first trimester, you don’t need any additional energy. This means that if you were maintaining a healthy weight before you became pregnant, you can continue eating the same amount. It is only in your second and third trimester that you need to eat a little more.”

But, how much more?

The professional advice from a dietitian is that an expectant mom who is at a healthy weight should take in an extra 350 kCal / 1470 kJ per day in her second trimester. This would be the equivalent to eating an extra half a cup of fruit or one tennis ball-sized fruit, a 175 ml of plain low fat yoghurt, two wholewheat crackers, two teaspoons peanut butter without added sugar and salt, and a 30 gram portion of a medium fat cheese.

In the third trimester, the recommended additional intake rises to just 460 kCal / 1930 kJ per day, and that would be equivalent to eating an extra one cup of fruit or two tennis ball-sized fruits, 175 ml plain low fat yoghurt, four wholewheat crackers with the same two teaspoons peanut butter without added sugar and salt, and a 30 gram portion of a medium fat cheese.

What should you do if you are overweight and pregnant?

Overweight and obesity can present health challenges during pregnancy, so health professionals do advise that women should get to a healthy weight before they fall pregnant. However, in South Africa where women’s rates of overweight and obesity are high, less than ideal conditions for pregnancy need to be managed.

“Pregnancy is not the time to think about dieting and weight loss,” says ADSA spokesperson and Registered Dietitian, Nazeeia Sayed, “An overweight pregnant woman should focus on the healthy eating of a variety of nutritious foods, and her weight gain needs to be monitored at her ante-natal check-ups. She should also focus on light exercise such as walking.”

Day also points out that: “Overweight and obese pregnant women would benefit from seeing a registered dietitian who can assist them with an eating plan which will support baby’s growth and ensure that they gain weight within healthy parameters.”

How can you eat healthily on a budget?

Day has some sensible tips:

• Eat fruits and vegetables which are in season and more affordable
• Get your family members and neighbours to shop with you for bulk fruits and vegetables that are more cost-effective
• Start a vegetable garden using water-saving ideas at home or in your community. NGOs such as Soil for Life and many more help households and communities to sustainably increase their access to fruits and vegetables
• Spend less money on fizzy cold drinks, junk food and take-aways, and use what you save to buy seasonal fruits and vegetables instead
• You can save money by reducing your meat intake by half and instead use beans, split peas and lentils to bulk up your favourite meat dishes. These legumes are a more affordable, healthy vegetable protein source that also include the B-vitamins and folic acid
• Buy frozen vegetables when they are on promotion – they contain as much or even more nutrients than vegetables which have been on the shelf for an extended period of time

What can pregnant women who can’t afford supplements eat to get the micro-nutrients important to pregnancy?

Pregnant women and those planning on falling pregnant should take a supplement of iron and folic acid, as these are essential nutrients needed for a healthy pregnancy.

Sayed points out that it is important for all pregnant women to know that they have access to the State ante-natal services because supplements such as folic acid, iron and calcium are included in their free healthcare.

Day also adds that there are many affordable food sources that provide these nutrients that are vital to a baby’s healthy development. “For instance,” she says “Green leafy vegetables such as spinach, morogo and legumes such as beans, split peas and lentils are good sources of folic acid and iron. You can also find staples such as maize meal and brown bread that are fortified with folic acid and iron. Amasi and milk provide calcium. Tinned sardines and pilchards provide calcium and iron, and chicken livers are another good source of iron.”

How can you use your pregnancy to develop healthier habits?

Pregnancy is a time when your health and the health of your developing baby is an absolute priority.   Day says that it is not only what you consume but also what you do not consume that counts. “Don’t drink alcohol when you are pregnant. All forms of alcohol could be harmful to your baby and the safest choice for your unborn baby is not to drink any alcohol at all when you are pregnant.”

Sayed concludes: “Pregnancy is not a state of ill health but a time to be enjoyed, and it can help you to develop life-long healthy eating patterns that you sustain as you become a role model for the new addition to your family!”

Keeping your healthy balance over the holidays

Chat Leave a comment December 11, 2017 nutritionadsa

We know it well, silly season is not for sissies. We always head into it with the best intentions not to give way to the over-indulgence; not to leave our healthy eating plans by the wayside, and to make sure we have the ‘me-time’ for prioritising the physical activity and self-care that we need to maintain our healthy balance. But we can trip up.

No sooner have we got through the swirl of team, company and client lunches, drinks and parties than we’re whirling off on holiday with non-stop plans for spending (well-deserved) time with family and friends. And, you know what? It’s actually, all good.

Our human drive to gather together around food is really not the problem. No matter what is available, what’s on offer and even, what might be pressed upon us, we still remain absolutely in charge of everything that we choose to eat or drink over the upcoming festive season. What’s critically important is how you think and how you decide to act in the moment.

For some, the legendary lavishness of the holidays is an excuse to let go despite the stated aspirations to achieve that bikini body this summer. It’s easy to take an ‘everybody’s doing it, I can’t avoid it’ approach, and lose your balance and your focus on your personal goals.

Or, you can see it for what it is – a highly social time that is good for you in so many ways, but will inevitably be accompanied by loads of food and drink. It’s important to stay mindful of this fact: you are completely in charge of how the holiday unfolds for you. You have all the power to maintain balance and progress on your healthy lifestyle goals – without suffering, and without setting yourself uncomfortably apart from others.

Healthy lifestyles have gained serious traction over the past years. Sure, no one has yet been able to convince Grandma to replace the condensed milk with low-fat yoghurt in her classic Christmas Day potato salad, but the chances are you will still find plenty of others in your social circles who, like you, want to start some new, healthier traditions and eating habits when it comes to the food we share over the festive season. It’s actually so unlikely at any holiday gathering this year that you won’t find some companions who also intend to stay focused on balanced eating in the context of a healthy lifestyle. Find them, band together and forge forward into a festive season that truly recharges mind, body and soul.

We asked Registered Dietitians, Retha Booyens and Mbali Mapholi, spokespeople for ADSA (Association for Dietetics in South Africa) to each give us their top festive season tips for mindful, in charge, healthy eating over the holidays:

Mbali says:

• It’s the same packet of chips – “Yes, you’re relaxing on the beach with friends and the context is the holidays – but the packet of chips being offered around is just the same as any other time, so, stick to your same reactions. If you’re not hungry, or if you would prefer a healthier snack, pass it on. This is not different advice from how to choose when waiters at a party are offering trays of canapes – just because it is in front of you, doesn’t mean you have to eat it. Be mindful about what you choose to eat. Sometimes when it comes to food offerings, we go on autopilot and think we need to hoover up everything in our sights just because it is on offer. But, we don’t. It’s just food. There will be more. There will be other contexts. We still have free choice, and we need to keep this in perspective – it is the same packet of chips you could say no to any other day, so say no today.”

Retha reiterates:

• Keep it in perspective – “If you find yourself in Rome on a rare holiday with the chance to enjoy an Italian Gelato alongside the Trevi Fountain – just go right ahead and enjoy it. But if the choice is about yet another third helping of Mom’s peppermint crisp tart, you can probably skip that this time around. If it is a genuine once in a lifetime experience, go for it, but if it’s a holiday habit that just trips you up, let it go.”

Retha says:

• You won’t feel happy if you just over-ride your healthy weight loss or weight management plans – “You can avoid the stress that compromises your enjoyment of the holidays by sticking to your goals and plans in flexible and practical ways. Keep your portion sizes in check at every meal. Cut back on the empty calories of alcohol by consciously reducing your intake and also drinking a glass of water between every glass of wine or beer. Never slake your thirst with an alcoholic beverage. Stick to your exercise regime. If you can’t access your usual classes, sessions and activities, then run, walk, ride or play physical games for a minimum of two and a half hours a week.”

Mbali adds:

• The devil is in the detail – “It’s not the holiday season that is the pitfall but rather our mindless reactions. Step away from the snack table. When you eat; choose well, chew slowly and be aware of what you are eating. Bring your favourite healthy dish to the family braai. Don’t hesitate to eat well and share that. Keep your eye on portion size and trade the treats you don’t want to miss out on with increased exercise and a more balanced meal before or after.”

 

For more information about ADSA or to find a dietitian in your area, please visit www.adsa.org.za

Women and Diabetes in the Spotlight this November

Chat 1 Comment November 14, 2017 nutritionadsa

Over the past decades, the rise of diabetes around the world has been so prevalent and extreme, it is sometimes referred to as the epidemic of our modern times. In 2017, the diabetes focus theme is Women and Diabetes. Globally, diabetes is the ninth leading cause of death in women, resulting in 2.1 million deaths each year. It is estimated that there are currently more than 199 million women living with diabetes, and by 2040, this total is expected to reach over 310 million.

Registered dietitian and ADSA (the Association for Dietetics in South Africa) spokesperson, Ria Catsicas says, “According to the latest mortality report for South Africa released earlier this year, diabetes is ranked as the leading cause of death in women, and the most important risk factor for developing Type 2 diabetes is obesity. At this time, more than 60% of South African women are either overweight or obese, putting them at higher risk than men of developing diabetes in the future.”

Gender also means that women experience additional health risks due to obesity. As Ria notes: “Almost 17% of pregnant South African women experience gestational diabetes which is directly related to obesity. This condition puts them at risk of experiencing high blood pressure during their pregnancy, miscarriages and still birth. In addition, the babies of mothers-to-be with gestational diabetes tend to be large which can contribute to complications during birth and are themselves at a higher risk of developing type-2 diabetes later in life. Obesity also plays a role in increasing the risks of female infertility.”

Optimal nutrition is key for the person with diabetes; it is also crucial for those who may not have diabetes yet, but are insulin-resistant and those with a family history of diabetes, as genetics are also a risk. Optimal nutrition is also essential for all women – up to 70% of cases of Type 2 diabetes can be prevented by following a healthy lifestyle.

Type 1 diabetes is managed by medication (injectable insulin and or tablets),a controlled diet and exercise; but when it comes to Type 2 diabetes, good nutrition along with other healthy lifestyle changes are usually the first line of treatment to manage diabetes, and if medication is required, a healthy diet can complement and often influence the medicine, to help avoid experiencing the life-threatening complications of diabetes. Tabitha Hume, also a registered dietitian and ADSA spokesperson, points out that common-sense healthy lifestyle changes can be a vital safeguard. “Balanced meals that are made up of a combination of high fibre, low-GI carbohydrates, lean protein and healthy plant fats with generous helpings of vegetables and salads and some fruit (in controlled portions) can be a general guide. However, plasma glucose control is very individual, depending on the severity of the diabetes, and the type and dosage of medication being used. Diabetics will need the help of a registered clinical dietitian who can support them in translating these guidelines into the practical meal plans that best suit their food culture, their taste preferences, daily routines and lifestyles.’’

ADSA spokesperson, Nasreen Jaffer agrees, “There is no ‘one size fits all’. In order to make a sustainable change to a healthier eating plan, all aspects of a person’s life must be taken into account. A working mom with kids at school does not have the same amount of time for food planning and preparation compared to a stay-at-home mom. It is the role of the dietitian to help tailor an eating plan that is healthy – as well as practical, affordable and do-able for the individual.”

All three experts agree that this year’s World Diabetes Day focus on women is relevant to the adoption of healthy lifestyles across South Africa’s population.   While many men play a prominent nurturing role in the home, and many are becoming increasingly interested in the impact of nutrition on health and physical performance, it is still common for women to take the dominant role in the nourishing of the family, and ensuring health and disease prevention.

Tabitha points out: “Since women are most often the home chef, the grocery shopper, and the planner of meals and snacks for children and the family, if nutrition education is targeted at women, there is a higher chance that healthy nutrition guidelines filter through the whole family and have the biggest impact. Family traditions, practices and cultures most often derive from the mother in a family which is why children often adopt the religion and language of the mother. This is where the ‘Mother Tongue’ phrase originates. South African women are encouraged to develop a ‘Mother Meal’ concept moving forward, helping to instil healthy eating habits in children from a young age.”

World Diabetes Day on 14 November aims to shine a light on the risks for developing diabetes; as well as the needs for regular screening, access to information, self-management education, treatments and support, which includes optimal nutrition.

RETHINK YOUR DRINK – CHOOSE WATER

Chat Leave a comment October 9, 2017 nutritionadsa

Clean and clear, refreshing and invigorating, we know instinctively that water is good for us. Yet, many of us have lost touch with water. Overwhelmed with the wide choice of what to drink, most of it sweetened with sugar, we’ve somehow left the simple, but profound goodness of water behind.

National Nutrition Week 2017, running from 9 to 15 October and, with its theme “Rethink Your Drink – Choose Water”, aims to help us rethink when it comes to water and get into the habit of making water our beverage choice each day. Water contains no kilojoules and hydrates. It is essential for health and is the best choice to quench thirst.

What the campaign highlights is that when we are not drinking water, we are probably choosing a sugar-sweetened drink which spikes our daily kilojoule intake, degrades our diet, and leads to weight gain and the onset of non-communicable diseases such as type 2 diabetes, heart disease and dental caries.

“The prevalence of obesity and non-communicable diseases in the country is alarming,” says Rebone Ntsie, Director: Nutrition, of the National Department of Health). “The South African Demographic and Health Survey conducted in 2016 found that the prevalence of overweight was 13.3% among children 0 – 5 years of age. About 67.6% and 31.3% of South African women and men respectively are overweight and obese. These findings show that overweight and obesity among children and adults have increased from earlier surveys. Replacing sugary drinks with water can help.”

Professor Pamela Naidoo, CEO of the Heart and Stroke Foundation South Africa (HSFSA)warns that the risk of coronary heart disease and ischaemic stroke rises with an increase in body weight. “There is also a clear link between sugary drink consumption and heart disease,” she says. “Indicators of heart disease such as blood lipids and uric acid also increase with an increase in consumption of sugary drinks.”

Daily consumption of two or more sugary drinks has been found to increase the risk of developing diabetes by at least 24% compared to consuming less than one sugary drink per month. According to Statistics South Africa, diabetes was the second leading underlying cause of death in the country in 2015, accounting for 5.4% deaths and the leading cause of death in females (7.1%).

On average, commercially produced sugary drinks contain the following amounts of sugar per 500 ml serving (2 average-sized cups/glasses):

• Sweetened fizzy drinks: 13 – 17 teaspoons
• Energy drinks: 13½ to 15 teaspoons
• Fruit juice: 12 – 16 teaspoons
• Sweetened milk or yoghurt-based drinks: 7 – 13½ teaspoons
• Sweetened iced tea: 8 – 10½ teaspoons
• Sports drinks: 4½ – 12 teaspoons
• Sweetened drinks, such as sweetened flavoured water, vitamin enriched water and coconut water: 4 – 8 teaspoons of water

The World Health Organization (WHO) recommends that the intake of free sugars, i.e. sugars added by the manufacturer, cook or consumer or sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates, should be less than 10% of the total daily energy intake for adults and children and less than 5% for further health benefits.

“This means that the maximum intake of free sugars from food and beverages per day for adult men and adolescents (14 – 18 years) should not be more than 12 teaspoons, and for adult women and children 5 – 13 years, not more than 9 teaspoons”, says Nicole Lubasinski, President of the Association for Dietetics in South Africa (ADSA).“To achieve more health benefits, the number of teaspoons of sugar from food and beverages per day for adult men and adolescents (14 – 18 years) should not be more than 6 teaspoons, and for adult women and children 5 – 13 years, not more than 5 teaspoons”.

Some sugary drinks have a nutrition information label, this will indicate how much of the carbohydrate in the drink is found as sugar”, says Carol Browne of the Nutrition Society of South Africa (NSSA). “Sugar is one of the primary ingredients in drinks, and so it will be listed high up on the list of ingredients. In milk based drinks some of the sugar will be the sugar from milk, and this is not classified as a ‘free sugar’. In these products the total sugar content on nutrition information label should be considered with the ingredient list.”

“It makes good sense to replace sugary drinks with lots of clean safe water”, says Rebone Ntsie. “Drinking lots of clean and safe water is essential for one’s health. Besides keeping you hydrated, it helps with digestion, regulate your body temperature, and to lubricate your joints. Furthermore, tap water is cheaper than any other drinks.”

“There are several ways to increase your intake of water”, says Abigail Courtenay, registered dietitian and spokesperson for ADSA.   “Make sure you always carry water with you; set reminders on your cell phone or notes at your desk every hour; drink water with meals; before and after exercising; and send a bottle of water with your child to school every day. You can also add fresh slices of lemon, cucumber, mint leaves, lime or fresh fruit to your water or unsweetened rooibos or herbal teas to add more flavour.”

On Wednesday, the 11th of October, ADSA (@ADSA_RD) will be hosting a Twitter Talk from 13h00 to 14h00 where dieticians and National Nutrition Week partners will be providing information, tips, ideas and advice on choosing water as the beverage of choice instead of drinking sugary drinks. Join the conversation live on Twitter, and follow the @ADSA_RD handle to get great ideas and tips. The Department of Health in the various provinces will also celebrate National Nutrition Week during the month of October.

For more information on National Nutrition Week 2017, visit the website: http://www.nutritionweek.co.za/

6 Eating Habits for Healthy Kidneys

Chat 1 Comment September 1, 2017 nutritionadsa

When it comes to health advice, our hearts are often in the spotlight. However, as equally vital organs, our kidneys really shouldn’t be relegated to the shadows. Worldwide, Chronic Kidney Disease (CKD) is on the rise – 1 in 10 people globally are affected, and that’s every bit as serious as cardiac disease.

Our kidneys work very hard for our bodies, and the downside of their dogged efficiency is that by the time we are bothered enough by the symptoms of CKD, the damage has been done. In the late stages of CKD, only ongoing dialysis or surgical transplant may help prolong life – treatments that are not available to many South Africans. This is why health professionals drawing attention to Kidney Awareness Week from 2 to 6 September, advocate for regular screening of kidney function, especially if you fall into the high risk categories.

Interestingly, similar to heart health, obesity, diabetes and hypertension put us at risk for CKD as well. The view of ADSA (the Association for Dietetics in South Africa) is that with the high prevalence of obesity, diabetes and hypertension in the country, it stands to reason that we need to become a nation aware of, and caring about our kidneys.

People who are overweight or obese are up to seven times more likely to develop end-stage renal disease compared to those of normal weight. A family history of CKD or renal failure is also a red flag indicating that you need to actively focus on the health of your kidneys. However, the prime culprit in the majority of CKD cases in South Africa (64%) is undetected or uncontrolled hypertension, which is abnormally high blood pressure. So a basic step in ensuring kidney health is regular blood pressure testing and adherence to treatment and lifestyle changes in order to keep your blood pressure in check.

Every day, our valiant kidneys help us dispose of the excess salt and water that we consume. In the process, they also happen to eliminate toxins that would otherwise build up and take down the living system that is our body. Our kidneys also play an important role in controlling our blood acidity and blood pressure levels. For those who are obese, the kidneys have to work harder, filtering more blood than normal to cope with the demands of the greater body weight. This increased workload can damage the kidneys and raise the risk of developing CKD in the long-term. “When kidneys do fail, the body is literally overwhelmed by excess water, salt and toxins, which defeat every other organ and body system,” says ADSA spokesperson, Registered Dietitian, Abby Courtenay, “The job of the kidneys may not be glamorous or poetic, like the heart, but it is every bit as important.”

The good news in all of this is that there is a lot we can do day to day to promote the health of our kidneys. Courtenay adds: “If you have been screened and diagnosed in the earlier stages of CKD, or need to implement measures because you suffer from obesity, diabetes or hypertension, you can make a significant positive difference just with your daily diet.”

“Nutritional strategies to deal with CKD, as well as its risk factors are well-researched and documented,” says Registered Dietitian, Cecile Verseput, “What’s important to note is that in the most up to date professional interpretation of the research available, the focus has turned from considering single nutrients to looking more holistically at an overall healthful dietary pattern, particularly rich in plant-based foods.” Cecile points out that recent SA consumer statistics show that fresh fruit and veg, as well as healthy sources of vegetable protein, are low shopping priorities in the country.

Here are her Six Top Tips for Boosting Kidney Health:

1. Go green – and red, yellow, orange, purple and blue! Boosting the fresh fruit and veg in your diet is one of the best ways to protect your kidneys. There are so many ways to make vegetables and salads a delicious part of your family’s eating.
2. Get real – Drop the high-salt, trans-fat takeaways and convenience foods like hot cakes. Cultivate a real interest and enjoyment in cooking from scratch with fresh, healthy ingredients. It’s so much more delicious, and good for your kidneys.
3. Be choosy about fats – They are not equal. Go for extra virgin olive oil and avocado oil rather than hard fats to protect the blood vessels in your kidneys.
4. Go nuts – Boost your intake of nuts and legumes. They are delicious, and provide healthy fats and fibre.
5. Forget the convenient fads – Let go of the sugar-sweetened drinks and treats, fast foods, processed and red meat.
6. Embrace plant protein power – Open up to the wide range of legumes, grains and nuts that are readily available and make them part of your daily eating. Swap red meat with legumes or alternatively with fish or poultry.

 

Why breastfeeding and work can, and should, go together

Chat 1 Comment August 1, 2017 nutritionadsa

Returning to work after maternity leave rates as one of the top reasons why mothers stop breastfeeding their babies before they should. The 2017 World Breastfeeding Week runs from the 1^st to the 7^th of August with the aim of uniting all sectors of society in the protection, promotion and support of breastfeeding. The campaign, co-ordinated by the World Alliance for Breastfeeding Action (WABA), identifies four critical focus areas, one of which is women’s productivity and work.

Working SA mums are entitled to a minimum of four consecutive months of maternity leave. Many take at least one month of that leave prior to the birth, and then make their return to work when their infants are just around three months old. However, exclusive breastfeeding of an infant from birth to six months is what is recommended as optimal nutrition by the World Health Organisation. Therefore, the only way that working new mums can meet these important health standards is if they can breastfeed or express breast milk for some months at their workplaces.

 

The benefits of creating workplaces that are friendly to nursing mums go beyond just the physical welfare of our new generations. Cath Day, registered dietitian and spokesperson for ADSA (The Association for Dietetics in South Africa) points out: “There is a vast body of scientific research that has shown that breastfeeding, as exclusive nutrition in the first six months and then as a supplementary food for two years and beyond, also protects and benefits the physical health of the mother; while impacting positively on her emotional well-being as she forms the essential bond with her new child. It is clearly in the interests of the employers of child-bearing women to protect, promote and support them during the times when they are breastfeeding because companies need their employees to be healthy and optimally productive.”

ADSA recommends that businesses formalise their support of breastfeeding in the policies, standards and practices of their employee wellness programmes.

So what can businesses do practically to protect and support the nursing mums on their workforce?

• Uphold the Law – Corporates must recognise and facilitate the legal rights of SA breastfeeding mothers enshrined in the Basic Conditions of Employment Act. Up until their babies are six months old, working mums are entitled to two, paid 30-minute breaks every work day for breastfeeding or expressing milk.
• Know and promote the benefits of breastfeeding – “It helps to have employers who are knowledgeable about why breastfeeding is so important and a commitment to protecting, supporting and promoting breastfeeding in the workplace,” says Cath Day. “As part of the employee wellness programme, registered dietitians can be engaged to make presentations to all staff on the advantages of a breastfeeding-friendly work environment and how to make it happen in your company. The straightforward facts and the inarguable science go a long way to reducing the discomforts and stigmas people might attach to breastfeeding.”
• Provide the place – Nowadays it is widely regarded as completely unacceptable for breastfeeding mums to have to lock themselves in a public toilet, or their car, to breastfeed or express milk at work because they have nowhere else to go. Many companies realise that a breastfeeding-friendly workplace means providing a secure and comfortable space for working mums to spend their 30-minute breastfeeding breaks. Preferably, this private room should have a door that locks, comfortable seating, plug points for breast pumps and a refrigerator for the safe storage of breast milk.
• Be flexible and adaptable – Part-time, flexi-time or temporary work-from-home plans can be very effective solutions for breastfeeding mums, and should especially be employed by companies who provide no proper facilities for the legal breastfeeding breaks in their workplace.
• Offer child-care facilities – A number of progressive companies with a clear focus on employee engagement provide workplace child care facilities for the babies and small children of their employees. This is ideal for breastfeeding mums as they can more easily and quickly breastfeed their infants and need to express less milk.

ADSA spokesperson Zelda Ackerman, whose areas of expertise include baby and child feeding, urges new working mums to know their rights and to get the support that they need from their bosses and colleagues so that going back to work doesn’t become a barrier to the continued breastfeeding of their infant. “It is really important for South Africa as a country to transform to a culture of being breastfeeding-friendly in every environment,” she says, “We have to consider the potential health burdens of being a country with exceptionally low rates of breastfeeding, and turn this trend around. From the family home to the work environment to society at large, breastfeeding mothers need support.”

Zelda’s top tips for breastfeeding mums returning to work include: 

• Before your return to work, give yourself enough time to get to grips with finding the pump that works best for you and regularly expressing milk – and give your baby enough time to get used to expressed breast milk. Time and practice will help you both to establish this as a stress-free routine before the big change up ahead.
• Also, ahead of time, build up a stock of breast milk at home – it can be refrigerated and frozen. Stored breast milk should always be dated, and you retain more nutritional quality if you refrigerate it immediately after you have expressed.
• On your return to work, have straightforward conversations with your bosses and/or team members, as necessary, so that they are clear about your breastfeeding goals and needs. Be clear about your legal right to two, paid 30 minute breastfeeding breaks each working day, and establish with them how this is going to work best for you and what accommodations you will need.
• If you encounter resistance or lack of support in your workplace, get help rather than give up breastfeeding. Other working mothers in your workplace and HR personnel may help to raise awareness of the importance of your continued breastfeeding. External sources of help can include breastfeeding support organisations and registered dietitians.
• You can reduce discomfort from engorgement and pace your two breastfeeding breaks optimally at work if you arrange your workday mornings so that you give your baby a good feed that ends just before you leave for work; and then breastfeed your baby again as soon as you get home. Co-ordinate this well with your baby’s caregiver so that they don’t feed the expressed breast milk just before you get home. If you are breastfeeding a baby older than six months of age, make sure your caregiver doesn’t provide late afternoon snacks so that your child is ready for a good breastfeed when you get home from work.
• Be patient and resilient. Our modern world doesn’t necessarily make breastfeeding easy, natural and stress-free. But it is as important as it has ever been to both you and your baby. The science is clear, the more you can; the better for you, your baby and our society at large.

Dietitians urge South Africans to ‘Eat Fact Not Fiction’

Chat 2 Comments June 12, 2017 nutritionadsa

Nutrition advice promising all sorts, from weight loss to healthier living and even cures for diseases, spread like wildfire across social media. In the era of ‘alternative facts’ and post-truth, ‘the latest, greatest nutrition advice’ from dubious sources can unfortunately tempt many away from accepted dietary guidelines and recommendations based on years of evidence.

‘Evidence and Expertise’ is the theme of Dietitian’s Week 2017, highlighting the important role of dietitians who are able to interpret nutrition science and dietary guidelines in order to customise nutrition advice for each individual. This is vital because from weight loss to a disease like diabetes, there is no ‘one size fits all’ best eating plan. Dietitians happen to be health professionals trained and qualified to do this.

Dietitians and Evidence

In the course of earning their degrees in the science of dietetics, dietitians are specifically taught the skills required to interpret scientific evidence. In order to maintain their professional registration with the Health Professions Council of South Africa (HPCSA), all practising SA dietitians also have to undertake ongoing studies that ensure they keep up with the latest knowledge provided by new and emerging evidence, in accordance with the Continuing Professional Development (CPD) programme. This means they have the latest evidence-based food, health and disease expertise at their fingertips – and you won’t find a registered dietitian in the country basing any recommendations on the long outdated food pyramid.

Dietitians and the Food-Based Dietary Guidelines

The country’s broad strokes dietary guidelines, on which public health messages are based, and which were developed according to the process recommended by the Food and Agricultural Organisation of the United Nations (FAO), have also evolved over the years, featuring a notable shift from the emphasis on nutrients to the focus on actual foods, which by nature contain a variety of nutrients. ADSA, the Association for Dietetics in South Africa, provides further clarity on the guidelines with its statement on the Optimal Nutrition for South Africans. The latest visual Food Guide from the Department of Health provides a very different picture from older models such as the Food Pyramid and represents the latest FAO recommendations.

Dietitians and Patients

But the reality remains that diet is highly personal. What we eat is rooted in our culture and tradition, shaped by affordability and accessibility, and inextricably intertwined with highly variable lifestyle factors such as weight, physical activity, emotional connection to food and our consumption of non-food substances, as well as various physiological differences and genetics.

“This is where the dietitian comes to the fore,” says ADSA President and Registered Dietitian, Maryke Gallagher. “If you take a disease such as diabetes, which is a prevalent lifestyle disease in the country, and is a condition that can be managed through diet, each patient needs a tailor-made plan and focused support to make their individualised diet work towards their well-being and health. When the situation demands change around something as fundamental to life as food, then broad strokes are not necessarily sustainable solutions.”

Dietitians and Sustainability

The role that the dietitian can play in helping the communities in which they work to secure healthy food systems that are good for both people and the planet is an emerging responsibility in the profession. Dietitans are increasingly involved in facets of our modern food systems including agriculture and alternative food production methods, natural resources and ecosystems, social justice and community health issues, as well as developing food policy and food systems research that takes sustainability into account.

Dietitians and Diseases

Some may associate dietitians with merely giving advice and support to someone who wants to lose weight, but dietitians work across a range of industries. They are also experts in providing nutritional advice with regard to serious diseases and conditions such as diabetes, heart disease, hypertension, liver disease, kidney disease, cancers, HIV/AIDS, TB, throat, stomach and intestinal disorders, as well as food allergies and intolerances, eating disorders, sports nutrition and life-stage nutrition (including the protection, promotion and support of breastfeeding as the best start in life). Apart from dietitians in private practice, they work in hospitals and communities, academia and industries. In addition to consulting with patients, dietitians are also involved in research, nutrition training and development of provincial and national policies.

Dietitians and Malnutrition

In South Africa, where the health issues that arise from the obesity epidemic stand side by side with those resulting from undernutrition, our dietitians’ work literally spans from one extreme to another. The South African Society for Parenteral and Enteral Nutrition (SASPEN), a supporter of Dietitian’s Week, highlights the essential role the dietitian plays in providing nutritional support to promote optimal nutrition to people in hospitals, where malnutrition is a common cause of the exacerbation of disease, delayed healing and prolonged hospital stays.

The Dietitian and You

It’s clear, that as a country, our need for dietitians is multi-fold, which explains why there’s a lot more than just dietary guidelines on the mind of a registered dietitian. In consultation, your dietitian is going to be taking in many factors unique to you to work towards helping you make optimal food choices. This includes your age and gender; your genetics, body size and body image; your environment, culture, spiritual beliefs and family life; physical activity level, mental well-being and general abilities; your work life and patterns; your budget; food preferences, eating tastes and cooking skills; as well as your existing health conditions and prescribed meds.

In the hopes of steering us clear of the latest trumped up ‘diets’ and promoting a return to genuine expertise and evidence, dietitians countrywide are suggesting that we ‘Eat Facts Not Fiction’.

In collaboration with the British Dietetics Association, Dietitian’s Week is held in SA from 12th to 16th June, with the 2017 theme ‘Evidence and Expertise’.

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

 

Statement on the outcome of the HPCSA inquiry into the conduct of Professor Tim Noakes

Chat 65 Comments April 21, 2017 nutritionadsa

The Association for Dietetics in South Africa’s (ADSA) former president Ms Claire Julsing-Strydom submitted a complaint about Professor Tim Noakes to the Health Professions Council of South Africa (HPCSA) in 2014 on behalf of ADSA regarding, what it considered, unconventional infant nutrition advice.

The complaint

The complaint was lodged after Professor Noakes advised a mom via Twitter to “ween” (sic) her baby on to a low carbohydrate, high fat diet. ADSA believed, at the time, that the advice:

1. was not based on current scientific evidence;
2. contradicted international and local guidelines for complementary feeding adopted by organisations like the World Health Organisation;
3. could negatively affect a baby’s health, growth and development; and
4. was provided via Twitter without an examination or consideration of the baby’s health or age and therefore nutritional needs. ADSA also considered it risky if other moms on Twitter took the same advice.

Professor Noakes did not advise the mom to continue with breastfeeding, which undermined its importance. For these reasons, ADSA considered the advice unconventional and requested the HPCSA to investigate further.

The HPCSA charge and inquiry

The HPCSA is a statutory body established to regulate registered healthcare practitioners and protect the public. The HPCSA considered the complaint and decided to hold an inquiry into what it considered “unprofessional conduct” that was “not in accordance with the norms and standards of your profession” and that Noakes “provided unconventional advice on breastfeeding on social networks (tweet/s).”

ADSA has lodged other complaints to the HPCSA to adjudicate in the past. Most cases are resolved mutually without the need for a detailed inquiry. It was never ADSA’s intention for this matter to span over 3 years and to progress to a hearing. The HPCSA follows a specific disciplinary process for all complaints. This case has gone through all the necessary steps and couldn’t be resolved or concluded in the preliminary inquiry phase. The HPCSA has autonomy on the type of inquiry it wished to institute and ADSA has co-operated fully with their decision.

The formal hearings began in June 2015 and continued in November that year. The inquiry continued in February and October 2016. The hearings have now been concluded and the HPCSA has issued its verdict.

ADSA’s concern

ADSA was concerned, when lodging the complaint in 2014, that a strict low carbohydrate, high fat diet for babies would not meet all the nutritional needs of a growing child. Current scientific evidence does not support an extreme low carbohydrate, high fat diet for babies. When foods rich in carbohydrates such as whole grains and legumes are avoided and other carbohydrate food sources such as dairy, fruits and vegetables are restricted, the diet can become deficient in certain essential nutrients, such as vitamin C, B1, B3, B6, folate, magnesium and fibre. Because infants and young children are considered a vulnerable group, the potential for nutrient deficiencies is a serious concern. Deficiencies can compromise growth, and cognitive and physical development. Restrictive diets for babies with medical conditions should only be followed under strict medical supervision with monitoring by suitably trained and registered healthcare professionals.

Dietary guidelines for feeding babies are developed by organisations such as the World Health Organisation and the United Nations Children’s Fund (UNICEF), based on a strong body of evidence. In South Africa, the Department of Health has adopted these recommendations. We also have Paediatric Food Based Dietary Guidelines backed by technical support papers published in 2013. This is a widely accepted scientific approach to child nutrition. The risks of experimenting with a baby’s development are immense and the long-term effect of low carbohydrate, high fat diets for babies is currently unknown. ADSA believed that the advice provided by Professor Noakes was against accepted common practice. The concern for the health of babies was ADSA’s primary interest when ADSA lodged this complaint.

The use of social media for professional purposes does pose interesting questions, especially for dietitians and other health care practitioners. While social media may be appropriate for generic public health messages such as how to reduce salt or sugar consumption in diets, social media may not be advisable for providing specific individualised, clinical nutritional advice to vulnerable groups such as babies, where little is known about their health and medical history. ADSA does recognise that social media provides significant opportunities for public health information and for use by health care professionals. However, clear guidelines are required to guide and regulate patient interaction outlining the use and limits of social media by health practitioners.

“ADSA accepts the verdict and we are relieved that the hearing has finally been concluded. We welcome the precedent this case provides on what we considered unconventional advice. The case also sets a precedent about the use and limits of social media by health professionals. For ADSA this hearing was never about winning or losing, or standing for or against Professor Noakes. It was about protecting the health of babies and future adults,” said Maryke Gallagher, President of ADSA.

“We will study the verdict in detail and decide what implications this case has for ADSA and dietitians. We also call on the HPCSA to provide guidelines for health professionals’ use of social media in their practice,” said Gallagher.

ADSA and its members will continue to provide dietary advice that is evidence-based and in line with guidelines provided by the national Department of Health and international bodies such as the World Health Organisation. A scientific and rigorous process is used to develop international and local dietary guidelines, and the outcome of the inquiry does not mean that these guidelines will now change. ADSA will consider new approaches and practices based on scientific evidence that has been adopted by credible health organisations.

About sponsorship and big foods

“Many dietitians and members of ADSA have been worried about the allegations made during the course of this inquiry that dietitians are unfairly favouring big food companies because they sponsor the organisation. ADSA wants to assure those concerned that we will never compromise ADSA’s independence as a result of corporate sponsorship. ADSA is a registered not-for-profit organisation (NPO) and relies in part on fundraising to sustain its work. In 2016, we received 63% of income from members. Our sponsorship policy is clear on non-influence by sponsors. We do not endorse any brand, product or retail chain. There is no conspiracy between big foods and dietitians to sell unhealthy food to South Africans. A healthy population through well balanced diets is what we strive for,” said Gallagher.

It is very unfortunate that the professionalism and integrity of a number of nutrition scientists in South Africa has been unfairly questioned during this inquiry. It is ADSA’s hope that the reputation of nutrition professionals and dietitians as nutrition experts will be restored. Despite the negative sentiment, ADSA believed it had a responsibility to enquire about an issue that had such significant consequences for dietitians and other health professionals.

On Tim Noakes

“We respect Professor Tim Noakes for his work as a sports scientist. He is a well respected A-rated scientist and is respected in academic circles. His work is pioneering and he has always tested conventional thinking. But, we have differed with Professor Noakes on this issue. We have no personal gripe with Professor Noakes. Our concern has always been about the health of babies,” said Gallagher.

This hearing has been rather divisive with strong views expressed on both sides. The debate has raised significant awareness about the importance of nutrition, which is positive. Health, wellness and nutrition should concern everybody. But, South Africans have also been confused by the ebb and flow of this divisive nutrition debate and the inconsistent nutritional advice provided over many years. That is unfortunate.

“I’m pleased this is over and we can now focus on other urgent nutrition challenges we have in South Africa,” concluded Gallagher.

Useful links:

ADSA’s position on infant nutrition:

Infant Nutrition Statement

Comprehensive Q&A:

Q&A

ADSA’s sponsorship policy:

ADSA Sponsorship Policy

Tim Noakes tweet: 

4. The HPCSA charge:

“guilty of unprofessional conduct or conduct which, when regard is had to your profession is unprofessional, in that during the period between January 2014 and February 2014 you acted in a manner that is not in accordance with the norms and standards of your profession in that you provided unconventional advice on breastfeeding on social networks (tweet/s).”

Is a Career as a Dietitian for You?

Chat 3 Comments April 10, 2017 nutritionadsa

Dietetics, the field of nutrition, health and the application of science-based nutrition knowledge offers a variety of distinctive career opportunities that goes beyond the usual view of the dietitian as someone who simply helps others lose weight. If you have interests in health, food, healthy lifestyle and science, you may well find your niche in this growing profession.

“A dietitian is a registered healthcare professional who is qualified to assess, diagnose and treat nutritional problems, as well as to advise on preventative nutritional strategies,” says Maryke Gallagher, registered dietitian and President of ADSA, the Association for Dietetics in South Africa. In South Africa, the minimum qualification for a dietitian is a four-year BSc degree and one-year of community service. To practice dietetics in the country, one must be registered with the Health Professions Council of South Africa (HPCSA). A registered dietitian is, therefore, a recognised expert in evidenced-based nutrition. This scientific expertise is vital in today’s world where there is an abundance of unscientific health and nutrition information, as well as a plethora of fad diets and nutrition gimmicks.

While dietitians are certainly the ‘go-to’ people for those battling with overweight and obesity, there is a lot more to the career than just sharing weight reduction and management expertise. What we eat has significant impacts on many other diseases and health conditions. Whether therapeutic nutrition or preventative nutrition, dietitians promote good health and wellbeing for all. There is much scope to tailor a career in dietetics to your personal passions. You may be interested in focusing on children’s health, maternal health, food allergies or eating disorders, or on some of the many medical conditions that require a dietitian’s management such as diabetes, heart disease, HIV/AIDS and intestinal disorders. In addition, when it comes to sports, nutrition also impacts on performance, and dietitians may often play integral roles on the teams managing high performance sportspeople.

Without doubt, there is a high need for registered dietitians in South Africa. While infectious disease such as HIV/AIDS and TB continue to be prevalent in South Africa, non-communicable diseases like heart disease, strokes, cancers and diabetes are actually the main causes of deaths (1). Yet up to 80% of heart disease, stroke and type 2 diabetes and over a third of cancers could be prevented by adopting a healthy lifestyle, such as eating a healthy diet, keeping physically active and avoiding tobacco products (2).   South Africa is ranked the most obese country in sub-Saharan Africa(3). Alarmingly, two out of three women and almost one in three men are overweight or obese, and almost 1 in 4 children aged 2-14 years are overweight or obese in South Africa(4). On the opposite side of the coin, chronic under-nutrition is also prevalent with 1 in 4 children aged 0-3 years suffering from stunting, a condition where a child grows to be small for their age due to poor nutrition(4). There is also a high incidence of micronutrient deficiencies, particularly vitamin A and iron, in South African children and women of reproductive age(4). South Africa has high levels of food insecurity with around 1 in 4 food-insecure South Africans experiencing hunger and a further 1 in 4 at risk of hunger(4).

Dietitians may work in a variety of settings with different areas of focus:

Private practice – like other health professionals, dietitians can set themselves up to consult privately with patients who need advice on nutrition therapy and support to make healthy eating a lifestyle change.

Hospitals – known as clinical dietitians, these practitioners primarily work in hospitals consulting with patients who are referred to them by doctors or other healthcare professionals. Their role in a patient care team is to assess and individualise nutrition therapy (whether an appropriate special diet, tube feed or intravenous feed) as an integral part of recovery or palliative care.

Community – these dietitians may be employed in the public sector, or by NGOs or community-based organisations. Their focus is generally on the promotion, protection and support of breastfeeding; growth monitoring and the prevention of malnutrition; nutrition promotion and education; promotion of healthy lifestyles to address non- communicable diseases; prevention and treatment of vitamin and mineral deficiencies; and addressing food insecurity issues.

Institution-based – dietitians also work in food service management providing healthy and specialised diets to people living in institutions such as senior homes, school hostels, welfare care centres, prisons and health care facilities. Their work includes planning, costing and developing menus; controlling implementing, evaluating and overseeing food service systems; and managing special dietary requirements.

Industry/Corporate – there are varied roles for dietitians in the food, retail, healthcare and pharmaceutical industries. They may advise on current food labelling legislation, nutrition regulations and the nutritional analysis of food items; be involved in product development; share latest developments and trends in nutrition; participate in nutrition-related marketing activities; lead corporate wellness programmes and conduct literature reviews.

Research/Academia – dietitians employed by educational institutions are involved in continuously providing new evidence-based nutrition information through on-going research and teaching and are responsible for the training of new nutrition professionals. 

Media/Publishing – in the Information Age, there is opportunity for dietitians, who have important knowledge to share, to generate expert content providing nutrition advice, latest evidenced-based nutrition news and views, commentary on nutrition issues and inspiration for healthy eating.

Do you have what it takes?

Maryke advises that a career in dietetics will suit those who:

• are interested in food and health
• enjoy and have a flair for Science
• would be fulfilled by a caring, helping profession
• are lifelong learners who are attentive to the on-going developments in Science
• are able to translate scientific knowledge into practical advice
• are comfortable in the role of the expert and like sharing knowledge with others
• have strong inter- and intrapersonal skills
• have a positive attitude and the ability to motivate others
• have empathy, understanding and tact

 

 

References

1. Mortality and causes of death in South Africa, 2014: Findings from death notification / Statistics South Africa. Pretoria: Statistics South Africa, 2015

2. Global status report on noncommunicable diseases 2010. Geneva, World Health Organization, 2011

3. World Health Organisation. 2015. Global Health Observatory Data Repository. Accessed June 2015. http://apps.who.int/gho/data/node.main.

4. Shisana O, Labadarios D, Rehle T, Simbayi L, Zuma K, Dhansay A, et al. South African National Health and Nutrition Examination Survey (SANHANES-1). Cape Town: Health Sciences Research Council, 2013.

 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

 

Salty South Africa – are we doing better after salt legislation?

Chat 1 Comment March 20, 2017 nutritionadsa

Despite South Africa passing world-leading legislation to reduce salt intake, too many South Africans eat too much salt, putting themselves at risk of heart disease and strokes. Today is the start of  Salt Awareness Week which runs from 20-26 March.

 

Salt – a forgotten killer

Excess salt intake directly increases blood pressure in most people, and exacerbates high blood pressure in people who already have this condition. “High blood pressure is not only caused by high salt intake, and factors such as genetics, obesity, fruit and vegetable intake, stress, smoking and a lack of exercise all contribute. However, reducing salt intake is a safe, affordable and effective strategy to reduce high blood pressure or avoid developing high blood pressure” says Prof Naidoo, CEO of the Heart and Stroke Foundation South Africa (HSFSA).

The World Health Organization (WHO) reports that it’s African region has the highest prevalence of high blood pressure globally. People of African origin are more prone to salt sensitivity, and excess salt is consumed through both liberal addition of salt to meals and as salt hidden in many processed foods. In South Africa, the prevalence of high blood pressure ranges from 30% to as high as 80% in adults over the age of 50 years (1) .

A world-leader in salt reduction

South Africa is ahead of the pack with ground-breaking legislation to limit the salt content of certain foods. June 2016 marked the implementation of these regulations that have reduced salt in commonly consumed foods such as breads, breakfast cereals, and processed meats. So far legislation has been hugely successful with most manufacturers complying, and some products have reduced salt content by 30 to 40%.

What can the food industry do?

During World Salt Awareness Week, WASH and the HSFSA are calling on manufacturers to put less salt in our food, and challenge everyone to read food labels and choose the lower salt options – it’s as easy as that! Salt legislation will reduce salt intake by approximately 0.85 grams per person per day, depending on the individual’s food choices. One study estimated that this level of salt reduction will result in 7 400 fewer cardiovascular deaths and 4 300 fewer non-fatal strokes every year in South Africa (2) .

The WHO recommends that total salt intake should not exceed one teaspoon a day, an amount equal to 5 grams. The average South African eats roughly 8.5 grams of salt per day (range of 6 – 11 grams), with some people eating significantly more than this (3) . Salt legislation is a good start, but it is inadequate to curb excess salt intake.

How do we eat so much salt?

“Salt intake is not easy to measure and is hidden in almost everything we eat, even sweet foods. When adding extra salt in cooking or at the table, all the pinches, shakes and grinds of salt add more salt than we actually need. One take-out meal can triple our salt limit for one day. Even something as simple as a cheese and ham sandwich can provide 2.5 grams of salt, already half the daily limit” says Gabriel Eksteen, Dietitian and Exercise Physiologist at the foundation.

Do YOU eat too much salt?

The Heart and Stroke Foundation SA launched an online salt calculator in 2015 in partnership with Unilever South Africa. This is the easiest way to see how much salt you eat, and which are the main salty culprits in your diet. The calculator has been carefully updated to improve accuracy and to reflect changes after salt legislation. Test your salt intake at www.saltcalculator.co.za . You may be surprised where your salt comes from!

How to reduce salt intake

Total salt intake includes what is already in the food, and what people add to food while preparing or eating the food. Choose foods wisely, keeping an eye out for food products with the Heart Mark logo and eat salty foods less often. How much salt is added at home is completely in the individual’s hands. When using salty ingredients like stock cubes, soy sauce or chicken spice as part of cooking, don’t add any further salt. Taste food while cooking and at the table, and think twice before adding more salt!

Get tested

One in every two South Africans with high blood pressure remain unaware of their condition. This prevents effective care and increases the risk of heart diseases and strokes. The HSFSA recommends that all adults test their blood pressure at least once every year. The public can get their blood pressure measured for free from 17 March until 9 April at all Dis-Chem pharmacies nationwide.

The next step forward

South African salt legislation will further reduce the salt levels of certain foods by 2019. Yet many foods are excluded from legislation, including fast foods. The HSFSA call on the fast food industry to clearly display the salt content of their meals, and to start reducing the salt content of their offerings. Graham MacGregor, Professor of Cardiovascular Medicine at The Wolfson Institute of Preventive Medicine and Chairman of WASH comments: “Salt damages our health. Salt reduction is the simplest and most cost effective measure to prevent thousands of unnecessary deaths from stroke and heart attacks every year. It is not just down to the individuals; manufactures must stop adding salt to our foods. During World Salt Awareness Week you can do something great for your health by eating less salt“.

 

1) Lloyd-Sherlock P, et al. Hypertension among older adults in low- and middle-income countries: prevalence, awareness and control.
Int J Epidemiol. 2014 Feb;43(1):116-28. doi: 10.1093/ije/dyt215

2) Bertram et al. Reducing the sodium content of high-salt foods: Effect on cardiovascular disease in South Africa. S Afr Med J
2012;102(9):743-745. DOI:10.7196/SAMJ.5832

3) Wentzel-Viljoen et al. “Use salt and foods high in salt sparingly”: a food-based dietary guideline for South Africa. South African Journal of Clinical Nutrition 2013; 26(3): S105-S113

Expert Tips for a Healthier Lifestyle

Chat 3 Comments February 22, 2017 nutritionadsa

February is national Healthy Lifestyles Awareness Month, with Healthy Lifestyles Awareness Day being celebrated on 22^nd February. The National Department of Health encourages all South Africans to live healthier lifestyles, through promoting healthy eating, regular physical activity, avoiding tobacco products, and drinking alcohol in moderation, if at all. But can improving our lifestyles have much of an impact on our health? According to the World Health Organization, the good news is that leading a healthy lifestyle can help to prevent 80% of premature deaths from heart disease and strokes and 60% of premature deaths due to cancer *.

A panel of health and wellness professionals, including dietitians, a psychologist, a sleep expert and a yoga instructor, give us their top tips on healthy eating, aiming to achieve balance, improving sleep and learning to relax to make our lifestyles healthier:

How to Get Healthy Eating Right

To transform poor eating habits into healthy ones, Raeesa Seedat, Registered Dietitian and ADSA spokesperson, says:

1. Start your day well: Eat breakfast! – Breakfast is linked to improved nutrient intakes, as well as improved concentration and alertness. Studies show that skipping breakfast is associated with increased stress, anxiety, depression, fatigue and tiredness.
2. Avoid temptation – The sight and smell of food is often enough to tempt us. Avoid keeping tempting but unhealthy foods around the house and avoid the treat aisles in the supermarket.
3. Shop smart – To avoid impulsive buying, plan your shopping with a budget and a list of what you need to buy and stick to it! If you don’t buy unhealthy foods, you won’t eat them.
4. Motivate yourself – Research shows that habits that don’t serve us can be overcome with good intentions. For example, having a conscious intention to eat healthier snacks helps to override a habit of making poor food choices.
5. Do not starve yourself – One of the most common triggers for unhealthy snacking is hunger. Eat smaller, more frequent meals. Do not get to the point where you are so hungry you could wolf down anything you get your hands on. Carry healthy snacks such as fruit, plain unsalted nuts or a tub of low fat yoghurt to work or school to snack on.

What small changes can we make to our daily eating that will help us move towards a healthier lifestyle? Kezia Kent, Registered Dietitian and ADSA spokesperson says:

1. Hydrate: Increase your daily water intake – being well-hydrated is important for overall health. Herbs such as mint, chopped fruit and lemon slices can all be used to make water more interesting. Remember that store-bought flavoured waters often have added sugar and should therefore be avoided.
2. Eat regularly through the day by trying to eat every 2-3 hours – Eating healthy snacks between main meals helps to maintain a healthy metabolism and can help to control portions at main meals. Your first meal or snack of the day should be within 90 minutes after waking up. Never skip meals.
3. Only eat until you feel satisfied – If you begin to feel uncomfortable or too full, then you’ve already eaten too much. If you still feel hungry after a meal, have some fresh vegetables with fat-free salad dressing.
4. Avoid eating while doing something else – eating while driving, watching TV, being on an electronic device or working prevents most people from actually realising what and how much they are putting into their bodies. Focusing on your food enables you to be aware of what your body wants and needs. Many also find they enjoy their food more and are more satisfied with what they have eaten.
5. Be active every day – it can be a considerable boost to your overall health to prioritize daily physical activity.   Even a short walk is better than nothing.

How to practice balance in your life

Raydene Naidoo, Psychologist from the South African College of Applied Psychology (SACAP) recommends:

• Focus on yourself from time to time and pamper yourself. You can’t expect others to nurture you if you can’t nurture yourself.
• Learn to say no without feeling guilty. Having reasonable boundaries is healthy, and it helps you to regulate how much you take on.
• Take time to nurture your relationships, especially with your loved ones.
• You are only human and you’re not always going to get the balance right. Rome was not built in a day. Allow yourself a cheat day but within moderation.
• Get a good night’s rest as often as you can, naps count too.
• Set SMART goals for yourself. Specific, measurable, attainable, realistic and time specific.

How to improve our sleep

Sleep is central to all body functions. By the time you are 30 years old, you have already slept for about 10 years. The basis of good sleep is to maintain good sleep hygiene. Dr Kevin Rosman from the Morningside Sleep Centre has this advice:

The sleep environment – the bed must be comfortable enough, the room quiet enough, dark enough, cool enough, and secure enough. Complete absence of sound would be the best, but is generally not possible. Second-best is a continuous quiet hum. Television is generally a bad idea. Sometimes double lining of the curtains may be necessary to keep the room dark enough. We sleep better at night when the environment is cool. If you have an air conditioner, for example, set the temperature to that which is comfortable for the “cooler” partner, and let the other simply add a blanket.

Winding down the brain – before going to sleep, one needs to give the brain a chance to wind down. Allocate between 30 and 60 minutes for this. Going to bed directly after working or after exercise can cause difficulty getting to sleep. Caffeine and alcohol can affect sleep, and sufficient time should be allowed after the consumption of these before getting into bed.

Regular sleep habits – because the body works on a number of different cycles, we sleep best at our usual bedtime. Getting up at the same time every day is also helpful.

How to relax more

An important part of a healthy lifestyle is stress reduction and stress management. Lexi Ryman, Co-Founder of Wild Thing Yoga & Body Conditioning, says “Taking time to switch off and quiet your mind is so important for so many reasons; for example, having your nose to the grindstone all the time limits our perspective, meaning we might not achieve our full potential.”

The practice of mindfulness underpins activities such as yoga and meditation. “Yoga is a form of moving meditation where your movement is guided by your own breath,” Lexi says “It is a complete and total mind-body-spirit overhaul and the benefits of practicing yoga range from the physical benefits of increased flexibility and strength right through to mental and emotional wellbeing.”

To practice mindfulness, start small. “Set your alarm clock for 10 minutes earlier in the mornings. Find somewhere quiet, with a comfortable seat. Close your eyes, and focus on your breath – allowing it to move freely in and out of your nose. Start with 5 minutes and see how you go from there. If you really aren’t a morning person, try it in the evenings. Tonight, instead of your usual routine of flicking on the TV when you get home, take a few moments, find a quiet space, no technology on or around you and just breathe. Find a way of moving your body that feels good in your body. Try out different exercise or yoga classes, until you find an environment that’s comfortable to you.”

To find a registered dietitian in your area who can assist you with a healthy lifestyle plan, visit www.adsa.org.za. 

* Global status report on noncommunicable diseases 2010. Geneva, World Health Organization, 2011

The facts about ADSA

Chat Leave a comment February 21, 2017 nutritionadsa

Have you ever wondered who ADSA is or why you should become a member? Read on to find out more about what ADSA does and how you can get involved.

The Association for Dietetics in South Africa, or ADSA, is the professional organisation for registered dietitians, and has been committed to serving the interests of dietitians in South Africa for the past 29 years. The Association is made up of a variety of members, from registered dietitians and nutritionists, to community service and student dietitians, international, retired and honorary members.

ADSA’s VISION: To represent and develop the dietetic profession to contribute towards achieving optimal nutrition for all South Africans.

ADSA’s MISSION: As the registered professionals in the field of dietetics and nutrition we support and promote the continued growth of the profession of dietetics in South Africa.

ADSA is a registered not-for-profit organisation (NPO) and unlike counterparts abroad, it is mainly driven by passionate and dedicated volunteers, most of whom are not remunerated for their time and services. The Executive (national) and Branch (provincial) Committee members serve for a 2-year term. Here are some of the many functions and activities the various portfolios are responsible for.

• President: directs, manages and guides the Association, oversees all its activities on a strategic level and builds strategic partnerships
• Communications: coordinates all internal communication with members, via the weekly bulletin and quarterly newsletters, managing ADSA’s website, and ADSA’s inputs into other scientific journals or newsletters, as well as co-ordinating a mentorship programme and bursary fund and being a member of the biannual national nutrition congress organising committee
• Public Relations: handles all aspects related to public relations, including planning and implementing nutrition and health-related awareness days, formulating and publicising statements based on evidence, acting as the official contact person for input into media content, monitoring of nutrition information communicated to the public and creating content to promote the profession in the public space, assisted by a team of spokespeople
• Sponsorship: recruits and manages suitable sponsors in line with ADSA’s updated rigorous sponsorship policy
• Representation: coordinates ADSA representatives on eight different official scientific or government groups or committees, as well as other interest groups, and manages the submission of comments to government on nutrition-related draft legislation
• Private Practicing Dietitians (PPDs): manages all professional issues relating PPDs, including the PPD database, addressing billing practices and providing assistance to PPDs on issues they may experience in private practice
• Continuous Professional Development (CPD): manages the accreditation of CPD events and online activities to create opportunities for continued education and upskilling of dietitians. Each year the 10 ADSA branches across the country are encouraged to host one CPD event per quarter and there has been on average 3 to 4 CPD-accredited events per branch per year. This portfolio also provides dietitians with access to latest scientific evidence, guidelines and resources through PEN.
• Membership: manages membership applications and coordinates member benefits. Liaises with members and non-members to establish needs to enhance membership benefits.
• Public Sector: establishes a support network and line of communication between dietitians in the public sector and ADSA, and communicates relevant developments, such as employer/labour negotiations to ADSA members
• Branch Liaison: acts as the communication link between ADSA branch chairpersons and the national Executive Committee to ensure consistency in operations
• Secretary: assists with organisational tasks for the Executive Committee, such as taking meeting minutes and record keeping
• Chief Operating Officer: part-time employed dietitian to assist with public relations, attend meetings on behalf of ADSA, and assist with other executive portfolios as and when required

The ADSA Executive and Branch Committee portfolio holders strive to meet the needs of the members they serve, by being in constant communication with members. This means that ADSA policy and strategic direction is continuously evolving to meet the changing needs of nutrition professionals in South Africa. Recent significant changes include an updated sponsorship policy, that includes a stricter process of selection and is based on international standards, as well as a review of membership benefits to determine the most appropriate fee structure. ADSA’s Constitution was also recently reviewed and updated to reflect the growth of the nutrition profession.

If you are a registered dietitian, nutritionist with a recognised nutrition degree, community service or student dietitian, we invite you to join us today. As your professional organisation, the more members we have, the stronger our collective voice, and the more we can do to achieve our vision and mission to grow the profession and to promote the nutritional well-being of our country.

To find out more about the benefits of joining ADSA or to find a registered dietitian in your area, visit http://www.adsa.org.za.

The Low Down on South Africa’s Sugar Tax

Chat Leave a comment January 17, 2017 nutritionadsa

The Minister of Finance announced in the February 2016 National Budget a decision to introduce a tax on sugar-sweetened beverages (SSBs), with effect from 1 April 2017, to help reduce excessive sugar intake by South Africans. The Association for Dietetics in South Africa (ADSA) welcomes this step as one part of the solution to address the obesity problem and improve the health of South Africans.

How much sugar do South Africans really consume?

When you think of sugar-sweetened beverages, the first thing that comes to mind is the regular fizzy drink, but the term encompasses far more than that. SSBs are beverages containing added sweeteners that provide energy (‘calories’ or kilojoules) such as sucrose, high-fructose corn syrup or fruit-juice concentrates. This includes carbonated drinks (fizzy soft drinks and energy drinks), non-carbonated drinks (sports drinks, iced teas, vitamin water drinks and juice concentrates), sweetened milk drinks and sweetened fruit juices. And many of us do not realise just how much sugar is found in these drinks. For example, a 330 ml bottle of iced tea has a little over 6 teaspoons of sugar!

ADSA is concerned that the intake of added sugars (sugars added to foods and drinks during processing by the food manufacturing companies, cook or consumer) is increasing in South Africa, both in adults and children. Some estimate that children typically consume approximately 40-60 g/day of added sugar, possibly rising to as much as 100 g/day in adolescents. High intakes of added sugar, particularly as SSBs, has been shown to lead to weight gain and cause dental caries. The added sugar in these drinks makes them high in energy (kilojoules). Because these drinks don’t make us feel full in the same way that eating food does, most of us don’t reduce our food intake to compensate, making it easy to consume too many kilojoules. Over time, these extra kilojoules can cause one to become overweight, putting us at risk for diabetes, heart disease and certain cancers. Obesity is already a massive problem in South Africa, with 2 in 3 women and 1 in 3 men being overweight or obese, as well as almost 1 in 4 children.

What is ADSA’s recommendation for sugar intake?

ADSA supports the recommendations by the World Health Organization (WHO) and the South African Food-Based Dietary Guidelines that we need to reduce the intake of beverages and foods that contain added sugars, such as sugar-sweetened beverages, sweetened yoghurts, frozen desserts, some breakfast cereals, ready-to-use sauces, cereal bars, health, savoury and sweet biscuits, baked products, canned or packaged fruit products, sweets and chocolates. The WHO advises reducing the intake of free sugars found in foods and beverages (including added sugars, but excluding sugars naturally present in fresh fruits, vegetables and milk) to less than 10% of total energy (kilojoule) intake for the day (i.e. 50 g of sugar, which is approximately 12 teaspoons per day), with a conditional recommendation to further reduce intake to 5% of total energy (approximately 6 teaspoons per day) for additional health benefits. The South African Food-Based Dietary Guidelines also advise to ‘use sugar and foods and drinks high in sugar sparingly’. To put this into perspective, a 500 ml bottle of a carbonated drink will provide your maximum sugar allowance for an entire day!

The sugar tax – is it a good idea?

The proposed tax on SSBs will mean roughly a 20% tax will be added on to sugary drinks, which is intended to decrease the purchase and consumption of SSBs. Encouragingly, in Mexico, a sugar tax has reduced sugary drink sales by 12% in the first year. The sugar tax is likely to affect shelf prices, but will also motivate manufacturers to reduce the amount of sugar added to their products.

ADSA welcomes the proposed tax on SSBs, but acknowledges that the sugar tax is only part of the solution to address the growing obesity problem. Just as taxing tobacco does not reduce or stop smoking by all people, taxing SSBs will not reduce or stop all purchasing and consumption of SSBs and reduce obesity on its own. Obesity is a complex condition, and sugar is not the only cause. There is a need for multiple interventions across a variety of different sectors to address unhealthy diets and lifestyles and have an impact on the obesity epidemic. ADSA recommends that revenue generated from the tax should go towards health promoting interventions, such as subsidies to reduce the costs of fruits and vegetables, education around healthy choices and creating an enabling environment to make those healthier choices easier.

In addition to reducing the consumption of SSBs to prevent obesity and promote long-term health, ADSA continues to recommend a healthy diet which includes whole grains, fruit, vegetables, nuts, legumes, healthy oils, proteins such as lean meats and seafood, and a reduced intake of processed meats and salt, accompanied by regular physical activity.

ADSA’s detailed Position Statement on the Proposed Taxation of Sugar-Sweetened Beverages, with references, can be accessed here: http://www.adsa.org.za/Portals/14/Documents/2016/Nov/ADSA%20Position%20Statement%20on%20Sugar%20Tax_Final_28%20Nov%202016.pdf

 

10 Healthy Ways to Survive the Festive Season Eating Frenzy

Chat Leave a comment December 15, 2016 nutritionadsa

Every year the festive season arrives and all our healthy eating plans go out of the window. There is no doubt that time to relax and enjoy ourselves is important to our well-being, but we tend to over-indulge in rich foods, sweet treats and alcohol. At the same time, we are cutting back on regular physical activity and staying up too late, too often.

This is not to say that we shouldn’t allow ourselves to indulge a little, but allow for eating in moderation and maintaining a varied diet. Ditching your weight loss or weight management plans, or letting go of your health conscious habits over the festive season stresses both body and mind. Of course, you want to enjoy yourself, and it’s certainly not the time to feel deprived, but you can avoid the holidays becoming an extended binge by using strategies to moderate the inevitable excesses.

We asked a team of registered dietitians from ADSA (Association for Dietetics in South Africa) to give us their top tips on how to balance holiday fun with staying healthy, and here’s what they have to say:

Surviving holiday parties: Don’t attend a party on an empty stomach – grab a small healthy snack before you go. When you get there, don’t rush to eat – socialize and settle into the festivities before you eat and keep your socializing away from the buffet table or appetizer trays – to help limit nibbling. (Cheryl Meyer)

Eat mindfully: The buffet table is an invitation to eat all you can, so first survey what is available, choose the foods you really want to eat, and then move away. Eat slowly, focusing on enjoying the taste and smell of each bite. (Jessica Byrne)

Eat what you love, leave what you like. Be picky – don’t deny indulges, but only eat treats that you really love – avoid “wasting” calories on non-favourites. Think quality rather than quantity. (Cheryl Meyer)

Make water your MVP (most valuable player) this holiday season:  Jazz it up with lemon, cucumber or even fruit cubes like watermelon ice cubes, adding an element of holiday indulgence to plain water. Also try plain fruit or herbal tea for a change.  Water and tea can help fill you up preventing holiday overeating or even overindulging in alcohol or fizzy drinks, both loaded with calories/ energy. (Hlanzeka Mpanza)

Balance less healthy meals with healthy ones: Choose only one less healthy item or meal per day.  For example: one day an English breakfast, the next day an ice cream and the next day a take away, but not all three on one day. Ensure the other meals are healthy by eating lots of fresh vegetables and fruit. (Zelda Ackerman)

Be a snack smuggler: Travelling, shopping and lack of routine during the holidays can lead to skipping meals, or grabbing that seemingly convenient fast food. To keep your appetite in check, never leave home without a snack. Fruit makes a refreshing and no fuss snack, and a small packet of unsalted nuts can easily fit in your handbag for when the hunger hits. (Jessica Byrne)

Avoid after-dinner nibbles and snacks: Those chocolates and biscuits that come out after an indulgent lunch or dinner are unnecessary calories and will probably only make you feel more uncomfortably full. (Lila Bruk)

Have your cake and eat it too: If you do have one of the many sweet treats on offer, keep your portion size as small as possible and choose the healthiest of what you can find. For example, generally fruit-based cakes and desserts are better choices, so an apple tart would be a better option than a chocolate cake, especially if you don’t eat all the pastry. (Lila Bruk)

Start your day with a wholesome breakfast: Have a low GI breakfast such as oats, wholegrain cereal or wholewheat toast with avocado or eggs. This will not only keep you satisfied, your sugar levels stable and hunger pains at bay, but will also prevent you from snacking on sugary treats that are empty calories with little nutrients. (Lucinda Lourens)

Get moving with friends and family: Spend quality time with friends and family these holidays, but instead of catching up over coffee and cake, make the most of the warm weather and plan to do something where you can be active together. Meet for a walk on the beach or get a group together and go for a hike. Go for a swim, or get the whole family involved in a post-lunch stroll around the neighbourhood. (Jessica Byrne)

This ADSA NutritionConfidence recipe, created by Chef Vanessa Marx, is perfect for keeping your health on track this holiday, while still indulging in delicious festive food: “Grilled Ostrich Fillet with Egyptian Dukkah and Cucumber Raita”.

Ostrich is a truly South African and healthy alternative for the braai this festive season! The raita bursts with flavour while being low in sugar and fat. Ostrich meat is a great alternative to other ‘red meat’ sources. Classified as a ‘white meat’ due to its fat content, it’s low in fat (even lower than some chicken cuts) and saturated fat; but also a good source of biologically available iron. This makes a great pairing with the “Spinach, Beetroot and Pomegranate Salad”.

What your dietitian wants you to know about diabetes

Chat 1 Comment November 15, 2016 nutritionadsa

There were 2.28 million cases of diabetes in South Africa in 2015 according to the International Diabetes Foundation and around 1.21 million people with undiagnosed diabetes. Considering these numbers it remains vitally important to continue educating South Africans about diabetes and to address the myths that are often associated with this lifestyle disease.

Nasreen Jaffer, Registered Dietitian and ADSA (Association for Dietetics in South Africa) spokesperson has a special interest in diabetes. She debunks some of the myths surrounding diabetes and nutrition:

People with diabetes have to follow a special diet or have to eat special diabetic foods.

People with diabetes do not have to follow a ‘special’ diet. People with diabetes need to make the same healthy eating choices as everyone else. Healthy eating choices include vegetables and fruit; whole grains; fish, lean meats and poultry; dairy products; seeds, nuts, legumes and plant oils. Everyone needs to limit fatty red meats, processed meats, salt and foods high in salt, and foods and beverages with added sugar.

There are foods that should be avoided completely.

The answer, is ‘no’. Moderation is key, the minute you’ve banned a certain food entirely, you’re likely to start craving it intensely. Your health and weight are more affected by what you do daily than what you eat once or twice a week, so if you’re in the mood for a piece of cake once in a while, buy a small one and share. If you deprive yourself of something you’re craving, it’s just a matter of time until your binge on it and sabotage your motivation. However, crisps, chocolates, and sweets are high in saturated and trans fat, while sugar-sweetened beverages like soft drinks, iced tea and energy drinks contain a large amount of sugar, so these have to be limited.

 If I am diabetic, my diet is going to be more expensive.

It is not necessary to buy expensive foods marketed to diabetics. Healthy eating can be economical, and is often cheaper than buying unhealthy treats. Buying seasonal fresh fruit and vegetables is cheaper than buying fruit juices and sugar-sweetened beverages. If you replace sweets, chocolates, crisps, puddings and cakes with fruits, yoghurt and salads as your snacks and desserts, you’ll find you will save money. Legumes, such as lentils and beans, are cheaper alternatives to red meat, while providing numerous health benefits.

Eating too much sugar causes diabetes.

Too much sugar does not necessarily cause diabetes, but because foods and drinks with added sugar are often energy-dense (high in kilojoules), consuming too much of these on a regular basis can lead to weight gain. This can put us at risk for type 2 diabetes. Sugar-sweetened beverages seem to have the strongest link to type 2 diabetes. ‘Sugar’ doesn’t only refer to the sugar added to tea and coffee, but also includes sugar and sweetened products added when cooking and at the table. Look out for hidden sugars in pre-prepared and processed foods, like some breakfast cereals, sweetened drinks, dairy products, sauces and sweet treats. People with diabetes should limit or avoid adding sugar as it can have a negative effect on blood sugar levels.

 People with diabetes cannot eat carbohydrates.

No, this is not true. While all foods that contain carbohydrates will affect your blood sugar levels, people with diabetes can still eat carbohydrate foods. There are healthy types of carbohydrates that you do want to include in your eating plan, and the type or quality of carbohydrate foods is important. Therefore, for optimal blood glucose control it is important to control the quantity, and distribute carbohydrate foods equally throughout the day. For example, choose wholegrain or high-fibre carbohydrate foods as they don’t increase blood sugar as quickly as refined grains, and make sure that each meal is balanced, containing not only carbohydrate foods, but also protein or dairy, non-starchy vegetables or healthy fats.

People with diabetes should restrict their fruit intake.

Because fruit contains natural sugars, too much fruit can contribute to an increase in blood glucose levels. However, eating fruit also adds fibre, and essential vitamins and minerals to the diet, so while people with diabetes should not eat excessive amounts of fruit, fruit should not be completely eliminated. Portion control is important, and people with diabetes should choose whole fruit rather than fruit juice. It is recommended that you consult your dietitian to calculate the amount of fruit that you should include in your daily diet.

If one of my parents has diabetes, there is nothing I can do about it – I will develop diabetes eventually.

If you have a genetic predisposition to type 2 diabetes, you have all the reason you need to embrace a healthy lifestyle. While genetics may contribute 30 to 40% to the development of any condition, including diabetes, environmental and lifestyle factors may have a 60 to 70% impact. If you maintain a healthy body weight, stick to a healthy eating plan, avoid tobacco use and keep physically active regularly, you have a very good chance of not developing diabetes.

If I have diabetes, I can’t exercise.

On the contrary, diabetes is a compelling reason to exercise regularly. The reason for this is that physical activity plays a very important role in lowering blood glucose levels. Exercise also predisposes your body cells to being more sensitive to insulin, and of course, it helps to achieve and maintain a healthy body weight. Aim for at least 150 minutes of moderate intensity activity a week, such as brisk walking, while doing some resistance or strength exercises at least twice a week. If you use insulin it is important to check your blood glucose levels before and after physical activity. If you get results below 6 mmol/l it is recommended that you lower your insulin dose or eat a healthy snack to prevent a hypoglycemic attack during or after exercise.

Early diagnosis of diabetes is vitally important. This year the theme of World Diabetes Day is “Eyes on Diabetes”, focusing on the screening for type 2 diabetes to ensure early diagnosis and treatment, which can in turn reduce the risk of serious complications. The sooner that elevated blood glucose levels can be treated and returned to normal, the better. If you are diagnosed with either pre-diabetes or diabetes, you need to start moving towards a healthier lifestyle that focuses on regular physical activity, good nutrition and weight-loss if you are overweight or obese.

Everyone over the age of 45 years should be screened for diabetes every 2 to 3 years, or earlier if you are overweight and have other risk factors for diabetes (such as a family history, high blood pressure or previous diabetes during pregnancy). If you haven’t yet been screened, visit a healthcare professional to find out if you are at risk.

Should you experience any of the following symptoms contact your doctor as soon as possible – sudden weight loss, hunger, blurred vision, tiredness, excessive thirst and frequent urination.

To find a registered dietitian in your area who can assist you with a diabetic-friendly lifestyle plan, visit www.adsa.org.za.

 

Why dietitians want you to love your beans!

Chat Leave a comment October 12, 2016 nutritionadsa

In celebration of National Nutrition Week: ‘Love your beans – eat dry beans, peas and lentils’ (9 to 15 October), we chatted to a few dietitians to find out why these foods, also known as pulses, should form an essential part of our diet.

To find out more about why beans are good for health, how to cook them, how to prepare them, snack ideas and great recipes, join the #LovePulses Twitter Talk on Wednesday, 12 October at 1pm (SA time) – follow our @ADSA_RD Twitter handle or the hashtag #LovePulses.

Why pulses?

• “Pulses are very economical in this tough economic time. Add pulses to meat dishes like mince and stews to bulk up your dish and make it go further”, says Registered Dietitian and ADSA (Association for Dietetics in South Africa) spokesperson, Monique Piderit.
• Beans, peas and lentils add a great variety to meal preparation, are affordable and good for our earth. – Nazeeia Sayed, RD (SA)
• Pulses are a good, inexpensive source of protein. – Kelly Schreuder, RD (SA)
• Pulses help to keep your blood sugar steady (making them a great option for diabetics) and lower your cholesterol. – Zelda Ackerman, RD (SA)
• Pulses are high in soluble and insoluble fibre, aiding good digestion and keeping you regular. – Mpho Tshukudu, RD (SA)
• Beans, peas and lentils are low in sodium, and provide important minerals like potassium and calcium, which can improve blood pressure. – Jessica Byrne, RD (SA)
• Pulses are a good source of plant-based iron and have a low glycemic index, keeping you fuller for longer. – Cath Day, RD (SA)

Cooking tips for pulses

• Tinned chickpeas, beans and lentils are just as nutritious as the dried versions. Stock up on tinned pulses for quick emergency meals, e.g. chickpeas and tuna, mince with tinned lentils or add tinned beans to your favourite salad. – Monique Piderit, RD (SA)
• Soak in the morning (ahead of cooking in the evening) using boiling water or use canned varieties to cut down on cooking time. – Nazeeia Sayed, RD (SA)
• Add salt at the end of the cooking process. Adding it at the begin increases cooking time and hardens the skins. – Mpho Tshukudu, RD (SA)
• Soaking and rinsing dry beans before cooking, as well as rinsing canned beans in water, can help to reduce hard to digest carbohydrates, which could cause flatulence in some individuals. – Jessica Byrne, RD (SA)
• Rinse tinned legumes well before serving, as this increases your tummy’s tolerance to beans, lentils and chickpeas. – Cath Day, RD (SA)

Great, easy snack ideas for pulses

• Drain a tin of chickpeas and place in a roasting pan drizzle with olive oil, cumin, paprika and black pepper. Roast for around 40 minutes for a quick and easy roasted chickpea snack. Store in an airtight container for a quick snack on the go. – Monique Piderit, RD (SA)
• Pulses can be used to make tasty dips, e.g. pureed chickpea and butternut, or white bean dip (flavoured with a little vegetable oil, garlic, lemon juice, sprinkling of salt and herbs).  Dips can be enjoyed with veggie sticks or crackers. – Nazeeia Sayed, RD (SA)
• Or keep it even simpler and just mash or blend pulses with garlic, herbs and spices for a delicious, healthy spread or dip. – Kelly Schreuder, RD (SA)
• Lentils are quick and easy to cook together with your brown rice, pearled barley or crushed wheat. – Zelda Ackerman, RD (SA)

“Pulses should be a regular part of a family’s healthy eating plan and can be used in a wide variety of dishes. Aim to include them in your diet at least four times a week,” says ADSA spokesperson, Jessica Byrne.

Love your beans for good health

Chat Leave a comment October 10, 2016 nutritionadsa

South Africa celebrates National Nutrition Week from 9 to 15 October, and aligning to the Food and Agriculture Organization of the United Nations (FAO) which has declared that 2016 is the ‘International Year of Pulses’, this year’s campaign theme is ‘Love your beans – eat dry beans, peas and lentils!’ echoing the country’s food-based dietary guideline to ‘eat dry beans, split peas, lentils and soya regularly’.

“There’s a good reason to put dry beans, peas, lentils and soya into the spotlight. Unfortunately, they are largely overlooked as they are often seen as a ‘poor man’s food’ and they can take a long time to cook. We should be eating them, along with a variety of foods, at least four times a week; and yet, many of us hardly include them in our diets. There’s just not enough awareness of how they contribute to healthy lifestyles, or how to use them well to make delicious meals,” says Ms Lynn Moeng-Mahlangu, Cluster Manager of Health Promotion, Nutrition and Oral Health at the National Department of Health. “However, this National Nutrition Week, we hope to share tips and recipes to inspire South Africans to eat more beans, peas, lentils and soya. For information on these tips, access the National Nutrition Week website”.

National Nutrition Week is a joint initiative by the Department of Health, the Association for Dietetics in South Africa (ADSA), the Nutrition Society of South Africa (NSSA), the Consumer Goods Council of South Africa (CGCSA), the Heart and Stroke Foundation South Africa (HSFSA) and the Consumer Education Project of Milk SA (CEP). “We are delighted that this year’s theme highlights these affordable, versatile and tasty foods that make such a vital contribution to our health when they are a regular part of the family’s healthy eating regime,” says ADSA President, Maryke Gallagher.

So much nutrition advice is centred on what we need to eat less of, but when it comes to pulses – your dry beans, peas and lentils – the message is about eating more!

Carol Browne from the NSSA highlights some benefits of pulses. “Beans, peas and lentils also provide exceptional nutritional value for money, having a high micronutrient to price ratio. What’s more, they improve soil fertility, are water efficient and have a smaller carbon footprint, promoting environmental sustainability.”

The top nutritional benefits of eating dry beans, peas, lentils and soya are that:

• They are low in fat, high in fibre and have a low glycaemic index
• They are naturally cholesterol-free
• They are naturally gluten-free
• They are a good source of plant protein, providing twice as much protein as wheat
• They are good sources of vitamins such as folate and minerals such as potassium and calcium

According to Professor Pamela Naidoo, CEO of the HSFSA, “Including dry beans, peas, lentils and soya regularly in your diet, along with other health promoting behaviours, contributes to better health, helping to improve blood pressure and the maintenance of a healthy weight, reducing the risk for conditions such as diabetes, heart disease and strokes.”

When it comes to cooking, pulses are wonderfully versatile and can be incorporated into the diet in many ways. “Pulses are excellent when used as the main ingredient in a vegetarian meal,” Linda Drummond from the CGCSA points out, “Or they can be used as an affordable way to extend meat in something like a meat stew or a bolognaise sauce. Cook up a large batch, portion and freeze to use to make a quick meal like soup or a bean salad.” As part of National Nutrition Week activities, a host of recipes celebrating beans, peas and lentils in tasty dishes are available on the National Nutrition Week website.

“Some people experience bloating and gas as a result of eating beans, but we would like to highlight steps that can be taken to prevent this from being a reason why many don’t include these nutritious foods in their eating plans”, says Maretha Vermaak from the CEP of Milk SA. Vermaak advises people to start with small amounts to build up one’s tolerance over time and to soak dry beans before cooking.

On Wednesday, the 12^th of October, ADSA (@ADSA_RD) will be hosting a Twitter Talk from 13h00 to 14h00 where dietitians and National Nutrition Week partners will be answering questions such as: Why are beans, peas and lentils good for health? How do we avoid getting bloated and windy after eating beans? What is the best way to prepare dry beans for cooking? How do I introduce more dry beans, lentils and peas into my children’s diet? What are some ways we can use beans, peas and lentils in meals and snacks? Join the conversation live on Twitter, follow the @ADSA_RD handle or track the hashtag #LovePulses to get great ideas and tips that will help you and your family to love dry beans, peas and lentils. The Department of Health in the various provinces will also celebrate National Nutrition Week during the month of October.

For more information on National Nutrition Week 2016, please visit the website: http://www.nutritionweek.co.za/

Time To Make Lifestyle Your Medicine

Chat Leave a comment September 28, 2016 nutritionadsa

103041_262 — GOOD MORNING AMERICA — DR. DAVID KATZ GM05 (CREDIT: ABC/ Ida Mae Astute )

“We could, as a culture, eliminate 80 percent of all chronic disease,” says Dr David Katz, one of the world’s leading proponents of lifestyle as medicine, during a recent visit to South Africa. “But my family and yours cannot afford to keep on waiting on the world to change. By taking matters into our own hands, we can lose weight and find health right now. We can reduce our personal risk of chronic disease, and that of the people we love, by that very same 80 percent. We can make our lives not just longer, but better.”

As current President of the American College of Lifestyle Medicine, the premise of Dr Katz’s work is based on the evidence of a litany of studies published since 1993 that show that around 80% of all chronic disease can be attributed to a particular short list of lifestyle behaviours. This is why cancers, cardiovascular disease, strokes, diabetes, dementia and other common killers are now commonly known as ‘lifestyle diseases’. Researchers have argued that they are not, in fact, ‘causes’ of death, but rather the tragic effects of disease-causing behaviours embedded in our lifestyles. As Dr Katz points out, the good news for us is that it means that 80% of chronic diseases are preventable if we make the necessary lifestyle changes.

“If you consider,” he says, “that a wealth of research has shown that people who eat well, exercise routinely, avoid tobacco, and control their weight have an 80% lower probability across their entire life spans of developing any major chronic disease, then we realize that this combination of not smoking, eating healthily, being physically active and managing weight is perhaps the greatest advance in the history of medicine.”

Internationally, Dr Katz is renowned for drawing our attention to what we are doing with our ‘fingers, forks and feet’. What we most need to reduce our risk of the most common diseases is to make sure our fingers are free of cigarettes, our forks are full of healthful food and that our feet carry us a fair distance each day. Stopping smoking may be hard, but it is a clear and possible goal. Body Mass Index (BMI) is a rougher measure, but it still serves to give us a fair enough indication of what our healthy weight should be. We know that at least 30 minutes of physical activity a day will go a long way to both managing weight and staying physically strong and limber.

However, with one fad diet after another capturing media attention and shifting us wilfully from low-fat to low-carb, from high-fat to high-protein, from vegan to carnivorous, there is unnecessary confusion and complexity about what really constitutes healthy eating.

Dr Katz cuts through the clamour of ‘the latest, greatest diet’ phenomenon by championing the simple, common sense advice of writer, Michael Pollan: “Eat food. Not too much. Mostly plants.” (In his book ‘In Defence of Food: Eater’s Manifesto’, Pollan expanded on what he means by ‘Eat food’ to assert that we should ‘avoid eating anything your grandmother wouldn’t recognize as food’.)

What most countries’ most recent dietary guidelines have in common is the recommendation of eating patterns that are higher in vegetables, fruits, legumes, nuts, whole-grains and seafood; and lower in red and processed meats, sugar-sweetened foods and beverages, as well as refined starches. As Dr Katz pointed out: “Additional strong evidence shows that it is not necessary to eliminate food groups or conform to a single dietary pattern to achieve healthy dietary patterns. Rather, individuals can combine foods in a variety of flexible ways to achieve healthy dietary patterns, and these strategies should be tailored to meet the individual’s health needs, dietary preferences and cultural traditions.”

“It was wonderful to experience a leading international authority supporting a message that is at the very core of the work of South African dietitians,” says Association for Dietetics in South Africa (ADSA) spokesperson, Cath Day, “Just because it can be such a profitable industry, there’s always going to be a ‘new’ idea for the next ‘right’ diet, which is usually based on some or other distortion of scientific evidence. But what Dr Katz emphasises is that, as nutrition professionals we already know exactly what balanced healthy eating is, and it is never going to be one single eating regime for everyone to follow. What we eat is rooted in our diverse cultures, affected by availability and influenced by our individual tastes. It is always possible for a person to transform to a healthy diet while fully taking into account their unique circumstances around food; and this is exactly what our dietitians work with clients to achieve.”

Dr Katz pointed out to the South African nutrition community that what conspires mightily against a culture of healthy eating in Western societies is far less about the distracting ‘noise’ of the latest fad diet. Instead he urged that the focus should remain steady on the proliferation and accessibility of a vast array of highly processed, fast and convenient foods which have invaded our eating regimes and are overwhelming our habits of sourcing fresh, natural foods and preparing healthful home meals from scratch.

“If lifestyle is the medicine, it is culture that is the spoon that makes the medicine do down,” concludes Katz. The trouble is that we currently have a culture that largely values convenience over health, and we make lifestyle choices, including what we do with our fingers, forks and feet accordingly.

Dr David Katz was in South Africa to speak at the 2016 South African Nutrition Congress hosted by the Nutrition Society of South Africa (NSSA) and ADSA. He invited the South African Nutrition community to join http://www.truehealthinitiative.org/ an international coalition uniting nutrition experts in the global consensus on lifestyle a medicine.
To find a dietitian in your area who can assist you with a healthy eating lifestyle plan, visit www.adsa.org.za

Get ready for National Braai Day!

Chat Leave a comment September 22, 2016 nutritionadsa

In celebration of one of South Africa’s favourite past times (braaing) and the day dedicated to it (National Braai Day) our dietitians, Monique Piderit and Brigitte Leclercq, have put together some practical tips for a healthier braai:

• A braai is a great excuse to get your greens in. Be creative when doing this, such as making interesting salads.
• Try alternate your protein sources instead of only eating red meat, which may become boring after a while- try something like stuffed fish (stuff with nectarines for something different)- always make sure you are making a sustainable choice such as choosing fish from the green SASSI-approved list.
• Grilled chicken and vegetable kebabs are an easy way to get your vegetable intake, without anyone noticing.
• Have a healthy snack before you go out for a braai. This will prevent you from being overly hungry when you arrive and less tempted to over-eat on snacks. If you are hosting the braai, be sure to start your fire early enough to eat at a reasonable hour. The later the lunch, the longer you may sit mindlessly nibbling away on unhealthy snacks.
• To keep your guests cool in the summer sun, serve cold water. Add colour and flavour using mint, lemon slices or strawberries, and top with lots of ice.
• Choose chicken or fish over red meat. Select barbeque basting to still ensure flavour. Flavour your food with fresh herbs and spices, and limit the use of salt.
• Leave condiments and toppings off starters, salads and side dishes. Substitute for flavour with lower fat condiments such as lemon juice, pepper, mustard, salsa and Tabasco. Make a potato salad with low-fat mayonnaise, or mix half mayo with low-fat yoghurt for a creamy alternative.
• Surprisingly, even salads at a braai can be laden with unnecessary calories by the addition of croutons, bacon bits, cheeses and salad dressings. Look for garden salads with more vegetables than high fat ingredients. Fill up half of your plate with healthy salad and veggies.
• Request that the host not dress the salad or ask for a portion before doing so. Add a splash of balsamic vinegar and olive oil and some black pepper instead of a pre-prepared salad dressing. Alternatively, offer to bring a salad to ensure you have a healthy option of veggies at the braai.

The weather promises to be amazing, so join friends and family to celebrate our heritage and braai!

 

Why breastfeeding should be everybody’s business

Chat Leave a comment August 1, 2016 nutritionadsa

It is common sense that ‘breast is best’ when it comes to feeding infants and young children. After all, breast milk is uniquely, organically fit for a singular purpose. Yet, South Africa has an extraordinarily low rate of babies breastfeeding exclusively in the first six months of their lives. In fact, at just 8% against a global rate that is almost 40%, the South African statistic is regarded by UNICEF as one of the lowest in the world. (http://www.unicef.org/southafrica/media_10469.htm)

The World Health Organisation (WHO) defines optimal infant and young child nutrition as breast milk exclusively up until the age of six months; and then breast milk supplemented by safe and appropriate foods up until the age of two years, or beyond. (http://www.who.int/nutrition/publications/infantfeeding/9241562218/en/)

“There is a significant body of scientific evidence that informs these global nutritional guidelines and attests to the many benefits of breastfeeding when it comes to the health and well-being of not just baby, but Mum as well,” says Cath Day, ADSA (Association for Dietetics in South Africa’s) spokesperson. “For instance, new research presented in The Lancet, an international medical journal, states that optimal breastfeeding could save the lives of 823 000 children a year, and there’s substantial evidence that breastfeeding can help to ward off breast and ovarian cancers in mothers too.”

With World Breastfeeding Week spanning the 1^st to the 7^th of August, we face the reality that the majority of women all over the world, but particularly in South Africa, don’t meet accepted international, or national, nutritional guidelines for breastfeeding their babies because they experience strong, often, culturally-institutionalised barriers to breastfeeding. And, that is why we all have a part of play in transforming the country into an enabling environment that properly supports, encourages and upholds breastfeeding mothers.

Over the past years, South Africa has taken steps to rectify the provision of inaccurate information by health care providers and implemented measures to mitigate the aggressive corporate marketing of breast milk substitutes which undermine breastfeeding. In addition, the country’s employment laws have enshrined the rights of mothers with infants under six months, who have had to return to work, to take two 30-minute breaks during work hours to express milk. (http://www.labour.gov.za/DOL/downloads/legislation/acts/basic-conditions-of-employment/Amended%20Act%20-%20Basic%20Conditions%20of%20Employment.pdf)

But clearly this is not enough, as reviews show we have stagnated at the exceedingly low rate of 8% for years on the most important marker of infant nutrition.

“The proper support needed to achieve the scale of breastfeeding that would meet global guidelines and significantly improve infant mortality in South Africa has to be multi-level and multi-pronged,” says Thembekile Dlamini, also a Registered Dietitian and ADSA spokesperson. “That is why breastfeeding should rather be viewed as ‘everybody’s business’ versus an activity that a mother feels she needs to guard and hide, perhaps even in her own home, family environment, workplace and community. A positive attitude to breastfeeding needs to permeate all aspects of South African society, across all socio-economic levels.”

This highlights the reality that breastfeeding as the source of optimal and exclusive infant nutrition is unfortunately, too often, transformed from a natural, basically unremarkable human activity securely bolstered not just by straightforward good sense but by modern scientific evidence too, into a contentious nutritional fashion or a fad, buffeted by fleeting, often self-serving opinions, agendas and perceptions.

Everyday barriers that breastfeeding women experience range from partners who are unsupportive due to self-interest to grandparents who morally disapprove of public breastfeeding. Corporate environments may not provide suitable facilities, nor accept the routines for lactating mothers who are back at work.

Let’s find ways and work together to support women who are trying to give their children the best start in life:

• Fathers and partners who are informed about the benefits of breastfeeding and supportive of a breastfeeding mother can have a major influence on successful outcomes
• Other family members, particularly grandmothers and aunts, who a mother might turn to for advice and support also have a considerable influence to bear when it comes to encouraging or discouraging breastfeeding
• Mothers also often rely on advice and support from their friends, especially those who might be more practiced mothers than they are. While there is much value in friends’ sharing their experiences of motherhood, the breastfeeding advice you give should be objective. Mothers who are experiencing difficulties with breastfeeding should be encouraged to get professional help before considering giving it up
• Employers can support breastfeeding mothers who have returned to work to establish a routine to express milk in private and comfortable surrounds

 

Breastfeeding support is available in South Africa:

• Mothers can obtain professional help with breastfeeding from lactation consultants, who are health professionals with advanced training in breastfeeding support http://www.salactationconsultants.co.za/index.php
• La Leche League South Africa is a voluntary organisation which provides information and support to women who want to breastfeed their babies. La Leche League Leaders are experienced breastfeeding mothers, trained and accredited by LLL, who are happy to help other mothers with questions and concerns about breastfeeding http://www.llli.org/southafrica.html

• Milk Matters is a community-based breast milk bank that pasteurises and distributes donations of screened breast milk from healthy donors to premature, ill and vulnerable babies whose own mothers cannot supply the breast milk to meet their baby’s needs. Their website has valuable information for breastfeeding mothers http://milkmatters.org/breastfeeding-breastmilk/

 

Breastfeeding provides the foundation for lifelong health and wellbeing. This year, the World Breastfeeding Week theme is ‘Breastfeeding: A Key to Sustainable Development’. The website is packed with useful and interesting information on wide range of positive impacts of breastfeeding on society and the planet http://www.worldbreastfeedingweek.org/resources.shtml

 

The Importance of Healthy Eating to Corporate Wellness

Chat 1 Comment July 1, 2016 nutritionadsa

Today is the first day of Corporate Wellness Week, which is running until 5 July.

Employees eat nearly half of their daily meals and snacks at the workplace, which means that what is consumed during working hours can have a great impact on overall diet and health. It’s not uncommon to find that many of us, who may well be healthy eaters at home, give way to speed and convenience when it comes to the food choices that are made, often under pressure, during working hours.

Corporate Wellness Week emphasises the need to put workplace nutrition in the spotlight. The calories we consume at work do count, as does the quality of the nutrients in the types of food we are choosing. While employers need to focus on the food that is being made readily available to employees, we also need to reflect on our choices and habits when it comes to eating on the job.

It is vital that companies focus on making healthy eating choices accessible and affordable. Canteen or cafeteria menus need to be in line with the SA Food-based Dietary Guidelines or developed together with a Registered Dietitian. Vending machines in the corporate environment should offer a majority of healthy eating options. Likewise, drinks and snacks made available at corporate meetings and events should be wholesome and healthy options. The benefits to businesses that care about healthy nutrition are far-reaching. There’s a wide array of research studies that provide comprehensive evidence of the effects of what we eat on performance. Who doesn’t want healthy, focused and productive employees?

There’s also a lot that each of us can do to ensure that we are eating healthily during working hours.

Monique Piderit a Registered Dietitian and spokesperson for ADSA (Association for Dietetics in South Africa) works regularly in the corporate sector and has particular insights into the challenges of workplace nutrition and its important place in Corporate Wellness. She recommends:

• Be aware of everything that you are eating and drinking during working hours. Yes, you are under pressure but every calorie, and every nutrient still counts just the same
• Take note of your eating habits at work, especially those triggered by workplace stress and pressure. If you find yourself routinely buying a packet of chips or a chocolate from the vending machine around the corner from your desk every time the going gets tough, it’s time to change your habits and make better choices that will really help you to feel better. For example, replace a crunchy crisp craving for healthier nuts, popcorn or pretzels, and a sweet tooth with fresh fruit or dried fruit like cranberries.
• If your healthy eating choices are limited by what’s available around you at or in close proximity to work, consider taking charge and preparing your own daily healthy lunchbox. It is actually not as much work as you may think, and it can be cost-saving too. When you get the balance of protein, carbohydrate, healthy fat and vitamins and minerals right in your lunchbox, you’ve aligned your workplace nutrition with your healthy lifestyle goals. When preparing dinner allow for a portion of food to be allocated for the next day. As you serve dinner, immediately set aside a portion of food into a container for lunch the next day.
• Make an effort to reduce your processed foods intake and go for the real thing. For instance, buy more lean chicken pieces than what you will eat for dinner, and then tuck a left-over drumstick in your lunchbox rather than spending extra on buying vienna’s and other processed meats for your lunchbox.
• Declare an outright ban on sugary drinks in the workplace which are often all too easily available. Make water your first port of call. You can bring it to work infused with citrus, ginger or mint. Choose rooibos or herbal teas as your hot drinks at meetings or have cooled as a homemade iced tea in summer.
• Stock up on nutrient-dense, fresh fruit, veg and nuts that are so easy to snack right at your desk. Maybe you can stock the fridge at work, or also choose long-lasting fresh produce options like citrus or bananas that can stand on your desk all week long.
• Also keep easy options at hand like wholewheat/high fiber crackers, salt and sugar-free peanut butter and lean biltong. These foods can keep for weeks at a time. Making the healthy options the closest to hand so that when you are under pressure you will grab something that is really good for you

As Monique points out: “We can’t talk about Corporate Wellness during this awareness week without talking about nutrition. A healthy employee is a focused and productive employee. What we eat is fundamental to our well-being in the short and long term. It is also fundamental to our performance in the moment. Work dominates the lives of adults and how we manage and choose our food at work is critical to our well-being.”

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

How can a Dietitian guide you through the Nutrition Minefield?

1 Comment June 7, 2016 nutritionadsa

From Great Aunt Phyllis, to your Facebook friend that lost 30 kilos last year, to the latest in the multitude of global ‘so-called experts’ who just published a fad diet book, everyone seems to know exactly what we should all be eating. And, unfortunately, very few of them agree with each other.

When it comes to food, just about everyone has strong opinions, views, and diverse assertions about what constitutes healthy nutrition. Caught in the crossfire of a flurry of intense beliefs and often forceful advice, we don’t know who to trust and where to turn to when we know we need to manage our nutrition better. It’s a minefield; and if we are not careful, we can find ourselves trying a bit of this and a bit of that, chopping and changing, and never reaching our healthy living goals – whether that is to lose weight, optimise our physical activity or manage a serious condition such as diabetes.

Because nutrition affects our health in many ways, there’s just about no place more important to find that calm, clear space in the eye of the storm. And, that is where you can find a steady, consistent ally in the nutrition expert, a Registered Dietitian. These are health professionals, regulated by law, who have spent a minimum of four years studying a relevant science degree at an established university. They commit themselves to on-going professional development that keeps them abreast of scientific evolution. They are therefore, a reliable source of the latest nutrition expertise that is wholly evidence-based; and it is this that can help you cut through the noise of the fad diets, sweeping universalities and old wives’ tales when it comes to working out what eating routine would be healthy and sustainable for you at your particular life-stage.

“A common misconception is that a dietitian’s work is simply focused on helping people lose or manage their weight, comments Cath Day, Registered Dietitian and spokesperson for ADSA (Association of Dietetics in South Africa). “While weight loss is an important aspect of dietetics, the reality is that the role of the dietitian is much, much broader.” As a result, dietitians do not only work in private practice; they are also employed across governments; businesses; social, educational, healthcare and research institutions.

Day points out that professional advice from a dietitian is important at different life stages, for instance to determine healthy eating plans for the different nutrition requirements of childhood and for old age, as well as during pregnancy and breastfeeding. “Dietitians also help patients over the long-term to prevent or improve the management of disease,” she says, “It is important to have professional nutritional advice if you are dealing with conditions such as eating disorders, hypertension, gastro-intestinal disorders, pre-diabetes and diabetes, kidney failure, cardiac disease, as well as cancer and HIV/AIDS.” For women, optimal nutrition can play an important role in preventing or improving osteoporosis and polycystic ovarian syndrome. The advice of dietitians is also often sought after in a wide range of states of health from those wanting to optimize their recovery from illness or injury, to athletes and others in peak health who want to improve their performance in sports and physical activities. After all, our greatest wealth is our health.

The great advantage that a dietitian offers is that they deal with each person and their nutritional needs on a completely individual basis. “Diets and dietary supplements are marketed as if they will work for everyone,” Day says. “But in truth, we are all very different when it comes to our eating habits, food preferences, physical activity and metabolic rates, and our lifestyle choices at any given time in our lives.” A dietitian works closely with you to determine an optimal nutrition plan that takes all these variances into account so that it is easier for you to make the necessary changes and sustain them over the long term. In addition, they are an advisor and a coach providing vital support and encouragement while you are on this journey.

Did you know?

Dietitians Week, 6^th to 10^th June, highlights the work and worth of dietitians and the impact of the dietetic profession. To find a dietitian in your area who can assist you with your nutrition journey, visit http://www.adsa.org.za/Public/FindARegisteredDietitian.aspx

ADSA will be joining theBritish Dietetics Association (BDA) and the South African Society for Parenteral and Enteral Nutrition (SASPEN) to celebrate Dietitian’s Week. Please keep an eye on our social media channels for more information.

Facebook www.facebook.com/adsarogza | Twitter www.twitter.com/ADSA_RD | Website: http://www.adsa.org.za

GETTING THE FACTS RIGHT ABOUT DIABETES

Chat 1 Comment November 13, 2015 nutritionadsa

Diabetes remains a major cause of death in South Africa, and the prevalence of the condition continues to rise. ‘People with diabetes have to follow a special diet or have to eat special diabetic food’ is just one of the common misconceptions surrounding diabetes. In commemoration of World Diabetes Day (14 November) ADSA (Association for Dietetics in South Africa) spokesperson and Registered Dietitian, Ria Catsicas, looks at some of these misconceptions that can result in people avoiding health testing or seeking treatment.

Ria has a special interest in the medical nutrition management of diabetes, metabolic syndrome and obesity and is the author of the book “The Complete Nutritional Solutions to Diabetes”.

#1: People with diabetes have to follow a special diet or have to eat special diabetic foods
“Actually, people with diabetes do not have to follow a ‘special’ diet. The whole family should eat healthy unprocessed foods such as fresh fruit and vegetables; whole grains; lean meats and poultry; low fat milk and dairy products; seeds, nuts, legumes and plant oils. Everyone should avoid or limit eating processed foods such as fatty red meats, processed meats, all foods made from white flour and foods with a high sugar content. Healthy eating is good for all of us as it is essential for supporting our immune systems and protecting us against disease, as well as to ensure that we have optimal energy levels throughout the day.”

#2: If I am diabetic, my food is going to be more expensive
“It is not necessary to buy expensive foods marketed to diabetics. Healthy eating can be economical, and is often cheaper than buying unhealthy treats. Buying fresh fruit and vegetables that are in season is certainly cheaper than buying processed fruit juices and soft drinks. If you eat fruits and salads as snacks and as dessert, you can save on the money you would have spent on buying biscuits, rusks, cakes, desserts, sweets and potato crisps.   Legumes, such as lentils and beans, are cheaper than red meat and high fat hard cheeses. A tasty bean curry is, for instance, a much cheaper meal than a red meat alternative.”

#3: Eating too much sugar causes diabetes
“There is truth in this statement, but it is too simplistic. Research shows that there is a correlation between the high intake of sugar-based soft drinks, energy drinks and fruit juices and the development of obesity. And, obesity, in turn, can be a significant contributing factor in the development of T 2 diabetes. However, a person’s complete diet must be taken into account. A diet that is characterized by the high intake of sugar, such as soft drinks, chocolates and sweets; as well as a high intake of refined starches, such as white or brown bread, pap, fast foods, biscuits, rusks and potato fries; while also poor in healthy foods such as fresh fruit, vegetables and whole grains, can contribute to the development of diabetes.”

#4: People with diabetes cannot eat carbohydrates
“Not all carbohydrates are unhealthy. Both the type and the amount of carbohydrate foods you eat at a meal will affect your blood glucose levels afterwards. Therefore, for optimal blood glucose control it is important to control the quantity, and be aware of the type of carbohydrates you are going to eat. Small portions of whole grains, fruit and vegetables that are evenly distributed throughout the day can contribute to optimal blood glucose control. Research has also shown that the consistency of your carbohydrate intake from day-to-day can help to optimize blood glucose control.”

#5: People with diabetes should restrict their fruit intake
“Yes, too much fruit can contribute to an increase in blood glucose levels. However, portion size is important. It is recommended that you consult your dietitian to calculate the amount of fruit that you should include in your daily diet.”

#6: People with diabetes should be on a high-fat diet
“There is no research to date which has proved that a high fat diet can contribute to either weight loss or improved blood glucose control. To lose weight, your calorie intake from both foods and drinks must be less than your energy expenditure on both voluntary and involuntary activity. The restriction of any food group, whether it is carbohydrates or fats or proteins can contribute to weight loss. To achieve successful weight loss, people with diabetes need to adhere to an eating plan that restricts their usual calorie intake. Research has shown that diets promoting extreme macronutrient manipulation, whether it is carbohydrates or fats or proteins actually lessen people’s adherence to the eating plan. It is much wiser for people with diabetes to develop sustainable healthy eating habits that can easily be incorporated into lifestyle for the long term. The best diet for a person with diabetes is a healthy eating plan that the person can adhere to. To facilitate adherence, a dietitian would take into consideration the individual’s cultural preferences; their budget constraints; their age and gender; the logistics of their daily life, such as their work circumstances or travel requirements; as well as their weight status, the medications they use and their activity levels.”

#7: There are no proven health dangers of consuming too much saturated fat
“It is well-established that a high intake of saturated fats can contribute to increased LDL cholesterol levels in some individuals. While it has not been proven is that increased LDL cholesterol levels contribute directly to cardiac events, this is because there are NUMEROUS compounding factors that would cause a heart attack. Atherosclerosis is an inflammatory condition and a high intake of saturated fats in a nutrient poor diet can aggravate inflammation. It has been proven that a high saturated fat intake in a nutrient poor diet can also contribute to decreased sensitivity of the body cells to the action of insulin.”

 #8: If I am diabetic, I should stop my medication and go onto a low-carb high-fat diet
“As a person with diabetes you should never stop your medication without your doctor’s recommendation and agreement that this is the best medical course for you. It has been established that when diabetes is diagnosed most individuals would have already lost 50% of the insulin-producing capacity of the Beta cells in the pancreas. Therefore, the optimal way to manage diabetes is to follow a healthy diet; to lose weight if overweight; to engage in physical activity, such as walking three to five times a week for 40 to 60 minutes at a time; and, to take appropriate medication on your doctor’s advice.”

#9: If one of my parents has diabetes, there is nothing I can do about it – I will develop diabetes eventually
“If you have a genetic predisposition to diabetes, you have all the reason you need to embrace a healthy lifestyle. While genetics may only contribute 30 to 40% to the development of any condition, including diabetes, environmental and lifestyle factors may have a 60 to 70% impact. If you maintain a healthy body weight, stick to a healthy eating plan, manage your stress and get regular physical exercises, you have a very good chance of not developing diabetes.”

#10: If I have diabetes, I can’t exercise
“This is not true at all. Diabetes is a compelling reason to exercise regularly as physical activity plays a very important role in lowering blood glucose levels. Exercise also predisposes your body cells to being more sensitive to insulin, and of course, it helps to achieve and maintain a healthy body weight. If you use insulin it is important to check your blood glucose levels before and after physical activity. If you get results below 6 m mol/l it is recommended that you lower your insulin dose or eat a healthy snack to prevent a hypoglycemic attack during or after exercise.”
To find a dietitian in your area who can assist you with personalised nutrition advice, visit www.adsa.org.za

HPCSA inquiry

20 Comments June 4, 2015 nutritionadsa

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

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

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

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

World Milk Day

Leave a comment June 1, 2015 nutritionadsa

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

Why?

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

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

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

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

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

Carte Blanche – Sugar Addiction

Leave a comment May 31, 2015 nutritionadsa

Tonight at 7pm Carte Blanche is airing an insert on ‘Sugar Addiction’ which includes an interview with ADSA President, Claire Julsing-Strydom. They asked some interesting questions and we would like to share those with you:

Is sugar addiction real?

The answer is that yes sugar can lead to addictive like eating behaviour. Food addiction is real, especially in individuals who have a predisposition towards addiction and addictive like eating behaviour. Studies refer to the hedonic pathway of food record, what we know is that excessive sugar intake alters dopamine and opioid neurotransmission thereby increasing food intake.  But it is important to note that BOTH sugar and high fat foods mobilise the latter establishing hard wired cravings in these areas.  Current literature indicates that addictive like eating behaviour can be attributed to refined carbohydrates (sugar and white flour) as well as fats.  The Yale Food addiction scale suggests that highly processed foods that combine sugar and fat are more likely to lead to addictive like eating behaviours.

How much sugar is too much?

The intake of added sugar appears to be increasing steadily across the South African population. Children typically consume approximately 40-60 g/day, possibly rising to as much as 100g/day in adolescents. This represents roughly 5-10% of dietary energy, but could be as much as 20% in many individuals. The South African Food Based Dietary guidelines recommend that sugar and foods and drinks high in sugar be used sparingly.  The World Health Organisation have in their most recent guidelines recommended reducing total energy from sugar to below 5% from the previous 10%.  This equates to about 25g pf sugar per day which is approximately the same as 5 teaspoons of sugar. Keep in mind then that a single can of cold drink will exceed 25g of sugar.

In a balanced diet what kind of sugars should we be eating?

Naturally occurring sugars in whole foods such as lactose in yoghurt or fructose in fruits which occur in a fibre matrix have a very different metabolic process then refined carbohydrates and sugar.  It is important to avoid the excess intake of sugar – there is allowance for moderate intake in accordance with dietary guidelines. However research does intake that intakes of added sugars in on the rise and people need to start adjusting their intakes.

Why does ADSA have sponsors that have products that contain sugar?

Woolworths and Pick n Pay are sponsors of ADSA they stock chocolate and colds drinks, but just because they stock these particular food items and are sponsors of ADSA, does not mean that we as ADSA endorse or promote these particular products.  Our sponsorship policy states that we don’t endorse products and in accordance with the South African Food Based Dietary Guidelines and evidence based information we make recommendations to our patients based on their individual nutritional requirements.

A food product that contains sugar can be included in a balanced meal plan as discussed earlier in line with local and international guidelines. Excess sugar intake however should be avoided as it is associated with adverse health risks. What is important to note is that when we have sponsorship discussions with industry it is made very clear that our sponsorship policy does not allow for endorsements in any way. ADSA is an NGO and all the dietitians that work for ADSA do so on a voluntary basis and do not get paid for the work that they do to serve the dietetics profession and the public by informing them on nutrition related matters. Various companies sponsor ADSA and all the funds that we collect through sponsorship are pooled. These funds are used in order to support the dietetics profession and ultimately the improvement of nutritional status for all South Africans. To read more on our sponsorship policy please visit our website: www.adsa.org.za

ADSA represents registered dietitians working in various spheres of nutrition and dietetics in South Africa

Leave a comment May 18, 2015 nutritionadsa

The Association for Dietetics is the professional organisation for registered dietitians in South Africa. The activities of the organisation are centred around representing and developing the dietetic profession to contribute to optimal nutrition for all South Africans.

Registered Dietitians are qualified health professionals registered with the Health Professions Council of South Africa (HPCSA) who have a minimum qualification of a four year scientific degree with training in all aspects and fields of nutrition and dietetics. Whether they consult privately to one client, work within a community or as part of the food supply chain, they have to adhere to best practice guidelines delivering sound dietary advice based on the latest scientific evidence.

ADSA members nominate and vote for members to serve on branch committees regionally or on the ADSA executive committee nationally, once every two years. These elected members serve on a voluntary basis, in their own time, without remuneration.

All committee members are registered dietitians working in different areas within nutrition and dietetics. The current executive committee has representatives from private practice, academia, government and the food industry.

As an association working in South Africa, we know South Africans eat a wide variety of foods from the entire food supply. We can’t ignore entire sections of the food industry, because they’re part of the daily diet of many South Africans.

We agree that while there are lot of nutritious, high quality foods on the market in South Africa, there’s a lot that can and needs to be improved when it comes to nutritional value and quality of some of foods sold in both the informal and formal food supply.

It’s therefore important that there are registered dietitians working in various sectors within the food industry, to influence changes that will benefit all South Africans.

Furthermore, registered dietitians working within the food industry have numerous important roles such as ensuring that foods are labelled correctly, as well as for ensuring compliance to various nutrition-related regulations, which provides the consumer with the information they require to make informed food purchasing decisions. They are also involved in managing nutrition-related queries about products, including ingredient queries, and can also be involved in corporate wellness programmes within the respective organisations, to name a few of their roles.

ADSA will continue to represent registered dietitians working in various spheres of nutrition and dietetics in South Africa, at all levels of the association, to ensure that the association is able to effectively represent and develop the dietetic profession to contribute to optimal nutrition for all South Africans.

Salt Awareness Week 2015

Leave a comment March 19, 2015 nutritionadsa

This week is Salt Awareness Week. My Kitchen magazine’s Lauren Shapiro chatted to ADSA spokesperson and Registered Dietitian, Alpha Rasekhala, about thinking twice before grabbing that salt shaker:

Also visit http://www.saltwatch.co.za

Kidney Health For All

Leave a comment March 12, 2015 nutritionadsa

“Kidney Health For All” is the theme of today’s World Kidney Day

Kidney diseases are silent killers, which will largely affect your quality of life. The mission of World Kidney Day is to raise awareness of the importance of our kidneys to our overall health and to reduce the frequency and impact of kidney disease and its associated health problems.

Nutrition plays an important role in keeping kidneys healthy

Registered Dietitian and ADSA spokesperson, Brigitte Leclercq recently visited the Seychelles to provide counselling to dialysis patients at Victoria Hospital. She is graduating with her Masters in Nutrition on kidney disease in June 2015 and will be presenting her research at the World Congress of Nephrology in March 2015.

Brigitte’s visit to Victoria Hospital was to help 100 dialysis patients with their meal plans, giving them guidelines on what they can eat and what they should avoid. During her two weeks in the Seychelles, Brigitte provided individual meal plans to each of the 100 dialysis patients at Victoria Hospital. In the Seychelles the rate of patients with kidney failure is extremely high, considering that over 100 patients are receiving dialysis in a population of 90 000 people. Seychelles is currently one of the most obese nations in sub-Saharan Africa. For optimum health, diets should consist of more healthy food options such as grilled fish and vegetables. Unfortunately there is a prevalence of diets high in fat in the Seychelles as most of the food is fried and too much takeaway food is being consumed.

High blood pressure and diabetes are the two biggest causes of kidney failure. Many people in the Seychelles and in South Africa who are overweight develop high blood pressure and diabetes, and eventually need dialysis unless they drastically change their nutrition and their lifestyle.

What can you do for your kidneys today?

www.worldkidneyday.org has the following 8 tips: to reduce the risk of developing kidney disease:

Keep fit and active

Keeping fit helps to reduce your blood pressure and therefore reduces the risk of Chronic Kidney Disease.

Keep regular control of your blood sugar level

About half of people who have diabetes develop kidney damage, so it is important for people with diabetes to have regular tests to check their kidney function.

Monitor your blood pressure

Although many people may be aware that high blood pressure can lead to a stroke or heart attack, few know that it is also the most common cause of kidney damage.

Eat healthy and keep your weight in check

This can help prevent diabetes, heart disease and other conditions associated with Chronic Kidney Disease.

Reduce your salt intake. The recommended sodium intake is 5-6 grams of salt per day (around a teaspoon). In order to reduce your salt intake, try and limit the amount of processed and restaurant food and do not add salt to food. It will be easier to control your intake if you prepare the food yourself with fresh ingredients. For more information on nutrition and kidney friendly cooking, visit our nutrition page

Maintain a healthy fluid intake

Although clinical studies have not reached an agreement on the ideal quantity of water and other fluids we should consume daily to maintain good health, traditional wisdom has long suggested drinking 1.5 to 2 litres (3 to 4 pints) of water per day.

Do not smoke

Smoking slows the flow of blood to the kidneys. When less blood reaches the kidneys, it impairs their ability to function properly. Smoking also increases the risk of kidney cancer by about 50 percent.

Do not take over-the-counter pills on a regular basis

Common drugs such as non-steroidal anti-inflammatory drugs like ibuprofen are known to cause kidney damage and disease if taken regularly.

Get your kidney function checked if you have one or more of the ‘high risk’ factors

• you have diabetes
• you have hypertension
• you are obese
• one of your parents or other family members suffers from kidney disease
• you are of African, Asian, or Aboriginal origin

*Brigitte Leclercq’s visit to the Seychelles was made possible by The Ministry of Health and the dialysis centre in the Seychelles and a travel sponsorship from Eden Island, who also sponsored posters and dietary notes for all the patients.

A word from Claire Julsing-Strydom (ADSA’s President) on Sponsorships

3 Comments February 19, 2015 nutritionadsa

“There has been a lot of conversation in the media and on social media channels, about ADSA’s sponsorship policy. This will probably be an ongoing conversation, but I would like to take this opportunity to share how we manage sponsorships.”

ADSA Sponsorships

I think it is important to talk about sponsorships for not-for-profit associations and am glad that consumers are asking important questions. I would like to give you a better understanding of how exactly sponsorship works for ADSA and also how it works when dietitians consult to food or pharmaceutical companies.

ADSA is an NGO and all the dietitians that work for ADSA do so on a voluntary basis and do not get paid for the work that they do to serve the dietetics profession and the public by informing them on nutrition related matters. Various companies sponsor ADSA and all the funds that we collect through sponsorship are pooled. This money is mostly used for administration costs associated with the day-to-day running of the association.  ADSA currently receives 34% of its funds from sponsors and the remaining 66% from the members.  Any nutrition-related content that is disseminated by ADSA is evidence based and ADSA is not allowed to endorse any food product.

We have previously been asked if we are influenced by ‘big food’, but because we follow a rigorous process when it comes to sponsorship, evidence-based information and never endorse product we can confidently say that we are not influenced by ‘big food’. Sponsors should never be allowed to dictate an organisation’s messaging and content, especially in the health sector where all information should be evidence based and ‘first do no harm’.

When it comes to dietitians in their capacity outside ADSA, they have to abide by certain ethical rules, practice evidence based nutrition therapy, provide full disclosures of conflicts of interest and are not allowed to endorse products. These are all part of the ethical rules compiled by the HPCSA.

Many people are asking ‘How does sponsorships affect a dietitian’s credibility?” If a dietitian is for example sponsored by the dairy association to do research on the milk intake in teenagers and their level of calcium then that dietitian should state that she was sponsored, but still follow the ethical rules of the profession and therefore produce factually correct information based on the results of the study and nothing more. Therefore a dietitian’s credibility will not be impacted by the latter considering that the ethical guidelines are always in place.

Current ADSA sponsors include:

Sea Harvest, EquiSweet, Kellogg’s, Pick n Pay, DSM, Woolworths, Nativa, Unilever, Parmalat, Pronutro, Health Connection

If you have any questions please send us a mail at info@adsa.org.za

ADSA Sponsorship Policy February 2015

All potential ADSA sponsors are to be evaluated to ensure that they are consistent with ADSA’s evidence-based approach to nutrition.

ADSA adheres to and enforces the following principles in its relationships with sponsors:

1. Scientific Accuracy

All sponsor materials, presentations and information shared with members are internally reviewed for scientific accuracy, adherence with ADSA’s positions and policies and for appropriateness for ADSA members. This review is done by the ADSA Executive Committee Sponsorship Portfolio holder and by the ADSA President.

2. Non-endorsement

ADSA does not endorse any brand, company product or service.

3. Non-influence

• ADSA’s programs, leadership, decisions, policies and positions are not influenced by sponsors.
• ADSA’s procedures and formal agreements with external organizations are designed to prevent any undue corporate influence.

General Requirements for Acceptance of ADSA Sponsors:

• Fit with ADSA strategic goals
• Scientific accuracy
• Conformance with ADSA positions, policies and philosophies
• ADSA has editorial control of all content in materials bearing the ADSA name
• Clear separation of ADSA messages and content from brand information or promotion
• No endorsement by ADSA of any particular brand or company product
• The inclusion of relevant facts and important information where their omission would present an unbalanced view of a controversial issue in which the sponsor has a stake

Disclaimer:

• Sponsorship enables ADSA—as it does for most non-profit organizations and associations across the country —to build awareness of ADSA and our members, and to share science-based information and new research with our members. ADSA is not influenced by our corporate sponsors, nor does ADSA endorse any of the sponsors’ products or services.
• ADSA communication and messages are based on evidence-based reviews of the latest and most authoritative science.
• ADSA builds and maintains its reputation by scrupulous attention to facts, science and honesty. It is at the discretion of ADSA whether to take on a sponsor. ADSA reserves the right to remove a sponsor at any given time at the discretion at the ADSA Executive Committee
• All communication sent out to ADSA members by sponsors must be evidence-based. The ADSA Executive Portfolio Holder and ADSA President review all communication sent out by sponsors to ADSA members.
• ADSA reserves the right to ask for substantiation of any claims made by sponsors’ products. Any products that are unable to substantiate their nutrition or health claims will not be communicated
• Any form of endorsement by ADSA is prohibited
• Sponsors are not allowed to have the ADSA logo on their communication to the public or on any promotional material. Similarly, sponsors are prohibited from publicising that they are an ADSA sponsor on the said communication.
• National sponsorship does not include interest group sponsorship and vice versa. The same criteria used to assess national sponsorship will be applied to interest group sponsorship

Healthy eating, healthy living in 2015!

1 Comment January 19, 2015 nutritionadsa

Signing up for the gym, eating more tuna and drinking 9 cups of water per day are the seasonal New Year’s resolutions that sit on the top of South African lists. Not to say eating healthier and exercising on a regular basis are not top priorities, but going on a whim when it comes to your health based on what you see on TV and the internet will see those resolutions be pushed down the list as the year progresses.

This is because simply downloading a meal plan for a quick fix diet will not necessarily work for your body, since most of the time they are generalised templates. Seeking expert advice from a Registered Dietitian should replace your first New Year’s resolution on your healthy list and this is where the Association for Dietetics in South Africa (ADSA) plays a vital role.

Consulting a Registered Dietitian (RD) will ensure that you get professional guidance as well as an analysis of what is best for your specific needs with regards to eating and gaining optimum health. “A Registered Dietitian is a trained professional in the nutrition field, providing expert advice and support to ensure you embody a balanced healthy lifestyle as a permanent one. It is essential for consumers to ask for a Registered Dietitian in order to receive nutrition info they can trust”, says Claire Julsing-Strydom, ADSA President.

A Registered Dietitian is:

• A qualified health professional registered with the HPCSA
• Has a minimum qualification of a four year scientific degree
• Has been trained in all aspects and fields of nutrition therapy

Registered Dietitians are involved in many different fields and areas of expertise including: Private Practising Dietitians, Therapeutic Dietitians (who mainly work in a hospital setting), Community Dietitians (who work in the public sector) and Food Service Management (managing healthy and specialised diets in institutions).

Nutrition is a science and there isn’t one solution that fits everyone. Registered Dietitians are the recognised experts in the field of evidence-based nutrition and will develop personalised nutrition plans for each one of their clients to ensure that they are able to stick to the plan and reach their goals. “Consumers need to be aware that there are many unscientific health and nutrition gimmicks around, with new fad diets launching all the time”, concludes Julsing-Strydom.

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

Launch of NutritionConfidence Recipes

Leave a comment December 8, 2014 nutritionadsa

We have partnered with award-winning chef, Vanessa Marx (from Dear Me), to develop the NutritionConfidence series of recipes.

The series, which launched in November, with three diabetic-friendly recipes, aims to showcase that delicious food can also be healthy, making it easier to eat the right food more often for a healthy body and mind.

“As part of our daily work we spend a lot of time looking at the scientific side of what we eat and how it affects our bodies, sometimes forgetting that eating food for most people is about so much more than just putting fuel in the body”, says Claire Julsing-Strydom, ADSA President. “In celebration of delicious food that inspires us to make our own meals and is also good for us, we created the NutritionConfidence recipes.”

Each recipe encourages local, close-to-home ingredients; offers alternative flavour tips; and highlights the ‘good-for-you’ hero ingredients. The three diabetic-friendly recipes include:

• Veggie Burgers – made with butternut, sweet potato, lentils and almonds, wrapped in iceberg lettuce and served with guacamole and salsa
• Rooibos, Pomegranate and Cinnamon Ice Tea – an everyday cold drink solution with all the flavour, but not all the sugar!
• Orange & Almond Torte – made with eggs, xylitol, ground almonds, baking powder and orange zest this is a great sugar and wheat free torte that will be loved not only by diabetics.

“Being a diabetic and a chef, I’ve always looked at ways to create food that is fresh, innovative, delicious and on trend, but also caters for different lifestyles”, says Vanessa. With a focus on using fresh, local ingredients and working with spices and herbs to create flavours, Vanessa’s style is the perfect combination for the NutritionConfidence recipes.

ADSA will roll out NutritionConfidence recipes every month, so pop onto the website www.adsa.org.za to find recipes to suit every occasion with a focus on light meals in January, Valentine’s Day in February, the outdoors in March and chocolate in April.