Nutrition - Parenting Hub

Advice from the experts

Food’s influence on childhood behaviour and learning

Worldwide, allergies are on the rise, and in South Africa a staggering 40% of sufferers are children, according to the Allergy Foundation of South Africa – affecting quality of life and learning potential. The problem, and solution, to common allergy symptoms, says world-renowned nutrition expert Patrick Holford, is diet. “One in three children with behavioural problems have allergic reactions to foods. Other than overt physical reactions, individual food allergies can affect thought processing and cause irritability, agitation, aggressive behaviour, nervousness, anxiety, ADHD, autism, hyperactivity and learning disabilities,” says Holford. A trial study conducted by Dr Joseph Egger, head of the Pediatric University Hospital in Munich, Germany, and his team in 1985, which studied hyperactive children to find out whether diet could contribute to behavioural disorders, found that 79% of the children participating reacted adversely to artificial food colourings and preservatives, but also found that different foods produced the same symptoms in different individuals. “In the 1980s, researchers found plenty of evidence that allergies affect any system in the body and are behind a diverse range of symptoms, yet this research has largely been ignored since,” says Holford. Patrick Holford is a pioneer in new approaches to health and nutrition, specialising in the field of mental health. Having suffered throughout his childhood and adolescence with migraines, sinus infections and ear infections, Holford sought a solution and discovered that his troubles were due to milk and yeast allergies. “The truth is that the majority of people are likely to suffer for years not knowing that they have an allergy – but also not knowing how to treat it,” says Holford. Not to be confused with an intolerance or sensitivity, an allergy is an exaggerated physical reaction to a substance where the immune system is involved. As our personal defence system, the immune system releases chemicals when it comes across a substance it doesn’t like. The chemicals released by the immune system in response to an allergy result in symptoms such as mood-, attention-, memory- and intellectual impairments, as well as behavioural problems, overt physical ailments and delayed reactions that make pinpointing the allergy difficult. Other symptoms of a food allergy include nausea, cramps, flatulence, fatigue, throat trouble, sweating, skin rashes, acne and boils, migraines, apathy and confusion, depression, and paranoia. “The good news is that you can grow out of most food allergies and reduce your child’s allergic potential,” says Holford. According to Holford, the best way to prevent and reduce allergic potential in your child is to stick to the following dietary guidelines: Completely remove wheat and dairy products from their diet for a month or so and see if their symptoms improve. Have an IgG ELISA food allergy test done and see a nutritional therapist. Improve your child’s digestion by including plenty of fresh fruit, vegetables and seeds in their diet. Ensure you keep antibiotics and painkillers to a minimum, as they damage the digestive tract. Include fish in their diet to ensure that they are getting sufficient Omega 3 oil, Zinc and Vitamin A. Avoid foods containing chemical food additives. The most common ones to look out for are aspartame, tartrazine and MSG. Eat whole, natural foods as much as possible. Choose organic food (free from pesticide residues). For further information on food allergies, nutrition and childhood behavioural problems, visit www.holforddirect.co.za.

October 19, 2018

Why breakfast really is the best way to start your day

The importance of breakfast has long been a part of the prevailing wisdom, and the habit of eating breakfast has always been a marker of a healthy lifestyle. Yet, if there’s a meal that is going to be skipped, it’s probably breakfast; and this is a pity because research clearly shows that there are many vital health benefits associated with eating breakfast regularly. Studies show that 1 in 5 South African children skip breakfast. For the first time, a broad coalition of health partners including leading non-profit organisations, health professional associations as well the National and Provincial Departments of Health, have aligned National Nutrition Week (9 – 15 October 2018) with National Obesity Week (15 – 19 October 2018) to promote a shared and very important message that eating breakfast is the best way to start your day. After our longest fast, a healthy breakfast kick-starts the metabolism, lights up mental functioning and boosts physical energy on a day-to-day basis. However, the health benefits of breakfast are not just experienced over the short-term. Studies show that eating a healthy breakfast regularly over the long term helps to reduce risks of heart disease and stroke, high blood pressure and Type 2 diabetes. This correlates with studies that show that children, adolescents and adults who eat healthy breakfasts regularly have better, sustainable weight outcomes and are at a lower risk of becoming overweight and obesity. “It is ironic that one of the common reasons for skipping breakfast is the desire to lose weight when it has the opposite effects,” says Rebone Ntsie, Director: Nutrition at the National Department of Health. “The lack of breakfast leads to a far greater risk of compensating with unhealthy snacks to get through to lunchtime and with bigger lunch portions.” Ntsie points outs that, according to the 2016 South Africa Demographic and Health Survey, 68% of women and 31% of men in South Africa are overweight or obese. Life-threatening, severe obesity affects around 20% of women and 3% of men. Approximately 13.3% of children under 5 years of age are overweight or obese; and according to the 2012 South African Health and Nutrition Examination Survey (SANHANES), 14.2% children aged 6 to 14 years are overweight or obese. CEO of the Heart and Stroke Foundation South Africa, Professor Pamela Naidoo says: “At least 80% of early deaths caused by heart disease and stroke can be avoided by following a healthy diet, which includes eating a healthy breakfast, in combination with regular physical activity and avoiding the use of tobacco. It is important to understand how the food choices we make contribute to overweight and obesity.” Many South Africans consume large amounts of sugary drinks and eat a lot of convenience foods that are typically high in sugar and fats. There’s also a common preference for highly refined starchy foods over those that are minimally processed and healthier. Taking in too much food energy from nutrient-poor foods leads to weight gain. However, making poor food choices is not the only issue. Professor Naidoo points out that our modern lifestyles easily lead to ‘portion distortion’. “Large portion size is also a major contributor to weight gain whether people eat out or at home,” she says. “With a gradual increase in the amount of food being purchased and served ready cooked, many people can no longer recognise the size of a healthy portion.” Lack of knowledge and poor food choices lead to unhealthy diets, which are a risk factor for non-communicable diseases. Dr Christine Taljaard-Krugell, ADSA (Association for Dietetics in South Africa) President, points out the importance of engaging with a registered dietitian to help make healthy breakfasts a habit for the whole family. “Other reasons so many South Africans skip breakfast include food not being available, it not being a family routine, time pressure in the mornings, not feeling hungry or not liking typical breakfast foods. From food budgeting to menu planning and meal preparation, there are solutions to all these issues. Information and help are available.” What should a healthy breakfast consist of? Breakfast should consist of at least one food group (excluding beverages). However, to stay fuller for longer and improve the variety of nutrients you take in at breakfast, it helps to include foods from three or more food groups. A rule of thumb is to choose a minimally processed starchy food combined with a food from at least one of the following groups: vegetables or fruit dry beans, lentils, split peas, soya fish, chicken, lean meat or eggs milk, maas or yoghurt plant oils, soft margarine, peanut butter In addition, it is important to drink clean safe water instead of a sugary drink. The ‘breakfast is the best way to start the day’ campaign offers some key messages to inspire making a healthy breakfast a long-lasting habit and family routine: Be ‘breakfast ready’ and beat the morning rush – Breakfast doesn’t have to be a big production – with some planning and preparation, it can be quick and easy. Before you go to bed at night, set up your kitchen for breakfast. Soak the oats and slice the fruit so you don’t have to do it in the morning. Cook extra maize meal porridge for the next day’s breakfast when making supper, or boil some eggs the night before. Make it healthy and enjoyable – “It’s easier to make breakfast a daily habit if you enjoy it,” says Carol Browne of the Nutrition Society of South Africa (NSSA). “While our cultures may define what breakfast foods are, there are really no hard and fast rules. It doesn’t matter whether you eat the same things as others for breakfast – it just matters that you have a healthy start to the day. This means having a minimally processed starchy food, as part of the meal, and combining it with food from at least one other food group.” For example, maize meal porridge with maas and an apple; brown bread with pilchards and sliced tomato; Last

October 11, 2018

Why nutritional supplements taste so good

Taste is highly personal. Think back to the last beverage you ordered. Maybe it was tea – and you were asked if you would like it served hot, iced, sweetened or unsweetened; with lemon or milk. In general, such decisions are influenced by your culture, your location, past experiences and even by your current state of health. “Nutritional products such as Ensure® have important health benefits however the taste of the product plays a critical role in the delivery of the nutrition,” explains Monica Tortorice, a senior flavour scientist at Abbott. We all know that sometimes making healthy food taste great is not as easy as it sounds, same as balancing the nutrients consumers need with the taste they want is a process on its own. This is exactly why Abbott puts flavor, texture and aroma first in every product it makes but also ensuring that products meets the therapeutic nutritional needs of their consumers. “The more nutrient-dense a product is, the more challenging it is to make the aroma and taste appealing,” says Tortorice. “Important ingredients like HMB (also known as beta-hydroxy-beta-methylbutyrate) is found in Ensure® NutriVigor, which helps in supporting muscle health. HMB on its own doesn’t taste that great however we need to include this ingredient to provide consumers with the muscle health support they need. These are primary considerations we take in our development process.” “It’s even trickier making products for people who are ill,” says Normanella DeWille, PhD, a research fellow and product developer at Abbott. “People who have cancer often have their sense of taste impacted. Everything tastes or smells different. At Abbott it’s our job to intensify certain flavour elements and sweetness levels to ensure our nutritional supplements are enjoyed by patients whilst they get the critical nutrition they need.” Starting with the best ingredients and processing techniques Behind every one of our products is a great recipe and quality ingredients. That’s why the Abbott team first sources the best ingredients by partnering with high-quality farms and trusted suppliers. “We look at each ingredient closely for its quality and the benefits it brings to our products,” says Normanella DeWille, “For example, our years of research tells us that combining proteins from milk as well as those from plants gives our products the smoothest mouthfeel possible, which has a huge effect on overall taste and experience.” The processing of these ingredients also matters. For example, exactly how protein is extracted from milk to produce milk protein concentrate affects taste and texture. We find that milk protein concentrate is a key ingredient in a wide range of complete nutrition products including Ensure® and PediaSure®. “If the protein is extracted in a harsh manner, for example through the use of excessive heat, there can be an impact on overall taste and texture,” said DeWille. Therefore, our scientists only work with suppliers that use gentle methods of extracting that protein. Minimizing undesirable tastes If you’ve ever turned up your nose at a piece of pungent fish, you’ve smelled exactly the sort of obstacles flavour technologists are up against in making nutritional products taste great. After all, some of Abbott’s products, include fish oil for omega-3 fatty acids, which play a valuable role in overall health and healing. And while fish oil can taste and smell fishy all on its own, once it oxidizes (reacts to oxygen), that smell gets even stronger. “Fortunately, through a lot of research, we’ve been able to find an antioxidant blend that prevents fish oil from oxidizing,” says DeWille. She explains that, when combined with rosemary extract through Abbott’s pending patent on the technology, those antioxidants help scientists get fish oil into their nutritional drinks and still taste great. The end benefit; your loved ones get all the nutrition they need and a great taste.Tapping into favourite flavours around the world Once a product’s nutritional base is made, it’s up to flavour scientists to turn that base into a nutrient-laden treat, so to speak. Fortunately, Abbott scientists have been perfecting their flavour technology talents for 30 years. While some flavors are universally appealing – chocolate, strawberry and vanilla are popular worldwide, whereas some countries have their own unique flavour preferences. So how do those global tastes play out within Abbott products? For example, mushroom and chicken soup are popular flavours for Ensure® in the United Kingdom. Also, wheat and green tea are loved in China and a special saffron almond flavour is popular in India. Once Abbott identifies preferred flavours and flavour combinations, Abbott scientists are able to dig into them to determine the best way to apply them to nutritional products for that specific market. The products then provide the nutrients that children, moms and adults need daily with different flavours that make drinking the nutritional shake exciting and delicious. Ensure® NutriVigor, Similac Mom® and PediaSure® are available at major retail pharmacies and retail outlets nationwide.

August 15, 2018

Pregnancy: Taking care of your nutritional and financial needs

By 1Life You’ve finally taken steps to confirm the reason behind your weird cravings, unexpected emotional outbursts, the fatigue as well as all the other unusual things that have been happening to your body of late and so begins the journey towards motherhood. One moment you only had yourself to worry about, and now you’re making way for the new bundle of joy that’s growing inside of you. When you are expecting, taking care of your nutritional needs goes well beyond ‘eating for two’. Instead, there are certain nutrients that your body needs during this journey, to ensure your baby is healthy and that you keep yourself in excellent condition as well. Maryke Gallagher, a registered dietician in Cape Town and President of the Association of Diabetics in South Africa, states that from a nutritional point of view, the first 1000 days are the most important. This includes the time the baby spends in the womb, where the first 1000 days are said to set the stage for healthy brain development, growth and appropriate weight gain and building a strong immune system. Having a healthy nutritional plan is therefore vital and can also assist with protecting against chronic diseases like diabetes, heart disease and high blood pressure later in life. As a result, what you put in your body during this period is extremely important. Some crucial nutritional needs include: Energy needs: These increase in the second and third trimester, but this does not mean you should eat for two. It means increasing the energy intake by 800-200kj per day, the equivalent of a small meal snack, like yoghurt, fruit and nuts, or a slice of rye bread with nut butter and a fruit. Protein needs increase: Focus on eating more safe proteins, at least twice per week. Options that are generally considered safe include trout, salmon, herring, pilchards and mackerel. Plant proteins are mostly incomplete proteins. This means that legumes like lentils, chickpeas and butterbeans need to be combined with grains such as brown rice, quinoa or barley to form complete proteins. Soya beans and tofu are some of the only complete plant proteins. It is generally believed that it is safe to be vegetarian while you are pregnant if you plan carefully to eat sufficient proteins that meet the body’s demands. Omega 3 Fatty Acids: These essential fats are important in pregnancy for healthy brain development in the baby. Fish is one such example of a good source of Omega 3 fatty acids, which you should consider before taking supplements to ensure that you are meeting your daily requirements. These type of vitamins reduce the risk of preterm birth and play a role in the visual acuity of the baby. Later in life, they play a role in the IQ and behaviour of the child. They also play a role in regulating the mood of the mother. Total fat intake: Every cell in the body is made up of fats, and cell membranes consist of phospholipids that influence how well cells communicate with each other within the body. Plant fats are particularly valuable and include nuts, seeds, avocado, olives, olive oil, and flaxseed oil. Micronutrients: These are essential vitamins, minerals and phytochemicals. During pregnancy, the important ones are Folic Acid, Iron, Calcium, Vitamin D, B12 and Choline. Choline plays a role in the first trimester development of the baby, in particular the brain development and formation of neural pathways. Choline is found in animal-protein-rich foods such as eggs and beef. Haricot beans, soya protein, pulses and dairy products (like milk and yoghurt) are good sources of Choline. Folic acid is found in fruits and vegetables such as leafy dark green vegetables, liver, legumes and fortified cereals. The above is all important to keep in mind. However, your nutritional needs are in fact only one of very many aspects that you will need to consider as an expecting mom. As you enter this new life stage, your financial needs are also set to change and you will then need to start asking yourself questions about your financial plan. Things like, can you provide for the wellbeing and financial security of your child, the schools you want them to attend and if you are saving enough towards their future education. Safeguarding your assets is also an important consideration, which ensures that these will go to your child in your absence. These are the first of many aspects related to your financial planning that you will need to consider as you enter this new chapter. When starting your pre–birth financial planning, do a financial needs analysis to determine what your future financial plan should look like. Then ask yourself if your current long-term insurance provider can adjust your cover to cater for your growing family and financial needs. If they are unable to, look for a provider who can – and one who will become your partner in providing financial assurance as your family grows.

June 27, 2018

Beat The Holiday Food Traps

The worst part of a holiday trip isn’t the packing before the holiday or the large crowds – it is the price your diet pays. As much as we look forward to a holiday, many of us fear enjoying it too much – and piling on the kilograms. It is no coincidence that when holidays get under way, your diet takes a nosedive. But is not just stress associated with travelling or the temptation and treats that take their toll on you. There seems to be the assumption that when you travel, you can’t eat healthily, so subsequently you don’t even make an attempt to. However, the correct foods can help ward off road rage, prevent jet lag and give you the energy to deal with your family when you finally get where you are going. You will also feel healthier, more alert, and have more fun once you reach your destination. Typical freeway fare includes fast food, microwave-ready service station options, pies, bags of chips, chocolate bars and lots of fizzy drinks. These foods are almost always full of bad fats, lots of calories and not much valuable nutrition. With a little bit of effort and willpower, you can navigate your way around the junk food and maintain your healthy diet while on a long road trip. Follow this guide to help you stay on the straight and narrow. Keep on reading to help you make the right food choices on the go. Breakfast on the run Always start your day of travelling with breakfast. Tempted to hit the Wimpy? Not so fast – beware of hidden fats and kilojoules – you also want avoid excess sugar. High carbohydrate meals e.g. restaurant or coffee shop muffins may improve your mood for a short time, but lots of sugar can also make you sleepy – which isn’t good if you are the driver. Your best bet is to look for lean protein. A protein rich breakfast can help increase the feeling of fullness and reduce cravings later in the day. Seed loaf or wholewheat toast with eggs is a good choice. Health bread or wholewheat bread contains a fraction of the kilojoules found in croissants or bagels. Rather choose ham over sausage or bacon (both are very high in artery-clogging saturated fat). Breakfast wraps are a good choice, but do avoid wraps that has words like loaded, meaty or cheesy in its name on the menu or packaging description. A common mistake people make is drinking a smoothie with their breakfast instead of drinking the smoothie as their meal. Smoothies are often high in kilojoules and high in sugar. Pick a smoothie that is made with fat-free yoghurt instead of ice cream and avoid ingredients such as fruit syrups. Skip Granola and fruit mix, despite its health reputation, granola contains more than 2000kJ (476kcal) and 30g fat per cup! It is often further loaded with dried fruit that sends the sugar content further through the roof (not to mention your blood sugar). If you do have time, it is best to prepare yummy “padkos” yourself. See below for ideas. Lunch on the go Tired of hearing…… How far yet? Now you also have to start thinking about lunch. If you weren’t organised enough to pack lunch, then it means hitting the one-stop along the freeway or the restaurant at the airport. Options such as grilled chicken sandwiches or wraps are a good idea, as long as they’re not loaded with cheese or sauces such as mayonnaise. Caution with pre-prepared salads – they are often drenched in salad dressings loaded with kilojoules, saturated fat and salt. All the salt is sure to make you feel uncomfortable and bloated in an already cramped car or airline seat. Sushi is another healthy alternative that contains healthy fats as well as omega-3 fatty acids. If you choose a burger, try to give the chips on the side a skip. A typical serving of chips provides you with 2310kJ (550kcal) and 20g fat – this is half of the typical amount of energy most women need in a day. Snack on the road The petrol gauge’s needle is edging towards empty…… and so is your tummy! You stop at a petrol station to fill up and inside the shop you are confronted with mostly unhealthy food choices. Bypass the high sugar and fat items on the shelves and look out for healthier options. Fat free yoghurt (or low fat if there isn’t any other choice) is a healthier option which is also high in calcium and protein. Bananas are high in soluble fibre that won’t bloat you and contain magnesium that helps with headaches while driving. Be careful with nuts – limit your portion size to a small handful. Nuts are high in fat (yes, it is the healthy fat but is still high in calories). Also, be cautious with protein bars, unless you eat a brand you know and trust (approved by your dietitian). You could very easily end up with a protein bar that’s closer to a chocolate than a healthy snack. Some manufacturers jam their bars with sugar. Pack Light Packing your own travel bag of food? Then make smart choices such as the following: Packets of instant Oats (original flavour) – ask for some boiling water at your pit-stop. Alternatively, pack individual portions of Futurelife or Pronutro (original or wholewheat flavour) – just add water or milk. Homemade sandwiches, wraps, pita breads or provitas with a lean protein filling. Chicken strips, mini bobotie bites, mini quiches (made without the cream and buttery short crust pastry) – see ‘Snacks and treats for sustained energy’ for recipes and more ideas Biltong: this practically fat free protein source will keep your mouth busy and fuller for longer. Fresh fruit or fruit snacks e.g. Low GI Safari Fruit Break Bars or Just Fruit Bars (also available at the practice) for a fibre-filled way to satisfy a sweet craving. Nuts: pack 30g portions that can

June 1, 2018

Quality Nutritional Supplements: A Benefit for pregnant moms

Expectant moms want the best for their babies but often feel overwhelmed by the information they receive on what is and isn’t good for them and their baby, which is often contradictory. Getting the right nutrients during pregnancy, and while breastfeeding, can help to ensure the best health outcomes for you and your baby, so it is important to be able to differentiate between facts and myths. Diet1 and appropriate nutritional supplementation2 play an important role in a healthy outcome for both mom and baby. Research has shown that conditions like excessive weight gain1,3,undernutrition caused by nutrient deficiencies2, and gestational diabetes4 during pregnancy can have a negative and lifelong impact on mom and baby.3,4 Abby Courtenay, a registered consulting dietician from Nutritional Solutions, provides tips below on how nutritional supplementation can help you have a happy and healthy pregnancy: When should you supplement your diet? If you suffer from loss of appetite, nausea or vomiting, supplementing your diet will help you reach your calorie and/ or nutrients goals. If you are not consuming enough calories, not gaining any or enough weight or carrying a high-risk pregnancy, a nutritional supplement may help to bridge any nutritional gaps.5 Nutritional supplements which are formulated to contain a variety of nutrients, can be used as a great on-the-go option for busy moms who don’t have the time to prepare healthy snacks. These nutrients include a combination of carbohydrates, proteins and fats which will assist to lower your glycaemic response6, ensuring that you have sustained energy throughout the day; as well as a host of micronutrients to support a healthy pregnancy. It is important for you to look after yourself during pregnancy and whilst breastfeeding your baby – a happy, healthy mom ensures a happy, healthy baby Similac® Mom provides an easy and convenient nutritional solution for expectant moms as well as for breastfeeding moms. Similac®Mom is available at all major pharmacy groups and selected retail outlets and via online shopping. References and notes: Source: https://nutrition.abbott/za Muktabhant B, Lawrie TA, Lumbiganon P, Laopaiboon M. Diet or exercise, or both, for preventing excessive weight gain in pregnancy. Cochrane Database of Systematic Reviews 2015, Issue 6. Art. No.: CD007145. DOI: 10.1002/14651858.CD007145.pub3. Haider BA, Bhutta ZA. Multiple-micronutrient supplementation for women during pregnancy. Cochrane Database of Systematic Reviews 2017, Issue 4. Art. No.: CD004905. DOI: 10.1002/14651858.CD004905.pub5. Nutrition Working Group, O’Connor DL, Blake J, Bell R, Bowen A, Callum J, Fenton S, Gray-Donald K, et al. Canadian consensus on female nutrition: adolescence, reproduction, menopause, and beyond. J Obstet Gynaecol Can. 2016 Jun;38(6):508-54.e18. Abstract available from: https://www.ncbi.nlm.nih.gov/pubmed/27368135 De-Regil LM, Fernandez-Gaxiola AC, Dowswell T, Pena-Rosas JP. Effects and safety of periconceptional folate supplementation for preventing birth defects. Cochrane Database Syst Rev. 2010 Oct 6;(10): CD007950. Abstract available from: http://www.ncbi.nlm.nih.gov/pubmed/20927767 Nutrition Working Group, O’Connor DL, Blake J, Bell R, Bowen A, Callum J, Fenton S, Gray-Donald K, et al. Canadian consensus on female nutrition: adolescence, reproduction, menopause, and beyond. J Obstet Gynaecol Can. 2016 Jun;38(6):508-54.e18. Abstract available from: https://www.ncbi.nlm.nih.gov/pubmed/27368135 Augustin LS, Franceschi S, Jenkins DJ, Kendall CW, La Vecchia C. Glycemic index in chronic disease: a review. Eur J Clin Nutr. 2002 Nov [cited 2013 Jul 6];56(11):1049-71. Abstract available from: https://www.ncbi.nlm.nih.gov/pubmed/12428171

May 1, 2018

Should you be giving your child fish oil?

Fish oil is one of the most studied nutritional and health products. The main components of interest in it are the omega 3 fatty acids. The human body cannot synthesize omega 3 and so it has to be sourced from the diet. Fish is one of the best sources of omega 3. The two main biologically active ingredients in omega 3 are docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Sources of fish oil include the processing of oily fish such as salmon, sardines, tuna and cod. Fish oil also contains some small amounts of vitamin A. In view of all this; it is now easier to tackle the question of whether fish oil should be given routinely to children. The first question every parent should consider is whether they are giving their children adequate fish oil through the diet. This can be answered easily by assessing the number of times in a week the children eat any of the oily fishes. This has to be several times week. In the U.S, the American Heart Association recommends more than 3.5 oz. of oily fish two times per week. Since many children’s diet is a reflection of what the adults are taking, it is likely that they also get inadequate fish oil from the diet and hence supplementation is necessary. Everything in proportion The typical western world diet consists of high omega 6 fatty acids intake. These are mainly vegetable oils. High consumption of these oils has been linked with a high incidence of degenerative disorders. In an ideal situation the ratio of omega 6 and omega 3 should be about 1:1. This helps to counteract the undesirable effects of omega 6. In some cases the consumption ratio is disproportionate with omega 6 being up to 10 times more than omega 3. To bring the ratio to near normal fish oil should be given to the majority of children. The benefits of fish oil for children There are many documented benefits to giving your children Omega 3, including: Healthy brain development Improved cognitive ability Health bones and joints Good eye health Reduced hyperactivity disorders symptoms Healthy skin How much fish oil should children be given? The amount of fish oil supplementation depends on the amount of omega 3 it contains. Therefore the dosage for children is given in terms of omega 3 amounts (total DHA and EPA) and it is age dependent. Different countries also have slightly different recommendations. Below is a suggested dosage regime. 0-12 months about 0.5 grams per day 1-3 years about 0.7 grams per day 4-8 years 0.9 grams every day 9-13 years 1.2 grams each day for boys. Girls can do with 0.2 less grams than boys 14-18 years 1.6 grams daily with girls in the same age bracket needing about 1.1 per day Some countries recommend dosages in terms of mg per kg of body weight. Ascertain your country’s guideline before giving fish oil to your children. Side effects of fish oil Fish oil is generally well tolerated. However, children with known allergies to the oil or certain sea-foods should better avoid it unless your doctor says it is okay. Cod liver oil is a type of fish oil sourced from the liver of cod. It contains a lot of vitamin A and D. These vitamins are fat soluble and if taken in excess have accumulating effects in the body and they can cause serious health effects. Never exceed manufacturers’ recommended fish oil dosage. Jane Hutton is a nutritionist and health enthusiast. She also enjoys rock climbing and sailing in her free time. She’s passionate about animal rights and works for an Omega 3 brand called NothingFishy. Facebook: NothingFishy Omega3 Twitter : @nothingfishyco

March 23, 2018

Experts Weigh In on Pregnancy and Nutrition in SA

Good nutrition before and during pregnancy may influence the pregnancy, the delivery and the health of mother and child later on. What you eat now will help your baby to grow healthily and give them the best start in life and help you to feel your best. We asked registered dietitians and ADSA (Association for Dietetics in South Africa) spokespeople to provide their top tips for healthy eating during pregnancy. Does eating for two mean doubling up your portions? “Additional energy is needed during pregnancy to support the growth demands of your baby, however the saying ‘eating for two’ has been taken out of context,” says Cath Day, Registered Dietitian. “During the first trimester, you don’t need any additional energy. This means that if you were maintaining a healthy weight before you became pregnant, you can continue eating the same amount. It is only in your second and third trimester that you need to eat a little more.” But, how much more? The professional advice from a dietitian is that an expectant mom who is at a healthy weight should take in an extra 350 kCal / 1470 kJ per day in her second trimester. This would be the equivalent to eating an extra half a cup of fruit or one tennis ball-sized fruit, a 175 ml of plain low fat yoghurt, two wholewheat crackers, two teaspoons peanut butter without added sugar and salt, and a 30 gram portion of a medium fat cheese. In the third trimester, the recommended additional intake rises to just 460 kCal / 1930 kJ per day, and that would be equivalent to eating an extra one cup of fruit or two tennis ball-sized fruits, 175 ml plain low fat yoghurt, four wholewheat crackers with the same two teaspoons peanut butter without added sugar and salt, and a 30 gram portion of a medium fat cheese. What should you do if you are overweight and pregnant? Overweight and obesity can present health challenges during pregnancy, so health professionals do advise that women should get to a healthy weight before they fall pregnant. However, in South Africa where women’s rates of overweight and obesity are high, less than ideal conditions for pregnancy need to be managed. “Pregnancy is not the time to think about dieting and weight loss,” says ADSA spokesperson and Registered Dietitian, Nazeeia Sayed, “An overweight pregnant woman should focus on the healthy eating of a variety of nutritious foods, and her weight gain needs to be monitored at her ante-natal check-ups. She should also focus on light exercise such as walking.” Day also points out that: “Overweight and obese pregnant women would benefit from seeing a registered dietitian who can assist them with an eating plan which will support baby’s growth and ensure that they gain weight within healthy parameters.” How can you eat healthily on a budget? Day has some sensible tips: Eat fruits and vegetables which are in season and more affordable Get your family members and neighbours to shop with you for bulk fruits and vegetables that are more cost-effective Start a vegetable garden using water-saving ideas at home or in your community. NGOs such as Soil for Life and many more help households and communities to sustainably increase their access to fruits and vegetables Spend less money on fizzy cold drinks, junk food and take-aways, and use what you save to buy seasonal fruits and vegetables instead You can save money by reducing your meat intake by half and instead use beans, split peas and lentils to bulk up your favourite meat dishes. These legumes are a more affordable, healthy vegetable protein source that also include the B-vitamins and folic acid Buy frozen vegetables when they are on promotion – they contain as much or even more nutrients than vegetables which have been on the shelf for an extended period of time What can pregnant women who can’t afford supplements eat to get the micro-nutrients important to pregnancy? Pregnant women and those planning on falling pregnant should take a supplement of iron and folic acid, as these are essential nutrients needed for a healthy pregnancy. Sayed points out that it is important for all pregnant women to know that they have access to the State ante-natal services because supplements such as folic acid, iron and calcium are included in their free healthcare. Day also adds that there are many affordable food sources that provide these nutrients that are vital to a baby’s healthy development. “For instance,” she says “Green leafy vegetables such as spinach, morogo and legumes such as beans, split peas and lentils are good sources of folic acid and iron. You can also find staples such as maize meal and brown bread that are fortified with folic acid and iron. Amasi and milk provide calcium. Tinned sardines and pilchards provide calcium and iron, and chicken livers are another good source of iron.” How can you use your pregnancy to develop healthier habits? Pregnancy is a time when your health and the health of your developing baby is an absolute priority. Day says that it is not only what you consume but also what you do not consume that counts. “Don’t drink alcohol when you are pregnant. All forms of alcohol could be harmful to your baby and the safest choice for your unborn baby is not to drink any alcohol at all when you are pregnant.” Sayed concludes: “Pregnancy is not a state of ill health but a time to be enjoyed, and it can help you to develop life-long healthy eating patterns that you sustain as you become a role model for the new addition to your family!”

March 12, 2018

Nutrition in pregnancy: Giving your baby the healthiest possible start

With so many myths out there about diet and pregnancy, no wonder new mothers-to-be feel confused about the do’s and don’ts of their own diets. To eat appropriately is the one thing a mother have a lot of control over, and wants to get 100% right, but is so afraid of getting it wrong. We are regularly told that our weight, nutritional status and health during pregnancy and breastfeeding have effect on a baby’s risk of developing disease in future, birth risks, the baby’s health and growth both in the uterus and after birth. Scary as it may sound, with the right dietary advice and support it can actually be quite easy to get your diet right with a few easy tips. Keep reading. Will my pregnancy cravings influence my child’s eating habits? Want your child to love veggies? Start early. Very early! New research shows that WHAT a woman eats during pregnancy not only nourishes her baby in the womb, but can influence a baby’s palate and food memories before he/she is born. The study found that a mother’s diet shapes her baby’s food preferences and acceptance later in life. Flavour perception develops as early as in the unborn infant and taste and smell continues to develop once they are born. In the womb, a fetus is surrounded and nourished on amniotic fluids, which is filled with the flavours of what the mom has eaten in the last few hours. The fetus starts to swallow large amounts of amniotic fluid from about 12 week’s gestation. By the time a women reaches her third trimester the fetus’s brain starts to communicate with the taste and smell receptors – for the baby to start to associate with certain flavours and odours in the amniotic fluid. A baby therefore already starts to build a memory bank of tastes and flavours during pregnancy. Amniotic fluid is therefore the first food for the baby to feast on and contains protein, sugars, fat and different flavours of the food that the mother eats. The fetus can detect these tastes and flavours – forming memories of these flavours and will prefer flavours that were previously experienced in the amniotic fluid. It was shown that if mothers who consumed carrot, anise or garlic flavoured food during pregnancy, their infants would be more accepting to flavours later in life. The flavour learning continues when infants experience the flavours of mother’s diet transmitted in breast milk, especially flavours such as anise, garlic, carrot, mint, vanilla. When babies start solids they showed greater liking for and acceptance of flavours to which they had early exposure. This means you can teach your baby to like broccoli from an early age! This varied experiences with food flavours increase food acceptance and may help explain why children who are breastfed are less picky during childhood. Formula tastes the same day-in and day-out. If you plan to formula feed your infant, and worry about the lack of variants in flavours just make sure you introduce your baby to the largest variety of solid food and flavours early on in the weaning period. To conclude, if you want your children to eat a healthy diet (e.g. their broccoli) or more adventurous diet, you should expose them to all the right, healthy flavours early on. Will WHAT I eat during pregnancy affect what diseases my child may have in later life? There are some studies that show that the mother’s diet may affect whether children have the risk for developing diabetes, heart disease, obesity or high blood pressure later in life. During the war, when pregnant women were exposed to very little food, especially in the first trimester, their children were more likely to be born heavier, taller and develop heart disease in adulthood. Some studies suggest that when an expectant mother has too little protein and too many carbohydrates in her diet, the child may have a risk of high blood pressure later in life. This also applies to when you do not supplement your diet with the recommended vitamin and mineral supplements e.g. folic acid, iron calcium and vitamin D. “Over nutrition” during pregnancy also has detrimental effects and may cause the fetus to grow faster than the fetus’s organs and can lead to liver, heart and kidney disease in adulthood. There is also a suggestion in research that if your diet is rich in omega 3 fatty acids (mainly available in oily fish and seeds) during pregnancy it can protect the baby against ailments such as high blood pressure and heart disease in adult life. Should I avoid certain foods during pregnancy to prevent my child from having food allergies? Many scientific studies have been done to investigate whether mothers who avoid certain foods in the diet during pregnancy can control the presence of allergies and eczema in their babies once they are born. They all concluded that babies might or might not present with food allergies and eczema, regardless of the mother’s diet, especially when there is a strong family history of food allergies. They also concluded that avoiding certain food in the pregnant mother’s diet have shown to affect the mother and the baby’s nutritional status. Both may run the risk of missing out on essential vitamin and minerals contributing to an inadequate nutritional intake and is therefore not recommended. You can actually do more harm than good by avoiding anything in the diet for instance nuts, fish, eggs, milk, citrus fruits to prevent allergies in your baby. If you as expectant mother do suffer from food allergies and need to avoid certain foods it would be of benefit to consult a dietitian who would be able to provide you with a nutritionally balanced diet and ensure both you and your baby get all the nutrients you require. Super foods for pregnancy Eggs: It contains choline that helps to reduce the risk of neural tube defects, such as spina bifida. In addition, studies suggest that choline is key to the

February 22, 2018

How to fix a broken diet?

Are you not getting the results you wanted or your diet plan stopped working? Every diet and exercise system is going to stop working at some point. No matter how great it seems initially, that diet will break. And when it does, your next step is crucial. In this newsletter we’ll be discussing the main strategies to fix a “broken diet” and start eating better. DON’T REALISE YOUR DIET IS BAD In my many years as a dietitian, I came well aware that we humans generally suck at realising what we’re eating. For one, we typically tend to remember the “good things” we do – how we turned down the rusks as they were going round the office last Friday, or how we managed to go a whole week without alcohol. And when we do something “bad” we’re really good at justifying it. “It was so-and-so’s birthday, “or “Yes, I did have that slice of cake, but my friend had 2 slices, so I’m not as bad as her,“ are common reasons I hear for making poor dietary choices. In fact, we’re so bad, that a study from the New England Journal of Medicine found that obese subjects underreported their food intake by an average of 47%, and overestimated the amount of calories burned from exercise by 51%. What does this mean? It means that we think we are eating a lot less than we are, and that we think the exercise we are doing is burning far more calories than it really is. End result – we make little progress and become disheartened with the results. STEP 1: GET TRACKING – KEEP A FOOD DIARY I am a huge fan of food logs. For a start, it gets a person thinking about exactly what they’re eating. Mindless eating is a big problem for many. Writing down everything one eat and drink, over a 2-week period, gets you off to a great start in identifying possible problem areas and underlying nutritional deficiencies. STEP 2: IDENTIFY AND CORRECT NUTRITIONAL DEFICIENCIES Most people think they need a complete diet and exercise make-over. “I have to cut out sugar… and dairy… and carbs… and saturated fat. Plus I have to eat more protein… more healthy fats… and more vegetables. I have to start drinking lots of water too. And exercise… maybe a 6 am boot camp… yeah.” I don’t know about you, but I get exhausted just thinking about changing all this, all at once and often people set themselves up for failure. Let’s call it the “Mission Impossible” approach. Often, people struggle with how they look and feel because their physiology doesn’t work the way it should. This can be hormonal imbalances, but it’s more often dietary deficiency: not getting the right nutrients, in the right amounts, to feel your best and get the best results. Dietary deficiencies are more common than you think A study published in the Journal of the International Society of Sports Nutrition showed that it’s really hard to get all the essential vitamins and minerals from food alone. Of the individual diets that were studied – every single diet was deficient in at least three nutrients. Some diets were missing up to fifteen nutrients! The most common deficiencies included vitamin D, zinc, calcium and some of the B-vitamins. The most common deficiencies I see at Paarl Dietitians are water (low-level dehydration), vitamins and minerals, protein (particularly in women and in men with low appetites), essential fats e.g. omega-3 fatty acids (95% of the population is deficient here), vitamin D, iron and B-vitamins. Bottom line: Dietary deficiencies are very common. Chances are you’ve got one, no matter how good you think your diet is. That’s a problem because when you’re deficient in key nutrients, your physiology doesn’t work properly. And when your body doesn’t work as it should, you feel rotten. Energy levels, appetite, strength, endurance, and mood all rely on getting enough of these essential nutrients. When you don’t get them, things break down. Correcting deficiencies Analysing a food log and blood testing can uncover specific nutrient deficiencies that can be corrected by means of dietary adaptations and nutritional supplementation. As soon as we get the nutrients we need, we thrive. Once we’re getting all the essential nutrients necessary for proper functioning we can move on to bigger issues. These include adjusting food amount (what some call calorie intake) and food type (which includes diet composition or the distribution of protein, carbohydrates and fats). STEP 3: DO NOT EXCEED YOUR METABOLIC RATE For our body to function normally, it needs a constant supply of energy and a variety of nutrients. The amount of energy or number of caloriesyour body uses to carry out these basic functions is known as your basal metabolic rate (BMR) — what you might call metabolism. Thus the metabolic rate is the rate at which the body burns calories. So how much should one eat? The problem comes in when energy is taken in excessive amounts. Too much energy and the body will store the excess as fat and you will gain weight. In other words, if your body uses 1500 kcal to maintain weight, you need to take in at least 500 – 1000 kcal less to lose ½ kg – 1kg per week, therefore a 1000 kcal diet plan. Our practice assess metabolic rate and an individual’s eating plan are devised according to the person’s metabolic rate. By knowing your metabolic rate, we are able to provide correct food amounts and portion sizes to ensure long term weight loss. The secret lies in calorie and portion control. Remember the success of weight loss is an individual approach. Don’t count calories, Be Calorie-Conscious Calorie counting can be very exhausting, time-consuming, confusing and incorrect! Plus this approach just doesn’t suit everyone’s’ lifestyle. Being ‘calorie-conscious’ is a much better approach. The term ‘calorie-conscious’ is a great one, and can often be a real eye-opener. I like to go over an individual’s food diary and pick

November 17, 2017

When to supplement your child’s diet

Children come in all shapes and sizes. But if you’re noticing that your child is shorter than her friends at school, it’s natural to wonder, “is my child growing normally?” Most children take well to eating solids for the very first time. Being naturally inquisitive, children will try a variety of gloopy and colourful tastes and textures. Unfortunately, as babies become toddlers, their tastes in foods begin to change dramatically. As parents, this period may be particularly stressful leaving you worried about whether or not your child’s diet adequately meets their growing needs. This is a greater concern if your child is growing more slowly than their peers. Therefore, it is important to know what the ‘norm’ is when it comes to your child’s growth and development. Registered dietitian Abigail Courtenay has answered a few questions commonly asked by moms. What are the consequences of undernutrition/ underweight¹ ²: Being underweight interferes with optimal growth and development as it is often related to nutrient deficiencies. Specific nutrients are required to support your child’s cognitive health, immunity and physical development. What are the causes for slow growth? There are many factors that could lead to slow growth namely: Poor appetite (this may also occur in healthy children) Acute or chronic illness Restrictive eating due to illness (like allergies) or misinformation Poor absorption (e.g. coeliac disease) Chewing or swallowing difficulties (e.g. children with cerebral palsy) What is considered normal eating behaviour? You can safely assume that children gaining weight appropriately according to their growth chart are getting enough to eat (even if you believe they should be eating more). Children from the ages of 3-5 years have demonstrated the ability to self-regulate their energy intake. Your child’s appetite will depend on a variety of factors such as level of tiredness, activity levels and growth spurts. Some children experience what is known as a food ‘jag’. This is when a child gets fixated on a certain type of food or food group and refuses all other foods. It is not clear how long these food jags last but often a child’s overall nutritional status is not affected by them. ¹ What can I do to help my child enjoy food more¹? Offer a variety of nutritious foods Repeat exposure to foods (sometimes it can take up to 15 repeated exposures before a food is liked/ tolerated) Scheduled meal and snack times (this makes eating a routine and assists in managing your child’s nutritional needs) Provide more frequent but smaller meals Be your child’s role model for healthy eating (i.e. eat healthy foods yourself!) Remove distractions at mealtimes (i.e. TV, tablets and phones) What should I avoid doing¹? Don’t force or pressurise your child to eat Don’t prepare separate or special meals for your child Don’t give rewards for trying new foods Why shouldn’t I force or pressurise my child to eat? Pressuring young children to eat may cause overeating, which may lead to excessive weight gain, or may cause them to actually eat even less as a result of the stress. Either way, pressuring children to eat may upset your child’s natural appetite control system, resulting in them ignoring their internal hunger and satiety cues. ¹ When should I consider supplementation (in the form of a nutritional drink)? If you are concerned about your child’s diet, observe slow growth patterns, or if your child is falling behind in height and weight, this could be a good opportunity to introduce a drink-type nutritional supplementation*. Drinks are often well tolerated by most children and can be made into fun and tasty snacks using a variety of flavours like hot chocolate or fruit puree. Drinks are preferential because they are easier to consume in-between meals, more than food, and may be more acceptable and manageable to a child. * PediaSure® is a tasty and convenient nutritional drink that can be used to supplement a child’s diet during these times. By giving two glasses of PediaSure® to your little one (as an early intervention) per day, you can support their nutritional status, promote healthy growth and normal development. ³ References and notes: Practice-based Evidence in Nutrition: Toddler and Preschool Nutrition – Influences on Appetite and Eating Behaviour. Key Practice Points. Last Updated: 2016-04-01. Mahan KL, Escott-Stump S. Krause’s Food and Nutrition Therapy. 12th edition. Philadelphia: Elsevier/Saunders Publishing. Huynh DTT, Estorninos E, Capeding RZ, et al. Longitudinal growth and health outcomes in nutritionally as-risk children who received long-term nutritional intervention. J Hum Nutr Diet. 2015; doi: 10.1111/jhn.12306: 1-13.

November 3, 2017

Cholesterol: Top foods to improve your numbers

If your diet gave you high cholesterol, it can lower it, too! It’s easy to eat your way to an alarmingly high cholesterol level. The reverse is true, too — changing what you eat can lower your cholesterol and improve the armada of fats floating through your bloodstream. Different foods lower cholesterol in various ways. Here are the top foods to lower your cholesterol and protect your heart. IN WITH THE GOOD Soluble fibre Soluble fibre binds cholesterol in the digestive system and drags them out of the body before they get into circulation. This type of fibre reduces LDL cholesterol levels more than a diet low in saturated or trans fats alone. Five to 10 grams of soluble fibre a day reduces LDL cholesterol by 5%. Barley, sweet potatoes, peas, carrots and beans are great sources of soluble fibre. They also take a while for the body to digest, meaning you feel full for longer after a meal. Bananas, apples, strawberries, prunes, citrus fruits are rich in pectin, a type of soluble fibre that also lowers LDL cholesterol. Omega-3 containing fish Eating fatty fish e.g. mackerel, trout, sardines, pilchards, snoek, salmon – two to three times a week can lower LDL cholesterol in two ways: by replacing meat, which has LDL-boosting saturated fats, and by delivering LDL-lowering omega-3 fats. Omega-3s can reduce blood pressure, risk of blood clots and triglycerides (fat in the blood that increases cholesterol) in the bloodstream and also protect the heart by helping prevent the onset of abnormal heart rhythms. In people who have already had heart attacks, fish oil — or omega-3 fatty acids — may reduce the risk of sudden death. Seeds Flax seeds have been shown in several meta-analyses to reduce total cholesterol and LDL cholesterol by 5–15%, reduce Lipoprotein (a) by 14% and triglycerides by up to 36%. Flax seeds are anti-inflammatory; it is a source of fibre, lignins as well as phytoestrogens that further protects against heart disease. The dose required for these effects is between 14 to 40 grams of flax seed per day. Important to note is that these health properties do not apply to flax seed oil. Chia seeds at a dose of 25 g per day is also good for cholesterol lowering. Sesame seeds at 40 g per day reduces LDL cholesterol by 9%. Unsaturated fats or plant fats A number of studies shows that eating nuts and avocados is good for the heart. Rich in mono (MUFA) – and polyunsaturated (PUFA) fatty acids, both can lower LDL cholesterol and they have additional nutrients that protect the heart in other ways. All nuts are high in calories, so a small handful will do. Make sure the nuts you eat aren’t salted or coated with sugar. To avoid eating too many nuts and gaining weight, replace foods high in saturated fat with nuts. For example, instead of using cheese, meat or croutons in your salad, add a handful of walnuts, cashews or almonds. Another good source of MUFAs is olive-, canola- and avocado oil. Try using these oils in place of other fats in your diet to get its heart-healthy benefits. Add it to a marinade or mix it with vinegar as a salad dressing. Both avocados and these oils are high in calories, so don’t eat more than the recommended amount (as indicated by your dietitian). Soy Eating soybeans and foods made from them, like tofu, soy mince, soy yoghurt and soy milk, was once touted as a powerful way to lower cholesterol. Analyses show that the effect is more modest — consuming 25 grams of soy protein a day (300g of tofu or 2 ½ cups of soy milk) can lower LDL cholesterol by 5 percent. Sterols and stanols Foods are usually fortified with sterols and stanols and these plant compounds interfere with the body’s ability to absorb cholesterol from food. Some margarines and yogurt drinks come with added plant sterols and can help reduce LDL cholesterol by 5 to 15 percent. However, for most people, it is not possible to achieve the optimum intake of 2g per day from foods. For example, the recommended daily dose can be obtained by using 25g (5tsp) Flora PRO.ACTIV spread per day that could be detrimental if you are watching your weight. Fortunately, there are also supplements available that are worth trying. Pomegranate Pomegranate is a potent antioxidant that lowers oxidation of LDL cholesterol. Consuming 250ml of pure pomegranate juice per day or one to two cups of pomegranate seeds is recommended. OUT WITH THE BAD Harmful LDL cholesterol creeps upward and protective HDL cholesterol drifts downward largely because of diet and other lifestyle choices. Genes play a role, too — some people are genetically programmed to respond more readily to what they eat — but genes aren’t something you can change. Here are things you can change. Saturated fats Typical sources of saturated fat include animal products, such as red meat, whole-fat dairy products, eggs, and also a few vegetable oils, such as palm oil, coconut oil, and cocoa butter. Saturated fat can increase your levels of “bad” LDL cholesterol. But it has some benefits, too — it lowers triglycerides and nudges up levels of “good” HDL cholesterol. The role of saturated fat in heart disease is currently under debate. For now, it’s best to be sensible and manage your intake of saturated-fat-rich foods. Refined carbohydrates Increased refined carbohydrate intake may be more important in having a detrimental effect on cholesterol levels than saturated fats. Refined carbohydrates have adverse effects on insulin resistance, LDL and HDL cholesterol as well as triglycerides levels, thus contributing to coronary heart disease risk more than saturated fats. Trans and hydrogenated fats The right amount of these fats are zero! Trans fats are a by-product of the chemical reaction that turns liquid vegetable oil into solid margarine or shortening and that prevents liquid vegetable oils from turning rancid. These fats, often found in shore-bought cookies, doughnuts, crackers, cakes, pies have no

October 9, 2017

Rethink Your Drink – Choose Water!

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/ National Nutrition Week Partners: The National Department of Health: www.health.gov.za The Association for Dietetics in South Africa (ADSA): www.adsa.org.za The Nutrition Society of Southern Africa (NSSA): www.nutritionsociety.co.za The Heart and Stroke Foundation South Africa (HSFSA): www.heartfoundation.co.za Consumer Education Project Milk South Africa: www.rediscoverdairy.co.za

October 6, 2017

Genetic Testing & Nutrition

Ever wondered why nutrition studies demonstrate so many conflicting results or why some people respond to one type of diet and others don’t? It might be because of us. Well, because of our different genes. Just about everybody benefits from a diet consisting mostly of whole, fresh foods. But when it comes to fine tuning for sport performance, weight loss or optimum health – our needs and reactions to specific foods might differ. And this difference likely depends on genetic variation. Humans are 99.5% the same, yet that 0.5% difference matters. This specific question led to the emerging science of genetic testing, called nutritional genomics (a.k.a. nutrigenomics) – the study of interactions between genes and diet. WHY TEST YOUR DNA? Your ability to lose weight and predisposition to specific illnesses all depend on how your genes interact with your environment. For instance, your genes may suggest that you’ll grow to somewhere between 1.65m to 1.7m. But your actual height is an interaction between genes and environment. If you grow up malnourished, you won’t reach 1.7m. What we eat early in life (and what our moms eat while they’re pregnant) can affect our genes and regulate our traits – including development of diseases, even decades later. Our genes can be influenced by all kinds of things, such as: Nutrient deficiencies or excesses (especially at crucial developmental stages) Dietary components (omega-3 fats, phytoestrogens, cruciferous vegetables, folate, to name a few) Sunlight and vitamin D Toxins (such as industrial chemicals, pesticides, heavy metals) Bacteria and viruses Exercise Alcohol and other drugs Circadian rhythms (such as sleep, shift work, travel across time zones) A host of other factors we probably don’t even know yet. It sounds a little scary…… but while we can’t control our genes themselves, WE CAN CONTROL HOW OUR GENES ARE EXPRESSED – whether they’re likely to get “switched on” or off. Genetic expression is strongly shaped by our environment, over which we DO have some power. So, if we know more about our genetic defects (called genetic variants), we might be able to adjust our lifestyle or environment in order to be healthier and prevent some illnesses. For example, some gene variants can tell us how your body metabolize certain foods. Others can tell us whether or not carcinogens in cooked meats will influence the development of colon cancer. And others can predict inflammatory response and predict DNA repair. Genetic testing may also be useful in exercise prescriptions. Specific genes have been identified with athletic potential and performance. If we know more about our own unique risk factors, we might be more likely to make healthier choices – choices that could impact our genetic expression HOW GENETIC TESTING WORKS It is as simple as 1-2-3! Do a cheek swab DNA testing is easy and painless, by taking a cheek swab sample (like they do in Crime Scene Investigations on TV) and then sending the sample back to the DNAlysis laboratory for analysis. Here they use modern technology to analyse a person’s sample in order to identify genetic variants and study the relationship between individual genes and diet – thereby gaining intimate knowledge about physiological processes that may not function optimally. Unlock your results DNA reports are generated that allows an individual to understand how their genes affect the way he or she respond to the environment e.g. the foods they consume or toxins they are exposed to. Optimise your diet and training plan DNA reports are used to refine your nutrition and exercise plan to manage your weight and health. Providing you with a diet plan tailored to your genes (be it low carb or low fat) and insight into optimal exercise intensity for weight loss. However, some people have the gene where physical activity does not help them lose weight! Certain genetic variants can shape possible behaviour traits such as impulsive tendencies and addictions. Knowing, for instance, that you’re probably constantly looking for a reward can help you understand why you might be more drawn to an exciting sport or tasty snack. And help you work with your dietitian and trainer to find nutritional, exercise and behavioural strategies that work for you. INSIGHT INTO THE DIFFERENT DNA TESTS DNA DIET DNA DIET tests a number of well-researched gene variations that impact metabolism, absorption and storage of fats and carbohydrates, as well as eating behaviour. It provides insight into how our bodies respond to different types of foods, it may also have a powerful influence on what we like to eat (bitter vegetables or sweets) as well as why some people get fat and others stay thin. Some gene variants affect appetite and satiety. Others appear to influence how efficiently people burn fat for energy. The DNA DIET report provides additional insight into how each individual reacts to carbohydrates, saturated fats and intensity of exercise, allowing a trained Nutrigenomic practitioner to further personalise your eating plan to suit your needs. DNA Diet tests some of the following genes involved in key metabolic processes: Obesity risk / insulin resistance Binge eating Carbohydrates metabolism Fat absorption DNA HEALTH DNA HEALTH tests for 36 gene variants that are known to have a significant effect on health and susceptibility to chronic diseases. DNA Health reports on genes involved in the following areas: Cholesterol metabolism and risk for heart disease Bone Health & risk for osteoporosis Vitamin B Metabolism and risk for cancer Inflammation and oxidative Stress Detoxification Insulin sensitivity/resistance and risk for diabetes Food Responsiveness, including Lactose intolerance, Caffeine processing, Salt sensitivity and blood pressure & Iron overload disorders DNA SPORT DNA SPORT tests genetic variants that influence injury risk, recovery, as well as power and endurance performance. Results provide insight into various biological areas that impact training responsiveness and sporting performance, optimal exercise selection, and injury and recovery strategies. The test is suitable for the elite performance athlete as well as the recreational athlete looking to maximize their fitness potential and reach peak levels of conditioning. DNA Sport reports on the following

October 2, 2017

Tackling the Fussy Eater

Selective eating or fussiness is a common phenomenon among toddlers, children and even adults. This may be a more serious situation than “I just can’t stand spinach”, and this may include toddlers or children who refuse food or meals altogether or limit, restrict or avoid total foods and food groups due to taste preference or anxieties. We explore causes and potential problems as well as some solutions. WHY SHOULD WE BE CONCERNED ABOUT SELECTIVE EATING AND LIMITED FOOD INTAKE? The main health concern in people with selective eating is risk of nutrient deficiencies, which happens quicker than we realise. It is very common for fussy eaters to suffer from brittle bones, iron deficiency and a poor immune system or mouth ulcers which can all be signs of nutritional deficiency. Poor dietary intake can also impact on the muscle mass, strength and energy levels of the individual. Furthermore, if it is a childhood problem, and is not dealt with, it can easily translate into an adult condition. WHEN SHOULD WE GET CONCERNED ABOUT SELECTIVE EATING AND LIMITED FOOD INTAKE? It is important to distinguish between when it is just a phase that will be overcome and when it is a rather serious situation that may need to be taken seriously and perhaps seek professional help. There are a few red flags to look out for: when less than 20 types of food are accepted when fear and anxiety is involved during eating or pertaining to food when entire food groups are rejected i.e. dairy products or meat or meat alternatives when it is causing stress and pressure in social situations when there are obvious signs of weight loss or nutritional deficiencies HOW TO TACKLE SELECTIVE EATING Put your mind at rest Anxiety over food intake and health will only make the situation worse so try to avoid it. If you have concerns about your child or loved one’s health, growth or weight due to the selective eating, send them for a health check at your GP or speak to a dietitian. If it is a recent development, be assured that it might be a passing phase. Rely on a good multi-vitamin and mineral supplement that provides 100% of the recommended daily intake of most vitamins and minerals and make sure it is cost effective and age appropriate. Keep a food diary To get more information on the quality of the diet, keep a detailed food diary of everything that was consumed for a week. Be specific about quantities, times and brand names of products. Have it analysed by a registered dietitian who often has computer software that can provide a detailed analysis. This will tell you exactly which nutrients are deficient in the diet that may need attention. Avoid the battles To fight, argue and nag is going to heighten the anxiety and make the situation worse. Try and avoid confrontation about the issue. In the case of children, they often thrive on attention, even if it is negative attention. Often if the bad behaviour or food refusal is ignored and not acknowledged, they will try something else to gain attention and the phase shall pass. Also be sure to give positive feedback when food was eaten and praise good behaviour. Avoid overcompensation and never force Do not fall into the habit of offering anything “as long as they will eat something”. Children especially, will start to accept more food if you rely on their hunger signals and not give any food they might desire. The more it becomes a manipulation tool, the harder it will be. Force feeding is strongly discouraged and will aggravate the situation. Rather remove the offending food, without an issue, and offer it at a later stage, avoiding offering a preferred option. Do not use food as a bribe or reward. Encourage frequent exposure Research shows that a food type needs to be offered around 8 to 15 times before it will be accepted. Keep offering a wide variety of food consistently without pressure, but with positive encouragement. Make meal times fun and relaxed Sometimes you have to be creative and pull out all the stops to make meal times fun and pleasant. Have a food fight in the garden, involve your child in cooking and baking, and make interesting shapes and fun food presentation. Have meal times together as a family. Set a good example for your children. About 20 – 30% of children have this issue at some point, so do not feel excluded or isolated if this is what is happening to you. If it becomes unmanageable, seek professional help before it all spirals out of control.

June 10, 2017

Toddler Food Battles

Solving a complex problem at work, finally achieving a personal goal is nothing compared to your child finishing a whole plate of food. Isn’t it amazing that no matter how big your accomplishments in your day, NOTHING, absolutely nothing compares to the satisfaction you get watching your toddler successfully finish a meal. You can sleep peacefully know your baby has eaten ‘well’! Having a fussy eater is more common than you may think. While some babies eat almost anything they can get their little hands on, other babies are a lot pickier. Some fussy eaters are simply trying to express their independence with a say in what, when, where and how they eat. Others just need some coaxing, distraction and gentle encouragement. Perhaps your family dinner table has become a battleground? Then it is time to take the stress out of mealtimes with your toddler and child, end the arguments over food, and feed your fussy eaters. There is nothing like a food battle to cause stress and anxiety in parents – take heart and remember fussy eating isn’t just common, it’s normal! Understanding your child A classic time for problems to arise is when your baby is 12 months old. As a child is more aware of the world his natural instincts make him more suspicious of new foods. Nature’s way of protecting us from eating food that is potentially harmful. If you’re one of the lucky parents that sailed through weaning, another common time for problems to arise is during the challenging 2’s. Having lulled you into a false sense of security, your toddler could wake one morning with dietary requirements that even a top chef would struggle to meet. Children’s appetites are affected by growth cycles and they have different taste preferences to adults. You will encourage her appetite to work properly if you give her more when she’s hungry and let her eat less when she’s not interested. Growth slows down and appetites fluctuate between one and five years of age. Studies have shown that most children get plenty to eat even if it seems like they are barely eating at all. Try looking at mealtimes from a child’s perspective. Toddlers have a different agenda: from their point of view, eating is a waste of their playing time, and if we make mealtimes boring by nagging, it’s even worse. Here are some tips to help your little fussy eater learn to eat better, while giving you some peace of mind. 1. Put your mind at rest: If you are concerned about the health of your child, take her for a check up at the doctor to rule out any potential health problems. Keep a food diary for 2 weeks and record EVERYTHING that she eats and drinks (include quantities). You can then get this assessed by a health professional to assess adequate nutritional intake. Give an appropriate vitamin & mineral supplement during the fussy eating phase. 2. Stay off the battle field: Remember picky eating can also be a child’s way of asserting his independence and may have less to do with the actual food than his need to push the limits of your authority and assert some control over his life. This is why pressurizing a child to eat often back fires and you become a ‘casualty of war’. 3. Wean at the appropriate age Weaning late has shown some link to fussing eating. Parents who delay introducing their babies to chewy food and a variety of tastes could find their babies grow up developing food fads. A recent study showed that babies should be introduced to a more varied diet between the ages of 6 to 9 months to decrease the risk of becoming fussy eaters. Babies learning to eat will spit food out, and this is more than likely due to a ‘tongue-reflex’ action than a sign that your baby doesn’t like the food. Keep trying with that food and soon he will get used to it and swallow. 4. Fun food presentation Sandwiches cut into moon shapes, cracker with a smiley face, carrot sticks as soldiers and apple boats can make food presentation more enticing Presenting meals as a smorgasbord from which they can pick and choose from a variety of colours, shapes and textures. Toddlers and young children prefer foods that are identifiable and not one big mush. Using a compartmentalized plate that prevents different foods from touching is a great help. 5. Make mealtimes fun and relaxed Use it as an extension of playtime and time when you and your baby can bond uninterrupted (no cell phone calls or sms’s !!!). Do puzzles, read a book, tell a story. 6. Educate Talk about the food and its value in simple terms. E.g. this piece of chicken will help your muscles grow strong like daddy (or superman!!) and this carrot will give you beautiful eyes like Cinderella! 7. Involve your child in food preparation By involving your child they will be likely to eat what THEY have made and may eat a bit while preparing their meal. 8. Empower your child in decision making Allow your toddler to choose between two food options. Children are more likely to eat food they have chosen for themselves. 9. Serve simple, easy to prepare meals. There is nothing more demoralizing than spending ages cooking a gourmet meal for your baby, who after the first spoonful turns her head away. Prepare easy meals that you know your child likes and should they refuse the food, offer one alternative that is a sure win e.g. Yogurt. 10. Milk intake By the age of one, babies need drink only 500ml of milk daily. Most babies can go onto cow’s milk from one years of age unless health reasons dictate otherwise. Do not substitute milk for meals 11. Social eating People are social beings as are our children. Nothing makes a toddler want his food more than having another toddler after his food. Invite a friend over

May 26, 2017

Cravings, Cravings, Cravings

‘Cravings’ are often the cause of overindulging and cheating on everyday healthy eating that contributes to weight gain. But…did you know that your ‘craving’ could be the cause of a deficiency in your diet or your body telling you that it needs a certain nutrient. Continue reading, if you want to know which nutrients you really need to nip those ‘cravings’ in the bud. Craving this…. Means you may be missing this… General overeating The science behind overeating, hunger and cravings is vast and can easily fill a book. We overeat for many reasons — hunger (the rumbling in your stomach) and appetite, of course — but also when we are tired or to celebrate, to be social, to soothe and to relieve boredom. However, a lack of silicon (found in nuts and seeds), tryptophan (found in cottage cheese, raisins, sweet potato and spinach) and tyrosine (present in orange, red, green fruits and vegetables, Vitamin C supplement) could also contribute to overeating. If you ‘crave’ the following foods, it could be your body telling you what you really need. Hormones and cravings As many as 70% of women suffer from PMS-related food cravings, bloating, fatigue, sleep disturbances, mood swings and irritability – any of which have the potential to sabotage a healthy diet. First, you have food cravings, usually for sweet, starchy foods with an underlay of fat, like chocolate ice cream. And then, your bad mood makes you say, ‘To hell with it!’ You lose your willpower to exercise and any control over what you are eating. What do we eat when those cravings hit? Chocolate is no. 1 on the hit parade, followed generally by other sweets. Salty foods, particularly chips, are a distant third. The hormonal ebbs and spikes that occur throughout a woman’s cycle are the major culprits in PMS. Cravings during PMS could further be exacerbated by a deficiency in zinc! Cravings, foods and moods Food also influences our mood and mood influences our food choices or could be the cause of you succumbing to that ‘craving’. If you find that your mood changes after meals and snacks, it may be that you’re lacking the nutrients that can help promote good mental health. Anxiety is often due to a deficiency of folic acid and magnesium. Folic acid can be found in foods such as meat, spinach, beetroot and asparagus. Depression could be made worse if your diet is lacking in vitamin B6 and B3 found in lean meat, oily fish (salmon, trout, tuna), whole grains, some fruits and vegetables as well as avocado. If poor concentration & attention is a problem then you need omega-3 fats and Vitamin B1 found in pork, seafood, whole grains, seeds and most vegetables. Insulin: Fuel for cravings Insulin resistance is a condition in which the body produces insulin but the body’s cells do not use the insulin properly. Insulin helps cells use blood glucose for energy. After you eat breakfast, lunch, or dinner, insulin is released into the bloodstream. Insulin’s job is to give muscles and organs permission to access sugar in the bloodstream. When people are insulin resistant, their muscle, fat and liver cells do not respond properly to insulin. As a result, their bodies need more insulin to help glucose enter cells. The pancreas tries to keep up with this increased demand for insulin by producing more. When there is too much insulin present, it contributes to sugar cravings as well as the “mid-afternoon lows.” Eventually, those sugar cravings lead to weight gain if we give in. Insulin resistance increases the risk of developing pre-diabetes, type 2 diabetes and cardiovascular disease. A person is classified as being insulin resistant if their middle circumference is >88cm (women) and >102cm (men). So get those measuring tapes out……or alternatively your Dietitian would be able to arrange for the necessary blood tests to be performed to determine if you are insulin resistant. Insulin resistance is a major global health concern that proves to be difficult to combat. Are you a victim? Tips on controlling those nasty cravings Have regular meals as well as snacks and DON’T skip meals. This will help maintain healthy blood sugar levels and prevent cravings. Limit starchy carbohydrates intake to meal times only and choose Low Glycemic Index starches. NO Starchy carbohydrate snacks – rather choose lean protein e.g. biltong, a small portion of nuts or yoghurt Exclude refined sugar like jelly, sweets or biscuits – this will only make the cravings worse! Know your metabolic rate: use it as an indication of the total carbohydrates that you need (and are allowed to eat) in a day –Your dietitian would be able to measure this for you. Have yourself checked out! Our dietitian’s take a complete diet history, assess your diet and establish which nutrients you are lacking in. Anél, Caryn or Sanmare can then advise you on how to make the necessary dietary changes to ensure a nutritionally balanced diet. If you are concerned about the nutritional adequacy of your diet, then make use of a good quality, comprehensive multi-vitamin/mineral supplement. Ask your dietitian for advice. Craving sugar and carbohydrates? Then consider using a chromium supplement. Chromium helps to maintain blood-sugar levels, by assisting insulin to do its job and keep the blood-sugar levels even which reduces sugar cravings. You require 200 mcg Chromium, twice a day, for control of cravings. Some forms of chromium may be toxic – so make sure you use the correct supplement. Discuss this with your dietitian, otherwise come and have a look at the practice where we stock the correct brands of chromium. Brushing your teeth is a tactic to help avoid late night snacking, which is mainly something that’s habitual. Many times when we eat late at night, it’s by force of habit, not because we are really ‘craving’ or hungry. Another tactic is to avoid the kitchen after a certain time at night, say 8pm. Many of us go in the kitchen like mindless zombies looking for stuff to munch on, so this “no kitchen re-entry” rule

May 2, 2017

Toddlers and food

Solving a complex problem at work, finally achieving a personal goal is nothing compared to your child finishing a whole plate of food. Isn’t it amazing that no matter how big your accomplishments in your day, NOTHING, absolutely nothing compares to the satisfaction you get watching your toddler successfully finish a meal. You can sleep peacefully know your baby has eaten ‘well’! Having a fussy eater is more common than you may think. While some babies eat almost anything they can get their little hands on, other babies are a lot pickier. Some fussy eaters are simply trying to express their independence with a say in what, when, where and how they eat. Others just need some coaxing, distraction and gentle encouragement. Perhaps your family dinner table has become a battleground? Then it is time to take the stress out of mealtimes with your toddler and child, end the arguments over food, and feed your fussy eaters. There is nothing like a food battle to cause stress and anxiety in parents – take heart and remember fussy eating isn’t just common, it’s normal! Understanding your child A classic time for problems to arise is when your baby is 12 months old. As a child is more aware of the world his natural instincts make him more suspicious of new foods. Nature’s way of protecting us from eating food that is potentially harmful. If you’re one of the lucky parents that sailed through weaning, another common time for problems to arise is during the challenging 2’s. Having lulled you into a false sense of security, your toddler could wake one morning with dietary requirements that even a top chef would struggle to meet. Children’s appetites are affected by growth cycles and they have different taste preferences to adults. You will encourage her appetite to work properly if you give her more when she’s hungry and let her eat less when she’s not interested. Growth slows down and appetites fluctuate between one and five years of age. Studies have shown that most children get plenty to eat even if it seems like they are barely eating at all. Try looking at mealtimes from a child’s perspective. Toddlers have a different agenda: from their point of view, eating is a waste of their playing time, and if we make mealtimes boring by nagging, it’s even worse. Some practical tips Here are some tips to help your little fussy eater learn to eat better, while giving you some peace of mind. Put your mind at rest: If you are concerned about the health of your child, take her for a check up at the doctor to rule out any potential health problems. Keep a food diary for 2 weeks and record EVERYTHING that she eats and drinks (include quantities). You can then get this assessed by a health professional to assess adequate nutritional intake. Give an appropriate vitamin & mineral supplement during the fussy eating phase. Stay off the battle field: Remember picky eating can also be a child’s way of asserting his independence and may have less to do with the actual food than his need to push the limits of your authority and assert some control over his life. This is why pressurizing a child to eat often back fires and you become a ‘casualty of war’. Wean at the appropriate age Weaning late has shown some link to fussing eating. Parents who delay introducing their babies to chewy food and a variety of tastes could find their babies grow up developing food fads. A recent study showed that babies should be introduced to a more varied diet between the ages of 6 to 9 months to decrease the risk of becoming fussy eaters. Babies learning to eat will spit food out, and this is more than likely due to a ‘tongue-reflex’ action than a sign that your baby doesn’t like the food. Keep trying with that food and soon he will get used to it and swallow. Fun food presentation Sandwiches cut into moon shapes, cracker with a smiley face, carrot sticks as soldiers and apple boats can make food presentation more enticing Presenting meals as a smorgasbord from which they can pick and choose from a variety of colours, shapes and textures. Toddlers and young children prefer foods that are identifiable and not one big mush. Using a compartmentalized plate that prevents different foods from touching is a great help. Make mealtimes fun and relaxed Use it as an extension of playtime and time when you and your baby can bond uninterrupted (no cell phone calls or sms’s !!!). Do puzzles, read a book, tell a story. Educate Talk about the food and its value in simple terms. E.g. this piece of chicken will help your muscles grow strong like daddy (or superman!!) and this carrot will give you beautiful eyes like Cinderella! Involve your child in food preparation By involving your child they will be likely to eat what THEY have made and may eat a bit while preparing their meal. Empower your child in decision making Allow your toddler to choose between two food options. Children are more likely to eat food they have chosen for themselves. Serve simple, easy to prepare meals. There is nothing more demoralizing than spending ages cooking a gourmet meal for your baby, who after the first spoonful turns her head away. Prepare easy meals that you know your child likes and should they refuse the food, offer one alternative that is a sure win e.g. Yogurt. Milk intake By the age of one, babies need drink only 500ml of milk daily. Most babies can go onto cow’s milk from one years of age unless health reasons dictate otherwise. Do not substitute milk for meals Social eating People are social beings as are our children. Nothing makes a toddler want his food more than having another toddler after his food. Invite a friend over who has a good appetite and watch how

April 26, 2017

Best Diet for your Genes

Ever wondered why some people lose weight on one type of diet and others don’t and why is there is so many conflicting results? It might be because of us. Well, because of our different genes. This specific question led to the emerging science of genetic testing, called nutritional genomics (a.k.a. nutrigenomics) – the study of interactions between genes and diet. Keep reading if you want to know more. GENES, DIET AND WEIGHT LOSS Dieting is often an endless cycle of losing weight and gaining it all back. Thousands of diets exist, but how do you know which one is best for you? The answer may lie in your DNA. The idea of the DNA DIET is rooted in the scientifically proven reality that dieting simply doesn’t work for many people. Popular diets are based on a presumption that ONE-SIZE-FITS-ALL. That is NOT true. For some people it is harder to lose weight than for others because of their genes. A now famous study conducted at Stanford University looked at the long-term effects of weight loss using a few different diets assigned at random. Results showed that some participants lost weight on one type of diet, such as low-fat, while others did not. The study then tested participants’ DNA for 3 specific gene variations and found that those using the best diet for their DNA lost 2-3 times more weight than those on the ‘wrong’ diet, not using their best DNA diet. DNA testing and following a weight loss diet based on your genetic make-up makes sense because our genes control hormone levels, enzyme levels – all the basic levels of metabolism. And how we metabolize food determines what happens to the nutrients and calories we take in. ONE SIZE DOESN’T FIT ALL Nutritional guidelines are for ALL individuals, but just like clothes, a “one-size-fits-all” approach is not applicable. These dietary recommendations are based on averages across large populations or responses of people, which could be irrelevant to others. For many years, doctors and dieticians have viewed diet the same way, assuming there is only one optimal diet for all. Research has shown otherwise and that this is likely not the case. Humans are 99.5% the same. Yet that 0.5% difference matters. Why is DNA testing so successful for weight loss? Research has shown that it is extremely important for successful weight loss to know the right amounts and ratios of macronutrients in your daily nutritional intake. Therefore knowing how many carbohydrates, proteins, saturated fats and unsaturated fats you should eat daily plays the most important role in your weight loss management plan. Research found that individuals who dieted using recommendations based on their actual genetic makeup lost 33% more weight than those who didn’t. HOW GENETIC TESTING WORKS It is as simple as 1-2-3! Do a cheek swap DNA testing is easy and painless, by taking a cheek swap sample (like they do in Crime Scene Investigations on TV) and then sending the sample back to the DNAlysis laboratory for analysis. Here they use modern technology to analyse a person’s sample in order to identify genetic variants and study the relationship between individual genes and diet – thereby gaining intimate knowledge about physiological processes that may not function optimally. Unlock your results The DNA DIET report is generated that allows an individual to understand how their genes affect the way he or she respond to foods they consume e.g. carbohydrates or saturated fat. The DNA DIET further determines the right amounts and ratios of macronutrients required on a daily basis by defining your weight loss nutritional type (e.g. Mediterranean, Low-Fat or Low-Carb). By knowing that, you can give your body exactly what it needs! No more cravings and constant hunger you have experienced with previous diets that resulted in unsuccessful weight loss. Optimise your diet and training plan The DNA DIET report is used to refine your nutrition and exercise plan to manage your weight. Providing you with a diet plan tailored to your genes (be it low carb or low fat) and insight into optimal exercise intensity for weight loss. However, some people have the gene where physical activity does not help them lose weight! INSIGHT INTO DNA DIET RESULTS Genetic variations make each of us unique in all sorts of ways, including how our bodies respond to different types of foods, it may also have a powerful influence on what we like to eat (bitter vegetables or sweets) as well as why some people get fat and others stay thin. Some gene variants affect appetite and satiety. Others appear to influence how efficiently people burn fat for energy. Obesity Risk The DNA DIET test will reveal if you have what is called the “increased obesity risk” gene called FTO. This gene plays a role in appetite control, meaning a person with this gene are likely to eat more, feel hungry soon after a meal and crave fattier foods more than someone without this gene. Then there is the gene that tells a person whether they are more likely to gain and regain weight as well as their ability to lose weight more slowly or faster than others. The DNA DIET will also indicate if you are genetically inclined to have a higher body fat percentage and higher waist circumference. Carbohydrate responsiveness Certain gene variants impact your ability to lose weight when carbohydrates are eaten. If a person’s carbohydrate sensitivity is very high, they are more likely to put on weight if they eat lots of carbs. This means to lose weight they’ll be better suited to a low carb diet and would need to restrict refined carbs significantly. If someone falls in the low risk category, they can eat carbohydrates and still lose weight. Eating behaviour Certain people are genetically more prone to forms of food and sugar addiction than others. Part of the reason for this is that some people are more predisposed to seek out pleasure than others. For instance, in our brain, there is a

March 20, 2017

Infant Food Fallacies – “Whole grains are good for you.”

This is partly an excerpt from the “Unlearn” chapter in my book Mila’s Meals: The Beginning & The Basics. Disclaimer: As with everything concerning food there are two sides to any debate raging around every one of the topics in this chapter – both sides will be defended with scientific proof, and ‘absolute’ recommendations. I am merely presenting my beliefs formed by my research and first hand experience of both Mila’s, and my own digestive issues. I encourage you to do your own research should anything mentioned here not ‘sit well’ with you. I am not trying to convince you of anything – I simply hope to provide information, and at the very least prompt you to question what has previously or otherwise been presented as absolute fact and truth. Whole grains ARE good for you and your little one, very good in fact – but here’s the catch – it depends on: When you introduce them, Which grains you eat, and How you prepare them, Eating unprepared grains, introducing them too soon, or eating gluten-containing grains can have negative health effects. When to introduce grains. Many traditional cultures have fed their babies grains before their first birthday – as their first food even – but they were all fermented first. For the reasons mentioned in my “Rice cereal is (not) the best first food for baby” blog post, it is best to wait until your little one is a year old before introducing grains. At this age, he/she will have more of the amalyse digestive enzyme that is needed to digest grains. According to The Nourishing Traditions Book of Baby & Childcare by Sally Fallon Morell and Thomas S. Cowan, if there is a history of celiac disease or gluten intolerance in the family, it is best to wait until your little one’s third year before introducing grains. Which grains to choose Properly prepared grains are nutritious – they are important sources of many nutrients, including protein, fibre, B vitamins and minerals (iron, magnesium and selenium). In order to avoid gluten, you need to avoid: Wheat Barley Rye Spelt Oats (unless the oats are certified gluten-free). See the chapter “Why Not Gluten, Dairy and Sugar?” in my book Mila’s Meals: The Beginning & The Basics for more on why avoiding gluten may be a great decision for you and your little ones. There are many naturally gluten-free grains to choose from including: Rice Quinoa Millet Buckwheat Sorghum Amaranth These grains are nutrient-dense, act as antioxidants and, help the body make serotonin, which improves mood while providing a calming, soothing effect on the nervous system. Preparation Whole grains are the hardest food for the human body to digest, and all grains contain anti-nutrients that must be neutralized before cooking. They all have phytic acid that can block the absorption of calcium, magnesium, copper and zinc as well as enzyme inhibitors that block the digestive enzymes needed to digest it. In order to unlock a grain’s nutritional potential, it is necessary to prepare them in a way that makes them more digestible – such as soaking them for 24 hours, fermenting or sprouting them before cooking. Preparing grains with a dollop of healthy fat (such as ghee or coconut oil) will help the absorption of calcium, phosphorus, iron, B vitamins and the many other vitamins that whole grains provide. I go into this in more detail in the “Feeding with Awareness” chapter of Mila’s Meals: The Beginning & The Basics… Enzymes, Nutrients and Anti-nutrients Digestive enzymes are primarily produced in the pancreas and small intestine. They break down our food into nutrients so that our bodies can absorb them. A nutrient is a substance that provides nourishment essential for growth and the maintenance of life. So what then are anti-nutrients? Anti-Nutrients As scientific research methods develop, new information on nutrition comes to light that challenges what we have previously held to be true about our food. One of these new pieces of information is that of ‘anti-nutrients’. Anti-nutrients interfere with the absorption of nutrients and digestion and, irritate the intestinal tract. Whole grains, nuts, seeds and legumes are all high in anti-nutrients. But these foods are meant to be good for you – right? Well yes – if they are correctly prepared, in a way that reduces the anti-nutrients. Anti-nutrients are part of a seed’s natural system of preservation. Nature has ensured that seeds won’t sprout until the perfect growing conditions exist. Two of these anti-nutrients worth mentioning are Phytic Acid and Enzyme Inhibitors. Phytic Acid Phytic Acid is the storage form of phosphorous – that is, seeds store phosphorus as phytic acid. Grains, nuts and legumes are all seeds and have high levels of phytic acid. So do other edible seeds such as pumpkin and sunflower seeds. When phytic acid is bound to a mineral in the seed, it’s known as phytate. Phytic acid is an anti-nutrient because it binds to essential minerals (such as calcium, copper, iron, zinc, and magnesium) in the digestive tract, making them less available to our bodies. Phytates also reduce the digestibility of starches, proteins, and fats. Enzyme Inhibitors Enzyme inhibitors are present in seeds to prevent them from developing (sprouting) until there are suitable growing conditions. Unfortunately eating seeds with enzyme inhibitors negatively affects our digestive and metabolic enzymes. It is not necessary to avoid foods containing phytic acid or enzyme inhibitors, but it is important to prepare them correctly – as our ancestors did. Correct preparation reduces the phytic acid, neutralises the enzyme inhibitors and increases the bio-availability of the nutrients. Grain preparation Soaking nuts, grains, seeds and legumes Soaking and fermenting nuts, grains, seeds and legumes is something our grannies (or granny’s granny) did and for good reason. It mimics nature’s ‘perfect sprouting’ conditions by providing moisture, warmth, time and slight acidity. As the seed begins to germinate while soaking, phytic acid is reduced, enzyme inhibitors are neutralised and the production of numerous beneficial enzymes begins. The action of these enzymes

March 17, 2017

Tips To Improve Healthy Eating In the Home

A hungry child is a less fussy child. After School is a great window of opportunity to get your child to eat something healthy as they generally come home starving having rushed lunch to spend time with their friends in the playground. A few simple ideas and a few minutes spent in preparation can make a big difference to your child’s diet. Instead of whole fruit in a fruit bowl cut up a selection of colourful fruits and arrange them on a plate. Have healthy snacks like mini cheeses, dried fruit, a bowl of salad with a tasty dressing on the table so that your child eats these rather than crisps or chocolate biscuits. Ways to include anti oxidants in your child’s diet? Use a wide variety of vegetables and prepare them in diverse ways. Aim daily to include 3 different colour fruits and/or vegetables. Crudites and dips are fun for children and make for easy and nutritious snacks. Vegetable versus fruit eaters. Some kids love their cooked veggies, but struggle with salads and fruit. Others will eat salads and fruit but turn their noses up at cooked veggies. Aim not to make an issue of their respective dislikes, rather applaud them for the foods they do eat and do a food challenge with the ones they find more difficult to consume. For example if you have a child that struggles with vegetables, you could make Monday green vegetable day where you and your child choose one green vegetable he is prepared to try. Then come up with a fun way to eat and prepare the veggie/ fruit of choice. Herbs are a great way to get anti-oxidants in the cooking. Hide and mix them in stews and gravies. Peeled baby carrots, cherry tomatoes, cucumber slices SAD sugar free bars Pure woolies fruit rolls Fruit salad Raisins Dried fruit men Fruit juices Smoothies Plain yogurt with fruit pulp “Don’t eat between meals.” “Don’t touch that cookie — you’ll spoil your dinner!” “Snacking will make you gain weight.” Chances are, you’ve said something similar to your children – or maybe heard it from your own mom. But snacking on the right foods is not harmful. In fact, it can have health benefits for kids of all ages. Snacking is not a bad thing – in fact, it’s a good thing – and it can actually help keep kids from overeating at mealtime. Studies show that snacking during the school day improves both mood and motivation, and may impact concentration. Snacks may help children maintain performance during times of high mental demand, like when taking an exam or making a class presentation. But even while we’re bombarded with choices by the snack food industry, it’s not always easy to find healthy snacks – much less get your kids to eat them. Here are six simple guidelines. 1. Relax the Food Ties That Bind While you may have strict nutritional guidelines for breakfast, lunch, and dinner, snacks are the place to give children some wiggle room. Give them a little of what they like (be it potato chips or a small chocolate) a couple of days a week, and you’ll have better luck getting them to eat healthy snacks the rest of the time. 2. Choose the Lesser of the Evils When it comes to ingredients like sugar and saturated fat, you might think most commercial snack foods are pretty similar, give or take a gram. But look a little harder at the label and you may find important differences. If, for example, you have two items that are equal in sugar, fat, and calories, sometimes you’ll find that one contains vitamins, minerals, and fiber while the other doesn’t.Opting for the more nutrient-dense snack will help ensure it has some redeeming value, even if some of the other ingredients are not top nutritional choices. In addition, keep an eye on the sugar content. Some snacks, even seemingly healthy ones like flavoured yogurt, are way over the top when it comes to added sweeteners. The American Medical Association says that when our sugar intake exceeds 25% of our total caloric intake, it impacts us nutritionally. But the World Health Organization sets the threshold at 10% – so sugar is an issue to consider. A quick way to tell if a snack has gone over the line: It’s over 250 calories a serving, it’s probably got too many empty calories. 3. Portion, Portion, Portion While it’s OK to give kids some leeway on choosing what snacks to have, it’s still vital to pay attention to portion size. It’s also important to look for snacks with low levels of fat, saturated fat, and trans fat. Even if the package says a snack has no trans fats, read the ingredient list to be sure. If you see the word ‘hydrogenated,’ it means it has some trans fat, so avoid that snack. If your child is battling a weight problem, paying attention to portion size and total calories is vital, but don’t deny the child the opportunity to snack. 4. Make It Easy to Eat Well Having trouble getting your kids to eat healthy snacks like fruits, vegetables, and whole-grain items? Make these foods easy to munch, and they will eat more of them. No matter what food it is you’re trying to get your child to eat, if you make it accessible, if it’s easy to eat, if it’s there waiting for them in the fridge or on the counter, you will increase the likelihood that they will eat it. But cutting up fruits and veggies into bite-sized pieces isn’t quite enough. Snacks should also be packaged in a way that makes it easy for kids to ‘grab and go’. The key is not only making snacks easy to eat, but also easy to share. Kids love to share their snacks at school and if you help them do that, they are more likely to eat what you prepare, rather then trade up for something from

March 10, 2017

What is Free Sugar Costing our Kids?

It’s no longer a secret that the vast majority of us are blissfully unaware sugar addicts. Modern conveniences in consumables are great at making life easier in the short term, but what about the long term implications? A report published in 2009 showcases that food addiction is plausible as “brain pathways that evolved to respond to natural rewards are also activated by addictive drugs. Sugar releases opioids and dopamine and thus might be expected to have addictive potential.” A further report published in 2013 indicates that sugar is as, if not more, desirable than addictive drugs such as cocaine. This research aims to prove that “sugar and sweetness can induce reward and craving that are comparable in magnitude to those induced by addictive drugs”. With these two findings it’s hard to believe that as parents we are still largely oblivious to the long term, damaging effects of over consuming sugar-dense foods and beverages. So a sugar tax maybe introduced, this will certainly help moderate and potentially reduce the average consumption of free sugars (sugar added to food and drink, as well as sugar found naturally in honey, syrups, fruit juices and fruit juice concentrates). But it will take a deeper understanding of what we consume to avoid the top health issues South Africans currently face – obesity, diabetes and heart conditions? All directly resulting from amongst other factors, but largely to sugar-dense diets and little to no exercise. According to a statement released by the World Health Organisation “adults and children need to reduce their daily intake of free sugars to less than 10% of their total energy intake. A further reduction to below 5% or roughly 25 grams (6 teaspoons) per day would provide additional health benefits”. So what is a safe recommended daily allowance for sugar? Although we all lead different lifestyles and have varying metabolic requirements, the UK’s Scientific Advisory Committee on Nutrition (SACN) have suggested the following: • Children aged 4 to 6 should have no more than 19g or five teaspoons of free sugars per day • Children aged 7 to 10 should have no more than 24g or six teaspoons of free sugars per day •Children aged 11 years and upwards, as well as adults, should have no more than 30g or seven teaspoons of free sugar per day To illustrate what this means, take a look at some of the popular beverages our children love, and their approximate sugar contents: • 250ml iced tea = 19g or four teaspoons of free sugar • 250ml flavoured drinking yoghurt = 26.8 g or five and a half teaspoons of free sugar • 330ml cola = 35g or seven teaspoons of free sugar • 330ml ginger beer = 37g or six and a half teaspoons of free sugar Overcoming an addiction is by no means an easy feat and the same holds true for sugar dependency. Almost all modern convenience consumables contain added free sugar especially children’s favourites such as cereals, beverages, fast foods and treats. So how do we reduce the excess sugars from our diets? Become aware, understand that food is medicine and always try to ensure that that all consumables remain as close as possible to their natural state. If sweetening is required, look at healthier options such as fresh fruit or vegetables. Read labels carefully, not all free or added sugars are labelled as sugars. For example: agave nectar, corn sweetener, dextrose, honey, corn syrup, sucrose, fructose, glucose and molasses. Limit sugar added beverages, cited as being responsible for the majority of added sugar in US diets. Try naturally flavouring water or using a SodaStream to make fun, healthier drink options. Their syrups also comprise one third of the sugar compared to regular sodas. Reduce your family’s super sweet sugar tolerance with a moderated sugar and bolstered wholefood diet. Over time consumables high in sugar will start tasting too sweet as your tolerance returns to its normal natural state. Bake instead of buying treats. Homemade treats will no doubt contain less added and highly synthetic sweeteners, and you have the ability to further reduce the sugar content with natural sweeteners like fruits or vegetables. One favourite cupcake recipe calls for swapping out a large portion of the sugar for a glass of white wine, the alcohol cooks out and makes a delicious, moist cupcake. The key to all healthy living is moderation and a balanced diet. This is not to say indulgent foods high in fat and/or sugar can’t be enjoyed, they can, but just not daily. Herewith a quick and easy recipe from SodaStream, for more fun recipes, please visit www.sodastream.co.za/recipe/. Raspberry Coolers for Kids Ingredients 1 bottle SodaStream Zero Cranberry Raspberry Fresh organic raspberries Mint Instructions Prepare the SodaStream Zero Cranberry Raspberry (flavoured to your liking) Throw in fresh organic raspberries Garnish with mint

February 13, 2017

Infant Food Fallacies – “Rice cereal is the best first food for baby.”

This is an excerpt from the “Unlearn” chapter in my book Mila’s Meals: The Beginning & The Basics. Disclaimer: As with everything concerning food there are two sides to any debate raging around every one of the topics in this chapter – both sides will be defended with scientific proof, and ‘absolute’ recommendations. I am merely presenting my beliefs formed by my research and first hand experience of both Mila’s, and my own digestive issues. I encourage you to do your own research should anything mentioned here not ‘sit well’ with you. I am not trying to convince you of anything – I simply hope to provide information, and at the very least prompt you to question what has previously or otherwise been presented as absolute fact and truth. “I’ve got to say I was fooled by this – by the clever marketing of the food companies and by the advice of the clinic sister. I fed her rice cereal (organic – but that really did not help the situation much). Poor thing! I stopped as quickly as I started (her tummy cramps were too awful after that first meal) and, this is why… Food has to be broken down into its nutrient components: amino acids, fatty acids, cholesterol, simple sugars, vitamins, minerals, etc. – our bodies absorb nutrients, not food. The body produces digestive enzymes that break down our food into nutrients. These nutrients are then absorbed and nourish the body. Digestive enzymes are produced in the pancreas, small intestine, saliva glands and stomach. Different digestive enzymes are needed to break down different types of food. In order to digest grains, your body uses an enzyme called amylase. Guess what? Pancreatic amylase is not produced by your little one (in sufficient quantities) until they are a year old – sometimes even later. The rule of thumb here is that it is not until your little one’s molar teeth are fully developed that they have sufficient quantities of pancreatic amylase to properly digest grains – this can be anywhere from 13 – 24 months of age. Amylase is provided in a mother’s breast milk and is produced by your little one’s saliva – but these are not sufficient to properly digest grains. Especially processed grains, or grains that have not been prepared properly. So what happens to this undigested rice cereal (or other grains)? Some undigested food (from other vegetable carbohydrate sources) benefits your little one – fermentation in the colon produces short chain fatty acids, which can improve nutrient absorption, enhance gut health, and even be used as a source of energy for both the microbes and baby. But since grains (especially) cannot be adequately digested, they start rotting. This rotting food matter feeds pathogenic bacteria and fungi (such as Candida) – and this imbalance can lead to food allergies, asthma, eczema, and other autoimmune disorders. Over time, the pathogenic bacteria and fungi (and their toxic by-products) create holes in the gut wall (known as Leaky Gut). A leaky gut allows toxins and partially digested food to spill directly into the blood creating an unpredictable mix of physical, behavioural, emotional and neurological symptoms. This is explained in great detail in Dr. Natasha Campbell-McBride’s book Gut and Psychology Syndrome. What else is wrong with commercially available rice cereal? Rice cereal is processed – meaning it is no longer a whole food. In order for the cereal to have a longer shelf life, the bran and the germ (the most nutritious parts) have been removed, simultaneously stripping the grain of its protein, fibre, nutrients and minerals. Artificial vitamins have to then be added back in – these are far less bio-available to your little one’s body and a poor replacement for nature’s version. Rice cereal is an extremely high glycaemic food – that is, it spikes the blood sugar. Rice cereal contains phytates (the salt form of phytic acid). Phytic acid is a naturally occurring chemical in grains, nuts and seeds. Phytic acid binds to essential minerals (such as calcium, copper, iron, zinc, and magnesium) in the digestive tract, making them less available to our bodies – and actually flushing them out of our bodies. While the majority of the phytic acid (or phytates) are found in the bran of the rice (which is removed during processing), there will still be some present. So, eating processed rice cereal may actually remove iron, zinc, calcium and magnesium from your little one’s body! Phytates also reduce the digestibility of starches, proteins, and fats. Please note that simply grinding grains at home and cooking them will result in an even higher amount of phytates in your little one’s food. All grains, nuts and seeds must be soaked, sprouted or fermented before cooking in order to break down the phytic acid. Please see the chapter Convenience vs. Conscience: Enzymes, Nutrients and Anti-nutrients in my book for more information on this. Commercial rice cereal fortified with iron. But surely this is a good thing? A baby is born with sufficient iron reserves to last them until they are 6 months old. While a mother’s breast milk is low in iron, the iron that is present is readily absorbed by her little one – as opposed to the artificial sources of iron found in fortified cereals and formula. While your little one may need additional sources of iron at the age of 6 months, it is far better to provide this from whole foods as opposed to supplemental drops or an additive in a nutrient deficient food. Good sources of additional iron are liver (raw), other cooked meat, blackstrap molasses, avocado and… soil! No, I am not suggesting you feed your little one soil, but the iron from soil is absorbed by the body. So a mouthful here and there while playing outside, as well as digging in the soil and walking barefoot is beneficial. Healthy soil is also a great source of probiotics! By healthy soil – I mean organic, not chemically fertilised and with

February 7, 2017

Childhood obesity in South Africa to soar unless we act now

If obesity in South African children continues to increase at the current rate, 3.91 million school children will be overweight or obese by 2025. On world Obesity Day, the Heart and Stroke Foundation South Africa, together with the World Obesity Federation, calls for decisive action from government, private sector and parents. Today is the second annual World Obesity Day and the theme is Ending Childhood Obesity: Act today for a healthier future. The Heart and Stroke Foundation (HSFSA) supports the World Obesity Federation (WOF) in this initiative to stimulate and support practical actions to address obesity. South Africa’s obesity epidemic could be described as complex. Our country’s past of poverty, inequality and a lack of education, coupled with rapid urbanisation has created a vulnerable population amidst a nutrition transition. The population group that is most vulnerable to this ‘obesogenic’ environment is children. Both children of overweight parents and children subjected to malnutrition during pregnancy or infancy are likely to become obese later in life. Children are brought up in an era of energy dense foods, increasing screen time and sedentary behaviour. The World Health Organisation (WHO) reports the fastest growth of obesity in the African region, where childhood overweight and obesity has more than doubled from 1990 to 2013 1. Childhood obesity in SA – our girls at greatest risk According to the most recent national survey, 14.2% of primary school children are already overweight 2. This prevalence is highest at 30% in girls living in urban areas. Being overweight as an infant increases the risk of being overweight as a child, which in turn increases the risk of being overweight as an adolescent and adult. Results from the Birth to Twenty study in Soweto recently showed that girls who were obese between the ages of 4 – 6 years, were 42 times more likely to be obese as teenagers compared to their normal-weight peers! 3 Clearly interventions should already be addressed at infants and toddlers. Cultural beliefs and poor knowledge of the consequences of obesity lulls many parents into inaction. Childhood obesity is not prevented, recognized or treated adequately. New figures from the World Obesity Federation estimate that by 2025, 3.91 million South African school children will be overweight or obese. This will result in 123 000 children with impaired glucose tolerance, 68 000 with overt diabetes, 460 000 with high blood pressure, and 637 000 with first stage fatty liver disease 4. The global action plan The complexity of the obesity epidemic is often cited to explain the little success in turning the tide and perhaps as an excuse not to make the changes we know are necessary. The 2016 WHO Report on Ending Childhood Obesityclearly outlines a comprehensive action plan. Recommendations include addressing norms, treating children who are already obese, promoting intake of healthy foods and physical activity, improved preconception and pregnancy care, healthier school environments, and curbing the marketing of unhealthy foods. The South African Department of Health have incorporated these guidelines in their own Strategy for the prevention and control in South Africa of obesity framework. Childhood obesity is singled out within this strategy as a specific area of focus, “given the large perceived benefit the interventions may yield”. We can end obesity if we act now Obesity is not a complex problem, for we have the tools to address it. We can end the childhood obesity epidemic if we act together. The President of the World Obesity Federation, Professor Ian Caterson, calls for decisive action “If governments hope to achieve the WHO target of keeping child obesity at 2010 levels, then the time to act is now.” Government action In the National Obesity Strategic Framework, Deputy Minister of Health Dr Joe Phaalhla writes “…It is our responsibility to empower people to make informed decisions and to ensure that they have access to healthy food by raising awareness and increasing the availability of effective initiatives and interventions.” The Government has shown intent by announcing tax on sugar-sweetened beverages, strategies to increase school sport, and draft legislation to restrict the advertising of unhealthy foods to children. Swift and effective implementation of these policies are vital. Professor Caterson from the WOF urges governments to act “Introducing tough regulations to protect children from the marketing of unhealthy food, ensuring schools promote healthy eating and physical activity, strengthening planning and building rules to provide safe neighbourhoods, and monitoring the impact of these policies.” Private sector and in particular the food industry There is no singular solution for obesity, and involvement of all sectors is needed. Food industry and especially fast food restaurants – still largely unregulated – needs to become part of the solution by producing healthier products and meals that are lower in added sugar, salt and fat, and by partnering with government and civil society to make healthy food choices more affordable. Collective advertising spend on unhealthy foods and meals are staggering, overpowering education efforts by government and NGOs. The HSFSA calls on the food industry to realise the vital role they play in South Africa’s obesity epidemic. It is time to make a choice to either help or hinder- practicing responsible marketing of foods aimed at children is a good place to start. Parents and caregivers Professor Pamela Naidoo, CEO of the HSFSA implores primary caregivers “Parents have the single biggest influence over their children’s risk of obesity. Mothers should aim for a normal weight before pregnancy, appropriate weight gain during pregnancy, and exclusive breastfeeding for the first six months. Parents should introduce healthy eating habits from six months onwards and lead by example to create an active lifestyle for the whole family.” Prof. Naidoo concludes “The HSFSA will continue its efforts to advocate for a healthier environment and create public awareness to prevent obesity as a major risk factor for heart diseases and strokes”. The Heart Mark is one such tool used to make it easier for consumers to make the healthier choice when faced with a variety of options at the supermarket. It helps

November 21, 2016

Sugar Drinks at School, a Leading Cause of Obesity and Impaired Learning

With hundreds of thousands of learners back at school, parents are reminded to restock their fridges and pantries with foods and beverages that provide brain-boosting nutrients to help their children perform at their best. SA’s recently released National Health and Nutrition Examination Survey (SANHANES) refers to the poor state of children’s school lunches in the country. Of particular concern is the high intake of sugary cool drinks – about 2 in 3 learners buy sugary drinks at least twice a week, with each soft drink containing up to 55g of sugar. According to the World Health Organisation (WHO) that is 40g more sugar than the recommended maximum daily limit for children. Drinking too many sugary drinks is considered to be the leading cause of obesity in adolescents, especially among schoolboys. The study points out that the prevalence of obesity has doubled in teenage boys the past six years, making them more prone to chronic lifestyle diseases such as diabetes. According to nutritional experts, these beverages are loaded with empty calories and provide little or no essential nutrients. They are linked not only to weight gain but also to poor health and tooth decay in children. Nutritionists recommend water or herbal teas as a healthier alternative to fizzy drinks or sugar filled fruit juices, with Rooibos tea topping the list. Ernest du Toit, spokesperson of the SA Rooibos Council says Rooibos is as effective as water for hydrating the body and has additional health properties that water doesn’t have. “Rooibos is affordable, tasty and amazingly beneficial for children. It is rich in antioxidants which helps to protect healthy cells from damage caused by free radicals and can reduce the risk of a variety of diseases, including cardiovascular disease and some cancers. Rooibos also prevents DNA damage, inflammation and is helpful in combating diabetes. “Added to this, Rooibos contains no caffeine, fats or carbohydrates, is a natural immune-booster and relieves allergy symptoms, which are common in children,” remarks du Toit. Sugary drinks have also been found to have an adverse effect on children’s brains. A study conducted by the University of California revealed that consuming excessive quantities of sugar-sweetened drinks can have a major impact on children’s brain function and impair their ability to concentrate and learn at school. In contrast, Rooibos tea will keep your child’s mind sharp since it shields the brain from stress and it protects against a process known as lipid peridoxation (whfree radicals damage brain cells and nerve tissues.) Du Toit adds that Rooibos is also incredibly nutrient-rich. “It is rich in Vitamin C, calcium, manganese and fluoride, helps to build strong bones and teeth, and is safe to consume without limit.” To help parents pack refreshments that will make the grade, the SA Rooibos Council has compiled the following Rooibos iced tea- and popsicle recipes that will have the kids asking for more. Rooibos iced tea: One litre of Rooibos tea using four to six teabags Sweeten the tea with honey to taste and leave it in the fridge to cool overnight Experiment with this basic iced tea, by adding mint, lemon, orange, granadilla, mango or apple, or a combination of flavours until you find one that your children love. You can even get them involved in mixing their own flavours. Note: Juiced or squeezed fresh fruit usually delivers the best results, but you can also use preservative-free fruit juice. Mixing it with cold Rooibos will make it go further and keeping a jug of it in the fridge should mean you don’t have to keep buying juice. The good news is that cold rooibos can be kept in the fridge for up to two weeks without spoiling. Rooibos ice-lollies: By pouring some Rooibos iced tea into popsicle containers or ice-cube trays and freezing it, you can also make fun, refreshing, healthy after school or sports treats.

February 12, 2016

Meal planning for the child with ADHD

Ask ten nutrition experts what you should eat and you will get ten, often-conflicting diet plans. Add Attention Deficit Hyperactivity Disorder (ADHD) to the mix and you will be even more confused. Firstly ADHD is not caused by diet. There have been numerous studies over the years to support this statement. Does diet affect ADHD children? Of course, Diet, as in “what we eat”, affects each one of us whether we have ADHD or not. If you feel unsteady on a stairway, you grab the banister to steady yourself. Likewise, if your child’s (or your) brain chemistry is off kilter with ADHD, favouring healthy foods engenders equilibrium. By providing a healthy diet and environment is the most pleasurable – and the least invasive – way to care for your loved ones and yourself. The information given in this article need not be exclusively for the use of the ADHD child but all members of the family will benefit from making this subtle yet effective change to their daily eating schedule. The diet for the ADHD child is the bedrock on which you need to build all other therapies. It is no use adding a handful of supplements to your child’s diet if their actual daily intake is not even meeting the basic recommended dietary intakes (RDI’s) for their age. Supplements added to a balanced healthy diet will be much more effective if taken with good food than as an isolated tablet. The ADHD child’s response to therapies like Occupational therapy, physiotherapy etc. will be much better if the child has the necessary energy resources to draw from during a therapy session. If your child requires medication to treat her ADHD symptoms then starting off with a sound, healthy dietary platform will only enhance the effectiveness of the medication. Likewise attentiveness, concentration and participation in class is a lot more probable if your child has eaten a healthy, well balanced breakfast and this is true for all children, not just children with ADHD. Allergies have also been studied extensively with their link to ADHD so let’s just briefly unpack this before we go into the details of some healthy diet tips. Children and adults, who have allergies, be they to foods, additives or the environment are not generally happy people while their allergies are aggravating them. A child who has rhinitis (runny nose) and is constantly sniffing and coughing due to the aggravation of a post nasal drip will struggle to sit still and focus on what the teacher is saying or the work he should be doing. The distinction needs to be made between ‘food allergies causing ADHD versus the symptoms of the allergy exacerbating the symptoms of ADHD. If you suspect your child has allergic tendencies to certain foods then you must get that seen to by taking your child to a specialist or undertaking an elimination diet under the advice of a trained professional. Having said all of this, changing diet is a process and not like taking a pill. It takes time, commitment and patience and more importantly ‘buy-in’ from the family members. When changing eating habits, it is important to involve the family members and give explanations. Children respond well when they understand. Children are also extremely trusting and if the change can make sense they will generally give it a good try. When making changes to the diet it is important to observe the context of the whole change process. For example if you cut out all chicken from your child’s diet, it may not be the lack of chicken that is causing irritability and discontent. It might be that you took away all her favourite meals in one shot and she’s a little upset about it. Looking at the whole picture is a good idea and moderation is always good. Wanting your child to eat well is one thing. Getting him to do so is another. As already mentioned the best way to get your child to eat well is to eat well yourself. That is having good food at hand and minimizing the less healthful choices. Letting your child help prepare food magically whets her appetite. Creating something yummy is empowering no matter what your age. Daily foods to include: Good Starches If you take in a lot of sugary treats such as sweets, fizzy and sugary cool drinks, cakes and biscuits it will cause your blood sugar levels to rise and fall due to the insulin (hormone to break down sugar) levels that will rise and fall. This constant up and down will result in mood changes and irritability. When children get a blood sugar drop, unlike us, they will try and feel better by getting busier and will do what ever it takes to stay alert which often results in over compensation. Offer low glycaemic carbohydrate foods as often as possible, like seed bread, rice, pasta, provitas etc. Foods are well labelled with Low Glycaemic Index labels and these should be foods of choice for your ADHD child. Limit fruit juices to 1 glass diluted fruit juice per day. Eat whole fruits instead. Aim to include 2 – 3 fruits per day. Offer water for thirst. Iced rooibos tea mixed with a little pure fruit juice is also a refreshing option. Remember however that it is the glycaemic (sugar) load of the whole meal that is important so including a protein with the carbohydrate will be an advantage to stabilizing blood sugar levels. This also helps when you offer starches that are a little higher on the glycaemic index, like a white hot dog roll or a tortilla. Good proteins Have a serving of protein rich food at every meal and snack, including breakfast. Sources of protein include eggs, fish, meat, cheese and soybeans, nuts, peanut butter. Eat snacks like cheese sticks and biltong slices. Good veggies For the good of your health, use a wide variety of vegetables and prepare them in diverse ways. Aim daily to include 3

February 4, 2016

Childhood Obesity

Globally, obesity is rapidly on the rise. For the first time in the history of mankind, the number of people who are overweight or obese measure up to the number of people who are underweight due to hunger. It has been estimated that if something is not done about the surge of obesity, half of all people will be overweight/obese by 2030. The most worrying is that this trend is not only seen amongst our adult population but also amongst children. Over a decade, overweight has increased from 10.6% to 18.2% in South African children aged 2 – 5 years. Consistently, girls and female adults are more affected. South Africa further carries a double burden of malnutrition with not only rising rates of childhood obesity but also still high prevalence of child undernutrition. Undernutrition places a child at especially high risk for developing obesity, which then promotes the vicious cycle which we are grappling with in the current socio-economic environment. Being overweight or obese increases one’s risk of heart disease and stroke, high blood pressure, diabetes and certain cancers. Overweight or obese children have an increased risk of developing these diseases earlier in life and are more likely to remain obese throughout their adult life. Not only does obesity have far reaching health effects for a child, but it also has vast social and economic implications. These can include bullying, teasing and low self-esteem, as well as increased healthcare costs and loss of income later in life. So what then is the cause for the increase in obesity amongst our children? Poverty, unhealthy diets and physical inactivity are largely to blame. According to Dr Vash Mungal-Singh, CEO of the HSFSA, “Our children are being brought up in an obesogenic environment where unhealthy foods are aggressively marketed to them, time in front of computers and televisions are increasing and appropriate environments for children to be active, safely, are few and far between.” With urbanisation we have also seen an increase in the consumption of sugar-sweetened beverages, energy-dense, nutrient poor foods and lower consumption of fruit and vegetables. Poor feeding practises early in a child’s life further exacerbates the problem. Studies have shown that there is a link between low birth weight and overweight later in life due to overfeeding as an infant. The introduction of ‘weaning foods’ too early (<6 months of age) is another key driver of obesity later in life. In fact a child’s risk starts even before birth with the health and diet of the mother, a concept referred to as the importance of the first 1000 days of a child’s life (from conception to 2 years of age). Poverty has an overarching impact within this context. Lower income groups tend to have higher obesity rates as they opt for foods that are cheap and the most filling, which often means high in energy, fat, sugar and salt with very little other nutritional value. The pregnant mother and young child are most affected. It is clear that obesity is in fact a very complex problem that requires a multi-pronged approach. We are therefore very fortunate to have the support of the National Department of Health in tackling this epidemic with a clear strategy and bold target to decrease the prevalence of obesity by 10% by 2020. This strategy builds on the guidelines of the WHO initiative on ending childhood obesity and includes a wide spectrum of activities including policy and legislative change, education, access to healthy foods and safe places to be active. The HSFSA wants to encourage all parents and caregivers to take action and play their part to prevent overweight and obesity in their own children, starting with the pregnant mother. It is imperative for all pregnant mothers to get appropriate care before, during and after pregnancy to ensure the healthy weight and growth of their babies. Exclusive breastfeeding for the first six months of an infant’s life, followed by appropriate complementary foods is a very effective way in reducing the risk of obesity. Providing healthy foods for young children and adolescents, limiting the intake of sugar-sweetened beverages and encouraging play time rather than TV time are all great strategies to combat overweight and obesity. Sources: For the first time in the history of mankind, the number of people who are overweight or obese measure up to the number of people who are underweight due to hunger. (Global Issues. Obesity. (2010). URL: http://www.globalissues.org/article/558/obesity) It has been estimated that if something is not done about the surge of obesity, half of all people will be overweight/obese by 2030 (Dobbs, R. et al. (2014). Overcoming obesity: an initial economic analysis. McKinsey Global Institute.) Over a decade, overweight has increased from 10.6% to 18.2% in South African children aged 2 – 5 years. (Shisana, O, et al, & SANHANES-1 Team (2013) South African National Health and Nutrition Examination Survey (SANHANES-1). Cape Town: HSRC Press.) Studies have shown that there is a link between low birth weight and overweight later in life due to overfeeding as an infant. (Vasylyeva, T.L., Barche, A., & Chennasamudram, S.P. (2013). Obesity in prematurely born children and adolescents: follow up in pediatric clinic: Nutrition Journal 2013, 12:150, http://www.nutritionj.com/content/12/1/150) Consistently, girls and female adults are more affected. South Africa further carries a double burden of malnutrition with not only rising rates of childhood obesity but also still high prevalence of child undernutrition. (Arington, C. & Case, A. (2013). Health: Analysis of the NIDS Wave 1 Dataset. National Income Dynamic Study. URL: http://www.nids.uct.ac.za/publications/discussion-papers/wave-1-papers) The Heart and Stroke Foundation South Africa (HSFSA) shines a spotlight on ending childhood obesity.

November 16, 2015

Making Sense Of Food Labels

By Gabi Steenkamp, Registered Dietitian, Food Labelling and Nutrition Consultant. www.gabisteenkamp.co.za. The information printed on all food labels in South Africa is regulated by the Department of Health regulations R146 (2010) for the labelling and advertising of foods, and there is no particular section that covers the labelling requirements for foods that are suitable for those with diabetes. Since the diabetic way of eating is all about basic good nutrition, all healthy foods are suitable for those with diabetes. However, they must be eaten in the correct serving size and combination to make up balanced meals. Such foods can be endorsed by Diabetes SA , but they have to comply with the specifications set out by the endorsement programme of Diabetes SA. Endorsed products and foods bear the logo below: For those foods that have not applied for the endorsement by Diabetes SA, the consumer must read the label to assess whether a food or product is suitable for those with diabetes or not, as most foods that are suitable for those with diabetes do not carry the Diabetes SA logo above. The most important information to look at on a food label is: The name of the product The total weight / volume The serving size The nutritional analysis information table The ingredients list The allergens declaration, if you suffer from a particular food allergy The name of the product The name given to a product is found on the main front panel of the packaging and should reflect what is inside the packaging. Should the name of the product not tell you what is inside the packaging, then an accurate description of the product is provided near the name. Giving a product a name such as ‘honey smacks’ is not very informative. The packaging could contain: Honey sweets Honey flavoured cereal An icecream product flavoured with honey or containing honey bits A chocolate with honey flavoured bits Honey flavoured drink, etc. But labelling this product as ‘Honey Smacks – honey flavoured popped wheat cereal’ tells you exactly what is in the packaging. You, as the consumer, have a right to know exactly what is inside any food packaging. Should this not be the case, you should contact the toll free customer services line, or email, of that product to make them aware of the fact; and contact a food labelling consultant who can then contact the company and have the error rectified. The label of the product below has a name that accurately tells what is in the packaging. TOTAL WEIGHT (MASS) or VOLUME The South African Bureau of Standards regulates the way in which the mass or volume of a product is stated on food packaging. All measures are metric and have a minimum lettering and number height. Knowing the total weight of what’s in the packaging, allows you to see immediately how many servings you will get out of one unit (be it a bag, jar, box, bottle, etc.). It also allows you to cross check if the serving size stated in the nutritional analysis table is do-able. In the above example, one fish cake must weigh 75 g (300 g divided by 4 = 75 g), which is a reasonably sized fishcake and is the size given in the nutritional analysis table for a single serving. THE SERVING SIZE The food labelling regulations stipulate that serving sizes stated in the nutritional analysis table, or anywhere on the label, may NOT encourage obesity and nutrition experts, such as a dietitian, determine the serving size to ensure that the serving sizes stated on pack are nutritionally correct and practical. For example, foods that make up the protein part of a main meal (such as fishcakes) should contain: Up to 1000 kJ per serving Less than 12 g fat per serving Less than 30% of total fat, as saturated fat per serving In the example of the fishcakes, you can see that in the second column of numbers in the nutritional information table, one fishcake weighing 75 g contains: 530 kJ 5.9 g of fat of which 1 g is saturated fat. The 1 g of saturated fat is less than 30% of the total fat (5.9%), so you can conclude that this is a healthy fishcake to have with your supper. You can also deduct from this that in fact you could have 2 of these fishcakes with your supper – provided of course you add the required 2-3 vegetable servings to make a balanced meal! But having all 4 fishcakes would encourage obesity and not be good for blood glucose control. On the other hand, foods eaten as a snack (such as icecream) should contain: about 500 kJ per serving and less than 6 g fat per serving Less than 30% of total fat, as saturated fat per serving In the example of the slimmer’s choice icecream given below, you can see that in the second column of numbers in the nutritional information table, one serving of 175 ml, contains: 492 kJ 2.3 g of fat of which 1.7 g is saturated fat. The 1.7 g of saturated fat is 74% of the total fat (2.3%), which means this snack contains too much saturated fat for good health and for those with diabetes since saturated fat increases the risk of heart disease, and particularly so for those with diabetes. For this reason, even though this is a controlled energy snack, it should only be eaten occasionally as a snack.

October 23, 2015

How Sugar Can Affect Our Children

Sugar is addictively awesome, but is the long term health effects really worth that momentary indulgence? It is blamed for most health issues, from behavioural problems to skyrocketing rates of childhood obesity and diabetes. Yet babies come into the world with a ‘sweet tooth’ (nature’s way of drawing them to breast milk), so you may wonder, how could an occasional lollipop or cupcake be so detrimental? In modest amounts, sugar can have a healthful place in a child’s diet (or an adult’s). But many kids get too much, too often. Worse, sugar-rich foods tend to be full of empty calories and often displace the nutritious foods children need. A recent landmark study of more than 3,000 babies and toddlers found that close to half of 7- to 8-month-olds are already consuming sugar-sweetened snacks, sodas and fruit drinks, a percentage that increases dramatically with age. These findings are of concern to health experts, since eating sugary foods at an early age makes you crave them even more later on. Fortunately, parents can do a lot to train their young child’s taste buds so that he or she doesn’t end up wanting sweetness so much. Beware of Hidden Sugars Sugar can hide in foods where you least expect it. Get in the habit of reading labels. You don’t always see the word “sugar” on a food label. It sometimes goes by another name, like sucrose, glucose, dextrose, fructose, maltose, malt sugar, fructose sweetener, liquid fructose, honey, molasses, anhydrous dextrose, crystal dextrose and dextrin on the ingredients list of packaged food. If any of the above-mentioned names appear in the first 3 ingredients of a product, it’s best to avoid the product. Also remember that ingredients are listed by decreasing weight so if you see sugar by any name near the top of the list, reconsider the product. Why should we cut back on sugars? Added sugar means empty calories which put kids at risk for obesity and health problems that can show up as early as adolescence. High-sugar diets can increase a child’s risk of developing Type 2 diabetes or the pre-diabetic condition known as insulin resistance syndrome. Tooth decay Sugar fuels the growth of bacteria which causes tooth decay. While fluoridated water and regular tooth brushing help prevent cavities, a steady stream of sugar in the mouth increases the likelihood thereof. When babies or young children have prolonged exposure to sugars found in sweetened water, fruit juice, milk, breast milk and formula such as giving a baby a bottle in bed or by sweetening a dummy, they are at an increased risk of tooth decay. That’s why dentists advise against putting babies to sleep with a bottle of milk (it contains milk sugar called lactose) or fruit juice, or letting them sip these drinks throughout the day. Behavioural problems When your child consumes refined sugars, there is a sudden spike in blood sugar levels. The body responds by producing a large amount of insulin, a hormone that sweeps sugar out of the blood and into body cells. When the sugar levels begin to fall, your body produces adrenaline which can contribute to hyperactivity in children to compensate for the low blood sugar levels. Blood sugar levels may then drop so quickly below normal that your child may feel shaky, sluggish, experience behaviour disturbances and impair learning by decreasing attention. This is often the case in children with Attention Deficit Hyperactivity Disorder (ADHD). A study comparing the sugar response in children and adults showed that the adrenaline levels in children remained ten times higher than normal for up to five hours after a test dose of sugar. Some children and adults are sugar sensitive, meaning their behaviour, attention span and learning ability deteriorate in proportion to the amount of sugar they consume. Children with ADHD are often sugar-sensitive. Not surprisingly, low blood-sugar levels can trigger a craving for more sweets, which creates a vicious cycle of sugar highs and lows. Childhood obesity Children gain too much weight when they take in more calories than they burn. Unfortunately, sugary drinks and treats typically supply calories above and beyond what kids need to satisfy their hunger. A can of soda contains ten teaspoons of sugar (160 calories), and many sweetened fruit drinks have as much or more. Regularly drinking even one sugary drink (soda, fruit punch or sweetened iced tea) a day increases the risk of obesity. Overweight or obese children are at increased risk of chronic conditions such as heart disease, high blood pressure, high cholesterol, type II Diabetes, asthma and sleep apnoea. 80% of children who is overweight before the age of 13 years, will be obese as adults. Weakened immunity Excess sugar intake can cause cold-like symptoms in children causing runny noses, excessive mucus, cough and symptoms of sinus infections. Consuming sugar also alters the balance between good and bad bacteria in children’s bodies, weakening their immune systems which leads to worsening of symptoms and prolonged recovery. Studies have found that excess sugar in the blood (including fruit sugar fructose and honey) caused a 50% drop in the ability of white blood cells to fight bacteria. In contrast, ingesting complex carbohydrates did not lower the ability of these white blood cells to engulf bacteria. The immune suppression was most noticeable two hours after eating lots of sugar, but the effect was still evident five hours after ingestion. Poor diet Sugar can cause stomach ache and poor appetite in children causing them to eat poorly when healthy nutritious food is offered. What to do as parents? Limit the amount of refined sugar in their diet by providing meals consisting of lean proteins such as lean chicken or beef, eggs or low-fat dairy and healthy fats such as nuts, seeds, avocado and olive or canola oil. Desserts and sweets: Limit portions of cookies, candies and other baked goods. Instead try fruit-based desserts. Cereals: Limit sugary cereals. Look for whole-grain cereals, such as oatmeal,

October 16, 2015

Food Fun For Fussy Families

If you think that everyone is going to love food as much as you, you’re wrong. Some of us just have no interest in the stuff other than to fill the gap. In fact, balance in a family almost dictates that if one person really loves food there will be someone else who doesn’t value it at all. So fine for us adults, we can take our chances with sub-par nutrition, but what if your little one is refusing all but their favourite five? Here are some tips for getting your kids to develop a healthier and broader view of food and to help the fussier ones to expand their palates. Get your child onto a good multivitamin. That way you can relax about their nutritional balance and take the fight out of mealtimes. The first step to expanding your child’s love of food is to make food something that is fun, relaxed, and choice-driven. Never force a child to eat something. Get your kids involved with the cooking. Cook, bake and generally have fun in the kitchen together. Even if they don’t eat what you’ve prepared together they will start to have positive associations with food. Start a veggie garden. Let your child have their own patch of garden where they can grow a variety of vegetables and fruit. Understanding where food comes from and experiencing the joy of your first harvest can go a long way to enticing kids to eat things out of their comfort zone. Enjoy your food. Yes, you. The more they see you enjoying a variety of foods, the more likely they are to try something new in the future. Eat meals together. Comment on your food – point out what you like about it – the colours, texture, flavours. Pretend that you are a food critic who has just received the most amazing meal ever and let them know why. If you don’t enjoy food then start by examining your own relationship to food before you address your child’s. Make sure your kids understand digestion. Read books together, find fun documentaries, discuss what happens when your food leaves your mouth. Use metaphors for the little ones if necessary, but get your kids to have a thorough understanding of their own bodies and WHY they need to eat a variety of foods. Show them other kids enjoying food. Let them eat with other children, invite kids over, watch Masterchef Junior, have cooking parties. Keep presenting new foods to your child. Even if they only eat their favourite few, just keep offering them some variety. Something at some point will pique their interest, particularly if they keep seeing you enjoying it. Don’t make a big fuss when this happens – just let it be a normal, natural thing for a child to eventually start broadening their reach. Give your kids some control. Children will sometimes use food as a control if the rest of their lives feel out of control or if they are lacking in independence. Make sure that your children have choices in their lives. Keep as much routine as possible when going through major life changes (death, divorce, moving house/schools, holidays, new babies etc). Make sure that the food issue isn’t just a symptom of something else. Food aversions often occur alongside other disorders such as autism, sensory integration issues, stress, other medical conditions. If you’re not sure, have your child checked by an Occupational Therapist, Gastroenterologist, Psychologist, Neurologist or Dietician. Have fun with food. Help your kids to see the joy of food outside of just eating it. Food is a full sensory experience – give them opportunities to explore it as such. Set up a still-life and let them paint a beautiful picture of food, let them sculpt with mashed potatoes, let them roll around in a tub of jelly, make potato stamps. Play games where you identify food by smell or touch. Have a food fight. Keep in mind that there is a difference between a fussy child and a child with food aversion. A fussy child will probably eat eventually if you just don’t offer their favourites and they get hungry enough, but a child with a food aversion will literally starve before trying something new. But whichever one your child is, every child can be enticed to branch out a bit when you add some love and fun into the food mix.

October 13, 2015

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