12May
Malnutrition Over and Under nutrition Dietitian Malta
Rowinda DimechAdult, Diets

Malnutrition Under and Over nutrition

Does malnutrition exits in Malta?

It is rare to think of malnutrition in Malta, being a developed country. Usually, when we speak of malnutrition we are more likely to think about third world countries such as Somalia and Sudan. Most probably we picture extremely underweight children with a big belly who we see on national television during a charity show. Unfortunately, malnutrition is more common than we think so let’s in more depth about this topic and check if you can relate.

What is malnutrition?

Malnutrition refers to poor nutrition due to under/over nutrition and micro-nutrient deficiencies. Undernutrition is when a person is not eating enough and might lead to stunting (low height for age), wasting (low weight for height), underweight (low weight for age) and micronutrient deficiency. On the contrary, over-nutrition is when a person over eats which might lead to overweight, obesity and diet – related diseases such as heart diseases, diabetes and kidney problems. Individuals who are over-nourished can still have micro-deficiencies in fact around 30% of women in their reproductive age from developed countries are affected by iron-deficiency anemia.

There are various medical conditions that can lead to malnutrition. Some of which are chronic diarrhea, chronic nausea, depression, Chron’s disease, dementia and eating disorders. These conditions all lead to either poor oral intake or poor nutrient uptake. Nowadays, new studies  are also showing that people who are malnourish are also at a higher risk of getting coronavirus. Malnutrition has various signs and symptoms.

Signs and symptoms of malnutrition

 

  • Unintentional weight loss
  • Lack of appetite
  • Reduced interest in food
  • Feeling tired all the time
  • Feeling weak
  • Getting ill often and taking a long time to recover
  • Poor concentration
  • Low mood or depression
Importance of a good diet

A varied and balanced diet is essential to keep you healthy and reduces the risk of chronic diseases. A proper diet refer to adequate carbs, protein, fats, fruit and vegetables. If, you suffer from any medical conditions get in touch for a tailored made diet in order to control the medical condition. A good diet for a specific medical condition may vary a lot from that recommended to the general public. In cases such as chronic nausea it may be suggested to decrease protein intake, increase carbs and fat intake and eat frequent snacks. This example illustrates the importance of an individualized diet/ meal plan done specifically for you.

I think that malnutrition is important to treat in order to prevent illness and complications of medical conditions. In other words, having adequate macronutrients and micronutrients in the diet will make you feel much better. A good diet will also affect your mental health reducing moods swings and anxiety throughout the day. A good diet is much more than simply how you look. It will affect your relationship with yourself, your family, friends and colleagues.

11May
Avocado Dip Dietitian Malta
Rowinda DimechDiets, Health, Recipes

Avocado Dip

Avocado is a fruit, many refer to it as a large berry fruit with a single seed. Although it is a fruit it has a different composition as it is high in fats rather than in carbohydrates. It is also a rich source of vitamin B and K. It is also rich in antioxidants known as phytosterols and carotenoids. Avocado can be eaten raw or cooked with meals.

Due to its high nutritional content it is ideal to be taken as a snack during the day. As a result of this, I choose to share this avocado dip recipe which can be taken as a snack with some crackers. In addition, this recipe can also be use as a sauce with meals as an alternative of other types of sauces/ dips for example mayonnaise.

Ingredients:

  • 1 avocado, mashed
  • 150g plain Greek yogurt
  • 1 small lemon squeezed
  • ¼ teaspoon garlic powder
  • Pinch of salt

Method:

  • Mix all the ingredients together and blend until smooth

This avocado dip recipe takes only 5 minutes to prepare it and serve. I encourage you to check out our recipe blog for easy, healthy and delicious recipes. Please, feel free to write any comments below. I will be happy to answer all your comments and queries.

02Apr
Tofu Burgers Dietitians Malta vegan
Rowinda DimechDiets, Health, Recipes

Tofu Burgers

This recipe of tofu burgers is high in various vitamins, minerals and anti-oxidants. Tofu is a low calorie, high protein dairy alternative. It is produced by a coagulating soya milk to form curds, a process similar to how dairy cheese is produced. It has a spongy texture so the herbs and spices are absorbed well to give a palate taste. In fact, these easy and healthy tofu burgers get plenty of flavour from the onions, garlic and different herbs such as mint and basil. In addition, this recipe also offers a spicy taste by using some chili sauce. This recipe is suitable for normal, vegetarian and vegan diets. In addition, it is also suitable for children who suffer from lactose intolerance or fussy eating. 

Ingredients:
  • 1 block tofu
  • 2 tablespoons tomato paste
  • 1 – 2 tablespoons chili sauce
  • 2 tablespoons fresh mint
  • 2 tablespoons fresh basil
  • 2 tablespoons parsley
  • 1 tablespoon garlic
  • 2 tablespoons onions
  • 5 tablespoons flour
  • Pinch of salt

Burger toppings:

  • Buns
  • Carrots
  • Cucumber
  • Lettuce
  • Chili sauce
  • 1 tablespoon olive oil

Method:

  • Put a heavy pan on the tofu to press out the water content for about 20 minutes.
  • In a bowl, mash the tofu using a fork until it becomes crumbly.
  • Add all the other burger ingredients in the bowl and mix.
  • Separate the mixture into 4 round burgers, using your hands.
  • Preheat the oven at 180 degrees Celsius.
  • Put 1 tablespoon of olive oil in a pan and fry the burgers to get a nice, brown colour on the outside.
  • Transfer the burgers into the oven and bake for 20 minutes.
  • Serve on a toasted bun with chili sauce, lettuce, carrots and cucumbers.

I enjoy this delicious recipe and therefore I invite you to try this healthy recipe, low calorie recipe that your entire family would love. I would love to hear from you what you think about this recipe. Leave your comments below 🙂

19Mar
Polycystic ovary syndrome PCOS
Rowinda DimechAdult, Diets, Health

Polycystic Ovary Syndrome (PCOS)

Do you suffer from Polycystic ovary syndrome (PCOS) and you were advised to cut carbohydrates?

Are you on a keto diet because of PCOS?

What is the right diet for PCOS?

What is PCOS?

 

Polycystic ovary syndrome, known as PCOS is a hormonal condition in women involving an unbalance production of androgens, insulin and progesterone. The cause of PCOS is still unknown but it could be genetic. In our body, each hormone is responsible for a specific function. If you have PCOS your body will produce more insulin which is important to regulate blood sugars levels. In turn this will cause your ovaries to react and produce the male hormones in high levels. One of these hormones is androgen hormone which is often low in women but if you have PCOS due to the increased insulin production your androgens will be high. This may cause excessive facial and body hair. In addition, high insulin will also affect progesterone to be produced in lower amounts than needed. Low levels of progesterone may lead to irregular periods or to miss your periods for a long time.

 

What are the symptoms?

 

PCOS is associated with various symptoms due to the hormonal imbalance. Apart from the symptoms of excess hair, irregular periods and missing periods mentioned above, it also includes having acne, a lot of small cysts in the ovaries and difficulty in losing weight.

It is important to recognize the symptoms of PCOS as it can put your health at risk for insulin resistance syndrome. In other words, the metabolic syndrome. This syndrome includes risk of obesity leading to Type 2 diabetes, high cholesterol levels and high blood pressure. It also leads to a higher risk of abnormal growth of the lining of the uterus and endometrial cancer.

How is PCOS treated?

Currently, there is no cure for PCOS but it can be managed by diet and lifestyle. Maintaining a healthy weight is the main factor to control PCOS as much as possible. This can be achieved by exercise and a balanced diet. Studies show that women with PCOS benefit from 30 minutes of exercise 5 times a week as there is a strong positive correlation with cardio – metabolic outcomes.

 

What diet is recommended for PCOS?

Currently, the trend for PCOS is a low or a no carb diet. As, I previously explained in my blog about carbohydrates , carbs offer various health benefits such as energy, protects against diseases and a rich source of vitamins & minerals. So the question for a women with PCOS is: should I eliminate carbs?

The evidence suggests that a diet for PCOS should contain a low glycemic index (GI). A low GI diet is rich in fiber, a type of carbohydrate which slows digestion, proteins and healthy fats. This diet rich in fiber causes a gradual increase in blood sugar levels rather than a spike, as shown in the graph below:

 

Some examples of high fiber foods are

  • Wholegrain bread
  • Wholegrain pasta and rice
  • Wholegrain cereals such as oats
  • Fruit
  • Vegetables

Studies  show that women with PCOS had an improved menstrual regularity when they followed a low GI diet as less blood sugar spikes improved insulin sensitivity. It is important to highlight that a low GI diet does not mean a low carb diet. It still means that 50% of your calorie intake should come from carbohydrates for proper metabolic and brain function.

In conclusion, the recommendation for a PCOS diet is high fiber carbs, lean proteins and healthy fats. So the good news is that you can still enjoy plenty of tasty carbs but choose high fiber ones. In addition, exercise can also moderate insulin levels. The minimum daily exercise recommendation is 30 minutes of any type of exercise which you love to do.

18Mar
Green Tahini Dip
Rowinda DimechDiets, Health, Recipes

Green Tahini Dip

Do you need some healthy snack ideas?

Do you need practical home-made food which is not time consuming?

This healthy green tahini dip recipe is a perfect combination to obtain your daily intake of Omega-3 fatty acids and Vitamin B. Unfortunately, Omega 3 is not abundant in our daily diets despite it’s beneficial nutritional impact on our health. It is also high in fibre for a healthy digestive system and anti-oxidants known as lignans for prevention of diseases. This green tahini dip added with three to four crackers is ideal as a healthy snack during the day. It takes only about 5 minutes of your time to prepare and it does not involve any cooking.

Ingredients:

  • 100 ml olive oil
  • 100 ml water
  • 30g tahini
  • Parsley
  • 1 clove garlic
  • Half lemon, squeezed
  • Pinch of salt

Method:

  • Mix all the ingredients together and blend until smooth.

NB: If the sauce is too runny you can add a little more of tahini

 

I encourage you to check out our recipe blog for easy, healthy and delicious recipes. In addition, if you want to change your eating habits or want more healthy, low in calorie recipe ideas I recommend you to order our recipe book ‘Everyday Cooking – a helping hand’. In this recipe book you will have more than 50 delicious recipes to cook for all your family, friends and your loved ones.

06Mar
Mini chicken pies
Rowinda DimechDiets, Health, Recipes

Chicken Mini Pies

Do you find it difficulty to cook twice a day for lunch and dinner?

Do you end up buying take away food for convenience?

Do you feel guilty after having a take away, especially if the reason being is that you don’t feel like cooking?

 

Frequently, lots of my clients feel that it is too much to cook twice a day. Honestly, I feel the same way too even though I love cooking. In addition, I notice that if they buy a take away they feel they’ve ruined their healthy eating habits. With this I have to strongly disagree. The reason being is that it depends on the frequency and the portion size eaten. In order to try to help out ease the stress of cooking twice a day I thought of something convenient which can be yummy, practical and still low in calories. In this blog I share a healthy recipe of mini chicken pies.

These mini chicken pies are prepared in about 25 minutes and takes about 50 minutes to cook. You will be able to make 4 portions from this recipe. Thehe other extra portions can be frozen and used for that day when you don’t feel like not cooking anything for lunch or dinner.

Ingredients:
  • Puff pastry
  • 2 teaspoons unsalted butter
  • 2 tablespoons olive oil
  • 3 tablespoons flour
  • 400 ml milk
  • 2 tablespoons freshly squeezed lemon juice
  • 280g chopped chicken breast
  • 100 g chopped carrots
  • 150g potatoes
  • Chopped fresh basil
  • Black pepper
  • Pinch of salt
  • 1 egg white
Method:
  • Preheat the oven at 200 degrees Celsius.
  • Put the carrots, potatoes and 1 tablespoon olive oil in a bowl and mix. Add a pinch of salt and pepper.
  • Spread the vegetable mixture on a baking sheet and put in the oven.
  • After 20 – 30 minutes remove from the oven and let the mixture cool.
  • Increase the oven temperature to 220 degrees Celsius.
  • Roll out the puff pastry to 1 cm thick. Cut the pastry a little bit bigger than the dish into 4 pieces. Keep the pastry ready and refrigerated until it is time to use.
  • In a saucepan, melt the butter and 1 tablespoon olive oil over moderate heat. Add the flour and whisk constantly for 1 minute. Add the milk while whisking and simmer the mixture for about 5 minutes until it thickened.
  • Add the lemon juice, chicken, vegetables and basil and stir.
  • Put the mixture into 4 dishes and top the dishes with the pastry. Press against the outside edge to seal.
  • Brush the pastry with the egg white.
  • Bake the pies in the oven for another 15 – 20 minutes until the pastry is golden brown. Serve.

 

This method will also help you to save your time from cooking the same dish and money spend on take away food. I suggest that you use that extra time and money to treat yourself, as you truly deserve. Let me know if you agree with me in the comments below 🙂

25Feb
Diet related conditions in children
Rowinda DimechChildren, Diets, Health

Diet Related Conditions in Children

Are you concerned about your child not eating enough?

Are you concerned that your child is losing weight or not growing enough?

Does your child have adverse reactions to food or diet related medical conditions?

 

Diet related conditions in children might affect your child’s eating, sleeping, playing and growing effecting his overall health, both physically and mentally. When infants and toddlers lose weight or don’t grow normally it is known as faltering growth as a result of malnutrition. In most cases, faltering growth is due to underlying conditions such as lack of appetite, poor food intake, poor nutrient absorption in the intestines and medical conditions such as celiac disease.

Cow’s Milk Allergy

The most common diet related condition in infants is cow’s milk allergy (CMA). In fact, CMA affects 1 in 20 babies in the first year. This happens when the baby’s immune system over-reacts to proteins found in cow’s milk. If your child has CMA he may show various symptoms that usually are related to their skin, gut or breathing. The most common symptoms are itching, hives, vomiting, diarrhea, blood in stools and wheezing. CMA usually stops when the child is 1 year of age but some grow out of at the age of 3 years.

Fussy eaters

Most common feeding difficulties in childhood that affect toddlers (1 to 2 years) are food refusal and constipation. Food refusal is a normal phase of early childhood, which peaks around 18 months of age but some children develop extreme food refusal. This extreme food refusal may starts at around 3 years when children experience intense fear for food. This fear towards food could be sensory including the sight, smell, touch, taste and texture of food. Or else it could also be behavioral, lack of certain micronutrients and medical conditions.

Constipation is very common especially when they are being potty trained at around 2 – 3 years, can also lead to poor food intake. Constipation is when your child has difficulty to pass stools. This can be treated by encouraging your child to make small dietary changes such as increase the water intake and fiber in his diet.

Food allergies and intolerances

Food allergies and intolerances can affect all age groups. Food allergies occur when your child ingest a certain type of food and there is an immune response to that particular food. Most food allergies in young children are outgrown by puberty but those diagnosed in late childhood often require life-long careful dietary management. Some common food allergies are egg allergy, milk allergy and peanut allergy.

On the other hand, food intolerances don’t produce an immune response. This means that in food intolerances your child may not always experience symptoms. It is recommended that unless your child experience symptoms he continues to eat that particular food. But if your child is experiencing migraines, diarrhea or abdo pain the intolerant food is eliminated from his diet. The most common food intolerance in children especially in teenage years is lactose intolerance. Both allergies and intolerance can be well managed by a proper dietetic assessment and dietary measures.

Gastrointestinal problems

Gastrointestinal problems are mostly common in infancy, toddlers and teenagers some of which are abdominal pain, acid reflux and chronic diarrhea. The good news is that these can be treated by dietary changes. In severe cases, these might lead to dehydration, mental fatigue and faltering growth. Some common digestive problems are Eosinophilic Gastrointestinal Disorders (EGID), Celiac disease, Inflammatory Bowel Syndrome (IBD) and Lactose intolerance. You can check my other blog about gastrointestinal problems in children for further detailed information.

Eating Disorders

In young children, as young as 9 years old and teenagers eating disorders such as anorexia nervosa and bulimia nervosa might kick in. Eating disorders continue on the increase in teenagers and can affect boys as well as girls.  Being aware of the signs of persistent damaging eating behaviour will help you to seek help when needed.  Doing this at an early stage is important, and prevents escalation of a problem which may spiral out of control. These are both serious mental health problems which require frequent and intense dietetic intervention.

I strongly recommend that if you notice any signs in your child’s behavior or symptoms it is important to seek professional advice. When there is any diet related conditions in children, it is important to speak to a dietitian who is specifically trained in the pediatric field and qualified in children.

13Feb
Valentines Red velvet pies Dietitian Malta
Rowinda DimechDiets, Health, Nutritonist, Recipes

Valentines Red Velvet Mini Cakes

February 14th is Valentine’s Day. It is a day to celebrate the people we choose to share our life. In other words, it is a day to celebrate our family, friends and lifelong lovers. In my relationship with my boyfriend I focus on good communication skills between us. I think that verbalising our love everyday is a good practise, but special days like Valentines, it’s also good to show your love with a memorable gift. I strongly believe that an easy and effective way to show your loved ones your sentiments is to bake them something delicious.

These Valentines red velvet mini cakes are perfect for such an occasion. If, you have a busy lifestyle, like me, this recipe takes only about 50 minutes to prepare and bake so time-wise it suits us as well.

Ingredients

Red velvet min cakes

  • 2 tablespoons unsweetened cocoa powder
  • 30g red food colouring
  • 2 tablespoons water
  • 300g white sugar
  • 100g vegetable oil
  • 2 eggs
  • 200g buttermilk
  • 1 teaspoon vanilla extract
  • 700g flour
  • 1 tablespoon white vinegar
  • 1½ teaspoon baking soda

Filling

  • 180g cream cheese
  • 100g salted butter
  • 1 teaspoon vanilla extract
  • 480g powdered sugar

Method

Red velvet mini cakes

  • Heat the oven at 175 degrees.
  • Mix the cocoa powder, food coloring and water. Put aside.
  • Mix together the sugar, oil and eggs. Add the buttermilk, vanilla extract and the food colour mixture, which was put aside.
  • Stir in the flour, vinegar and baking soda until the whole mixture is combined.
  • Pour the mixture using a round spoon onto a baking sheet.
  • Bake for around 7 minutes.

 

Filling

  • Mix the cream cheese, butter, powdered sugar and vanilla extract.

 

Red velvet mini cake with filling

  • Spread a tablespoon onto the bottom side of the mini cake. Then, top with the bottom side of another mini cake.
  • Put in the refrigerator. Serve.

I hope you enjoy these valentines red velvet mini cakes and share it with your loved ones on this special day. If, you would like to have more delicious recipes with all the nutritional information order our recipe book.

Happy Valentines Day!!

26Jan
GasChildren and Gut health Nutrition and Diet
Rowinda DimechChildren, Diets, Health, Nutritonist

Children and Gut Health

How important is gut health in children?

Does your child suffer from abdominal pain?

Is it negatively affecting his nutritional intake?

 

In children, gut health is one of the most important as it can affect all the other organs and body parts. The gastrointestinal system or gut is the body’s largest organ system. It is responsible for digestion, absorption and elimination of food and bacterial waste.

Your child should always be given sufficient time to eat his food without distractions. It is also important to calmly encourage your child to chew food well. This will result in enough time for your child’s gut to release digestive enzymes to help in digestion. Hunger and appetite are controlled by internal digestive hormones and external influences such as the sight and smell of food. Simple as it sounds, the act of chewing food well, signals satisfaction to the brain, which in turn helps control hunger and appetite.

Digestion begins in the mouth, with the production of salivary amylase. It continues in the stomach and upper intestines, stimulating the production of digestive enzymes and hormones. The gut illustrates its adaptive qualities by regulating nutrient absorption depending on your child’s needs.

Gastrointestinal problems are common in infancy, toddlers, children and teenagers. There are various gastro symptoms which can be controlled or treated by diet. These include difficulty swallowing, poor appetite, indigestion, acid reflux, nausea, stomachache, vomiting, bloating, chronic diarrhea and constipation. These symptoms can be identified quickly from your observations as a parent as you might see tantrums during feeding your child or discomfort, vomiting, pain and faltering growth. In addition, your child may be grown enough to express his own symptoms to you himself.

Common digestive disorders in children are:

  1. Eosinophilic Gastrointestinal Disorders (EGID)

These are disorders in which white blood cells in your child’s digestive tract causes inflammation and swelling. This results in pain, discomfort and may even result in swallowing difficulty. The most common is known as eosinophilic esophagitis. Unfortunately, there is no cure but proper diet and steroid medication will help your child to control his symptoms. Diet plays an important role as certain foods might be causing the allergic reaction in your child’s gut.

 

 

  1. Celiac Disease

Celiac disease is a serious reaction when your child eats gluten which is found mainly in wheat, barley and rye. This condition can only be treated by a gluten free diet which will stop the damage being done to your child’s intestines. On another side note, it is important that gluten should be part of a normal diet if celiac disease is undiagnosed. This will prevent future health complications such as developing celiac disease itself.

  1. Inflammatory Bowel Disease (IBD)

Inflammatory bowel disease is a term used to describe certain disorders such as ulcerative colitis and Crohn’s disease. These types of disorders involve chronic inflammation of your child’s digestive tract. IBD is most commonly found in teenagers. In both types of IBD, your child experience reduced appetite, diarrhea, rectal bleeding, abdominal pain, fatigue and weight loss. There are various types of diets that can be used such as gluten free diet, lactose free diet, low fiber diet or high fiber diet and low FODMAP diet.

  1. Lactose Intolerance

Lactose intolerance is very rare in young children. Usually, lactase production remains quite active until children are at least 10-12 years old. Studies show that European children are less likely to develop lactose intolerance, even as they grow older.

Lactose is a type of carbohydrate therefore it causes an intolerance. Food intolerance is different from a food allergy. In a food allergy, your child’s body develop an immune system reaction towards that particular food. If, your child has a true milk allergy he must not ingest even trace amounts of any form of milk or dairy products. If, your child has lactose intolerance he can still consume lactose-free milk and dairy products.

If, your child is suffering from any gastrointestinal problems I strongly recommend you to pay a visit to your child’s pediatrician. Then, if your child’s gastrointestinal issues directly relates to food I strongly encourage you to speak with a dietitian. This is of utmost importance that your child have good gut health as it affects your child’s physical, psychological and emotional wellbeing.

 

20Jan
Milk and breast cancer
Rowinda DimechAdult, Diets, Health, Nutritonist

Milk and Breast Cancer

Does dairy cause breast cancer?

Should we eliminate dairy from our diet, especially women?

Is it better to use alternative milks like soya milk?

 

What is the evidence about milk and breast cancer

I encounter lots of women who have a ‘phobia’ for dairy and dairy products. I can understandably empathies with all women who worry about this issue. This reason being because the internet is full of misinformation about milk. Apart from the misinformation on the web, there are also published studies that drinking dairy milk is associated with cancer. One particular study  was published in the International Journal of Epidemiology that concluded that drinking dairy milk is associated with a greater risk of breast cancer by 30%. In this study, dairy products as such cheese and yogurt don’t appear to have any effect on breast cancer.

This type of research is known as an observation study. This describe and potentially identify a correlation between milk intake and the rate of breast cancer occurrence in women. The problem with observation studies is that they don’t identify a cause and effect. Therefore, its aim is to direct scientists to ask the right questions and conduct proper studies. Observational studies are not intended to be used to inform clinical decisions for dietitians. In other words these studies cannot guide us on what to eat or not to prevent cancer. In nutrition studies, researchers use food frequency questionnaires and diet recall methods to find out what subjects are eating. This is because a person who drinks soya milk could have been eating more fruit and vegetables. While people who consumed dairy milk could also consume junk food on a regular basis. Therefore, their diet wasn’t measured in terms of quantity and quality.

 

What is the evidence about soya milk and breast cancer?

In addition, I frequently hear women say that they consume soya milk as it is ‘healthier’ than dairy milk. Evidence on the relationship of soya and breast cancer are very limited. In other words, more research is needed for conclusive evidence whether soya increases or decreases the risk of breast cancer.

In both cases, the research is inconclusive but there is a lot of strong evidence about other foods which prevent the risk of having cancer such as fruits and vegetables. In addition, milk is important for its calcium intake for strong bones, teeth and Vitamin D synthesis.

Recommendations

Till now, from the thousands of studies assessing the relationship between dairy milk and breast cancer we cannot conclude that there is a relationship. Some studies found that there might be an increase in risk, some found no relationship at all.  Other studies suggested that dairy milk is protective against breast cancer. This means that more research studies need to be carried out as it is concluded in a systematic review  published in The American Journal of Clinical Nutrition.

In conclusion, I would strongly suggest to stick with the current evidence based recommendations of having 3 portions of dairy products per day. These could be 1 glass of milk or alternative milk such as soya, yogurt and cheese. In addition, always try to include fruit and vegetables for their anti-oxidant properties. Also, don’t forget to exercise and keep fit for maximum immune system function and well-being.

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