Sweet Life Magazine issue 15

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Issue 15

Spring 2015

LIFE CAN BE SWEET, WITH DIABETES

Also

- Delicious dinner ideas - Kids exercise advice - Expert interviews - And more!

Diabetes Education

in schools

(what you need to know)

Free! Take one now

PLUS: How to deal with the stigma of diabetes

SLM15_Cover.indd 1

www.sweetlifemag.co.za

2015/08/17 12:21 AM


Enjoy peace of mind Monitor your loved one’s blood glucose levels remotely using your smartphone and online reports.

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To ensure your phone is compatible, visit: www.accu-chek.co.za/dmapp Download your free Accu-Chek Connect app:

For more information contact your healthcare professional.

Experience what’s possible. ACCU-CHEK, ACCU-CHEK PERFORMA and ACCU-CHEK PERFORMA CONNECT are trademarks of Roche. ©2010 Roche Diabetes Care

Call Toll Free: 080-34-22-38-37 www.accu-chekconnect.co.za

AccuChekSubSahara

Error Code Self Help: *134*76243#

1. Ziegler R, Cavan DA, Cranston I, et al. Use of an Insulin Bolus Advisor Improves Glycemic Control In Multiple Daily Insulin Injection(MDI) Therapy Patients With Suboptimal Glycemic Control: First results from the ABACUS trial. Diabetes Care. 2013; 36: 3613-3619. 2. Kocher S., Tshiananga J.K., Koubek R. Comparison of Lancing Devices for Self-Monitoring of Blood Glucose Regarding Lancing Pain. Journal of Diabetes Science and Technology; September 2009 Volume 3, Issue 5: 1136-1143. Roche Products (Pty) Ltd Diabetes Care PO Box 1927, Randburg www.accu-chek.co.za / www.diabetes.co.za ACUST 141202a

0055 ACCU_AC Connect Sweetlife Ad.indd 1

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I know we might not technically know each other as friends, but each time we finish putting together an issue of Sweet Life I get so excited to share it with you: it feels like sharing a gift with friends. This issue is no different. When I was first diagnosed with diabetes, I remember thinking, “Thank heavens I’m 25 and not a child or a teenager - that must be so difficult.” Being diagnosed as an adult meant that I could understand all the many faces of diabetes and make the right decisions for me - and my health. But diabetes in children - especially Type 1 diabetes - is a reality for so many people, young and old. That’s why we’ve dedicated this issue to all the kids (and young adults) with diabetes, and the family and friends who care for them and share their lives. We talk about exercise, and diet, and the stigma and emotions surrounding diabetes: I think there’s a little something for everyone in this issue, no matter your age. Our last issue of the year will be in November, and we’ll be talking about diabetes in the workplace. If there’s anything in particular you’d like us to explore, please let me know by emailing me on hello@ sweetlifemag.co.za. This is your magazine, and we want it to be as helpful as possible.

EDITOR Bridget McNulty

ART DIRECTOR Mark Peddle

PUBLISHER Claire Barnardo

ADVERTISING SALES TFWcc: Tessa Fenton-Wells

CONTRIBUTORS Carine Visagie, Claudine Lee, Genevieve Jardine, Jeanne Berg, Joel Dave, Leanne Kiezer, Lucia Viglietti, Luisa Farelo, Nadine van Driel, Riekie Human, Roxanne de Villiers, Sarah Hall, Zaheer Bayat.

Welcome

Hello friends!

ADVERTISING ENQUIRIES Box 52301, Kenilworth 7745. Tel: 021 761 2840. Fax: 021 761 0442. Cell: 082 320 0014. Email: tessa@tfwcc.net

EDITORIAL ENQUIRIES PO Box 12651, Mill St, 8010. Email: info@sweetlifemag.co.za

COPYRIGHT Published by The Editors Publishing House CC. Copyright The Editors Publishing House CC. All rights reserved. Reproduction in whole or part is prohibited without prior permission of the Editor.

Until next time,

Bridget McNulty, Editor Diabetic South Africans

PS: Want to make sure you get your free copy of Sweet Life? Check out page 4 for details.

sweet_life_mag

The views and opinions expressed in this magazine are those of the contributors and not necessarily those of Sweet Life. Always consult a specialist before making any changes to your diet or medicine.

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Free copies!

SWEET LIFE AVAILABLE AT ANY DIS-CHEM!

Sweet Life is available at all DisChem stores nationwide! Pick up your FREE copy of Sweet Life from any Dis-Chem store in South Africa, or from your local support group or pharmacy. Find your nearest Dis-Chem store:

www.sweetlifemag.co.za/dischem

Local pharmacies and clinics: Want to get Sweet Life in your area? Let us know where your local clinic or pharmacy is, and how to get hold of them, and we’ll send them free copies of Sweet Life. Email us on hello@sweetlifemag.co.za

Community

You can also read Sweet Life online at: www.sweetlifemag.co.za/magazine

Meet our diabetic experts: Sweet Life has a fantastic Panel of Experts who are all leaders in the field of diabetes. They give us advice on everything we publish so that you can be sure you’re only getting the very best information to help you live a happy, healthy life with diabetes. Here are the wonderful experts on our panel: ENDOCRINOLOGISTS: Meet

PROFESSORS

Zaheer Page 21

Dr. Zaheer Bayat

MBBCh (Wits), FCP(SA), Cert Endo is a specialist physician and specialist endocrinologist working in Gauteng. He is the chairman of SEMDSA: the Society for Endocrinology, Metabolism and Diabetes of South Africa.

Dr. Joel Dave

MBChB PhD FCP Cert Endocrinology is a Senior Specialist in the Division of Diabetic Medicine and Endocrinology at the University of Cape Town and Groote Schuur Hospital and in private practice in Cape Town.

Timothy Noakes

MBChB, MD, DSc, FACSM, (hon) FFSEM (UK) is a Professor in the Discovery Health Chair of Exercise and Sports Science at the University of Cape Town. He is also cofounder with Morné du Plessis of the Sports Science Institute SA.

Wayne Derman

MBChB BSc (Med) (Hons) PhD is the Director of the Chronic Disease Lifestyle Rehabilitation Programme based at the UCT Sports Science Institute of SA, where he is also Professor of Sport Science and Sports Medicine.

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Ajita Ratanjee is

a registered dietician and the founder of Easy Health Wellness in Moreleta Park. Her special interest is ICU nutrition and diabetes.

Cheryl Meyer is a

registered dietician and member of the ADSA* who is passionate about diabetes and works in private practice in Bryanston.

Genevieve Jardine

is a dietician based in Durban who is registered with ADSA* and specialises in diseases of lifestyle, including diabetes.

DOCTOR

DIABETES EDUCATORS

Dr. Claudine Lee

Jeannie Berg is

is a family doctor (GP) with a passion for diabetes. She is based in Hilton, KwaZulu/ Natal and also runs an insulin pump centre.

the Chairperson of DESSA: the Diabetes Education Society of South Africa, and a registered pharmacist and diabetic educator.

SUPPORT GROUP EXPERT Jenny Russell is

Branch Manager of DSA Durban and is passionate about educating diabetics on how to lead a healthy lifestyle. She also holds the Community portfolio on the DESSA KZN committee.

PODIATRISTS

Andy Blecher is a podiatrist in Cape Town and currently runs the Western Cape Diabetic Foot Clinic with a team of other specialists.

Faaiza Paruk holds

a Bsc Dietetics (Hons) from the University of the Western Cape and is a member of ADSA*. She specialises in diseases of lifestyle. *ADSA = Association for Dietetics South Africa.

Kate Bristow is

a qualified nursing sister and certified diabetes educator who runs a Centre for Diabetes in Pietermaritzburg, KwaZulu/Natal.

Community

DIETICIANS:

OPHTHALMOLOGIST: Dr. Dale Harrison is an ophthalmologist in private practice in Cape Town, and a sessional consultant at Groote Schuur Hospital. His motto is simple: Get your eyes checked annually.

BIOKINETICISTS

Anette Thompson

M Tech Podiatry (UJ) and B Tech Podiatry (SA) is currently Chairperson of the Footwear Committee of the SA Podiatry Assoc.

Sarah Hall is a registered biokineticist BSc (Med)(HONS) in Exercise Science (Biokinetics) UCT who works for Wellness in Motion in Parkmore.

Ilona Padayachee

is a biokineticist in private practice in Port Elizabeth. She studied HMS (Human Movement Science) Hons Biokinetics at NMMU.

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Partner’s Corner

This is your space…

“M

y son is a Type 1 diabetic, but I don’t want to be overly protective and make him feel he can’t do anything. Do you have any tips for parents of diabetic children, and how to make life normal?’ Sam Shongwe.

The first thing to do is make sure he is safe at school. Let a responsible person know what his diabetes involves so that they can keep an eye on him. By doing this you won’t have to keep phoning him or the school to make sure he is okay: this will only embarrass him and make him withdraw from friends and fun. Remember, he can also play sports and take part in physical activities just like any other child: you just need to plan – first talk with his doctor, and then help him with the

routine of glucose testing, planned eating, and insulin. Work out a plan that he’s happy and comfortable with. Encourage your child and allow him to socialise. Let him do parties, sports, sleepovers and camps if he wants to. Discuss a back-up plan with him when he does, but try to let him do his thing. Most importantly, help your child to become more independent by getting him to take an active part in his diabetes care while he’s still young. Encourage him to solve problems and make choices with you about adjusting insulin doses, for example. Help him create a good lifestyle so that his diabetes doesn’t become too difficult to manage and hijack his life. Self-care is the key to developing any child’s independence and selfesteem: it’s important to get your child involved in self-care as soon as he is able to – with your supervision, of course.

Ask the expert: Jeanne Berg, Diabetes Educator “Self-care is the key to the development of any child’s independence and selfesteem. Remember: you are not letting your child go, you are letting him grow…”

Partners

Dear Sam, The first thing you must realise is that a child with diabetes is still a child. He should not be treated differently than a child who does not have diabetes. Granted, you have more issues to cope with – like good food choices, insulin and testing – but these things shouldn’t stop him from having a normal, happy childhood.

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Ask the expert:

Ask the Dietician

Genevieve Jardine

Diabetic-Friendly Kids Menu “A

s the mom of a diabetic child, I’m constantly wondering what to make her that is delicious but won’t spike her blood sugar. Could you give me some basic guidelines please?” Bernadette Simons.

As a mother of three (constantly hungry) young boys I am kept on my toes when it comes to healthy eating. Although my children are not diabetic, I practice ‘diabetic-friendly’ eating in my household. The bottom line is that you want your children to eat real, whole foods. This means no foods that are manufactured, processed and refined: time for a cupboard clear-out!

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Here are some menu options:

Breakfast:

• Bring back eggs for breakfast! Make eggs more interesting and nutritious by adding vegetables and baking in a muffin tray as mini crustless quiches. Serve with chopped strawberries or other brightly coloured fruit. • Try making your own cereal out of nuts and seeds, coconut shavings and some rolled oats. This can be eaten with plain yoghurt or milk. Use vanilla, cinnamon and ½ a grated apple to sweeten it naturally.

Lunchboxes:

• Move away from a daily sandwich for lunch. Try choosing other low GI starch like baby potatoes or corn on the cob. • Add some protein – chicken drumsticks, hard-boiled eggs, meatballs, homemade fish cakes or

“The bottom line is that you want your children to eat real, whole foods.” cheese. Remember protein makes you feel fuller for longer and doesn’t spike blood sugar levels. • Add a small amount of colourful fruit like a fruit kebab or fruit salad. • All lunchboxes should have vegetables! If your child doesn’t like salad, give some cucumber and carrot sticks, baby tomato kebabs or cucumber sandwiches (2 slices of cucumber with cheese or cream cheese in the middle).

Dinner:

• Most traditional South African dinners are one-pot meals like curry, stew, cottage pie or spaghetti bolognaise that are high in starch and low in vegetables. Try adding more vegetables to stew, curries and mince. Make the mashed potatoes with added cauliflower, add lentils to brown rice, and use baby marrow or aubergine instead of pasta. • Always serve dinner with vegetables on the side. Raw carrot sticks, sliced cucumber or snap peas are kid-friendly. Children need to get used to eating vegetables that are not hidden in food but out in plain sight!

Ask the Dietician

For children with diabetes, you need to make meals novel, colourful and exciting, while reducing refined carbohydrates and harmful fats. It’s important to break away from the rut of cereal for breakfast, sandwich for lunch and one-pot meal for dinner. Parents need to constantly focus on increasing fresh foods and not wait for dinner to try and make up the daily vegetable intake…

Remember: Children learn eating habits from their parents so you need to set the example. Tastebuds are influenced early on by processed foods with hidden sugars and fats, so it’s up to you to encourage your kids to eat – and love – real food. 09

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10 Fast Facts About Hypoglycemia Hypoglycemic episodes (hypos) can be a scary experience for all involved: here’s what you need to know to deal with one.

Healthy Living

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In case of a severe hypo, a glucagon emergency kit may be necessary. This once-off injection instantly raises the blood sugar, and is particularly useful when the person with diabetes is unconscious or unable to swallow.

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Symptoms of this are confusion, drowsiness, changes in behaviour, seizure and eventually coma.

If blood glucose drops too low it can get to the stage where the brain is not getting enough glucose.

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Test often to keep your levels as well controlled as possible.

The optimal blood glucose range is 4 to 7mmol/l. With a hypo, blood glucose levels are usually lower than 3mmol/l.

A hypo is a sudden low blood sugar episode. Notify all those close to you what to do in an emergency and how to use a glucagon injection.

The best thing to treat a hypo is fast-acting carbohydrates: 15-20g of sugary carb (a few sweets, 2 tablespoons of raisins, a tablespoon of honey or half a cup of fruit juice).

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Initial symptoms are nervousness, sweating, intense hunger, trembling, weakness, palpitations, or trouble speaking (depending on the person). The key is to catch low blood sugar early – as soon as it starts dropping – and treat it with a small dose of something sweet.

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Ask the expert: Dr Claudine Lee, GP “I believe continuous monitoring is the key to avoiding hypos.”

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Charity

Sweet Life Gives Back

Here’s one of the inspiring organisations we’ve partnered with to give back to the community.

Who is Ethembeni

Ethembeni is a 15 year old ministry - a tribe of hope based in KZN Midlands on a shared journey with families from vulnerabiltiy to wholeness.

“We see a future where all families are free from HIV & AIDS & TB”

What do they do?

We offer comprehensive and gender specific care, development and prevention services to over 600 families each week affected by HIV, AIDS and TB.

How can you get involved?

Share your story of hope with us at director@ethembeni.co.za Come and visit when next in KZN Midlands. We love volunteers. Email: volunteers@ethembeni.co.za Like our facebook page at: www.facebook.com/ ethembenihivaidsministry Contact details: www.ethembeni.co.za, director@ethembeni.co.za, 033 3305943

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Taking

s e t e b a i D

n o i t a c u Ed to Schools

When Roxanne and Derick de Villiers wanted to enroll their son Noah in school, they didn’t think diabetes would be an issue. When it turned out to be, they turned the situation around. Here’s their story. WORDS: BRIDGET MCNULTY PHOTOS: MARK PEDDLE Photos taken at Noah’s current school, Curro Century City.

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Has it become any easier with time? It has, it really has. You know that old saying that time is a healer? We believe time is a teacher. Diabetes is now second nature and so much a part of life. Having other family members also educated about Type 1 diabetes has made it easier as well because they can also test and inject when necessary. What’s the hardest part about being diabetic for Noah, do you think? We asked Noah this question, and he said when his sugar is low it’s hard because he feels tired. When did Noah start pre-school? Noah actually started pre-school the January before he was diagnosed. When the pre-school was informed about his diagnosis, the principal and his class teacher were at the hospital and were really supportive about this change in his life. What

really impacted our lives positively was that they were prepared to learn and take part in this process too. Were you worried about sending Noah to school because of his diabetes? Initially yes, because this was so new to us. Many moms cry when they drop their kids off at pre-school for the first time, and then call up the school a good few times to check if their little one is doing okay. So imagine when the testing and injections need to be part of the school day? You would naturally be a little worried. How was the school application process? At Noah’s first pre-school in 2012, he was already enrolled ahead of being diagnosed. The principal was open to being taught and her staff also trained. This was a huge blessing. We then made a home move and Noah needed to move pre-schools. The school we enquired at was

Inspiring

Can you tell us about Noah’s diagnosis? It was just before his 3rd birthday. Children at that age are so inquisitive and don’t want to be restricted in any way: they have no cares in the world except to play, learn and laugh… When Noah got really sick and then diagnosed with Type 1 diabetes, we were really emotional. Here was our little boy who had this huge change in his young life: nurses and needles – that’s a picture we will never forget. But we can promise you this: in the midst of those overwhelming emotions, your parental instinct to protect your child immediately kicks in and your mind opens up so much to take in all that you need to. There is an urgency to get on top of the changes and adapt as quickly as possible.

“There is a big need, a big want and a big drive for education in this area. Minds need to be changed about diabetes and its management within the school system.” amazing. We were honest upfront about our interest in the school and that we were enrolling a child with Type 1 diabetes. The head of the Montessori pre-school was forward thinking and welcomed the training with open arms: what Type 1 diabetes is, how it is managed and also how long and short acting 13

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process in place and were on board to becoming the forward thinking, proactive and progressive school that they are. A beautiful school/ parent relationship exists now, and they are already talking about training the Grade One teaching staff next year.

Inspiring

insulins work. We put a chart in place which included testing times, various meal types, activities Noah would take part in (like kids soccer) and how many units he would need depending on his readings / meals / activities. Applying for Grade R was a little bit different and more involved. They had never had an application that included full disclosure of the child having Type 1 diabetes. We had a few meetings with the Executive Head and we pressed on for the understanding that we (the school and parents) could put a fair process in place that would protect both the child and the school without discarding school laws. We needed to be a voice for Noah, for other diabetic children to follow and especially for the parents of diabetic children who go through this worry and want to enroll their precious children at the schools of their choice. The Executive Head and Regional Head of Noah’s grade school were true blessings because they agreed to put the suggested

What advice would you offer to other parents about diabetes education in schools? The education is ongoing. It is never a once-off. Urge the school to have more teacher / parent sessions to talk openly about Type 1 diabetes. Whether your medical support is private or public, involve the nurse or pediatrician looking after your child. There is a big need, a big want and a big drive for education in this area. Minds need to be changed about diabetes and its management within the school system. Do you have any tips for parents whose children have just been diagnosed? As you take in the medical information, as you spend endless hours reading up and educating yourself, it’s easy to get scared and caught up in the difficulties that come with this change. Make sure you also read success stories of the children who have gone on to live awesome lives: it will help inspire you. And a faith tip? Take the time to pray, for yourself and your child. God gives wisdom and guidance. What makes your life sweet? For Noah, having control of the DSTV remote and the Smart Tab (laughs out loud) and for us, his parents, seeing him so confident and secure even though he lives with diabetes.

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The Stigma of Diabetes Children with diabetes often experience stigma, and may not know how to deal with it. Here’s how to make life easier for your child. WORDS: CARINE VISAGIE

When Njabulo Dlamini was diagnosed with diabetes at the age of 16, he didn’t reveal his diagnosis to his friends. Fear of being called a drug addict, and standing out from the crowd, made him keep it a secret until the age of 19.

experience to break down some of the myths about the condition. But many other children with diabetes still have to deal with rejection and ridicule – so much so that their mental and physical health suffers.

After he met Jenny Russell from Diabetes South Africa’s Durban branch, this young man (also an Idols star) started using his

Is there something that can be done to eliminate this social side effect of diabetes? We asked the experts.

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Your child should always have their medical info and emergency contact details on hand: an ICE band or MedicAlert bracelet will do the trick. Find out more at medicalert.co.za

When parents, teachers and other role models make a diabetes diagnosis and the day-to-day management a simple part of life, other children are more likely to accept this model as the norm. “Children don’t usually have preconceived prejudices, and they tend to follow models of behaviour set out for them,” says paediatric endocrinologist Dr Michelle Carrihill. “There’s no reason for children with diabetes to feel stigmatised if everyone is shown the right way to behave.” Parents have a special role to play in this process, which starts with giving school staff and classmates the correct info. The more informed others are, the less likely it is that they’ll treat the child with diabetes differently.

How You Can Help: Not sure where to start? Here are some guidelines*:

• Learn as much as possible about your child’s condition and do a simple presentation to teachers and classmates explaining what diabetes is, and what blood glucose testing and insulin injections involve. This moves the kids’ response away from fear and suspicion towards acceptance. • Provide teachers with written information about your child’s needs. Include: 1. A care plan for your child’s routine school day. 2. A plan for days when the routine isn’t followed (for example, during outings).

Special Feature

Red alert!

Don’t Make a Fuss

3. Signs and symptoms that could indicate a problem. 4. What to do in an emergency, including all necessary contact information.

* From Dr Carrihill, Jenny Russell and diabetes educator Kate Bristow.

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Special Feature

Make these plans with the teachers’ input, so that their roles are clear and accepted. A diabetes educator, dietician or diabetes specialist nurse can assist.

• Explain to teachers that blood glucose testing, additional trips to the bathroom and eating extra carbohydrates may sometimes be necessary. No big deal should be made of this. • Explain that your child can exercise and also take part in outings, just like the other kids: there’s no need to treat them differently. • Some kids are okay to inject in front of friends, while others are not. Ask the school

to provide an area where your child will feel comfortable to test and inject. This could be the corner of a classroom or the nurse’s office, as long as the space is clean and quiet. They shouldn’t have to resort to the school bathroom. • Ask teachers to provide positive support and encouragement, especially if your child seems anxious. Also ensure that a staff member is always available to them, so that they know who to ask for help.

* From Dr Carrihill, Jenny Russell and diabetes educator Kate Bristow.

Backpack checklist: Make sure your child’s backpack always has: • Testing equipment (a glucose monitor, lancets and strips). • Insulin in a small cooler bag. • A quick-acting sugary food or drink (like Super Cs). • A glucagon emergency kit for severely low blood sugar emergencies: be sure to show teachers and older friends how to use it.

Join the Community: Does your child have diabetes? Come and talk to us about it at www.facebook.com/DiabeticSouthAfricans

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Sweet Life is lucky to have an amazing Panel of Experts giving us advice to share with you each issue. Meet Dr Zaheer Bayat, one of our Endocrinologists. How are you involved with diabetes?

I run a tertiary diabetic clinic at a state run facility in Gauteng. We have close to 3000 diabetic patients at our clinic and we treat both Type 1 and Type 2 diabetes. I am also the current chair of SEMDSA (the Society for Endocrinology, Metabolism and Diabetes in South Africa). And I teach about diabetes and diabetes-related problems to medical students and specialists in training. Lastly, I sit on various national and regional advisory boards looking at new diabetesrelated drugs and technologies.

How did you get started in the field? After completing my basic speciality training, I was drawn to endocrinology, mostly because I have grown up watching both my parents having to live with diabetes. I wanted to make a difference, to them and the community and the country at large.

What is your best advice for parents of children with diabetes? Be part of your children’s life. Give them enough rope to learn to be independent but make sure they know you are always only a call away to help them if they need it.

Do you think there will be a cure for diabetes within the next 20 years?

A complete cure… not yet. But we are getting close!

What makes your life sweet?

Meet the Expert

Dr Zaheer Bayat

My three kids, wife and family – they are my everything.

Visit Dr Bayat at South Block Suite 201, Mediclinic Sandton, Johannesburg. Call 011 709 2198 to make an appointment. Meet the rest of our experts at www. sweetlifemag.co.za/about-us

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“Having diabetes doesn’t make me different. But having my Dis-Chem Clinic on my side makes all the difference.” Diabetes Type 2 sufferer

When I was diagnosed with diabetes,

I thought my whole life would change for

the worst, and I’d never be ‘normal’ again!

However, thanks to my Dis-Chem

Clinic Sister, I realised that with the

right diet and lifestyle changes,

a suitable exercise programme,

regular blood glucose monitoring and medication management, diabetes doesn’t rule my life. I do. If you suffer from diabetes,

talk to your Dis-Chem

Clinic Sister: seriously, when you know there’s someone

who can (and will) help you

get on with life, you just feel

differently about the whole thing.

In a good way!

Clinic Call Centre 0861 117 427 Customer Careline 0860 347 243 careline@dischem.co.za www.dischem.co.za

GO Advertsing 72549

“Remember, having diabetes doesn’t make you any different.”


“It’s the specialised diabetes training that makes our Dis-Chem Nursing Practitioners different.” Lizeth Kruger Head of Clinics

Dis-Chem’s commitment to providing the highest standards of diabetic care goes

beyond offering prescription medication

and monitoring aids, vitamins, supplements and condition-specific foodstuffs at our famously affordable prices: now, the nursing practitioners who run our Dis-Chem Clinics all undergo

extensive training in this highly specialised field.

So, in every one of our 84 branches nationwide, you’ll find a qualified

professional who can advise you on all aspects of diabetes, including: • HbA1c screening

• Regular monitoring and treatment adjustment

• Medication and

condition management

• Nutrition, exercise, lifestyle

“But having professional help to manage it makes a big difference.”


Day Tripping Spring weather makes for great outings for the whole family. Here are our top choices around South Africa for a lovely day out. WORDS: CLAIRE BARNARDO

If you’re in… Cape Town SPIER WINE FARM Head to Spier for a Winelands-inspired day trip, with more than enough to keep the youngsters happy. While you enjoy your wine tasting, the kids can experience their own grape juice tasting. They can also explore the farm on a two-wheeled Segway or get carried away with Spier’s Eagle Encounters. During the holidays, there’s a daily kids’ activity programme. Find out more: 021 809 1100 or www.spier.co.za

THE BLUE TRAIN AT MOUILLE POINT PROMENADE If there’s something iconic and for kids then it’s the Blue Train along the promenade. Having chugged along for decades, it’s a perfect day outing. The miniature train loops three times around a track that looks out on a beautiful sea-view of passing ships and Robben Island. There’s also a safe play park near it and pathways for bicycles. Find out more: 083 314 9200

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If you’re in… Durban DUCK ‘N DECK ANIMAL FARM Go to the Duck ‘n Deck Animal Farm in Hillcrest for the day. There’s so much to enjoy, from pony rides to face painting and treasure hunting. Plus a whole lot of animals including sheep, goats, pigs, exotic ducks, geese, horses, and all kinds of birds for the kids to meet. Grab a bite to eat at Tiksiloo when you’re done. Find out more: 031 7681029 or www.duckanddeck.co.za

Lifestyle

still long enough, have a cuppa at the tea room. Find out more: 021 799 8783 or www.sanbi.org/gardens/ kirstenbosch

FUNWORLD Head to Durban’s Funworld for fullon family carnival fun. And this one’s for the adults too! Enjoy the fair together as you try out all the rides, and go on the cable car for incredible views of the beachfront from the air. You’ll find age-appropriate rides for big and small kids: from the Breakdance for the older kids, to the Carousel for the littlelies. Find out more: 031 332 9776

KIRSTENBOSCH BOTANICAL GARDENS With endless green lawns on which to burn some kiddie energy, Kirstenbosch is a great place to take the kids for the day. Not only can they run around in the incredible natural environment, but there are also lots of areas for children to explore like The Dell water feature. Pack a picnic, or if the kids will sit

PHEZULA SAFARI PARK Just outside Durban in the Valley of 1000 Hills is another solution to your what-to-do. Phezula boasts a game park and a crocodile and snake park. You can go on a game drive or take an educational tour and learn more about the reptiles. You’ll meet Ramesis the 90-year

“There are also lots of areas for children to explore.” 25

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old Nile crocodile and Cleo the 42kg Burmese python. As well as many types of snakes from the African Rock python and Green Mamba, to the Egyptian Cobra and Puff Adder. Find out more: www. phezulusafaripark.co.za/

If you’re in… Johannesburg

Lifestyle

DELTA PARK As a parent there’s nothing like going somewhere fantastic that’s also free! Delta Park is one of those treasures. It’s got beautiful trees and expansive lawns – an ideal family location. It’s a big hit in the parenting circle for the natural space, plastic play equipment, and massive, old shady trees just perfect for a picnic. There are also bike trails in the park if you want to take the bikes. Find out more: 011 888 4831 THE ZOO Remember the magic of going to the zoo for the first time? If it’s a fun and educational family outing you need, then take your children

to the zoo. Over 100 years old, it’s still as relevant and has even more to offer than when you were little. You can see over 320 species of animals including some very rare, endangered ones, plus the fierce ones too. For something extra special, choose from their day, night or sleep-over tours: you get to go behind-the-scenes to see how the zoo works, or you could venture into the night and meet nocturnal animals. Find out more: 011 646 2000 or www.jhbzoo.org.za MINI STEAM TRAINS Nothing could be cuter than these mini steam and electric trains (well, nothing except your child, of course!) In Florida Park and open to the public every 1st and 3rd Sunday of the month, this is a great way to spend an afternoon with your kids. What’s more, adults are allowed on them too! It’s not often that you get to take part as well. So take a little trip on one of these choo-choos, and pack your picnic to have on the lawn afterwards. Find out more: 011 046 9179

“Remember the magic of going to the zoo for the first time?”

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ADVERTORIAL

Caring for your children’s feet Caring for your feet is a vital part of caring for yourself. There is a quote “Your feet take you to where your heart wants to go”. We forget this and take our feet for granted. Usually only once feet problems arise do we start taking greater care of them. But prevention is far better than cure. Making sure your feet are adequately cared for is a critical part of anyone living with Diabetes, especially as they become older. Children with diabetes rarely have negative complications with their feet and tend to break the “rules of diabetes” and run around barefoot. This is not a problem, providing their feet are checked every day and any problems are picked up early. Like any diabetic, once a problem does arise, the poor circulation as a result of diabetes will slow the healing process. It’s critical that feet are monitored daily and adequately cared for. One of the most common issues with children’s feet is cracked heels and dry feet. The revolutionary Diabetic foot cream, Recharge your FEET has been developed and formulated specifically to treat this problem as well as various other foot

issues faced by Diabetics. Used daily, the product assists in preventing foot problems and improving the condition of the feet. Once problems arise, it is also highly effective in healing and treating various conditions. The unique combination of ingredients works on improving and stimulating circulation and nerve damage while the natural base oils intensely nourishes dry skin and allow other potent active ingredients to deeply penetrate and deliver maximum benefit to the feet. Natural anti-fungals are included to fight infections, natural anti-inflammatories reduce swelling and promote healing and natural soothing ingredients reduce pain and improve comfort. The combination of powerful anti-oxidants used, help defend and protect the feet, which is of utmost importance in children who are barefoot. Recharge your FEET should be used in conjunction with a good foot care routine such as checking feet daily for any problems, keeping foot hygiene at a high standard, drying feet properly, wearing comfortable shoes and looking after toenails.

For more information on Recharge your FEET and Recharge DIABETICARE visit www.rechargeyourlife.co.za, Phone 0861 477 915 or email info@rechargeyourlife.co.za.

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FAQ: Exercising with Diabetes As a parent, you obviously want what’s best for your child – but what is really best when it comes to exercise and children with diabetes? Here’s what you need to know (adults can learn a little something, too!)

Work It Out

WORDS: RIEKIE HUMAN

Although experts agree that it’s crucial for kids with diabetes to exercise, you need to make sure they’re doing it safely. Thankfully, it’s easier than you think… We got all the answers from experts in the field.

What kind of exercise should my child do? “The most helpful exercises encourage muscle contraction and increase the effect of insulin.” What does that mean? The exercise helps

more glucose to be transported out of the blood stream and into the cells to be used: body weight exercise and resistance training are particularly good at this. However, young children should take part in all kinds of exercise, particularly cardiovascular for the development and health of the heart, lungs and lipid profiles (cholesterol), and team sports to encourage skills and develop confidence. Sarah Hall, biokineticist at Wellness in Motion, Morningside

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Top Tips

Ball sports are especially good for children with diabetes. “They involve a combination of exercises like jogging and sprinting, and research has found that this is best for stability in blood sugar levels.” Contact sports like karate can be tricky, especially for children with insulin pumps, as the pump could get damaged – and the same applies to horse riding. Still possible, of course, but with some extra care taken. Andrew Heilbrunn, head biokineticist at the Centre for Diabetes and Endocrinology (CDE) in Houghton

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• Don’t let your child exercise if their blood sugar is too high: over 16mmol/l or too low: under 4mmol/l, or if ketones are present. • Make sure your child's blood sugar is in the target range before exercise, in order to avoid low blood sugar. • Talk with your doctor about lowering your child’s insulin dose before exercise, if necessary. • Inject insulin before exercise in a site other than the body parts about to be used. For example, if your child will be running, don’t inject in the legs. • Watch for symptoms of low blood sugar for 12 hours after exercise, especially if it’s a new kind of exercise. • Make sure your child drinks water so they don’t get dehydrated. • Choose something fun for you and your child to do together and they’ll learn that getting active is just as enjoyable as relaxing. You could go to dance classes, swim, learn to surf, take up yoga, go on hikes, play tennis or even join a soccer team. There’s even something called laughter yoga if you really want to have a good time…

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What time of day should my child exercise? The best time for kids with diabetes to exercise is before breakfast and before supper. “They’re less likely to hit lows at those times. Before breakfast, they’ll be quite insulin-resistant and are unlikely to experience a drop in blood sugar.” The worst time to exercise? An hour or two after meals, when insulin in the system can cause more frequent lows. Andrew Heilbrunn

Work It Out

How long should my child exercise for? That depends on the child: what they’re capable of and how fit they are. “The general recommendation is 1 to 2 hours, but take into account the type of exercise, your child’s age and their fitness level. And remember to limit exercise to 30 to 45 minutes if it’s a new sport or type of exercise – and then closely monitor their blood sugar levels, before and after exercising.” Sarah Hall

What else do I need to know about exercise and diabetes? It’s important to give the coach a list of symptoms of high and low blood sugar, as well as detailed instructions of what to do if your child goes low. “A child with low blood sugar will be irritable, have a headache and blurry vision, and generally feel horrible.” If your child’s blood sugar is too high, they will feel tired and thirsty. Dr Claudine Lee, GP If your child exercises for more than one hour, any time of the day, they should have a protein snack, like full-cream yoghurt or small yoghurt-coated rice cakes, before going to bed. “Sustained energy overnight is crucial, as it prevents hypos between 2 and 4am.“ Also, always have a quick-acting sugar snack on hand (fruit juice, sweets or honey) to treat low blood sugar, and make sure the coach knows how to use a glucagon pen in case of emergency. Andrew Heilbrunn

Ask the expert: Sarah Hall, Biokineticist Studies have shown that children with Type 1 or Type 2 diabetes are generally less physically active than those without: the exact opposite of what the situation should be! Some advantages of increased physical activity for children with diabetes: • Better health • More confidence • An improved response to insulin and blood sugar control

• A greater awareness of diabetes and their bodies • The prevention of conditions associated with diabetes, like obesity and heart disease • Improved weight management

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Seven Delicious Dinner Ideas Wondering what to make for dinner tonight? Here are seven exciting ideas to suit every cook: budget-friendly, easy, on-the-go and a weekend treat, with three readers’ dinners made healthier and more diabetic-friendly. Enjoy! PHOTOS: MARK PEDDLE FOOD EDITOR: LUISA FARELO

Inspired by you

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Look out for our healthy tips from Pick n Pay's dietician, Leanne Kiezer, to make these dishes even better for you! 33

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Grilled Boerie, Cauli Mash and Relish protein

2123kJ

22g

fat

carb

30g 24g

fibre

sodium

9g

474mg

per portion

energy

Serves: 4 500g boerewors 1 head cauliflower 1T low-fat cream cheese Olive oil, for frying 1 onion, finely sliced 2 cloves garlic, crushed

Try this!

1 apple, peeled and grated 1 tin tomato and onion mix Pinch of chilli Few drops Worcestershire sauce Salt and freshly ground pepper

READER'S DINNER Nicolene Nikki Van Niekerk’s “Tomato onion stew with wors and pap”

Method: Preheat oven to 200°C. Place boerewors on a wire rack in a small roasting tray and roast for about 30 mins. Heat a little olive oil and gently cook onion and garlic until soft. Add the grated apple, tinned tomato, pinch of chilli and Worcestershire sauce. Cook sauce gently for about 20 minutes or until thickened. Season to taste with a little salt and pepper. To make the cauliflower mash: Boil the cauliflower until soft. Drain and return to pot to mash (using a potato masher). Mix in the cream cheese and season with a little salt and pepper. Serve the boerewors with the cauliflower mash, tomato and onion relish and a fresh green salad.

Top tip:

Boerewors is high in saturated fat. A healthier alternative is low-fat sausages, which also have a lower sodium content.

Inspired by you

Health hotline

0800 11 22 88 healthhotline@pnp.co.za

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Crispy Brussels Sprout Salad protein

1494kJ

11g

fat

carb

fibre

sodium

22g 9g

6g

528mg

Serves: 4 400g Brussels sprouts, washed Olive oil Salt and freshly ground black pepper Pinch of dried chilli Juice and zest of 1 lemon 4 rashers bacon, roughly chopped and cooked until crispy 2 avocados, peeled and cubed 1 round low-fat feta, crumbled

Top tip:

When choosing bacon to use in this recipe, buy lean bacon and remove all the visible fat before cooking, to lower the fat content.

per portion

energy

Method:

Preheat oven to 200째C. Separate the leaves of the Brussels sprouts and scatter onto a baking tray. Drizzle with a little olive oil and season with salt, freshly ground black pepper, pinch of dried chilli and the zest of a lemon. Roast in oven for about 10 minutes or until leaves are just beginning to crisp around the edges. Remove from oven and set aside to cool. Scatter crispy Brussels sprouts onto a platter and add the bacon, avocado and feta. Drizzle with a little extra olive oil and a good squeeze of lemon juice just before serving. Serve with one slice of low GI bread per person.

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Tasty Chicken Stir-Fry protein

fat

carb

fibre

sodium

21g

7g 16g

5g

631mg

per portion

energy

828kJ

Serves: 4 Vegetable oil, for frying 1t sesame oil 400g chicken fillets, sliced into thin strips Freshly ground pepper 1 onion, thinly sliced 2 cloves garlic, crushed 1 small piece ginger, finely grated 1 chilli, thinly sliced (optional)

Inspired by you

½ head of broccoli, cut into chunks 2 small carrots, thinly sliced 2 small courgettes, thinly sliced 125g mushrooms, thinly sliced Handful coriander, roughly chopped 4T low sodium soy sauce Juice of 1 lime

Method: Season chicken with black pepper and set aside. Heat a little vegetable oil and sesame oil until hot and fry chicken pieces until brown and almost cooked through. Remove from pan and set aside. Fry onion, garlic, ginger and chilli until lightly golden brown. Add the remaining vegetables and stir-fry for a few minutes until they have softened but still have a slight crunch. Return chicken to pan and add soy sauce and lime juice. Allow chicken to cook through completely and sauce to reduce slightly. Serve immediately, topped with coriander.

Top tip:

Eating lots of different vegetables is not only delicious but good for you as each vegetable has a different variety of nutrients.

Health hotline

0800 11 22 88 healthhotline@pnp.co.za

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Korean Beef Lettuce Wraps protein

fat

carb

fibre

sodium

30g

9g

5g

1g

490mg

per portion

energy

883kJ

Serves: 4

500g beef strips Vegetable oil 2 carrots, peeled and thinly sliced 1 small cucumber, thinly sliced Handful fresh coriander, washed 1 head butter lettuce, leaves washed and separated For the marinade: 1t ground black pepper 2 cloves garlic, crushed 1t sesame oil 3T soy sauce 1T mirin 1 red chilli, finely sliced

Method: Place beef strips in a glass bowl, add all the marinade ingredients and mix well. Marinade for at least 30 mins. Heat a frying pan with a little oil. When hot, sear beef strips in batches (don’t overcrowd the pan!) Remove from pan and set aside to cool. To make the wraps: Place a little beef into each lettuce cup and top with a few carrots, cucumber and coriander. Drizzle over any leftover pan juices, wrap up and serve immediately.

Top tip:

Because this dish has such a low carbohydrate content, you could consider a cup of fresh fruit salad with some plain yoghurt as a healthy dessert. 37

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Serves: 4

Thai Soup with Dumplings protein

fat

carb

fibre

sodium

480kJ

11g

5g

9g

3g

718mg

per portion

energy

Method: To make the dumplings: Make a paste from spring onions, ginger, garlic, and coriander (in a food processor). Add the chicken and soy sauce and blend until just combined. Roll into golf sized balls and place in fridge for 30 minutes to firm up. To make the soup: Heat a little vegetable oil and gently fry spring onions, ginger and lemongrass for a few minutes. Add the tom yum paste and fry for 30 seconds to release the flavour. Add the chicken stock and bring to a simmer. Add the chicken dumplings and poach gently for 10–12 mins or until cooked through completely. Add the mushrooms, cherry tomatoes, baby spinach and mange tout for the last 5 mins of cooking. Pour into bowls and serve immediately, topped with a little coriander.

READER'S DINNER Fiona Majobe's "Soup and bread"

Inspired by you

For the soup: Vegetable oil, for frying 2 spring onions, finely chopped 1 piece ginger, peeled and finely grated 1 stalk lemongrass, inner layer chopped 1T tom yum or Thai red curry paste 2 cups low-sodium chicken stock, 2 cups water 125g mushrooms, sliced 50g cherry tomatoes 50g baby spinach 50g mange tout, thinly sliced Soy sauce to taste

For the dumplings: 3 spring onions, roughly chopped 1 small piece ginger, peeled and grated 1 clove garlic, peeled and chopped Coriander sprigs 200g chicken breasts or thighs, cut into cubes 1t low sodium soy sauce

Try this!

Health hotline

0800 11 22 88 healthhotline@pnp.co.za

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READER'S DINNER

Sweet Potato Shepherd's Pie protein

1373kJ

32g

fat

carb

fibre

sodium

12g 23g

3g

401mg

per portion

energy

Try this!

Method:

Serves: 4 Olive oil 1 onion, finely chopped 2 cloves garlic, crushed 1 carrot, peeled and finely chopped 1 stick celery, finely chopped 500g lean mince 2T tomato paste

Val Opperman's "Homemade Shepherd's Pie"

1t flour 1 cup beef stock Few splashes Worcestershire sauce Salt and freshly ground pepper 3 sweet potatoes, peeled and cut into rough cubes Âź cup low-fat yoghurt Pinch of nutmeg

Heat a little olive oil in a pot and gently cook onions, garlic, carrots and celery for a few minutes over a medium heat, until softened. Increase heat and add the mince, breaking it up with a wooden spoon. Brown the meat, then stir in the tomato paste and flour. Season lightly with a few splashes of Worcestershire sauce, salt and pepper. Add the beef stock, cover with lid and simmer for about 40 minutes or until meat is soft and sauce has reduced slightly. Meanwhile, boil the cubed sweet potatoes until soft and tender. Drain and mash until quite smooth. Add the yoghurt, a pinch of nutmeg and a little salt and pepper and mash well. Spoon the mince into a casserole dish and top with the mash. Place under a grill for a few minutes to brown slightly. Serve with steamed green vegetables.

Top tip:

The low GI sweet potato not only enhances the flavour of this dish but also greatly increases the beta carotene content: always choose sweet potato over potato. 27 39

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Mushroom and Lentil Burgers protein

1290kJ

12g

fat

carb

fibre

sodium

18g 22g

9g

218mg

per portion

energy

Serves: 4

Method:

1 x 410g tin lentils, drained and rinsed Olive oil, for frying 1 onion, finely chopped 2 cloves garlic, crushed 3 small courgettes, grated 125g mushrooms, finely sliced Zest of 1 lemon Salt and freshly ground pepper 2 slices brown bread, crumbled into breadcrumbs 1 egg Lettuce, for serving Guacamole, for serving

Place the lentils into a glass bowl and mash. Don’t mash too smooth as it’s nice to have some texture. Set aside. Heat a little olive oil and gently cook onions and garlic for a couple of minutes or until soft and translucent. Add the courgettes and mushrooms and fry until any liquid has cooked away. Season with lemon zest and a little salt and pepper.

Remove from heat and allow to cool. Add the cooled courgette mix to the lentils, together with the breadcrumbs and egg, and mix well. Shape into 4 equal sized patties and place in fridge for 30 minutes to firm up. Heat a little more olive oil and fry burgers for about 5 minutes on each side until golden brown. Serve on lettuce leaves with roasted sweet potato wedges and guacamole.

Top tip:

These burgers offer many nutrient benefits: they are high in fibre, mostly healthy fats and a variety of vitamins and minerals.

Health hotline

Inspired by you

0800 11 22 88 healthhotline@pnp.co.za

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Healthy eating is vital for children to help them reach their optimum potential, both mentally and physically. Start by following these 6 steps: 1. Encourage children to enjoy a variety of foods. Children need relatively more energy and nutrients to fuel their rapid growth and development. Different foods offer different nutrient benefits, so expose your children to as many healthy and new foods as possible. Feed your children regular small meals and healthy snacks.

2. Provide plenty of vegetables and fruits every day. Different vegetables and fruits contain different nutrients, like vitamins, minerals and fibre. So it's important to eat a variety each day. ‘Plenty’ means at least five portions of different vegetables and/or fruits a day.

3. Children should have milk, cheese, yoghurt or maas every day. Full-cream and reduced-fat milk, cheese and yoghurt are a source of calcium – a crucial mineral for the development of strong bones.

4. Lean meats, chicken, fish or eggs can be eaten every day – and include regular servings of dried beans, split peas, lentils and soya, too. These foods are important

sources of protein, which is essential for growth. Lean chicken, fish, lean meat and egg yolks are also sources of easily absorbable iron and other nutrients. Fatty fish provides omega-3 fatty acids, so serve sardines, pilchards, salmon, herring or mackerel at least twice a week. Dried beans, split peas, lentils and soya are cheaper plant sources of protein which also offer a source of fibre.

5. Use fats and sugars sparingly. Children should not have very low-fat diets, however the quality of the fats they eat is important. Restrict animal fats and choose unsaturated fats such as olive or canola oil, avocado, peanut butter and nuts more often. Sugar can form part of a balanced eating plan, but in moderation. Restrict sweets and chocolates to treats and give your children water, milk or diluted fruit juices to drink rather than soft drinks.

6. Encourage them to drink lots of clean, safe water. Water is the cheapest yet best drink of all. Start your children on water when they are young and it will remain a good habit for the rest of their lives.

Pick n Pay is committed to promoting health and wellbeing among South Africans, and employs the services of a registered dietician, Leanne Kiezer, to provide food and nutrition-related advice to the public. For your nutrition and health-related queries, contact >> healthhotline@pnp.co.za >> Toll free on 0800 11 22 88

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Nutrition for children

Nutrition for children

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Children reinvent your world for you.

Last Word

Susan Sarandon

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