1. Diet Preventing Diseases: Lessons from HSFSA Shân Biesman-Simons RD(SA)

2. Need for information Local research Public To establish needs for specific groups e.g. - rural and urban - different cultures South African MEDICAL RESEARCH COUNCIL

3. Limited Statistics Prevalence data show shifts in dietary intake Particularly in black population (>75%) In urban blacks in last 50 yrs: –Fat intake (16.4 - 26.2% of total energy) –Carbohydrate intake (69.3 - 61.7% of total energy)

4. Collaborate with stakeholders Other established local or international foundations Expert insights, best practice Before adopting programmes – do appropriate country specific research

5. Collaborate with stakeholders Related organisations such as –World Action on Salt and Health (WASH) –5-a-day –International Union of Nutritional Sciences (IUNS) Create unified lobby groups To advocate for healthier foods for the country, including more veg & fruit, less salt, less fat

6. WASH on Na content of cereals Research shows Na content in global brands varies significantly from country to country Kelloggs All Bran Na content per 100g – 2.15g (Canada) – 0.65g (USA) – 0.70g (RSA) Requirement for HSFSA Heart Mark – < 0.4g

7. Collaborate with stakeholders Food industry Heart Mark and Restaurant Programme Improve quality of commonly consumed foods, e.g. bread, margarine, etc. Encourage food manufacturers to lower sodium content

8. Heart Mark Heart Mark – established 22 years ago To help consumers easily identify healthier options Independent testing by reputable laboratory Dietitian involved in regulating Heart Mark products Criteria different for different food categories Criteria consider total, trans and saturated fat content, cholesterol, fibre, sodium and added sugar

9. Collaborate with stakeholders Medical community Medical professionals dont have time for educating patients For secondary prevention - market services so patients can be referred Heart Mark Diet Line 0860 223 222

10. Use uniform health messages National Guidelines In SA: Food based dietary guidelines

11. SA Food Based Dietary Guidelines Enjoy a variety of foods Make starchy foods basis of most meals Chicken, fish, meat, milk or eggs can be eaten daily Eat plenty of veg & fruit every day Eat dry beans, peas, lentils and soya regularly Use salt sparingly

12. SA Food Based Dietary Guidelines Use fats sparingly Drink lots of clean, safe water If you drink alcohol, drink sensibly Use food and drinks containing sugar sparingly and not between meals Be active

13. Include other risk factors Physical inactivity Smoking Cardiovascular guidelines help with other diseases

14. Keep messages simple Consider level of education Should be age appropriate If possible in mother tongue

15. Use of media & website Community radio stations – good response Community newspapers Publicise web addresses and links www.heartfoundation.co.za

16. Capitalise on programmes HSFSA Childens Programme uses train- the-trainer approach Children take message home Encourage education of the community at large Use practical tools e.g. food gardens

17. Shân Biesman-Simons RD(SA) Tel: +27 21 447 4222 shan@heartfoundation.co.za www.heartfoundation.co.za For more information