Reflexologist, Veronica Tift, elaborates on how, if unbalanced, the five elements can cause ailments and pain.

Take a moment to think about how completely and totally unique you are. Everything about you is like no one else on this planet of 7,5 billion. Your fingerprints, personality, genomes and cellular operating instruction are all unique to you. How incredible!

This is where many ancient healing practices had it right, looking at us as the unique humans we are and our deep connection with earth and its elements. Observing the changes in nature and the changing cycle of us humans: birth, adulthood, maturity, aging and dying.

Using five essential features of nature: fire, earth, wood, metal (or air) and water, ancients explained the complex traits of our bodies and minds. These are not literally the elements that make up our bodies, but more metaphorically.

One of these elements is produced by one element and then produces another, this creates a cycle of the five elements within each of us that require balance.

The five elements

The five elements, fire, earth, wood, metal (or air) and water, are broken down into different categories. These include seasons, physical traits, body type, taste, colour, emotion and sound.

While a person is made up of all five elements, there will always be one or two more dominant. So, for example, if we look at the different emotions, you might be quicker to anger or feel frustrated easily (a trait of people with a dominant wood element), or you are incredibly well-organised (like metal element types). Maybe you are more introspective (like those with a strong water element), or possibly you struggle with depression or are passionate (a dominant fire element).

When we experience extremes in our mood, tastes, sense of smell or even over doing it on a colour, this can indicate that there is an imbalance in that related element.

Each person’s element requires different ways of bringing their individual element into balance. A fire dominant will need lively, energetic people with fun activities to help balance emotions, while an earth dominant will look to supportive friends and family, or metal dominant will detach for a while when under stress.

Imbalance in elements causes illness

Ever wondered why you seem to struggle more at different times of the year? The elements correspond with a season: water with winter; wood is with spring; fire with summer; metal with autumn; and earth with late summer.

Extreme imbalances in nature produce forest fires that rage out of control, and flooding and massive storms. When we think of extremes and imbalance in the body, we see illness, fevers, indigestion, high blood pressure and pain. Balancing the five elements within us help generate well-being and enable us to cope better with stressors.

Find balance with reflexology

Reflexology is a very well-rounded complementary therapy. When a client comes into my practice for the first time, I ask a couple of questions. For example, what emotion seems to come up when stressed and the time of the day when they feel extremely tired.

I notice the quality of a person’s hair and the colour of the clothes they might wear often when coming to see me, even what tone of voice a person speaks in: if they have a slight way of singing (earth) or speak in a shouty way (wood). All this tells me what element might be out of balance.

Then when I begin working on the feet, I have a better understanding of what the client’s needs are based on which element might be out of balance.

The body is mirrored on the feet through points called reflexes. Looking at the element out of balance, I can stimulate the reflex that best allows balance to be restored through the body’s own healing ability.

Help yourself

There are many online resources to find out which element might be your dominant and the best ways to balance it.

Visit your local reflexologist. Make sure they are trained in the elements and meridian therapies. This will help you delve deeper into the incredible world of the five elements, giving you specific insight on how to take care of yourself.

Note, as reflexologists, we should never claim to cure a specific disease or diagnose. If you have experienced this with a reflexologist, they might not be qualified to practice.

References:

Dougans, Inge. 2005 Reflexology- the 5 elements and their 12 meridians a unique approach

Axe, Dr Josh. 2021, Ancient Remedies for modern Life

Haas. Dr Elson M. 1981, Staying healthy with the seasons

Wills Pauline. 1995, The reflexology manual

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A shift in working habits affecting work-life balance since the start of the pandemic could be contributing to greater risk of burnout. But, reassessing how we manage demands in our daily routines can make a significant difference.

Sticking to a fixed schedule has become more difficult than ever, perhaps even more so for working parents and people working from home. A 24-hour weekday should ideally be made up of roughly eight hours each for working, sleeping and private time, which would include family responsibilities, rest, and leisure. This ideal balance isn’t always possible, and at times we need to be flexible with a few hours of overtime for urgent work priorities. This should be the exception, however, not the rule.

High expectations

In the last two years a pattern has emerged where productivity expectations seem to be higher than ever, and this shows no sign of abating. While work demands may be intense, it’s very often the pressure employees put on themselves that may alter work-life balance.

This has given rise to an ‘always on’ trend, which is persisting in many workplaces even among those not working from home. The technology and online platforms many people use for work can be convenient for keeping in touch with colleagues and cutting down on travel time, allowing us to pack more meetings into the day, but this can be intrusive after working hours and set a pace that is unrealistic and unsustainable.

Setting boundaries

Work demands are intense, and often we place further pressure on ourselves by trying to meet every expectation. If you feel you can’t even find time for a quick tea break, bear in mind that it’s simply not humanly possible to maintain good concentration solidly for eight or nine hours without a rest. Taking a short mental health break will help to keep you more productive throughout the day.

When the workday has ended, people often tend to take their work home both physically and emotionally. Actively working overtime, as well as time spent processing the demands of the day, worrying about tomorrow, and anxieties about our work can intrude on personal time.

Set boundaries for yourself on how you manage your time, and define a cut off point for work because there will always be priorities no matter how much extra time you put in. If a healthy work-life balance is not restored in time and a person is unable to replenish themselves sufficiently, it can have consequences for mental and physical health.

The need to decompress

Although working from home has allowed employees some flexibility and has squeezed a little extra time into our schedules, one advantage of commuting is that it offers a clear divide between work and home, and the time to decompress and evaluate the day.

After a full day’s work, it’s common to experience depleted emotional energy levels. After logging off work, we would all like to start relaxing but usually there are domestic tasks to be attended to first, such as preparing meals.

Taking a little time, if possible after work when you aren’t expected to be busy with anything else, to refresh your mind before transitioning into domestic life. Taking a breather to shrug off the stress of the workday can be helpful for fulfilling the need to put some distance between our work and home lives and help us transition into private family time.

Parents face extra demands

Parents often face additional demands, as parenting is a full-time job in itself. Working parents may feel worn out by the time they get home, but this is often when parenting time begins. There may be homework to oversee, preparations for school the next day, and bath time, and while you might be physically present for your family, it’s just as important to be emotionally present too.

By the time there is a chance to relax, parents may be so exhausted that they have no resources left for nurturing their personal lives and making the most of any spare time left before going to bed.

We are not meant to only work and sleep

When a person is approaching burnout, often the first thing to fall away is a sense of enjoyment. As human beings, we aren’t meant to only work and sleep. Don’t forget, we need to enjoy ourselves and invest time in our relationships.

Couples may sit together watching a series or scrolling through their phones but lead very separate lives. Spending time together should be about sharing and relating to each other, but often people at risk of burnout feel too exhausted to be fully present, and this could be a sign that it’s time to reassess your work-life balance.

Leisure time is vital for recharging our emotional energy and is therefore necessary to be at our best for both work and family. All too often, it’s only when people are burnt out to the point where they are no longer able to function in their working or home lives, that they reach out for professional support.

Often, we place so much value on the time we spend being productive, but not nearly as much as we should on replenishing our own mental and physical health. If you find you are starting to feel overwhelmed or demotivated, reach out for professional mental health support.

For information about mental health and services, and accessing care, or for help in an emotional crisis, Netcare Akeso is here to help. In the event of a psychological crisis, individuals can phone the Netcare Akeso crisis helpline on 0861 435 787, 24 hours a day, to talk to an experienced counsellor. 

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Diabetes educator, Tammy Jardine, offers 12 guidelines for healthy meal planning and explains why meal planning is important for diabetes management.

Diabetes is a condition where your body can’t properly use and store food for energy. The fuel that your body uses for energy is called glucose. Glucose is made in the blood from different types of carbohydrates, a nutrient found in food.

A high amount of this carbohydrate nutrient is found in foods, such as fruit, milk, some vegetables, starchy foods, and sugar. To control your blood glucose (blood sugar) you’ll need to choose healthy foods and limit the amount of the foods mentioned that are high in carbohydrate.

There is no perfect diet for people living with diabetes and you’ll find many contradictions as to which diet is best for diabetes. Instead of taking costly supplements and restricting food groups in your daily diet, it’s recommended that you eat foods that are high in nutrients and that you eat a variety of different foods. It’s always best to seek out a dietitian who has a special interest in diabetes to help you identify what foods are best for you as an individual.

Try these general guidelines for healthy meal planning:

1. Monitor blood glucose

Always monitor your blood glucose to help determine whether you need fewer meals or whether you do better on smaller more frequent meals. Every person is individual and depending on how diabetes affects you will help to identify what type of eating routine is best for you.

2. Eat vegetables

Although there is a lot of different information about what is the best diet for diabetes, the one consistent factor is that vegetables are important. Vegetables are high in fibre and high in vitamins and minerals. A variety of vegetables should make up 50% of your daily intake.

In addition to veggies like cauliflower, carrots, beans, and salad veg, be sure to include dark green leafy vegetables like spinach, kale, and broccoli. These are high in magnesium. You may need to limit these if you are on warfarin; check with your dietitian. Vegetables don’t have to be raw but if you cook them, steam or stir-fry until still crispy as soggy veggies are never appetising.

Try to add at least ½ cup of beans into your weekly meals about three times a week. Beans are high in fibre which helps to control blood glucose. These can be canned but be sure to drain them and rinse them to get rid of most of the salt. Beans include kidney, pinto, black beans, butter beans, cannellini beans and chickpeas.

3. Avoid processed foods

They are usually crammed with preservatives and additives. Clean, whole foods are a much better choice and if they are closer to the way they come from the earth, the better. For example, choose a mealie (corn on the cob) rather than mealie meal. Also, if you choose starches that are whole grain instead of the more processed versions (white versions), you’ll get more fibre, vitamin B, magnesium, omega 3 fatty acids and folate.

4. Identify your tolerance for carbohydrates

You can do this by testing your blood glucose before (pre-meal) and two hours after (post meal) eating a meal of carbohydrates. Use an app like FatSecret or MyFitnessPal to determine the amount of carbohydrates you’re going to eat. If your blood glucose post meal is more than 2 above the pre-meal reading, then you know you need to eat less carbohydrate.

Once you’ve identified your individual tolerance level then use the apps to calculate the portion of meals you usually enjoy and help with meal planning.

5. Eat berries

Berries are the best fruit to eat as they contain very little sugar and are high in antioxidants which help protect your body from everyday damage. Fruits are generally high in a sugar, called fructose, so watch the amount that you eat at a time and never have more than three portions a day.

6. Palm size protein

Protein foods like meat, eggs, chicken and fish can be eaten daily. Try to keep your portion to the size of your palm at a meal. It doesn’t really matter how much is red meat but do try to have three portions of fish a week (about 180-270g per week). Fish that is naturally oily like mackerel, pilchards, salmon and trout are excellent choices as they are high in omega 3 which is heart healthy and good for your immune system.

Stay away from the breaded and deep fat fried variety. They don’t count in your goal of 60-90gportions three times a week and the crumb will add to your carbohydrate limit.

7. Avoid non-nutritious foods like sugar and sweeteners

Sugar will increase blood glucose. This includes sucrose sugar (the one we use in beverages and cereal) as well as honey. Although sweeteners are generally safe for people with diabetes, they still don’t add value to your diet and water is still the number one recommended beverage. If your urine is dark, you need more water, and try to replace fluid if you have been to the loo.

8. Calcium is important especially if you are on metformin

Calcium is found in green leafy veg, as well as the bones of fish (like pilchards and canned salmon), in nuts, and also in dairy products. Milk does contain its own carbohydrate, called lactose, so be sure to consider it in your individual tolerated carbohydrate limit. Limit cheese to three times a week as it’s high in salt.

9. Limit salt

Try to use less salt added to foods and use more herbs, garlic, ginger, cinnamon, and chilli to flavour your foods. 

10. Avoid processed and packaged snacks like crisps, sweets and chocolate

This is a guideline that everyone wanting to be healthier should follow and not only people with diabetes. Like the guideline number 3 and 7, they are packed with preservatives and additives and add no real nutritious value to a healthy diet. Also, they do seem to have an addictive quality and the less you eat of them, the less you will crave them.

11. When eating out, remember your carbohydrate tolerance limit

If you know you can only tolerate a small amount of carbs then choose a meal with a protein and veg or salad and avoid the carb loaded pasta.

12. Avoid alcohol

People tolerate alcohol differently but in general limit alcohol to one to two drinks since low blood glucose can often be mistaken for drunkenness. Also, avoid sweet drinks like mixers and the sweeter wines and spirits, like brandy and rum. Rather choose the dry wine and white spirits, like gin, vodka and cane. Avoid tonic as it has even more sugar than coke. Mix drinks with water, soda water or sugar-free sodas.

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EPT Recovery took to the MTB trails of the Stellenbosch Winelands all in the name of youth living with Type 1 diabetes. We find out more.

In October 2021, leaders in the sports recovery arena, EPT Recovery, invited a group of mountain bike enthusiasts to the Stellenbosch Winelands for a weekend of exhilarating mountain biking, a charity auction and luxury spoils.

With a national footprint, EPT Recovery provides a comprehensive sports recovery solution to prominent sporting events throughout the country. EPT Recovery is co-founded and managed by two prominent Stellenbosch-based biokineticists, Francois Retief and Russell Looms.

EPT Recovery took to the MTB trails of the Stellenbosch Winelands all in the name of youth living with Type 1 Diabetes. It’s their belief that through awareness and the generous support of our community, life can be sweet for those living with diabetes.

Inspiration

Proceeds from the fundraising drive have been channelled to the fundraising efforts of the EPT initiative charity drive. The EPT initiative fundraising drive was inspired by EPT co-owner, Russell’s young daughter being newly diagnosed with Type 1 diabetes at the age of 7 years in April 2021.

Through EPT’s love for mountain biking, they embarked on an awareness campaign to touch the lives of children living with Type 1 diabetes.

Successful day

The 2021 EPT Winelands MTB Experience was EPT’s second annual fundraiser of its kind, bringing together a group of like-minded riding aficionados to the prestigious Lanzerac Wine Estate to ride the nearby trails and enjoy all the facilities this diverse Stellenbosch estate has to offer.

An exciting morning in the saddle culminated with a wonderful lunch at Lanzerac’s Manor Kitchen restaurant, where guests were able to enjoy the warm hospitality of this iconic property.

The afternoon was joined by the National Manager from DSA National Office, Margot McCumisky, who witnessed an exciting auction taking place where bidders gave generously towards the lot. The proceeds of which will be directed to DSA Youth with Type 1 diabetes Warriors Projects.

Sport is an incredible medium to bring us together for a good cause.

For more information on EPT Recovery, visit eptrecovery.com

Dietitian and diabetes educator,Tammy Jardine, explains what carbohydrate counting is and how it helps in managing diabetes.

Carbohydrate counting (carb counting) is a meal planning method that allows you to match your insulin doses to the different types and amounts of carbohydrates you eat.

The carbohydrate nutrient has the greatest impact on post meal blood glucose, with a smaller and slower contribution from protein. The effect of fat is negligible.

When you eat carbohydrates, they break down into glucose. You need insulin to transport the glucose out of the bloodstream and into the body’s cells. This means that the more carbohydrates you eat, the more insulin you need.

Therefore, if you could quantify (count) the carbs in the meal and take the appropriate amount of insulin to match it, the next blood glucose should neither have risen nor fallen excessively. In other words, you are now mimicking the way the pancreas works.

By combining insulin doses based upon carbohydrate content with corrective doses, you have the opportunity at every blood test and injection of insulin to maintain normal glucose levels, or to bring errant blood glucose back into range. This reduces the fluctuation in blood glucose levels and reduces the risk of hypoglycaemic reaction from taking too much insulin when blood glucose levels are normal, or when too little carbohydrate is eaten at a meal.

Carbohydrate counting is a technique that is easy to learn and apply and offers the ability to match insulin doses with food eaten, carb counting offers flexibility in food choices that is often much appreciated. Carb counting is effective in controlling blood glucose levels and giving you flexibility.

What foods contain carbohydrates?

Carbohydrates are a nutrient found in large amount in starches, like foods made from grains: rice, maize, barley, wheat, oats, and rye; or starchy root vegetables, including potato, sweet potato, beetroot, carrots, turnip and onion. Carbohydrates are also found in dairy, fruit, legumes (beans and lentils), sugar and honey.

In a healthy meal plan, most carbs should come from nutrient-dense foods like whole grains, legumes, fruit, and vegetables. Nutrient-dense foods are high in vitamins, minerals and fibre.

Some sugary foods (cakes, biscuits, pastries and chocolate) can be included in your meal plan but should be limited (just like in any healthy eating plan) as they usually contain very few necessary nutrients.

Use common sense and indulge in moderation. Carb counting will help you decide how to include these foods in your meal plan.

Initially carb counting is a challenge as you need to identify carbs in food and how they affect you as an individual. It takes practice, trial and error, but as you persist it will come easier.

Tools to help with carb counting 

• Measure portion sizes

It’s easy to overestimate portion sizes so it’s recommended that you use measuring cups and scales at home. Get into the habit of checking portions so that you keep portions in check. Learning portions sizes at home will help you to judge portions more accurately when you eat at a restaurant or dinner party.

When eating at home, always use the same bowl, cup, plate or glass. That way if you always pour milk to a certain point on the glass, then you know that you are eating a consistent amount of food and can expect a consistent blood glucose reaction.

Create a spreadsheet or list of foods that you typically eat at home and then look up the carb values. Then if you’re a person of habit and like to eat a certain band of cereal, you’ll always know how many carbs you’re getting.

• Use technology

Calorie counting apps are really helpful in identifying carbs in foods. Make a list of the most common meals you eat. Some examples are MyFitnessPal, Carbs & Cals, and FatSecret. Useful websites include www.nutritiondata.com and www.eatright.org

Things to remember

Other tools include food labels, measuring tools, and recipe books. If you’re using food labels, always make sure that you’re looking at the amount of carbs in the portion that you’re eating and not only in 100g.

Pre-portion snack foods by measuring out single servings and putting them into small plastic containers or sandwich bags. This can help control your portions since it’s way too easy to keep grabbing crackers or nuts directly from the package without realising how much you’ve eaten.

Also remember that because a food says that it’s sugar-free on the label doesn’t mean that it doesn’t have carbohydrates.

Some restaurant chains will have the nutritional content of the foods on the menu so look up online so that you can make a choice before ordering.

When eating out, avoid sauces and don’t be afraid to ask the waiter how a meal is prepared or what ingredients are in the food.

For special dinners, eat the foods that are special and avoid the other foods that you can get at any time. For example, if you really love apple pie, then skip the mashed potatoes and bread at the meal and make the dessert your carb portion at the meal. Just be sure to watch your portion size.

What would you have to do?

Keep a very detailed food diary of the carb amount eaten together with corresponding blood glucose levels.

You will need to measure your blood glucose at least morning, midday and evening. If there aren’t excessive increases or decreases in the readings, then you know you have matched the insulin to carbs well.

If they are rising too much (greater than 2-4) then you know that you ate too many carbs at the previous meal and that you need to adjust either the amount that you ate or the dose of insulin that you took.

Provided that they are going lower (by more than 2-4) then you know that you’re giving too much insulin for what you have eaten at the previous meal and you need to either eat more or lower the short-acting insulin dose.

Initially, be very consistent with the amount of carbs that you eat at each meal as this will help to identify how much insulin you need for a specific amount of carbs. Knowing this will help you to be flexible with your insulin doses and adjust according to what you feel like eating.

Carb counting only influences your short-acting insulin. Your long-acting insulin will most likely stay the same and you would not adjust this insulin based on blood glucose or meals eaten.

How many carbs should you eat?

How many carbs you need is dependent on age, height, weight, level of physical activity, current blood glucose levels, and blood glucose targets. Your diabetes educator and dietitian can help you to determine this sweet spot.

Other factors to consider in carb counting

Physical activity, high fat meals and alcohol can have an effect on carb counting.

Physical activity has a various effect on blood glucose so it’s vital to monitor blood glucose to see how exercise affects you as an individual. Most people would require less insulin with a meal post exercise as exercise usually reduces blood glucose as the muscles suck up any glucose post exercise. This is individual so work with your diabetes educator to perfect this for you.

Alcohol also usually reduces blood glucose if it hasn’t been taken with sugary mixer. Keep alcohol to moderate amount (two drinks for men and one drink for women). If this seems impossible then be sure to measure you blood glucose often as symptoms of a hypo can often be confused for drunkenness. Don’t count carbs in alcohol as part of your carbs to match with insulin.

Fat slows the digestion of food in the stomach. This delay means that you may have a blood glucose level that looks fine after eating but spikes before your next meal. Sometimes a high fat meal will require a little more insulin more insulin. Work with your diabetes educator to help you with this scenario.

Step-by-step starter guide to carb counting

1. Identify foods in carbs using tools and calculate the total of all the carbs in the meal or snack.
2. Try to keep carbs to similar totals at each meal while your dose of short-acting (mealtime) insulin remains at a standard dose at each meal.
3. Record your reaction to different meals so that when you eat those meals again, you can make the necessary adjustment to portion or insulin dose to create less flexibility in your blood glucose readings.
4. Consider factors like fat, alcohol, and physical activity when you’re deciding on your insulin dose.
5. Consider your premeal blood glucose level. You may need a bit more insulin to bring down high blood glucose. This is called a correction dose. Speak to your diabetes educator to determine this dose for you.
6. Calculate your insulin dose considering the above factors and give the insulin dose.
7. Record the blood glucose 2-4 hours after the meal. If it’s too high or low, consider where your calculation could be perfected.

We get over 40 different nutrients a day from food. It’s perfectly okay to eat and enjoy food. It’s just as important to also learn how to balance food, medication, and activity, so that you’re meeting your goals in managing your diabetes. What works for someone else may not work for you so identify and record how your diabetes reacts to these factors.

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Header image by Adobe Stock

Dietitian, Annica Rust, helps us understand why the body needs salt as well as why too much is dangerous.

Salt (sodium chloride) is important for your body as it performs vital functions, but consuming more than your daily requirements can be harmful. Most people consume on average 9-12 grams of salt per day, which is double the recommended maximum intake.³ It’s therefore no surprise that 13% of deaths caused globally are by high blood pressure and that on average 225 South Africans are killed by heart disease every day.⁵

The role of salt in food

Salt is commonly used to enhance the flavour of food, in addition to its commonly known benefit of being a preservative, which inhibits bacteria growth and increases the freshness and shelf life. Salt is also used to improve the texture and appearance of food.^1,2

The role of food in our body

The human body needs a small amount of salt to perform vital functions, such as conducting nerve impulses, contracting and relaxing muscles and to maintain the water and mineral balance in the body.¹

How much salt is needed to maintain the vital functions?

We need a minimum intake of 500mg of sodium (1/4 teaspoon of salt) a day to perform vital functions², however it’s recommended that adults don’t exceed 2000 mg of sodium which is equal to 5 grams/1 teaspoon of salt per day. This will prevent high blood pressure (hypertension) and the associate risks of cardiovascular disease, strokes and heart attacks.

Eating too much salt

With a high intake of sodium, your kidneys can’t keep up to excrete the excess sodium in the blood and sodium will accumulate in the bloodstream. To compensate for this, your body will retain additional water to dilute the sodium. However, this in turn will increase your blood volume.

An increase in your blood volume will put unnecessary strain on your heart as it needs to work harder, which over time contributes to high blood pressure. High blood pressure further increases the risk for a heart attack, stroke and cardiovascular conditions. This is especially a problem if you have diabetes, which already places you at an increased risk of a heart attack, stroke and cardiovascular disease. ^1,2

High blood pressure also increases the risk for chronic kidney disease and osteoporosis. Osteoporosis occurs with a high intake of salt which can further increase the amount of calcium that is excreted via urination, causing low blood calcium levels. Low blood calcium levels will result in the breakdown of bone to release the necessary calcium in the bloodstream to maintain blood calcium levels.¹

 Steps to reduce your salt intake

1. Reduce processed and restaurant/fast food

Processed and restaurant foods accounts for more than 70% of the sodium intake of Americans. Cutting down on processed foods will therefore be beneficial to lower your salt intake.⁶

2. Label reading & logo identification

It’s valuable to look at labels, especially the nutritional information table as well as the ingredients listed when deciding which product to buy.

When comparing products, look at the amount per 100g and not the amount per serving. When looking at the ingredient list look out for sodium, monosodium glutamate (MSG), baking soda or sodium bicarbonate or any words containing the term sodium, nitrites, nitrates and salt.

The order in which the ingredients are listed is important as it serves as a rough indication as to how much of that ingredient is in the product. Ingredients will always be listed in descending order of weight (largest to smallest weight). Usually, the first three ingredients that appear in the list make up the largest portion of the product. Make sure that salt is not one of top three ingredients.⁴

Look out for food items with the Heart and Stroke Foundation South Africa logo, given that these food items will be lower in sodium when compared to similar products.

3. Stop using the salt shaker on the table 

4. Reduce the amount of salt when cooking, by using more herbs, unsalted spices and strong flavoured food components to flavour your food.

5. Be aware of hidden sodium

Many food items already have a high amount of sodium included, such as bread, breakfast cereals, processed meats and sausages, stock, soup and gravy powders as well as brick margarine.⁴

When in doubt contact a registered dietitian for assistance. For more information on sodium, please visit The Heart and Stroke Foundation of South Africa

References

1. https://www.hsph.harvard.edu/nutritionsource/salt-and-sodium/ [10 February 2022]
2. Centers for Disease Control and Prevention. 2022. https://www.cdc.gov/salt/role_of_sodium.htm [9 February 2022]
3. World Health Organisation. 2020. https://www.who.int/news-room/fact-sheets/detail/salt-reduction [10 February 2022]
4. Salt watch: https://www.heartfoundation.co.za/wp-content/uploads/2017/10/Salt-brochure.pdf [10 February 2022]
5. Heart & Stroke Foundation. 2022. https://www.heartfoundation.co.za/
6. American Heart Association. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/sodium/hold-the-salt-infographic[10 February 2022]

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Yoga teacher and Type 1 diabetes patient, Rachel Zinman, expands on which yoga practice is best for you as an individual.

I’ve been practicing yoga since I was 17 and teaching and sharing yoga worldwide for more than 25 years, so when my diagnosis, at age 42, of Type 1 diabetes came along, it absolutely floored me.

I was convinced that I could reverse my condition and spent six years trying my best. I couldn’t accept that Type 1 diabetes is an autoimmune disease with no known cure.

When life hits rock bottom it’s the simple things that resonate. For me it was my yoga mat. The postures and the meditation kept me sane. I wanted to run away but there was nowhere to go. Slowly and gently I found my way back. First, I found a way to accept my diagnosis. Then I realised that yoga had saved my life.

Ayurveda – how can we keep the body in total balance?

My personal passion for understanding the complexity of the body and how to achieve optimum health happened when I was introduced to the sister science of yoga, Ayurveda. If you’ve never heard of Ayurveda, it means the science of life, and like yoga it considers the body/mind mechanism as a whole and asks the question: how can we keep the body in total balance?

Ayurveda is based in the theory that the body, being composed of the five elements: earth, water, fire, air and ether, is constantly trying to balance itself. And that the mix of elements in each person is completely unique. In other words, it’s not one size fits all.

Each element has a specific quality. For example, ether or space is vast and open while air is light and fast-moving. In Ayurveda, those qualities translate into both body type, and mental and emotional characteristics.

A person who is forthright and charismatic with a more muscular physique has a predominance of the fire element. Whereas someone who is loving and stable with a strong and sturdy build has more earth and water. And someone who has a light frame, quick mind and an artistic bent tends to have more air and ether in their system. What one body thrives on can be another’s downfall. That’s why it’s important to understand your constitution and then find a yoga practice that fits your type.

Benefits of finding a yoga practice that fits your type

In my 30 years’ experience of yoga practice and teaching, I have found that working with a practice that suits you as an individual, decreases stress which in turn leads to a more positive attitude, better blood glucose control and a range of other benefits such as:

• Increased physical strength
• Improved flexibility
• More muscle tone
• Increased insulin sensitivity
• Weight loss
• Better sleep
• Improved function of the internal organs
• Better blood circulation
• Better concentration
• General overall well-being

What is your Ayurvedic type?

Often, we head to the gym or yoga studio and choose a style of yoga that we think we should do. But what we think we should do isn’t always the right practice. If you’re a sucker for hot tamales, garlic and chilli but you always end up with heartburn, you might want to rethink that craving and have cucumber soup instead.

So, if you’re loving hot yoga, but wonder why you keep going hypo, or adore a yin class, but can’t shed those extra kilos. It might be worth knowing your Ayurvedic type by taking this quick ayurvedic quiz.

Vata dominant constitution

1. Do you have a light frame?
2. Are you highly creative and innovative?
3. Do you get stressed easily?
4. Do you crave light, dry foods like salads and crisps?

If you said yes to three or more, you most likely have a Vata dominant constitution. The perfect practice for you is restorative yin yoga, or a slow gentle hatha. Something that’s grounding and nurturing where you can focus on your breath.

No matter what type of diabetes you have, you’ll need to take things slowly. Your priority is to keep the nervous system calm.

Pitta dominant constitution

1. Are you muscular with a medium frame?
2. Do you tend to get angry or frustrated?
3. Do you crave spicy, hot and strong flavoured foods?
4. Are you super organised and focussed?

If you said yes to three or more, you most likely have a Pitta dominant constitution. A cooling practice is best for you. A slow gentle hatha, a yin class, restorative or an easy vinyasa flow. For Pitta, the focus is on keeping your cool. Your tendency is to go hard until you burn out. So, learning to relax, rest and explore gratitude can radically alter the way you approach life.

Kapha dominant constitution

1. Do you have a heavier frame and find it hard to lose weight?
2. Are you patient, loving and calm in the face of stress?
3. Do you crave sweets, bread and fatty foods?
4. Are you good at completing tasks and following directions?

If you answered yes to three or more, you most likely have a Kapha dominant constitution. Your heavier build and slower temperament can benefit from an invigorating practices like Power and Ashtanga vinyasa yoga. The key word for you is energising and stimulating. Anything slow will grind you to a halt. Your biggest challenge is to stay active and motivated.

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One of the biggest fears for people living diabetes is having a low. The good news is that lows are usually avoidable and fairly easy to treat if you have the correct tools at hand.

It doesn’t matter if you have Type 1 or 2 diabetes, having a low (hypoglycaemia) is one of the most frightening experiences you can imagine. So, why do people living with diabetes have lows?

Causes of hypoglycaemia

In very rare occasions, oral diabetic medication can cause a low glucose level. Usually, it’s only insulin that will be potent enough to cause your glucose to drop significantly.

Of all the insulins available, the newer analogue insulins are also less likely to cause a low, so if you’re still taking the same medication as five years ago, perhaps now is the time to change. Added to that, it’s usually the short-acting insulins that are taken at mealtimes that will cause the biggest drop in glucose levels.

The newer, basal or long-acting insulins are more likely to drop your levels across the board and very unlikely to result in a precipitous drop severe enough to cause a ‘hypo’ (glucose level <3,5 mmol/L).

Common factors that cause lows

Most commonly, people have hypos at night as their dinner time short-acting insulin isn’t ideally matched to the food they eat. Adjusting these levels may require a bit of fine-tuning and input from a diabetic educator, dietitian and diabetologist.

The elderly and those with compromised kidney function may also battle with glucose levels that drop for no apparent reason. Eating regular meals and testing often to detect lower levels become especially important in these cases.

Alcohol can also cause glucose levels to drop. Typically, all alcohol is made from carbohydrates: grapes, hops etc. Initially, glucose levels rise as you drink and then they drop as the alcohol is metabolised. A confounding problem in this regard, is we tend to eat less as we drink more, so your body’s ability to maintain normal glucose levels becomes more difficult. Make it a habit to have something to eat with your alcohol to prevent the drop in your glucose levels. Once again, make sure you check your levels often and speak to your doctor about how to avoid this problem.

Exercise can also cause glucose levels to drop as you utilise the calories. However, different types of exercise can result in high or low readings. Once again, it’s best to speak to your healthcare team and get specific and individual advice. Always make sure you’re able to test your levels before and after exercising, and have snacks and insulin available when exercising.

Avoiding a hypoglycaemic event

Regular testing is the obvious answer to how to avoid a low. The more you test, the more you know your own body and can predict how different activities will affect your glucose levels.

You have the option of traditional finger prick glucometers which give point in time measurements, or if you’ve access to a continuous glucose monitor, these give very valuable information on trends throughout the day. Many of the monitors also have alarms that predict levels that are falling too fast, so you can be alerted to lower glucose levels before you actually become symptomatic.

Eating regular meals and, particularly for older people, having a small bedtime snack may also be important in preventing a hypoglycaemic event. Regular snacking isn’t imperative, however, if you find your levels are dropping overnight, then this may be the answer. Ensuring you eat a healthy meal even when you know you will be drinking alcohol is also an important step in preventing unnecessary hypoglycaemic attacks.

If you feel the typical symptoms of low glucose levels, these are often an early indicator that you need to rectify your levels. However, many of the symptoms may also indicate a high glucose level so be sure to test and check. These symptoms may be hunger, thirst, shaking or sweating, feeling tired and weak, restlessness or poor concentration, headaches, or even stomach ache and nausea.

Those who suffer from low glucose levels on a regular basis, may not experience these symptoms at all (hypoglycaemic unawareness) so be aware that your levels may drop without you knowing.

Treating a hypoglycaemic attack

The quote from Robert Burns, “The best-laid plans of mice and men often go awry” is quite fitting for anyone living with diabetes. If you’ve had diabetes for a while, you’ll know that having a hypoglycaemic attack is almost inevitable at some point in your journey. But, as it’s with all of life’s challenges, it’s how you pick yourself up afterwards and recover and learn from the experience that is really important.

The following guidelines seem quite simple but, in the panic, and stress of hypoglycaemia, they can be extremely challenging. Find a partner, parent or close friend (or even a few friends) who know you well and can support you through these times.

1. Any blood glucose value below 3,5 mmol/L is considered a low blood glucose value.
2. For children below six years less than 4mmol/L is a low blood glucose value as they tend not to recognise their symptoms, or they can’t tell you.
3. Start with a quickly absorbed carbohydrate (100ml fruit juice or 3 teaspoons of honey or 15g glucose sweets).
4. Test your glucose levels 15 mins after.
5. If the glucose levels are still <4mmol/L, repeat step 3.
6. If the glucose levels have risen, follow up with a longer-acting carbohydrate (half cheese sandwich or three whole wheat biscuits with cheese).
7. Retest after 15 mins again to ensure levels have gone up.

Why different snacks?

The theory behind the different snacks is that the short-acting carbohydrate will push the levels up quickly, whilst the long-acting carbohydrates (low-GI) will maintain it up there. Do not give insulin for these snacks. Think of these snacks as medication rather than food. You’re eating them to raise glucose levels not because you’re hungry.

Glucagon pens do work but tend to raise the glucose levels too much and may need to be repeated to maintain normal glucose levels. However, they are a good option in a severe emergency whilst waiting for more specialised care.

If you have a hypo just before a meal, you can also skip step 6 and just have your regular meal instead (but perhaps consider an insulin adjustment).

It may seem like intense testing and perhaps not necessary, but it does give you a very good indication as to how your body reacts. It may also seem like very small amounts of food but you’re not wanting to rebound your levels to >15mmol/L but rather keep them as stable as possible.

Perfect hypo kit

All the snacks listed above can also be kept in a small container and don’t need refrigeration so can be easily kept on hand and replaced as necessary. Put some extra test strips and a glucometer, your emergency contact details and medical aid information into the same container and you have the perfect hypo kit.

Managing the rollercoaster of lows

One of the biggest problems we see with treating hypos is patients tend to overcompensate for low glucose levels and then end up with high levels. This then results in extra insulin at the next meal and consequently another drop. This rollercoaster continues and contributes significantly to feelings of fatigue and hopelessness as well as increasing risk of developing diabetes complications.

Try to avoid the panic that often happens and results in people having two sandwiches, a whole can of cooldrink, a bunch of grapes and their favourite chocolate to treat a low. This is a feast, not the right way to treat hypoglycaemia and will only complicate matters further.

If you’re battling, spend some time with your healthcare team and get them to assist with individual advice. Eliminating lows is the first step in gaining better control of your diabetes

An irrational fear

Actually, a very rational fear! What often tends to happen is people prefer to have higher glucose levels to prevent the feeling of hypoglycaemia. If you’ve ever suffered a severe hypoglycaemic attack, you’ll know exactly why you don’t want to feel out of control and so fearful ever again. Work with your healthcare team to slowly bring your levels down to a safe place so that you don’t have to deliberately run too high.

Hypoglycaemia is one of the most common and disastrous events that someone with diabetes can experience. However, they are generally avoidable and most certainly, manageable. Speak to your diabetes team and find out how you should be managing your levels so that you are in control and not riding the crazy rollercoaster all the time.

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