Dr Brighton Chireka
We have recently had articles linking it to diabetes and many people are now wondering if isitshwala/sadza is bad for them. I have been asked on several occasions by concerned people. They want to know if isitshwala is bad for them. Does isitshwala cause diabetes? Should we stop eating it? Before I start to answer these questions let us look at isitshwala and define it.
What is isitshwala/sadza?
Isitshwala in isiNdebele or sadza in Shona is a cooked mealie-meal that is the staple food in Zimbabwe and other parts of Southern Africa. isitshwala in appearance is a thickened porridge and is commonly made with white maize (mealie-meal). This mealie-meal is referred to as impuphu/hupfu in IsiNdebele and Shona respectively. Despite the fact that maize is actually an imported food crop to Zimbabwe, it has become the chief source of carbohydrate and the most popular meal for most of us. Before the introduction of maize, isitshwala was made from finger millet flour which is zviyo (Shona) or inyawuthi (IsiNdebele). Isitshwala is generally eaten using one’s hands without the aid of cutlery. It is rolled into a ball before being dipped into meat, sauce/gravy, sour milk or stewed vegetables to name just a few relishes.
What does sadza contain?
Isitshwala contains mainly carbohydrates and it is advised that it should make approximately one third of our diet.
What are carbohydrates?
Carbohydrates are sugars that break down inside the body to create glucose. Glucose is moved around the body in the blood and is the primary source of energy for the brain, muscles, and other essential cells. There are two main types of carbohydrates, simple and complex. The more refined the carbohydrate the more quickly it is converted to glucose and released into the bloodstream. This can cause peaks and troughs in blood sugar levels and results in variable energy levels — refined or simple carbohydrates should make up only about 10 percent of our daily carbohydrate intake.
Complex carbohydrates, such as those found in starchy foods such as isitshwala, potatoes, bread, rice, whole grains, pasta and oats release glucose more slowly into the bloodstream providing more stable and sustainable energy levels to the body.
Isitshwala also provides fibre which is essential for good digestion and elimination. However, all mealie- meal is not created equal. The more refined the mealie-meal, the more simple carbohydrates and less fibre it contains. The coarser the grain such as roller meal (umgaiwa) the better the fibre content and complex carbohydrates. Ideally we should be having our isitshwala made from sorghum/millet based meals or the less refined meali-meal (umgaiwa).
So is Isitshwala bad for us?
We need to remember that we are what we eat and do after that. There is a lot of misleading information about how bad carbohydrates are and our isitshwala is not spared as well. Weight control is about ensuring a balance between calories consumed (what we eat) and calories burnt (what we use). Too many calories (a huge portion of isitshwala) equal weight gain, too few calories (small portion of isitshwala) result in weight loss and just the right balance between what we eat and what we use equals weight maintenance.
It’s not only what we eat that matters most, it’s also what we do after eating. Our lifestyles promotes laziness as we are no longer walking or exercising. We are spending most of our time sitting and we hardly walk as we now drive everywhere. Just try to recall the time you spend sitting watching television or on social media chatting to friends. Another issue is that we are taking a lot of simple sugars unknowingly in our diets. We may have our portion of isitshwala but what we are eating in addition to this is very important. A lot of us do not drink water but juices and fizzy drinks. It may be shocking to know the amount of sugar in a can of a fizzy drink.
For example, fizzy drinks (like coke) contain 10.6g of sugar per 100ml — so that’s 35g in a 330ml can (equivalent of seven teaspoons) and 26.5g in a 250ml can (equivalent of 5 1/2 teaspoons).
We are recommended to take only 30g (six teaspoons) of added sugar per day. This means that we will have taken more than the recommended sugar if we just drink one can of coke a day. We have not looked at our breakfast, lunch and supper to find out the amount of added sugars we will be getting. The juices that we drink have added sugar and if we drink tea or coffee several cups daily and put sugar in these hot drinks then we are going over the top with our sugar intake. Let’s say for example one drinks four cups a day of hot drink and puts one teaspoon of sugar in each cup. This means that per day that person is taking four teaspoons of sugar and if that person drinks two cans of soft drinks then their intake of sugar per day becomes frightening.
Zimbo way of eating
So let’s look at ourselves in most urban areas at lunch time. We drive to places like Mereki (Harare) or eSibayeni in Matshobana (Bulawayo) for lunch and because we are still at work we decide to have soft drinks. Normally we have one can of Coke before having our isitshwala.
As already pointed out, isitshwala is cooked with refined mealie-meal which is simple carbohydrates that increase the already high blood sugar from the fizzy drink. We then down our isitshwala with another can or cans of a soft drink. We also hardly look at the portion of isitshwala that we take but we all know that it is a big portion.
We do not walk at all as we have our runners who buy meat and drinks for us while we enjoy music in our cars. We then go back to work with our tummies full of food and proceed into the lift to get to our respective offices. We are back to sitting at our desks and do some work.
We have hardly walked yet we have consumed lots of sugar. I deliberately left out alcoholic drinks but you can read about dangers of alcohol in my other article.
The large servings of isitshwala on the plate, the added caloric intakes from meat with the lack of adequate physical activity result in weight gain. This is especially true for those of us in the diaspora where meat is always available and often reasonably priced. The maize meal we use here is highly refined and has low fibre which is not good for our health. The weight gain sadly puts us at high risk of developing diabetes.
It’s not sadza/isitshwala that is bad for us, but it is the maize meal that we use, the size of portion and what we do after eating it as well as other sugary drinks that we end up taking. We must enjoy our sadza/isitshwala but we need to be fully informed on the healthy lifestyle.
We must remember that several risk factors have been associated with type 2 diabetes and these include: family history of diabetes, overweight, unhealthy diet, not exercising, increasing age as we get older, high blood pressure, certain ethnicity, history of diabetes in pregnancy called gestational diabetes and poor nutrition in pregnancy, all increases one’s chance of developing type 2 diabetes. Changes in diet (to western diet) and physical activity (no longer walking, now using cars) related to rapid development and urbanisation have led to sharp increases in the number of people developing diabetes. Addressing these factors will reduce our chances of developing this disease. As you can see it’s not the sadza as such but a lot of factors as outlined above, so we can enjoy our sadza and stay healthy.
Here is what you can do to cut down on sugar and stay healthy.
These tips may help you cut down on sugar:
* instead of sugary, fizzy drinks and juice drinks, go for water or unsweetened fruit juice (remember to dilute fruit juices for children to further reduce the sugar)
* if you take sugar in hot drinks or add it to cereal, gradually reduce the amount until you can cut it out altogether
* check nutrition labels to help you pick the foods with less added sugar, or go for the low-sugar version
* choose tins of fruit in juice, rather than syrup
* choose wholegrain breakfast cereals, but not those coated with sugar or honey.
* As a rule of thumb, vegetables should cover half your plate, meat a quarter of the plate and sadza/isitshwala the other quarter.
* If you make a relish which combines meat with vegetables, make sure that there are more vegetables than meat in your pot.
* Make your sadza/isitshwala using higher fiber, unrefined maize, sorghum or millet meals.
* Enjoy your traditional foods (including sadza) but remember that portions matter and exercising as well.
About the writer: Dr Brighton Chireka is a Zimbabwean General Practitioner and a Health Commissioner based in South Kent Coast in the United Kingdom. You can contact him at: firstname.lastname@example.org. You can read more of his work on his blog at DR CHIREKA’S BLOG.
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions.