19Sep
Anxiety and dehydration
Rowinda DimechAdult

Anxiety and Dehydration

What is anxiety?

Can dehydration be caused by anxiety or vice versa?

What is the link between anxiety and dehydration?

 

Anxiety is a natural response to stress. Normal levels of stress are beneficial for our overall health as this drives you to perform better tasks. However, when the levels of stress reach a high level this may lead to chronic anxiety. Anxiety hits everyone from time to time, for example starting a new job, taking a test, giving a speech or moving to a new place are all normal situations where anxiety kicks in. This ordinary type of anxiety is a feeling that comes and goes and it doesn’t effect you negatively in your life.

On the other hand, if this type of feeling lasts for at least 6 months or more you might have an anxiety disorder. People suffering from anxiety disorders experience an intense feeling of fear all the time. Sometimes this can be debilitating which leads you to stop doing chores or things you enjoy. The American Psychiatric Association reports that women are more likely to suffer from anxiety disorders than men. There are various types of anxiety:

  • Panic disorder
  • Phobia
  • Social anxiety disorder
  • Obsessive-compulsive disorder
  • Separation anxiety
  • Illness anxiety disorder

In addition, there are various mental health illnesses and medical conditions that feature anxiety as part of their symptoms. Some of which are:

  • Post-traumatic stress disorder (PTSD)
  • Depressive disorders
  • Obsessive compulsive disorder (OCD)
  • Personality disorders
  • Chronic diseases such as chronic obstructive pulmonary disease (COPD)
  • Inflammatory conditions such as arthritis
  • Substance use disorders
  • Chronic pain such as fibromyalgia

What causes chronic anxiety?

Chronic anxiety is an anxiety disorder which alters how you think, feel and even act. The cause of anxiety is not the same for everyone. And unfortunately it is not something that goes away easily. Some common causes of chronic anxiety are:

  • Stress
  • Heat
  • Dehydration
  • Emotional trauma
  • Financial concerns
  • Chronic medical conditions
  • Substance or drug abuse
  • Genetics

Dehydration

This blog is about anxiety in relation to dehydration. So now we’re having a look at dehydration before we go in detail about their association together. Dehydration is when your body loses water more than you drink. Common causes for dehydration are excessive sweating, vomiting and diarrhea. In this period of time, dehydration is quite common due to this temperature and heatwaves. There are various signs and symptoms for dehydration. These are:

  • Fatigue
  • Dry mouth
  • Increased thirst
  • Little urination
  • Dry skin
  • Constipation
  • Dizziness
  • Headache
  • Low blood pressure
  • Rapid heart rate
  • Rapid breathing

Dehydration is important to be treated as it can lead to life-threatening complications such as heat exhaustion, heatstroke, seizures, kidney failure and coma.

The link between anxiety and dehydration

In my profession, I encounter people who drinks about 4-5 L per day. This is simply too much water and overhydration simply overload your kidneys to work harder. The strange thing is that these clients experience true sensations of thirst, so the question is this – are you thirsty because your body really needs that large amount of fluids or is it a symptom of anxiety?

Excessive thirst could be a symptom of anxiety due to a lot of factors. Some of these are:

  1. Dry mouth

Anxiety may cause a dry mouth which will give the same sensation of thirst. This can happen as anxiety removes fluids from the mouth to send them to the stomach to produce more acid. Therefore, this mechanism can make you feel thirsty when you’re not.

 

  1. Excessive Urination

During periods of anxiety you may tend to urinate more frequently throughout the day. Therefore, this will cause water loss from your body. The increasing fluid requirements will cause you to feel thirsty.

 

  1. Excessive sweating

Anxiety can cause you to sweat a lot both during the day and the night.

 

  1. Breathing through your mouth

Anxiety may cause mouth breathing unknowingly. This will cause a dry mouth which in turn gives you a feeling of thirst.

On the other hand, if you are dehydrated this also gives a feeling of anxiety. This is because when you are dehydrated you may experience the same symptoms one feels with anxiety. Some of these symptoms common for dehydration and anxiety are:

  • Dizziness
  • Headaches/ migraines
  • Muscle fatigue
  • Weakness
  • Increased heart rate

Since, anxiety and dehydration gives the same symptoms it can leave you confused which is which. Therefore, it is important to be mindful and be aware of your diet and stress levels. As a dietitian, I would recommend that if you experience any symptoms of the common symptoms mentioned above first thing to do is to drink a glass of water. If after a few minutes you start to feel better than it is dehydration. If, your symptoms persists it is probable that you are experiencing anxiety symptoms. Anxiety symptoms can be soothed by breathing techniques, use of lavender, some relaxing music and diet.

Diet play an important role to control your anxiety. Start by being mindful of what you are eating. Try to include fruit and vegetables. Make sure that you are eating and drinking enough throughout the day. In addition, some specific foods which may help are chamomile and oily fish. Also, it would be ideal if you stay away from coffee, soft drinks and alcohol for a while as these may increase your anxiety symptoms. If, you are unsure about the best diet for anxiety please speak to a dietitian.

If, you would like to receive more nutrition information and recipes please subscribe to our website. In addition, if you would like more healthy recipes with low calorific intake I encourage you to order our recipe book. Let me know what you think in the comments below.

30Aug
Watermelon Tequila
Rowinda DimechAdult, Recipes

Watermelon Tequila

Would you like a refreshing dessert?

Or maybe a dessert idea for when you host a party at your home?

Watermelon Tequila

 

Watermelon – one of my favorite summer fruits. You can have it as a healthy snack or dessert. Watermelon is low in sugars and fats. It is rich in vitamin C, potassium and magnesium which helps you boost your immune system for optimum health and wellness. The nutrition information of watermelon per 100g:

 

Per 100g
Carbohydrates 8g
Of which sugars 6g
Fibre 0.4g
Proteins 0.6g
Fats 0g

 

Today, I decided to give this fruit a twist for when you host a home party. In my opinion, I think that this is ideal to serve as a finger food. Or as a dessert at home when you have no guests at all, simply for you and your loved one. I remind you, that if you have young children it is important to put it in a safe place out of their reach. It will look exactly like a normal watermelon slice. So, be careful you don’t want to find your child drunk unexpectedly.

Here is the watermelon tequila recipe I prepared for you!

Serves 6 people

Prep time: 20 minutes

Chill time: 40 mins

Total time: 60 minutes

İngredients

  • 250g white sugar
  • 200 ml water
  • 120 ml tequila
  • 50 ml triple sec
  • Watermelon
  • Mint

Method

  • Add the sugar and water together in a saucepan and boil. Keep stirring the mixture until all the sugar dissolves.
  • Let the mixture cool a bit and add the tequila and triple sec.
  • Refrigerate the tequila syrup.
  • While the tequila syrup is cooling down, cut the watermelon into 12 slices about 2 cm thick.
  • Pour the syrup on the watermelon and refrigerate for about 40 minutes.
  • Remove the watermelon from the syrup and place them on a platter.
  • Garnish with some mint and serve.

Let me know what you think of this recipe in the comments below. If, you would like to receive more free recipes please subscribe to our website. In addition, if you would like more recipes like this one I encourage you to order our recipe book. It contains 50 healthy, low calorie recipes all with nutrition information inside.

15Aug
Diet Myths
Rowinda DimechAdult, Health

Diet Myths

What are the most popular diet beliefs for weight loss?

Are these beliefs true or just myths?

In this blog we go in detail about some popular diet myths.

 

Written by Ms Dilara Kamisli; Updated by Ms Rowinda Dimech

 

As a dietitian I continuously hear diet myths from people all around me – family, friends, colleagues and clients. In my opinion diet myths are dangerous beliefs as they impact your quality of life, especially your psychological and emotional well being. This is why in this blog we are going in detail about some of the most common diet myths.

 

 Myth #1 CONSUMING BREAD MAKES YOU GAIN WEIGHT

 

The myth that bread cannot be eaten on a regular basis in your diet is a myth! Unfortunately, I believe that this myth has always been preached. We, dietitians, have been hearing a lot of people saying ”I don’t consume bread” based on this believe. Research shows that bread is one of the best carbohydrate resources that needs to be part of our daily food intake. Bread helps you not to get hungry so quickly. This is because bread is a complex carbohydrate. Therefore, one of the most important things about consuming the bread is the portion size of bread you are eating, rather than totally eliminate it from your diet. In addition, if you suffer from diabetes, it would be ideal if you consume wholemeal bread instead of white bread. Wholemeal bread bread will help you control your blood glucose levels and calorie intake since it is rich in dietary fiber.

 

Myth #2 FAT BURNING MIRACLE FOOD

 

Flavored water, vinegar, pills, branded smoothies, etc. Unfortunately, people always expect to lose weight (which they gained in a long period of time) fast by consuming these kind of products. Actually, it sounds very tempting: “weight loss in a short period of time” but what about the consequences. What does these miracle foods do to your body? What is the long-term effect? Is it possible that a fast weight can really be  lost?

 

We, healthcare professionals often hear, ‘’I’m drinking  lemon water,  green tea , herbal  teas,  etc and I am lost 10 Kg in 2 weeks.’’ To start explaining this think about it this way: if weight loss can be done with any tea, pills or any food product, there would be no such problems with ‘obesity’ in this world. So, now let’s explain it more scientifically. Rapid weight loss will occur due to huge calorie deficit in your diet. This will be much less than the minimum calories/energy your body needs. This will result in muscle loss rather than fat loss. Therefore, it is important to lose weight slowly over time so that it doesn’t alter your metabolism. And as I always emphasize in my blogs, there is no food that will  make you gain or lose weight. It all depends on the portion sizes consumed throughout the day.

 

Myth #3 THİNKİNG THAT YOU WİLL LOSE WEİGHT BY STARVİNG

 

I don’t eat anything all day long, I eat very little, why can’t I still lose weight? You might think that the less you eat the more weight loss you will achieve. Actually when we skip meals, this leads to a slower metabolism. In fact, when you try to lose weight in this way, muscle loss will occur and hence the slower metabolism, leading to malnutrition. Since a diet like this is not sustainable for a long period of time you will quit the diet. So when this happens and you start having a normal diet again you will end up gaining weight faster due to a slower metabolism.

 

Myth #4 CONSUMİNG HEALTHY FOODS WİTHOUT LİMİTS (SUPERFOODS)

 

There is this believe in today’s society that ‘‘I can consume as much as I want if it is healthy’’. There is nothing that can be eaten in an unlimited amount in nutrition and any excess food you eat will be stored as fat in the body. Therefore, it is important to eat a healthy diet by having an adequate and balanced diet.

 

Myth #5 COMPARISON OF SOMEONE ELSE’S DİET AND POPULAR FAD DİETS

 

It is of utmost importance that nutrition is individualized. This is because diet varies according to gender, weight, height, age, level of physical activity, hormonal problems, lifestyle and eating habits and medical conditions such as diabetes, Irritable bowel disease, Irritable bowel syndrome and other metabolic syndrome. The  only reason you should want to lose weight is to be healthier and improve your quality of life.

 

İn today’s web one finds a lot of myths about food and diet. The truth is that all type of food contains a certain amount of calories. Calories are used by the body in the same way since all our physiology and metabolic pathways work the same since we are all human beings. Therefore, I would advise that if you would like to lose weight and not sure what to follow as a diet, it is best to leave it in the hands of a dietitian. If, you would to seek professional advise kindly contact us. İn addition, please subscribe to our website for more nutrition information and free recipes.

 

 

08Aug
iron deficiency anemia
Rowinda DimechAdult, Children

Iron deficiency anemia

Do you feel continuously tired and week?

Have you noticed any changes in your child such as irritability or fussy eating?

We’ll take a look at iron-deficiency anemia and how we can treat it by diet.

What is anemia?

Anemia is a worldwide health problem affecting both developed and developing countries. Anemia can occur at all stages of life. It can present during pregnancy, infancy, toddlers, children, adolescence, adulthood and elderly age. According to the WHO statistics, anemia affects about 42% of children and 40% of pregnant women. There are different types of anemia which are aplastic anemia, megaloblastic anemia, sickle cell anemia, spherocytosis and iron-deficiency anemia. In this blog we are going to focus on iron-deficiency anemia as it’s the one which can be caused by lack of iron in our diet, leading to malnutrition.

Symptoms

There are various symptoms of iron-deficiency anemia. Some individuals may experience a few or a lot of symptoms whereas some may have no symptoms at all. The symptoms of iron-deficiency anemia are:

  • Fatigue
  • Weakness
  • Dizziness
  • Nausea
  • Lack of appetite
  • Pale skin
  • Poor immune function
  • Rapid or irregular heartbeat
  • Shortness of breath
  • Cold hands and feet

In addition to the above symptoms children may also experience symptoms such as:

  • Irritability
  • Fussy eating
  • Tongue enlargement
  • Enlarged spleen
  • Pica

Iron-deficiency anemia is important to be treated as its symptoms can lead to serious health complications. Some of which are interfering with normal daily activities and chores, heart failure and developmental delay in children.

Iron- deficiency anemia and diet

Iron-deficiency anemia can be treated by diet. The below is a list of food and their iron content. The food marked with orange shows that the food is rich in iron. So, if you or your child suffers from iron-deficiency anemia make sure that you include plenty of the listed below in your diet.

 

  Source of food Per 100g (mg)
Vegetables and fruit Spinach 2.0
Tomato puree 2.0
Dried apricots 2.5
Gains products Oatmeal 3.0
Dry cereal 12.0
Pasta and egg noodles 1.0
Meat Alternatives Tofu 5.0
Soybeans 3.5
Lentils 2.0
Beans 1.5 – 3.0
Pumpkin seeds 2.5 – 7.5
Peas 0.5 – 1.5
Sausages, meatballs, fish sticks 1.7 – 3.2
Canned baked beans 1.5
Nuts 2.4 – 4.0

 

    (75g portion)
Meat Duck 1.8 – 7.4
Venison 2.5 – 3.8
Beef 1.4 – 3.3
Lamb 1.3 – 2.1
Chicken 0.4 -2.0
Turkey 0.3 – 0.8
Liver 4.9
Fish and seafood Octopus 7.2
Oysters 3.3 – 9.0
Shrimp, scallops, crab 2.2
Canned sardines 1.7 – 2.2
Canned clams 2.0
Mackerel, trout, bass 1.4 – 1.7
Canned tuna in water 1.2

The daily recommendation for iron in adults is 8.7 mg in men and 14.5 mg in women. The daily requirements of iron in children are: 7 mg from 1 to 3 years, 10 mg from 4 to 8 years, 8 mg from 9 to 13 years and 11-15 mg from 14 to 18 years. Here, I added some recipes which are rich in iron:

Conclusion

It is important to include iron in your diet in a balance way. This is because if iron exceeds 20 mg per day it may cause constipation and gastro problems both in adults and children. In certain cases, especially in women with a heavy menstrual period it is difficult to treat iron-deficiency anemia with diet only. Therefore, iron supplements can be prescribed along with a healthy balanced diet.

If, you or your child suffers from iron-deficiency anemia and would like a proper meal plan please do not hesitate to contact us. If, you would like to receive more nutrition information and recipes please subscribe to our website. In addition, if you would like more healthy recipes with low calorific intake I encourage you to order our recipe book. It contains 50 healthy, low calorie recipes all with nutrition information inside. Let me know what you think in the comments below.

25Jul
Stress and weight gain
Rowinda DimechAdult

Stress and Weight gain

Is there an association between stress and weight gain?

Is cortisol, a by product of stress, responsible for weight gain?

Let’s see what the scientific evidence is!

 

Stress

 

Stress is defined as any type of change that causes physical, emotional or psychological tension in your body. In everyday life, everyone experiences stress which can be short term or long term. A certain level of stress on a daily basis its ok but a higher level of stress for a long period of time might have a health impact on your body. Some of the common signs and symptoms for prolonged stress are:

  • Mood swings
  • Gastrointestinal disorders
  • Sleeping problems
  • Headaches
  • Frequent colds
  • Feeling tired & low energy
  • Muscle tension, especially the neck and shoulders
  • Increased heartbeat
  • Decreased sex drive
  • Anxiety and depression

It is important to understand how stress is affecting your physical and mental health. However, it is also important to recognize how your mental health might be affecting your stress level. In fact, studies show that psychosocial stress was associated with greater weight gain both in men and women. During long periods of stress the cortisol level increases which are associated with abdominal obesity.

What is cortisol?

 

Cortisol is a stress hormone produced by the body when the brain perceive a stimulus of the thread. This leads to a fight or flight response which immediately produce a high heart rate and increase energy requirements. As soon as this happens our body will stop insulin production so that it prevents any available glucose from being stored. In addition, high cortisol levels will be produced in order to use the available glucose and glycogen stores for energy.

 

Ways on how cortisol induce weight gain

 

  1. Increased appetite

The above mentioned available glucose during prolonged stress periods increases the appetite for high calorific foods. In fact, this studyshows that women eat more calories and sweets when they are exposed to stress.

 

  1. Increased hunger

When we eat, our body produces insulin which helps the glucose from food to be used by our cells. However, during prolonged stress levels the body’s metabolic pathways changes with the result that not enough insulin is produced. In turn this will lead to high glucose levels in the blood. Since the body cells will not be able to use the available glucose, they will continue signaling the need for food to the brain. Therefore, your body will keep telling you that you are hungry.

 

  1. Increased belly fat

Abdominal fat has more cortisol receptors and therefore this hormone is able to transport and store more fat in this area. Evidence also shows that people who are under stress burn less calories than non-stressed individuals. This means that due to high cortisol levels our body is able to metabolize fat at a slower rate.

 

How to manage stress levels and diet

 

Although some situations of stressful situations are inevitable we can try to manage it. Here are some strategies for maintaining your stress levels under your control:

  1. Exercise

As everybody knows exercise is beneficial for weight loss, proper immune system function, mental health, feeling energized and promotes better sleep. During exercise the feel good hormones are produced in our body, known as endorphins. These help to reduce stress. According to the WHO , we should opt for 30 minutes of exercise every day. With that said I would suggest that it is best to aim for a low – moderate intensity exercise beacuse high intensity levels of exercise can increase cortisol levels.

 

  1. Meditation

Meditation is a mind and body practice with a known history of increasing calmness, physical relaxation, mental health, reduces stress and enhance your overall wellbeing. Therefore, as meditation helps you to calm down it decrease your cortisol levels and will also help you to improve your sleep quality.

 

  1. Enough sleep

Sleep is important for a person’s health and wellbeing as its process affects your physical and mental function. It also affects good immunity performance and how our metabolism work. If you are not sleeping enough this will increase your cortisol levels and increase cravings for sugary foods.

 

  1. Good diet

A healthy well balanced diet is essential to keep our gut happy. By now, evidence show that our gut is our ‘second brain.’ In fact, the gut produces 90% of serotonin, a hormone which is responsible for feeling positive and cheerful. In addition, a well-balanced diet including plenty of fruit, vegetables and omega-3 promotes reduction of cortisol production and therefore stress relief.

Conclusion

As it can be concluded, it is important that if you want to lose weight you keep your stress levels in check. Apart for losing weight for aesthetics reasons, managing high stress levels are also important to prevent health complications. If you follow the strategies advised for managing stress is not enough please consult a doctor or a healthcare professional.

 

05May
Food labels - how to read them
Rowinda DimechAdult

Food Labels – what you need to know

What are food labels?

Food labels are important information found on each food product as these also provide instructions to consumers. In addition, from the manufacturer’s side a food label is important as it helps his product to stand out. In fact, 85% of consumers reports that their decision to buy a food product depends on the information found on the food product. This information helps you make informed choices when buying foods for you and your family. A food label will contain information such as:

  1. The food product

All food labels must have the name of the product. I think this is the obvious information as you cannot but a product not knowing what’s inside it. In addition, you cannot buy a packet saying that it contains biscuits and then when you open it you find pasta! This is a guarantee that the product is what we think it is.

 

  1. Manufacturer’s details

These details include where the product was made. This information is important so that if you have a complaint you can contact the manufacturer directly. In addition, this information is extremely important for people suffering from any food allergies or diet related conditions. In certain cases, the food label won’t be clear enough for example a person suffering from coeliac disease may be extremely sensitive to gluten and the normal threshold will still make that person ill. Therefore, the manufacturer needs to be contacted to clarify the exact content of gluten in the product.

  1. Nutrition information

In this section, we find product-specific information such as the serving size, amount of calories and nutrient information at the main or top section. At the bottom section, there is the % daily values and the number of calories used for general nutrition advice. These are highlighted in the nutrition label below.

  1. Ingredients

On all food labels the ingredients of the food product must be listed according to quantity. So, the first ingredient in the ingredient list is the most abundant while the last ingredient listed is the least abundant. In addition, the allergens must be highlighted bold in this section for example milk, nuts and fish.

  1. Expiry date

Each product has a different shelf-life which would have been determined by a set of experiments in the laboratory. This is important for HACCP and food safety. In other words, it is important for the consumer to consume food which is safe and of good quality. A product can have either ‘use by’ or ‘best before.’ What is the difference?

The phrase ‘use by’ means that the food product must be consumed till that date. If, the product is consumed after that date it is probable that it will make you feel sick due to bacterial growth and other pathogens. These type of products are usually milk and dairy products.

On the other hand, the ‘best before’ means that the quality of the product is at its best before that date. If, you consume that product after that date it will not make you sick but it would have changed its taste or crispiness for example crisps.

Read More
04Apr
Artificial sweeteners nutrition dietitian
Rowinda DimechAdult, Health

Artificial Sweeteners

Are artificial sweeteners beneficial or harmful to our health?

Are artificial sweeteners really effective in reducing blood sugar levels in diabetics?

If so, at what cost?

 

What are artificial sweeteners?

Artificial sweeteners offer a sweet taste without any calories. There are different types of sweeteners such as saccharin, acesulfame, aspartame, noetame and sucralose which are approved for consumption by the U.S. Food and Drug Administration (FDA). In order for the approval of these sweeteners in the food supply chain there has been a comprehensive safety assessments and experiments.

In addition, the American Heart Association (AHA) and American Diabetes Association (ADA) also agreed with the use of artificial sweeteners to replace white sugar. The reason behind this is that since sweeteners do not contain any calories they can reduce overweight, obesity and the risk of metabolic syndrome. Metabolic syndrome refer to a group of metabolic disease such as diabetes, cardiovascular, kidney and liver diseases. But, is there a cost?

Effects on health

It is argued that since sweeteners are calorie free these can be a way of calorie and carbohydrate control. It is known that overweight and obesity is mainly caused by high calorie intake from overeating. Therefore, by adding sweeteners to food instead of sugar they help reduce obesity, diabetes and tooth decay.

On the other hand, there is a positive correlation between sweetener consumption and obesity. Till now there isn’t a reason for this but it could be psychologically. A person consuming sweeteners may think “these are diet biscuits so it’s all right to eat as much as I want.” In fact, I encounter this type of thinking frequently in my profession and usually leads the person eating a whole packet of biscuits. This will result in an enormous amount of calories being ingested at one go and therefore contribute to obesity instead the other way round.

Another drawback of sweeteners is that they are much sweeter in taste than white sugar. Therefore, people who use sweeteners on a regular basis may have changes in their taste buds. They may start to find naturally sweet food such as strawberries, sour meaning unpalatable. This may also suggests that sweeteners may have a tendency to be addictive for an individual too.

 

Sweeteners and health impact

 

Sweeteners are not metabolized by our body like the other foods we eat. It is known that sweeteners are digested by our intestinal bacteria. Therefore, these may have an effect on our gut health. A study shows that individuals who consumes sweeteners on a daily basis have higher body mass index (BMI), blood pressure and blood glucose levels. In addition, people who did not usually consume sweeteners were given 5 mg/Kg/day which resulted in half of them developing poorer glycemic control meaning high blood glucose levels. This type of research is still in the early stages and further research and studies are required for evidence based data.

One of the sweeteners known as aspartame contains phenylalanine. This is an amino acid which must be avoided by people who suffer from Phenylketonuria (PKU). PKU is a rare condition where the amino acid phenylalanine is unable to be metabolized by the body. When aspartame is one of the ingredients it must be labelled ‘contains aspartame (a source of phenylalanine).’ So, it is important that if you suffer from PKU you check all the food labels properly.

Conclusion

As you can see from the information above sweeteners can be both beneficial and harmful to health. If, you have a normal weight I suggest that you don’t consume sweeteners or food containing sweeteners. On the other hand, if you are trying to lose weight I would suggest the use of sweeteners with caution. In other words, the use of sweeteners should be limited as much as possible. When it comes to food there are always plenty of options to choose from so I suggest to choose wisely. I will end this blog by an answer from an obesity and weight-loss specialist at Harvard-affiliated Boston Children’s Hospital. When he was asked about sweeteners his answer was:

“Sugar-containing foods in their natural form, whole fruit, for example, tend to be highly nutritious—nutrient-dense, high in fiber, and low in glycemic load.

On the other hand, refined, concentrated sugar consumed in large amounts rapidly increases blood glucose and insulin levels, increases triglycerides, inflammatory mediators and oxygen radicals, and with them, the risk for diabetes, cardiovascular disease and other chronic illnesses.”

 

09Feb
Bulimia Nervosa
Rowinda DimechAdult, Children, Diets, Health

Eating Disorders – Bulimia Nervosa

Do you feel out of control around food?

Do you tend to go out of bed to binge during the night?

Do you feel uncomfortable in your body size and lack of self confidence?

 

This month we’ll continue to have a look at Eating disorders. The first blog was on anorexia nervosa and today we shall focus on bulimia nervosa. Eating disorders are affecting a lot of people worldwide. In fact, it’s are on the rise as we are living in an era where everyone became conscience about food and what they are eating. There are three main eating disorders which are anorexia nervosa, bulimia nervosa and binge eating disorders. Bulimia nervosa is especially common among adolescents and women. Boys and men tend to suffer less but unfortunately it is also on the increase.

What is the bulimia nervosa?

Bulimia nervosa is a type of eating disorder, potentially life-threatening if not taken care of. A person suffering from bulimia nervosa has binge eating episodes. A binge is when a person over-eats massive amount of food in a short period of time, usually 1 or 2 hours. Then, fear and anxiety drive the person to restrict his diet in order to prevent weight gain. In addition, a person with bulimia nervosa may resort to self-induced vomiting after eating, perform excessive exercise and use diuretics or laxatives in order to sooth his anxiety.

There are some official diagnostic criteria for bulimia nervosa, in Diagnostic and Statistical Manual of Mental Disorders V (DSM-5). These are as following:

  • Consuming an amount of food that is definitely larger than most people would eat within an 1 hour and usually in hiding
  • A sense of losing control over eating during the binge episode
  • Remittent unbecoming compensatory behaviour in order to prevent weight gain, such as vomiting, laxatives or diuretics, restricting food or excessive exercise
  • Bingeing and purging both occur, averagely, at least once a week in three months’ time period
  • Self-esteem is overly affected by physique

Unfortunately, the cause of eating disorders is still unknown but there is strong evidence that it may be caused by various factors such as family history, personality traits and environmental factors. In fact, it is well known that a person may be more prone to develop bulimia when:

  • Family members are obese or have an eating disorder.
  • Have a perfectionistic personality trait.
  • You have a job or do a sport that emphasizes body size, such as bodybuilding, modelling, ballet, swimming or gymnastics.
  • Continuously dieting or exercising in order to lose weight or change your physique.
  • Have a distorted body image or think that your body should be looking like someone else’s body.

 

Signs and Symptoms

 

Someone who suffer from bulimia nervosa may have appropriate weight for his height and age. Unfortunately, the person may still perceive himself as being too heavy and therefore wants to lose weight. Patients suffering from bulimia often display the following symptoms:

 

  • Being obsessed with body shape and weight
  • Bingeing and feeling a lack of control or inability to stop eating
  • Compulsively and excessive exercising
  • Using laxatives or diuretics
  • Self induced vomit after eating
  • Restricting calories, fasting or avoiding certain foods for periods of time

Treatment should be comprehensive and include several types of therapy. The most effective way to treat bulimia is to get a team approach which includes a doctor specialized in mental health, registered dietitian and even your relatives. There are several treatment options which are recommended which are psychotherapy, medications such as fluoxetine and nutritional management.

 

Nutrition management

 

Individuals suffering from bulimia nervosa have the tendency to be rigid, controlling, obsessive-compulsive, impulsive and extreme perfectionist. By extension they should be discouraged from sticking to rigid meal plans and rigorous exercise routines. It should be emphasized to make the meals regular and maintain satiety throughout the day to stop binging. This can be accomplished through composing a healthy, well-balanced and flexible eating plan.

Many patients may request weight-reduction meal plan, which is not recommended as further restrictions may be triggering the disease. It can contribute to the onset of binge-purge cycle. Diet should consist of breakfast, 2 main courses and 2 – 3 snacks throughout the day. The meal plan should have clear and planned structure. Patients should be thought to eat their meals regardless of feeling hunger and not to skip the meals.

 

Eating disorders such as bulimia nervosa are serious conditions which should be dealt holistically in a professional way from specialised healthcare professionals in this topic. If you think you might have this condition seek professional help immediately. If, you are concerned about your child or a friend that might be suffering from bulimia nervosa encourage them to seek help.

07Jan
Anorexia Nervosa dietitian nutritionist Malta
Rowinda DimechAdult, Children, Diets, Health

Eating Disorders – Anorexia Nervosa

Are you or your child experiencing intense fear near food?

Has eating become stressful?

Is diet hindering you from going out to meals with your friends or loved ones?

 

If, you answered one of these questions, yes, I encourage you to read this blog. This blog is dedicated to all those women and adolescents who are suffering in silence due to an eating disorder. This subject has become very special for me after 3 years working with clients suffering from this illness.

 

What are eating disorders?

Eating disorders are serious mental health illness associated with a person’s eating behaviors. This involves obsessive thinking about weight and food. This obsessive thinking may lead to the most common types of eating disorders which are anorexia nervosa, bulimia nervosa and binge eating disorders.

These conditions can have consequences such as medical issues, anxiety, depression, suicidal thoughts, growth and development problems in children. It is known that every 62 minutes a person dies from an eating disorder.

 

What is anorexia nervosa?

Anorexia nervosa is a type of eating disorder. It’s characterized by an intense fear of gaining weight and distorted perception of body image. People suffering from anorexia nervosa try to maintain their weight at the lowest possible point, by reducing food intake and/or exercising a lot. These actions contribute to a starvation mode in the body which can lead to serious medical conditions, as mentioned above.

According to the diagnostic criteria from Diagnostic and Statistical Manual of Mental Disorders (DSM-V) are as follows:

  1. Restriction of energy intake relative to requirement, leading to a significantly low body weight
  2. Fear of gaining weight, becoming fat or persistent behaviour that interferes with weight gain, despite significant low weight.
  3. Disturbance in a way in which a person perceive his body weight and shape or persistent lack of recognition of the current low body weight.

 

What is the cause of anorexia nervosa?

 

The exact cause of anorexia is not known. People diagnosed with anorexia may have a bad body image and have the drive to be focused on being, ‘perfect’. They may also have the tendency to look for ways to control their lives. Unfortunately, the onset of anorexia is a combination of biology, psychology and environment aspects.

Even though it’s not yet clear which genes are responsible, there may be genetic sequences in the DNA that make some people more prone to develop anorexia nervosa. Many individuals may have a genetic tendency toward perfectionism, sensitivity and perseverance which are all features associated with this illness. On the other hand, some patients diagnosed with anorexia may have obsessive-compulsive personality features which helps to stick with such strict and restrictive diets and deny eating despite the feeling of hunger. Unfortunately, the environment also plays a role. Nowadays there is the trend to emphasize and promote thinness. Triumph and self-esteem are often equated with being thin. False body images from media like television or print media can significantly influence young people, especially teenage girls and promote the desire for thinness.

 

Symptoms and signs

 

The primary sign is apparent weight loss or very low body weight. It should be emphasized that not everyone will demonstrate the same symptoms. Appropriate early diagnosis and immediate treatment increase the chance of a positive outcome as severe malnutrition may lead to numerous physical signs and symptoms such as the following:

 

  • Extreme weight loss
  • Noticeable thinness
  • Cold intolerance
  • Low body temperature with cold limbs
  • Irregular heart rhythm
  • Fragile hair and nails
  • Amenorrhea
  • Abdominal pain and constipation
  • Dizziness or fatigue
  • Facial hair

 

Tips for anorexia nervosa

As a registered dietitian working with clients suffering from anorexia nervosa and specializing in mental health, I have a few tips that you or your child can try. Here we go:

  • Set a structured meal plan throughout the day
  • Plan your meals ahead
  • Think quality instead of quantity
  •  No food discrimination
  • Keep a food diary

If you are a parent or know someone with anorexia nervosa you can still help him out. Let’s see the do’s and don’ts.

DOs

  • Do speak and ask the person how they are feeling
  • Do encourage them to seek help from a doctor
  • Do be available for them

DON’Ts

  • Don’t discuss the subject  of food and eating around that person
  • Don’t mention anything about the way they look – not positive neither negative
  • Don’t try to insult and shame the person for his/her new eating habits

 

Anorexia nervosa is quite a challenging illness and requires professional help. If you think that you might be suffering from this illness seek help immediately. On the other hand, if you notice that your own child or friend is suffering from this disorder speak to them immediately and offer help. The early, the better. If you have any queries please contact us.

15Dec
Inflammatory bowel disease IBD
Rowinda DimechAdult, Children, Diets, Health

Inflammatory Bowel Disease

Do you feel bloating and gastro intestinal discomfort? 

Does your diet affect these symptoms?

Do you suffer from an intestinal disorders?

 

Intestinal disorders

Intestinal disorders are becoming more common worldwide such as irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) both in adults and children. The most common factors which may affect these conditions are stress, viral infections, alcohol consumption and poor diet. IBS might be mixed with inflammatory bowel disease, IBD, as they show quite the same type of symptoms. It is important to note that IBS is different from IBD as IBD includes chronic diseases such as Chron’s and Ulcerative Colitis.

 

What is Inflammatory bowel disease?

IBD refers to a group of bowel diseases mainly Crohn’s disease and Ulcerative colitis that cause inflammation in the various areas of the digestive tract. The cause of IBD remains unknown. It is believed that diet and stress aggravate the symptoms but are not the cause therefore it is more likely that genetics and malfunctioning of the immune system is the cause of IBD.

Crohn’s Disease

Crohn’s disease causes inflammation of the digestive tract which can be from the mouth to the anus. Usually, the inflammation part appears in patches next to other healthy tissues. This leads to various symptoms including abdominal pain, diarrhea, fatigue, reduced appetite, weight loss, malnutrition and blood in your stools according to where the inflammatory patch is in your digestive tract. Other signs and symptoms which are not so common are inflammation of the skin, eyes and joints, kidney stones, anemia, and delayed growth and sexual development in children. Crohn’s symptoms also overlaps with diverticulitis. It is also believed that Crohn’s is a secondary reaction of diverticulitis, although more research is still needed.

Ulcerative Colitis (UC)

On the other hand, UC contributes to ulcer formation in the tissues of your digestive tract mainly the large intestines, rectum, and anus. In UC the damaged areas are continuous so if the inflammation starts in the large intestine it continues till the anus. The symptoms are quite similar to Crohn’s disease. These include abdominal pain, fatigue, diarrhea, blood in stools and weight loss. Symptoms usually develop over time and sometimes can be life- threatening.

Inflammatory bowel disease complications

IBD can lead to severe consequences such as malnutrition, colon cancer and blood clots if left untreated and can become life-threatening. Unfortunately, there is no cure for IBD but current medication such as corticosteroids along with diet changes can greatly reduce the symptoms of the disease. Severe IBD may require surgical procedures to remove the damaged parts of the gastrointestinal tract. There are different surgical procedures for Crohn’s and Ulcerative colitis since they affect different parts of the gastrointestinal tract.

IBD may take a long time to diagnose. It can be diagnosed by using a combination of procedures such as endoscopy for Crohn’s and colonoscopy for Ulcerative colitis. Your doctor may also check your stool samples in order to make sure that it is not caused by an infection. In such cases, antibiotics may be prescribed. In addition, probiotics may also be recommended as they can improve symptoms although there is no concrete evidence about this till now.

Appropriate diet

Fortunately, both Crohn’s and Ulcerative Colitis can be improved by adopting the right type of diet. There are various diets which are recommended such as low FODMAP diet, Plant based diet, High fiber diet, Low residue diet, lactose- free diet and gluten-free diet. The recommended diet would be chosen based on the symptoms being experienced by the individual.

As you can see from this blog and other blogs on gastroenterology, there are various intestinal disorders. It is important that if you or your child suspects of any intestinal disorders you contact your doctor and a registered dietitian. In all intestinal disorders, food plays a role in improving symptoms and quality of life!

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