Bodylanguage issue 05 autumn 2014 by Health-Bytes

A better health care experience altogether

Autumn 2014

Issue 05

Top spa's in Suid-Afrika

Troef jou moegheid

Health risks associated with obesity Change your lifestyle

Drowning

amonst children Educating children on the danger

f l e s u o j r Sorg vi

The 5 S's of cancer Protect your friends, family and yourself

Headphones & hearing loss Is anyone listening?

FREE

COP

en kyk mooi na jou kinders

Issue 5 | 2014

contents

up close and personal

your body

02 CEO Note

18 Top spa’s in Suid-Afrika Troef jou moegheid

08 Health bites – short bits

24 The 5 S’s of skin cancer

of info to digest while

Educate yourself to be sunsafe

on the go

32 In the know

interact

Stop smoking by numbers

03 Contributors 04 Must haves

from the experts

Great products and give-aways 06 Profile 13 things to know about

12 Obesity Health risks associated with it

14 Drowning amongst children

Dr Ravi Govender

What to do first

07 Intercare events

16 Onbeskryflike genade

What happened over the

'n Ma vertel…

last few months

22 Hearing loss & headphones Is anyone listening?

your health 05 Recipe – Grilled salmon fillet

10 Health advice – Burns What to do first

Take care of your skin in the sun!

26 All about – Salt How much do you know? 30 In the know 5 things to do before 9am

CEO note This year, the Intercare Group will focus on enhancing patient experience at all our hospitals and medical and dental centres. We have reached the stage in the evolution of health care delivery where a patient-centred approach to health care, which, inter alia, includes an exceptional patient experience, is no longer an option but a necessity.

patient-centred approach does not only refer to world-class clinical care, but it also addresses all aspects of the patientâ&#x20AC;&#x2122;s encounter with the service provider. At the majority of health care providers, the primary relationship is considered the one between doctor and patient. The staff members see themselves acting in supporting roles. However, from the perspective of the patient,

Editorial Publishing editors Christa Grobler christa@health-bytes.co.za Marilize Eygenberger marilize@health-bytes.co.za Content editor Itha Kieser

all interactions are important. Hence, we will be taking revolutionary steps to design superior ways of delivering care, whereby health care providers and patients are collaborators in the innovation process. Intercare has tasked a major research house to help us better understand the needs and perceptions of patients. However, your comments, experience and feedback to

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

assist us in the process are most welcome and can be sent to myexperience@intercare.co.za. I trust that 2014 will be a great and blessed year for all of us and that our new patient-centred approach will be a pleasant experience.

Dr Hendrik Hanekom CEO Intercare Group

Design Cohoots in Design Janenne Smit Proofing Albert Buhr 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.

Issue 05 | 2014

contributors

3 Andrea Abendroth is an audiologist working for Kind 2 Hearing, based in the Parkview Lifestyle Centre. She studied speech language therapy and audiology at the University of Pretoria and also has undergraduate and honours degrees in psychology. "I enjoy working with people, knowing that I make a difference in their everyday lives. As yet I have not chosen to specialise, as I enjoy all aspects of my career as an audiologist, but would eventually like to specialise in the counselling needs of people diagnosed with special needs."

Elana Esterhuyse is an editorial assistant and language practitioner at LekkeSlaap.co.za. She obtained a BA in humanities and an MPhil in document analysis and design at the University of Stellenbosch.

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 will then be able to make a difference and â&#x20AC;&#x153;create the better health care experience altogetherâ&#x20AC;? on a daily basis. Please email us at:

Dr Zelda Smook has been with Intercare in Fourways since 2008. Apart from being an avid tennis player and the (GP) SA Vets Tennis Captain for Ladies 35-40s, she also plays golf. She has a special interest in orthopaedics and paediatrics.

info@intercare.co.za with any suggestions, ideas and things you would like to see on these pages.

Juandri Steytler completed a B. Dietetics Degree at the University of Pretoria. She previously worked at the Chris Hani Baragwanath Hospital in the Neonatal Theatre and ICU wards and also dealt with paediatric patients, which is her passion. She started a part-time private practice in Johannesburg, where she worked with diabetic and overweight patients. Juandri is also registered as one of the DNAlysis dieticians, where a patient is provided with a personalised gene-based diet to optimise his/her health and wellness. 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.

20th April easter sunday

Must haves

GIVING AWAY SOME FABULOUS GOODIES! GIVE AWAY-

Must haves To stand a chance to qualify, email the product code with your name and surname to competitions@health-bytes.co.za. Please use Body Language 05 in the subject line. Competition closes: 28 May 2014.

On the go with new USN Diet Whey high protein slab USN has just launched their new carb-conscious high protein slab. It contains 14g protein per 45g bar and only 2g sugar. It is the perfect high protein snack to be consumed in between meals, but have one maximum twice a week. It is also suitable for diabetics and comes in two flavours: chocolate crunch and chocolate mint. The benefit of having this snack replacement bar in your handbag is that it is convenient, high in protein and delicious!

USN is giving away three boxes of Diet Whey high protein slabs to three lucky readers. Product code for the give-away is USN.

Make your move with Lorna Jane Cook Me – I’m so easy Inspired by the love of cooking, and the desire to provide healthy and convenient meals, Cook Me introduces a fresh and fun range of foods, including pasta sauces, quinoa, couscous and risotto mixes. Influenced by the Italian way of life, these traditional, wholesome, all-inone meals are sure to take away the hassle of shopping for, chopping and preparing ingredients, making cooking easy and a real pleasure. It contains no added preservatives, colourants or flavourants. The water has been removed, using a long, low-heat process to preserve the best qualities – nutrients, flavours and colours. These easy and healthy ready-to-cook meals are available from www.yuppiechef.com.

CONGRATULATIONS!

Lorna Jane, Australia’s award-winning active-wear label for women, is now available in South Africa. More than two decades after opening its first store the core identity remains the same. It is first in fitness and fashion and is designed for women by women. The aim is to inspire women – through active living. The brand endorses a three-pillared philosophy of MOVE NOURISH BELIEVE and it is this mantra, together with the clothing, that encourages and motivates women globally. Lorna Jane is not simply a clothing label, but a way of life. The brand offers on-trend, sporty, sexy active-wear with superior hi-tech fabrication and construction to improve your performance, motivate you and inspire you to move, nourish and believe every day. For your nearest store in Gauteng or KwaZulu-Natal, visit www.lornajane.co.za. Capetonians can count the days as the Cape Town store will be opening this April in Sea Point! Lorna Jane is giving away a hamper to one lucky reader to the value of R1 000. Product code for the giveaway is LJ.

Congratulations to the winners of the Summer issue of Body Language: Karen Lorio and Samantha Clarke each won a hamper from Vondi's pet shop and Marie Riley won the Oregon Scientific Air Sanitizer. 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 and they are at the discretion of the sponsor/suppliers who are responsible for delivering the prizes and not Health Bytes Publishers or Intercare.

GIVEAWAY

ToRecipe: see yowww.foodnetworktv.com ur products on these pages please email us at: info@health-bytes.co.za Issue

Grilled

05 | 2014

4 es v ser

Salmon Fillet

with honey-mustard sauce

Ingredients

Method

 265 ml ( cup) Dijon mustard

1 Whisk together the mustards, honey, horseradish, mint and ¼ teaspoon of salt and ¼ teaspoon of pepper in a small bowl. Let it sit for at least 15 minutes before using.

 2 tablespoons whole-grain mustard  3 tablespoons honey  2 tablespoons prepared horseradish, drained  2 tablespoons finely chopped fresh mint leaves  Salt and freshly ground black pepper  905 g fillet salmon, skin on  2 tablespoons canola oil  1 bunch watercress, coarsely chopped  1 small red onion, halved and thinly sliced  2 tablespoons aged sherry vinegar  2 tablespoons extra virgin olive oil

2 Heat the grill to high. Brush the salmon with the oil and season with salt and pepper. Place the salmon on the grill, skin side down, and grill until golden brown and slightly charred, for about 3 minutes.   3 While the salmon is cooking, place the watercress and onion in a medium bowl, add the vinegar, oil, salt and pepper and toss to combine. 4 Place the salad on a platter, top with the salmon fillet and drizzle with the mustard sauce.

Serve

this delicious fish with a herb salad

Difficulty: Easy

Preparation time: 10 mins

Cooking time: 10 mins

A day in the life of ...

13 THINGS

TO KNOW ABOUT ... Dr Ravi Govender, Medical MD at Intercare Wilgeheuwel. 1.

Where did you grow up? I grew up in Merebank, Durban.

2. What do you like to do in

your free time? I like to spend time with my family or play golf.

Who is your mentor? My late father – he was firm, outspoken, very generous and an educationist. He taught me to set my own standards and not to follow others.

What is your favourite food? Mutton curry and rice.

Who shares your home? My dear wife Maliga and two dogs.

What irritates you? People who take undue advantage of others, dishonesty and racism.

Perfect happiness is ... To travel the world, play golf and attend major sport events around the globe.

Best advice you have ever received? Do what you are best at, try to achieve 100% and know your core strengths.

What would you still like to do? See my children achieve their goals, spend more time with my wife and see the world.

fun facts Likes  M y country

10.

Where do you go for holidays? Holidays are spent with my family in Durban.

11.

What music are you listening to? Fusion Music by Vishwa Mohan Bhatt.

12.

I can’t go a day without ... Breakfast, reading Liverpool FC’s website and viewing sport results on DSTV.

13.

What would people be surprised to learn about you? I was a cricket administrator for 30 years, was the President of KwaZulu-Natal Cricket Union for three years and was also the tour doctor in South Africa for the past two years to the Manchester United and Manchester City Football Clubs.

Dislikes  P oor service delivery Fun to me is  Good music  S pending time with my family

Issue 05 | 2014

Intercare events: over the last few months Intercare competition

Fourways 10 year celebrations

ntercare recently launched a competition at primary schools. Congratulations to Franco Nolan (Laerskool Totius) and Joshua Mouton (Curro Hazeldean Primary). They each won a Lenovo 3G tablet.

n 15 November 2013 Intercare Fourways celebrated their 10th anniversary at Wandies Place in Soweto. There was singing and dancing, speeches, stunning food and more dancing!!

Above: Franco Nolan, his dad (Bennie) and Rene Verwey (Intercare Tyger Valley).

Joshua Mouton and Leonie Coetzer (Intercare Silver Lakes)

A sports star amongst us

e are proud of Dr Z e lda S mook, Inte rcare F ourw ay s, w ho w as se le cte d as captain for the S A Ladie s te nnis te am touring to F lorida, US A in April this y e ar for the 2014 ITF S e niors World Championships. We ll done !

Health bites

health bites Short snippets of info to learn and digest while on the go: Health tip

Smiley facing – a new language?

:-)

Since their appearance in a post to Carnegie Mellon University computer science general board from Professor Scott E Fahlman in 1982, the pattern of activity that smiley faces evoked has become attached to what has been previously just punctuation. No babies are born with innate neural response to these emotions. Nowadays these faces activate face-sensitive areas of the cortex because we've learnt that it represents a face – it’s a culture-created neural response, a new language that is changing our brains, according to new Australian research published in the journal Social Neuroscience. And to decode them, we've produced a new form of mind activity. The faces are very special from a psychological point of view – we pay more attention to faces than we do with anything else. When we look at an image of a real face, we recognise the position of the mouth relative to the nose and eyes, and then a very specific part of the brain is triggered. When this image is inverted, we get another specific pattern of brain activity. But does the same apply when we look at a smiley faceA? When 20 participants viewed images as well as inverted images of real faces; smiley face emoticons (involving the use of a colon, hyphen and parenthesis), and a meaningless string of characters to determine the pattern of electrical activity in the brain, which formed part of a study, face-specific brain activity was triggered by the images of real faces both upright and inverted. Interesting enough, the same was triggered by the emoticon only when in the conventional configuration :-).

Smoking, drinking and not consuming enough fruit and vegetables can affect a man’s sperm count and contribute to sterility.

Gesondheidswenk Maak seker dat jy aktief is en beweeg vir ten minste 15 minute nadat jy ‘n groot maaltyd gehad het. Selfs om net om die blok te stap, kan vertering en die afbreek van vette in jou sisteem aanhelp.

Velkanker op bedekte liggaamsdele... As blootstelling aan die son velkanker veroorsaak, hoe gebeur dit dat sommige velkankers steeds voorkom op liggaamsdele wat nooit die son sien nie – tussen die tone, onder die voete, of naby geslagsdele? Die son se ultravioletstrale beskadig ons gene en dis grotendeels die hoofoorsaak van velkankers, sê Prof Ian Olver van die Kankerraad in Australië. Tog bestaan die wanpersepsie dat die son die enigste oorsaak van velkanker is. Toe nou nie! Velkanker is die resultaat van veranderde of beskadigde gene wat as selle groei en ander weefsel binnedring. Dit word nie net veroorsaak deur een genetiese verandering nie – daar is gewoonlik ‘n volgorde van gebeure oor ‘n lang tydperk. Die velkankers in onopsigtelike areas is waarskynlik ‘n melanoma – die mees gevaarlike velkanker. Steeds kan die twee

minder gevaarlike soorte – "basal cell" en "squamous cell" velkankers ook in daardie areas voorkom. Wees paraat vir enige veranderinge wat moontlike kanker kan wees. Veltoetse is belangrik maar let ook op na kleiner veranderinge: jou vel se kleur, ‘n verandering in pigmentasie, grootte, vorm of bloeding – tree dadelik op.

Go the natural way A balanced, healthy diet is the best way to get your daily fill of goodness. Leading vitamin and mineral supplements are no replacement for a varied diet.

Issue 05 | 2014

Too much of a good thing Nowadays there seems to be a supplement for virtually everything. While labels state that supplements are only useful if our diet is deficient, many of us still reach for the vitamin bottle as added insurance in our quest for wellness. You should only think about taking supplements if you have an identified deficiency, a very poor diet or are a woman who is planning a pregnancy. The only supplement that should be considered by the majority is a broad spectrum vitamin and mineral supplement. Sitting side by side on the shelf with multivitamins are what's known as 'single nutrient supplements' which contain just the one key vitamin or mineral as opposed to being part of a package of nutrients. Some of the common single nutrient supplements we take are vitamin C, B complex, calcium and vitamin E. The scientific evidence is pretty clear that in the absence of a diagnosed deficiency, long-term use of vitamin and mineral supplements have little benefit. While overdosing on vitamins and minerals from food (including those fortified with nutrients) is extremely rare and almost impossible, supplements are a whole different story. In particular with supplements where the doses can be larger than would be found in a general multivitamin and mineral supplement. Some common sideeffects that can occur from everyday vitamins include:

Lifestyle diseases plaguing spaces to exercise but also to afford and get healthy food – a supermarket poor in Khayelitsha will stock all the fattiest Vier gesondheidswenke vir die langpad High blood pressure, diabetes and other cuts of meat. NCDs are also affecting lifestyle diseases are no longer just for South Africans at younger ages. He people in modernising nations, it is thinks that the answer lies in prevention wreaking havoc amongst South Africa’s and proposes that health authorities poorer communities. It refers to illnesses draw on lessons learned from the that can be prevented by changing HIV epidemic, such as awareness the way of living, e.g. eating better, drinkcampaigns and patient management ing less alcohol or quitting smoking. programmes. South Africa will also Hyper-tension or high blood pressure, need to get to the root of risk factors. In diabetes and heart diseases are also 2013, Health Minister Dr Aaron Motsocalled non-contagious diseases (NCDs). aledi amended the Food Products, According to Bob Mash, Professor of Cosmetics and Disinfectants Act to Family Medicine and Primary Care at define a maximum salt content for an Stellenbosch University’s Faculty of array of food. The new restrictions would Medicine and Health Sciences, NCDs require most bread producers to reare emerging among all South Africans duce the salt content of loaves by one – particularly amongst those in poorer percent by 2019. According to Mash, communities. One in ten people living in bread is the biggest contributor of salt to Cape Town is estimated to be diabetic, South Africans’ diets and by cutting the however, recent research in Cape Town’s salt content, it may lead to massive relow-income Bellville-South area found ductions in the number of people who rates of diabetes three times that. Poorer die of stroke and heart disease each communities struggle to not only find safe year. Source: Health-e news.

 Doses of vitamin C above one gram can cause diarrhoea.

 A large intake of zinc can reduce or prevent iron and copper absorption and can contribute to impaired immunity, heart problems and anemia.

 Iron toxicity is common with even small amounts above the recommended dietary intake, having the potential to cause gastrointestinal upset, nausea, fatigue and joint pain.

 Too much selenium can lead to problems, including hair-loss, gastrointestinal upset, fatigue and mild nerve damage.

 High levels of vitamin B6 can cause nerve damage.

"Chick flicks" for therapy One of the biggest divides in malefemale relationships are the “chick flicks” — movies like “Terms of Endearment” and “The Notebook” that often leave women in tears and men bored. A fascinating new survey shows that sappy relationship movies made in Hollywood can actually help strengthen relationships in the real world. A University of Rochester study found that couples who saw and sang about topics raised in movies like “Steel Magnolias” and “Love Story”, were less likely to divorce or separate than couples in a control group. Surprisingly, the “Love Story” intervention was as efficient at keeping couples together as two intensive therapist-led methods. The findings, while preliminary, have significant implications

One of the great divides in male-female relationships is the “chick flick”

for marriage counselling efforts. The movie intervention could become a self-help option for couples who are reluctant to join formal therapy sessions or could be used by couples who hold out in areas with less access to therapists. “A movie is a non-threatening way to get the conversation started,” said Ronald D. Rogge, an associate professor of psychology at the University of Rochester and the lead author of the survey. “It’s very exciting because it makes it so much easier to reach out to couples and help them strengthen their relationships on a wide scale.”

Health advice: By Health Bytes

s n r Bu

Burning is the greatest cause of unnatural death in South African children under the age of five – it commonly results from the sun, scalding by hot liquids, fire, electricity or chemicals.

WHAT TO DO FIRST Remove the source of the burn. For minor burns including second-degree burns limited to an area no larger than 5 cm in diameter, take the following action: 1.1 Cool the burn. Hold the burned area under running cold water for 10 – 30 minutes, immerse in cold water or cool with a clean cloth or sheet soaked in cold water. Cooling the burn reduces swelling by conducting heat away from the skin. 2 Remove clothing and jewellery from the burnt area as swelling could make it difficult to remove later. 3 Cover the burn with a sterile gauze bandage. Wrap it loosely to avoid putting pressure on burned skin. Bandaging keeps

Caution

pecifically young children have extremely sensitive skin and even a burn from a cup of coffee can prove fatal. If you know what to do when someone is burnt, you may be able to limit injuries. Better still, try to prevent a tragedy from happening in the first place. Pain is not an indicator of the severity of a burn. Burns are classified into first-, secondand third-degree burns, according to the depth and size of the burn. First-degree burn (superficial thickness). The least serious are those in which only the outer layer of skin (epidermis) is burned. The skin is red – looks like mild sunburn and maybe a bit swollen and painful. Second-degree burn (partial thickness). Both the first and second layers of skin (epidermis and dermis) are burned. Blisters develop and the skin takes on an intensely reddened, blotchy appearance. Seconddegree burns are very painful.

air off the burned skin, reduces pain and protects blistered skin. 4 Take an over-the-counter pain reliever, such as ibuprofen and paracetamol. Never give aspirin to children or teenagers.

Third-degree burn (full thickness). The most serious burns are painless and involve all layers of the skin. Fat, muscle and even bone may be affected. Areas may be charred black or appear hard and white. The burnt area will be swollen and may have burst open, but because of the extensive damage to nerve endings, it may not be painful.

For major burns call an ambulance. In the meantime:

Don't use ice, butter, Vaseline or anything else. Putting ice directly on a burn can cause frostbite, further damaging the skin. Don't break blisters as they protect against infection and help the healing process. Don’t remove clothing that sticks to the skin.

CALL AMB AN ULA FOR M NCE AJOR BURN S 1.1 Cover the area of the burn. Use a cool, moist, sterile bandage, cloth or towel. 2 Moisten the patient’s lips with water and keep him/her calm. 3 Check for signs of circulation (breathing, coughing or movement). If there is none, begin cardiopulmonary resuscitation (CPR) if you are trained to do so. 4 Don't remove burnt clothing near or at the site of the burn. However, make sure the victim is no longer in contact with smouldering materials or exposed to smoke or heat. 5 Don't immerse severe large burns in cold water as this could cause shock, smoke or heat.

Call an ambulance or get help immediately if:     

the burn was caused by chemicals or electricity; the burn area is larger than the person’s palm; the person has inhaled smoke; the burn is on the face, genitals, joints, hands or feet; the victim has a temperature, or feels hot and cold (shock).

BE SUNSMART

Skin cancer is one of the most common cancers in SA

WARNING SIGNS FOR SKIN CANCER (ABCDE)*

A-symmetry - a mark with one half unlike the other (not symmetrical). Common moles are round and symmetrical Border irregularities - scalloped/poorly defined edges. Common moles are smooth and have even borders Colour changes - tan, black, brown, red, white, blue. Common moles are usually a single shade of brown or black Diameter - larger than 6mm Evolve – grows bigger and becomes more prominent

LOWER YOUR SKIN CANCER RISK Skin type Type ONE •Red or blonde hair (tends to have freckles) •Blue or green eyes

Type TWO •Blonde or light brown hair •Blue or brown eyes

Type THREE •Brown hair & eyes

Type FOUR •Dark brown hair & eyes

Type FIVE

Reaction to the sun Sunburn

Tan

Easily

Never

Sensitivity: Extreme

Easily

Greatest risk of developing skin cancer so make sure you protect your skin. Check your skin regularly, be aware of any changes and see a doctor if you notice anything. Recommend SPF 50 sunscreen.

Gradually to light brown

Moderately

Although skin tans more easily, it’s still vulnerable to UV damage that can lead to skin cancer. Remember that a tan is not a healthy glow. Always protect your skin during the hottest part of the day. Recommend SPF 30-40 sunscreen.

Rarely

Easily

art Choic

SUNSCREEN

SUNSCR

EEN SPF20 SPF50

Never Sensitivity: None, except for eyes, palms of hands, soles of feet, earlobes & lips

Deeply pigmented

80%

Your skin offers more protection against harmful UV rays than other skin types. Recommend SPF 20 sunscreen, especially on sensitive areas.

of sun-induced skin damage occurs before the age of

Always apply sunscreen regularly (SPF of 20 - 50) according to skin type Avoid sunbeds & sunlamps

As above. Recommend SPF 20-30 sunscreen.

C DE

Spot the spot - check your skin carefully every month (follow A, B, C, D, E Rules*)

FotoFinder - cutting edge screening technology for skin cancer at some of our CANSA Care Centres & Mobile Health Units countrywide

Sponsored by

LOTTERY

NATIONAL

at least

SunSm

Sensitivity: Moderate

Sensitivity: Minimal • Black or dark brown hair & eyes

Wear sunglasses with a UV protection rating of UV400

UV400

•Dark brown hair & eyes

Type SIX

Wear protective clothing; wide brimmed hats & UV protective clothes/swimsuits

Minimally

Sensitivity: High

Minimally

Avoid direct sunlight between 10am & 3pm. Stay in the shade or under an umbrella as much as possible

What you need to know

Sensitivity: Very High

Sometimes

ALL SKIN TYPES SHOULD:

N LDTF

Toll-free 0800 22 66 22 www.cansa.org.za

Health advice

Health risks

associated with

Obesity

Obesity is recognised as a global epidemic and is associated with various comorbidities, including hypertension, insulin resistance and other components of the metabolic syndrome.

What is Obesity?

besity can be classified as a state of adiposity in which body fatness is above the ideal of a body mass index of 30-39.9. Obesity is a result of an imbalance between food consumed and physical activity. National data have shown an increase in the calorie consumption of adults and no change in physical activity patterns. However, obesity is a complex issue related to lifestyle, environment and genes. Many underlying factors have been linked to the increase in obesity prevalence such as:  Increasing portion sizes  Eating out more often  Increasing television or computer viewing  Changing labour markets  Fear of crime that prevents outside activity Overweight adolescents often become obese adults. Obese individuals are at increased risk for comorbidities of type 2 diabetes, hypertension, stroke, certain cancers, infertility and other conditions.

Overweight adolescents often become obese adults Managing Obesity Etiology  Excess energy intake  P hysiologic, metabolic and genetic factors

 Inadequate physical activity

Classification  BMI > 30  E xcess body fatness (Male: 8% – 24%, females: 21% – 35%)

 A ndroid vs gynoid fat distribution

 H ormonal changes (e.g. insulin and leptin)

Associated chronic disorders metabolic syndrome    

Glucose intolerance Insulin resistance Hyperlipidemia Hypertension

Juandri Steytler, dietician, Johannesburg; info@mydietclinic.co.za

*Th Europ e latest ean guide waistline 80 cm line is: (w and 9 omen) 4 cm (men )

Issue Issue 04 05 | 2013/14 | 2014

Metabolic Syndrome is also known as Insulin Resistance Syndrome or Syndrome X. The syndrome is characterised by the simultaneous presence of insulin resistance, high blood pressure, elevated blood cholesterol, increased blood glucose levels and abdominal obesity. Whether this syndrome is purely genetic is not known yet but factors that contribute are:

 F amily history of diabetes,

    

hypertension, heart diseases, gestational diabetes and impaired glucose tolerance test E xcessive energy intake P hysical inactivity O verweight (BMI > 25 kg/m2) and Obesity (BMI > 30 kg/m2) O lder than 40 years of age S moking

Diagnosing Metabolic Syndrome Look out for any three of the following:  W aist circumference of > 102 cm (men)*; > 88 cm (women)*  Triglycerides > 1.7 mmol/L  HDL Cholesterol < 1.0 mmol/L (men); < 1.3 mmol/L (women)  Blood pressure > 130 / 85 mmHg  Fasting glucose > 6.1 mmol/L  1 20 minute post-prandial glucose challenge

Having an apple-shaped figure (when most of the excess weight is around the abdominal region), which is most common amongst men and postmenopausal women, also contributes to the development of Metabolic Syndrome. Fat in the abdominal area is situated around the organs and becomes metabolically active (not only storage fat). Consequences Metabolic Syndrome increases risk for the development of diabetes type 2, gout, hypertension, heart diseases, stroke and atherosclerosis – a condition where the arteries and veins are blocked due to build-up of fat/cholesterol; this fat build-up may be released from the arterial wall as a clot which then passes through the brain or heart, causing either an embolism or stroke).

7.8 – 11 mmol/L

Treatment – Lifestyle change  W eight loss is considered the first line of treatment for overweight patients with Metabolic Syndrome.

Nutritional management  E nergy intake reduction  A ppropriate nutrient supplementation

 N utrition, meal planning and portion size education

 A ppropriate dietary intervention (following a low-GI diet, with regular meals and controlled portion sizes) – the low-GI eating plan will result in moderate insulin demands and therefore improve insulin resistance and most likely a reduction in waist circumference. The correct dietary adaptations will also reduce cholesterol levels.

 P hysical activity will promote weight loss and improve insulin sensitivity.

 W eight loss medication can be prescribed by a doctor in severe cases when lifestyle modification alone does not achieve the desired results. These drugs must still be taken with a kilojoulerestricted, well-balanced diet.

 Other medication: Insulin-sensitising drugs may be prescribed to increase insulin sensitivity BUT it has to be combined with a lifestyle change.

 Surgery: bariatric surgery.

Lifestyle modification strategies

 S etting easy-to-achieve short-term goals

 S elf-monitoring - Food and activity records - Regular weighing and measuring

 Stimulus control  S hop when not hungry and with a grocery list

 E at when not on the run, do not eat in your car or in front of the television

 Confronting barriers

- Problem-solving steps - Planning your day, e.g. packing a lunchbox

 Stress management  Social support They key to dietary treatment is that the eating plan has to be customised as nutritional needs are unique to each person.

Feature: Dr James Nutt, General Practitioner, Intercare Glenfair

What to do first

Drowning

amongst children Drowning is one of the main causes of unnatural deaths amongst children in South Africa. The sad truth is that almost all of these deaths are potentially preventable by proper supervision of children who are not yet able to swim, educating children on the dangers of open water sources and fencing off swimming pools or installing good quality safety nets.

Issue 05 | 2014

ccidents can happen quickly and a child can sustain permanent brain damage within minutes of being deprived of oxygen. Small children can even drown in a large basin used for washing dishes or a small fish-pond, despite the water being only a couple of centimetres deep. These factors should be taken into account when making one’s home child-safe or when visiting places with open water sources.

Have the telephone numbers of your local emergency services written down where it is easily accessible

EP T S T S IR F E H T G TAKIN In case of neardrowning – what are the first steps that should be taken in order to save somebody’s life? Even though circumstances will dictate the exact actions, the following can serve as a guideline:

Resuscitation Parents, older siblings and caregivers

Do not administer other first aid methods

should all be familiar with basic resuscitation techniques. The earlier

Do not try to remove water from

CPR is initiated, the sooner fresh

the patient’s body as this can lead

oxygen starts circulating through

to vomiting and aspiration.

the bloodstream to the brain and

Wait for the paramedics.

flushing away toxins which have built up due to oxygen starvation. Minutes can literally mean the difference between brain damage and normal brain function.

Specialised care Despite severe initial oxygen deprivation, medical units like the

Call an ambulance

paediatric intensive care unit (PICU) at Netcare Garden City Hospital,

Call an ambulance and continue with CPR at the site of the accident. Do not rush to the hospital – rather wait for the paramedics to arrive. Note: Have the telephone numbers of your local emergency services written down

Source: www.picu.netcare.co.za/ drowninginchildren.html

where it is easily accessible (on the fence of the swimming pool, refrigerator door, etc.) In a state of panic during an emergency one may be unable to recall telephone numbers that are not regularly used.

specialising in near-drowning treatments, can achieve excellent recovery results with methods such as cooling down the body to below normal temperatures and vital function support. Never give up hope.

Feature: Geskryf deur Riekie le Roux

Onbeskryflike Genade ‘n Ma vertel:

My kind het amper verdrink

y drie-jarige dogtertje, Jenique, neem reeds swemlesse vandat sy nege maande oud is. Drie weke voor die ongeluk kon sy die breedte van ons swembad met gemak deurswem sonder enige hulpmiddels. Sy het ook vining na die kant gegryp, as sy wou rus. Op Maandag, 18 November 2013 het my Graad 1 seuntjie se maats by ons kom swem en Jenique wou toe ook swem. Terwyl ek haar swemklere en beltjie aangetrek het, het sy gevra: “Mamma, ek kan mos swem, hoekom moet ek dit aansit?” Ek antwoord toe: “Daar is vandag baie kinders in die swembad en dis net veiliger.” Sy het dit aanvaar. Ek was rustig. Almal was waterveilig toe ek vir 'n oomblik die huis ingaan om koeldrank vir almal te maak. Soveel mense vra gewoonlik na so 'n ongeluk: “Hoe lank was sy onder water?” Ek weet eerlik nie – dokters raai so ongeveer twee tot drie minute. Ek het uitgekom en

haar handjie bo die water gesien – aanvanklik gedink sy speel, maar toe ek haar uithaal, besef dis ernstig. Haar beltjie het op die gras gelê. Ek het besef ek moet haar vinnig by 'n dokter kry. Ek het gillend met haar by die hek uitgestorm en met die Here se genade is daar op daardie oomblik 'n ma op my pad gestuur wie besig was om langs haar draffende dogter te bestuur. Ons bly ongeveer 1.5 km van die Intercare Glenfair praktyk af en terwyl ons soontoe gejaag het, het ek gebid en mondtot-mond asemhaling toegepas. My man, Andre, het intussen 'n gebedsketting begin. Dr James Nutt en die mediese span van Intercare Urgent Care het bepaal sy het nog 'n hartklop en hulle het haar onmiddellik suurstof gegee, die water uit haar longe en maag gepomp en haar verder gestabiliseer. Die moontlikheid van breinskade was egter groot. Die

praktykbestuurder, Cornelia Naude, het intussen die hulp van Netcare 911 ingeroep en daar is besluit om haar per helikopter na Garden City Kliniek te neem waar Dr Bartlett, 'n kundige in naby-verdrinkings, haar ontvang en verder behandel het. Op Saterdag, 23 November 2013 is Jenique ontslaan met geen long- of breinskade van enige aard nie. Ons dogtertjie is perfek! In my hart glo ek dat die Here haar in die helikopter aangeraak het. Daar was soveel gebede. Hy het dit verhoor en was ons genadig. Namens al die le Roux’s wil ons graag Dr Nutt en die personeel van Intercare bedank vir die professionele wyse waarop hulle ons dogtertjie se noodgeval hanteer het. Hul flinkheid met die reël van die helikopter en paraatheid vanaf die oomblik toe Jenique daar aangekom het, het bygedra tot ons Engelkind se volkome herstel. Ons sal jul ewig dankbaar bly.

Does your arthritis treatment 2: •

Reduce your symptoms?

•

Allow you to stay active?

Ask your doctor for the new medication from AstraZeneca for the symptomatic relief of osteoarthritis, rheumatoid arthritis and ankylosing spondylitis.

References: 1. Woolf AD, Pleger B. Burden of major musculoskeletal conditions. Bull WHO 2003;81(9):646-656. 2. Kalunian KC. Patient information: Osteoarthritis treatment (Beyond the Basics). Available from Uptodate.com. Last accessed 2013/02/28. AstraZeneca Pharmaceuticals (Pty) Ltd. Reg. No. 1992/005854/07. Building 2, Northdowns Office Park, 17 Georgian Crescent West, Bryanston, 2191. Private Bag X23, Bryanston, 2021. Tel: (011) 797-6000. Fax: (011) 797-6001. www.astrazeneca.co.za. Expiry Date: October 2014. Activity ID: 76329

KEEP MOOOVING

Living with arthritis can be frustrating. Too often, arthritis pain restricts your activity, productivity and quality of life.1 By managing your arthritis pain better, you’ll be able to take back control and do the things you enjoy, with fewer compromises and limitations.

LekkeSlaap: Elana Esterhuyse, redaksionele assistent – LekkeSlaap

Troef jou moegheid

Top spa's in Suid-Afrika Verbeel jou 'n plek waar geen motors verbyjaag en spoedvrate die verkeersligte ignoreer nie – 'n plek sonder spitsverkeer en die geraas van swaar voertuie op 'n besige pad.

ierdie plek bestaan, en jy hoef nie ver te ry, land-uit te vlieg, of op 'n eiland te gaan kuier om dit ten volle te ervaar nie. Vir 'n wegbreek uit die boonste rakke, is 'n spa-wegbreek die beste medisyne om weer daardie huppel in jou stap terug te sit. Suid-Afrika spog immers met talle wêreldklas spa's mét akkommodasie-geriewe vir ekstra gerief. Vir 'n naweek van rus en om te verfris, besoek dié gunsteling-plekke in ons mooi land vir top behandelings én LekkeSlaap!

Vir sakpas ontspanning Boulders Lodge & Spa**** Dorp: Oudtshoorn, Wes-Kaap Spa-naam: Boulders Spa Spa-ure: Maandag – Saterdag: 09.00 – 18.00

Vir pret en avontuur is 'n besoek aan Oudtshoorn se Kangogrotte en volstruisplase definitief 'n moet, maar vir sakpas ontspanning is Boulders Spa die top keuse. Die spa bied verskeie behandelings met Annique- en Vitaderm-velsorgprodukte. Nooi sommer 'n vriendin saam vir 'n spa-besoek of bederf jou geliefdes met geskenkbewyse wat vir drie maande lank geldig is. Vir die res van die dag kan jy Oudtshoorn verken of verder in die luukse Boulders Lodge ontspan. Die lodge spog onder meer met 'n skitterblou swembad en borrelbad buite op die dek. En terwyl die kleinspan op klimrame kan klouter, kan jy tyd vir jouself afknyp vir behandelings.

Breek weg na die Wynlande Santé Hotel & Spa***** Dorp: Paarl, Wes-Kaap Spa-naam: Bakwena Deluxe Spa Spa-ure: Maandag – Saterdag: 09.00 – 18.00; Sondag: 09.00 – 16.00 Hierdie oord tussen die berghange van die majestueuse Simonsberg bergreeks, is net 40 minute se ry vanaf Kaapstad

Internasionale Lughawe. Gaste wat by die hotel oorbly, geniet komplimentêre toegang tot die gesondheidsgeriewe wat die volgende insluit: 'n unieke binnenshuise hidro-swembad met vloeistofklank; multihoogte liggaamsproeiers; nekmassering en teen-stroom weerstandswem; 'n private sondek; ten volle toegeruste gimnasium; sauna; stoomkamer; jacuzzi en slakvormige multi-dimensionele storte. En dan praat ons nie eens van die behandelings wat gaste by die Bakwena Deluxe Spa kan geniet nie …

Issue 05 | 2014

Die beste in Suid-Afrika Pepperclub Hotel & Spa***** Dorp: Kaapstad, Wes-Kaap Spa-naam: Cayenne Spa Spa-ure: Maandag, Dinsdag, Donderdag en Saterdag: 09.00 – 18.00; Woensdag en Vrydag: 09.00 – 19.00; Sondag (hoogseisoen) van 10.00 – 16.00

Melk en heuning in die Kaap O on Kloof Boutique Hotel & Spa

CNN : er TravellLuukse este ” “Die B in SA otel H

Dié hotel is gesetel in die hartjie van Kaapstad en word volgens CNN Traveller as die Beste Luukse Hotel in Suid-Afrika beskou, en is sowat R400 miljoen werd. Verwag 5-ster luukses as standaard geriewe. Die Cayenne Spa, op die agtste vloer is na mening die gewildste spa in Kaapstad. Vertoef by die sauna of verhitte swembad, geniet 'n behandeling in een van die vier behandelingskamers, of gaan oefen in 'n ten volle toegeruste gimnasium met die mees inspirerende uitsig denkbaar.

Vir die gesin Hans Merensky Hotel & Spa**** Dorp: Phalaborwa, Limpopo

Dorp: Bantry Bay, Wes-Kaap

Spa-naam: Indulgesenses Spa

Spa-naam: Milk & Honey Boutique Spa

Spa-ure: 09.00 – 22.00

Spa-ure: Maandag – Sondag: 09.00 – 18.00

Die gesinsvriendelike Hans Merensky Hotel & Spa spog met 143 kamers – van hotelkamers tot kothuise, selfsorgeenhede en junior suites, konferensiegeriewe vir tot 200 afgevaardigdes en 'n spa met basiese behandelings teen bekostigbare pryse. Plaaslike en internasionale gaste vertoef graag hier, omdat dit aan die Nasionale Krugerwildtuin grens en 'n unieke kombinasie van gholf en wildbesigtiging bied.

In die skilderagtige Bantry Bay, in die skadu van die ongerepte Leeukop, staan hierdie paradys, gereed vir gaste wat glorieryke rustigheid wil ervaar. Die houtdek met 'n beeldskone skemer-uitsig oor oor die Atlantiese Oseaan asook die geur van jasmyn, sal jou bekoor – om nie eens te praat van die innoverende en wereldbekende Theravine-produktereeks nie.

Stilte in die stad Stillness Manor & Spa Dorp: Tokai, Kaapstad, Wes-Kaap Spa-naam: JoJos@Stillness Spa-ure: Maandag – Vrydag: 08.00 – 19.00; Saterdae: 09.00 – 17.00, Sondae en vakansiedae: 09:00 – 15:00 In dié klassieke Kaap-Hollandse herehuis, tussen pragtige wingerde en woude van die Constantiavallei, kan jy verwag om bederf te word. Die herehuis spog met sewe ruim suites vir luukse verblyf vanwaar Kaapstad en die Kaapse Wynlande verken kan word. JoJos@Stillness bied gesondheidsgeriewe en 'n volle reeks opwindende spa-behandelings aan dagbesoekers, korporatiewe reisigers en toeriste. Die spa bestaan uit vyf behandelingskamers, 'n sauna, stoomkamer, ten volle toegeruste fiksheidsentrum en 'n groot binnenshuise swembad. As vrede, afsondering, privaatheid en 'n beeldskone uitsig jou droom is, is dit nét die plek vir jou.

LekkeSlaap

Spaar vir dié spa

'n Unieke pawiljoen-ervaring

Karkloof Spa***** Dorp: Pietermaritzburg, KwaZulu-Natal Spa-naam: Karkloof Spa

Summerfields Rose Retreat & Spa***** Dorp: Hazyview, Mpumalanga

Vir 'n een-keer-in-'n-leeftyd ervaring is Karkloof Spa sonder twyfel die beste keuse. In hierdie luukse boetiek-lodge met 16 villas, 'n uitgebreide wêreldklas-spa en 'n 3 500 ha perseel met diere, sal jy soos 'n adellike behandel word. Karkloof Spa se alles-insluitende akkommodasiepakkette sluit onder meer luukse verblyf, onbeperkte maaltye, peuselhappies en drankies, privaat begeleide wildritte, WiFi, 'n wasserydiens en 'n portier in. Asof dit nie genoeg is nie, word onbeperkte spa-behandelings en onbeperkte gebruik van die Hydro se terapiefasiliteite ook ingesluit. Hierdie bestemming-spa met sy oop ruimtes en intieme eksklusiwiteit, omvat elke aspek van 'n heerlike reis om te rus, herstel of te genees.

Spa-naam: Summerfields Rose Spa Spa-ure: Maandag – Sondag: 08.00 – 16.00

Summerfields Rose Retreat & Spa is geleë op een van die oudste plase in die Sabie-vallei, sowat 10 km van die Nasionale Krugerwildtuin af. Dit is egter die unieke en bekroonde spa-pawiljoen langs die Sabierivier – waarin die seekoeie teen skemer bad – wat dié spa-ervaring besonders maak. Jy kan 'n hele reeks behandelings geniet terwyl jy uitkyk oor die berge en voëltjies hoor fluit, sonder vensters of deure wat die uitsig belemmer. Daar is ook spa-kamers met onder meer 'n stoomkamer, jacuzzi, swembad en Vichy-stort. Gaste kan die spa as 'n dagfasiliteit gebruik of hier oornag vir ekstra gerief.

'n Turkse modderbehandeling Emoya Luxury Hotel & Spa**** Dorp: Bloemfontein, Vrystaat Spa-naam: Emoya Spa

Emoya Luxury Hotel & Spa is op die westelike grens van Bloemfontein geleë en bied sakpas-verblyf en 'n vyf-ster spa – die enigste spa in sentraal Suid-Afrika met Turkse Rasul-geriewe ('n modderbehandeling). Die spa het onder meer agt behandelingskamers; 'n verhitte rotspoel met waterval; 'n eksotiese stoomkamer met rots-jacuzzi: waterval en kleurterapie; Emoyavoetbaddens in 'n woud-opset en 'n sauna. Vir 'n unieke ervaring, is dit sonder twyfel dié plek om te besoek … veral as jy in die outentieke “shack” wil oornag.

As die jaar te lank begin voel, kliek gerus www.lekkeslaap.co.za, tik een van die instansies hierbo in die soekgleuf op die tuisblad in, en bespreek 'n luukse ontspanningswegbreek om weer so vars soos 'n briesie te voel.

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 youâ&#x20AC;&#x2122;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 .

Feature: Andrea Abendroth: Speech Language Therapy and Audiology

is anyone listen

ing?

Hearing Loss &

Headphones Adults and children are commonly exposed to loud music. Between earbuds connected to iPods or MP3 players, loud music can cause hearing loss. As parents we may often find ourselves asking our teenagers to remove their headphones so we can speak to them â&#x20AC;&#x201C; we may want to consider doing it even more often.

efore we can understand how MP3 players could affect our hearing, we probably need to understand how hearing works. Hearing is the multifaceted process of picking up sounds and ascribing meaning to those sounds. Being able to hear is crucial for us to understand the world around us.

The ear is divided into three parts: the outer ear, middle ear and inner ear. The outer ear is comprised of the ear canal and the eardrum or tympanic membrane. The middle ear is the space behind the eardrum containing three small bones, connected in a chain, known as the ossicles. The inner ear, also known as the cochlea, is made up of tiny hair cells embedded in a fluid environment. Sound waves enter the outer ear and vibrate against the tympanic membrane, causing the ossicles to vibrate within the middle ear, which in turn creates movement of the fluid in the inner ear. The movement of the hair cells then

Issue 05 | 2014

sends electric signals to the auditory nerve to the brain. These electrical signals are then interpreted by the brain as sound. As with any structure in the human body, damage can cause impairment or severe loss of function. There are three types of hearing loss: a conductive loss, where the origin of the loss lies in the outer ear and can generally be treated medically; a sensorineural loss, where the origin of the loss lies either in the inner ear in the auditory nerve or in the brain or in a combination of the two. The combination of the two may occur, resulting in a mixed hearing loss. A hearing loss as a result of excessive exposure to noise is called a NoiseInduced Hearing Loss (SNHL) and is sensorineural of nature. Sensorineural hearing loss cannot be cured medically. The exposure to noise can be once off or over an extended period of time and may have a number of different origins. Currently, as audiologists and as parents we should be most concerned about extended exposure to noise in the form of music listened to through personal audio devices (PAD). More and more children and

adolescents have access to PADs in the form of MP3 players such as iPods – spending more time listening to these devices. Studies show that there are an increasing number of children aged between six and 19 who suffer from noise-induced hearing loss as a result of using earphones while listening to music at a high volume. You may be asking yourself why listening to music is having such an effect on our hearing now and why, when we were listening to rock bands using our Walkmans back in the day, this was not the case. The simple explanation for this is that current technology allows for hours of uninterrupted listening, PADs are able to store thousands of songs per device and their battery life is vast in comparison to those of older instruments. It appears as if the way in which people listen to their PADs may also have an effect on the degree of the hearing loss, with insert earphones, known as earbuds, causing more damage than headphones that fit over the entire ear. The reason for this may be that the earbuds play music directly

onto the tympanic membrane and are not able to impede enough of the background environmental noise necessary to hear music clearly, resulting in the listener increasing the output volume of the PAD. Symptoms of a noise-induced hearing loss may include sounds we are able to hear being distorted or muffled, or difficulty hearing or following a conversation in a crowded or noisy environment. Tinnitus is, in addition, often a symptom of a noiseinduced hearing loss and can be defined as a ringing or buzzing sound in the ear. If you or your children are experiencing these symptoms, make an appointment with your closest audiologist or ENT (ear nose and throat surgeon) for a diagnostic assessment.

Facts you should know: By adhering to the following tips, exposure to music through PADs may prove less detrimental: 1 Switch to headphones: 1. Headphones isolate background noise making it possible for the listener to listen to music at lower volumes.

2 Listen at volumes lower than 85 decibels: A lawnmower’s sound is measured at approximately 90 decibels, so listen to music just a little softer than that. 3 Lower the maximum volume setting on your PAD: Some PADs allow the listener to restrict the maximum level of volume – that way you can’t accidentally turn your music up too high.

4 Limit your listening: The louder the music, the shorter the duration you should listen. 5 Use the 60 / 60 rule: Listen to your PAD for 60 minutes at 60% of its maximum volume.

: avoiduced

-ind noise ss ing lo hear

6 Take a break: Giving your ears a “break” from your PAD allows them a chance to rest and hopefully to restore themselves to optimal functioning. 7 Don’t use earbud earphones: Earbuds are more likely to cause damage to hearing cells than headphones. 8 Never max it out: Although tempting, avoid listening to your PAD at its maximum volume.

99. Don’t fall asleep while listening: Your PAD is not able to tell if you’re awake or asleep, and will therefore continue to play music at levels or durations which may be harmful to your hearing. If you need music to fall asleep, consider playing classical music from a speaker on your bedside table at a low volume.

So let’s take some advice from Max Ehrmann’s Desiderata (well-known prose poem written by the American writer). “Go placidly amid the noise and haste, and remember what peace there may be in silence.”

If you are concerned about your hearing or that of a loved one, please feel free to contact us at www.kind2hearing.co.za or on our toll-free number 800 200 100.

Feature: Article by Dr Zelda Smook

The five S's of

skin cancer To be sun safe, you not only have to take extra precaution and protection – especially from a younger age – but also have to inform yourself about skin cancer, the different types and the vital signs to look for.

ccording to statistics published by CANSA (Cancer Association of South Africa), in December 2004, 80% of skin damage that could lead to skin cancer occurred before the age of 18, and since then, not much has changed. Let's be honest, not many under 18s apply at least a factor 15 sunscreen to their entire bodies – starting 20 minutes before exposure and thereafter every 2 hours – and wear wide-brimmed hats, UV 400 protected sunglasses and long-sleeved shirts while playing around in the blazing heat of an African afternoon (or anywhere else in the world). As Africans, we lead a more outdoor-oriented lifestyle than any other country, spending most of our days outdoors indulging in sports activities such as golf, tennis, hockey, cricket, water-skiing, cycling, swimming, etc.

SLIP! SLAP! SLOP! SEEK! SLIDE! No, this is not the title of the latest Leon Schuster movie, but a variation of the Australian Skin Cancer Awareness Campaign slogan – ran until early January 2010 and re-launched at Intercare in January 2014.

Issue 05 | 2014

25 30+

SLIP

SLAP

SLOP

on some PROTECTIVE CLOTHING that covers up as much of your body as possible.

on COPIOUS AMOUNTS OF SUNSCREEN at least 20 minutes before exposing your body to the sun and make sure to reapply every two hours whilst being outdoors.

on a WIDE-BRIMMED hat that shades your face, neck and ears.

SPF 3

ction Porte (Sun s r) last Facto ours 2,5 h

The question now is: What is a good sunscreen? The best sunscreen is one that complies with the following:

SPF 15 – 30+

SPF is a laboratory measure assessing the ability of that particular sunscreen product to filter out harmful rays. It works around the theory that for every factor, you will have five minutes protection from harmful rays before you get sunburn. Hence, a factor 30 sunscreen product will protect you from the sun for a period of 2,5 hours. Always remember that a sunscreen is a combination of chemicals which either in their own right or in combination reflect or absorb the UV rays from the sun. Thus, the more you apply, the better your protection. The biggest mistake most people make is that they do not apply ENOUGH sunscreen.

shade often, if not all the time, and limit your sun exposure between 10am and 3pm.

Water resistant

There is no such thing as waterproof sunscreen. You should ALWAYS reapply sunscreen after swimming, towel-drying, perspiring, etc.

SLIDE on SUNGLASSES labelled UV 400, which indicates that they are approved by CANSA for effective UV protection.

Protect your friends, protect your family, protect yourself...

3 BASIC SKIN CANCERS There are three major kinds of skin cancer namely, basal cell carcinoma (BCC) – the most common form of skin cancer, squamous cell carcinoma (SCC) and malignant melanoma. 1 Basal Cell Carcinoma (BCC) (BCC – 75% of all skin cancers) appears as a raised, translucent, pearly nodule that may crust, ulcerate and sometimes bleed. BCC is rarely a fatal disease and therefore is often left untreated, or even ignored. But, should it be left to grow, it could lead to severe disfigurement.

2 Squamous Cell Carcinoma (SCC – 2nd most common of skin cancer), usually appears as a raised, pink opaque nodule or patch that frequently form ulcers or sores in the centre of the lesion.

Broad spectrum

Covering UVA and UVB rays.

SEEK

Always be aware that any “change” is not good. If you have any suspicious lesion, and if anything itches, changes, bleeds or pains, consult your local GP immediately. You are your own best mole mapper.

3 Malignant Melanoma (The scariest of them all) appears as small brown, black or multi-coloured patches with an irregular outline and may crust and bleed. What makes it so scary? Statistics indicate that one person dies of melanoma every 62 minutes and one in 55 people will be diagnosed with it during their lifetime. The most common cancer for adults aged between 25 – 29 years and 65% of cases of melanoma can be attributed to UV radiation from the sun. The most important aspect of detecting a melanoma is for you, the patient, to be vigilant. The characteristics of melanoma are: A. Asymmetry – the lesions are irregularly shaped B. Border – Borders are irregular and uneven C. Colour – multiple colour combinations of brown and black D. Diameter – more than 6mm in diameter E. Elevation

In the know: Information published by Heart Foundation and CANSA (Cancer Association of South Africa)

HOW MUCH DO YOU KNOW ABOUT

Salt?

with ShopSCIENCEs, t N a CO ingredien er

od nev for go resh whe f ok at g buyin le and co the l possib to contro e a m lt nd ho of sa levels additives. other

We all know that we need to eat less salt, but that doesnâ&#x20AC;&#x2122;t mean losing out on flavour. Learning about the sodium content in foods and new ways to prepare it will also help to achieve your desired sodium reducing goal.

alt, also known as table salt or rock salt (halite), is a crystal line mineral that is composed primarily of sodium chloride (NaCl), a chemical compound belonging to the larger class of ionic salts. It is absolutely essential for human and animal life, but can be harmful to animals and plants in excess. Salt is one of the oldest, most ubiquitous food seasonings and salting is an important method of food preservation. The taste

of salt (saltiness) is one of the basic human tastes. Chloride and sodium ions, the two major components of salt, are needed by all known living creatures in small quantities. Salt is involved in regulating the water content (fluid balance) of the body. The sodium ion itself is used for electrical signaling in the nervous system. Because of its importance to survival, salt has often been considered a valuable commodity during human history. However, as salt consumption has increased during modern times, scientists have become aware of the health risks associated with high salt intake, including high blood pressure in sensitive individuals. Therefore, some health authorities have recommended limitations of dietary sodium, although others state the risk is minimal for typical western diets. Sea salt versus table salt Both sea salt and table salt contain about 40% sodium. Sea salt is obtained directly through the evapo-ration of seawater. It is usually not processed or undergoes minimal processing and, therefore, retains trace levels of minerals like magnesium, potassium, calcium and other nutrients. Table salt, on the other hand, is mined from salt deposits and then processed to give it a fine texture so it is easier to mix

and use in recipes. Processing strips table salt of any minerals and additives it may have contained, are usually incorporated to prevent clumping or caking. While these attributes may make sea salt more attractive from a marketing standpoint, there are no real health advantages of sea salt. Salt and cancer Research has shown that rates of nasopharyngeal cancer are high in areas where Chinese-style salted fish is very common. Other studies have linked eating large amounts of foods preserved by salting and pickling with an increased risk of stomach cancer. The incidence of stomach cancer is greater in parts of the world (such as Japan) where diets traditionally include foods that are salt-preserved. During Heart Awareness Month September 2014, radio DJs around the country dared to bare it all in an effort to raise awareness about cardiovascular disease in South Africa. They had their vitals tested to determine their heart age â&#x20AC;&#x201C; that is, the true health of their hearts â&#x20AC;&#x201C; and inspired the public to do the same. However, when asked about the health effects of salt and in which foods hidden salt could be found, more than half of the DJs questioned were in the dark.

Issue 05 | 2014

Limit your salt intake to 5 g (1 teaspoon) of salt a day! Foods rich in sodium

fast

foods ed

sss proce t and ighes are h s d o o f ium in sod

Most people know that they should try and limit the amount of salt they eat – few realise how bad it is for your heart. South Africans eat twice as much salt as they should, and in fact they should limit their salt intake to no more than 5 g (1 teaspoon) of salt a day. A high salt diet is a leading cause of high blood pressure and one in four South Africans over the age of 15 years are affected by hypertension. High blood pressure is the single most important risk factor for stroke, in fact, the World Health Organisation sees hypertension as an even greater health risk to your health than smoking. Fifty five percent of the salt consumed comes from hidden sources like processed foods. Bread is the number one culprit, followed closely by fat/ butter spreads, stock cubes, soup powders, breakfast cereals and savoury snacks. CVD (cardiovascular disease) is the second biggest killer in our country, after HIV/AIDS. Every hour five people suffer a heart attack, ten people suffer a stroke and ten of these people die! However, let’s remember that 80% of CVD is preventable through diet and lifestyle changes. It is in everyone’s interest to become more aware of the salt they consume on a daily basis.

Foods in their natural state contain very little sodium. Fast foods and processed foods are highest in sodium. Processed foods include snack foods, deli items, bakery products, canned foods and prepared foods like salad dressings and spaghetti sauces. Table salt, soy sauce and other condiments are high in sodium. Ordinary salt (table salt) is 40% sodium and 60% chloride. More than 40% of the sodium comes from the following foods:

          

Bread and rolls Cold cuts and cured meats (deli or packaged ham or turkey) Processed meats (sausages, bacon and ham) Pizza Fresh and processed poultry Soups Sandwiches and similar foods (hot dogs and hamburgers) Cheese (natural and processed) Mixed pasta dishes (lasagne, spaghetti with meat sauce and pasta salad) Mixed meat dishes (meat loaf with tomato sauce, beef stew and chili) Snacks (chips, pretzels, popcorn and crackers)

In the know Travel health: By Dr Konrad Bekker – Intercare Parow

Lets see how much you know... Tick the correct boxes: 1

Which of the following foods can increase your blood pressure?

read

eN Fact utrition s lab el

a. Fats b. Sugars c. Salt d. 2

Fizzy drinks

Which of the following foods can help decrease your blood pressure? a. Fruit and vegetables b.

Low fat milk

c. Fish d. 3

All of the above

Which of the following options have the highest salt levels? a. Milk b. Bread c. Fruits d.

Raw almonds

Which of the following options contain high amounts of salt? a. Polony b. Pizza c.

Stock cubes

All of the above

How did you fare with your knowledge of salt? Correct answers to the questions: 1= c; 2=d; 3=b; 4=d

Steps to cut down on sodium intake Learning about the sodium content in foods and new ways to prepare foods will help to achieve the desired sodium reduction goal:  R ead the Nutrition Facts label to see

 B uy fresh, frozen (without sauce),

how much sodium is in the food

or low sodium or no-salt-added canned vegetables

 C heck the Nutrition Fact label for lower sodium choices and compare sodium  in different brands of foods — like frozen meals, packaged soups, bread, dressings/sauces and snack foods — select those products with the lowest  sodium content

 P repare own food whenever possible. Do not salt foods before or during cooking and limit salt shaker use at the table

 A dd flavour without adding sodium. Use herbs and spices instead of salt  to add flavour to foods. Try rosemary, oregano, basil, curry powder, cayenne pepper, ginger, fresh garlic or garlic powder (not garlic salt), black or red pepper, vinegar or lemon juice and no-salt seasoning blends 

 B uy fresh or frozen (not processed) lean meat rather than canned, smoked or processed meats like luncheon meats, sausages, bacon and corned beef. Check the package on fresh meat and poultry to see if salt water or saline has been added:

R inse sodium-containing canned foods, such as tuna, vegetables, and beans before using. This removes some of the sodium C hoose fat free or low fat milk and milk products, such as milk, yogurt, cheese and fortified soy beverages (often called soy milk) instead of processed cheese products and spreads, which are higher in sodium C hoose unsalted nuts and seeds, as well as snack products such as chips and pretzels, that are marked ‘low sodium’ or ‘no-saltadded’ – or rather have a carrot or celery stick instead S odium in soy sauce, ketchup, salad dressings and seasoning packets can add up. Choose ‘lite’ or ‘reduced sodium’ soy sauce and ‘no-salt-added’ ketchup/ tomato sauce, add oil and vinegar to a salad rather than bottled salad dressings and use only small amounts of seasoning from flavouring packets instead of the entire packet

 A sk to see the nutrition information in restaurants and choose a lower sodium option.

Source: www.heartfoundation.co.za; www.cansa.org.za

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In the know

THINGS TO DO BEFORE 9AM Try wakeand little up a to liveearlier, more a little these with f habit ive s:

Mornings are a madcap time for many of us but these early hours are significant in accomplishing things in your day – after all – early mornings are when you have the most control of your priorities.

ise and shine beautifully – it is a glorious day filled with infinite possibilities. Don’t believe me? It is true. Sure, we cannot control what happens throughout the day, but we can certainly control what we do before the day begins. Getting up early might be a challenge to you, maybe not... Whether you are an early bird or a roll-over-and-hit snooze kind of person, there is real beauty in having a carpe diem type of attitude towards your morning routine. Understandably, this may not apply (nor appeal) to everyone – mothers or shift workers out there cannot necessarily spend their mornings the same way. But even on a day off – if you get one – try and wake up a little earlier, to live a little more with these five habits: 1. Go to bed early – prepare for an early start There is nothing worse than getting up at the crack of dawn with only a few hours of sleep under your belt. Make sure you tuck yourself into bed early and set your alarm (with a cute message to yourself for extra motivation). Allow enough time for your morning rituals before your working day begins. 2. A bit of endorphins goes a long way If your early morning allows two to three hours to do whatever pleases you, take it. For some, it may be setting out for a morning run, or it may include a morning meditation. Engaging in an activity that will give you the gift of endorphins, or an exercise that works your muscle, is an ideal way to begin your day with a positive perspective and added energy. Say hello to a brighter, more productive you.

Issue 05 | 2014

3. Have a little ritual It’s always nice to have your ‘thing’ you do each morning. Maybe it’s cooking your kid’s pancakes, tending to your flourishing herb garden or if you’re creatively inclined, writing like a mad woman in your journal. This will get you excited to take on the day and will add a special touch to your morning time.

Jumpstart your life before the day has even begun!

4. detox Technology Try not to check your emails, Instagram, Facebook, Twitter – the whole lot – until you’ve indulged in your rituals. Waking up and latching onto technology is not the best way to start your day. It’s also easy to get sucked into the vortex, only to resurface hours after a social media scrawl. We suggest, once you’ve spent some time doing whatever it is you choose, only then think about diving into your phone. For some, the perfect time for checking emails is whilst they’re sipping on their morning coffee, or when they have completed all of their rituals. It’s totally up to you. The key? Stay away… at first.

5. & savour every bite Nourish Naturally, this is a given in our eyes. For many of us who used to be a breakfaston-the-go (does coffee count?), or worse, no-breakfast-at-all type of person. We can attest to the fact that we’re a hundred percent reformed. Breakfast is now a sacred time – an opportunity to eat our overnight oats, green smoothie or pancakes and enjoy every last bite. To nourish is to flourish, and ensuring we fuel our bodies with the good stuff is our secret weapon to performing and being our best. Now, we know it may be challenging at first, especially if you’re a morning rusher, however, we encourage you to see your mornings in a new light. Get up an hour earlier, to live an hour more. Of course, don’t feel compelled to adhere to our rituals. Why not create your own?

CREATE YOUR OWN MORNING RITUAL 

Rise and shine

 Writing in a gratitude journal - listing

 Make a batch of green juice that will

five things, then work your way up

last you a few days

 Sending a loved one a text

 Stretch

message, just because…

 Making two healthy breakfasts – one for you, one for…



6. 

Scour the web for inspiration

 Pick a word of the day – expand your

Floss your teeth

vocabulary

 Take five and visualise how you

 Post something inspiring on your social

would like your day to pan out and what you want to achieve

media, perhaps you’ll inspire others too

 Do a crazy dance in your living room 

Read your favourite blogs

 Practise affirmations in the mirror…

Pack your lunch

“I am beautiful”, “All is well in my world”, “Today, I am brimming with energy and overflowing with joy”

 Plan your day with to do list from most important, to least important

Hopefully this will inspire you to re-think your morning routine and jumpstart your life before the day has even begun. We all have different schedules, so fit in whatever you can. It’s all about creating the right rituals that work into your life – you write your own rules!

Source: Images and gym wear: www.lornajane.co.za

In the know

ST P Smoking by numbers

What happens inside our bodies after we stub out that last cigarette is quite interesting – in fact – mind-blowing, and even after years of smoking, quitting can still be beneficial and make a difference. The human body is amazingly resilient and within minutes, drastic changes take place.

hese are just a few of the benefits of quitting smoking for good. It lowers the risk for diabetes, improves the functioning of blood vessels, the heart and lungs. Quitting while you are younger will reduce your health risks more, but quitting at any age can give back years of life that would otherwise be lost if you continue to smoke.

Source: www.cansa.org.za

benefits Quit smoking NOW and see why.  20 minutes after quitting the healing process begins and your heart rate and blood pressure drops  12 hours after quitting the carbon monoxide level in your blood drops to normal  2 weeks to 3 months after quitting circulation improves and your lung function increases  1 to 9 months after quitting coughing and shortness of breath decrease; cilia (tiny hair like structures that remove mucus from the lungs) start to regain normal function in the lungs, increasing the ability to remove mucus, clean the lungs, and reduce the risk of infection  1 year after quitting the excess risk of coronary heart disease is half that of a continuing smoker’s  5 years after quitting the risk of cancer of the mouth, throat, esophagus and bladder are cut in half and cervical cancer risk falls to that of a nonsmoker  1 0 years after quitting the risk of dying from lung cancer is about half that of a person who is still smoking; the risk of cancer of the larynx (voice box) and pancreas decreases  1 5 years after quitting the risk of coronary heart disease is that of a non-1smoker  2 5 years after quitting the stroke risk can fall to that of a non-smoker

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

Does your arthritis treatment 2: •

Reduce your symptoms?

•

Allow you to stay active?

Ask your doctor for the new medication from AstraZeneca for the symptomatic relief of osteoarthritis, rheumatoid arthritis and ankylosing spondylitis.

KEEP MOOOVING