Caine Tibbs – Volunteering changes life

We hear how volunteering at Diabetes South Africa changed Caine Tibbs career pathway and how he is using his Type 1 condition to help others.


Caine Tibbs (42) lives in Lakeside, Cape Town.

Diagnosed at age four

Caine was diagnosed with Type 1 diabetes when he was four years old. “I was told that I got up often during the night to drink water as I was unusually thirsty and would urinate a lot. My mom kept telling me to stop drinking water at night. When this continued, it was thought that I had a bladder infection, and I was taken to a doctor and then was diagnosed with diabetes,” Caine explains.

“Since there is no history of diabetes in the immediate family, it was thought that it could have resulted from a virus which I had a few months prior.”

Treatment

From the time Caine was diagnosed, he has been taking insulin injections. “I think I started on two to three per day, and now over the past 10 to 20 years I use four injections per day. I recall initially taking regular insulin and insulin isophane human in my youth but over the past years I have been taking insulin glulisine (fast-acting) and insulin glargine (long-acting) which seem to be providing me with more consistent and stable glucose levels and in general more regulation regarding my glucose readings.”

The 42-year-old says that his good management consists of strictly keeping to routines regarding his testing, eating habits and exercise.

Change of eating habits

Caine says as a family, their way of eating changed once he was diagnosed. “My mom would not have any cakes, biscuits, sweets or cooldrinks in the house. We ate balanced meals, ensuring that the whole family was an example to me.”

“I have to admit that my condition has generally been quite stable, barring the occasional hypo due to environmental and emotional circumstances. Although there definitely has been a slight degradation regarding my body’s ability to use insulin effectively and with the general way in which the disease progresses, I have managed to remain relatively fit and healthy, also as a result of keeping to a controlled and balanced diet and what works for me individually.”

Volunteering changes life

“For a few years, I struggled to find permanent employment and went through a very depressive, self-loathing almost destructive state and was feeling like I had nothing to offer and that I wanted to give up.”

“I sat down one day and gathered my thoughts regarding my life experience, the work I had done so far, the challenges and problems I had faced as a result of having diabetes and how I had overcome them. I thought that if I, just an ordinary person, was dealing with all of this and could overcome the majority of obstacles thrown at me, then there must be other people experiencing the same, and perhaps in some way I could use my condition and experience to assist, support and uplift others,” Caine explains.

Caine applied to volunteer at Diabetes South Africa (DSA), Cape Town branch last year November and was afforded the opportunity. His volunteer duties involved assisting with processing membership applications, telephonic support and basic administration and operational duties.

Thankfully Caine’s ability and willingness to help the diabetes community was rewarded by him being offered a full-time job at DSA at the beginning of the year.

He goes on to explain that his duties are similar to when he was volunteering. “However, I have taken on more of a managerial role and helping to co-ordinate and run a project with the National Manager and one of our large sponsors, aQuellé with their Have a Heart for Diabetes campaign.”

“I have taken over as the Branch Manager of the Western Cape operation and this includes a more focussed approach to finding funding opportunities and increasing our membership numbers. I’m looking forward to the challenge.”

Structure and routine

The 42-year-old admits that he is a methodical and systematic person in that he likes structure and keeping to schedules. “I eat the same foods for breakfast and lunch each day. I only drink one cup of coffee in the morning and ensure I drink a litre of water every day and monitor my glucose level before each meal and generally try to follow the same routines in life.”

He adds, “I find that this helps with controlling my glucose levels. I believe that eating regularly, testing my glucose regularly and eating balanced and healthy low glycaemic meals can only better improve my control.”

When asked what his healthy habits are, Caine responds, “I don’t smoke or drink alcohol and ensure I drink more than 1 litre of good quality spring water every day, not tap water. I hardly ever eat junk food or highly processed foods; I believe that if you want your body to function at an optimal level, then you need to supply it with the best possible ingredients. I stay away from taking medication for every ache and ensure I don’t consume products containing added sugars; this is effectively an acid and a contaminate and your body needs to remain at a balanced pH level, or at least a slightly more alkaline state otherwise it degrades internally and allows for more disease to grow and increases the possibility of internal inflammation.”

“My grandfather always used to say, ‘You are what you eat’ which is a saying I try to live by. Thus, I eat low-GI food often and a balanced meal every night, consisting of protein in the form of meat (limiting red meat), starch in the form of potatoes, brown rice, or whole grain pasta with two different colour vegetables.”

Diabetes complications

Thankfully, Caine hasn’t experienced many diabetes complications other than occasional peripheral neuropathy in his arms and hands, and damaged blood vessels in his eyes which resulted in laser surgery on both eyes and a vitrectomy on his right eye.

He adds that he occasionally suffers with sleep issues. “This is mainly due to hypoglycaemia, but not often. Since I’ve been on a more stable night-time insulin and I have taken the time and trouble to test my glucose before I go to bed, in the interest of putting my mind at ease, I find that I’m able to sleep better and more soundly, and I don’t often wake up feeling concerned or being hypoglycaemic.”

“Stress also plays a big role in that if I have had a very stressful day or have over-exerted myself physically or even emotionally, it can lead to my glucose level falling quite drastically when I’m asleep at night, and then my body and my muscle’s feel completely drained, sore and weak the next day.”

He adds that when he is very active on days when there is high humidity or temperatures can also cause his glucose level to drop suddenly, so it is important that he doesn’t overexert himself in these conditions.

We wish Caine all the best in his new role at DSA and thank him for his desire to help the diabetes community.

Laurelle Williams is the Editor at Word for Word Media. She graduated from AFDA with a Bachelor of Arts Honours degree in Live Performance. She has a love for storytelling and sharing emotions through the power of words. Her aim is to educate, encourage and most of all show there is always hope. Feel free to email Laurelle on editor@diabetesfocus.co.za

MEET OUR EDITOR


Laurelle Williams is the Editor at Word for Word Media. She graduated from AFDA with a Bachelor of Arts Honours degree in Live Performance. She has a love for storytelling and sharing emotions through the power of words. Her aim is to educate, encourage and most of all show there is always hope. Feel free to email Laurelle on [email protected]


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Little steps to achieve real me time

Veronica Tift clarifies how little steps to me time can make a big difference in your well-being.


Ah, some me time! I run the bubble bath, light the candles, grab a glass of wine and climb in, wanting all my problems to melt in the magical bath water and to not think about the terrible day I had. That works for about a minute; turns out it’s all I think about, replaying what I could have said to that ‘Karen’ today. Is this really me time?

Sometimes me time (self-care) isn’t sexy and as glamourous as the bubble bath advert. Personally, self-care is an ever-changing journey depending on what is happening in my life at the time. What do I need right now? I need to hydrate (coffee doesn’t count, apparently), deep breaths, a good stretch and a few seconds to notice my body, the morning sunlight, and giving it little moments of care.

What feels right for you? What do you want and need for yourself? These are questions that will get you closer to understand what little steps you can take to help you care for yourself.

Step one

Limit the amount of time you spend with toxic people or information. Delete that Facebook page that makes you angry. Check the time you spend online looking at things that don’t make you feel great. Let go of the fear of missing out (FOMO) and learn to say no.

Little daily steps may not be fun, but they are important for everything else to be possible. Go to bed at a reasonable hour. Pay your bills on time. Stay home on a Wednesday. Floss. I know that these don’t sound like loving yourself, but by doing all these little things, allows you time and space to really enjoy your me time.

Challenge yourself

What can feel like a big step may be to challenge yourself and I don’t mean beating your Solitaire score. I mean with something enriching and interesting; challenges that force you to grow and something for yourself.

Assess your relationships

This one can feel like a tricky step but have those difficult conversations. We all need social interactions, and the quality of those relationships has a direct relation to the quality of your life. If a relationship is not working for you but you don’t want to lose it, tell the person how you are feeling.

Rest

This can mean that wonderful bubble bath, or it could be lying on the couch or in the arms of someone you care about and who cares about you.

You don’t need to spend a fortune to rest, while a hammock in the Maldives sounds like the ultimate way to rest, it’s not the only way.

Journaling

This is another little step you could do every day. Reflecting on the day can assist you in understanding areas of your life that need to be worked on and that you are grateful for. Celebrate the good things in your diary, clear things that are bugging you and write down desires that you have for yourself.

Take note of your mirror neurons

Emotional contagion happens every time we interact with others, mostly without noticing. Ever felt calmer being around a person or feel angry the angrier someone else becomes. Basically, your mirror neurons in your brain give you this ability to feel stressed around a stressed person and calmer around a person who is calm.

Explore alternative therapies

Reflexology is a great way to explore alternative therapies and learn new things and explore ways of healthy living that you can include in your me time.

Most reflexologist and healthcare workers enter the profession because we genuinely want to help people. When you spend time in an environment with calm and caring people, your mirror neurons will respond, and your body will benefit.

The body is a mirror of your mental and emotional state. Emotions leave imprints in your muscles and nervous system; think about how you tense your body in response to mental and emotional stress.

By exploring body work, like therapeutic massage and reflexology, the physical effects of stress on your body could be eased. Regular treatments have better results and like regular exercise is good for the body, body work should be part of self-care.

Reflexology can be done every week or once a month depending on your budget and time.

Meditate

Meditation just 10 minutes a day is another little step you could take. Harvard, the University of Montreal, Johns Hopkins and a meta-analysis have all proven that meditation aids in the reduction of depression, anxiety, stress and reducing pain.

I geek out on the science of meditation or mindfulness and that is why I include a five-minute meditation at the end of a reflexology session. Some of my clients will come in and meditate during the entire reflexology session, but even five minutes a day can have a benefit.

Put yourself first

Give yourself permission to put yourself first, even if just for an hour. Act from true care and from a sense of compassion for yourself, your well-being and putting yourself above the should and to-do-list.

Just doing one thing can make a change in your life. Take little steps each week and soon me time could be truly supporting and help you cope better with all the other stress you have to deal with daily.

Veronica Tift is a therapeutic reflexologist, registered with the AHPCSA, based in Benoni. She continues to grow her knowledge through attending international and local courses on various subjects related to reflexology. Veronica has a special interest in working with couples struggling with infertility.

MEET THE EXPERT


Veronica Tift is a therapeutic reflexologist, registered with the AHPCSA, based in Benoni. She continues to grow her knowledge through attending international and local courses on various subjects related to reflexology. Veronica has a special interest in working with couples struggling with infertility.


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Why is Fabulite fab?

Estée van Lingen, a registered dietitian, tells us why the Fabulite range is ideal for people living with diabetes.

When planning meals or snacks, people living with diabetes have to be careful of what and how much of certain food they consume. When you have to restrict carbohydrate (especially sugar) as well as fat intake, it can make healthy choices limited and also mean that less appetising options be consumed for health purposes.

It’s also important to have protein-based snacks to assist in controlling blood glucose levels compared to only having a sugar or carbohydrate by itself as a snack.

So, the question, Should I rather have low-fat, sweetened yoghurt or plain full cream? must have crossed your mind.

The Fabulite range

Thankfully, now you don’t have to wonder anymore. Parmalat has designed a tasty yoghurt range called Fabulite. This range of delicious yoghurts has no added sugar and no fat. Each yoghurt contains protein and calcium which are nice benefits to consuming yoghurt. This making it a perfect option for someone living with diabetes or anyone wanting to limit their sugar intake. You can have all of these benefits without compromising on taste and still enjoy a delicious meal or snack.

The Fabulite range is Halaal approved and consists of different flavours to suit every individuals taste preference, such as plain, vanilla, strawberry, blueberry and pomegranate, and black cherry. Each flavour can be found in 1kg or 6 x 100g tubs.

Fabulite can be added to a healthy diet as part of breakfast, snacks or even main meals. For breakfast and snacks, it can be enjoyed by itself or topped with berries, nuts and seeds, or even added into a smoothie.

Fabulite’s fruit range can be enjoyed as a guilt-free dessert; while everyone else is consuming something sweet, you can have a healthier alternative that is on par in the taste department.

The yoghurt can also be frozen as lollies to make an appetising healthy yoghurt lolly.

The plain fat free Fabulite yoghurt is perfect as a salad dressing or an alternative to mayonnaise or cream in recipes.


Nutritional value

Nutritional information: (per 100g)

Yoghurt Plain Fat Free Fat free fruited Fat Free Vanilla
Energy (kJ) 200 210 210
Protein (g) 3,8 3,2 3,4
Glycaemic Carbohydrates (g) 6 8 6
Of which total sugar (g) 3,1 3,1 3,1
Total fat (g) 0,2 0,1 0,2
Calcium (mg) 110,9 102,9 100,2

Sugar

For a 100g serving, it only has 200 – 210kj which is less than a fruit serving, and has 6 – 8g of carbohydrates which is equal to 1 tsp of sugar. This is basically the sugar from the milk called lactose as there is no added sugar. Only 3g of that is the sugar.

Fat and calcium

The fat content is also less than 1g which is the perfect low kilojoule, fat-free snack. Calcium is definitely a bonus as you need calcium for strong bones and teeth, and most people don’t meet their calcium needs, increasing the risk for osteoporosis (low bone density). Calcium recommendations are 1000mg per day or more depending on individual needs.

So, go on and try one (or all) of these delicious flavours and expect to be surprised by how satisfying eating a healthy snack can be and soon even the whole family will enjoy these yoghurts as well.

Estée van Lingen is a registered dietitian practicing in Randburg and Fourways, Gauteng. She has been in private practice since 2014 and is registered with the HPCSA as well as ADSA and served on the ADSA Gauteng South Committee for 2020 – 2022.

MEET THE EXPERT


Estée van Lingen is a registered dietitian and has been in private practice since 2014. She is registered with the HPCSA as well as ADSA and served on the ADSA Gauteng South Committee for 2020 – 2022.


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Time for your annual checks

Sister Lynette Lacock explains why annual checks are imperative for people living with diabetes.


Why annual checks?

Diabetes is a complicated chronic condition that effects many areas of your body. Uncontrolled diabetes is a major risk factor for deterioration of your health. It’s important to know the condition of your eyes, feet, teeth, heart and kidneys. To do this, you need to have a yearly assessment and learn how to keep these areas healthy and problem free.

Eyes

Sometimes a rapid deterioration in eyesight is the first sign of diabetes. Elevated blood glucose affects the capillaries, feeding the retina in the back of your eye which will affect your vision. People with diabetes are also prone to cataracts and glaucoma.

This annual check is much more than reading an eye chart to check your vision. You should expect your doctor to dilate your eyes with drops and look into your eyes with special magnified lenses.

Finding problems early and being treated will go a long way in preserving your eyesight.

Feet

Checking your feet daily is vital. Note any cracks or sores that aren’t healing, changes in the nails or colour of the skin. Even changes in sensation can mean you need to see your doctor before your annual check-up.

Uncontrolled diabetes can lead to peripheral neuropathy which means you may not feel that your shoes are too tight or that they are giving you blisters. If you already have decreased sensation, then paying attention to your feet is imperative.

Diabetes can also cause circulatory problems that cause delayed healing. For this reason, if you have a cut or ulcer that isn’t healing on its own you need to see your doctor as soon as possible.

Teeth

Seeing your dentist regularly will not only help you keep your teeth clean and gums healthy, but it can also reduce the risk of heart disease.

Cleaning and flossing your teeth regularly will decrease the amount of bacteria in your mouth so there is less bacteria to get into your bloodstream therefore reducing your risk of heart attack.

On an annual visit, your dentist will check for cavities and gum disease. While you are there, book an appointment with the oral hygienist and have your teeth cleaned.

Remember with elevated glucose levels you’ll already be more prone to infections and gum disease, so this check is important.

Heart

Having diabetes makes it more likely that you will suffer from heart disease. Therefore, you need take special care to keep your heart in the best shape possible.

There are multiple tests your doctor can do to check your heart depending on your age, condition and symptoms. These tests may include the following:

Electrocardiogram checks the electrical circuitry.

Echocardiogram or ultrasound to check heart and its blood supply.

Stress Test to see how your heart reacts to physical activity.

Coronary angiogram to measure and possibly widen vessels.

Kidneys

Hypertension and uncontrolled blood glucose can cause kidney damage over time. So, first and foremost you must keep these two conditions under control. Once damaged it can’t be reversed.

One of the first signs that there is damage to the kidneys filtering system is protein in the urine. This can be determined from a urine test in your doctor’s rooms. They may also want to draw blood and check kidney function by looking at how well they filter waste from the blood.

It’s also essential to let your doctor know if you have any symptoms of a bladder infection, such as frequent urination, burning and cloudy urine. An untreated bladder infection can lead to kidney damage as well.

Final thought

You may have noticed that all these check-ups have something in common: checking for problems related to microcirculation. Because diabetes can affect the small blood vessels, it will also affect the health of the organ or tissue they are supplying blood and oxygen to.

As explained before, the main culprits are uncontrolled blood glucose and hypertension. By checking your blood glucose levels and blood pressure regularly and making sure it’s within normal limits, you will prevent some of the progressive damage that occurs when you have diabetes.

Knowing the results of your annual checks will empower you to stay on top of your diabetes and to do your best to keep yourself healthy and prevent future problems.


References

https://www.paceyemd.com/blog/i-have-diabetes-how-often-should-i-have-my-eyes-checked/

https://www.cdc.gov/diabetes/library/features/healthy-feet.html

https://www.sharecare.com/health/diabetes-oral-health/can-my-dentist-diagnose-diabetes

https://www.webmd.com/diabetes/diabetes-your-heart-tests-you-may-need

https://www.hopkinsmedicine.org/gim/faculty-resources/core_resources/Patient%20Handouts/Handouts_May_2012/Preserving%20Kidney%20Function%20When%20You%20Have%20Diabetes.pdf

Sr Lynette Lacock

MEET THE EXPERT


Sr Lynette Lacock received her Bachelor’s Degree in Nursing and Biofeedback Certification in Neurofeedback in the US. She has over 30 years’ experience in healthcare which has enabled her to work in the US, UK and South Africa. Initially specialising in Cardiothoracic and Neurological ICU, she now works as an Occupational Health Sister. She is passionate about teaching people how to obtain optimum health while living with chronic conditions.


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Top chronic diseases in SA

Do you know what the top chronic diseases are in SA? Diabetes is one of them.


What are chronic diseases?

A chronic diseases are defined broadly as conditions that last one year or more and require ongoing medical attention or limit activities of daily living or both. They are long-term illnesses caused by a combination of genetic, physiological, environmental, and behavioural factors

Chronic diseases, also known as non-communicable diseases, are the leading cause of death and disability worldwide, accounting for nearly 60% of all deaths and 43% of the global disease burden.

Although chronic diseases are frequently associated with older age groups, evidence suggests that thousands of South Africans are dying of chronic diseases before the age of 70.

Top chronic diseases in SA 

Stroke and heart disease

The sheer number of heart disease or stroke fatalities is a growing concern in SA. According to the Heart & Stroke Foundation, 215 people die from heart disease or strokes daily. Every hour, five people have heart attacks, and 10 people have strokes. Because there is a lack of awareness about cardiovascular disease, many people go undiagnosed and untreated until it is too late.

Diabetes

One in every three adults (13 million) in South Africa has impaired fasting glucose, putting them at high risk of developing Type 2 diabetes. Diabetes is the country’s second deadliest disease, according to Statistics South Africa’s 2021 report on mortality and causes of death.

It has claimed more lives than HIV, hypertension, and other forms of heart disease combined. It’s a leading cause of blindness, kidney failure, heart attacks, stroke, and amputation of lower limbs.

Arthritis 

Osteoarthritis is the most common type of arthritis in South Africa, with a prevalence rate of 55.1% in urban areas and between 29.5% and 82.7% in adults over 65 years of age in rural areas.

As many patients are unsure how to manage their symptoms, arthritis coexists with other chronic conditions. This disease is surprisingly common among children, affecting one to four out of every 1000.

Cancer

Cancer care is expected to cost $240 billion (R4160 billion) by 2030, according to the most recent Centers for Disease Control and Prevention (CDC) and National Cancer Institute estimates, due to healthcare inflation over the previous decades.

Despite declining cancer rates, the CDC predicts that cancer will remain one of the leading causes of death in SA. It’s estimated that nearly 110 000 new cancer cases will be diagnosed in SA by 2020, with over 56 000 cancer-related deaths accounting for one-quarter of all premature non-communicable disease-related mortality.

The most effective cancer prevention measures continue to be early screenings, raising awareness about preventative techniques, and developing strategic partnerships.

Obesity

Obesity statistics in SA are concerning, with approximately 31% of men and 68% of women obese. Being overweight and obesity can lead to various lifestyle diseases, including diabetes and heart disease.

Obesity is a major issue in adults and children, with more than 13% of South African children aged 6-14 years classified as overweight or obese.

Education, promoting access to healthier foods, and providing preventive care to paediatric patients can help maintain a healthy weight.

Alzheimer’s disease 

According to the most recent World Alzheimer’s Report, SA has 4.4 million people over the age of 60 living with the disease. Around 187,000 of these people have dementia.

Alzheimer’s disease isn’t a normal part of ageing. Although most people with Alzheimer’s are 65 and older, people younger than 65 can also develop the disease. It’s the most common cause of dementia that worsens over time. In most cases, the symptoms develop gradually and become severe enough to interfere with daily activities.

Epilepsy

More than 500 000 people in SA have epilepsy. Seizures caused by epilepsy can sometimes result in death. People with epilepsy may also have poor mental health or other impairments that are difficult to detect.

Asthma

Asthma affects more than 20% of children and 10-15% of adults in SA. It’s not uncommon for those suffering from the illness to be hospitalised during an attack, which can significantly reduce their quality of life.

High blood pressure

High blood pressure, also known as hypertension, affects more than one in every three adults in SA. Because there are rarely any symptoms or visible signs that blood pressure is high, it’s referred to as a silent killer.

As a result, more than half of people with high blood pressure are unaware of their condition. Symptoms such as headaches, visual disturbances, nose bleeds, nausea, vomiting, facial flushing, and sleepiness may sometimes occur, typically with extremely high blood pressure. It would be best if you didn’t wait for symptoms to appear. High blood pressure becomes more common with age, but anyone, regardless of age, gender, fitness level, or lifestyle, can develop it.

HIV/AIDS

In SA, the overall HIV prevalence rate is estimated to be around 13.7%. In 2021, the total number of people living with HIV was expected to be approximately 8.2 million. HIV infection affects an estimated 19.5% of adults aged 15 to 49 years.

Tuberculosis

In South Africa, tuberculosis is a significant public health concern. Every year, approximately 450,000 people contract the disease, with 270,000 also infected with HIV.

TB kills approximately 89,000 people per year, or 10 people every hour. Effective treatments are available, and the country has made significant progress in combating the disease, but much more is required to bring it under control.

This article is attributed to Affinity Health.

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Smart shopping tips for picking heart healthy pork

Did you know that lean pork cuts are approved as part of the Heart and Stroke Foundation’s eating plan? We learn three smart shopping tips to pick heart healthy pork.


Latest Statistics South Africa figures show that nearly one in every five South Africans suffer from diseases of the circulatory system such as heart disease, high cholesterol, hypertension and strokes.

The good news is that following a healthy, balanced diet, including plenty of fruits and vegetables can significantly reduce your risk of circulatory disease. And, the extra good news is for meat-lovers: lean pork cuts are approved as part of the Heart and Stroke Foundation’s eating plan, which means that fresh pork can play a starring role in your weekly meal planning.

Professional food scientist, Melindi Wyma, Group Technical Manager of Eskort notes that this includes lean pork cuts, such as fillets, tenderloins, roasts and steaks.

“Not only is pork one of the most affordable meats by a wide margin, but unlike red meats, such as beef or lamb, most fat on lean pork cuts sits on the outside of the meat rather than within the meat itself. This makes it very easy to trim or remove as part of low-fat and heart-healthy diets,” she explains.

“In comparison to beef and lamb, lean pork also contains low amounts of cholesterol and saturated fats which can raise your risk of heart disease, and high amounts of the polyunsaturated fats which can actually help to improve your cholesterol levels and support healthy cell development.”

Powerful pork

According to a study by the Agricultural Research Council, pork also packs a powerful punch of essential nutrients for supporting healthy hearts such as vitamins B1 and B3, and magnesium.

For example, vitamin B1 or thiamine plays a crucial role in the breakdown of nutrients and carbohydrates for energy, efficient cell functioning, and well-performing nervous systems, brains, muscles, stomachs and intestines. Critically, it also plays a key role in passing messages between nerves and muscles and maintaining normal cardiac function.

Likewise, vitamin B3 or niacin can help to lower cholesterol and boost energy, while magnesium is vital for combatting heart disease, supporting blood vessels, and helping to maintain a normal heart rhythm.

Shopping tips for healthy pork choices

  • Look for lean cuts with less than 3 millimetres of visible fat.

This can include a wide variety of cuts, such as fillets, loin, roast or chops, lean pork mince, and even pork goulash.

  • Moderate your portions.

The South African Pork Producers Association notes that households can safely eat up to 560 grams of lean pork divided over five or six meals each week for a balanced, heart-healthy diet.

  • Select high quality brands and fresh products.

Choose fresh cuts from quality, trusted brands with lower fat, sodium, and cholesterol content for most nutritional benefit.

This article is attributed to Eskort.

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Call for policy changes to prevent SA childhood obesity

The Healthy Living Alliance (HEALA) calls for urgent policy changes to prevent SA childhood obesity.


Childhood obesity in SA

Approximately 13% of South Africa’s children under five years are overweight, more than double the global average.1 Being overweight and developing obesity in early childhood increases the risk for adult obesity, as well as associated conditions like high cholesterol, diabetes and high blood pressure. All of these conditions are increasingly prevalent in South Africa.1

Childhood obesity is a serious medical condition that affects children and teens. It’s particularly troubling because the extra kilos often start children on the path to lifelong health problems. Childhood obesity can also lead to poor self-esteem and depression.2

The main cause of overweight and obesity among children is the consumption of high-calorie diets; those that are rich in salt, sugar and fats.1 This is also influenced by other factors such as household poverty coupled with the high cost of healthy foods.1

South African children’s fast-food consumption rates are high.3 In a 17-country study completed in 2014, researchers found that fast-food consumption among South African children and adolescents was more frequent than in high-income countries such as Japan and Belgium.3

“Highly processed and unhealthy foods have become increasingly accessible and affordable over the last three decades, leading to a global increase in weight issues and obesity, especially in the poorest and most vulnerable communities and households,” says Nzama Mbalati, Programmes Manager at HEALA.

Sugar consumption

One of the major factors associated with obesity is sugar consumption. South Africans are estimated to consume up to 24 teaspoons of sugar per day, double the daily WHO recommendation.4

South Africa passed a Health Promotion Levy (HPL) on sugary beverages in 2018.5 Commonly known as sugar tax, it has led to considerable reductions in the purchase and consumption of taxable drinks, proving that legislation can support consumers to reduce intake of unhealthy foods and beverages.5

“Currently, at least 85 countries have sugar-sweetened beverages (SSB) taxation,” says Mbalati. “Data from countries like the UK and Mexico indicates that SSB taxes successfully reduce sugar consumption. In SA, people are buying 28% fewer sugary drinks since the government implemented the HPL in 2018. In addition, the levy has slashed the South African beverage sector’s use of sugar by a third. The combination of the two has cut sugar intake in the country by nearly a third. It is now time for the sugar tax on drinks, currently at 10% of the cost per litre, to be doubled and this needs to happen soon.”

Mbalati stresses that this is critical to address the country’s raging diabetes epidemic and the high rates of obesity that fuel it. “South Africans are addicted to sugar. With more than a quarter of the population living with obesity, we are among the top 20% of the most obese nations in the world. More than 4,5 million people have diabetes, with diabetes being the second-largest cause of death after tuberculosis.”

Mbalati adds that sugary drinks should be drastically reduced in children’s diets. “Even 100% fruit juice with no added sugar contains a lot of sugar with none of the fibre you would find in a piece of fruit to help fill you up. Encourage kids to drink mostly water and plain milk. Get them to eat whole fruit, like an apple, instead of drinking apple juice.”

Visit whatsinourfood.org.za for more information.

Instagram: instagram.com/betterlabels_za

Facebook: facebook.com/betterlabelsza


References

  1. Statistics on children in South Africa: Overnutrition in children, Sambu, W. Children’s Institute. University of Cape Town. [Nov 2019]. Available from:http://childrencount.uct.ac.za/indicator.php?domain=4&indicator=96
  2. Childhood obesity. Mayo Foundation for Medical Education and Research (MFMER). [Dec 2022]. Available from:https://www.mayoclinic.org/diseases-conditions/childhood-obesity/symptoms-causes/syc-20354827
  3. South African Child Gauge 2020: Food and nutrition security. May, J.; Witten, C.; Lake L. Children’s Institute. University of Cape Town. [2020]. Available from:http://www.ci.uct.ac.za/sites/default/files/image_tool/images/367/Child_Gauge/South_African_Child_Gauge_2020/ChildGauge_2020_screen_final.pdf
  4. McCreedy, N.; Shung-King, M.; Weimann, A.; Tatah, L.; Mapa-Tassou, C.; Muzenda, T.; Govia, I.; Were, V.; Oni, T. Reducing Sugar Intake in South Africa: Learnings from A Multilevel Policy Analysis on Diet and Noncommunicable Disease Prevention. Int. J. Environ. Res. Public Health 2022, 19, 11828. Available from: https://doi.org/10.3390/ijerph191811828
  5. Stacey, N; Edoka, I; Hofman, K; Swart, EC; Popkin, B; Shu Wen, N. Changes in beverage purchases following the announcement and implementation of South Africa’s Health Promotion Levy: an observational study. The Lancet. 5, 4, E200-E208. [Apr 2021]. Available from:https://www.thelancet.com/action/showPdf?pii=S2542-5196%2820%2930304-1
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Beginners guide to healthy eating

Healthy eating means putting your health first by feeding your body nutritious foods. We learn easy ways to transition into a habit of healthy eating.


The term healthy eating can mean different things to different people. Everyone appears to have an opinion on the healthiest way to eat.

Adding to the confusion, online nutrition articles can be downright perplexing with contradictory and frequently unfounded suggestions and rules. This makes it challenging to eat in a healthy way that works for you.

The truth is that eating healthy doesn’t have to be difficult. It’s possible to nourish your body while also enjoying your favourite foods.  After all, food should be enjoyed rather than feared, counted, weighed, and tracked.

Why is eating healthy important?

Before we understand what healthy eating entails, it’s critical to know why it matters. First and foremost, food is fuel and provides your body with the calories and nutrients required to function. Your health may suffer if your diet lacks calories or one or more nutrients.

Similarly, if you consume too many calories, you may gain weight. Obese people are at a much higher risk of developing Type 2 diabetes, obstructive sleep apnoea, and heart, liver, and kidney disease. Furthermore, the quality of your diet influences disease risk, longevity, and mental health.

While ultra-processed foods are associated with increased mortality and a higher risk of conditions, such as cancer and heart disease, diets rich in whole, nutrient-dense foods are associated with increased longevity and disease protection.

Are specific diets necessary?

Certainly not. Although some people need, or choose, to avoid certain foods or follow diets for health reasons, most people don’t need to follow any specific diet to feel their best. That’s not to say that certain eating habits can’t be beneficial. Some people feel the healthiest when they follow a low-carb diet, while others thrive on high-carb diets.

Eating healthy generally has nothing to do with following diets or specific dietary rules. Healthy eating means putting your health first by feeding your body nutritious foods.

The specifics will differ depending on your location, financial situation, culture and society, and personal taste preferences.

How to make eating healthy work for you

Food may be one of the many puzzle pieces that comprise your daily life but making nutrition a priority is the first step toward eating a healthier diet.

This doesn’t mean you have to spend hours grocery shopping or meal prepping, but it does require a little thought and effort, especially if you live a busy lifestyle.

Stock up on these items when you go grocery shopping

  • Fresh fruits and vegetables
  • Protein sources, such as chicken, eggs, fish, and tofu, as well as bulk carb sources (canned beans and whole grains).
  • Healthy fat sources, such as avocados and olive oil.
  • Starchy vegetables, including white potatoes, sweet potatoes, and butternut squash
  • Nuts, seeds, nut butter, hummus, and olives

Practical tips 

The suggestions below can assist you in making the transition to a healthier diet.

Make plant-based foods a priority

Plant foods, such as vegetables, fruits, beans, and nuts, should comprise most of your diet. Try including these foods, particularly vegetables and fruits, at every meal and snack.

Ditch take-outs

Cooking at home allows you to diversify your diet. If you’re used to ordering takeout or eating out, start by cooking just one or two meals per week.

Regular grocery shopping

If you keep healthy foods in your kitchen, you’re more likely to prepare healthy meals and snacks. Make one or two grocery runs per week to keep nutritious ingredients on hand.

Recognise your diet will only sometimes be perfect

Progress, not perfection, is essential. Meet yourself exactly where you are. Cooking one homemade, veggie-packed meal once a week is significant progress if you eat out every night.

Avoid sugar-sweetened beverages

Limit your intake of sugary beverages, such as soda, energy drinks, and sweetened coffees, as much as possible. Regularly consuming sugary beverages may be harmful to your health.

Choose foods that are filling

When you’re hungry, your goal should be to eat nutritious foods rather than consume the fewest calories possible. Choose protein- and fibre-rich meals and snacks that will keep you full.

Consume whole foods

A healthy diet should include whole foods like vegetables, fruits, beans, nuts, seeds, whole grains, and protein sources like eggs and fish.

Drink water

Water is the best way to stay hydrated, an essential part of healthy eating. If you’re not used to drinking water, get a reusable water bottle and flavour it with fruit slices or lemon juice.

You can also consult with a registered dietitian if unsure how to improve your diet. A dietitian can assist you in developing a long-term, nutritious eating plan that fits your needs and schedule.

This article is attributed to Affinity Health.

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Weight loss: more than just eating less and being more active

Dr Paula Diab sheds light on the physiological mechanism of weight loss and gain then looks at the methodologies that can assist in achieving and maintaining the desired weight.


Did you make any New Year’s resolutions for planned weight loss, go on diet, spend more time in the gym or start some new type of exercise? Have you kept up with any of those goals as yet?

Don’t feel alone or despondent about these goals. In this fast-paced, instant-gratification world in which we live, such goals are extremely common. However, the rewards aren’t as easy to achieve as we think they are.

Obesity as a chronic disease

Obesity has recently been recognised by the international healthcare community as a chronic disease. What this means is that the mechanisms that cause obesity are persistent and long-lasting and various complications may be associated with the condition as well.

The European Medicines Agency states that “Obesity is recognised as a chronic clinical condition that usually requires long-term therapy to induce and maintain weight loss and is considered to be the result of complex interaction of genetic, metabolic, environmental and behavioural factors, which are associated with increases in both morbidity and mortality.”

The World Health Organization has recognised obesity as a threat to both developed and developing countries and estimates that over 650 million people worldwide are affected by it.

The Canadian Medical Association has declared “obesity to be a chronic medical disease requiring enhanced research, treatment and prevention efforts.”

The bottom line is that treating obesity is more complicated than cutting out sweets and going to gym more often.

What is obesity?

Many people and healthcare institutions consider a body mass index (BMI), a simple height to weight ratio, as the only indicator of being over or underweight. In addition, it’s suggested that all types of people from all races and ethnic backgrounds be subject to the same parameters. Some exceptions have been made but generally a BMI of > 25 is considered overweight and > 30 is obese.

This is also changing. I’m not a big follower of action movies but my teenage son tells me that Dwayne Johnson (aka The Rock) is 1.96m tall and weighs 118kg. That gives him a BMI of 34; very soundly in the obese category. I’ll certainly be last in the queue of people to go up to him and tell him he’s overweight.

More recently, we have started looking at a multitude of other factors to determine if someone is overweight and how this may or may not affect their health. Some of the factors we consider are:

  • Medical co-morbidities – cardiac disease, arthritis, fertility problems, diabetes, etc
  • Mental concerns – depression, social isolation, etc.
  • Functional ability – can the person continue their desired daily activities without limitation?

These are all important indicators that will guide as to how we should approach the management of obesity. Few would argue that The Rock has any limitations on his functional abilities.

Complications of obesity

Does this mean that we can ignore a higher BMI and allow people to choose their desired weight as they please? Not really. Research indicates that people with a higher BMI are definitely prone to developing a range of complications and that obesity has a significant impact on life expectancy. People with a BMI over 40 have a predicted only 50% chance of reaching the age of 70 compared to those with a BMI < 30 who have an 80% chance.

Complications range from other metabolic diseases, such as diabetes, which has a significant impact on other health concerns in itself, to cardiovascular disease and some types of cancers.

Gout, arthritis and bone disease also become more prevalent due to the mechanical strain on joints and muscles and mental health complications, such as depression, also are more frequent.

Weight loss improves complications

Whilst this may sound like a very negative situation, the reality is even a modest weight loss will have an enormous effect on reducing these complications.  

What causes obesity?

It’s probably fair to say that most people think that weight gain is due to an imbalance between energy intake and energy expenditure. People who are overweight, either eat too many calories or do too little activity. Losing weight therefore requires more activity or fewer calories. This is not true.

It has now been scientifically proven that weight gain or loss is far more complex than this and that the main organ responsible for controlling weight is our brain.Genetics play a vital role in regulating this control; if your family is overweight, it’s very likely that you have similar genes that will dictate how your body responds. Other organs in the body such as the pancreas, gut and adipose tissue (fat tissue) also influence your metabolism and how you process energy in the body.

Restricting energy intake (eating less) is also not an effective means of weight loss as hormones, such as leptin, are downregulated as energy restriction occurs. Low leptin levels cause the body to conserve energy and trigger a response in the brain that you are hungry and need to eat. This is not a will-power issue but a genuine lack of energy in the body which causes weight to regain as your body adapts to the feeling of hunger and desire to eat.

The role of the brain in controlling appetite

Until recently, the impact of the brain in appetite has been largely overlooked. Homeostatic eating is eating for hunger. This is what we generally don’t do. It is, however, what most animals do. They hunt when they are hungry and eat until they have gained enough calories to survive.

Hedonic eating

Hedonic eating is eating for pleasure and is under control of the mesolimbic system. This is the eating that happens at Christmas lunch or at a wedding or when we eat out at a restaurant with friends. It’s mediated by feelings of wanting or liking to eat and not by satiety or hunger.

A want-to-eat is mediated by dopamine, a hormone implicated in reward-behaviour system. The more we eat, the more we reward our brain and drive future such behaviours. Liking-to-eat is associated with pleasure derived from eating and is mediated through opioid and cannabinoid receptors. No one would dream of hosting a celebration and serving just a small amount of food to allow your guests to survive and combat starvation. We like tasting different foods, we like socialising while we eat, we like food that tastes good.

We have the privilege of being able to indulge in hedonic eating and not just eat when we are hungry. It’s the executive functioning in the pre-frontal cortex of our brains that decides when we are hungry. Over years of over-riding the need to eat and the want to eat, our brains develop alternate pathways.

In addition, each time we gain weight, our brains use that as a new set-point, a new normal to which it governs our weight regain. Many of us will relate to the experience of going on a diet, eating fewer calories but as soon as you go into a maintenance phase again, you regain the weight to where you were initially.

How do medications work?

Some older weight loss preparations have a more short-term effect and aim to speed up metabolism; these generally work very well in the short-term but have little effect on the underlying problem.

Others act on energy wastage and bind fat in the gut to reduce calories absorbed. Again, this can work well in the short-term but aside from some negative side effects, do very little to address the pathways in the brain.

Newer formulations of medications to manage weight have recently been developed and licenced for use and are much more effective at addressing the chronic underlying pathology that results in weight gain.

What we need is a drug that acts on the pathways in the brain to reset the weight set-point and override the feelings of hunger and desire to eat as well as improve metabolism in the gut, pancreas and other metabolic organs.

By reducing gastric emptying, you feel fuller for a longer period of time thus decreasing the desire to eat. Within the liver, metabolism is also affected reducing glucose production and enhancing glucose sensitivity.

Such drugs also have a positive effect on cardiac function, but the most significant effect is the action directly on the brain which results in decreased food intake, improved satiety and sustained weight loss.

Patient feedback

There has been great success using these drugs with my patients and some of the comments talk directly to the mechanisms in which they work. Comments relating to how their focus shifts away from food and they can get on with normal daily activities without being fixated about their next meal or how little they should be eating.

Other comments relating to the ability to sit at a table and eat what they feel they need to eat rather than what they want to eat and actually feel full and satisfied at the same time. The medication also has a significant effect on combatting the cravings that people feel in between meals and the extra snacks that we have just because they taste nice.

Summary

Shifting from a BMI-centric approach of treatment where we are purely trying to target a number to a more complication-centric focus where the multiple co-morbidities associated with obesity are addresses as well as the often unseen mental complications will certainly result in better outcomes in managing weight and obesity.

Counselling, self-monitoring, physical activity and diet are most certainly vital aspects of weight management achieved through interaction with a holistic multi-disciplinary team. This includes dietitians to address the obvious aspects of diet and a doctor skilled in obesity management to know which drugs and possible surgical options suit each patient as well as multiple other practitioners as individual patient needs dictate.

Our healthcare system is perhaps not ideally suited to deliver obesity management in such a way, but it will be a great leap forward if we can shift our focus from thinking that weight loss is a quick-fix that requires more activity and fewer calories to one of understanding the chronic nature and multi-faceted cause of weight gain.

Accurate and effective pharmacological treatment is the future of weight management and treating obesity as a disease and not a lack of will power and poor decision-making will go a long way to helping those who need medication to access it.

Dr Paula Diab

MEET THE EXPERT


Dr Paula Diab is a diabetologist at Atrium Lifestyle Centre and is an extra-ordinary lecturer, Dept of Family Medicine, University of Pretoria.


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Sex and diabetes complications

Daniel Sher briefly covers how sexual dysfunction manifests in people with diabetes and gives some pointers for improving your sex life.


Does diabetes affect your love life? Do people with diabetes have an increased risk of sexual dysfunction? Unfortunately, the answer is yes: many people with diabetes also have sexual dysfunctions. As if we didn’t already have enough to worry about.

How common are sexual problems in people with diabetes?

In a recent study, 36% of men with diabetes reported a sexual disorder. The most common culprits were erectile dysfunction (in which a man struggles to get or maintain an erection) and orgasmic dysfunction (in which a man struggles with the timing of ejaculation).

What about women? The study found that 33% of women with diabetes experience a sexual disorder, including low sex drive, reduced vaginal lubrication or difficulties with reaching orgasm.

Why is this such a problem? Sexual health problems have a profound burden upon the psychological well-being of people with diabetes. Research tells us that people who have both diabetes and sexual dysfunction tend to experience:

  • Reduced overall quality of life
  • Greater risk of running into diabetes complications
  • Overall poorer blood-glucose control
  • Poorer psychological adaptation to diabetes demands
  • Bigger risk of running into diabetes distress, or burnout.

Diabetes and relationships

The stress of managing diabetes can most certainly spill over into your relationship. One study found that two thirds of the people with diabetes interviewed said that their condition negatively affected their relationship with existing or potential partners. Why is this the case?

For some, diabetes can translate to low self-esteem and feeling less attractive as a result of their condition. There is already a huge amount of stigma faced by people with Type 2 diabetes.

For those with Type 1: children with diabetes often experience exclusion and othering during their school years, which can set them up to feel inadequate later in life.

What else? Generally speaking, sex and love require a person to be present and connected. It can be tough to connect with your loved one on this level if your mind is focused on your blood glucose. At the same time, though, diabetes is a 24/7 job, we never really get to switch off.

Stress is not sexy

We all know that living with a chronic condition can be stressful; and stress, quite simply, is not sexy. How so? Literally, high levels of stress send your brain into fight-or-flight mode, pushing adrenaline and cortisol (stress hormones) into your system. While these brain-body changes are great for helping you fight against or flee from a predator, they are not particularly useful when you’re trying to have sex.

Stress also makes a person less likely to be in the mood for romance; and it may mean that you simply don’t have time or energy to connect with your partner. Finally, stress tends to spike blood glucose levels, meaning that you have a greater risk of microvascular complications that can lead to sexual disorders.

Aside from that, people with Type 2 diabetes in particular often experience a far higher risk of major depression. People with Type 1 very often experience anxiety disorders. Both depression and anxiety disorders often involve sexual problems as symptoms.

What can you do?

First things first: if you are experiencing erectile dysfunction as a male with diabetes, it is vital to bring this up with your doctor, no matter how uncomfortable this might feel. Why? Erectile issues can, at times, be early warning signs for life-threatening heart conditions. Getting early treatment here can save lives.

Aside from that, often, sexual disorders in people with diabetes can be treated. At times, the treatment is medical; often, psychological input can help. Reach out to your doctor, psychiatrist or psychologist to find out more about getting the right support.

Generally, looking after your diabetes is the most important step to take in managing or preventing sexual issues. But remember that this is not a condition that you can thrive with if you’re doing it alone: learn to lean on your partner, community and treating team.

If you are feeling overwhelmed or hopeless about your diabetes, you might be struggling with diabetes distress (or burnout) which can worsen sexual dysfunction. Burnout and stress-management can be achieved through practices, such as mindfulness meditation, frequent physical exercise and proper time management, so that space for self-care is prioritised in your schedule.

Summing up

If you, as a person with diabetes, are finding that the condition is interfering with your love life, you are not alone. Research shows us that sexual dysfunction is a big risk factor for living with Type 1 or Type 2 diabetes. Unfortunately, sexual dysfunction placed on top of the demands of diabetes makes a stressful condition that much more challenging to manage. For this reason, it’s a really good idea to take proactive action as soon as you notice unwanted sexual symptoms creeping in. How? Speak up! Push through the discomfort and raise this issue with your doctor, so that you can get the treatment and support that you deserve.


References

 Corona, G., Isidori, A. M., Aversa, A., Bonomi, M., Ferlin, A., Foresta, C., … & Lombardo, F. (2020). Male and female sexual dysfunction in diabetic subjects: Focus on new antihyperglycemic drugs. Reviews in Endocrine and Metabolic Disorders, 21, 57-65.

 Van Cauwenberghe, J., Enzlin, P., Nefs, G., Ruige, J., Hendrieckx, C., De Block, C., & Pouwer, F. (2022). Prevalence of and risk factors for sexual dysfunctions in adults with type 1 or type 2 diabetes: results from Diabetes MILES‐Flanders. Diabetic Medicine, 39(1), e14676

MEET THE EXPERT


Daniel Sher is a registered clinical psychologist who has lived with Type 1 diabetes for over 28 years. He practices from Life Vincent Pallotti Hospital in Cape Town where he works with Type 1 and Type 2 diabetes to help them thrive. Visit danielshertherapy.com


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