Why all the fuss about intermittent fasting?

Dietitian, Chantal Walsh, explain the how intermittent fasting works and how it is an eating pattern rather than eating plan.


Intermittent fasting (IF) has become quite a buzzword and there is no shortage of freely available information about it. With its many promises to assist with weight loss, especially around the belly, control insulin levels and help brain function, it’s no wonder that we are all intrigued by this new pattern of eating.

What is intermittent fasting?

It’s an eating pattern that cycles between periods of fasting and feeding. During the fasting phase, there is a significant restriction of calories. On feeding days, there is no specific calorie requirements or certain types of foods recommended but rather focuses on when you should be eating them. It’s therefore not an eating plan but rather an eating pattern.

Patterns of intermittent fasting

There are numerous patterns of intermittent fasting that can be used.

  • 16/8 fast

In this pattern, you will fast for 16 hours and then eat for eight. This is often the pattern where we skip breakfast and only start eating about 16 hours after your last evening meal. This is followed for seven days a week.

  • 5/2 fast

With this pattern, you will restrict your calorie intake to 500 – 600 calories for two non-consecutive days, while the other five days you have your normal consumption.

  • Eat stop eat

This involves a 24-hour fast one to two times per week, where no calories are consumed on those days.

  • Alternate days

In this pattern, there is a restriction of calorie intake every second day (to around 500 calories), while on the feed days you continue your normal intake.

  • Warrior fast

This fast focuses on a 20-hour fasting period followed by a 4-hour feasting period. This is normally for the dinner meal that is a large portion of unrestricted foods.

  • Spontaneous fast

The last of the fasting patterns is where you choose a meal or two to skip as and when you feel it necessary.

Possible benefits

What does science say? Firstly, let’s look at reduction in adipose tissue and weight loss. It’s suggested that due to the limited time that you get to ‘feed’ that there is a reduction in calories and therefore results in weight loss.

In a review1, it was found that intermittent fasting reduced body weight by 3–8% over a period of 3–24 weeks. This was on condition that the food items that were chosen during the ‘feeding’ times where healthy food choices. Ensuring that the meals were balanced, incorporating loads of vegetables, lean vegetables and complex carbohydrates.

It’s therefore important to consider the nutrient density of the food choices, ensuring an intake of a variety of vitamins, minerals and other essential elements.

An observational study2 of overweight and obese men during the religious fast of Ramadan reported that since obesity is accompanied by increases in adiposity and changes in appetite-regulating hormones, if we decrease weight it alters the abnormal release of these hormones, which might be useful in managing obesity. Ramadan IF improved body composition and produced some positive changes in these hormones, these changes in hormone levels persisted for three weeks after the end of Ramadan.

With the possible weight loss that is experienced with calorie conscious IF, glucose (sugar) and lipid (blood fat) can also be improved. A 2017 review3 on intermittent energy restriction (IER) and time-restricted feeding (TRF) found that there are possible benefits of these styles of eating on weight loss and metabolic health. However, most of the studies are on animals and there is very little evidence currently in human studies.

In comparison to a calorie-controlled, nutrient density diet, it was found that long-term the effects on weight loss and lifestyle health benefits are similar to that of IF.

Yay or nay?

If you are considering intermittent fasting, consider the type of IF programme that suits you and ensures that you don’t get too hungry or that it affects your mood stability. Ensure that the types of foods that you choose are nutrient dense and full of vitamins and minerals. Monitor the calorie intake; you still want to stay within your specific daily requirements. It will take time to adjust to the new style of eating and for the body to adjust, be patient.

It’s important to remember that IF is one of the tools in your nutrition toolbox, it will need to be combined with basic nutrition guidelines, sufficient water intake and exercise. To help with the success of this style pattern, please contact a registered dietitian.


References

  1. Barnosky et al., 2014
  2. Zouhal et al., 2020
  3. Antoni et al., in 2017

MEET THE EXPERT


Chantal Walsh RD (SA) is a practicing dietician in Gauteng. She has a special interest in lifestyle illness (weight loss, cholesterol, hypertension) and sports nutrition and encourages clients to make small changes to reap the great health rewards. She is also a trained and practicing Pilates instructor.

Make family fitness fun this festive season

Whether there is one person or a few in a family who have diabetes, this may affect lifestyle habits and choices of the family. Wendy Vermaak informs us how to make family fitness fun.


Now that we are nearing a time of holiday or rest and recuperation from a tough 2020, the lifestyle habits of a family (as opposed to just those of each individual) become more evident. This is because when everyone in the family spends so much concentrated time together without the usual commitments of work and school, the choice of meals, leisure and activity times and family fitness must take the whole family into account.

Each generation teaches and guides the younger generations of which lifestyle choices are healthy and important. This follows through from where you decide to go on holiday, what meals you eat, how you plan your leisure or relaxation time and budget, and what physical activity you engage in, and so on.

Children learn from example

Research shows that children learn lifestyle habits from an early age, and that by a mere nine years old, they already have an established idea of what lifestyle habits are perceived to be the ‘norm’.

This is based mostly on their limited exposure to what their own family has taught them, as opposed to have experienced what other family’s lifestyles are like. Children learn by example from their parents and grandparents’ behaviour. Modelling a good example of healthy lifestyle habits entails regularly engaging in:

  • Regular exercise
  • Eating a healthy diet
  • Refraining from alcohol, drugs and smoking
  • Drinking enough water
  • Good hygiene
  • Getting enough quality sleep

Children learn from what they see, and parents choosing healthy lifestyle habits as a regular and continual choice day by day, as opposed to merely lecturing your children, has a much bigger impact on their learning response to healthy lifestyle habits.

What type of family is yours?

Choices that affect our families are whether you are the type of family who always goes away over holidays to rest, or decides to stay home.

Is your family avid campers? Adventure holiday seekers? Hotel or resort guests, or rather road trippers? Often your choices of where you go on holiday also affects what food choices you make and the physical activity level you choose to engage in.  

Whatever the choice, families have an opportunity to be physically active anywhere or anytime. Exercising should not be a mere chore to get through, or something to try to fit in when one finds the time.

As early as 1819, Edward Stanley wrote: “He who has not time for exercise, must create time for illness.” This lifestyle choice stands for every person of every age, and what better way to institute this healthy standard in your family than over the festive season break when families are often all together?

Use movement to develop relationships

Exercising together as a family is a great way to use movement to develop relationships and spend quality time together. Movement is an essential part of everyday life, for people of all ages. Movement affects development, learning, communicating, work capacity, health, and quality of life. Exercising together promotes open communication, and the feel-good endorphins promote good family relations as well. Encourage less screen time and more physical outings or games or sports as a family.

Exercise – the most underutilised medicine

Research shows that for those who are sedentary more than seven hours a day are 47% more at risk of developing depression than those who sit for four or fewer hours a day.

Women who don’t exercise at all have a 99% increased risk of experiencing depressive symptoms compared with those who exercise regularly.

Physical activity helps beat stress and prevents or treats many other health concerns and diseases. It is considered the most underutilised medicine and has the least amount of side effects as opposed to most medication.

Physical activity, whilst being fun, can have positive impacts on health, such as decrease dementia risk by 30% which is a specific concern for the elderly, and physical fitness levels improve cognitive performance (e.g. concentration, memory) for children and adults alike.

Exercise reduces the risk of certain cancers, such as breast cancer by 20% and colon cancer by 35%. It can decrease cardiovascular disease risk by 35% and Type 2 diabetes risk by up to 40%. More than 150 minutes of exercise each week is associated with a 0,89% drop in HbA1c.

One of the major benefits of having family as exercise buddies is that they are excellent accountability partners.

How to make family fitness fun

  • Put music on and have a dance contest.
  • Walk the dogs as a family.
  • Go on a hike in your area.
  • Turn a board game into an active game.
  • Play a game of cricket, touch rugby, or any sport in your back yard.
  • Complete an exercise routine in the garden/on the beach.
  • Build a sandcastle.
  • Ride your bike (or hire one for a cycle outing).
  • Participate in an online challenge.
  • Try a new skill that’s physically demanding, such as rock-climbing, or a dance class, or an aqua class.
  • Work as a team to complete physical tasks in and around the house, such as mowing the lawn, washing the car, cleaning the windows, mopping the floors, etc.
  • Incorporate exercise into your outings, such as visiting a zoo or street market where you can walk around a lot.

Before you start your family fitness, it’s always best to:

  1. Get the go-ahead from your doctor and to discuss possible medication changes.
  2. Consult with a biokineticist to discuss a suitable exercise programme to minimise any complications. Biokineticists are trained in monitoring blood glucose levels and effects of exercise on insulin, required nutrition, and specific exercise prescription for each patient noting their level of fitness, medication, and disease profile. Find a biokineticist near you www.biokineticsSA.org.za
  3. Use the right gear. Wear well-fitting, cool clothing and the right footwear to look after your feet. Also inspect your feet often to check for blisters, cuts and injuries. If you suffer from foot problems, avoid weight-bearing exercises and opt for cycling or swimming.
  4. Wear your medical alert bracelet or other identification when you exercise. The info should include your name, address, doctor’s details and phone number. If possible it should also include your medicine details.
  5. Inform the person you are exercising with that you have diabetes or any other major health conditions, whether it be a coach of any organised sports team, team players, friends or family. Explain to them how to respond if you should have a hypoglycaemic episode.
  6. Monitor your blood glucose before and after exercising and refrain from exercise if you are feeling ill.

Be aware of symptoms of hyperglycaemia (extreme thirst, hunger and urinations, blurred vision, fatigue) and hypoglycaemia (hunger, shaking, dizziness, confusion, sleepiness and weakness)

Written by Wendy Vermaak on behalf of the Biokinetics Association of South Africa.


Wendy Vermaak is a biokineticist in private practice in Johannesburg, Gauteng. She has a keen interest in falls prevention and balance rehabilitation, and is also the marketing director for Biokinetics Association of South Africa (BASA).


Header image by FreePik

Positive planning and mind-set to stay physically active

Michelle Jonck informs us that positive planning and state of mind are two key factors to initiate and achieve sustainable behaviour changes, such as increasing physical activity.


Despite physical activity (PA) being a cornerstone of diabetes management, it is by far the most underused1. The multiple benefits of physical activity for all ages in almost every population, including people with diabetes have been well-established.

These benefits include improvements in glycaemic control, insulin action, cardiovascular fitness, systemic inflammation, diabetes-related health complications and mental health1. In a study2, the level of HbA1c among diabetic patients was decreased by 0,73% and 1,33% after 16-weeks post-intervention and one-year follow-up, respectively.

Considering the positive health impact of PA, it’s imperative for diabetic and pre-diabetic patients to become and remain physically active. Positive planning and state of mind are two key factors to initiate and achieve sustainable behaviour changes.

Breakdown perceived barriers

Too often PA is neglected, particularly in those with other comorbidities due to perceived barriers. Multiple studies have confirmed lower levels of PA in diabetic patients compared to non-diabetic patients.

In most cases, however, the factors regarded as barriers do not hold true. In a study3, 62% of the study population listed lack of time, workload and other engagements as a barrier to increase PA.

While most people have hectically busy schedules and might find it hard to include an exercise routine into their daily lives, small changes in daily tasks can significantly increase levels of PA. For instance, taking the stairs at work instead of the elevator (which you must wait for in any case), walking to a colleague’s desk to ask them a question instead of sending an email, getting up in your lunch break for a walk instead of staying in to check social media.

Many of us have that one series we just must watch. Why not get on the treadmill while watching or stand up and march during the ad-breaks? If you have time for social media and online streaming, you sure have time to be physically active. Therefore perceiving lack of time as a barrier does not hold true. It’s rather how you choose to spend your time.

As little as 10 minutes of PA each day can improve fitness levels. Although longer exercise durations result in greater improvements, the saying, “Anything is better than nothing” holds true when it comes to physical activity.

Tips for becoming more physically active daily

  • Take more steps throughout the day.
  • Take the stairs instead of an elevator whenever possible. If climbing upstairs is too difficult, start by taking the stairs only going down.
  • Walk on moving walkways instead of standing still.
  • Park at the furthest end of a parking lot instead of searching for the closest parking.
  • After every 30 minutes spent sedentary (sitting down) get up and move for three to five minutes.
  • Take short walks during work breaks instead of remaining seated.
  • For every excess calorie you eat, add 20 steps to your daily total.
  • Minimise screen time (maximum two hours/day) and stand up to change the channel or perform some physical activity while watching TV, such as walking on a treadmill or cycling on a stationary bicycle.

Weakness and illness

Two other factors perceived as barriers toward PA include weakness and illness including joint pain and pregnancy3. It’s important to remember PA doesn’t necessarily mean running, skipping, jumping and heavy weight lifting, but rather increasing incidental activity and engaging in even low-intensity exercise or unstructured forms of PA.

Activities, such as golfing, gardening, dancing and mild walking, done for 30-45 min is beneficial for health, even if it doesn’t improve fitness levels.

In a recent study on adult women, regular, moderate (brisk) walking decreased their risk for developing diabetes similarly to engaging in more vigorous activity, demonstrating that intensity may not be as important as participation in any PA1.

While people with diabetes are more likely to experience comorbidities, such as high blood pressure, heart disease, obesity and other diabetes-related complications, that may limit their ability to participate in more intense activities, they should exercise as intensely as possible but not so excessively hard that they lose the motivation to continue, develop an athletic injury or put their health acutely at risk.

Begin with easy unstructured exercise including taking more daily steps and simply standing up more often. The talk test is another tool to help guide your exercise intensity. If you aren’t able to talk while going for your daily walk, you can slow down the pace a bit enabling you to have a slightly breathless conversation with your workout partner.

Safety tips

  • Always include a proper warm up and cool down (five minutes at lower intensity).
  • Check your blood glucose before and after exercise.
  • Be aware of the signs and symptoms of hypoglycaemia and hyperglycaemia.
  • Always carry a fast-acting sugar drink or sweet.
  • To reduce the risk of hypoglycaemia, make sure to eat one to three hours prior to exercising.
  • Individuals with peripheral neuropathy should consider non-weight bearing activities, such as swimming or stationary cycling, to minimise trauma and potential injury to their feet and lower extremities.
  • Individuals with proliferative retinopathy should avoid any jumping, jarring or breath holding activities including heavy weight lifting.
  • A biokineticist will be able to further assist with any safety concerns you might have with regards to physical activity, exercise and your health condition.

A positive mind-set is needed

It might be easy to list constraints and limitations when it comes to PA but this is where a positive mind-set is important. Instead of placing your focus on what you can’t do rather focus on what you can do and the benefits derived from PA.

Factors that enable and encourage individuals to perform some form of PA are called enablers. These include: health related benefits, such as blood pressure control, diabetes control, reduced joint pain and weight management as well as feeling good, social support and professional advice.

Knowing the risks associated with a sedentary lifestyle and changes that can be brought about by PA can encourage a lifestyle change. One study1 suggested that PA participation is higher when individuals are made aware of what constitutes an unhealthy lifestyle and when they perceive themselves as being more susceptible to diseases that can result from inactivity.

Serotonin and endorphins, better known as the happy hormones, are also released during PA. These makes one feel good, which in turn further encourages engagement in PA.

Social support is another vital factor when it comes to sustainability. Participating in activities, such as walking, as a family not only creates support but also a feeling of accountability, connection and a common goal.

Obtain professional advice

Lastly, obtaining professional advice and encouragement for lifestyle change can often be the determining factor towards behaviour change.

As a biokineticist, I’ve dealt with many patients who started a supervised physical activity routine due to doctor’s orders. In this regard, a study4 found positive changes in physical fitness levels were greater for individuals given an actual exercise prescription with a detailed regimen. Conducting a fitness assessment prior to starting such a programme and supervised participation therein also had a positive effect.

Biokineticists are health professionals concerned with health promotion, the maintenance of physical abilities and final phase rehabilitation by means of individualised scientifically-based physical activity programme prescriptions. Therefore, they can assist by prescribing the appropriate duration, intensity and type of exercise. Plus, educate you about certain safety precautions at stake for a variety of medical conditions. To find a biokineticist, visit www.biokineticssa.org.za. If you live in a remote area or when on holiday, you can always consider an online consultation.

Remaining physically active

Becoming and remaining physically active is crucial to living well with diabetes. Frequent regular exercise of any type is the key to effective blood glucose control because the heightened insulin action in exercised muscle persists only for one to two days1.

Although most clinical trials follow improvements after an exercise intervention over a six to 16-week period, improvements are likely to result from exercise with a duration of one or more years. One can conclude that incorporating PA as an integral lifestyle behaviour over a lifetime will have the greatest benefits. Luckily all PA accumulated during the day counts. Change your mind-set, plan for exercise, set realistic goals and focus on what you can do.

Improve sustainability of a physically active lifestyle

  • Set realistic short-term and long-term goals.
  • Keep an activity diary.
  • Set up non-caloric rewards for achieving short- and long-term goals.
  • Schedule physical activity into your daily routine and keep these appointments.
  • Exercise with someone to increase motivation and safety.
  • Include variety in your daily activities: alternate higher intensity activities with lower intensity and more fun activities.
  • Set up a good support system by making it a family or team effort.
  • Increase incidental activities (those that form part of your daily life) to accumulate a greater total exercise time.
  • Ensure slow and steady progression in the duration and intensity of structured physical activity to prevent overuse injuries and demotivation.
  • Include both aerobic and resistance training.
  • Undergo periodic fitness assessments and revision of physical activity programmes and self-management goals for PA to provide reinforcement and continued motivation for participation.

References:

  1. Colberg, S.R.   Encouringing patients to be physically active: What busy practitioners need to know.  Clinical diabetes, 26(3):123-127.
  2. Najafipour, F., Mobasseri, M., Yavari, A., Nadrian, H., Aliasgarzadeh, A., Abbasi, N.M., Niafar, M., Gharamaleki, J.H. & Sadra, V.   Effect of regular exercise training on changes in HbA1c, BMI and VO2max among patients with type 2 diabetes mellitus: an 8-year trial.  BMJ Open Diabetes Research & Care, 5(e000414):1-7.
  3. Pati, S., Lobo, E., Desaraju, S. & Mahapatra, P.   Type 2 diabetes and physical activity: barriers and enablers to diabetes control in Eastern India.  Primary Health Care Research & Development, 20(e44):1-6.
  4. Nielsen, P.J., Hafdahl, A.R., Conn, V.S., Lemaster, J.W. & Brown, S.A.  2006.  Meat-analysis of the effect of exercise interventions on fitness outcomes among adults with type 1 and type 2 diabetes.  Diabetes Research and Clinical Practice, 74:111-120.


This article was written by Michelle Jonck on behalf of Biokinetics Association of South Africa (BASA).


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Fresh inspiration for eating vegetables

Dietitian, Jessica Pieterse, shares fresh inspiration to motivate you to eat more vegetables and get out of that cooking rut of preparing the same meals every week.


Including plenty of vegetables in your diet will promote good weight management, support your immune system, aid a healthy gut and more. Most vegetables are low in calories so there is a lot of freedom to include them in your diet even when you want to lose weight.

It’s best to eat veggies that are different colours. The colour provides a unique set of vitamins, minerals and phytonutrients. For example, a purple eggplant has very different health qualities to a red tomato.


Purple veggies

Beetroot: Roasted with a sprinkle of tahini; or a salad with rocket and goats’ cheese.

Eggplant: Baked Melanzane with layers of eggplant, tomato gravy topped with a light sprinkle of Parmesan cheese; or grilled rounds with marinade of balsamic vinegar, garlic, olive oil and chilli.

Cabbage: Raw purple shredded cabbage slaw with radishes and beetroot. Dress with plain yoghurt, dash of soya sauce and honey.

Red onion: Finely diced salsa salad with onion, tomatoes, lime juice, fresh coriander and garlic.

Photo by tomateoignons from Pexels.

 


The greens

Broccoli: Roasted with lemon and chilli; or finely chopped raw salad with shredded baby spinach, spring onions and chopped almonds dressed in olive oil, oreganum, pepper and a drop of Dijon mustard.

Asparagus: Chargrilled with a dash of lemon juice added just before serving.

Green beans: Sautéed in soy sauce, fresh ginger and garlic with a sprinkle of chopped cashew nuts.

Brussel sprouts: Cut in half and roast with a light sprinkle of Parmesan cheese, salad with celery, yoghurt dressing.

Baby marrow: Raw spiral salad with avocado and feta cheese dressed in lemon juice, olive oil, garlic and black pepper; or cooked with mushrooms in a tomato gravy with eggplant and sweet peppers known as a ratatouille.

Peas: Steamed with mint; or boiled and cooled in a salad with snap peas, cucumber and rocket.

Cucumber: Sliced round salad dressed in plain yoghurt, fresh dill and a dash of lemon juice.

foodiesfeed.com -Healthy green brussels sprouts with onion.
foodiesfeed.com - Grilled asparagus with limes and sesame seeds.

Orange veggies

Carrots: Roasted with dill, light sprinkle of curry powder and olive oil; or roasted with paprika, fresh parsley and olive oil.

Butternut: Roasted cubes with thyme, pepper and olive oil.

Pumpkin: Roasted cubes with cinnamon; or steamed and mashed with salt and pepper.

foodiesfeed.com -pumpkin salad with feta and seeds.
foodiesfeed.com - Baked carrots on a chickpeas salad.

The whites

Cauliflower: Roasted florets with a light sprinkle of curry powder and olive oil; or raw finely chopped salad with pine nuts, dried cranberries dressed in plain yoghurt, light mayonnaise, garlic, wholegrain mustard; or blended cauliflower ‘rice’ as a lower starch rice substitute.

Mushrooms: Sautéed with thyme and garlic; or raw added to a green salad; or baked whole brown mushrooms topped with garlic, chilli and spring onion.

Fennel: Roasted thin slices sprinkled with balsamic vinegar and olive oil.

Photo by Karolina Grabowska from Pexels.

Red veggies

Tomatoes: Roasted whole cherry tomatoes with balsamic vinegar; or fresh salad with layers of thin mozzarella and fresh basil dressed with olive oil and balsamic vinegar.

Capsicum peppers: Roasted stuffed whole peppers with baby marrow, onion, tomato, rosemary, beaten egg and garlic.

Photo by Richa Singh from Pexels.
Photo by Tranmautritam from Pexels.

MEET THE EXPERT


Jessica Pieterse is a registered dietitian and owner of Dish Up Dietitians. She practices in Edenvale, Johannesburg and has a special interest in women’s health and gut health.


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Finding peace when family has diabetes

Nelia Drenth shares how both her husband and son made (and still make) peace with their diabetes and how they taught the rest of the family to do the same.


Nelia Drenth (66) lives in Pretoria with her husband, Rendert. They have three adult children and four grandchildren.

I am sticking my neck out by writing this article, because I don’t have diabetes. But two of the most important people in my life do.

Hubby

My husband, Rendert’s, diagnosis (Type 2) just before his 60th birthday was not really a surprise as his father (also named Rendert) lived with diabetes from the age of 54 until he died at the age of 79. He was a horticulturalist and beekeeper. People who knew him always made a joke to say that he was so healthy because of all the bee stings. I shall always remember his mugs of cold black tea waiting for him in the kitchen after working outside and how he enjoyed this treat his wife prepared for him. Diabetes did not stop him in his tracks, but, having survived WWII may have had something to do with his resilience and perseverance. Not to forget his supporting family: six children and quite a lot of grandchildren.

My son

I still remember the day my son, Rendert Jr, was diagnosed with Type 1 diabetes, at the age of 31, after a few months of not feeling well, tiredness and loss of weight.

Type 1 diabetes is an unknown illness in both our families and as you can imagine, rocked our boats more than just a little bit. Our spirits soon lifted when his treatment had an immediate positive effect. Today, at the age of 41, he is still doing great.

But, as most of you know, there are many changes to be made; physically (adapt or die), emotionally (you’re not the only one with diabetes, so stop crying), socially (have some desert!) and spiritually (why me, Lord?)

Both hubby and son continue with life, work in the garden, do their jobs, travel, laugh a lot and inspire us all. They have taught me that to make peace with diabetes, I have to remember who they are and not think of them as their diagnosis (Treat me like you always did, as your husband and your son. I am not diabetes, I am still me).

They have taught me the pleasure of companionship. We can still have fun. (And yes, we do have fun!).

And they have taught me that I should treasure their resilience and bravery for being able to adapt and live a meaningful life.

But maybe the most important lesson was to trust them that they will act responsibly while living with diabetes.

Diabetic holiday survival manual

For people with diabetes, holidays can be fraught with temptations and make you want to hibernate. Mignon Jordan shares her diabetic holiday survival manual for you to be more mindful and survive the holiday temptation.


Many of my clients get so anxious and scared when holiday season is approaching. This is due to the mind-set that all the year’s hard work will go out the door. The simple question everyone asks is what can I do as a person with diabetes to resist the holiday snacks and over-sized seasonal meals?

Holiday times are such a special time to spend with family and friends and just to relax after a long, hard year. This can also get so challenging because your blood glucose levels don’t ever take a holiday. The good news is you don’t need to have uncontrolled blood glucose levels while enjoying seasonal activities. What if I guarantee you this: you can still enjoy parties and social gatherings with everyone else and have controlled blood glucose levels, if you follow the following steps.

The diabetic holiday survival manual

  1. Plan-ahead

When visiting a restaurant with family or friends, make sure you know what type of food is being served and what time the meal will be eaten. This gives you time to prepare.

Choose the best of worst

Choose a balanced meal of whole grain starch, vegetables and lean protein. If the choice of meal is not determined by you, choose the best of the worst. For example: the choice between chicken pie, lasagne or steak casserole with rice. These choices might be difficult to choose from so go for the option that contains the least refined carbohydrates, like white flour, and also with the least saturated fat, like cream/fatty meat/saucy food.

  • The chicken pie dough is a refined carbohydrate, which means it is high-GI and will spike your blood glucose levels and make it drop down soon after.
  • The lasagne option is high in saturated fat due to the cheese sauce and mince used.
  • The steak casserole with rice contains starch, protein and vegetables. The white rice is not low-GI but the overall fat content will be lower than the other two options which will be great for the waist line and the vegetables will assist to lower the overall GI of the meal. This option will win!
  1. I am the host for dinner

This makes it easier, because now you have control over what is served and what times.

  • Make sure the meal contains a good amount of vegetables and whole grain starch in controlled amounts and lean protein.
  • Stick to braaing, grilling, steaming or baking the food instead of frying.
  • If there is a lot of leftovers, give it as a take away to your guests.
  1. Always ask if you can bring something to an event

This will allow you to bring snacks that you know will be suitable for yourself, something you will feel safe to eat. Focus on snack ideas everyone can enjoy and that are diabetic friendly, like fruit kebabs with yoghurt dip, popcorn, nuts and dried fruit, whole wheat crackers with low-fat cream cheese dip or veggie sticks and hummus.

  1. Don’t arrive hungry

Make sure you have your snack as per usual before arriving at the event. This will prevent over-indulgence in the snacks provided which most probably will be high in fat and sugar.

  1. Be mindful when there is a buffet meal

When you look at the big amount of food and the wide variety in front of you, think before you place it on your plate. Think about what will affect your glucose level the most and what your body actually needs. Minimise big amounts of refined carbohydrates and saucy dishes.   

  1. Always use a side-plate

This is so effective to keep your portion small and prevent over-indulgence. 

  1. Choose the dessert selectively

If grandma’s famous chocolate mousse is served, it will be impossible to resist, right? Enjoy a small amount of the dessert and cut out the mash potato/roll at the main dish to minimise the carbohydrate load you are eating. Ask if you can bring a pudding that you know is diabetic friendly, such as a low-sugar milk pudding/cake. 

  1. Drink alcohol in moderation

Remember alcohol consumption causes blood glucose drops when consumed in excess. Also check the sugar content of alcoholic drinks and stick to the options with the least carbohydrates and sugar content. The Heart and Stroke Foundation South Africa recommends that if you drink alcohol, then do so in moderation. This means not more than two drinks per day for men and one drink per day for women. Remember that alcohol does not only have an impact on your glucose level but also your cholesterol levels.

  • ONE DRINK IS: 340 ml beer, 120 ml wine, 60 ml sherry or 25 ml spirits.
  1. Be active

Being physically active can assist to burn off the extra calories eaten during holiday times and improves your insulin sensitivity. This doesn’t mean you need to spend hours exercising, even walking is good enough. Just move.

  1. Test your blood glucose levels constantly

Make sure you test before and after meals to ensure you take the correct amount of insulin or medicine for the unusual holiday meals.

  1. Be aware of social cues

When you are at a party or dinner, the usual thing people do is eat constantly. Beware of “unconscious eating,” the tendency we all have is to absent-mindedly take a cookie or a sweet when you walk pass it. A little here and there can add up quickly. Say no to seconds, as you will not want seconds because you are hungry but because it is delicious.

  1. Get back up and onto the station wagon

Mistakes happen and by simply having a day of eating energy-dense carbohydrate rich meals and snacks shouldn’t demotivate you to get back on track. Guilt feelings of over-eating is a negative emotion which leads to more emotional eating, especially on high sugary foods leading you to feeling even worse and eating even more. It is a vicious cycle.  

Try this delicious Spinach and roasted red pepper dip.

MEET THE EXPERT


Mignon Jordaan is a registered dietitian. Her heart’s desire is to make a difference in people’s lives with her knowledge of nutrition. Being a Type 1 diabetes patient herself, she can walk the journey of “mindful eating” with her clients.


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How to curb festive season binge eating

Dietitian, Retha Harmse, shares good advice on how to curb festive season binge eating.


During the festive season, there are usually two groups of people. The first group is incredibly motivated to look good in their swimsuits and keep their fitness levels up. Then you have the ‘We-will-try-next-year-group’. The problem with both approaches is that the aim is short-term and not lifestyle-orientated and that is bound to yield disappointing results. Add the incredible pressure and stress endured the entire year and you basically end up with individuals who are just tired. Tired of exercise, tired of dieting and tired of worrying about a lifestyle.

How to create good eating behaviour during the festive season 

It is imperative to remember that good eating behaviour during the festive season isn’t something entirely new or foreign. Healthy eating is identical to good eating behaviour all year round, with the exception that the temptations are much more.

Festive season indulgences make it much more difficult to make the healthy choice but keep in mind that it should be a lifestyle and not just a diet. Then there is the dreaded dietitian phrase no one wants to hear: “It is all about balance.”

The number of times I have heard, “Then I messed up and decided to only start again next Monday” is vast. When people forget or run out of time to brush their teeth, do they wait until next Monday to start over again? No. Or at least I hope not.

But when it comes to diet, people do this all the time. Changing this mind-set can go a long way. Healthy eating or good eating behaviours aren’t only for a specific time, it is for now. Balance is important now, not only in the next year. Balance gives you the freedom to eat an ice cream or Malva pudding without guilt and enjoy a wonderful nutritious salad in the same breath. Balance gives you the power to say no to a second or third helping because you know that you can have it again. In essence, balance takes away the pressure of having to be perfect all the time. A lifestyle approach to the festive season encourages physical activity and healthy food intake but is also less restrictive in the manner that it allows indulgence and a bit more leniency.

Will I ever have the opportunity to eat this again? 

Control and prevent festive season binge eating by asking yourself the question: Will I ever have the opportunity to eat this again? and make your decision based on that. For example, if you are contemplating a third helping of your mother’s Peppermint Crisp Tart, ask yourself the question. The probability is very high, therefore rather give it a skip this time.If you are in Rome and contemplating whether to enjoy an Italian Gelato next to the Trevi Fountain, ask yourself the question. If you are lucky enough to travel a lot, you can give it a skip but if you resemble the general population, chances are that this is a once in a lifetime opportunity, so enjoy your Gelato!

Coping with feelings of being overwhelmed by food

If you feel overwhelmed with all the options and temptations while on holiday, take a step back. Remind yourself that you are in control of what you eat or don’t eat. Don’t give food too much power over you.

  • Don’t go shopping on an empty stomach, you will end up making unhealthy decisions and buying much more than you need.
  • Stock up on healthy snacks, if you have healthy options close by, you are less likely to make poor food choices.
  • When you have a certain craving, enjoy that specific indulgent food but practice portion control. Satisfying the craving will prevent binging later.
  • Don’t beat yourself up. Sometimes it is just as important for your mental sanity to just enjoy the piece of cake.

Practise mindful eating 

Mindfulness is the psychological process of bringing your attention to experiences occurring in the present moment. Therefore, mindful eating refers to using mindfulness to reach a state of full attention and to be more aware with regards to your experiences, cravings and physical cues when eating.

  • Eat slowly and without distraction. Sit down for each meal. Chew slowly and thoroughly, putting your knife and fork down between bites.
  • Listen to physical hunger cues and eat only until you’re full. Using a smaller plate can help with this.
  • Distinguish between actual hunger and non-hunger triggers for eating. Especially in ‘silly season’ feelings of happiness, loneliness, depression and anxiety can trigger emotional eating. Boredom is also a non-hunger trigger for eating.
  • Engage all your senses by noticing colours, smells, sounds, textures and tastes. Savour and enjoy every bite.
  • Appreciate your food.
  • Learn to cope with guilt and anxiety about food.
  • Eat to maintain overall health and well-being.
  • As previously mentioned, lifestyle changes focusing on overall health and well-being is much more effective than a short-term and restrictive diet.

The dos and don’ts for the festive season

  • Keep your portion sizes in check. It’s often not what you eat, but the amount that can lead to weight gain at any time of the year.
  • If you do drink alcohol, do so in moderation. Alcohol contains a lot of empty calories and sugars and can quickly lead to weight gain. Plan to have water or soda water with a slice of lemon or lime between each drink to pace your consumption. NB! Don’t drink and drive.
  • When braaing, skip the chips and creamy dips and rather snack on fresh zucchini or cucumber sticks, broccoli florets, carrot curls, red and green peppers. Serve with a low-fat dip or spread, such as hummus, yoghurt with herbs, fat-free sour cream or fresh salsa.
  • Embrace the seasonal summer fruits. Enjoy a beautiful tray of fresh fruit as a wonderful and refreshing end to any meal. Pineapple, kiwi, mango, pomegranate, grapes, guava, lychees, papaya, banana are a colourful feast for the eyes and taste buds.
  • Be moved by the holiday. Strive for at least 150 minutes (2 ½ hours) of moderate to vigorous activity per week. It will not only help you cope with the stress of the holiday bustle, but it can also help compensate for some of your over-indulgences. Make it part of your daily activities: park further away from the shop’s entrance, take the stairs instead of the elevator, carry your groceries as a substitute for lifting weights. Every bit of physical activity you can sneak in counts.
  • Maintain your weight throughout the holidays by still eating three meals every day, starting with breakfast and snacking between meals. Snacking prevents you from overeating during the next meal.

N.B! Make these healthy living tips part of your routine the whole year round, not just for the holidays.

MEET THE EXPERT


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


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Sleep is the foundation of overall health

Enough deep, restorative sleep is one of the most powerful tools available to us in our health toolkit, yet it’s so often compromised. Dr Maureen Allem expands on this.


To accommodate busy schedules, unrealistic deadlines and the pressures of society, we steal the hours from our sleep time, but it may well be one of the most detrimental decisions that we make.

Our busy lives require us to keep a whole lot of balls up in the air and with only 24 hours in a day, sleep is generally where we steal the extra hours from. “I’ll sleep when I’m dead” is a phrase commonly used, but the truth is that the shorter your sleep, the shorter your life.

Many are fooled by thinking that they can make up for lost sleep over the weekend after a week of late nights and early mornings.

Keeping a consistent schedule is best for the body, and fact is that you can throw your body off even more by trying to catch up on sleep, which can create a vicious cycle as it’s then harder to sleep during the week.

Sleep as a superpower

Sleep should be regarded as a personal superpower, and a lack thereof not at all negotiable. The physiological impact that sleep has on the body is spectacular, but it’s not only the number of hours that you spend in bed that counts, the quality of deep sleep is as important.

The body experiences different types of deep sleep before and after midnight, both which are very important. Therefore, consistently going to bed at a late hour can be detrimental to your health.

During the sleep stages the body goes through various processes, all of which are very important to optimise health. The first and second sleep stages are very light and combined can make up approximately 55% of total sleep.

The earlier hours of the night are generally when stage three deep sleep, also known as slow wave sleep, occurs. This stage is vital for detoxification processes, tissue repair, hormone balancing, immune regulation and more. This is one of the most important sleep stages, and at least 25% of total sleep is spent in this stage to ensure enough restorative, deep sleep.

During the later part of the night, we get more REM deep sleep, which is stage four of the sleep cycles. This phase is important for the processing and consolidation of memory, formation of new memories, learning, and more. This stage should ideally make up 20% of our total sleep time.

The vicious cycle

A high intake of refined sugar and carbohydrates causes inflammation in the body, and it’s known that high inflammation in the body causes restlessness, which in turn disturbs healthy sleep.

High inflammation means that the third stage of sleep is interrupted, and as this stage is important for the body to restore itself, insufficient stage three sleep is associated with high blood pressure, high blood glucose, insulin resistance and weight gain.

Due to this inability to restore blood glucose levels among others during this vital phase of sleep, sleep deprivation is linked to Type 2 diabetes, metabolic syndrome, congestive heart failure and even short-term memory loss, mood disorders and increased systemic inflammation to name but a few.

The lack of sleep causes havoc with energy levels, which in turn create cravings for high sugar and refined carbohydrates during the waking hours, which raises inflammation in the body and again disturbs the sleep processes. It becomes a vicious cycle that needs intentional intervention to start restoring blood glucose levels and healthy deep sleep. 

Optimising your health

Because it’s clear that blood glucose levels impact sleep and vice versa, managing both is crucial. As the body cycles through the different stages several times in the night, you should aim to get enough uninterrupted sleep to ensure that the right time is spent in all the different cycles.

To optimise sleep:

  • Establish a bedtime routine which includes going to bed at the same time and waking up at the same time each morning, even on the weekends.
  • Aim for seven to eight hours of sleep each night.
  • Limit blue light entering your eyes by limiting the use of electronic devices at least two hours before bedtime. Blue light disrupts your internal body clock or circadian rhythm, and further blocks melatonin which balances cortisol.
  • Wind down an hour before bedtime by reading something spiritual, doing some pre-sleep meditation or practicing some deep-belly breathing.
  • Ensure that your room is completely dark, as even the smallest amount of light can disrupt the internal body clock, and in turn your pineal gland’s production of melatonin and serotonin.
  • Avoid caffeine and alcohol from midday, as both are known to disrupt sleep.

Stabilise blood glucose levels, which will in turn help with better sleep:

  • Eliminate sugar and refined carbohydrate from the diet.
  • Eliminate additives and tartrazine from the diet as it’s known to disturb sleep.
  • Eat smaller meals closer to bedtime.
  • Intermitted fasting between 14 and 16 hours can stabilise blood glucose levels, but should be done only in consultation with a medical practitioner.

Nothing stands in isolation

A holistic approach to health is required to maintaining optimal health. The Renewal Institute termed the five pillars of health as a guideline to ensure that all aspects of healthy living are addressed.

Pillar 1: Nutrition

Eating a well-balanced diet that consist of nutrient-rich foods is important to fuel the body. Correct supplementation goes hand in hand with a healthy diet, as not all the nutrients required are accessed through the food we consume.

Pillar 2: A healthy gut

The gut involves around seven to nine metres of digestive organs with a surface exposure area almost equivalent to a tennis court. Along this vast contact surface, we have hormones, bacteria and signals which have an impact on our overall health. Gut health needs to be optimised for improved digestion, bacterial balance, absorption of nutrients and elimination of toxic waste.

Pillar 3: Managing stress

In our modern lifestyles, we have become almost too accustomed to unnatural chronic stress exposure. This causes inflammation, increased oxidation or cell damage, hormone imbalances and stem cell and DNA damage.

Stress management techniques that are practiced regularly is essential for the body to reset, as chronic stress can disrupt cortisol levels, leading to weight gain and possibly disturbances.

Pillar 4: Healthy exercise

A sedentary lifestyle has been found to be as dangerous to our health as smoking. It’s important to find a regular activity routine that incorporates flexibility, aerobic exercise and strength training without over-stressing the body unnecessarily. High Intensity Interval Training (HIIT) is particularly effective to level blood glucose levels.

Pillar 5: Sleep

Sleep optimisation forms the foundation for overall health. Quality is as important as quantity. Deep restorative sleep maximises the effect of all the other pillars previously addressed.

It’s important to note that no single pillar stands in isolation and that all contributes to a person’s health and well-being. If you are out of sync, it may very well impact the other, and therefore a holistically balanced lifestyle should be the aim.

MEET THE EXPERT


Dr Maureen Allem is the founder and Medical Director of the Renewal Institute. She is a general practitioner with a special interest in aesthetic procedures and integrative and anti-ageing medicine.

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