Healthy times October 2016 by Healthy Times

SURVIVING SUMMER ALLERGIES

HOW TO KEEP YOUR HEART HEALTHY

TIPS TO HELP YOU SLEEP

NOVEMBER 2016

The skinny on juicing

MAKE THIS HOLIDAY YOUR

HEALTHIEST

BOB AND EUCHARIST MABENA How they keep love

strong

Be sun-safe this summer

contents NOVEMBER 2016

27 4

FROM THE EDITOR

COVER FEATURE: HEALTHY RELATIONSHIPS Bob and Eucharist Mabena on what makes love last

HEALTHY SUMMER Top tips for a healthy summer

HEALTHY EATING Proposed tax on sugar-sweetened drinks

HEALTHY BODY 10 self-care tips for diabetes

HEALTHY EATING Juicing

CONSUMER KNOW-HOW How to read a food label

HEALTHY SKIN Here comes the sun

AGEING WELL Design your smile

HEALTHY EATING You don’t have to deprive yourself

HEALTHY SUMMER Surviving summer allergies

HEALTHY BODY Young breast cancer survivors

HEALTHY FINANCES Controlling the costs of medication

HEALTHY HEART Risk factors and symptoms of heart disease

HEALTHY BACK Strategies for a strong, stable spine

HEALTHY PETS Keep your pets safe this summer

HEALTHY SLEEP Sleep disorders and how to get a good night’s slumber

HOW TO… Do a DIY pedi like the pros

HEALTHY HOLIDAYS Holiday eating and ﬁtness

HEALTHY EYES Eyecare basics

FROM THE EDITOR

summer sun

he older I get, the more relieved I feel when spring and summer roll around. I just don’t seem to have what it takes to cope with the cold of winter anymore – even if our winters are short, sharp affairs. So I’ve been delighting in the profusion of spring blossoms in my neighbourhood, when I take my daily walk. They always cheer me, and I’m looking forward to the change of lifestyle summer brings. Somehow, in summer, it feels a lot easier to stay healthy. We are blessed with magnificent summers in South Africa, and we spend a lot more time outdoors being active, whether it’s playing beach volleyball, splashing around in the pool with the kids, or hiking through our country’s varied landscapes. But while we all need some sunshine to help our bodies to manufacture vitamin D, the African sun comes with its fair share of hazards – skin cancer being one of them. So we’re urging you to be sun-safe this summer, on p35. Slather on the sunscreen, stay indoors during the hottest part of the day, and always wear a hat when you’re going to be outside for an extended period. But there’s a lot more to health than just your skin, of course, so we’ve packed this issue with all kinds of advice, from all kinds of experts, on how to keep healthy from top to toe. You’ll find tips on diet, exercise, eye health, diabetes, and how to get a good night’s sleep. We even have your holiday covered – no more getting back from holiday tired, overweight and unfit. Follow the advice in our article on p70 and you’ll come back feeling as you should – rested, revived and rejuvenated.

We’re urging you to be sun-safe this summer.

Holiday season is almost upon us, so until then, we wish you the strength you need to get through all of the end-of-year deadlines and parties and school events. Keep the basics in place – eat well, exercise, get enough sleep and drink moderately – and you should have the stamina you need.

Mandy Collins Editor

4 l HEALTHY TIMES

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SOAKING UP THE

EDITORIAL Editor: Mandy Collins Art Director: Janine Wait Content Manager: Raina Julies Copy Editor: Joy Capon Contributors: Louise Ferreira, Caryn Gootkin, Georgina Guedes, Penny Haw, Nia Magoulianiti-McGregor, Zaza Motha, Prevashni Naidu, Tamara Oberholster, Nicole Sparrow Cover image: Nic Baleta

FulvicForce

COVER FEATURE: HEALTHY RELATIONSHIPS

Friendship,

FAITH AND FUN

Bob and Eucharist Mabena on what makes love last 6 l HEALTHY TIMES

Even the best relationships can run into difficulties from time to time. Whether you’re working long hours, adjusting to the changes and challenges children bring, or keep arguing about money, you’re not alone. Louise Ferreira speaks to radio host Bob Mabena and his wife, Eucharist, about how they keep their relationship healthy, and asks two professionals for advice

ob Mabena (47) has worked in radio for over two decades. He hosts a popular weekday evening show on Kaya FM, and has his own media consultancy. His wife, Eucharist (36), works at MRC Media in Sandton, “basically running the office”. It was at the restaurant just outside her office building, in fact, that the two first realised they were attracted to each other. “We were friends; we still are,” Eucharist says. “But we actually really hooked up at this very restaurant four years ago in August.” “The month after my birthday,” Bob adds. He knew immediately that he wanted a serious relationship. “It was the second day we started going out, and he said, ‘If I could, I would put a ring on you’, and I thought he was mad,” says Eucharist. “I laughed it off. I actually texted him back and said, ‘You’re crazy, go to sleep.’” Bob eventually proposed in January last year, and the two celebrated their first wedding anniversary this October. Their son, Elihu, is now seven months old. When they talk about their relationship, what Bob calls “the M-word” often comes up: maturity. Clearly, it is a quality they value greatly. “I’m three years short of 50,” he says. “If I’m not mature by now…” “Being mature really helps in relationships. I believe that when you get into a relationship, you have to put your cards on the table. Your partner has to know what makes you tick, what drives you up the wall. If that communication channel is always open, I don’t feel like I’m nagging when I bring up something that bothers me,” Eucharist says. What is the most important thing for you in a relationship? “Respect,” she says immediately. “If you give respect, that’s what you get back.” Bob believes that learning new things about yourself and your relationship is valuable. He hates conflict and is used to avoiding it; now he’s making the effort to talk about it instead. “I’m also learning to divorce issues from people – not saying ‘you made me feel this way’. So I’m getting better at communicating.” “[In an argument] I used to pack up and go, to get myself out of this environment. Now I’ve learnt to stay calm, to engage the issue,” says Eucharist. They communicate openly and, as such, have a trusting relationship. “We’re open, hey,” says Bob. “I don’t hover around my phone; she

doesn’t hover around hers. It gives you peace of mind.” “He knows what upsets me, and I believe he will not hurt me intentionally,” Eucharist adds. “And vice versa.” Again, maturity plays a big role. “I always tell my friends I don’t have to worry about my husband, because he’s not a boy. This is a mature man who knows what he wants.” Fun and playfulness are a must for the Mabenas, and it’s clear from the affectionate way in which they interact with each other. During our interview, they laugh often. “Before we got our boy, we played a lot,” Bob says. “He’s only seven months old, so you can imagine, since the pregnancy and seven months, we haven’t played all that much. He’s got all the playtime in the world!” Eucharist explains that they differ when it comes to “quite a few things”. “Raising kids – okay! Our style of raising kids really differs. I’ve got my boy from a previous relationship, who is 10 years old, and he’s got five of his own, who are grown up. He thinks I’m soft, and I think I’m the one who’s really strict, because I’m the one who will get them to do it. I’m learning his style, and it’s hard. I raise my kids how I was raised, and I come from a very strict background. He’s more friendly.” Having children forces a couple to make huge adjustments to their lives. Dr Adele Romanis, a clinical psychologist from Johannesburg, says one of the major issues she sees in her practice is partners who don’t make time for themselves as a couple. This happens especially after having kids, when the distinction between the marital relationship and the parenting relationship blurs; one example is referring to each other as Mommy or Daddy. “The marital and the parenting relationship have to run parallel,” Romanis points out. In a country like South Africa, where the work culture is prominent, and we have to deal with traffic and long commutes, couples who then get home and have to take care of the kids are often too tired to make time for themselves or each other. “Date night is rare, and then it’s always going to the same restaurant, sitting in the same chairs, having the same conversation,” Romanis says. She suggests that couples make time to do something fun together, such as ten-pin bowling or a comedy show. Communication is one of the keys to a healthy relationship. Why, then, is lack of communication such a common complaint?

Image: Nic Baleta

“If that communication channel is always open, I don’t feel like I’m nagging when I bring up something that bothers me.” – Eucharist Mabena

HEALTHY TIMES l 7

COVER FEATURE: HEALTHY RELATIONSHIPS

“People feel like they do communicate, because they’re talking, they’re having conversations,” Romanis explains. “But they need to look at the effectiveness of their communication.” It is the responsibility of both parties to ensure that they’re getting the message across, as well as making sure they understand what their partner is saying to them. One of the best ways of doing this is to repeat what you understood, Romanis says. If this is a big problem and you’re arguing often, suggesting that you’re not communicating properly, ask your partner what it is that you’re doing and saying that is unclear. Tertia Carroll, director of FAMSA (Families South Africa) on the West Rand, has spent years observing relationships. In a marriage or long-term partnership, members of two different families form their own family. “Too many people underestimate the enormous adjustment this brings about,” Carroll says. “[Even] two families staying in the same suburb, speaking the same language, sharing the same ethnic background, still constitute two cultures. The partners in the new family need to decide what they will ‘keep’ from each family of origin and what they will adopt from other role models in society, or create their own norms and values.” If these decisions are not made consciously, as pressure increases from careers and children, and lifestyle choices, conflict may arise. Carroll suggests pre-marital counselling and marriage enrichment as ways to prepare for possible future conflict. What about people who struggle to trust their partner? “When there is a shift in emotional distance, or in behaviour, people are very good at picking it up,” Romanis says. “Mistrust also comes from the other person’s need for reassurance. “Trust issues are often the result of trust difficulties in a previous relationship. You definitely should take care of unfinished business before moving onto the next relationship, otherwise it’s unfair on the new person.” In this kind of situation, mistrust also tends to escalate more quickly, even when the other partner has displayed no unusual behaviour. At the same time, you should trust your gut instinct, Romanis says. If something doesn’t feel right, you should address it. “For example, you can say, ‘I feel some distance; is there anything you’d like to bring to my attention? I feel like you’ve pulled away.’ It’s important that you say this is how you feel, rather than just accusing your partner of pulling away.” Finances can be a big problem, as people often don’t want to talk about money. Romanis suggests having a regular “financial date night” to discuss it, but not the week before or after you get paid. “Money has a lot of emotions attached to it, a lot of power and control,” she says. “So it’s really about being upfront and having the hard conversations, because, at the end of the day, the bills still have to get paid.” She points out that different people handle money in different ways. Some are spenders, some are savers; some people are good at

sticking to a budget, others are not. “A lot of the time the saver will take control and restrict the other person’s spending, which can be quite frustrating. It feels like they’re being parented.” She adds that spending is important too, and that managing your finances doesn’t have to involve trying to hang on to every cent. Ultimately, Romanis says, relationships should be fun. “They’re work and they’re serious, but they should also be fun.”

“The marital and the parenting relationship have to run parallel.”

8 l HEALTHY TIMES

TOP TIPS FOR A HEALTHY RELATIONSHIP Tertia Carroll, director of FAMSA West Rand, shares 10 tips for keeping your relationship healthy • Make time for each other. • Talk about everything, good and bad. Never rely on rumours or assumptions. • Learn each other’s love languages. These are: words of affirmation, physical touch, gifts, quality time, acts of service. • Be the “safe place” for your partner. • Loyalty above all is key to a good marriage. • Seven areas on which couples must agree are: finances, relating to in-laws, friends, parenting children, sex and intimacy, recreation and religion. • Forgive easily. • Your partner/spouse is your first priority. Friends, family, children, careers are seasons in your life. Your spouse will be there when you are old, if you cherish your relationship. • Be your spouse’s best friend: honest, transparent, dependable, trustworthy, fun to be with. • Maintain weekly date nights. Away from the family. Alone. Intimate. If you don’t build your relationship, it will lack in the inevitable storms. What you put in is what you get out.

Image: Nic Baleta

– Adele Romanis

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HEALTHY TIMES l 9

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

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HOT AND UNBOTHERED

HEALTHY SUMMER

We’ve got you covered with our top tips for a healthy summer

LIFE-GIVING WATER

BERRY LOVELY

To improve your diet this summer, have a cup of mixed fresh berries every day. They’re packed with antioxidants, which may help to reduce the risks of age-related illnesses, and damage to your body’s tissues. They’re also full of fibre, which helps to keep your cholesterol low.

Images: ©iStock.com/fcafotodigital/IvanZivkovic/lutavia/MorePixels

EAT HEALTHY FATS

One of the healthiest parts of most Mediterranean diets is olive oil. This monounsaturated fat contains essential fatty acids that help your skin to resist UV damage and keep it moist. In order to protect your skin and keep it supple, consume about one tablespoon (15ml) of olive oil a day – just add it to a healthy salad or fish dish, or drizzle it over your food for extra flavour. Cold-pressed extra virgin olive oil is the best way to consume it if you’re not cooking with it. You can use ordinary olive oil for cooking. And it’s not just your skin that will benefit. Studies report that people in Mediterranean countries have longer life expectancies, and lower risks of heart disease, high blood pressure and stroke, compared with North Americans and northern Europeans.

It’s easy to dehydrate in summer. Remember that sweating is your body’s inbuilt cooling system, so when it’s hot, your body loses more water. And if you exercise in the heat, you sweat even more than usual. Dehydration can leave you feeling tired, and it can also make you eat more than you need – our body’s hunger and thirst mechanisms sometimes get confused. So it’s vital to ensure that you take in sufficient fluids, especially water. One way to ensure you’re hydrated is to keep an eye on your urine, which should be a pale straw colour. If it’s completely transparent, you’re drinking too much, and if it’s a dark yellow, you need to drink some more. And if you don’t fancy the taste of plain water, add lemon, slices of cucumber or chopped strawberries for some low-calorie flavour. Or opt for healthy alternatives such as green tea or coconut water.

COME IN, THE WATER’S LOVELY

There’s nothing like a swim to cool you down, provide impact-free exercise and leave you feeling refreshed. Swap some of your morning runs for a good workout in your gym or public pool. Start by swimming for 10 minutes and then gradually increase your time over the following weeks, until you can swim a kilometre at least. Most gym and public pools are 25m long, so that means building up to 40 lengths. Mix it up with a variety of strokes, and do a few lengths of just kicking, for super-toned legs. But if swimming laps isn’t for you, why not join an aqua aerobics class? To get the best out of it, work against your natural buoyancy, so that you resist against the water pressure. You can also create your own aqua aerobics workout by doing jumping jacks, marching and jogging in any pool. Sources: WebMD, The Mayo Clinic, Medical News Today H E A L T H Y T I M E S l 11

HEALTHY EATING

TAKE THE BITTER WITH THE sweet

The South African government is planning to heavily tax sugar-sweetened drinks. Mandy Collins asks the experts if it’s likely to have the desired impact

or some time now we’ve been paying so-called “sin tax” on alcohol and tobacco products, and the next sin we’re going to atone for with our wallets is set to be sugar. Government has proposed a tax on sugarsweetened drinks from next year. The rationale behind the tax is growing concern worldwide around excessive sugar consumption, which is one of the contributing factors to a sharp increase in obesity and associated lifestyle diseases, such as cardiovascular disease and diabetes, as well as dental caries. There has been a great deal of debate around this issue already. Predictably, the beverage industry is opposed to the tax, as it stands to lose the most, thanks to potential falling revenues. Many are questioning whether the tax is likely to change consumers’ behaviour.

“Sugar and refined carbohydrates are at the root of what causes insulin resistance, the precursor to diabetes.” Images: ©iStock.com/mattjeacock/solidcolours

– Dr Peter Hill

Research, however, seems to indicate that it will. Dr Peter Hill, a diabesity practitioner, says: “Diabetes and obesity – or diabesity – are chronic diseases of lifestyle. They require lifestyle modification. Before I did any research into this issue, my gut feeling was that the impending sugar tax was a way for the state to line its coffers. “However, I have looked at large review articles that examine the effects of other, similar taxes – on alcohol and tobacco. In the case of tobacco, raising the price was highly effective in changing the behaviour of young adults and those in lower socio-economic groups. For alcohol, raising the price is also effective in reducing excessive alcohol consumption. “Then I looked at a review article for taxes on sugar, done in

2013, and all the studies showed that higher prices resulted in lower demand for sugarsweetened beverages.” Adds dietician and FAB Quotient co-founder Celynn Erasmus: “Prof Karen Hoffman from the Wits School of Public Health has done some excellent research in this area, and her research findings demonstrate that taxing sugared beverages will create the desired effect of changing behaviour. “There is compelling evidence to support the notion that sugared beverages are a source of significant nutrient-void kilojoules, which in part account for the overconsumption of both kilojoules and sugar among many South Africans. The tax in itself creates awareness that this category of ‘foods’ is not an ideal choice. “Perhaps, at the very least, parents will think twice about serving these beverages to their children. However, I don’t feel that it should be a standalone strategy. It needs to form part of a multi-pronged approach towards combating the obesity epidemic in South Africa.” Hill agrees. “The tax, for me, is part one. There’s no point in doing this if you allow school tuckshops to sell sugared beverages, even at a higher price. I’d like to see the state taking sugar out of our schools completely, and making access to it more difficult for kids, as has been done with smoking and alcohol.” Hill says there is reason to be very concerned about South Africa’s children. “A study done in Umtata showed that 20% of children aged 13-17 had high blood pressure. Also, remember that Type-2 diabetes used to be called mature onset diabetes. That is no longer the case.” Of course, obesity is more complex than just one ingredient or foodstuff. All kinds of factors are feeding the global obesity epidemic. But, as Hill points out, sugar and refined carbohydrates are at the root of what causes insulin resistance, the precursor to diabetes. Erasmus offers a closing thought: “While it is in the interest of the government to assist the population in making better choices, ultimately the onus is on the individual to manage their health and lose weight. There is no one-size-fits-all approach to losing weight effectively, but sustainable weight loss involves making changes to your diet and your physical activity that you can sustain long-term.” H E A L T H Y T I M E S l 13

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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 S.A., 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 (Cape Town) and Life Hilton Private Hospital (KZN) provide 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 third Novalis Tx™ system will become operational at specialist Life Healthcare oncology centre in Pretoria, Gauteng, in early 2017.

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

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ADVERTORIAL

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

Life Healthcare

@LifeHealthcare_

using photo voltaic (PV) panel installations at Life Anncron Hospital (North West province) and Life Fourways Hospital (Gauteng). The Life Fourways Hospital installation is the most recent, with a total of 1 846 solar panels which cover the roof of the entire hospital. On a sunny day the PV can generate approximately 3 MWh of energy each day, which is enough to power 272 houses with power every day.

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 BODY

10 for diabetes

SELF-CARE TIPS

Have you or a loved one recently been diagnosed with diabetes? It’s undoubtedly a daunting and bewildering time. Fortunately, there is plenty of information and support available to assist you in managing the condition. Penny Haw asked for help from the experts in compiling a toolkit

INFORM YOURSELF, EMPOWER YOURSELF. Diabetes is the shortened name for diabetes mellitus, the condition in which the pancreas does not produce insulin or enough insulin (Type 1 diabetes), or your body is unable to use insulin effectively to move glucose into the cells that require it (Type 2 diabetes). But what does that mean for you? The first step in diabetes self-care is to learn as much as you can about your condition (without feeling overwhelmed), so you can treat it effectively, and live as happily and healthily as possible. A good understanding will empower you to make the right choices about your health. There are several free sources of information about diabetes available in South Africa, and it’s worthwhile reading as much as you can. But the best information is that which you receive one-on-one initially from your doctor and, thereafter, from a diabetes educator or other specialist healthcare worker. This interaction will focus specifically on your condition and the treatment thereof, within the context of your general health and lifestyle. You might also consider joining a diabetes support group in your area. Important to note, too, is that support is valuable not only to someone with diabetes, but also to their family and friends. So, where possible, include your loved ones in meetings with healthcare practitioners and support groups. There are also several specialist diabetes magazines available, both in print and online, which offer

Image: Shutterstock

Support is valuable not only to someone with diabetes, excellent information. These include Diabetes Lifestyle (published by the Centre for Diabetes and Endocrinology (CDE)) and Diabetes Focus but also to (produced by Diabetes South Africa (DSA)). their family BRACE YOURSELF. If you have Type 1 2 diabetes, always carry sugary sweets and friends. or drinks with you. Wear a MedicAlert or Mediband bracelet with the appropriate information, such as “Diabetes. Give sugar if confused”, written on it.

GETTING TO GRIPS WITH GLUCOSE. Managing diabetes means ensuring there is not too much or too little glucose in your blood. Glucose gets into your blood from the food you eat, particularly carbohydrates. This means you have to watch what,

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when and how much you eat, and you need to exercise regularly. You might also have to take tablets or have insulin injections. Your health practitioner will prescribe the appropriate treatment and teach you how to monitor your glucose levels. The important thing is to know when to test and how to act on the results.

EAT RIGHT. Because food is what puts glucose in your blood, what, when and how much you eat are crucial to your health. You need to eat the right proportions of different types of food. The age-old story applies: it’s all about moderation and balance. Space more or less consistently sized meals evenly throughout the day. It’s preferable to eat small quantities regularly rather than a few large meals, and always eat protein with carbohydrates. Not all carbohydrates are bad, but refined carbohydrates (such as white bread, white rice and pasta) “dump” large amounts of glucose into your blood. Wholegrain and low-GI (glycaemic index) carbohydrates in small portions enter the bloodstream slowly and have less of an impact on blood glucose levels. If possible, eat at the same times each day. Use salt and sugar sparingly, and eat small amounts of fat. Drink plenty of water, keep alcohol consumption low, and avoid sweetened drinks, fast food, cakes and sweets, and refined carbohydrates.

Exercise is one of the three pillars of diabetes management.

TEST AND KEEP RECORDS. Measuring, monitoring and recording your glucose levels can expedite effective diabetes management. Not all people with diabetes have early-warning signs of hypoglycaemia (low blood sugar), which is why it is important to regularly check your blood glucose levels. Keep a record of your test results to take with you when you next visit your doctor or clinic.

GET TO KNOW THE SIGNS. Once you know you have diabetes, it becomes easier to recognise your body’s warning signals indicating you have too much or too little glucose in your blood. For high blood glucose levels, signs include going to the toilet more often than usual, feeling tired and weak, experiencing great thirst, and/or not seeing well. When you experience any of these, it could mean you are not eating healthily, exercising and/or taking your medicine as prescribed. If you are indeed doing all of these things, you need to return to your doctor or clinic for advice.

BE EXTRA-ALERT FOR LOW BLOOD GLUCOSE. If you take diabetes tablets or insulin and you begin sweating; feel confused, faint, weak, shaky, nervous, irritable or even drunk; and/or your heart begins pounding and your arms and hands feel numb, these could be signs you have too little glucose in your blood and are suffering hypoglycaemia. Eat a sweet or have a sweet drink immediately, followed by a sandwich.

10 GET MOVING. Physical activity helps to control diabetes, and has many other health benefits, such as lowering cholesterol, improving blood pressure, reducing stress and anxiety, and enhancing general wellbeing. Exercise is one of the three pillars of diabetes management, the other two being diet and medication. Try to exercise at least three times a week, for 30 minutes each time.

BE VIGILANT ABOUT MEDICATION. Take medication as prescribed. Do not stop unless your doctor tells you to. If you take tablets, take them with meals at the same time every day, and make sure you always have enough medication. If you need insulin injections, learn how to test your glucose levels, manipulate doses and inject yourself skilfully to make injections as pain-free as possible. Your doctor, nurse or clinic sister will be able to help you with this. Pay close attention to information about taking and storing your medication. 24 l H E A L T H Y T I M E S

WHERE TO FIND HELP • Centre for Diabetes and Endocrinology (CDE), 011 712 6000, www.cdediabetes.co.za • Diabetes South Africa, 086 111 3913, 021 425 4440, www.diabetessa.org.za

Images: Shutterstock

TAKE SPECIAL CARE OF YOUR FEET, EYES AND MOUTH. Small injuries incurred by people with diabetes can easily become infected, which is why it is important to take special care of your feet. Because diabetes can reduce the flow of blood to your feet, they need additional attention. Check your feet for wounds every day. Clean and dry them – particularly between the toes – and use lotion to keep feet soft, but don’t put it between your toes. Keep your toenails trimmed in a neat, safe way. Do not walk barefoot. Wear comfortable, well-fitting shoes. Check the insides of shoes carefully for foreign objects before putting them on. High blood sugar can affect your eyesight. Have your eyes tested annually – even if they seem fine. Brush your teeth twice daily, visit your dentist regularly, and don’t forget to remind him or her that you have diabetes.

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info@pierre-fabre.co.za

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HEALTHY EATING

PUTTING THE squeeze ON

Drinking your nutrients from fresh fruit and vegetable sources would sound like a tempting proposition to most time-pressured, reasonably health-conscious folk engaged in the daily 9-5 grind. But, suggests Prevashni Naidu, before you rush out to buy yourself the Bentley of juicers, get the facts about juicing ﬁrst

Images: ©iStock.com/Dzevoniia and supplied

ave you caught the Netflix documentary Fat, Sick and Nearly Dead, which chronicles the healthy-eating mission undertaken by Aussie entrepreneur Joe Cross? If you have, you’ve probably also seriously contemplated embarking on your own juicing transformation journey. There is no doubt that the juice trend has taken a firm hold of the world’s health-seekers, says Tamara Ogilby, owner of The Juice Kitchen in Hillcrest, north of Durban. “The market is still relatively small in South Africa, but it’s fast gaining momentum. To put it into perspective, there are as many juice bars in New York as there are coffee shops. Even Starbucks now Tamara and Mark Ogilby offers fresh cold-pressed juices.” Ogilby, who has designed her menu with the help of leading diet experts, started her juice bar after relocating from the UK three years ago. “My husband and I moved back with our three small children, and we soon realised that the juice revolution which was taking place in London, New York and Australia hadn’t hit South African shores yet. We started juicing when our children were born as an easy and effective way of getting them to get their required daily intake of fruit and veg.” Danielle Roberts, nutritionist for the Sharks rugby team, has also observed an increased interest in juice-based diets among clients. “There are certainly many health benefits of drinking freshly juiced fruits and veggies,” says Roberts, who concedes that Dietary Guidelines recommending eating upwards of four to six portions of fruit and vegetables a day is a tough ask for most, and suggests juicing to get your daily fix of nutrients if you don’t have time to get the full complement in through eating alone. “I think of it as a great motivator to set good eating patterns for the day. I usually make myself a healthy breakfast juice or smoothie,

and I know I’ve given my immune system a boost. I find that it staves off cravings for unhealthy snacks during the day, if used to supplement a healthy meal plan.” According to health authorities such as the Mayo Clinic, fruits and vegetables do retain most vitamins, minerals and plant chemicals (or phytonutrients) through the juicing process. “They contain valuable compounds called flavonoids and anthocyanins, which guard against cellular damage, which is very common in modern lifestyles that expose us to chemicals and pollution,” Roberts explains.

JUICING AND SUPERFOODS

Getting the highest nutritional value from your juice, however, requires substantial research and experimentation, suggests Prime Human Performance Institute dietician Keri Strachan, whose first course of action with all of her clients is to establish the very best eating patterns, before supplementation or juicing is even considered. Enter the era of the “superfood”. With so many fruits and vegetables facing the rap over the pesticide and herbicide toxins present in them, it’s a relief to know that experts have started directing us towards foods that are naturally nutrient-dense and, basically, awesomely beneficial to our health and wellbeing. Introduced as a term in 2004, a “superfood” was defined by Dr Steven Pratt (author of Superfoods Rx: Fourteen Foods That Will Change Your Life) as a food that is readily available; contains essential nutrients that enhance longevity; and has scientifically based health benefits. Not only are these foods extremely beneficial to our health and immunities, but they are so nutrient-dense that they increase our natural energy levels, while at the same time helping us to lose weight. Incorporating superfoods in your juicing recipes, therefore, could give you that extra nutrient boost you’re looking for. (For a list of superfoods that could easily be included in your daily juicing ritual, see The Juicer’s Superfood list on page 28.)

There are as many juice bars in New York as there are coffee shops.

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A QUICK WAY TO WEIGHT LOSS?

Juice proponents are quick to point out, however, that long-term juice diets should not be seen as the magic bullet to weight loss. Roberts, whose work with the Sharks has given her an intimate understanding of the athletic body type and its nutritional requirements, explains the cons of sustained juice fasting to lose weight. “Apart from the loss of fibre that interferes with gut health, the high levels of fruit sugars and the lack of protein are major triggers to ill health some time down the line. If you’re aiming for good health, and muscle mass, which becomes even more significant to overall physical wellbeing as we age, juicing alone can severely compromise your health.” Strachan adds: “Most juice fasts contain far too few kilojoules, which causes your metabolism to slow down in order to conserve energy, so once you return to your usual diet, you’ll most certainly end up regaining the weight, and maybe even more. Avoiding solid foods that contain essential nutrients such as fibre can be extremely detrimental to your health. Fibre is extremely important for your digestive health, which is your gut. Good gut flora determines your entire immune system and how well-equipped you will be to fight off disease and infection.”

Apart from the loss of fibre that interferes with gut health, the high levels of fruit sugars and the lack of protein with sustained juice fasting are major triggers to ill health some time down the line.

EXPERT RECOMMENDATIONS BEFORE YOU BEGIN • Juicing should never substitute medical treatment or medical diagnosis. Always consult with your physician and a dietician before stopping a course of medication. • If you do decide to go on a “juice fast” or “juice cleanse”, make sure your recommended dietary allowance needs are met. Never go below 1 200 calories or 5 500 kilojoules (this is the minimum amount of energy required to maintain healthy bodily functioning). • Pesticides and bacteria thrive on unwashed fruits and vegetables. Thoroughly wash your ingredients before juicing, along with the utensils and cutting boards you use to prepare your ingredients for the juicer.

THE PERFECT HOME JUICER?

Juicers are a big investment. Do your research before purchasing. Masticating, or cold-pressed, juicers crush and mash ingredients, using every last bit of produce being pulped. Consumer Reports (http://www.consumerreports.org/cro/juicers/buying-guide.htm) says these juicers can jam when grinding tougher fruit and veg varieties, so look for options with a reverse button. Although slightly more expensive, masticating juicers tend to leave more healthful and fibre-rich pulp in the juice. Centrifugal juicers are the second most-common types of juicers available. Known commonly as “juice extractors”, they use a rapidly whirling disc that cuts the produce, then spins it to separate the juice from the pulp. 28 l H E A L T H Y T I M E S

Images: ©iStock.com/gmevi and Shutterstock. Infographic supplied

• While drinking fresh is always recommended, you can store your juice in an air-tight, preferably glass container to drink later on. Exposure of the juice to air and bacteria may do you more harm than good.

CONSUMER KNOW-HOW

HOW TO READ A

food label

You are what you eat, they say, but when you read the label on some food products, it can make you wonder exactly what it is you’re putting into your body. Caryn Gootkin ﬁnds out what you need to know to interpret food labels

onsumers are more interested than ever before in what goes into the food products they buy – and with good reason. They want to be able to make informed choices about what to eat and feed their families. “On a very practical level,” says nutritional therapist Hannah Kaye, “if you have someone in the family with allergies or on a restrictive diet – no gluten, no lactose, etc – it becomes absolutely essential to read food labels correctly.” The good news for concerned consumers is that South Africa has strict regulations about how food products must be labelled and how they may be advertised.

INFORMATION THAT MUST APPEAR ON A FOOD LABEL

Food producers and distributors use carefully designed labels to promote their products to consumers. To avoid misleading marketing and to empower consumers, the regulations provide that certain information must appear on a food label. This includes: • The name of the product and a description (if not obvious from the name); • A list of ingredients, in descending order of mass; • A list of all common allergens – egg, cow’s milk, gluten, goat’s milk, fish, seafood and molluscs, tree nuts and peanuts; • Storage conditions; • Net contents in metric units; • Country of origin; • Date – best before/use by/sell by; • If nutritional claims are made on the product, the Typical Nutritional Information Table in the prescribed format; and • For vegetarian food – whether its lacto-/ovo-/or vegan. 30 l H E A L T H Y T I M E S

IT’S ALL ABOUT THE… INGREDIENTS One of the purposes of the food labelling regulations is to enable the consumer to make informed choices about food products, based on what they are made of, and how much of each ingredient is in the product. To achieve this, ingredients must be listed in descending order of weight, the first ingredient being the heaviest. “In addition,” says registered dietician and nutrition and food label consultant Gabi Steenkamp, “the list of ingredients must give the percentage of any ingredients which are emphasised in the product name or anywhere else on the label. So, if a product is called blueberry pie, for example, the percentage of blueberries in the pie must be indicated in brackets after the word ‘blueberry’ in the ingredients.”

THE NUTRITIONAL INFORMATION TABLE

The law requires producers and distributors of food products with nutritional claims to include specific information on their labels. “Products without nutritional claims don’t have to contain nutritional information, but it’s usually added voluntarily to most food products,” says Steenkamp. Either way, this information must be contained in a prescribed format. The table below, taken from the regulations, shows how nutritional information must be presented. Note the difference between the two columns – the first shows values per 100g of product, the second values per serving size, which differs from product to product. For Kaye, two of the most important things to look for in a product are trans fats and sodium. “If you pick up something that contains trans fats, put it back. We know they’re linked to chronic disease. Also avoid high sodium (salt content), especially in ready meals and kids’ meals.”

TYPICAL NUTRITIONAL INFORMATION (packed/ready-to-eat)

Serving size xxg/ml

Per 100g

Per single serving (xg)

Energy (kJ) Protein (g) Glycaemic carbohydrate (g) of which total sugar (g) Total fat (g) of which saturated fat (g) of which trans fat (g) of which monounsaturated fat (g) of which polyunsaturated fat (g) Cholesterol (mg) Dietary fibre (g) Total sodium (mg) Any other nutrient/food component, which must be declared in alphabetical order – vitamins, minerals, then others

Images: ©iStock.com/alexskopje/JimVallee and Shutterstock

Additional information, if relevant: 1. Items in orange aren’t required if giving voluntary nutritional information. 2. If packed in liquid, state whether mass is net or drained. 3. State whether nutritional information refers to ready-to-eat or as packed. 4. State how dietary fibre was calculated.

HOW HEALTHY IS ‘HEALTHY’ FOOD?

The law forbids certain types of claims made in connection with food products. It also prohibits using the word “healthy”, and any words or symbols that mean the same – such as “wholesome”, “nutritious”, “full of goodness” – in connection with food products. This means the words can’t form part of the name of a product or be used on labels or in marketing material. “The law only allows claims made within measurable parameters,” says Steenkamp. “This is designed to protect the consumer, because how do we define ‘healthy’? What’s good for you might not be good for me.”

CAN YOU TRUST WORDS SUCH AS ‘LIGHT’ AND ‘REDUCED’ ON FOOD LABELS?

One type of claim that can legally be made on food labels (and in marketing food products) is a claim about the nutrient content of the food (“high in fibre”, “low in fat”, “no added sugar”, “high in vitamin C”). Comparative claims (“light”, “reduced fat”) are also allowed. “Both the nutrient content and the wording of claims are legislated,” explains Steenkamp. “So a product can only claim to be high in vitamin C if it contains at least 60mg of vitamin C per serving. Also, food distributors should only use words like ‘reduced’, ‘less than’ and ‘light’ when comparing different versions of the same foodstuff. Products must be clearly labelled showing the difference in the relevant nutrient. And you can only make comparative claims if this difference is at least 25%.” The “light” version of the product must clearly state that, for example, “35g of this bar (half a bar) contains 36% less energy and 28% less sugar than the regular bar”. Steenkamp, who often advises companies on compliance with food labelling laws, knows from experience that “this is a lot of information to fit on a small bar”.

WHAT DOES THE FUTURE HOLD?

The current food labelling regulations are in the process of being replaced. “There are a few significant changes the new regulations will bring that will protect the consumer, some of which are rather stringent for the likes of retailers, restaurants and marketers of foodstuffs,” says trade mark attorney Karen Kitchen. Kitchen highlights one that many consumers – but very few fastfood chains – will welcome: the prohibition on marketing unhealthy food and beverages to children under the age of 18, which will include a ban on gifts to encourage children to consume unhealthy foods. Now that’s food for thought!

The law requires producers and distributors of food products with nutritional claims to include specific information on their labels. WHAT ARE E NUMBERS? E numbers are allocated on an international basis to all additives, including vitamins, to create consistency throughout the world. In many countries, only the E number is given in the ingredients list. Fortunately, South African law doesn’t require E numbers. “We are more protected here than in other countries,” says Steenkamp. “South African food producers have to list additives by name – they can’t hide behind E numbers.”

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looking good

WHY IS SO IMPORTANT TO WOMEN TODAY

OMEN OF THE 21ST CENTURY – STRONG, CAPABLE, DETERMINED, SELF-ASSURED AND BEAUTIFUL

The world is changing rapidly and women are playing a major role in politics and business, on movie screens, on the sporting field, and in everyday life. Gone are the days when most women stayed home and kept a low profile. Today’s women are sharp, sassy and out there, making waves and making a name for themselves, achieving in a multitude of different spheres that were once the domain of their male counterparts only. With this changing face of society, more and more women are turning to nonsurgical aesthetic solutions to keep themselves looking good. Injectable nonsurgical solutions are becoming a part of many women’s beauty regimes, along with regular manicures and trips to the hairdresser. Allergan, a major pharmaceutical company and manufacturer of soft-tissue fillers and muscle-relaxing neurotoxin, recently completed a massive study undertaken to determine what drives women to investigate and undergo these procedures. The results are fascinating.

7 700 WOMEN INTERVIEWED ACROSS 16 COUNTRIES A total of 7 700 women were surveyed across 16 different countries, including Australia, Brazil, Canada, China, France, Germany, Italy, Japan, Mexico, the Netherlands, South Korea, Spain, Thailand, Turkey, the UK and the US. Their ages ranged from 18 to 65 (average age was 40).

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These women were asked various questions about their concept of beauty, concerns about their face, their facial skincare regimes, treatments they would consider or would never have, and their feelings about wrinkle-relaxing injections and dermal fillers. Across all countries, women want to look beautiful first and

foremost for their own satisfaction – validation from others matters less. Seventy-four percent of women said they make the effort to look good primarily for themselves, compared to 37% for their partners and 15% for their friends. Across the world, a wedding was the key event that women said they wanted to look and feel beautiful for. A new job or career came second for women in Brazil (46%), Italy (44%) and Spain (48%), while in Thailand and South Korea it was a new relationship.

WHAT IS DRIVING WOMEN’S DESIRE TO ENHANCE THEIR APPEARANCE? When asked why they would consider seeking an aesthetic treatment, 42% of women cited a desire to boost self-confidence – the same percentage that claimed a desire to improve the look of sagging skin. What we are seeing is that it is no longer just about what they see in the mirror; it’s not only about how they look; it’s also about how they feel about themselves. Over 40% of respondents want to boost their self-confidence. Even in Brazil, where physical looks are considered very important and beauty-enhancement treatments are widely accepted, 48% of women said the main trigger for treatment would be a desire to boost self-confidence and feel good about themselves, compared to 39% who said the main reason for treatment would be to treat fine wrinkles on the face.

older women is to try and soften this disconnect, helping them to project an image that correlates with how they feel. When asked what elements contributed most to a person’s outer beauty, 56% of respondents stated skin quality and complexion, 56% said body shape and figure, 48% eyes, 35% facial shape, 32% facial harmony, 27% hair, 17% bone structure, 17% skin tone, and 17% lips/mouth shape. With so much emphasis being placed on skin quality, it’s not surprising that 81% of respondents follow a regular skincare regimen, with women in Asia (China, South Korea and Thailand) spending the most on this. Global beauty concerns varied from country to country, but bags under the eyes and dark circles are the most common concern, followed by a double chin, loss of fullness in the cheeks, and loss of volume in the lips. Sagging is a major concern in France and Mexico, and age spots in Japan and Brazil.

“The most beautiful thing you can wear is confidence.”

LOOKING GOOD FOR ONE’S AGE IS MORE IMPORTANT THAN LOOKING YOUNGER

Just as women are starting to play more pivotal roles in all levels of society, so they are also starting to take control of their appearance. Most don’t want to look younger; they want to look their best and make the most of what nature has given them. Many women are proud of their age and the life experiences that come with age. This explains the rapid growth in nonsurgical aesthetic interventions worldwide. A recent study (HARMONY study) of 100 patients who were treated with a combination of wrinkle-relaxing injections, dermal fillers and an eyelash-growing compound found that all of the patients reported a significant improvement in satisfaction with facial appearance, psychological well-being, and social confidence levels.

– Blake Lively

THE MAIN GOAL FOR SEEKING NONSURGICAL AESTHETIC TREATMENTS IS A DESIRE TO BOOST SELF-CONFIDENCE Women across the world are entering a new era of self-realisation: an era where they want to look good for themselves and the emotional impact of how they look is more important than the changes they see in the mirror. Women want to look good so they can feel good. When asked what motivates them to use beauty treatments, 63% said “beautification”, or looking beautiful, compared to 50% who wanted to address the signs of ageing.

INNER BEAUTY VS OUTER BEAUTY Women all over the world agree that there are two aspects to beauty: inner and outer beauty. Inner beauty reflects attributes such as kindness and loyalty that define one’s character, while outer beauty refers to physical appearance. Which is more important? It varied according to country and age of the respondent. In Mediterranean and South American countries, outer beauty was rated as more important, with Turkey rating it the highest, while in Canada and the US and Scandinavian countries, inner beauty was rated as more important. Globally, the older a woman is, the more likely they are to rate inner beauty as more important. What happens in reality is that women often begin to look more tired, sad, and angry as they age, and subsequently their physical appearance doesn’t reflect their inner beauty. The art in treating

WHAT CAN WE EXPECT IN THE COMING YEARS? As the role of women in society continues to grow, I predict we will continue to see a growth in the skincare and nonsurgical aesthetic procedure industries. The fact that a woman’s outward appearance is linked to her self-confidence levels and that women are choosing these procedures for themselves rather than for their partners or anyone else is indicative of the shift we are seeing in global attitudes already. Sixty-five percent of women surveyed around the world agree that facial fillers are more socially acceptable than they were five years ago. Nonsurgical interventions such as skin resurfacing combined with injectables will continue to be the cornerstones of treatments that women seek to boost their self-confidence and self-esteem. In a world where women are increasingly taking centre stage, looking good and feeling good about oneself go hand in hand. By Dr Natasha Chapman, a general practitioner with a special interest in aesthetics, based at Aesthetics on 5th in Hyde Park, Johannesburg.

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

HEALTHY SKIN

HERE COMES

the sun

We’ve been told the sun is Public Enemy No 1. So how do we balance that against its superpowers as a ‘sunshine vitamin’? Nia Magoulianiti-McGregor ﬁnds out

Images: ©iStock.com/IakovKalinin and Shutterstock

nly mad dogs and Englishmen go out in the midday sun,” English playwright Noel Coward once wrote. Not true. Plenty of South African baby-boomers spent hours baking in the midday sun, slathered in baby oil, using tin foil as a reflector to hasten the effects, while blackskinned South Africans, until very recently, dismissed potential sun damage with the African-American refrain “black don’t crack”. These days, messages are unequivocal: don’t go out in the midday sun – or any time around it when the sun is more direct. Wear sunscreen. Wear protective clothing. We now know that all skin, black or white, is prone to discolouration, accelerated ageing and pigmentation from sun exposure. “It’s the UVA and UVB, you see,” says CANSA’s heath specialist, Prof Michael Herbst. “The A is for ageing and the B is for burning.” Both can damage the skin and cause skin cancer, although UVB is “more problematic”, he says. Yet, despite all of the messages of keeping skin safe, rates of skin cancer in South Africa continue to rise exponentially – making up 30% of all cancers in the country. The Western Cape, in particular, is estimated to have the highest incidence of newly reported cases of melanoma in the world, overtaking Australia. “We are not altogether sure why,” says Johannesburg dermatologist Dr Robert Weiss. “But with rates of melanoma highest in sunny countries which contain any pale-skinned populations, we extrapolate that there is a connection.”

Researchers, he says, are still not sure whether childhood burning or intermittent severe exposure is the critical factor. “But any burning is a bad idea, and using a sunbed – which has been proved to dramatically increase melanoma risk – is just foolish.” Still, not all skin is equal under the sun. Weiss says dermatologists adhere to a classification based on six skin types, depending on the skin’s ability to burn or tan. “Type one typically burns very easily and does not tan. Type six would be a very dark black skin, which burns very little. The paler the skin, the more susceptible it is to skin cancer.” Adds Herbst: “Darker skins contain more melanin than lighter skins, and melanin protects our body against UV radiation. People with albinism, where the melanin pigment is not produced, have no inherent protection at all from the sun and are most at risk.

REDUCING RISK • Avoid direct sunlight between 10am and 3pm. Stay in the shade or under an umbrella as much as possible, but be aware you are still at risk from sun reflected via sand or pool tiles and water. • Wear wide-brimmed hats and long-sleeved shirts. Darker colours which absorb more UV light offer more protection that lighter colours. • Eyes are vulnerable to UV light. Wear sunglasses with a UV protection rating of minimum UV400. • Avoid sunbeds and sunlamps – CANSA has requested the Minister of Health to ban the use of sunbeds by anyone under the age of 18. (Sunbeds have been banned outright in Brazil.) • Sunscreens are effective only for certain types of skin cancer prevention, such as squamous carcinoma. Genetic melanomas (Bob Marley developed a melanoma under his toenail) can affect everyone, depending on family history. Sources: CANSA, Environmental Working Group

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HEALTHY SKIN

TRUST ME ON THE SUNSCREEN • Products usually expire two years after manufacture. Avoid using a product that has been opened and used after a year has passed. • Apply sunscreen from SPF 15 to 50, according to skin type. • Always apply 20 minutes before going into the sun, so that it can be absorbed first. • Check for the CANSA SunSmart Choice seal. • Avoid sprays. They don’t provide a uniform coating and are easier to inhale, which is bad for your lungs. • Steer clear of products with oxybenzone of more than 6%. • Steer clear of products containing retinyl palmitate, a form of vitamin A. A US study suggests it may speed the development of skin tumours when applied to the skin in sunlight. • Reapply every two hours – despite promises, no product is sweatproof or waterproof. Sources: CANSA, Environmental Working Group

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KIDS’ STUFF No sun exposure for any child under six months. After six months, short periods of protected sun exposure out of peak hour is permissible. Toddlers must wear wide-brimmed hats and protective clothing – look for suitable child-friendly wrap-around sunglasses with UV protection. According to CANSA, just two blistering burns before the age of 18 can dramatically increase the risk of getting skin cancer later in life. Sources: CANSA, Environmental Working Group

Images: ©iStock.com/PeopleImages and Shutterstock

“Even so,” he says, “dark-toned skins should also safeguard themselves against excessive sunlight, even though they wouldn’t need a high SPF in their sunscreens.” Yet, to complicate matters, while the sun is a health hazard, in moderation it provides some free health insurance. When asked about the implications of no sun exposure at all, Weiss says: “Utter misery, I suspect! No vitamin D, osteoporosis, seasonal affective disorder (SAD) syndrome, which is a form of depression triggered by changing seasons…” “Vitamin D,” says Herbst, “is not truly a vitamin, but a hormone. It strengthens bones and lowers the risk of certain cancers, including breast, colon, kidney, pancreatic, prostate and ovarian cancer. It can also help to lift people’s mood.” Known as the “sunshine vitamin”, sunlight will help to lift serotonin levels, and can benefit pregnant women suffering from depression, studies have shown. Sunlight also has a beneficial effect on skin disorders such as psoriasis, acne and eczema. Herbst recommends taking in about five to 10 minutes of sunshine a day on bare skin – with no sunblock – preferably on the inside of the forearm, which has less melanin that the outside. For the rest of the time, protection is mandatory. “South Africa subscribes to European Union standards with regard to sunscreens,” says Herbst. “But not all companies comply with regulations.” The organisation periodically buys a product that carries CANSA’s

SunSmart Choice seal off the shelf to test for compliance. “We maintain the right to take a sample and send it to a laboratory for checking. Consumers should look out for the seal, which shows that CANSA has approved the product.” He also advises consumers to look for a broad-spectrum sunscreen – which protects from both UVA and UVB rays – and, further, says Herbst, “scrutinise the list of ingredients and avoid any product with more than 6% oxybenzone, a UV-filtering compound that disrupts hormones. “Don’t bother buying anything with an SPF of over 30. SPF 50 doesn’t give you more protection than SPF 30, and may give sunbathers a false sense of security. Anything over 50 and you’re just throwing away money. “SPFs hold a numerical value in that, if your exposed skin starts burning after 15 minutes in the sun, SPF 15 will give you 15 times longer in the sun without burning. But as no sunscreen is ‘sweatproof ’ or ‘waterproof ’, you should reapply any sunscreen – preferably with an SPF of 15 or over – every two hours.” The World Health Organization advises applying 35ml of sun cream at a time. That equates to seven teaspoons – one for the head and neck, one for each arm and leg, and one each for the chest and back. Finally, remember the shadow rule: watch your shadow – short shadow, seek shade. As with everything, adhering to sensible limits is the key. As Weiss says, “moderation usually poses few problems”.

AGEING WELL

DESIGN YOUR

Images: ©iStock.com/bluecinema/Valerie Loiseleux

ou can slather on the anti-wrinkle creams and miracle lotions, or even book yourself in for facial fillers or a facelift, but ageing teeth may still add years to your face. Enamel erosion, tiny cracks, yellow stains and receding gums are all subtle changes that can add years to your smile, but, luckily, there’s something you can do about it. “Cosmetic dentistry has many advantages,” says cosmetic dentist Dr Norman Cahi. “A beautiful, symmetrical, white smile is coveted by everyone in the world. It gives your face vitality and youthfulness. It can boost your self-confidence, create a wonderful first impression, and even lead to both personal and professional success.” That sounds like a tall order, a lot for your teeth to take on, but your smile goes wherever you do – and a beautiful smile really can open doors. Just consider how self-conscious you feel when you realise you’ve been walking around with a piece of spinach in your teeth. Your teeth are on display all of the time. So, what are your options? First, if your teeth are skew, you could consider orthodontics – it’s not just for adolescents. “About 25% of the orthodontics done in the US is done on adults,” says orthodontist Dr Mark Jackson. “This happens for a variety of reasons: ‘there wasn’t an orthodontist in town when I was growing up, the dentist never told me I needed anything, I was a little brat and wouldn’t have them, my parents couldn’t afford it...’. Today, with the increased demand for cosmetic dentistry, the bar is being raised, and interdisciplinary dentistry is becoming the norm in order to achieve better results.” You’re looking at a commitment of anywhere between a few months and two years, depending on complexity, to have your teeth straightened, with some minor discomfort and restrictions as to what you can eat that won’t damage the braces. “But apart from the initial curiosity from friends and family (which is soon forgotten), the journey is identical [to that of children],” says Jackson. “Adults may have tougher bone to deal with, which could mean it takes a bit longer, but otherwise everything is the same. Adults may also have had more prior damage, or they may have lost teeth over the years, and that can complicate things a little. Also, more adults suffer from gum disease, which may have to be

One of the simplest ways to knock years off your appearance is to brighten your smile. Mandy Collins ﬁnds out what your options are

Your smile goes wherever you do – and a beautiful smile really can open doors.

dealt with before braces are fitted.” There are many advantages to having orthodontics, even as an adult. “As the teeth and jaws are part of the big picture, one has to ask what they are there for,” Jackson points out. “Essentially, the teeth and jaws are a crushing or chewing machine, and the better the machine works, the less the wear and tear on it. It’s the same as the gearbox in your car – it works much better if it fits together the way it was designed, and the chance of damage is reduced if you don’t crash and grind every time you change gear!” Another option to consider is veneers. “These are contact lens-thin ‘shells’ made from porcelain or ceramic, which are cemented onto and over prepared front teeth to mask, hide and improve minor imperfections like

H E A L T H Y T I M E S l 39

AGEING WELL

it and the enthusiasm to undergo the treatment,” he says. “It is up to the vigilance, experience and skill of the dental professional to make a call on who may not be a good candidate, but, in my experience, this almost never happens.” In terms of orthodontics, Jackson says: “People who want to improve their smiles and general oral health, and are motivated, make great patients. These patients work with the restorative dentist in order to get the teeth into a position where they can be restored to the best aesthetics and function. However, adults who have multiple missing teeth, poor oral hygiene and gum disease are often less than ideal candidates for orthodontics.” If you are considering cosmetic dentistry and you require orthodontics as well as other procedures, it’s important to get your dental professionals talking to each other to plan the best order in which to do things. “The dentist can do better and more natural restorations if the teeth are in their correct position – so preparing spaces for implant placement is sometimes needed,” says Jackson.

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

Cosmetic dentistry is for anyone who desires a beautiful smile, has the ability to pay for it and the enthusiasm to undergo the treatment. “It’s no use putting in implants and then deciding further down the line that orthodontics are required. The implants can get in the way and compromise the outcome, and not allow the orthodontist to position the teeth for an optimum result.” Also, always remember that any medical or dental procedure will come with risks, so ensure you ask all of the questions you have, and find out what the possible risks and complications are. “Patients need to be fully warned of the most common risks (such as root-canal treatment becoming necessary) during the course of cosmetic dental procedures,” says Cahi. “A thorough, detailed history and assessment, with the patient’s full understanding and consent, are vital to the success of any treatment.”

QUESTIONS TO ASK AT YOUR CONSULTATION What types of cosmetic dentistry/orthodontics do you specialise in? What procedure do you suggest will give me the best results? If there is more than one possible procedure, what are the pros and cons of each? What are the potential risks or complications? How many consultations will this require? Will there be pain with this procedure and, if so, how will it be handled? Can I see before-and-after pictures of your dental work? How does the payment work, and how much will it be?

Image: ©iStock.com/AnthiaCumming

small gaps, irregular edges, discoloured fillings, and teeth with a lessthan-perfect shape or alignment,” says Cahi. Because veneers are individually sculpted for each patient, it is nearly impossible to tell the difference between a veneer and a natural tooth. They also resist coffee and tea stains, and cigarette smoke, because of the materials they’re made of. So your natural teeth remain largely intact, with only a minimal amount being altered to fit the veneer. Crowns, however, see quite a lot of your natural tooth being ground away. “They’re full coverings and usually made from pure porcelain or ceramic,” says Cahi. “They are cemented over previously prepared teeth that are damaged, broken down or have been roottreated. Or we can link three or more crowns together to replace a tooth that’s missing, between two other teeth.” Depending on the condition of your teeth, and as long as you have good bones in your jaw, you can also choose to have implant crowns, which are porcelain crowns fitted over a titanium metal rod that has been surgically placed into the bony socket of a missing tooth. Implants have many benefits, as they are the next best thing to healthy, natural teeth, especially if your other option is dentures. Implants are strong and stable, and they restore a lost tooth so that it looks, feels, fits and functions like a natural tooth. Finally, there’s teeth whitening, which is professionally supervised teeth bleaching done on all vital teeth, using either an LED/blue light and bleaching gel, or trays without a light – both very popular options, says Cahi. “Teeth whitening is the most-requested dental cosmetic procedure today, all over the world. It offers a brilliant improvement to your smile for a basic fee of about R4 000 to R5 000, and is the cornerstone of all dental cosmetic treatments carried out today.” Many people worry that it might weaken the enamel of the teeth, but Cahi says that’s a misconception. “Teeth whitening does no damage to tooth structure long-term whatsoever,” he says. “The active ingredient is hydrogen peroxide, which has been used as an antiseptic in medicine and dentistry for 100 years.” Of course, just because procedures exist, it doesn’t automatically mean you’re a good candidate for them, but Cahi says most people can safely undergo cosmetic dentistry procedures. “Cosmetic dentistry is for anyone who desires a beautiful smile, has the ability to pay for

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Unlocking the potential of

GREEN TEA Is every day a struggle? Do you suffer from low mood? No energy? Blood sugar imbalance? Extra ﬂab that you can’t shake off ? A feeling of constant tiredness?

urely we are meant to feel better than we do. Many of us are plagued with ill health and chronic inflammation, thanks to our modern lifestyles, increasingly high stress levels, polluted environment, poor gut health, and an over-reliance on processed, chemically enhanced foods. We often don’t even know we are suffering from inflammation, as it goes undetected for years before it manifests into a chronic disease. This low-grade systematic inflammation is known as the silent killer. We need to rethink our approach to disease. To take a biological system from dysfunction back to function, before disease sets in, we often need to support good diet, pure water, clean air, regular exercise, enough sleep and stress management with some good nutritional supplementation. Most chronic disease starts with inflammation, so a supplement to reduce inflammation and to help the body’s detoxification processes is instrumental in damage-proofing the body from the modern world we live in. Clinical studies of green tea have demonstrated its potential ability to reduce inflammation, balance blood sugar (assisting those with insulin resistance), improve liver function and detox, and reduce negative cholesterol levels, as well as the risk of heart disease. Over and above these benefits, green tea is known to boost the metabolism, allowing you to burn more fat for energy, resulting in weight loss. People using green tea report increased vitality, energy and a feeling of wellbeing. 42 l H E A L T H Y T I M E S

The challenge, however, is that to reap the benefits of green tea, you need to drink upwards of 10 cups of high-quality tea per day, every day. Green tea is active for only three to four hours, meaning it constantly needs to be taken. The same challenge lies in regular green tea supplements; to really obtain the benefit, you need to take them throughout the day, often three to five times per day. A group of South African scientists has developed an extract named Origine 8, which has been proven, through a single capsule taken once per day, to deliver over 24 hours of activity and 15 times more of the beneficial catechin found in green tea than regular supplementation. The clinical evidence proves we can conveniently and effectively unlock the potential of green tea.

While green tea is generally regarded as safe, it is important that you consult with a medical professional trained in botanicals should you have a health-related condition. Users may or may not experience an initial detox process, which is a positive, as the body rids itself of unnecessary toxic overload. It’s suggested that you drink additional water during this time. While green tea will start to have an immediate effect from the very first time you take it, the benefits will increase gradually over time.

HEALTHY EATING

YOU DON’T HAVE TO

deprive yourself

If you are consistent about making small, healthy changes to the way you eat, the results will begin to show. “Being balanced and flexible means implementing the 80/20 principle, which has helped me to sustain a balanced approach to healthy eating. If you stick to healthy nutritional guidelines closely 80% of the time, then, despite unhealthy choices 20% of the time, you should still obtain great results.” The problem is, we want to lose weight much faster than we gained it. And as Erasmus points out, no-one goes to bed skinny one day and wakes up overweight the next. “Most people gain (or lose) weight so gradually, they cannot really figure out how it happened,” she says. “But that 44 l H E A L T H Y T I M E S

extra glass of wine, that packet of chips or that chocolate after dinner can easily creep up and stockpile to an extra 1 000kJ, or more, per day. That means 365 000 extra kilojoules per year, which means a possible weight gain of almost 10kg over a year.” But how do you make permanent changes? The answer is, slowly. It’s not what we want to hear, because we’re all hoping for that magic bullet, but if you are consistent about making small, healthy changes to the way you eat, the results will begin to show. Philippa Bredenkamp, a dietician from the Mindful Eating practice in Linksfield, Johannesburg, says the first thing you need to do is ensure you’re drinking enough water. “You do need to get enough water, plus water lost during exercise,” she says, “and you can check your hydration by keeping an eye on your urine, which should be light-yellow to clear. “It sounds like the same boring old advice, but there’s a very good reason for it,” she says. “What most people don’t realise is that your body confuses thirst and hunger. So you need to look out for those times where you feel like nibbling, but can’t figure out what you want to eat. Usually, you’re actually thirsty, and if you have a glass of water, you’ll feel better and the craving will go away.” It’s also wise to rethink your

DRINK ENOUGH WATER!

Images: Shutterstock

he fact is that diets are not a long-term solution to weight loss. Mostly, people lose weight while they stick to the diet, then return to their normal eating habits and the weight piles back on – sometimes with reinforcements. The key, therefore, lies not in dieting, but in changing your lifestyle forever. Dietician and FAB Quotient co-founder Celynn Erasmus, of the Resilient Energy Center, says that for permanent weight loss, you need to pay attention to what you eat, and make good choices more often than not. “A structured diet eventually ends, but healthy eating should never stop,” she says.

It’s time to get off the diet rollercoaster and make simple lifestyle changes that will help you to get to a healthier weight, writes Mandy Collins

drinks altogether, says Erasmus. “In the colder months, it may be easier to go for milky drinks such as lattes, chai tea or hot chocolate, which contain more kilojoules. Did you know that a gourmet coffee such as a double vanilla or hazelnut latte can contain more than 900kJ, or 12 teaspoons of sugar? Diluted calories and kilojoules count! A significant concern about liquid energy is that beverages don’t ‘pull up the handbrake’ on your appetite. Liquids don’t switch off your hunger in the appetite centre in the brain.” And it doesn’t even have to be a terribly fancy coffee to be sabotaging your efforts. “A full-cream cappuccino is the equivalent of two slices of bread. A skinny cappuccino is like one-and-a-half. Rather have two to three filter coffees every day, with a dash of milk,” says Bredenkamp. “Also, drinks like flavoured waters can have six or seven teaspoons of sugar in them. Some clients come to me, and when we add up their drinks, they are having 40 or more teaspoons of sugar, just in their drinks. Any drink that’s sweet – fruit juice, iced tea – has sugar in it. Don’t think that juice and iced tea are the healthier options.” Both dieticians emphasise the importance of not starving yourself. “You cannot be hungry and lose weight at the same time. So if you’re starving yourself, your hunger will win and you’ll hit that deprivation cycle,” says Bredenkamp. “When you skip meals, you get onto the sugar rollercoaster. Your blood sugar crashes, then your body starts searching for something sweet to eat. So your blood sugar surges, then crashes… and the cycle is repeated. “Don’t under-eat,” Erasmus agrees. “Your fuel tank cannot run on empty. But don’t overeat either – you will feel sluggish and lethargic. And rather than avoiding foods, make more positive choices. Choose real, unprocessed food – the closer to nature, the better. Be balanced and allow for some flexibility. And have fun! Eat with enjoyment and gratitude in order to feel nourished. Above all, listen to your body. It will tell you more than all the nutrition experts on the planet.”

For permanent weight loss, you need to pay attention to what you eat, and make good choices more often than not.

ACCORDING TO THE DIETICIANS, THESE ARE EIGHT SIMPLE STRATEGIES THAT YOU CAN IMPLEMENT EASILY, WITHOUT FEELING DEPRIVED:

Don’t skip starches. Complex carbohydrates are vital, because they’re your body’s fuel. You might not need them at night, but you definitely need them during the day.

2 3

Eat strategically. Eat lightly and often, in small quantities, and don’t eat a heavy meal at night.

Set yourself up for success. The truth is you won’t accomplish all of your goals overnight. Be realistic about where you are and what you can achieve in a certain period. Select one simple thing and make it a habit – reduce the sugar in your coffee from two teaspoons to one, or drink more herbal tea. Just do one thing and do it well.

Be careful about your portion sizes. Use a smaller plate, or use strategies such as eating half of everything on your plate, and then reassessing your hunger. If you’re still hungry, eat half of what is left, and repeat.

Get more sleep. There are several reasons why too little sleep is adversely affecting your waistline. Restricted sleep is thought to increase the hormone ghrelin (which makes you want to eat) and decrease leptin (a hormone which tells you to stop eating). Lack of sleep also increases cortisol release, and people who stay awake longer are more likely to snack excessively, and possibly on the wrong foods. Finally, sleep deprivation may also alter the body’s ability to manage body temperature, which can result in lowered energy expenditure.

Add colour to your plate. There is compelling evidence that eating a diet rich in fresh produce may reduce your risk for stroke, cancer, heart disease and diabetes. Aim to have at least three to four tennis ballsized servings of vegetables per day, ideally each of a different colour: red, purple, green, yellow, white and orange. Vegetables are nutrientrich and kilojoule-poor, making them super-waist-friendly.

Veggies first. Dish up your vegetables and salad before you load up on proteins and starches. Think of your fresh produce as being the main attraction on your plate, and you’ll change the balance of what you consume.

Choose the right carbs. Aim to eat carbohydrates that are high in fibre, and in the slow-release groups. Vegetables, many fruits and unrefined starches such as barley, whole grains and legumes are high in fibre, which means they release more slowly into your bloodstream, leaving you fuller for longer, and, best of all, fibre is calorie-free! Losing weight doesn’t have to be a process of misery and deprivation. By making small changes to your lifestyle, you can get rid of the excess weight, keep it off, and, most importantly, do so in a healthy way. H E A L T H Y T I M E S l 45

THINGS YOU SHOULD KNOW ABOUT SPRING ALLERGIES Spring is in the air, and so are billions of tiny pollens that may trigger allergy symptoms in many people. This condition is called seasonal allergic rhinitis, commonly referred to as hay fever. When allergic reactions affect the eyes, nose, and throat, the symptoms are often categorised as rhinitis. Allergic rhinitis is an extremely common illness that is often mistaken for an ordinary cold. However, rhinitis may develop into more severe problems such as asthma. Hay fever can affect your quality of life. It can lead to sinus infections, disrupt your sleep and affect your ability to learn at school or be productive at work. SYMPTOMS Allergy symptoms occur when your immune system overreacts to an allergen – something that is usually harmless, such as plant pollen, dust mites or moulds. If you have an allergy, your immune system acts as if the allergens were dangerous, releasing a chemical called histamine, which causes allergy symptoms. If the allergen is something you breathe in from the air, your reaction will most likely affect your eyes, nose and lungs. HOW DOES THE TEST WORK? Together with your doctor, you can discuss which allergens to test for. Your doctor will take a small blood sample and send it to a

symptoms, and the search for the true cause can continue. This means you or your child can avoid taking unnecessary measures to reduce exposure. It also means you can avoid taking allergy medications (like antihistamines) when they aren’t truly needed. You are not exposed to any allergens during the testing procedure, hence there is no risk of allergic reactions.

laboratory for analysis. The results are sent back a few days later. The test is quantitative and measures the amount of allergy antibodies in the blood (IgE), which is an indicator of allergic sensitisation. Based on a physical examination, your case history and the results of your blood test, your doctor will be able to make a proper diagnosis. THE RESULTS CAN HELP OPTIMISE TREATMENT The test result can help identify your unique allergy proﬁle. With this information, you and your doctor can tailor an individual action plan to reduce exposure to those triggers, which will: • decrease the symptoms • decrease the risk of a severe allergic reaction • decrease the need for medication A negative test result can help your doctor rule out speciﬁc allergies as a trigger of the

ASK YOUR DOCTOR ABOUT A BLOOD TEST FOR ALLERGY A blood test will help your doctor determine if you are allergic, what you are allergic to and may even rule out allergy. A blood test is quick and simple and is available to you through your doctor. A blood test can test for hundreds of allergens, such as weeds, trees, pollen, mould, food, and animal dander. Adults and children of any age can take a blood test, and it can be performed irrespective of skin condition, medication, symptom, disease activity and pregnancy. Any doctor can take the blood sample and request the test and the tests are covered by medical aid. DO YOU SUSPECT ALLERGIES BEHIND YOUR SYMPTOMS? Allergies are very common and we often treat the symptoms, without ﬁnding the cause!

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

SURVIVING SUMMER

HEALTHY SUMMER

allergies

Nothing could be more disheartening than looking forward to your summer vacation, only to spend it fending off pounding headaches, red, swollen eyes, a stuffy nose and itchy skin rashes, writes Prevashni Naidu. Welcome to allergy season

Images: ©iStock.com/AlexRaths/AndreyPopov/bgfoto

any people struggle with seasonal allergies, says Durban allergist Dr Ahmed Manjra. “Worldwide, the prevalence of allergic disorders such as asthma, eczema, food allergies and allergic rhinitis has been steadily increasing.” What’s causing the increase? According to Manjra, a number of contributing factors have led to the creation of a “perfect storm” for sufferers of allergies. “Factors such as urbanisation, increased pollution levels and greenhouses gases are wreaking havoc to some extent, but we are also dealing with lifestyle changes that have cumulatively made allergies so endemic.” Most significant is the general adoption of a more western lifestyle and diet, and, interestingly, the too-sterile living environment it has manifested. Manjra describes a term called the “hygiene hypothesis”: “Basically, children born into more urban environments are not receiving the levels of stimulation required to build up their immune systems naturally, to fight off the increased levels of allergens we are exposed to in modern-day living. They’re receiving antibiotic treatments way too early in life and are not spending enough time outdoors, to develop a resistance to even common allergens like pollen and dust.” The outlook is not all doom and gloom, though. According to Manjra, as much as there has been increased allergy prevalence, there have also been a few significant health breakthroughs in the treatment and management of allergies, to the point where they do not interfere with daily living.

BACK TO BASICS

Getting back to basics, and understanding whether you have allergies or not, say the experts, is the first step to creating an effective allergy survival plan. The Allergy Foundation of South Africa (AFSA, http://allergyfoundation.co.za/) describes a person as having a “hypersensitivity” reaction when they have a response to things in the environment that are harmless for most other people. An allergy occurs when the person’s immune system is causing this reaction. A non-immune hypersensitivity reaction is sometimes called an “intolerance”, such as those we have to some foods. “The first step is for the doctor to hear all the details about a possible reaction. This will help them tell whether the reaction was an allergy or not, and if it was an allergy, what kind of reaction it was, and whether it was mild or severe,” explains allergist Prof Michael Levin of the University of Cape Town.

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HEALTHY SUMMER

Manjra suggests keeping a diary of your symptoms and incidences when you believe you were experiencing an allergic reaction. “The presentation of allergies is usually the same,” outlines homeopath Dr Danny Pillay. “You get redness, itching and swelling. Depending on which part of the body is affected, the symptoms may vary. In hayfever, the redness, swelling and itching affects the eyes and nasal passages. Swelling, irritation and congestion of the mucous membranes in the eye, nose and sinuses cause difficulty in breathing, sneezing and all the eye symptoms.” You can have tests done to establish whether you are indeed experiencing an immune reaction to allergens. These can be blood tests (the ImmunoCAP) or skin-prick tests. The results of these tests are usually very accurate and define the methods of treatment that should be used. Manjra explains that there are predominantly two types of allergens: those that are perennial, and active throughout the year, such as household dust mites, and those that are seasonally active, such as high pollen counts, prevalent in spring and summer months. “Knowing your trigger allergens allows you to take steps to reduce exposure to them. For example, people who are allergic to dust mites should try to reduce the house dust in their homes,” says Levin. Once the allergen has been identified, treatment options can be investigated. As an example, Pillay explains that once inhalant allergies are discovered, a patient is also monitored for evidence of asthma, as the condition is sometimes linked to an underlying inhalant allergy. “While allergies of the upper respiratory airways (nose, sinuses) and eyes result in hayfever, allergies of the lower respiratory tract can cause asthma.”

TREATING YOUR ALLERGY Treatment options have vastly improved over the last few decades. Treatments include: Antihistamines: These are usually taken orally and reduce many of the uncomfortable allergy symptoms people experience. Nasal sprays: These are often used to treat hayfever or allergic rhinitis by providing sufferers with a dose of anti-inflammatory-containing “corticosteroid”, and should be used daily to help to prevent the underlying swelling and inflammation associated with hayfever symptoms. Medicated eyedrops: There are many different types. Ask your doctor for advice. Inhaler treatments: These include the pumps typically used by asthma sufferers.

Homeopathic treatments: There are over-the-counter preparations that you can get from health shops and pharmacies. It is advised to visit a homeopath, who will consult with you and prescribe an individual and appropriate medicine for you. Commonly prescribed remedies for hayfever include allium cepa, arsenicum album, natrum muriaticum, arundo donax, merc sol and histaminum. The key to a living an unhindered, allergy-free lifestyle, says Manjra, is to know your allergen and seek preventive treatment as soon as possible. “We test children of any age. If we begin treatment early enough, there should be no reason why you shouldn’t enjoy a symptom-free holiday, or life,” he adds. For more information, contact the Allergy Foundation of South Africa on 081 405 8442

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Image: Infographic supplied

Allergen immunotherapy: A longer-term allergy treatment breakthrough in recent years is a process known as desensitisation, or immunotherapy, which involves the patient being exposed incrementally to larger doses of the allergen, in order to allow the body to naturally build up a tolerance for it. These treatments, however, can take up to three years.

HEALTHY BODY

No age

Breast cancer isn’t something only middle-aged and older women face. Louise Ferreira spoke to some young breast cancer survivors

RESTRICTI N

reast Cancer Month has just passed, with its usual reminders to perform regular self-exams. But what many don’t realise is that the disease is not restricted to older women. Two young women, neither of whom had a family history of breast cancer, share their stories.

BONNY VAN ASWEGEN, 31

At 29, Bonny went to her GP about a lump in her breast. The doctor suggested it was a fibroadenoma and told her not to worry, but within two months the lump had grown and a second one had appeared under her arm. She was eventually diagnosed with triple-negative breast cancer, which meant that her cancer was not hormone-responsive. Before she could have surgery, however, they needed to shrink the tumour with chemotherapy. She underwent six sessions of a type of chemo they called the “Red Devil”, 21 days apart, before her mastectomy. “My first session of the Red Devil was so bad that I ended up in hospital. I was in isolation for two weeks. I went home after that and my hair started falling out in chunks. I had long hair,” she gestures at her short ponytail, “so that was traumatic for me. I cut it shorter, but at night my husband and I would wake up full of hair, all over our faces.” She was “man down” after every chemo session, barely able to move, which was particularly hard on her sons, who were 10 and six at the time. “But luckily my husband is amazing. I think we actually fell more in love after my diagnosis, because I didn’t realise he loved me that much. I don’t think he even realised it!” she says with a laugh. It was a very scary experience – especially, Bonny admits, after Googling her cancer and it hit home that she might die. But she had tremendous community support, including from the Christian company she works for. “I almost felt like the whole world was praying for me.” She had to take some unpaid leave, but fortunately her provident fund kicked in. “Everyone should have a provident fund,” she says. Bonny was a good candidate for a lattimus dorsi flap (lat flap), where muscle and tissue from the upper back are used to reconstruct the breast. She simultaneously underwent a reduction of her other breast so that both would be more or less the same size. After 30 sessions of radiation, there is no trace of her cancer.

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Images: Shutterstock and supplied

At night my husband and I would wake up full of hair, all over our faces.

LIESL DE BRUIN, 34

A year-and-a-half before Liesl was diagnosed, at age 31, she found a lump in her breast. It turned out to be a cyst that needed to be drained, so when the lump flared up again in April 2013, she wasn’t worried and decided to wait until her scheduled gynaecologist appointment in November. But within three months the area started getting red and very warm, and by the time she saw her doctor, she was worried. Her gynaecologist immediately sent her for a biopsy, and the results came back positive. A second biopsy showed that the cancer had spread to her lymph nodes. Liesl was fit and healthy, training six times a week, but six months of chemotherapy wore her down. She began with four sessions of the “Red Devil”. Within two weeks she started noticing the hair loss; in four more days all of her hair was gone. “Ridiculously, I shaved my hair into a short style. The next day, when I got into the shower and the water hit my hair, it came out in patches. I had to call my friend, who has been my hairdresser for most of my life, to come and take it all off. She ended up crying more than me. “I thought I was going to rock GI Jane. But let me tell you, there’s a big difference between shaving your hair and losing your hair.” Her hair was such a huge part of her femininity, Liesl says. She eventually ended up with 12 different wigs, several of them brightly coloured (and most of them cheap). It wasn’t just her hair; despite feeling too sick to eat during the chemo, she was gaining around 3kg a week because of cortisone treatment. “I just ballooned.” She had a mastectomy, simultaneously undergoing a lat flap. “I felt very disconnected from my body. I was an extrovert before I got sick, but during the treatment I turned into a recluse. I was, little by little, losing myself and losing my confidence,” she says. A friend finally convinced her to try online dating, “just to get out there and have normal conversations with people”. She is now engaged to a man she met on Tinder at the end of her treatment. “Life goes on after cancer. Life doesn’t stop. And the world never stops turning,” Liesl says. “The world goes on without you.”

I was an extrovert before I got sick, but during the treatment I turned into a recluse.

BREAST EXAM

All breasts are shaped differently, and one breast is usually larger than the other. Know the feel of your breasts; some feel fatty, some smooth, some lumpy. It’s important that you know your breasts and can recognise any changes. Examine your breasts both standing and lying down. Stand in front of the mirror, lift your arms to the side, and check that the skin of the breast does not pull in. Relax your arms on your tummy and use your left hand to check your right breast with the flat of the hand. Do not squeeze the breast or lift your arm above your head to feel the glands (lymph nodes). If your arm is bent, you can feel the glands beautifully. Any pain, any nipple discharge, any mass, any “I am not sure” – please see a doctor or clinic that has an interest in breast care. Do not be afraid to question your doctors. Go for second opinions, and do not be pressured into unnecessary surgery to find out what something is. An ultrasound at a reputable unit for a young woman, and a mammogram and ultrasound if you’re over 40, is the way to start. – Prof Carol-Ann Benn

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HEALTHY FINANCES

medication

ith the rising costs of healthcare presenting a huge challenge for family budgets, many people are looking for ways to slash the costs of medication (among other things). Unfortunately, medication is highly regulated and pharmaceutical companies aren’t in it for the good of their hearts, so reducing costs isn’t an easy thing to do. However, there are some ways in which the average consumer can plan, structure or do without medications to reduce their overall healthcare costs. You’re not going to save yourself a fortune, but a little awareness and careful management can go a long way towards easing financial pressures… in this area at least.

GO GENERIC

The first and most obvious medicine cost-saving route is to use generics in place of the known-brand-name medications you are prescribed. Some people are understandably wary of using cheaper alternatives for fear that they may not be effective, but properly understanding what generics are and how to use them can alleviate some of the concerns around these medications. “A generic is a form of medication at the same strength, in the same dosage form (for example, a tablet) and administered in the same way as the originator medicine,” says Val Beaumont, a pharmaceutical consultant. “There is a misconception that a generic is a drug that only does a similar sort of thing to the originator, but this is not true – it is actually chemically identical.” She explains that when the patent expires on a pharmaceutical product, other pharmaceutical companies can then use the formulation to create their own generic medications. These are cheaper than the originator because these companies have not had to spend the time and money on research. In South Africa, medications are regulated by the Medicines Control Council (MCC), which applies world-class standards, so users can rest assured that generic medications in this country are safe and effective.

People take their health seriously, and no one wants to mess around with medication, but there are ways in which you can cut costs to give your budget some breathing room, writes Georgina Guedes

Despite these guarantees, many people still claim that generics don’t work as well as the originators. Although this can usually be attributed to some kind of “reverse-placebo effect” – where users believe they aren’t getting results because they are sure the medication is of a lower quality – in very rare cases, there is a possibility that they might have a different reaction to the fillers in the drug. “While the active chemical components of generic medication are the same as the original formulation, the additional components – the fillers – don’t have to be,” says Beaumont. “In some cases it’s possible that these different formulations might cause slight differences in the patient’s outcomes.” This shouldn’t usually matter, because, for instance, if your body takes a few minutes longer to respond to a pain medication, it’s not going to make a huge difference to your recovery. However, in some medications – seizure medications are an example – a tiny difference can affect the patient’s outcomes. Beaumont explains that this doesn’t mean the generic is less effective; it just means that the specific patient responds differently to it – and as mentioned, these cases are extremely rare. For this reason, however, Beaumont recommends discussing the use of generics with your doctor or pharmacist, especially if you are using chronic medication for a serious condition. “And it is a good idea for users of chronic medication to either stick with the original medication or with a specific generic, so that they can stabilise on a particular brand and formulation.” The South African government has created the Medicines Price Registry (MPR), which the public can use to check whether they are being charged the correct fee for their medication. Code4SA has made this information into a useful online tool that will also help you to identify generics. You can check it out at mpr.code4sa.org.

A little awareness and careful management can go a long way towards easing financial pressures.

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Images: ©iStock.com/heliopix/Juanmonino/Sezeryadigar

CONTROLLING THE COSTS OF

MAKE INFORMED DECISIONS

ASSESS WHETHER CHRONIC MEDICATION IS FOR A PMB

If you are a member of a medical aid or hospital plan and you are on chronic medication for a condition such as bipolar disorder or hypothyroidism, your condition could be covered under Prescribed Minimum Benefit (PMB) regulations. Ricky Rohrbeck, an independent financial adviser with Select Independent Advisers, explains that these regulations state that medical aids may not refuse to cover the costs of your treatment for the listed conditions – even if you are out of funds. You will have to get your GP or specialist to complete the PMB form for you to submit to your medical aid, but once that admin is out of the way, any claim should be covered. This can make a big difference to your out-of-pocket expenses over the course of the year. “You can visit the Council for Medical Schemes website to find out if your chronic condition is listed as a PMB,” says Rohrbeck.

It is a good idea for users of chronic medication to either stick with the original medication or with a specific generic, so that they can stabilise on a particular brand and formulation.

If you visit a doctor when you are suffering from a cold, flu or gastroenteritis, they will prescribe medication that will make you feel better. However, generally speaking, there are no cures for these viruses and the medication you have been given is purely providing symptomatic relief. For this reason, if a doctor wants to prescribe a list of drugs, find out if they are strictly necessary or just for your own comfort – and whether there are any affordable, over-the-counter alternatives. For instance, while nose sprays have decongestants in them, many people report great relief with a simple saline (salt water) spray, and others say that steaming their sinuses with an aromatic oil opens the airways. Spending a couple of days in bed is usually all the treatment that most people need for the majority of ailments. Of course, if you need symptomatic relief and can’t find it any other way, you should take the prescribed medication – but bear in mind that the drugs are not fighting the actual illness. People also spend a lot of money on vitamin supplements that aren’t actually doing anything for them. “Unfortunately, vitamin supplements are mostly just wellmarketed and costly products that don’t really improve your health,” says Dr Isabel Thompson, a Johannesburg general practitioner. “All you need to do to get your vitamins is to eat home-cooked meals with lots of vegetables – and in fact, even if you don’t eat particularly well, your body is probably still getting what it needs.” Unless a supplement has been recommended or prescribed by a doctor for a specific condition or deficiency, you probably aren’t doing your health any favours, and you certainly aren’t doing your wallet any good, by self-medicating. There’s no denying that medication is expensive, and when you need it, there really is no alternative. But by implementing a few practical and sensible measures, you should be able to control your expenses a little.

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HEALTHY HEART

Missing

A BEAT

Most of us know that pain or tightness in the chest may well signal the onset of a heart attack, writes Caryn Gootkin. But how many of us understand what we can do to avoid getting to that point – or that there are other, less obvious, symptoms of heart disease, the No 1 killer in the world?

ne of the Heart and Stroke Foundation South Africa’s (HSFSA) core messages is that at least 80% of early deaths caused by heart disease and stroke can be avoided by following a healthy diet, doing regular physical activity, and not smoking. With that in mind, let’s look at three causes of heart disease – cholesterol, hypertension and inflammation – and how to avoid them.

Cholesterol comes from the food we eat and is also produced by our body, which needs it to remain healthy. It builds cell membranes, fights off infections and helps with the proper functioning of hormones. But having too much cholesterol in your blood is one of the most important risk factors for cardiovascular disease. Increased cholesterol levels can be caused by hereditary factors and poor lifestyle habits, such as alcohol abuse or diets high in saturated and trans fats. High blood cholesterol contributes to thick, hard deposits in the arteries, causing them to narrow and harden, a disease known as atherosclerosis. A clot that forms in and blocks a narrowed artery that feeds the heart or brain can result in a heart attack or stroke. What makes getting to grips with cholesterol so complicated is that there are different types of cholesterol that make up the total cholesterol levels in our body. It’s not enough to know your total cholesterol number – ensure that your high-density lipoproteins (HDL) (“good” cholesterol) are high enough, and your low-density lipoproteins (LDL) (“bad” cholesterol) and triglycerides (total amount of fat in the blood) are low enough. HDL is “good” because it acts as a scavenger, collecting excess LDL and transporting it back to the liver. If your HDL levels are too low, small LDL particles can enter and damage the arteries, triggering an inflammatory response that narrows the arteries and causes plaque formation. 58 l H E A L T H Y T I M E S

THE LOWDOWN ON CHOLESTEROL

Blood triglycerides are absorbed from food or manufactured in the liver to store unused calories as fat. Gabriel Eksteen, dietician and physiologist at HSFSA, explains that having abnormally high levels of fasting triglycerides in the bloodstream is an independent risk factor for heart disease, as they affect clot formation, thereby increasing atherosclerosis. “This is typically due to genetic causes, insulin resistance or high alcohol intake,” he says.

KNOW YOUR NUMBERS – CHOLESTEROL

The scary truth about cholesterol is that many people with high cholesterol feel perfectly healthy and don’t experience any symptoms, which is why it is often referred to as a “silent killer”. The good news is that if you have a family history of heart disease – or simply want to find out your cholesterol levels – a fasting blood test (called a fasting lipogram) will reveal your numbers.

WOMEN AND HEART ATTACKS

Most of us have seen movies where actors clutch their chest and fall to the ground. We may even believe that heart disease is the domain of men – but we’d be wrong. While women are just as prone to heart attacks, the scene in the movie may be less dramatic, as women’s symptoms are often far subtler. It is important to note the different ways women can experience heart attacks. “Women can experience a heart attack without chest pressure,” says Dr Nieca Goldberg, medical director of the Joan H Tisch Center for Women’s Health at NYU’s Langone Medical Center. “Instead, they may experience shortness of breath, pressure or pain in the lower chest or upper abdomen, dizziness, lightheadedness or fainting, upper-back pressure or extreme fatigue.”

Target values for cholesterol levels in individuals without other medical conditions: (If you are already at risk of heart disease or have diabetes, stricter limits may apply.) Lipid Levels

mmol/l

Total cholesterol

< 5.0

LDL cholesterol

< 3.0

HDL cholesterol (women)

> 1.2

HDL cholesterol (men)

> 1.0

Triglycerides

< 1.7

What makes getting to grips with cholesterol so complicated is that there are different types of cholesterol that make up the total cholesterol levels in our body. HOW CAN I LOWER MY BAD CHOLESTEROL AND TRIGLYCERIDES, AND INCREASE MY GOOD CHOLESTEROL?

Based on your lipogram, and if they think diet and lifestyle changes alone won’t be enough, your doctor may recommend that you take cholesterol-lowing medication, known as statins. (See text box “Statins – saint or sinner?” for more about statins.) Practising the following diet, exercise pattern and lifestyle habits will also help you to achieve your cholesterol targets: • Choose healthier unsaturated fats (such as nuts, seeds, avocado, olive and canola oils), and limit saturated and trans fats. Eat fish rich in omega-3 fats at least twice a week. • Eat a diet high in both soluble and insoluble fibre, which means plenty of fruit, vegetables, legumes (beans, peas, lentils) and unrefined grains. • Avoid food and drink high in added sugars. • Exercise regularly (at least 30 minutes five times a week). • Quit smoking and avoid second-hand smoke. • Drink alcohol only in moderation. • Maintain a healthy weight.

BLOOD PRESSURE – IT’S ALL ABOUT THE NUMBERS

The term blood pressure refers to the pressure of your blood in your arteries – or how hard your heart has to work to pump blood through your blood vessels. When the walls of the arteries lose their natural elasticity, they become stiff and your blood vessels narrow, causing your heart to strain. High blood pressure, also known as hypertension, is another silent killer; often there are no symptoms of this disease, the most common chronic disease of our time and the single biggest risk factor for heart disease and strokes, according to the HSFSA. (“In severe cases of extremely high blood pressure, sufferers may experience headaches, nosebleeds, tiredness, shortness of breath, flushing or dizziness,” says the HSFSA’s Eksteen.) Doctors, nurses and pharmacists measure blood pressure by placing a blood pressure cuff on your arm and reading the results immediately. It’s that easy. Strange, then, that only half of hypertensives know that they suffer from high blood pressure. This is due to a combination of low levels of testing, the absence of warning symptoms and the belief that you only have to start worrying about your blood pressure when you hit middle age. “We have to address blood pressure from the top down, starting with improved diagnosis in people unknowingly suffering from this silent disease,” said Dr Vash Mungal-Singh, haematologist and former CEO of the HSFSA, on World Hypertension Day earlier this year. The HSFSA recommends that all people over 21 have their blood pressure tested regularly.

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HEALTHY HEART

KNOW YOUR NUMBERS – BLOOD PRESSURE

A blood pressure measurement is expressed as two numbers, one over the other. The top refers to systolic pressure (SBP), which occurs when the heart contracts; the bottom refers to diastolic pressure (DBP), or heart relaxation between beats. So a reading of, for example, 130/90mm Hg means that SBP is 130 and DBP is 90. Healthy blood pressure range (according to the HSFSA) Normal

< 120/80 to 129/84

High normal

130/85 to 139/89

If your blood pressure is higher than this, you have hypertension: 140/90 to 159/99

Moderate hypertension

160/100 to 179/109

Severe hypertension

>180/110

HOW CAN I MAINTAIN A HEALTHY BLOOD PRESSURE? Blood pressure can often be controlled by lifestyle modification, but medication is sometimes necessary and your doctor will discuss the various options with you. Aim to lower your blood pressure by following these lifestyle and dietary guidelines: • Eat a healthy, balanced diet. • Reduce your salt intake to no more than 5g (1 teaspoon) a day. (“This includes what you add to food and what is already in foods that you buy,” says Eksteen.) • Eat at least five servings of a variety of fruits and vegetables each day. • Choose wholegrain and high-fibre foods instead of refined versions. • Limit saturated and trans fats, replacing them with healthier unsaturated fats (such as canola oil, olive oil, peanut butter, nuts and seeds, avocado or fish). • Try to include fatty fish (sardines, pilchards, salmon, mackerel) at least twice a week. • Drink no more than one (for women) or two (for men) units of alcohol per day. • Exercise regularly (at least 30 minutes five times a week). • Quit smoking and avoid second-hand smoke. • Maintain a healthy weight. 60 l H E A L T H Y T I M E S

REDUCING INFLAMMATION

Chronic inflammation is the body’s response to certain physiological triggers – excess weight, physical inactivity, high glucose and insulin – that cause plaque to form in the arterial walls, contributing to both atherosclerosis and peripheral artery disease. “Atherosclerosis is primarily a chronic inflammatory disease, resulting from an immune response within the vascular walls,” says the HSFSA’s Eksteen. “This immune response is influenced by what we eat, toxins like tobacco smoke, stress and activity levels, to highlight the most important factors.” The good news is that you can reduce current and prevent future inflammation by losing weight, exercising, and reducing your insulin and blood sugar levels.

High blood pressure, also known as hypertension, is another silent killer; often there are no symptoms of this disease, the most common chronic disease of our time and the single biggest risk factor for heart disease and strokes. STATINS – SAINT OR SINNER?

Statins work by blocking the enzyme the liver needs to make cholesterol, and are therefore highly effective at removing cholesterol from the bloodstream. While many in the medical fraternity regard statins as among the safest drugs available, there is some controversy around the side-effects of these drugs, which include atorvastatin (Lipitor) and simvastatin (Zocor). “In general, statins are safe and do lower the risk of atherosclerosis complications, especially heart attacks,” says Dr AD Marais, professor of chemical pathology and advisor to the HSFSA. “A few persons per 100 will report some muscle aches, and it is not always easy to know if this is due to the medication, but in some instances it definitely can be. When there is an extreme effect on the muscle, the kidney may be harmed as a consequence, but the condition usually recovers fully. Like with other medication, there can be a range of uncommon effects, including changes in bowel habits, liver injury, and many others.”

Mild hypertension

HEALTHY BACK

STRATEGIES FOR A STRONG, stable spine You can’t really ‘grow a backbone’, so look after your spine, says Georgina Guedes

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The human body is not designed to spend hours sitting.

Images: Shutterstock

he spine is an often neglected part of our healthcare routine. However, it’s a vital part of our skeleton and nervous system, and we ignore it at our peril. The spine is the made of 33 stacked vertebrae, providing the main support for the body and protecting the spinal cord from injury. The spinal cord transmits neural signals between the brain and the rest of the body, and for this reason it is vital to the overall health of the human body. We spoke to two practitioners of spine health – a physiotherapist and a chiropractor – to get the low-down on exactly what you should be doing to maintain the health of your spine.

GET YOUR DESK RIGHT

According to Johannesburg chiropractor Dr Robin Maris, there are a range of things that you can do to support the health of your spine. The starting point, however, is always the ergonomics of your desk – if you are a frequent computer user. “The human body is not designed to spend hours sitting,” he says. “It is important that we move around and change position.” He says laptops are one of the biggest problems, because they encourage users to work hunched over and leaning forward, which increases cervical lordosis (the inward curve of the neck) and thoracic kyphosis (the outward curve of the upper back), and decreases lumbar lordosis (the inward curve of the lower back). “All of these lead to back, neck and shoulder pain,” says Maris. “[In addition,] every centimetre your head leans forward doubles the pressure on C6 and C7 (neck vertebra), and the nerves from that area supply your arms and hands, so you might experience pain and numbness all the way down your arms.” For this reason, people spend a lot of money on expensive ergonomically designed chairs, in an attempt to support their posture. According to physiotherapist Tamzyn Ellis-Clark, the best position for your body on your chair – whatever it costs – is to have all the angles at 90 degrees. “Your ankles to feet, bent knees and thighs to hip should all be at 90 degrees. Your computer screen should be at head level, and your arms should be supported by your table, to reduce stress on your shoulders and your neck,” she says. “You should also consciously correct your posture every half an hour to 45 minutes – when you find that you are starting to lean or slump.”

KEEP MOVING

However, no matter how well positioned your workspace is, remaining in one position for too long just isn’t good for your spine. For this reason, Ellis-Clark tells her patients to stretch regularly – every hour or so – by doing the following stretches: • Stretch your neck to each side for 10 seconds – with your right hand gently pulling your right ear towards your right shoulder, and your left hand gently pulling your left ear towards your left shoulder. • Put your chin to your chest for 10 seconds – with your hands pulling your crown gently downwards. • Then do the “pretend to smell your armpit” stretch for 10 seconds each side – with your right hand pulling your head diagonally towards your right pit, and your left hand pulling your head diagonally towards your left pit. “It only takes 50 seconds,” she says. “You have the time to do it, and it will really help your spine.”

Another area that is causing back and neck trouble for people all around the world is the increased use of cellphones and tablets.

IT’S NOT JUST YOUR DESK

According to Maris, there is a new product on the market called the Varidesk, which can be adjusted to allow users to sit or stand, so they can change position throughout the day while using it. If you don’t have the money to purchase this type of workstation, you can still achieve some of the benefits by setting your desk space correctly, but also finding a standing space to work at and alternating throughout the day, taking your cue from your body. Both practitioners recommend regular exercise to maintain the health of your spine. “Dance and swimming are great,” says EllisClark. “Pilates and yoga are often considered to be the best exercises for spine health, and they are fantastic, but if you have any kind of a back injury, like a prolapsed disk, the stretches can pull your back out of alignment. Always speak to your yoga or pilates instructor before you start, and keep them updated on any injuries, so that they can let you know what stretches or positions you should avoid.” Generally speaking, physiotherapists don’t recommend running for spine health, because of the high impact. “I recommend a variety of different exercises,” says Maris, and says he would add resistance training to the mix.

While a great deal of the focus on spinal health centres around the ergonomics of your desk, less attention is paid to another place where you probably spend an equal amount of time: your bed. Maris says that if you find that you are waking up in the morning uncomfortable or in pain, and have no underlying conditions, you need to find a different solution that works for you. “It’s a matter of personal preference and trial and error,” he says. “I don’t recommend springs over memory foam, but I do suggest that you go for medium or hard, and not a soft bed.” However, he strongly recommends memory foam pillows – the pillow-shaped ones, not the contoured ones – for the support they offer your neck. Another area that is causing back and neck trouble for people all around the world is the increased use of cellphones and tablets. “They’ve even coined a medical term for it – text neck,” says Maris. To reduce the symptoms caused by tilting your neck forward and curling your spine around your device, again, try to be posture-aware, but also take regular breaks. “You can’t sit there looking at a screen without moving for three hours straight,” Maris says. Most people know that by sitting at their desks for extended periods of time, they are doing damage to their back and neck. Most of the exercises and lifestyle adjustments recommended by Ellis-Clark and Maris are easily within reach of most people – they just require attention and commitment.

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H S UE A P LP TLHE M Y EPNE T S

KEEP YOUR

pets safe

THIS SUMMER Higher temperatures outdoors can mean more visits to the vet. Here are some ways to keep your pets healthy during the warmer months DON’T GIVE THAT DOG A BONE

We all know the stereotype of a dog with a bone, and many people give their dogs bones after a braai. However, dogs get very little nutritional value from eating bones, says Dr Guy Fyvie, veterinary advisor at Hill’s Pet Nutrition South Africa. “The nutritional value is in the meat, cartilage and sinew attached to the bone, not the bone itself. Chewing bones has a minimal effect on ‘cleaning the teeth’ and is more likely to fracture the tooth, which is often not noticed and can cause root abscesses in the first premolars.” But bones carry other dangers too: they can puncture soft tissue in the mouth or the gut. “Bone bits or wholeswallowed bones often get stuck in the oesophagus, just above the heart, and also in the stomach or intestines, necessitating life-threatening surgery,” he says. “Why take the risk of major abdominal surgery for minimal nutritional benefit?” He adds that braai bones are especially not recommended, because of sharp edges and sticky-out bits (eg chop bones/T-bone), splinters (especially chicken), excess fat, salt, spices and sauce.

PET FOOD FOR PETS

Fyvie says, ideally, pets need a complete, balanced diet, and adding human leftovers to your pets’ food can throw that diet out of balance. “Obesity is reaching epidemic levels in the pet population, with vets saying more than half the pets they treat are overweight and at higher risk of diabetes, arthritis, cancer, etc. Rather than ‘treating’ with food, give your pet attention.”

BE WATER-WISE

Dogs – like humans – can dehydrate if they don’t get enough water during exercise, so if you are walking your dog, don’t do so between 11am and 3pm, when heat and humidity levels are at their highest. This is especially important for dogs with short snouts, such as bulldogs, which can’t pant as efficiently in humid weather, because they have narrowed nostrils and windpipes. If your dog shows signs of heat stress – heavy panting, dry or brightred gums, thick drool, vomiting, diarrhoea or wobbly legs – move them to a cool place, drape a damp towel over their body, moisten the cloth frequently, and get them to the vet as soon as possible. Also ensure your pets always have access to plenty of clean, fresh water, and, on particularly hot days, add a couple of ice blocks from time to time.

“Until one has loved an animal, a part of one’s soul remains unawakened.” – Anatole France

MAKE THOSE FLEAS FLEE

Fleas are a problem all year round, but they’re especially bad in summer. Ensure that you use good-quality flea control on your cats and dogs. Your vet will be able to advise you on the best products to use, depending on the kind of animal and its weight. Ticks can also be a problem and are potentially fatal, so check your dogs and cats for ticks, or ask your vet for a suitable product that will repel ticks.

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HEALTHY SLEEP

Find your

SNOOZE BUTTON

hose who suffer from insomnia don’t need anyone to tell them how unbearable it is. The frustration and anxiety of having difficulty falling asleep, waking up too early, or awakening often and being unable to get back to sleep at night are aggravated by knowing you’ll be tired and irritable, lack energy and have trouble concentrating the next day. For those with chronic insomnia (that is, they suffer from poorquality sleep at least three nights a week for more than a month), the consequences of excessive daytime sleepiness, and mental and physical fatigue can be critical. The good news is that the body of knowledge on sleep disorders and how to treat them is more advanced than ever, and continues to grow. In addition, there are more and more sleep specialists around to help you, using effective new methods – increasingly without medication. Earlier this year, the American College of Physicians published a new set of guidelines on managing chronic insomnia in adults. Most notably, it recommends “cognitive behavioural therapy for insomnia (CBT-I) as the initial treatment for the disorder”. CBT-I involves goal-oriented psychotherapy that helps people to change their behaviour and beliefs about sleep. Although it requires more time and effort than popping a sleeping pill, CBT-I has proven 66 l H E A L T H Y T I M E S

an effective, long-term treatment for chronic insomnia – without the potential side-effects associated with medication. A study led by the University of Minnesota found CBT-I resolved or lessened the symptoms of chronic insomnia in 70-80% of people who were treated. “That’s not to say all cases of insomnia can be effectively treated without medication,” says Durban-based clinical psychologist and neurophysiologist, and executive member of the South African Society of Sleep Medicine, Michelle Baker. “In some cases, short-term medication is used with CTB-I. In others, appropriate medication – for example, a sleeping tablet – is the only solution. But, whereas in the past, busy general practitioners didn’t always have the time to uncover the reasons why patients suffer insomnia, and were thus inclined to prescribe sleeping tablets as the solution, these days, armed with a different approach and more specialist knowledge about sleep disorders, more of us are offering CBT-I.” Another factor driving change in the treatment of sleep disorders is (what else, but) technology. Until recently, healthcare practitioners had to refer patients to sleep clinics or hospitals to undergo sleep studies (polysomnogram, or PSG, tests) to diagnose sleep disorders. These days, nifty mobile devices make it possible for patients to take the tests at home overnight. PSG tests are necessary to assess whether or not insomnia is associated with any other specific sleep disorders, such as sleep

Sleep problems are also often associated with other health conditions, such as anxiety, arthritis, asthma, cancer, depression and pain.

An occasional night of restlessness is one thing, but chronic insomnia is debilitating. Penny Haw looks at sleep disorders and how to get a good night’s slumber

apnoea (pauses in breathing or shallow breaths during sleep), restless legs syndrome (a neurological disorder characterised by unpleasant sensations in the legs and an uncontrollable urge to move them) and periodic limb movement disorder (the repetitive, involuntary cramping and jerking of the limbs, which happens only during sleep). PSG testing can also help to identify just how serious a person’s insomnia is. “Sleep state misperception disorder is a condition where people actually sleep better than they think they do. This is often identified by a sleep test, which reveals how they really sleep,” says Baker, who is currently working on a thesis on insomnia in women, as part of her doctoral studies at the University of the Witwatersrand. “Sleep problems are also often associated with other health conditions, such as anxiety, arthritis, asthma, cancer, depression and pain,” she says. “Overthe-counter and prescribed medication, and alcohol are used as coping mechanisms to get to sleep.” Insomnia patients’ circadian rhythm (that is, the internal “body clock” that regulates the timing of sleep) also needs to be clinically

assessed. Circadian rhythm disorders are caused by numerous factors including shift work, jet lag, pregnancy and medication. Once the cause of insomnia has been determined, through initial consultation and (where relevant) PSG, the most effective treatment can be proposed. Where this is CBT-I, treatment involves several regular visits (Baker’s programme typically involves five sessions) to a clinician, who undertakes a series of assessments, asks the patient to keep a “sleep diary”, and works with them to adjust non-productive sleep schedules and change their beliefs about insomnia. Therapy includes learning breathing, mindfulness and visualisation techniques, and other methods to help to improve sleep. The essence of getting sleep right, however, says Baker, is to avoid extending sleep. The ultimate goal is to consolidate sleep to your correct sleep phase. “The challenge for some people,” she concludes, “is not only that CBT-I requires longer to take effect than taking a sleeping pill, but also because insomnia can get worse during the initial stages of treatment, before it gets better. But the long-term result of CBT-I is worth the patience. It’s sustainable and has none of the potential for harm that medication has.”

HEALTHY SLEEP

BEAT INSOMNIA with good sleep habits Bad sleep hygiene sometimes not only leads to insomnia, but also perpetuates it, say neuropsychiatrist specialising in sleep disorders Dr Irshaad Ebrahim and research neuropsychologist Mariza van Wyk, both of the Constantia Sleep Clinic. Here are their top good sleep hygiene tips. • Where possible, go to sleep at the same time each night and get up at the same time every morning. • Do not nap during the day, because you risk upsetting your circadian rhythm. • Get regular exercise. Try not to exercise too vigorously close to bedtime, because it might stimulate you and make it hard to fall asleep. • Make sure you get adequate exposure to natural light. Light exposure helps to maintain healthy sleep-wake cycles. This is particularly relevant for older people, who are not necessarily as active as others and spend more time indoors. • Avoid caffeine, alcohol and nicotine late in the day. Caffeine and nicotine are stimulants and can keep you from falling asleep. While alcohol can speed the onset of sleep, it disrupts the second half as your body metabolises it. • Don’t eat a heavy meal late in the day. • Drink enough water at night to keep you from getting thirsty, but not so much as to wake you up to go to the toilet. • Follow a soothing routine that helps you to relax before sleep. Read a book, listen to music or take a bath. • Try to avoid emotionally upsetting conversations or activities just before bedtime. • Ensure your bedroom is comfortable, that it is dark, quiet, and not too warm or too cold. If light is a problem, wear a sleeping mask. If noise is a problem, try earplugs or a “white noise” machine. • Associate your bed with sleep and sex only. “Your brain must associate your bedroom only with those two things, and not texting, doing emails or watching television,” says Ebrahim. “All devices, including cellphones and iPads, should be avoided at least an hour before bedtime, as they not only distract you from winding down, but they also emit blue light, which has a stimulating effect on the brain that, in turn, promotes wakefulness.” • Go to bed when you’re truly tired. If you can’t fall asleep and don’t feel drowsy, get up and read or do something that is not overly stimulating, until you feel sleepy. • Insomnia can be caused by worry. If this is the case, make a to-do list before you go to bed. This can help to ease worries overnight.

Another factor driving change in the treatment of sleep disorders is technology.

H O W T O…

DO A DIY PEDI

like the pros

Who says being time-pressed means no time for yourself? Former beauty editor Nicole Sparrow shows you how to get your feet summer-ready, at home

inally, it’s sandal season, but before you flaunt your feet, some maintenance may be in order. In today’s world, many people are time or cash-strapped. However, don’t let that stop you – you can easily achieve fab-looking feet at home. Before you get started, do a quick audit of your pedicure tools. You will need an abrasive foot file to buff dry skin, nail clippers or scissors, cuticle nippers to trim away thickened skin around the nails, a file to smooth trimmed edges, and a thick cream to condition rough, dry feet. If you don’t have these items, you’ll find everything at your nearest pharmacy and most major supermarkets. If you’re planning a paint job, it goes without saying you need nail polish remover, cotton wool rounds, basecoat, your favourite nail polish shade and topcoat. You can get away without fancy foot washes and scrubs, but it does make the experience more pampering.

CHOOSE A SPACE AND GET COMFY

Once your pedi toolkit is fully stocked, you’ll also need some items from around your home: a bowl large enough for you to soak your feet (or alternatively, haul out that home foot spa you’ve forgotten you had); two towels (one on the floor and the other to dry your feet); enough warm water to fill the bowl deep enough to comfortably soak your feet; and any foot products you may have, such as a foot scrub and a foot soak. Find a comfy chair, put a towel on the floor in front of it, and place the bowl of warm water on the floor. Use the abrasive file to buff your feet while dry – you’ll shift more skin that way. (Take the

If you regularly battle with dry, cracked heels, consider using a heel balm on a daily basis to keep the skin soft and conditioned. manual labour out of this stage by springing for an electronic foot file, available at most major pharmacies.) Once your feet feel smooth, soak them in warm water. If you have a granular foot scrub, massage that in and then soak again. Add your foot soak to the water (if you don’t have one, a squirt of shower gel will do) and relax. After 5-10 minutes, pat your feet dry and trim your nails. It’s better to do this after soaking, as nails will be softer and easier to cut and file. There’s no rule on the best cut. Straight across or rounded at the edges? Do whatever makes you comfortable. Massage your foot cream all over your feet, and don’t forget your nails. Pay attention to typically dry areas, such as your heels, and if you regularly battle with dry, cracked heels, consider using a heel balm on a daily basis to keep the skin soft and conditioned. While you’re at it, massage your insteps. If you spend a long time on your feet, or you’re a runner, the muscles often become fatigued and a massage will bring welcome relief.

PAINT-JOB PREPPING

The secret to ensuring your nail polish goes the distance is all down to the prep work. Your nails need to be free from cream in order for polish to adhere, so wipe each nail with a cotton wool round soaked in polish remover. Apply your base coat and allow to dry. Next, apply one coat of colour, allow to dry and then apply a second coat. Finish with a top coat to seal the colour and add shine. Did you know that it can take up to seven days for your nail polish to completely cure? It goes without saying, then, that you should avoid wearing closed shoes or socks for a good few hours afterwards, because even though your paint job may feel touch-dry, it can still shift and dent. Or opt for gel polishes. Some ranges have a top coat that cures in normal sunlight, while others require investing in a UV lamp. Gel polishes require a long soak-off time to remove, but the trade-off is longer-wearing colour.

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HEALTHY HOLIDAYS

YOUR BEST holiday YET

Sometimes it feels as if we do holidays wrong; we arrive home tired, overweight and unﬁt. Tamara Oberholster ﬁnds out how to make your next holiday do what it’s supposed to do: leave you feeling revitalised and ready to take on the world

olidays are about rest and relaxation. The point is to return to work (or school) refreshed and revitalised. Yet unhealthy holidays can leave you more worn-out than before, whether it’s from eating too much, not getting enough sleep or exercise, or battling jetlag. Thankfully, with a little planning, you can have a healthier holiday, whether you’re at home or away.

AVOID OVERINDULGING (BUT STILL ENJOY YOURSELF)

Registered dietician Jacqui McKay says the main foodrelated holiday challenges people face are a lack of routine, combined with more socialising. “You may be eating out at restaurants (where you can make a good choice, but the portion and preparation aren’t always controlled) or at friends’ houses (where you often don’t have a choice of what you are served),” she says. “Alcohol intake can also affect your portion sizes and food choices. If you’re away, hotels and buffets can make eating healthily more challenging.” Her advice is not to write off your holiday in terms of healthy eating. “Stock up on lots of fresh fruit, vegetables and salads (including crudités) so that, in between socialising, you have healthy options at home,” she says. “Experiment with interesting smoothie and salad recipes. Cut out sugary drinks and fruit juices, as these are kilojouledense. Drink plenty of water, and remember the golden rule for parties and restaurants: don’t arrive starving, as your choices and portions could get out of control.” Another way of making extra holiday kilojoules disappear is to make an effort to exercise for at least 40 minutes every day. “Keep moving and keep hydrated; then you can afford the afternoon nap and a few extra snacks and sundowners,” says McKay. She notes it’s also important to compensate after an indulgent meal. “For example, if you have a big brunch, just have a fruit and plain yoghurt for lunch. Or, if you want dessert, cut out the carbohydrate at your meal. Don’t avoid social occasions – just watch portions, and be wise with what you eat beforehand and at the next meal.”

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HOLIDAY EATING – TOP TIPS

Dietician Jacqui McKay’s advice for healthier holidays: • Watch portion sizes. • Keep your activity levels up. • Whenever possible, fill half your plate with salad or vegetables. • Opt for a spritzer or light beer instead of a cocktail or sugary cider. • Choose water/sparkling water with lemon and mint instead of fruit juice or sugary cold drinks. • Snack on fruits and crudités with hummus or cottage cheese, or popcorn, instead of chips and dip. • Choose salad or vegetables instead of fries. • Compensate for indulgences whenever possible. • See a registered dietician for healthy recipes and more detailed guidance with portion sizes.

MAKE TIME TO MOVE

Not many people feel like hitting the gym while on holiday, but getting some exercise can help you to feel your best. According to Tarryn Seagram and Cheryl Whelan, co-founders of TransformHERS Ladies’ Outdoor Fitness Programme, it’s possible to strike a balance between relaxing and maintaining your fitness. “Making exercise fun is key to staying motivated while in holiday mode,” Seagram says. “Incorporate your family members into the workout – have a family challenge so everyone is involved, including the kids. Workouts needn’t take up too much of your time (you are on holiday, after all). Instead, make it a power 30 minutes per day.” Whelan adds: “It’s also helpful to change your mindset from ‘taking time off ’ to ‘keep moving’. It’s a sure way to beat the holiday bulge (because, let’s be honest, we all consume too much when we have time on our hands), and to return home feeling revived and ready to tackle your usual routine.”

KEEP HEALTHY WHILE GLOBETROTTING

If you’re planning an overseas holiday, there are a few additional health-related matters to consider. Dr Cora Bopape-Chinyanga says one of the most common issues is jetlag. “Jetlag, also known as time-zone change syndrome or desynchronosis, is a real phenomenon. Flights are not comfortable enough to sleep on, and this disturbs your normal circadian rhythms (sleep and wake times). Your body and its hormones have those rhythms established in your own time zone. On long travel over multiple time zones, this goes into disarray,” she explains. To combat this, Bopape-Chinyanga suggests sleeping on the flight if you can, and avoiding caffeinated drinks and alcohol while flying, as well as later in the day at your destination. “Take a few days to settle into a new time zone and routine,” she says. “Try not to party and stay up all night. Go to bed at night in a dark environment and stay awake during the day.” Another common challenge is that foreign foods, while exciting, may harbour different micro-organisms. “Some may cause harm; Images: ©iStock.com/RuslanDashinsky and Shutterstock

MAKE EXERCISE FUN!

HOLIDAY FIRST-AID KIT

Dr Cora Bopape-Chinyanga suggests packing the following: • Antiseptic balm. • Antiseptic detergent (small container). • Cotton wool. • Bandages/plasters. • Over-the-counter painkillers (choose paracetamol rather than codeine, which is a controlled substance in some countries). Anything that needs more than these supplies should be dealt with at a medical facility.

some may not,” Bopape-Chinyanga says. “The same suggestions apply for staying healthy in your own country – wash fruit and vegetables thoroughly before consuming. Make sure meat, especially chicken and pork, are cooked well and right through. Eat at reputable restaurants. In terms of alcohol, anything in moderation is acceptable. If possible, buy bottled water. Keep well hydrated throughout the day.” It’s also important to check beforehand if there are any vaccinations or prophylaxis required for the regions you’re visiting, Bopape-Chinyanga notes. “Travel health insurance is also mandatory and is reasonably priced in South Africa.” Health pointers aside, she has one final piece of important advice: “If you are travelling with your children, don’t forget to take their unabridged birth certificates!”

Take a skipping rope or TheraBand with you – they don’t take up much space and can give you a good workout in a short space of time. FUN HOLIDAY FITNESS

Tarryn Seagram and Cheryl Whelan suggest the following:

AWAY HOLIDAYS

• On coastal holidays, do brisk walks along the beach, stopping every 100m for star jumps or push-ups. • Take a skipping rope or TheraBand with you – they don’t take up much space and can give you a good workout in a short space of time. • Many resorts have tennis courts (and racquets for hire). Challenge your partner to a game, or set up a family round-robin tournament. • Do aqua exercises in the pool. Run on the spot; use a pool noodle to support you and kick underwater (on your front and your back); and, while standing, do fast, small circles with breaststroke movement with your arms underwater.

HOLIDAYS AT HOME

• Put on music and dance. If you’re exercising as a family, take turns to choose the next dance move for everyone. • Take your workout to the streets – do interval runs between streetlights in your neighbourhood or between songs on your iPod. • Cycle around your neighbourhood or at a local cycle park. • Take your dogs for a walk in the park – you’ll all enjoy the exercise. • Visit an ice-skating or roller-skating rink with the family. This is a good workout for your legs and core.

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HEALTHY EYES

Eyecare BASICS

Eye health isn’t something to be taken lightly. Zaza Motha offers some information to help you face the facts

ou should have your eyes checked at least every two years, but ideally on a yearly basis. So says Fikile Makhoba, an optometrist and owner of Fikile Makhoba Optometrists, which operates in the Johannesburg CBD. “There are many diseases, such as glaucoma or diabetic retinopathy, that don’t have symptoms in the early stages. Such diseases can lead to permanent visual loss in the long run,” Makhoba says, emphasising that an eye examination is not just about getting spectacles, but also about checking the health of your eyes. Routine eye exams are important, regardless of your age or physical health, adds Shruti Desai, an optometrist and owner of TheEyeMakers Optometrist & Shruti Desai Eyewear Boutique.

causes problems with depth • Blurred vision; perception and can lead to • Difficulty when using a amblyopia. computer; • Eye-teaming problems: Even • Eye strain or fatigue, if your eyes appear to especially when reading; be properly aligned, it’s • Difficulty seeing at night; possible that they do not • Frequent headaches and work together efficiently as double vision; a team. Binocular vision • Burning, itchy, painful, tired, can cause problems such as teary/watery eyes; and headaches and eye strain, • Vision loss. and affect reading and other near-vision tasks. • Focusing problems: These problems can range from incompletely developed focusing skills in children to normal age-related issues.

Desai lists examples of the conditions that your optometrist will be looking for: • Refractive error: This refers to near-sightedness, far-sightedness and astigmatism. • Amblyopia: This occurs when the eyes are misaligned or when one eye has a much higher degree of refractive error than the other. • Chronic systemic diseases: Optometrists are often the first healthcare professionals to detect high blood pressure, high cholesterol and diabetes. • Age-related conditions: As you age, your chances of developing an age-related eye problem increase. For example, cataracts affect at least half the population aged 65 and older. Detecting and treating age-related eye problems early can help to maintain quality of life and reduce the risk of permanent vision loss. • Strabismus: This relates to crossed or turned eyes. Strabismus

“The frame that you wear can say a lot about your personality. I always believe that if you choose the right frame, chances are you will definitely wear your glasses,” says Makhoba. “The general rule is that the shape of your sunglasses or eyeglasses should be the opposite of your face shape,” notes Desai. The main aim of sunglasses is to protect your eyes from excessive UV radiation. “You need to choose the lens colour with care, after choosing the shape. This can affect how well you detect contrast and differentiate colours,” adds Makhoba. “This is particularly important when driving, to distinguish the traffic light colours.”

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CHOOSING A PAIR OF SPECTACLES

Images: Shutterstock and supplied

SIGNS THAT YOU SHOULD GET AN EYE TEST