Author: Diabetes Focus eMag

When food stands still

Posted on by
Share

Dr Angela Murphy shares one of her patient’s stories to explain the connection between diabetes and gastroparesis.

Ms DL is a 28-year-old lady, who was diagnosed with Type 1 diabetes at the age of 15. She had poor control from the start due to not being able to accept the diagnosis. She was admitted regularly with diabetic ketoacidosis, with extreme dehydration. During these episodes, she would go into renal failure. Closer questioning revealed that symptoms would begin with nausea and vomiting. She had been experiencing bloating after meals for over a year.   A gastric emptying study was done, which showed significant gastroparesis.

What is gastroparesis?

It is a condition where the stomach does not empty properly, resulting in food not moving into the small intestine. Normally, the muscles of the entire gastrointestinal tract contract and release rhythmically to move food along, which is necessary for the digestive process. This muscle action is controlled by the vagus nerve. However, damage to the vagus nerve results in weaker, poorly contracting muscles and slows the movement of food out of the stomach.

Causes

Unfortunately, there are many causes – it can occur as a complication of surgery to the gastrointestinal tract; as part of neurological disorders; infective and inflammatory conditions; or in underactive thyroid disease. Over a third of cases are due to diabetes, and in some cases no specific cause can be found.

Poorly controlled diabetes can result in damage to the vagus nerve, and is the most common known cause of gastroparesis. Patients classically present with stomach pain, bloating, indigestion, nausea and vomiting. In an insulin-dependent diabetic patient, vomiting will lead to ketones, and the presentation may look like an episode of ketoacidosis. In addition, patients may have documented reflux disease or irritable bowel syndrome (IBS), and the symptoms may be attributed to these conditions. A careful examination and history is needed to work out the sequence of events.

Diagnostic tests

Ms DL had a variety of tests to diagnose her problem, such as:

  • Upper gastrointestinal gastroscopy is performed by either a gastroenterologist or a surgeon, and can be carried out as an outpatient. The patient fasts for six hours, then a flexible camera is used to look inside the oesophagus, stomach and the duodenum (the first part of the small intestine).
  • Barium meal and follow-through is when a patient must fast for eight hours and then drinks barium – a chalky type liquid – that is used as the contrast agent. A series of X-rays are then taken. Barium lines the gastrointestinal tract so will show any obstruction, such as food in the stomach, quite clearly on the X-ray.
  • Ultrasound allows the radiologist to exclude any disease of the gallbladder or pancreas.
  • Gastric emptying scintigraphy is usually the gold standard for diagnosis. The patient fasts from the night before and is then required to eat a bland meal which is radiolabelled with technetium. A camera then scans the abdomen to follow the progress of the radiolabelled food hourly for four hours after a meal. If more than 10% of the meal is in the stomach after four hours, the diagnosis of gastroparesis is made.

Treatment

Ms DL was started on domperidone (prokinetics) and erythromycin (antibiotic). After 10 months, the episodes returned despite medical treatment. She then had a gastric pacemaker inserted, which only seemed to give benefit for six months. Ms DL recently spent weeks in hospital being treated with anti-nausea medication and intravenous fluids. Unfortunately, there was no way to improve the result with the pacemaker so she was given the option of Botox injections; however, the relief in symptoms after this was very short. After almost two years of suffering, Ms DL underwent a sleeve gastrectomy. (See medical explanations below).

  • Prokinetics are drugs that improve the contraction of the stomach muscles, and move food through to the small intestine more effectively.
    • Metoclopromide is the active ingredient in Maxalon and Clopamom. This should be taken 20-30 minutes before meals. It helps reduce nausea and vomiting. Although it is approved for gastroparesis, it may have side effects, such as tardive dyskinesia – a movement disorder which causes shaking.
    • Domperidone
  • Erythromycin is an antibiotic. When it is prescribed chronically at low doses, it improves stomach muscle contractions. Unfortunately, it can also cause nausea and stomach cramps which limits its use in the gastroparesis patient.
  • Anti-emetics are anti-nausea drugs.
    • Prochlorperazine (Stemetil) is useful when the patient is acutely ill, however, it has even more side effects with chronic use than metoclopramide.
  • Antipsychotic drugs
    • Chlorpromazine (Largactil) has frequently been used in patients with severe, persistent hiccups. Its actions on muscle have also worked in the patient with gastroparesis with some degree of success.
  • Botulinum toxin is used when a gastroenterologist injects Botox directly into the pylorus (the valve between the stomach and duodenum involved in the rate of gastric emptying) using an endoscope. This relaxes the valve, keeping it open for longer periods allowing food to pass through. The results of Botox are quite variable; some patients have relief of their symptoms for months, while others find no improvement.
  • Gastric pacemaker is a neurostimulator device which can be surgically implanted. This is normally done in patients with symptoms not responding to medication and diet changes. The battery-operated device has electrodes that are inserted into the stomach muscle wall. This then sends signals at regular intervals to stimulate the stomach muscle.   Studies have found that sending pulses that have a higher frequency than normal gastric contraction improves nausea and vomiting more effectively. However, more work needs to be done to refine this treatment for patients.
  • Jejenostomy is a feeding tube which is placed through the abdominal wall directly into the jejunum (the second section of the small intestine). Special, balanced liquid food can then be given to the patient. It is commonly used in a malnourished, dehydrated patient.
  • Surgery
    • Sleeve gastrectomy is a near total gastrectomy performed via keyhole surgery.
    • Roux-en-Y gastric bypass is when a small pouch is made from the top of the stomach and is attached to a loop of jejunum.

In both these surgeries, by removing most of the functional stomach it is possible to relieve symptoms of nausea and vomiting. Patients must be well-prepared, even though the dietary changes required are essentially the same as they should be following: small regular meals (see info on diet below).

Surgery is the treatment of last resort, but in my patient, this was life-changing. In the months post-surgery, she has had fewer and fewer episodes of vomiting. Generally, her symptoms have declined and her quality of life has improved incredibly.

Diet

There are several useful measures patients can take to improve symptoms:

  • Eat six small meals a day; this gives the stomach a chance to empty.
  • Limit the amount of fatty foods.
  • Limit fibre as it also takes longer to digest.
  • Eat in an upright position.
  • Avoid late evening meals.
  • Avoid carbonated drinks.
  • If the patient is very symptomatic then a liquid diet is the best choice until improvement.

Gastroparesis and diabetes

There is no doubt a vicious cycle exists when diabetes and gastroparesis occur together; high blood glucose directly slows down gastric emptying. Poor diabetes control for more than 10 years increases the risk of damage to the autonomic nervous system. The autonomic nerves control the automatic functions of the body, such as heart beat, blood pressure and gastric emptying.   The erratic emptying of food into the small intestine makes timing of insulin doses very difficult, and patients often swing from high to low blood glucose levels. It may be necessary to change the insulin regimen to get better control, and frequent blood glucose testing is vital.

Gastroparesis severely impacts a patient’s quality of life. Most patients with gastroparesis will respond to dietary changes, prokinetics and erythromycin.   However, for those that don’t, it is important to pursue more invasive treatment until relief of symptoms is achieved.

MEET OUR EXPERT - Dr Angela Murphy

Dr Angela Murphy is a specialist physician working in the field of Diabetes and Endocrinology in Boksburg. She is part of the Netcare Sunward Park Bariatric Centre of Excellence and has a busy diabetes practice.

Are we only knocking on social media doors?

Posted on by
Share

When last did you call a friend or have a friend call you? Or are your relationships dependent on digital technology?

It is tough to experience the heart-wrenching loneliness in a connected world. The sad reality is that many people are experiencing loneliness while they are seemingly having so much fun in the social media world.

When we experience hard times, it can become apparent that people don’t visit. Yes, they check-in via Facebook, WhatsApp, and the rest of the myriad of social media applications, either by sharing inspirational messages, jokes or virtual hugs to brighten your day. However, deep down we all long for someone to knock on our front door. Someone who has taken the time to see if what you’re posting online is the reality at home. Someone who cares enough to put their busy schedule aside to look you in the eyes and find out how you’re really doing.

This is the friend who wouldn’t mind that you’re still in your pyjamas, even though it’s early afternoon. This is the friend who understands that the selfie you posted earlier today, doesn’t really reflect what you actually look like at present, because you just didn’t have the strength to get dressed. This is the friend who not only wants to reach out to you, but who needs you too. Remember, while your life changes, friends and family do their utmost best to support you and adjust, but they might not know how to.

We, as a society, give so many  detailed updates about what we are going through, where we are, what we are eating, how we feel, and what we’re experiencing that friends start thinking that they don’t need to call to find out how we are doing, as they already know thanks to social media – they have ‘checked-in’ via Facebook by clicking  on the ‘Like’ button.

The reality is while one person is fighting a physical health battle, someone else is struggling through depression. Another person is experiencing the loss of a loved one, while another is dealing with the heartache of a friend who has been diagnosed with a life-threatening disease. The point is we all need each other! And, don’t forget about the friend who has finally hit their ‘lucky break’ after three years of hard work and perseverance. Friends also need us to celebrate with them.

When I was a little girl, I remember watching my mom as she was having a phone conversation. It was so different from the mobile device conversations my son observes me having. She would hold the phone, while sitting still next to the receiver, which was connected to the source. She was attentive, really involved and so focused on the conversation. She memorised phone numbers and had a handwritten phonebook. Having a telephone conversation was an occasion to look forward to and a moment to connect.

These days, we rarely call. We depend on social media and electronic messages to keep our relationships alive. We take phone calls while driving or cooking dinner, with the phone clinched between a squashed cheek and stressed out shoulder. 

Are we having quality conversations? 

Are we aware of the tone of voice, the heavy pauses and real intention of the call? 

Having a long list of Facebook ‘friends’, hundreds of WhatsApp messages and Instagram followers may create the sense that we matter, that we belong, and that we’re needed and cared for. Yet, the feeling of loneliness doesn’t go away, no matter how many messages we receive.

The digital knock on the door just cannot feed this hunger. We all long for a real personal connection and a voice that shares empathy and compassion. Better yet, we crave eye contact and a hug from a human being. The increase in compassion deficit syndrome, especially amongst the youth, is alarming. We have to be aware of this side effect of an overdose of social media and being bombarded with messages from all platforms.

Digital communication does offer various benefits, and it certainly has made positive impacts on many levels. That said, it seems that it is quite difficult to keep a balance and to  guard against the fear of missing out (FOMO).

We’re expected to be available every minute of the day, however, perhaps it’s time to put on a new pair of glasses to get a better perspective, and to nurture those relationships that matter.

All we are actually doing is going back to basics. It will take some effort, time and, possibly, cost you money to enjoy that coffee together or to make the phone call. However, when it comes to extraordinary relationships, the ones that fulfill your needs and purpose, the value far outweighs the investment you make – bit by bit.

How to stay connected by disconnecting:

  • Call people on their birthdays. You can still wish them blessings on their Facebook profiles, however, they’ll appreciate hearing your voice, and, if possible, seeing you on their special day. 
  • If friends are going through difficult times, call them with the intention to listen or, better yet, go visit. You then can share motivational cell phone messages as extra encouragement once you have better context. 
  • When a friend is experiencing trauma, it can be hard to find the right words to say. In fact, most of the time, we really have to be very careful with the words we use, because even though it is meant well, it could hurt. How about a visit? Yes, actually going to your friend’s house and knocking on the door. Then just sit with them, be there in the stillness by lending your ears and hugs as they process what they’re going through in the safety of your comfort.
  • Schedule face-to-face visits ahead of time (even if it’s once every three months) to ensure it happens and you don’t get to the end of the year, wishing you had a chance to share time together.
  • Be there for each other. A message is not going to help feed your friend’s family if she has just had surgery and can’t prepare dinner. She’ll appreciate it if you run to the shops for her or bring over a cooked meal.
  • Ask for help. By dropping the ‘all is ok’ mask and asking for help, you can receive blessings and solutions. If you prefer to act the role of the perfect Pinterest woman with everything balanced and perfect, you might have to cry alone, and miss the opportunity to learn from others who have gone through the same dark valley. 
  • Accept help from friends. It might be their love language and a way for them to support you. If you don’t accept the help offered, you could be rejecting the blessing sent to you, and miss the opportunity to allow a friend to be there for you in a tangible way.
  • Oh, and those wonderful unexpected calls. Is it not lovely when a friend calls just say hello and reminds you that he/she cares? Take a moment every day to call a friend and thank them for their friendship, and remind them how magnificent they are. 
  • Time to collect mail from your postbox. Can you imagine the surprise and joy when you receive a handwritten letter from a friend? The time that is used to put pen to paper shows that you treasure that extraordinary friend even more.

MEET OUR EXPERT - Rianette Leibowitz

Rianette Leibowitz (@Rianette) is a cyber safety activist for SaveTNet Cyber Safety (@SaveTNet), which aims to save lives by creating awareness of responsible online engagement. Her upcoming book Not For Sale – Relationships of Influence talks about the power of extraordinary relationships of influence.
Rianette Leibowitz (@Rianette) is a cyber safety activist for SaveTNet Cyber Safety (@SaveTNet), which aims to save lives by creating awareness of responsible online engagement. Her upcoming book Not For Sale – Relationships of Influence talks about the power of extraordinary relationships of influence.

Agents for Change by Noy Pullen

Posted on by
Share

African traditional medicine and Western medicine:

how, when and where can we meet?

The significance of the traditional healer in contemporary society

The World Health Organisation (WHO) estimates that 80% of people in Africa regularly consult traditional healers, and advocates incorporating safe and effective traditional medicine into primary healthcare systems1.

South Africa was one of the first countries to recognise the significance of collaboration. In 2005, parliament approved a law to recognise the country’s estimated 200 000 healers as healthcare providers in an attempt to bring traditional healers into a legal framework2. Recent meetings, held in Pretoria, have strengthened relationships and possibilities for collaboration between the Department of Health and the recognised traditional medicine organisations.

Credo Mutwa – renowned Zulu sangoma and author – experienced both Western Christianity and traditional African folklore as a child. In his view, traditional and modern medicine both serve the well-being of their patients and contribute to a healthy community. However, traditional healing encompasses body, spirit, the personality and ancestors of a patient, and the prescription of traditional medicine, whereas the formal health sector tends to focus on specific symptoms, treating the disease rather than the individual situation3.

Dr Velaphi Mkhize, an initiate regarded as an authority on African traditions, culture, ancestral wisdom and African healing, pleads for recognition of both disciplines in his comprehensive article: ‘Africa’s two worlds of healing: their challenges’. As the origin of both is Ancient Egypt, Western medicine should acknowledge the African uniqueness of being able to heal both the physical body and the soul, which allopathic medicine does not claim to do. Some conditions cannot be cured by Western medicine and others cannot be cured by African medicine so the two systems need each other in service of all South Africans. He posed the question: How can we marry the two for the betterment of our communities and for humanity?4

Can training in diabetes management emulate the success of the HIV/AIDS model in KwaZulu-Natal?

The South Africa prevalence (> 7%), increasing and risk factors (BMI, obesity and cholesterol levels) for diabetes make a case for urgent intervention and cooperation of health practitioners in all our communities5. Dr James Hartzell, a professor at South Africa’s University of KwaZulu/Natal medical school, initiated a project to improve collaboration between doctors and 350 healers trained in caring for people with HIV/AIDS.

In his experience, people take their traditional healers seriously, and when the healers are willing to be trained, they recognise symptoms and refer to the health facilities. When referring patients to the clinics, they wish to be regarded as part of the team. According to Dr Hartzell, “They are just asking for at least basic information back from the biomedical team, which is often hostile to them, such as what were patients given in terms of treatment.”

The training of 350 healers included prevention, voluntary counselling and testing, home-based care and antiretroviral therapy. The healers are empowered to make an impact on patient compliance and management when there is collaboration with the biomedical team. Traditional healers can assist with advice on good nutrition, lifestyle changes, a positive attitude, and many good herbal remedies strengthen the immune system6. Together with the formal healthcare sector, they could ensure improvement in diabetes awareness, prevention and management.

Why are they sidelined?

For the most part, healers, according to Itai Madamombe, a United Nations staffer, are not officially recognised by governments. Not including them in the formal structures could have serious consequences. Patients, putting their trust in the healer, may disregard their medical doctor’s advice or take herbal medicines without regard for possible dangerous interactions with pharmaceuticals. By working with these healers, doctors would find colleagues in the patient’s own community7.

Collaboration with all stakeholders

As an outreach project of Diabetes South Africa (DSA) – Agents for Change – seeks to empower all those living with (i.e. patients and families) and working with (i.e. health providers) diabetes-related conditions with knowledge and skills, so they can collaborate as a team.

Traditional doctor and community leader, Joseph Makhubu, recently heard about the project and, with great enthusiasm, booked 30 traditional healers and invited us to Duduza Township in Ekurhuleni to offer the first module of the Agents for Change training. This module focuses on the pathophysiology of diabetes, signs and symptoms, risk factors, and the significance of lifestyle changes of the participants themselves.

He explained that the formal health sector has shown continued interest in the role of sangomas and the efficacy of their herbal remedies. Some of which are being researched include buchu, aloe and Sutherlandia frutescens. On the other hand, traditional healers were most willing to be a part of the diabetes team and to learn more about diabetes and how the two disciplines can collaborate for the benefit and health in the communities.

Dr Henning Morr – a medical doctor supporting departmental programmes, training and research, including community health and community development – works with traditional doctor Joseph Makhubu. Their research found that traditional healers empowered with basic medical knowledge feel safer in their decisions and have more patients. ‘Co-educational’ training is requested, role plays, dialogues, not aiming at shifting traditional healers to the modern system, but rather to understand and find ways of collaboration8.

A role play between Dr Ethel Ndlovo Phillips and traditional doctor Joseph Makhubu during the Agents for Change project.

A role play between Dr Ethel Ndlovo Phillips and traditional doctor Joseph Makhubu during the Agents for Change project.

How, when and where can we meet?  

In the South African medical Journal, J P de V van Niekerk, posed the question: how is it possible for such a diverse and often conflicting range of systems and views to be accommodated sensibly, peacefully and to the benefit of South Africa’s people? He concludes in his editorial, that establishing a council for traditional healers could face insurmountable problems. However, acceptance and respect for their respective domains of truth has enabled health professionals to collaborate successfully with traditional healers to address some of South Africa’s major health challenges9.

References:

  1. Traditional healers boost primary health care – Reaching patients missed by modern medicine Itai Madamombe <http://www.un.org/africarenewal/taxonomy/term/290> : Africa Renewal: January 2006 <http://www.un.org/africarenewal/taxonomy/term/322>  www.un.org/…/traditional-healers-boost-primary-health-care
  2. Ibid
  3. http://credomutwa.com/books/zulu-shaman/
  4. http://soaha.org.za/wpp/africas-two-worlds-of-healing-their-challenges
  5. http://www.idf.org/membership/afr/south-Africa
  6. http://soaha.org.za/wpp/africas-two-worlds-of-healing-their-challenges  (Footnote 1)
  7. Ibid
  8. 2010: Morr H., Makhubu, J., McKay V.: “Primary health care and traditional health practitioners (THP): lessons learned from a comprehensive health and life skills pilot project in Duduza, South Africa” Oral presentation, Traditional Medicine Conference, Durban, July 2010.
  9. South African Medical Journal March 2012, Vol. 102, No. 3 SAMJ editorial www.samj.org.za/index.php/samj/issue/view/123/showToc

Agents for Change is sponsored by:

Healthy eating – a family affair

Posted on by
Share

A healthy meal plan isn’t just for people with diabetes. In fact, the dietary guidelines recommended for people with diabetes are the same as those recommended for the rest of the population. That means your family doesn’t need to prepare separate meals for you at home – they can simply adopt your healthy habits. Follow these 10 tips to build a balanced and healthy meal plan for your whole family.

  1. Enjoy a variety of foods.

Not one food can deliver all the necessary nutrients for you and your family, so you should make sure that your family eats different types of food.

  1. Make starchy foods part of most meals.

A small portion of good quality carbohydrates helps to give the body energy. Choose high-fibre starchy foods – like high-fibre breakfast cereals, whole grain bread and wholewheat pasta – over more refined versions for sustained energy to help your family through the work or school day.

  1. Eat dried beans, split peas, lentils and soya regularly.

Beans and legumes are good sources of protein, fibre and B vitamins, and they also help to improve blood glucose control. Aim to include beans and legumes in your family’s menu at least twice a week.

  1. Eat plenty of vegetables and fruit every day.

Vegetables and fruit contain loads of different nutrients, like fibre, vitamins and minerals. Your family should eat at least five portions of vegetables and fruit daily to make sure they get a variety of nutrients needed for health.

  1. Have milk, maas or yoghurt every day.

Encourage your family to enjoy at least three servings of dairy foods per day to ensure they develop strong, healthy teeth and bones. Aim to choose versions with less added sugar where possible.

  1. Drink lots of clean safe water.

Water is the best way for your family to stay hydrated and should be their first choice when choosing a beverage. It is the cheapest yet best drink of all. Start your children on water when they are young and it will remain a good habit for the rest of their lives.

  1. Use salt and food high in salt sparingly.

Eating too much salt increases your risk of high blood pressure (hypertension) and health conditions in the long term. Let your family enjoy the natural taste of foods by not adding salt to meals and avoiding salty ingredients in your cooking, such as stock cubes and soup powders.

  1. Use sugar and food and drinks high in sugar sparingly.

Limit foods with added sugar, like cookies, sweets, chocolates and sugar-sweetened drinks. Keep sugary foods as ‘special occasion’ treats, and practice portion control when you do enjoy them.

  1. Fish, chicken, lean meat and eggs can be eaten daily.

Protein helps to provide the body with strength and structure, while repairing damage and promoting growth. Including protein in your meals also helps to improve blood glucose control. Oily fish is also a great source of omega-3 fatty acids which helps to protect against heart disease.

  1. Choose good quality fats.

Beware of eating excess saturated and trans fats. When you and your family use fats, choose unsaturated sources like olive and canola oil, oily fish, tub margarines, avocado, peanut butter and nuts.

Pick n Pay Health Hotline

Did you know that Pick n Pay employs a registered dietitian to provide free food and nutrition-related advice to the public? Whether looking for guidelines on managing your condition, weight loss tips, healthy eating tips for kids, how to manage food allergies, how to interpret food labels or any other food-related query you have always wanted answered, our registered dietitian is just a phone call away.

Contact the Pick n Pay Health Hotline on 0800 11 22 88 or email healthhotline@pnp.co.za to start your nutrition conversation.

Click here for delicious recipes

MEET OUR EXPERT - Leanne Kiezer

Registered Dietitian BSc Diet, PgD Diet UKZN, MSc Nutrition NWU. Leanne joined Pick n Pay as the resident dietitian in May 2014. She is the voice behind the Pick n Pay Health Hotline, providing advice to customers on a range of nutrition and health-related topics. She also provides nutrition input as part of the Pick n Pay food development team, and ensures that all communication is in line with the most recent advances in nutrition science and research.

Recipes by Pick n Pay

Posted on by
Share

Logo PNP.jpeg

People with diabetes can still enjoy pasta! Just remember to choose the whole wheat, higher fibre version, and keep your pasta servings controlled, eating no more than one cup of pasta at a meal.

These pasta dishes, as cooked by Justine Drake on Just Cooking, bring you healthy, heart-warming and easy-to-prepare meal solutions as things begin to cool down towards autumn – brought to you by Pick n Pay! See more of what Justine and the Fresh Living team have been preparing by visiting www.picknpay.co.za

Ingredients

  • 300g whole wheat fusilli, cooked and cooled
  • 4 baby marrows, sliced lengthways and chargrilled
  • 1 red pepper, chargrilled, peeled and sliced
  • 250ml leftover chicken, shredded
  • 500ml baby spinach

Hummus dressing

  • 125ml plain low-fat yoghurt
  • 60ml hummus
  • 60ml freshly squeezed lemon juice
  • 5ml ground cumin
  • 5ml ground coriander
  • 1 dash milled pepper

Method

  • Toss salad ingredients together.
  • Whisk dressing ingredients together, pour over salad and mix well.

Ingredients

  • 500g whole wheat spaghetti
  • 400g pilchards in tomato sauce
  • 1 glug olive oil
  • 4 garlic cloves, sliced
  • 1 pinch dried chilli flakes
  • 1 handful Calamata olives, pitted
  • 30ml capers
  • 1 handful flat-leaf or curly parsley, chopped
  • 1 dash salt and milled pepper
  • 1 squeeze lemon juice

Method

  • Cook the spaghetti according to the packet instructions.
  • Drain the pilchards, reserving the sauce.
  • Break the pilchards into chunks.
  • Heat the oil and fry the garlic and chilli flakes until fragrant.
  • Add the reserved tomato sauce and heat. Add a splash of water if needed.
  • Stir in the pilchards, olives and capers and cook for a minute or two.
  • Add the parsley, and gently toss the mixture through the cooked spaghetti.
  • Season and drizzle with a little lemon juice.

Ingredients

  • 1 glug olive oil
  • 1 bunch spring onions
  • 1 garlic clove
  • 2 x 170g cans tuna in brine, drained
  • Finely sliced peel of ½ fresh lemon
  • 1 fresh lemon, juiced
  • 125ml chicken or vegetable stock
  • 1 cup cherry tomatoes (optional)
  • 80g rocket leaves
  • 1 handful basil
  • 1 handful fresh parsley
  • 1 dash salt and milled pepper
  • 500g whole wheat spaghetti, cooked

Method

  • Heat the olive oil.
  • Fry the spring onions and garlic for a second or two.
  • Add the tuna and lemon and stir-fry for two minutes.
  • Add the stock and tomatoes and cook for a minute.
  • Add all the herbs and season.
  • Toss into the hot spaghetti.

Great things to add:

Shaved baby marrows, fresh chilli, broccoli florets, olives and/or capers.

Spicy Tomato and Brinjal Penne

Tomatoes are a great source of the antioxidant lycopene. Serves 4

Ingredients

  • 1 packet of whole wheat penne
  • 1Tbsp. olive oil
  • 1 red onion, chopped
  • 2 cloves of garlic, chopped
  • 2 medium-sized brinjals, sliced
  • 3ml dried chilli flakes
  • 1 can of tinned tomato
  • 250g cherry tomatoes
  • 45ml tomato paste
  • 80g reduced-fat feta

Method

  • Cook the pasta according to packet instructions. Drain and set aside.
  • Heat that oil in a pan and fry the onion until soft.
  • Add the garlic and fry for another minute.
  • Add the brinjal, and sauté for a further 10 minutes.
  • Add the chilli, tinned tomato, cherry tomatoes and tomato paste, and simmer covered over a low heat for 10 minutes.
  • Dollop sauce over the pasta and serve sprinkled with feta.

Shopping List

The ingredients referred to in the recipes above are available from Pick n Pay:

Vegetables
Baby marrows
Red pepper
Baby spinach
Spring onion
Tinned tomato
Brinjal
Cherry tomatoes
Red onion

Condiments
Chicken or vegetable stock
Tomato paste

Fruit
Lemon

Protein
Chicken breasts
Plain low-fat yoghurt
Pilchards in tomato sauce
Tuna in brine
Fat-reduced feta

Starch
Whole wheat fusilli
Whole wheat spaghetti
Whole wheat penne

Fats and oils
Hummus
Olive oil
Calamata olives

Herbs and spices
Ground cumin
Ground coriander
Milled pepper
Fresh garlic
Dried chilli flakes
Salt
Fresh parsley
Rocket
Basil

Other
Capers

Logo PNP.jpeg

Pick n Pay is committed to promoting health and wellbeing among South Africans, and employs the services of a registered dietitian to provide food and nutrition-related advice to the public. For all your nutrition and health-related queries, email healthhotline@pnp.co.za or call 0800 11 22 88. 

Is butter healthy?

Share

If you have diabetes, you have an increased risk of developing cardiovascular disease. To reduce this risk, it is essential that you optimise your nutrition as part of a healthy lifestyle. Trying to understand the effects of dietary fats on your heart and health is not easy, and it still remains a topic of confusion and, in some instances, fierce debate. Read more…

Watermelon gazpacho

Posted on by
Share

Fabulously refreshing for those hot summer days.  Serves 4

Ingredients

  • 4 cups watermelon, seeded and cut into chunks
  • 1 packet ground almonds
  • 60 ml red wine vinegar
  • 1 clove garlic, crushed
  • 1 red chilli, seeded and finely chopped
  • 1 red onion, finely diced
  • 1 small red pepper, seeded and finely diced
  • ½ cucumber, finely diced
  • 1/3 cup fresh coriander, chopped
  • 1 pinch salt
  • 1 pinch of black pepper
  • 1 dash of olive oil

METHOD

  1. Purée watermelon in a food processor. Add almonds, vinegar, garlic and chilli. Blitz well.
  2. Mix onion, pepper, cucumber, tomato and coriander together.
  3. Set aside ½ cup (125ml) vegetable mixture to serve with gazpacho.
  4. Add remaining mixture to blender and purée until smooth.
  5. Season to taste and refrigerate for at least 1 hour for flavours to develop and for soup to chill.
  6. Serve in small, well chilled glasses with a drizzle of olive oil and a sprinkling of reserved vegetable mixture.
  7. Drizzle dressing over salad and serve.

Pick n Pay is committed to promoting health and wellbeing among South Africans, and employs the services of a registered dietitian to provide food and nutrition-related advice to the public. For all your nutrition and health-related queries, email healthhotline@pnp.co.za or call 0800 11 22 88.

Tutti frutti terrine

Tutti frutti terrine

Posted on by
Share

Serves 4

Ingredients

  • 500 ml sparkling apple juice, at
  • room temperature
  • 60 ml castor sugar or sweetener
  • 20 g powdered gelatine
  • 250 g strawberries, halved
  • 125 g blueberries, halved
  • 125 g gooseberries, halved
  • 4 nectarines, pitted and sliced

METHOD

  1. Place 1 cup (250ml) apple juice into a small saucepan with sugar or sweetener and stir over a low heat until sugar dissolves.
  2. Sprinkle gelatine over a few tablespoons of cold water and allow to soak for a minute, then add to warm juice mixture.
  3. Stir until gelatine has dissolved. Allow mixture to cool, then stir in remaining apple juice.
  4. Grease a loaf tin and pour in 2 cups (500ml) gelatine mixture.
  5. Add some fruit and refrigerate to set.
  6. Arrange remaining fruit in loaf tin and top up with remaining juice mixture. Refrigerate for a few hours or overnight to set.
  7. Unmold by running a hot knife around edges of tin. Turn out onto a serving platter. Top with fruit and serve with low-fat custard or ice cream.

 

Pick n Pay is committed to promoting health and wellbeing among South Africans, and employs the services of a registered dietitian to provide food and nutrition-related advice to the public. For all your nutrition and health-related queries, email healthhotline@pnp.co.za or call 0800 11 22 88.

Grilled tuna steaks pineapple citrus salsa

Grilled tuna steaks with pineapple and citrus salsa

Posted on by
Share

Serves 4

Ingredients

  • 4 tuna steaks, (150 g each)
  • 10 ml olive oil
  • 10 ml fish rub

Salsa

  • 1 pineapple cubed
  • 1 grated lemon peel
  • 2 ruby grapefruits or large oranges, peeled and segmented
  • 125 ml freshly squeezed orange juice
  • 15 grams fresh mint, roughly chopped

METHOD

  1. Heat a griddle pan. Roll tuna steaks in oil.
  2. Season tuna well with fish rub.
  3. Sear for 2 minutes on each side or until cooked to your liking.
  4. Toss together salsa ingredients and serve with the tuna.

Pick n Pay is committed to promoting health and wellbeing among South Africans, and employs the services of a registered dietitian to provide food and nutrition-related advice to the public. For all your nutrition and health-related queries, email healthhotline@pnp.co.za or call 0800 11 22 88.

Seared beef carpaccio wasabi dressing

Seared beef carpaccio with wasabi dressing

Posted on by
Share

Serves 4

Ingredients

  • 400 gram beef fillet
  • 3 Tbs olive oil
  • 1 Tbs sesame oil
  • 1 Tbs grated ginger
  • 45 ml wasabi paste
  • 2 tsp sugar
  • 75 ml lime juice, and grated peel of 5 limes
  • 3 Tbs fresh coriander
  • 2 Tbs fresh mint
  • 1 cup cabbage, finely shredded
  • 250 g mangetout,finely sliced
  • 2 carrots, peeled and shredded
  • 4 bunches spring onions, finely shredded
  • 6 radishes, finely sliced

METHOD

  1. Season fillet.
  2. Heat olive oil in a large saucepan until hot.
  3. Sear fillet for a few minutes on both sides until rare (or about 10 minutes for medium rare).
  4. Remove from pan and set aside to cool.
  5. Blitz sesame oil and remaining olive oil with ginger, wasabi paste, sugar, lime juice and peel, coriander and mint.
  6. Mix three quarters of dressing with cabbage, mangetout, carrots, spring onions and radishes.
  7. Place finely sliced fillet on a bed of salad. Drizzle over dressing, sprinkle with sesame seeds and serve.

Pick n Pay is committed to promoting health and wellbeing among South Africans, and employs the services of a registered dietitian to provide food and nutrition-related advice to the public. For all your nutrition and health-related queries, email healthhotline@pnp.co.za or call 0800 11 22 88.