Teenagers and Diabetes

I am a type 1 diabetic and have been so for nearly thirteen years. And it hasn't always been smooth sailing, in fact, it still isn't, despite me being in my early twenties. I often struggle to maintain a balance between diet, exercise,studying, drinking alcohol and socialising. Not maintaing this balance, plays havoc with my blood sugars, causing them to zig-zag.
One might think this combination of a dietitian and diabetic, whose blood sugars ought to be more on the "straight and narrow" odd, but it highlights the fact that type 1 diabetes is often difficult for anybody, specifically for teenegars and young adults, to control.

Factors Upsetting Blood Sugar Control

As a teenager grows up through to a young adult, it is a period of social development and awareness. It is also a time of networking, forging new friendships and relationships; discovering the bliss of an ice cold beer or the sharp ecstasy of a shooter; the rush of a first cigarette or even the thrill of a recent crush glancing your way. Suddenly, any reminders of blood tests and insulin are soon forgotten or ignored.

At a braai or party, sweet fruit-coolers, beers and mixes form the basis of many teens' alcohol repetoires. Personally, I'm not a big drinker, but often feel very uncomfortable after several drinks and instinctively, I know my blood sugar is high. Despite the cries of "Hey! Why aren't you drinking!", I down numerous glasses of water and monitor my blood sugar more closely. Alcohol, especially in the form of shooters, causes spikes in blood sugar, which may later crash and cause serious hypos, whereas plain spirits will cause the blood sugar to plummet.

At that same braai or party, there may be potato crisps to snack on, as well as garlic bread and soft, white rolls to munch. Combined with a lack of vegetables and fatty meat, these will also contribute to a higher blood sugar.

Another important factor to consider, is the lack of discipline, in terms of the blood tests and insulin injections. It is very hard as a teenage diabetic, to see so many other kids stuff chocolate, biscuits, cokes and other junk foods into their mouths, while the diabetic teen has to eat a much more restricted diet. It is much easier, to ignore the condition and eat what you like. Teen's moods, friends, levels of activty as well as changes in hormones also change frequently, making diabetes management that much harder. But this is where the discipline comes in.

Why Bother?

Poor blood glucose control results in retinopathy (damage
to the retina of the eye); cataracts; nephropathy (kidney problems, where the
kidneys battle to excrete the excess glucose from the body); neuropathy
(nerve damage, whereby the patient feels a "pins and needles"
sensation in the feet and legs) and cardiovascular disease and strokes (poor
circulation can also affect the blood vessels in the genital areas, causing
impotence). Diabetic teens should keep their feet in good condition, to prevent
problems occurring in later life. The longer the poor control lasts,
the more severe the complications.

Ways To Help Manage Your Teen's Diabetes

Managing diabetes as a teen or young adult is tough or just a big fat pain in the ass, but it is possible to achieve! I've managed without any complications so far, haven't I? There are several ways to mange the condition, some of which, got me through to wher I am today. These are:

1. Several consecutive meetings with a Daibetic Nurse Educator, who will help the teen amke better choices regarding diet, drinking alcohol, partying and socializing and exercise.

2. Establish priorities i.e. what is really important to the teen? Is social acceptance really worth sacrificing one's health? The teen must be encourages to find a balance between the two.

3. There are new insulins and other devices (e.g. insulin pumps) on the market, which offer more flexibility in terms of food and insulin dosages and they make diabetes management much easier.

4. A diabetic teen needs a strong support system around him: someone to understand his moods; to understand and interpret his feelings of sadness, anger, fear or shame; to see if his sugar is low or sky high; to help him make the right lifestyle choices and to undertsnad any other problems. It will also help if the whole family is involved; they should know how diabetes works, what to do in a particular situation and they can also be involved at mealtimes.

5. Help the teen build confidence, especially in himself. He must believe that he can control thios condition and thus he needs support from his family and friends.

6. A healthy lifestyle with everything in moderation will help level out his blood sugars. Always have alcohol with meals to prevent hypos and be aware of the effect of alcohol on blood sugar levels several hours after drinking. Exercise and a low GI diet will help even out any spikes.

I hope I have shown you that teens and young adults are capable of managing
their own diabetes. Its a rocky ride and you don't always get a lollipop at the
end, but the reward appears ina different form: excellent health with no
complications and the ability to live life to the fullest!

I encourage any other teens or young adults to email me and tell me their experiences or troubles. I hope to perhaps specialize in this field and I feel that, being a diabetic and knowing how it feels, will benefit me in this endevour.

Food of The Week: Tomatoes

You Say Tomato, I Say Tomato...

As I sat in my nutrition lectures this morning, I became very aware of people sniffling loudly next to me, behind me, and in fact right around me and I immediately hunch over and sigh. The plague of the common cold has once again taken over! In fear of becoming a victim, I attempt to boost my immune system and this I have discovered, can be helped by eating lots of anti-oxidant rich tomatoes. Thus, tomatoes are the word of the day and the Food of the Week!

Whats so cool about tomatoes?

• Tomatoes are available all year round.



• They can be red, yellow, orange, green, purple or brown in colour. There is also a tomato species which is striped!


• Tomatoes are vegetables, as voted by the Supreme Court in the States in 1893! However that remains very controversial, as most consider it to be a fruit nowadays!
  
• Tomatoes originally came from the Andes region in South America and they were brought to Europe by Spanish explorers. They were either thought to be poisonous and or an aphrodisiac and were thus met with some resistance! They only gained popularity in the 1900s and are still incredibly popular today.
  
• Tomatoes are part of the nightshade family, which includes belladona, tobacco, chillies, eggplants and potatoes.


• China, the United States (particularly California) and Turkey are the main producers of tomatoes.
  
• The term "tomato" in Italian is "poma amoris", which in English means "love-apple".

Reasons to Eat Tomatoes:

There are various reasons why the average Joe should eat a tomato nearly every day; the main reason being due to the health benefits. These benefits are widely known and scientifically acknowleged.

1. Tomatoes are rich in Vitamin A and C, which are carotenoids and anti-oxidants.


2. They are a good source of fibre, which lowers cholesterol levels and helps prevent constipation.


3. Tomatoes also help prevent heart disease and reduce the body's abilities to make blood clots, thus improving the health of blood vessels. Current studies are also showing that this helps in preventing diabetes.


4. Tomato juice is a natural anti-inflammatory. Inflammation and oxidative stress have been linked to many chronic diseases of lifestyle such as cancer, diabetes, artherosclerosis and Alzheimer's disease.


5. Tomatoes are also good sources of Vitamin K, which is necessary for bone health and helps prevent bone demineralisation.


6. Tomatoes contain large amounts of lycopene, an powerful anti-oxidant and carotenoid.

What is an anti-oxidant?

This is a compound which prevents against oxygen damage by neutralizing free radicals (chemicals), which normally cause damage to the cells of the body as well as cell membranes.

What is a carotenoid?

A carotenoid is a fat-soluble compound in plants usually used in photosynthesis. They provide plants with their bright colours (hence the bright red of the tomato), anti-oxidant activity as well as a source of Vitamin A.

Lycopene, as an antioxidant is said to flush out free radicals in the body in large amounts. Our bodies don't make lycopene naturally, so we need it from tomatoes and other vegetables. Tomatoes have the highest amounts of lycopene and there is a controversy around whether or not organic toamtoes have more lycopene than conventionally grown ones. Lycopene is fat-soluble and is thus best utilized in foods containing good forms of fat. The action of lycopene is also enhanced when it is cooked and to get the most lycopene, you should eat the whole tomato!

Let's Not Call The Whole Thing Off....

Seeing as it was Valentines Day a little while ago, one would think you would need to look after your heart and keep it strong. Recent studies have shown that lycopene in tomatoes has significant effects in preventing cardiovascular disease, ensuring your heart is healthy and strong. As they are anti-oxidant rich, tomatoes significantly lowers LDL, the "bad" form of cholesterol, by interfering with its synthesis. High cholesterol is one of the major factors in causing heart attacks, strokes and other forms of heart disease. Antioxidants will also prevent further atherosclerosis, because they effectively help stop the oxidation of cells (especially those in the cardiovascular system). So if you want to help protect your heart for next Valentines Day, you need to reap the benefits of tomatoes!

Lycopene is known to help prevent various cancers such as breast, endometrial, prostate, colon, lung and pancreatic cancer. Pancreatic cancer is one to note, as it is a very serious form of cancer and often goes undetected, until it has spread throughout the body. Lycopene protects against cancer by activating cancer-preventative phase II enzymes. Lycopene also reacts with and enhances other phyto-nutrients in tomatoes, which also helps protect against these cancers.

You say "Tomato", but I say however you happen to pronounce "Tomato" is immaterial, the important thing is to eat as much of this nutrient-packed "love-apple" as possible! You can have it sliced in sandwiches or salads; use it as a base for a pasta sauce or casserole or you can eat them as is! You will soon see the effects of these anti-oxidants and carotenoids upon your health as well as have the peace of mind that your cancer risk will be lowered! So the very next time, you hear a sniffle, a cough or a WHACHOOO! (sneeze), think anti-oxidants and tomatoes!

Being Underweight: Quite A Weighty Issue

South Africa is a unique country in the sense that it has more obese individuals than underweight ones. However the number of individuals that are underweight, is quickly increasing. In both cases, weight control often appears impossible to manage. Sometimes being underweight is a result of imposing restrictions on what one eats in fear of becoming obese or just because one wants to lose weight. Sometimes, it is due to genetics. I have many friends who have come to me, wanting to learn more about it and what they can do about it.

To determine if you are underweight, calculate your BMI (Body Mass Index), by dividing your weight (kg) by your height squared (m squared). The normal range is between 18.5 and 24.9. You are considered underweight if your BMI is below 18.5.

There are various health implications for an underweight person and these can be prevented through a sufficient diet. Implications include:

• Poor immune function - a diet which lacks essential nutrients, vitamins and minerals, which are needed for the immune system to protect against bacteria and other organisms.


• Improper wound healing - the immune system is weakened and thus wounds don't heal as quickly or efficiently as they should.


• Higher risk of infection - an underweight person is more vulnerable to infections due to a weak immune system, as the body cannot protect itself against bacteria and infections.


• Poor heart function - an underweight person's diet often lacks essential nutrients to ensure that the heart works properly. The poorer the nutritional status, the weaker the heart will be and the risk of heart complications increases.


• Other health implications include: hair loss, inelastic skin, low muscle mass, poor bone structure, low blood pressure and hormone imbalances.

Being underweight can be due to several reasons, some of which include poor absorption of food (due to wasting of the muscle surrounding the intestine); wasting disease; emotional stress; improper diet and lack of appetite; nausea and vomiting as well as habits formed in childhood, like food aversions.

The Weight Watch:

Underweight individuals should try to find out why they are underweight and address those particular issues. Monitoring your weight is important, especially if you struggle to put on weight. It is well recognised that putting on weight is often much more difficult than losing weight and this is usually aggravated by a sense of nausea and a poor appetite. Often many underweight individuals tend to eat fattening and unhealthy foods to put on weight, and this also has undesirable consequences. Despite this, many health professionals recommend high kilo-joule diets, rich in good fats, carbohydrates (starches) and protein. The main goal of underweight individuals should be to increase their energy, vitamin and mineral intakes by eating small, frequent meals rich in these nutrients. This should also prevent any further weight loss.

Reasons for Being Underweight (usually due to unplanned weight loss):

• Lung, colon or pancreatic cancer or leukemia.
• Peptic ulcers, inflammatory bowel disease, chronic pancreatitis, coeliac disease.
• Diabetes Mellitus.
• Thyroid problems (overactive thyroid).
• Infections such as HIV Aids, Tuberculosis, fungal diseases and parasites.
• Depression, schizophrenia or Alheimer's Disease.
• Certain medications cause nausea, diarrhoea or loss of appetite.

The underweight person should also determine their ideal goal weight, (a dietician will work this out for you) and aim to achieve that by eating an extra 125 kJ (30 calories) per kg of body weight per day. This is the safe recommended intake for weight gain. Elderly, ill or severely malnourished individuals should be eating an extra 168 kJ (40 calories) per kg per day and a large portion of this intake should consist of protein.

Piling on the Pounds:

To put on weight, you have to consider your diet, as this will most likely change to accommodate those extra kilojoules. Many suggest that a way to do this is to increase one’s fat intake (as the fat intake increases, so do the kilojoules increase). Some tips to do this are:

• Serve poly or mono-unsaturated fats with vegetables and use oil-based salad dressings. Butter can also be used, but be aware of the cholesterol content (too much cholesterol leads to heart problems).


• Add cheese to certain foods such as omelettes or pasta, to increase the protein and fat intake of your diet.


• Full- cream dairy products should be eaten instead of the low-fat varieties.


• Cream, evapourated milk or full cream milk can be added to soups, desserts and sauces.




• Fish, minced meat, chicken and cheese can be added to dishes to increase the protein content.


• Drink full-cream or fruit juice with meals, as this will help increase the kilo-joule content of the meals.


• Try to avoid drinking too many liquids at the beginning of the meal, as this will fill you up and you may lose your appetite.


• Also try to avoid eating fatty foods before or at the beginning of the meal, as this too will fill you up and you may not have an appetite.

• Eat at least three times per day and have snacks between those meals. Snacks can include peanut butter or cheese sandwiches, yoghurts, crackers or provita and avocado or cream cheese dips.
  
  There are also various tips to help increase your appetite:
  
• Choose different types of foods, as a variety of foods contains different nutrients. Another way to encourage this, is to eat at different restaurants.


• Have meals with family and friends and try to have a set mealtime, in a specific room, with no distractions (e.g. telephone calls). The more routine mealtimes are, the easier it is to encourage the habit.


• It is very important to eat something at every mealtime, even if you have lost your appetite.


• Different colours and textures are important as they help make food more appealing. make an effort in presenting your food and the way you set your table, so as to encourage you to eat. you've made all this effort, so why not?


• Regular exercise, such as a brisk walk also helps stimulate your appetite.

Help along the way:

Often seen as a miracle for weight gain, nutritional supplements are used to help increase the kilo joule and protein intakes of individuals. These are usually in the form of liquid drinks and come in various flavours. These supplements usually provide 100% RDA (Recommended Daily Allowance) of vitamins and minerals but as they are low in fibre and phytochemicals (found in fruit and vegetables), they shouldn’t replace meals. It should be noted that the vitamins and minerals which these supplements contain, do not cause weight gain; they merely replace any loss of essential nutrients. There are also drugs which improve your appetite and lead to weight gain.

Gaining weight has always been a tricky task and unfortunately there is no miracle cure. A high energy diet and regular exercise is the key to gaining weight. On a high energy diet alone, you will just gain fat; the exercise helps with the fat distribution. It is always important to speak to a qualified dietician or doctor about putting on weight. Broaden your mind and your body and you shall feel a lot more confident, because narrow-mindedness doesn't get you anywhere! Good luck!

Information for this blog post was obtained from these two sources:

Antia FP, Abraham P (2002). Clinical Dietetics and Nutrition. New Delhi:Oxford University Press.

Hark L, Deen D (2007). Nutrition For Life: The definitive guide to eating well for good health. London: Dorling Kindersley

Beyond Beans On Toast: Cheap, Modern and Modest Student Food

Monday was an incredibly unusual and surreal experience for me, as I took my younger sister to the airport. She was flying down to Cape Town for her first year of varsity. My sister has always been a "high maintenance" child and I often wondered how she would adapt to student life and cope financially. I struggle to see her settling with baked beans on toast for supper, after she'd spent all her money, partying the night before! I have also previously found myself in this exact situation before and have happily settled for beans on toast in the past. However, now fearing the boredom of having to settle for beans on toast, I search for healthy, modern and modest student food.

As a student, money is tight and Mom is no longer there to make your favourite cottage pie or roast chicken. It is now up to you, the student to get creative and make the most of your food money allowance and whatever ingredients you have in your fridge. Some recipes may require planning and this is important if you want to start budgeting properly and allocating money for certain things. Student food needs to be inexpensive, but of good quality and it must be nutritious. It should also be easy to prepare, reliable and it shouldn't have you still cleaning the kitchen way past the finishing of your degree! Although many student meals are simple variations of each other, this doesn't make them any less cheaper, interesting or nutritious. Below are some tips to help ease you into budgeting your student meals.

• There are many foods which are inexpensive, nutritious and are great as leftovers. These foods include: beans; boiled or mashed potato; bread or rolls; chicken pieces; tuna; pasta; beef cuts; lentils; bacon; pumpkin; spinach and eggs. The idea behind this is to save the money, which would have been used to buy more food, so you can use it for another dish.

• A necessary way of making your meals go further, is to bulk them up. This can be done through adding extra vegetables, meat, beans and other legumes, eggs or cheese, for example spaghetti bolognaise can go further by adding more vegetables, beans or lentils or soya mince. It could also be made into lasagne, if you use lasagne sheets and make a thick, cheesy white sauce. By adding extra ingredients, you are also improving the nutritional status of the meal.

• Fresh food is best to use and is usually preferred, especially in the case of fruit or vegetables. Often frozen vegetables lose their nutrients when frozen as compared to fresh vegetables,thus you are not getting your money's worth. With fresh vegetables, you may have the opportunity to add a different vegetables to your dish, such as broccoli florets or sliced courgettes or cabbage, and you may be getting more nutrients.

Making certain foods is often much cheaper and healthier than buying their ready-made counter-parts. A good example of this is chicken nuggets. You can easily make your own batter using beaten egg and breadcrumbs and bake the crumbed chicken pieces, rather than just buying them. This way, you can also control what goes into your nuggets as well as the fat content.

• Often "power foods" are the cheapest and healthiest foods to eat (see one of my previous blog posts "Buying Superman Food with a Mini-Me budget). Power foods include: peanut butter; legumes such as beans and lentils; sardines or tuna; oats; red, yellow and green vegetables; citrus fruits, banana and papaya; barley; brown rice and sweet poatato.

Whilst studying, many students experience an attack of the Munchies and this can often become expensive over time. Cheap, nutritious snacks include: trail mix (including dried fruit, raisins and nuts); popcorn; cheese melted on wholwheat toast and ants on a log- celery sticks smothered in fat free cottage cheese, with raisins (ants) on top.

• Dried herbs and spices are useful in making meals tasty and they last a long time and are therefore value for money. Be aware of the salt content in some spices. As a healthier alternative, you could also grow your own herbs.
  

After searching the net and coming across many blog posts with students asking for recipes for certain dishes, I decided to pick the most common ones and give links to some student-friendly recipes. Many of them have had good reports, so try them and let me know!

1.) Chicken Stir-Fry

2.) Chicken Curry

3.) Spaghetti Bolognese

4.) Bobotie

5.) Chicken Noodle Soup

6.) Tuna Fish Cakes

7.) Dahl and Pumpkin Soup

8.) Crispy Parmesan Chicken with Soft Basil Tomatoes

9.) Red Lentil Soup (vegetarian)

10.) Roast Sweet Potato Chilli Chips

11.) Spanish Omelette

12.) Pasta With Tomato Sauce

As a "HealthNut", dedicated to food, its quality and its benefits, I am also interested in helping create healthy meals which are tasty, inexpensive, filling and appealing to other students. Eating healthily on a budget requires a lot of discipline and a change in attitude regarding the types of foods you eat. Through writing this post, I too have discovered that there are so many simple and cheap meals that I could still make whilst at varsity and many of these recipes use foods that could be incorporated more, into my diet. And so I leave you with a little piece of encouragement and inspiration: lets all look beyond baked beans and allow for the exhilaration and anticipation of fantastic, money-savvy, modern and modest student meals!

Food Of The Week: Fish and Shellfish

Why did the trout cross the road?
Because it was the chicken's day off!

If I were to ask you how many times per week, you ate fish or shellfish, what would your answer be? Would you be glancing down at the floor, sweating profusely and telling me you don't really like fish? Or would you be telling me a whopper (oh! You eat fish everyday!) and giving me a cheeky grin? Well here is the opportunity to improve your health, give the chicken a break and reap the benefits of eating fish.

Something Fishy? Indeed!

• Eating fish two times per week greatly reduces your risk of developing heart disease. This discovery stemmed from the Inuits, whose risk of heart disease was very low and whose diet was mainly based on fish.


• Fish and shellfish are rich protein sources (15-20 % protein is found in fish muscle) and the amino acids combined to make up that protein compare favourably to those in milk, meat and eggs. More than 2.6 billion people get at least 20% of their animal protein from fish.


• Fish contains very minute amounts of carbohydrate.


• Fish and shellfish are also both rich in vitamins such as B Vitamins and Vitamin Cand D. Fatty fish have higher proportions of dark muscle tissue and thus a higher proportion of fat, hence the high concentration of fat-soluble Vitamins A,C,D and E.
  
• Fish and shellfish are also rich in most minerals.
  
• In white fish, such as cod, most of the fat is found in the liver, hence the fish is used to supply our diets with cod liver oil.


• Fish and shellfish are low in saturated fat and cholesterol (high cholesterol levels in the blood are related to a high intake of saturated fat, rather than a high intake of cholesterol-rich foods). As the fat content in a fish falls, so does the protein content.


• Fish and Shellfish are also well known for being rich sources of omega-3 fatty acids.

The Omega-3 Fatty Acid Deal:


Omega-3 fatty acids are a type of healthy fat found in oily fish such as salmon, mackeral and sardines as well as shellfish. The amounts of fatty acids vary, depending on the type of fish or shellfish. As a rule of thumb, the fattier fish contain more fatty acids than leaner white fish, but this will also vary amongst the different fish species and how the fish are farmed.

• These fatty acids increase your "good" cholesterol (HDL cholesterol) and reduce your "bad" cholesterol (LDL cholesterol) as well as triglycerides (fat).


• Omega fatty acids also help prevent blood clots, by stopping the platelets sticking together and attaching to the artery walls, forming a clot.


• Omega fatty acids help the blood vessels constrict less, so the heart is less vulnerable to irregular heart rates.


• Omega-3 fatty acids help protect against arthritis and depression.

Tips To Ensuring The Fish You're Buying is Safe:

• Fish and shellfish should be stored and prepared correctly, to ensure they are safe to eat.


• Most microbes (bacteria) are destroyed during cooking,thus it is best to cook the fish, unless it is being prepared by a certified sashimi chef.


• Avoid eating fish which contain high amounts of mercury, such as swordfish, shark and marlin, as this is dangerous to the nervous system, particularly in infants. Tuna contains small amounts of mercury, whilst fish like cod, haddock and salmon have very little mercury.


• When buying fish at a market, buy as soon as the market opens, as the fish will be the freshest.


• The freshness of fish is determined by the colour of the gills and the clearness of the eyes. Fresh fish will have bright red gills and clear eyes, so avoid any fish that has murky brown gills or cloudy eyes.


• The fish should also have firm flesh and should smell of the sea, not fish!

Have A Fish Braai!

Having a fish braai is an excellent way to introduce people to the idea of eating fish. A great example of this is the great Cape Classic: a snoek braai. And having fresh fish marinaded and grilled over hot coals, is great for those wanting to improve the health of their hearts! With a fish braai, the fish is easy and quick to cook; its nutritious and its yummy and it's ideal in this hot summer weather!


When braaing fish or shellfish, brush them slightly with olive oil, which will stop them sticking to the rack.

Ensure the rack is clean, as the fish will easily pick up the flavours of the food that was previously cooked on there.

• Try and use the freshest fish availible.


• Fish fillets cook very quickly, so be aware of over-cooking them.


• Add spices and herbs such as rosemary or thyme, by sprinkling them over the fish or shellfish and this will give the fish a divine taste and aroma.


• Lean fish steaks and shellfish should be left in marinade before going on the braai.


• If one cannot braai, you can always fry your marinaded fish lightly on a griddle- pan.

It is obvious that the benefits of eating fish often far outweigh any risks, and it is important that we make the effort to improve our health status. So as an incentive, I have left my famous tuna salad recipe below: so why not make it, taste it, wipe the mayo off the side of your mouth, lick your lips and let me know what you think! Adios!

Famous Tuna-Salad Recipe:

This salad can usually feed about three people, however my sister can polish it off in one go, she loves it so much, so proceed with caution! I usually put the salad with a few lettuce leaves on a roll...mmmmm. Nuff said.

Ingredients:
1 large spring onion, sliced
2 medium sized tomatoes, chopped
4 or 5 medium-sized gherkins, chopped
1 can tuna, drained
2 tbls French mayonaise (I use the Woolworths one)
3 fresh crispy rolls
a few lettuce leaves, washed and sliced
salt and pepper

What to do:

Add all the chopped ingredients and tuna together and mix. Add the mayo and season with salt and pepper. Place into rolls with lettuce and wolf down!