Chronic diseases like diabetes, high blood pressure, cardiovascular disease (heart disease and stroke) and cancer can be prevented if you eat a healthy diet and keep
Increasing numbers of South Africans, including children, are eating an unhealthy diet which is high in fat, salt and sugar, and at the same time are not getting enough exercise.
As a result, more and more of us are becoming overweight or obese and are suffering from high cholesterol, high blood pressure and high blood sugar levels. These are all important risk factorsfor chronic disease.
South African nutrition experts have developed guidelines to help us understand how to eat more healthily (see overleaf). These guidelines are suitable for adults, as well as for children who are 5 years
and older. It is especially important to teach our children to eat healthily from a young age as this will protect them from getting chronic diseases in adulthood. If you already have a chronic disease, following these guidelines will help you control your condition and feel better.
Brinley is a retired panel beater, and a diabetic. We are sitting in his lovely kitchen chatting, while his wife, Joyce, makes us tea. As I add two teaspoons of sugar to my tea, I notice that Brinley doesn’t add any. Almost as if he is reading my mind he says, “I take my tea without sugar now. The way I ate had to change when I found out that I was diabetic”.
According to Brinley, he used to overeat. “I used to enjoy my six doughnuts and tea with sugar in the mornings, I ate take-aways for lunch and I had two big plates of food at supper time”, he says.
But all that had to change when he was diagnosed with diabetes. He was given a diet sheet, which explained all the foods that he had to cut out and the foods that he should eat more off. “It was very difficult at first to get used to the lifestyle change, especially the diet part. But with the support of my wife, I succeeded.”When Brinley says this, his wife Joyce also chips in, “I decided that everyone, the children and myself, would eat the same food as my husband, so we could support him.”
Meals in the couple’s home are now much healthier.
Joyce says that she uses only a little oil to cook food and she makes sure fresh vegetables and fruits are always plentiful. She says that most of the foods that she now buys are the healthier options, like brown bread instead of white bread, and more chicken and fi sh than red meat. She also makes sure that everyone’s food portions are not too big, especially Brinley’s. Brinley says, “I am lucky I have the support of my daughters and my wife. I honestly don’t think I could have made the adjustments on my own.” Joyce smiles shyly and says, “I used to bake the doughnuts and the biscuits that he used to overindulge in. Now, I don’t bake these unhealthy treats anymore, because I don’t want to tempt him.” It is very clear that husband and wife are on the same page when it comes to healthy eating.
They also mention that they feel particularly lucky because three of their daughters are in the health fi eld and they provide them with lots of information on diabetes management. “The children watch their father like a hawk. If he wants to eat something that he shouldn’t eat, they will take it away,” Joyce chuckles. Brinley adds, “I am used to it now, so I am more in control than I used to be”. When asked how he manages to be so self-disciplined he says, “it is di?fficult, but with the right mindset and if you live in a home where you get encouragement, you can control yourself.” He adds that faith has also played a central role in his life. Joyce agrees. “Everything is possible when you have faith. God gives you strength,” Joyce says. When asked what health benefi ts they have experienced as a result of eating more healthily, Brinley beams and says, “I have lost a lot of weight. I used to be a size 42 and now I am a size 32. My wife has also lost some weight, and she never gets sick, it’s amazing.” Joyce nods to a? rm what Brinley has just said. She adds with a smile, “A healthier diet makes you feel lighter and more energetic as well.”
What is a healthy balanced meal?
The plate below is a visual guide to show you how much of each food group you should be eating in order to have a healthy, balanced diet. Ideally, you should eat 3 small meals a day, with healthy snacks between meals.
- Half your plate should consist of vegetables, salads or fruit
- A quarter of your plate should consist of high-fibre starchy foods (e.g. brown rice, wholewheat pasta, coarse mielie meal or pap, sweet potato, madumbi or brown/ wholewheat/seeded bread)
- The other quarter of your plate should consist of lean protein(e.g. fish, skinless chicken or lean meat, beans or lentils)
- The meal should also contain a small serving of fat (e.g. vegetable oil, soft margarine, avocado or unsalted nuts)
HEALTHY EATING GUIDELINES
Have low-fat milk, maas or yoghurt every day.
Dairy products are anexcellent source of calcium and are important for healthy bones and teeth.
Eat less sugar and avoid food or drinks high in sugar.
Too much sugar can make yougain weight, increasing your risk of chronic disease. Sugar in your diet can come from sugar added to hot drinks, cereals and cooking, but very high amounts of sugar are also found in cakes, biscuits, doughnuts, sweets, chocolates and sweetened cold drinks and fruit juices.
Enjoy a variety of food.
Eating lots of different types of food will give your body all the nutrients it needs. The more colourful your plate of food, the more variety you will have.
Drink plenty of clean, safe water every day.
You need about 6 to 8 glasses of water a day. Most of this can come from tap water, but drinks such as tea, coffee or fruit juice mixed with water can count as well.
Eat dried beans, split peas, lentils or soya at least twice a week.
These foods are good, affordable sources of protein, are low in fat and high in fibre. Replacing meat in some meals with these foods will benefit your health.
Try to eat five portions of vegetables and fruit a day.
Adding lots of vegetables to soups and stews can help you reach the target of 5 portions. Remember to eat fruit and vegetables from the different colour groups and to include some raw fruit and vegetables in your daily diet. The vitamins, minerals and fibre in these foods protect against many diseases.
Add less salt to your food and avoid processed foods high in salt.
Eating too much salt can raise your blood pressure and increase your risk of stroke, heart attack and cancer. Some salt in our diets comes from salt added at the table or during cooking, but more than half the salt we eat comes from processed foods. Examples of high salt foods are: stock cubes, soup powders, chips, crisps and processed meats like polony and viennas. Salt intake should not be more than one teaspoon of salt a day from all sources. Substituting salt with spices, herbs and lemon juice will help you cut down on the amount of salt you eat. If you gradually add less salt to your food, you will soon not notice the difference.
Eat less fat and use the healthier type of fats or oils.
Eating too many fats and fried foods can make you gain weight and cause heart disease. Decrease the amount of fatty red meat, butter, hard margarine, cream, lard and
ghee that you eat. The high amounts of saturated fats in these foods can increase your cholesterol and block you blood vessels, which can lead to a heart attack or
stroke. Rather use good (unsaturated) fats like sunfl ower or canola oil and soft tub margarines in small amounts, and include nuts, seeds, peanut butter and avocados in your diet. An easy way to cut down on saturated fat is to always remove the visible fat from meat and the skin from chicken.
Drink plenty of clean, safe water every day.
You need about 6 to 8 glasses of water a day. Most of this can come f rom tap water, but drinks such as tea , co? ee or fruit juice mixed with water can count as well.
If you drink alcohol, control the amount you drink.
Drinking alcohol has been linked to various cancers, including cancer of the throat, breast, colon, liver and prostate. It is recommended that women should not have more than one drink a day and men not more than two drinks a day. One drink is equal to a can of beer (340 ml) or a small glass of wine (120 ml) or a tot of spirits (25 ml). If you are diabetic or have hypertension, it is best to avoid drinking alcohol altogether, as it can raise your blood sugar and blood pressure. Pregnant and breastfeeding women should also not drink any alcohol at all, as it can cause serious damage to the baby’s growing brain
Small portions of chicken, fish, meat or eggs can be eaten every day.
It is best to limit eating red meat to only a few times a week. When choosing chicken or red meat, choose lean options. Try to eat at least one vegetarian main meal and two fi sh meals a week. Good options are fresh or tinned pilchards, snoek, sardines or tuna. Eggs are also a good, and more a? ordable, alternative source of protein to meat.
Use healthy cooking methods.
Avoid deep frying your food. Grilling, steaming, microwaving, slow-cooking and baking are much healthier cooking methods. If you do fry your food, stir-fry or pan-fry using only a little oil.
Make high-fi bre starchy foods part of most meals.
Eating high-fi bre food helps you feel fuller for longer, lowers your cholesterol and keeps your digestive system healthy. High-fi bre foods lower your risk of developing obesity, heart disease and cancer. Good examples are brown or wholewheat bread, coarse maize meal (pap), oats and brown rice.
Nonofo has been a mother for 28 years, and for all of those years, she has tried to make sure that her family has eaten healthily; something that she says has not always been easy. “The lifestyle nowadays makes it difficult. The food that we eat is nothing like the food that we, my generation, grew up eating. It’s all junk food now or processed foods”.
But she persevered. She was determined that her children would grow up in a home with a culture of healthy eating.
Nonofo says, “I don’t serve a meal at my house without vegetables. Never! I always made sure that my children ate plenty of fruits and vegetables, that they drank lots of water and stayed away from sugary foods like Coke and sweets.” She adds, “I was very strict when it came to junk food and they knew it. I packed school lunches for them, because I didn’t want them going to the tuck shop or vendor to buy junk”.
She acknowledges that it is not easy to make kids eat vegetables, or to stay away from sweets and chips. But she believes that if a parent is strict and consistent, healthy eating will become ingrained in a child. “My kids had junk food like KFC only once in a while and not as a norm. The norm was a wholesome, homecooked meal. But these days… you fi nd with many families, that KFC is the norm and a home-cooked meal is the unusual thing,” she says sadly. She insists that eating healthily is not as complicated or as expensive as some people say.
“That can just be an excuse. I mean, you can get a head of cabbage, tomatoes, onions, potatoes, and change from the money you would spend on KFC for the family”. When asked how she managed to persuade her own kids to eat lots of vegetables, she says, “The thing about kids is that you have to make something sound exciting for them to buy into it. I used to tell my kids that eating carrots will make them have X-ray vision like Superman,” she laughs. “I always associated a healthy habit with one of their favourite super heroes, and it worked.” “I cannot emphasis enough how important I think it is for parents to instil a culture of healthy eating in the home. Surely, a big part of your responsibility as a parent is to make sure that your children eat healthily, so that they grow up to be healthy adults”, Nonofo says. She also mentions the importance of physical activity.
“Children must also be encouraged to be active. Push your kids to go outside and play, instead of buying them Play Stations.” When asked how she herself was raised, she says proudly, “During our time, everything we ate was fresh from our garden. Meat was also fresh. You knew what was in the food that you ate because you either produced it yourself or you got it from another local farmer. But nowadays….” She trails o? and does not finish her sentence. One senses that she feels a certain sadness at how things have changed – for the worse. “Right now, diabetes and hypertension are rife in my extended family. This is because they have been careless about their lifestyle.”
When asked how she feels about this, she says that it scares her. “It makes me watch what I eat even more, because I have seen how these diseases can a? ect a person. My own mother has both hypertension and diabetes, and really, it is a fate that I do not want for myself or any of my children.” “I mean, some of these illnesses can be prevented with a little e?ffort in watching what you eat and being active”, she says. “At my age, I am still fi t and healthy. And to be honest, I look even better than some of the younger people I know. If they are not obese, they are sickly, because they don’t have a healthy lifestyle.”
Most of the processed and take-away foods we eat are loaded with kilojoules, fats, salt, artificial flavourants, colourants and sugar.
No matter how good they might taste, you should only eat these foods very occasionally if you want to stay healthy. Eating too much of these foods is one of the main reasons why South Africans are becoming more and more overweight and unhealthy.
One way to avoid buying fast or street food too often is to rather pack your own lunch box for work or school. This can also help to save you money.
The Top 10 most unhealthy foods South Africans love to eat
Chips and crisps.
These foods are high in salt and fat. Brightly coloured chips are also full of artificial colourants and fl avourants, which have been linked to allergies and hyperactivity disorders.
2. Fried chicken and fried fish.
Fried chicken and fried fi sh, whether from take-away restaurants or from the vendor at the side of the road, are foods that are usually very high in saturated fat and salty fl avourants. Ask for your fi sh or chicken to be grilled instead, and if possible for the skin to be removed from the chicken before it is cooked. If this is not possible, take the skin o? yourself before you eat it.
This food is unhealthy because it is deep fried, usually in oil that has been used many times. It is full of kilojoules, but has no nutritional benefi t and almost no fi bre. It is appropriately named because it just makes you fat!
4. Gatsbys and Kotas.
‘Gatsbys’ and ‘Kotas’ are also high fat, high salt, high energy and low fibre foods, which have very poor nutritional value. The atchar many people like in their Kotas is also made with lots of oil and salt.
5. Hot Dogs, Russians and Polony.
These meats are made from highly processed, poor quality meat, which is usually high in saturated fat, salt and additives to make them taste better. They also contain chemicals called nitrates, which have been linked to colon cancer.
Commercially produced hamburgers are usually high in saturated and trans fats, salt and added flavourants. Home-made hamburgers with brown rolls, good quality, lean meat and fresh vegetables are tastier, less fattening and much healthier.
7. Pies and pizza.
Like hamburgers, pies and pizzas are usually loaded with saturated fats and salt from cheese and salty meats. A healthier option would be to use mozzarella cheese on your pizza, and to choose vegetables and lower fat meat toppings, such as chicken strips, instead of salami and bacon.
8. Bunny chows.
Bunny chows are unhealthy if white bread loaves are used and they are fi lled with deep fried chips and fatty meat. A healthier option would be a brown loaf fi lled with lean meat like chicken, or a bean or
9. Sweetened fruit juices and cold drinks.
Drinking too many sweetened drinks can make you gain weight. Overweight/obesity increases the risk of developing type 2 diabetes, hypertension, heart disease and cancer. Try and avoid drinking these kinds of drinks or drink them only occasionally. Rather drink water to quench your thirst.
10. Cakes and sweets.
Baked goods, like doughnuts, cakes, biscuits and sweets are usually very high in sugar and saturated fats like palm oil, coconut oil or butter. Many of these foods, when made in factories, also contain trans fats or partially hydrogenated fats, which are particularly bad fats. These foods are also high in kilojoules and can make you gain weight. They should only be eaten very occasionally.
How to eat out more healthily
In addition to most take-away meals being loaded with fat, salt or sugar, the portions are often far too big. However, eating out and buying takeaways can still be part of a healthier lifestyle if you choose your meals carefully.
A few tips to remember:
- Choose take-away food outlets that provide healthier options, such as grilled or baked foods, and not just deep-fried, crumbed or battered foods.
- Choose salads and veggies on the side instead of chips.
- If the portion is too big, eat half of your meal and keep some for lunch the next day.
- Try to avoid sauces made with cream or mayonnaise, or at least order the sauce on the side, so you can control the amount of sauce you use. Tomato based sauces are usually the better, lower
Easy guide for reading food labels
You’ll soon learn which foods are the healthier choices if you start reading food labels. There are a few things you need to look out for on labels when shopping:
The first few ingredients listed on the ingredients list make up the largest part of the food. Therefore, rather avoid or eat less of a food if the following words are listed in the first few ingredients.
- Fat, oil, lard, butter, cream, shortening, trans fat (or partially hydrogenated fats).
- Salt or any word with ‘sodium’.
- Sugar, which can also be labelled as sucrose, glucose, maltose, dextrose, cane sugar, corn syrup, fructose.
How to overcome difficulties to healthy eating
Here are some ideas on how one can overcome the difficulties many people mention when it comes to eating more healthily:
Cost – “healthy foods are too expensive”
- Buy seasonal vegetables and fruit because this is when it is the most economical
- Buy in bulk and share with your friends and family
- Plant your own vegetable garden
- Buy more vegetables instead of fruit
- Look out for specials
- Eat more beans and lentils as these are inexpensive, nutritious foods
- Skim milk powder is more economical than unhealthy coff ee/tea creamers
- Tinned fi sh in excellent option and may cost less than fresh fish
- Whole chicken is cheaper per kilogram than buying chicken already cut into portions – you can save by cutting the chicken yourself (remember to remove the skin and fat)
“Someone else does the shopping and cooking”
- Make the whole household aware of the importance of healthy food and use our information to help you
- Offer to cook or shop if you can
“I don’t like healthy food” or “My family doesn’t like healthy food”
- Explain to your family how eating healthily is important to prevent disease
- Encourage your family to be adventurous. Try different tastes and cooking methods by trying some new recipes from the Pharma Dynamics and Heart and Stroke Foundation’s ‘Cooking from the heart’ recipe book
- Make gradual changes and take small steps, e.g. cook a healthy meal once a week at first
“The shops in my area do not stock healthy food”
- Speak to shop/spaza managers and ask them to stock healthier options (e.g. lean meat, low fat and lower salt products)
- Grow your own vegetables
“I don’t have a fridge or stove in my house”
- Choose foods which don’t need to be refrigerated, e.g. skim milk powder, tinned fish
- Consider buying a microwave, which is cheaper than a stove
“Take-aways are easier” and “I like take-aways too much”
- Choose healthier take-away options
- Reduce the number of times you eat takeaways
- Experiment with the quick, easy and tasty meals from the Pharma Dynamics and HSF ‘Cooking from the heart’ recipe book
- Make take-away foods at home, the healthier way!
- healthy burger on whole-wheat roll
- with oven-baked chips
- battered s kinless c hicken b aked in the oven
- home-made pizzas with lots of vegetables and less cheese
“I don’t think healthy eating is important enough in my life”
- Think about what it would mean for you and your family if you became disabled from something like a stroke, heart attack or cancer at a young age
- Having a chronic disease of lifestyle may cause you to lose income and medical treatment can be very expensive and timeconsuming
- By eating well, you can live longer and live a healthier, happy life
“My husband likes me to be fat”
- Explain to your husband how eating healthily is important to prevent disease
- Overweight is a serious risk to your health,and is a major cause of many diseases, such as high blood pressure, diabetes, heart disease and strokes
Need Support To Quit?
Remember there is professional help on the other end of the phone, if you phone the Cancer Association Quitline on
SA National Council on Alcoholism and Drug Dependence (SANCA)
Toll Free Number: 086 14 SANCA / 086 14 72622
Telephone: 011 892 3829
National Helpline: 0861 HELP AA (435-722)*
Lifeline South Africa
A 24 hours professional counselling service for 365 days a year
Telephone: 086 132 2322
SA Depression and Anxiety Group
Helpline (8am – 8pm, 7 days a week): 0800 20 50 26 or 011 262 6396
Department of Social Development
24 Hour Substance Abuse Helpline: 0800 12 13 14
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