RETHINK YOUR DRINK – CHOOSE WATER

Chat Leave a comment October 9, 2017 nutritionadsa

Clean and clear, refreshing and invigorating, we know instinctively that water is good for us. Yet, many of us have lost touch with water. Overwhelmed with the wide choice of what to drink, most of it sweetened with sugar, we’ve somehow left the simple, but profound goodness of water behind.

National Nutrition Week 2017, running from 9 to 15 October and, with its theme “Rethink Your Drink – Choose Water”, aims to help us rethink when it comes to water and get into the habit of making water our beverage choice each day. Water contains no kilojoules and hydrates. It is essential for health and is the best choice to quench thirst.

What the campaign highlights is that when we are not drinking water, we are probably choosing a sugar-sweetened drink which spikes our daily kilojoule intake, degrades our diet, and leads to weight gain and the onset of non-communicable diseases such as type 2 diabetes, heart disease and dental caries.

“The prevalence of obesity and non-communicable diseases in the country is alarming,” says Rebone Ntsie, Director: Nutrition, of the National Department of Health). “The South African Demographic and Health Survey conducted in 2016 found that the prevalence of overweight was 13.3% among children 0 – 5 years of age. About 67.6% and 31.3% of South African women and men respectively are overweight and obese. These findings show that overweight and obesity among children and adults have increased from earlier surveys. Replacing sugary drinks with water can help.”

Professor Pamela Naidoo, CEO of the Heart and Stroke Foundation South Africa (HSFSA)warns that the risk of coronary heart disease and ischaemic stroke rises with an increase in body weight. “There is also a clear link between sugary drink consumption and heart disease,” she says. “Indicators of heart disease such as blood lipids and uric acid also increase with an increase in consumption of sugary drinks.”

Daily consumption of two or more sugary drinks has been found to increase the risk of developing diabetes by at least 24% compared to consuming less than one sugary drink per month. According to Statistics South Africa, diabetes was the second leading underlying cause of death in the country in 2015, accounting for 5.4% deaths and the leading cause of death in females (7.1%).

On average, commercially produced sugary drinks contain the following amounts of sugar per 500 ml serving (2 average-sized cups/glasses):

• Sweetened fizzy drinks: 13 – 17 teaspoons
• Energy drinks: 13½ to 15 teaspoons
• Fruit juice: 12 – 16 teaspoons
• Sweetened milk or yoghurt-based drinks: 7 – 13½ teaspoons
• Sweetened iced tea: 8 – 10½ teaspoons
• Sports drinks: 4½ – 12 teaspoons
• Sweetened drinks, such as sweetened flavoured water, vitamin enriched water and coconut water: 4 – 8 teaspoons of water

The World Health Organization (WHO) recommends that the intake of free sugars, i.e. sugars added by the manufacturer, cook or consumer or sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates, should be less than 10% of the total daily energy intake for adults and children and less than 5% for further health benefits.

“This means that the maximum intake of free sugars from food and beverages per day for adult men and adolescents (14 – 18 years) should not be more than 12 teaspoons, and for adult women and children 5 – 13 years, not more than 9 teaspoons”, says Nicole Lubasinski, President of the Association for Dietetics in South Africa (ADSA).“To achieve more health benefits, the number of teaspoons of sugar from food and beverages per day for adult men and adolescents (14 – 18 years) should not be more than 6 teaspoons, and for adult women and children 5 – 13 years, not more than 5 teaspoons”.

Some sugary drinks have a nutrition information label, this will indicate how much of the carbohydrate in the drink is found as sugar”, says Carol Browne of the Nutrition Society of South Africa (NSSA). “Sugar is one of the primary ingredients in drinks, and so it will be listed high up on the list of ingredients. In milk based drinks some of the sugar will be the sugar from milk, and this is not classified as a ‘free sugar’. In these products the total sugar content on nutrition information label should be considered with the ingredient list.”

“It makes good sense to replace sugary drinks with lots of clean safe water”, says Rebone Ntsie. “Drinking lots of clean and safe water is essential for one’s health. Besides keeping you hydrated, it helps with digestion, regulate your body temperature, and to lubricate your joints. Furthermore, tap water is cheaper than any other drinks.”

“There are several ways to increase your intake of water”, says Abigail Courtenay, registered dietitian and spokesperson for ADSA.   “Make sure you always carry water with you; set reminders on your cell phone or notes at your desk every hour; drink water with meals; before and after exercising; and send a bottle of water with your child to school every day. You can also add fresh slices of lemon, cucumber, mint leaves, lime or fresh fruit to your water or unsweetened rooibos or herbal teas to add more flavour.”

On Wednesday, the 11th of October, ADSA (@ADSA_RD) will be hosting a Twitter Talk from 13h00 to 14h00 where dieticians and National Nutrition Week partners will be providing information, tips, ideas and advice on choosing water as the beverage of choice instead of drinking sugary drinks. Join the conversation live on Twitter, and follow the @ADSA_RD handle to get great ideas and tips. The Department of Health in the various provinces will also celebrate National Nutrition Week during the month of October.

For more information on National Nutrition Week 2017, visit the website: http://www.nutritionweek.co.za/

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

Chat 1 Comment March 20, 2017 nutritionadsa

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

 

Salt – a forgotten killer

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

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

A world-leader in salt reduction

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

What can the food industry do?

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

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

How do we eat so much salt?

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

Do YOU eat too much salt?

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

How to reduce salt intake

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

Get tested

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

The next step forward

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

 

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

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

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

Love your beans for good health

Chat Leave a comment October 10, 2016 nutritionadsa

South Africa celebrates National Nutrition Week from 9 to 15 October, and aligning to the Food and Agriculture Organization of the United Nations (FAO) which has declared that 2016 is the ‘International Year of Pulses’, this year’s campaign theme is ‘Love your beans – eat dry beans, peas and lentils!’ echoing the country’s food-based dietary guideline to ‘eat dry beans, split peas, lentils and soya regularly’.

“There’s a good reason to put dry beans, peas, lentils and soya into the spotlight. Unfortunately, they are largely overlooked as they are often seen as a ‘poor man’s food’ and they can take a long time to cook. We should be eating them, along with a variety of foods, at least four times a week; and yet, many of us hardly include them in our diets. There’s just not enough awareness of how they contribute to healthy lifestyles, or how to use them well to make delicious meals,” says Ms Lynn Moeng-Mahlangu, Cluster Manager of Health Promotion, Nutrition and Oral Health at the National Department of Health. “However, this National Nutrition Week, we hope to share tips and recipes to inspire South Africans to eat more beans, peas, lentils and soya. For information on these tips, access the National Nutrition Week website”.

National Nutrition Week is a joint initiative by the Department of Health, the Association for Dietetics in South Africa (ADSA), the Nutrition Society of South Africa (NSSA), the Consumer Goods Council of South Africa (CGCSA), the Heart and Stroke Foundation South Africa (HSFSA) and the Consumer Education Project of Milk SA (CEP). “We are delighted that this year’s theme highlights these affordable, versatile and tasty foods that make such a vital contribution to our health when they are a regular part of the family’s healthy eating regime,” says ADSA President, Maryke Gallagher.

So much nutrition advice is centred on what we need to eat less of, but when it comes to pulses – your dry beans, peas and lentils – the message is about eating more!

Carol Browne from the NSSA highlights some benefits of pulses. “Beans, peas and lentils also provide exceptional nutritional value for money, having a high micronutrient to price ratio. What’s more, they improve soil fertility, are water efficient and have a smaller carbon footprint, promoting environmental sustainability.”

The top nutritional benefits of eating dry beans, peas, lentils and soya are that:

• They are low in fat, high in fibre and have a low glycaemic index
• They are naturally cholesterol-free
• They are naturally gluten-free
• They are a good source of plant protein, providing twice as much protein as wheat
• They are good sources of vitamins such as folate and minerals such as potassium and calcium

According to Professor Pamela Naidoo, CEO of the HSFSA, “Including dry beans, peas, lentils and soya regularly in your diet, along with other health promoting behaviours, contributes to better health, helping to improve blood pressure and the maintenance of a healthy weight, reducing the risk for conditions such as diabetes, heart disease and strokes.”

When it comes to cooking, pulses are wonderfully versatile and can be incorporated into the diet in many ways. “Pulses are excellent when used as the main ingredient in a vegetarian meal,” Linda Drummond from the CGCSA points out, “Or they can be used as an affordable way to extend meat in something like a meat stew or a bolognaise sauce. Cook up a large batch, portion and freeze to use to make a quick meal like soup or a bean salad.” As part of National Nutrition Week activities, a host of recipes celebrating beans, peas and lentils in tasty dishes are available on the National Nutrition Week website.

“Some people experience bloating and gas as a result of eating beans, but we would like to highlight steps that can be taken to prevent this from being a reason why many don’t include these nutritious foods in their eating plans”, says Maretha Vermaak from the CEP of Milk SA. Vermaak advises people to start with small amounts to build up one’s tolerance over time and to soak dry beans before cooking.

On Wednesday, the 12^th of October, ADSA (@ADSA_RD) will be hosting a Twitter Talk from 13h00 to 14h00 where dietitians and National Nutrition Week partners will be answering questions such as: Why are beans, peas and lentils good for health? How do we avoid getting bloated and windy after eating beans? What is the best way to prepare dry beans for cooking? How do I introduce more dry beans, lentils and peas into my children’s diet? What are some ways we can use beans, peas and lentils in meals and snacks? Join the conversation live on Twitter, follow the @ADSA_RD handle or track the hashtag #LovePulses to get great ideas and tips that will help you and your family to love dry beans, peas and lentils. The Department of Health in the various provinces will also celebrate National Nutrition Week during the month of October.

For more information on National Nutrition Week 2016, please visit the website: http://www.nutritionweek.co.za/

Big hearts can protect little hearts this Heart Month

Chat Leave a comment September 15, 2016 nutritionadsa

Our Friends at the Heart and Stroke Foundation South Africa (HSFSA) are doing their bit during Heart Month to raise funds for upgrading of paediatric cardiac care units. They teamed up with the Paediatric Cardiac Society of South Africa (PCSSA) to shine a spotlight on congenital heart disease and the fact that many parents are unaware of their child having a heart condition.

Heart disease affects children too

“There is something wrong with your baby’s heart” – these are the words no parent wants to hear. Yet one in 100 babies are born with congenital heart disease (CHD). It is the most common birth defect worldwide and sadly, 10% of these babies do not reach their first birthday.

“The real tragedy is that many parents don’t know that their baby might have a heart defect,” says Professor Pamela Naidoo, the new CEO of the HSFSA. She says inherited heart conditions affect around 1% of the population. “It has happened that a family only realises that there is an inherited heart condition when a child or family member collapses on the rugby field or while engaged in an activity.”

Wanting to prevent such tragedies, the HSFSA is launching a new campaign this September during Heart Month – the Smart Little Hearts campaign. In a joint initiative with the PCSSA, the campaign sets out to increase awareness about CHD and arm parents with the knowledge they need to get their children screened at birth, as well as to raise funds to support children affected by the condition.

Heart disease in children can be treated

Although there is nothing that can be done to prevent congenital heart disease, there is a lot that can be done for new born babies, if it is detected early. Special care and treatment can prevent it being fatal and can reduce the impact of disability later in life.

Paediatric cardiologist and president of the PCSSA, Dr Liesl Zuhlke says, “Often congenital heart disease is missed or diagnosed too late. Some babies born with a heart defect can appear healthy at first and can be sent home with their families before their heart defect is detected. Babies with undiagnosed critical CHD are discharged and then deteriorate rapidly or die. About 20% of deaths thought to be Sudden Infant Syndrome (SIDS) are actually CHD.”

Dr Zuhlke believes every child should be tested for CHD before they leave the hospital. And a breakthrough in the detection of the condition in the form of a simple test, called pulse oximetry screening, means that this is not an idle wish – even in under-resourced South African hospitals.

Pulse oximetry screening is a simple, non-invasive test that determines the amount of oxygen in a baby’s blood and the baby’s pulse rate. Low levels of oxygen in the blood can be a sign of a CHD. The test is endorsed by the World Health Organisation (WHO), which advocates that it should be in every health facility worldwide – but it is not widely used in South Africa.

“Unfortunately, the test is not carried out routinely in this country,” says Professor Naidoo. “It’s not part of routine care and the technology is not available in all maternity units and health facilities.

“In fact, maternity units and paediatric cardiac units in hospitals around the country are poorly equipped and under resourced,” continues Naidoo. “They need more equipment and healthcare personnel to screen every new born baby. But there is also much that can be done to brighten up these areas in hospitals to make them more child-friendly.”

A room with a heart

About 11 000 babies are born each year in South Africa with congenital heart disease. The majority of these will need on-going medical care. As many of the paediatric cardiac care units in South Africa are cold, unfriendly places, the HSFSA wants to raise funds to refurbish these health facilities and improve the quality of the lives of children with heart disease.

Seven paediatric cardiac care units in the South African public healthcare system have been identified as being in urgent need of upgrades to be more child-friendly. And the HSFSA has opened an SMS donate line (SMS “SMART” to 38502 to donate R10) to help raise funds to achieve this.

“Help us turn scary hospitals into warm and loving environments for our Smart Little Hearts. Just R10 can help to put a smile on the face of a child suffering from heart disease,” says Professor Naidoo.

Hearts big and small at risk from heart disease in SA

The Smart Little Hearts campaign forms part of a bigger awareness drive that the HSFSA will be running in September for Heart Awareness Month. “Heart diseases and strokes are the second biggest killer in South Africa after HIV/AIDS,” says Professor Naidoo.

She says people in South Africa are becoming less active and eat more unhealthily resulting in obesity, diabetes and hypertension all being on the rise. These are big risk factors for heart disease. “If we continue leading these unhealthy lives, the impact of heart diseases will get worse,” warns Professor Naidoo.

The good news is that up to 80% of heart disease can be prevented by living a healthy and balanced lifestyle – getting enough exercise, eating a balanced diet, not smoking and drinking little alcohol. It is also vital that people get themselves tested to find out if they are at risk for heart disease so that they can manage their risk factors.

This September, the HSFSA is partnering with Dis-Chem Pharmacies nationwide to provide free testing for blood pressure, cholesterol and blood glucose, risk factors that contribute to heart disease.

By getting tested, people will help themselves – but they can also help raise funds for the HSFSA Smart Little Hearts campaign. Local healthcare organisations MNI Lifestyle and Patient Focus will make a donation towards the campaign for every person tested this Heart Month.

“This is just another way that big hearts can help protect themselves and little ones this Heart Month,” says Professor Naidoo.

Want to help?

SMS the word “Smart” to 38502 to donate R10 to improve the lives of children in paediatric cardiac care units in South Africa as part of the Smart Little Hearts campaign.

Visit www.heartfoundation.co.za for more information.

 

CALCULATE YOUR HIDDEN SALT

Leave a comment March 3, 2016 nutritionadsa

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