Updated 30 December 2013

Diet 2013: the good, the bad and the ugly

DietDoc looks back on the dietary highlights and lowlights of the last year.

The last week of a year is a time for reflection and remembering what was news during the past 12 months. From a dietary point of view, 2013 was characterised by both good and bad news. Let’s first look at the bad news before we turn to the rather more positive findings and advances.

Obesity - an ever-growing problem

The release of the findings of the first South African National Health and Nutrition Examination Survey (Sanhanes-1), indicated that overweight and obesity is increasing inexorably especially in females from 27% in 2003 to 39.2% in 2012.

This is indeed cause for serious concern because women who are overweight or obese when they fall pregnant have a much higher incidence of pregnancy and birthing complications and their infants may be programmed in utero to also gain weight. The latter possibility may account for the increase in overweight in boys and girls from 10.6% in 2005, to 18.2% in 2012.

The newspapers had a field day accusing our nation of being "slobs" who are obese, inactive, and addicted to alcohol and cigarettes. The outlook, therefore, looks very gloomy for the nation as a whole because a high incidence of obesity and inactivity is also linked to many of the diseases of western lifestyle such as type 2 diabetes, polycystic ovary syndrome (PCOS) and infertility, metabolic syndrome, cancer, arthritis and heart disease.

Diet solutions

2013 also saw the usual upsurge in over-the-counter slimming products offering a quick fix to a population desperate to lose weight. But all was not doom and gloom on the diet front this year.

A major scientific study conducted in Spain by Dr Ramon Estruch and his coworkers (2013), found that approximately 30% of heart attacks, strokes and death from heart disease can be prevented by eating a Mediterranean diet.

The Mediterranean Diet has repeatedly been found to be the protective against developing heart disease, as well as obesity, provided you stick to the basic principles of eating plenty of fresh fruit, vegetables, fish, legumes, nuts, whole grains and monounsaturated oil derived from olives and olive oil.

Good news on the diet horizon is that a new pharmaceutical slimming product known as Belviq has at last been approved by the FDA in America.

This slimming pill contains lorcaserin hydrochloride, which is a so-called serotonin 2C-receptor agonist. Serotonin is a chemical produced in the brain and other organs of the human body, which affects mood and appetite.

A deficiency in serotonin has been linked to manifestations such as depression, low self-esteem, insomnia, panic attacks, eating disorders, anxiety, food cravings and overeating.

Various drugs have been developed to increase serotonin levels in the brain to combat the above mentioned symptoms. Lorcaserin is one of these drugs which can increase serotonin levels and thus reduce appetite which when used in conjunction with an energy-reduced diet and exercise should lead to weight loss.

Unfortunately Belviq is not yet available in South Africa, but at least we have the prospect to look forward to that the product should be approved in future and that Belviq will be able to assist the obese in this country to lose weight.

Revised FBDGs and the SA Food Guide

This year also saw the expansion of the use of the first uniform SA Food Guide. A Food Guide can be defined as "a visual reminder, to support messages from the Guidelines for Healthy Eating". A concerted effort is being made by the dietetic and nutrition fraternity in cooperation with the Department of Health to propagate the basic ideas contained in the updated Food-Based Dietary Guidelines (FBDGs) and illustrated by the SA Food Guide.

The prime goal of Food-Based Dietary Guidelines and the SA Food Guide, is education of the entire population and of people from all age groups to understand what foods to select to maintain good health and prevent disease.

Other advances

In view of the fact that up to 23% of adults suffer from Irritable Bowel Disease (IBS) which seriously impacts on their quality of life, researchers at the Monash University in Melbourne concentrated on identifying foods that make IBS worse.

They have coined the name “Fodmap”, which stands for “Fermentable Oligosaccharides Disaccharides Monosaccharides And Polyols”. Dr Sue Shepherd of the Monash University has designed a low Fodmap diet which has been accepted as an effective diet therapy for IBS.

The fact that 75% of IBS patients show improvements in their symptoms on the low Fodmap diet, makes it particularly valuable to IBS sufferers worldwide.

TIP:  If you suffer from IBS and would like to learn more about the Fodmap diet, read this article or ask your registered dietitian to help you apply the principles of this diet to your condition.

New soft drink regulation

From April 2013, an amendment to the South African soft drinks regulations specifies that all caffeinated energy drinks must state on their cans “Not recommended for children under 12 years of age; pregnant or lactating women; persons sensitive to caffeine". In addition, the front of the cans must display the warning “High caffeine content” in letters large enough to be easily visible.

While we can but hope that this sensible regulation will be adhered to by the manufacturers of soft drinks that contain caffeine, the public and parents in particular need to firstly inform their children that caffeine-laced energy drinks are harmful and secondly not allow children to buy such drinks at tuck shops and sporting events.
Continuing Challenges

In addition to our obesity epidemic which at the moment appears to be a totally insurmountable problem, diseases and potential dietary solutions that remain elusive, are fibromyalgia and various types of cancer.

Hopefully the new year will provide us with greater insights and provide additional solutions to these conundrums, some of which are as old as time.

It is always good to remember that nutrition is a constantly evolving science and that nothing is written in stone. As scientists and researchers discover more about the intricate workings of the human body and mind, it is possible that we will have to change our approach to diets and adjust our thinking, but one thing is sure, namely that we will continue to be dependent on the food we eat for our energy, health and survival.

(Woman measuring her waist from Shutterstock)

Dr Ingrid van Heerden is a registered dietician and holds a doctoral degree in Nutrition and Biochemistry. She believes that "we are what we eat" and offers free nutrition and weight loss advice via her DietDoc service on Read more of her articles.


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