Registered dietitian, Raeesa Seedat, educates us on why our choice of breakfast is so important.

Importance of breakfast

Breakfast is an important part of the diet that contributes significantly towards daily nutrient intakes. Consumption of breakfast leads to positive health behaviour, improved stress management, feeling energetic, and making less unhealthy snack choices.

Skipping breakfast results in fatigue, sub-optimal concentration levels, as well as an increased risk for developing obesity. In people living with diabetes, skipping breakfast can have negative consequences. Studies show that breakfast skipping is associated with increased average blood glucose, poor glycaemic control and increased HbA1C levels.

Skipping breakfast can also lead to an increase in energy intake in the form of lunch, snacks and supper. Achieving and maintaining blood glucose targets is the primary objective for diabetic treatment. Carbohydrate intake is the determining factor in whether this objective is achieved.

Carbohydrates

In all meals, carbohydrates are an important part of a healthy balanced diet. The amount and quality of carbohydrates directly impacts blood glucose levels.

Refined starches and sugars from processed foods are linked with weight gain and poor glycaemic control. These include white bread, white rice, potatoes, certain breakfast cereals and crackers, refined pastas, chips and crisps, sugar sweetened beverages, sweets, muffins and sweetened baked goods.

It is recommended that added sugars, refined and processed carbohydrates be restricted in favour of high-fibre and low-glycaemic index (GI) carbohydrates. The low-GI concept describes how foods consumed impact blood glucose levels.

Food sources of carbohydrates with a low-glycaemic Index (foods with a GI-level below 50) should provide the main source of energy in a diabetic diet. It is recommended they provide 40-50% of the daily energy intake.

Carbohydrates that have a low-GI are gradually absorbed into the bloodstream. This leads to improved control of blood glucose levels after eating as well as optimal insulin release. It is recommended that a diet with a low-GI content be consumed to aid treatment of diabetes, coronary heart disease and possibly obesity.

 A low-GI diet is characterised by:

• Increased intake of wholegrains, nuts, legumes, fruit and vegetables.
• Decreased intake of potatoes, white rice, white bread, cookies, cakes, sweets, sugar sweetened beverages and sugar coated breakfast cereals.

Fibre

Dietary fibre is defined as the carbohydrate found in food products that is not digested by the stomach or absorbed in the gastrointestinal tract. Fibre has multiple benefits for the human body. It keeps the digestive tract healthy, lowers cholesterol levels, helps control blood glucose levels and promotes a healthier colon by increasing good gut bacteria.

For people living with diabetes, a high-fibre intake is associated with improved outcomes, better satiety (keeps you fuller for longer) and prevents obesity. It may also prevent heart disease, constipation and colon cancer.

The recommendations for fibre intake are as follows: 20 to 35 grams of fibre from raw vegetables and unprocessed grains. High-fibre carbohydrate sources includes legumes, wholegrain breads and cereals, whole fruits and vegetables. These should be included as part of the daily carbohydrate intake.

The goal of 20 grams or greater of fibre per day may be difficult to achieve for some, as large amounts of fibre may cause bloating and gas. Fibre should be slowly incorporated into the diet if one is not accustomed to large amounts of fibre in the diet.

What to eat for breakfast

It is strongly suggested that wholegrain be added to your morning meal. This may be in the form of a porridge or cereals. Look for options that list whole wheat, whole oats, or other wholegrain first on the ingredient list without added sugars.

Choose breakfast cereals with greater than 6 grams of fibre per 100 grams.  Ready-to-eat breakfast cereals are highly-processed and have a very little to no fibre.

Oats and oat bran

Oat bran is a cereal product that has been receiving increasing attention.  Originating from oat grain or oat flakes, fragmented and separated to remove the starchy endosperm from the fibre containing fractions, it is nutrient rich.

It is particularly high in soluble fibre which helps control blood glucose levels and lower cholesterol. The substance found in oats responsible for this effect is β-glucans. It binds to water to form a gel inside the digestive tract, thereby increasing the viscosity of the food and delaying gastric emptying.

This delayed absorption of nutrients also means that carbohydrates are absorbed slower, leading to improved blood glucose levels after meals. Oat bran may be consumed daily as a breakfast cereal and can also be added to soups or be used in baking as a partial substitute for flour.

Conclusion

Do not skip meals, especially breakfast. Include a high-fibre, low-GI breakfast cereal, such as oats, oat bran or bran flakes daily. Avoid poor quality carbohydrates that are sugar-rich and processed. Consume a healthy balanced diet including high-fibre, low-GI carbohydrates.

MEET THE EXPERT

Raeesa Seedat is a registered dietitian, based in the northern suburbs of the Western Cape. She is very passionate about dietary management of disease with the application of clinical research and science. She also has a special interest in chronic conditions, such as diabetes, cardiovascular disease as well as gastroenterology.

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Everything we do is intertwined with all things surrounding family, especially feasting. This can leave us feeling utterly satiated, or sometimes utterly guilty. All aspects of our lives should include feeling good and enjoying the positive health benefits without the long-term risks.

Feeling

Health costs associated with chronic medications, surgeries, prolonged hospital stays and rehabilitation places a large financial burden and poses significant challenge for healthcare systems and the global economy. It has been said that 5-20% of all health spending is utilised for the management of diabetes¹.

Most people know of that feeling of having a bad day which often leads to reach for a quick pick-me-up snack which gives immediate gratification and seems quite pleasurable at the time. However, over time this affects our health in quite drastic ways.

Feel-good activity

An even better ’feel-good’ activity can be attained with moderate physical activity. Physical activity is often described as medicine, and not only has few risks and almost no side effects, but rather excellent long-term benefits.

Fitter, stronger people feel more capable in activities of daily living, perform better at work or play, have better cognitive ability, better psychosocial interaction, have more energy, and lower risks of other co-morbidities.

In fact, it is recommended by the World Health Organisation that every person get at least 30 minutes of moderate-intensity exercise per day or 150 minutes per week.

Just one bout of exercise of moderate intensity for 30 minutes would give you an immediate boost to your system, lowering blood glucose levels and blood pressure, better sleep, and releases endorphins, known as ‘feel-good hormones which helps lift mood and combats stress.

So, instead of feeling your way through the kitchen cupboards for a sugary snack, rather feel your way towards your workout gear. If restrictions to exercise are leaving you feeling frustrated, then consult a biokineticist who can assess, prescribe rehabilitation and get you back to your preferred choice of activity to get you to your health goals and ‘feeling’ fit.

Supervision by a biokineticist

Due to the many considerations and concerns when it comes to exercise training for people living with diabetes, it is recommended that exercise is done with the supervision by a qualified health professional, such as a biokineticist.

Biokineticists are qualified health professionals responsible for rehabilitation of persons with chronic, orthopaedic and neurological conditions through individualised exercise prescription. They are specifically trained and educated to work with individuals affected by chronic and non-communicable diseases, such as diabetes.

Correct exercise prescription from a biokineticist has consistently shown to improve glucose uptake, increase insulin sensitivity, improve circulation and reduce risk of complications, such as cardiovascular disease. It also plays a large role in weight reduction, which is an important component of diabetes management and prevention.

Family

Fluctuations in blood glucose can also be incredibly difficult and frustrating to deal with. This means it can also have an impact on your immediate family who are alongside your day to day choices and frustrations.

Medical expenses also place a huge financial burden on the individuals and their families. If health status declines further and disability, such as blindness, amputation, stroke or heart attack, occurs; this would have an impact on the whole family, and even caregiving may be needed. This is a significant liability for families to bear and may have further financial implications.

Incorporate exercise as daily living

Sometimes people living with diabetes will need to rely on close surveillance by their family to help keep their health monitoring in check, or to assist someone suffering with a hyper/hypoglycaemic attack.

Symptoms of hyperglycaemia (thirstiness, blurred vision, weakness, nausea, vomiting and coma) and hypoglycaemia (fatigue, shakiness, dizziness and loss of consciousness) can have a huge impact on daily living.

One of the keys to positive family involvement is to instil healthy lifestyle habits, such as exercise or recreational physical activity for the entire family.

Exercise and physical activity is for everybody, of every age. Children love to play. Most of their play involves movement and vigorous exercise, so it’s a perfect opportunity for families to engage in physical activity whilst engaging in play with their children. This helps with healthy quality time and bonding, and teaches children that exercise is an important part of day-to-day life. Children learn lifestyle habits from an early age from their parents, so the earlier a family starts this lifestyle habit, the better.

The recommended amount of exercise necessary for children is around 60 minutes per day. The elderly might not be as inclined to start exercising, but once the health improvements begin to be noticeable, it is hugely motivating.

The same specification of exercise for adults of 150 minutes per week still applies for the elderly. Specific exercise prescription will need to be considered for the age, preference, and capability of each person. From children to grandparents, from recreation to elite sportsman, a biokineticist can help create individualised rehabilitation or prescription.

Feasting

The saying “A moment on the lips, a lifetime on the hips”describes our love/hate relationship with unhealthy eating. Type 2 diabetes is mostly considered as a lifestyle disease which occurs because of poor lifestyle choices, including smoking, physical inactivity and poor diet.

Therefore, one of the most effective management strategies for Type 2 diabetes is lifestyle change to better manage weight and promote optimal health. Such changes include improving diet by reducing intake of refined sugar and increasing intake of fruits, vegetable and wholegrains, smoking cessation, as well as committing to regular exercise and physical activity.

‘Feasting’ or bingeing on foods and drink that are high in sugar is largely to blame for the diabetes epidemic and no amount of exercise can make up for these poor dietary choices.

Feasting often appeals to our search for ‘feeling good’. It’s most often also associated with family time and celebration. Unfortunately feasting also seems to be rather excessive as opposed to necessary. It also tends to be focused on large portions and taste instead of healthy nutrition.

You can’t outrun a bad diet

It takes approximately 42 minutes of brisk-walking to burn off the calories from your average chocolate bar. One sugary soft drink would require a walk for 26 minutes, and two slices of a large pizza would require 1 hour and 23 minutes to work off. Basically, one can’t outrun a bad diet. Therefore, committing to making sustainable changes to your diets is of such importance.

Choice is king

Diabetes is a condition faced by many people across the globe. It has many burdens on the individual level, but also affects families and the global economy.

However, it is easily manageable through lifestyle changes, including making better dietary choices and participating in regular exercise and physical activity. To reduce global healthcare costs and the prevalence of this devastating condition, we encourage you all to make the first step to a healthier lifestyle, and visit a biokineticist near you.

For more information on where to find a biokineticist or on the profession itself, visit www.biokineticssa.org.za or call 012 6441506.

References

 Edition, S. (2015). IDF Diabetes Atlas, the Seventh Edition. Retrieved from http://www.diabetesatlas.org/resources/2015-atlas.html

Manuscript, A. (2012). The Psychological Impact of Living With Diabetes. Changes, 29(6), 997–1003. https://doi.org/10.1016/j.biotechadv.2011.08.021.Secreted

Roglic, G. (2016). WHO Global report on diabetes: A summary. International Journal of Noncommunicable Diseases, 1(1), 3. https://doi.org/10.4103/2468-8827.184853 Han Cho, 2015

Saadia Kirsten Jantjes shares helpful tips to keep you and your family active during this period of social distancing.

With social distancing and self-isolation becoming a part our daily lives due to the outbreak of COVID-19, it is a great chance to optimise on some family time and establish familial bonds. A great way to do so is through exercise.

Managing your diabetes means coming up with exciting ways to keep fit and active, especially since most gyms are either closed or too high-risk.

One of the major benefits of exercise, apart from weight management, is the major and positive effect it has on boosting the immune system, which is imperative at this point.

Get started

If you’re still new to exercise and not sure where to start, there are many online videos and workout programmes which you can download, either on Pintrest or YouTube. A word of advice, make sure the source is reliable and that the content is provided by a registered fitness trainer.

Change it up

If you are working from home and taking care of the kids, doing the same thing each day will become monotonous. Add variation so that you are doing different activities each day ranging from cardio activities, like walking or running, to strength training activities, like weight training or Pilates.

Make it rewarding

Create little challenges and make it competitive, rewarding and fun. Other than getting your Vitality step or workout rewards, make it rewarding to work out as a family. You can do a timed workout or obstacle course. Use incentives, such as chores, to see who gets to choose the next movie or series, or who gets a special treat to keep the morale up at home.

Track your progress

It’s a good idea to do some basic measurements (weight, height, circumference measurements like waist, hip, thigh) and a basic fitness test to track your progress. This can be something simple like seeing how many push-ups and squats you can perform in one minute. Retest and redo your measurements every week to make sure you’re on track and making progress.

Be mindful

It is a stressful time, which could result in increased anxiety for both you and your family. This isn’t helpful when it comes to managing your diabetes. Incorporate activities, such as yoga and meditation, into your exercise plan to find a good balance between physical fitness and mental health.

It is a trying and testing time for everyone. Taking care of your and your family’s health and well-being is of the utmost importance, so make sue you are taking time to stay fit, healthy and mentally active.

MEET THE EXPERT

Saadia Kirsten Jantjes is a physiotherapist with a passion for health and wellness. With a second degree in Sport Science, exercise is one of her favourite rehabilitation tools, to not only rehab injuries but prevent injuries too. Saadia has her own private practice in Morningside, Johannesburg, while working at a Sub-Acute Clinic and furthering her studies in Pilates.

Lila Bruk advocates that water should be your essential tonic for optimum health.

Over 70% of the body is made up of water, and water has many essential roles within the body. It is necessary for important body processes, such as digestion, excretion and metabolic functioning. It, therefore, should come as no surprise that drinking enough water is essential for optimum health.

Regular plain water is best

There is a huge variety of bottled water available now, including flavoured carbonated waters, as well as those that promise additional health benefits (e.g. slimming water).

However, flavoured waters often contain just as much sugar as regular sugary soft drinks, or else have large quantities of artificial sweeteners.

Similarly, those waters that claim that they boost your metabolism, or give you more energy are usually packed full of substances, which may be detrimental to your health and/or can even adversely affect your body’s response to certain medication.

For example, ginseng is often added to slimming waters and energy drinks, as it allegedly helps to boost energy levels. However, ginseng can, in fact, interact with blood thinning medications and intensify their affects, which in turn can lead to bleeding problems. For this reason, regular plain water is your best bet.

How much water do I need?

For every kilogram you weigh, you need 30ml. Therefore, to work out how much water you need, multiply your weight in kilograms by 30. So, if you weigh 60kg; 60kg x 30ml = 1800ml. You would need a minimum of 1800ml or 1,8l of water.

Then for every 30 minutes of exercise you do, you need at least an additional 250ml of water.

Therefore, if you weigh 60kg and do an hour of exercise on a given day, you need: 1800ml + (2 x 250ml) = 2300ml or 2,3l. This means you need at least 2,3l water per day.

Of course, on very hot days or when you’re doing particularly strenuous exercise, you may need even more fluids.

Alternatives

As mentioned previously, natural uncarbonated water is preferable. However, if you don’t like the taste, you can add lemon juice, a dash of fruit juice, orange slices, or even mint leaves. Some prefer to drink hot fluids, which is also totally acceptable, as water is good for you regardless of the temperature.

Also remember that other liquids can also contribute to your fluid intake, such as rooibos, herbal or fruit teas and vegetable soups.

For the warmer summer months, try making your own iced tea using a fruity, non-caffeinated tea as a refreshing alternative to plain water.

If you find that increasing your fluid intake leaves you taking far too frequent bathroom breaks, don’t despair. Rather, keep up with your water-drinking and before too long, your body will have adapted to the increased fluid intake.

Is it possible to drink too much water?

Yes, it is. More than approximately six litres a day can, in fact, be dangerous. If one drinks too much, it can cause the body’s sodium levels to drop (otherwise known as hyponatremia), which can have many detrimental effects on the body, such as swelling of the brain.

Can water help me lose weight?

Yes, it can aid weight loss in three main ways:

1. Often one mistakes thirst for hunger, which results in one eating when in fact the body needs fluid. Also, in this situation when one’s body is crying out for fluids, it is usually sweet, starchy foods that one craves. Therefore, by drinking enough, one can minimise the risk of eating unhealthy snacks.
2. Fruits, vegetables and wholegrain breads, grains and cereals are all rich in fibre and an essential part of a healthy low-fat eating plan. Fibre acts as a sponge in the body, as it absorbs water and makes you feel fuller for longer. Therefore, you’re less likely to snack on unhealthy choices. However, if you don’t drink enough, you won’t get the full ‘filling-up effect’ of fibre.
3. Even mild dehydration has been found to detrimentally affect athletes’ sporting performance. Therefore, by drinking enough you can be sure that you’ll train at your optimum intensity. Thus, ensuring that you burn the maximum number of calories during your training session, and in this way optimising your weight loss.

So, in conclusion, look at water as your essential tonic for optimum health, rather than a good mixer or a precursor to ice cubes, and prepare to reap the benefits!

MEET THE EXPERT

Lila Bruk  is a registered dietitian and nutritional consultant in private practice in Johannesburg, Gauteng. She is passionate about promoting health and good nutrition and thus has written in over 350 general and health-related publications. She gives regular lectures on nutrition-related topics, and appears regularly on television and radio. Her areas of interest include nutritional management of lifestyle diseases (including diabetes, insulin resistance and heart disease), digestive disorders (e.g. Crohn’s disease, Irritable Bowel Syndrome), eating disorders, food allergies and sports nutrition.

Header image by FreePik

We learn how to monitor blood glucose levels with purpose with the Accu-Chek® Testing in Pairs.

Whether you are newly diagnosed or have been living with diabetes for some time, it is important to manage your blood glucose. Monitoring your blood glucose (or sugar) levels forms an important role in helping you understand what is happening on a day-to-day basis.

Remember that one blood glucose value from a check does not tell you the whole story! When you consistently check at the right time and frequently enough in a structured manner, blood glucose patterns emerge. This can give you a better understanding of the fluctuations in your blood glucose, which are linked to your daily habits.

Accu-Chek® Testing in Pairs is a simple paper tool designed to help you see changes in your blood glucose before and after a specific meal, exercise, or other event. Use it to discover how one thing in your daily routine can affect your blood glucose.

What could you learn?

• Does what and how much I eat make a difference in my result?
• How does activity/exercise affect my blood glucose?
• Does packing my lunch instead of eating out affect my blood glucose?

Tumi’s example

Tumi would like to learn how breakfast affects her blood glucose. Here’s how it works:

1. Start with a simple question and use your blood glucose results to see what works for you.
2. Each day, check your blood glucose before the meal or activity, and write the number in the Before column. Check it again two hours after the meal or activity, and write it in the After column.
3. How did your blood glucose change? Look out for any changes above 2,8 mmol/L.

What do I want to learn?

How does breakfast affect me?

Tumi learnt that a breakfast lower in carbohydrates had a much smaller impact on her blood glucose levels than a breakfast higher in carbohydrates. The Accu-Chek® Testing in Pairs tool showed her that even small changes could make a big impact on her blood glucose control.

You can take that same step today. Simply visit the Accu-Chek® website to download a copy of the Accu-Chek® Testing in Pairs tool, and see for yourself how before-and-after testing can make a difference.

In a world saturated by health gimmicks, miracle eating plans, and fitness fads, there is finally something that takes its clients’ goals as seriously as they do. It goes by the name of JEFF.

Introducing JEFF

Johno’s e-Fitness Faculty (JEFF) is a revolutionary new fitness service that balances the ease and accessibility of a mobile fitness programme, with the comfortingly human input of a personal trainer and a simple, balanced eating plan.

The brainchild of top sports conditioning coach, Johno Meintjes, JEFF is an innovative digital fitness, nutrition, and coaching concept that can serve anyone, anywhere, at any time.

How does it work?

The JEFF model is designed to help refine your health and fitness strategies by providing a structured training routine and personalised nutritional programme that is overseen by a remote team of real-life, approachable, and fully qualified personal coaches. It puts you in charge but makes you 100% accountable to making real, sustainable, life-long habit changes.

The reality is that if you could have done this by yourself, you would have done it already. The mentoring and coaching side of JEFF is the part that brings it all together.

Tried, tested, and trusted

Before creating the programme, JEFF’s founder, Johno, spent six years working with South Africa’s top national cricket, hockey, and rugby teams.

Since launching, JEFF has been used by the likes of Maps Maponyane, Lady Kitty Spencer, Graeme Smith, Jacques Kallis, and Mark Boucher (to name but a few) to become slimmer, fitter, happier versions of themselves.

What does it consist of?

Whether signing up for the 7-week gym-based programme, 14-week gym-based programme, or 7-week home-based programme, clients receive the following support to ensure that they smash their fitness objectives:

• Tailored eating plan
• Bespoke weekly training programme
• Five-six hours/week of self-paced training
• Personal coach
• Virtual coach support daily
• Assessments every three weeks
• Supportive community vibe

It’s clear that the combination of clean eating, daily support from a skilled coach and the flexibility of independent exercise is a winning formula for overall well-being.

Dependable results

On average clients lose 5-7kg, 1-2 clothing sizes and 8cm off the waist on the seven-week plan, and 10kg, 1-3 clothing sizes, and 13cm off the waist on the longer 14-week plan.

With clients logging dependable results such as these in short periods of time, it is small wonder that JEFF has welcomed hundreds of clients on six different continents over the last year.

Helping ordinary people become their best selves

From professional athletes to people who simply feel as though their health and fitness goals have slipped by the wayside, with JEFF’s affordable professional help, there has never been an easier way to regain mastery of your own health.

Click here for more information on JEFF