Meet registered dietitian, Jessica Oosthuizen

Chat Leave a comment November 30, 2018 nutritionadsa

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

Why did you become a registered dietitian?

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

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

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

What does being a registered dietitian mean to you?

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

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

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

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

Start with a focus on quality, quantity and frequency!

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

What is your biggest challenge as a dietitian?

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

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

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

How do you handle difficult clients/patients?

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

What is your opinion on fad diets?

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

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

 

ABOUT 

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

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

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

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

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

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

 

 

Diabetes in the Family, How to Cope

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.

Meet the ADSA President!

Chat 4 Comments August 23, 2018 nutritionadsa

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

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

 Why did you become a Registered Dietitian?

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

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

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

What has been your career highlight?

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

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

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

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

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

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

How do you see a nutrition champion?

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

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

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

What is your favourite dish and your favourite treat food?

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

 

More about Christine

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

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

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

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!”

“No day is ever the same”

Chat Leave a comment January 26, 2018 nutritionadsa

We chatted to Registered Dietitian, Jessica Byrne, who is currently undergoing her Masters studies in Therapeutic Nutrition and fulfils the role of chief operating officer for ADSA, to find out why she became a dietitian, what she loves about her work and what the challenges are:

Why did you become a Registered Dietitian?

Biology was always my favourite subject at school, and I knew from fairly early on that I wanted to follow a career in health. Finding out more about dietetics when I started varsity, I knew it was the perfect fit for me, incorporating science as a base but also allowing me to work with people on a more personal level.

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

For most people their first thought about a dietitian is that our job is helping people to lose weight. But I love that our profession is involved in such a diverse range of areas, and with that it brings versatility and variety. For me no day is ever the same. One day I could be seeing patients in the ICU, and the next assisting a journalist with evidence-based content for an article on nutrition, through my role in ADSA.

In my work in the hospital setting, it is rewarding to know that through providing nutrition therapy, I am contributing to enhancing the recovery of that patient and improving their health.

What has been your career highlight?

A recent highlight for me is when I represented ADSA and the dietetic profession at parliament, where I presented ADSA’s position and recommendations for the sugar tax. It was an exciting experience, and certainly not something I saw myself doing when I first became a dietitian!

What are the most challenging aspects of your career?

The public is being exposed to more nutrition information that ever before, but unfortunately not all this information is accurate, from credible sources or might not be appropriate for every individual. Trying to correct these misperceptions around diet is an important part of a dietitian’s work.

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

I don’t let it get to the point where the entire day has been filled with poor eating choices, but if I’m having something less healthy I don’t beat myself up about it, but try to really savour it and know that I will get back on track at my next meal. I truly believe that moderation is key to keeping yourself on track long term, rather than putting yourself under unnecessary pressure to always make the healthy choice. That is why I follow the 80:20 rule – 80% of the time make the healthier choice, and then allow yourself that 20% for a treat now and then, without feeling guilty about it.

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

• ‘Please don’t look at what I’m eating!’ (I’m not the food police and I do not judge, especially as I don’t know what the rest of your eating patterns and lifestyle are like.)
• ‘So, do you ever eat chocolate/cake?’ (Of course I do, just not every day!)
• My initial thought was to add ‘What do you think about (insert current diet trend)?’ to this list because, let’s be honest, we don’t want to be talking about work when we’re out enjoying time with friends. But in fact, I don’t want people to stop asking that question! It actually makes me excited when someone asks a dietitian for their opinion on a new diet trend or popular headline they might have read. They are trying to make their mind up about a particular issue, and it’s a fantastic opportunity as a healthcare professional to provide guidance that is scientifically sound and based on evidence.

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

Dietitians are all trained and qualified to treat any patient presented to them. However, some dietitians might have special interests and be more knowledgeable in certain areas, so this can be useful to guide you on finding the right dietitian for you.

 What is your favourite dish and your favourite treat food?

I love so many different foods, it’s so difficult to choose a favourite dish. It might sound cliched, but I really do love veggies! I love trying new dishes where veggies are the hero, particularly using vegetables to take a boring salad to something super tasty. And when it comes to a treat food, without a doubt, my favourite would be anything that contains chocolate!

Jessica holds both a B.Sc degree in Physiology and Biochemistry, and a B.Sc (Medical) (Honours) degree in Nutrition and Dietetics from the University of Cape Town. She is currently undergoing her Masters studies in Therapeutic Nutrition at Stellenbosch University. Before joining ADSA in the role of chief operating officer, Jessica worked at the Heart and Stroke Foundation SA where she provided up-to-date scientific content for media, planned public awareness and education campaigns, and worked on local government projects. Jessica also consults at private hospitals, where she is responsible for the nutritional management of critically ill, medical and surgical patients.

To find a dietitian in your area please visit the ADSA website and click on the PUBLIC button.

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.

Getting the right help can change your life!

Chat Leave a comment November 3, 2017 nutritionadsa

We are sharing success stories to find out why people decide to see a dietitian, what happens on the journey, what the hardest part of that journey is and what results are achieved. This week we chat to Julie Greensmith, who started seeing Registered Dietitian Nathalie Mat after she was diagnosed with Diabetes. Here is her story ….

Tell us about your journey with your dietitian

I changed doctors. I have always been a shut up and get on with it person. After a battery of blood tests to create a profile for my new doctor, she phoned me and asked “Did you know you were a diabetic?” I had no idea and the shock was mixed with the relief of understanding why I had been only half alive for a very long time. I had absolutely no energy, some days I could hardly get up, walking was becoming more and more painful. I even gained weight if I ate a lettuce leaf and seemed to be permanently swollen. Shoes were impossibly difficult. In my volunteer work I am communicating with people all the time and frequently having to stand up and address groups. My concentration was disappearing, I could not think and kept just losing words. It was very scary, I felt out of control and my world was shrinking. All this time I had thought well this is what getting old is all about (I am 72 or to look at it another way I have been 37 twice).

On hearing the word Diabetes my husband immediately went out and bought the Banting book and we went strictly onto the Banting diet. Although I lost 6 kilos I plunged into depression and being no stranger to depression I knew what was happening but just could not get control of it. One really bad day my husband just said enough is enough and made me a piece of rye toast with apricot jam. Within twenty minutes I felt absolutely fine again. A colleague from Lifeline suggested I should see Nathalie Mat, a registered dietitian – which proved to be the best thing ever that could happen for me and a turning point in my recovery.

I was greeted with kindness, consideration and understanding. My fear at being in unknown territory was fully understood and allayed. I felt so supported. My preferences were discussed and incorporated as far as possible and I never felt judged. She was very happy to discuss recipes and wine with my husband (my chef and food policeman) and look for ways of adapting and fitting them into my programme. She also has a great collection of tasty recipes. Not only is Nathalie highly qualified with a huge depth of knowledge, she is so willing to share it finding simple ways of explaining absolutely everything. I understand and trust the importance of all the steps we have taken which makes it so easy to trust the process and feel fully committed to it. It is one thing to have the knowledge but being so enthusiastic and prepared to share is a great gift. It makes me feel like a respected equal and I have felt that partnership thought our journey.

She has understood my fears and celebrated my triumphs, however small. I have felt heard, supported and understood through the whole process.

Perhaps best of all when I don’t stray at all from my diet I never feel as hungry as I did in the past.

Tell us about your results

So far I have lost 20 kilos. I used to be sick all the time with gastro and flu. That hasn’t happened for 18 months now. When I wake up early in the morning I get up with energy. All my blood tests register within the recommended parameters.

My mind is firing on all cylinders again and all thoughts of giving up my work have flown out of the window. I am able to be creative and busy. My movement is far better and my legs and feet are no longer swollen and far less painful. Between the Podiatrist and Biokinetisist I am very mobile and my balance is coming back. Nathalie and my Biokinetisist have worked together to design a programme that addresses both their needs to get the best results they can with my limitations. I have a life back and, let’s face it, is important, my dress size has gone down 3 times which my credit card and sewing machine are busy rectifying.

What was the hardest part of the journey

This is a difficult one to answer. Any hurdles I have had to overcome have been self-imposed. Of course certain deprivations can suddenly get the better of me and I fall off the path now and then. When that happens I see the results on the scales and the rise in my feelings of hunger and those realisations spur me on back into the disciplines of my eating plan. I am so supported by my relationship with Nathalie, my new doctor, and by my husband who is joining me in treating our older age years as a team effort.

I have struggled with the exercise and fighting with my damaged foot and the pain and a certain degree of laziness!

What are the top three tips you can share

Sometimes it is not good to shut up and get on with it. Getting the right help can change your life.

Communicate. Talk about the difficulties you are experiencing with your dietitian and be one hundred percent honest so that you can work out a plan together and trust the process. Leave your ego outside the door.

Patience. Be patient and don’t beat yourself up and set impossible targets that are bound to disappoint, dishearten and even sabotage you.

Trust. Trust the process and embrace it fully.

What dietitian Nathalie Mat says

When I first met Julie, she had not felt well for a long time. Poor blood sugar control was affecting her nervous system and her immunity. She was ready to make changes, but really needed assistance finding the right fit for her body. Diabetes is a scary diagnosis that does not have a simple cure. I wanted Julie to know that she had a partner in understanding her body and the limitations of her blood sugar control. Her eating along with close monitoring by her GP helped stabilize her blood sugar levels and Julie even learnt how she could incorporate less healthy options into her lifestyle without affecting her health.

Julie has amazing support in the form of her husband. He noticed that Julie was regularly having energy dips. I recommended we use a new device which continuously monitors blood sugar levels and we discovered that Julie was spending much of her day with low blood sugar. Julie’s doctor has since dropped Julie’s diabetes medication by half!

Julie has made incredible changes to her health. Her support from her husband as well as her consistent efforts have played a pivotal role in her success. I have so enjoyed being part of her journey to health and look forward to celebrating ongoing successes.

 

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

 

“I believe in moderation, not deprivation”

Chat Leave a comment October 4, 2017 nutritionadsa

Meet registered dietitian Abby Courtenay, who is serving on the current ADSA executive committee and looks after the PR portfolio. We chatted to her about why she loves being a dietitian, what the challenges are and what people should consider when deciding which dietitian to consult:

Why did you become a Registered Dietitian?

From a young age I had an interest on the effects of nutrition on the human body. I vividly remember reading the ‘How my body works’ books and being fascinated by the complexity of the digestive system. By the time I was in standard 9 (or grade 11), I knew I definitely wanted to become a dietitian. Strangely though, in Matric I changed my mind and pursued a degree in architecture. After 1 year I realized that architecture was not my passion and so I started my BSc degree and subsequently was accepted for dietetics at the University of Pretoria in 2007. People often ask if I regret my round about journey to dietetics, but I made some amazing friends along the way and learned a great deal about myself in that time. I don’t think I would be the dietitian I am today, had it not been for my experiences.

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

I have been in private practice for almost 3 years, and I still feel a great sense of pride and joy when I receive feedback from my patients telling me how amazing they feel. I think that many people feel pretty terrible on a daily basis, but with correct diet and adequate lifestyle changes they can truly reach their full potential. I strive to incorporate a strong message of moderation and I do not believe in deprivation.

What has been your career highlight?

I will be attending FNCE conference in Chicago (coming up in October 2017), so for me I feel like all my hard work and dedication to my career and dietetics  has culminated to this point and I am beyond excited to represent South African dietitians at an international conference.

What are the most challenging aspects of your career?

Trying to correct nutrition misconceptions. People unfortunately get their nutrition information from un-credible sources (usually on the internet) and it can be challenging to correct these perceptions. I believe that for dietitians, knowledge is power and the more you arm yourself with current, up-to-date nutrition information to more you can educate the population.

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

To be honest I don’t ever feel as if my day has been nutritionally disastrous. When you give yourself permission to eat all foods you remove the guilt from eating and thus stop the diet cycle (binge, guilt, deprivation and repeat).

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

• Do you ever eat *insert indulgent food here*? Of course we do, we are only human and can eat anything in moderation!
• Don’t judge what I am eating/ buying! This will often happen at a braai or when I see someone at the shopping mall, and I can promise you that I never judge and don’t give my professional opinion unless it is asked for!
• Can you print me/ email me a diet? All the plans I do are individualized, it is not a “mik-and-druk” process. In order to be successful (with regards to dietary change), you will need to see a dietitian for a one-on-one consultation. She needs to get to know your medical history, lifestyle, likes and dislikes, level of nutrition education and current diet history before she can even think of creating a plan for you!

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

If you have a specific medical problem, ask the dietitian if this is her special interest. If it is not, ask if she can refer you to a dietitian who is more knowledgeable in your problem area and the dietitian should also be conveniently situated, so that it is convenient for you to see her regularly .

What is your favourite dish and your favourite treat food?

I like to experiment in the kitchen and try to update my recipe folder on a regular basis, so don’t ever have a ‘favourite dish’ but rather a favourite dish of the week. At the moment I am trying out a homemade tuna and butterbean fishcake.

My favourite treat food is without a doubt baked cheesecake!

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

More about Abby

Abby Courtenay RD (SA) is an associate dietitian at the Nutritional Solutions Grayston and Melrose. She graduated with a Bachelor of Dietetics at University of Pretoria and also holds a Masters’ degree in Nutrition from the University of Stellenbosch.

She is registered with the HPCSA and is the current ADSA Executive Public Relations portfolio holder and previously served as the Public Sector portfolio and Communications portfolio the ADSA Gauteng South branch.

Abby has a special interest in: maternal, infant and child nutrition; renal and oncology nutrition. In addition to that, she also has extensive experience working with adults within the realm of weight loss and treatment/ prevention of lifestyle-related conditions.

Abby is a regular guest writer for Living and Loving, ChildMag and Clicks magazine, and also contributes as a nutrition expert to medical newsletters both to the public and healthcare professionals through Ann Lake Publishing. Abby is a regular contributor to various radio stations including Radio Cape Hope and Radio 702 and has appeared on television in relation to various nutritional matters.

‘Making a contribution to the bigger health picture’

Chat Leave a comment September 8, 2017 nutritionadsa

We chatted to Neil Stephen, Chief Dietitian at Addington Hospital in Durban, to find out why he became a dietitian, what he loves about his work and what the challenges are:

Why did you become a Registered Dietitian?

I developed an interest in nutrition when someone at the gym suggested I should see a dietitian to improve my performance.  I asked my parents if they knew of any dietitians and they told me that my cousin Nathan was one.  Later I decided to change from a general BSc to BSc Dietetics.  I was going to pursue a career in sports nutrition… which is the last thing I am interested in now.  To my surprise I was one of very few males in the class,  I had no idea that dietitians were mostly female!

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

I have quite a diverse range of areas I really love.  Top of the list is child health, followed by critical care, maternal health, student training and lastly, monitoring and evaluation of health systems and programmes (I’m a bit of a nerd).  I work daily with patients who have very little or nothing.  These patients are so humble and appreciative of any assistance you give them, whether its counselling or treatment.  The most satisfying moments are when I bump into moms with their young children or babies, who stop me, and they proudly tell me they are still breastfeeding. Another is when an acutely ill malnourished child improves over night and I know that nutrition has greatly contributed to the positive outcome.  Finally, its awesome speaking to previous interns and finding out they are succeeding at what they do. 

What has been your career highlight?

Well I started to collect data on every patient I treated when I started working.  I had a good amount of information per patient.  I put together a cool spreadsheet in excel to do my monthly stats for me, and eventually got my whole department on to it.  After a few years I decided to study further and used the information I had been collecting over the years.  So a highlight was definitely that I was selected to present my research for the MEC and Head of the KZN Department of Health.  Being selected really made me feel like I was valued and was making a contribution to the bigger health picture. 

What are the most challenging aspects of your career?

I think that for me its been a long journey of challenges and realisations which have grown me into the dietitian I am today.  Working in the public sector, I experience first hand the outcomes of social and economic  issues that face the general population on a daily basis.  It is heartbreaking to find that children are severely malnourished purely because they have a limited access to food.  A large proportion of patients of all ages are referred for HIV related problems which are often hard to manage and outcomes may be poor.  I need to mention that I love pregnant moms, children, and critically ill patients because they almost always accept advice and are compliant – the challenge is the patient who is resistant to change, because they don’t embrace the importance of lifestyle and dietary change.

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

Hahaha, I usually just take a nap.

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

• How can I lose the fat on my….(insert body part!!)???
• Isn’t there some kind of a pill or something I can take??
• I don’t eat carbs.

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

Dietitians are all equally qualified to treat any patient presented to them.  If you have a specific need, some dietitians will list their special interests, one of which you may be looking for. 

What is your favourite dish and your favourite treat food?

• Favourite dish – Butter Chicken Curry with garlic butter naan bread
• Favourite treat food – chocolate mousse (I can eat it by the litre)

 

Read more about the career of a registered dietitian: Is a career as a dietitian for you?

 

NEW NutritionConfidence recipe: Fish en Papillote

Chat Leave a comment August 18, 2017 nutritionadsa

“Many people do not know how to cook fish or dislike making their entire kitchen smell like fish. Cooking fish en papillote (in a baking paper parcel) is an easy way around both these issues”, says Nathalie Mat, registered dietitian and creator of our latest NutritionConfidence recipe.

The fish used in this recipe is hake, a fish on the SASSI green list. You are welcome to use any other fish in the recipe. Choosing a SASSI green listed fish will ensure that your heart-healthy dish is also one that is healthier for the planet.

If you have “vegetable resistant” children, get them involved in packing their own parcels. They can choose more of the vegetable they prefer and limit the ones that they do not like. Involving children in cooking improves familiarity with foods and increases the likelihood that these foods will be eaten.

Ingredients per parcel

½ a yellow pepper

2 baby marrows

150-200 g hake fillet

1 slice of lemon

Black pepper to taste

Herbed dressing

30 g fresh parsley

10 g fresh basil leaves

1 tbsp capers

4 tbsp olive oil

Juice of ½ – 1 lemon (to taste)

Black pepper to taste

Method

1. Heat the oven to 200˚C
2. Fold baking paper to make a large square and then cut the folded paper like you did in school to make a rounded heart shape. Cutting a shape like this increases the amount of food you can easily seal into the parcel.
3. Chop the pepper into batons; trim and quarter the marrows.
4. The vegetables will form a bed on which we will place the fish. Open the baking paper and near the centre fold, make a layer of peppers. Top with a layer of marrows. Finally, place the fish on the marrows.
5. Season the fish and place the lemon slice on top of the fish. To close the parcel, close the heart shape. With the edges lying together, start at the top of the heart, making small overlapping folds the whole way around to the bottom of the heart. Be sure to fold the bottom of the heart securely so that the parcel does not open in the oven.
6. Place the parcel in the oven for 15-20 minutes. If the hake fillet is 2cm or thicker leave it in the oven closer to 20 minutes. If you have a thinner fillet the fish will be ready after 15 minutes. If you are not sure, this steaming method is a gentle way of cooking fish, leaving it up to 20 minutes should not be a problem. With practice, you will become more confident with this way of cooking.
7. For the herbed dressing: put all the ingredients (start with the juice of ½ a lemon) and blend until nearly smooth. Check for acidity, add more lemon juice if needed and season to taste. Blend one last time.
8. Serve by letting everyone empty their parcels onto their plates. Top the fish with 2-3 teaspoons of herbed dressing. This dish is delicious served with boiled baby potatoes or herbed whole-wheat couscous and a green salad.

The herbed dressing is delicious dotted onto the fish before cooking but it does lose its vibrant green colour when cooked.

 

Nutritional information per parcel (175g fish) with 3 teaspoons herbed dressing:

Energy: 1308 kJ; Protein: 37.2 g; Carbohydrates: 6.9 g; Fat: 14.1 g; Sodium: 268 g

 

Meet the new ADSA President!

Chat Leave a comment August 16, 2017 nutritionadsa

We chatted to Nicole Lubasinski, the new ADSA President (July 2017 to June 2019), to find out about her plans for ADSA and why she became a dietitian, what she loves about her work and what the challenges are:

As the new President, what are you looking foward to achieving?

I am looking forward to playing a role in unifying the profession, continuing to build a great Association for all our fellow dietians and to achieving ADSA’s vision – to represent and develop the dietetic profession to contribute towards achieving optimal nutrition for all South Africans.

Why did you become a Registered Dietitian?

This is a complicated question for me to answer as there were many factors in play. Food is a key part in our daily lives, as with most young girls weight and food were an intricate part of my life growing up. I wanted to be able to understand our relationship with food better and to hopefully help other people come to terms with it too.

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

I think it’s similar for most dietitians. We tend to be the patients last resort for many patients and the “ah ha” moment that happens when people realise achieving a healthy balanced lifestyle doesn’t have to be restrictive or stringent. And that dietitians can often work in favourite foods to limit the sense of deprivation.

What has been your career highlight?

I think the achievement that sticks out the most is receiving my IOC diploma in Sports Nutrition in Switzerland. The reason being is I completed my final assignment whilst in hospital after delivering my little girl & she happened to be breastfeeding at the time of submission.

What are the most challenging aspects of your career?

Being the last resort, people have preconceived ideas about what a dietitian is or does. Automatically people judge you for your appearance and food choice, or feel you will judge them for theirs.

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

Everything in moderation. Add in an extra few KMs or reps in my work out session. Life happens and its ok. We tend to be pretty hard on ourselves and I think that needs to change.

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

• “Oh goodness, I better not eat this in front of you then”
• “So what’s the best way to lose weight”
• “Oh really, I would of thought dietitians needed to look a certain way”

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

Someone you can relate to. A patient relationship with a dietitian is more than “just tell me what to eat”. The ups and downs that come with changing a lifestyle or dealing with a health condition can be emotional, it’s good to have someone in your corner who will motivate you in a way that works for you.

What is your favourite dish and your favourite treat food?

Oh wow, just about anything my mom cooks. But my all-time overly decadent high day and holiday meal is grown up Mac and Cheese. One of our wonderful ADSA chefs needs to tailor this to be more nutritionally balanced

 

 

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

 

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”.

Navigating the journey to healthy living

Chat Leave a comment November 8, 2016 nutritionadsa

We recently chatted to Registered Dietitian, Alpha Rasekhala, to find out why he became a dietitian, what he enjoys most about the work her does, the challenges he faces. Alpha is also a member of the ADSA (Association for Dietetics in South Africa) Executive Committee and looks after the Representation Portfolio (Liaising with the Association’s Representatives to obtain feedback from nutrition and profession related bodies on which they serve and to obtain and provide feedback from the Association to these nutrition and profession related bodies)

Why did you become a Registered Dietitian?

I grew up in Limpopo and severe acute malnutrition was a problem. I always wanted to find a solution. As subsistence farmers we had a good harvest of maize, wild spinach,  nuts and peanuts. During high school the marketing manager from University of the North came to my school to inform us about the new dietetic programme the university was running.  I knew then and there that dietetics was my passion and could help me find the solution to my community’s malnutrition problems.

What do you enjoy most about the work you do?

I work as a private practising dietitian. I love the fact that I educate people on positive diet changes and navigate the journey to healthy living with them. It is such a great feeling when I help a client to make a turn around turn from poor nutrition choices to better choices and experience the improvement in health.

What are the most satisfying moments?

I always have a big smile on my face when a client makes the connection between the chronic disease of lifestyle and the bad food choices. Helping a client find the missing piece of the nutrition puzzle and transform their relationship with food is so rewarding.

What have been your career highlights?

I have worked in government, industry and private health sector. I have done a full circle in dietetics. I have been honoured to serve on the board of dietetics and nutrition for 10 years. I have learned about governance and regulations. I am on the ADSA executive committee, for the second time. I have completed my masters in dietetics. I have met amazing people through my dietetics journey.

What are the most challenging aspects of your career?

Nutrition misinformation. There is a lot of advise out there and it can be downright confusing to sort through it all and make sense of it. Most people can cook and think that dietetics is all about cooking. The majority of people forget that nutrition is a science, and the advise given is evidence based. Poor nutrition advice has life implications which have serious consequences.

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

I am never on diet. I enjoy food. My motto is moderation is key.

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

• Email me a meal plan as if we are in a business of issuing out meal plans. People do not understand that a lifestyle change is needed to achieve a goal.
• What should I do to lose weight?
• Are carbohydrates fattening? No magic food causes weight loss and no food is inherently fattening. Eat a variety of foods from leagues, meat, dairy, grains, fruits, vegetables and small amount of fat daily.

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

Look for a dietitian who understands your cultural background, beliefs, socio economic status and eating habits. Someone who will listen to you and work with you and be a partner through your journey to a healthier you.

What is your favourite dish and your favourite treat food?

My favourite dish  is samp and beans, spinach and beef stew.

My favourite treat is strawberry cheese cake.

To find a Registered Dietitian in your area, visit the Find a Registered Dietitian page on the ADSA website. 

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