Advice from the experts
Kath Megaw

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
Parenting Hub

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
Milas Meals

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
The Heart & Stroke Foundation

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
Parenting Hub

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
Parenting Hub

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
Parenting Hub

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
Parenting Hub

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
Parenting Hub

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
Parenting Hub

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
Parenting Hub

Nutritional Deficiencies: Know the Signs


You might think nutrient deficiencies are a thing of the past, reserved for sailors trapped at sea. But even today, it’s possible to lack some of the essential nutrients your body needs to function optimally. Nutrient deficiencies alter bodily functions and processes such as water balance, enzyme function, nerve signalling, digestion and metabolism. Resolving deficiencies is important for optimal growth, development and function. Nutrient deficiencies can also lead to other diseases. For example, calcium and vitamin D deficiencies can cause osteopenia or osteoporosis, two conditions marked by brittle bones and inadequate iron can cause anaemia, which zaps your energy. Tell-tale symptoms are usually the first clue that you might be low in one or more important vitamins or minerals. In this newsletter we’ll try to help you detect nutritional deficiencies since knowing what to look for is part of the battle. Who is most at risk of nutrient deficiencies? A healthy diet can provide all a growing body needs, but the reality of our busy lifestyles and sometimes finicky eating habits can lead to a nutrient deficiency. Even if you do eat well, other factors – such as your age, lifestyle and certain health conditions (digestive issues e.g. Coeliac Disease) – can impact your body’s ability to absorb the nutrients in your food. Nutrient requirements are also increased during different stages of the lifecycle when the body calls for additional vitamins and minerals. Teenagers Rapid growth during adolescence requires extra nutrients to provide in the baby’s increased demands. These increased needs, coupled with dysfunctional eating or poor eating habits due to peer pressure, erratic eating times and increased activity levels, make adolescents the ideal candidates for supplementation. Elderly  The aging process may increase the need for some nutrients due to the fact that the elderly do not always eat enough of the right kinds of food or that the body is no longer able to absorb nutrients effectively. Elderly are very often at risk of developing zinc deficiency. Smoking Even moderate smoking can reduce the body’s vitamin C level significantly. Should one smoke in excess of 20 cigarettes per day vitamin C levels can be reduced by as much as 40%. Alcohol  Excessive alcohol intake will not only enable you to dance naked on table tops at parties, but can also interfere with the body’s ability to absorb B complex vitamins such as thiamine. Exercise programmes Intensive exercise regimes may increase the need for anti-oxidants, B-vitamins and protein. When a weight reducing diet is combined with an increase in exercise levels, nutrient needs are increased even more, especially that of the B complex vitamins. Stress – Living in the fast lane Busy lifestyle as well as high stress levels can increase your body’s demand for certain nutrients and if not met can cause nutritional deficiencies. Restricted diets Individuals that avoid certain foods like in the case of food allergies or intolerances or have dietary restrictions for example vegetarians may miss out on essential nutrients. Vegetarians are especially at risk of developing vitamin B12, zinc, iron or calcium deficiency. Weight loss programmes Individuals who are often on weight-reducing diets may find it difficult to meet the recommended level of nutrient intake for their age.  This is especially the case if you eat less than 1600kcal a day – placing you at risk of nutrient deficiencies. Most weight loss plans are less than the above-mentioned number of calories and therefore warrant the use of nutritional supplements such as a multi-vitamin/mineral supplement. Medication Certain medications interfere with the absorption of nutrients e.g. long term Metformin usage (seen in Type 2 Diabetics, Insulin resistance and PCOS) increases the risk of vitamin B12 deficiency. Regular measurements of vitamin B12 blood levels during long term treatment should preferably performed to detect possible deficiency. Women using oral contraceptive agents (the pill) could experience low levels of several vitamins – especially vitamin B2, niacin, vitamin B6, folic acid and vitamin C. Laxatives can reduce the absorption of fat-soluble vitamin A, D and E. Meanwhile, soil quality, storage time and processing can significantly influence the levels of certain nutrients in your food, such that even healthy produce may not be as nutrient-rich as you may think. Know the signs: Nutrient deficiencies can be sneaky, unless you are seriously deficient for some time, you may notice no symptoms at all, leading you to believe (falsely) that your body is getting all the nutrition you need. Thankfully our body gives us small warning signs, helping us figure out what nutrients we might be missing out on. Eye, hair, nail, mouth and skin symptoms are among the early outward warning signs of vitamin and mineral deficiencies. Here’s how to recognise common nutrient deficiencies. Hands If you tend to have very cold hands it may indicate magnesium deficiency or perhaps could be a symptom related to hypothyroidism or chronic fatigue. Nails If you have small white spots in your nails it may indicate the deficiency of minerals but more often, it indicates zinc deficiency. A zinc deficiency is also indicated by longitudinal ridges on the nails. While transverse ridges could be indicative of a protein deficiency. If your nails are soft or brittle it is a possible sign of magnesium deficiency. Interestingly, if you bite your nails it is usually because your body is low in minerals. Hair Coarse, dry and brittle hair is often caused by  zinc and/or vitamin A deficiency. While dandruff could be due to a deficiency in vitamins B2, B6, zinc, magnesium, biotin. Greying of the hair is usually a sign of the times but it can also be exacerbated by a deficiency in folic acid, pantothenic acid, biotin and minerals. Hair loss can be caused by a lack of protein, zinc, vitamin B6, selenium, biotin. Skin Dry skin in general is caused by a deficiency of vitamins A, C and essential fatty acids. If you have B-vitamin deficiency, your skin on your face and sides of the nose will be greasy red scaly. Seborrheic dermatitis around your

October 8, 2015
Parenting Hub

Top Tips For Healthy Kids Parties

Growing up in the 80’s, parties typically involved red frankfurters with tomato sauce, sugary fizzy cool drinks such as Coke, Cream Soda, Fanta as well as multi-coloured jelly and chips loaded with colourings, preservatives, bad fats and sugar.  Parents didn’t seem to be nearly as conscious of party food as they are now.  We all love the memory of those retro party treats but it is a cause of concern that our children are being filled with such nutrient-poor foods – particularly when a birthday party seems to be a weekly event for many children. Children parties however, is an occasion to celebrate and to have fun.  Parties unfortunately very often involve excessive amounts of sweets, treats, snacks and drinks that contain too much sugar and poor quality fats.  If children have more than one party over one weekend, this is more than likely what they’ll be filling up on.  We all know too well what the consequences are… uncontrolled blood sugar levels with adverse effects and healthy, nourishing food are replaced by those foods with very little nutritional benefit.  So how can parents ensure that kids enjoy parties but do not overload on second-rate food?  Read on for some handy tips. The offenders at Kids Parties Salt  Many of the snacks found at kids parties are high in salt.  A high salt diet during childhood could increase the risk of other conditions later in life.  Like anything there is place for a small amount of salt in a child’s diet.  If your child is healthy and have a healthy weight, or on cheat days.  What’s more, in small amounts, salt can even encourage nutritious eating.  Some kids might love homemade popcorn if it had a little salt on it – which is a much healthier snack than commercially produced crisps or savoury biscuits which is loaded with salt and hydrogenated fats.  Always remember, moderation is key! The daily recommended maximum amount of salt children should eat depends on age: •1 to 3 years – 2g salt a day (0.8g sodium) •4 to 6 years – 3g salt a day (1.2g sodium) •7 to 10 years – 5g salt a day (2g sodium) •11 years and over – 6g salt a day (2.4g sodium) Sugar: Sugar intake escalates very quickly if a child eats or drinks lots of processed foods or beverages – foods usually found at kid’s parties.  The problem with sugar is that it provides empty calories (energy of no nutritional value) that rob the body of nutrition to strengthen the immune system.  Too much sugar also causes cold-like symptoms e.g. runny noses, excessive mucus, cough and symptoms of sinus infections.  It contributes to tooth decay and behavioural problems.  The sudden glucose spike & subsequent glucose drop below normal blood glucose levels contribute to an increased adrenaline production and this causes hyperactivity in children. Excess sugar may lead to stomach ache in children and subsequently they will eat poorly when healthy nutritious food is offered.  Large amounts of sugar put children at risk of health problems that can show up as early as adolescence e.g. overweight, obesity, insulin resistance, pre-diabetes and type 2 diabetes. The average primary school child should not consume more than six teaspoons of added sugar per day. The American Heart Association recommends limiting children’s sugar intake to 3-4 teaspoons per day. Added sugar includes sugar that you add to tea, cereal and other food, but also the sugar added to refined or processed food. Sugar content of some processed food: Product Equivalent amount of sugar Fizzy cool drink (Coke, Fanta etc.) – 340ml can 10 teaspoons Oros – 300ml 6 teaspoons Ice tea – 340ml 6 teaspoons Flavoured water – 500ml 5 teaspoons Jelly sweets – 75g (small packet) 14 teaspoons Bite-size chocolate bar 2 teaspoons Plain chocolate – 4 squares 3 teaspoons Tomato sauce – 2 tablespoons 5 teaspoons From this table you can clearly see that consuming party foods with hidden sugar, a child can very easily exceed their daily recommendation for the next few days just by going to one party in a week. Fat: Fat comes in different forms and has different qualities, thus are some better than others.  Although it is recommended that fat should be limited in the daily diet – children are still growing and developing and need a certain amount of fat, especially the beneficial ones.  The problem with children’s parties is that most of the typical party foods are very high in Trans-fats or Hydrogenated fats. Trans-Fats or Hydrogenated (man-made) fat are the worst fats and are found typically in processed foods such as hard brick margarine, biscuits, chips, crackers, cakes, commercially baked goods e.g. pastries, doughnuts.  It is usually listed as “partially hydrogenated” or “vegetable oil shortening” in the ingredients list.  These fats increase the risk of disease (e.g. cancer, heart disease).  In large amounts trans-fatty acids can also affect brain function as it interferes with the role of omega-3 fatty acids in the brain. Another problem with the fatty party foods such as boerewors, ‘slap chips’, chips and melted cheese is that it contributes to constipation.  The type of fat present in these foods slows down the movement of food through the digestive track increasing the risk of constipation, especially if your child is prone to constipation. Top Tips For Kids Parties Before the party Make sure your child has eaten a healthy well-balanced meal or snack before the party starts.   Children’s eating behaviour is usually driven by hunger.  A hungry child will spend most of the party time around the sweets table eating whatever is available but generally children prefer to spend their party time playing if they’re not hungry. At the party  Children will eat what is served at the party.  If healthier food is offered at the party – that’s what they will eat. If healthy foods are served together with unhealthy options, chances are that the children will choose the unhealthier options.  Therefore it is better to

August 4, 2015
Parenting Hub

Salt Swaps – 8 Easy Exchanges

Most of us eat too much salt, which can lead to high blood pressure and eventually to heart disease and strokes. Changing how much salt we eat is not that easy, especially because most of the salt that we eat is already in the foods we buy. Choosing foods lower in salt can sometimes be difficult, and requires scrutinizing labels for sodium content. This is not always that practical during a rushed visit to the supermarket! This month we want to make eating less salt a little easier and more practical. We have come up with a list of 8 easy swaps to reduce your daily salt intake. 1. Swap salted nuts for unsalted nuts As easy as that! You can also swap salted peanut butter for the unsalted version. This is a no-added-cost, like-for-like swap that we all should do. 2. Processed meat for fresh meat Processed meats like polony, viennas, and other sausages are some of the saltiest foods we eat. Prepare a little more chicken or mince for supper, and use it as a sandwich-filler for the next few days. Tuna can also be a better choice, just rinse out the saltwater from the tin. 3. Salty flavourings for unsalted flavours Spices like barbeque or chicken spice contain mostly salt. If you use them together with table salt or stock cubes, the salt in your meal can double or even triple! Try unsalted flavours like cumin, coriander, paprika, curry powder, garlic, or mixed herbs. You can still add some salt to the meal but remember to taste first and only add a little. 4. Potato crisps for home-made popcorn Crips are VERY salty and not something we should eat as a daily snack at work or at home. We can make popcorn at home in less than 10 minutes for an inexpensive and healthy snack. See the recipe here to flavour your popcorn and keep the salt low! 5. Be the best at breakfast Although we think of them as having a sweet taste, breakfast cereals can have a lot of hidden salt we don’t taste. An easy swap is to choose a cereal that has no salt added, like choosing Weetbix lite without sugar and salt instead of the usual Weetbix. Or eat oats porridge instead of bran flakes. You can also look at the nutritional information on the cereal box and compare different cereals for their sodium content to choose the one lower in salt. 6. Swap cheese for cheese Hard cheese, feta cheese and processed cheeses like cheese spread or cheese slices are very salty. One step better is using cottage cheese or sometimes eating unsweetened yoghurt instead. 7. Choose your fat carefully Hard margarine or salted butter can have surprisingly high salt levels. Rather choose soft margarine to spread on bread or oil like canola when you are cooking. 8. Choose a fruit The last swap is an easy one. Swop your usual snack of biscuits, crackers or biltong for a fruit. Fruits are super low in salt, and also high in healthy fibre, potassium and vitamins. Try to eat an extra fruit every day!

May 18, 2015
Parenting Hub

ADHD And The Foods We Eat

ADHD: The most common childhood disease ADHD is the most commonly diagnosed childhood disease and is said to affect approximately 10% of the South African population. It could be present from birth (often not recognised) or early childhood and usually persists into adulthood. It is often undiagnosed in adult, which is an unfortunate oversight, since appropriate treatment helps control symptoms and improves quality of life. The term ADHD denotes Attention Deficit Disorder with &/or without hyperactivity & has been used to describe both ADD and ADHD as well as all aspects of the condition more accurately. ADHD is a chronic condition of the brain that makes it hard for those affected to control their behaviour. According to the American National Institute of Mental Health, two to three times more boys than girls are affected by the disorder and the reason for this is uncertain. Problems generally associated with ADHD include inattention, hyperactivity and impulsive behaviour. This can affects nearly all aspects of life. How can I tell if my child has ADHD? Most specialists believe that a child shouldn’t receive a diagnosis of ADHD unless the core symptoms of ADHD appear early in life and create significant problems at home and at school on an ongoing basis. Ideally ADHD should be assessed and diagnosed by a multi-disciplinary team. As there is no proven diagnostic test for ADHD at this time, a clinical diagnosis is usually made by a paediatrician based on specific criteria. It is a process that involves several steps and it requires information on behaviour. Information is required form parents, teachers, carers, health professionals for an official diagnosis to be made. In most children with ADHD, a diagnosis are made from the age of 5 – 7 years (formative school-going age), although some of the symptoms could be present from birth. These symptoms must significantly affect a child’s ability to function in at least two areas of life – typically at school and at home. It is important that the symptoms, be present for a period of more than six months in all situations. This helps ensure that the problem isn’t with only a particular teacher or with their parents. Most children with ADHD don’t have all the signs and symptoms of the disorder, and they may be different in boys and girls. Boys are often more likely to be hyperactive and girls tend to be inattentive. In addition, girls who have trouble paying attention often daydream, but inattentive boys are more likely to play or fiddle aimlessly. Boys also tend to be less compliant with teachers and other adults, so their behaviour is often more conspicuous. What causes ADHD? Parents often blame themselves when a child has been diagnosed with ADHD. However, the cause of ADHD is at present still unknown. Experts are investigating a number of genetic and environmental causative factors – some of these theories have led to dead ends, some to exciting new avenues: Altered brain function & anatomy: There is an imbalance of certain neurotransmitters or poor nerve communication and transport in certain parts of the brain. Genetics (70-80% of cases): There is great deal of evidence that ADHD runs in families and if one person in a family is diagnosed with ADHD there is a 25-35% probability that another family member also has ADHD. Exposure to toxins such as cigarettes and alcohol during pregnancy, high levels of lead in the bodies of children. Brain injury: only small percentage of children with ADHD has been found to have suffered from traumatic brain injury. There is no clear answer! What we do know is that ADHD is a condition of the brain, likely caused by unknown factors which influence nerve communication and transport in certain parts of the brain, which has a strong genetic basis. Common misconceptions:  Food additives and sugar has long been controversial. Some research suggests that artificial colourings and preservatives may be associated with hyperactivity in children. But an association is not the same as a proven “cause-effect” relationship. There is no proof that food additives cause ADHD. Poor parenting, family problems, excessive TV watching, poor teachers and schools, food allergies or excessive sugar intake are not thought to cause ADHD. These environmental factors may contribute and worsen ADHD symptoms though but are not the cause. How is ADHD treated? Optimal treatment is still a matter of debate and every family wants to determine what treatments will be the most effective. It is thought that lifestyle can either reduce or strongly exaggerate symptoms of ADHD. Clinical experience has shown that the most effective treatment for ADHD is a combination of: Medication, when necessary Dietary intervention The correct supplementation of vitamins and minerals Exercise Therapy and counselling to learn coping skills and adaptive behaviours Medication  There is a wide range of medications available, the most common being Ritalin, Dexedrine, Adderall, Concerta. Medication does not cure ADHD. The role of medication is to control the symptoms when taken and works effectively in 70% of ADHD cases. Each medication has its negatives. The most likely side-effects include reduced appetite, corresponding weight loss, headaches, nervousness, irritability, tummy aches, nausea & vomiting, sleep disturbances. It is found that 30% of cases don’t respond or do not tolerate prescribed medication for ADHD. In these cases there is no other option then to opt for dietary treatment. Diet and ADHD Each child requires an individual approach. Helping a child with ADHD is like trying to solve a jigsaw puzzle. Puzzle pieces might include low iron status, poor diet, essential fatty acid deficiencies, magnesium deficiency, zinc deficiency, sensitivity to food stuffs such as artificial colourants, flavourants and preservatives. Remember each child is a unique puzzle with different puzzle pieces. It is therefore essential to consult a dietitian specialising in the field. Diet in itself does not cause ADHD but can worsen the symptoms. Diet modification however does play a major role in the management of ADHD and the associated symptoms. When dietary changes are made the results could

March 26, 2015
Parenting Hub

Childhood Overweight And Obesity

When it comes to the low down on healthy eating and weight loss, most of what we read in the media, and what is portrayed on television, is directed at adults with little attention focused on children. But what about our children and where do they stand in the battle against the bulge? Childhood obesity: The problem we are facing South Africa has been experiencing an increase in obesity over the past 2 decades, especially among children and adolescents and is reaching epidemic proportions. According to the International Obesity Taskforce one out of every 10 children is overweight.  13.5% of South African children (between ages 6-14 years) are overweight and/or obese. Scary about this statistic is that it is higher than the global prevalence of 10%. It is further estimated that 1 in 5 children is either overweight or obese. Research show that girls are more likely to be overweight or obese. Ironically in developing countries like South Africa, where underweight and poor growth have been the main health concerns in children, overweight and obesity are now becoming significantly prevalent as a consequence of a poor diet and energy dense foods combined with increased sedentary activity. Childhood obesity is a serious medical condition that affects children and adolescents. It occurs when a child is well above the normal weight for his/her age and height. Childhood obesity is particularly troubling because the extra kilo’s often start kids on the path to health problems that were once confined to adults, such as diabetes, high blood pressure and high cholesterol. What causes childhood obesity Although there are some genetic and hormonal causes of childhood obesity, most excess weight is caused by kids eating too much and exercising too little. Children, unlike adults, need extra nutrients and calories to fuel their growth and development. So if they consume the calories needed for daily activities, growth and metabolism, they add kilo’s in proportion to their growth. But children who eat more calories than needed, gain weight beyond what’s required to support their growing bodies. However the picture is much more complex when one takes a look at all the risk factors involved in the development of childhood obesity. Many factors, usually working in combination, increase your child’s risk of becoming overweight. These risk factors include: Genetic conditions: These rare genetic diseases and hormonal disorders predispose a child to obesity. They include conditions like Prader-Willi syndrome, Bardet-Biedl-syndrome, Cohen syndrome and affect a very small proportion of children. Diet: Regular consumption of high-calorie foods e.g. foods high in sugar and fat, together with low fruit and vegetable consumption. Inactivity: Sedentary kids are more likely to gain weight because they don’t burn calories through physical activity. Inactive leisure activities, such as watching television or playing video games, contribute to the problem. Family factors: It is well known that obesity ‘runs in families’. If a child comes from an overweight family he/she may be genetically predisposed to put on excess weight, especially in an environment where high-calorie food is always available and physical activity isn’t encouraged. For children under the age of 10, if one parent is obese, it doubles the chances of the child developing adult obesity. If both parents are obese, there is an 80% chance that the child will be obese. Psychological factors: Some children over eat to cope with problems or to deal with emotions. How to tell if my child is overweight or obese? Do you know when to be concerned about your child’s weight? Of course, all children gain weight as they grow older. But extra kilo’s – more than what’s needed to support their growth and development – can lead to childhood obesity. Not all children carrying extra weight are overweight or obese. Some children have larger than average body frames. Children normally carry different amounts of body fat at the various stages of development. So you might not know just by looking at your child if his/her weight is a health concern. One of the tools that we use to determine if your child is obese/overweight is the Body Mass Index (BMI) chart.  By calculating your child’s BMI you will be able to determine where they fall on the BMI-for-age chart. Using the chart, your child’s BMI is compared to that of other children of the same sex and age. Cut-off points on these growth charts, help identify overweight and obese children. You can calculate your child’s Body Mass Index (BMI) for their age and gender by the following equation: Current weight (kg) ÷ (Height x Height) = BMI. E.g. 30kg ÷ (1.35 × 1.35) = 16.5 kg/m.  Then plot the number you have obtained against your child’s age on the chart below. This will serve as an indication of their nutritional status i.e. if they are overweight or obese and is it important that a paediatric dietitian evaluate your child. Your dietitian can give you advice on your child’s specific dietary needs and help you to make sure that they are receiving a nutritionally adequate diet and one that is right for them, while losing weight. International cut-off points for body mass index for overweight and obesity by sex between 2 and 18 years (adapted from Cole et al., 2000) e (years) Overweight (kg/m) Obese (kg/m)   Boys Girls Boys Girls 2 18.41 18.02 20.90 19.81 3 17.89 17.56 19.57 19.36 4 17.55 17.28 19.27 19.15 5 14.42 17.15 19.30 19.17 6 17.55 17.34 19.78 19.65 7 17.92 17.75 20.63 20.51 8 18.44 18.35 21.60 21.57 9 19.10 19.07 22.77 22.81 10 19.84 19.86 24 24.11 11 20.55 20.74 25.10 25.42 12 21.22 21.68 26.02 26.67 13 21.91 22.58 26.84 26.76 14 22.62 23.34 27.63 28.57 15 23.29 23.94 28.30 29.11 16 23.90 24.37 28.88 29.43 17 24.46 24.70 29.41 29.69 18 25 25 30 30 Middle circumference is another important tool that is used to determine your childs’ risk of developing disease e.g. diabetes or heart disease. If you are worried that your child is putting on too much

January 5, 2015
Parenting Hub

Is Grassfed Really Better?

A lot of us are horrified by how animals are treated in feedlots and as a result, there is a decided trend toward pasture-raised animals. The newly-instated Grass-fed Association of South Africa, with its aim to establish an environmentally friendly and economically viable grass-fed meat industry, bears testimony to this. There are many reasons why grass-fed is indeed better, not the least of which the fact that putting beef cattle into feedlots and feeding them grains, goes completely “against the grain” for these animals. Grazing animals such as cattle, sheep and buck are endowed with the ability to convert grasses, which we humans cannot digest, into flesh that we are able to digest. They can do this because they possess a rumen, a 45 or so gallon fermentation tank in which resident bacteria convert cellulose into protein and fats. They are, on the other hand, very inefficient at converting corn and other grains, so we have to do this feedlot thing on a massive scale to feed all the meat-eaters of the world. However, it’s still cheaper and faster, so our meat supply is now almost all feedlot meat. But the unnaturally fast weight gain of animals in feedlots could not be achieved without enormous quantities of corn, soy-based (read GM) protein supplements, antibiotics and other drugs, including growth hormones. Apparently up to 70% of all antibiotic use around the world is on animals. This leads directly to the development of antibiotic-resistant bacteria with new “superbugs” increasingly rendering our antibiotics ineffective for treating disease in humans. We are brainwashed into believing that “grain-fed” beef is nutritionally superior, but is it? Producers are even rewarded higher grades for well-marbled flesh which is what you will get in grain-fed beef, however is this better for us? Marbled flesh is simply fat that can’t be trimmed off, as it lies within the flesh. A sirloin steak from grass-fed beef may have as little as half the fat of a steak from feedlot beef. However what’s even more important is the kind of fat. The high, imbalanced levels of omega-6 fat in grain and corn-fed animals tends to promote inflammatory processes, insulin resistance and interference with omega-3 fat metabolism. The fat in grass-fed meat is rich in desirable omega-3 fats, also found in  coldwater fish, flaxseeds and walnuts.  A grass-fed steak typically has about twice as many omega-3s as a grain-fed steak. Sadly though, when cattle are taken off grass and shipped to a feedlot to be fattened on grain, they immediately begin losing the omega-3s they have stored in their tissues.  Meat from pastured cattle may also be up to four times higher in vitamin E than feedlot meat, and much higher in conjugated linoleic acid (CLA), a nutrient associated with lower cancer risk. There are also environmental benefits to grass-fed beef – it is far less polluting, with their droppings becoming nutrients for the next pasture. Grain we feed our feedlot cattle accounts for a staggering amount of fossil fuel energy and vast quantities of chemical fertilizer. So grass-fed beef certainly has its advantages, but it is typically more expensive, and I’m not at all sure that’s a bad thing. Most of us eat far too much meat anyway! Meatless Mondays? What a brilliant idea! Grassfed vs Organic vs Natural It’s important to remember that organic is not the same as grass-fed. You may find organic beef and dairy products that are hormone- and antibiotic- free but the animals still spent their lives in a feedlot simply eating organically grown grain. What about the “natural” label? All that usually means is that the animal was raised in a feedlot but without growth hormones and antibiotics added to their non-organic feed. There can still be as many as 100 cattle, weighing from 350 to 600kgs, living in a pen the size of a basketball court.

October 20, 2014
Lynne Brown

Vitamin Antagonists

Do you think you eat healthily enough and yet you are still prone to frequent occurrences of infections and other health challenges? Perhaps your nutrient intake and the nutrients your body makes are, to a significant degree, being cancelled out by vitamin antagonists. A vitamin antagonist is essentially the same thing as an antivitamin. It is a substance that blocks or inhibits the chemical action of a vitamin in the body. Processed foods are one of the main causes of vitamin loss in our bodies, with refined white sugar and flour being top of the list of culprits that deplete our vitamin stores. However there are many other vitamin antagonists such as artificial stimulants, drugs and, above all, stress. Stimulants Caffeine for example depletes the body of the B vitamins. The high tannin levels in tea can also cause iron depletion if drunk in excess. Alcoholic beverages deplete B vitamins as well as vitamin C from the body. It is also well known that cigarette smokers have lower Vitamin C levels than non-smokers do. A single cigarette can deplete as much as 35 mg of Vitamin C from the body. Calcium & phosphorus are also depleted in cigarette smokers. Our bodies need sustainable energy, not energy artificially boosted by the short-lived highs from these negative stimulants. When one’s metabolism is stimulated artificially many enzymes, vitamins and minerals are used. These artificial stimulants whip up the heartbeat and flow of blood and oxygen to the different parts of the body and brain. It is like throwing benzene on a fire: The fire will burn higher and brighter, but only for a short time, after which it will be completely burned out and the body feels a loss of vitality and energy. Drugs Drugs or medicines are serious stress producers in the body. Because vitamin C reacts with any alien substance in the bloodstream, all drugs can be considered to be vitamin C antagonists. Birth control pills are anti-vitamins, especially of riboflavin, B6, B12 and folic acid. Aspirin interferes with digestive processes and can result in stomach bleeding. It may result in especially high losses of Vitamin C and A, folic acid and calcium and potassium. Diuretics are drugs prescribed medically to promote weight reduction, or to relieve pressure of retained fluids. They work by increasing the flow of urine which in turn results in great losses of B and C vitamins and the minerals potassium and magnesium. All laxatives, including the herbal types, are vitamin antagonists. Mineral oil, commonly used as a laxative, absorbs the fat soluble vitamins A, D, E, K which are then eliminated with the stool together with calcium and phosphorus. Beta blockers, drugs taken mainly for hypertension, decrease nocturnal melatonin, a naturally occurring hormone which basically tells your body to go to sleep, and this probably accounts for some of these agents causing insomnia.Statins (cholesterol lowering drugs) reduce production of an enzyme known as Co-enzyme Q10 which is, ironically, essential for heart health. Antibiotics suppress the growth of the beneficial or friendly bacteria population in the gastrointestinal tract and consequently the synthesis of vitamin K and may result in yeast infections and gastric problems.Antacids containing aluminium hydroxide can result in bone demineralization due to decreased absorption of phosphates. Anticonvulsants given to epileptics may result in folate, vitamin B12 and D deficiencies. Cortisone is an antagonist of vitamin B6 (pyridoxine) and blood-thinning medications may destroy vitamin A in the body. The solution This has been only a partial listing of a few specific vitamin antagonists or antivitamins. We know that all drugs and medications have side-effects, some of them serious. In many cases these may simply be the result of deficiencies in specific nutrients that these drugs have created in your body. If you’re a coffee or Coke addict or need to be on drugs for a specific health condition then it would be a good idea to supplement with a good quality whole food multivitamin and mineral supplement which should cover most of the bases. Alternatively consult a nutritionally-based health care practitioner to determine deficiencies that your specific medication or lifestyle may be causing and address these accordingly Stress Finally the greatest thief of all, robbing the body of nutrients and producing many free radicals, is stress. We might not come face to face with a lion everyday but we do experience numerous everyday stresses. Surgery, accidents, overly exhausting work or exercise, lack of sleep, exposure to extremes of heat or cold and emotions such as fear, hatred, anger, worry and grief, all produce great levels ofstress in the body. The B vitamins, vitamin C as well as proteins and minerals, are all depleted and/or can not be assimilated as a result of stress. And don’t think for a minute that the other vitamins can be properly or fully utilized when the body is under stress—they can’t!

October 17, 2014
Paarl Dietitians

Brain Food For Exams

Our brain, a mass of fat and protein weighing about 1.4 kilograms (equal to 3 bricks of butter), is the organ that makes us human, gives us the capacity for art, language, moral judgments and rational thought. It’s also responsible for each of our personality, memories, movements, and how we sense the world. So, one would think that it is the organ that we would take the most care of. We have days dedicated to heart, kidney and bone health, but how often do we take time to appreciate our brain and make sure we are looking after it! What we eat can have a direct impact on how well our brain works. Our brain is a hungry organ and reportedly uses 20-30% of our daily energy intake. Relative to its size and weight, that is rather demanding and if we don’t take in adequate nutrition, our brain is going to go hungry. None of us feel good when we are hungry, so just imagine how your brain must feel when it goes hungry. Just by skipping breakfast alone, you can adversely affect brain functions like fluency when speaking, ability to solve problems and motivation to tackle tasks. What we need to realise is your brain works just like your car. Just like your car requires good quality petrol, oil, water, brake fluid and other components to function well, so does your brain. The nutrients key to your brains health and function include glucose, vitamins & minerals and other essential chemicals. If you want to keep your brain fit and healthy and make sure it serves you well, keep reading to learn more about food and brain health. Glucose = carbohydrate = brain power The ability to concentrate and focus comes from the adequate supply of energy – from blood glucose – to the brain. The glucose in our blood comes primarily from the carbohydrates we eat – foods including fruit, vegetables, cereals, bread, sugars and lactose in milk. Eating breakfast and regular meals containing some carbohydrate ensure you will have enough glucose in your blood. Low GI carbohydrates are the best choice as they will ensure a steady supply of glucose to your brain. Not having enough glucose in the blood makes us feel weak, tired and our minds cloudy. This may happen when we don’t eat enough carbohydrate-containing food e.g. when you are following a low carbohydrate diet or if you have an erratic eating patterns. However, though glucose ensures good concentration and focus, once your blood glucose is within the normal range, you CANNOT further boost your brain power by eating more carbohydrates and increasing your glucose levels. This will not make you smarter but only cause you to gain weight! Your dietitian would be able to guide you on how much carbohydrates you need to prevent weight gain. Choose fats wisely Our brains are made of around 40% fat, and our cells need fats to maintain their structures, therefore an adequate supply of healthy fat is needed to maintain brain health. Healthy fat choices include the mono-unsaturated fats like olive oil, avocado pear, nuts and seeds and omega 3 rich foods like pilchards, sardines, salmon, trout and walnuts. If you don’t like fish you may decide to take an omega 3 supplement. Make sure your omega 3 supplement has a high proportion of the active ingredients – Eicosapentaenoic acid (EPA) and Docosahexaenoic acid (DHA). Take up to a total of 1g/day of these essential fatty acids every day. We stock various omega-3 supplements at the practice that meets the recommended dosage. Include protein at each meal Tryptophan is one of the building blocks of protein, and has been shown to play a role in depression. Studies have shown that adding pure tryptophan to the diet of people with depression can improve their mood. Tryptophan is found in most foods like seafood, dairy, nuts, seeds and legumes, but is found in the largest quantity in turkey, chicken and red meats. Protein also contains essential nutrients and eating it little and often helps to keep us feeling full, which in turn, can prevent overeating. Fresh meat, poultry, fish, shellfish and eggs are the best sources of protein. Fill around one-third of your plate with a protein food. Don’t forget your fruit and veggies and wholegrains Wholegrain cereals, peas, beans, lentils, nuts, seeds, fruits and vegetables are rich in a range of vitamins and minerals that your body needs in order to function well. These foods are also rich in B vitamins, (including folate) and zinc, which evidence suggests is important in managing depression. Try to eat at least five different fruits and vegetables daily to get all the vitamins and minerals you need. Drink enough fluid Water makes up 85 percent of the brain weight. So, it is but natural that lack of water can lead to brain shrinkage. Researches have shown that dehydration not only shrinks the brain tissues but also adversely affects concentration and memory. So, how much water is required by the body every day? Drink water according to your body weight. Dividing your weight in kilograms by 30 gives the amount of water in litres a day. For example, if you weigh 75 kg, drink (75/30= 2.5) 2.5 litres of water spread out over a day. Be careful of caffeinated beverages though. Caffeine may affect your mood and may lead to withdrawal headaches and to low or irritable mood when the effects wear off. Drinks such as coffee, cola, energy drinks, tea and chocolate all contain caffeine. Avoid all energy drinks, and try to limit intake to three cups of coffee, or five cups of tea a day. Alcohol also has a dehydrating effect. Drinking too much alcohol can also lead to B vitamin deficiencies, and can make you more depressed or anxious. Try to limit intake to no more than two to three drinks on no more than five days per week. Try to include a super food each day Super foods

October 15, 2014
Parenting Hub

Vitamin D – Are You Getting Enough

“I have never seen any medical diagnosis as widespread and so profoundly affecting peoples’ health and well-being as the current epidemic of Vitamin D deficiency.”  — Dr. Soram Khalsa, M.D.- ‘The Vitamin D Revolution‘) At a seminar held for the Association for Nutritional Therapy in Cape Town a while back, we learned that most South Africans, even those who do spend plenty of time outdoors under our powerful sub-tropical sun, are vitamin D deficient. I decided I had to put this somewhat incredible statement to the test. Being a sun worshipper who spends a lot of time in my garden, if I proved to have low vitamin D levels, then I would have to believe that most South Africans have. So I took myself off for a blood test for 25-hydroxyVitaminD (or 25(OH)D), the only reliable way to know what your levels are. Well blow me down! In the middle of our South African summer I only just made it into the 50-75 ng/ml range, recommended by Vitamin D experts. Apparently one needs to be in this range to really benefit from the protective or therapeutic properties of Vitamin D. Well now I understand why there is such a hoo-ha about vitamin D deficiency being at the root of a plethora of modern day degenerative diseases. Needless to say 2000IU per day Vitamin D3 was immediately added to my supplement regime and 6 months later, mostly Winter months, I’m thrilled to report that my level had risen to 71 ng/ml. Remember the new school of thought is that the right time to expose your body, without sunscreen, to direct sunlight is when your shadow is shorter than your height. Well have you noticed this is never the case on a Winter’s day? Not even at midday. So taking vitamin D supplements in Winter seems to be non-negotiable. I would have preferred to simply eat more Vitamin D rich foods however it is extremely unlikely one can get enough from one’s diet. Apparently two servings of fatty fish like salmon, tuna, sardines or mackerel would have to be consumed every day. Most of us would have to resort to canned fish which is definitely not ideal. There is a ton of research which links higher levels of vitamin D (and/or increased sun exposure) with reduced risk of a range of conditions including diabetes, multiple sclerosis, several forms of cancer (including skin cancer), arthritis, heart disease and depression. Ha! and we thought vitamin D was only good for keeping healthy bones and teeth! Who can expect to have low vitamin D levels? The elderly, anyone who does not get enough sun exposure and people who have cancer, heart disease, diabetes, osteoporosis, arthritis or suffer from depression. Also if you are prone to chronic fatigue, memory loss or dementia, joint, muscle and back pain, muscle weakness, bone fracture and falling risks, it can do no harm to have your vitamin D3 levels checked. Pregnant and breastfeeding women are at considerable risk of being deficient, which puts the child at risk too of future health problems. For teenagers suffering from depression a simple vitamin D deficiency may be the cause. In a recent study vitamin D supplementation in depressed teenagers resulted in increased well-being, improvements in depressed feelings, irritability, tiredness, mood swings, sleep difficulties, weakness, concentration and pain. If you decide to go for the 25-hydroxyVitaminD blood test and don’t know what to do with the results please seek advice on the appropriate vitamin D dose to supplement for your particular circumstances. It all depends on your starting level, how much sun exposure you are able to get and your present health profile and diet. Most people will need more than the generally recommended 400IU daily intake. Vitamin D supplementation is safe, however overdosing, although unlikely, can result in toxicity, so, if in doubt, rather seek professional advice. It is also very important that you take a D3 supplement as opposed to D2. If you really think about it, disease is much more likely to be due to a deficiency in some vitamin/mineral complex than in a deficiency of a drug.

September 25, 2014
Parenting Hub

Beware The “All Cheese, Fat And Meat You Can Eat” Diet

Although I am in favour of the Paleo/Banting/Ketogenic Diet and see it as a fundamentally healthy way of eating that mirrors the diet we evolved to eat and is in accordance with our innate physiology, alarm bells are ringing! This diet in the hands of followers who have scant knowledge of nutritional needs of the body or harm that can be done by toxic chemicals, becomes dangerous! I see people losing unwanted kilograms but at what cost? Here are some of the dangers I see: Eating only protein and fat and totally avoiding vegetables – any man’s dream! I hear of people eating just eggs, bacon and more bacon for breakfast. Some may even have a 400g steak for breakfast – nothing else! So what’s the problem with this? Firstly no acid-alkaline balance. Your vegetables are alkaline-forming and proteins, oils and fats are acid-forming. You need a balance or else disease will prevail. Cancer thrives in an acidic environment. High protein diets can lead to acidosis setting the stage for osteoporosis, hormonal imbalances and gut dysbiosis and can potentially lead to kidney stones, arthritis and gout. Secondly, you’re missing out on essential nutrients and anti-oxidants found in vegetables. Without them you are putting yourself at risk of vitamin and mineral deficiencies as well as oxidised or rancid cholesterol which can result in arterial plaque and inflammation. Thirdly, processed meats such as bacon are known to be potentially carcinogenic (cancer-forming) due to the nitrosamines formed during frying. Even non-processed meats, if from commercial sources and not from grass-fed animals, are full of toxins such as xenoestogens, antibiotics and growth hormones. Remember too that toxins are stored mainly in fat cells so the more fat you are eating from feedlot animals, and not those reared on the veld, the more toxins you are taking in. Fourthly, there’s the matter of “eat all the cheese you want” statement. There are good cheeses and bad and the bad ones from feedlot animals are just as high in the toxins mentioned for meat. Processed cheese is also high in sodium and eating too much of it can result in magnesium and potassium imbalances, never mind that cheese is also highly mucous-forming and constipating! Perhaps you find that you were but are no longer losing weight on this diet? My guess is you’re one of those eating too much protein. Did you know that a significant percentage of excess protein will ultimately be converted to sugar and stored as fat? You simply have to stick to the rules: protein portions should be no bigger than the area and thickness of the palm of you hand, minus fingers. And you simply have to include 5-7 cups of vegetables and fruits daily to benefit from this type of eating plan. Without the fibre provided by these foods constipation will be the order of the day. They are also your anti-oxidants, neutralising free radicals and slowing down ageing. This diet is also devoid of all grains so if you’re not eating organ meats, nuts and seeds then watch out for vitamin B deficiencies including biotin. If hair-loss occurs or your stress levels rise, a vitamin B supplement would be adviseable. Also have your homocysteine levels checked. High levels can cause hardening of the arteries and to reduce these levels you need most of the B vitamins which are abundant in whole grains which you are no longer eating! My intention is not to throw cold water on an eating plan that is working for you, all I ask is that you do not compromise your health for the sake of weight-loss. The good news is that two positives have come out of everyone “banting” these days: the harmful refined carbs are out and the no-fat and low-fat myths have been busted! Hoorah!

September 18, 2014
Nutripaeds

Why go for rice cereal when we have so many other delicious options?

Honestly, as a Mom and dietitian there is no reason to start food introductions with rice cereal. Rice cereal has been a long-time staple of the food introduction folklore, but there is no science or even practical reasoning behind it.  Rice cereal has very little nutritional value.  It is starchy, full of carbohydrates with little to no protein or fat and very few vitamins and minerals.  Even the iron that is added to most brands is very poorly absorbed and frequently contributes to constipation. And that whole “add rice cereal to the bottle to make them sleep through the night” idea?  Sorry, it’s a myth. Why go for rice cereal when we have so many other delicious options?   Here are some ideas for the different age groups: 4-6 months, pureed food (the Allergy society recommends to wait until at least 4-6 months before introducing solid foods.  I strongly agree.  There is no downside to waiting past 4 months, as mothers milk is by far the best and most nutritious food.) Avocado (a great first food!  Full of healthy fats, mild in flavour) Carrots (add a drizzle of olive oil to increase the calories) Sweet potato Hubbard squash/butternut/pumpkin (mixed with a little cinnamon – yum!) Pear Banana Apple Mango 6-9 months, pureed food, start small finger food Berries (except strawberries, which can be allergenic – wait until 12+ months to introduce those) Broccoli, kale, chard and other “brassica” family vegetables Cucumbers Yogurt Cream cheese Poultry (even though it’s expensive, organic is really the best) Ostrich or venison Lamb Pork Egg Nut butters Beans and lentils (mixed with some chicken stock – yummy!) Sunflower and pumpkin seed butter (thinned) Grains like oats, rice, quinoa, buckwheat Blackstrap molasses (you can add a little to just about everything to increase iron and calcium) 7-12 months, mashed or finger food Orange and other citrus Strawberries Grapes Tomato Barley, rye and wheat Mushrooms Honey Soy Beef (pureed beef stew in tomato stock is so delicious!) Obviously there are a lot more foods.  Fruit and Veggies can be introduced daily, new one every day to increase range and variety. With the protein foods – Start with one food at a time and wait 3-4 days before introducing a new food (this is to see if there is a delayed food intolerance that may not be immediately noticeable). Once one food is well tolerated you can mix and match (or mix and mash) – e.g., chicken and pumpkin, avocado and peas. There are lots of opinions on how to introduce foods and when to add spices and herbs.  Personally, I think adding flavour is a great idea while the child’s palate is still developing.  Many infants start with extremely spicy curries and peppered dishes.  I don’t recommend that – unless your family is already used to some heat – but definitely consider adding a dash of cinnamon, a pinch of paprika, or some ground herbs like basil, thyme or oregano.  Just remember that infant portions are very small, so the spice needs to be proportionate. Making your own is so much more fun (and less expensive) than buying baby food jars.

August 27, 2014
Good Night Baby

What Role Does Nutrition Play When It Comes To Your Child’s Sleep?

Not as much as you might be thinking…. Very often, when we talk to clients their main concern is that milk, milk supply, solids or the lack thereof, are the causes of their child not sleeping. This is a natural reaction due to the kinds of information new mothers are exposed to. In hindsight, I am embarrassed to admit, that I was shoving (and I mean, literally: forcefully, SHOVING) rice cereal down my 3 month old’s throat because I was convinced that he was hungry. This was supported by the sage advice of the older generation, who insisted that once I started feeding my solids, he’d magically start sleeping through. I also tried (with little success) “topping up” my baby’s breastmilk with formula because—as the nurse was telling me—he continued to wake at night because he is NOT receiving sufficient nutrition from me. I was also informed by loving friends and strangers alike that I should change the formula that I’ve selected for the young one, because my baby might in fact be lactose intolerant, therefore the current formula was causing him discomfort as it was being processed by the digestive system. Does any of this sound familiar? With the popularity of this type of ill-advice, it is very easy to fall into the “over-nutrition” trap. Moms, just because you are breastfeeding does not mean your child is not able to sleep through! What If I told you that only 5% of sleep problem cases have their root causes in nutrition challenges!? It is far more likely that that your baby has not yet developed the skill of soothing him/herself, and therefore nutrition is not the problem. The fundamental rule to remember is that your baby’s sleep is regulated by his/her brain and not by the stomach. When nutrition does play a role: Nevertheless, a hungry baby will not sleep well either; so here is a checklist to use to rule out whether nutrition is the problem: Is your baby growing according to his/her growth curve? Essentially, is your baby gaining weight steadily? Is your baby older than 6 months? If “yes”, solids can be introduced. How old is your child? If your child is younger than a year, milk is more important. If your child is older than a year, solids should be the primary source of nutrition. Does your child receive protein rich nutrition if he/she is older than 6 months? Does your child have a sufficient intake of minerals like Zinc, Magnesium and Iron? Does your child eat/drink too much salt, sugar or caffeine? These additives could spike energy levels, leaving the child in a hyper-alert stage. Is your baby drinking too much water, rooibos and/or juice? Remember, juice has a high concentration of sugar/fructose. Sugar is a drug – like it or not. We would live to believe that the hype around sugar is no more than drama-mongering by puritan foodies. Unfortunately they are right. People die from diseases every day that started (and ended) with their relationship to sugar. By sugar I am referring to high fructose corn syrup, which appears in just about every kind of sweetened convenience food, drink and confectionary. As well as good old table sugar. Of course there is a place for sugar, but when the average person has no idea about moderation it is good practice to abstain as much as possible. Possibly the most interesting research regarding sugar is not only the effect on the endocrine system, but the effect on the brain.  Researchers reported in the “Neuroscience & Bio-Behavioural Review Report” in 2008 that “intermittent dietary sugar consumption alters extracellular dopamine in the brain, much in the way an addictive drug does. Moreover, when this intermittent sugar consumption ceases, dopamine levels are affected and signs of withdrawal can become evident. Not only can extracellular dopamine levels be affected but so too can the dopamine receptors themselves.” The sugar addicts and chocoholics were right! To  initiate  a  restful  sleep  we  need  to  encourage  foods  that  support  sleep-inducing  neurotransmitters  such  as  serotonin  and  melatonin.  Traditionally  these  are  foods  rich  in  tryptophan  and  B  complex  vitamins.  Growth  hormones  are  also  released when  we sleep  and these are essential for not only growth but also healing and repair.

August 21, 2014
Paarl Dietitians

My life as a Dietitian but a MOTHER to a fussy eater

Thrown away yet another plate of your child’s food? OR is he/she refusing to eat anything else than french fries for the last two days – if anything at all? Have you gone from begging, to nagging to screaming just to get in one bite of veggies? Well, JOIN THE CLUB! I am a dietitian (yes dietitians too can have children with eating troubles) and a mother of a 4 and 2 year old. My 4 year old daughter has been introduced to every possible fruit and vegetable as a baby and ate it all – from potatoes to leeks and peppers!! But once the terrible two’s hit she started refusing all her favourite healthy foods and everything on top of that. She would not even taste something new. If she could eat mini cheddars for a month she would and will NOT get tired of it. I wanted to pull the hair out of my head and became worried that she’ll develop nutritional deficiencies. I simply started implementing my knowledge as dietitian and it really worked – we are making great progression and every week she started to taste something new and the next week she will eat it – like it’s just another French fry… As parent we make a common mistake and assume kids won’t eat or like certain foods and there is a perception that kids like chicken nuggets, fries and sandwiches and we are hesitant to introduce foods we fear they won’t eat. Our attitude towards food are just as important as the foods we offer. I want to share a few tips which really worked for me: DO NOT make separate food for your child – I cannot stress this enough..If he doesn’t want to eat the food you prepared for him..whatever you do..DO NOT give in to temptation and give something else!! Children are master manipulators and food is one of the mayor ways to manipulate parents. This you should keep on implementing, but it worked like a charm Eat at least one meal together as a family – monkey see..monkey do! Let them help in food preparation – it helps them to learn about certain foods and get familiar with it. Give small portion and praise your child for eating…even if it is just a bite. Don’t give anything else than water in the hour before meals, this will ensure your child is hungry Minimize distraction – try and avoid watching television while eating Whatever you do try to not bribe with dessert or don’t use food as a reward. He will start to think of sweets as good and veggies as nasty. Try and organise to eat with friends whose children eat well – good examples work well, but do not give too much attention NEVER force a child to eat. If he rejects the food, stay calm, remove the plate, keep it in the microwave and when he complains he is hungry later on, offer the same food Be patient. Some children are slow eater Remember … kids eat with their eyes. So if you have to make a flower with cucumber and tomatoes or a sun with oranges, just do it, because the last thing you want is a teenager who still needs to have the crusts cut off of the bread and eats nothing but starch and meat!! Keep introducing a new food with every meal. It takes 10-15 times for your toddler to see a new food before he/she will try it Remember children’s tastes changes, so one day he’ll hate something, next month he will love it, so KEEP CALM … and KEEP COOKING !

July 24, 2014
Lynne Brown

Diet & Delinquency – A Connection?

We are all aware that “we are what we eat”, however our knowledge is usually limited to the fact that the wrong foods could cause heart attacks, obesity and compromise our immune systems but the idea that they can also affect our minds, even our behaviour is less known. However Patrick Holford in his book “Food is better medicine than drugs” says: “…children and adults with ADHD often have one or more nutritional imbalances that, once identified and corrected, can dramatically improve their energy, focus, concentration and behaviour” and “The combination of the right vitamins, minerals and essential fats can truly transform children with learning and behavioural difficulties.” He quotes the following four nutritional solutions that have been well proven to make a difference: Sugar-free and low GL diets Essential fats especially Omega-3s Vitamins and minerals Allergy-free and additive-free diets Go sugar-free There are a number of possible causes of ADHD but the most common is blood sugar problems. Sugar is rocket fuel to an ADHD child so you can expect him to get out of control. Dietary studies consistently reveal that hyperactive children tend to eat more sugar than other children and while going from sugary drinks to sugary snacks throughout the day, some of these kids consume 50 teaspoons of sugar in a day. Yes, for proper brain function he does need a constant supply of glucose to his brain but this is best achieved by controlling insulin levels. Do this by ensuring your child has protein and carbohydrate at every meal and snack, e.g. fruit and nuts or rice and fish. Eliminate sugars and refined carbohydrates such as white bread and white rice from his diet and replace with complex carbohydrates such as brown rice, rolled oats, lentils and barley. Also replace fizzy drinks and fruit juices with clean water. Essential Fats Children diagnosed with ADHD often show symptoms of essential fatty acid deficiency, such as excessive thirst, dry skin, eczema and asthma. Omega-3s are found in oily fish such as sardines, salmon and mackerel but most ADHD children will also need to take fish oil capsules daily, containing at least 200 mg EPA and 100 mg DHA. Flax, sunflower and pumpkin seeds are good sources of omega 6 and 9 and should be added to food or used as snacks every day. Pumpkin seeds are also high in magnesium which is calming. Use only olive oil in cooking and salads. Vitamins and Minerals It is well documented that academic performance improves and behavioural problems diminish significantly when children are given nutritional supplements. A whole green food supplement, such as the dried juice of barley grass, would be best here since it is easily digested and contains enzymes, vitamins and minerals that work together synergistically. Nature knows best! ADHD sufferers are commonly deficient in two minerals in particular, namely magnesium and zinc. Identify food sensitivities One study showed that ADHD children turned out to be seven times more likely to have food allergies than other children, the most common being dairy products and wheat. A very high percentage of ADHD children react to food colourants and flavourings, MSG, dairy, chocolate or oranges. Other problematic foods are corn, yeasts, soya, peanuts and eggs. If your ADHD child also exhibits some of the following symptoms of nasal problems and excessive mucus, ear infections, facial swelling, tonsillitis, digestive problems, bad breath, bedwetting, then a food allergy test is worth doing. Otherwise avoid all processed foods and treat your child to natural, wholesome food that you have prepared yourself! A treatable disorder Though it may take trial and error to find out what works for your child, it is well worth the effort. Effective treatment will allow individuals to realize their abilities and intelligence, making huge differences in their self-esteem and capacity to function in the world.

July 18, 2014
Parenting Hub

Raising a Food Smart Kid

I often find myself reminding parents that children learn to eat much in the same way that they learn to walk, talk, read and write.  It is with encouragement and by example that children learn and this applies to healthy eating habits as well. Children will experience hunger and through a process of introducing solids to complement a once milk only diet, children learn to chew and swallow with relative ease. Making healthy food choices is not, however a natural instinct.  When given a choice, most young children would choose the least healthy option. The responsibility of maintaining a nutritionally sound diet, therefore, remains the responsibility of the parent. While you cannot expect children to be responsible for their food choices, you can certainly teach them how to eat healthily by ensuring that you: 1. Provide a variety of healthy foods at meal times. This might seem fairly obvious but by presenting a healthy, well balanced plate of food, you are teaching without words. Children cannot be expected to choose healthy foods without exposure from an early age. 2. Eat as many meals as possible together as a family. Meal times should be a positive experience as they are a great opportunity to promote a healthy relationship with food.  Shared meals are also a perfect opportunity to set an example as parents. 3. Set the example for healthy eating. If you do not eat something, you cannot expect your children to eat it.  At the same time, eliminating foods from your children’s diet based on parental preferences is not advisable.  Each different food offers a different benefit and it is therefore important to present your children with the opportunity to eat a varied diet. If you are not willing to compromise on occasion, creativity will be essential. Use the lunch box if necessary. 4. The option to make a healthy choice must always be available. Even if your children do not like vegetables, make them and serve them. It is best to pair one liked vegetable with a not-so-liked vegetable (just 1/2 a cup will do). Do not force your children to eat it but do not allow them to dictate what is served. Then be sure to eat that vegetable off your own plate. 5. Educate your children in fun and creative ways. Do not leave the responsibly of nutrition education and creating healthy eating habits to your child’s school teachers. While lessons on healthy eating might be covered, they cannot be revisited sufficiently nor can they have value without the daily practice of healthy eating. Growing vegetables with your children can increase their interest and the likelihood of consumption. It need not be a very big garden, Start with green beans, cherry tomatoes or spinach. Nurturing vegetables will nurture responsibility. Involve your children in shopping and food preparation with age appropriate activities. Weighing the fruit and vegetables is a task you can delegate to children from a fairly young age. Chopping veggies or setting the table are subtle ways of encouraging the intake of healthy foods and introducing children to the responsibility that good nutrition requires. Involve your children in weekly menu planning and within reason, allow them to the choose meals they would like to eat but you must have the final say and be sure to include the vegetables they may intend to avoid.  Planning a weekly menu can encourage variety and open the door for discussions about food and healthy eating, outside of meal times. 6. Do not make a fuss of your child’s eating habits. As mentioned above, positive, relaxing meal times are very important and I really cannot stress enough just how vital it is not to create issues surrounding food. Children will not starve themselves easily but if you allow them to use food to manipulate you, they will not hesitate. As I said, the responsibility lies with the parents and this includes control. Do not force a child to finish their food or punish them for not doing so. Never use treat foods as a punishment or reward. Making the effort to help your children develop healthy eating habits from the get go and subtly encouraging them to make healthy choices will reap untold rewards.

April 10, 2014
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