LIFE CAN BE SWEET, WITH DIABETES
Issue 16
Summer 2015
Also
- Festive-friendly recipes - De-stress at work - And dealing with weight issues
Agents for Change
Outreach in the workplace
Free! Take one now
PLUS: How to cope with diabetes and a full-time job
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This month is all about diabetes and spreading awareness of the condition we live with every day. My question to you is: How are you proudly diabetic? I know at times it can be really difficult - and irritating, frustrating and depressing - to live with diabetes. I know that it’s not something that any of us chose for ourselves. But seeing as we’re stuck with it for the rest of our lives, how can we make the best of the situation? That’s what we want to focus on here at Sweet Life: how we can live our best lives with diabetes. This issue is all about diabetes in the workplace: how to cope with a chronic condition and a full-time job when it comes to food, exercise, colleagues and everything in between. We also look at weight and diabetes - a question we get asked on our Facebook page all the time. If you haven’t joined us for one of our Diabetic South Africans chats on Wednesdays at 8pm on Facebook, what are you waiting for? It’s a space to talk about anything and everything diabetic-related. Lastly, the whole Sweet Life team would like to wish you the most wonderful, relaxing, healthy and happy festive season. 2015 has been an amazingly sweet year, and we can’t wait to share 2016 with you! Until next time,
EDITOR Bridget McNulty
ART DIRECTOR Mark Peddle
PUBLISHER Claire Barnardo
ADVERTISING SALES TFWcc: Tessa Fenton-Wells
CONTRIBUTORS Alexanne Tingley, Anette Thompson, Buyelwa Majikela Dlangamandla, Charis Le Riche, Cheryl Meyer, Claudine Lee, Genevieve Jardine, Ilona Padayachee, Jeanne Berg, Joanne Lillie, Joel Dave, Kate Bristow, Leanne Kiezer, Luisa Farelo, Nadine van Driel, Nicole McCreedy.
Welcome
Happy National Diabetes Month!
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.
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:
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.
PROFESSORS
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.
DOCTOR
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.
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.
DIABETES EDUCATORS Meet
Jeannie Page 21
Dr. Claudine Lee
is a family doctor (GP) with a passion for diabetes. She is based in Hilton, KwaZulu/ Natal and also runs an insulin pump centre.
Jeannie Berg is
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.
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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Does diabetes run in your family? Then sit up and take notice.
If your child has type 2 diabetes or if type 2 diabetes runs in your family, you may want to learn more about the SITup research studies. The SITup studies are evaluating an investigational medication for type 2 diabetes, called sitagliptin, to learn if it can help control blood sugar levels in children and adolescents. What we learn in this study may help us develop new future options for managing type 2 diabetes in children and adolescents. There are two types of studies in the SITup programme: • One type for those who have not taken oral diabetes medication or insulin in the past 12 weeks • One type for those currently taking metformin therapy but whose diabetes is still not under control Your child may be eligible to participate in one of the studies if he or she: • Is 10 to 17 years old • Has an A1C level between 6.5% and 10% If your child has not been tested for type 2 diabetes or you are unsure of his or her A1C level, contact your doctor. Study participation is voluntary. Your child will receive all study medications, study-related tests and procedures, and testing supplies. Study has been approved by Pharma Ethics Research Committee and the Medicine Control Council
LEARN MORE MK0431 Poster_ZAF_ENG_v3-2_2014.10.01
Call 021 699 0772 for more information & to find a centre near you in South Africa
Partner’s Corner This is your space…
“A
friend at work is diabetic, and I’ve never really thought about it before because he seems to handle it really well. But last month he had a scary episode where he started shaking and we had to put sugar on his tongue. How can I help him to feel okay about it?” Sini Webster
The person with diabetes may feel insecure, embarrassed and afraid of being seen as different: it can be difficult to know how to support or assist them. The most important thing is to develop trust so that they know that they will not be made fun of or penalised for having diabetes. Information about diabetes and how to manage it is key: good communication leads to a healthier, more productive workplace.
The shaking was probably caused by an episode of low blood sugar. Other symptoms include sweating, heart palpitations and – if the blood sugar is very low – disorientation. It is important for those with diabetes to choose a few colleagues who know how to quietly assist and not panic: • Encourage the person with diabetes to have a few sweets, 2 to 4 teaspoons of sugar in water, or half a glass of Coke or juice. If they are unable to swallow, place the sugar or some jam on their tongue. • Once their blood sugar has been raised by the sugar, they should have something healthy to eat to stabilise it: a piece of fruit or a slice of health bread and peanut butter. • If possible, they should test their blood sugar at this point. If they are disorientated or unconscious, call an ambulance.
Ask the expert: Kate Bristow, Diabetes Specialist Nurse “The most important thing is to develop trust so that the person with diabetes knows that they will not be made fun of or penalised for having diabetes.”
Partners
Dear Sini, The word “diabetes” can lead to (unnecessary) concerns in the workplace about productivity and reliability. Co-workers who don’t have much information about the condition may feel unsure how to treat colleagues who are testing blood sugar, taking medication and possibly having hypoglycaemic (low blood sugar) episodes during work time.
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Ask the expert:
Ask the Dietician
Cheryl Meyer
Making the Right Choices (at Work) “I get invited to lots of business meetings and workshops that are catered… Needless to say, none of the catering is healthy! What do I choose or how do I deal with this situation?” Rene Prinsloo.
Many of us consume at least half of our meals and snacks during work hours, which makes our food choices in catered meetings and workshops very important. Here are three steps to consider: Step 1: Build your plate 1. Aim to fill half your plate with vegetables or salad. Look out for vegetable skewers, veggie sides, crudités (chopped raw veg), soup or salads. 2. Next, add a healthy carbohydrate: either a wholegrain or high fibre starch or a piece of fruit. Look out for: • Wholewheat bread • A seeded roll • Wholewheat pita • Wholewheat pasta/noodles • Wholewheat wrap • Brown or basmati rice • Fresh fruit 3. For long-lasting brain and body power, add a source of protein. Some good protein choices: • Lean cold meats • Grilled chicken
• Mini meatballs • Legumes like beans or lentils • Fish like tuna, sardines or pilchards • Cottage cheese • Boiled eggs 4. Sauces like low-fat mayonnaise, sweet chilli sauce, hummus or guacamole are optional but not essential. Avoid: • Deep-fried foods (like samoosas,
spring rolls or vetkoek)
• Sausage rolls and pies • Croissants, muffins or other pastries
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• Our food, health and lifestyle choices affect our productivity. • There is a 66% increase in risk of lower productivity for employees with an unhealthy diet (when compared to those with a healthy diet). • An unhealthy diet, not enough exercise, carrying excess body weight, high blood pressure, high cholesterol and depression have all been shown to increase the risk of lost productivity.
Step 2: Choose portions with caution 1. Be sure to start the day with a balanced breakfast and keep healthy snacks or a packed lunch on hand to avoid arriving at a meeting hungry. 2. Use smaller plates and serving spoons to manage how much you dish up. 3. Sit far away from the food to avoid “picking” at it. 4. Use the size of your hand to determine sensible and healthy portion sizes: • A fistful is equal to one cup and can be used to estimate the portion size for carbohydrates (starches and fruits). • The size of the palm of your hand can be used to estimate the portion size for protein. For a stew, curry or casserole this is about ½ cup. • The tip of the thumb is equivalent to one teaspoon and can be used to guess the portion size for all oils, butter or mayonnaise. • The thumb itself can be used to guess the portion size for peanut butter or hard cheese.
Step 3: Carefully consider your choice of drink: Some good choices are: • Still or sparkling water • Tea or coffee • Vegetable juice • Low-fat milk
Ask the Dietician
Did you know?
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10 Fast Facts About Ketoacidosis Ketones and ketoacidosis are often mentioned in relation to diabetes, but what are they exactly?
1
Healthy Living
Ketones result when your body burns fat for energy. Ketones make the blood more acidic. A urine test is traditionally used to test for ketones: some blood glucose meters can also test for ketones.
They are formed when the body doesn’t have enough insulin to use glucose for fuel.
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Ketones in the urine are a warning sign that your diabetes isn’t under control.
Symptoms of DKA are thirst, frequent urination, high blood glucose, constant tiredness, nausea, vomiting, abdominal pain, dry/flushed skin, breathing difficulty and confusion.
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Diabetic ketoacidosis (DKA) is caused by ketone levels being too high.
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DKA is rare in Type 2 diabetics and more common in Type 1 diabetics with uncontrolled blood sugar. If these symptoms ring a bell, see a doctor as soon as possible to get your blood sugar under control.
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DKA is serious and can lead to diabetic coma.
Ask the expert: Dr Claudine Lee, GP “DKA is life threatening if left untreated, so don’t hesitate. If the need for hospital arises the ketones can be washed out within a day or two. Sometimes the cause of DKA is infection and this needs to be treated.”
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ADVERTORIAL
The importance of lifetime care for diabetic feet Proper foot care is extremely important for all people with diabetes. Taking good care of your feet every day can lower your chances of losing a toe, a foot or a leg. Managing your blood sugar can also help keep your feet healthy. Diabetes can lower the amount of blood flow to your feet, causing numbness and tingling, as well as changes to the shape of your feet and toes. Over time, the likelihood of this occurring increases. When loss of sensation in the feet occurs you may not feel a small pebble inside your sock or a blister on your foot. This in turn can lead to cuts, sores and even ulcers which do not heal. Using a diabetic foot cream not only improves the overall condition of your feet, but can assist in preventing foot problems before they arise. Recharge your FEET is an exceptional foot cream which has been developed and formulated specifically to treat the various foot issues faced by diabetics. The unique combination of ingredients works on improving and stimulating circulation and combatting nerve damage.
The natural base oils intensely nourish dry skin and allow other potent active ingredients to deeply penetrate and deliver maximum benefit to the feet. Natural antifungals are included to fight infections, natural anti-inflammatories reduce swelling and promote healing and natural soothing ingredients reduce pain and improve comfort. Powerful anti-oxidants are used to help defend and protect the feet. Recharge your FEET has developed a guide to healthy diabetic feet, which includes checking feet every day, protecting them from extremes in temperature, keeping them clean and dry, wearing comfortable shoes and most importantly, applying a good natural diabetic foot cream daily to prevent complications. Their website displays this full guide as well as other useful information regarding caring for diabetic feet.
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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Creating Change
WORDS: BRIDGET MCNULTY
Inspiring
We chat to Buyelwa Majikela Dlangamandla, a diabetes educator who trains local healthcare workers in a programme called Agents for Change, about diabetes in the workplace and the most important lessons for diabetics (all of us!) to learn. Can you tell us about Agents for Change? Agents for Change is a diabetes training outreach programme, supported by the World Diabetes Foundation, that aims to improve diabetes care in rural and semi-urban areas of South Africa. The goal is to empower healthcare providers and people living with diabetes to manage their diabetes to prevent diabetes-related complications. The first part is two days of intensive and interactive training that provides participants with a sound knowledge of diabetes. Practical skills in preventing and managing
lifestyle conditions are demonstrated, like how to prepare affordable healthy food. Participants set their own goals of what they wish to change in their lifestyle habits and workplace. Six months later, the same participants come back for the second phase where they share their experiences, successes and challenges in carrying out their planned changes. We focus on behaviour counselling and the stages of change. People with diabetes are invited and they volunteer to share their real life experiences to be discussed as case studies for learning.
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How are you involved? I run the workshops with Noy Pullen, the project manager. How did you become interested in diabetes? My father had diabetes and so did all of his siblings, so there’s a family connection. I have also been working as a diabetes educator since 1995 at Groote Schuur Hospital and am currently working as a clinical educator at the University of Cape Town. What is the most important message you share in your training? Three things: 1. Choosing a healthy lifestyle can prevent and/or delay the onset of diabetes. 2. People living with diabetes can enjoy a healthy, normal life. 3. A positive attitude leads to a meaningful life.
tes affects people who live with it, so it wouldn’t be right for me to offer advice. Because diabetes affects people differently, the approach should be personal. I do notice that those who have accepted diabetes as part of their lives and taken charge of their own health find it easier. What makes your life sweet? Living in the moment, love and smiles from people around me.
“Agents for Change has trained more than 1,500 healthcare workers and reached more than 100,000 South Africans since 2008.”
What is the most surprising lesson for the participants? That the effect of physical activity on blood sugar levels is similar to that of blood glucose lowering medicines and insulin. Once they have finished their training, what happens? They are encouraged to start support groups and vegetable gardens. Those groups are called “Khula Groups”. They get continued support from the project – reading material and gifts – and they are always linked to the project manager on SMS or email. How many people has Agents for Change helped? Agents for Change has trained more than 1,500 healthcare workers and reached more than 100,000 South Africans since 2008. What advice would you offer to diabetics who are struggling? I can never fully understand how diabe-
To find out more about Agents for Change: www.worlddiabetesfoundation.org and click on Projects. Or contact Noy Pullen: linoia@mweb.co.za / 072 258 7132 Or Buyelwa: buyelwa.majikela-dlangamandla@uct.ac.za / 082 7473 055
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Sweet Life Gives Back
Here’s one of the inspiring organisations we’ve partnered with to give back to the community. Who is MusicWorks?
Charity
MusicWorks builds on South Africa’s rich musical heritage by using music as a clinical tool to improve the psycho-social wellbeing of children and young people in Cape Town’s marginalised communities. MusicWorks’ vision is for children and young people to generate hope and possibilities for their lives through shared engagements with music. Our mission is to join with communities to facilitate connection, healing, expression and restoration by offering direct music interventions and training, grounded firmly in reflective practise.
What do they do?
MusicWorks’ main objectives are: • To strengthen the resources of children and young people through individual and group music therapy sessions. • To offer safe and creative spaces where children and young people can master a musical skill, make personal discoveries, and become agents of change in their own lives and in their communities. • To extend and strengthen the support systems of children and young people through the provision of Capacity Building Workshops and Creative Music Facilitation training to childcare workers and teachers.
How can you get involved?
Due to the nature of our work, we only take occasional volunteers. However, there are many other ways to get involved. Get in touch with MusicWorks by emailing Alexanne Tingley on info@musicworks.org.za or calling 021 671 5196. Or visit their website at www.musicworks.org.za
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Weighty Matters WORDS: JOANNE LILLIE
Whether you battle to lose weight or struggle to gain it, maintaining a healthy weight is a constant battle for many people with diabetes. Here’s how to make lasting changes.
Weight On Controlling blood sugar levels is the starting place for achieving your target weight with Type 1 diabetes, as high blood sugar levels will cause glucose to be lost in the urine and result in weight loss, says dietician Genevieve Jardine. Many people find that once their glucose levels are under control, weight management becomes much easier.
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A normal body mass index (BMI) is essential for people with diabetes. “As the BMI increases, the amount of insulin required to maintain a normal glucose level also increases, because patients become more insulin resistant,” explains endocrinologist Dr Joel Dave. An elevated BMI is also associated with high blood pressure (hypertension) and high cholesterol (dyslipidemia).
Top Tips to Build Mass: 1. Go for low GI: To balance your glucose levels, lower GI carbs such as wholegrains, beans, sweet potatoes and some fruit (like plums and apricots) are great choices, as they are less likely to spike your blood glucose. Milk and yoghurt also have a low GI. Just remember that low GI food still has to be eaten in the right portion. 2. Eat more often: Rather than three meals a day, eat six smaller meals a day. Check your blood sugar more often and inject accordingly if you decide to try eating this way. Don’t skip meals as you will miss opportunities to increase your calorie intake. 3. Fat has more calories than carbohydrates or protein: Fat contains 9 calories per gram, while carbs and proteins contain 4 calories. So it makes sense to eat more fat when you’re aiming to put on a few pounds. Just be aware that you need to choose healthy fats. Cook with more olive or canola oil, get plenty of nuts and seeds, and add avocado and olives to salads. 4. As long as your kidneys are in good shape, you can add protein powder to yoghurt or smoothies. This helps you gain weight as lean muscle mass rather than fat.
Special Feature
Weight Off
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Healthy eating, regular physical activity, and medicine (if prescribed), are the key elements of Type 2 diabetes management. For many people with diabetes, the most challenging part of the treatment plan is working out what to eat.
Special Feature
Top Tips to Lose Mass: 1. Aim to reduce your energy intake while sticking to a healthy eating pattern. This means getting all the nutrients you need, in as few calories as possible. How? By focusing on nutrient-dense foods such as green vegetables, some fruits (especially berries) and beans. 2. Carbohydrates from vegetables, fruits, wholegrains, legumes and dairy products are better than from other sources, especially those with added fats, salt and
sugar. The most carb-dense foods include those with refined white flour: breads, biscuits, pastries, cakes, as well as white rice and potatoes. Limit these as much as possible! 3. A Mediterranean-style diet may boost weight loss and benefit blood sugar control and cardiovascular risk factors. This means: • Eating mostly plant-based foods, such as fruits and vegetables, wholegrains, legumes and nuts • Keeping carbohydrate levels as low as possible • Using healthy fats, such as olive oil or coconut oil • Using herbs and spices instead of salt to flavour foods • Limiting red meat to no more than a few times a month • Eating fish and poultry at least twice a week
The role of diabetes drugs Medications such as the injections Exenatide (Byetta, Bydureon) and liraglutide (Victoza) improve blood sugar control and they may also lead to weight loss. These medications stimulate the release of insulin by the pancreas and can help with weight control by curbing appetite and helping you feel full for longer.
“They act on the appetite centre in the brain to reduce appetite and increase satiety. They also decrease stomach emptying and increase nausea, both of which make a person eat less,” says Dr Dave. Discuss your medication, side effects and your weight with your endocrinologist.
Ask the expert: Genevieve Jardine, Dietician “Learn to respond to hunger and not appetite. Often a high carbohydrate diet makes people hungry whereas enough protein and healthy fats helps you feel fuller for longer.”
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4:42 PM “The most important thing is to develop trust so that the person2015/10/08 with diabetes
Sweet Life is lucky to have an amazing Panel of Experts giving us advice to share with you each issue. Meet Jeanne Berg, one of our Diabetes Educators. How are you involved with diabetes?
I am actually a pharmacist as well as a diabetes educator who stays in a town the city people would classify as “rural”. I have a great relationship with the doctors here: they refer patients to me for diabetes counselling and training. I also visit new patients in hospital and for follow-up they come to the pharmacy. We do an annual children’s camp sponsored by SASOL and I do free training for the local state hospitals.
How did you get started working with diabetics?
In about 1993, I started buying meters to sell to patients and organised a diabetes open day in my town. From there, my life has just been eating and sleeping diabetes! I have been lucky enough to attend quite a few international and local conferences as well.
What is your best advice for people with diabetes in the workplace? Some people find it hard to share that they have diabetes. But there must be someone at work you can trust who knows that you have diabetes in case of an emergency. Sometimes, people with diabetes
are scared that they will be discriminated against or even lose their jobs: we must keep on fighting for justice in these cases.
What has been the biggest change in diabetes during your career?
As educators, our role has changed from “telling or ordering” the patient what to do, to “coaching and compromising with” the patient to make good decisions about their diabetes. We must be diabetes whisperers, not wranglers. We educate patients and give them skills to empower themselves. Of course, technology has really made an enormous change in how we do things, too.
What makes your life sweet?
Meet the Expert
Jeanne Berg
I have great kids and my mother (at the age of 83!) is still running my sister’s practice... So much sweetness: my colleagues in the diabetes field, my friends all over the world. Can it get any better? Get in touch with Jeanne by emailing jeannieberg@hotmail.com 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.”
Five Ways to De-stress… At the Office Just because you’re at work doesn’t mean you can’t unwind and relax.
Lifestyle
WORDS: CHARIS LE RICHE
Recent studies by the international research company Bloomberg found that South Africa has the secondhighest levels of stress in the world. Stress can lead to depression, anxiety, sleep problems and irritability – and although it’s a killer for anyone, it has a major effect on your blood sugar levels. That means it’s even more important for diabetics to keep their stress levels in check.
Luckily, you don’t have to quit your job and go on a meditation retreat to do so! There are a number of ways to unwind during your lunch break. Here are five of our favourites.
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Meditate
We all know that yoga is a great way to relax your mind and body, but you don’t have to bring your yoga mat and leotard to work – there are short mini-meditations that you can do while sitting at your desk. Simply stop what you’re doing and close your eyes. Breathe deeply and focus on your breathing: count three full inhales and exhales, and then slowly open your eyes again. You can do this exercise throughout the day and it will literally only take a minute.
Play
I don’t mean skipping rope (unless you want to!) but getting away from your desk is one of the best things you can do to combat stress. So put down your pen and step away from the computer. Head outside and take a walk or find a spot to sit while you sketch or write. Do whatever you enjoy best – as long as it means you get away from the office for a bit. You’ll be amazed how problems seem more manageable when you have a moment to clear your head.
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Laugh
It may seem like a cliché, but laughter often is the best medicine, especially in the workplace. Sometimes you just need some comic relief in a high tension moment to relieve everyone’s anxiety. So share some funny stories with colleagues or watch a silly video. Anything that lightens the mood is a good thing!
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Hit the gym
Another sure way to beat stress is to work it out through exercise. Any kind of exercise will help blow off some steam, so pick something you know you will enjoy and are comfortable with, whether it’s yoga, pilates, spinning, swimming or running on the treadmill. As long as you’re working up a sweat, you’re doing your body (and mind) some good.
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Enjoy some “me” time
Lifestyle
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If you can’t get away from the office, try to enjoy a little “me” time while at your desk – even if it is only for 20 minutes. Put on your earphones and listen to your favourite music (music is a great anti-stress tool) and take some time out to doodle or browse Pinterest or Instagram. This can help improve your attitude about the work at hand and put things in perspective. Never a bad thing!
Fancy a cup of tea? In many situations – at home or in the office – a cup of tea is just the thing you need to calm down. Many cultures have been using tea for medicinal purposes for centuries. Here are a few teas that can help you combat stress: • Chamomile: A firm favourite among people who need to relax. • Green: Not only high in antioxidants but also contains theanine which is known to help with stress (it does contain caffeine though, so look out for the decaffeinated kind). • St John’s Wort: Famous for its ability to treat depression, this tea
also helps with anxiety. • Lemon Balm: Great for helping you sleep, Lemon Balm tea helps overcome depression, anxiety and nervousness. • Lavender: Another tea that helps with sleeplessness, lavender is known for its soothing qualities. 25
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ADVERTORIAL
Rural Healthcare New clinic and integrated wellness centre opens in Manxili, KwaZulu-Natal Sanofi South Africa and its partners, the Tobeka Madiba Zuma Foundation (TMZF) and the Department of Health, formally handed over one of the first integrated wellness centres in Manxili, in rural KwaZulu-Natal, on September 5, 2015. Manxili is a sizable rural community of 13,000 people and was identified as an area in need of additional assistance during consultations with the Umzinyathi District Health Department, with the purpose of initiating a project that was aligned to the Government’s key objectives. Prior to the building and opening of this clinic, members of the Manxili community had to rely on a mobile clinic or make the difficult journey to the nearest health care centre in Nquthu.
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In 2012, Sanofi South Africa, the Tobeka Madiba Zuma Foundation and the Department of Health signed a Partnership Compact to implement various initiatives aimed at increasing access to healthcare services, treatment and healthcare information and education with a major focus on HIV/AIDS and TB, breast cancer and cervical cancer. As part of this partnership and compact signed, Sanofi and the Tobeka Madiba Zuma Foundation offered to build and donate the first integrated wellness centre in Manxili. This initiative is aligned to Government’s National Strategic Plan (NSP), aimed at achieving an integrated management and controlling the spread of
2015/10/08 11:59 AM
ADVERTORIAL TB and HIV/AIDS infections in the country. This is in keeping with the President’s key objectives of social and infrastructural development in rural areas. “When we began looking for a partner in the private healthcare system to assist, we approached Sanofi because of its longstanding commitment to supporting healthcare initiatives,” says the First Lady Tobeka Madiba Zuma. “As a country, we face major health challenges, which we can only overcome if the public and private sectors work together with communities. Manxili is a great example of what can be achieved through a shared vision and partnerships.” John Fagan, General Manager of Sanofi South Africa, adds, “We are proud to be associated with this partnership initiative which is fully aligned to Government’s socio-economic and rural objectives, and will also contribute to the sustainability and development of the community.” The Manxili clinic is another example of Sanofi’s enduring collaboration with the Department of Health. Over the past seven years, Sanofi has successfully implemented the TB FREE project in partnership with the National Department of Health through a donation of €15 million from Sanofi. The TB FREE initiative supported the Department of Health’s TB Control Programme by training over 55,000 Directly Observed Treatment (DOT) supporters who assist TB patients to ensure adherence and completion of their TB treatment, and also to run TB education and awareness campaigns. Phase II of the project, INHIBIT TB, was launched in 2014 and focuses attention on the screening
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“When we began looking for a partner in the private healthcare system to assist, we approached Sanofi because of its longstanding commitment to supporting healthcare initiatives.” First Lady Tobeka Madiba Zuma
of family contacts of people diagnosed with TB in their homes. This offers family members an opportunity to be screened for TB and HIV. In 2014, Sanofi and TMZF opened an upgraded oncology high care ward at Charlotte Maxeke Johannesburg Academic Hospital, the only centre providing chemotherapy as part of cancer treatment protocol. The Manxili clinic promises to be another successful partnership to help those in need.
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How to Exercise at Work Long office hours and travelling to work by bus or car can make it hard to find the time to exercise‌ Here are some fun ways to squeeze it in at work.
Work It Out
WORDS: NICOLE MCCREEDY
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It’s no surprise that most people spend too much time each day sitting. These habits are having a negative affect on our long-term health and are increasingly linked to being overweight and obese, the development of Type 2 diabetes, some types of cancer, and even an early death. How’s that for inspiration to get moving! Experts say that those of us who work desk-based jobs should aim to stand and do light activity throughout the day. In some countries, workers are encouraged to spend up to half of their eight-hour working day standing. This may not be possible for many of us, but we can all take at least ten minutes here and there at work to fit in some physical activity. Being active is especially important when you have diabetes. There are many benefits to regular activity, but the biggest one for diabetics is that it makes it easier to control blood sugar levels. Regular movement can also help you avoid sore wrists and stiffness.
Use the space available Making simple adjustments to your routine can help to increase your daily activity. We’ve all been told to take the stairs instead of the lift, but there are many other things you can do to inject some movement into your day. Avoid sitting at your desk during your lunch break, and instead head outside or to the parking lot for a quick stroll. If you need to take a meeting, suggest that you “walk and talk” with your colleagues. Another option is to find an empty office or conference room where you can shadow box, run on the spot or do a few walk-lunges or some yoga poses. If you have diabetes, it’s obviously important to be aware of your blood sugar levels. Depending on the type of activity you plan to do, carry a snack or eat a 15g portion of carbohydrate beforehand to prevent low blood sugar. 29
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Exercises to do at your desk We asked biokineticist Ilona Padayachee and podiatrist Anette Thompson for a few exercises you can do while seated at your desk to tone your muscles and lift your heart rate, without breaking a sweat.
Work It Out
Seated toe raises: Seated upright at your desk with your core pulled in tightly, lift your toes while keeping your heels firmly on the ground. When you lower TOP TIP! your toes, push them into Remember to the ground and pull them repeat the back. Alternate your feet. exercise on Complete 3 sets with 10 each side. repetitions in each set. Seated straight-leg raises: Keep your back straight, your chest out and your shoulders down. Straighten your right leg out in front of you and tighten the quadricep muscle. Raise the foot off the floor approximately one ruler height (20 to 30 cm). Repeat on the left side.
Calf raises: Stand in front of a desk or other piece of furniture you can hold on to for balance. Raise your heels off the floor and slowly lower them.
Leg extensions: Seated at your desk with your core pulled in tightly, sit on the edge of your chair and extend your right leg until it is level with your hip. Hold this position for 10 seconds and then lower your leg slowly. Alternate sides. Complete as many as you can and try to increase your holding time slightly every week.
Heel raises: These can be done while standing or seated. Lift your heels up as high as possible. Keep the weight on the big toe side of your foot. Hold for two to three seconds at the top, then lower. Repeat 25 times. Heel raises are helpful because they improve circulation and tone the calf muscles.
Ask the expert: Anette Thompson, podiatrist “Doing 300 heel raises a day is the same as going for a long walk. People who haven’t done them before should aim for 50 heel raises in a day, then gradually build up the repetitions until you can do them all in your lunchtime.”
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PRINT.pdf
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2015/02/16
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2015/09/10 8:11 AM
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Special Occasion Treats
With the festive season just around the corner, we all want a little something delicious to eat‌ But how do you treat yourself without spiking your blood sugar? By having small portions of these delicious treats, specially created for the Sweet Life festive season! PHOTOS: MARK PEDDLE FOOD EDITOR: LUISA FARELO
Look out for our healthy tips from Pick n Pay's dietician, Leanne Kiezer, to make these dishes even better for you! 24
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Flourless Chocolate Tart protein
7g
fat
carb
32g 15g
fibre
sodium
4g
153mg
per portion
energy
1565kJ
Method: Preheat oven to 180째C. Place butter and chocolate into a bowl and allow to melt gently over a pot of simmering water. Beat together the eggs, vanilla essence and sugar until light and pale. Stir the melted chocolate and butter mix into the whisked eggs and gently fold in the ground almonds. Pour into a lightly greased and lined 22cm baking tin. Bake for 40 minutes or until firm to the touch. Remove from oven and allow to cool for 15 minutes in tin before tipping out and cooling completely. Dust with sifted cocoa powder and serve with fresh berries.
Makes 1 cake 200g butter 200g dark chocolate, broken into pieces 4 eggs 1t vanilla essence
2T sugar 100g ground almonds Cocoa powder, for dusting Seasonal berries for garnish
Top tip:
This is a treat that is not too high in carbs, but does have a very high fat content, particularly saturated fat, which is not recommended for good heart health. Enjoy a very small serving for a special occasion!
Health hotline
0800 11 22 88 healthhotline@pnp.co.za
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Baba Ganoush with Tortilla Crisps protein
fat
carb
fibre
sodium
6,5g
10,5g
29g
7g
464mg
Serves: 4 (as a snack)
2 medium aubergines, washed and pricked all over with a fork 3T tahini paste 1T olive oil 1-2 cloves garlic, roughly chopped Zest and juice of 1 lemon Salt and black pepper Pinch of chilli (optional) 4 wholewheat tortilla wraps
per portion
energy
895kJ
Method:
To make Baba Ganoush: Preheat oven to 200°C.
To make tortilla crisps:
Roast whole aubergines in oven for about 45 minutes or until soft.
Preheat oven to 200°C.
Remove from oven and allow to cool.
Slice tortilla wraps into bite-sized triangles and place onto a baking tray.
Slice open and scoop out flesh. Blend in a food processor together with the tahini, olive oil, garlic, lemon zest and juice, a sprinkle of salt and pepper and a pinch of chilli. Whiz until smooth.
Bake in oven for about 10-12 minutes or until golden and crisp.
Serve with the tortilla chips or crudité.
Top tip:
Aubergines are rich in antioxidants, particularly nasunin which is found in the skin and gives them their purple colour. They are also an excellent source of soluble fibre. 25 35
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Salt & Thyme Sweet Potato Crisps protein
fat
carb
fibre
sodium
441kJ
3g
4g
17,5g
3g
340mg
per portion
energy
Serves: 4 2 sweet potatoes, skin on and scrubbed clean 1T olive oil Salt and freshly ground black pepper A few sprigs of thyme
Method: Preheat oven to 190°C. Slice the sweet potatoes as thinly as possible into rounds. Drizzle over the olive oil and toss until lightly coated. Place onto an oven tray and season with salt and pepper. Pick the thyme leaves and sprinkle on top. Roast in oven for about 20-30 minutes or until golden brown and crisp. * You may need to toss during roasting as some sweet potato rounds may crisp up quicker than others.
READER'S TREAT
Omar Said's �Salt and Vinegar Crisps"
Try this!
Top tip:
Sweet potatoes are rich in beta carotene, offer a source of fibre, and they have a lower GI (Glycemic Index) than regular potatoes.
Health hotline
0800 11 22 88 healthhotline@pnp.co.za
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Guilt free Baked Chicken protein
fat
carb
23g
15g
31,5g
fibre
sodium
0,5g 489mg
per portion
energy
1463kJ
Serves: 4 8 chicken pieces Olive oil for drizzling FOR MARINADE: 500ml buttermilk 2 cloves garlic, crushed ½t paprika A few sprigs of thyme, leaves picked FOR DUSTING: 1 cup flour 1t baking powder ½t cayenne pepper Salt and pepper
Method: Mix marinade ingredients in a bowl and marinade chicken overnight. Preheat oven to 190°C. Mix flour, baking powder and cayenne pepper. Dip chicken pieces into the flour mixture and shake off any excess. Season lightly with salt and pepper and place onto a lightly greased oven tray. Drizzle with a little olive oil and roast in oven for about 30-40 minutes or until golden brown and chicken is cooked through. Serve with sweet potato crisps and a large salad.
Top tip:
Take note of the carb content of these chicken pieces coated in flour! Be careful to cut back on any other carbs that you are having and focus on more vegetable crudites. 37
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Healthy Apple Crumble and Custard protein
9g
fat
carb
10g 37g
fibre
sodium
5g 76mg
per portion
energy
1065kJ
Method: Preheat oven to 190°C. Heat the coconut oil and add cinnamon and nutmeg. Fry for a few seconds to release the flavour, then add apples and lemon zest. Fry until golden brown and slightly softened. Place into a baking dish and cover with oats. Bake in oven for 15 minutes or until oats are golden brown. Serve warm with vanilla custard. To make custard: Whisk together the egg yolks, sugar, cornflour and vanilla until creamy and pale. Heat milk in a saucepan until just simmering. Slowly pour hot milk over egg mixture while continuing to whisk. Pour mixture back into saucepan and place over a very low heat, stirring continuously until slightly thickened. Serve immediately with the apple crumble.
Serves: 4
4 apples, peeled and thinly sliced 1T coconut oil 1½t ground cinnamon ½t ground nutmeg Zest of 1 lemon ½ cup oats
CUSTARD: 2 egg yolks 2t sugar 1t cornflour 1t vanilla essence 600ml low-fat milk
READER'S TREAT Keith Heydenrych's "Apple Crumble"
Try this!
Top tip:
This is a far healthier version of the traditional apple crumble, but be careful of the carb content. Don’t eat other carbs at dinner if this is your dessert, and mind your portion size!
Health hotline
0800 11 22 88 healthhotline@pnp.co.za
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Crustless Milk Tart protein
682kJ
6g
fat
carb
fibre
sodium
7g 21g
0g
85mg
Makes 1tart
20g butter, softened 3T sugar 1t vanilla essence 2 eggs ½ cup flour
per portion
energy
Try this! Method:
½t baking powder 2 cups low-fat milk Ground cinnamon for dusting
READER'S DINNER Nomar Khumalo's "Milk Tart"
Preheat oven to 180°C. Cream together the butter, sugar and vanilla until pale and creamy. Separate the eggs (setting aside the egg whites for later) and add the yolks to the creamed mixture, then mix well. Sift together the flour and baking powder. Add to the creamed mixture alternately with the milk. Whisk the egg whites until stiff peaks form and gently fold into the milky mixture. Pour into a greased 22cm tart tin and bake for about 30-40 minutes or until golden brown and just set. Cool completely before dusting with cinnamon and serving.
Top tip:
This is a healthier dessert which is also rich in calcium and protein, due to the milk content. If you halve the sugar content and substitute it with a granular sweetener like Sugalite, it will lower the total carb content. 27 39
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Quick Berry & Mint Sorbet protein
435kJ
4,5g
fat
carb
1,5g 20g
fibre
sodium
5g 45mg
Method:
per portion
energy
Serves: 4 1 x 400g mixed frozen berries A few sprigs of fresh mint 1 cup low-fat plain yoghurt Zest of 1 lemon
Place all ingredients into a jug blender and blend until smooth: mixture should have a slush puppy consistency. Pour into a freezer container and freeze for about 3 hours or until set enough to scoop. Serve as is and enjoy! * Be careful not to freeze for longer as it freezes rock hard and will need to defrost slightly to scoop.
Top tip:
Berries provide so much more than a sweet source of energy: they are known for their many health benefits which come from their deep, rich colour (from flavonoids).
Health hotline
0800 11 22 88 healthhotline@pnp.co.za
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Although the holidays can be a tricky time to maintain your wellness routine, use these tips to keep you on track while still being a part of all the fun! Try to maintain your regular eating habits wherever you can. When you aren’t attending a function or celebration, follow your normal healthy eating plan. Spread your meals evenly across the day, and don’t skip a meal in anticipation of a large lunch or dinner.
Contribute to the dinner spread by offering to bring a side dish to the party. Make something you
If eating out: - choose a restaurant or café that serves a variety of healthy options - try to choose grilled, roasted or baked meat or fish instead of fried and ask for sauces to be served separately - ask for vegetables or salad to be served without added butter or dressing - avoid skipping meals as you will arrive ravenous at the restaurant or party and will be more likely to over indulge
know to be on the healthier side, like a vegetable crudité starter, a side salad or fruit kebabs for dessert.
If you are going to enjoy a helping of dessert, plan ahead and keep your portions small. Cut back on the starch portion in your main meal and fill up with plenty of nonstarchy vegetables and salad instead.
Stick to your fitness routine as much as possible and set time aside to do activity most days. Remember that every small bit counts, so even if you cannot get to the gym for your usual 30-minutes, three shorter 10-minute bursts of physical activity throughout the day still add up to a healthier version of you! 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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Healthy holiday tips
Healthy holiday tips
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It’s hard to beat a person who never gives up.
Last Word
Babe Ruth
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Allevyn Life treatment advert (APRIL)210x148advert.pdf
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