Red Lentil Veg Curry

Chat Leave a comment March 27, 2019 nutritionadsa

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

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

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

INGREDIENTS (serves 1)

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

2 handfuls baby spinach

1/2 small onion

1 large tomato

1 clove garlic

Salt and pepper

1/2 tsp turmeric

1/2 tbsp coriander

1 tsp cumin

Fresh chopped chilli (to your taste)

1 tbsp olive oil

Fresh coriander

PREPARATION

Boil the lentils until tender.

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

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

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

Mix the lentils into the mixture.

Top with coriander.

NUTRITIONAL VALUES

Per serving:

Energy: 245 kCal

Carbohydrates: 23g

Protein: 10g

Fat: 14g

 

‘Stay consistent’ – success story: Simone de Pinho

Chat Leave a comment March 18, 2019 nutritionadsa

We chatted to Simone de Pinho about her journey with registered dietitian Michelle McDermott.

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

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

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

Tell us about your journey with the dietitian?

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

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

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

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

Tell us about your results / successes?

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

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

What was the hardest part of the journey?

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

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

What are the top three tips you can share?

• Stay consistent

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

• Exercise is key to ensuring that your mindset is correct

What the dietitian says

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

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

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

 

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

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

Chat Leave a comment March 11, 2019 nutritionadsa

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

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

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

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

Tell us about your journey with the dietitian?

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

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

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

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

Tell us about your results / successes? 

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

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

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

What was the hardest part of the journey? 

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

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

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

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

What are the top three tips you can share?

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

What the dietitian says

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

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

 

Banking Your Breastmilk Saves Lives

Chat Leave a comment March 6, 2019 nutritionadsa

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

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

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

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

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

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

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

Who can bank their breastmilk?

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

How does banking my breastmilk work?

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

 

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

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

Chat 1 Comment March 4, 2019 nutritionadsa

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

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

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

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

 Tell us about your journey with the dietitian?

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

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

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

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

Tell us about your results / successes? 

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

What was the hardest part of the journey? 

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

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

What are the top three tips you can share?

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

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

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

What the dietitian says

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

Healthy Eating for a Healthy Pregnancy

Chat 5 Comments February 11, 2019 nutritionadsa

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

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

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

What nutrients should moms-to-be focus on?

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

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

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

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

What should moms-to-be avoid?

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

Reach out and get help when you need it

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

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

Success Story: Zandra Sissing

Chat Leave a comment February 8, 2019 nutritionadsa

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

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

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

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

Tell us about your journey with the dietitian

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

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

Tell us about your results / successes

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

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

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

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

What was the hardest part of the journey?

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

What are the top three tips you can share?

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

What the dietitian says

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

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

 

 

Ride For Hope

Chat 1 Comment December 7, 2018 nutritionadsa

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

 

 

Bernadine Blom

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

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

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

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

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

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

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

Ride for Hope

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

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

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

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

We currently have 305 new organ donors successfully registered.

 

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.

BUSTING THE BREAKFAST MYTHS

Chat 1 Comment October 8, 2018 nutritionadsa

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

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

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

Myth #1 I am skipping breakfast to lose weight

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

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

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

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

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

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

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

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

Myth #5 Not eating breakfast saves us money

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

 Top tips for affordable, healthy breakfasts include:

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

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

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

Why Breastfeeding is the Foundation of Life

Chat Leave a comment August 6, 2018 nutritionadsa

 

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

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

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

 Breastfeeding saves you time

• Breastmilk is always available
• Breastfeeding requires no preparation

Breastfeeding saves you money

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

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

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

Breastfeeding boosts mom’s health

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

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

Tips for expressing breastmilk

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

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

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

Meet Registered Dietitian, Nazeeia Sayed

Chat 1 Comment July 4, 2018 nutritionadsa

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

Why did you become a Registered Dietitian?

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

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

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

What has been your career highlight?

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

What are the most challenging aspects of your career?

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

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

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

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

“I didn’t know dietitians ate cake.”

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

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

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

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

What is your favourite dish and your favourite treat food?

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

 

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

Nutrition at the centre of sustainable corporate wellness

Chat Leave a comment July 2, 2018 nutritionadsa

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

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

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

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

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

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

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

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

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

 

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

Meet Registered Dietitian, Retha Booyens

Chat Leave a comment May 31, 2018 nutritionadsa

We caught up with registered dietitian Retha Booyens, who is passionate about nutrition and dietetics, to find out what drives her,  why she chose dietetics as a career and how she is making a difference through her work:

Why did you become a Registered Dietitian?

Contrary to what people believe, dietitians are actually foodies and love experimenting. I can remember that from a young age I loved food and eating, but also loved health and being active (athletics, acrobatics, hockey, netball etc). It seemed like an obvious decision to become a dietitian, but I need a bit more convincing. I took a gap year and did shadowing in dietetic lectures, at clinical dietitians and outpatient consultations. And after that there was no turning back.

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

The pleasure is in the small things, like a client progressing to solids after a long battle on IV nutrition and tube feeds or helping someone reach personalised goals (such as athletes).

Knowing that I can be an instrument in the saving of a person’s life is a tremendously satisfying feeling. I have a huge passion for critical care and renal dietetics and love to see how I can not only save someone’s life but also improve quality of life.

What has been your career highlight?

Becoming an ADSA spokesperson and being able to share my passion on a larger scale (in print, radio, etc).

Very close second was hosting a radio talk show (Bite for Life with Retha Booyens) on a local radio station in North West before relocating.

What are the most challenging aspects of your career?

Having to make peace with the fact that I cannot help everyone.

Knowing the vast amount of misinformation that is available, that is not only unsustainable but also damaging to people’s health. That is why I’m passionate about my Facebook page and Instagram account, just another platform where I can share evidence-based nutrition guidelines.

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

I always try to remind myself (and my clients) that it is a lifestyle and not a diet. Therefore there are bound to be weddings, parties and other occasions where over-indulging will happen.

What I do after a day where I didn’t make all the right choices is just to get back on the wagon the next day and get back into my usual healthier routine.

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

• Then you shouldn’t look what I have on my plate now.
• Can you give me a sample meal plan?
• You probably never eat unhealthy foods.

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

Choose someone that you feel comfortable with and can relate to. Someone who will be able to support you on an emotional level as well.

The relationship between a dietitian and client/patient is far more than just ‘what you eat’ and therefore you need someone that will be able to assist with the other aspects besides the food.

What is your favourite dish and your favourite treat food?

The dish I love making is any type of interesting salad – I love to invite people over and them saying ‘I didn’t know that healthy food can be this tasty.

On the other hand, when I treat myself I love to have anything Italian – so pastas and pizzas are right at the top of my list.

 

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

“Teaching nutrition is my passion”

Chat Leave a comment April 20, 2018 nutritionadsa

 

We chatted to Registered Dietitian Zelda Ackerman who runs Family 1^st Nutrition and is the author of a wonderful book called ‘Eet Reg (Bevry jouself en jou kinders van emosionele eet)’. We wanted 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?

My interest in nutrition started when I was at school. In Grade 8 we learned about nutrients and their functions in the body in Home Economics. This fascinated me and I decided that I wanted to become a dietitian.

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

I enjoy teaching groups of parents and dietitians about nutrition the most! Teaching nutrition is my biggest passion, more specifically teaching about paediatric nutrition.

The most satisfying moment is when a patient tells you how they followed your advice and how good they feel since changing their lifestyle!

What has been your career highlight?

My career highlight was when my book Eet Reg was published in May 2016. It was a great honour to be approached by NB Publishers and be offered a contract to write about what I love.

What are the most challenging aspects of your career?

Staying motivated to make a difference when people do not follow your advice and rather opt for quick fixes (which you know will only last for a few weeks).

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

Contrary to what most people may think I am not a health food freak. I eat healthy 90% of the time and I enjoy it! But when I eat junk or unhealthy food I don’t feel guilty or bad about it at all. I enjoy it and go back to eating my normal healthy food the next meal.

If I eat unhealthily for a longer time period, due to for example being with family who eat unhealthy, I’ll eat smaller portions of starch and larger portions veg to get back on the right track.

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

• “Oh boy, now I have to tuck in my tummy”
• “You probably only eat healthy foods”
• “I have to come and see you!”   … and then they don’t!

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

Nutrition is such a broad field and I believe you should look for someone who has personal experience if possible and then lots of experience in the specific conditions / age group that you need advice on.

What are your favourite dish and your favourite treat food?

My favourite food is vegetables. My favourite meal would be one with a few different types of vegetables and a few different types of salads.

I don’t believe in calling any food a treat, because that gives food an emotional connection. As I explain in my book Eet Reg, I believe food should not have emotional connections, but should be only for nutrition. My favourite sweet food is a good quality dark chocolate!

 

If you are looking for a dietitian in your area, please visit the ADSA website

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.

Women and Diabetes in the Spotlight this November

Chat Leave a 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

 

6 Eating Habits for Healthy Kidneys

Chat 1 Comment September 1, 2017 nutritionadsa

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

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

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

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

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

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

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

Here are her Six Top Tips for Boosting Kidney Health:

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

 

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

 

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.

‘I feel healthier, fitter and more energetic!’

Chat Leave a comment July 26, 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 Adrienne Bewsher, who started seeing Registered Dietitian Monique Piderit following a general health check-up which highlighted concerns around her weight and fitness. Here is her story ….

Tell us about your journey with the dietitian

Just before my 45^th birthday late last year, as part of a Women’s Development programme at work, I had a general health check-up and the results highlighted that I was both overweight and totally unfit! I knew I had to do something about that, so, in November 2016, I decided to visit a dietitian, Monique Piderit at Nutritional Solutions, and have a DNA Diet test done. I received the results of my DNA Diet test and the best eating plan for my body was a low-fat diet. Monique put together a very practical eating plan for me which was so easy to follow and apply to my lifestyle. I also had full range of blood tests done to understand my overall health – my overall Cholesterol and LDL-Cholesterol were high, whilst my Vitamin D levels were low.

Working with Monique, we set realistic weight loss goals which are achievable and keep me motivated.

Tell us about your results

Since November 2016 I continue to have regular “weigh-ins” with Monique which help to keep me on track and teach me more about healthy nutrition. I am so thrilled that I have lost over 10% (8kgs) of my body weight in 8 months, plus my Cholesterol levels have dropped to low risk levels.

To improve my fitness, I decided to take up running. As a full-time working Mom of 5 year old twins, I needed to find a form of exercise that would fit into my time constraints

and my lifestyle. I started off using an App that taught me to run 5kms in 8 weeks (although it took me more like 12 weeks to complete the programme!). Then in May this year I discovered “Catch Me If You Can” (CMIYC) – a running community exclusively for women in South Africa. CMIYC motivates women at various stages of their running journeys to get out and run together. They have various locations throughout the country, with Team Leaders in different areas who setup running dates throughout the week. Apart from getting fit, there are the added benefits of safety in numbers, tremendous support, motivation and friendship from the other women. I am proud to say that I have completed several 5km and 10km races and have entered my first half-marathon in November this year!

At 45, I now feel healthier, fitter and more energetic than I have for at least the past 10 years.

What was the hardest part of the journey?

My biggest challenge has been sticking to eating healthy during holidays like Christmas and Easter. When I do “de-rail” I am gentle but firm on myself and get back to healthy eating as quickly as possible. Just because I had a “cheat” meal doesn’t mean that I write off the entire day or weekend, but rather get back on track again the very next meal.

What are the top three tips you can share?

Banish the word “diet” from your vocabulary. For me, it comes with such negative connotations and makes me feel immediately hungry! Rather think of yourself as following a healthy lifestyle, as it will benefit so much more than just your weight.

Find a form of exercise that works for you. I do not have the time to drive to gym to do a workout, but road running works for me. If you can, persuade a buddy to join you for your workouts – you will feel far more guilty cancelling on them.

Set yourself goals. I am extremely target driven and by implementing achievable goals, both from a weight-loss and exercise point of view, I am getting there one step at a time. Celebrate when you achieve those goals – you deserve it!

What the dietitian says

I met Adrienne just before her 45^th birthday. From day one, her motivation levels were high and her energy to make a change for her health and wellbeing was so strong. I think that’s why Adrienne has done so well (and continues to do so) – it became less about weight and more about health.

Adrienne joined a social running team called Catch Me if You Can which consists of like-minded ladies. She started with short 5km runs, progressing up to doing 10km running events. Running is a great way to boost energy levels, improve sleep, and help with weight loss, and Adrienne soon got addicted to that well-known runners high. Last I saw her, she told me she signed up for her first half-marathon in November. I am so proud of her for being so steadfast in her decision to be health. Who knows, maybe next we’ll be talking running nutrition as she trains for Comrades. Adrienne is a great example of how weight loss is just a by-product of choosing a healthy lifestyle first and foremost.

Is a Career as a Dietitian for You?

Chat 3 Comments April 10, 2017 nutritionadsa

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

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

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

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

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

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

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

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

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

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

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

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

Do you have what it takes?

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

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

 

 

References

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

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

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

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

 ABOUT ADSA

ADSA, the Association for Dietetics in South Africa is one of the country’s professional organisations for registered dietitians.  It is a registered non-profit organisation served by qualified volunteers. The Association represents, and plays a vital role in developing the dietetic profession so as to contribute towards the goal of achieving optimal nutrition for all South Africans.  Through its network of ten branches ADSA provides dietitians with the opportunity to meet and network with other professionals in their provinces. Through its comprehensive Continuing Professional Development (CPD) system, ADSA supports dietitians in meeting their mandatory on-going learning, which is essential to maintain their registration status with the Health Professions Council of South Africa (HPCSA). Visit: http://www.adsa.org.za

 

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

Chat 1 Comment March 20, 2017 nutritionadsa

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

 

Salt – a forgotten killer

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

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

A world-leader in salt reduction

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

What can the food industry do?

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

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

How do we eat so much salt?

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

Do YOU eat too much salt?

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

How to reduce salt intake

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

Get tested

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

The next step forward

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

 

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

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

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

Meet registered dietitian, Thembekile Dlamini

Chat 1 Comment March 13, 2017 nutritionadsa

We chat to registered dietitian and ADSA spokesperson, Thembekile Dlamini to find out why she became a dietitian and what she loves most about her work. Thembekile works at the Free State Department of Health, is busy doing her PhD in Public Health and has a special interest in paediatric nutrition.

Why did you become a Registered Dietitian?

Saving lives has always been my first priority but I didn’t want to do it in the usual and obvious ways that society dictates. I saw a need to communicate the science of nutrition especially for the benefit of the black community. I thought if I understood healthy eating in any context, I would then be able to disseminate information correctly and with sensitivity to cultural preferences. That way I knew I would make a difference and save lives through nutrition.

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

I am mostly based in the paediatric ward, doing both inpatients and outpatients. When I meet a helpless soul in the ward admitted for whatever condition, just knowing that I will make a difference in their life makes my life and work enjoyable.

Most satisfying moments: every time my little patients get well and are discharged and I know I made a huge difference on their journey to getting better.

What has been your career highlight?

I have a couple of those:

• When mortality rates of a hospital dropped within 3 months of my arrival in the facility.
• When my child health and nutrition research paper got an award for best poster presentation in 2015 in the whole province.
• Getting a Gold award for saving cost of service delivery in the province through my hard work.

What are the most challenging aspects of your career?

Working with the most disadvantaged communities which cannot afford even the basic foods. Counseling them becomes a challenge because they always highlight their affordability challenges.

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

I have a few of those but when they happen, I drink lots of water and morning exercise.

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

• Please give me a diet
• I want to loose weight
• Give me a list of the right foods to eat

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

• Dietitian must be registered with the Health Professions Council of South Africa
• Dietitian must have a practice number and/or have a facility practice number
• Must be easily accessible
• Must be reliable
• Must have a love for people
• Must provide quality services

What is your favourite dish and your favourite treat food?

Pap and Masonja (Mopani worms) in tomato sauce!

I love Rum ‘n Raisin ice cream. A bowl of that is the perfect treat!

Expert Tips for a Healthier Lifestyle

Chat 3 Comments February 22, 2017 nutritionadsa

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

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

How to Get Healthy Eating Right

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

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

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

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

How to practice balance in your life

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

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

How to improve our sleep

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

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

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

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

How to relax more

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

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

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

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

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

CHICKEN SKEWERS, DIPS & SEED FLATBREAD

Chat Leave a comment November 18, 2016 nutritionadsa

We love this recipe – it makes a delicious starter for summer entertaining. Making your own dips and marinade rather than using store-bought varieties gives you more control and means you know exactly which ingredients have gone into those dishes.

Not only are the chickpeas in the hummus rich in slowly-digested starch and fibre, helping to control blood sugar levels, but they are also a great source of plant-based protein, vitamins and minerals.

Using whole-wheat flour and oat flour in the flatbread adds healthy fibre, lowering the glycaemic index and aiding in blood sugar control. Because this is still a carbohydrate-containing food, people with diabetes should enjoy the flatbread in appropriate portions.

Homemade chicken skewers are a great lean protein option, and this protein further lowers the glycaemic index of the meal.

RECIPE (Serves 4 as a main or 8 as a starter/snacks)

Chicken skewers

600 g free-range chicken breast

2 lemons

1 Tbsp wholegrain mustard

salt & black pepper

30 g chopped oregano

8 sosatie sticks (you can cut them in half if you want smaller ones for snacks)

 TO MAKE IT

• Cut the chicken breasts into cubes, about the size of an ice cube
• Put the chicken in a mixing bowl, and add the zest and juice of the lemons, mustard, and chopped oregano, then season with salt and pepper.
• Leave the chicken to marinade in the juices for an hour or so
• Skewer the cubes of chicken onto the sticks
• Put a pan onto a medium/high heat and add some canola oil
• When the pan is hot, add your chicken skewers, and allow them to cook on the first side for about 2 or 3 minutes before turning them. Cook the other side for another 2 or 3 minutes and then check between the pieces of chicken to see that the flesh is white, and no longer translucent. You want the chicken to be cooked all the way through, but not dry. Remove from the pan and set aside until you are ready to serve.

Hummus

1 can chickpeas, drained

125 ml Extra virgin olive oil

Juice of 1 fresh lemon

salt & pepper

5 ml tahini

1 garlic clove, peeled

1 Tbsp toasted sesame seeds

 TO MAKE IT

• Put the chickpeas, oil, lemon juice, garlic, tahini into a blender or food processor, and season with salt & pepper.
• Blend together until smooth
• Scrape the hummus from the jug with a spatula into a serving bowl
• Top the hummus with toasted sesame seeds and drizzle with olive oil

Tzatziki

1 cup plain yoghurt

Juice of 1/2 a lemon

15 g fresh mint

salt & pepper

1/2 a cucumber

TO MAKE IT

• Grate the cucumber into a bowl, and squeeze off the excess water
• Add the yoghurt, lemon juice, mint, and season with salt & pepper and put into a serving bowl

 Tomato Pesto

100 g sun-dried tomatoes in oil

30 g roasted plain almonds

10 g fresh parsley, chopped

TO MAKE IT

• Roughly chop the tomatoes
• Put the sundried tomatoes with the oil into a blender
• Add the roasted almonds & chopped parsley
• Pulse the blender to combine the ingredients into a chunky pesto
• Scrape from the blender into a serving bowl

Seed flatbread

100 g whole-wheat flour

100 g oat flour

150 g cake flour

100 g plain yoghurt

250 g water (lukewarm)

1 sachet yeast

2 tsp salt

50 g mixed seeds: sesame, flax, sunflower, poppy, pumpkin

TO MAKE IT

• In a large mixing bowl, add the flours, yeast, salt and seeds and mix together
• Mix together the water and yoghurt
• Make a well in the middle of the dry mixture and gradually add the yoghurt/water mixture little by little and mix together to form a dough.
• Stop adding liquid once the dough comes together, or add extra if you find the dough to be too sticky.
• Knead the dough together to form an elastic ball of dough.
• Separate the dough into golf ball sized balls
• Put a griddle pan onto a medium high heat
• Dust a clean working surface with a little flour, and roll each dough ball into a flat bread (about 3mm thick).
• Place the flatbreads onto the hot griddle and allow to cook until a little golden and firm on the first side, and then repeat on the other side.

TO SERVE

On a large board or platter, place the flatbreads and drizzle with a little olive oil. Place your bowls of dips and you chicken skewers onto the platter and sprinkle with fresh herbs

 

 

What your dietitian wants you to know about diabetes

Chat 1 Comment November 15, 2016 nutritionadsa

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

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

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

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

There are foods that should be avoided completely.

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

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

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

Eating too much sugar causes diabetes.

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

 People with diabetes cannot eat carbohydrates.

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

People with diabetes should restrict their fruit intake.

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

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

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

If I have diabetes, I can’t exercise.

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

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

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

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

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

 

Lentil, Pea and Sweet Potato Curry

Chat 1 Comment November 2, 2016 nutritionadsa

Food blogger, Taryn Littleton, created this delicious curry for us.

We love the legume and sweet potato combo – both are sources of low glycemic index carbohydrates, rich in slowly digested starch and fibre, helping to control blood sugar levels.

Also, eating dry beans, peas and lentils at least 4 times a week can help prevent chronic diseases, including cardiovascular disease, diabetes, cancer and overweight, as well as improving gut health.

 

INGREDIENTS (serves 6)

• 2 tbsp avocado oil
• 2 onions, finely chopped
• 2 cloves garlic, minced (crushed)
• 2 carrots, finely chopped or grated
• 2 tsp grated fresh ginger
• 2 tsp ground coriander
• 1 tsp ground cumin
• 1 tsp ground tumeric
• 1/2 tsp ground cinnamon
• 1/2 tsp chili powder
• 1 large sweet potato, peeled and cut into bite-size cubes
• 1/2 cup red lentils
• 5 tomatoes, chopped
• 1 cup reduced fat coconut milk
• 1 cup vegetable
• 1 tsp garam masala
• 1 pinch of salt
• 1 tsp honey or brown sugar
• 1 cup basmati rice
• 1 cup green peas
• 2 tbsp chopped fresh coriander
• 1 tbsp lemon juice

METHOD 

1. Heat the oil in a large saucepan over a medium heat and cook the onions for 10 minutes, stirring occasionally.
2. Add the garlic, carrot, ginger, ground coriander, cumin, turmeric and chili and cook, stirring, for 1 minute. Add the potato and lentils and stir to coat with the spice mixture.
3. Add the tomatoes, coconut milk, stock, garam masala, salt and sugar, bring to the boil and cover with a lid.
4. Reduce the heat to medium and simmer, covered, for 20 minutes, stirring occasionally.
5. While the curry simmers, cook the rice.
6. Add the peas to the curry and simmer, uncovered, for 5 minutes.
7. Remove from the heat and stir in the coriander and lemon juice.

SERVING SUGGESTIONS

Tomato and onion salsa: Combine 2 tomatoes chopped and ½ onion finely chopped. Season, mix and enjoy served with your curry.

Serve on a bed of rice with a dollop of plain yoghurt and with a tomato and onion salsa.

VARIATIONS

• Replace the coriander with fresh mint. Serve with naan bread instead of rice.
• For more nutrients add in a cup of frozen veg.

NUTRITION INFORMATION per serving (excludes serving suggestions, recipe serves 6)

Energy: 1316 kJ Protein: 10.6 g Carbohydrate: 52.0 g Of which, total sugars: 9.4 g Fat: 8.2 g Fibre: 10.0 g Sodium: 302 mg

Source and image: Taryn Littleton for the Association for Dietetics in South Africa

It’s the year of the pulses – try this Lentil Bobotie

Chat 1 Comment October 14, 2016 nutritionadsa

It’s the year of the pulses and the theme of National Nutrition Week is ‘Love your beans – eat dry beans, peas and lentils’, so this delicious Lentil Bobotie, created by chef Vanessa Marx, is the perfect family meal.

We love lentils (and you should too)! Dried lentils are a quick cooking legume, taking just 15 – 20 minutes to cook with no need to remember to soak them beforehand. The also pack a lot of punch, they are: low in fat, high in protein and high in dietary fiber.

Legumes (including lentils) provide a valuable and cost-effective source of protein and other nutrients. A 2010 review by Drenowski of different foods found that beans were among the top 5 classes of food having the highest micronutrient to price ratio, making them exceptional nutritional value for your money.

 

INGREDIENTS

(serves 4)

2 cup lentils, cooked

30ml canola oil

1 onion, peeled & chopped

2 cloves garlic, peeled & finely chopped or crushed

20g grated fresh ginger

100g green beans, chopped

1/2 cup raisins

2 carrots, peeled and diced

1 red pepper, diced

1 can chopped tomatoes

1/2 cup water

30ml mild curry spice

5ml ground cinnamon

2 bay leaves

2 free-range eggs

1/4 cup low fat yoghurt

2ml ground turmeric

salt & pepper

10g fresh coriander, chopped

2 extra bay leaves

METHOD

1. Put a large pot on the stove on a medium heat and add the oil.
2. Add the chopped onion, ginger & garlic and sauté lightly for about 5 minutes.
3. Then add the carrots, red pepper, green beans and raisins and continue to sweat for another 5 minutes.
4. Add the curry spice, cinnamon and bay leaves and stir in for 2 minutes.
5. Add the chopped tomatoes and water and stir in.
6. Cook the sauce for about 15min until slightly thickened and the vegetables have softened a little.
7. Add the lentils and season with salt and pepper to taste and mix in.
8. Put the lentil mixture into an oven proof dish and set aside.
9. In a bowl, whisk together the yoghurt, eggs and turmeric.
10. Pour the egg mixture over the lentil bobotie and place the 2 bay leaves on top.
11. Bake the bootie in the oven at 180ºC for about 20min until the egg custard has set and is slightly golden brown on top.
12. Remove from the oven and serve hot with chopped fresh coriander.

NUTRITION INFORMATION: per serving (recipe serves 4)

Energy: 1441 kJ Protein: 16.1 g Carbohydrate: 49.6 g Of which, total sugars: 24.1 g Fat: 11.0 g Fibre: 14.0 g Sodium: 94 mg

Visit the National Nutrition Week website for more recipes that include beans, peas and lentils!

Ostrich Stew with Gremolata

Leave a comment September 30, 2016 nutritionadsa

A great choice for health-conscious red meat lovers and a wonderful in-between seasons recipe – Ostrich Stew with Gremolata, created by chef Vanessa Marx.

Our dietitians say: Ostrich is a great tasting lean read meat. It is low in fat (only 1.4 g fat per 100 g meat), rich in protein (22 protein per 100 g meat), lower in cholesterol than other red meats (only 60 mg per 100 g meat), and a good source of biologically available iron  (3.2 mg iron per 100 g serving of meat)

INGREDIENTS

500 g ostrich fillet cubes

1 tablespoon (15 ml) canola oil

2 cans (400 g each) chopped tomato

1 cup (250 ml) red wine

1 carrot

1 onion

100 g mushrooms

100 g green beans

10 g thyme, fresh

10 g rosemary, fresh

1 can (400 g net, 244 g drained) beans e.g. kidney, butter beans or cooked sugar beans, drained and rinsed

salt & pepper

1 tablespoon (15 ml) xylitol

2 cloves garlic

10 g Italian parsley

1 lemon

METHOD

1. Peel and chop the onion and carrot, and slice the mushrooms and green beans.
2. Place a large pot on a high heat and add the oil. Once hot, add the onion, mushroom and carrot and sauté for 2 minutes.
3. Add the ostrich cubes, chopped tomato, wine and chopped herbs and reduce the heat to low.
4. Allow the pot to simmer for about an hour, stirring occasionally, the sauce will reduce and thicken and the ostrich will soften. Once this happens, add the green beans and season with salt and pepper, add the xylitol and the can of beans & stir.
5. Simmer the stew for another 5 minutes to cook the green beans.
6. To make the gremolata, chop the fresh garlic finely, chop the parsley and zest the lemon. Mix the parsley garlic & lemon zest together.
7. Serve the stew hot and sprinkle with the fresh gremolata.

NUTRITION INFORMATION PER SERVING

(recipe serves 4)

Energy: 1400 kJ Protein: 35.6 g Carbohydrate: 23.8 g Of which, total sugars: 9.1 g Fat: 6.7 g Fibre: 17.2 g Sodium: 180 mg

 

 

Time To Make Lifestyle Your Medicine

Chat Leave a comment September 28, 2016 nutritionadsa

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

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

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

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

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

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

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

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

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

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

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

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

Get ready for National Braai Day!

Chat Leave a comment September 22, 2016 nutritionadsa

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

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

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

 

Celebrating Heritage Day with Food!

Chat Leave a comment September 20, 2016 nutritionadsa

In celebration on Heritage Day (24 September), ADSA member Mpho Tshukudu and food writer Anna Trapido, authors of the wonderful cookbook EAT TING, share one of their many ‘traditional recipes with a modern twist’ with us!

EAT TING will make you fall in love with timeless African flavours – while also improving your health and well-being. Lets celebrate our heritage and get cooking:

Modernised Dikgobe Salad of Red & White Sorghum, Fennel & Radish

Ingredients

(Serves 8)

2 cups wholegrain sorghum (red, white or a mix), rinsed

salt

1/2 cup cowpeas or letlhodi (mung beans)

1 large fennel bulb, cut lengthwise into thin slices

2 tbps olive oil

freshly ground black pepper

1/3 cup orange juice

1/4 cup lime juice

1 shallot or small onion, finely chopped

2 tbsp chopped fresh dill

1 tsp finely grated orange zest

1/2 cup olive oil

5 large radishes, thinly sliced

1/4 cup olives, pitted and halved

2 tbsp finely chopped fennel fronds

1/2 cup fresh dill sprigs

Method

Place sorghum in a pot, add water to cover by about 3cm and season with salt. Place cowpeas in a separate pot and add water to cover. Bring both pots to the boil, then reduce heat and simmer, uncovered, until tender and water is absorbed (about 45 minutes to 1 hour). Add additional water to the cowpeas if needed. Preheat the oven to 200˚C. Toss fennel slices and 2 tablespoons olive oil in a medium bowl to coat. Season with salt and freshly ground pepper. Spread fennel slices out in a single layer on a baking sheet. Roast until fennel is crisp-tender and beginning to brown in spots, about 18 minutes. Cool on baking sheet.

Whisk orange juice, lime juice, chopped shallot, dill and orange zest in a medium bowl. Whisk in 1/2 cup oil and season to taste with salt and pepper. Set vinaigrette aside.

Mix cooked sorghum and cowpeas in a salad bowl; add fennel and juices on baking sheet. Add radishes, olives, fennel fronds and dill sprigs. Drizzle vinaigrette over and toss to coat.

GI is lowered by the ascorbic acid in the fruit juices.

Nutritional values per serving

Energy: 834,6 kJ

Carbohydrate: 25,6 g

Protein: 6,3 g

Fat: 9,9 g

Unsaturated fat: 8,5 g

Saturated fat: 1,3 g

Fibre: 2,6 g

 

“I’m fascinated about the effect of food on our health”

Chat Leave a comment September 16, 2016 nutritionadsa

We chatted to Registered Dietitian, Kelly Schreuder who also has professional culinary experience, 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?

I was very interested in health and the prevention of disease – always reading about nutrition and fascinated about the effect of food on our health.

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

I love supporting individuals through healthy lifestyle change. Everyone is totally unique and it’s very satisfying to work out what inspires and motivates each person. Everyone also has a point of readiness they need to reach before lifestyle change starts to feel easier and I love getting people to that point.

What has been your career highlight?

Running a sustainable business – making a living doing what I love and working on things that inspire me.

What are the most challenging aspects of your career?

Running my own business! Even when you love what you do, there will always be admin, chores, and those days when you’d rather not show up.

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

Get over it and start again – always going back to what I know works for me.

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

• “Oooh…Don’t look at what I’m eating!” (We trust that you are able to make your own decisions and we are not always perfect either)
• “Is this fattening?” (The answer will always be “it depends”)
• “What do you think of [insert latest diet trend]?” (unless you want a long answer that will also end up being something along the lines of “it depends”!)

Generally though, we are quite used to answering these questions, so bring it on!

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

Good rapport with the person. Our training is the same, and you should always feel that you can trust a dietitian, and get good advice, but when you have to work with someone long-term, it really helps to enjoy the time you spend with them.

What is your favourite dish and your favourite treat food?

At the end of the week I like to chop up all the leftover vegetables in my fridge and make a kind of fried rice (with brown rice, ideally) with spring onions, garlic and ginger. Favourite treat: Chocolate with nuts – any kind will do. I have a couple of squares almost every single day after dinner, with a cup of plain rooibos or green tea.

To find a dietitian in your area visit the ‘Find A Dietitian’ section on the ADSA website.

 

 

Add to your ‘must try’ dessert list: Avocado Chocolate Mousse

Chat Leave a comment August 24, 2016 nutritionadsa

We just couldn’t resist re-sharing this amazing ‘Raw Avocado Chocolate Mousse’ – a much healthier alternative to regular chocolate mousse and just as delicious. The mousse is packed with healthy unsaturated fat and an ideal alternative for vegans. It also contains none of the major allergens (cows milk, egg, soya, tree nuts, peanuts, wheat/gluten) and is ideal for individuals suffering from allergies to these food items. Developed by chef, Vanessa Marx, this should be at the top of your list of ‘desserts I must try’.

Our dietitians say:

Avocado pears contain primarily mono-unsaturated fats that have been shown to assist in keeping your heart healthy! They are also a good source of Vitamin E, which keeps your skin healthy and speeds up healing, as well as protecting red blood cells; Folic Acid, which helps with the production of red blood cells; and Selenium, which is an integral part of anti-oxidants (these help protect body cells from the damaging effects of free radicals and also needed for the proper functioning of the immune system)

RECIPE

Makes 4 portions

Ingredients

1 ripe avocado

1 ripe banana

1 orange

3 tablespoons cocoa powder

2 tablespoons xylitol

How to make it

– cut the avo in half. Remove the pip from the centre and discard. Remove and discard the skin too.

– in a food processor, add the avo, banana, cocoa powder, and xylitol.

– zest and juice the orange and add both to the food processor.

– blend the mixture until completely smooth and dark chocolate brown. The sweetness and darkness can both be adjusted by adding more or less xylitol and cocoa powder. The xylitol can also be substituted with honey, a low calorie or non-nutritive sweetener.

– you can remove the orange and replace with another flavour variation like cinnamon, lemon zest etc.

– spoon the mousse into 4 glasses for serving and refrigerate until ready to serve.

– serve with fresh fruit or biscotti

The nutritional value serves 4:

Energy: 1075 kJ

Protein: 3 g

Carbohydrate: 17 g

Total fat: 19 g

Dietary Fibre: 6.5 g

Sodium: 46 mg

To download the recipe card, visit http://www.adsa.org.za/Public/Recipes.aspx

Flying the flag for nutrition – Meet Lisanne du Plessis (RD)

Chat Leave a comment August 17, 2016 nutritionadsa

We chatted to registered dietitian Lisanne du Plessis who is a senior lecturer and the Head of Community Nutrition at Stellenbosch University, to find out why she became a dietitian, what she loves the most about the work she does and what she wishes people would stop saying when they meet a dietitian.

Why did you become a Registered Dietitian?

While I was in high school, I was randomly selected to take part in the MRC’s Coronary Risk Factor Study (CORIS). I was fascinated by the information provided to us about the ways in which nutrition could prevent and treat diseases. Two dietitians (Edelweiss Wentzel-Viljoen and Marjanne Senekal) were part of the research team who visited my hometown, Robertson, for this project and I was inspired by the prospects of the profession. I went on to study BSc Dietetics at Stellenbosch University and it was a very proud moment for me when I could write “RD/SA”, and for some time now, also “NT/SA” behind my name.

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

I am a senior lecturer at Stellenbosch University in the Division of Human Nutrition. I enjoy teaching, experiencing students who engage with nutrition theory in a positive way, watching them translate the theory into practice, seeing them graduate with big smiles and when they say: “Mam, you have instilled a passion in us for infant and young child nutrition” – those are golden moments for me.

What has been your career highlight?

I am fortunate that there have been many. I was exposed to wonderful, humble and sincere people in my very first job as a community dietitian. I have treasured the life lessons I learnt from them during my career. I was honoured to serve the profession on the ADSA Western Cape branch and the ADSA Executive committee in my early career and I also served as ADSA President (2002-2004). I have met amazing mentors and colleagues who have become friends and partners in flying the flag for nutrition; I have seen interesting and beautiful places and have had the opportunity to listen and speak to diverse nutrition audiences. Obtaining my PhD and surviving to tell the tale is the latest on the list of career highlights!

What are the most challenging aspects of your career?

Juggling life (husband, children, home, family, friends) with an intense and diverse workload.

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

Sigh…and try to do better the following day. I enjoy exercise – so that helps!

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

• Please don’t look in my shopping trolley/plate!
• I usually eat healthily.
• Can you work out a diet for me?

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

They should always feel that the dietitian carries their best interest at heart.

They should be able to build a trust-relationship with a dietitian fairly quickly.

They should be convinced that the dietitian is truthful when he/she says: “we practice evidence-based nutrition.”

What is your favourite dish and your favourite treat food?

I love many different kinds of food and especially enjoy tapas-style meals. I am well-known for my love of chocolate and bubbly!

 

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

 

 

Why breastfeeding should be everybody’s business

Chat Leave a comment August 1, 2016 nutritionadsa

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

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

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

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

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

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

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

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

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

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

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

 

Breastfeeding support is available in South Africa:

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

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

 

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

 

It is never too early to change to a healthy lifestyle

Chat Leave a comment July 18, 2016 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.

It is never too early make lifestyle changes and start a nutritional journey that will benefit you for the rest of your life.  This week we chat to 16-year old Chad Niebur, who started seeing Registered Dietitian Zelda Ackerman last year:

Tell us about your journey with the dietitian?

The journey with my dietitian was definitely a very insightful one. We’d usually arrive in the morning just before we headed off to the grocery store to stock up on the newest list of food products suggested, and reducing the amounts of some of the others that we’d usually buy. From the first to the last session, there was always something new to learn. A new food item to add, another one to reduce. We’d be asked how the week prior went, if we were keeping up with our exercise regime, etc. All and all, it was very insightful and much more easy going than I expected.

Tell us about your results?

My results were definitely more prominent than I expected. Within two months I went from baggy tracksuit pants and to skinny jeans. I can remember within the first three weeks losing just over four kilos, and went on to lose much more over time.

What was the hardest part of the journey?

The hardest part of my journey was cutting out Coca-Cola, but over time I grew to miss it less and less. To this day I don’t drink Coca-Cola at all, nor do I miss it.”

What are the top three tips you can share?

• Find a healthy substitute to you favourites drinks and snacks. I replaced Coca-Cola with carbonated water and a low-cal fruit juice concentrate.
• Don’t really make a big deal out of it, treat it as something you’ll be doing for the rest of your life and you’ll come to accept, get used to, and genuinely favour it over the way you used to live.
• Try and get the rest of the family involved, it’s definitely easier since there will be a lot less junk food in the house.

Feedback from Chad’s dietitian, Zelda Ackerman

Few patients really make a complete lifestyle change, and Chad really did! He changed his eating habits and became much more active. He used the eating plan as a guide, not as something that controls him. He learned to make healthy choices and be in control of his own eating habits. His mother was extremely supportive without being controlling, an attribute that is vital for parents to help their children attain an ideal body weight. I am very proud of Chad and his mother Sharrin.

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

‘Balance is key!’ Our latest success story

Chat Leave a comment June 24, 2016 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 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

“We all make mistakes or have bad days” – meet dietitian, Faaizah Laher

Chat Leave a comment June 22, 2016 nutritionadsa

Why did you become a Registered Dietitian?

Cooking has always been a favourite pastime and being Indian so many of our occasions revolve around food and the kitchen. Helping people through what they eat became an interest when I was in high school and applying for a degree in dietetics seemed like the most natural and ‘next step’.

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

The feeling when a patient with a perforated bowel or frozen abdomen – after a prolonged stay in ICU, high care and general ward – os finally able to leave the hospital and able to eat normally. When a renal patient who feels like they have no hope realises there are healthy and nutritious food choices they can make to ensure they live a healthy life.

What has been your career highlight?

My healthy cooking demos – getting this project off the ground and inspiring participants to eat and lead a healthier life. Translating nutrition knowledge into little pieces of practical advice for a magazine article or radio interview.

What are the most challenging aspects of your career?

The uncertainty when I left government service to start a private practise. Private can be a lonely place and fostering new relationships and keeping old ones close is so important!

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

Get right back into eating healthy again. We all make mistakes or have bad days. Accept it, learn from it and move forward.

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

• I really need to come see you! (As they rub their tummy)
• Oh, so should you really be eating that?
• Email me a diet, I don’t eat but I just keep putting on all this weight!!

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

Proximity to your work or house. Someone located close to you makes follow ups easier and also enables success in terms of achieving goals and relationship building. Consider choosing a professional that has an interest in the needs you have. Not all are comfortable in terms of allergies/ paeds and other specific conditions.

What is your favourite dish and your favourite treat food?

• Favourite dish at the moment: Tandoori chicken grilled perfectly, with a crunchy salad and grilled potatoes. Using the leftovers in a wrap the next day for work! .
• Popcorn!!

 

New Recipe: Veggie Frittata

Chat 3 Comments June 10, 2016 nutritionadsa

Our latest NutritionConfidence recipe (developed by chef Vanessa Marx) is quick, easy, packed with good nutrition, and a versatile choice for breakfast, brunch, lunch or dinner. It may sound exotic but a veggie frittata is really just a fancy omelette mixed with colourful vegetables and cooked in the oven.  Once you get comfortable making a frittata, branch out and make different flavours by swopping in seasonal vegetables like broccoli, cauliflower, tomatoes or spinach.

What the dietitian says: Eggs are a good source of high quality protein. They are also one of the few foods that contain high concentrations of Choline – essential for normal development and linked to improved memory and performance.

This recipe serves 8

INGREDIENTS

6 large free-range eggs

salt and pepper

1 tablespoon olive oil

½ a medium onion

½ a red pepper

2 courgettes

100 g mushrooms

100 g mozzarella, grated

50 g feta, crumbled

5 g Italian parsley, chopped

5 g fresh coriander, chopped

METHOD

1. Preheat oven to 200°C.
2. Beat the eggs together, season and set aside.
3. Drizzle the olive oil into a large ovenproof, non-stick frying pan and set over medium heat on the stove.
4. Slice up the onion, red pepper, courgettes and mushrooms.
5. Add the sliced vegetables to the pan and fry until they begin to get a little colour.
6. Add the beaten eggs and the cheese and mix slightly. Turn the heat down to medium-low and cook for three to five minutes until a crust begins to form on the bottom (do not stir the mixture).
7. Place the pan in the oven and bake for 10 minutes until the mixture has set.
8. Remove the pan from the oven and allow the frittata to cool slightly (five minutes).
9. Tip the frittata out upside down onto a board or platter, sprinkle with the chopped parsley and coriander and serve warm.

NUTRITION INFORMATION: Per slice (8 slices per frittata)

Energy: 527 kJ Protein: 9.5 g Carbohydrate: 3.9 g Of which, total sugars: 2.6 g Fat: 9.6 g Fibre: 0.9 g Sodium: 195 mg

Healthy Nutrition during Pregnancy

Chat 1 Comment June 9, 2016 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 Bonnie Classen, who started seeing Registered Dietitian Alex Royal when she fell pregnant:

Tell us about your journey with the dietician? 

Over the past few years I have strived to lead a healthy lifestyle, with my food choices being based around eating as many real foods as possible, and minimal processed and refined foods. Despite my diet being healthy for the most part, I still  found that I still struggled in a few areas – such as afternoon slumps, sugar cravings, and low energy during certain times of the day.

After falling pregnant, I felt it would be a good idea to visit Alex Royal for a dietetics consultation, to help guide me on the optimum food choices during my pregnancy. As the majority of my food choices were already healthy, I was very curious to see the assessment of my current diet, as I couldn’t imagine what possible improvements could be made.

Wow did I have a lot to learn !!

 While on the whole my food choices had been good, Alex highlighted so many interesting points regarding my current diet. From the excessive amount of fat I was eating each morning (I was shocked to hear how much fat I was consuming with my breakfast each morning, I had no idea), my very low calcium intake, and so much more.

Using my existing food choices and lifestyle – Alex helped adjust my current eating regime. Adjustments were made to my meals. From distributing my fat intake more evenly throughout the day, increasing of calcium, including protein & vegetables during certain times and so much more.

 As Alex worked with my current eating style and diet when making these adjustments, these changes weren’t very challenging to implement into my daily routine, which made them far more manageable to achieve.

What a difference these seemingly simple changes made to my life !

She also helped highlight some really important information to me regarding my dietary needs during pregnancy, such as the importance of calcium intake during pregnancy and the daily recommended dosage, as well as information on all the other essential nutrients required during pregnancy.

During our second consultation Alex also suggested I bring in all my vitamins, and assessed my vitamins dosages, giving fantastic suggestions on inclusions and improvements here too.

 Tell us about your results? 

The results I achieved after implementing the dietary changes were nothing short of fantastic! My afternoon slumps diminished, and I realized that my previous afternoon ‘sugar’ cravings was simply hunger – I was eating lunch far too early in the day and then only eating dinner after 7pm. So without an afternoon snack, was starving by 5pm!

By adjusting my food quantities, including protein into my breakfast each morning, and spreading out my fat intake –  I also felt far more sustained throughout the day.

Alex also gave me tips on how to ‘give in’ to my pregnancy craving, but ensuring that this was done with the right food choices, so that the extra calories I was consuming weren’t empty calories. She took my pregnancy experiences into consideration when creating my customized eating plan. Despite being starving, I was also struggling with severe nausea (a combination I didn’t know was possible prior to pregnancy!) After most meals, I then also suffered from heartburn and indigestion, making eating full-size meals very unpleasant.

One of Alex suggestions was to eat a healthy snack a few hours after dinner, which ensured I still got my extra calories required despite eating a small dinner. By also eating this healthy snack before the hunger & cravings hit, I felt satisfied and managed to avoid the late night “pregnancy” sugar binges I found myself giving into prior to my consultations.

During my consultations Alex tracked my pregnancy weight gain, ensuring this was on track, while still increasing my muscle mass. I have now managed to maintain an extremely healthy weight gain throughout my pregnancy. I have not only loved my pregnancy body, but also feel such a great sense of confidence that I have given my baby the best head start in life, by ensuring she has had the optimal nutrition needed 🙂

 What was the hardest part of the journey? 

The hardest part was to be more disciplined in preparing lunches and snacks for my work day. While packing lunch was easy (as we generally made a generous healthy dinner the night before – and took leftovers to work), I never prepared any snacks for work.

So it took some time to adjust to having to be slightly more disciplined in my preparation each morning, but the results were worth it! By simply taking those 15 minutes each morning to pack for the day, I now am completely able to avoid the 5pm ‘binge’ I found myself falling into each afternoon.  

What are the top 3 tips you can share? 

• From the 2nd trimester you should increase your daily calorie, but the extra food you eat shouldn’t just be empty calories, as it should provide the nutrients for your growing baby needs. It is also easier than you think to get these extra calories!
• You can get creative with your eating schedule during pregnancy. As mentioned, I suffered from extreme nausea, heartburn and indigestion when eating full-size meals, often making meals unpleasant. By splitting up your meals and eating smaller meals and snacks at different times within the day, it helped ensure I still consumed the calories and nutritional intake during pregnancy, while avoiding the excessive pregnancy heartburn & indigestion i experienced with larger meals.
• Be prepared !! When you have a busy work schedule, it is very easy to get caught up in your day and go for long stretches without food, then give in to the ‘convenient’ foods that are in reach (these usually being unprocessed, sugar filled snacks) By simply making time to prepare your lunches & snacks for your day ahead, you can maintain your healthy diet habits and continue to feel sustained throughout the day.

Feedback from the Alex Royal

It was an absolute pleasure to help Bonnie along this path. She made excellent dietary and lifestyle changes which benefited both her and her little one. Her body composition improved during her pregnancy with her body fat decreasing while her muscle mass improved. She managed her cravings and followed the meal plan to the letter, including the nutrients that we needed to focus on to help her baby develop and grow well.  Her motivation and commitment to her health and to her baby’s well being was inspiring.

“Sensible, long-term healthy eating is not the sexiest of subjects” – meet dietitian, Hlanzeka Mpanza

3 Comments June 8, 2016 nutritionadsa

Why did you become a Registered Dietitian?

By accident actually. My father brought a career guidance book home that featured a dietitian when I was in standard 9.  I was fascinated about the idea that everyday food could help with getting the most out of life whether in sports, work, disease and general mental well-being. I still am.

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

I work in the food industry. I believe this is the most exciting area to work in in dietetics today as there is so much happening in the field of food policy worldwide. My job as an industry dietitian is to make nutrition relevant and accessible to our consumers through relevant  products, messages and projects. And most importantly to provide our consumers with nutrition information that they need to make informed choices.  I like knowing that when we hit that sweet spot between the right health message and product/ project, we can positively change lives of millions of people every-day.

What has been your career highlight?

For a black girl from very humble beginnings, my job has allowed me to travel to places I never thought I’d see in my life. After qualifying, I registered as a dietitian in the UK, where I later went to work as I travelled my way around the continent over a number of years.  I not only got to work and live with diverse people from all over the world, I did it whilst still feeling like I was making a difference in peoples’ lives. Those years were special for me.

What are the most challenging aspects of your career?

Sensible long-term healthy eating is not the sexiest of subjects.  How do we as a profession get better at enabling the general public to eat better, without bells and whistles?  I’d like us to crack the key to population-wide healthy eating messages that are based on nutrition science yet are simple, engaging and accessible (not just financially but culturally as well).  We have to get to a point where investing in credible nutrition is the only sensible choice. At the moment, there is so much information clutter that the general public is mostly confused about what sensible healthy eating is. And when people are not food literate, they are not able to make lifestyle changes that they need to make for them live longer, more productive lives.

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

Except I don’t call them nutrition disasters. I call them celebration days like when your BFF gets a promotion and you share one big cake between the two of you or sad days when you get ceremoniously dumped by your ‘not-really-serious-boyfriend’ and you eat all the food in the house.  The problem is when sad and celebration day kind of eating becomes the norm, which is when you need to start recreating a healthier normal.  How I cope is I pick myself up the following day and go live my best life, it’s all about trying to do better every-day. I believe food is a legitimate way of coping with emotional events and marking milestones, that’s ok.  I don’t think shame and guilt are useful when it comes to sustainable healthy eating.

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

Are you really going to eat that?

How do I gain muscle or lose weight?

Don’t look at what I’m eating! (this makes us feel like the food police, which we’d like to think we are not)

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

Find someone who gets you and your vision. Someone who understands what you want to achieve. Other than when dealing with certain medical conditions, success in nutrition is mostly relative. Define what success means for you, your health, your culture, your work, your mental well-being, your budget, stage of life, support system, etc. Choose someone that can help you navigate what success means for you and how to get there without giving up the most basic parts of yourself that make you YOU. You are more likely to be successful when you do that.

What is your favourite dish and your favourite treat food?

It changes, right now I am loving ujeqe obrown ( steamed brown bread) that I make at home a serve with everything. As a treat, I have a weakness for  spicy chicken wings from the orange fast food chain.

4 NUTRITION TIPS FOR HEALTHY LIFESTYLE AWARENESS MONTH

Chat 1 Comment February 19, 2016 nutritionadsa

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!

 

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

“I enjoy helping clients design their wellness paths” – Meet dietitian, Mpho Tshukudu

Chat 1 Comment November 20, 2015 nutritionadsa

Why did you become a Registered Dietitian?

My favourite childhood memories are around food. My mother constantly told me about hungry children somewhere in East Africa, and I thought I would work for the World Health Organisation and feed hungry children. When I graduated, I had been exposed to different aspects of dietetics and nutrition and the initial plan was not an option. I still dream of the coastline of Kenya.

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

I enjoy helping clients design their wellness paths. They do have some knowledge and as I guide them, they gain confidence to assess what is right for them.

Satisfying moments: when clients meet their health goals and experience how a healthier body feels, how food and self-love can enhance their life and energy levels.

What has been your career highlight?

Since I studied Functional Medicine, I have widened my understanding of the relationship between diet, lifestyle, genetics and disease processes and this has influenced my practice.

What are the most challenging aspects of your career?

Dealing with clients who do not want to take responsibility for their health, and wanting to blame someone and rely on medication.

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

I really do not have those days. It helps that I do not have a sweet tooth, and because of my allergies to nuts, gluten and soya – nothing in the stores will be permissible to sort out any need for emotional and comfort eating.

I make time to prepare and enjoy my meals. I eat whole foods and do enjoy them tremendously. Yoga is my moving meditation and it helps to clear my mind.

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

“Please give me a diet “

“Do I look fat?”

“I am on this diet. Is it healthy?”

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

Someone who takes into consideration your culture, lifestyle, socio-economic status, family and social life. You have to be able to relate to the dietitian, to form a trusting relationship.

What is your favourite dish and your favourite treat food?

My daily treat : honest hot chocolate (raw, organic and milk and sugar free), coconut cream and milk.

My favourite dish is whole grain sorghum risotto with mushrooms and a mature (12 or 18 months) cheese.

 

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

“I made a complete lifestyle change” – Glenise’s Story

Chat 1 Comment October 19, 2015 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 Glenise Valentyn, who started seeing Registered Dietitian Retha Mostert after she struggled to fall pregnant and was diagnosed with insulin resistance. Here is her story ….

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

When I visited a gynaecologist, because I was struggling to fall pregnant, he did some tests and I was diagnosed with insulin resistance. He explained the dangers involved for the baby and me, should I fall pregnant and advised me to immediately start with a healthy lifestyle. I decided to see a dietitian.

Tell us about your journey with the dietitian?

I made my first appointment with Registered Dietitian Retha Mostert soon after I saw the gynaecologist. She worked out very easy meal plans (not diet plans) for me. All the ingredients were readily available at our supermarket. I could prepare food that my whole family enjoyed. She taught me how to make the right choices when making decisions on what to eat. I was very comfortable with her. A little bit later I found out that I was pregnant. I visited Retha throughout my whole pregnancy, looking forward to my bi-monthly visits with her.

Tell us about your results / successes?

I could feel a difference in myself right after I started to see Retha. I had much more energy. I only gained a total of 5kg throughout my whole pregnancy. Most of it was only in the last weeks. The gynaecologist was very worried at first that I wasn’t gaining weight, but she checked the baby’s progress and growth and was happy. I was tested for insulin resistance during my pregnancy and there was no sign of it. I gave birth to a normal baby daughter of 2.89kg. My weight after the birth of my baby was less than before I fell pregnant. Seeing Retha helped me make a complete lifestyle change.

What was the hardest part of the journey?

The hardest part was to resist pregnancy cravings. I always had to remind myself of the consequences of eating the wrong foods.

What are the top three tips you can share?

1. Believe in yourself
2. Trust your dietitian
3. Always plan ahead and put your plans in writing

What the dietitian says (a few words from Retha Mostert)

Throughout her pregnancy Glenise was so motivated. Her sugar levels were showing warning signs before the pregnancy and by making smart food choices she kept them under control throughout her pregnancy. She proved that its not necessary to ‘eat for two’ when you are pregnant. Even when she went for her regular check-ups with her gynaecologist, he couldn’t believe that she herself was not gaining a lot of weight, but sonars confirmed that her baby was growing the way she should. At 38 weeks Glenise had a healthy baby girl! What better reward can there be?

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

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

Chat 6 Comments October 8, 2015 nutritionadsa

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, 13^th 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.

Breastfeeding and Work – Let’s Make it Work!

Leave a comment July 31, 2015 nutritionadsa

Every year, World Breastfeeding Week is celebrated from 1-7 August and this year’s theme is ‘Breastfeeding and Work – Let’s make it work!’.

Optimal infant and young child feeding is defined by the World Health Organisation as ‘exclusive breastfeeding from birth for the first six months of life and starting from six months of age, feeding safe and appropriate complementary foods, along with continued breastfeeding for up to two years of age or beyond’

South Africa’s paediatric food-based dietary guidelines state ‘Give only breast milk, and no other foods or liquids, to your baby for the first six months of life’.

“Women from all communities need to be supported to continue to breastfeed when they return to work, and everyone should work together to ensure that breastfeeding mothers receive the support they need”, says ADSA spokesperson, Catherine Pereira. Most women do not receive adequate maternity protection and returning to work is often a barrier to breastfeeding because a mother becomes separated from her baby for long periods of time. Many mothers struggle to balance breastfeeding and paid work, therefore stopping breastfeeding earlier than they should.

Did you know?

• Breastfeeding mothers in South Africa are protected by the Basic Conditions of Employment Act and are legally entitled to two 30-minute breaks per day for breastfeeding or expressing milk if their infants are younger than 6-months!
• The Act also states that an employee is legally entitled to at least four consecutive months maternity leave, during which time breastfeeding can be established at home.
• In 2011, the Tshwane Declaration of Support for Breastfeeding in South Africa was signed by the Minister of Health and many other stakeholders. This stated that “the promotion, protection and support of breastfeeding requires commitment and action from all stakeholders, including government and legislators, community leaders, traditional leaders and healers, civil society, HCWs and managers, researchers, the private sector, employers, the women’s sector, the media and every citizen”.

How can we ensure that the workplace is breastfeeding- and mother-friendly?

• Have a breastfeeding-friendly room, corner or space in your workplace where mothers can breastfeed their babies or express milk.
• Ensure that there are refrigeration facilities for mothers to store breast milk if they are expressing.
• Support part-time work arrangements for breastfeeding staff.
• Make sure that your employees or employers know the legal rights of breastfeeding women.
• Show a positive attitude towards friends and colleagues that are breastfeeding mothers.
• If you are a woman who managed to breastfeed when you went back to work, share your experiences as inspiration for other women.
• Fathers and partners should read up on breastfeeding and how they can support women.
• Breastfeeding women should form or join support groups, such as La Leche League or contact a lactation consultant.
• Listen to women’s needs and respect a woman’s decision on infant feeding and offer support for her choice without prejudice.

Do you know why breastfeeding is so important for your baby?

• Give your baby only breast milk for the first six months; no other food or drink is needed at this age. If a baby is given other food and drink, they will consume less breast milk and receive less nutrition.
• Babies are protected against infection when they are breastfed. In addition to containing all of the nutrients your baby needs for the first six months, breast milk also contains antibodies that help to protect your baby against illness.

Did you know that a dietitian can assist you with breastfeeding? 

Dietitians are trained to assist mothers with breastfeeding as well as to assist mothers with continued breastfeeding when returning to work. Click here to find a Registered Dietitian in your area visit the Association for Dietetics in South Africa’s website.

For information and resources on WBW 2015, including posters, infographics and other documents from around the world, visit www.worldbreastfeedingweek.org

Work highlight – “Being able to witness how positively nutrition changes affect clients’ every day lives!” – Meet The Dietitian

Leave a comment June 24, 2015 nutritionadsa

As part of our ‘Meet the Dietitian’ series, we chatted to Lila Bruk about why she became registered dietitian, what she loves about her work, how she copes after a day of nutrition disaster and bad eating choices, and what people should look out for when choosing a dietitian.

Meet Lila Bruk a registered dietitian (RD) in private practice (Lila Bruk & Associates)

Why did you become a registered dietitian?

I have always been passionate about health, but I was particularly interested in the nutrition side and liked how dietetics allowed for creativity as well as interaction with people.

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

I love meeting new people, guiding them on their journeys and seeing them achieve their goals along the way. Without a doubt, the most satisfying moments are when people start to feel a significant difference in their health, energy and wellbeing and being able to witness how positively these changes affect their every day lives.

What has been your career highlight?

There have been so many, so it’s hard to pick, but I would have to say being involved with many high-profile projects and companies is definitely a highlight. Having said that, every day is filled with highlights and seeing my clients’ progress and being there when they achieve their goals is always so rewarding.

What are the most challenging aspects of your career?

This would definitely be managing the different sources of misguided nutrition information out there. Unfortunately the public gets so many conflicting nutrition messages from so many different sources that it can lead to them being extremely confused. This is especially difficult when the source of the nutrition information is seemingly reputable websites, health professionals, celebrities or other media. A lot of my time is then taken up trying to debunk many of the myths and misconceptions that these sources have put forward.

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

I think the best thing is to try to get back on track as soon as possible. Trying to cut out food from the next day will only backfire and you will land up overeating at a later stage. Getting back on your plan is the best strategy.

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

• “Do you eat like this?” – dietitians are people too. Sometimes we have good days and sometimes bad, but ultimately most of the time we do our best and make good choices.
• “I don’t like the taste of healthy food” – healthy eating is not all about boiled chicken and steamed broccoli! Healthy food can also be delicious, vibrant, tasty and exciting. It’s all about preparing it right.
• “I hate exercise” – being more active is all about finding something you enjoy. If you hate running and love dancing, then by all means do the dancing!

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

Try to find out whether the dietitian has dealt with similar situations to yours, but also see how you feel about them, whether they inspire confidence and whether they have a good reputation and the right qualifications.

What is your favourite dish and your favourite treat food?

My favourite dish is grilled teriyaki salmon with steamed veggies. My favourite treat would be frozen yoghurt or liquorice 🙂

Lila Bruk is a registered dietitian and nutritional consultant in private practice in Illovo, Johannesburg. 

She graduated from UCT with a Bachelor of Science degree in Microbiology and Biochemistry in 2002, followed by a Bachelor of Science Medical (Honours) degree in Nutrition and Dietetics in 2004 also from UCT. In 2010 she completed a Masters in Nutritional Sciences through the University of Stellenbosch in the fields of body image in pre-adolescent girls, digestive disorders (e.g. IBS), sports nutrition and food allergies.

Lila is passionate about promoting health and good nutrition and thus has written for various general and health-related publications such as O Magazine, FairLady, COSMOPOLITAN, Women’s Health, Men’s Health and Longevity. She also gives regular lectures on nutrition-related topics around the country, and appears regularly on television and radio. 

Her main areas of interest include nutritional management of lifestyle diseases (including diabetes, insulin resistance and heart disease), glycaemic index, food allergies, post-operative nutrition, sports nutrition, adolescent body image and digestive and gastrointestinal disorders (e.g. Crohn’s disease, Irritable Bowel Syndrome).

Lila is registered on the Discovery Vitality Dietician Network and thus is accredited to perform Discovery Vitality Nutrition assessments. Lila is registered with the HPCSA (Health Professionals Council of South Africa) and the Association for Dietetics in South Africa (ADSA). She holds the Sponsorship portfolio on the ADSA Executive Committee for the July 2013 to June 2015 term of office. She was also the chairperson for the ADSA Gauteng South branch from July 2009 to June 2013.

New NutritionConfidence recipe – Stuffed chicken breast wrapped in proscuitto

Leave a comment June 22, 2015 nutritionadsa

We love our latest NutritionConfidence recipe because it is the perfect easy-to-prepare option for a dinner party and is sure to wow guests.

This recipe is for special occasions and can be served with beautiful, seasonal vegetables, which at this time of the year include: asparagus, beetroot, broad beans, broccoli, brussel sprouts, fennel, Jerusalem artichokes, Kale spinach, parsnips, pumpkin, radishes, turnips and watercress.

Our dietitians say:

This is the lower fat version of bacon wrapped chicken breast stuffed with creamy feta and spinach. Leaner or lower fat protein options are used in this recipe – skinless chicken breasts instead of thighs; prosciutto ham instead of bacon; and Danish feta instead of Greek feta. To lower the saturated fat content of this recipe further, use reduced fat soft feta and remove excess visible fat from the prosciutto before cooking. Unfortunately the sodium content of this dish is high – the feta cheese and prosciutto ham being the main contributors. So rather keep this meal for special occasions!

Stuffed chicken breast wrapped in prosciutto

Makes 2 portions

Ingredients

2 free-range chicken breast fillets

100 g soft Danish style feta

100 g baby spinach

10 ml olive oil

4 long slices of prosciutto ham

Pepper

2 tablespoons chopped parsley

Zest of half a lemon

How to make it

1. Heat a medium pan on a high heat.
2. Add the olive oil and the baby spinach. Season the spinach with a pinch of pepper, and sauté the spinach until just wilted.
3. Remove the spinach from the pan and put into a mixing bowl to cool. Once cooled, squeeze any excess liquid from the spinach and crumble the feta into the spinach. Add the lemon zest and parsley and mix to combine.4
4. Preheat the oven to 180 deg C.
5. Lay two slices of prosciutto onto a chopping board, slightly over lapping.
6. Place the chicken breast on top of the prosciutto slices. Make a lengthways slit down the middle of each chicken breast, to butterfly it. Split the feta and spinach mix into two and stuff one half of the mixture into the chicken breast. Repeat the same process with the other chicken breast and stuff with the other half of the spinach mixture.
7. Roll the chicken breast up, wrapping it in the prosciutto.
8. Use a toothpick to pin and seal the ends of the chicken roll.
9. Put a non stick pan on medium heat.
10. Brown the chicken breasts for about 2 minutes until golden brown, turning them every couple of seconds for an even colour.
11. Transfer the breasts into an oven proof dish and bake in the oven for 12 minutes.
12. Remove from the oven and remember to remove the toothpicks.
13. Serve with a fresh seasonal salad or side dish of your choice.

Nutritional Value (per portion)

Energy: 1063 kJ

Protein: 35.2 g

Carbohydrate: 2.1 g

Total Fat: 11.6 g

Dietary Fibre: 2.3 g

Sodium: 1082 mg

To download the recipe card, visit http://www.adsa.org.za

Next week we start with our new series of NutritionConfidence recipes that will be perfect for the coming Winter months.

Making sustainable lifestyle changes and creating new habits – Michael’s success story

Leave a comment June 9, 2015 nutritionadsa

This week we chat to Michael North, as part of the series of success stories we will be sharing over the next couple of months. Michael started seeing Registered Dietitian, Elienne Horwitz, when he started gaining weight and feeling unhealthy:

Why did you decide to see a dietitian? (Michael’s before story)

The short answer is I was getting fat and feeling and unhealthy and all my attempts at watching what I ate and drank were short lived and unsuccessful. I was exercising a bit, mountain biking on the weekend and playing the odd game of squash, but these were usually followed by reward lunches with my friends.

Combined with this was that some friends who I would generally beat up the hills and round the trails started beating me! I also started noticing how slow I was getting and how steep and more difficult the hills were becoming. I guess when the lunches were getting longer and more taxing than the mountain biking, I knew I needed some help.

Tell us about your journey with the dietitian?

My first visit to Elienne was for a Discovery Vitality assessment that a friend from work said I should do to get points on my card to qualify for the discounts. After doing this and realising that the dietitian was not a scary food nazi intent on making me feel useless unless I weighed the same as I did in primary school and only ate salad and tofu, I knew that I needed to step up if I wanted to make any changes. Elienne was really friendly, honestly wanted to help and also had a nice, but slightly strict way about her.

She made me aware of what I ate but also explained why things were good or bad. If I didn’t like some of the food items she suggested, she always had several alternative options and by explaining why I needed those food choices I was, over time and with some practice, quite easily able to choose my own alternatives.

Elienne started out by giving me a breakdown of the number of carb, protein, dairy and fat portions I should eat a day and when and how I should eat them; breakfast, mid-morning snack, lunch, mid-afternoon and dinner.

I started swimming with a group at my local gym and was still mountain biking a bit so she showed me how I should adjust my diet during exercise and for recovery after.

The basic principle was not a quick weight loss scheme but more of a healthier living choice, which facilitated weight loss until reaching a weight appropriate for my height and age, etc. So my journey was not a very quick one but my weight loss and fitness levels gradually but consistently went in the right direction.

Tell us about your results / successes?

I think it took me about a year but I lost 18 kg and quite a few centimeters. I also started cycling more, doing events like the Argus and several open water swims. Most importantly, I just felt better.

After a while I started looking for other challenges to help keep me active and on track with my plan instead of back to the pub everyday! I joined a group called Embark, in Sea Point to train for the Ironman 70.3 event in East London and not only completed the triathalon, but also won the Embark “Most Improved Over All” award at the club after party. I was quite proud of that, considering that I had sworn to never run more than 5km in my life!

The following year I joined another triathlon group (My Training Day) and in April 2014 completed the full Ironman. Now the bug has bitten and this year I improved by time by about 30 minutes.

I still keep pretty much to the same eating plan that Elienne put me on in the beginning but am able to eat a bit more now with all the training I am doing. What is great though is that I now know that when I go off track a bit and maybe pick up a kilo or two and it doesn’t take much to fall back into the routine of eating properly and losing the excess again.

What was the hardest part of the journey?

Avoiding beer, red wine and pizza!

In the beginning, the hardest part was eating 5 times a day. Generally in the past I would not eat breakfast or eat very little, then be so hungry by lunch that I would eat a big, junk food lunch and would justify it by saying that I hadn’t eaten all day “so it was ok”. Then I did the same for dinner.

What are the top three tips you can share?

• If you want to eat more, exercise more and substitute some of the bad stuff for good stuff.
• If you want to lose weight, don’t make excuses, you know that pies and chips are not going to help.
• If you can, go to a dietitian or someone like that to help get you started on your way and explain the ins and outs of the process. Being held responsible for your progress with regular weigh-ins can be a real help and motivation to say no to the extra beer or second helpings.

What the dietitian says

Michael lost 18kg, 13% body fat and 15cm around the waist over 16 months. He slowly changed his habits and started putting more energy into planning and preparing his meals and increasing his levels of exercise. He maintained his weight even a year later.

The most important reason Michael managed to lose the weight and keep it off was because because he did not diet – he made sustainable lifestyle changes and slowly created new habits.

“People don’t eat nutrients, they eat food” – Meet The Dietitian

1 Comment May 22, 2015 nutritionadsa

Over the next couple of months we will be introducing you to some of the amazing dietitians we work with every day. We are going to find out why they became registered dietitians, what they love about their work, how they cope after a day of nutrition disaster and bad eating choices, and what people should look out for when choosing a dietitian.

Meet Nathalie Mat, a clinical dietitian in private practice.

Why did you become a Registered Dietitian?

I grew up in a family that loves and celebrates food but is also concerned with health. What really drew me to becoming a dietitian is that dietetics is based in science but requires artful skill for successful implementation. People don’t eat nutrients, they eat food and it’s my job to help interpret ever-evolving nutrition research into real food that people can eat and enjoy.

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

My heart absolutely sings when someone walks into my office looking vibrant and healthy and tells me how much better they feel – and all we did was fine tune their eating. I love seeing people transform their health and their relationship with food. It is wonderful seeing people achieve their goals and it is a privilege to share the journey with them.

What has been your career highlight?

Presenting my thesis at an international congress and receiving my masters in nutrition was a definite highlight. I’ve also really enjoyed serving as the ADSA Gauteng South chair and being part of my profession.

What are the most challenging aspects of your career?

Because everyone eats food, almost everyone has a theory on nutrition that is their own and is unique to them. Helping people find their individual recipe for health is my job – but I have to fight a lot of misperceptions. Just because something worked for your aunt/friend/colleague does not mean it’s right for someone with your genetic background or lifestyle.

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

Firstly, if I am making a slightly less healthy choice, I really savour and enjoy it. I think food is meant to be enjoyed! I then make sure that I get back on the healthy bandwagon as soon as possible; I do not wait for Monday. Life is about balance. Your arms and legs won’t fall off if you eat a chocolate; just make sure that you’re choosing chocolate 10-20% of the time and making healthy, balanced choices the other 80-90% of the time.

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

Everyone always asks for a quick tip to losing weight – I don’t mind answering but people tend to ask a second time because they do not like my answer of “Eat more vegetables”. It makes me laugh.

If someone meets me for the first time and we’re having a meal, they often say “please don’t watch what I’m eating”. If it’s Saturday night or after hours, I’m not on the clock. I love answering nutrition questions but I am not secretly calculating everyone’s kilojoule intake.

“I have ; what should I eat for that”? I do my best work when I am in my office; if you’re keen on getting quality nutrition advice, go and see your dietitian for an appointment. Not only can a dietitian miss important points while you’re both eating dinner or having coffee, you are not likely to remember everything that was said over a meal.

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

I think the most important aspect of working with any health professional is that they should hear you. Finding the right dietitian is like finding the right psychologist – you need to be on the same page. You’ve found the right dietitian for you if he/she can create a way of eating that is sustainable in the long term; is manageable (in terms of money, time and effort); and is tasty.

What is your favourite dish and your favourite treat food?

I love everything. I really enjoy eating a wide variety of cuisines and styles so my favourite dish can change every time I’m asked. I am loving fragrant Indian curries at the moment. In terms of a favourite treat, my parents are both Belgian so I think chocolate will always be one of my favourites.

Nathalie Mat completed her Bachelors in Dietetics at the University of Pretoria where she is completing her Masters. Nathalie has experience in both State and Private hospitals and clinics. As a qualified personal trainer and avid cook, she is able to translate up-to-date scientific information into practical and achievable goals for her patients. Nathalie has been published across a variety of media and platforms including CPD activities, Oprah Magazine, Business Day and e-tv. She has worked as a guest lecturer and enjoys a variety corporate work. She’s the treasurer and chair for the ADSA Gauteng South branch.

Quinoa & Fig Salad

1 Comment April 24, 2015 nutritionadsa

With beautiful weather forecast for most of the country for the long weekend, our latest NutritionConfidence recipe “Quinoa & Fig Salad” is the perfect meal. We love the combination of sweet, salty and sour in this recipe. A lovely vegan main meal containing a good combination of protein, carbohydrate and healthy mono-unsaturated fats. Also perfect as a side salad for a braai this weekend!

Our Dietitians Say

Quinoa is a good source of fibre, folate, magnesium, manganese, phosphorus and B vitamins. It has an amino acid score of 106, which indicates a complete high-quality protein. Quinoa is also a good source of carbohydrate and contains roughly the same amount of carbohydrate than a 100 g portion of cooked brown rice.

And importantly, figs are currently in season here in South Africa and available at most grocery stores.

RECIPE

Serves 4

Ingredients

1 cup white quinoa

2 cups water

8 purple figs, cut into quarters

100 g walnuts, raw & unsalted

200 g mixed salad greens (rocket, baby spinach, watercress)

1/2 cucumber

120 ml extra virgin olive oil

50 ml white wine vinegar

1 tablespoon honey

1 teaspoon smooth Dijon mustard

How to make it

– Preheat the oven to 150 deg C.

– Put the quinoa & water into a medium saucepan on a medium heat. Cook the quinoa for about 20 minutes until it expands and opens slightly. Cook with the lid on. Remove from the heat and strain the excess water from the quinoa. Season with a pinch of salt and leave the quinoa to cool.

– Roast the walnuts on an oven proof tray for about 10 minutes, check on the walnuts now and then to make sure they don’t burn. Remove the nuts from the oven and leave to cool.

– Using a peeler, peel the cucumber to make long thin ribbons. Peel around the cucumber using only the firm outside parts. Discard the middle part of the cucumber with the seeds or eat as a snack.

– To make the dressing: whisk the vinegar, honey & mustard in a mixing bowl. Slowly drizzle the olive oil into the bowl, while continuously whisking to combine.

– Assemble the salad greens on a large plate or platter. Sprinkle the cooled quinoa over the salad leaves. Arrange the figs and cucumber ribbons on top of the salad. Sprinkle the roasted walnuts over the salad and drizzle with the dressing.

– Serve as a light main course or as a healthy side salad to your favourite dish.

The Nutritional Value serves 4

Energy: 2689 kJ

Protein: 11.3 g

Carbohydrate: 51.3 g

Total Fat: 44 g

Dietary Fibre: 41 g

Sodium: 8 mg

Liquid Assets

Leave a comment April 9, 2015 nutritionadsa

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:

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

Success Story – Carla Schoeman

1 Comment March 31, 2015 nutritionadsa

Over the next couple of months, we are going to share some success stories with you and find out why people decide to see a dietitian, what happens on the journey, what is hardest part of that journey and the end result from the client’s point of view.

First up is 32-year-old Capetonian, Carla Schoeman, who consulted with Registered Dietitian, Catherine Boome:

Why did you decide to see a dietitian? (Carla’s before story)

I have lived a relatively healthy life, eating what I thought was a balanced diet, and exercising regularly but not really seeing or feeling the results I felt I deserved with the effort. I do have some hormonal challenges that also complicate weight loss and felt that I was just getting heavier and heavier –despite pretty much always being on some form of a diet.

I tried my best to hate all carbs and mostly avoided sugar. But not only did I not lose weight, I gained weight, a little more every year. I’ve always been a runner and despite drastically increasing my mileage over the years, I kept getting slower.

At the end of 2012, I just decided enough was enough! I needed to get really serious about my health. I clearly didn’t have all the answers so decided to find someone who does. This was a big step for me – I’m a very proud person and asking for help didn’t come easy.

Tell us about your journey with the dietitian?

I was referred to Catherine Boome by a friend who raved about her holistic, “normal” approach to food and nutrition. I wasn’t too keen on weighing things or counting points, so this was a big plus. I met with her at the end of January 2012 and told her my story.

I expected her to be as perplexed as I was about my weight gain/lack of weight loss but she wasn’t. She was convinced she could help me. After spending about 90 mins with her going over my routine, my likes and dislikes etc. she developed a personal plan for me.

A week later, after spending some time explaining to me how my hormonal imbalances are impacting the way food behaves in my body, she presented me with a plan that not only compensates for that, but also included carbs! (I was worried about that!) .

The main focus was on portion control – helping me understand what my body really needs, how much and how often. She also spent quite a lot of time preparing me mentally – calling me out on being too hard on myself and not having faith in my abilities to accomplish my goals.

The plan was so simple, I couldn’t believe it. It was applicable to pretty much every part of my life. Even when I went out for dinner with friends, I was able to make smart choices within the eating plan, no matter what restaurant I was in.

Once I understood why my body was being so stubborn about weight loss, I could work with that to make smarter food choices. Even after the “diet” finished.

Catherine was also fantastic in providing leadership when I decided to enter the Argus – helping me make the best choices for my body’s needs over such a long distance. She helped me prepare for holidays, giving me tips on what types of foods I should favour when I’m in another country and not in control of the preparation or the menu.

Every time I had a question (or a meltdown), Catherine calmly provided me with the information I needed to make the right choice. She is part and parcel of my success story – she provided the framework I needed to get to where I wanted to be, and which allowed me to be “in charge” of the decisions I made.

Tell us about your results?

I refuse to weigh myself so the only times I’ve been on a scale in the past 5 years has been in Catherine’s office. Three months into the plan I had lost about 6kgs. No one was more surprised than me.

I continued to lose another 8kgs by the end of 2013. That was 14kgs in about 11 months. I dropped 2 dress sizes and my entire body composition changed. Also, I went from average runner to a really good one – taking almost 30mins off my average time for a half marathon.

At the end of 2013 Catherine gave me a maintenance plan. I check in with her every 6 months to keep myself accountable and I’ve managed to keep my weight consistent over the past 15 months, since finishing the plan. I also talk to her regularly for advice on changes in my routine, or when I’m training for a particular race. I feel so in tune with my body, I can feel when I’ve had an unhealthy couple of days – and I know exactly how to fix it. No need for a panic, or a crash diet. I just go back to the basics that Catherine gave me.

What was the hardest part of the journey?

For me the biggest hurdle was to actually make the appointment to go and see her, as I couldn’t imagine that she would be able to tell me something I didn’t know. I was very wrong!

That first winter was pretty tough too because I was less active and therefore home more and wanted to eat more! Catherine provided some great advice and ideas that got me around those hurdles without any long-term damage. Socially I struggled a bit with friendship-dynamics changing when I gave up alcohol, but mostly I was very well supported in my journey. I haven’t given up alcohol completely – I love my red wine, but now have it as a treat when I’m with friends. It’s not part of my daily routine anymore.

What are the top three tips you can share? 

1. The dietitian’s advice won’t help you unless you do what she says.
2. The only way to get lasting results is to make lifestyle changes. You can’t do a fad diet and expect a long-term result. It must be about being healthy, first. Weight loss is a consequence of that.
3. It’s TOTALLY worth it

What the dietitian says (feedback from Catherine Boome)

Carla was destined to succeed right from the minute she walked into my rooms. She was very motivated to be healthy but just so confused with what, when and how to eat in order to manage her weight. She had been making a great effort to lose weight but she was not being rewarded with the results she deserved. Something just did not make sense and she decided to approach an expert in food and nutrition to help her make sense of it all.

We started with basic Nutrition 101. Nutrition Education in order to facilitate a good understanding of food as a source of nutrition and fuel for the body, understanding metabolism and how certain food choices and eating habits can affect the body’s metabolism, hormones, insulin response, fat burning capabilities and therefore the ability to either gain or lose weight.

It was important for me to find out a bit about Carla – her food preferences, type of work, lifestyle patterns, exercise and hobbies in order to put together something that would fit into her way of life so that it would be practical for her to follow.

I then put together an individualized eating plan for Carla to follow and encouraged her to return to me periodically (as and when it suited her) for more support and motivation. This would also be an opportunity to tweak the plan if we needed to, or to answer any questions she might have had.

Incorporating healthy eating habits into Carla’s life did not appear to be too difficult, in fact she made it look very easy! This was a result of her motivation levels and go-getter personality. I believe that benefits of her improved energy levels, vitality and overall health served as a great motivator for her to keep going.

I believe that one needs to learn HOW to eat in order to manage weight, as opposed how to learning NOT to eat. This is such a valuable lesson for many of my patients.

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

Sustainably Farmed Kob Stuffed with Fennel & Orange

Leave a comment March 27, 2015 nutritionadsa

Next up in our NutritionConfidence recipe series is a simple and tasty fish recipe from Chef, Vanessa Marx. This recipe is perfect for a gourmet meal that is also good for your health. An added bonus is that sustainably farmed kob is also good for the environment.

Our dietitians say:

There are many benefits to eating fish more often. Fish includes key micronutrients: mineral phosphorus, selenium, potassium, iodine, zinc and magnesium and vitamins B2, B12 and D.

The South African Healthy Eating Guidelines emphasise the importance of fish intake – it should be at the top of your list when choosing a protein for a meal.

The aim should be 2 – 3 portions of fish per week.

RECIPE

Makes 4 portions

1 whole sustainably farmed kob

1 medium fennel bulb, sliced

1 orange

1 lemon

20 g dill

20 g chives

30 g butter

50 ml olive oil

Salt & black pepper

Tin foil

– stuff the belly of the fish with the sliced fennel, chives and dill

– slice half of the orange and half of the lemon

– stuff the slices of citrus into the fish

– use the remaining half of the orange and lemon for the juice, and squeeze the juice over the fish

-rub the outside of the fish with butter and drizzle with olive oil

– season with salt & pepper

– wrap the fish up in 2 layers of foil

– place on the braai over medium to low coals for about 15 minutes, then turn the fish for a further 15 minutes

– unwrap the fish from the foil, taking care to reserve the juices which you can use to dress the fish when serving.

The nutritional value serves 4:

Energy: 1459 kJ

Protein: 23.7 g

Carbohydrates: 9 g

Total fat: 22.5 g

Fibre: 4 g

Sodium: 788 mg

To download the recipe card, visit http://www.adsa.org.za/Public/Recipes.aspx

Salt Awareness Week 2015

Leave a comment March 19, 2015 nutritionadsa

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

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

Skipping breakfast will do more than damage your health

2 Comments March 13, 2015 nutritionadsa

It’s 6am, you are up and about and ready to start your day, but have no appetite or time to eat breakfast, and so you decide to postpone eating until the next meal of the day, which is only at 12pm. In essence, choosing not to eat breakfast means you are consciously making the decision to hamper your health as well as your performance at work or even at home. Perhaps it’s because you want to lose a few kilos?

Registered Dietitian Nathalie Mat puts that weight-loss myth to rest and explains how, by not eating breakfast, you are in fact depriving your body of sufficient nutrients that it needs in order to function on a daily basis. “Our bodies are not given any food overnight while sleeping, the first meal of the day helps to get our body started and get our metabolisms going,” says Mat. “Skipping breakfast is associated with higher weight gain and poorer performance.”

Perhaps you struggle to gulp down a meal in the morning due to the fact that you simply do not possess an appetite at that time. According to Mat, you are not alone: “Many people report having no appetite in the morning. I often find this is because they are eating too large a dinner. Reducing the size of your dinner may improve your morning appetite.” Choosing healthy foods that form a balanced meal will ensure your blood sugar levels are consistent meaning you won’t burn out later that morning, which is often the case.

“A healthy breakfast is a balanced one that includes a mix of wholegrain starchy foods (such as high fibre cereals, porridge, wholegrain or sourdough bread and even legumes like as beans or chickpeas) and protein rich foods (such as dairy products, eggs, lean meats or fish),” says Mat. “For example, it could be oats porridge with low fat milk, bran rich cereal with milk or wholegrain bread with some cheese, egg, beans or even peanut butter.” You can also add fruit to your breakfast. Fruit is a natural source of sugar but should be consumed as fresh fruit rather than juice if you want to control your blood sugar levels well.

Not only will eating a decent breakfast improve your performance throughout the day, but sustaining a lifestyle that is balanced in general will put diseases like cancer, strokes and heart attacks at bay. “Poor diet, physical inactivity and smoking are believed to contribute to those conditions,” says Mat. “These can be prevented by managing your lifestyle choices.”

The sooner you make the first step by eating the first, crucial meal of the day, the sooner you will begin living a more health and vitality-filled life.