Dietitians urge South Africans to ‘Eat Fact Not Fiction’

Chat 2 Comments June 12, 2017 nutritionadsa

Nutrition advice promising all sorts, from weight loss to healthier living and even cures for diseases, spread like wildfire across social media. In the era of ‘alternative facts’ and post-truth, ‘the latest, greatest nutrition advice’ from dubious sources can unfortunately tempt many away from accepted dietary guidelines and recommendations based on years of evidence.

‘Evidence and Expertise’ is the theme of Dietitian’s Week 2017, highlighting the important role of dietitians who are able to interpret nutrition science and dietary guidelines in order to customise nutrition advice for each individual. This is vital because from weight loss to a disease like diabetes, there is no ‘one size fits all’ best eating plan. Dietitians happen to be health professionals trained and qualified to do this.

Dietitians and Evidence

In the course of earning their degrees in the science of dietetics, dietitians are specifically taught the skills required to interpret scientific evidence. In order to maintain their professional registration with the Health Professions Council of South Africa (HPCSA), all practising SA dietitians also have to undertake ongoing studies that ensure they keep up with the latest knowledge provided by new and emerging evidence, in accordance with the Continuing Professional Development (CPD) programme. This means they have the latest evidence-based food, health and disease expertise at their fingertips – and you won’t find a registered dietitian in the country basing any recommendations on the long outdated food pyramid.

Dietitians and the Food-Based Dietary Guidelines

The country’s broad strokes dietary guidelines, on which public health messages are based, and which were developed according to the process recommended by the Food and Agricultural Organisation of the United Nations (FAO), have also evolved over the years, featuring a notable shift from the emphasis on nutrients to the focus on actual foods, which by nature contain a variety of nutrients. ADSA, the Association for Dietetics in South Africa, provides further clarity on the guidelines with its statement on the Optimal Nutrition for South Africans. The latest visual Food Guide from the Department of Health provides a very different picture from older models such as the Food Pyramid and represents the latest FAO recommendations.

Dietitians and Patients

But the reality remains that diet is highly personal. What we eat is rooted in our culture and tradition, shaped by affordability and accessibility, and inextricably intertwined with highly variable lifestyle factors such as weight, physical activity, emotional connection to food and our consumption of non-food substances, as well as various physiological differences and genetics.

“This is where the dietitian comes to the fore,” says ADSA President and Registered Dietitian, Maryke Gallagher. “If you take a disease such as diabetes, which is a prevalent lifestyle disease in the country, and is a condition that can be managed through diet, each patient needs a tailor-made plan and focused support to make their individualised diet work towards their well-being and health. When the situation demands change around something as fundamental to life as food, then broad strokes are not necessarily sustainable solutions.”

Dietitians and Sustainability

The role that the dietitian can play in helping the communities in which they work to secure healthy food systems that are good for both people and the planet is an emerging responsibility in the profession. Dietitans are increasingly involved in facets of our modern food systems including agriculture and alternative food production methods, natural resources and ecosystems, social justice and community health issues, as well as developing food policy and food systems research that takes sustainability into account.

Dietitians and Diseases

Some may associate dietitians with merely giving advice and support to someone who wants to lose weight, but dietitians work across a range of industries. They are also experts in providing nutritional advice with regard to serious diseases and conditions such as diabetes, heart disease, hypertension, liver disease, kidney disease, cancers, HIV/AIDS, TB, throat, stomach and intestinal disorders, as well as food allergies and intolerances, eating disorders, sports nutrition and life-stage nutrition (including the protection, promotion and support of breastfeeding as the best start in life). Apart from dietitians in private practice, they work in hospitals and communities, academia and industries. In addition to consulting with patients, dietitians are also involved in research, nutrition training and development of provincial and national policies.

Dietitians and Malnutrition

In South Africa, where the health issues that arise from the obesity epidemic stand side by side with those resulting from undernutrition, our dietitians’ work literally spans from one extreme to another. The South African Society for Parenteral and Enteral Nutrition (SASPEN), a supporter of Dietitian’s Week, highlights the essential role the dietitian plays in providing nutritional support to promote optimal nutrition to people in hospitals, where malnutrition is a common cause of the exacerbation of disease, delayed healing and prolonged hospital stays.

The Dietitian and You

It’s clear, that as a country, our need for dietitians is multi-fold, which explains why there’s a lot more than just dietary guidelines on the mind of a registered dietitian. In consultation, your dietitian is going to be taking in many factors unique to you to work towards helping you make optimal food choices. This includes your age and gender; your genetics, body size and body image; your environment, culture, spiritual beliefs and family life; physical activity level, mental well-being and general abilities; your work life and patterns; your budget; food preferences, eating tastes and cooking skills; as well as your existing health conditions and prescribed meds.

In the hopes of steering us clear of the latest trumped up ‘diets’ and promoting a return to genuine expertise and evidence, dietitians countrywide are suggesting that we ‘Eat Facts Not Fiction’.

In collaboration with the British Dietetics Association, Dietitian’s Week is held in SA from 12th to 16th June, with the 2017 theme ‘Evidence and Expertise’.

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

 

Time To Make Lifestyle Your Medicine

Chat Leave a comment September 28, 2016 nutritionadsa

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

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

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

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

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

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

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

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

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

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

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

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