Healthy Times May 2016 Edition

MENTAL WELLNESS

COLDS AND FLU

FAMILY HEALTH

AGEING WELL MAY 2016

GET A HANDLE ON HEADACHES

When to be concerned

DIABETES Time to change our

IT’S YOUR BODY

Take an active role in your healthcare

attitude to getting tested

Muvhango’s

GABRIEL TEMUDZANI talks

fitness, food and family

6

FOODS THAT COULD BOOST YOUR IMMUNE SYSTEM

TOO BUSY FOR GYM?

Get a good workout at home

contents

MAY 2016

38

34 4

FROM THE EDITOR

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COVER FEATURE Working out at home

12

PROFILE Muvhango’s Gabriel Temudzani talks fitness, food and family

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HEALTHY WINTER Fight colds and flu

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SUPPLEMENTS The vitamins and minerals we need for good health

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HEALTHY EATING The art of mindful eating

26

AGEING WELL What you can do today to stay vibrant and healthy as you age

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34

HEALTHY BODY Breast-cancer risk, screening and beating the odds

38

HEALTHY FINANCES Make your medical aid work for you

47

HEALTHY YOU How to be a good patient

50

HEALTHY MIND Treating anxiety disorders, depression and burnout

57

HEALTHY FAMILY With busy lives, how can you raise a family that prioritises health?

64

HEALTH FOCUS The dangers of untreated diabetes

68

EVERYDAY HEALTH Headaches and migraines

28

AESTHETIC MEDICINE Men are increasingly feeling career pressure to look younger and fresher

70

HEALTHY PETS Some pointers to taking the best care of your furry friend

33

HEALTHY FEET Ways to ensure that your feet stay healthy

72

HEALTHY RECIPES Simple soups

57

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FROM THE EDITOR

– even in winter

elcome to Healthy Times. We’re excited to be bringing you a magazine packed with health information for the whole family.

It’s a little easier to stay healthy in summer – there’s a lot of active fun to be had in the sun, and we’re more inclined to tuck into a big salad instead of heavy comfort foods. And winter is really when we start to feel the effects of colds and flu. So to give you the best chance of a flu-free winter, we’ve put together some hints and tips on page 15.

It’s also the time of year when your medical aid savings balance starts to look a little low and that self-payment gap begins to loom. It might be a little late for us to help you this year, but we’ve put together a comprehensive guide on how to get the most out of your medical aid, how to make it last, and how to really use those rewards programmes to your best advantage. You’ll find it on page 38.

With the alarming increase of Type 2 diabetes worldwide (see page 64), we know how important it is to parents to ensure that their children grow up to be as healthy as possible.

With that in mind, we have some ideas about how to keep the whole family healthy, on page 57. And just in case you aren’t getting all of the nutrients you need from your diet, we’ve spoken to local and global experts about what supplements you should be taking, and why.

To give you the best chance of a flu-free winter, we’ve put together some hints and tips.

There’s really something of everything in this edition of Healthy Times – from a bit of glitz and glamour with cover star Gabriel Temudzani from Muvhango (page 12) to a story of triumph over breast cancer (page 34), as well as everything you need to know about this devastating disease.

Here’s to your healthiest winter yet, with a little help from us at Healthy Times.

Mandy Collins Editor

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SALES Project Manager: Roman Ross romanr@picasso.co.za Tel: 021 469 2498 Sales Consultants: Jay Deary, Merryl Klein, Alec Rompelman, Yoliswa Stivin Advertising Co-ordinator: Vanessa Payne Copy Editor, Advertorials: Lynn Berggren Design Intern: Nichole Liedeman PRODUCTION Production Editor: Shamiela Brenner Distribution: Shihaam Adams subscriptions@picasso.co.za Tel: 021 469 2523 Printing: Paarl Media Gauteng MANAGEMENT Senior Bookkeeper: Deidre Musha Business Manager: Lodewyk van der Walt General Manager, Magazines: Jocelyne Bayer Published by

Times Media Building Central Park, Black River Park Fir Street, Observatory, 7925 Tel: +27 21 469 2400 Fax: +27 86 682 2926

Disclaimer While every effort has been taken to ensure that the information in this publication is sound, it is expressly not designed to diagnose or treat a medical condition or health problem. The information does not constitute medical advice. It is also subject to personal interpretation and may become dated or obsolete. The publisher, editor, authors and their employees or agents, therefore, cannot accept responsibility for the information in this publication or for any errors, omissions or inaccuracies contained therein, whether arising from negligence or otherwise. They are therefore not liable for any direct or indirect effects of the information. Please consult a qualified healthcare practitioner regarding any medical or health issues.

Copyright: Picasso Headline. No portion of this magazine may be reproduced in any form without written consent of the publishers.

The publishers are not responsible for unsolicited material. Healthy Times is published by Picasso Headline Reg: 59/01754/07. The opinions expressed are not necessarily those of Picasso Headline. All advertisements/advertorials and promotions have been paid for and therefore do not carry any endorsement by the publishers.

Image: Cobus Bodenstein

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KEEPING HEALTHY

EDITORIAL Editor: Mandy Collins Art Director: Janine Wait Copy Editor: Joy Capon Contributors: Louise Ferreira, Georgina Guedes, Penny Haw, Cath Jenkin, Nia Magoulianiti-McGregor, Zaza Motha, Amanda Ngudle, Libby Peacock, Phindi Sibiya Cover image: Christoph Hoffmann

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With a heritage dating back to 1973, Phoenix House Addiction Rehabilitation Centre has a long-standing reputation for their effective work with addicts and alcoholics.

No longer a part of the NPO SANCA, Phoenix House is under new management, offering private, affordable in-patient treatment for substance abuse.

The authentic 1933 building in Martindale, which is 30 minutes from Sandton, has been refurbished, and the renovated residential facilities offer a pleasant yet structured, disciplined and therapeutic environment for people seeking recovery.

Building on the foundation of its established legacy, Phoenix House offers treatment programmes of various lengths, which are based on the Minnesota Model of Care, and incorporate the wisdom of the 12-step recovery programme, which has been greatly successful for the treatment of substance abuse for more than 60 years. Our programmes are all abstinence based, and patients are guided through a process of understanding the nature and extent of their problem, how their unique characteristics create barriers and/ or strengths for recovery, and the importance of relying on a power greater than themselves rather than willpower.

The goals of treatment are: acceptance of being an alcoholic/addict; acknowledgement of a loss of control/powerlessness over the abused substance; and adherence to abstinence. www.phoenixhouse.co.za

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For more information and orders, including free delivery to your door, visit www.nutribullet.co.za or call 0861 777 997. Recommended selling price: R2 495

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AFRICA HEALTH Africa Health is the continent’s largest healthcare exhibition and medical conference. Due to industry demand, Informa Life Sciences Exhibitions launched the inaugural Africa Health Exhibition and Congress in Johannesburg in May 2011, and since then, the show has grown from strength to strength.

The 2016 event is expected to be the largest to date and will attract more than 7 000 healthcare professionals, and will play host to more than 500 of the world’s leading healthcare suppliers, manufacturers and service providers. Alongside the exhibition will be 17 CPD-accredited conferences, which will cover a broad range of medical disciplines, including imaging and diagnostics, internal medicine, biomed, quality in healthcare, public health, patient safety, nursing and ethics.

This general medical exhibition aims to attract healthcare professionals in every field to network, share knowledge and engage in business.

The exhibition is free to attend for all healthcare and trade professionals, and the conferences are only charged at R100 per conference (R300 if paying on-site).

COYNE HEALTHCARE Moorings 1 Portswood Ridge Portswood Road V&A Waterfront Cape Town, 8005 Tel: 021 421 9144 Email: info@coynehealthcare.co.za

Go to www.africahealthexhibition.com or contact africahealth@informa.com or +27 10 500 8145 for more information.

Public Health

PUBLIC HEALTH ENHANCEMENT FUND

The overwhelming quadruple E n h a n ce m e n t F u n d WO R K I N G TO GE THE R TO E N HA N CE HE A LTH burden of disease in South Africa is something that no single sector, public or private can successfully address on its own or working in isolation from each other. Aiming to establish a social compact in healthcare, the Social Compact Forum (SCF) and the Public Health Enhancement Fund (PHEF), were launched in 2012. This is a compact between the Minister of Health, Dr Aaron Motsoaledi and 22 Private sector healthcare and pharmaceutical companies. The SCF interacts with the Minister of Health, whilst the PHEF acts as its financing instrument, executing three jointly agreed projects, all of whom are intended to boost human resource capacity in public health. The PHEF collects and disburses funds for the benefit of three transformative healthcare projects. These projects include financial support for Masters and PhD students who pursue research into HIV/AIDS and TB. Thus far, 57 Masters and PhD students have been enrolled through the MRC and five have graduated. This is set to significantly boost our country’s research capacity in coming years. The second project aims to increase the intake of medical students across the country by funding 100 medical students.

All students have to originate from rural-based communities, with an intention of them returning to rural communities once they qualify. This is an effective way of ensuring medical services in those communities where health services are most needed. The third project involves funding of the health leadership academy, which sets out to boost management capacity at health institutions. For more information on the PHEF and its partners, visit www.phef.co.za.

NOVO NORDISK At Novo Nordisk, we are driving change to defeat diabetes and other serious chronic conditions. Novo Nordisk is a global healthcare company with more than 90 years of innovation and leadership in diabetes care. This heritage has given us experience and capabilities that also enable us to help people defeat other serious chronic conditions: haemophilia, growth disorders and obesity.

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HEALTHY TIMES l 7

advertorial

largest healthcare event in africa to focus on

collaborative innovation

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From 8-10 June 2016, regional and international healthcare professionals and medical experts will gather at the sixth annual Africa Health Exhibition and Congress, taking place at the Gallagher Convention Centre in Johannesburg

olving Africa’s biggest healthcare challenges requires a collaborative approach between governments, healthcare professionals and specialists, as well as with industry leaders who continuously launch new techniques and technologies into the market. This year, the Africa Health Exhibition and Congress aims to overcome the continent’s health problems by fostering collaboration between the various stakeholders.

Hosted by Informa Life Sciences Exhibitions, the Africa Health event is the continent’s largest healthcare exhibition, and is the ultimate platform for healthcare professionals and medical experts across Africa to share their insights into addressing the continent’s specific healthcare needs, while staying updated on the latest developments in medical science.

The event is expected to attract more than 7 000 healthcare professionals, and will play host to more than 500 of the world’s leading healthcare suppliers, manufacturers and service providers. More than 160 regional and international presenters will speak at 17 CPD-accredited conferences over the duration of the congress.

Delegates will also be turning their attention to some of the continent’s deadliest diseases, with a specific focus on new solutions.

Other topics include: digital healthcare (strategies for navigating the changing technology landscape); initiatives to promote access to affordable healthcare in various African regions; emerging healthcare trends; and innovations and solutions to providing quality healthcare on the continent.

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The Africa Health Exhibition and Congress will host distinguished local and international speakers and industry leaders, including: • Dr Jide Idris, commissioner for health, Lagos State Ministry of Health, Lagos, Nigeria; • Haruna Jibil, deputy permanent secretary, Botswana Ministry of Health; • Dr Gerald Gwinji, permanent secretary, Ministry of Health and Child Care, Ministry of Health Zimbabwe; and • Prof Melvyn Freeman, director, Department of Health, Johannesburg, South Africa.

According to Jamie Hill, director at Informa Life Sciences Exhibitions, the event will focus on some of the major healthcare challenges faced by developing countries in Africa,

AFricA HeAltH 2016 conFerence list

such as maternal health, non-communicable diseases, controlling disease outbreaks, and telemedicine and the role it plays in Africa, amongst others.

The exhibition will host the industry’s leading companies from more than 34 countries. Numerous sponsors and exhibitors promise to update delegates and visitors on the latest advancements in medical technology, which in turn could be used to tackle some of the healthcare issues that plague Africa.

Managing director of Dräger South Africa (Pty) Ltd, Marius Fourie, says: “Dräger is proud to participate again at Africa Health and to be a Gold Sponsor of the event. It’s the right platform for us to show our latest innovations and solutions to the African market. We’re looking forward to fruitful discussions during the three days of the show.”

The exhibition is free to visit for all healthcare and trade professionals, and provides the perfect platform for healthcare peers to network and exchange ideas on how to take African healthcare to the next level.

“The health sector in Africa has realised that a new strategy and approach is needed,” Hill adds. “Ultimately, the goal is to maximise value for patients by ensuring that the best

health outcomes are achieved at the lowest possible cost. Our aim is to position Africa Health as a platform for African healthcare professionals and medical specialists to share their expertise on some of the latest healthcare trends, as well as working towards solving some of the continent’s greatest healthcare problems.”

• Quality management Conference – 8 June • Gastroenterology Conference – 8 June • emergency medicine and eCG Conference – 8 June • medical managers Conference – 8 June • total Radiology Conference – 8-9 June • Public health Conference – 8-9 June • hospital Build Conference – 8-9 June • Decontamination and sterilisation (CssD) Conference – 8-9 June • Wound Care Conference – 9 June • internal medicine Conference – 9 June • health technology assessment Conference – 9 June • healthcare management Conference – 9-10 June • Nursing Conference – 10 June • Patient safety Conference – 10 June • south african Preventive medicine Conference – 10 June • Clinical engineering Conference – 10 June • ethics, human Rights and medical law Conference – 10 June all proceeds collected from the conferences will be donated to the ChOC Childhood Cancer Foundation south africa. Conferences are only R100 each to attend if you register online beforehand, or R300 if you register at the event.

The event will focus on some of the major healthcare challenges faced by developing countries in Africa.

PArtners Africa Health is supported by the Clinical Engineering Association of South Africa (CEASA), Public Health Association of South Africa (PHASA), Southern African Health Technology Assessment Society (SAHTAS), Academy of Nursing South Africa (ANSA), Alliance of South African Independent Practitioners Associations (ASAIPA), Association of Private Health Facilities in Tanzania (APHFTA), Burundi Healthcare Federation, CSSD Forums of South Africa (CFSA), East Africa Healthcare Federation (EAHF), Eloquent Learning Health, Infection Control Society of Southern Africa (ICSSA), International Federation for Medical and Biological Engineering (IFMBE – Clinical Engineering Division), Kenya Healthcare Federation, Rwanda Healthcare Federation, SA Federation for Mental Health, South African Public Health Medicine Association (SAPHMA), South African Society of Medical Managers (SASMM), Uganda Healthcare Federation (UF) and the Gauteng Tourism Authority.

For more information on Africa Health, or to register, visit www.africahealthexhibition.com or contact the organisers directly on africahealth@informa.com or +27 10 500 8145.

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COVER FEATURE: WORKING OUT

It’s too cold and dark in the morning to go for a run, and you’re too busy to get to the gym…

Phindi Sibiya finds out what you need to get a good workout at home

NO EXCUSES

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eeping in shape, working out, exercising ... it’s rare to witness someone’s eyes shine with delight at the thought. And with the mercury dropping, it’s bound to be difficult to ditch the electric blanket at 5am for your daily jog.

But you may not need to. Johannesburg fitness instructor Denie Matsiela says you need only a good 30-45 minutes of working out in the comfort of your living room, all while catching up on recorded episodes of your favourite TV series.

To work out effectively at home, you’ll need some exercise equipment (look for something that will work well without clogging up your living room). What you buy will depend on your needs, so don’t just go for the first thing you see on TV – get some advice.

Have a chat with a salesman who knows his stuff, so he can recommend the right product, or get advice from an exercise expert.

Personal trainer Jamie Stuart says it’s important to keep in mind which areas of your body you want to target, and what your goals are. Do you want to lose weight, maintain it or tone up? “If you want to tone up, you may want to look into purchasing a treadmill or bike,” says Stuart. If you’re looking to build muscle, you might need free weights.

Have a chat with a salesman who knows his stuff, so he can recommend the right product, or get advice from an exercise expert. And if you have small children, you need to take safety into account and ensure they don’t have access to your equipment.

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Below are a few ideas of what to look into, with some exercises from the trainers.

DUMBBELLS:

These are short bars with a weight at each end, used typically for exercise and/or muscle-building. Besides being relatively inexpensive, they are a great muscle-toner and are very compact. And they’re not just for building the arms, Stuart says; you can use them to build leg muscle too.

To do this, hold one dumbbell in each hand, stand on your toes and lower yourself to a normal standing position. This works the calves. You can do this one leg at a time or both at the same time. Stuart suggests two to three sets of about 20 repeats.

INDOOR TRAINING BICYCLE:

This is a great space-saver, as it can be stored against the wall after use. Some are even foldable and can be packed away in a cupboard. They come in different shapes and sizes. And if you already have a road bicycle, you can convert it into a stationary trainer with a device that holds the back wheel.

PILATES BALLS:

These large balls, used properly, can target core muscles, which are essential for stability and good posture. They are usually teamed up with dumbbells. There are dozens of ways to use the ball. Here are three: 1. The ball sit-up: This targets the abdominal muscles, but also allows you to exercise your hip muscles. Lie on the ball, with your lower back on the ball and your knees bent, feet flat on the floor. Place your hands behind your ears. Raise your upper back, pause and lower it back down. Breathe out when contracting your abdominal muscles, and breathe in when returning to the starting position.

2. The one-legged ball squat: This targets your buttocks and quadriceps.

It also stabilises the muscles in your thighs. Place your exercise ball between a wall and your lower back, with a large portion of the ball against your pelvis. Position your feet so that you can lower yourself into a sitting position and still keep your knees at a 90-degree angle.

Now lift one leg off the floor and bend the other knee to 90 degrees, keeping your knees over your ankles, and inhale. The ball will roll up your back as you bend your knee. Exhale and pull your abs towards your spine, and straighten the left knee, coming up to a standing position. Swap legs. Do 10 reps on each leg for two to three sets.

3. The ball table top: This workout focuses on your chest, shoulders and back muscles. Kneel next to the ball, placing your forearms on top of the ball, with your back straight. Raise your knees from the floor and straighten out until your legs are fully extended. Take a short pause, and return to the starting position. Remember to keep your back straight throughout – and just do as many as you can. This is a tough exercise, so build up slowly.

Images: ©iStock.com/bluestocking/ gchutka/gpointstudio/PeopleImages/Yuri_Arcurs

If you are time-stressed or struggle to fit exercise in, there are some great exercise apps that you can load on your smartphone or tablet.

RESISTANCE BANDS:

These rubber bands come in a variety of sizes, lengths, shapes and colours, and don’t take up any space. Here are some ways to use them: 1. The front squat: Stand on the band, your legs slightly apart. Holding the ends, pull the band up to each shoulder. Sit straight down with your chest out and abs firm, as if sitting on an imaginary chair.

Ensure your knees stay over your toes. Slowly straighten up again and repeat up to 10 times.

2. Lateral band walk: Tie the band into a loop and step inside it, with the loop around your ankles. Now, put your feet slightly apart to create some tension on the band. Next, half squat, then walk forward, left and right, keeping the tension on the band. Eight to 10 steps should do.

3. Seated abduction: Sit on a bench or chair; tie the band into a loop and put it around both legs, just above the knees. Place your feet slightly wider than your shoulders and press knees out, turning your feet in as your legs move apart. Hold for two seconds and bring your knees back together. Do this at least 15-20 times.

Matsiela is quick to point out that exercising first thing in the morning doesn’t give you the immediate right to wolf down fried bacon and eggs. “Have some oatmeal and fruit. Or some wholewheat toast.

Balance that out with some fibre-rich cereal.”

And then, when it’s cold outside, ditch the afternoon cravings for a rich lamb shank stew in favour of a protein shake. “It’s like a meal replacement, so you won’t starve. And in the evening you can have your greens and some fish, for example.” He advises, however, that those who need help to eat healthily should consult a registered dietician. “It’s important to consult the professionals, because what works for you may not work for the next person.”

If you are time-stressed or struggle to fit exercise in, there are some great exercise apps that you can load on your smartphone or tablet, such as the seven-minute workout. They may not be perfect, but they are better than doing nothing, and they can be a good way to kickstart a more rigorous exercise programme.

Anelise Brown, who is a self-confessed fitness freak, says the sevenminute workout really worked for her. “I still prefer my rigorous daily workouts at the gym, though,” she says. Karabo Mdluli, who works at a hair salon in Melville, said he tried it once. “I wasn’t entirely impressed, but I wasn’t disappointed either.”

Whatever you decide to do, it’s important that you don’t use winter as an excuse to become a couch potato.

And remember – always – to consult your doctor before you start any new exercise programme. It’s a good idea to book a single session with a personal trainer too, just to check that you are doing the exercises properly, and won’t injure yourself.

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SU P RP O PF LI LEEM E N T S

POWER Muvhango’s Gabriel Temudzani talks to Phindi Sibiya about building bodies

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glory

abriel Temudzani plays the powerful Azwindini Mukwhevo, the Chief of Thathe, on SABC2 flagship drama Muvhango.

However, it’s not just his on-screen presence that commands viewers to tune in daily at 9pm. Or his habit of twirling his phone in his hand when it rings.

The growth of Gabriel Temudzani’s female fanbase over the past few months has been ascribed, in no small part, to his enviable physique.

He assures us it is not the result of steroids. “You notice a man who works out, firstly, through his arms and chest. So, the tricep machine does it for me,” says Temudzani.

He credits his toned body to a four-days-a-week workout at an undisclosed gym, and jogging with his wife, Refilwe, when he’s not shooting. “I have a heavy working schedule, so it gives us time to connect and bond,” he says. “It’s not just a lifestyle, but a collective effort. And it’s more encouraging to have a jogging partner, as it motivates you.”

Temudzani says he doesn’t stick to one routine. “I try my best to balance my exercises, so that I work on my entire body, but I focus mostly on my legs, triceps, biceps and abs. I then follow up with a 20-minute run on the treadmill.”

He adds, however, that at times he pushes the boundaries, working out for between an hour and an hour-and-a-half – all while attempting to ignore fans snapping away on their smartphones and wanting to talk.

He smiles. “It has become the norm. It can be rather distracting, but I’ve learned to take it in my stride.”

Commonly held health advice is that building a good, healthy body is based 75% on food and 25% on the exercise you do – a guideline our cover guy doesn’t seem to follow very well.

“While I’m fully aware that what you put in your body is important, I eat almost everything. It’s not entirely by choice, but it’s not always easy to spot a turkey-on-rye sandwich while you’re on the road, which is something I have to do a lot.”

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Image: Christoph Hoffman

It’s not just a lifestyle, but a collective effort.

SA HEALTH & FITNESS EXPO (SAHFE) 2016 CTICC 5-7 AUGUST 2016

We are excited to announce that SAHFE 2016 will be taking place at the Cape Town International Convention Centre for its second year running!

Due to popular demand from sponsors, exhibitors and visitors, we will be growing the expo to include three halls, totalling 6500m2, two stages, an outdoor space, clearly demarcated zones featuring various categories, and a huge activity area with interactive sport, health and fitness workshops and classes.

For further information, contact olivia_green@sahfe.co.za or visit www.sahfe.co.za

JOIN THE MOVEMENT BECOME AN EXHIBITOR!

HEALTHY WINTER

FIGHT COLDS AND FLU Winter means colds and flu, but there is a lot you can do to keep yourself healthy. Healthy Times has rounded up some essential information for you to arm yourself against illness this winter

6 FOODS TO BOOST YOUR IMMUNE SYSTEM The old adage “prevention is better than cure” applies to colds and flu as much as to anything else. Eating a healthy diet, especially one that contains immuneboosting foods, can help you to put up better defences against colds and flu.

Here are six foods to add to your winter table: 1. Mushrooms are packed with selenium, a mineral, as well as two vitamin Bs: riboflavin and niacin. All three play an important role in keeping your immune system healthy.

Images: ©iStock.com/Kadir Barcin/Laser222/Ugurhan Betin

2. Oysters contain zinc, which has been shown to have virus-fighting powers, probably because zinc helps to create and activate white blood cells involved in the immune response.

3. Watermelon might be hard to find in winter, so keep it in mind the next time you have a summer cold too. When it’s ripe, it contains an antioxidant called glutathione that helps you to fight off infection. Glutathione is highest in concentration in the pulpy, red flesh near the rind.

IS IT THE FLU OR JUST A COLD?

We love to tell people we have the flu, but, most commonly, it’s just a cold or an upper respiratory infection.

So how do you know what it is? Experts recommend that you take your temperature.

Colds and flu have many symptoms in common, but a cold will rarely give you a temperature above 37.5°C. Body and muscle aches are also more common with the flu.

4. Wheat germ is the part of a wheat seed that feeds a baby wheat plant, and it’s rich in nutrients. It’s a great way to get zinc, antioxidants and B vitamins into your system. It also contains a good mixture of fibre, protein and healthy fats.

5. Yoghurt with live cultures can ease the severity of a cold, so ensure that you buy a good-quality product, and if you can find one with added vitamin D, even better.

6. Your mother was right – spinach really is good for you. It contains folate, which helps your body to make new cells and repair DNA, and it’s also packed with fibre and antioxidants. It’s best eaten raw or lightly cooked.

H E A L T H Y T I M E S l 15

HEALTHY WINTER

PREPARING FOR THE SEASON

Just like the inoculations you received as a child, the flu shot is a vaccination, and it protects you from the three or four flu viruses that are most likely to make you sick during that year’s flu season. It’s not foolproof, but it will arm you against the most serious strains.

Almost everyone over the age of six months should get a flu shot, but some people are in the “more at risk” category and should definitely have one every year: • Children aged six months to five years; • Pregnant women; • Adults over the age of 65; • People with existing health conditions; and • Travellers and people living abroad.

The best time to get the flu shot is in April or May, before winter sets in, but you can still get it later in the year. Most pharmacies will offer flu shots as one of their services, or you can visit your doctor.

The vaccine kicks in after about two weeks, but you can still get the flu, as it will protect you only against three or four strains. However, if you do get sick, there is a good chance you will have a milder form of the illness.

Finally, it’s a myth that you can get the flu from the flu vaccine. But you may experience sideeffects that mimic cold or flu symptoms.

Some of these are: • Soreness or swelling at the point of injection; • Aching; • Nausea; and • Slight fever.

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Colds and flu have many symptoms in common, but a cold will rarely give you a temperature above 37.5°C. UNDERSTANDING ANTIBIOTIC RESISTANCE There is a good reason why your doctor is resisting giving you an antibiotic for your flu: you probably don’t need it, and to give you one would add to a global concern around antibiotic resistance. Here’s how it works.

Bacteria are single-celled organisms found all over the inside and outside of the body. Many are not harmful; some are actually helpful – such as those that live in the digestive system. But disease-causing bacteria can cause illnesses.

Viruses, however, are tiny microbes that can’t survive outside the body. They cause illness by invading healthy cells.

Antibiotics fight infections caused by bacteria in both humans and animals.

They do this either by killing the bacteria or making it difficult for the bacteria to grow and multiply. But they have no effect on viruses – and viruses are what cause colds and flu. And when you take antibiotics, either unnecessarily or at too low a dose, or without completing a full course, bacteria start to mutate and adapt, and become resistant to those antibiotics. You effectively start to create superbugs.

Antibiotic resistance has been called one of the world’s most pressing publichealth problems. It can cause illnesses that were once easily treatable with antibiotics to become dangerous infections, prolonging suffering for children and adults – multidrug-resistant tuberculosis is one example.

To help to fight antibiotic resistance, ask your doctor if there are things you can do to get better without using antibiotics. If you do need to take them for a bacterial infection, take them exactly as you are instructed. Don’t ever skip doses or stop taking them early, unless instructed to do so by your doctor. And never pressure your doctor to prescribe one for you.

Sources: WebMD, The Mayo Clinic, US Centers for Disease Control

Images: ©iStock.com/Daniel Loiselle/Sezeryadigar

THE FLU VACCINE: WHAT IS IT?

As the days shorten and the nights begin to get cooler, most of us know that colds and flu are probably lurking. The cold weather itself doesn’t cause us to get ill, but it may play a role, because we spend more time indoors, which means we’re in close contact with other people who infect us.

Changes in humidity can also be a factor, especially when the humidity is low. And the cold weather makes the lining of the nose drier, which makes it more vulnerable to infection by a virus.

Most colds and flu require three things: rest, fluids and symptomatic treatment. Because they are caused by viruses, not bacteria, an antibiotic is not required.

And most will last seven to 10 days, but if they last longer, or your mucus goes from being clear and runny to being thick and yellow or green, it’s time to see the doctor. Sometimes you get a secondary bacterial infection in your lungs, sinuses or ears.

Then you may need antibiotics.

And remember that one of your best defences against contracting colds and flu is to wash your hands regularly, particularly after they’ve been in contact with high-traffic areas such as handrails, doorknobs and supermarket trollies.

supplements

Don’t compromise on Food is a vital source of energy and wellbeing, but often we don’t get the essential vitamins and minerals we need, and in sufficient quantities, even if we’re eating a fairly balanced diet. Zaza Motha finds out which vitamins and minerals we need for good health

Images: Shutterstock; supplied

d

espite your very best efforts, it is impossible to consume enough food in order to meet our daily nutritional requirements.

So says Patrick Holford, one of the world’s leading nutritional health experts. “Most people don’t realise that our ancestors, before cars and fridges were invented, were getting way more nutrients from their diet than we do today,” he says.

Holford points out that the food they ate was whole and organic, as refined foods had not been invented yet. “But the biggest reason was simply because they ate a lot more,” he says. “They had to. All of their life consisted of physical work – collecting water and firewood – and they didn’t have modern conveniences.

More calories were burnt, which means more food was eaten. Today we are so sedentary, we just can’t eat enough to get enough vitamins and minerals.”

nutrition expert patrick Holford says a healthy diet is no guarantee you’re getting all the nutrients you need.

Dietician Celynn eramus recommends you do your own research and be responsible for your own health.

Our ancestors, before cars and fridges were invented, were getting way more nutrients from their diet than we do today.

A bAlAnced diet is not enough

But what if you take good care to ensure that you eat a balanced diet? holford says it’s no guarantee of getting all of the nutrients you need. First, he says, the chances of your diet meeting all of the recommended Daily amounts (rDas) is very slim. “second, ‘need’ is so subjective. third, few know what a well-balanced diet is, and fewer eat one,” he explains. “europe’s rDa for vitamin D is 5mcg, while the average woman in the UK achieves 2.6mcg, about half,” notes holford. “the average woman also falls short of the rDa for iron (11.2mg vs rDa of 14mg), magnesium (226mg vs rDa of 375mg) and zinc (7.6mg vs rDa of 10mg).

h e a l t h y t i m e s l 19

supplements

the solution, therefore, is to take a vitamin and mineral supplement – and there is a dizzying array on the shelves to choose from.

Celynn erasmus, a south african registered dietician and co-author of The F+A+B Quotient (Fuel, activate, Behave), describes a supplement as “a natural or nature-identical food component that is made into a tablet, capsule, syrup or drink. Vitamin and mineral supplements are used with the specific intention of increasing the daily vitamin and mineral intake.” and it’s vital that you choose a supplement that works best for your needs, ensuring that you are getting not just vitamins, but minerals too.

Vitamins are essential not only for our survival, but for our wellbeing. holford nutrients

rDa

Gla* ( 6) (mg) – ePa/DPa/Dha* ( 3) (mg) – Calcium (mg) iron (mg) magnesium (mg) Zinc (mg) iodine (mcg) selenium* (mcg) Chromium* (mcg) manganese* (mcg) Key Average Diet Good Diet Shortfall

800 141 300 15 150 – – –

explains: “the right amount can not only prevent disease, but reverse it. magnesium (300mg a day) lowers blood pressure, chromium (500mcg) controls diabetes and vitamin C (1g an hour) stops viral infections.” so how do you choose? erasmus recommends considering the following points before taking a multivitamin supplement.

“First, never diagnose yourself. Consult a registered dietician or health professional for advice. second, choose a well-known brand or reputable manufacturer. “third, do your own research and be responsible for your own health. make sure that the product you consume is backed up by credible scientific research. and finally, continually review your need to take supplements.”

100% rDa

20 60 (800:Good Diet) 12.8 272 9.3 10 40 50 3

oDa

400 15

50

50 912.5 350 193.5 70 6

240

shortfall 50 shortfall 600

100 1000

shortfall 200 shortfall 5 shortfall 150 shortfall 10 shortfall 60 shortfall 50 shortfall 30 shortfall 4

1000 20 500 20 300 100 100 10

RDA = Recommended Daily Allowance ODA = Optimum Daily Allowance (diet plus supplements) * Items marked with an asterisk have no RDA Includes Vitamin D created by 20 minutes sun exposure per day.

More Vitamin D may be needed in winter.

how Diets compare This chart shows the levels of minerals and essential fats the average diet – and a good diet – can provide. You can also see how they deliver in terms of the RDA (the government’s recommended daily allowance) – and how both fall short of the ODA (optimum daily allowance) that’s needed for optimum health.

The shortfall is worth supplementing.

Don’t be average when it comes to your health “In order to live a fulfilled life with boundless energy, being average or mediocre won’t cut it,” says Holford. In 1984 he founded the Institute of Optimum Nutrition, and the first question he asked was: “Which intake of each nutrient equates to the maximum possible wellbeing?”

On further investigation into the effects of vitamins, minerals and essential fats on everything from IQ , memory, energy, immunity and lifespan to pregnancy, he came up with what he calls Optimum Daily Allowances (ODAs).

The ODAs are often 10 times the standard RDAs, which reflect only the minimum level of nutrients required to prevent obvious vitamin deficiencies such as scurvy (vitamin C), beriberi (vitamin B1) and pellagra (vitamin B3). The ODAs focus on optimum health rather than minimal nourishment, says Holford.

The ODA chart illustrates the disparity between ODAs and nutrients provided by a standard diet (black bars). There is a shortfall in nutrients provided by a healthier diet with whole foods, fruits and vegetables (grey bars), which fails to meet the ODAs for each nutrient. “That’s why I’m convinced of the essential role of supplements to top up the shortfall in nutrients from the diet,” says Holford.

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life stages: supplement accorDingly Your nutritional needs also change as you age, so if you’re eating and supplementing with the same things all your life, you might be getting too much of one thing and too little of another.

“The older you get, the more you need, because the body and the digestive tract are less efficient,” says Holford. For example, two in five people over the age of 60 do not absorb enough vitamin B12 (from meat, fish, eggs and milk) to prevent premature brain shrinkage. The most important nutrients to increase as you age are B vitamins and antioxidants.

“For example, when I was younger I took 1 000mg of vitamin C. Now I take 2 000mg daily,” says Holford. “By the way, a gorilla in a fruit-rich jungle can eat almost that. We live in concrete jungles and struggle to get 100mg.”

When you are short on nutrients, your body will channel nutrients to the essential life-support functions, he explains. “When you’re young you can get away with ‘sub-optimal nutrition’, but insidiously, you are ageing faster. You can tell how fast you are ageing by measuring your telomere length. When we make a new cell, we have to copy the instructions contained in the spiral chromosome that files our DNA. At the end of the chromosome, much like the hard bit of a shoelace, is the telomere.

With every cell copy, the telomere length gets shorter. When you run out of telomere you die. It is the most accurate measure of how long you’ve got.

“According to Nobel prize-winner and professor Elizabeth Blackburn (University of California), you can lengthen your telomeres this way: the higher your B vitamins, omega-3s, vitamin D, and the lower your homocysteine level, the longer your telomeres. Supplement-takers consequently have longer telomeres.”

The other myth is that you can “overdose”, he says. “I have trained over 5 000 nutritional therapists. Collectively, we have treated over 100 000 people. I have never seen an overdose. The most you are likely to get is loose bowels, if you have too much vitamin C. For many people that is a benefit.

“One is also advised not to have too much vitamin A, but the only death that has occurred was from a man eating a polar bear’s liver. The American CDC (Centers for Disease Control) has been monitoring mortality for decades. None has been reported linked to vitamin supplementation.”

The bottom line is that everybody is different – and every body is different – so if you are concerned that you might be falling short of good nutrition, it’s worth consulting a dietician, who will be able to assess your diet and give the advice – and any supplements – you might need.

Chart: © Patrick Holford

what is a supplement?

HEALTHY EATING

THE ART from OFjudgment MINDFUL to EATING: compassion

In an age of constant media consumption, the pressure to be young, thin and beautiful can be immense. But are diets worth it? Louise Ferreira looks at a different way of treating your body

Images: ©iStock.com/momcilog/PeopleImages

f

ood has become a battleground. Fad diets and ads on rubbish bins promise a new, slimmer you; magazines and lifestyle gurus lecture on the evils of certain food groups. Deciding whom you should believe can be difficult.

Amid this confusion, mindful eating promises not weight loss – although this can be an added benefit – but a healthier relationship with food and your body. Developed in the early 2000s by Jean Kristeller, an American psychologist specialising in eating disorders, the mindfulness approach is about eating with awareness and attention.

Xenia Ayiotis, an intuitive eating counsellor and mindful eating coach based in Pretoria and Johannesburg, explains: “Mindful eating means not eating and multitasking. It is not eating in front of the TV, in your car, on the go.”

It is not a diet. Quoting author Geneen Roth, Ayiotis says that for every restriction, there is an “equal and opposite binge.

“One of the main reasons why diets don’t work is that they don’t address why you eat when you’re not hungry.

You can follow the rules, but unless you learn what your triggers are to overeat, you’re not going to find a solution.

“I practise mindfulness-based intuitive eating. Intuitive eating is really just listening to your body, tuning into your body signals, paying attention to hunger and satiety cues.

Are you tired? How are you feeling emotionally? What is going on in your mind?”

DIETING AND SELF-ESTEEM

We eat for two reasons, Ayiotis says. “The one is to fuel and nourish our bodies. The second is for the pure pleasure of the experience. It doesn’t help to judge food as good or bad. The minute you eat a piece of cake, you think you’ve blown it. This is typical diet mentality.”

According to RJ Chippindall, a clinical psychologist from Johannesburg who often works with Ayiotis, diets follow a one-size-fits-all approach. “Restrictive dieting doesn’t allow for flexibility and individuality. It sets people up for failure, leading to a vicious cycle in terms of low self-esteem. They feel bad about their inability to stick to something.”

Celynn Erasmus, a registered dietician, author and professional speaker from Johannesburg, adds that people find it incredibly difficult to stick to diets. Yo-yo dieting, in particular, affects your self-esteem. “You feel like a success when the number goes down on the scale, then like a failure when it goes back up again. Eventually you give up.”

The physical consequences of repeat dieting can be severe, she warns. “Dieting can create a certain amount of stress in your life, further adding to stress hormones like cortisol. If you lose a lot of weight quickly, that can shock the body. When you go off the diet, your body goes from starvation to storage mode. Your metabolism thinks a feast is coming and it must store the food in case you fast again.”

Typically, when people gain additional weight after a diet, they gain visceral fat (fat around the middle), she says. This is particularly unhealthy. The constant stress on your metabolism can also increase insulin resistance.

H E A L T H Y T I M E S l 23

healthy eating

compassion for yourself Mindful eating is about non-judgment.

“There are going to be times when you’re eating in front of the TV or rushing through a meal, and that’s OK,” Ayiotis says. “But if you come from a history of dieting, you will beat yourself up over it: ‘I’m doing it wrong, I’m not sticking to it.’ It’s important not to turn mindful eating into another diet.”

One of the steps in the mindful eating process is accepting your body for what it is. “When clients first come to me, they hate their bodies. They find it difficult to grasp that they can’t change something they don’t accept. They think that if they accept their bodies, they won’t change them.”

Chippindall adds: “Initially, it can be very difficult for people to take on board, as it goes so strongly against what they’re used to. It can be very frightening. We tend to be punitive when we make mistakes, and non-judgmental compassion is a cornerstone of the approach.”

The first thing Ayiotis tells her clients is that they’re not going to look at losing weight. “The minute you focus primarily on weight loss, it creates dysfunction with food.”

People can develop disordered eating or a dysfunctional relationship with food for various reasons, but it is often entrenched from a young age, says Chippindall. For example, children are often told to finish their food because other people are starving, or that they won’t get dessert if they don’t clean their plates. This teaches them to ignore their body’s hunger and satiety signals.

Unless you learn what your triggers are to overeat, you’re not going to find a solution.

The current obsession with “clean eating” is also a concern for Ayiotis. “It’s a myth that carrying a bit of extra weight means you’re unhealthy. It’s really not dependent on your size,” she says. For many of her clients, the prime motivator is health, but obsessing about eating healthily is not healthy.

“If you’re stressing every time you eat chocolate or cake, or, God forbid, wheat or pasta, your body tenses up and digestion becomes difficult, plus the body releases cortisol. It is sometimes okay to eat food with zero nutritional value, for the pure pleasure of it. Like a Fizzer, or Doritos. Kale chips will never be a substitute for Doritos! If you feel awesome being vegan or not eating gluten, by all means go for it. But let’s not turn it into another righteous, militant approach to eating.”

Chippindall and Erasmus agree that mindfulness is an effective approach.

“As you listen to your body, you make different choices,” Erasmus says. “You listen to satiety cues. On some days we are hungrier than others, because of a range of factors, including hormones.”

Chippindall points out that a mindfulness approach can have an effect on other areas of your life too. “In workshops we do basic mindfulness practice; we don’t just focus on food.”

Ayiotis has the final word: “Mindful eating is the middle way between restriction, dieting and overeating. It is a kinder, slower, more gentle approach to changing our behaviours and patterns with food and eating.”

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“Mindful eating is eating with intention to care for ourselves and attention to our food. It is eating in the present moment, noticing preferences with no judgment. Mindful eating is being aware of physical sensations, thoughts, feelings and emotions as we eat.” – Center for Mindful Eating

Images: ©iStock.com/STEEX/Yuri_Arcurs

the problem with “clean eating”

AGEING WELL

TO HEALTH, HAPPINESS

and longevity It’s said you’re never too young to age well.

Nia Magoulianiti-McGregor looks at what you can do today to stay vibrant and healthy as you age

Add some spice to your cooking. Many studies show curcumin – an extract of turmeric – has major benefits for both your brain and your body.

Turmeric has been used for centuries in India – which has lower prevalence of Alzheimer’s and Parkinson’s than Western countries – and in Ayurveda and Chinese medicines. Now scientists around the world are studying its properties.

Celia van der Merwe of Stellenbosch University’s Department of Medical Sciences researched curcumin for her PhD. She says adding curcumin directly to Parkinson’s disease cells in a laboratory “substantially improved the conditions of the cells at molecular level”. It also played a “protective” role. Japanese research indicates the spice extract has also been shown to play a beneficial role in Alzheimer’s patients, and research is ongoing.

And while not a cure, researchers have found that curcumin could be helpful in treating painful inflammatory conditions such as tendonitis and arthritis.

26 26 ll Hh Ee Aa LlTt Hh Yy Tt Ii M m Ee Ss

Ageing is as much a state of mind as it is a state of physiology. Lie about your age – especially to yourself.

THINK SHRINK In about 400BC, Greek philosopher Socrates said: “The unexamined life is not worth living.” It still resonates today, says clinical psychologist Yvette Esprey. “Having a basic curiosity about yourself and sifting through psychological baggage in two particular areas – relationships and understanding one’s response to stress – can help us lead healthier lives in older ages.

“If you can learn from, or at least start understanding, what happens to you in relationships, it will help you navigate life. Do you need space in relationships to refuel? How much closeness and intimacy can you tolerate?

This will help you make more mindful choices about, say, living with a partner, or the type of partner to choose.”

Esprey also says understanding your response to stress – “do you retreat, do you become obsessively productive or become physically sick?”

– helps you to predict your response to, say, a new job or relationship, and will help you to establish coping mechanisms, rather than drinking or overeating. “If you know yourself, you expand your realm of capacity to enjoy the world and make conscious choices, rather than just reacting to events and traumas.”

Images: ©iStock.com/Maartje van Caspel/mediaphotos/Joakim Leroy/Warren Goldswain

BRAIN GAIN

social animal

Eat, drink, bE mErry Drink one glass of red wine every evening, advises Johannesburg specialist physician and anti-ageing doctor Dr Craige Golding. “Low amounts of alcohol protect the heart,” he says.

Red wine contains resveratrol, which is believed to be a key ingredient in helping to prevent damage to blood vessels, reduce low-density lipoprotein (LDL) cholesterol (the “bad” cholesterol) and prevent blood clots.

Golding says eating healthily is imperative. “Tomatoes contain heart-protecting anti-cancer lycopene, vitamin C and other antioxidants, while blueberries, blackberries and cherries contain unique anti-ageing antioxidants called proanthocyanidins. “Eat artichoke hearts,” he says. “They detox the liver and kidneys.”

Exercise for half an hour every day – try walking, gardening or a dance class. Golding believes in the mind-body connection and says, for added benefits, think young. “Ageing is as much a state of mind as it is a state of physiology. Lie about your age – especially to yourself – and keep young-feeling friends around.”

Cancer research studies have shown that cancer patients with less of a support system are definitely more compromised.

Call a friend, visit your mother – good relationships can add years to your life. A wealth of research shows that a meaningful social life is one of the biggest predictors for health, happiness and longevity.

Esprey says cancer research studies have shown that cancer patients with less of a support system are definitely more compromised. “Human beings need connection to thrive. The importance of attachment is laid down as infants, who have no capacity to survive without a caregiver.”

Researchers from a 2010 study undertaken at the University of Utah concluded that the protective effect of having healthy and fulfilling relationships is comparable to that of quitting smoking.

Study author and psychologist Dr Julianne Holt-Lunstad notes: “Despite modern advancements, it appears that our relationships nonetheless still impact odds of survival.”

A study completed this year at a North Carolina university, of 14 000 participants, concurs. It shows older adults are more at risk of developing hypertension from social isolation than from diabetes, and, says author Prof Kathleen Mullan Harris, it shows clearly that social relationships “not only buffer some of the effects of stress, but help with coping”.

sEx flEx Switch off the TV and go to bed. Sexologist and author Catriona Boffard says sex is good for us on a physical and emotional level, and may ward off stress, depression and anxiety, which are often found to be related to ageing. “The release of good hormones and chemicals triggered by good sex include oxytocin (which also has the power to lower blood pressure), serotonin and dopamine, which helps make us feel more loved, wanted, content and happy,” says Boffard.

Sex is also good for our self-esteem. “Being close to another person and feeling wanted helps increase self-confidence,” adds Boffard.

“It’s so important to keep sexually active into our later years. Sex is an excellent workout for women’s pelvic-floor muscles, which will improve bladder control and help avoid incontinence – a condition that will affect about 30% of women at some point in their lives.”

At the same time, a number of studies, including a Harvard Medical School study and a 10-year follow-up study published in the European Urology journal, show that men who ejaculate frequently (at least 21 times a month) at a young age have a lower risk of getting prostate cancer.

think thanks Time for that gratitude journal. Focusing on what you have rather than on what you don’t means you’ll sleep better, have fewer aches and pains, less aggression, more friends and more self-esteem (because you’re not comparing yourself to others).

In her 2014 research called Effects of Measured and Manipulated Gratitude on Biomarkers of Health and Ageing, Dr Wendy Mendes of the University of California, San Francisco, says people in her study group with high levels of gratitude had lower anxiety and depression. “They’re more socially connected, and less likely to believe social hierarchies are the way to organise society.”

When blood samples were analysed, her team found that people who are higher in gratitude have a lower resting blood pressure. She found that they showed fewer risk factors for cardiovascular disease – they had higher levels of good cholesterol, lower levels of bad cholesterol – and had lower levels of creatinine, indicating strong kidney function. h e a l t h y t i m e s l 27

aesthetic medicine

Give your career a lift – a facelift here’s a greater number of men choosing cosmetic surgery and other non-invasive facial procedures than ever before. If you laid the numbers down in a business chart at a top-level executive meeting, the arrow would be traversing firmly upwards.

And it’s those very executives who are upping the numbers in the nip-and-tuck industry. It’s a trend in evidence around the globe – and South African men are catching up fast.

The American Society for Aesthetic Plastic Surgery recently reported that since 1997, when the society started collecting data, there has been a 273% increase in the number of procedures performed on men. They noted “dramatic increases” in both surgical and non-surgical options in the last five years.

The favourites for men include blepharoplasty (an eyelid lift), male breast reduction (the “moob” job) and facelifts. That’s as the British Association of Aesthetic Plastic Surgeons reveals that the number of British men going under the knife for cosmetic-surgery procedures has doubled over the last 10 years, and Australian figures report that men now make up about 20% of the patient base at some clinics.

28 l h e a l t h y t i m e s

What’s changed?

Johannesburg plastic surgeon Dr Vernon Ching says while some of these procedures are designed to make a Nip and Tuck wife happy (“I’m looking better and younger after surgery and I want him to keep up with me”) or to gain some leverage in the dating pool after a divorce, older men are increasingly feeling the heat in the workplace.

He says it’s usually men in their 40s and 50s who are choosing to “upgrade” themselves, most often with non-invasive procedures such as Botox and fillers, although a fatty or “jowly” area beneath the chin (which requires some liposuction) are concerns for many men.

“People are gauged on the impression they make within the first five seconds of an introduction – if they are overweight, they’re perceived as lazy, for example. If they are wrinkled or saggy, it may seem as if they will have difficulty keeping up in a stressful, competitive working environment.”

Clinical psychologist May Cotterell agrees that while looking younger formerly fell squarely in the lap of women, society has become tougher on men. “Increasingly men fear being judged according to their looks. While a man may be at the top of his

Images: ©iStock.com/GeloKorol

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Men are increasingly feeling the pressure in their careers to look younger and fresher, writes Nia Magoulianiti-McGregor

aesthetic medicine

One Italian study proves him right (Searching for a job is a beauty contest by Giovanni Busetta and Fabio Fiorillo and Emanuela Visalli, University of Messina, University Politecnica delle Marche). Researchers sent out more than 10 000 identical CVs, changing only first name, last name, address and photo. The average callback rate was 30% across all of the CVs sent out. For attractive women, it was 54%, and for attractive men, 47%. Less attractive men had a 26% callback rate.

Not all surgery is radical, says Ching. “Some men just want to change the perception that they are always angry and tense – caused by entrenched furrows between their eyebrows, for example – to looking relaxed.”

However, Lamont notes: “There is often an overlap between cosmetic and functional surgery. Some men with heavy, low eyebrows start experiencing problems as they age, with excess eyelid skin making it difficult for them to see.”

In the US, plastic surgeons are increasingly performing what has been called the Forbes Lift: a necklift, eyelift, jawline recontouring, with occasional liposuction. Named after the US business magazine and website read by top management, the Forbes Lift leaves a few wrinkles (good for gravitas), but communicates a “fresh, just-been-on-holiday” look.

But why are are men colluding with that sense of ageism in the workplace?

“Fear,” says life coach Judy Klipin. Klipin, whose clients include CEOs and other corporate executives, says the workplace is evolving rapidly. game professionally, if what he sees looking back at him in the “There is a lot of overt, as well as covert, pressure on older and middlemirror doesn’t reflect a youthful vigour, he may worry about being aged people. With technology moving so quickly, that old-fashioned idea discriminated against.” of institutional memory and experience is not as Cotterell says it’s about a feeling of important in a fast-paced environment, and older surgery stats: “powerlessness in a dominant youth culture. people fear becoming obsolete and losing their Globally, the surgical procedures “This is also often compounded by stereotypes incomes, their lifestyles and perks. performed most frequently on men – for example, the belief that older workers can’t “Sometimes older people feel off-balance in 2014 were: adjust to technology, are more likely to take sick and out of their depth, which feeds into people’s • eyelid surgery days or work fewer hours, in favour of spending unconscious fears of not being good enough – • Rhinoplasty time with family,” she adds. “There is also the idea there is a common limiting belief, ‘If I were better, • liposuction that older people are uncomfortable working for it would be better’ – so choosing plastic surgery is • Gynaecomastia (breast reduction) younger bosses.” a way of making them feel less of a dinosaur in a • Fat grafting It seems the idea of experience and maturity in youth and beauty-obsessed culture,” she adds.

Source: International Society of Aesthetic the workplace has given way to a Dinosaur Man Ching is in no doubt that a nip-and-tuck or a Plastic Surgery perception, so that men, fearful of losing their little Botox works. “It’s a good investment. There positions or not being promoted up the corporate is a lot of competition out there and, thanks to ladder, are, increasingly, calling the new number on their speed-dial: the media, people look up to youth and to people who look good their plastic surgeon. for their age. But, also, if you look better, you start to act in a more Plastic surgeon Dr Alastair Lamont says the experienced, lined, lively way. Men are giving themselves a little jump-start, and then older man is “less fashionable” in the workplace. “He may find eating and exercising better as a result.” himself in competition with a vital, young-looking man – and goodIt’s the non-invasive procedures that work best, suggests Ching, if looking people get better breaks. It’s been proven via studies that the men want to avoid downtime and then having to answer too many better-looking you are, the better chance life affords you. And if men questions. “They don’t usually like to tell the other guys what they’ve look better, they feel better and are more confident.” done,” he says.

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Images: ©iStock.com/Troels Graugaard

Men are giving themselves a little jump-start, and then eating and exercising better as a result.

HEALTHY FEET

PUT YOUR BEST foot FORWARD

Basically you want a shoe that will both support and cushion your foot.

Your feet work very hard for you every day.

Healthy Times looks at ways to ensure that they stay healthy and happy

Images: ©iStock.com/momcilog/PeopleImages

t

here is very little to compare with the feeling of getting home and kicking off our shoes. We don’t give much thought to our feet, but they do take the weight of our whole body, every day, and in most cases could do with a little more care.

Johannesburg podiatrist Mark Karam says foot problems can quickly lead to discomfort and affect the way you walk.

And that sets up a chain reaction that can in turn cause knee, hip and back problems. “Your feet shouldn’t hurt every day,” he points out. “And if you are experiencing this kind of discomfort, it’s usually because you aren’t wearing the right shoes, or because something in your gait needs to be corrected.”

Podiatrists provide a host of foot-friendly services, barring pedicures, which you will have to get at your local beauty salon. If you have corns, calluses, warts and ingrown toenails, podiatrists can treat them and give you advice on how to avoid their return.

“But we also deal with foot function,” says Karam, “so if you have knee, foot, Achilles or heel pain, then it’s a good idea to see a podiatrist to have your gait assessed.” Often, sorting out an issue with the way you walk will resolve the other pain, but if the podiatrist can’t fix that, you will be referred to a specialist.

There is a misconception, Karam says, that every visit to the podiatrist will result in orthotics – inner soles that support your feet in different ways to adjust their biomechanics. “We deal a lot with the sporting population, like runners,” he says, “but that doesn’t mean you’ll always get an orthotic. We can advise people on the best shoes to get, for example, depending on their gait.”

He adds that if you do have orthotics, you need to have them checked annually, but they don’t always need to be replaced.

“Unfortunately, while children are still growing, they will need replacing once a year, but if there’s no change in size, often we can repair and resurface them to ensure they are still doing their job.”

TIPS FOR HEALTHY FEET

1

Dry your feet well after your bath or shower, especially between the toes, to prevent fungal infections.

2 3

When you trim your toenails, cut them straight across to prevent ingrown toenails.

Go shopping for shoes after lunch – your feet swell as the day progresses, so buying shoes when your feet are at their biggest means the shoes will always be comfy.

4

Vary your heel height so your feet aren’t in the same position day in and day out. And keep super-high shoes for special occasions only.

5

Decrease your risk of athlete’s foot and verrucas by wearing flip-flops when you shower at gym or in hotel bathrooms.

Source: www.nhs.uk

THE SHOE MUST FIT “The rule for shoes is that you want a slight heel, with a wedge rather than a flat shoe like pumps or flip-flops,” says Karam.

“And the wedge should be about 2cm high. Soles are better in rubber rather than leather, and a leather upper is preferable.

Finally, lace-ups are better than other kinds of fastenings – basically you want a shoe that will both support and cushion your foot. The slight elevation at the heel will help to take the strain off your arches, calves and heels.”

H E A L T H Y T I M E S l 33

s teraal pt h h l iyn be ohdeyr e

Be breast-aware

w

orldwide, one in eight women will get breast cancer (or a precursor) at some point, and figures are rising. In South Africa, numbers are substantially lower, at about one in 25.

“The bottom line is that although our statistics are going up, they are, surprisingly, much lower than global figures,” says Dr Herbert Cubasch, head of the Batho Pele Breast Unit at Chris Hani Baragwanath Academic Hospital in Soweto.

Sixty percent of patients have no identifiable risk factors, 30% have a family history, and only 10% account for genetic breast cancers, explains Prof Carol-Ann Benn, specialist surgeon and head of the Helen Joseph and Netcare Milpark Breast Care Centre.

Education is key for early detection, she stresses. “Know your body, and if something feels different, looks different, or you have any persistent symptom, access healthcare.”

risk factors

Document your family history on both sides and be vigilant, advises Benn. Be particularly aware of cancers diagnosed in family at a young age, and family trends of melanoma, ovarian, pancreatic and bowel cancer.

Risk factors include starting periods early, late menopause, having children late and never having breastfed. Decrease your risk by exercising, eating healthily and cutting down on alcohol consumption, says Benn.

Oral contraceptives pose no risk. Long-term hormone replacement 34 l h e a l t h y t i m e s

therapy has a small risk, but too much alcohol, obesity and lack of exercise are greater threats.

“We know from international statistics that breast cancer is a disease of urbanisation. Rural, Third World areas have a lower incidence,” notes Cubasch.

take responsiBility

prof Carol-ann benn

Breast cancer usually presents as a painless mass, and any symptom deserves medical assessment, says Benn. She believes this country needs community-based educators, talking to women in their own language, educating them to examine their breasts and explaining how to access breast clinics.

Examine your breasts regularly (for tips, visit www.cansa.org.za/stepshow-to-do-a-breast-selfexamination-bse). A simple Warning signs trick, says Benn, is to stand • a lump in the breast or armpit; in front of a mirror and • puckering of the skin of the breast; lift your arms to the side, • a change in the skin around the watching your breasts nipple, or discharge; move. Another, rather than • Dimpling or retraction of the nipple; lifting your arm above your • an unusual increase in the size of head when examining the one breast; armpit, is to relax and bend • one breast unusually lower than your elbow at the side. This the other; will enable you to feel the • an enlargement of the glands; and glands, lymph nodes and structures better with your • an unusual swelling in the armpit. opposite hand.

Source: The Cancer Association of Advanced breast South Africa (CANSA) cancers in South Africa

Images: Shutterstock and supplied

Libby Peacock outlines what you need to know about breast-cancer risk, screening and beating the odds

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HEALTHY BODY

accounted for 80% of cases 20 years ago – now, they account for 60%, thanks to education and awareness, says Benn.

Only 1% of breast-cancer patients are male, and most lumps in men and boys are caused by gynaecomastia (a harmless enlargement of tissue), explains Cubasch. Although lumps are usually benign, ask a doctor if something worries you. “Put in perspective, in men I see probably 10 times more gynaecomastia than I see breast cancer.”

MAMMOGRAM LOW-DOWN

In the UK, breast screening is done three-yearly from the age of 50, and in Scandinavian countries from 40. In South Africa, finances are not available for a population mammogram screening programme, but CANSA recommends regular screening from the age of 40.

No screening is 100% accurate, but mammogram accuracy is improved with the use of digital mammography, tomosynthesis (which creates a threedimensional image), concomitant use of ultrasound, double reading and peer review, notes Benn.

Mammograms look for changes in density and calcifications, and their strength lies in the comparison of the current examination with the previous one. Ultrasound is used to confirm types of masses and to look at lymph nodes.

While diagnostic imaging is getting better and better, mammograms “don’t always give straight answers”, cautions Cubasch, adding that screening at too young an age can cause harm. “Only 30% of the earliest cancers develop into full-blown cancer – but we don’t know which ones are aggressive and which ones idle.”

HOLISTIC APPROACH

Image: Supplied

The best prognosis is achieved by treating each patient – and cancer – individually, Benn believes. “Show the patient the outcomes, allow her to be part of the choices, listen to her. She is the most important person in the room.”

MORE INFO

The Breast Health Foundation: 0860 283 343, www.mybreast.org.za CANSA: 0800 22 66 22, info@cansa.org.za, www.cansa.org.za/cansa-carecentres-contact-details

BETTINA’S STORY

Bettina Hodgson was 43 and living in Melbourne when she was diagnosed with the earliest form of breast cancer. She recalls: “I was examining my breasts one night and found a lump. I went to see my GP, who sent me for a mammogram and ultrasound. When the results came back, they seemed alright, but there was something she wanted to examine further.

“When I saw the breast surgeon a few weeks later, he did a quick physical check. All seemed okay, but he wanted to have a closer look.”

After further investigation, Hodgson was sent for a biopsy and was diagnosed with ductal carcinoma in situ (DCIS), or Stage 0 cancer. A month-and-a-half later, she had a double mastectomy and breast reconstruction.

“I felt like my world was crumbling. I was scared, I was in despair, I was worried – for my kids and my husband, but, weirdly, not for myself. The first thing we did was to research DCIS. I saw how lucky I was – catching the cancer at an early stage, having the best doctors to help me.”

Before the mastectomy, Hodgson had a sentinel node biopsy to check if the cancer had spread into the lymphatic system. The results were clear, so there was no need for chemotherapy or radiation therapy afterwards.

“Quick detection saved me. I was lucky to have a GP who wanted to do that further investigation. My advice to others is to do regular self-examinations. Know your breasts, what’s normal and what’s unusual. Go for mammograms, especially older women. And don’t be afraid ... the earlier it’s detected, the better.

“Breast cancer has changed my life – mostly for the better. I appreciate every waking moment with my husband and my kids.”

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MAKE YOUR

medical aid

WORK FOR YOU Most people struggle to make their medical savings last the whole year. The solution, it seems, is to be more strategic and frugal about your medical expenses, says Georgina Guedes

38 l H E A L T H Y T I M E S

t

he start of cold-and-flu season coincides, almost like clockwork, with the dreaded email from your medical aid to let you know that your medical savings account has bottomed out. For the rest of the year, you are going to be self-funding your medical expenses, so you’d better hope that you don’t fall foul of any unexpected illnesses.

Easier said than done...

While you can’t always avoid illness, you can try to structure your medical aid usage and your medical spending so that you’re not left high and dry just in time for winter.

Get your medical aid riGht

Of course, the first thing you should look at is whether your medical aid is meeting your needs. “Probably not,” says Ricky Rohrbeck, a broker at Select Independent. “Everyone should be on a comprehensive plan so that they are completely covered, no matter what happens. But comprehensive plans are unaffordable for most South Africans, so customers have to consider what sacrifices they are willing to make in certain areas.”

He explains that these sacrifices could include taking a cut in cover so that, in the event of a hospitalisation, the medical aid won’t cover more than 100% of medical aid rates. Customers can also cut their savings account and only have a hospital plan. Or they can cut their threshold cover, which kicks in after they’ve spent a certain amount out of their own pockets, after their medical savings have been depleted.

“You just have to decide which of these areas you’re willing to sacrifice when structuring your medical aid,” Rohrbeck says.

He also advises keeping careful track of your out-of-pocket medical expenses every year, to get a clear picture of exactly how much your family’s health is costing you. “If you consistently blow through your medical savings, you may find that it is cost-effective to move up a plan,” he says.

You can also buy gap cover, which is a separate medical insurance product that covers a shortfall on your medical aid’s hospitalisation cover. “This means that if you are faced with extensive specialist costs that aren’t covered in full by your medical aid, your gap cover will kick in,” Rohrbeck explains.

Another reason why medical savings often run out in the second half of the year is that people tend to overspend in the first half. either for the total cost of treatment or consultation out of your savings, or you can pay only the medical aid rate, and pay the shortfall yourself.

“If you choose, for example, the Discovery Health medical aid rate, you will have to pay the balance yourself, but your medical savings account will last longer, and you can claim the money you paid yourself back from SARS when you file your taxes, provided that your total out-of-pocket expenses are sufficient to earn a refund,” says Nzama.

Even if this is not the case, structuring your payments in this way means that your savings will last longer, and you won’t be paying lump sums out of pocket in the second half of the year.

Images: ©iStock.com/Nastco and Shutterstock

use your medical savinGs wisely

Advance planning can get you only so far, and many families simply have to make do with the medical cover they have, and then start self-funding. However, by being more strategic about the way you use your medical savings, you can make them last longer.

“You can manage your medical savings account to last longer, like your bank account, by making informed decisions about how you spend the funds available in your account on your day-to-day medical needs,” says Sinenhlanhla Nzama, head of Technical Marketing at Discovery Health.

Although your medical savings account contains your money, it is important to remember that the way you spend that money is subject to the medical aid’s rules. With some medical aids, you can elect to pay

HhEeAaLlTtHhYy TtI iMmEeSs l l 39 39

HEALTHY FINANCES

BUILD A RELATIONSHIP WITH YOUR GP It is worth building a relationship with a general practitioner for a number of reasons – the foremost of which is that it can potentially save you a significant amount of money. But first, be sure that the doctor you are visiting provides affordable care.

“Of course, it’s important to have a doctor you like and trust, but if they cost so much that you try to avoid visiting them, that’s not benefiting you much,” says Rohrbeck. “Instead, try to identify a doctor in your area who is part of your medical aid’s network and will charge you reasonable rates, and then get to know them over time.”

This will put you in a position to save money – as many family doctors will talk to you over the phone to let you know if you need to come in when you aren’t sure, and some will write repeat prescriptions for minor ailments such as hayfever without requiring you to come in for a full consultation.

“Never hesitate to consult a health professional if you are ill, but, on the other hand, only do so when this is necessary. This preserves your medical savings account,” says Nzama.

And Rohrbeck adds that you can also consult with a pharmacist for free if you are unsure about your symptoms.

It is also worth speaking to your GP about the extent of the medical services they provide. Some GPs, for instance, will carry out Pap smears, saving women from having to pay gynaecologists’ fees. And it is not necessary to take small children to a paediatrician for minor ailments such as colds or tummy upsets, which a GP can easily treat and monitor.

“Use your GP as your gateway,” says Rohrbeck. “In many cases, they are all you need, but if your condition needs specialist intervention, they will refer you on.”

Another reason why medical savings often run out in the second half of the year is that people tend to overspend in the first half.

Profmed medical scheme doesn’t have a medical savings account, but an out-of-hospital benefit that comes out of the scheme’s risk benefit.

“People have a tendency to use their benefit while they have it. They’ll use it at the beginning of the year, but it makes more sense to save it for bigger or more expensive items, rather than just using it because it’s there,” says Graham Anderson, principal officer of Profmed.

While most medical expenses are, by their very nature, unexpected, it is possible to plan for certain regular costs – such as annual screening procedures, check-ups at the gynae, regular visits to any specialists for ongoing conditions, and visits to dentists and optometrists.

“Rather stagger these throughout the year so that you don’t use up all your medical savings in the first couple of months, allowing some room for unexpected, but unavoidable expenses along the way,” suggests Rohrbeck.

40 l H E A L T H Y T I M E S

SAY YES TO GENERICS

Of course, medical consultations are only a portion of the medical expenses that families incur. The other major cost is that of medication – and as anyone who has been to the pharmacy can attest to, drugs are not cheap. One way of bringing down the cost of medication is to ask your doctor or pharmacist for a generic alternative to the medication you need.

“Ask your doctor to prescribe a generic, if one is available to treat your condition, or ask your pharmacist if a generic is available,” says Nzama. “Generic medicines are usually significantly cheaper than original brand medicines, and are as effective.”

Even so, many patients are reluctant to use generic drugs, as they fear they won’t have the same results. This is extremely unlikely to be the case, and patients should be encouraged to use generics without fear.

“Generic medicines are made when the patent on the original drug expires,” explains Julia Lancefield, a technical manager at GlaxoSmithKline.

“These products are the equivalent formulation of the original medicine, but

Image: ©iStock.com/Oliver Hamalainen and Shutterstock

If you are faced with extensive specialist costs that aren’t covered in full by your medical aid, your gap cover will kick in.

healthy finances

it is possible to make them less expensive as there are no research and development costs.”

In many cases, the generic is even made by the same company that makes the original product, so it is not only equivalent, but identical.

And South African standards will not allow for medications to be dispensed that do not work or are harmful in any way.

“No product may be legally dispensed in South Africa unless it has been tested and shown to be safe and effective. There have been reports of generics that do not meet the registered requirements, but these generally have been obtained illegally,” Lancefield says.

Image: Shutterstock

Use yoUr rewards programme Many medical aids offer customers some kind of rewards programme, which provides them with lifestyle benefits and, more importantly, helps them to live healthier lives by rewarding them for doing so. If you are signed up for one of these programmes, it is important that you understand and use them – you could save yourself money, and you will probably end up engaging in healthier and more financially sound activities.

“Customers should understand their programmes and engage with them,” says André Larisma, managing director of Sanlam’s rewards programme, Sanlam Reality. “It doesn’t take much to start moving up in status and improve your benefits, so make sure you’ve understood the basics of the programme.”

These kinds of activities include engaging online by, for example, reading an educational article or doing a retirement calculation, updating your contact details or carrying out an

annual medical screening procedure.

If you find that you are short of cash, investigate the benefits that your medical aid’s rewards programme offers and opt for those that will help you with your regular monthly expenses, rather than just the lifestyle rewards.

“We have people who are getting a lot of value out of Reality on things like gym fees, flights, movies and restaurants,” says Larisma.

“But many customers were asking us to help them with their day-to-day spend, so for this reason we introduced the Money Saver card, which allows them to earn really generous rebates on items like petrol, groceries, pharmacy items and clothing.”

In this way, people are also using programme benefits to reduce their cost of living.

Rohrbeck adds that some medical aids, such as Momentum’s, go a step further to provide financial incentive for healthy activities, by paying out cash into their customers’ medical savings accounts in return for healthy activities.

However, Anderson stresses that when selecting a medical scheme, it is important to put your family’s needs ahead of the benefits. “A medical scheme is not a rewards programme. It’s nice to get flights and movie tickets, but look at your family’s needs and make your choice based on that.”

It is clear that all medical aids can’t be all things to all people, but by being aware of the limitations of the option you have chosen, it is possible to structure your benefits and expenses in such a way that you minimise the impact of the surprises that your year has in store for you.

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Life Healthcare is one of South Africa’s largest private hospital groups.

We employ over 15 200 permanent people who provide healthcare services of exceptional quality through our extensive network of 63 healthcare facilities situated throughout South Africa. We are well represented across seven of South Africa’s nine provinces, as well as the country’s highly populated metropolitan areas.

OUR VISION Life Healthcare’s vision is to be a worldclass provider of quality care for all. Our core values are aligned with this vision, and we encourage our employees to behave in a manner that places our patients at the centre of the business.

COMPLEMENTARY SERVICES Our main business is providing acute hospital care to our patients. However, we also offer a wide range of complementary healthcare services: rehabilitation; mental health; and renal health.

Rehabilitation Life Rehabilitation is the leading provider of acute rehabilitation services in the country, h Ee Aa Ll Tt H h Yy Tt Ii M m Ee Ss 44 l H

operating almost two-thirds of all private acute rehabilitation beds in South Africa. We offer specific, outcomes-driven, physical and cognitive rehabilitation for patients disabled by stroke, brain or spinal trauma, and other disabling injuries or conditions.

Mental health Life Mental Health’s dedicated facilities include general psychiatry, treatment for substance dependence or other addictions associated with psychiatric disorders and, in certain cases, some psychiatric sub-specialities for high- and medium-acuity users. These services are offered in seven dedicated facilities across three provinces.

We are particularly proud of Life Esidimeni, which offers a network of 12 facilities and

engages in delivering healthcare services to indigent patients, under contract to the national and provincial departments of Health and Social Development. In addition to providing clinical treatment and care, Life Esidimeni is developing and phasing in a new approach to chronic, institutional mental healthcare, aligned to the Mental Health Care Act. Renal health We offer acute and chronic renal dialysis services through our network of 10 facilities situated throughout the country, providing more than 245 renal dialysis stations. The specialised services support patients in renal failure who require outpatient-based chronic renal dialysis, home-based peritoneal dialysis or acute renal dialysis in hospital.

LocaL expansion and investment in infrastructure Life Healthcare continues to grow the capacity of its facilities to care for more patients.

To ensure our hospitals and equipment are on par with world-class standards, Life Healthcare invested a substantial amount during the current financial year on facility upgrades and new builds.

Life Hilton Private Hospital (KwaZuluNatal), the Group’s newest and ‘greenest’ hospital, is a 94-bed multidisciplinary hospital that enhances Life Healthcare’s patient care offering in the greater area with its easy access to major highways (N3), five operating theatres, and more than 40 associated resident specialists. The hospital boasts a six-bed intensive care unit, a six-bed high-care unit and a five-bed neonatal ICU, a maternity and paediatric unit, a 24-hour accident and emergency unit, and an eight-station renal dialysis unit.

The Group recently acquired the Genesis Maternity Clinic, a state-of-the-art private maternity and midwife facility in Johannesburg. The clinic is a natural birth facility with highly qualified and caring staff of midwives, nurses and doulas, backed by a strong support team of gynaecologists and paediatricians. Each mother stays in her own private room for the entire labour, birth and recuperation period. The rooms are large with king-sized beds and cribs to accommodate the baby. All rooms have en-suite bathrooms and in their own private gardens. Fathers are encouraged to be part of the birthing and bonding process, and may stay at the clinic.

internationaL expansion Life Healthcare is in the process of establishing a sizeable international business portfolio.

The Group acquired Scanmed Multimedis, a leading healthcare provider in Poland, which includes Sport Klinika (SK) and Kliniki Kardiologii Allenort (KKA), among others.

innovative tecHnoLoGY The Life Healthcare Group continuously strives to excel in our field of work. We are proud of being at the forefront of providing innovative technology to our patients. oncology Life Vincent Pallotti Hospital’s oncology centre in Cape Town provides advanced radiation therapy to cancer patients with difficult-to-reach tumours through treatment with the Novalis Tx™ system. The system shapes the radiation beam precisely to the patient’s tumours, ensuring that the best possible treatment dose is delivered, while healthy tissue is protected. The radiation beam also adapts to the patient’s breathing and other body movements, in order to continuously maintain safe, complete and accurate treatment.

A further two systems will become operational at specialist Life Healthcare oncology centres in Hilton (KwaZulu-Natal) and Pretoria (Gauteng) later in 2016.

SK offers orthopaedic and rehabilitation services through an outpatient clinic, which employs 100 people, including 18 physicians.

Facilities include six consultation rooms, three operating theatres, 46 beds and a rehabilitation centre.

KKA is one of the leaders in cardiac care and has seven in-patient cardiology centres located in central and northern Poland.

Max Healthcare is a leading provider of healthcare services in India. Life Healthcare recently increased its share in Max Healthcare to 46%. Pushpanjali Crosslay Hospital, one of the many Max Healthcare hospitals, focuses on high-growth specialties including oncology, neuro, renal, orthopaedic and cardiac sciences.

The facility employs 250 doctors, 450 nursing staff and offers 11 theatres, four labour rooms, one cath lab, and has 340 beds.

nursinG at tHe centre of patient care The Life College of Nursing, established 18 years ago, is an accredited private higher education institution, training students in various nursing and health sciences programmes. Its objective is to create and sustain a resourcing pipeline for nursing and other hospital departments. Our training focuses on the integration of theory and practice to enhance clinical excellence and enable improved patient outcomes. More than 1 000 nurses graduate from the college each year.

Ensuring that our hospitals are staffed with appropriately skilled nursing staff remains a key priority. While Life College of Learning, as well as universities, provide well-trained nurses, it is the Group’s responsibility to ensure continuous professional development. Our nurse educators and registered nurses develop Continuous Professional Development (CPD) modules for all categories of nurses and, during 2015, they distributed 136 CPD modules.

Life Healthcare implements a number of supportive initiatives to assist nurses to focus on quality patient care. One of the many initiatives addresses the administrative burden on nursing staff, where more time is often spent on administrative tasks and less on important clinical tasks. Technology is being leveraged with the introduction of eICU and the Impilo system, which uses advanced algorithms to predict patient outcomes and assist doctors using a cloud-computing platform. The aim of these and future programs is to free up nurses so they are able to spend more time at the patient’s bedside, particularly registered nurses, to ensure positive patient outcomes and a satisfying patient experience.

patient-centred care Our focus is to place our patients at the centre of care in everything we do. This patient-centric approach lies at the core of our vision to be a world-class provider of quality healthcare for all. It is the “golden h e a l t h y t i m e s l 45

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thread” that runs through our mission, values, strategy, hospitals, clinics, and one which unites our doctors, nurses, executives, management and every employee behind providing and delivering unmatched quality of care at every touch point along a patient’s journey through our facilities.

Our CARE programme is specifically designed to achieve this objective. The programme sensitises staff to be more thoughtful and to demonstrate genuine caring in the way they engage with patients by being compassionate and professional, by working efficiently, by providing information when asked, and by doing the small things that truly matter.

The programme involves intensive training of CARE champions across the country. Training of 24 000 employees, management, partners, doctors, students as well as service providers is currently under way and aims to provide the tools to engage with patients in a more thoughtful manner across all hospitals and facilities.

DOCTOR PARTNERSHIPS Life Healthcare has a network of over 2 700 specialists and other healthcare professionals who use the Group’s hospitals to provide clinical treatment across the spectrum of medical disciplines. Doctors in South Africa are not employed by the Group, and are independent clinicians with freedom of choice regarding private practice and the selection of hospitals for patient referral and treatment regimen. Doctors are attracted to Life Healthcare’s hospitals because of the modern facilities, new technology, the quality of care provided by the nursing staff, management’s understanding of doctors’ needs and their focus on fostering lasting professional relationships with them.

ADVANCEMENT OF PHARMACISTS Hospital pharmacy has evolved over the past decade from being mainly dispensarybased to where pharmacy services are becoming available at ward level and at the patient’s bedside, making pharmacists part of the multidisciplinary healthcare team caring for patients. Life Healthcare has created opportunities for the development of pharmacists interested in a clinical career path, and to deliver these critical skills to the business in order to support growing clinical

strategies. We also provide development and career opportunities for pharmacists with a more commercial focus, those who play an important role in pharmaceutical cost and asset management in our hospitals, aiming to improve efficiency and sustainability.

Pharmacists in Life Healthcare are very involved in the development of staff to build capacity in pharmacy, and significant numbers of learners have qualified as pharmacist’s assistants under the guidance of their tutors. Our structured internship programme has provided a robust grounding for pharmacy graduates to develop their careers in hospital pharmacy.

EMPLOYEE HEALTH SOLUTIONS Life Healthcare Group’s employee health and wellness services, Life Occupational Health and Careways, offer proactive solutions to minimise employee health risks, and aims to reduce healthcare costs and improve employee productivity. This integrated employee health solution manages the full employee health and wellness cycle through standardised quality systems, occupational health services, wellness interventions, health education and clinical protocols.

A flexible approach enables the structuring of tailor-made packages to suit the individual needs of employees. We offer these services to more than 427 000 employees across 365 clinics countrywide.

ENVIRONMENTAL SUSTAINABILITY We are committed to limit any harmful impact on the environment through our business activities.

Due to the current environmental challenges faced both locally and globally, monitoring of our water consumption has become a critical focus for the Group. Our hospital water consumption is monitored via an online metering system that provides live data at 30-minute intervals. We have embarked on a group-wide water-storage project to ensure that each of our hospitals has an extended backup water supply to equip us to deal with prolonged water outages. To reduce water consumption, we are focusing on greywater recovery for irrigation purposes.

Life Healthcare is reducing its dependence on the national electricity grid through the expanded use of our solar energy project

Find more information at www.lifehealthcare.co.za 46 l H E A L T H Y T I M E S

Life Healthcare

@LifeHealthcare_

using photo voltaic (PV) panel installations – such as at Life Anncron Hospital (North West province), which is one of the largest hospital PV projects in Africa, and features 1 711 (250W PV) panels. We are currently in the process of installing a larger PV project at a hospital in Gauteng. The project is due for completion by end of September 2016.

CORPORATE SOCIAL INVESTMENT Life Healthcare takes its responsibilities as a corporate citizen very seriously and is a proud supporter of the Public Health Enhancement Fund (PHEF) introduced by the Minister of Health in November 2012.

The aim of PHEF is to build South Africa’s capacity to respond to the growing national health needs through collaboration, and greater alignment between the private and public health sectors.

Similarly, the focus of Life Healthcare’s corporate social investment (CSI) initiatives is to build capacity by supporting projects that further the health and education of young people within disadvantaged communities in southern Africa.

This is done through our 76 Sizanani projects, driven by each of our facilities.

Through our Eye Care programme, driven by Life Healthcare ophthalmologists, we have fully sponsored cataract surgeries for indigent patients.

In 2015, we addressed some of the local backlog by giving 150 people their sight back. Two sponsored, fully equipped mobile clinics have also been provided to the SA Council for the Blind, in support of the cataract blitz operations in underserviced Mpumalanga and Limpopo provinces. More than 1 800 patients per year have benefited from cataract removals in the past eight years.

LifeHealthcare

HEALTHY YOU

HOW TO BE A

good patient It’s your body, your health, and if you take an active role in your healthcare, you will get the best possible care from your doctor.

Healthy Times lays out some guidelines

t

he days of abdicating responsibility to your doctor are over. In an information-rich world, patients are better educated about their health, and can be much more active in working with their doctors to get better, instead of simply sitting up, shutting up and taking their medicine.

“Communication between patients and doctors is vital,” stresses Johannesburg general practitioner Brendan Lyne. “We’re doctors – not mind readers,” he says. “You need to tell your doctor about any current and past issues, even if you find it embarrassing, or think it’s not relevant. We need all the pieces to put the puzzle together.

And often, things that you think are unrelated can be the missing piece in the puzzle.”

Patients who take an interest in their health work with us – instead of against us – and have far better outcomes as a result.

Image: Shutterstock

Lyne says you should tell your doctor the following at your appointment: • Any symptoms you are having.

• Your health history – jot down a few notes before you go, if necessary.

• Personal information, such as any stressors or life changes you are going through.

• Any medicines you are taking, including herbal or alternative medications, as these can interact with allopathic medicines. In fact, take them along, so your doctor can see what strength they are and how often you are taking them.

• Any medication side-effects you are experiencing.

• Any test results that relate to your symptoms – take along X-rays and reports, blood tests or any other tests you had prior to the appointment.

ASK QUESTIONS

“Don’t be afraid to ask your doctor anything you don’t understand,” says Lyne. “If you don’t, he or she will assume you do understand everything.”

It’s okay to interrupt, he says, and ask as soon as you have a question,

or you may forget. You can even write down questions before you go.

“It helps us enormously if patients take the time to understand what is going on in their bodies,” says Lyne. “Patients who take an interest in their health work with us – instead of against us – and have far better outcomes as a result.”

GIVE YOUR DOCTOR FEEDBACK

One of the biggest frustrations for doctors is that patients don’t tell them when treatment isn’t working, or if they’re experiencing side-effects.

“Everyone responds differently to medication, but we can’t adjust the medication or change it completely if we don’t know it isn’t working, or it’s making you feel strange,” he points out. “Don’t just stop taking it – come back and see us again and we can find a different option for you.

This is especially important for people going onto chronic medication.”

COMPLY WITH TREATMENT

It’s important to follow the instructions you are given around when and how to medicate, or scheduling tests or appointments with specialists.

“This is the patient’s side of the contract,” says Lyne. “We can only recommend a course of action – it’s up to the patient to follow it and then give us feedback on whether it is working or not.”

And if you’re confused or if you’ve forgotten some information, it’s perfectly okay to contact your doctor and ask for clarification – they would much rather you did that than simply stop the treatment or take it incorrectly.

CAREFUL HOW YOU GOOGLE

The internet is a great source of information about your illness, but it can also be terribly harmful, as a great deal of information out there is simply incorrect. Instead of googling your symptoms (or that of a family member) and frightening the living daylights out of yourself, go and see your doctor first.

Once you have a diagnosis, then you can read around the topic on some reputable medical websites, such as www.mayoclinic.com or www.webmd.com. And steer clear of health blogs or any site that doesn’t reference large, double-blind clinical trials – a single study conducted on 20 people is not good evidence.

H E A L T H Y T I M E S l 47

healthy mind

Mental illness isn’t all in the mind

Superman and Wonder Woman aren’t real. The rest of us are, which is why it is okay to ask for help – particularly when it comes treating anxiety disorders, depression and burnout, writes Penny Haw

b

urnout, depression and anxiety disorders are different illnesses, but they share several important traits. They are all real and highly prevalent, and each carries the unfortunate, age-old stigma of mental illness.

It’s ridiculous, really. We don’t hide conditions such as broken bones (“Would you like to sign my cast?”) or asthma (“Just a minute, I need to fetch my pump”). But, fearing others will judge and treat us differently, many of us downplay, deny and even try to hide mental ailments. Burnout,

50 ll hh ee aa lltt hh yy tt ii m m ee ss 50

depression and anxiety disorders are illnesses. They are not character flaws. And, unlike many character flaws, they respond to treatment and can be controlled. But help is required.

Ego, says Johannesburg psychiatrist and clinical psychologist Dr Frans Korb, adds to the reluctance to seek treatment. People find it hard to admit they need help, particularly psychological help, because they imagine it’s a sign of weakness.

“Depression and anxiety disorders are biological illnesses. There are certain chemicals in the brain, including serotonin, noradrenalin and dopamine, which regulate mood and the way people feel. When

the concentration of these chemicals becomes abnormal, people need medication to restore the balance. That is why the conditions need to be treated from a medical point of view,” he says. “Unfortunately, stigma works against people coming forward for help. However, once patients accept their condition is medical, it reassures them and they are more inclined to seek professional help.”

The lines that distinguish burnout, depression and anxiety disorders are sometimes blurred. A 2014 study entitled Relationship between burnout and depressive symptoms: A study using the people-centred approach concluded that “burnout and depressive symptoms seem to cluster together and develop in parallel”.

At the same time, it is not unusual for someone with depression also to suffer an anxiety disorder or vice versa. According to the Anxiety and Depression Association of America, almost half of those diagnosed with depression are also diagnosed with an anxiety disorder.

When this happens, the symptoms are more severe and can take longer to resolve. To understand them, it’s necessary to consider the illnesses individually.

It is not unusual for someone with depression also to suffer an anxiety disorder or vice versa.

Images: ©iStock.com/PeopleImages/Squaredpixels

Beginning with Burnout Perhaps because it is a more recently identified illness and generally relates specifically to stress in the workplace (while depression and anxiety disorders are broader phenomena that touch all aspects of our lives, whether at work, home or play), burnout does not suffer the same stigma as the other two. It is, however, no less dangerous.

Burnout, says Cape Town psychologist Anelle Naudé-Lester, is a state of extreme emotional, psychological and physical exhaustion, resulting in a loss of interest and motivation. It happens when we continually accept and respond to demands without pausing to confirm that we have the means to meet them. Just as there is a limit to the number of plates a waiter can carry, there is a limit to how much a person can take on before everything comes crashing down.

“The road to burnout is often paved with good intentions,” adds Naudé-Lester. “Being hardworking, motivated and idealistic are not harmful – until you add new responsibilities and unrealistic expectations to the mix non-stop, don’t take care of yourself, measure and judge yourself harshly, and ignore your general health.”

Working too hard and taking on ever-more responsibilities can, she says, be the effect of burnout, rather than the cause. Being productive becomes a lifeline, even after it has stopped being satisfying. You appear to be capable of juggling endless demands without faltering.

You’re admired, even envied, by others.

Sometimes it takes the unforeseen to happen to trigger the final fallout. Perhaps you experience retrenchment, divorce, death or even a relatively minor setback. Suddenly, you’re overcome by waves of exhaustion, frustration and helplessness. Your endless “to-do” lists seem insurmountable and meaningless. You feel unappreciated and

Burnout warning if you answer “yes” to any of these questions, you might be heading for burnout: • Doing more and more, but accomplishing less and less?

• Doing ever-more, but feel less and less appreciated?

• making endless lists and convinced you alone can do what needs to be done?

• if you stop, everything will fall apart?

• exhausted, but sleep doesn’t help?

• sad for no obvious reason?

• experiencing a lack of purpose and meaning?

• Feeling increasingly detached from relationships?

Source: Psychologist Anelle Naudé-Lester

alone. The engine seizes and burnout ensues.

“Burnout,” says professor of philosophy and former contributing editor of Psychology Today, Sam Keen, “is nature’s way of telling you you’ve been going through the motions, [but] your soul has departed.”

When people reach a point where they need to take time off work because of burnout, they often feel they have let others down.

This a dangerous time. If the condition is left untreated, it can lead to depression. h e a l t h y t i m e s l 51

healthy minD

Dealing with Depression

Working too hard and taking on evermore responsibilities can be the effect of burnout, rather than the cause. he is five times less productive than an employee who takes time off from work for treatment. Even so, two-thirds of people with depression do not seek help. This is why, says the operations director of SADAG, Cassey Chambers, it is important to emphasise that depression, anxiety and burnout can be treated and controlled like almost any other illness – even when they occur at the same time.

anD then there is anxiety Studies show a high percentage of people with major depression also suffer generalised anxiety disorder (GAD). Because they so often appear together, GAD and depression are referred to as “the fraternal twins of mood disorders”. But, although they share similarities and treatment is sometimes the same, GAD and depression are fundamentally different.

Everyone experiences anxiety. It’s normal under many circumstances, but chronic, continuous anxiety is not. People with GAD experience fear, panic and fretfulness in situations where most are unconcerned. They are likely to experience constant anxiousness and have panic or anxiety attacks without obvious triggers.

People with GAD often have difficulty falling or staying asleep. The condition can be accompanied by symptoms such as muscle tension, 52 l h e a l t h y t i m e s

Do you have an anxiety DisorDer? if you identify with several of the following persistent symptoms, you might be suffering from an anxiety disorder: • you are always tense and worried.

• your work, school or family responsibilities are affected by your anxiety.

• you avoid everyday activities because you are anxious.

• you are beset by fears you know are irrational, but cannot get rid of them.

• you believe terrible things will happen if you don’t do specific things a specific way.

• you experience unexpected bouts of heart-pounding panic.

• you imagine danger and disaster await you around every corner.

Source: US National Institute of Mental Health

headaches, sweating, trembling and twitching. They may feel out of breath, lightheaded and even nauseous. GAD can be very debilitating, making it impossible to carry out normal activities. Some GAD patients are driven to unusual repetitive actions or compulsions, and are diagnosed with obsessive-compulsive disorder (OCD).

“GAD is a condition that sometimes quietly pervades a person’s life and then takes over quickly,” says Durban anxiety coach Sarah Rogers. “Although I think we need more awareness around it – no one should have to suffer anxiety silently – I do see more and more people seeking help for GAD. This is helped, at least in part, by the increased availability of other avenues for treatment beyond the traditional therapeutic space, including life coaching, support groups and social work therapy.”

“Anxiety disorders can be successfully treated with non-invasive, occupational therapy in children as young as three or four,” says Kerry Wallace, a Cape Town occupational therapist specialising in early intervention in children. “We see many cases of early-onset anxiety, which, when effectively treated, prevents future disorder. We encourage parents not to delay in seeking help when they notice their children are overly anxious.”

Burnout, depression and GAD are far more prevalent than we realise. If you think you or anyone you care about might be suffering from any of these conditions, encourage them to get help immediately.

As is the case with any other illness, accurate diagnosis is the first step to safe and effective treatment. Let’s stop the stigma and embrace good mental health.

where to finD help • • • •

Consult your GP. Call SADAG on 011 234 4837 8am-8pm.

SADAG 24-hour helpline: 0800 12 13 14.

SMS SADAG 31393 (they will call you back).

Image: Shutterstock

Diagnosed when someone feels persistently unhappy, empty, tearful and hopeless, or has lost interest in almost all activities, depression is a complex illness. Other indicators include fatigue, feelings of worthlessness, changes in appetite, insomnia or excessive sleeping, agitation, lack of concentration, and recurring thoughts of suicide or death.

Of course, circumstances make us all feel this way at times.

Depression is when the symptoms are intense, last for more than two weeks and are severe enough to cause suffering and/or the inability to function normally. Aches, pains and a weakened immune system are also markers of the illness.

“Recognising your own depression can be difficult,” says Korb. “It often takes comments by partners, friends or colleagues – like ‘you are different’, ‘you are not yourself ’, ‘you are not the same’ or ‘you don’t laugh or join in the fun anymore’ – to make you aware you are not well. It’s important to take heed of these observations. They indicate you might need help.”

According to the World Health Organisation, depression will be the leading cause of disability worldwide by 2030. The illness significantly impacts on productivity. In addition to general fatigue and low energy, impaired intellectual abilities mean patients have trouble focusing, making decisions, solving problems, and planning and remembering tasks.

In fact, The Impact of Depression at Work study conducted by the South African Depression and Anxiety Group (SADAG) shows that when an employee has depression, but continues to go to work, she or

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HEALTHY FAMILY

RUNS IN THE

family

f

With busy lives, escalating food prices and constant stimulation, how can you raise a family that prioritises health? Libby Peacock consulted the experts

Images: ©iStock.com/BraunS/peangdao

igures show that up to 70% of women and a third of men in South Africa are overweight or obese. So is one in four girls and one in five boys aged between two and 14 – and less than two-thirds of children exercise weekly.

These figures from the Heart and Stroke Foundation SA indicate that this country has the highest obesity rate in sub-Saharan Africa – and lifestyle is to blame. “South Africans eat too much, drink too much alcohol, and don’t move enough,” says Dr Vat Mongol-Singh, CEO of the foundation.

In addition, several studies have shown a link between fitness and academic performance. Research published recently in the Medicine & Science in Sports & Exercise journal suggests that fit children do better at school, while those who start off unfit but then get in shape also improve their grades.

So, how can families get fit and healthy?

“In an ideal world, healthy exercise habits would not be forced – it would happen naturally, purely through the example set by parents,” says exercise physiologist and founder of Vivendi Wellness Prof Ross Tucker. “What really matters is each individual, and the implications of even one percent being overweight.”

He advises fostering positive emotions around exercise. “It should

not be ‘you have to’, but ‘you want to’.” No-one exercises for exercise’s sake; they do it because they have a positive association with exercise – there’s an emotional reason for it, he says. For children, this comes from parents’ commitment to be physically active.

New studies come out all the time, notes Tucker, but the amount of exercise you should do is the amount you can do, he believes. Commit to incremental changes. “You don’t have to go from zero out of 10 to 10 out of 10 straight away – it’s all about habit and healthy routine.”

A good way to get children into the exercise habit is through play.

“If a child spends four hours in front of the TV and half an hour doing sport, it’s unhealthy. If you can change that to three hours in front of the TV and one hour of exercise, it’s already an improvement.”

Lead by example. If you don’t eat salad or broccoli, how can you expect your kids to?

PENNY WISE

Food is expensive and it’s more time-consuming to plan healthy meals, but if you line up your weekly meal plan once a week, you will save, says Cape Town nutritional therapist Hannah Kaye.

“Veggies are expensive, so buy twice per week as per your meal plan – this will cut down on wastage.” Bulk-buying items such as free-range chicken is cheaper than buying smaller packs. Nuts and seeds are pricey, so buy in bulk and freeze the rest. Plan five basic school lunches ahead and use dinner leftovers with salad for the next day’s lunch. ”For fussy eaters, offer the same plate of food as for the rest of the family,” recommends Kaye, advising against separate meals or caving in to demands for unhealthy food.

A hungry child will eat.

Exposing children to as many different tastes as possible helps to expand their preferences and can have a positive influence on previously disliked foods, adds Lifestyle and wellness expert, author and TV personality Lisa Raleigh.

“Offer as many variations of healthy foods as you can to create a less fussy palate.”

H E A L T H Y T I M E S l 57

healthy family

HealtHy body, HealtHy mind

Family breakfasts tend to be rushed. “Eggs are my No 1 recommendation.

They’re much better than sugary cereals, and cheaper, and come in many different forms – boiled, poached, scrambled, fried or as omelettes,” says Cape Town nutritional therapist Hannah Kaye.

For a quick, healthy fix, she recommends an egg pancake made by mashing egg and banana together, and then frying in coconut oil. If you must have cereal, go for as plain as possible, and add nuts to bring up the protein and good fat content, she advises.

Junk food is called that for a reason, says Tucker. “Generally, if it comes in a box, it’s less healthy than if not.” But it’s important to be strategic. “Understand your own limitations. Add one more vegetable a day. Or replace one bad thing with a good thing. Most people would be better off without sugars – but I would never eliminate something totally.” Humans are not just physiological machines, he adds. Food has emotional connotations and benefits, and if you take one thing away, it will usually be replaced by something else.

Lifestyle and wellness expert, author and TV personality Lisa Raleigh suggests shaking up your presentation of healthy foods to kids. “Baby carrots and dip can be an after-dinner treat, while frozen grapes skewered on toothpicks could be seen as an icy reward versus an obligation.”

Chips and biscuits visible in the cupboard create unnecessary temptation. Kaye suggests snacking on homemade granola bars or trail mix containing nuts, seeds, coconut flakes and raisins. Good sources of energy also include avocado and free-range biltong.

Sugar – white or brown – is a no-no, as is white bread, she believes, and any food containing hydrogenated or trans-fats. “Lead by example.

If you don’t eat salad or broccoli, how can you expect your kids to?”

Seven a day

Eating fruit and vegetables is associated with a lower risk of death from any medical cause, a 2014 study by researchers from University College London and published in the Journal of Epidemiology and Community Health suggests. The more you take in, the greater the protective effects.

Kaye proposes five veg and two fruit a day. “Work veggies around five portions on a plate, without getting hung up about measurement.

One stalk of broccoli is better than none.” Include them in lunchboxes, after-school lunch and dinner.

Fruit juice (except if it’s home-made and 100% pure) and fruit-type snacks “that don’t actually resemble fruit” don’t count.

Raw salad veg such as tomato, peppers and carrot require zero

Get active lisa Raleigh has some family-friendly suggestions:

• make a vegetable patch with your kids. Children often have added interest in fresh produce they have helped to grow. Start small with a tub of tomatoes or a herb pot.

• incorporate fitness-based errands into your children’s list of chores.

Fetching the post, watering the garden and helping to clean the pool may be more valuable tasks for less active children than chopping veggies for dinner.

• if you want your children to get more active, lead by example with child-friendly activities, and they are likely to join you.

• Get your kids in on the tracker craze. they will love wearing a tech gadget, and you have inadvertently supplied yourself with a tool to check up on their fitness.

• younger role models can have a more persuasive effect on children than their parents. introduce them to slightly older peers who serve as great examples.

• if your child is older and has lost interest in the activities you used to do together, let them bring a friend.

• equip your home and weekend activities for exercise. trampolines, sports equipment and swimming pools encourage fun activity outdoors, as do planned opportunities to do things such as hike, rollerblade or go to the park.

effort – offer them daily at lunch, and steamed, fried or roasted vegetables with the evening meal, says Kaye. Don’t skimp on broccoli or cauliflower; they have essential health benefits.

SwitCH it oFF

Screen time may displace more active pursuits, while also interfering with getting enough sleep, according to the American Academy of Paediatrics.

Instituting a non-screen-time day works for many successful people struggling with an addiction to social media, says Tucker, so boundaries are important. “Parents can take the lead here – if you want to stop a behaviour, you can legislate against it.”

He advises setting aside family time without screens every day or week. “Do it in a positive way, because it’s good for you.” One way to do this is through “temptation bundling” – if you’re dealing with something your children don’t want to do, combine it with something they enjoy.

Visit www.isitallergy.co.za to download a free allergy e-book

ADVERTORIAL

Inflammation: THE MODERN-AGE EPIDEMIC

DIETARY AND LIFESTYLE CHANGES: The typical Western diet is the number one cause of premature death and disability. Red meat, especially if it is not pasture-reared, is inflammatory. Animals that are fattened are fed grains, which increase the amount of Omega-6 fat in their muscles.

If the ratio of Omega-3 to Omega-6 is too high in our bodies, the result is inflammation.

As a result, the occurrence of chronic inflammatory diseases such as eczema, asthma, allergic rhinitis, osteoarthritis, autoimmune diseases and cancer has sky-rocketed. Consume animal products that are free of antibiotics and hormones, from animals that have consumed their natural diet, living in a natural state.

Sugar, especially added sucrose, fructose and glucose, can lead to increased levels of 60 l H E A L T H Y T I M E S

inflammation. Sugar has been added to the prepared food we buy. If it has been made in a machine, it probably contains preservatives, bad fats or sugar. Remove all sugar, refined sugar, artificial sweeteners, honey, agave. Avoid refined and processed foods; cook your own food.

Increase good fats (such as avocado, coconut oil, raw nuts and seeds, fatty wild fish, pasture-reared animal protein). Increase foods that combat inflammation (such as olive oil, ginger, rosemary, cloves, turmeric, and organic apple cider vinegar). Remove all forms of gluten (such as rye, barley, oats, wheat).

EXERCISE Try to get up to at least 10 000 steps a day. This will help you to keep fit and improve circulation.

Use an app if you don’t have a step counter.

MANAGE STRESS The hormones that are produced when we are stressed are detrimental to our health if they are chronically elevated. High levels of adrenal hormones like cortisol in the early stages of stress can lead to abnormalities in sugar metabolism, and may eventually lead to insulin resistance. Find a suitable way to address the stress levels in your life. Get enough good sleep – at least eight hours a night.

WEIGHT Your BMI should be below 25. Unless you are an athlete and carry a large amount of muscle mass, BMI is a good yardstick measure to determine a healthy weight.

ENVIRONMENT We all know that, at the moment, the quality of water in our country is very poor. South Africa also uses extraordinary amounts of chlorine to purify the water. Personally, I encourage my

patients to buy a water purifier before they buy their flat-screen TV, or the pram for the new baby!

SUGGESTED ACTION PLAN Take Omega 3 (not 6 and 9) supplementation at least twice daily.

Check that it is pharmaceutical grade, and free of heavy metals. Include fatty, naturally fed fish such as tuna, pilchards, sardines or salmon twice a week. If you’re a vegetarian, eat chia seeds or one tablespoon of ground flax seeds daily.

Curcumin supplements are fantastic, curcumin is one of the most powerful natural anti-inflammatories at our disposal. It works on multiple inflammatory pathways and actually supports liver health and is anti-cancerous.

Make sure that the supplement you are using has been researched to improve absorption of the curcumin. Curcumin is not well absorbed and if a regular extract is used large amounts are required to receive the benefit.

I use a supplement that contains BCM 95 as the manufacturer has used the essential oils of the turmeric root to improve absorption.

Some suppliers use piperine(black pepper) and artificial substances such as polysorbate 80 which could be harmful, to improve absorption.

Check the labels. BCM-95 works quickly and effectively at reducing inflammation and in my experience the benefits can be felt within the first 3 days of use.

Take a probiotic daily. It has been shown that many of the inflammatory diseases we suffer from are gut mediated, but do not present as gut issues.

Images: ©iStock.com/angelsimon/Oliver Hoffmann

h

ave you ever dealt with pain? Do you suffer from heart disease? Peripheral neuropathy? Food allergies?

Diabetes? An autoimmune condition? Stroke? Dental issues? Thyroid issues? Cancer? Alzheimer’s?

Premature ageing? Depression?

Many of us are plagued by chronic inflammation, thanks to our increasingly high stress levels, overmedicated lifestyles, our poor gut health, and an overreliance on processed, chemically enhanced foods. We often don’t even know we are suffering from inflammation, as it often goes undetected for years before it manifests itself as a chronic disease. Our lifestyle is the most influential factor in determining the risk for developing chronic inflammation and disease.

With inflammation, this can often go back 20-40 years!

Dr Helen Muir advises how best to protect your health now before chronic disease sets in

HEALTH FOCUS

With prevalence of the condition increasing worldwide, South Africans need to change their attitude towards getting tested, says Amanda Ngudle

THE DANGERS OF UNTREATED diabetes

w

ithout a national registry for diabetes, information on incidence, prevalence and impact of the condition in South Africa is at best an informed “guesstimate”, say local medical experts.

The International Diabetes Federation (IDF) estimated in December 2015 that 7% of South Africans between the ages of 21 and 79 have diabetes. And while diabetes ranks as the sixth leading cause of death nationally (Statistics South Africa, 2014), when deaths from diabetes are taken together with deaths from common complications seen with uncontrolled diabetes (such as cerebrovascular, heart and hypertensive diseases), that would move it into second place.

Health practitioners say the reasons behind conflicting figures reported in the media include poor healthcare statistics and lack of proper research in reporting. In addition, as the World Health Organisation’s (WHO) website points out, because Type 2 diabetes, in particular, may take between seven and 12 years to manifest, it makes the actual statistics all the more difficult to pin down.

A WHO report on diabetes trends (April 2016) stated that the number of people with diabetes worldwide has nearly quadrupled since 1980, from 108 million to about 422 million adults living with the condition. It adds that diabetes prevalence is increasing worldwide, particularly in low and middle-income countries.

The causes are wide and complex, but in the case of Type 2 diabetes, the WHO blames the sharp rise on mostly poor nutrition and a widespread lack of physical activity, which are important environmental triggers of the expression of a genetic potential for Type 2 diabetes.

64 l H E A L T H Y T I M E S

DIABETES: THE BASICS

“Diabetes is a common, costly and challenging chronic condition with no satisfactory cure at present,” says Michael Brown, a clinical consultant at the Centre for Diabetes and Endocrinology in Johannesburg.

“Most cases of diabetes are classified into two major types. Although people who develop diabetes may complain of classic Michael Brown symptoms, most do not – they don’t know they have it, and continue to feel relatively well despite an underlying cardiovascular risk. Uncontrolled diabetes can result in complications, but the good news is that diabetes is controllable.”

About 5% to 10% of people with diabetes are affected by Type 1 diabetes. In this form of the condition, the body makes no insulin, because beta cells that make insulin are mistakenly destroyed by the person’s own immune system. In essence, it’s an autoimmune disease. People with Type 1 diabetes must take two or more injections of insulin every day. Type 1 diabetes is usually diagnosed in children and young adults.

Type 2 is the most common form of diabetes, accounting for 90% to 95% of cases. This kind of diabetes usually occurs in people who are older, or in those who are overweight (about 80% of people with Type 2 diabetes are overweight). However, in recent years, more children and teens are developing Type 2 diabetes, most likely because of obesity and inactivity.

If you have Type 2 diabetes, you produce insulin, but your body doesn’t use it properly. This is called insulin resistance. At first, your pancreas makes extra insulin to make up for insulin resistance, but your production of insulin decreases progressively over time, until you develop diabetes.

CLASSIC SIGNS AND SYMPTOMS OF DIABETES

Diabetes is not something you should take lightly. If you experience any of these symptoms, it’s vital that you seek medical help without delay.

TYPE 1:

• • • •

Frequent urination; Thirst; Rapid, unexplained weight loss; and Extreme weakness and fatigue.

CHANGING YOUR MIND ABOUT DIABETES

Despite the surge in the incidence of Type 2 diabetes, specifically, in recent years, however, it appears many still don’t take the threat of developing the condition seriously. Part of the problem may lie in myths that still surround diabetes – for many it is still considered to be a disease of the rich, or the old.

Dr Lebo Shakoane “Conflicting viewpoints come from the fact that diabetes was once considered a health condition that affected the wealthy,” says Dr Lebo Shakoane, a Johannesburg general practitioner. “Doctors used to keep a closer eye over patients with diabetes than they did over others, but it wasn’t until such patients lost limbs or sight that most started seeing the seriousness of the condition.”

Nhlanhla Nombewu, a make-up artist who was diagnosed with Type 2 diabetes in 2008, says not even her mother’s diabetes prepared her for the inevitability of her own diagnosis. “Even when the symptoms drove me to see a doctor, I didn’t expect to test positive for diabetes,” she says.

Fortunately for Nombewu, the signs were Nhlanhla Nombewu glaring and rapid. “I had

Extreme thirst and unexplained weight loss can be an indication of diabetes.

Images: Shutterstock and supplied

TYPE 2:

Usually none in the first few years of having the condition. Thereafter, the same symptoms as for Type 1 diabetes may develop, but often not so dramatically.

In addition, patients may experience one or more non-specific symptoms, including: • Tingling or numbness in hands or feet; • Very dry skin; • Sores that are slow to heal; and • More infections than usual.

H E A L T H Y T I M E S l 65

HEALTH FOCUS

“The doctor said that, because of high cholesterol found in my blood tests, chances were high that it was caused by my poor diet. I used to eat rubbish, like steak, pap, chips, and I loved my beer. I was overweight, but I thought it was a sign of good health,” he says.

“That’s why we call it a lifestyle condition. People who realise that diabetes is a perfectly manageable, but potentially serious risk to their health, and are willing to choose their health over irresponsible lifestyles, are able to live very long, fruitful lives,” states Shakoane.

Both Nombewu and Thabethe had to wean themselves off their favourite beverages. Nombewu, who says she could easily down a 1.5-litre Coke in a day, has replaced that with water. She also stopped consuming white sugar and white rice. “I sometimes miss my old lifestyle, but I unfortunately can’t go back there, because it eroded my health,” she says.

Thabethe stopped drinking beer. “It actually left a bitter taste in the mouth. After the doctor explained to me how much weight it was making me gain, and the dangers of not making those changes, I actually started hating my old way of eating. Now I even go to gym.”

HOPE IN YOUR HANDS

“Unlike other chronic diseases, diabetes’ ferocity or control depends on the patient’s discipline,” notes Shakoane. “And the discipline can only come from a positive attitude. Positive attitude will drive a patient to take the test for diabetes before they get sick, and this, in return, can actually help the patient in many ways.

“If the test returns negative for diabetes, they can still start taking better care of themselves or intensify whatever measures have helped them. If it’s positive, they can adopt a new lifestyle immediately, before too much damage has been caused. There are people who were diagnosed with the condition at a very young age who are well into their senior years, leading healthy lives.”

frequent urination and was always thirsty, no matter how much water I drank. Within three days of developing the symptoms, I woke up feeling so dizzy I almost fell over. That’s when I went to the clinic.

After the tests, I was sent straight to hospital, where I was admitted for my blood glucose to be controlled. I was there for a whole week, and the doctors said I could have died. My blood glucose was at 28mmol/l.

Normal blood glucose ranges between 4 and 7.”

For George Thabethe, a long-distance truck-driver, the symptoms were not so typical. “My skin became very dry and itchy. My fingers and toes used to release a very strange sensation; it felt like they were releasing pins. My eyesight got blurry overnight, but I put all of the symptoms down to spending too much time on the road. Never once did I think I would test positive for Type 2 diabetes. At only 30, I felt that I was just not a candidate.”

He admits he would not have gone for tests if the last symptom had not surfaced. “I had erectile dysfunction. No man wants that kind of embarrassment. So I rushed to my doctor, and sadly, I was diagnosed with diabetes. I am the first person in my entire family, from both sides, to have the condition.

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GESTATIONAL DIABETES

As the name suggests, gestational diabetes occurs during pregnancy, when the placenta, which connects your baby to your blood supply, produces high levels of various hormones. Almost all of them impair the action of insulin in your cells, raising your blood glucose.

Modest elevation of blood glucose after meals is normal during pregnancy.

Gestational diabetes usually develops during the second half of pregnancy, and can affect the baby’s health and growth.

Images: ©iStock.com/jonas unruh/upsidedowndog

Uncontrolled diabetes can result in complications, but the good news is that diabetes is controllable.

EVERYDAY HEALTH

Heads

There’s no doubt headaches and migraines can be debilitating, but fortunately, serious underlying causes are rare, writes Mandy Collins

YOU WIN…

c

hances are, at some point in your life you’ve had a headache. And while some seem to suffer from them more than others, they’re a very common affliction, causing pain or discomfort in the head, scalp or neck.

While a bad headache might make you feel awful, the good news is that serious causes of headaches are rare. Most of the time, you can sort yourself out with some over-the-counter (OTC) medication, and simple lifestyle changes.

“The typical headache is a tension headache,” says Dr Naeem Brey, a consultant neurologist at Tygerberg Hospital. “Most patients describe it as feeling like there’s a tight band across their forehead and the back of their head, and sometimes into the neck itself.

Some say it’s a feeling of pressure.

“Tension headaches are usually episodic and are easy to sort out with OTC medication. They’re usually mild to moderate and last for a few hours, but if they persist for a few days, then it’s time to discuss them with your doctor and get some prophylactic [preventive] treatment.”

Surprisingly, Brey says prophylaxis might typically take the form of an antidepressant – even though you’re not depressed. “In neurology, we often use other medications for migraines and pain management,” he says. “Drugs like antidepressants, antihypertensives and anti-epileptic medications may help in preventing headache recurrence.”

MIGRAINES There is a lot about the cause of migraines that isn’t understood, but genetics and environmental factors appear to play a role, according to the Mayo Clinic. Migraines might be caused by changes in the brainstem and its interactions with the trigeminal nerve,

The duration of a migraine can be anything from three hours to three days.

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a major pain pathway. Imbalances in brain chemicals – including serotonin, which helps to regulate pain in your nervous system – may also be involved.

Whatever the causes, migraine sufferers know just how debilitating these headaches can be – when a colleague or family member genuinely suffers from migraines, chances are they have much more than just a bad headache.

“There are several different kinds of migraines,” says Brey. “Classic migraines come with what’s called an aura or a haze, which is a visual disturbance. An area of your vision might be blurred, dark or have bright zigzag lines,” he says. “This can be concerning for patients, especially in association with a headache – they think they have a tumour or they’re having a stroke. But it’s actually reassuring to get an aura with a headache, because the headache suggests that a diagnosis of migraine is more likely.”

Migraines are also often accompanied by nausea and/or vomiting, and an aversion to food. You may also experience photophobia (aversion to light) and phonophobia (aversion to loud noises). “This is why many migraine patients prefer to lie down in a darkened room,” notes Brey.

The duration of a migraine can be anything from three hours to three days. “For most people, OTC non-steroidal anti-inflammatories and paracetamol in conjunction with anti-nausea medication will sort it out. But if your migraines are frequent, you might need to take migraine-specific medication like a triptan, or even an anti-epileptic.”

There is also the common migraine – this is a throbbing, painful headache, often on one side of your head, but without the aura to forewarn you of its onset. “And rarely you may have a vestibular migraine, where you have the onset of dizziness, nausea and vomiting, with or without headache,” says Brey.

The key, he says, is to work out what is triggering your headaches.

And as soon as triggers are mentioned, people are happy to offer up a list of foods to avoid – coffee, chocolate, citrus and cheese being

favourites. “That’s simply not the case in the majority of patients,” says Brey. “And people don’t do well with lifestyle changes. Studies have shown that if you tell 200 people to make lifestyle changes, only one person will actually do what you suggest.

“More commonly, migraines are brought on by skipping meals, lack of sleep and hormonal changes, like menstruation or pregnancy.

And a very important consideration in female patients with migraine is to inform them of the increased stroke risk when taking certain oral contraceptives and smoking.”

Brey says he often has to reassure people that they don’t have a tumour. “The key is that if those symptoms settle and you have no other problems, you probably have a migraine.”

Cluster headaChes Cluster headaches are very rare and typically occur in males. They are exceptionally severe. “Generally they occur behind the eye, which becomes red and teary, and are accompanied by nasal congestion,” says Brey.

They’re called cluster headaches because they cluster at certain times during the day – so you’ll get them at the same time every day, or you’ll get them constantly for three months and then they’ll disappear. Usually they carry on for three to six months, and for about 30 minutes at a time.

“They’re also called suicide headaches because they are so painful,” says Brey. “The few women who get them say they’d rather give birth again, and most men say they’d rather have kidney stones.”

When your headaChe should Worry you Headaches on their own are usually no cause for concern, but there are some red flags to look out for, says Brey. “If your headache is in combination with seeing double, a weak arm or leg, speech disturbances, a fever and neck stiffness, or persistent blurred vision, get to your doctor or the nearest emergency centre immediately.”

Images: ©iStock.com/anatchant and Shutterstock

rebound headaChes

When an ordinary headache strikes, most of us know what over-the-counter medication works for us, whether it’s paracetamol, ibuprofen, aspirin, or sometimes a combination analgesic. But in some cases, Brey warns, the withdrawal of these drugs may actually be causing you pain, resulting in what is known as a rebound headache. the overuse or misuse of pain-relief medication is usually at fault – people take too much of the medication, or take it for too long. then, when it wears off, you experience a withdrawal reaction, prompting you to take more medication, which only leads to another headache and the desire to take more medication. the cycle continues until you start to suffer from chronic daily headaches and more severe headache pain. this is especially true if you are taking meds that contain caffeine, or those that contain opioids (eg codeine or tramadol). Caffeine is added to these compounds to speed up the action of other ingredients. and if you add that to the caffeine you normally consume, you might make the likelihood of a rebound headache even greater.

Usually, gradually reducing the quantity of medication you’re consuming until you discontinue it will help to control your headaches better. some people might need to be “detoxified” under more carefully controlled medical conditions. either way, you need to talk to your doctor if you suspect you have rebound headaches, so that you take yourself off the medication in the healthiest, safest way.

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HEALTHY PETS

Pet health IS FAMILY HEALTH Cath Jenkin offers some pointers to taking the very best care of your furry friend HAPPY PAWS, HEALTHY DIETS

With the wide range of convenience foods on the shelf, finding the right food for Fido or Felix can be overwhelming. For all pets, whether furry, scaly or otherwise, your first port of call should always be your vet, says Mari Borain, a qualified animal behaviourist at Good Pet South Africa.

“Your pet’s healthy diet starts with your healthy relationship with your vet. Consult with them as they assess your pet, and stick to the species-specific, vet-approved diet,” she advises.

Dog behaviourist Pam Naudé of Canine Communications – Doggy Minds adds: “There’s a big focus right now on canine nutrition, with many people looking to adopt a raw diet for their dogs. A change of diet can help with behavioural and health issues, but a raw diet is not appropriate or necessary for every dog. It’s essential that you get the correct advice on the balance they need when it comes to protein, vitamins and minerals. Bear in mind, too, that pets’ needs change as they get older.”

Ensuring your pet gets all of the nutrients it needs is the first step to ensuring a long, healthy life for it.

KEEP THEM LOOKING GOOD

Even though they may look as if they have it all under control, dogs do need grooming and bathing, especially if they have a longer coat. Regular brushing, bathing and nailclipping can form part of your routine with your dog.

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In general, short-haired dogs should be bathed once a month, while longer-haired dogs may need more than a monthly splash in the tub. Make sure you use dog shampoo, and not a brand made for humans or other animals.

Cats, on the other hand, usually don’t need any human help when it comes to keeping clean, but a regular session with a comb, to pull out any tangles or knots in long fur, can help.

If your cat has extralong hair, you’ll need to brush it regularly to keep the coat in tip-top condition. You won’t need to bath your cat, unless they happen to fall into something sticky or have a medical condition that requires it. Don’t forget, you’ll need a specialised cat shampoo for this too.

Ensuring your pet gets all of the nutrients it needs is the first step to ensuring a long, healthy life for it.

PLAYTIME!

“All dogs should get walked, and the time taken can depend on your family’s routines and dog’s needs. Sometimes even a drive in the car can be fun for the dog,” says Naudé.

“Your dog also needs mental stimulation, and not just physical exercise, so let them sniff around and

explore the world beyond your yard. A dog’s No 1 organ is its nose, and it needs to be able to put its nose down and learn about the world outside. Remember that playing with your dog is important too – playing fetch is not just a physical game, but a mental one too.”

While your feline may seem to be a lower-maintenance pet, cats also need to be entertained and exercised. Borain notes: “Cats don’t need to be walked, like dogs, but they do need exercise. We’d recommend climbing equipment, especially if they’re indoor cats, as cats love to climb and playtime is important. Cat posts, feathery toys and even a lid-free cardboard box are a great start when you’re looking for cat toys.”

KEEPING PETS TICK AND FLEA-FREE

Ticks and fleas cause enormous discomfort to pets, and there are a variety of options for keeping these pests away from your animals – from medications applied to the skin in a single spot to dips you can get from your vet (although these probably won’t go down well with cats).

You can also try flea collars, for both dogs and cats. There are two basic types: one emits a gas that repels pests, and the other has medication that seeps into the fat layer on the dog’s skin or active ingredients that spread using the dog’s natural skin oils.

DOES MY PET NEED MEDICAL INSURANCE?

Cats don’t need to be walked, like dogs, but they do need exercise.

Seasoned dog and cat owners might quip that having a pet can be just as expensive as having a child, and, if you happen to have a pet with certain medical issues, this could almost be true.

Medical insurance for pets makes a lot of sense when you tally up those vet bills. Just as for humans, you can choose between relatively inexpensive hospital plans or fully comprehensive packages.

VISIT TO THE VET

A FURRY FINAL WORD

Going to the vet may not be your pet’s favourite thing to do, but it is an important part of petcare, especially when they fall ill. You’ll also need to ensure that your cats and dogs are regularly vaccinated, as this can prevent a wide range of diseases, including rabies, distemper and respiratory diseases.

Your vet can supply you with a list of important vaccinations. Many veterinary practices now make use of online, email or SMS reminders when your pet needs to have an injection or a check-up.

It’s important to work with your vet – if you’ve taken your pet in for treatment and the treatment doesn’t appear to be working, pick up the phone or take your pet back. Your vet can’t adjust treatment if he or she doesn’t know that there is an issue.

Adding a furry friend to your family is an important decision to make.

Consider it carefully before adopting, and remember that it can be hard work catering for the needs of an animal. All that hard work will be worthwhile, though, as a companion pet could give you and your family years of joy.

KEEPING TRACK

Images: Shutterstock

The world of technology can also help you to be a better pet parent.

Borain recommends getting your animals microchipped. “Your dog or cat won’t just find their way home if they get out or lost. There are now also trackers you can get for pets that use GPS technology to locate them, and which can feed that information right to your phone.

But microchipping your animal is the most essential step.”

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HEALTHY RECIPES

up

One of the best things about winter is a bowl of steaming soup. And it’s a good way to get in some of your fivea-day vegetables too, says Mandy Collins

QUICK BEAN AND VEGETABLE SOUP

QUICK PEA AND HAM SOUP

SUPER-QUICK TOMATO SOUP

Olive oil for frying 1 onion, chopped 1 stick of celery, cut into 1cm cubes 1 carrot, cut into 1cm cubes 1 red pepper, cut into 1cm cubes 2 baby marrows, cut into 1cm cubes 1 tin (410g) chopped tomatoes in tomato juice 750ml vegetable stock (from a stock concentrate or cube) Salt and pepper, to taste 5ml sugar 1 can (410g) of your favourite beans

15ml olive oil 15ml butter 1 onion, chopped 500g frozen peas 1 litre vegetable or chicken stock (from a stock concentrate or cube) 150g cooked ham, cut into 1cm pieces (optional) Salt and pepper to taste

1 jar best-quality napoletana (or similar) pasta sauce 1 handful basmati rice or small pasta shapes

METHOD:

Heat a little olive oil in a pot over a medium heat, and gently fry the onion, celery and carrot until the onion looks glassy. Add the red pepper and baby marrows, and fry gently for a further two to three minutes. Add the tinned tomatoes, vegetable stock and sugar, and bring to the boil.

Simmer until the vegetables are tender. Adjust seasoning to taste. Blend the soup until it’s smooth, in a liquidiser or using a stick blender (you can also mash the soup with a potato masher if you don’t have a blender). Drain the beans and add them to the soup. Warm the soup gently until the beans are heated through.

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METHOD:

Heat the olive oil and butter in a pot over a medium heat, and fry the onion gently in the mixture until it becomes translucent. Add the peas and stock, and bring to the boil. Allow to simmer away for about five minutes or until the peas are tender. Purée the soup in a blender or with your stick blender until it’s bright-green and homogenous in texture. Taste and adjust seasoning if necessary. Add the ham if desired, and warm through. Serve with warm, crusty bread.

METHOD:

Empty the contents of the jar into a pot. Fill the jar with water, and add that to the pot.

Throw in your handful of rice or pasta and bring the soup to the boil, stirring constantly to keep the pasta and rice from sticking. Simmer until the rice or pasta is done. Serve with grilled cheese on toast.

If you freeze the leftovers into individual portions, you have a great lunch ready to go, with only some reheating required.

Images: ©iStock.com/AnnaVolotkovska and Shutterstock

SOUPED

s

oup can be one of the healthiest foods around, if you lay off the cream. Filling and nutritious, it’s also a quick and easy dinner, and if you freeze the leftovers into individual portions, you have a great lunch ready to go, with only some reheating required.

You also don’t need anything fancy – just the simplest of ingredients and a few minutes on the stove, and you’ll soon have something delicious to eat.

Try these simple recipes – even the most ham-handed of cooks should be able to manage them. You can add any other vegetables you like to the vegetable soup, and it’s always worth having a jar of good pasta sauce in your grocery cupboard to make this delicious tomato soup.