All the ways that Dietitians do Prevention

Across the world, health and social care services are under stress; and in South Africa, the inaccessibility of quality health care for many people remains one of the country’s intractable problems. These pressures have intensified the focus on the prevention of disease as the key driver of public health. At the forefront of prevention is food. As one of the only healthcare professionals trained and qualified to interpret the latest nutrition science and dietary guidelines, dietitians play multiple roles in the prevention of diseases.

Dietitians Do Prevention is the theme of the 2018 Dietitians Week which starts today and runs until 8th of June. To create awareness, ADSA (Association for Dietetics in South Africa) joined SASPEN (South African Society for Parenteral and Enteral Nutrition), ENASA (Enteral Nutrition Association of South African) and HDIG (Hospital Dietitian Interest Group) in highlighting the six major ways that Dietitians Do Prevention and help to reduce the burden of disease in South Africa through their vital work.

ADSA spokesperson Jessica Byrne points out that: “Not many people are aware that dietitians, who must be registered with the HPCSA (Health Professions Council of South Africa) in order to practice their profession, are employed across many different sectors from industry to communities; as well as in health, research and educational institutions. Across the board, they play a key role in disease prevention.”

ADSA_Dietitians Do Prevention_JPG

 

The Six Ways that SA Dietitians Do Prevention, are:

Guidance during first 1 000 days – Dietitians support expecting mothers to promote healthy pregnancies and prevent complications, but their work doesn’t end there. Jessica Byrne says: “Due to the country’s suboptimal rates of breastfeeding, the dietitian’s promotion of breastfeeding, monitoring of infant growth and ongoing guidance as a baby starts to also consume solids has become critical prevention work. Breastfeeding not only provides the best source of nutrition for a baby but also promotes growth and enhances the vulnerable immune systems of babies to help prevent disease.”

Public Health and Primary Prevention – Healthy eating and hydration is essential for health. Dietitians work to educate the general public on good food choices to maintain their health, which helps prevent illnesses and avoid diet-related conditions such as diabetes, malnutrition or obesity. Dietitians do prevention at community level through the promotion of house hold food security and the drive to eliminate hunger. Various community projects involve the services of a dietitian.

Mental Health and Addiction Recovery – Good nutrition and a healthy diet can impact positively on both the prevention and management of mental health conditions, including helping to support recovery and prevent relapse in the case of addictions.

Hospital, rehab and home-based care – “You will find dietitians working right across the health care system,” says Alta Kloppers, spokesperson for HDIG. “This is because nutrition plays such an important role in survival, recovery, rehabilitation and symptom relief, as well as reducing the risks of further illnesses and preventing more admissions to hospital and other health care services.” Dietitians do prevention through screening of hospitalised patients to identify patients at risk of developing malnutrition, and providing specialised nutrition interventions to manage specific diseases and conditions.

Optimising Health and Secondary Prevention – Dietitians do prevention by helping people with existing conditions such as diabetes, kidney failure or dementia to optimise their nutrition in order to get relief from symptoms, prevent complications and enhance their quality of life. This will include individualised dietary advice and appropriate follow-up and monitoring.

Making Every Contact Count through Healthy Conversations – Dietitians don’t just advise on diet and nutrition when they do prevention. Instead they engage also with clients on the other issues related to good health such as the importance of physical activity and not smoking. They also take into account the social and emotional factors that can easily contribute to a client’s need for a healthier lifestyle. Conversations with dietitians can then easily direct people to where they can also access professional help for the non-dietary issues that also impact on disease prevention.

“The important message of this year’s Dietitian’s Week,” says Lizl Veldsman SASPEN’s spokesperson, “is that it is impossible to separate disease prevention from nutrition and therefore, from the work of a dietitian.”

Lynne Mincher, ENASA spokesperson agrees: “Good nutrition is the foundation of prevention and recovery. Whether you are talking about supporting breastfeeding tube-feeding or oral nutritional supplements, a person recovering from an operation or guiding someone with a chronic condition such as diabetes, we need that expertise of the dietitian right at the frontlines of prevention.”

A collection of “Dietitians Do Prevention” recipes by South African dietitians has been published and includes 39 recipes, covering breakfast, lunch, dinner and snacks. Each recipe comes with a prevention message. It can be downloaded here: http://www.adsa.org.za/Public/DietitiansWeek2018.aspx

You can also download the Dietitian’s Week infographic here: http://www.adsa.org/za/Public/DietitiansWeek2018.aspx

 


Meet Registered Dietitian, Retha Booyens

ADSA_Meet the Dietitian_Retha BooyensWe 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


Turnip Tagliatelle with Chicken & Herb Sauce

Registered Dietitian and food blogger Cheryl Meyer, from Dish & Delite, kicks off our new series of NutritionConfidence recipes with a delicious ‘Turnip Tagliatelle with Chicken & Herb Sauce’. As always, the focus is on real food that is healthy and delicious, encouraging local, close-to-home ingredients.

We love this recipe because turnips are easy to spiralize and make lovely veggie noodles. When raw, they can tend to have a sharp distinct taste, warming them softens the flavour and makes for a perfect veggie noodle base for your dish.

Cheryl says: “Veggie noodles are a great way to the boost the vegetable component of a meal and plain yoghurt serves as a nutritious alternative in this twist on classic creamy carbonara.”

INGREDIENTS

(serves 4)

4 medium turnips

4 teaspoons olive oil, divided

4 chicken breasts, cubed (approx. 125 g each – 500 g)

4 leeks

250 g mushrooms

2 teaspoons crushed garlic

½ cup plain yoghurt

2 large eggs

30 ml fresh chopped parsley

¼ cup grated parmesan cheese

Salt and pepper, to season

METHOD

  1. Heat 2 teaspoons olive oil in a non-stick pan and cook the cubed chicken pieces. Set the cooked chicken aside.
  2. Slice the mushrooms and leeks.
  3. Heat the other 2 teaspoons of olive oil and soften the mushrooms and leeks. Just before cooked, add the garlic for the last 2 minutes. Remove and combine with the chicken.
  4. Peel turnips and cut the ends off flatly and evenly. Spiralize them to tagliatelle thickness (blade C on the inspiralizer).
  5. Boil turnip noodles for 2-3 minutes.
  6. In a small bowl or jug whisk the egg, yoghurt and parsley together well. Season with salt and pepper.
  7. When the turnip noodles are done, drain them, return them to the pot off the heat, pour in the egg mixture and toss until evenly coated (the warmth of the cooked noodles cooks the egg but it is important to do this off the heat, otherwise the egg will scramble when you add it, and we don’t want that).
  8. Serve the noodles topped with the chicken, leek & mushroom mixture and garnish with grated parmesan cheese.

 

Nutrition Information: Per serving

Energy: 1487 kJ Protein: 38.7 g Carbohydrate: 25.7 g Of which, total sugars: 11.0 g Fat: 14.8 g Fibre: 4.7 g Sodium: 303 mg

 

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

 


Is a Career as a Dietitian for You?

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

 


Time To Make Lifestyle Your Medicine

DR. DAVID KATZ

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

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

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

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

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

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

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

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

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

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

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

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


Celebrating Heritage Day with Food!

Mpho Image.pngIn 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”

We chatted to Registered Dietitian, Kelly Schreuder who also has professional culinary experienceadsa_kelly-schreuder2, 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.

 

 


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


CALCULATE YOUR HIDDEN SALT

The Heart and Stroke Foundation South Africa (HSFSA) joins forces with World Action on Salt and Health (WASH) to increase awareness on salt and health.

In 2016 the emphasis of World Salt Awareness Week is on hidden salt. This is the salt in our foods that we don’t see or even taste, but that still contributes to our total salt intake. To help the public evaluate their salt intake, HSFSA and Unilever South Africa will also introduce a first in SA – a digital salt calculator.

Salt and health

The World Health Organization (WHO) recommends a daily salt limit of 5 grams per day (about one teaspoon). In a 2011 South African study more than half of adults exceeded 10 grams salt a day, at least doubling this recommendation1. The main consequence of excessive salt intake is raised blood pressure, which in turn leads to heart diseases and strokes. In fact the WHO regards raised blood pressure as the single biggest contributor to heart diseases worldwide2.

Given that a devastating 1 in every 3 adults in South Africa suffer from high blood pressure, a reduction in salt intake is an easy win to prevent high blood pressure, improve existing high blood pressure, and thereby reduce the 220 fatalities from heart disease and strokes every day.

Salt and our food

The food we buy already contains salt. In fact 55% of the salt we consume is from salt added during the manufacturing process. Often we cannot see the salt, neither can we taste it – hence the term hidden salt. In higher-income communities the contribution of hidden salt can be as high as 75% of total salt intake3. Hidden salt includes much more than potato chips, take-outs and boerewors. Foods such as breakfast cereals, breads, ready-made meals, sauces, spreads, cheeses and processed meats all contain hidden salts and can increase salt intake considerably.

Reducing salt intake requires two broad approaches: reduce salt added to food during manufacturing, and reduce the excessive use of salt and salty products at home.

Salt legislation is around the corner

In 2013 Health Minister Aaron Motsoaledi signed progressive legislation to reduce the salt content of a range of highly salted foods in South Africa. June 2016 is the first deadline for this stepwise reduction programme. With only 3 months to go, all eyes will be on South Africa as the first country to legislate such a wide range of foods. Early indications suggest that industry is making excellent progress towards it.

Is salt legislation enough?

On its own legislation will reduce per capita salt intake by 0.85 g per day. Whilst this is enough to start a shift in cardiovascular mortality, much more is needed4. The next step is to empower consumers to buy lower salt options and use less salt at home.

Empowering South Africans to know their own salt intake

When 1 000 South Africans were asked whether they believed they eat too much salt, 83% said no. Yet the study results further showed that 75% in reality consumed excessive salt5. Hidden salt is the main reason for this discrepancy, as salt you cannot taste or see is not fully accounted for.

The HSFSA in partnership with Unilever South Africa is introducing a new salt calculator to help South Africans evaluate their salt intake to start making better food choices. The salt calculator estimates salt intake based on the frequency by which common foods are consumed, and then provides feedback on current intake and tips on making better food choices.

Hlanzeka Mpanza, dietitian at Unilever says “Only when you know which particular foods in your diet contributes the most to your total intake, can you effectively cut down on hidden salt. You can start to choose lower salt options by comparing products”.

HSFSA encourages members of the public to use the new salt calculator to measure their salt intake, and to start making changes. The equation is simple: check your salt – change your salt.

The salt calculator went live on Monday 29 February at www.saltcalculator.co.za

THE Heart and Stroke Logo1 (2) (1) copySalt watch logo

 


Raw Chocolate Truffles

Spoil the one you love with some homemade ‘Raw Chocolate Truffles’ made from raw cocoa paste, dates, goji berries, raw almonds, sunflower seeds, flaxseeds, cinnamon and honey.

Our dietitians say:

Date flesh is a high source of energy and 100 g of flesh (about 4 mejool dates) can provide an average of 1300 kJ. It is rich in mainly fructose and glucose; low in fat and protein; and a good source of magnesium, potassium, copper, selenium and manganese. The consumption of 100 g of dates can provide over 15% of the recommended daily allowance from these minerals.

Vitamins B-complex (especially Vitamin B6) are the major vitamins in dates and they are an excellent source of dietary fiber (up to 8.0 g/100 g).

Last, but not least, dates are a good source of antioxidants, mainly carotenoids and phenolics.

We love this recipe:

Easy to make, package in a beautiful box and voila … a great gift for mom.

The raw chocolate balls are also a great dessert option – and can double up as a high energy lunchbox snack or perfect ‘take along’ energy boost for runners or cyclists.

Ingredients

100 g raw cocoa paste

100 g dates

30 g goji berries

50 g raw almonds, chopped

20 g sunflower seeds

20 g flaxseeds

2 ml cinnamon

20 g honey

*Makes 20 truffles

How to make it

– put the dates into a small saucepan and cover with a little water. Cook the dates in a medium high heat until soft (about 5 minutes) and the water has evaporated. Mash the dates into a purée and set aside.

– gently melt the cocoa paste on a low heat.

– mix the melted cocoa paste, date purée, goji berries, almonds, seeds, cinnamon and honey into a firm paste.

– roll the mixture into 15g balls and dust with cocoa powder, or roll in seeds or coconut to decorate.

The nutritional value per truffle (makes 20 truffles):

Energy: 254 kJ

Protein: 2 g

Carbohydrate: 4 g

Total fat: 3.2 g

Dietary Fibre: 1.1 g

Sodium: 48 mg


Healthy eating, healthy living in 2015!

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

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

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

A Registered Dietitian is:

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

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

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

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