SIBO – Small Intestinal Bacterial Overgrowth

Have you ever heard of SIBO?

Can SIBO be treated?

What to do in your diet if you suffer from SIBO?

Here’s what to do to elevate your symptoms!


SIBO! We don’t usually hear this word often but that doesn’t mean that it is rare. In fact, it is considered quite a common condition. Unfortunately, there are no reliable date on how many people are diagnosed with SIBO. In this blog, we are going to look across the latest researches to answer these questions and provide you with current, scientific data.

SIBO stands for Small Intestinal Bacterial Overgrowth. This condition affects the small intestine and occurs when there is an abnormal increase in the overall bacterial population. These bacteria are not commonly found in that part of the digestive tract as they usually found in other parts of the gut, where they are eliminated regularly. SIBO can cause various symptoms such as:

  • Abdominal bloating
  • Abdominal pain
  • Constipation
  • Indigestion
  • Gas and flatulence
  • Diarrhoea
  • Fatigue
  • Malabsorption of macro and micro-nutrients
  • Nausea
  • Vitamin deficiencies
  • Anaemia
  • Weight loss
Possible causes of SIBO

This condition is not yet well understood and there are numerous potential culprits. To list some:

  • Anatomical and structural problems inside and outside the small intestine such as scar tissue.
  • Other medical conditions such as IBS or IBD, coeliac disease and diabetes mellitus can slow down the digestion of food.
  • Absence of antimicrobial barriers such as pancreatic enzymes which naturally prevent bacteria from inhabiting the small intestine.
  • Drugs that change the pH level of stomach acid can also weaken your immune system.
  • Poor Immune System caused by cancer, HIV, coeliac disease, IBS or IBD.
Treatment of SIBO

SIBO can be treated with:

  • long term antibiotics
  • diet changes


When it comes to diet reversing nutritional deficiencies is an important part of treating SIBO, especially among individuals who had severe weight loss. In addition, a low FODMAP Diet may also be prescribed. FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides and polyols. The diet focuses on excluding carbohydrates that are high in the mentioned types of sugars i.e. oligosaccharides, disaccharides, monosaccharides and polyols. Foods containing this type of sugars can ferment in your intestines, act as bacterial food and you end up with SIBO symptoms.


If, you suffer from any of the symptoms above and you still don’t know what’s causing it I suggest you visit your doctor or a registered dietitian. If, you would to have to dietitians help kindly contact us. In addition, please subscribe to our website for more nutrition information and free recipes.


Ruby Red Mocktail

Are you looking for a refreshing drink this summer?

Are you looking for a sweet drink which can be enjoyed by all your family?

Here’s the recipe for you – Ruby Red Mocktail!


Mocktail is a non- alcoholic drink, usually made up of fruit juices, soft drinks, herbs and flavorings. This recipe of Ruby Red Mocktail contains mainly 3 ingredients which are cranberry, rosemary and lemonade. It is super easy to make. I decided to give it the name of ‘ruby red’ due to its colour from the cranberry juice.

This recipe offers plenty of micronutrients such as vitamin A, Bs and C, iron, calcium and proanthocyanidins. Proanthocyanidins are a type of anti-oxidants specifically found in cranberries which prevents urinary tract infections. If, you suffer from frequent urinary tract infections I suggest that you include more recipes with cranberries to your diet. In addition, since this recipe is non-alcoholic therefore it is ideal for all your family even if you have young kids. In fact, I would encourage you to try this recipe for your child since it offers a sweet taste but contains much lower sugars and calories than sugary drinks such as soft drinks.


Serves 4

Total time 10 minutes


For the rosemary syrup

  • 1L water
  • 800g sugar
  • 150g fresh rosemary
  • 4 whole cloves (optional)


  • 90g rosemary syrup
  • 90g cranberry juice
  • 90g lemonade


  • In a saucepan add the water, sugar, rosemary and cloves over medium heat. Simmer for 10 minutes until the sugar dissolves.
  • Remove the cloves and store in the fridge.
  • Add the rosemary syrup, cranberry juice and lemonade together and stir. Taste the mixture and adjust according to your palatable taste.
  • Garnish with rosemary and serve.
Other similar healthy recipes drinks:


Let me know what you think about 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.


Tuna Salad with Sour Cream Sauce

August…the hottest month of the year! Currently, with temperatures reaching over 40 degrees Celsius in Malta, it might become a continuous struggle to cook nutritious meals. And, it is understandable! This heat is leaving everyone exhausted with an attitude of ‘I don’t want to do anything!’ Usually, I love summer as I don’t suffer from heat but this year I have to admit that I want it to pass as quickly as possible. If, you are experiencing the same feelings about summer this year and you don’t feel like cooking I have the perfect recipe prepared for you. This Tuna Salad recipe is perfect for this period of time as it doesn’t involve any cooking. It is quite quick and easy to prepare in fact it takes only 15 minutes.


In addition, this tuna salad is full of vitamins, minerals and anti-oxidants. It is rich in vitamin A, Bs, C and E from the vegetables. It is also rich in omega-3 from the tuna and almonds. Omega-3 rich foods are important in our diet  as they lower cholesterol, reduces the risks of heart problems and optimize proper mental function. This recipe is also rich in anti-oxidants such as capsanthin, violaxanthin, lutein, quercetin and luteolin. These are important for proper immune function and to prevent cancerous cell formation in our body by reducing oxidative stress.


Serves 4 persons

Preparation time: 15mins

Chill time: 30 mins

Total time: 45 mins

  • 150g light sour cream
  • 1 tablespoon fresh lemon juice
  • 80g peas
  • 80g celery
  • 80g green bell peppers
  • 60g onions
  • 60g olives
  • 360g canned tuna
  • Lettuce leaves
  • 60g toasted almonds
  • Put the sour cream, lemon juice, peas, celery, pepper, onion and olives in a bowl.
  • Cover the bowl and chill for 30 minutes up to 4 hours.
  • Place some lettuce at the bottom of a plate.
  • Mix the tuna with the chilled mixture prepared in the first step.
  • Put the mixture on the lettuce and sprinkle some almonds.


Other similar recipes:

Avocado Salad with Feta Cheese

Quinoa, Sweet Potato Salad


Healthy Drinks suggestions with this recipe:

Homemade Strawberry Lemonade

Non-alcoholic Sangria

Alcoholic Pear Harbor Cocktail


I hope you enjoy it and please let me know in the comments below. Also 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.


Pearl Harbor Cocktail

Would you like a refreshing, sweet beverage in the hot summer days?

And would you like a tropical inspired cocktail after a long day at work?

Here’s the perfect cocktail for you!


This Pearl Harbor Cocktail was invented in the late 1980s, in Hawaii. It is well known for its fruity and sweet flavor. This bright green cocktail was originated as Hawaiian people wanted to relax after a long day at work and enjoys a beverage that reflects the beautiful island. It is a perfect cocktail for cooling down after a hot summer day.

This beverage is quite easy to make – simply mix all the ingredients together. Ideally, this Pearl Harbor cocktail is served ice-cold. So, I would recommend that apart from adding ice you also store the bottle of vodka in the freezer before preparing the cocktails. In addition, there is a tendency that sweet tastes undermine the taste of alcohol. so, be careful if you don’t taste a strong taste of vodka – it is still there!

Total time: 5 mins

Serves 1 person

  • 45g Vodka
  • 15g melon liqueur
  • Pineapple juice
  • Ice cubes
  • Pineapple chunks

Breakfast Shakshuka

Are you bored having porridge for breakfast?

Are you looking for healthy & delicious breakfast ideas?

Have you ever heard about breakfast shakshuka?


written by Ms Weronika Kordjaka, updated by Ms Rowinda Dimech


This recipes name ‘ breakfast shakshuka’ means ‘all mixed up’ and it is made from poached eggs in a rich and spiced tomato sauce. It is a traditional Israel breakfast although it originated in either Yemen or Tunis. Try this easy and delicious recipe, which undoubtedly is worth trying for your loved ones and friends!



  • 200 g canned tomatoes
  • 2 eggs,
  • 2 slices of whole grain bread
  • 1 tablespoon of olives, sliced
  • 1 tablespoon of olive oil
  • ground pepper
  • salt
  • mixed herbs


  1. Sprinkle olive oil on the pan and add the tomatoes. Mix it with the condiments, bring to boil, cover and let simmer for about 5-10 min until tomato sauce will get thickened.
  2. Use the spoon to make some indentations in the sauce and crack the eggs inside them.
  3. Add the olive slices on the top and cover the skillet over low-medium heat and leave until the whites will get settled.
  4. Slip off the cover and garnish shakshuka with chives, basil, parsley or herbs.
  5. Serve with toasted bread.


Nutritional information


Nutritional information
Per 100 g
Energy (Kcal) 437
Protein (g) 20,8
Carbohydrates (g) 32,1
of which sugars (g) 5,3
Fats (g) 24,1
of which saturates (g) 5,4
Fibre (g) 8
Salt (g) 1,9


This recipe can be modified by adding other ingredients such as cheese, seeds and cream. As you can see, this recipe is healthy, quick and most importantly delicious. Let me know what you think of this breakfast shakshuka recipe. Leave me your comments below. If, you would like more of these recipe you can order our recipe book. It contains 50 low calorie recipes all with nutritional information inside!


Feeding Problems in Children

Is my child having a well balance diet?

Am I giving my child too little or too much food?

Is my child growing well, after all?


Unfortunately, there are various feeding problems in children which leads to growth problems such as faltering growth, stunting, under-nutrition, and over-nutrition. These types of growth problems may all lead to malnutrition and health problems. As health professionals, in order to assess growth in children we use growth charts. Children grow at different pace from each other. In fact there are various healthy shapes and sizes among children. Some children of the same age might be tall, short, small and big as it depends on genetic factors, nutrition, level of physical activity, health conditions and the environment.

Growth charts are a standard tool which is used for your child’s checkups. Basically, they show the pattern of your child’s height and weight over time. During a normal checkup a doctor or a dietitian observe the growth pattern in children to check if the child is growing proportionate. When, the growth in children in not proportional it might be an indication of health problems.

Normal growth is when a child continue to grow on the same centile for both weight and height and therefore growth is proportional. So for example if when your child was born his height and weight started on the 50th centile he should continue to grow on that centile. If, your child falls a centile from weight it means that there is faltering growth which leads to underweight and malnutrition. If your child’s weight remains increasing on the same centile and your child’s height stops, this is known as stunting. Stunting also leads to malnutrition. On the other hand, if your child moves up to a centile it means that he is gaining weight which may lead to overweight and obesity.

Nutrition and weight problems

Faltering growth, stunting, overweight, obesity and malnutrition can be caused directly by nutrition. Faltering growth, stunting and malnutrition can be caused by various reasons which includes:

  • Loss of appetite

This can be directly associated with lack of certain vitamins such as iron and zinc deficiency. It can also be caused by constipation which is very common in children. Constipation may be a sign that your child’s diet is lacking in fiber and proper fluids amounts. If, you suspect that this might be the reason for your child’s poor nutrition I encourage you to check with a registered dietitian for a proper food assessment.


  • Mental health conditions

Unfortunately, mental health conditions in children are being seen more frequently and also at a younger age. Depression, anxiety and eating disorders are all mental health conditions which affects poor oral intake in children. It is important that if you notice any signs in your child you seek immediate help from your doctor or a healthcare professional.


  • Health conditions

There are various gut related conditions in children which may lead to poor oral intake or malabsorption of macro-nutrients. These include coeliac disease, Crohn’s disease, lactose – intolerance, acid-reflux and nausea. Fortunately, all these health conditions can be controlled and improved by nutrition.


  • Fussy eaters

Sometimes children may refuse to eat the food presented to them. The reasons for this may be due to sensory, psychological and behavioral issues. If your child is a fussy eater, your child and family requires a healthcare team approach. The healthcare professionals must be appropriately trained and specialized in this area.


On the other hand, overeating on a daily basis leads overweight and obesity. Overweight and obesity are risk factors of diabetes, cardiovascular diseases, liver problems, certain types of cancers and mobility problems. Children with mobility problems may not perform so good in physical activities at school. This may lead to a low self-esteem leading to psychological issues and mental health conditions.

As you can see from the information above feeding problems in children are quite a complicated matter. There are various health conditions, psychological, behavioral and environmental issues which could be the cause of feeding problems in your child. If you notice any signs please seek immediately help from your doctor and a registered dietitian.


Traditional Kwarezimal Recipe

Would you like a high protein dessert?

And an easy, quick and tasty dessert?

It’s that time of year for a Traditional Kwarezimal recipe!


We are always celebrating a religious feast especially in Malta, and this always comes with a traditional sweet food. This time of year we enjoy ourselves with traditional sweets such as Sfinec ta’ San Guzepp (Zeppoli) and kwarezimal. Kwarezimal are high in protein from almonds and offer various vitamins and minerals from the various spices. If, you suffer from diabetes or simply prefer it low in carbs you can use a sweetener instead of white sugar. I hope you enjoy this traditional Kwarezimal recipe!


  • 400g pure ground almonds
  • 350g white sugar
  • 1 tablespoon cocoa powder
  • 1/4 teaspoon cinnamon
  • 1/4 teaspoon ground cloves
  • 1/4 teaspoon nutmeg
  • Orange zest
  • Mandarin zest
  • 1 squeezed orange
  • 2 tablespoons orange blossom water
  • 2 tablespoons flour


  • Mix the ground almonds with the sugar, zests, cocoa, spices and orange flower water into a stiff paste.
  • Transfer onto a lightly floured surface and roll into a 6 cm thick roll.
  • Cut into 2 cm slices and roll lightly into a cylinder shape.
  • Place on a lined baking sheet with baking paper and flatten lightly with your fingertips.
  • Mark crisscross with a knife and bake for 10 minutes at 180°c until slightly browned.
  • Allow the kwareżimal to cool down and drizzle with honey and sprinkle with the nuts.

Let me know what you think of this tradition kwarezimal recipe. Leave me your comments below. If, you would like more of these recipe you can order our recipe book. It contains 50 low calorie recipes all with nutritional information inside!


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.


Breakfast cereal cinnamon flavor

Are you looking for some quick breakfast idea?

Do you think that healthy and well-balanced breakfasts are time-consuming?


written by Ms Weronika Kordjaka, updated by Ms Rowinda Dimech


To start with and answer the above question ‘not anything alike’! This recipe is full of fiber for optimum intestinal function, vitamins and minerals to help you boost your energy when you wake up. So here, is a recipe for super healthy, quick and drool worthy breakfast!



  • 50 g old-fashioned rolled oats
  • 1 cup of milk
  • 1 medium apple
  • 1 tablespoon of peanut butter
  • 1 tablespoon of ground cinnamon



  1. Prepare saucepan. Combine milk and oats, than bring to a boil.
  2. Simmer uncovered for about 5 minutes until thickened and remove from heat.
  3. Transfer porridge into bowl.
  4. Peel the apple and chop into slices, add to bowl.
  5. Garnish with peanut butter and sprinkle with cinnamon.

Oatmeal may sound a bit boring, but trust me there are thousands of ways to prepare it! You may add different kind of fruits, nuts, sesame or honey for more sweetness. You can also prepare bake oatmeal, especially when you are dieting and experience strong sweet cravings. This recipe will help you feel full and satisfied, so you don’t have to be worried about being ‘forced’ to buy junk food on your way to work. Let me know what you think of this healthy breakfast. Leave me your comments below. If, you would like more of these recipe you can order our recipe book. It contains 50 low calorie recipes all with nutritional information 🙂


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.


  • 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’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.

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