Women and Diabetes in the Spotlight this November

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.


“I believe in moderation, not deprivation”

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.

‘Balance is key!’ Our latest success story

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 Robyn White, who started seeing Registered Dietitian Kezia Kent after she had her second child.

Tell us about your journey with the dietitian?

My husband and I went to see Kezia Kent after the birth of our 2nd daughter. I was the heaviest I had ever been in my life and decided that I needed to focus on my health and fitness so that I could be an example for my daughters. What I loved about Kezia instantly is that we could be honest with her. I was not an easy client. I told her I had Irish blood in me and loved potatoes, that I had given up wine obviously for 9 months during my pregnancy and had no desire or intention to give it up again so it needed to be in my eating plan, and that I had a small obsession with Woolworths Hazelnut Cappuccinos! Kezia included all of these in my eating plan! Additionally Kezia always explained very thoroughly the importance and effects of each food group. I always left her sessions feeling I had gained knowledge and power. Kezia’s words constantly pop into my head, “Remember the word “die” is in diet, we do not diet, this is an eating plan and way of life!” This has really changed my perception and thinking around food and eating!

Tell us about your results?

My very first appointment with Kezia was the first day I was allowed to exercise after my C-section surgery. That day I ran/walked 5km in 58 minutes. Exactly 5 weeks later I ran 5km in 38 minutes! It was a huge accomplishment! My eating plan (even with having only 4 – 5 hours sleep each night because of the baby) had increased my energy levels drastically. I had honestly not felt so energetic and “good” in many years! In 16 weeks I have lost 12 kgs and the greatest feeling is being able to feel like I am maintaining that easily. And I finally fit into the clothes I was wearing before both my babies! Exactly 4 months after having my second daughter I ran my first ever half marathon! What an amazing feeling.

What was the hardest part of the journey?

Honestly, having the willpower to order a jacket potato over chips when we went out for meal (that Irish blood)! I sometimes had to seriously give myself a pep talk. But it got easier and eventually I was choosing sweet potatoes over normal potatoes. What a change for me!

On par with that, my husband and I are very sociable and have a very sociable family and circle of friends. It was hard to go to braais and events and not want to snack on chips and biltong, but we did not stop being sociable. We took our own healthy snacks, learnt how to make our own healthy dips and still enjoyed the social events.

What are the top three tips you can share?

  • Exercise is so important! I make it a priority. Even with work, being a wife and mother to a toddler and a baby, it is a priority and I always feel so good afterwards.
  • Listen to your dietitian, they know better and they are way more qualified! I learnt so much from Kezia and will be eternally grateful.
  • Balance, balance, balance! Balance is the key! I always remember Kezia’s advice that you have to have that one cheat meal. But have the self-control and willpower to eat healthy again the next day. Great advice!

What the dietitian says

The most exciting moment for me was when Robyn came in with her husband and they both said to me, almost simultaneously, “It’s time for that health change”. That determination and drive from the get go will put a smile on any dietitian’s face. I knew immediately that Robyn wanted to improve her eating habits not just for herself but to ensure that the family is as healthy and adequately nourished.

Robyn knew it was not going to be easy, especially with a busy household, but she went forward with the plan knowing that she cannot follow this way of eating for a couple of weeks, it needed to be a lifestyle change. A lifestyle that does take a degree of planning, changing the snacks at social events, getting your friends on board and of course ensuring that it is manageable for all, even if potatoes are served with dinner. I reassured Robyn that my stance in general is not to exclude or cut out food, but rather encourage the addition of more nutrient dense foods as well as enjoying those small delicacies in life in a responsible manner. How boring would life be without that small bite of chocolate!

Robyn has lost a significant amount of weight but more importantly a large percentage of body fat. But her confidence in herself is far more of an achievement.

Well Done Robyn!

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


Liquid Assets

Considering a juice fast? Read this first. Lauren Shapiro from My Kitchen magazine chatted to ADSA spokesperson and Registered Dietitian Nathalie Mat to find out if this is just another fad diet or if there is more to it:

ADSA_My Kitchen_Liquid Assets_April15

http://www.tfgclub.co.za/mykitchen

MyKitchen_April15 Cover


Healthy eating, healthy living in 2015!

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

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

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

A Registered Dietitian is:

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

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

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

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