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Mental Health Matters Journal for Psychiatrists & GP's

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Literacy is a luxury that many of us take for granted.  We depend on written communication for information, guidance, and access to heath care information That is why SADAG created SPEAKING BOOKS and revolutionized the way information is delivered to low literacy communities. It's exactly what it sounds like.a book that talks to the reader in his or her local  language, delivering critical information in an interactive, and educational way.

The customizable 16-page book, accompanied by local celebrity audio recordings, ensures that vital health and social messages can be seen, heard, read and understood..

We started with books on Teen Suicide prevention , HIV, AIDS and Depression, Understanding Mental Health and have developed over 30 titles, such as TB, Malaria, Polio, Vaccines for over 30 countries.

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The Winter Comfort-Eating Trap The season of stews, sloppy sweaters and sloth is here. But if you give in, you could end up refusing invitations to pool parties when summer comes. Heres a simple way to stay in shape.

About to slipper-shuffle to the kitchen for hot chocolate and a snackwich before burrowing back under the duvet? Stop! Winter can do strange things to a womans psyche and body, encouraging comfort eating and exercise avoidance. And this despite knowing the price you could pay when summer arrives. Just the thought of it can have you reaching for another chocolate... But not this winter!

Comfort eating is about consuming specific foods in specific situations – such as the onset of colder weather – for psychological comfort. It has various causes, but a survey by marketing professor Brian Wansink of the University of Illinois in the US found it stems mostly from past associations between different foods and certain people (Dad loved mash and gravy) or events in your life (Mom always made malva pudding on winter weekends).

Comfort foods tend to be high in simple carbohydrates regardless of the season, but these can be especially appealing in colder weather. Eating a high-carbohydrate meal increases the release of serotonin (the feel-good chemical) in the brain and leads to a feeling of fullness, says Cape Town psychologist Janet Earl, who treats eating disorders. This helps you deal with emotional emptiness.

Comfort foods also tend to have smooth, creamy textures and sweeter tastes, associated with baby foods and a time when you felt secure and loved. But individual preferences can differ widely, as a whip around a gathering of Durban students confirms. When Im cold and miserable, I just want samp, beans and sweet tea like gran made it, says 22-year-old Miriam Cele, while her friend Layla Pillay, 21, turns to bean roti and chips, and Karen Woodley, 20, craves buttered muffins – and chocolate, of course!

It seems winter may trigger our need for comfort foods because of the mild depression some people experience from shorter, greyer days. Seasonal affective disorder (SAD) and its milder variation, winter blues, are associated with northern winters, but can also occasionally occur in the southern parts of Australia, South America and SA. These moods are more common in younger people and women, says Heather McAlpine, training manager for the SA Depression and Anxiety Group. Theyre caused by lack of sunlight, and symptoms include changed eating patterns, increased appetite, lethargy and weight gain. Carbohydrate craving has been experienced by women with SAD, particularly around 4pm and 9pm, says Earl. Research has shown there can be a decrease in subjective depression after having a carbohydrate-rich meal – that is, after comfort eating.

There are other physiological reasons for comfort eating in winter. Cool weather once signalled our ancestors to eat more so as to gain weight for extra warmth and protection against the elements – a survival instinct that McAlpine says seems to persist. And in winter your social activity often revolves more around food, says Earl, so the temptation to eat is greater. In summer you might go to the beach with friends instead of drinking red wine around a fireplace.

1. Fix your thinking
If youre eating because colder, darker days are feeding an underlying depression, find the causes, says Petrene Soames, author of The Essence Of Self-Healing (Fleetstreet Publications). These generally involve poor feelings about yourself. Trace their roots, she says. Then choose not to see things in those negative ways again. If you battle to do this, get psychological help – otherwise weight gain and diminishing self-esteem can drag you deeper into depression. Its all about recognising the psychological role food is playing for you and doing something to address that, says Earl.

Soames recommends that you think of something amazing or sweet that you have done or thats happened to you. Allow yourself to feel all the good feelings this brings you – breathe them all through your body. Evoke that memory whenever youre tempted to comfort-eat.

2. Address your eating
Rather than avoiding winter comfort foods, which can just make you crave them more, try to change to healthier alternatives, says Durban dietitian Carol Browne. Make a routine of planning meals in advance, so when youre cold and low and tempted to indulge, youve got a wholesome meal on hand. If you still want that comfort food afterwards, a small portion is more likely to satisfy you, she says.

Make stews and casseroles with vegetables and legumes instead of red meat, suggests Durban dietitian Priya Lalla. Control portion size by cooking these in bulk and freezing modest helpings. Retain the thick, creamy texture in sauces and soups by using evaporated non-fat milk or pureed potatoes instead of cream, and use apple sauce to replace some of the butter or oil in cakes and puddings for occasional treats with hot, fat-free milk custard. And if you feel like pizza, Lalla suggests ordering vegetarian or chicken with less cheese.

Eating a little four or five times a day can help you control the urge to eat, says visiting British nutrition guru Patrick Holford, author of The New Optimum Nutrition Bible (Piatkus) – and dont skip breakfast. Oats, sweet potatoes, brown basmati rice and rye or whole-grain breads have a low glycaemic-index load, he says, which helps keep blood sugar and mood stable.

For all this, dietitians say that when you crave comfort foods such as chocolate or a snackwich, youre unlikely to be satisfied with healthier alternatives such as rye bread and sugar-free jam. If you want something, says Browne, the best way to stop thinking about it is to eat it. But set rules. Dont eat comfort food instead of meals, and concentrate when you eat it – dont just wolf it down in the car on the way home from the shop. Be reasonable when youre deciding how much youll have. Your brain apparently reaches its optimum level of savouring food after four bites, which should satisfy the craving. Chew slowly, says Browne, and relish the food in your mouth.

3. Get exercising
Excess kilos creep on when you take on more energy than you expend but its not easy braving the cold and dark to exercise in winter. Its also not safe to jog alone, so join a group for motivation and security or get an exercise buddy and power-walk in a shopping mall, says Browne. Your exercise time will also be a time to chat and let off steam. If you walk just before shops open in the morning, lights are on, security is present, climate is controlled and there are no shoppers in your way. Find a flight of stairs to go up and down. Just be sure not to turn it into a shopping or eating extravaganza!

Gym membership drops in winter and soars in spring but it takes six months to get into shape for summer, so nows when you should be working out, says Durban fitness and lifestyle coach Noeleen Bridle of Strength & Mind. Besides, exercise not only burns kilojoules – it also releases endorphins that help control appetite and elevate mood, helping you keep winter blues at bay and control the urge to comfort-eat.


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