A better health care experience altogether
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Winter 2013
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Issue 02
Skincare regime for teens Mind over matter: Useful advice for parents with teenagers
Prepare
Return of the farm child in the face of technology
for your first
How to take care of your health
... in just 12 weeks
from your 20’s to your 40’s
10km race
Fighting influenza
FREE
Y
COP
NET#WORK BBDO 8015661/E
Every year, approximately 5 000 South Africans require a kidney transplant. Of these, not even 10% get the kidneys they need. Become a kidney donor while you’re still alive or after death and save a life. After all, you only need one kidney to live a perfectly normal life, as does someone else. Contact us at n k f s a @ m w e b . c o . z a o r ( 0 11 ) 4 4 7 2 5 3 1 .
Winter 2013
1
contents up close and personal
4
from the experts
02 CEO's note
14 All about –
Message from Intercare Group
Understanding your
teenager’s behaviour
CEO Dr Hendrik Hanekom 04 Health bites –
18 Sensory health –
Short bits of info to digest
while on the go
28 In the know –
Why kids need to be kids
Pets can enhance interact
12
03 Contributors
your wellbeing
06 A day in the life of ...
your health
Dr Moekie Stampa, get to
22 Recipe – Fig fancy,
know one of our dedicated staff
nutritional facts and health
members, who is a Dentist at
benefits of figs in your diet 27 Health boost – Super snacks
Intercare Gonubie 11 Must haves –
for the 4pm slump
Great products and give-aways we
30 First aid – Anaphylactic Shock,
want you to know about
know what to do 32 Wellbeing – Stop
your body
procrastination as it saps
08 Teen skincare tips –
your time and energy.
Treating common skin problems 12 On the run –
18
Get fit fast in just 12 weeks, try our easy plan 16 Health matters – How to keep Seasonal influenza at bay and keep healthy during the colder months 24 Healthwise Guidelines for every decade, get healthy at any age
22
Making your own recovery the first priority in your life
2
CEO note Dear patient, in supporting your endeavours to find the balance between work, family and managing your health throughout this winter, the Intercare Group brings you the second edition of our exciting Body Language magazine bursting with information, advice and tips to enhance both your health and your lifestyle. To ensure a wholesome lifestyle, it is vital that your entire family reap the benefits of a healthy outlook on life. That’s why this edition is chockablock with advice for parents with younger kids and teenagers as well as guidelines for healthy living from your twenties to your forties and beyond. Remember how you used to play as a child? It’s time to rediscover your environment with your child. Muse over happy childhood memories and find out from our child development specialist how to create opportunities
for your child to use all his senses as he explores his surroundings in a playful manner. If you have a teenager in the house, you are bound to face some challenging encounters. Before jumping to conclusions, learn more about why your teen’s behaviour is actually quite in order and get to understand this fascinating phase when you read our article on how the adolescent’s brain works. And if you wish to escape from dealing with work stress, family mat-
ters and all the other daily demands, set yourself a new goal for this chilly season: train for your first 10km race! With expert instructions from our biokineticist you will be fit and able in no time! On this blissful note, we wish you and your dear ones a warm, cosy and flu-free winter!
Dr Hendrik Hanekom CEO Intercare Group
Newsflash: Intercare is proud to announce the opening of the new day hospital and the new sub-acute hospital at Southdowns Centre, Irene, Centurion.
Editorial Publishing editors Christa Grobler christa@health-bytes.co.za Marilize Eygenberger marilize@health-bytes.co.za
Editorial enquiries Unit 11, Bellfour Office Park, Corner of Rodger & Edmar Street, Bellville, Cape Town, 7530 Tel: 021 917 8804 Fax: 021 917 8801 info@health-bytes.co.za
Design Blinc Design, Bronwen Moys Proofing Marietjie Yelverton Business managers & publishers Christa Grobler & Marilize Eygenberger Printing CTP Print
Indemnity: The information contained in Body Language is intended for general informational and educational purposes only, and not to replace professional medical advice. Persons requiring any medical advice or treatment should consult their relevant qualified health-care professional. The publisher cannot accept any responsibility for any act, omission, loss, damage, or the consequences thereof caused
Advertising: Body Language is published quarterly. FREE copies are distributed at Intercare Medical and Dental Centres. To advertise, please contact our advertising department at: Tel: 021 917 8804, Fax: 021 917 8801, info@health-bytes.co.za
by reliance by any person upon the information contained in the publication. The information included in Body Language is subject to copyright and all rights are reserved. The information may not be sold, resold, transmitted or otherwise made available or disseminated in any manner via any media to third parties unless the prior written consent of the publisher has been obtained.
Winter 2013
contributors
3 Kathy Rautenbach, BSocSc (Psychology and Industrial Sociology) UCT, is the owner of Kidz Discovery in Camps Bay. For the past 12 years she has run BrightStart preschool preparedness programme. She is passionate about providing sensory-rich, innovative and fun learning platforms. Health Bytes Publishers Christa Grobler (MSc Biochemistry, MBA) and Marilize Eygenberger (BPharm, MBA) have extensive experience in the pharmaceutical industry with regard to patient education, sales, marketing research, scientific knowledge (disease and products) and pharmacy management.
Dr Anusha Lachman, Child and Adolescent Psychiatrist at Tygerberg Hospital Child & Family Unit.
Petrus Janse van Rensburg – Biokinetikus BSc Menslike bewegingskunde, BA Hons Sport wetenskap met Sport Sielkunde, BA Hons in Biokinetika.
Dr Rakesh Newaj, MBBCh (Wits), FC Derm (SA), is a dermatologist specialising in the diagnosis and management of general dermatology. He offers a range of services, including mole screening, excision of skin cancer by surgical and other methods. Dr Heloise Wessels, practicing as a general practitioner at Intercare Silver Lakes.
We want to hear from you ... We would like to invite all patients and customers to air their views and provide us with input regarding this magazine. In doing so, we can remain relevant and actual. We will then be able to make a difference and to “create the better health care experience altogether” on a daily basis. Please email us at: info@intercare.co.za with any suggestions, ideas and things you would like to see on these pages.
Take Note: Like us on Facebook: Become a fan of Intercare on Facebook by joining us on our page: ‘Intercare Health Care Group’. www.intercare.co.za
Health bites
4
healthbites
Short snippets of info to read and digest while on the go ... take heed of the following ...
Die griepseisoen is hier: Herinner kinders om hulle hande gereeld vir 20 sekondes te was!
Acupuncture may be antidote for allergies
Restaurantreëls: Wenke vir die gesin
Acupuncture's potential role in treating allergies should be investigated further, according to authors of a new study.
Omdat ’n mens nie altyd seker is hoe restaurantetes voorberei word en watter bestanddele daarin is nie, kan uiteet, hoe aangenaam dit ookal mag wees, ‘n negatiewe uitwerking op jou gesin se voeding hê. Dis jou plig as ouer om toe te sien dat jou kinders goed ingelig is omtrent gesonde en ongesonde keuses sodat hulle die geregte sal kies. Hier is ‘n paar basiese reëls: V ermy enigiets wat gebraai is of met broodkrummels bedek is. V ermy te veel brood voor die hoofgereg. I ndien voorgeregte bestel gaan word, kies eerder slaai of groente. M oenie sout by jou gereg voeg nie. V ermy koeldrank en bestel sommer water vir die tafel. M oedig jou kinders aan om maer proteine op die spyskaart uit te soek.
Acupuncture already helps to relieve pain in some patients, and the latest study hints that it might relieve sneezing and itchy eyes as well. Most patients plagued with sniffles brought on by seasonal allergies turn to antihistamines for relief, but when they don't get relief, some opt for alternative treatments like acupuncture. This is when tiny needles are inserted just under the skin at specific points in the body to reduce certain symptoms. Although a new study shows that acupuncture may provide some allergy relief, researchers say a placebo effect may be responsible for some improvement. Experts advise that more research needs to be conducted on the issue.
Fast food linked to asthma & allergies in kids Fast food may be convenient, but your immune system may pay the price for eating them frequently. According to a study published in the journal Thorax, fast food is linked to an increased risk of asthma, eczema and rhinitis among children and teens. The study also found that eating fruit could protect against these disorders among all age groups. Eating fast food meals at least three times a week was linked to a 39% increased risk of severe asthma in teenagers and a 27% increased risk among children aged six and seven. Fruit, on the other hand, seemed to have the opposite effect on asthma symptoms; three or more servings of fruit was associated with a 11% decrease in severe symptoms in teens and a 14% drop in severity of suffering in kids.
5 Baby’s first foods from around the world Kim McCosker, mother of three, asked our global Facebook family what babies around the world eat and found the answers interesting to compare. In her book Baby Bowl: Home-cooked Meals for Happy, Healthy Babies and Toddlers, she explores first foods for babies in different parts of the world and finds that it varies a lot. The first solid foods for some are what we would expect to find on a grownup restaurant menu in our part of the world! America Oats, barley and rice cereal; pureed vegetables and fruit Australia Rice cereal; pureed vegetables and fruit Brazil Beans of many types and colours (black, red, white) China Rice porridge, followed by mashed fruits, soft vegetables, tofu, and fish Ghana Maize (corn) porridge
Folic acid in pregnancy may help lower autism risk
France Artichokes and tomatoes Japan Rice cereal and radish Middle East Hummus and baba ganoush
Taking folic acid before pregnancy and during the first several weeks of pregnancy may help reduce the risk of autism for those children by 39%, according to the Journal of the American Medical Association (JAMA). Taking folic acid marks one of the first tangible things a woman can do to reduce her risk of giving birth to a child with the disorder.
New Zealand Rice cereal and pureed sweet potato South Africa Maize (corn) porridge and fish Thailand Khao tom (rice soup) United Kingdom Rice cereal; pureed vegetables and fruit.
Gesondheidsfeit Een van die grootste wanopvattings deur baie Suid-Afrikaners is dat kanker nie voorkom kan word nie. Volgens Dr Anchen Laubscher, mediese dokter by Netcare en Netcare 911, kan ‘n gerame 40% van kankers voorkom word deur die instelling van ‘n gesonde leefstyl, gereelde mediese ondersoeke en deur voorkomende stappe te neem soos inenting.
Alcohol & diet soda may be a bad mix Researchers gave students vodka drinks with regular soda and with diet soda. The diet soda group were about 20% more intoxicated than those who mixed regular soda with liquor, according to research published in the journal Alcoholism: Clinical & Experimental Research. Sugar in your mixed drink actually slows down the effects of alcohol according to researchers.
A day in the life of ...
6
14 THINGS
TO KNOW ABOUT ... Dr Moekie Stampa, one of our dedicated staff members, who is a Dentist at Intercare Gonubie. 1.
I am ... a Christian, wife, mother of two and a health care professional (in that order).
2.
I was born in ... Grahamstown (Eastern Cape).
3.
I share my house with ... my husband, two children, an ‘adopted’ young man and two Ridgebacks.
4.
7.
My friends and I like ... talking! (I am a woman after all).
8.
I listen to ... mostly classical, but also 80s music.
9.
People would be surprised to know that ... despite being a bubbly and happy soul, I am a stickler for detail, quality and ethics.
10.
Perfect happiness is ... knowing that my life has a purpose in the grand scheme of things. Success to me means ... to do whatever your hands find to do, and to do it well.
11.
Everything in moderation, but ... not laughter. I like British humour best.
5.
If I weren’t doing what I do, I would be ... in cross-cultural missions in a third-world country.
12.
I’d like to be remembered as ... a person who lived life to the full and in the process glorified God.
6.
I can’t go a day without ... my team. I delegate, train, give feedback and then rely on my team. My dental assistant and domestic worker are invaluable members of my team.
13.
I’m scared of ... NOTHING. “If God is for you, who can be against you?”
14.
I would like to meet … No request in this department!
“One of my life mottos is ... do not worry about tomorrow. Each day has enough trouble of its own."
fun facts Likes: People who are team workers People’s people ‘The cup is half full’ people
Dislikes: Arrogant and boastful people Lazy people (“slapgatte”) Liars
My Best Places: Places: Victoria Falls Shops: NONE! (A necessary evil) Restaurants: Ninadeli, a coffee shop in East London
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Feature article: By dermatologist Dr Rakesh Newaj
8
Top skincare tips for teenagers Addressing teen acne and common skin problems
A
lmost every teenager has at least one skin issue. Teenagers pay more attention to their appearance and a good skin helps to boost confidence. Not only are skin problems becoming more prevalent, there is also an upsurge in the cosmetic industry, with many trying to prey on this vulnerable target market. Many factors compound skin problems, such as global warming, pollution, severe stress, food eaten and lack of exercise. These factors can all add up and manifest on our skin. Above all, the hormonal changes that occur during the growth spout of teenagers tend to make them more prone to diseases like acne. However, one can take a few simple measures during childhood and the teenage years that can result in long-lasting good skin. Skincare regime for teenagers Start by identifying the skin type one has. Skin types are classified into normal, dry, oily and combination skin.
F ew teenagers have normal skin, which consists of an even, smooth
skin tone, soft texture and no visible blemishes, red spots or flaky patches. Normal skin has only few imperfections because of the balanced amount of moisture and oil and good blood circulation. Teenagers that are blessed with normal skin should only use a mild cleansing soap twice a day and a strong sunscreen. No other skincare regime is required. D ry skin is dull, flaky and itchy with almost invisible pores. The skin
surface can feel rough due to the abnormal shedding of skin cells. Teenagers with dry skin should wash the face with lukewarm water and a mild cleanser twice a day. Abrasive substances like toners and scrubs will irritate the skin, leading to more dryness and unevenness. A moisturiser, for example Physiogel AI cream without alcohol and perfumes, tends to soothe the skin and lock in healing moisture, especially after a shower. This will result in a soft and supple skin. O ily skin is a little more challenging. Extra care is needed to deal
with shiny, acne-prone skin. Teenagers with oily skin have large open pores, blackheads and at times an uneven complexion. Hormones like oestrogen and testosterone increase in teenage years, stimulating the sebaceous glands to produce more oil. Taking care of oily skin requires washing the face three times a day with plain soap and water. Over-the-counter cleansing pads help dissolve the oil and removes
Winter 2013
9
Take a few simple measures during childhood and the teenage years that can result in long-lasting good skin.
excess dirt from the skin surface. The use of non-comedogenic facial products is favoured as they do not tend to clog the pores. Rigorous removal of the sebum (oil) from the face can result in overcompensation and aggravation of the situation. T eenagers with combination skin have
both oily and dry areas. Usually the “Tzone” (forehead, nose and chin) tends to be oily with large pores and blackheads, while the cheeks appear rough due to dryness. In this case, the use of a mild soap and lukewarm water twice a day may suffice. A plain moisturiser used only on the dry areas can normalise the skin tone. Common teenage skin problems The most common skin disease affecting teenagers is acne (pimples). The pimples usually occur on the face and less frequently on the chest and back. Basically the sebaceous glands get stimulated to produce more oil. This oil accumulates in the skin due to genetically determined blockages at their exit. Bacteria break down the oil, leading to swelling, inflammation and pustules. Pimples should not be squeezed or popped as this can spread the inflammation, worsen the acne and lead to permanent scars. Early medical treatment can be very beneficial and can result in long-term remission. Do not be fooled by expensive cosmetics that claim to treat pimples but
Sun protection Teenagers with all skin types require good sun protection. A good sunscreen is one with both a high UVB SPF and UVA SPF. A sunscreen with SPF greater than 30 is advocated when outside. Refrain from staying in the sun between 11am to 2pm and renew sunscreen regularly. A wide brim hat and long sleeves tend to offer some protection and should be used when possible. According to the latest research, most sun damage occurs during a young age, leading to various skin cancers later in life.
do not have the required level of evidence to support them. However, the use of facial cleansers containing salicylic acid or glycolic acid can help to get rid of the dead skin cells and lead to a slight improvement. Keratosis pilaris is so widespread, yet rarely talked about. It presents as rough skin mainly on the upper arms that can fluctuate seasonally. This roughness is a result of dead skin cells around hair follicles not shedding normally. This condition is life-long and can also affect the face and legs. Treatment is aimed at improving the condition by exfoliants, like a 20% urea cream. Warts are very common in children and can persist into teenage years. They are unsightly growths affecting mainly the hands and feet. These are caused by the human papillomavirus and can spread to other parts of the body. Thus early treatment can lead to quick resolution. A simple home remedy involves the use of lemon skin, soaked in brown vinegar for at least two days. Then pieces are placed on the wart every night and secured with tape. This can be continued for up to four to six weeks. Contact a medical practitioner if complete resolution is not seen during that time. There are many other diseases that can inflict teenagers and most of them need proper medical management. As far as skin care goes, one should keep it simple as expensive products rarely equates to flawless skin.
Key points to remember Taking a few simple measures during childhood will ensure long-lasting good skin. Many factors impact on our skin so take note of the following and try to incorporate into your daily routine:
se sun screen daily, with a U factor of SPF 30 or more A wide brim hat will help keep sun exposure from your face
Eat a balanced diet – nutrition affects the skin Drink plenty of water every day to flush out toxins Get enough exercise – helps manage stress levels Follow a skin routine that suits your skin type and skin tone, keep it simple
First, the product applies for endorsement.
Next, it is thoroughly tested by an independent, accredited lab.
The laboratory results are then examined by a team of dietitians.
Levels of fats, cholesterol, fibre, sodium and sugar are checked to see if nutritional criteria are met.
Now the product is ready to receive our stamp of approval.
But not before its packaging is assessed for nutritional accuracy according to our strict requirements.
It may seem excessive, but it means that every Heart Mark approved product is nutritionally sound. Look out for the healthy choice you can trust.
TJDR (CT) 39013/E
THIS IS WHAT IT TAKES TO GET A HEART MARK
Winter 2013
Products we love & want you to know about!
Must haves
We’re giving away some fabulous goodies! To stand a chance to qualify, SMS the product code (e.g. SW) and your name and surname to 34298 (R2 per SMS). Competition closes 8 July 2013.
Sweet and Wild
4aKid products
I
nspired by nature, Sweet and Wild is an exciting range of natural, plant-based products that are specifically designed to protect and nurture children’s delicate skin. Using ingredients that include African marula oil, aloe vera, jojoba and olive oil plus aromatic essential oils, they have created a soothing range especially for the young – or young at heart! They select the safest and most effective essential oils and botanicals for their individual properties, for example to heal, calm, refresh or for antibacterial purposes – and with natural fragrances of Creamy Soda, Fruit Sorbet and soothing Sweet Dreams, they smell good enough to want to eat. For more information go to www.sweetandwild.co.za. Sweet and Wild is giving away a hamper to the value of R400. Product code for give-away is SW.
GIVEAWAY
4
aKid specialises in the wholesale and distribution of innovative baby-proofing items, childsafety products, kids clothing and trendy baby accessories, making life easier and simpler for moms and dads. We love their Safety Angel Pool Alarm. The Safety Angel is a pool alarm used for protecting children or pets from drowning. When the bracelet is immersed into the water, the base unit will sound an alarm and vibrate. The detecting distance is about 50 meters. Safety Angel can be used for swimming pools, garden ponds, rivers, sea water the beach or anywhere where there is open water that can pose a risk to your child. The cost is R855 for a base unit with one wristband, the bracelet. For more information visit www.4akid.co.za. 4aKid is giving away a hamper for one lucky reader to the value of R350. Product code for give-away is 4K.
GIVEAWAY
11
To see your products on these pages please email us at: info@health-bytes.co.za
Doctor Duve
D
octor Duve Cellulite Gel contains a highly effective slimming complex that stimulates lipolysis (fat burning) and therefore promotes the elimination of metabolic waste products. Horse chestnut extract firms the skin’s tissue and promotes micro-circulation. Caffeine stimulates the lipometabolism and supports the breakdown of fat deposits. An extract of African pepper refreshes the skin and has an invigorating effect NMF (natural moisturising factor). Components such as lactic acid, urea and pyrrolidine carbonic acid have intensely moisturising properties. The result: Skin appears significantly smoother and tighter! Note: It is safe to use Doctor Duve during and after pregnancy. For further information on how to use and order the product please contact Doctor Duve by calling 079 438 0061 or send an email to reyjeane@doctor-duve.co.za. (www.doctor-duve.com) Doctor Duve is giving away one tube of Dr Duve Cellulite Gel to the value of R1000. Product code for give-away is DD.
GIVEAWAY
Give-away terms and conditions: The winners will be the first correct entries drawn after the closing date. In the event of the judges not being able to get hold of winners on details supplied, alternative winners will be selected. The judges’ decision is final and no correspondence will be entered into. Winners must be prepared to be photographed for publicity purposes. The prize is not transferable and may not be converted into cash. Please note: Give-away prizes / hampers may differ from the images depicted here, they are at the discretion of the sponsor / suppliers.
How to: By biokineticist Petrus Janse van Rensburg
12
in just 12 weeks
Run your first 10km race If you sometimes wonder how athletes on TV make running look so easy, we can help you do the same for a 10km run. Our 12-week plan will help you ease into distance running.
P
erhaps you’re still trying to stick to your New Year’s resolution or you enjoy setting new goals and the sweet success of achieving them. You may love to gym or climb mountains, but if you start running distances, you would see that very little makes you feel better than a good run. People start running for a variety of reasons. Whatever your reason, you'll experience many physical, mental and emotional benefits from the sport. Running improves your cardiovascular health Running strengthens the heart and ensures the efficient flow of blood and oxygen throughout the body, which helps decrease your risk of cardiovascular disease. Exercise combined with maintaining a healthy diet naturally reduces your blood pressure. If you have high cholesterol, running can also help keep it under control.
from zero to hero
You can lose weight Running is a very efficient way to loose weight. It is one of the most extreme weight loss exercises in terms of visible results. You can meet new people Some runners enjoy the solitude of running on their own, but other runners see running time as social opportunities. Joining a running group can help you set goals and accomplish it. Running improves energy levels Running can boost your energy. Runners who run in the morning state that they have improved energy levels during the day. Just be careful not to run too far in the morning, as it can have the opposite effect as well. Running will help you feel good about yourself Regular runners report an enhancement in their confidence. The benefits of running are increased if you set a specific goal, such as running a 10km race, and accomplishing it.
Winter 2013
Your 12 week programme
13
Week
Walk
Jog
Repeats
Sessions per week
1
6 min
1 min at easy pace
3
3
2
5 min
2 min at easy pace
3
3
3
3 min
4 min
4
4
4
2 min
5 min
4
Aim for 4!
5
2 min
8 min
3
4
6
2 min
9 min
3
4
7
1 min
11 min
3
4
8
5 min
20 min to 30 min
0
2
Congratulations on making it to week 8! For your first run this week, try walking for five minutes to begin and end the workout, and run for 20 minutes in between. By the end of the week, try to run for 30 minutes without stopping.
From week 9, aim to run for 30 minutes four times a week, and you’ll notice that your stamina and fitness will continue to improve. Soon you’ll be ready to run your first 10km – in approximately 60 minutes. Week
Mon
Tues
Wed
Thurs
Fri
Sat
Sun
9
30 min
Off
30 min
Off
30 min
60 min
Off
10
30 min
Off
30 min
Off
30 min
40 min
Off
11
30 min
40 min
Off
40 min
30 min
60 min
Off
12
30 min
40 min
Off
40 min
30 min
60 min
Off
TIPS
1 Use your breathing as your guide. You should be able to carry on a conversation while running and your breathing shouldn't be heavy.
2 Drink water at the end of your workouts to rehydrate. 3 When walking, ensure you're not taking a leisurely stroll. Pump your arms so that your heart rate stays elevated. You'll still be getting a good cardiovascular workout and it will make the transition back to running easier.
4 Once you can successfully run for long stretches, don't feel as if you have to abandon the run/walk method. Some long-distance runners use it in training runs and races to help reduce muscle soreness and fatigue. 5 Expect to feel a little soreness the first week or two. 6 If you feel more than general muscle soreness, back off! Don't keep running through an injury. If you feel pain, rest and use ice. Visit www.biokinetics.org.
za to find a biokineticist in your area who can help identify muscle imbalances, your gait pattern and provide a specific strength and conditioning programme suitable to your needs. 7 If you have to take a break for injury or family commitments, don't give up! If you miss a workout or two, just pick up where you left off. If you have an extended break, you might want to back up a week or two. 8 The days of the week listed here are just for guidance. Run on the days that best suit your schedule. Just remember that rest days are just as important as training days. 9 Visit www.runnersguide.co.za for information on races in your area. Having a goal to work towards will keep you on track and the sense of achievement will be greater if you commit to doing a race or two.
Running is versatile and inexpensive Running requires very little equipment and can be done almost anywhere. It is very important though that you get a good pair of running shoes. Get your running style and stride tested before buying a pair of shoes to avoid injuries. Running can help with stress relief Running is a great cure for stress, emotional strain and even mild depression. Research has shown that healthy adults who exercise regularly are generally happier than those who don't.
How to get started Get medical clearance from your doctor
before you get started if you are very unfit or have any health concerns or risks of heart disease. Invest in a proper pair of running shoes. Choosing the right running shoes is important to prevent injuries. Before you start your workouts, make sure you warm up properly by walking for 10 minutes. End your workout with a cooling down and stretch session. Then get going The time spent exercising should comprise walking and running, beginning with mostly walking and gradually transitioning into more and more running in order to condition the heart and lungs, as well as muscles, connective tissue and the mind. You may be tempted to progress faster, but you would be wiser to work at this progression pace. If you can use a heart monitor, your heart rate (HR) should be between 60% and 70% of the maximum HR. If you do not know your maximum HR, use the formula 220 minus your age until better information is available.
All about: By Dr Anusha Lachman, Child and Adolescent Psychiatrist at Tygerberg Hospital Child & Family Unit
14
Adolescence:
Fathoming teenagers’ brains to catch their drift “Why fit in when you were born to stand out?” Dr. Seuss famously asked.
P
eople have long questioned this class of human beings that we call teenagers … What on earth are they doing? What is wrong with these kids? Why do they act like they have marshmallows for brains? These questions pass judgement even as they begin to enquire. Through the ages, most answers have cited “dark forces disguised as hormones” that uniquely affect the teenager. Freud saw adolescence as an expression of tortuous psychosexual conflict; Erik Erikson saw it as the most tumultuous of life's several identity crises. About hormones … If we are to believe the popular media then the prototype of a teenager is typically a rude, volatile, rebellious brat who is ungrateful, irresponsible and whose purpose in life is to upset, stress and raise the blood pressure of his longsuffering parents. This is of course a gross misrepresentation – most teenagers go through adolescence smoothly and happily, without falling pregnant, becoming addicted to drugs, landing in jail or dropping out of school! Still, there remains a stubborn tendency for us to blame the difficulties experienced in this life phase on hormones. Hormones most certainly are responsible for the changes in physical growth and development characteristic of
puberty. But the full extent to which hormones actually influence adolescent brains remains unknown. Hormones may have nothing to do with the fact that your daughter can’t stand the sound of your singing voice or your dress sense, but it’s a safe bet that your teenager’s fixation on sex and social standing is pretty much hormone related. The brain changes … In the past few years, research has shown that the brain of a teenager really does function very differently from an adult’s. Two technologies – PET (positron emission tomography) scans and fMRI (functional magnetic resonance imaging) – have enabled the study of the teenage brain over time, and what research shows is that this teen brain is very much a work in progress. There are areas that deal with motor control and hand-eye coordination that are at optimal functioning, which explains why your teen is so much more technosavvy (think iPad/Xbox/DVD remote/ DSTV settings) than you could hope to be! But there are other areas – not surprisingly, the ones responsible for “executive functioning” (such as planning ahead and weighing priorities) – that continue to develop well into young adulthood. During adolescence there
are changes involving the way the brain processes rewards and pleasure. “Rewarding stuff feels more rewarding.” This is accompanied by an increase in attentiveness to social rewards and information and can lead to risky, sensation-seeking behaviours, such as driving too fast or drug experimentation. Maturation of the brain, including the regulation of impulses, thinking ahead, planning and weighing risk lead to improvements in self-regulation and can permit the individual to put the brakes on the sensation-seeking behaviours, but they occur very gradually and are not complete until the mid-twenties. This can have a big effect on how parents understand their children. It’s important for parents to realise that teenagers may not be as able as adults to think ahead and envision the future consequences of their actions, resist pressure from others and to forgo immediate rewards to get a bigger payoff later. As difficult as it is for parents to grasp, adolescents don’t always make poor choices just to be annoying or due to temporary insanity – this sort of behaviour appears to be a predictable part of the identity-formation process, which begins in the early years but dramatically accelerates during adolescence. That’s when children begin playing different roles, figuring out if
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they’re gay, straight, or bisexual, whether they’re nerds or cool. At the same time, their frontal lobes aren’t fully developed, which means that the appetite for experimentation doesn’t necessarily go along with the capacity to make sound judgements or to see into the not-so-distant future. In other words, by their very nature, teenagers are not especially focused on or equipped to assess the consequences of their actions. A recent review in NATURE Neuroscience (2012) suggested that adolescent brains appear more responsive to changes in environmental and social cues than any other phase of life. So on the one hand it makes the adolescent brain more adaptive to social competencies in adulthood, but on the other hand it hints at the vulnerabilities of this system. Sleep patterns Another fascinating phenomenon that plays havoc with parents is the adolescent sleep pattern. Suddenly the child who always woke you up at the crack of dawn when you were desperate to sleep turns 13 and can neither be dragged out of bed in the morning or be forced into bed at night. It may just seem like a case of teenage rebellion, but actually its biology – the circadian rhythm of the brain has changed. Teenagers simply can’t or don’t want to get out of bed that early. Research has shown that the amount of melatonin (the hormone that regulates sleep-wake cycles) increases later in the day in teenagers than in adults. In addition, the biological trigger for sleep, called the sleep pressure
What about substances? Many teenagers may diet or experiment with substances as a necessary experience when negotiating their social and environmental pressures. The good news is that most teenagers will not develop a major eating disorder or drug addiction – an important thing to remember when times get difficult. But teenagers who feel unable to trust an adult in a safe home base to be understanding and supportive are more likely to develop ongoing emotional and psychological problems. However difficult it may feel, parents need to try to be as honest and consistent as is possible with their teenagers. Experimenting and challenging teenagers need a home to return to that is safe, respectful and accepting and with rules and boundaries that help contain them from within.
It’s important for parents to realise that teenagers may not be as able as adults to think ahead and envision the future consequences of their actions.
USEFUL ADVICE
Am I a bad parent? Research has shown that most teenagers actually like their parents and feel they get along well with them. Adolescence may be a time when the process of growing up can help people make positive changes. Parents may sometimes start to feel that they have failed, but although adolescents are becoming more independent, they
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rate, slows down in adolescence.
still have a lot to learn from you about how to behave. Adolescents can be irritating and test one’s patience, but choose your battles carefully. If you don’t want them to swear, don’t swear yourself, if you don’t want them to get drunk or violent, don’t get drunk or use violence yourself. All parents hope that their children will get through
adolescence unscathed so that they will grow to happy independence. But the reality is that adolescence is a bumpy ride between their need for independence and their need for reassurance. The secret is to accept that you have to give up control over your child. It's no longer desirable or possible to order them to do things – you'll only
create battles and even more resistance. For right now it will help to kick off your shoes, sip on your drink and wish their developing brains a smooth ride and remind them of the echoing words of Dr. Seuss: “Today you are You, that is truer than true. There is no one alive who is You-er than You.”
Health matters: By Dr Heloise Wessels (Intercare Silver Lakes)
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Fighting
inf luenza Seasonal influenza is an acute viral infection caused by an influenza virus. It is characterized by the sudden onset of high fever, dry cough, headache, muscle and joint pain, severe malaise (feeling unwell), sore throat and a runny nose.
T
he time from infection to the onset of the illness (the incubation period) is approximately two days. Most people will recover within a week, but high-risk persons are exposed to the risk of severe illness or even death. Preventing influenza The influenza vaccine (the flu shot) is the most effective way of preventing the disease. Simple infection control measures such as hand washing and covering your mouth and nose when you sneeze can effectively prevent influenza transmission.
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17 Remember: It is never too late to vaccinate
Influenza vaccine The influenza vaccine can reduce severity and prevent 70% to 90% of the influenzaspecific illnesses in healthy adults, reduce the severity of illnesses and complications in elderly people by 60%, and prevent 80% of the deaths amongst elderly people. When to get the vaccine? Because the influenza virus differs each year, one needs to vaccinate each year before the flu season, which normally falls between May and October. How effective is the vaccine? Antibodies (proteins that destroy the influenza virus)
administer to people who are allergic to eggs. Who should be vaccinated The WHO (World Health Organisation) recommends annual vaccinations for: Elderly and disabled individuals People with chronic medical conditions, such as diabetes, kidney disease and HIV infection Adults and children with chronic lung and heart conditions, for example children with asthma Other groups such as pregnant women, healthcare workers, those with essential functions in society, as well as children from ages six months to two years.
Infection control The infection can be controlled if you follow this advice and tips: Wash your hands with soap and water to limit the spread of influenza. Cover your mouth and nose while coughing or sneezing. Do not touch your eyes, nose and mouth as germs are spread this way. Stay at home for 24 hours after the fever has gone, except to seek medical care.
Limit contact with other people while you are ill. All the Intercare practices have the influenza vaccine in stock and can administer the vaccine in preparation of the influenza season. It is not necessary to make an appointment. Our friendly sisters will assist you with the vaccination.
Because the influenza virus differs each year, one needs to vaccinate each year before the flu season. are produced two weeks after the vaccine had been administered. What are the side effects of the vaccine? Tenderness at the injection point Body aches, headache and low grade fever – these should resolve within two days Studies have shown that the flu vaccine is safe to
Should I get an antibiotic? Since antibiotics kill only bacteria – and no viruses – they will not help treat the flu or colds. However, about 5% of colds develop into secondary bacterial infections for which antibiotics constitute a useful treatment.
are signs that flu may have developed into something serious like pneumonia: Difficulty breathing Persistent fever, coughing, congestion or headaches Vomiting or inability to keep fluids down Painful swallowing
When should I see a doctor? See a doctor if you have any of these symptoms, as they
Top tip Say yes to Grandma's chicken soup. When we get a cold, neutrophils congregate in
the infected area to fight the virus, producing inflammation that causes runny noses and sore throats. Researchers have found that homemade chicken soup may help inhibit neutrophil migration, ward off inflammation and prevent upper respiratory infection. The individual components of the soup appear to have medicinal properties and help rehydrate our bodies with salts and minerals.
References: Up to date: http://www.uptodate.com/contents/influenza-prevention-beyond-the-basics?source=see_link; WHO website: http://www.who.int/mediacentre/factsheets/fs211/en/index.html
Sensory health: By Kathy Rautenbach, child development specialist and owner of Kidz Discovery
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Does your child struggle to climb trees, make mud pies and explore his world with all his senses without gadgets? Is he unusually fussy or picky, or struggling at school? Sensory processing disorder may be the culprit, but take heart, help is available.
Sensory wise Return of the farm child in the face of technology
I
have fond memories of the sensory-rich lives we had as children on the Karoo farm where I grew up. We rode our bikes freely, climbed trees and large rocks, swam in muddy dams and hardly ever wore shoes as toddlers and young children. This is a far cry from the toddler I see with an iPad in hand. He is sitting with legs to his sides on the lounge floor, exploring fascinating educational apps under the watchful eye of his mom who prefers to have this digital babysitter amuse him in the safety of the home rather than risk a fall down at the public playground slide or getting him all dirty. I recall a specific occasion on the farm when after a challenging game of bok-bok (a variation of leapfrog), we built an imaginary town out of matchboxes, sticks and mud in the dust. My younger brother happily scraped a can along its side to make a road while the older one manoeuvred his bicycle to test the robustness of our make-shift bridges. To our disappointment, our “strange” cousin from the city totally refused to join in. He stood clumsily aside with horror on
his face at the sight of our muddy play and shielded his ears from the scraping sound. And, on discovering where milk comes from, he repeatedly protested he’d never drink milk again. Four decades ago sensory processing disorder (SPD, sometimes referred to as dysfunction in sensory integration or DSI/SID), was unknown in South Africa. This could have helped us to contextualise our cousin’s atypical responses to what one can regard as ordinary, everyday sensory experiences.
How sensory processing works The majority of us take sensory processing totally for granted. Our nervous systems process messages from the seven (not five) senses and convert them into appropriate motor and behavioural responses. To elaborate, the seven senses are sight, hearing, touch, taste, smell, and the less well-known senses of proprioception (feedback from muscles and joints) and movement (vestibular – the body’s “GPS” orientation in space). In essence then,
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19 CONNECT WITH YOUR CHILD
sensory integration dysfunction or SPD is a condition where signals from our body and our environment get muddled up in the brain, resulting in inappropriate responses. Some people overreact to sensory input like touch or compensate by avoiding contact. On the other end of the spectrum, if a person is underresponsive to sensory input, they may take a long time to register something such as high temperature or they actively seek movement like spinning. The third dimension, developmental dyspraxia, is less common. In this case, the child has difficulty with ideation (conceptualising), formulating a plan (motor planning) and executing any new action like learning to ride a bicycle. According to the SPD Foundation, one in every 20 children is affected by symptoms of sensory processing disorder, which impacts on their ability to participate fully in everyday life. That incidence is on the rise. The symptoms of SPD vary in type and severity. While most of us get overloaded by sensory information occasionally, for children and adults with SPD, these difficulties are debilitating, and can disrupt everyday life. The symptoms are frequently overlooked and misdiagnosed, perhaps as ADHD (attention deficit hyperactivity disorder),
0-3 years is Piaget's sensorimotor stage of development. This is the window of time in which our children's brains are most receptive to taking in sensory information from their environment, processing it and developing perceptual foundations for learning. as many health care professionals are not trained to recognise the underlying sensory issues. What causes SPD? The ongoing nature-nurture debate rages. Much is written about genetic predisposition and our inborn neurological threshold as the most significant factors in SPD. Annemarie Lombard, occupational therapist and author of Sensory intelligence, urges us to also consider the influence of nurture.
Sources & Support Want to find out more? The following websites have useful information: Sensory Processing Disorder: Poster of a child with Sensory Disorder (SPD) www.spdbayarea.org Sensory Processing Disorder (SPD) Foundation www.spdfoundation.net For signs, symptoms and background information on sensory integration www.incrediblehorizons.com
When and where should you get help? If SPD symptoms get in the way of concentration, socialising or result in emotional meltdowns, the child will struggle to learn and reach his or her full potential. If symptoms persist with frequency, intensity and duration and the child has difficulty self-calming, trust your instinct as a parent, and consult a professional. Look for an experienced occupational therapist who is SI certified (only about 20% have this specialised
training) on the OTASA/SAISI website, www.instsi.co.za. Intervention from a young age, with the appropriate treatment, is vital to prevent learning problems down the line. Children with SPD are often labelled “naughty”, “lazy”, or “stupid”, and rarely reach their academic potential without early intervention. Some are ostracised by their peers due to difficulty participating in group activities such as sport, which is clearly of great social importance to boys.
Sensory health: By Kathy Rautenbach, child development specialist and owner of Kidz Discovery
20 Are you connected to your child? “Obviously our genes weigh heavily, but past 20 years, with SPD four times more thresholds are moulded by the way we prevalent among boys.” are brought up. Our sensory thresholds It seems unlikely that genetics are a mix between DNA has evolved so and sensory diets, and dramatically over the I call them our sterile and contained past four decades. This “farm living environments phenomenon must children” are most certainly therefore be fuelled because they by changes in the way contributing.” need space our children are raised A leading professional in the paediatric treatment and the opportunities and time to of SPD, Cape Townthey are exposed to play freely based Kerry Wallace, in our technologyand to get says: “0-3 years is Piaget's dominated age. After all, their hands sensorimotor stage of it is indeed the way the dirty. development. This is the child responds to the window of time in which environment that defines our children's brains are most receptive this condition. to taking in sensory information from Mush Perrins, a paediatric their environment, processing it and occupational therapist, echoes these developing perceptual foundations for sentiments: “Children today are under learning. Our fast-paced lifestyle in cities a lot more pressure and stress than has definitely contributed. We have seen 40 years ago. The pace of life is much a marked increase in diagnosis over the faster with more expectations placed
The child with sensory processing disorder (SPD) SPD checklist of symptoms:
Adapted from original artwork done by Melissa Zacherl 2004, mother to a child with SPD.
I have trouble focusing and/or concentrating
I hate having my hair washed, brushed or cut I cry and shield my eyes from the sun and other bright lights I have “selective hearing” or difficulty listening
I am overly sensitive to loud sounds such as vacuum cleaners & blenders
I am a picky eater, I resist new foods & textures
I am always smelling people, food and objects
I complain about tags in my clothing
I chew on everything
I seem to be unaware of normal touch or pain, I often touch others too soft or too hard
I have poor fine motor skills, such as handwriting and cutting I have difficulty dressing myself
I hate being tickled or cuddled
I sit with my legs in a “w” position I put my socks on ”just so” or maybe I never go barefoot
DO YOU KNOW ME?
I have poor gross motor skills, such as running and riding a bike I always walk on my tiptoes
Parents who are consumed with needs-based parenting, briefly hovering over their children merely to give instructions to au pairs and the overscheduled children in their wake, will miss important cues. Get down to your child’s level and connect with him or her. In her book The out-of-synch child has fun, Carol Stock Kranowitz suggests seven “drops”: Drop your voice – when you whisper people listen. Drop your body – get down to the child’s level, on the floor. Drop your TV remote – this is your chance to relate to your child in a meaningful way. Drop your guard – allow your child to take safe risks. Drop your defences – don’t ignore it, follow your instincts. Drop the gadgets – avoid batteryoperated toys or electronic gizmos. Give “kid power” a chance. Drop the misconception that fun is frivolous – kids savour pleasurable experiences and that is what memories are made of. They don’t need external stimulation all the time. One could add some more: Turn off the iPad or tablet when you are not around, rather than letting kids use them unattended. Drop the cellphone and switch it off. Make eye contact, be present, connect and engage in child-directed fun. Play on the floor, allow them to make those mud cakes or slurpy tea, paint the tiles with water or transform into a backyard detective on a snail’s trail on your balcony. You don’t need a farm for that. There might not be much you can do about your child’s genes, but you can provide appropriate, sensory, nurturing experiences for your child. As suggested by Lombard in Sensory Intelligence, it is vital for parents to be attuned to the child’s sensory preferences and tolerances and to manage a sensory diet for the varied members of the family. Go ahead with parenting instinct, be intuitive, playful and be present!
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on children. For most, both parents need to work. I see many children who are a misfit in their environments. I call them “farm children” because they need space and time to play freely and to get their hands into the earth and dirty. Children can no longer play safely in their community environment or even in their own gardens. Their space and free playtime is restricted.” Be sensory wise Tamar Ovadia, sensory integration (SI) trained occupational therapist states: “Sensory enrichment from a young age is important for promoting healthy sensory processing later on during the school years and preventing sensory processing difficulties later on. Early intervention is best as the brain is still developing.” Through our endeavours to protect our children in a crime-conscious society today, we effectively ‘cottonwool’ our kids and deny them valuable opportunities to explore and engage in their environment freely. Those opportunities will have to be created to make them sensory wise. That's why we offer child development programmes at Kidz Discovery where children can have ample fun-learning opportunities to get messy and to explore all their senses in safety under mom’s gentle guidance in a group environment. “Much can be done at home too", says Ovadia, “from exploring different textures, hunting for toys in their sandpit, creating obstacle courses with everyday objects like cushions, rolling them like sausages and getting them messy." Tamar Ovadia reminds us that with whatever sensory activities children are engaging in they should never be forced to do something like get messy or swing, if they don’t want to do it. A child needs
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Parents need to support their children's explorations attaching a ‘positive emotional tag’ to the experience, for example, ‘Wow that feels squishy’ or ‘Mmmmm that tastes good’. to feel like he is in control of his own sensory environments so that he feels comfortable enough to explore further and create positive sensory experiences. Kerry Wallace urges: “Parents need to support their children's explorations attaching a ‘positive emotional tag’ to the experience, for example, ‘Wow that feels squishy’ or ‘Mmmmm that tastes good’, as the toddler mouths the unfamiliar object. A negative reaction or parents who overprotect their offspring from this normal drive to find out about the world are doing them a grave disservice. Experiencing the world from a 2D screen is equally limiting. Children under two years should not be exposed to TV, never mind electronic tablets and other technology. Research shows that the attention span of children exposed to TV before the age of a year is halved, and the attention span of those exposed between one and two years is reduced by a third. Humans are social beings and our brains are designed to develop in response to engagement with the people in our world. Through interactions, the connections between the various sensory processing areas, the emotional and physical centres are strengthened. This sets the stage for the development of socially attuned children who can think for themselves and solve real-life problems through collaboration with others.” It is not clear if the TV effect applies to iPads or tablets too as there seem to
ALLOW TIME TO PLAY FREELY
be too little research data on the subject according to the American Academy of Paediatrics (AAP). However, Healthland advised parents to eliminate screen time for children under two, citing concerns about language delays and disrupted sleep. While some of the apps promise great hand-eye coordination and may enhance learning in the slightly older three to seven year old child, it is crucial to have parental discussion and making it a shared experience. “By simulating conventional toys (like Lego) they don’t teach children the crucial skills that come from physically engaging the world in three dimensions”, says Dr. Dimitri Christakis from the A.A.P.
Sources: Sensory Intelligence: Why it matters more than IQ, Annemarie Lombard; The out-of-synch child: Recognising and coping with sensory integration dysfunction, Carol Stock Kranowitz; The out-of-synch child has fun: Activities for kids with sensory integration dysfunction, Carol Stock Kranowitz; Sensory integration and self-regulation in infants and toddlers: Helping very young children interact with their environment, G. Gordon Williamson & Marie E. Anzalone; Sensory integration, autism and attention deficit (hyperactivity) disorder, paper by Prof André Verster, Department of Paediatrics and Child Health, University of the Free State; A user's guide to the brain, John J. Ratey M.D., Professor of Psychiatry at Harvard
Acknowledgements: Thanks to Kerry Wallace for guidance and insights, Tamar Ovadia for valuable input as well as Annemarie Lombard and Mush Perrins for their contribution.
Recipe: www.bbcgoodfood.com
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Mediterranean
Fig &
mozarella salad ...
PER SERVING: 286 calories, protein 10 g, carbohydrate 11 g, fat 23 g, saturated fat 6 g, fibre 3 g, sugar 9 g and salt 0.3 g. Ingredients
Method
2 00 g fine green beans, trimmed
1 In a large saucepan of salted water,
6 small figs, quartered
blanch the beans for 2–3 minutes. Drain, rinse in cold water, then drain on kitchen paper. Arrange on a platter. Top with the figs, red onions, mozzarella, hazelnuts and basil.
1 red onion, thinly sliced 1 x 125 g ball mozzarella, drained
and ripped into chunks 5 0 g hazelnuts, toasted and chopped s mall handful basil leaves, torn 3 tbsp balsamic vinegar 1 tbsp fig jam or relish 3 tbsp extra-virgin olive oil
2 In a small bowl or jam jar with fitted lid, add the vinegar, fig jam, olive oil and some seasoning. Shake well and pour over salad just before serving.
Try adding some parma ham and boiled egg for a variation to the recipe to add some extra protein. Here are some serving tips: Sweet, succulent fig fruit is best enjoyed as it is, without any additions. Fresh figs are a great addition to salad, in cakes and ice creams. Dried ones can be added to soup, stews and to enrich poultry, venison and lamb. Dry figs are excellent additions to muffins, cakes, sandwiches, pies, and cheesecakes. Enjoy marinated figs with raspberry sauce.
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Nutritional facts and health benefits of figs in your diet
elicious, sweet fig fruit is one D of the prime fruits enjoyed since antiquity in the human history. Fig is naturally rich in many health benefiting phyto-nutrients, antioxidants and vitamins. Dried figs, in fact, are a concentrated source of minerals and vitamins. The fully ripe fig has a bell or pear shape with succulent flesh.
F ig fruit is low in calories. 100 g fresh fruits provide only 74 calories. However, they contain health benefiting soluble dietary fibre, minerals, vitamins, and pigment antioxidants that contribute immensely to optimum health and wellness.
ried fruits are concentrated D sources of energy. 100 g dried figs provide 249 calories.
F resh as well as dried figs contain good levels of the B-complex group of vitamins such as niacin, pyridoxine, folates, and pantothenic acid. These vitamins function as co-factors for the metabolism of carbohydrates, proteins and fats.
F igs are available all season round. One may find fresh as well as dried figs at the shops. While buying fresh figs look for ripe fruits, which are soft in hand and emit a sweet aroma.
F ig fruits perish rather quickly and should be eaten while they are fresh or else should be placed in the refrigerator where they can be kept for 2–3 days. Place them in a plastic zip packet and store in the refrigerator. However, dried figs can be kept for 6–8 months. Source: www.nutrition-and-you.com
Feature: By Health Bytes
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Health care in your 20s, 30s & 40s
Establish a healthy lifestyle at every age – here's how
At this age your life is a whirlwind – you’ve got your first real job, friends play an important role in your life and you may date, get married or even start with a family. This is the time to create good habits and set the stage for healthy ageing.
20s
Nutrition M ake fast food healthy. Grabbing dinner on the go means you may be missing out on crucial nutrients, so choose healthy convenience foods. D rink to your health! Avoid packing on the pounds with margaritas and cosmos and rather opt for a light beer – it is filling, so you’re less likely to want a second! Key nutrients P rotein: If you are always on a diet and mainly eating girl foods such as frozen yogurt and low-fat muffins you’ll need protein to keep you full and provide you with the building
blocks to make and keep calorieburning muscle. Eat food such as skinless poultry, lean steak, fish, eggs and beans. Potassium: You can get your daily dose by enjoying two cups of fruit, such as an apple, banana and fresh strawberries, as well as two and a half cups of vegetables. This will assist your muscles and heart in functioning properly. Omega-3 fats: Salmon and tuna and also walnuts, ground flaxseed and canola oil will boost a feel-good chemical, serotonin, in your brain that can help in countering depression. Supplements C alcium – for stronger bones V itamin D – so that your body can absorb the calcium I ron – for menstrual cycles F olic acid (folate) – to produce healthy red blood cells and to aid in rapid cell division and growth such as during pregnancy
Skin care In your 20s you may not be concerned about fine lines and wrinkles caused by the sun, but wearing sunblock is the most important step you can take to prevent sun damage. And if you are serious about protecting your skin, wear a hat. You should establish a skin care regime of proper cleansing and moisturising, sticking to natural products. It is suggested that anything you can’t pronounce should not be used on your skin! It is advisable to consult a dermatologist to assist you in identifying skin problems early so that you can prevent aggressive treatments when you are older. Check-ups and screen tests B lood pressure C holesterol S kin check for odd-shaped and changing moles P ap smear and breast exam D ental
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Grabbing dinner on the go means you may be missing out on crucial nutrients, so choose healthy convenience foods.
30s
You are most probably still following a busy lifestyle juggling the demands of kids and a career. No time to indulge in a beauty treatment? Well, it’s important to put your health first and to reduce your stress levels by allocating some time to hobbies or meditation. Nutrition I n your 30s you may see signs of diabetes or hypertension and a good eating plan can reduce the risk of these diseases. A void drinking sodas as it interferes with calcium absorption and can only add to unnecessary calorie intake. S tart drinking red wine (in moderation!) as it contains antioxidants. Key nutrients F olic acid: It is critical for supporting a healthy pregnancy and to help your body make new cells. Folic acid also reduces the risk of heart disease and you can ensure adequate intake by eating food such as chickpeas, asparagus, spinach, broccoli, avocado, orange juice and fortified whole grains. P hytonutrients: Dark chocolate, red wine and coffee all contain the necessary antioxidants that slow down the ageing process and fights off heart disease. Iron: If your body has an iron deficiency, you may feel physically drained and mentally challenged. To ensure that you perform well with cognitive tasks you should
eat your daily quota of clams, lean beef, fortified cereal, soybeans, pumpkin seed and skinless poultry. Supplements C alcium – for stronger bones M agnesium – for optimal calcium absorption V itamin B – to ensure all-day energy P robiotics – to cope with digestive changes F ish oil – for the prevention of breast cancer and to improve your mood Skin care As you approach your 30s you may start seeing dynamic lines around the eyes and between the brows caused by facial expressions. This is also the time that your body’s ability to renew damaged skin cells begins to decrease. To prevent your skin from looking dull you can use an exfoliator to smooth the skin and stimulate cell renewal that will brighten up your complexion. Good nutrition and a skin care regime remain very important. Check-ups and screen tests B lood pressure C holesterol S kin check for odd-shaped and changing moles P ap smear and breast exam D ental T hyroid E ye exam B one density
Exercise and fitness Weight-bearing exercise is very important to keep up bone strength and to prevent osteoporosis. Throughout your 20s, 30s and 40s exercise at least three, but preferably five, times a week for 30 minutes per session. Remember that if you don’t keep on exercising, you may lose whatever bone gains you have made! Avoid smoking – it hampers the work of bone-building cells and it enhances your chances of cancer. Recommended exercise that are high impact, muscle building and resistance training include: walking jogging dancing tennis aerobics (Although swimming and biking are great exercises they are not weight-bearing.)
Whether you are in your 20s, 30s 40s or beyond, basic nutritional health measures, exercise and regular check-ups remain vitally important and it is wise to consult your medical practitioner regularly.
Feature: By Health Bytes
26
From your 40s onwards you require approximately 100 calories a day less than you used to.
You may find that you are gaining control over your time and that you have more time for yourself. This is a phase in your life where you can concentrate on improving your health and fitness. If you are trying to beat your belly bulge, eat every three to four hours to keep your metabolism going and do cardio exercises regularly, as well as resistance training.
40s
Nutrition It is reported that for every decade after 40 you require approximately 100 calories a day less than you used to (that is, almost 1% less of your daily requirement). Key nutrients C alcium: Your daily requirement of 1 000 milligrams of calcium is very important as you approach menopause and you can ensure sufficient intake by eating low-fat dairy and taking a calcium supplement. V itamin D: This nutrient is needed to assist your body in absorbing the calcium and to protect against breast and colon cancers. Salmon, shrimps and eggs contain Vitamin D but you may need to also take a supplement. F ibre: A mix of soluble fibre from fruit, vegetables and oats and insoluble fibre from whole wheat
bread and bran helps decrease cholesterol and your risk for colon cancer. B eta-carotene is essential for skin health and immune function and you can enjoy apricots, broccoli, carrots, papaya, peach, red peppers, spinach and tomatoes. Supplements Calcium – for stronger bones V itamin D – so that your body can absorb the calcium Vitamin K – for bone building Skin care In your 40s gravity starts playing a role, and smile lines grow deeper and sun damage takes it toll. Your pores may be larger and your skin looser and less supple. Be sure to use an antioxidant-rich moisturizer and high SPF sunscreen to maintain proper hydration in a thinning epidermis. If you are considering fillers to help diminish fine lines, consult a specialist and seek professional advice. Check-ups and screen tests Blood pressure Cholesterol S kin check for odd-shaped and changing moles Blood sugar Mammogram Colonoscopy Dental Eye exam
40s and beyond Many women prefer to deal with menopause symptoms such as hot flushes and loss of libido with natural medicine rather than hormone replacement therapy, as some hormone therapy has thought to have been associated with certain types of cancers. Some studies suggest that long-term use of soy products lessens the severity of menopausal symptoms, so speak to your gynae to find out what’s best for you. Another health concern at this stage is heart disease, especially since menopause can lead to rising cholesterol levels. Essential Fatty Acids play an important role in maintaining heart and brain health, good blood circulation and healthy functioning of the eyes, skin, joints, hair, immune and nervous system. They form part of every cell in the human body and are necessary for cell growth and division. At this stage, you need to guard against osteoporosis. Make sure you take enough calcium and vitamin D. These two substances work together to form bone deposits, but vitamin D is one of the hardest nutrients to find in food, so this is an area where supplements are really essential. Calcium and magnesium are essential for healthy bones, teeth, hair and nails and play a vital role in blood clotting, nerve conduction and many cellular functions.
Sources: www.fitnessmagazine.com (Healthy for life: what to eat in your 20s, 30s, 40s and beyond, by Karen Ansel); www.goodhousekeeping.com (Got strong bones? How to prevent osteoporosis); www.pgeveryday. com (Get tested: Must-have screenings for your 20s, 30s, 40s, 50s and 60s); www.trueharmonywellness.com (Health secrets you need to know today, by Dr Denise Grobe); Los Angeles Times, 23 September 2012 (Skin care in your 20s, 30s, 40s, 50s, 60s and beyond, by Alexandral Drosu.)
Snacks what to choose
Health boost
ES
IN PICTUR
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GOOD IDEA Water You might simply be thirsty when you think you’re hungry.
You’ve hit the 4pm slump, and the vending machine’s at hand. What will give you a healthy boost? Whatever you do, you need to choose something that will fill you up and increase your energy without railroading your healthy eating plan. As always, look for snacks high in protein and fibre – these are best to keep blood sugar stable.
GOOD IDEA Fruit juice Look for 100% fruit juice, no sugar added.
GOOD IDEA
GOOD IDEA
Mixed nuts and dried fruit Steer clear of nuts and fruit covered in chocolate, or even so-called “yoghurt”, which often is just another kind of chocolate.
GOOD IDEA
Baked chips These are a little lower in fat and kilojoules than regular, fried chips.
Pretzels Once again, this gives you the benefit of baked rather than fried – just remember, as with anything, moderation is key. Chocolate Anything this sweet will give you an energy spike and leave you just more drained afterwards.
Biltong Just check it’s lean. Those pieces of white fat are pure heartattack material.
Droëwors Very high in fat — stay away.
GOOD IDEA
Fruit and nut bars: Should keep hunger at bay for some hours. Cereal bars: Some are higher in sugar than others — read the label.
BAD IDEA Muffins These are loaded with fat and sugar — even the ones that masquerade as “health” muffins.
Chips High in fat, high GI … don’t go there.
BAD IDEA Sources: www.webmd.com, www.medicinenet.com, www.forbes.com, www.wellsphere.com
BAD IDEA
Fizzy drinks The fizziness can give you unpleasant digestive sideeffects, and the sugar is just plain bad. Want the sugar-free kind? Artificial sweeteners are even worse for you than sugar.
BAD IDEA
In the know: By Dr Reena Cotton, veterinarian in private practice
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KEEP A PET –
Keep healthy The vital role that pets play in our wellbeing should not be underestimated.
D
ave adopted two dogs against the advice of his friends. They were big dogs, needing a lot of exercise and Dave’s home was small and his garden even smaller. He had reached that stage of his life where he should be free to come and go without being tied down by pets, never mind the cost of feeding them, argued his friends. Dave had agonized for weeks about taking on the dogs. In the end his decision was influenced by his conscience. They were healthy middle-aged dogs that would be otherwise euthanized when their owners emigrated. As soon as he made up his mind to adopt the dogs, he slept well for the first night in weeks. He began a routine of running every morning with the dogs and taking a shorter evening walk after work. He soon became fit and lost weight. When construction work was being done on a nearby property, his was the only house
in the street not burgled. He also made new friends while out with his dogs.
Comforting creatures If you are an animal lover you will relate to the pleasure a pet can give: being met at the door by an excited cat or dog after a hard day at the office; the happy calling of a parrot long before you have even turned into your driveway or just cuddling up on the couch in front of the TV with a furry dog or cat. When you spend time with your pets, without being aware of it, your body spontaneously starts to produce more feelgood hormones and less stress hormones, resulting in improved health and decreased stress-associated conditions like headaches, ulcers and inflammatory bowel disease. Researchers found that pet owners have lower blood pressure, cholesterol and heart rates
Nowadays volunteers bring their pets to visit patients in many of our South African hospitals, sometimes with heartwarming results that are not achieved by medical treatment.
and a decreased incidence of strokes than non-pet owners. It was also found that among people who have had heart disease, those with pets were significantly less likely to actually die from heart attacks and other heart diseases than those who didn’t have pets. Although sceptics may argue that the ability to care for a pet suggests a healthy and wealthy owner, one with a higher income, and thus being able to better invest in health care, there is ever-increasing evidence to back the assumption that keeping pets really does enhance one’s health and wellbeing.
Benefits to children Children growing up in homes with pets have fewer allergies, and when allergies do occur, they tend to be less severe. It often happens that people that are allergic to cats or dogs and who have become tolerant to these animals when living with them and having their symptoms disappearing, reacquire the allergies when the pets die or they are no longer exposed to them. Children growing up with pets learn to love and care for another being, enabling them to relate to and love others. Animal-assisted therapies can benefit children with conditions ranging from autism, attention deficit hyperactivity
Winter 2013
29 disorder (ADHD), cerebral palsy and cancer.
Caring companions Pets are especially beneficial in providing psychological support to their owners. Just by being there they reduce anxiety, depression and loneliness. In England, as long ago as the 18th century, animals were brought in to help calm mental patients, reducing the amount of drugs and harsh restraints needed such as being tied to their beds. In the United States, patients recovering from mental trauma (post-traumatic stress) during the Second World War were encouraged to work with farm animals. Nowadays volunteers bring their pets to visit patients in many of our South African hospitals, sometimes with heartwarming results that are not achieved by medical treatment. It is commonly believed that our need to be loved is even more important to our happiness than financial wealth. Pets give us unconditional love, which in turn helps us to love more, contributing to our sense of wellbeing. They often fill the gap left by the absence of children, partners and friends.
Scientists have shown that the frequency of a cat's purr improves bone density and speeds up healing of bone, muscle and other tissue. This has relevance not only to everyday injuries, but also to people suffering from osteoporosis, post surgery and even to astronauts who lose bone and muscle density when at zero gravity.
Some animals can be trained to detect life-threatening conditions in their human companions. They can sense that their owner’s blood sugar is dropping, that he is about to have an epileptic fit or even detect pregnancy and illnesses like some forms of cancer. Alerting the owner can give him time to take steps to treat or prevent the situation. Working dogs allow their handicapped owners to maintain their independence by opening and closing doors for them, guiding their visually-impaired owners, warning hearing-impaired owners when the phone is ringing, providing physical support and carrying things for them. Working dogs will often provide more reliable and faithful companionship to their owners than caregivers or family members and, furthermore, their presence adds to the attention and care of the handicapped owner. Obesity, one of the biggest epidemics of the 21st century, can be battled at the park. Dog owners tend to be more active than people who don’t own
dogs because dog owners, such as Dave, run and walk their dogs, breathing fresh air, getting fit and losing weight while they meet other dog owners and enjoy the local paths and trails in their neighbourhood. This in turn results in reduced heart disease, diabetes, arthritis and other conditions.
Smile on your dile If you have watched a cat play, heard a parrot imitate a member of your household, been mesmerized by fish swimming in a fish tank or stroked a dog, you will know how, for that moment at least, you felt more relaxed, amused and at peace with your world. It is because your pet contributes to your health and wellbeing.
Chil grow dren ing u p wit pets h learn and c to lov are fo e r ano being the them , enabling r to rela te to love & other s.
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First aid fact file: By Health Bytes
FIRST AID FACT FILE
Anaphylactic Shock
Know what to do!
An allergy is hypersensitivity to a substance (allergen) that is not normally considered to be harmful.
A
llergies are triggered by the immune system, which reacts to the allergen as though it were a harmful substance invading the body. The most extreme, life-threatening allergic reaction (anaphylaxis) can cause shock, a sudden drop in blood pressure and narrowing of the airways. In people who have an allergy, anaphylaxis can occur minutes after exposure to a specific allergy-causing substance (allergen). In some cases, there may be a delayed reaction or anaphylaxis may occur without an apparent trigger. 1 Some common anaphylaxis
triggers include: Medications, e.g. penicillin. Foods such as peanuts, tree nuts, fish and shellfish Insect stings from bees, yellow jackets, wasps and hornets If you've had any kind of severe allergic reaction in the past, ask your doctor if you should be prescribed an epinephrine auto-injector to carry with you. 2 If you're with someone having an allergic reaction with signs of anaphylaxis: Immediately call an ambulance or your local medical emergency
number. Ask the person if he or she is carrying
an epinephrine auto-injector to treat an allergic attack (e.g. EpiPen). If the person says he or she needs to use an auto-injector, ask whether you should help inject the medication. This is usually done by pressing the auto-injector against the person's thigh (See box). Have the person lie still on his or her back. Loosen tight clothing and cover the person with a blanket. Don't give the person anything to drink. If there's vomiting or bleeding from the mouth, turn the person on his or her side to prevent choking. Get emergency treatment even if symptoms start to improve. After anaphylaxis, it's possible for symptoms to recur. If you're with someone having signs of anaphylaxis, don't wait to see whether symptoms get better. Seek emergency treatment right away. In severe cases, untreated anaphylaxis can lead to death within half an hour. An antihistamine isn't sufficient to treat anaphylaxis. These medications can help relieve allergy symptoms, but work too slowly in a severe reaction.
3 Signs and symptoms of anaphylaxis include: Skin reactions including hives, itching, and flushed or pale skin Swelling of the face, eyes, lips or throat Constriction of the airways, leading to wheezing and trouble breathing A weak and rapid pulse Nausea, vomiting or diarrhea Dizziness, fainting or unconsciousness
How to administer an auto-injector Many anaphylaxis sufferers carry an auto-injector with a measured dose of a known treatment for an attack. Help the person having the attack to find and inject the medication. This will often look like a pen. Hold the auto-injector in your fist, and pull off the safety cap and press tip against their thigh through their clothing. This will automatically inject the person with the drug. If you carry an auto-injector check the expiry date of the medication frequently to make sure it has not expired.
Remember: This fact file features vital emergency and first aid information to keep close at hand. While the fact file offers guidelines it does not substitute or replace hands-on training by experts. IMPORTANT: It is best to obtain training in first aid before a medical emergency occurs.
INTRODUCING
THE COMPLETE PROBIOTIC
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WIN
IN
Lactobacillus plantarum 423 & Enterococcus mundtii ST4SA
AW
maintain and balance intestinal flora in the entire gut SEARC
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Developed through award-winning research. Suitable for vegetarians.
Cipla Medpro (Pty) Ltd. Reg. No. 1995/004182/07, Rosen Heights, Pasita Street, Rosen Park, Bellville, 7530. Tel (021) 943 4200, Fax (021) 914 4699. E-mail: medicalpa@ciplamedpro.co.za Website: www.cipla.co.za
Wellbeing: By Health Bytes
32
Stop procrastinating I
t was a very busy day at the office. I didn’t have lunch. I’m at home now, but the day is not over yet and important reports need to be done. I’m playing Spider Solitaire on my computer – it’s my time! The little voice in the back of my head is nagging me: those reports ... Procrastination is the one flaw that most adults openly admit to in our time-pressured society. It usually leads to further frustrations, difficulties, anxieties, selfreproach, low self-esteem and even a depressed state of mind. It is a myth that procrastination is a symptom of laziness; it is more often the result of work overload. Procrastination grows in that field between our good intentions and taking action. We actively divert our attention from attending to those important, high-priority activities. Our excuses are endless: tomorrow is another day; I’ll be wiser; I’m too tired; I’ve worked hard already; and there is still plenty of time. Only about 20% of people are real procrastinators. These people put off everything: at home, at work and in their social lives. This contributes to a lot of anxiety and can lead to depression. Most of us are merely delaying some tasks.
HOW DO WE ESCA PE? With all the modern diversions like Play Station II, Google and DVDs, it has become so much easier to delay, so how do we escape from going on these detours?
You are not lazy, just normal. But procrastination saps your time and energy.
can think more constructively 3. Ask yourself: what is the discomfort that is so difficult to bear? (This question helps one to realise that the discomforts we are dodging – uncertainty or
fun activity that you can allow yourself to really enjoy — have your dessert after the meal! 5. Put the brakes on negative self-talk or talk that exaggerates the negative aspects of a task and also focus on what could be good about it. 6. Some people are more action orientated by nature and others are more introspective. Learn to accept who you are so that you dwell on it less. 7. Convince yourself to do only ten minutes of a specific task before you put it off. You usually become more involved with the task, completing tasks and having a better quality of life as well as improved self-esteem. 8. Break down tasks into smaller increments and have a specific, step-by-step plan of action so as not to feel overwhelmed.
1. Become aware of what needs and emotions drive your procrastination and then find more positive ways to fulfil these needs. 2. Record the reasons you use to convince yourself in your selftalk to procrastinate so that you
fear of performing badly – are just “mental fabrications, pure fictions,” says William Knaus.) 4. Learn to face those frustrating aspects of tasks that you don’t enjoy, rather than dodge the discomforts through avoidance. Then enjoy a break with some
Even though procrastination often develops in childhood through rebellion against demanding parents, it can become extremely time and energy consuming. So take some time to get going in small increments, ten minutes at a time. Oh, and do remember to enjoy the dessert!
South Africa’s no. 1 Pharmaceutical company 1 Approximately 1 in 4 products dispensed in South Africa is an Aspen product 2
Generations of South Africans have trusted the Aspen brand. Ask for your Aspen product.
References: 1. IMS TPM Dec 2012. 2. ImpactRx Data Dec 2012, S3 and above. A16089 03/13