Packaged food that is high in salt, sugar and fat may soon have to carry warning labels, according to a top health official.

“We hope to introduce regulations about front-of-pack warning labels by late this year or early next year,” said Lynn Moeng, Chief Director of Nutrition in the Department of Health.

“This will assist people to know what is in packaged food because most people don’t know what they are eating,” said Moeng.“The problem will then be how to deal with the food that isn’t packaged. People are excited to buy those combos – the chicken, chips and a fizzy drink – without knowing what is in them.”

She was speaking at the launch of the #Whatsinmyfood campaign on Thursday, organised by the Healthy Living Alliance (HEALA), which aims to educate ordinary people about the unhealthy ingredients lurking in processed food.

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HEALA Executive Director Sibongile Nkosi welcomed Moeng’s announcement, saying that the current ingredient labels on processed food were confusing.“The food industry uses many different words for sugar and salt to conceal what is in their products, so clear warning labels will make it easy for people to identify unhealthy food,” said Nkosi. 

“We have launched our campaign because people have the right to know what is in the food they eat. 

Identify unhealthy food

Think of the mother in a squatter camp preparing a lunchbox for her child. She just goes to the nearest shop and buys polony. She doesn’t have time to read what’s in it. We want to help her to identify unhealthy food, but also get shops to stock the healthy food grown by local small scale farmers.

”HEALA’s campaign comprises of advertisements to be flighted on TV and radio warning people about high levels of salt, sugar and fat in cereal, fruit drinks, polony and white bread. Also speaking at the launch, Professor Sue Goldstein from Wits University’s School of Public Health warned of the “corporate determinants of health”.

“The tobacco, alcohol and food industries all use similar tactics to keep information about their products from people,” said Goldstein. In 2016, Chile ruled that food high in added sugar, saturated fat, kilojoules and added salt had to display a black stop sign on the front of their packages. 

Any food with these warning signs also cannot be sold in schools or advertised to children under the age of 14.  

A study published two weeks ago to evaluate how mothers of young children had responded to the new policy found that it was changing what mothers were buying.

“Many mothers described that their children requested healthier food and used the stop signs as shortcuts to distinguish healthy from unhealthy food choices. As a result, many mothers said that they have changed the foods they purchase for their children,” said the study’s lead author, Dr Teresa Correa, from Diego Portales University in Santiago. 

Moeng said government was using both regulation and engagement with the food industry to address obesity.

– Health-e.

Kerry Cullinan

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After being involved in a road accident in Port Elizabeth, a biker in his 40s had a Cape Town surgeon to thank for his survival.

The biker had sustained life-threatening injuries, and Cape Town surgeon, Dr Wimpie Odendaal, on holiday in the city along with his wife, jumped in to attend to his injuries.

In a statement, Netcare said that Dr Odendaal, who was first to arrive on the scene, recognised that the motorcyclist had sustained serious chest injuries and was able to perform a life-saving emergency procedure with only rudimentary tools while waiting for emergency medical services to arrive. 

Seconds after the accident

“My wife, general practitioner Dr Christa de Wit, and I were on holiday in Port Elizabeth and were driving with my sister-in-law Louise, who is a nursing sister, on a quiet, leafy back road when we happened upon the scene of a road accident,” Dr Odendaal, who practises at Netcare Blaauwberg Hospital, recalls. 

“Clearly, the accident had happened just seconds before we arrived. My wife immediately asked Louise to call emergency medical services. 

“An injured man was sitting upright in the middle of the road, and a woman, clearly very distressed, was standing next to her damaged car. While he was visibly in pain, it was not initially obvious that he had sustained severe injuries. 

“Within seconds, however, the man’s condition deteriorated. He became very short of breath, lost consciousness and no pulse could be discerned.”

Saving a life… with a pocket knife

Dr Odendaal and his wife immediately began performing cardiopulmonary resuscitation (CPR) on the man. 

“The veins in the patient’s neck were distended and his trachea had shifted. It became evident that he had developed a tension pneumothorax, which is a life-threatening condition where air becomes trapped between the membranes surrounding the lungs. 

“Not only does tension pneumothorax compress the lung, making breathing difficult, if not impossible, it also decreases the flow of blood to the heart and can very quickly lead to cardiopulmonary arrest. I knew that something would need to be done immediately to relieve the tension pneumothorax, or the man would have little chance of survival. 

“By this time, a few bystanders had gathered at the scene and, as I had no medical equipment in my car save for a plastic mouthpiece for mouth to mouth resuscitation, I shouted to ask if anybody had a sharp object I could use.

“I was offered a pocket knife, and had no other choice than to use this to open the fifth intercostal space anterior to the midaxillary line, which is a specific area between the ribs on the side, to relieve the pressure. If it weren’t for this emergency intervention, the man would most likely have died within minutes.”

Small, vital improvements

After Dr Odendaal’s intervention the patient’s condition briefly improved, and a basting needle was fetched from a nearby house, which he used to keep the hole in the patient’s side open.

An ambulance soon arrived at the scene and the emergency personnel assisted with resuscitating the man. 

“We used an endotracheal tube and bowl of water to devise a makeshift underwater drain to restore negative pressure to the pleural cavity and prevent the space from refilling with air. A large bore drip needle was used to relieve a second tension pneumothorax,” Dr Odendaal explains. 

“The patient was intubated and adrenaline was administered intravenously, and soon he was stable enough that we could transport him to the emergency department at a nearby hospital.”

According to Dr Odendaal, the man spent several weeks in hospital recuperating from his injuries, which included 14 rib fractures, cardiac and pulmonary contusions, a broken pelvis and a broken foot – and has since been discharged, and is continuing his recovery at home.

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Ritalin, a widely used stimulant drug to treat attention-deficit/hyperactivity disorder (ADHD), likely poses no risk of heart damage in children, new research in monkeys suggests.

The findings are “very reassuring,” said the study’s principal investigator, Dr Steven Lipshultz.

Sudden cardiac death

Each year, more than 1.8 million children in the US take drugs to treat ADHD. Concerns have been raised that Ritalin, Concerta and other forms of methylphenidate could harm children’s hearts.

Some studies have reported an increase in sudden cardiac death among children taking methylphenidate or other stimulant drugs for ADHD.

But this new study found that five years of high doses of methylphenidate did not damage the hearts of 30 rhesus monkeys. That length of time is similar to how long children and adults would use the drugs.

“Even high-dose chronic [methylphenidate] stimulant therapy did not result in any evidence of abnormal structures or function in the hearts of the monkeys,” said Lipshultz, chair of paediatrics at the University at Buffalo School of Medicine and Biomedical Sciences, in New York.

However, his team cautioned that the results of animal research are not automatically applicable to humans.

One ADHD specialist unconnected to the study agreed.

Man vs. Monkey

“The [animal] study cannot be automatically applicable to humans,” said Dr Victor Fornari, who directs child and adolescent psychiatry at Zucker Hillside Hospital in Glen Oaks, New York.

Still, the findings “provide compelling evidence of the cardiac safety of this important evidence-based treatment for ADHD,” Fornari said.

About 10% of US children have been diagnosed with ADHD and related disorders. Up to 70% of them take prescription stimulant drugs, so possible heart risks associated with the drugs are a major concern, study author Lipshultz said in a university news release.

The US Food and Drug Administration has ordered some prescription stimulants to carry black box warnings stating that children with underlying heart disease should use these medications with caution.

In Canada, a stimulant drug was removed from the market after it was linked to a small number of sudden cardiac deaths. Sales of the drug later resumed.

“This controversy has persisted without answer,” Lipshultz said. “Yet the number of prescriptions for these medications for children with ADHD continues to expand.”

Another expert said the new findings should help ease concerns.

Each case is unique

The study results “are overall re-assuring in terms of cardiac safety and long-term use of stimulants for ADHD in otherwise healthy individuals,” said Dr. Andrew Adesman, chief of developmental and behavioral paediatrics at Cohen Children’s Medical Center in New Hyde Park, New York.

However, he added that the study “does not address clinical concerns about the safety of stimulants in individuals with certain types of heart disease.”

Therefore, “health care providers need to continue to screen children for cardiac problems prior to prescribing stimulant medications like Ritalin, Concerta or Adderall, since there are some individuals who may still be at increased risk for potentially serious heart problems if treated with stimulant medication,” Adesman said.

Lipshultz noted that the findings are good news for another type of pediatric patient: young cancer survivors.

“I have cared for children and adolescents who have survived childhood cancer, who now are experiencing severe learning disabilities as a result of their cancer therapies. They become my patients because their hearts have been damaged, an unfortunate effect of the successful treatment of their childhood cancer,” he said.

“Current recommendations state that children such as these, with underlying heart disease, should avoid chronic stimulant therapy because of the concern that it could further damage their hearts,” he explained. “However, these prescription stimulants often allow these children to do much better with their learning progress.”

The new findings suggest that, in many cases, these medications can be prescribed to these children as well, Lipshultz said.

The study was funded by the US National Institutes of Health. It was recently published in the journal Pediatric Research.

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Joel Mnisi (52) was born without any disabilities, but after suffering from sugar diabetes he has had to have both legs amputated and is now wheelchair bound.

Three years after being diagnosed with diabetes, and a year after his second foot was surgically removed, Mnisi is struggling to adjust to life as a double amputee.

Wounds heal slowly

Mnisi has type 1 diabetes, a genetic condition that runs in the family. He lives in a house without wheelchair ramps in Bridgeway Village outside Tzaneen.

He lost his left leg in 2017 after being diagnosed with sugar diabetes a previous year. His right leg was amputated in March 2018 after it starting to swell and got painful, exactly like his left foot.

“It felt like my foot was burnt. There was a blister on my left toe, and because I slept around a fire at a funeral the previous night, I thought I burned myself. I went to the clinic and they gave me medication to treat the wound, but it didn’t heal. So I went to the hospital and that’s when they confirmed the wound was because of diabetes,” he said.

Diabetes is known to cause wounds to heal slowly. According to the Journal of Clinical Investigation, diabetic foot ulcers are a leading cause of amputations and affect 15% of people with diabetes.

Mnisi stays alone in a one bedroom house which he describes as a mountain to climb as he is unable to get in or out without assistance.

Supportive relatives

“It’s very difficult to stay alone, especially when you are a person living with a disability. My house does not accommodate my special needs. It doesn’t have ramps – even for the toilet. My son-in-law is the one who is helping me, but he is leaving to study soon,” said the 52-year-old.

Greater Tzaneen Municipality (GTM) has agreed to assist Mnisi so he can easily manoeuvre around his yard while waiting for an emergency house.

“The Municipality will in meantime organise a ramp for the gentleman so that he can get into his house, and also to the toilet. His name will also be included in the list of emergency houses,” said GTM communication officer Patricia Muchabi.

Mnisi said it has been difficult to accept his disability, although his family has been supportive.

“It has not been a simple to accept the condition. You don’t get used to being without legs, especially when you were born with two good legs. However, my relatives support me and they have also accepted my condition. That also gives me strength to accept, and to realise it’s not all over.”

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Mogale Mojela