Category: 2021 Autumn – Diabetes Focus eMag

Shape Facebook Competition Terms and Conditions

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By entering the competition, I hereby agree to the terms and conditions of the Shape Facebook Competition, as stipulated below.

  1. The organiser of this competition is Adcock Ingram Healthcare (Pty) Ltd and/or its designated agencies and is collectively referred to as “the Organisers”.
  2. By entering the competition and/or accepting the prizes, all entrants, winner/s and their companions agree to be bound by the terms and conditions below (“Rules”).
  3. I agree that I do not have any serious underlying medical conditions that may affect my overall health or that may be exacerbated by following a kilojoule-restricted diet or by using an artificial sweetener made of xylitol or saccharin.
  4. The competition commences on 15 March 2021 and ends on 13 April 2021 (“Period”).
  5. To qualify as an entrant in the competition you must be a citizen or a permanent resident of South Africa, currently residing in South Africa, and be 18 years or older at the date on which you enter. The Organisers, their directors, members, partners, employees, agents, consultants and/or any other person who directly or indirectly controls, or is controlled by them, or any supplier of goods and services in connection with the competition and their spouses, life partners, parents, children, siblings, business partners or associates are not eligible to participate in, or enter the competition. No entry is valid until a validation process determined by the Organisers has taken place.
  6. To enter, entrants must Follow the Shape SA Facebook Page, Share the Diabetes SA Shape Post and tag two Facebook friends in the comments section.
  7. One successful entrant will win a Shape product hamper worth R500.
  8. The overall winner will be chosen at the discretion of the Organisers.
  9. The “Prizes” consist of: Shape products to the value of R500.
  10. The winners will be notified by Diabetes SA on 14 April 2021 and their details will be posted on the Diabetes SA Facebook page. If after 7 working days the Organisers have not been able to reach any of the respective prize winners, the unreachable prize winner will forfeit the prize and the Organisers reserves the right to offer the unclaimed prize to a substitute winner selected in accordance with the promotion rules.
  11. The prize is non-transferable in any way.
  12. The decision of the judges is final. No discussion or correspondence will be entered into.
  13. The Organisers do not accept any responsibility for lost, damaged or delayed entries as a result of any network or mobile telephone hardware or software failure of any kind. Proof of sending will not be accepted as proof of receipt. In the event of any dispute the decision of the Organiser is final.
  14. In the event of unforeseen circumstances the Organisers reserve the right to substitute the prize for an alternative prize of equal or greater value. No correspondence will be entered into in this regard.
  15. The Organisers will interpret the rules at their sole discretion.
  16. By entering the competition, all entrants will be deemed to have accepted and be bound by the rules and consent to the use at no consideration of their personal data for the purposes of the administration of this competition and for marketing purposes related to and flowing from this competition. All entry instructions form part of the rules.
  17. The Organisers reserve the right to terminate the competition at any time and for any reason whatsoever, without notice. In such event, all entrants hereby waive any rights, which they may have against the Organisers and acknowledge that they will have no recourse or claim of any nature against the Organisers.
  18. All entrants and winners indemnify the Organisers and its employees and agents against any and all claims for any loss or damages, whether direct, indirect, consequential, or otherwise, arising from any cause whatsoever related to their participation in any way howsoever in this competition.
  19. These Terms and Conditions and any issues or disputes which may arise out of or in connection herewith (whether such disputes or issues are contractual or non-contractual in nature, such as claims in tort, for breach of statute or regulation or otherwise) shall be governed by and construed nature, such as claims in tort, for breach of statute or regulation or otherwise) shall be governed by and construed in accordance with South African law. Entrants hereby irrevocably submit to the exclusive jurisdiction of the South African courts to settle any such dispute or issues.

RA Approval number: 202103011090474

Clenergy

Welcome to Clenergy Kitchen

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The Diabetes Focus team experienced a lunch at Clenergy Kitchen. We give you the low-down on this guilt-free eatery. Plus, Tammy Jardine, shares her perspective as a dietitian and having diabetes.

It’s always pleasurable to go and sit down in a restaurant and socialise with friends while enjoying good food together. Upon entering the clean and simplistic restaurant, we were welcomed by the friendly and charming owner, Abdulla Miya, and his staff.

As you sit down, the array of health foods, supplements and vitamins catch your eye and you know you just must inspect what is on offer in the display after lunch. You are more than likely to walk out having purchased your favourite health snack.

Abdulla shared his vision with us and his passion was apparent and so the excitement built-up to taste the food. It’s clear that this isn’t only about making a profit, but rather this is about offering solutions to consumers who still want to enjoy the treat of eating out but also to know what they are putting in their body won’t aggravate any allergies or health issues.

As we are left to choose our meals from the menu, the start of a wonderful food journey commences. By the end of the meal, our tummies are full and the conversation is all about how good things tasted and the good impression of the overall experience. Plus, we even got to meet the head chef. That is always a bonus!

Left to right: Owner, Abdulla Miya and Head Chef, Andre Brown.

About Clenergy

Clenergy started with an ambitious dream of Abdulla Miya. Since he is insulin resistant, he found it hard to find restaurants that offered meals that would comply with his health concerns. So, he set aside his career of marketing and advertising and after six months, Clenergy Kitchen – guilt-free eatery was opened in November 2019.

What makes Clenergy different?

Clenergy provides customers with a truly safe place to enjoy the pleasures of delicious food without having to compromise their health.

They have set out on a journey to provide guilt-free meals that break the paradigm of what is generally expected of healthy food. Clenergy’s goal is to provide restaurant meals, fast food favourites and decadent desserts that consumers crave, in a much more beneficial way. The Keto and Banting way.

The menu is completely wheat-free, low carb and sugar-free. While all the meals are sugar-free and low carbs. This means that anyone wanting to lose weight or who has diabetes can enjoy all Clenergy meals.

A brand that you can trust

Their healthy food only earns a spot on their menu after it has met the requirement of being decadently delicious. Food is one of life’s greatest pleasures and at Clenergy, they don’t compromise on that at all. But more importantly, the goal is to create a brand that customers can trust.

They guarantee that all their foods are wheat-free, low-carb and sugar-free (no added refined sugar). This means that all meals are Keto and Banting friendly. Standing by these three key values allows customers to lower their sugar intake. How? Refined sugars are found in many foods, desserts, drinks, sauces and condiments, but by taking the sugar out, they reduce your sucrose intake.

However, high carbs, such as wheat, maize, rice, and potatoes, also convert to sugar once inside the body. So, this way they reduce your intake holistically as well. This allows consumers to avoid sugar related ailments without compromising on their food’s taste and while still being able to satisfy their cravings.

What is on offer?

Not only is Clenergy a sit-down restaurant but you can order take aways from the local menu as well as a variety of 24 frozen meals. They also offer various meal plans that can be delivered in Gauteng, Cape Town, Durban and regional areas.

Meal plans offered:

  • Keto
  • Banting
  • Premium Keto/Banting
  • Vegetarian
  • Weight loss
  • Premium weight loss
  • Body Building
  • Diabetic
  • Vegan
  • Juice
  • Custom

To find out more about these meal plans and delivery visit clenergy.co.za

Next step

The vision doesn’t stop here, Abdulla aims to open more Clenergy franchises across South Africa. He also has a bigger dream of suppling hospitals with healthy meal options. We wish him and his team great success!

A Type 1 dietitian’s perspective

On walking into Clenergy, I was extremely aware of the sugar-free, healthy food marketing which was new and refreshing and I already felt positive that the foods would most likely be high in fibre and made with clean, low processed ingredients.

When the owner, Abdulla Miya, started to share his story and talking about low carbs, I must admit that I had my reservations and even wondered whether he thought that only sugar contributed to total carbs since the menu included toasted sandwiches, pizza, burgers and pasta. I decided to put my scepticism aside and base my review subjectively on taste and objectively on how the meal affected my blood glucose.

Obstacles of testing

I admitted to myself that this was probably not the best day to review a restaurant meal by blood glucose since I had eaten a big slice of red velvet cake that morning at 11am to celebrate my husband’s birthday.

I thought I had injected enough insulin for the piece of cake and checked my blood glucose before I left home. It was 13,9 – yikes! I decided not to inject more insulin and to test before eating at the restaurant and give insulin then.

As fate would have it, I left my meter and the insulin on the kitchen table (what can I say – life happens) and therefore did not test or inject any insulin before the meal.

Choosing what to eat

At the restaurant, I scrolled through the menu thinking about what I would order if I could eat anything I wanted without thinking about the effect it would have on my blood glucose. I chose the Arabiatta Pumpkin Pasta with Chicken. It’s a tomato and chilli based sauce on pasta made from pumpkin spaghetti (spirals of pumpkin).

The pasta was a little harder than original pasta but still delicious and satisfying. The portion was filling. I did share some in exchange for a taste of the other meals that were ordered around the table. The Toasted Chicken Sandwich was loaded with chicken but the bread was a little too oily for me. It took a bit of coaxing to get over the green base of the pizza, but once I got over that the zucchini pizza was super tasty.

The burgers had big meaty patties and generous amount of topping but the roll was a little spongy. Certainly, all the meals were flavourful and totally acceptable alternatives to the carb-rich originals.

I didn’t stop there. My sweet tooth was pleading to try the beautifully displayed and irresistibly tempting dessert options. We chose the Chocolate Torte and Cheese Cake to share between us. The cakes were rich and didn’t disappoint, with very little aftertaste from the sugar substitutes.

Testing blood glucose after meal

I left for home certain that my blood glucose would have sky-rocketed from the feast I’d enjoyed and especially because my last blood glucose reading was high and I had not injected any insulin for what I had eaten at the restaurant.

To my surprise, my blood glucose had dropped from the high teens to 10,2. I had purposely not corrected with insulin when I got home since I wanted to see if the meal would spike me later. It did not. My blood glucose dropped even further to 8,3 before dinner (about six hours after the restaurant meal).

Frozen ready meals

I also purchased three frozen ready meals to try at home. I wanted to try the Arabiatta Pasta again to see if it would be as good at home. The portion was smaller than the restaurant portion but still as tasty. I also tried the Coconut Fish Bake and the Spinach Lasagne. All were delicious.

The nett carbs (total carbs minus fibre) of these frozen meals were listed as follows:

  • Arabiatta Pasta (300g) 0g net carbs
  • Spinach Lasagne (300g) 14.5g net carbs
  • Coconut Fish Bake (300g) 15.9g net carbs

Every person can tolerate different amounts of carbs. I did give insulin for the carbs in the lasagne and the fish bake based on my individual carb ratio and my blood glucose did not spike. I estimate that I had to give a third of the amount of insulin I would have had to give if the meals were not carb reduced and used original rice and pasta. Usually if I have a meal with rice or pasta, I feel lethargic and bloated but I felt really good after eating these carb-reduced meals and extremely satisfied as they have lots of flavour.

Note for people with diabetes:

The only way to identify your tolerance for carbs is to test before the meal and two hours’ post meal. Ideally two hours post the meal, your blood glucose should rise no more than 2mmol/L more than it was before your meal.

For me, the Clenergy options were well-tolerated. So, why not try them for yourself?

MEET THE EXPERT

Tammy Jardine is a qualified diabetes educator and a registered dietitian. Living with diabetes for over 15 years means that she knows first-hand how difficult it can be to achieve and maintain optimal blood glucose control with good lifestyle habits. She believes that diabetes affects every person differently and takes the time to understand how it’s affecting the individual and to help them manage it effectively. With more than 20 years of experience working as a dietitian in the UK and SA, she has a passion for helping people live a better and happier life with good food. Tammy currently works from Wilgeheuwel hospital. Email: tamjdiet@gmail.com

Clenergy is situated at 51 Greenfield Road, Greenside, Jhb.

Opening hours: Monday – Thursday (9:00 – 17:00). Friday – Sunday (9:00-20:00).

Agents for Change – Exploring the intangibles of primary healthcare

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Noy Pullen informs us about the birth of Agents For Change, all that the project has achieved and what they aim to achieve with effective communication in the field of health.

Agents for Change is an unusual project. Its efficient and sound methodological approach is proving successful in dealing with root causes to changing lifestyles that are highly difficult to deal with. The courses seemingly also prove to be effective as a supplement to the current ongoing training healthcare staff. – Extract from a report by Hanne Strandgaard, World Diabetes Foundation project manager, after a field visit to the ‘Agents for Change Project’ in South Africa.

 The current debate around communication in the field of health

A conversation is currently developing online through an international communication network initiative. Here are some of the provoking questions posed by the participants, all of whom work in the field of health empowerment

  • The health community seems not to be able to learn lessons, tagging communication onto the end of any intervention. When will we ever learn to interweave communication strategy (not just politicians and experts telling people what to do) but engaging people in difficult situations to hear their solutions?
  • If you had R500 a month to live on how would you juggle it? I always maintain that poorer people are often much cleverer with their money than the middle classes. They need to be.
  • It’s the same with finding solutions that will work locally. Buckets of money go to big PR firms and advertising firms who make clever slogans and nicely animated ads, basically sending the messages that the experts think best.
  • For almost a year, governments all over the world have been struggling to control spread of the COVID-19 pandemic. Literally hundreds of billions of dollars have been spent on appliances, supplies, hospital equipment and space to accommodate COVID patients. But what has been spent on social research to find out why people don’t follow these guidelines? Does anyone finance controlled experiments to validate communication interventions? I believe if a fraction of what is spent on treatment of diseases was spent on social, psychological and communication research, and findings were used, the pandemic stats would be different today. But who is listening?
  • Let us look at health issues and how they are communicated. Most of the information is too clinical and not accessible. Statistics shared are causing panic instead of encouraging behaviour change. The way healthcare facilities have been operating is creating stigma and discrimination, especially for people with limited information.
  • Knowledge paternalism, or to put it more bluntly, god complexes are a major causal problem with its failure to listen to lived experiences of patients. Motivational interviewing seems to work, in part at least, by dialogue and listening.
  • Brazilian educator, Paulo Freire, compares the conventional or ‘banking’ concept of education (in which students/patients receive, file and store the knowledge from the ‘experts’) with that of the people’s own lived experiences. These lived experiences are, for Freire, the primary source of knowledge which can be translated and used to overcome learning barriers.

The birth of Agents for Change

Such questions and dilemmas faced Noy Pullen as early as 1996 in her capacity as journalist and communication liaison at Diabetes South Africa head office. Passionate telephonic discussions with Trudy Bodenstein, a progressive pharmacist and diabetes activist, led to the conception of Agents for Change. Trudy and Noy would spend two days with health providers, exploring existing barriers to reaching the diabetes community, as well as ways to improve communication about diabetes management, nutrition and lifestyle.

The first courses were run in Kwa-Zulu Natal for the Department of Health, sponsored by the South African Sugar Association. When Noy moved to Cape Town, Trudy started a family, so Noy and Buyelwa Majikela Dlangamandla, diabetes nurse specialist, met and employing their diverse strengths, created the present model.

The present model

Agents for Change metamorphosed into a three-tiered project. The health providers attend a two-day module and are asked to set their own health goals, also indicating how they propose to enhance interaction with patients and colleagues. After three months, the same participants meet again and share what they experienced.

This second module is called Empowering the Patients. Here the health providers who attended the first module are invited to share their successes and challenges over the past three months. These are converted into living case studies. Diverse counselling skills are introduced to address these issues.

A multi-disciplinary group attends so that the whole team is involved. Depending on the needs and availability in each region, doctors, psychologists, physiotherapists, food scientists and dietitians, health promoters, paramedics, matrons, sisters, home-based carers and other community workers are invited. In this way, everyone is considered.

Impact over the years

Agents for Change in its present form has offered more than 200 modules (with each participant attending both modules). There is an average of 30 participants on each module. This affects the lives of their colleagues to whom in-service training is offered 3000 x 10 = 30 000. These health providers probably influenced at least 200 patients each.

Agents for Change has influenced the lives more than seven million considering families, churches and friends. WDF project manager, Hanne Strandgaard, wrote in her field report there was evidence from participants whom she met during her site visits, that Agents for Change still influenced  individuals more than five years after the course had been completed. People stay in touch.

Who is invited?

Participants are selected by the Department of Health or NGOs focusing attention on outlying regions around the country. The Department of Health or the NGO provides the venue and the participants’ travel.

Last words from one group of participants

‘Aha! Moments’ from the Agents for Change project

  • The right way of eating, the right portions at the right time can prevent diabetes or improve management.
  • It begins with me. I can assess my own risk factors for getting diabetes and can reverse this process. I must first help myself before I start helping my patients.
  • We enjoyed the way you served the food, the leafy salads and the lemon and cucumber water to drink.
  • Watching my own weight is important. I enjoyed the healthy eating demonstration and promise I will help others do the same.
  • I learnt a lot. The main thing is giving hope. Based on Tim’s story (one of the true stories in the diabetes manual – My Diabetes Toolkit) you can live a long time with diabetes.
  • Tim’s story helped me know how to live a balanced lifestyle. Being active after eating and not lying down. Because of Tim’s story I now know the symptoms.
  • Because we learnt that diabetes is a killer of our people. I am happy to learn how to help people.
  • My grandmother has diabetes. I have learnt a lot of tools I can apply in the home.
  • My mother-in-law has diabetes. I will help her plan her groceries so that she eats less fried food.
  • The main message I picked up about diabetes is that one does not have to die from diabetes. I always thought it was a killer disease.
  • We do not have clinics where we live, only mobile clinics. It’s why we help the elderly. It’s us who work with the youth in the community. We have been empowered to do so.
  • I have learnt about the co-morbidities with diabetes like hypertension and glaucoma and can now start an awareness campaign to prevent and /or manage diabetes.
  • I have learnt that stress makes diabetes worse. It made me realise that I give my dad stress. I am going to stop doing that.

Below are comments from the participants of what they aim to achieve before the nest module:

  • I want to lose 5kg before the next module.
  • I want to change my cooking habits.
  • Less fatty food and polony and more of what we ate here on the course.
  • Use less oil. Boil and steam my food.
  • Cut down on my alcohol. One glass of wine once a week.
  • Start with two push-ups and increase.
  • Reduce my sugar by half. Do daily vowel exercises.
  • Reduce sugar and do stretching exercises.
  • The vowel exercise helps with my heart palpitations. I will continue with them.
  • My grandchildren loved the vowel exercise. It also helps my asthma
  • Change to low-GI bread at home.
  • I am going back to soccer.

Impact of Agents For Change

The below is an extract from World Diabetes Foundation field trip report:

  • Improved clinical knowledge of diabetes and impact of lifestyle and nutrition on health.
  • More effective collaboration between HCP, healthcare workers and patient.
  • Increased number of food gardens among participants and communities.
  • More effective patient interaction groups.
  • More effective hands-on use of the distribution of Diabetes Focus and other Agents for Change tools to motivate and sustain these groups.

How is Agents For Change funded?

The Agents for Change project has been supported by the World Diabetes Foundation, various trusts, banks as well as pharmaceutical companies. Funding from these communities enables this work to continue. Participants who wish to attend can contact us. Details below.

Many experts who have been involved with this initiative have been impressed by the relatively low-cost per project. A course for 30 people for two days’ costs in the region of R42 000. This includes travel costs and accommodation for both course presenters, as well as healthy eating presentations during the courses.

The course material consists of practical tools, such as monofilaments, tape measures for waist circumference, recipe guides for healthy colourful food, food gardens manuals, a counselling manual called Discovering Hope, and a colourful comprehensive Q&A style, user-friendly diabetes manual, called The Diabetes Toolkit.

All materials are developed or sourced by the presenters. Fun physical activities are shared. Attendees also receive a Hand Jive portion guide and the Five pointed star guide, addressing physical, rhythmical, community, individuality and spiritual health.

AGENTS FOR CHANGE ADDRESSES FULLY THE SITUATIONs DESCRIBED BY THE COMMUNICATION NETWORK INITIATIVE COMMENTS IN THE INTRODUCTION. THE AGENTS FOR CHANGE PROJECT NEEDS FUNDING FOR NEXT YEAR. YOUR ASSISTANCE WOULD ENABLE THIS VALUABLE WORK TO CONTINUE. CONTACT DETAILS BELOW.

Please contact Noy Pullen if you would like more information: linoia@web.co.za or 072 258 7132.

DSA new logo
AGENTS FOR CHANGE IS A DIABETES SOUTH AFRICA PROJECT MANAGED BY NOY PULLEN.

SPONSORED BY:

The Coca-Cola Company plans to retire TaB

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The Coca-Cola Company updates us on the decision to discontinue TaB and their latest product offerings.

Over the next two years, The Coca-Cola Company will retire select products, such as TaB, in various markets around the world. This move is part of a global portfolio refresh, prioritising category-leading brands with the greatest potential for scale. This portfolio refresh will allow the Company to invest in scaling brands and creating a portfolio of drinks that are positioned to capture growth in a fast-changing marketplace.

As part of this process, the Company plans to retire TaB globally; this includes South Africa. TaB broke new ground in 1963 when it was introduced as The Coca-Cola Company’s first-ever ‘diet’ soft drink. It became a cultural icon in the 1980s and maintained a small but loyal following over the last few decades, primarily among fans who grew up with the beloved brand.

 

For those consumers who prefer low calorie/low kilojoule, caffeine-free beverages, we continue to offer Coca-Cola No Sugar No Caffeine in South Africa.

For those consumers who prefer low calorie /low kilojoule, no sugar beverages, we have Coca-Cola No Sugar, Coca-Cola Light, Fanta No Sugar, Sprite No Sugar, Stoney Gingerbeer No Sugar and Schweppes Tonic No Sugar.

Facts about Coca-Cola products

  • Coca-Cola Original Taste is the original full sugar, developed in 1886.
  • Coca-Cola Original Taste Less Sugar contains 30% less sugar per 100ml compared to Coca-Cola Original Taste, and contains a blend of sugar and sucralose.
  • Coca-Cola No Sugar is sweetened with a blend of aspartame and acesulfame potassium (or Ace-K). Together, they create a great taste without sugar and without calories. Coca-Cola No Sugar contains caffeine.
  • Coca-Cola No Sugar No Caffeine is sweetened with a blend of aspartame and acesulfame potassium (or Ace-K). Enjoy Caffeine Free Coca-Cola Zero Sugar’s crisp, delicious taste with meals, on the go, or to share.
  • Coca-Cola Light is sweetened with a blend of aspartame, acesulfame potassium (or Ace-K) and sucralose. Together, they create a great light taste without sugar and without calories. Coca-Cola Light contains caffeine.
  • We have other “No-Sugar” brands within our portfolio. These include Fanta No Sugar, Sprite No Sugar, Stoney Gingerbeer No Sugar and Schweppes Tonic No Sugar.
We recommend that anyone with diabetes who has questions about their diet, contact their doctor.
Diabetic skincare

Diabetic skincare during COVID-19

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Over the past year, you may have noticed a flare up of very dry, rough or flaky skin, which could be a direct result of your blood glucose reacting to stressful situations. Eucerin UreaRepair PLUS is here to offer you and your family immediate relief and protection.

Recommended by medical experts, Eucerin UreaRepair PLUS offers immediate dry skin relief with its unique formulation.

Learning to navigate your diabetic journey during a global pandemic has no doubt added an intense amount of pressure to your daily routine. Between glucose monitoring, following a diet plan, and sticking to a strict medication regime, keeping physical stress under control may be leaving you with a couple of worrisome side effects.

How high blood glucose affects the skin

By now you’re probably well aware of the effect high blood glucose can have on blood vessels. With the constant stress of COVID-19, your blood glucose can easily spike which can cause your veins to contract and harden.

Blood carries the necessary nutrients and oxygen that your skin cells need to stay healthy. When the vessels narrow, it becomes difficult for them to efficiently transport blood throughout the tiny capillary fields that feed your skin, often leading to dry skin.

Not only are the supply of nutrients affected with restricted blood flow, your white blood cells that fight disease causing viruses and bacteria also struggle to travel through these narrowed blood vessels. As a result, if you cut or scrape your skin, the skin is less capable of defending itself against infections.

It’s therefore important to use the correct treatment for your dry skin condition. According to a recent study conducted by world-renowned physicians on Diagnosis and Treatment of Xerosis cutis, urea, an organic compound found in the Eucerin UreaRepair PLUS range, is the gold standard for the treatment of dry skin.

What is urea?

Urea is a compound with the unique ability to treat two different skin factors. As a natural moisturising ingredient, it binds moisture into the outermost layers of skin while simultaneously supporting desquamation (skin peeling, which is the natural process by which the skin sheds dead skin cells). Therefore, a healthy desquamation is linked to smooth skin.

Eucerin UreaRepair PLUS range

Each product within the range plays a significant role in treating problem areas and has been uniquely formulated to relieve, revitalise, and replenish dry skin conditions.

Key products that specialise in diabetic skincare

Eucerin UreaRepair PLUS 5% Urea Lotion

Suitable for people with Type 2 diabetes, it is designed to give dry, rough, and bumpy body skin the daily care it needs. It contains a unique combination of ingredients: urea, ceramide and other natural moisturising factors that lock moisture in and repair the skin´s natural protective barrier to prevent further moisture loss. The formula has been clinically and dermatologically proven to deliver immediate relief and intense, long-lasting moisturisation, delaying dryness and roughness for up to 48 hours. 

Eucerin Intensive Lip Balm Anti-Inflammatory Soothing Care 10ml

The unique combination of active ingredients in Eucerin Intensive Lip Balm Anti-Inflammatory Soothing Care makes it a highly effective solution for extremely dry, cracked, chapped lips.

  • Soothing Licochalcone A reduces redness and calms irritation.
  • Evening primrose oil helps regenerate the lips’ natural protective barrier.
  • Panthenol moisturises, regenerates, and promotes healing.
  • Glycerol intensively moisturises to leave lips feeling soft and smooth.

The balm is also suitable for use on the perioral skin around the mouth, and for conditions, such as lip-lick eczema, cheilitis or dry lips caused by a medical treatment.

Eucerin UreaRepair PLUS 5% Urea Hand Cream 75ml

The skin on our hands is more exposed to external aggressors than any other part of our body, especially during COIVD-19. Frequent sanitising and hand washing means it is often in contact with harsh chemicals. A stable barrier function protects us from these external factors and keeps skin hydrated. When the skin barrier is impaired, skin may lose moisture and hands can look and feel very dry, red and scaly.

Eucerin UreaRepair PLUS 5% Urea Hand Cream contains urea, ceramide and other natural moisturising factors that offer a significant decrease in dryness even after six, high-temperature hand washings. It has been clinically proven to deliver both immediate relief and intense moisturisation for very dry, rough and strained hands. It strengthens skin’s natural barrier, making skin resilient to dryness for up to 48 hours.

Eucerin UreaRepair PLUS 5% Urea Replenishing Body Wash Fluid 400ml

Many soaps and cleansers contain harsh alkali detergents that wash away the epidermal lipids and moisturising factors that form the skin’s natural protective barrier. This leaves it prone to dryness and irritation.

Eucerin UreaRepair PLUS 5% Urea Replenishing Body Wash Fluid contains very gentle cleansing agents, making it suitable for cleansing very dry, rough body skin. It is further enriched with urea and natural moisturising factors which protect skin from drying out further and relieve the itchiness that often comes with dry skin.

Eucerin UreaRepair 5% Urea Replenishing Face Cream 50ml

This cream is a light and gentle everyday moisturiser for dry to very dry and tight skin. Enriched with urea and lactate, two naturally occurring compounds that bind in moisture, it instantly hydrates the facial skin, reducing the feeling of tightness to give it a smooth, supple feel. It is ideal for use under make-up or after shaving.

With more than 100 years of expertise in the science of skincare, Eucerin is now one of the world’s most trusted skincare brands. Years of dedicated research continues to develop innovative and effective products for happier, healthier skin.

Eucerin. Life-changing power of dermatological skincare.

For more information please visit www.eucerin.co.za

References:

  1. Diabetes News Journal, High Blood Sugar Levels Affect How Blood Vessels Contract, Marta Silva. January 2016.
  2. IDF Diabetes Atlas (7th): a global report published by the International Diabetes Federation (IDF), Brussels, Belgium (2015)
  3. Diabetic skin: background and treatment / Eucerin. Data on file.
sugar

Sugar aka…

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Registered dietitian and diabetes nurse educator, Tammy Jardine, educates us on the many hidden names of sugar (there are over 50) and why sugar is seen as a villain.

Sugar is the new villain in the diet industry and making it even more wicked is that sugar is a master of disguise. Historically, the misconceptions about sugar in the greater health industry has revolved around white sugar, otherwise known as table sugar. 

White sugar is the end product of refining and processing of cane sugar. During this process, moisture, minerals and compounds that give them their darker colour are removed, as a result forming white refined sugar. With these nutrients removed, sugar provides energy but has no other nutritional value. Sugar is therefore often referred to as empty calories, adding no value to a healthy diet. Cancer, obesity and diabetes have been linked to white sugar consumption.

For decades, it has been advised that people with diabetes avoid sugar as it has a high glycaemic index (GI), which implies a rapid increase of blood glucose after eating.

Daily sugar limit

The Scientific Advisory Committee on Nutrition (SACN) recommends the following limit for added sugars in the diet for the general population.

Age group Maximum added sugar value per day
4 to 6 years old No more than 19g
7 to 10 years old No more than 24g
11 or over No more than 30g
People with diabetes 25g or less

For reference:4 grams of sugar is equal to a teaspoon of sugar.

The hidden names of sugar

However, just because you don’t see ‘sugar’ on the ingredient list when scanning a food label does not guarantee the item is sugar or sweetener-free. Sugar goes by a number of different names, making it easily unnoticed. Sugar has over 50 different names. While some of these names are more obvious, like brown and cane sugar, others are trickier to spot (e.g. maltodextrin and dextrose).

Most common names for sugar that you may find on an ingredient list

  • ‍Basic Simple Sugars (monosaccharides and disaccharides) – dextrose, fructose, galactose, glucose, lactose, maltose, sucrose.
  • Solid or Granulated Sugars – beet sugar, brown sugar, cane juice crystals, cane sugar, coconut sugar, castor sugar, corn syrup solids, date sugar, demerara sugar, malt, glucose syrup, grape sugar, icing sugar, ethyl maltitol, dextrin, maltodextrin, muscovado, raw sugar, sucanat, turbinado.
  • Liquid or Syrup Sugars – agave nectar, syrup, barley malt, molasses, rice syrup, caramel, carob syrup, corn syrup, evaporated cane juice, fruit juice, golden syrup, high fructose corn syrup, honey, invert sugar, malt syrup, maple syrup, sorghum syrup, treacle.

Why is sugar added to food?

Sugars are being added to a huge range of foods from bread and hams to more obvious foods, such as cakes and biscuits. Sugar is added to foods to increase the shelf life since sugar is a preservative and it also makes foods more palatable. Most of us will be aware of more obvious sugar, such as sugary fizzy drinks, cakes and biscuits but there are also other foods which contain a lot of sugar that may not be immediately obvious.

However, it’s not just added sugar that can increase blood glucose levels. Sugar is a form of carbohydrate. Carbohydrate is one of three macronutrients found in food. Carbohydrates breakdown to glucose (sugar) through the process of digestion. We now know that all carbohydrate raises blood glucose levels.

Forms of sugar

Sugar can be found in three forms.

  • Natural – There are natural sugars found in fruit, milk-based products, honey, and vegetables.
  • Added – Also called free sugars, these are the sugars that are added to a whole range of processed foods and drinks, including microwave meals, pasta sauces, breakfast cereals, biscuits, sweetened drinks and desserts. These are the sugars listed above.
  • The product of the digestion of more complex carbohydrates – Many of us are unaware that starchy foods like bread, rice or potatoes are broken down by digestion into surprisingly large amounts of sugar. A small slice of whole-meal bread is equivalent to three teaspoons of sugar. It’s important therefore that your diet does not contain too much carbohydrate either (e.g. bread, pasta, rice).

Clarifying Total carbohydrate on nutrition label

Therefore, for somebody with diabetes, it’s the total sugar burden from any of the three sources (natural, added or as a product of the digestion of complex carbohydrate) which need considering to keep blood glucose levels low. This is identified as the total carbohydrate on a nutrition label.

Carbohydrates and sugar raise blood glucose levels quickly and require insulin to be produced (or taken by injection) as high blood glucose levels over time cause damage. Many people find that sugar has addictive qualities meaning that we may crave sugary foods even if we know they’re not good for us. Insulin causes the cells of your body to take up the free glucose in your bloodstream. So, having too much sugar means having or needing more insulin.

Nutrition label laws

By law, all packaged food and beverage nutrition labels must display the carbohydrate and sugar content per serving. The best way to ensure you’re not consuming excess added sugars is to get in the habit of always scanning the ingredient list before you throw the item in your trolley.

Keep in mind that ingredients are listed by quantity from high to low: the closer to the front of the list, the more the product contains. If you spot any of above sugar names listed on a label, keep in mind it’s not automatically a no-go. It’s the amount of sugar that counts. If the total carbohydrate count is 1-2 grams, it’s still fine to have if you’re following a low-carb lifestyle. That’s why it’s also important to always look at the total carbohydrate content.

Three different sources of sugars that make up our total dietary ‘sugar burden’

Shown as 4g teaspoon of table sugar equivalents:

Naturally occurring sugar (1) Foods with added sugar (2) Foods digested down into sugars (3)
Banana
4.9 teaspoons/100g		 Coco pops
21.85 teaspoons/100g		 Sasko brown bread
10 teaspoons/100g
Honey (Floaris group Organic raw)
20.6 teaspoons/100g		 Coca Cola
2 teaspoons/100ml		 Boiled spaghetti
3.7 teaspoons/100g
Spar low fat Milk
1.25 teaspoons/100ml		 Marie biscuits
18.5 teaspoons/100g		 Mc Cains Skinny fries
4.75 teaspoons/100g
Raisins
17.1 teaspoons/100g		 Medium fat strawberry yoghurt
(Parmalat)3.75 teaspoons/100g		 Basmati rice
6.8 teaspoons/100g
Apple juice
4.3 teaspoons/100ml		 Lindt dark chocolate mint intense

12.75 teaspoons/100g

 Baked potato
6.3 teaspoons/100g

When it comes to picking starchy foods, such as rice, bread and any other products made from flour, it’s best to opt for whole grain versions of these products. This is because the fibre in wholegrains impact upon blood glucose levels more slowly than the more refined forms of carbohydrate. However, portion control is still the most important as higher levels of fibre rich or unprocessed carbohydrate can still raise blood glucose levels substantially.

To identify how much total carbohydrate you can tolerate, test your blood glucose before you eat, and two hours after you eat the food. Ideally your blood glucose should not increase by more than 2mmol/L after the food is eaten.

How to cut down on sugar

The good news is that reducing sugar intake reduces the likelihood of needing medication and diabetes-related complications. Cutting back on all sources of sugar is a great strategy to stay healthy.

  • Cut down on sugary drinks – non-diet versions of cola, lemonade, tonic water.
  • Swap fruit juices for water and whole fruit.
  • Replace sugary cereals with plain porridge, whole grain cereals or lower carb breakfasts.
  • Avoid having ready meals on a regular basis.
  • Make your own pasta or curry sauce. You can make larger portions and freeze what you don’t need for a future meal.
  • Get into the practice of having fruit instead of sugary snacks or desserts.
  • Don’t have takeaways more than once a fortnight.

MEET THE EXPERT

Tammy Jardine is a qualified diabetes educator and a registered dietitian. Living with diabetes for over 15 years means that she knows first-hand how difficult it can be to achieve and maintain optimal blood glucose control with good lifestyle habits. She believes that diabetes affects every person differently and takes the time to understand how it’s affecting the individual and to help them manage it effectively. With more than 20 years of experience working as a dietitian in the UK and SA, she has a passion for helping people live a better and happier life with good food. Tammy currently works from Wilgeheuwel hospital. Email: tamjdiet@gmail.com

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food rewards

Changing your mind-set of food rewards for children

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Dietitian, Retha Harmse, explains the negative effects of food rewards for children that can occur later in their lives.

Food rewards are common practice in South Africa. One of the first questions I ask a patient when they step into my office is ‘What does your relationship with food look like?’ The answer gives a good indication and insight into their eating habits.

It’s no coincidence that the first time any of us were exposed to eating or nourishment, it was literally in our mom’s arms as babies being fed and comforted. Food, comfort and rewards are so closely linked and are then strengthened through repeated exposure.

However, we are in a dangerous zone for developing an unhealthy relationship with food when we reinforce those neural pathways in our brains (thought patterns) by:

  • Offering food as a response to discomfort, pain or hurt (e.g. going to the dentist).
  • To regulate emotions (e.g. when a child is sad, offering food to make it better).
  • As a reward for achievement (e.g. good marks on a test).
  • To elicit desired behaviours or to avoid an undesired one (e.g. using food as a bribe).

What does the research say?

When it comes to food, the research is clear that persuading children with dessert to eat their vegetables, for instance, is not effective. There are various other risks involved with food rewards, such as:

They will perceive the reward as more desirable than the food they are being bribed to eat.

  • Studies have found that when parents use food as a reward or punishment, children are more likely to prefer high-fat, high-sugar foods (which are often used as rewards). Food rewards are often desired more and become the favourite. This is because they tend to be ‘treats’ that may be restricted at other times and in essence, they become ‘prized’. Studies suggest that when these foods become freely available, they tend to be overeaten.

There might be a decreased preference for non-reward foods.

  • When children get used to reward eating, their liking for the food-that needs-to-be-eaten to get the food reward decreases. Consequently, offering a child a reward in exchange for eating their peas will not help them to like peas more. Rather, they could begin to dislike them.

Food rewards, such as being obligated to eat something or given food to alter behaviour (e.g. sit still or keep quiet), might also override children’s natural hunger and satiety cues.

  • A study in the journal Eating Behaviours found that adults who recalled their parents using food as a reward or punishment were more likely to report issues with food like binge eating and restricted eating. Professionally speaking, I can confirm this. These are usually patients who tend to emotional or comfort eat and use foods to soothe.
  • Development of an emotional crutch. When food rewards are used to make a child feel better, children can become reliant on them to help regulate their emotions. This has been associated with emotion-induced overeating in later life and can contribute to overweight and obesity.

Alternative rewards

Just because we have established that food is not a healthy or viable way to reward children (or ourselves) doesn’t mean that performance or achievements can’t be celebrated or rewarded.

Parents can offer several other rewards, not related to food, to reinforce good behaviour. Consider these creative options:

  • Trip to the library, zoo, or another favourite outing.
  • Embarking on a physical activity together as a family, such as hiking, cycling or playing tennis.
  • New art supplies or colouring books.
  • Pencils, stickers, or other supplies that can be taken to school.
  • Listening to their favourite music as a family.
  • Extra reading time before bedtime.
  • Playdate or sleepover with a friend.
  • Playing a favourite board game with a parent.

Perhaps the most powerful incentive is something we don’t even consider as a reward: the time parents spend with children (such as quality time together following positive behaviour).

Food may therefore feature somewhere in an effective reward plan, but rewards found in the parent-child relationship count far more than those found in the fridge.

Parents need to be the role model

Strategies that encourage healthy eating include creating a positive, healthy food environment and for parents to be the role models. Below are some examples.

  • Being offered healthy choices and watching parents enjoy good food are strong influences.
  • Involving children in vegetable gardening, shopping and preparing healthy meals and snacks can also nurture lifelong healthy food habits.
  • Let them listen to their bodies. Try not to force them to eat when they’re not hungry or if they don’t like a certain food (try offering the same item again at other meals, perhaps cooked a different way).
  • Serve a wide variety of nutrient-rich, kid-friendly foods.
  • Don’t show concern or get upset if your child turns down a food.
  • For young children, keep servings small. For all family members, use portion control and healthy serving sizes.
  • Don’t use food as a plaster or to make your child happy. Children are like sponges, not only soaking up information but learning associations that can stay with them for life. Recognise that how you deal with your child’s upsets now can influence how they deal with their emotions later in life.

Finally, make mealtime pleasant. Don’t argue, talk about problems or discipline children at the table. Family meals should be relaxed, happy occasions where you can talk about your children’s day and share experiences.

Retha Harmse is a Registered Dietitian and the ADSA Public relations portfolio holder. She has a passion for informing and equipping the in the field of nutrition. She is currently in private practice in Saxonwold, Houghton and believes that everyone deserves happiness and health and to achieve this she gives practical and individual-specific advice, guidelines and diets.

MEET THE EXPERT

Retha Harmse is a registered dietitian and the ADSA Public relations portfolio holder. She has a passion for informing and equipping patients in the field of nutrition. She is currently in private practice in Saxonwold, Houghton and believes that everyone deserves happiness and health and to achieve this she gives practical and individual-specific advice, guidelines and diets.

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Pamela Molefe

Pamela Molefe: My journey of diabetes, being a nurse and part of DSA

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Pamela Molefe shares her journey of living with Type 2 diabetes, being a nurse and how she joined Diabetes South Africa.

Pamela Molefe (77) lives in Port Elizabeth. She has two sons and one daughter. She worked at Livingstone Hospital for 20 years and was transferred to Provincial Hospital Port Elizabeth where she worked for 11 years in a Head Injury Unit.

Getting diagnosed

In 2004, I was on night duty when I had to go to hospital at 23:00 to be examined as I wasn’t feeling well. As a routine before being examined, a specimen of urine was obtained and tested. Four parts of glucose was detected. A finger prick was done to test my blood glucose, and 14mm/l were the results. My diagnosis was Type 2 diabetes.

I found the news weird as I never had any symptoms. Then, I was asked about the family history regarding health, and I had no clue of any relative who had diabetes at that time. I was in real denial, telling the doctor all sorts of stories, like I have eaten sweets, and I have just taken a coffee with three spoons of sugar. The doctor looked at me, knowing that I was in denial, and said ‘Diabetes will kill you’. My prescribed treatment was Glucophage 500mg BD (twice daily). I was shocked and thought it’s the end of the world for me.

Family history

After two or three days, vividly it dawned on me that my two aunts died from diabetes at the ages of 80 plus. My mother died, at the age of 58, due to cancer of the pancreas. I assume diabetes would have affected her if she didn’t pass away from cancer.

After being diagnosed, my weight dropped drastically and my superior in the ward noticed. She called me and spoke strongly about the need to eat. Honestly, I had lost my appetite. Gradually, I picked up weight after two months. I’m on treatment that I comply with and thus I am a controlled diabetes patient.

My eldest son (50) has also been diagnosed with Type 2 diabetes.

Simple treatment

Even though there is medication for Type 2 diabetes, there are simple interventions that you can implement to manage your health and not have to take medication.

  1. Sunlight for 20 minutes daily which gives you vitamin D.
  2. Rest regularly during the day.
  3. Exercise but be careful not to over-strain.
  4. Healthy diet (there’s no such thing as a diabetic diet).
  5. Self-confidence and independence (don’t expect other people to run after you).
  6. Real friends who will journey with you during this condition.
  7. Join a wellness group (sharing with each other about the condition).

Finding out about DSA Port Elizabeth

Because I wanted to be active, I got a job in a frail care centre and retirement village. This is where I got to know about DSA Port Elizabeth from my nursing manager, Barbara Coetzee. Her husband had diabetes and Barbara was attending the Diabetes SA wellness group on his behalf. So, she recruited me to attend and I was eager to gain knowledge.

We had our meeting once a month at St Georges Hospital from 19:00 to 20:00, with different speakers. I enjoyed the educational talks and looked forward to the next ones.

After two years, I was approached to join the Management Board of DSA Port Elizabeth. They wanted an IsiXhosa speaking member. I immediately said yes.

DSA nursing advisor

Since being on management, I was made nursing advisor. This means at every monthly meeting as I enter the hall there are early birds who are waiting for their blood pressure and blood glucose to be checked. Many questions are asked and if I am unable to answer, I refer the question to the relevant speaker.

Annually, we (Martin, Elizabeth and myself), visit Jeffreys Bay for a workshop at the Pellsrus Clinic. Even there, I have my table with pamphlets and I check patients blood pressure and blood glucose. It’s much appreciated by the residents concerned. Surely, they missed us in 2020 due to lockdown.

I also attended a workshop in Walmer Township where different health conditions were highlighted and I was assigned to represent our diabetes wellness group. I also visited New Brighton location where most of the attendees were pensioners.

Every year, we get invited by big companies to their wellness day for different health conditions. I enjoy these functions as I have the longest queue at my desk as it’s more of IsiXhosa speaking people attending. We supply them with informative pamphlets and educate them on diabetes. They are usually eager to have their blood pressure and blood glucose checked as most don’t get a chance to go to their local clinics to do check-up unless they are sick.

During lockdown, we, as board members, meet through our WhatsApp group when the need arises. I hope this year there will be a difference from these pandemic restrictions. I’m still eager to serve in the coming year as a board member.

Always learning and sharing the knowledge

At work, Barbara assigned me to take care of the diabetic residents in that institution. I became the favourite, as when I was off residents would ask for me as they trusted me, especially those who were on insulin injection.

I acquainted myself with our well-equipped DSA library which has informative books and I learnt that diabetes is not the end of the world and the best care is what I listed as the simple treatment. Just maintain it in all stages of life. If one follows that trend which is far cheaper than medication, you can survive as diabetes is a lifestyle condition. But remember to always take your diabetes medicine as prescribed by your doctor and to see him regularly for check-ups.

Pamela Molefe testing at Pellsrus, Jeffreys Bay.
Counselling an employee at Autocast.