NEW Recipe: Lettuce & Pea Soup

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

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

 The dietitians say:

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

INGREDIENTS (Serves 4)

5 ml         butter (1t)

5 ml         olive oil (1t)

3 leeks    well washed and sliced with the green tops

1 ml         dried crushed garlic (¼ t)

2.5 ml     salt (½ t)

1              head of butter lettuce, finely sliced

250 g      frozen peas (1½ c)

1.25 L     boiling water (5 c)

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

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

125 ml    chopped parsley (½ c)

METHOD

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

NUTRIENTS PER serving (200 ml of soup)

Energy                                   740 kJ

Protein                                   6.7 g

Carbohydrates                     28.0 g

Total sugars                         6.2 g

Added sugar                        0.0 g

Total Fat                                3.1 g

Saturated fat                         0.8 g

Fibre                                      6.4 g

Sodium                                 773 mg

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

FOOD FOR SENSITIVE TUMMIES

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

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


ADSA News for Private Practising Dietitians

One of the ADSA Executive Committee portfolios takes care of the needs of Private Practising Dietitians (PPDs) in South Africa. There have been some important developments in the private practice dietetics space due to the work of the ADSA PPD portfolio. Please read all of the information below if you run a private practice.

Practice cost survey

ADSA and the Hospital Dietitians Interest Group (HDIG) have been engaging with Healthman, a healthcare consultancy, to improve dietetic billing since 2016. The rates at which private practicing dietitians are remunerated have not been based on real-life practice costs. The following survey will help change this and you have a chance to be part of it!

We need as many dietitians in private practice as possible to answer the following survey. Please send this link onto non-ADSA members in private practice to help us reach as many dietitians as possible.

Important: all results are independently collated by Healthman and no dietitian will see the survey data.

Completed entries will be entered into a lucky draw for a R1000 Pick ‘n Pay voucher.

After this initial survey, we will need a minimum of forty practices to submit their financials to help assess if dietitians are fairly remunerated considering the cost of running a practice. The weekly mailer will include further information.

Please click the following link to answer the survey: Dietetics Practice Profile Survey 2017

The survey will take about 10-20 minutes to complete.

Professional Indemnity Insurance

The public are protected by the Consumer Protection Act which covers all services, including those provided by a dietitian. If a patient suffers harm or loss due to negligence, they are entitled by this act to sue the service provider – and this may include you as a dietitian.

Professional indemnity insurance is highly recommended for any private practising healthcare practitioner. ADSA has negotiated excellent rates for professional indemnity cover for dietitians. Please log onto the member section of the ADSA website and look under the PPD section (http://www.adsa.org.za/Members/PPD.aspx) to get the latest forms to apply for cover for the year.

Clarity on billing practices

Dietitians use time-based billing. As part of the consultation with Healthman last year, the descriptors were updated and sent to medical funders. Please click here: Dietitians Coding Structure 2017 to download the up-to-date billing codes. Changes to codes include re-inserting the term “planning” into the descriptors (which had been removed in 2006) and adding to the rules and modifiers. Please take the time to read through these. Previously there was confusion around whether or not a dietitian could charge for time spent planning without the patient (non-contact medical nutrition planning). This change now means that a dietitian can charge for non-contact medical nutrition therapy. This amount is capped at 50% of the total time claimed.

Update on Discovery Vitality benefits

Many dietitians have asked questions around changes in the Discovery Vitality programme. Please click here for a letter from Craig Nossel, head of the Vitality programme, explaining why the changes have been made. Letter from Craig Nossel

Some practical information with regards to the new changes:

  • To claim points, Vitality members must submit their statement from the dietitian to the medical aid and points will be automatically allocated.
  • If the person is not a member of the Discovery Health Medical Scheme, they can email their statement to: claimsvitalitypoints@discovery.co.za and points will reflect automatically.
  • The dietitian no longer needs to enter anthropometry in the same way she/he did for the Vitality Nutrition Assessment.
  • 1000 points will be awarded for seeing a dietitian per year.
  • The appointment must be at least 30 minutes long.
  • If a dietitian is working at a wellness day and the company covers the cost of the assessment, a zero-cost statement with the Vitality member’s information can be used to claim points.
  • The Vitality Weight Loss rewards programme is yet to be launched – dietitians will be made aware of what is happening before the programme launches.

ADSA and the Discovery Vitality team regularly meet to discuss developments.

As always, if you have any questions or concerns you would like us to raise, you are welcome to contact Nathalie Mat: adsappdqueries@gmail.com.

 


The facts about ADSA

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

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

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

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

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

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

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

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

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


The Low Down on South Africa’s Sugar Tax

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

How much sugar do South Africans really consume?

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

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

What is ADSA’s recommendation for sugar intake?

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

The sugar tax – is it a good idea?

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

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

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

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

 


10 Healthy Ways to Survive the Festive Season Eating Frenzy

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


Why dietitians want you to love your beans!

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

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

Why pulses?

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

Cooking tips for pulses

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

Great, easy snack ideas for pulses

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

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


“I love the versatility our profession”

Monique_1We chatted to Registered Dietitian, Monique Piderit who works mostly in the corporate wellness space, 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 heard about dietetics for the first time when I was in 2nd year at Wits doing a BSc. I soon realised that all my subject choices where right in line with the types of subjects done in dietetics. It was one of those “aha” moments where I realised I have just fallen in love with my future profession.

If you ask my mother this question, she will tell you I was born to be a dietitian. From an early age, it was natural and easy for me to choose the healthier foods. I disliked fatty meats, chicken skin, and creamy-based foods, and processed meats like polony made me ill. I was quite happy to have milk with my meals, never went overboard on sweets and chocolates, and there was never a struggle as a toddler to eat veggies. It really is just something that is instinctive for me to be healthy and thus it’s easy to lead by example.

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

I love the versatility our profession. People think dietitians just help with weight loss diets. The truth is almost every medical concern, disease or condition can be managed, treated, or even prevented with good food choices.

Also, I enjoy how impactful our profession can be. I work mostly in the corporate wellness space. Employees spend 1/3 of their time at work, making the workplace the ideal opportunity to promote and encourage healthy nutrition. I am involved in onsite nutrition consultations, canteen audits, nutrition workshops and article writing for corporates, all impactful yet undervalued ways to address nutrition.

What has been your career highlight?

There are many dietitians that I look up to and admire in our profession, and when these dietitians express acknowledgement in the work that I do, it is hugely fulfilling. It is gratifying and rewarding when your mentors, dietitians who love and protect profession as much as you do, recognise and compliment you on your contribution to the profession.

What are the most challenging aspects of your career?

Everyone eats, so everyone thinks they’re an expert in nutrition. The truth is nutrition is far more complex than calories and not as simple as just being about food. On a daily basis, dietitians, the nutrition experts who study for years to practice, are confronted by people who (unknowingly) cannot discern evidence-based nutrition from sensationalist ‘fact’ found on the internet. It has been a personal challenge to learn how best to address the controversial questions in a friendly manner, remaining true to the science. Regardless, my immense pride to be a dietitian always helps me keep my head high.

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

I never let it get to a point of an entire day of poor choices, but rather a cheat window where I allow myself to relax the nutrition strings, thoroughly savouring and enjoying the less healthy choice. It’s so vital to change how you think about food. Food nourishes the body and is not a sentence to a life of unhappiness. There will be meals where you overeat or eat incorrectly. But the power resides in you that at the next meal or even in the very next bite you decide you are in control. Be kind to yourself. No one is perfect (not even your dietitian).

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

  • Are you really going to eat that? Dietitians are humans and have taste buds and emotions like everyone else. When you’ve eaten well most of the time, your body can certainly tolerate a little cheat here and there, so yes, I’m not only going to eat that but delight in every bite along the way.
  • So tell me, what’s your opinion on Banting? The answer is I don’t have an opinion, I have a position, a position that, like other health care professionals guided by science, is based on scientifically-sound, evidence-based, high quality research.
  • Can you make me a meal plan quickly? Meal plans take time and effort and require an understanding of your needs, likes, dislikes, medical history, budget, lifestyle, etc. If meal plans were the ultimate answer, then one could simply download one of the thousands on the internet and be healthy, happy, skinny, and fit. A meal plan is a guide to healthy eating, not the ultimate answer.

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

Our relationship with food is so very intimate and personal that you need to be comfortable to open up and share that with your dietitian. You need to find a person that you trust in and can connect with. It’s also important to remember that dietitians are the leading experts in nutrition and you should note red flags when the person favours a certain diet, pushes sales of a product that you “have to have”, or “prescribing” weight loss medication. Chances are this person is not a dietitian.

What is your favourite dish and your favourite treat food?

My family is Portuguese and I am the first generation to be born in SA. The culture, language, and of course, food, is still a large part of who I am. A freshly baked, hot bread roll with butter or perfectly plump roast potatoes are an all-time comfort and favourite. I am also not inclined to part with my beloved red wine (red grapes count as a serving of fruit, surely?

Monique is a registered dietitian with a background in corporate wellness and Masters degree in Dietetics in sports nutrition. Guided by evidence-based nutrition, Monique believes in an integrated approach to wellness where the key to being healthy is to adopt small yet sustainable changes to your lifestyle. Monique is a member of the ADSA (Association of Dietetics of South Africa) Gauteng South branch and registered with the HPCSA (Health Professionals Council of South Africa). She is also a Discovery Wellness Network dietitian and DNAlysis accredited practitioner.

 

 


How can a Dietitian guide you through the Nutrition Minefield?

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

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

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

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

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

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

Did you know?

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

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

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

Trust a Dietitian


Dietitians and consumers deserve more credit

ADSA Executive Member, Maryke Gallagher, has responded to a recent article by Sonia Mountford, published on the BizNews website, entitled “Dietitians dishing you up a daily menu of unhealthy eating advice”

http://www.biznews.com/health/age-well/2015/05/25/are-dietitians-dishing-up-a-daily-menu-of-unhealthy-advice/

DIETITIANS AND CONSUMERS DESERVE MORE CREDIT

By Maryke Gallagher (van Zyl)

The recent article by Sonia Mountford in BizNews titled “Dietitians dishing you up a daily menu of unhealthy advice?” makes several allegations against the Association for Dietetics in South Africa (ADSA) and, regrettably, also brings an honourable profession into disrepute.

I would like to address some of the concerns and provide a more balanced view on the issues raised.

Ms Mountford’s arguments are not new and she quotes several international studies to justify her arguments but references no credible empirical research locally that finds an “unhealthy”, compromising and complicit relationship between big foods and dietitians, which she claims.

ADSA is not the only body that raises funds from the sector in which it operates. It’s a common practice and there is nothing sinister about it. That is exactly why ADSA is open and transparent about who our sponsors are and our sponsorship policy is readily available on ADSA’s website. Sponsors should never be allowed to dictate an organisation’s messaging and content, especially in the health sector where all information should be evidence-based and ‘first do no harm’. We firmly believe that, as health professionals, we follow this mantra and that our members have sufficient training to be able to assess evidence-based, peer reviewed literature and are aware of possible undue influence.

The independence of ADSA is not compromised by the support it receives from the food industry. While, in a perfect world, professional associations should be completely independently funded, we, like many other associations, don’t have the resources or benefactors to support the work we do to promote the profession and provide ongoing professional training to members. We are proud that we raise 66% of our funds from members’ fees, but this is insufficient to sustain the organisation. Only 34% of our funds are raised from sponsors, with their full understanding of our sponsorship policy.

Many of our sponsors are retail competitors which in itself mediates unfair advantage of one product or company over another. The most we get from any one sponsor annually is about R60 000. Ms Mounford’s concern creates the impression that we are cash flush and powerful enough to dictate a nation’s diet. Far from it. An operating budget of less than R500 000 annually to serve roughly 1 350 dietitians nationally is hardly the resources required to conduct the work we do let alone indulge in the antics we’re accused of.

Dietitians themselves have a code of conduct that specifies that they are committed to providing systematically assembled, evidence-based advice after careful assessment and diagnosis based on the individuals nutritional and health status, and must take the necessary steps to avoid bias and commercial interests.

ADSA does not recommend or endorse brands, products or services. Our donors are not permitted to publicise their support nor use our logo on their websites or on their products. Anyone who has recently consulted a dietitian would know that, rather than promoting a brand or products, dietitians advise patients to read the labels of products and consume foods that address their particular health needs, whether it’s no sugar, low fat, low salt, high fibre or reduced carbohydrates, for example. Dietitians are trained as experts in nutrition and that training includes being able to interpret scientific evidence and separate fact from marketing hype. Ultimately, we educate our patients by providing sufficient information to empower them to make informed food and purchasing choices. Patients can choose to shop at large retailers, eat organic foods or support local farmers markets. It’s their choice.

ADSA does contribute to related draft legislation as do many NGOs, industry bodies and even members of the public. This is not unusual and ADSA does not unfairly influence legislation in the interest of big foods. ADSA has often submitted comments that might be considered unpopular by some food companies. We comment on legislation to benefit the health of all South Africans based on current best practice. To craft legislation in the absence of such evidence would be ill advised. Ultimatley Government drafts regulations based on its own policy considerations which, at present, is guided by the fight against Non Communicable Diseases (NCD’s) such as hypertension and obesity. ADSA strongly supports the policy of reducing such NCD’s through diet.

Finally, South African consumers can take comfort that the local food industry is highly regulated. Food labelling regulations, for example, include permitted and/or prohibited nutrition and health claims, endorsement and the presence and levels of additives.


Carte Blanche – Sugar Addiction

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

Is sugar addiction real?

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

How much sugar is too much?

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

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

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

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

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

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


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

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

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

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

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

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

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

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

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

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


Basic Nutrition Guidelines and Needs of Infants

There is global recognition that the first 1,000 days of life (from conception to two years of age) is a key window of opportunity for improving health outcomes during childhood and into adulthood. Optimal infant and young child feeding is defined by the World Health Organisation (WHO) as exclusive breastfeeding from birth to six months and continued breastfeeding to two years and beyond along with complementary feeding from the age of six months (World Health Organisation, 2003). South Africa has adopted these recommendations.

Babies should be given only, where possible, breast milk from birth until the age of six months. Following the 6 month period, small amounts of food introduced into a baby’s diet, called complementary foods, should be safe, available, affordable, appropriate and culturally acceptable. Breastfeeding should continue while complementary foods are introduced, for up to two years of age and beyond.

The principle of responsive feeding, (i.e. when a child communicates feelings of hunger and satiety through verbal or non-verbal cues and the mother/caregiver responds appropriately) should guide the amount of complementary food that is offered. Since each child’s needs differ, each child consumes different quantities of breast milk and complementary foods, and each child grows differently, the amount of complementary foods should not be overly prescriptive.

The WHO and the Institute of Medicine (IOM) (IOM, Dietary Reference values 2006) recommend that an infant’s energy (which is provided by breast milk and complementary foods) should come from about 30 – 45% of total fat, 6 – 7% of protein with the remainder from carbohydrates. This is very much in line with the composition of breast milk at that age. It is also recommended that infant diets do not contain more than 15% of energy from protein, until more is known on the effect of protein on obesity later on in life (Michaelsen & Greer 2014). Major expert paediatric committees such as the The European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN), American Academy of Paediatrics (AAP) and Canadian Paediatric Society (CPG) support these guidelines, until more research becomes available on the matter.

High nutrient needs, due to babies’ rapid growth and development in the first two years of life, coupled with the relatively small amounts of complementary foods eaten in this period, means that the nutrient density in complementary foods must be very high. Gradually increase the amount of food, number of feeds and food variety as your child gets older.

Guidelines on suitable complementary foods                                   (Du Plessis, et al., 2013)

  • Provide a variety of foods to ensure that nutrient needs are met. This includes vegetables, fruit, whole grains, meat and meat alternatives (meat, poultry, fish, eggs, legumes, nuts, seeds and nut butters) and dairy products (from the age of 12 month and in addition to, but not replacing breast milk).
  • Foods from animals (meat, poultry, fish or egg) should be eaten daily, or as often as possible to meet protein and iron needs. In infants and young children, vegetarian diets cannot meet nutrient needs, unless nutrient supplements or fortified products are used.
  • Dark green leafy vegetables and orange coloured vegetables and fruit rich in Vitamin A (e.g. sweet potato, carrot, pumpkin, broccoli and spinach, mango, peaches, apricot, paw-paw) should be eaten daily.
  • Provide diets with an adequate fat content (from plant foods e.g. vegetable oils, avocado, nut butters and foods from animals, listed above, and also including breast milk).
  • Use fortified complementary foods or vitamin-mineral supplements for infants, as needed or prescribed.

Low nutrient-dense liquids, such as tea and coffee, energy-dense sugar-sweetened drinks, an excessive intake of fruit juice, high-fat and salty snacks, and highly refined starchy carbohydrates worsen poor nutrient intake and displace healthy food in the diet, and are therefore not recommended for complementary feeding.

When considering nutrition guidelines and dietary advice, it is very important to differentiate between public health messages and those that are tailored to meet the specific needs of individual members of the public. Public health messages are intended for the general public, and can be communicated as “blanket” evidence-based messages based on proven public health problems in a population and based on the profile of the majority of the population. Messages to individual members of the public should be interpreted following a one-on-one consultation with a qualified healthcare worker, based on scientific reasoning and motivation for deviation from the public health message, if needed and appropriate.

Restrictive diets for infants should only be followed in specific medical conditions and under strict medical supervision.

Sources:

  1. Du Plessis LM, Kruger S, Sweet L. Complementary feeding: a critical window of opportunity from six months onwards. South African Journal of Clinical Nutrition 2013;26(3)(Supplement):S129-S140 Available at http://sajcn.co.za/index.php/SAJCN/issue/view/67/showToc (Accessed 25 April 2015)
  2. Pan American Health Organization PAHO/World Health Organization (2003) Guiding Principles for Complementary Feeding of the Breastfed Child. Available at http://whqlibdoc.who.int/paho/2003/a85622.pdf (Accessed 15 April 2015)
  3. World Health Organization (2003) Global Strategy for Infant and Young Child Feeding. WHO: Geneva.
  4. Institute of Medicine (IOM). Dietary Reference Intakes Essential Guide Nutrient Requirements. 2006.
  5. Michaelsen KF, Greer FR. Protein needs early in life and long-term health. Am J Clin Nutr 2014 Jan, 99(suppl):718S-22S.
  6. Agostoni C, Desci T, Fewtrell M et al. Medical position paper on complementary feeding: a commentary by ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutri, 2008; 46(1): 99-110.
  7. Handbook of Paediatric Nutrition, 3rd Edition, American Academy of Paediatrics, 2005.
  8. Grueger B; Canadian Paediatric Society. Weaning from the breast. Paediatr Child Health 2013;18(4):210

For more information, contact the Association for Dietetics in South Africa +27 (0)82 376 4446


Gluten & Sugar Free Brownies

This month seems to be all about chocolate, so we thought we’d share a recipe that is all about chocolate, but a much better alternative to other sugar-laden chocolate treats (and because the recipe contains no flour it is perfect for anyone who is gluten intolerant). Chef Vanessa Marx created the most delicious Gluten & Sugar Free Brownies, our latest NutritionConfidence Recipe.

Our Dietitians say: 

Historical evidence shows that cocoa has been used in a medicinal capacity for over two thousand years (since the time of the ancient Mayan and Aztec civilisations and following its introduction to Europe in the Middle Ages).

A large Harvard study showed that cocoa consumption is associated with decreased blood pressure, improved blood vessel health, and improvement in cholesterol levels, among other benefits.

The cocoa bean’s therapeutic properties can be attributed to certain constituent compounds, known as flavonoids.

RECIPE

Makes 48

Ingredients

200 g raw cocoa paste (solid)

375 g ground almonds

6 whole free-range eggs

250 g xylitol

300 g cocoa butter

50 g desiccated coconut

3 tablespoons cocoa powder

1 teaspoon baking powder

How to make it

– Preheat the oven to 160 C

– Grind together the cocoa paste, ground almonds, coconut, cocoa powder & baking powder.

– Whisk together the eggs and xylitol until light and fluffy and the xylitol is dissolved.

– Melt the cocoa butter.

– In a large bowl, fold together the ground cocoa mixture & the egg mixture until combined.

– Fold the warm cocoa butter into the mixture until all combined.

– Pour the batter into a greased baking dish and bake for 30-40min until set.

– Leave to cool a pond then slice into squares

The nutritional value serves 48:

Energy: 572 kJ

Protein: 2 g

Carbohydrate: 6 g

Total fat: 12 g

Fibre: 1.7 g

Sodium: 13.5 mg

Enjoy! If you want to download the recipe card visit: http://www.adsa.org.za/Public/Recipes.aspx


Kidney Health For All

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

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

Nutrition plays an important role in keeping kidneys healthy

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

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

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

What can you do for your kidneys today?

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

Keep fit and active

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

Keep regular control of your blood sugar level

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

Monitor your blood pressure

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

Eat healthy and keep your weight in check

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

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

Maintain a healthy fluid intake

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

Do not smoke

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

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

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

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

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

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


Raw Avocado Chocolate Mousse

Finally, a dessert that is as yummy as it is ‘good for you’. We love this ‘Raw Avocado Chocolate Mousse’ as a very clever alternative to regular chocolate mousse. A plant based chocolate alternative, the mousse is packed with healthy unsaturated fat and an ideal alternative for vegans. Besides this perk, it 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.

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


Response to Grass Consumer Group Questions

Grass Consumer Group asked us some very important questions on Twitter last week. Some of our answers won’t quite fit into 140 characters, so we’ve put together a Q&A in response to their questions:

Question1: ‘You state that you share science-based research with your members – what about public awareness? Any sugar studies? How do you promote the nutritional well being of the community?

We are involved in numerous activities to raise public awareness around nutrition issues including National Nutrition Week, a Department of Health initiative to inform the public on practical ways to incorporate the South African Food Based Dietary Guidelines. This includes messages around sugar.

We also support the South African Food Based Dietary guidelines that clearly state the following about sugar: “Use foods and drinks containing sugar sparingly, and not between meals” and agree with the following abstract from SAJCN on the reviewed dietary guidelines 2010: “This should remain unchanged. An excessive intake of sugar should be seen as a public health challenge that requires many approaches to be managed, including new policies and appropriate dietary advice.” (http://www.sajcn.co.za/index.php/SAJCN/article/view/752)

The South African Food Based Dietary guidelines and this technical paper were shared with dietitians and nutritionists at the 25th Congress of the Nutrition Society of South Africa and the 13th Congress of the Association for Dietetics in South Africa.

A document “Guidelines for Healthy Eating Information for Nutrition Educators” was created to be used by nutrition educators in the public sector.

We have partnered with PEN Global Resource for Nutrition Practice, a dynamic knowledge translation subscription service to bring our members the most up-to-date, evidence-based nutrition resources.

ADSA Spokespeople are always available to engage with the media on nutrition topics and communicate nutrition messages to the public via ADSA website http://www.adsa.org.za, ADSA blog https://nutritionconfidence.wordpress.com/, ADSA Twitter account https://twitter.com/ADSA_RD and ADSA Facebook page https://www.facebook.com/ADSAorgza.

We share nutrition information around many topics, including but not limited to strategies to reduce salt intake (we are involved in the Salt Watch campaign), sugar, obesity, portion control, food labeling, nutrition during pregnancy, breastfeeding, nutrition for active kids, nutrition for cancer patients and nutrition for optimal diabetes management.

We have in the past (and will continue in the future) been involved with campaigns during Salt Awareness Week, Breastfeeding Week, Diabetes Month and many more.

Question 2: How do you approach your sponsors? Who approaches whom? What is a gold sponsor?

Some of our sponsors have approached us directly and others we approach. We (ADSA) and some of our members work with industry and think that is a powerful way to make change happen. We believe that it is important for us and dietitians to be involved with the food industry – imagine the food supply if we didn’t.

At the same time we don’t believe in endorsing brands to the communities within which we work, hence the decision to remove logos from our public-facing channels as this can influence public perception. Our sponsors are also not allowed to use the ADSA logo on their websites or with their products. We don’t hide our sponsors (https://nutritionconfidence.wordpress.com/2015/02/19/a-word-from-claire-julsing-strydom-adsas-president-on-sponsorships/) but don’t allow for endorsements of any kind and therefore have made these changes to our sponsorship policy. More info about our sponsors or their products are only available to our members through the Log In function on our website. It hasn’t always been like this, but we learn and evolve and make changes.

Our members are trained health professionals that are able to look at a variety of food products (that are used by the public) with the necessary knowledge to ascertain how and when various nutrients and food products would be beneficial for a client based on their individualised nutritional requirements.

We are currently working with corporates outside the food industry, to get them on board as sponsors, because we are unable to function as a not-for-profit organisation without financial support. The income from our membership fees only covers 66% of the budget we need to continue educating and supporting our dietitians, as well as promoting the nutritional well being of the community. Sponsorship funds are pooled and use for the administrative costs. All nutrition related matters or purchasing of functionalities like PEN will come from membership fees, which have increased dramatically in the last year to accommodate these changes.

We have various tiers of sponsorship, which are based on the level of financial contribution a company makes and offers different benefits to the sponsor. These benefits are all related to industry affairs and member communication, not public interaction or communication. Our sponsors have never influenced decisions made by ADSA and donate funds to the association to promote the dietetics profession in South Africa and ultimately improve nutrition education to the public through dietitians and we are grateful to our sponsors for their assistance.

Question 3: Please respond to why you promote sports cereal bars for kids and suggest sweetened low fat flavoured milk drinks for kids as per this article on your website: http://www.adsa.org.za/Portals/14/Documents/Nutrition%20Info/NutritionTipsForActiveChildrenByKarlienSmit.pdf

The @GrassAction tweet with regards to the article was taken out of context. We advocate evidence-based, individualised advice.  When choosing foods, context, portion and frequency are key considerations. This article specifically referred to active kids that take part in sports and is backed by relevant evidence.

As medical professionals we are bound by ethical codes and at all times ensure that our content is backed-up by evidence. The links are included in the article. Please have a read-through and let us know if there are specific questions you have about the evidence or flaws within that evidence.

We stand by this article, within the context of “An ideal training diet for active children”.

___________________________________________________________________________

We find that many South African’s blindly follow nutrition advice and fad diets without asking questions, digging deeper and really looking at the research. Without consumer groups like Grass Action some questions would never make it into the public space. Thank you for asking the tough questions.


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

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

ADSA Sponsorships

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

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

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

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

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

Current ADSA sponsors include:

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

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

ADSA Sponsorship Policy February 2015

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

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

  1. Scientific Accuracy

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

  1. Non-endorsement

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

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

General Requirements for Acceptance of ADSA Sponsors:

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

Disclaimer:

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