Healthy Eating for a Healthy Pregnancy

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

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

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

What nutrients should moms-to-be focus on?

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

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

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

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

What should moms-to-be avoid?

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

Reach out and get help when you need it

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

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


A Delicious One-Pot Meal!

Beef and Butternut Casserole with Mushrooms and Tomato

We love the latest NutritionConfidence recipe from the authors of Food for Sensitive Tummies, registered dietitians Cath Day and Gabi Steenkamp! It is packed with vegetables (a whopping four servings), high in fibre and a good source of iron. Comfort food, which is still a healthy balanced meal.

This is a meal-in-one casserole, which is easy to prepare ahead of time. Perfect for dinner guests and to make during a very busy week. Butternut contains double the starch compared to the other vegetables, so may be used as a carbohydrate in this dish. Since there are four other vegetable servings, the butternut can serve as the starch of the meal.

RECIPE (Serves 4)

INGREDIENTS

1 onion

1 leek

4 cloves garlic

2 rashers bacon, optional

2 sprigs fresh rosemary

2 t olive oil

2 bay leaves

1 butternut, large (800 g)

250 g  mushrooms, mixed are most delicious

410 g  tinned chopped tomatoes (1 x 410 g tin)

150 ml red wine, optional

500 g beef goulash pieces, check for minimal visible fat.

8 black olives

2.5 ml salt & freshly ground black pepper (½ t)

METHOD

  1. Preheat the oven to 180ºC
  2. Peel the onion and chop. Trim, wash and slice the leek. Peel and slice the garlic.
  3. Heat a large pan or ovenproof casserole on medium heat.
  4. Finely slice the bacon. Pick the leaves off the rosemary sprig and chop finely.
  5. Pour the olive oil into the hot pan, add the sliced bacon, chopped rosemary and the bay leaves and gently fry, stirring regularly
  6. Add the sliced garlic, chopped onion and leek and cook for 10 minutes, stirring regularly.
  7. Meanwhile, peel and cut the butternut into bite size cubes and add to the pan.
  8. Clean the mushrooms and cut off the stems. Add both the stems and whole mushroom tops to the pan.
  9. Add the meat cubes, pour over the wine and simmer for 10 minutes.
  10. Add the tinned tomatoes.
  11. Rinse the tomato tin out with quarter tin of water and add to the pan or casserole.
  12. De-stone the olives by cutting in half. Add to the casserole and mix in gently.
  13. Bring the casserole to a boil and then place in the pre-heated oven to bake for 45 mins, until thick and delicious.
  14. Serve on its’ own as a complete balanced meal.

NUTRIENTS PER SERVING (600 g)

Energy                                                      1918 kJ

Protein                                                      30.3 g

Carbohydrates                                         31.3 g

Total sugars                                               4.5 g

Added sugar                                              0.0 g

Total Fat                                                     18.5 g

Saturated fat                                              7.7 g

Fibre                                                           7.7 g

Sodium                                                       682 mg

One serving is equivalent to 1 carbohydrate, 4 proteins and 4 vegetables

 


Pregnancy and Nutrition

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!”


NEW Recipe: Lettuce & Pea Soup

Our latest NutritionConfidence recipe is from the authors of Food for Sensitive Tummies, registered dietitians Cath Day and Gabi Steenkamp. A perfect winter warmer Lettuce & Pea Soup.

We love this recipe because it is a really smart way of including green leaves into your eating routine during the cold winter months! A great starter for a dinner party.

 The dietitians say:

  • This delicious soup contains a whopping 4 vegetable servings, making it a really healthy meal and gets you very close to your 5 a day quota.
  • In addition, it is high in fibre, making it the perfect meal for helping sensitive tummies keep regular. The fibre comes from the peas, chickpeas and the lettuce.
  • The benefits of increasing your fibre intake for gut health is well documented – healthy gut = happy you!

INGREDIENTS (Serves 4)

5 ml         butter (1t)

5 ml         olive oil (1t)

3 leeks    well washed and sliced with the green tops

1 ml         dried crushed garlic (¼ t)

2.5 ml     salt (½ t)

1              head of butter lettuce, finely sliced

250 g      frozen peas (1½ c)

1.25 L     boiling water (5 c)

15 ml      chicken flavour or vegetable stock powder (1 T)

125 g      tinned chickpeas (½ x 410 g tin, drained)

125 ml    chopped parsley (½ c)

METHOD

  1. Melt the butter and olive oil together.
  2. Add the leeks and crushed garlic and salt.
  3. Sauté over medium heat for 3 minutes until soft.
  4. Add the sliced lettuce and the peas.
  5. Add boiling water and stock powder.
  6. Boil for 5 minutes uncovered.
  7. Add the chickpeas and heat through.
  8. Add the parsley and liquidize until the soup is smooth.
  9. Reheat before serving.
  10. Optional: serve with one slice of bread with avocado as a topping, per serving (½ avocado is equivalent to 2 fats)

NUTRIENTS PER serving (200 ml of soup)

Energy                                   740 kJ

Protein                                   6.7 g

Carbohydrates                     28.0 g

Total sugars                         6.2 g

Added sugar                        0.0 g

Total Fat                                3.1 g

Saturated fat                         0.8 g

Fibre                                      6.4 g

Sodium                                 773 mg

One serving is equivalent to ½ carbohydrate, 1 protein and 4 vegetables.

FOOD FOR SENSITIVE TUMMIES

Do you suffer from winds, burping, cramps, heartburn, constipation and/or diarrhoea as well as bloating? Then the book, “Food for Sensitive Tummies” is for you! Having a sensitive tummy or super sensitive tummy (irritable bowel syndrome) can be one of the most debilitating health issues to deal with. In Food for Sensitive Tummies, Gabi Steenkamp and Cath Day show you how you can cut down on the ingredients and food that cause you problems and still prepare a whole range of recipes that are simple, affordable and delicious to eat. Their recipes also feed your gut microbiome with nourishing food substances important for maintaining health. From fresh and healthy breakfast ideas, to wholesome mains such as Butternut, Aubergine and Rocket Lasagne, cooking for sensitive tummies has never been so easyL 

Food for Sensitive Tummies can be ordered directly from the authors via this page or via email (info@catherineday.co.za or info@gabisteenkamp.co.za).


Time To Make Lifestyle Your Medicine

DR. DAVID KATZ

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


Why breastfeeding should be everybody’s business

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

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

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

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

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

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

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

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

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

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

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

 

Breastfeeding support is available in South Africa:

  • Mothers can obtain professional help with breastfeeding from lactation consultants, who are health professionals with advanced training in breastfeeding support http://www.salactationconsultants.co.za/index.php
  • La Leche League South Africa is a voluntary organisation which provides information and support to women who want to breastfeed their babies. La Leche League Leaders are experienced breastfeeding mothers, trained and accredited by LLL, who are happy to help other mothers with questions and concerns about breastfeeding http://www.llli.org/southafrica.html
  • Milk Matters is a community-based breast milk bank that pasteurises and distributes donations of screened breast milk from healthy donors to premature, ill and vulnerable babies whose own mothers cannot supply the breast milk to meet their baby’s needs. Their website has valuable information for breastfeeding mothers http://milkmatters.org/breastfeeding-breastmilk/

 

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

 


How can a Dietitian guide you through the Nutrition Minefield?

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

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

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

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

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

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

Did you know?

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

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

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

Trust a Dietitian


4 NUTRITION TIPS FOR HEALTHY LIFESTYLE AWARENESS MONTH

February is Healthy Lifestyles Awareness Month and with high rates of obesity and the so-called ‘lifestyle’ diseases, such as diabetes, it’s quite clear that South Africans need to develop more awareness about making healthy eating choices. We asked four of our dietitians what South Africans should know about nutrition:

  • Let’s head for the kitchen and start cooking, invites Cath Day, RD:

“My top tip to my clients is to start cooking your own healthy meals from scratch as often as possible, using the freshest and healthiest ingredients. It’s the best way to control not only everything that goes into your meal, but also portion sizes. If you cook often at home, you have full awareness of making healthy eating choices most of the time. Cooking with fresh, healthy ingredients, making delicious meals and snacks can easily be fun rather than a chore. You can cultivate a family culture of great enjoyment at healthy eating by involving your partner, your kids, the whole family, and even, friends in preparing and sharing healthy food.”

  • Let’s limit the sugar, advises Catherine Pereira, RD:

“ADSA supports the recommendations by the World Health Organisation (WHO) that added sugar intake should be limited to no more than 5 % of total energy intake. The South African Food Based Dietary Guidelines states that ‘sugar, and foods and drinks high in sugar should be consumed sparingly’. These foods include all types of confectionery (biscuits, cakes, etc.) as well as sugar-sweetened drinks. The key to getting this right is to become far more aware of ‘hidden’ sugars. We all know that when choose to eat a packet of sweets, we’re eating too much sugar; but we’re perhaps less aware that when we order an iced tea or a glass of wine at a restaurant, these also spike our daily sugar intake beyond sensible levels. When it comes to avoiding empty calories, what we drink counts every bit as much as what we eat; and we need a far higher level of awareness of our actual daily sugar intake in order to make sure we are keeping to the guidelines.”

  • Let’s get over obsessing over restrictive or fad diets, says Kezia Kent, RD:

“Following your friends’ latest diet or the newest fad promoted on social media is not necessarily going to work for you as it may be working for others. Eating healthily should be tailored specifically for you and it should happen every day, not just over a time when you are trying to lose weight. There is always going to be a ‘latest’ diet; and chopping and changing according to fads can prevent you from developing sensible and sustainable healthy eating habits that truly suit your lifestyle and your body. Especially, avoid diets that promise you’ll lose weight quickly. Slow, steady weight loss lasts longer than quick, dramatic weight loss. If you lose weight quickly, you may lose muscle and water which increases your chances of regaining the weight. If you need to change to healthier eating or need to lose weight, get professional advice to develop a sustainable plan for you.”

  • Let’s be careful about making carbs an enemy, warns Monique dos Santos, RD:

“There’s an immense amount of attention on low carb-high fat diets right now. We’ve got to keep the perspective that there are good reasons to include carbohydrates in our diets. Obviously, you want to limit sugar and refined starches, but there are carbohydrates in many, many foods that are good for us. Our bodies rely on a combination of carbohydrates and fat for energy to fuel daily activities. Carbohydrates are the brain’s number one energy source so cutting out carbs will zap your energy levels and leave you feeling fatigued. When carbs are limited excessively, you get really, really cranky. We also need carbohydrates to build muscle (in combination with sufficient protein in the diet and training). Fibre-rich carbohydrates such as fruits, some vegetables, legumes and wholegrain starches like oats, wild rice, and whole-wheat pasta are important for gut health. Let’s not forget that many carbs are also rich in other nutrients. If you restrict fruits, vegetables, and wholegrains then you are also limiting your intake of nutrients like vitamins, minerals, and antioxidants. B-vitamins, vitamin C, beta-carotene, magnesium and other essential micro-nutrients are all found in carbohydrate-rich foods.”

Our ‘Fishcakes with Barley Salad and Lemon Drizzle’ recipe ticks all the boxes – high in fibre, packed with omega 3 fatty acids, heart healthy mono-unsaturated fatty acids, an array of vitamins and minerals and contains a great balance of protein, carbohydrate and fat; and besides that its good for the earth and tastes yummy!

 

Fishcakes2

Serves 4

FISHCAKES

Ingredients

1 x can (400 g) of mackerel (middle cut)

1/4 cup oat bran

1/2 cup grated carrot

1 free-range egg

Zest of 1 lemon

10 g chopped fresh herbs (chives, dill, parsley)

Salt & pepper

2 tablespoons avocado oil

How to make it

– drain the mackerel of any liquid, and put it into a large mixing bowl.

– using a fork, shred the fish up until it’s fine and there are no large chunks.

– add the oat bran, carrot, egg, lemon zest, and chopped herbs, and mix well. Leave the mixture to stand for a bout 30min in the fridge, so the oat bran soaks up excess liquid in the mixture.

– separate the mixture into 8 equal sized balls, and shape them into patties.

– season the fishcakes with salt & pepper.

– put a large non-stick frying pan onto a medium heat and drizzle the oil into the pan.

– once the pan is hot, add the fishcakes and fry on the first side for around 2 minutes, until golden brown. Turn them over and repeat on the other side.

BARLEY SALAD

Ingredients

1 cup cooked pearl barley, cold

40 g watercress

1/2 medium cucumber

1 avo

50 g almonds, raw & chopped

50 g mixed bean sprouts

100 g cherry tomatoes, cut in half

50 g sliced red onion

10 g basil

10 g fennel

100 g feta

Salt & pepper

How to make it

 – wash the cucumber, tomatoes, and herbs.

– using a peeler, shave the cucumber into ribbons.

– cut the avo in half, remove the skin & pip and cut the avo into chunks.

– in a large bowl, mix together the barley, cucumber ribbons, almonds, bean sprouts, tomatoes, onion, tear the fennel & basil up and add to the salad.

– assemble the salad on a platter. Spread the barley salad mixture on the bottom of the platter. Add the chunks of avo, and crumble the feta over the top of the salad. Sprinkle the watercress on top of the salad.

LEMON DRIZZLE

Ingredients

zest & juice of 1 lemon

1teaspoon smooth Dijon mustard

4 tablespoons extra virgin olive oil

1 teaspoon chopped chives

Salt & pepper

How to make it

– whisk together the lemon juice, zest & mustard.

– drizzle the olive oil into the lemon mixture whilst whisking.

– mix int he chopped chives, and season with salt & pepper.

 

Bon appetit!

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


LET’S TALK ABOUT ‘HEALTHY EATING IN THE WORKPLACE’

What we eat at our place of work has a huge impact on our overall diet and influences our productivity. The prevalence of overweight and obesity combined is now 65% for females and 31% for males (2012 South African Health and Nutrition Examination Survey – SANHANES) and unhealthy workplace eating behaviour is believed to be playing a role in South Africa’s growing obesity problem.

The Association for Dietetics in South Africa (ADSA) has partnered with National Nutrition Week since the late 1990s to highlight important nutrition messages to South Africans. “In line with our continued efforts to support South Africans in living healthier lifestyles and to promote dietitians as the go-to experts for nutrition advice, the issues around healthy eating in the workplace are close to our hearts and something our dietitians deal with on a daily basis”, says ADSA President, Maryke Gallagher.

Employees consume at least half of their meals and snacks during work hours, making this an important place to promote healthy eating. Registered Dietitian, Alex Royal, says that healthy eating at work can be a challenge as there are often too many temptations: the vending machine, the sweets trolley, colleagues who have bad habits that influence others. “During a busy day we don’t have time (or forget) to prepare healthy meals or even forget to eat. So blood glucose levels drop, resulting in an energy dip and potentially cravings, especially for highly processed and sugary foods. This fuels the cycle of unhealthy eating at work”, Royal concludes.

The question is what can employers do to create a healthier food environment at work? Suggestions include changing meal options available at work to be in line with the guidelines for healthy eating, offering a variety of foods, controlling portion sizes, overhauling vending machines and kiosks to include healthy snack options, offering drinks that are not sugar-laden and changing the menu of food provided during meetings. Cath Day, Registered Dietitian and ADSA spokesperson, also offers some tips for employees:

  • Before grabbing a snack, first ask yourself if you are really hungry or if you rather need to take a break from what you are doing. Going for a short walk or getting some fresh air – may be all you need.
  • Don’t skip meals or healthy snacking between meals. Skipping meals and snacks results in dips in blood glucose (sugar) levels and thus you will be more likely to crave unhealthy foods.

We often talk about school lunchboxes, but what about work lunchboxes? These go a long way in giving employees more control over what they eat during the day. According to Registered Dietitian Kelly Schreuder the goals of a healthy work lunchbox include: Variety and balance of foods, providing a variety of nutrients, including protein, carbohydrates, fat and micronutrients. Real food, as opposed to processed snacks and those that are high in added sugar, excess salt and poor quality fat, and portion control.

And what about fluids – what should we be drinking while we are at work? “The simple answer is that water should be the main beverage we are drinking while working but there are many other healthy options to choose from as well. People often forget that beverages can contain a large amount of energy (and many beverages contain too much sugar such as sugar sweetened beverages and fruit juice) so we need to be more mindful about what we are drinking”, say ADSA spokesperson Catherine Pereira.

Being active in the workplace is also important and employees should try to be as physically active as possible. Durban-based dietitian, Hlanzeka Mpanza says that it is not impossible to include some physical exercise in the workday. Use the steps instead of the lift; form an exercise club with colleagues and try to fit in a 15 minute walk during the lunch hour; wear a pedometer during the day to keep track of activity levels and as a motivator; and stretch your legs by walking over to your colleagues’ desk instead of sending them an email.

What we eat affects our mood, how alert we are and our overall productivity. We asked dietitian Maryke Bronkhorst why food influences us in this way. “Some foods contain nutrients that are used to manufacture certain brain chemicals that may enhance mental tasks like memory, concentration, and reaction time.   Protein foods enhance the brain’s production of dopamine, a natural brain chemical that helps one to feel alert. Large quantities of carbohydrates, on the other hand, result in the production of serotonin, a natural brain chemical that can cause drowsiness, but glucose in the bloodstream is the brain’s main source of energy. So it’s important that you eat at regular intervals and choose low glycaemic index options to prevent your blood sugar levels from dropping too low”, says Bronkhorst. Lean biltong, a small handful nuts, a piece of fresh fruit e.g. blueberries, vegetable crudités with a dip like hummus and plain yoghurt flavoured with handful of berries are great ‘go-to’ snacks.

On Tuesday, 13th October ADSA (@ADSA_RD) is hosting a #WorkplaceNutrition twitter talk from 1pm to 2pm. The talk will focus on healthy eating and healthy living in the workplace providing employees with tips, ideas and advice about achieving a better nutrition balance during work hours. Dietitians and National Nutrition Week partners will be answering questions such as:

  • What are challenges employees face with healthy eating at work?
  • What can employees or workplace do to improve healthy eating during the workday?
  • What should be included in a work lunchbox?
  • What should we be drinking while we are working?
  • How do we stay active while working?
  • What are the go-to snacks that give energy needed to work well?

Join the conversation live on Twitter, follow the @ADSA_RD handle or track the hashtag #WorkplaceNutrition to get some great ideas and tips on how to eat healthily at work.