Issue 14
Winter 2015
LIFE CAN BE SWEET, WITH DIABETES
Also
Diabetes and
- Expert interviews - Diabetic diet advice - Fitness focus - And more!
Motherhood (our pregnancy issue)
Free! Take one now
PLUS: The best lunch (and lunchbox!) ideas
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Discreet bolus delivery, and still stepping out in style.
The Accu-Chek Combo system. For discreet bolus delivery without touching the pump. ®
• By wireless two-way communication between the pump and meter • Supporting tighter control of post-prandial blood glucose values 1,2 • Sensitive occlusion detection provides additional safety 3 Operating your pump remotely with the meter means you don’t have to touch your pump to bolus or check the screen once it’s placed under clothes.
Experience what’s pos possible. For more information contact your Healthcare Professional 1H.Zisser et al. Clinical performance of three bolus calculators in subjects with type 1 diabetes mellitus: A head-to-head comparison. Poster presented at the 46th EASD Meeting, Stockholm Sep.2010. 2A.McDaniel et al. Differences in management of post-prandial hyperglycaemia by automated bolus calculators is due to distinct insulin on board algorithm. Poster presented at the 2nd international conference on Advanced Technologies & Treatments for Diabetes, Athens, Greece Feb. 2009. A237. ³”Andreas Buhr et el. Time delay to occlusion detection of insulin infusion pumps. Poster presented at the 5th International Conference on Advanced Technologies and Treatments for Diabetes Barcelona, Spain, February 2012”
Roche Products (Pty) Ltd Diagnostic Division PO Box 1927, Randburg Toll free: 080-Diabetes (Dial 080-34-22-38-37) www.accu-chek.co.za / www.diabetes.co.za Ref: COMB 140124
2343_Accu-Chek - Carbo & Cals Ad - Sweetlife.indd 1
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Welcome to a very special pregnancyfocused issue of Sweet Life, where we tell you all you need to know for a diabetic pregnancy (as well as lots of other info for a happy diabetic life!) As you can see from the cover, I was recently pregnant, so I have a lot of first-hand advice to share - as well as things I wish I’d known before I fell pregnant! But even if pregnancy isn’t on your horizon (and never will be), there’s still loads of helpful info for you in this issue of Sweet Life. I don’t know about you, but one of the meals I struggle with most is lunch - and how to make it delicious and healthy when there are a million other things to be done at that time of day... We’ve come up with some great ideas for lunch, and lunchboxes, that should solve that problem. Dinner is next, in our Spring issue in September. So if you’d like us to give your favourite dinner a makeover, let us know on Facebook (Diabetic South Africans). And while you’re there, don’t forget to join us for our weekly diabetes chats: Wednesdays at 8pm. As always, if there’s anything you want to see in Sweet Life - the magazine or the website - please let me know (email hello@sweetlifemag. co.za). I love hearing from you! Until next time,
EDITOR Bridget McNulty
ART DIRECTOR Mark Peddle
PUBLISHER Claire Barnardo
ADVERTISING SALES TFWcc: Tessa Fenton-Wells
CONTRIBUTORS Carine Visagie, Cheryl Meyer, Craig Paxton, Cindy Tilney, Claudine Lee, Jeanne Berg, Joel Dave, Leanne Kiezer, Lucia Viglietti, Luisa Farelo, Nadine van Driel, Sarah Hall, Shelley Lewin.
Welcome
Hi there!
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.
COMPETITION RULES Winners will be randomly selected and notified by telephone or email. Prizes are not transferable and cannot be exchanged for cash. The judge’s decision is final and no correspondence will be entered into.
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
Joel
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…
“I
’m sure all husbands worry about their pregnant wives, but it’s extra worrying because my wife is diabetic and has to be in such strict control – or it could harm our baby. I’m trying to be supportive, but sometimes it’s difficult… Especially because she’s so emotional!” Mark Roberts
Pregnancy is a powerful experience, with huge hormonal changes and a life-changing event. A woman with diabetes has even more on her plate. It is wonderful that you are supportive. Part of your support should be helping your wife eat the right food, check her blood sugar regularly and do the right exercise. The fear you have for your baby is real, but this is true for any pregnancy. Hopefully you have worked out an action plan with your health care team. If your wife is keeping to her programme, the risk of anything going wrong is minimal.
Contact her gynae or endocrinologist if you feel that something is wrong: it is natural to worry, but try not to nag. Mood swings tend to happen most frequently in the first 12 weeks of pregnancy. Between 3 and 6 months your wife will start to feel better and have more energy. Hopefully she will feel less emotional. The emotions are difficult to cope with, I agree. It can be very helpful to allow yourself time out! Remember that a pregnancy affects both partners: the golden rule is to talk about how you are feeling. Voice your worries, concerns and anxieties. This goes a long way to relieving them. Most importantly, don’t forget to take time for you and your wife to relax together and enjoy this exciting time. Sometimes just being supportive and loving is the best thing you can do. Enjoy your baby!
Ask the expert: Jeanne Berg, Diabetes Educator “Remember that a pregnancy affects both partners: the golden rule is to talk about how you are feeling.”
Partners
Dear Mark, You have my sympathy! Women who are pregnant can be on a real rollercoaster of emotions – highs and lows and everything in between. While some women ‘bloom’ during pregnancy and are full of life, others are tearful and apprehensive.
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Ask the expert:
Ask the Dietician
Cheryl Meyer
Need to Know: Pregnancy Diet “B
eing both diabetic and pregnant makes it difficult to know what to eat – there are so many things I have to avoid! And I’ve been craving sweet things. Any advice?” Sameshnie Naidoo
The diet for pregnant women with diabetes should be a healthy, well-balanced eating plan aimed at supporting the pregnancy and promoting blood sugar control. This is essential for the wellbeing of both mom and baby. Of course, being both pregnant and diabetic means that there are more foods on the ‘Do Not Eat’ list, as your normal diabetic diet has a new list of things to avoid. But bear in mind that it’s only for nine months, and that it’s for the best possible cause: your healthy child.
Foods to avoid:
Here’s a list of foods that you shouldn’t eat when you’re pregnant: they pose a potential food safety risk and might make you ill or harm your baby. • Soft cheeses like Brie, Camembert, and blue-veined cheeses unless the label says they are made with pasteurised milk.
Must Do’s for a Healthy Pregnancy: • Stop smoking • Avoid alcohol • Eat a healthy, balanced diet • Keep active
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• Processed cold meats or deli meats unless they are reheated until steaming hot. • Refrigerated paté or meat spreads (canned is fine). • Refrigerated smoked seafood unless as an ingredient in a cooked dish like a casserole. • Raw or partially cooked eggs and dishes that contain these, like homemade mayonnaise. • Raw or undercooked meat and poultry • Unpasteurised juice • Raw sprouts • Raw or undercooked fish or shellfish
" The American Academy of
Nutrition and Dietetics (AND) recommends pregnant women avoid fish high in mercury like shark, swordfish and marlin. Also limit the amount of fish and shellfish lower in mercury like prawns, canned light tuna and salmon to 360g or less per week.
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*Cravings for non-food substances like sand or chalk (a condition called pica) can be dangerous as these items contain lead or other toxic substances. If you’re craving non-food items, consult your doctor.
Being both diabetic and pregnant can feel restrictive from a diet point of view… When you’re lacking motivation, just remember that everything you eat your baby is eating too: so put down the junk food and pick up a carrot!
Top tip
Get great lunchbox snack ideas on page 41.
A Note on Cravings: Whether it’s pickles and ice cream or other odd combinations, both cravings and food aversions are common during pregnancy. Although the exact cause is unknown, taste perceptions may change with hormonal changes. Cravings are generally harmless*, unless foods you crave replace more nutritious foods, or all you want is junk food. If broccoli loses its appeal, for example, substitute another vegetable that you enjoy and tolerate.
Ask the Dietician
The good news? You don’t need to give up caffeine entirely. The AND recommends keeping your intake below 300mg/day, which is about one or two servings of coffee or tea. And of course rooibos is naturally caffeine free, so you can have as much as you like!
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10 Fast Facts About Pre-Eclampsia Not sure exactly what pre-eclampsia is or how to spot it? Here’s what to watch out for.
1
Pre-eclampsia is high blood pressure during pregnancy that causes hypertension.
Healthy Living
It usually starts after the 20th week of pregnancy and improves 6 weeks after birth.
Symptoms include: severe headaches, problems with vision, abdominal pain, vomiting, swelling, not feeling your baby’s movement, and feeling ill. Treatment is medication or early delivery.
5
It must be closely monitored as it can result in an early delivery.
Women with diabetes are at higher risk of pre-eclampsia.
2
Preeclampsia, gestational diabetes or hypertension during pregnancy can increase a woman’s risk of developing Type 2 diabetes up to 18 times.
Type 1 diabetics are 2 to 4 times more likely to develop pre-eclampsia than those without diabetes. It is picked up by elevated proteins in the urine (which leak from the kidneys).
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If your blood pressure is above 120/80 you need to see a doctor.
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Your risk of developing pre-eclampsia is higher if you are obese or have a maternal history of high blood pressure.
Ask the expert: Dr Claudine Lee, GP “One of my patients had pre-eclampsia and had to have her baby early. She had perfect blood sugar during pregnancy, but not before. Luckily, all went well, but it’s a scary condition: expert care and quick action are vital.”
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Here’s one of the inspiring organisations we’ve partnered with to give back to the community.
Who is Axium Education? Axium Education is a non-profit organisation based in the rural village of Zithulele in the Eastern Cape. We have two objectives: 1. To grow passionate, knowledgeable rural educators in the critical areas of language, maths and science. 2. To grow a new generation of quality rural professionals by providing opportunities for talented rural students to succeed
Charity
Sweet Life Gives Back
What do they do? • At the Ekukhuleni Centre, 90 high-potential students receive additional tuition in maths, science, leadership and English and then lead afternoon study groups at their schools, which we support with materials and visits. • Masakhane involves 120 students who attend afternoon classes three times a week, using Netbooks to learn maths and learning from a fun, interactive English programme. • Our Community Readers programme encourages young, unemployed adults from the local community to read with young children and grow a love of stories. • Professional networks provide opportunities for 60 educators from 20 schools in the area to meet together for professional development.
How can you get involved? We’re always looking for quality volunteers – young and old – to invest in the amazing students we work with. We also welcome any donations of stationery, computers, tablets, phones and sports kit, all of which can be put to good use in the programmes we run. Find out more at www.axiumeducation.org
Get in touch with Axium by emailing Craig Paxton: craig@axiumeducation.org, calling 082 459 9877 or writing to PO Box 803, Mqanduli, Eastern Cape, 5080.
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A New
t e e w S
Life
Inspiring
Sweet Life editor and Type 1 diabetic Bridget McNulty shares her pregnancy story – and what she wishes she’d known before she fell pregnant. WORDS: BRIDGET MCNULTY PHOTOS: MICAELA DE FREITAS
How long have you been diabetic? I was diagnosed in October 2007, so it’s been nearly 8 years now… It was a very dramatic diagnosis: I was admitted to ICU for five days and was apparently only three days away from a diabetic coma because my blood sugar was so high. Did you have to prepare to fall pregnant? I told my endocrinologist, Dr Joel Dave, ahead of time that my husband Mark and I were thinking of
having a baby, and he gave me the go-ahead because my blood sugar was already well-controlled: my HbA1c results were 7.0 and below for the year before I fell pregnant. I also mentally prepared for the pregnancy, because I knew it would require a lot of discipline and that my diabetes would become even more of a full-time job than it already was! How did having diabetes affect your pregnancy? I had to be in extremely tight control
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very strict with my diet. But it’s amazing how much easier it is to resist treats when your motivation is the health of your baby. It’s also such a limited amount of time with such a definite end goal, so it was much easier than I anticipated. Still challenging, of course, but not at all impossible. How was the birth experience? As smooth as I could have hoped for! I chose to have an elective C-section: it was either that or an induction, as all babies born to diabetic moms have to be born at 38 weeks. In the week before Arthur’s birth my blood pressure started creeping up, and I was retaining a lot of water. Because diabetics are at greater risk of pre-eclampsia, my gynaecologist decided to bring the birth forward two days, from the Monday to the Saturday.
“It’s amazing how much easier it is to resist treats when your motivation is the health of your baby.”
throughout – HbA1c results of 6.0 and below (which I didn’t think was possible before I fell pregnant!) and blood glucose results of 7.8mmol/l or below an hour after eating… Where possible. What that meant was that I had to snack an hour after eating to make sure my blood sugar didn’t go low an hour after that, when the insulin was at full effect. I also had to test even more frequently than usual (up to 8 times a day). I had HbA1c tests every month and saw my endocrinologist every month, and I couldn’t indulge in pregnancy cravings like eating a whole tub of ice-cream! I was
I nearly had to go in on the Friday and was waiting on blood test results at 10pm on Thursday night to see if I had to go in the next morning at 6am! That was pretty stressful. But I got a day’s grace period to catch my breath and prepare. I had the first slot of the day, because you’re not allowed eating before a C-section and because of my diabetes I obviously couldn’t go for hours without eating. So we had to be at the hospital before 6am… It was hugely exciting, and hugely nerve-wracking. Arthur, our baby boy, was born totally healthy and weighed in at a (very) healthy 4.5kg. We fell in love with him instantly. What is it like having a young baby, with diabetes? Now that Arthur is nearly a year old (he was born in July), things are a lot easier, 13
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Inspiring
but it was a real challenge in the early days. Breastfeeding plays havoc with blood sugar control, and causes really persistent lows. Sleep deprivation is tough to deal with, and it’s so overwhelming having a new baby and trying to learn how to be a parent that my diabetes kind of took a back seat for a while. I remembered to inject and test, but that was about it. It felt like riding a wave… It’s now stabilised significantly, thank goodness, and I feel a lot more confident about both parenting and being a diabetic parent! How do you balance a busy life with eating right and exercise? It’s tough… But isn’t it tough for all of us? I have set exercising times – Saturday morning yoga is cast in stone – and I do a lot of planning ahead for meals so that I don’t find myself starving and tempted to eat something I shouldn’t. Now that Arthur can eat family meals with us, it’s actually a lot easier because I’m so conscious of what I’m feeding him and making sure it’s as healthy as possible. What do you think the biggest challenge of a diabetic pregnancy is? Although 9 months doesn’t seem like that long at first, it’s a really
long time to be non-stop superdisciplined. I remember when I was halfway through thinking, “Really? There’s another four-and-a-half months of this constant monitoring, strict diet and never cheating?” It was a challenge! What advice would you offer to diabetics who are struggling? You will feel so much better if you get your blood sugar under control. It is so worth it in terms of health and energy and general happiness to do what it takes to get good control. I know how hard it can be, but the reward is a healthy, happy life with diabetes – and that’s about as good as it gets. What makes your life sweet? My darling baby boy, my wonderful husband, my awesome family and friends and the sweet life I’m living!
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0215 3882_NovoTwist A5 LP_Layout 1 2015/05/13 5:23 PM Page 1
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Easier attachment The “Just Twist” bayonet fitting makes needle attachment easier,1 and features an audible and tactile click to confirm correct attachment.
Reliable insulin deposition 5 mm NovoTwist® needles are reliably inserted into subcutaneous fat in both adults and children with minimal leakage.3
Novo Nordisk offers the following needles to be used with these Novo Nordisk devices: NovoFine® Needle FlexPen® NovoPen® 4 NovoPen Echo®
p p p
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p p p
ALWAYS remember to check that your doctor has added your needles to your chronic script References: 1. Sommavilla B et al. Safety, simplicity and convenience of a modified prefilled insulin pen. Expert Opin Pharmacother 2008;9(13):2223-32. 2. Hansen B et al.. Needle with a Novel Attachment Versus Conventional Screw-Thread Needles: A Preference and Usability Test Among Adults with Diabetes and Impaired Manual Dexterity. Diabetes Technology & Therapeutics 2011;13(5);1-7. 3. Hofman P et al. Defining the ideal injection techniques when using 5-mm needles in children and adults. Diabetes Care 2010; 33:1940–1944. Novo Nordisk (Pty) Ltd. Reg. No.: 1959/000833/07. 2nd Floor, Building A, 345 Rivonia Boulevard, Edenburg, Rivonia, Sandton 2128, South Africa. Tel: (011) 202 0500 Fax: (011) 807 7989 NT RLC 0215 3882 0316
Pregnancy and Diabetes 101 Motherhood is a great adventure and (morning sickness aside!) being pregnant is magical. Inside of you, a perfect little baby is growing… Here’s what you need to know to ensure everything goes smoothly. WORDS: CARINE VISAGIE
If you have diabetes, or get diabetes during pregnancy, you’ll naturally want to know what you can do to stay healthy. We spoke to endocrinologist Dr Veronique Nicolaou, obstetricians Dr Veronique Eeckhout and Dr Manasri Naiker, and registered dietician Emily Innes to learn more about diabetes and pregnancy.
Gestational Diabetes Explained:
Gestational diabetes occurs for the first time during pregnancy and goes away again after birth. Uncontrolled blood sugar levels in gestational diabetes can be as dangerous as in Type 1 and Type 2 diabetes. It may be possible to control your blood sugar with diet and exercise, or medication may be necessary. The medication will most likely be stopped after pregnancy, but it’s important to get your blood sugar tested again six weeks after delivery to rule out Type 2 diabetes.
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Get this right before pregnancy Keen to start a family? Don’t ditch the contraceptives yet. To prevent complications, our experts say you first need to: 1. Tightly control your blood sugar levels. This means keeping your HbA1c below 6.1% for three months. 2. Lose excess weight. Being overweight ups your risk of complications during pregnancy. 3. Take a 5mg folic acid supplement (three months before pregnancy and through the 2nd trimester). 4. Stop smoking.
Stay healthy during pregnancy If all goes according to plan, you’ll soon be pregnant. Congratulations! Now is the time to focus on your baby’s growth and development, which
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If all goes well, it’s possible to deliver your baby naturally. The timing is more important than the method of delivery. Your doctor will most probably induce to deliver naturally at 38 weeks, or do a C-section if there are other problems (for example, if you have a large baby). To control your blood sugar during labour, an insulin pump and a dextrose drip will be used, and your sugar and ketone levels will be checked every 2 to 4 hours.
How to Stay Zen
Pregnancy can be stressful for moms with diabetes. To stay relaxed, our panel advises to get enough rest: sleep 7 to 8 hours a night, go for pregnancy massages if you can, practise deep breathing, and take things easy at work. Also ask for support from loved ones, and empower yourself with information.
(still) means managing your blood sugar levels as well as you can. Poorly controlled blood sugar can lead to a higher risk of infections, hypoglycaemia (low blood sugar), pre-eclampsia (high blood pressure) and ketoacidosis. Excess amniotic fluid is also an increased risk and can lead to premature delivery.
Special Feature
Natural birth or C-section?
Existing diabetes-related problems may worsen during pregnancy and your baby could grow too big, which increases the risk of stillbirth, birth trauma and respiratory distress. But this is all if your blood sugar is uncontrolled: stay in good control and you’re likely to have a perfectly normal, healthy pregnancy. 19
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5
steps to stay in good control:
Special Feature
Step 1: Eat well
• Choose high-quality, nutritious foods. Steer clear of refined carbohydrates. • Include healthy fats and lean protein at each meal. • Eat plenty of vegetables (and some fruit) every day. • Don’t be tempted to eat for two!
amount of insulin you need may double or possibly triple during pregnancy. Women with Type 2 diabetes who use only oral medication (like metformin) before pregnancy may require insulin at some point. The good news is that metformin is safe to take during pregnancy. Step 4: Monitor your blood sugar frequently
Step 2: Exercise • Talk to your medical team about physical activity. Exercise is a key part of diabetes management, but can sometimes be risky (for example, if you have high blood pressure). Keep your pulse rate below 140 beats per minute at all times. Step 3: Get your treatment plan right • If you have Type 1 diabetes, talk about your insulin dosage with an endocrinologist: the
• As many as six times a day (before meals and snacks, and one hour after eating). • Find out from your medical team if you should be doing any other checks (like ketone testing). Step 5: Visit your gynaecologist regularly • Your doctor will tell you how often to come: some recommend very two weeks until 32 weeks of pregnancy. After this, schedule a weekly visit until your baby is born, if necessary.
Our experts: • Dr Veronique Nicolaou, specialist physician and consultant endocrinologist, Chris Hani Baragwanath Academic Hospital • Dr Veronique Eeckhout, gynaecologist and obstetrician, Medi-Clinic: Cape Town • Dr Manasri Naiker, gynaecologist and obstetrician, the WomanSpace: Cape Town • Emily Innes , registered dietician: Cape Town
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Meet the rest of our experts at www.sweetlifemag.co.za/about-us
Dr Joel Dave Sweet Life is lucky to have an amazing Panel of Experts giving us advice to share with you each issue. Meet Dr Joel Dave, one of our Endocrinologists. How are you involved with diabetes?
As an endocrinologist, many of the patients I see each day have diabetes. In addition, I regularly give CME (Continuing Medical Education) talks to colleagues (local and within Africa) and I am also involved in outreach programmes in disadvantaged communities and Zimbabwe.
What advice would you give to those with diabetes who want to fall pregnant?
It is definitely possible to have a safe and event-free pregnancy, but it involves pre-planning and a good multi-disciplinary team, including a dietician and a gynaecologist with diabetes experience.
Why is a diabetic pregnancy so tricky?
There are lots of reasons why a diabetic pregnancy can be tricky, but you can decrease this possibility by pre-planning and ensuring good diabetes control
before conception. After that, once good habits have been forged, it is a lot easier – especially if the patient has assembled a team of healthcare providers with which they feel comfortable.
Have you had many diabetic pregnancy success stories?
Definitely. It’s a little more difficult than a pregnancy without diabetes, but with a good team effort most diabetic pregnancies are successful.
What makes your life sweet?
Meet the Expert
Find out how Dr Dave helped Sweet Life editor Bridget McNulty with her pregnancy.
It is fantastic to see the joy and relief on my patients’ faces once they have delivered a healthy baby. With planning and teamwork it is definitely possible. Find out more about Dr Dave at www.endocrine.co.za or visit him at Library Square in Wilderness Road, Claremont, Cape Town. Call 021 674 0695 to make an appointment.
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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.”
ADVERTORIAL
The Power of Diabetic Supplements We get some great tips from Dr Geert Verhelst, leading global authority on diet and diabetes, about the ideal diabetic diet and supplements.
What’s the best advice you can offer those with Type 2 diabetes? To focus on changes in lifestyle, because these are much more important than taking drugs or food supplements. The most important lifestyle changes are losing weight if necessary, doing more physical exercise and switching to a healthy diet.
Why is it important to take diabetic supplements? Even if you make the right lifestyle changes, supplements can still help achieve a better glucose level and combine with medication to improve their effect. The better the glucose control, the better we can ward off diabetic complications. I am especially thinking of cinnamon, such as the water-based extract rich in polyphenols (and found in Diabecinn), which can significantly lower fasting glucose levels by promoting the uptake of glucose into the cells. I am also thinking of the mineral chrome, that helps to reduce an elevated glucose level by supporting the hormone insulin, and of zinc, that has been shown to promote carbohydrate metabolism by promoting the production, storage and secretion of insulin.
What makes your life sweet? What is a healthy diet? Say no to all kinds of processed food, especially those containing any kind of sugar (fizzy drinks, candy, chocolate bars, cookies) or refined cereals (white bread, white rice, white pasta). Build your menu around basic, unrefined food sources like fresh vegetables and fruit, nuts and seeds, wholegrain products, quality poultry and lean meat, fatty fish, fermented dairy products, legumes and beans.
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Fresh fruit in the morning and occasionally some dried fruit like apricots, plums, figs and dates. I am also a big fan of stevia: if you can find a good extract, rich in “rebaudioside A�, in most cases it gives a neat, sweet taste without a bitter after-taste. It is a good solution for diabetics too, since it does not influence the blood sugar level.
Find out more about Diabecinn at www.diabecinn.co.za
2015/06/04 1:11 AM
ADVERTORIAL
Smart Tips for Winter Foot Care During the winter, it is important for people with diabetes to take special care of their feet. The cold and dryness in the winter months increase the risk of diabetic foot problems such as infection and injury. Health experts advise that all diabetes patients should check the condition of their feet every day. Follow our top tips for caring for feet during the winter months: 1 Socks & Footwear: Wear good quality thick, breathable socks that keep feet dry. Feet continue to sweat in colder temperatures and it is important to wear socks that promote air circulation and keep perspiration away. Choose comfortable shoes that allow for toe movement and choose materials that keep the feet warm because diabetic neuropathy may prevent one from feeling that the feet are cold. 2 Keep feet dry: Damp feet may develop fungal and bacterial infections. Dry feet thoroughly after bathing or showering. Make sure the area between the toes is dried properly as this is where fungal infections commonly develop. 3 MOISTURISE: Keeping the feet well nourished prevents cracks in heels and
fissures that are painful and are prone to infection. During winter, feet become excessively dry so the importance of moisturising feet every day cannot be over emphasised. A natural diabetic foot cream such as Recharge your FEET will not only keep feet well moisturised, but will also help circulation and fight and prevent infection.
4 Manage your diabetes: Work with your health care team to manage all aspects of your diabetes: diet, exercise, medication & supplementation. Try Recharge DIABETICARE 2 in 1 Diabetic supplements to help maintain a healthy lifestyle
heated foot massagers, hot water bottles and electric blankets on high temperatures.
6 Check and care for your feet: All diabetics should check feet daily for dryness, swelling, fungal infection, cracked heels, cuts, bruises, wounds, corns and calluses. Clip and file nails regularly. Take special care of your feet through the winter months to ensure complications associated with diabetic feet, don’t arise.
5 Be careful of overheating: Because of neuropathy, diabetics have a decreased ability to feel hot temperatures on the feet. It is advisable therefore to avoid
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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2015/06/05 1:08 AM
Pure Joy
Here are 15 ways having children in your life makes you happier all round… (even if they’re not your own). WORDS: CLAIRE BARNARDO
1. ENJOY THE MOMENT Children are naturally mindful of every single moment, and take you along for the (wonderful) journey. To really know what it is like to live consciously, all you need to do is spend time with a child. 2. BE YOUNG AGAIN Spending time with kids allows you to relive your youth again: everything you did and didn’t get to do. Playing with toys, reading your favourite children’s books and playing at makebelieve are all some of the day-to-day activities with a child. 3. KEEP FIT Have you spent an afternoon with a two-year-old recently? It’s one quick and sure way to get in shape! They will have you running around in no time. 4. LAUGH ALOUD! Children say the
funniest things all the time. They can also be quite profound and real in understanding the world. It’s amusing and special all at once. 5. SOCIAL BUTTERFLY You get to meet a whole new group of friends through play dates, school, the library, and family time at parks. Being a parent is a unifying experience. 6. NEW VIEW You can experience the world through new eyes and fall in love with life all over again. There are so many first experiences that you can share with a child. And this time around you get to buy the toys you really want… 7. ALL BETTER A child can change the worst of adult days into something bright just by saying one sentence, or giving one little hug.
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12. DEEP ANSWERS Children are inquisitive and won’t settle for a simple explanation. They test your general knowledge and understanding constantly, which is a great way to keep your mind active.
9. ADVENTURE Kids enjoy life in full doses. Whether it’s exploring the garden or baking, building tents or drawing, it’s all one big adventure when you’re around a little one.
13. PATIENCE Spending time with a child is one sure way to refine your patience and your ability to do things slowly and one at a time.
10. PURPOSEFUL Looking after a child gives you a greater sense of direction and purpose in life. You are able to be your best self around them. 11. PLAYTIME They also remind you about what’s really important in life… and it’s not the laundry, or the dishes.
14. FOCUS In our busy world of screens and meetings, it is a great joy to be able to focus on someone as they learn their way in the world. 15. LOVE, LOVE, LOVE Children really do make your heart grow bigger and more beautiful. They make you smile more easily and look forward to things you might have taken for granted.
Lifestyle
8. GET CREATIVE Kids are at their creative height the younger they are, so you can flex your creativity too. Play-doh, paint, dancing, singing, storytelling… The possibilities are endless.
Kids in Need of Quality Time If you don’t have your own children, don’t worry: there are plenty who still need you. Why not volunteer at a children’s home, hospital or as a kangaroo carer? Here are a few places to contact if you’re looking for somewhere to give back to a little person.
• WESTERN CAPE: St Joseph’s Home: 021 934 0352 or www. stjosephshome.org.za
• GAUTENG: Kid’s Haven: 011 421 4222 or www.kidshaven.org.za • KWAZULU-NATAL: Child Welfare: 031 312 9313 or www.cwdd.org.za
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2015/06/05 12:34 AM
A Fit Pregnancy Staying active during pregnancy is the best thing for you – and your baby. Here’s what you need to know to keep as healthy (and fit) as possible.
Work It Out
WORDS: CINDY TILNEY
While exercise may not be what you feel like doing when you’re expecting, experts agree that it has a host of benefits: besides being a natural mood-lifter, there’s no denying how good it is for you. “In pregnancy, it’s always better to exercise than not – even with a chronic disease such as diabetes,” says personal trainer Shelley Lewin, who offers specialised pre- and postnatal exercises in Cape Town.
“Staying active is not only important for the physical and emotional health of the expecting mother – research has shown that unborn babies thrive if their moms are active. Unless you have a specific medical condition that puts you and your unborn child at high risk during pregnancy, it can only work to your advantage,” she says. “And in people with diabetes, it can help the body to process glucose more effectively.”
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“Exercise in any form may require a reduced amount of insulin because exercise increases glucose uptake in the cells,” explains biokineticist Sarah Hall. “The intensity of the exercise you are doing will determine this: lower-intensity exercise can lead to a recommended insulin reduction of roughly 20%, as opposed to a possible 50% with higher intensity exercise.” This is further complicated by insulin needs often doubling during pregnancy, so consulting a doctor is a must.
Healthy exercise tips during pregnancy: REMEMBER: If you have diabetes, it is essential to get the all-clear from your doctor before starting an exercise programme, particularly if you are pregnant.
What can exercise do for pregnant diabetics?* • • • • • • •
Lower blood sugar Improve insulin sensitivity Control blood pressure Increase energy Reduce after-meal blood sugar spikes Encourage restful sleep Lower gestational weight gain According to the American College of Obstetricians and Gynaecologists (ACOG).
* Type 1, Type 2 and gestational diabetes
• Check your blood sugar before and after exercise (Type 1 diabetics). • Always take a ‘quick-fix’ snack, such as a banana, along with you when you exercise, so that you have a sugar source on hand in case of hypoglycaemia (low blood sugar). • Stay away from forms of exercise that carry a high risk of falling, and avoid lying on your back with the head below the level of the heart, as this can restrict the blood flow to your baby. • Wear a heart rate monitor during cardiovascular exercise, and keep your heart rate to 140bpm or below. In the past, there was a widely held belief that pregnant women should stay away from all cardiovascular exercise – but modern research has shown that this does not hold true. The good news? If you’ve been exercising regularly, you can carry on very much as normal, agree Hall and Lewin – provided the activities are not extremely high-impact, do not involve fast or sharp changes in direction, and do not cause surges in blood pressure or adrenalin. 29
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Ideal pregnancy exercise
Work It Out
Both experts recommend 30 minutes of moderate physical activity three times a week, such as walking, swimming, aqua aerobics and light weightlifting under the guidance of a certified ante-natal instructor. The ligaments tend to naturally relax during the second and third trimesters of pregnancy, so be careful not to overstretch during warm-ups – and if you are weight training, use machines rather than free weights to avoid any hyperextension injuries. “Building up core strength is important in pregnancy,” says Lewin, “but as your tummy grows, you should stay away from certain intense core exercises, such as tummy crunches – instead opt for opposite leg and arm lifts, or practice stability work on a Pilates ball.” Kegel exercises are also important during pregnancy, as they strengthen the pelvic floor muscles.
Be gentle with yourself during pregnancy: stay away from contact sports and aggressive forms of exercise. And be aware of your body and how hard you are pushing yourself during workouts. “The ‘talk test’ is always a good marker of whether you’re pushing yourself too hard,” says Lewin. “If you are exercising at the right level, you should be able to talk at the same time – but if you’re struggling to take in breath and unable to hold a conversation, it means you are pushing yourself too hard.” Find out more about pregnancy exercise at www.homefit.co.za
“Staying active is not only important for the physical and emotional health of the expecting mother – research has shown that unborn babies thrive if their moms are active.”
Ask the expert: Sarah Hall, Biokineticist
Warning Signs Don’t exercise if you have: • Pregnancy-induced hypertension • Ruptured membranes • Placenta praevia • Vaginal bleeding of any kind • Incompetent cervix (when the cervix is weak and opens too early) • Or if you are expecting twins or more
If you experience any of the following during exercise, stop immediately and seek medical help: • Sudden calf swelling • Headaches • Decreased foetal movement • Chest pains • Any amniotic leakage • Excessive overheating
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12:10:19 PM
7 Ways To Do Lunch Lunch can be such a tricky meal to get right: how do you whip up a balanced plate between work, school, meetings and rushing around? Here are seven different ways to do just that: budget-friendly, easy, on-thego and a weekend treat, with three readers’ lunches revamped to be healthier (and more delicious!) 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
2015/06/05 12:49 AM
Chicken Barley Salad protein
1503kJ
26g
fat
carb
9g 43g
fibre
sodium
1g
282mg
per portion
energy
Serves: 4 1 cup pearled barley Olive oil 250g button mushrooms, roughly chopped 1 leek, finely chopped Zest and juice of one lemon 1 clove garlic, roughly chopped
100g baby spinach leaves, rinsed 200g shredded leftover chicken 15g mint leaves, roughly chopped 15g flat leaf parsley, roughly chopped 15g basil, roughly chopped
Try this!
READER'S LUNCH Dorothy Du Preez’s “Chicken salad and 2 slices of toast”
Method: Cook barley, then remove from heat, drain and set aside. Fry mushrooms and leeks in a little olive oil until golden. Add garlic and saute for 30 seconds, until just fragrant. Add lemon juice and zest and cook for a further minute or two. Turn off the heat, add the baby spinach and allow to wilt. Finally, add the drained barley, shredded chicken and herbs to the pan and toss all the ingredients until well combined. Transfer the warm barley salad onto a platter and serve.
Top tip:
Barley is an excellent example of a high-fibre grain that can be used to help thicken soups and stews over winter.
Inspired by you
Health hotline
0800 11 22 88 healthhotline@pnp.co.za
24 34
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2015/06/05 12:50 AM
Beetroot Hummus protein
fat
carb
fibre
sodium
437kJ
3g
8g
8g
2g
75mg
Makes: 1½ cups 2 beetroots, peeled, cooked and roughly chopped 1 can chickpeas, drained and rinsed 1 clove garlic, crushed Juice and zest of 1 lemon 2-3T tahini paste Pinch of ground cumin 3-4T olive oil Salt and freshly ground pepper
per portion
energy
Method:
Place all ingredients into a food processor and blend until smooth. Season with salt and pepper. Serve with crudite like carrot, cucumber and celery sticks, baby tomatoes, and any other chopped raw vegetables you have.
Top tip:
A novel way to prepare hummus – the beetroot boosts the antioxidant content and provides a wealth of other vitamins and minerals. 25 35
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2015/06/05 12:50 AM
Cape Malay Chicken Curry protein
fat
carb
fibre
sodium
821kJ
21g
7g 16g
2g
411mg
per portion
energy
READER'S LUNCH
Try this!
Geophrey Mholo’s “Chicken curry with white rice”
Serves: 4 1T canola oil 1 onion, finely chopped 2 cloves of garlic, crushed 1 chilli, deseeded and finely chopped 2T finely grated ginger 1-2T curry powder (to taste)
1 x 400g tin tomatoes ½ cup chicken stock 400g skinless chicken pieces on the bone Squeeze of lemon juice 10g fresh coriander, chopped
Method: Heat oil in a pot and sauté onion, garlic, chilli and ginger for about 2 minutes. Add curry powder and fry to release the flavour. Add tomatoes and stock and bring to a simmer. Add chicken and cook, covered, for 20-30 minutes, or until cooked through. Season with a squeeze of lemon juice. Serve with fresh coriander, low-fat raita and a large portion of vegetables.
Low-fat Raita: ½ cucumber, cubed 1 cup low-fat plain yoghurt Salt and freshly ground pepper Squeeze of lemon juice Mix together the cucumber and yoghurt and season with salt, pepper and a squeeze of lemon juice.
Inspired by you
Top tip:
Low-fat chicken curry is a great way to warm up on a cold winter night! The raita in this recipe replaces the need for chutney, helping to lower the sugar content of your meal.
Health hotline
0800 11 22 88 healthhotline@pnp.co.za
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2015/06/05 12:50 AM
Hearty Beef and Bean Soup protein
fat
carb
fibre
sodium
939kJ
29g
4g 22g
6g
887mg
per portion
energy
Serves: 4
1 onion, finely chopped 2 cloves of garlic, crushed 2 carrots, peeled and roughly chopped 3 sticks celery, finely sliced ½t smoked paprika 400g stewing beef or chuck steak 50g tomato paste 1l beef stock (diluted by half) 1 tin kidney beans 100g spinach
Method: Heat a little olive oil in a heavy based pot and sautÊ onion, garlic, carrots, celery and paprika for a few minutes or until vegetables begin to soften. Add the beef and brown well. Stir in tomato paste and cook for 1 minute. Pour in stock, cover and allow to simmer over a low heat for about 1½-2 hours, or until meat is tender. Add the beans and spinach and cook for a further 10 minutes. Season with salt and freshly ground pepper and serve immediately.
Top tip:
Kidney beans are not only full of cholesterol-lowering fibre, they are also a great source of other vitamins and minerals. 37
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2015/06/05 12:50 AM
Moroccan Spiced Meatballs protein
31g
fat
carb
fibre
sodium
13g 18g
3g
359mg
Method: Place the mince, onions, garlic, parsley, egg, allspice, cinnamon, salt and pepper into a large mixing bowl. Mix together (using your hands) until all ingredients are well combined. Roll into golf ball sized meatballs. Heat a little vegetable oil in a large pan and fry meatballs in batches until golden brown. Remove and set aside. Using the same pan, heat a little more oil and fry the onions until golden brown (about 10 minutes). Add the beef stock, bay leaf and meatballs. Bring to a simmer, cover with lid and cook over a very low heat for about 20 minutes. Remove the lid and simmer for a further 20 minutes. Garnish with the chopped herbs and serve with brown rice, roasted vegetables and a little yoghurt.
per portion
energy
1317kJ
Serves: 4 450g minced lean beef 1 onion, finely chopped 2 garlic cloves, crushed 30g flat leaf parsley, roughly chopped 1 egg 1t ground cinnamon 1t allspice Salt and freshly ground black pepper
Vegetable oil, for frying 400g baby onions, peeled 1 cup beef stock 1 bay leaf 1T fresh coriander, roughly chopped 1T fresh mint, roughly chopped Low fat plain yoghurt, for serving
Top tip:
Wherever possible, choose lean mincemeat, as the fat content is much lower. Also choose lowersodium beef stock to help lower the sodium content of this recipe.
Inspired by you
Health hotline
0800 11 22 88 healthhotline@pnp.co.za
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2015/06/05 12:50 AM
Spinach and Leek Pie protein
fat
carb
fibre
sodium
835kJ
10g
8g 23g
3g
320mg
per portion
energy
Method: Preheat oven to 180째C. Heat a little oil and gently fry onion, leek and garlic until soft. Remove from heat and add cooked spinach, cottage cheese and egg. Mix well and season with grated nutmeg, salt and pepper. Lightly grease a 24cm quiche tin with a little olive oil and line with 1 sheet of filo pastry, allowing the excess to hang over the sides. Brush pastry with a little olive oil and layer with another sheet of pastry. Repeat this process until pastry is finished. Place spinach filling into the centre, and fold the pastry to cover the top. Brush with a little olive oil and place in oven for about 25-30 minutes or until crisp and golden brown. Remove from oven and allow to rest for 5 minutes before serving.
Serves: 4 1T olive oil (plus extra for brushing pastry) 1 onion, finely chopped 1 leek, finely sliced 2 cloves of garlic, crushed 400g spinach, cooked and squeezed dry 100g low-fat smooth cottage cheese 1 egg, lightly beaten Grated nutmeg Salt and pepper 5 large sheets of filo pastry
Top tip:
Popeye was right! Spinach is one of the most important green leafy vegetables, and a great source of a variety of micronutrients, including antioxidants. 27 39
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2015/06/05 12:50 AM
Tuna Quinoa Salad protein
1653kJ
15g
fat
carb
fibre
sodium
29g 23g
5g
592mg
per portion
energy
Try this!
Serves: 4 Salad: 1 cup cooked quinoa 1 can tuna chunks 1 punnet cherry tomatoes, halved 1 small cucumber, diced 1 yellow pepper, diced ½ packet olives, pitted 1 chilli, deseeded and finely chopped Handful parsley, roughly chopped ½ cup sweetcorn 1 avocado, chopped
READER'S LUNCH Gareth Pike's "Tuna and cous cous"
Dressing: 3T olive oil 1t Dijon mustard 1t honey (optional) Juice of ½ lemon Salt and freshly ground pepper
Method: Toss together all salad ingredients and pour onto a serving platter. Place all dressing ingredients into a small jar and mix well. Drizzle a little dressing over the salad just before serving.
Top tip:
This recipe’s fat content is higher, but the fats are largely the heart-healthy monounsaturated kind.
Health hotline
Inspired by you
0800 11 22 88 healthhotline@pnp.co.za
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Leanne Kiezer, Registered Dietician
The foods you eat at work are important to your overall health, productivity and wellbeing. Planning the right meals and snacks helps to maintain normal blood sugar levels, meet your nutrient requirements and resist snacking on more energy dense foods that can cause weight gain. It also helps you sustain your energy levels throughout the day. Choose one from each of the below categories to build a balanced lunchbox:
Lean proteinbased food
High-fibre starchy food
Vegetables
Boiled egg
Plain instant oats
Cherry tomatoes
Low-fat milk
Homemade high-fibre rusks
Carrot sticks
Low-fat yoghurt
High-fibre, low GI wholewheat bread or roll
Cucumber sticks
Cold meat
Wholewheat pita
Fresh salad
Fruit
Healthy fat
Whole fruits (a ready-to-go snack)
Hummus
Dried fruit (¼ cup per serving)
Avocado
Mixed fruit salad or fruit kebabs
Low-fat mayonnaise (1 tablespoon per serving)
GET MORE IDEAS ONLINE www.sweetlifemag.co.za/ diabetes-info
Top tips:
Lunchbox Ideas
Planning Your Lunchbox
• Remember to drink water throughout the workday - keep a jug or bottle on your desk for frequent sipping. • Keep a few non-perishable snacks in your work drawer or bag: dried fruit and nuts, wholewheat crackers and peanut butter, or a sachet of plain instant oats. • Keep your lunch safe in a clean insulated lunch box or bag. Pick n Pay is committed to promoting health and wellbeing among South Africans, and employs the services of a registered dietician, to provide food and nutritionrelated advice to the public.
For your nutrition and healthrelated queries, contact: >> healthhotline@pnp.co.za >> Toll free on 0800 11 22 88
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Brought to you by
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If there is love, there is hope that one may have real families, real brotherhood, real equanimity, real peace.�
Last Word
Dalai Lama XIV
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2015/06/05 12:24 PM
DIABECINN ORIGINAL - the nature-based solution
Diabecinn™ Original is a water-based cinnamon extract (ZN112) for people with type 2 diabetes. Diabecinn Original contains a water-based cinnamon extract (ZN112) proven to be highly effective for diabetics. •
• • • •
Whole ground cinnamon has been shown to reduce fasting blood sugar levels in humans by up to 29%, triglycerides by up to 30%, LDL cholesterol by up to 27 % and total cholesterol by up to 26%1. Clinically proven to support healthy glucose metabolism and normal blood sugar levels2,3. Diabecinn Original may help reduce blood sugar levels, triglycerides, LDL cholesterol and total cholesterol in patients with Adult Type 2 Diabetes1,2 May be used with anti-diabetic diets or medication Free from sugar, lactose, gluten coumarin and contains no added preservatives.
Availability Diabecinn™ is available at health shops, independent pharmacies, Dis-Chem, Clicks, Pick n Pay, Medi-Rite and Springbok Pharmacy. For more information call +27 11 516 1700.
Find us on Facebook.com - Search for “Diabecinn”
References: 1. Khan A, Safdar M, Ali Khan MM, Khattak KN, Anderson RA. Cinnamon improves glucose and lipids of people with Type 2 diabetes. Diabetes Care. 2003 Dec;26(12):3215-8: 2. Mang B, Wolters M, Schmitt B, Kelb K, Lichtinghagen R, Stichtenoth DO, Hahn A. Effects of a cinnamon extract on plasma glucose, HbA, and serum lipids in diabetes mellitus Type 2. Eur J Clin Invest 2006; 36 (5): 340 -344 3. Crawford P. Effectiveness of cinnamon for lowering hemoglobin A1C in patients with Type 2 diabetes: a randomized, controlled trial. J Am Board Fam Med 2009 Sept – Oct
S0
Each Diabecinn capsule contains 112mg water-based cinnamon extract (ZN112) (equivalent to approx. 1232mg dried, whole ground cinnamon)
D21.13 others. Combination Western Herbal This medicine has not been evaluated by the Medicines Control Council. This medicine is not intended for diagnose, treat, cure or prevent any disease.
Part of Litha Healthcare Group Limited
Reg No: 1994/008717/07
LP952 02/2015
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