Banting on a bud­get A ru­ral health doc­tor lives on R300 for 14 days

14 DAYS, R300: A RU­RAL DOC­TOR TAKES ON THE CHAL­LENGE AND, IN TURN, QUES­TION HER AS­SUMP­TIONS ABOUT OBE­SITY AND NU­TRI­TION SOUTH AFRICA

Marie Claire (South Africa) - - CONTENTS - WORDS AND PHO­TO­GRAPHS LEILA HART­FORD

as I lift the lid of the pot the un­mis­tak­able stench of dog food hits my palate be­fore it reaches my nos­trils. I gag, take a step back and pinch-close the tip of my nose. Then, lean­ing for­ward to peer over the rim, I in­spect my ‘din­ner’. It’s day 11 of my Banting-on-a-bud­get chal­lenge and pig trot­ters are on the menu tonight. I had to call my grand­mother for ad­vice on how to cook them. She sug­gested boil­ing them for at least six hours. Four hours in, they still re­sem­ble leath­ery hu­man feet bathed in dirty grey wa­ter.The fatty, sinewy sed­i­ment has left a rim of grime around the edge of the pot, which I strug­gled to scrub clean af­ter­wards. It’s not look­ing (or smelling) promis­ing. Be­fore tak­ing my first bite, I try to re­mind my­self of why I am putting my­self through this.

I cast my mind back to the mo­ment the idea was con­ceived. I spent one of my week­ends off in Cape Town, and was gen­uinely sur­prised and in­trigued by how Tim Noakes’s food ‘revo­lu­tion’ had taken Cape Town by storm. Hordes of peo­ple were lin­ing up out­side book­stores to get their hands on a copy of The Real Meal Revo­lu­tion. I was told that Woolies had a crit­i­cal short­age of cau­li­flower. My over­ac­tive imag­i­na­tion couldn’t help but pic­ture hud­dles of newly con­verted Ban­ter rev­o­lu­tion­ar­ies meet­ing in se­cret, spread­ing the motto ‘liver-ty, me-qual­ity, fat-er­nity’ while some­where in the South­ern sub­urbs Pro­fes­sor Noakes hosted lav­ish din­ner par­ties, with tow­ers of cheese for starters, a suc­cu­lent suck­ling pig for mains, and meatballs in­stead of mac­a­roons for dessert. The hordes would march to his manor de­mand­ing an­swers (Where do I buy duck fat? Won’t I get a heart at­tack? What is psyl­lium husk any­way?). To one and all he would re­ply: ‘Let them eat STEAK!’

The up­heaval of the French Revo­lu­tion led to the abo­li­tion of the French monar­chy but left the de­mands of the pro­le­tariat largely un­ad­dressed. When I re­turned to the vil­lage in ru­ral Mpumalanga where I live and work, I met a 19-year-old who was mor­bidly obese de­spite be­ing im­pov­er­ished. It dawned on me that the cur­rent culi­nary and nu­tri­tional up­heaval in the Cape is a pas­time for the bour­geoisie, while the nu­tri­tional needs of the ma­jor­ity of the pop­u­la­tion have largely

been ig­nored. A re­cent ar­ti­cle in lead­ing sci­en­tific jour­nal The Lancet re­ported that 42 per cent of South African women are obese, and the com­bined rate of both over­weight and obese women is 69,3 per cent. Food-in­se­cure and low-in­come cit­i­zens are par­tic­u­larly vul­ner­a­ble to obe­sity. While lim­ited re­sources, ac­cess to af­ford­able food, fewer op­por­tu­ni­ties for phys­i­cal ac­tiv­ity and greater ex­po­sure to obe­sity-pro­mot­ing prod­ucts are some of the many rea­sons cited to ex­plain this phe­nom­e­non in the de­vel­oped world, there are still many open-ended ques­tions re­gard­ing the obe­sity epi­demic in South Africa. This is where Tim and I agree: surely there must be some­thing wrong with what we are eat­ing, and not just how much we are eat­ing?

This is how the idea was born. I de­cided to see if it is pos­si­ble to Bant on a tight bud­get. Look­ing at the most re­cent cen­sus, I was able to cal­cu­late that the av­er­age person in my district spends a mere R150 per week on food. I set my­self a tar­get of two weeks, and then started pre­par­ing for the chal­lenge. I gave away the con­tents of my pantry, fridge and freezer. I parted with my stash of Turk­ish de­light and liquorice, and put the case of red wine un­der lock-and-key. I did a recce to the lo­cal Sho­prite and planned what I could buy with my 150 Rand-elas. As it turns out, I couldn’t buy much. I worked and re­worked my shop­ping list un­til fi­nally set­tling on the fol­low­ing items: eggs, frozen chicken pieces, but­ter, milk, tea, cab­bage, sweet potato, onion, chilli and gar­lic.

The first few days were rel­a­tively easy. I was able to come up with some gen­uinely tasty meals, and although the fear of run­ning out of food be­fore the week was up made me sig­nif­i­cantly de­crease my av­er­age por­tion size, sur­pris­ingly, I didn’t feel hun­gry. The lack of va­ri­ety was lim­it­ing, but lim­i­ta­tions breed cre­ativ­ity and I was forced into find­ing ways of rein­vent­ing the same 10 in­gre­di­ents to fool my­self into be­liev­ing that I wasn’t eat­ing the same thing day in and day out. I also learnt to eat ev­ery­thing! And by that I mean ab­so­lutely ev­ery­thing. If I cooked chicken for din­ner, I would keep the bones and boil them up to make a broth for lunch the next day. I used the skins of the sweet pota­toes I peeled to make chips as a light

When you have so lit­tle, the thought of wast­ing any­thing be­comes ab­surd, al­most of­fen­sive

snack over the week­end. I even reused my tea bags. When you have so lit­tle, the thought of wast­ing any­thing be­comes ab­surd, al­most of­fen­sive.

The high­light of the first week was al­most cer­tainly break­fast. A pre­vi­ously mun­dane meal con­sist­ing largely of muesli and yo­ghurt, or per­haps some toast or ce­real, was now an op­por­tu­nity to stretch my cre­ativ­ity. The award for best break­fast would have to be shared be­tween my poached egg on a sweet-potato rosti and my sweet potato por­ridge, which I made by peel­ing half a sweet potato, boil­ing it un­til soft and then mash­ing un­til smooth.To this I added some milk and but­ter.The re­sult was a silky, sweet por­ridge that re­minded me of baby food.

The chal­lenge be­came sig­nif­i­cantly more dif­fi­cult over the week­end, when I re­turned to my home in Jo­han­nes­burg. I re­alised for the first time just how im­por­tant it is to es­tab­lish an eat­ing plan that is so­cially ac­cept­able. Look­ing back, I think this will be one of the great­est chal­lenges that we’ll have to over­come when tack­ling the obe­sity prob­lem in South Africa. It’s one thing to fol­low a strict diet when you live and eat alone, but when you are of­fered home-made rusks or mama’s lasagne, and have to sit down at the din­ner ta­ble munch­ing on a bowl of cab­bage or yet another egg in­stead, the Banting life­style starts to feel more like a life sen­tence.

By the end of week one I was lust­ing af­ter some new in­gre­di­ents to work with and I en­thu­si­as­ti­cally drew up my next shop­ping list. I had been ad­vised to ven­ture into the aw­fully for­eign world of of­fal, so I added a tub of chicken liv­ers and two pig trot­ters to my miserly bas­ket: two strangers sit­ting side by side with my clos­est foodie friends, baby mar­row and av­o­cado. For­tu­nately avos grow read­ily in Mpumalanga and are rel­a­tively cheap. I paired them with eggs, mashed them into a gua­camole, baked them for lunch, and also just ate them neat. Av­o­ca­dos are such boun­ti­ful fruit – packed with all the fats, vi­ta­mins and min­er­als you need – and pre­sented in the se­duc­tive pear shape of a Re­nais­sance nude, with flesh just as pale and soft.

The eter­nally ver­sa­tile baby mar­row was a key in­gre­di­ent in most of my favourite meals in week two. It has al­most as many uses as it has names (zuc­chini,

cour­gette, mar­row, squash). I steamed it, grilled it, noo­dled it and grated it; all to great ef­fect. My favourite meal was a bowl of zuc­chini tagli­atelle topped with a mar­i­nated and braai­ied chicken thigh. Another high­light was when I dis­cov­ered a recipe to make my own yo­ghurt. It was sur­pris­ingly easy and re­sulted, if I say so my­self, in the most de­li­cious yo­ghurt I’ve ever tasted.

As ex­pected, the hard­est part of the week was the of­fal. I man­aged to trans­form the liv­ers into a rather scrump­tious pâté, but the trot­ters were un­sal­vage­able. Even af­ter all that boil­ing, they re­mained chewy and flavour­less. The main draw­back, though, was not their hor­ren­dous odour or bland taste, but rather the lack of sub­stan­tial meat. Most of the weight you pay for is made up in bones and sinew. That night I went to bed feel­ing ut­terly un­sat­is­fied and very an­noyed that I had thrown R21 down the drain.

But just a few days later, the chal­lenge was over. In two weeks I had lost 1,7 kg, and gained in­nu­mer­able life lessons. I learnt that even if you have very lit­tle, it’s pos­si­ble to stretch your bud­get be­yond the sea of starch. I learnt to be more con­scious not only of what I con­sume but also of the chal­lenges so many peo­ple in my com­mu­nity face. While I did this by choice, for many of my pa­tients, putting food on the ta­ble (be it rice and pap or eggs and av­o­cado) is an ev­ery­day strug­gle, and I was hum­bled by the ex­pe­ri­ence.

I learnt that although we may not have all the an­swers when it comes to the carb ques­tion, or enough ev­i­dence to back up one the­ory over the next, as a na­tion we need to start ad­dress­ing the obe­sity epi­demic be­fore it is too late.

We need po­lit­i­cal com­mit­ment from our lead­er­ship to cre­ate a food en­vi­ron­ment where healthy liv­ing be­comes the de­fault choice. This com­mit­ment starts with aware­ness and un­der­stand­ing, which I be­lieve can only be gained by walk­ing, for a day, a week, or two, in some­one else’s shoes.

Munch­ing on a bowl of cab­bage or yet another egg, the Banting life­style starts to feel more like a life sen­tence

LEILA HART­FORD

Doc­tor, pub­lic health

en­thu­si­ast, am­a­teur chef and blog­ger.

DAY 9 ZUC­CHINI FRIT­TERS TOPPED WITH A PER­FECTLY

FRIED EGG, TOMATO AND BEEF SOUP AND CHILLI CHICKEN ON ZUC­CHINI NOO­DLES.

WEEK 2

DAY 12 BAKED EGG,

AV­O­CADO, SWEET POTATO AND ONION FRIT­TATA.

DAY 10 SCRAM­BLED EGGS WITH GUA­CAMOLE AND CHICKEN LIVER PÂTÉ SERVED WITH ZUC­CHINI CIA­BATTA AND CAB­BAGE WRAPS.

DAY 8 AV­O­CADO WITH BOILED EGG AND BEEF STEW.

DAY 11 OMELETTE, CHICKEN LIVER PÂTÉ ON ZUC­CHINI BITS AND OF­FAL.

DAY 14 AV­O­CADO, EGG AND MAYO ON ZUC­CHINI SLICES AND CHICKEN,TZATZIKI AND FRIED ZUC­CHINI.

DAY 13 FRIT­TATA SLICES, BRAAI­IED CHICKEN

ON ZUC­CHINI TAGLI­ATELLE AND HOME-MADE

YO­GHURT.

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