Stress and Emotional Eating

Stress is a state of emotional tension and can be classified into mild anxiety and pathological or chronic stress. Mild stress can help the body to react in resolving faster situations that need immediate attention such as daily life problems. Pathological stress is usually accompanied by feelings of guilt, fear, tension and anxiety for an extended period of time and it often causes symptoms such as tachycardia (hart rate that exceeds the normal range), digestive disorders, diarrhea, headaches, dry mouth and depression. It can also cause a series of hormonal and emotional reactions in the body leading to the accumulation of excess weight.

In pathological or chronic stress, the brain triggers the production of a hormone called cortisol which in combination with other hormones such as norepinephrine, glucagon and somatropin, have adverse effects on the body. Cortisol reduces the body’s ability to burn fat and encourages its storage in the abdomen. The development of abdominal fat is often a risk factor for heart disease and diabetes. The production of cortisol by the body is generally linked with obesity, resistance to insulin action and reduction of memory.

Humans with stressful lifestyles that consistently fail to have nutritious meals due to time constraints or other factors are usually led to the consumption of ready meals that are high in fat. Also, they tent to take increasing quantities of caffeine which causes dehydration that increases production of cortisol by the body.

Pathological stress is often accompanied by a host of negative emotions leading to large numbers of humans developing emotional polyphagia (excessive eating). Emotional overeating is amongst the most common forms of eating disorders. Humans who suffer from this disorder find refuge in the easiest form of pleasure: food consuming and in particular foods rich in salt and sugar.  These types of food provide a temporary relief from problems but result to the increase of body weight.

Although total stress relief is difficult to achieve, it can be significantly reduced in several ways. A key factor of reducing stress is to adopt a diet rich in nutrition. The consumption of fruits and vegetables such as citrus fruits, strawberries and peppers that are rich in vitamin C, contribute to the reduction of cortisol which subsequently leads to stress reduction and therefore prevents accumulation of fat in the abdomen. Scientific researches showed that a diet rich in seafood results in humans feeling emotionally better as these foods are rich in omega-3 oils which can reduce mild depression. Limiting the consumption of coffee to 2 cups a day and increasing hydration will help reduce cortisol levels therefore prevent the accumulation of abdominal fat. Also, the consumption of carbohydrates (bread, bulgur, rice, etc.) increases serotonin levels a substance that improves the mood.

Working out regularly can also contribute towards the reduction of stress. Exercising causes the production of endorphins in the body that improve the mood and help in weight loss with the result of increasing the confidence.

In general if the stress derives from the fact of being overweight, it should be considered as a sign to loose weight, begin a diet balanced in nutrition and start exercising.

Studies suggest that sleeping 7-8 hours daily will result to a 37-48% reduction of cortisol which will prevent accumulation of abdomen fat.

In conclusion, pathological or chronic stress can be reduced once a balanced diet rich in nutrition is adopted amongst with exercising and sufficient sleeping.  In addition, these factors will also lead to the reduction of excess weight.

Yiannis Kerimis MSc, R.D (USA)

Clinical Dietitian

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Myths and Truths about Nutrition

On a daily basis we receive a wealth of information in regards to nutrition and weight loss. Often the source of this type of information originates from non-specialists thus false impressions are made. What are the myths and truths related to diet?

“Olive oil has fewer calories than other oils.”

Olive oil in comparison with other oils has the same caloric value as all oils are in fact fats that contain 9 calories per gram.  The reason olive oil is recommended instead of other oils is due to its high nutritional value. It contains mainly monounsaturated fats, which are positive qualities for the health of the heart, and also contains vitamin C which acts as an anti-ageing and anti-cancer agent.  Although olive oil is a healthy choice it should be consumed in moderation as 1 teaspoon contains 45 calories.

“Whole grain products contain fewer calories in comparison to the non-whole grain ones.”

This is a false perception as whole grains products have exactly the same calories with the difference that they provide more nutritional value. For example, a slice of brown bread has the same calories as a slice of white bread. Whole grain products provide a large amount of dietary fiber which is responsible for the health of gut.

Also, they contribute towards maintaining blood sugars in balance and they are undoubtedly richer in complex B vitamins that maintain the smooth functioning of the metabolism and nervous system.

“It’s better to consume honey and brown sugar rather than white sugar when trying to lose weight.”

Brown sugar has the same calories as white sugar.  The difference is that it has a higher nutritional value and provides nutrients such as magnesium, potassium and sodium. Honey also offers more vitamins and minerals than white sugar, which is nutritionally valueless, but many are not aware that it contains more calories.

“Aspartame sweeteners are carcinogenic”

Large organizations, such as the World Health Organization, suggest that aspartame is completely safe and it is not associated in any way with carcinogenesis.

There are no good or bad foods but instead good and bad eating habits.  All foods can be part of a diet as long as they are chosen correctly and consumed in moderation.  Food of same groups may contain the same value in calories but certainly some contain more nutrients than others and provide vitamins and fiber important to the human body.

In general, for matters related to correct nutrition one should seek the advice of a specialist and trust only scientific studies with validity that have their sources in the researches of experts.

Yiannis Kerimis MSc RD

Clinical Dietitian

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Healthy Nails, Hair & Skin

Many believe that cosmetics is one of the most important factor for keeping up appearances but in reality diet is the major factor which is crucial for healthy skin, hair and nails.

Fragile nails with pigmentation, dull hair that break easily and oily skin with pale color is often evidence of a diet with deficiencies in nutrients that are vital to our body.

Hair

To reduce hair loss and maintain shiny hair with natural growth we need to consume foods that are rich in the following:

Vitamin D:  It promotes proper development of tissue and cells.

Sources:  Vegetables, such as spinach and red peppers, liver and eggs.

Biotin:  It improves metabolizing fat in the scalp area.

Sources:  Eggs, liver and cereals.

Iron:  Iron deficiency causes increased hair loss.

Sources:  Red meat, poultry, fish, eggs and some vegetarian sources such as legumes and spinach.

Copper: A must for proper oxygenation of the scalp.

Sources: Liver, seafood and seeds.

Zinc:  Responsible for the production of keratin which is the main structural protein of hair.

Sources: Meat, liver, seafood, eggs and soy.

Skin

Our body excretes on a daily basis around 2.4 liters of fluid which should be replenished with adequate water intake (8-10 glasses) to reduce skin greasiness, remove toxins and to properly hydrate the skin.  Increased water consumption, massage and exercise that increases blood circulation along with reduced intake of saturated fat (animal fat), salt and caffeine, can reduce the appearance of cellulite which is a problem many women face. Some other nutrients needed to revitalize skin are some antioxidants such as Vitamin A and Vitamin C that can be found in citrus fruits, watermelon, apricots and some non-green vegetable.  Antioxidants protect our genetic material (DNA) and neutralize harmful substances in the body called free radicals. Vitamin C also promotes creation of collagen and helps revitalizing the skin. Smokers should consume more Vitamin C than non-smokers. Another antioxidant is Vitamin E which is found in dark green vegetables, grains and some vegetable oils such as olive oil.  Vitamin E also reduces any burns resulting from exposure to the sun.

Nails

The three major nutrients needed for healthy nails are protein, calcium and zinc. With protein (keratin) being the main structural material of nails it is important to include meat, poultry, seafood and legumes in our diet.  Calcium helps strengthen nails and its lack causes thin and fragile nails. Sources of calcium are dairy products, dark green vegetables, sardines, etc.  Zinc helps reduce nail pigmentation and can be found in meat, low-fat milk, brown rice, beans etc. Finally, inadequate iron intake causes nails to grow thin and fragile that easily break.

In conclusion, a proper diet for healthy skin, nails and hair should include dark green vegetables such as spinach, fruits and non-green vegetables that are usually rich in antioxidants such as Vitamin A and C. To strengthen nails foods rich in calcium, for example low fat milk, should be added to our diet.  In general, the consumption of lean meat, poultry, seafood and legumes is vital as these foods are rich in protein which is the basic structural material of hair, skin and nails.  Foods high in protein often contain iron and zinc, essential ingredients for the healthy development of the nails and hair. Finally, water is an important factor for proper hydration and detoxification of the skin and should be consumed in adequate amounts.

Yiannis Kerimis MSc RD

Clinical Dietitian

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Glycaemic Index

With the term glycaemia index we mean the way the blood sugar increases in the blood after  a meal.  Foods which might influence the blood glucose are mainly carbohydrates containing meals such as pulses ,milk, fruits, milk products and sugar.  The range of increase of the glycaemia index depends on the kind of the carbohydrates, the way of preparation and  how well ripe the sources are.

Carbohydrates are divided in the simple ones  which are found in sugar, fruits, juices, milk products and honey and in the complex ones.   The complex ones are found in cereals, pulses, bread, rice, potatoes and pastas.   Simple carbohydrates  increase the blood glucose quicker than the complex ones.

Blood glucose increases quicker after the consumption of processed food with reduced fibre  e.g  white bread has higher glycaemia index than  brown bread. Fibre reduces the absorption of glucose and keeps the blood sugars in balance, however low fibre food stuff induce increase of blood glucose and an immediate production of insulin. Insulin is a hormone which regulates the sugar blood levels and the storage of fats.  A sudden drop of the blood sugar can cause weakness and make the person feel hungry more easily.

Glycaemia index is also influenced from how well ripe fruits are e.g a well ripe banana will increase the blood glucose more than a non ripe banana. Another important parameter is how well cooked a meal is e.g  al dente pasta have low index  than well cooked pasta, so they will increase the blood sugar less.

In conclusion the glycaemia index is defined by the degree certain food stuff influence the blood level. Processed foods without fibre, simple carbohydrates, well ripe fruit and over cooked meals increase the blood sugar contrary to the complex carbohydrates and food rich in fibre.

Yiannis Kerimis MSc RD

Clinical Dietitian

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Pregnancy and nutrition

Women during pregnancy are particularly in need of a healthy and balanced diet to ensure proper fetal development and the reduction of complications during pregnancy. The idea that a pregnant woman should eat for two is not true and excesses should generally be avoided.

During  the first quarter of the pregnancy the woman should avoid any increase in calorie intake and under normal circumstances  to expect a  weight gain of 1-2 kilos. Over the next 6 months the expectant mother should increase her calorie intake by 200-300 more than her usual consumption and an average increase of 4-5 kilos per quarter should normally be expected.

The basis of nutrition during pregnancy should be wholegrain carbohydrates such as wholemeal bread, cereals, pasta, rice, oatmeal and breakfast cereals. Wholegrain carbohydrates provide energy, vitamins and fiber necessary in aiding constipation, which occurs in many women during pregnancy.

Essential for normal development of the fetus are of course fruits and vegetables that are rich in beta-carotene, vitamin C and fiber. The fruit can be eaten as a snack in between meals while salads and vegetables should always accompany the main dish. It is recommended to consume 5 servings of fruits and vegetables a day, eg 2-3 servings of vegetables and 2-3 servings of fruit. Apart from fruit and vegetables the consumption of legumes/pulses is also recommended but those that cause bloating and indigestion should be avoided. A good complement to legumes/pulses is orange juice or tomatoes because of their high content of vitamin C which increases the absorption of iron found in the pulses.

An important vitamin during pregnancy is folic acid which is essential for the neurological development of the fetus. In addition to supplements of folic acid, the expectant mother should consume green leafy vegetables such as spinach or greens. Oranges, almonds, walnuts, sesame and pulses are also a rich source of this vitamin. Almonds and nuts should always be unsalted and consumed in small quantities due to their high content in calories.

Meat, poultry and seafood are necessary during pregnancy because they provide protein needed for normal fetal development while red meat is also a rich source of iron. According to surveys the frequent consumption of fish during pregnancy lowers the chances of postpartum depression.

Finally, both the fetus and the expectant mother are in need of calcium consumption therefore three servings of dairy produce is recommended on a daily basis. One dairy serving equals one cup milk, one small yogurt or one slice cheese.

What should be avoided during pregnancy:
• Soft cheeses like Brie, Camembert, blue cheese and all dairy products made from unpasteurized milk.
• Raw seafood, poultry and meat that are not cooked thoroughly and soft-boiled eggs.
• Vegetables and fruit that are not washed thoroughly.
• Honey whose packaging has been unsealed for several months.
• Excessive consumption of liver. Liver’s high source of vitamin A can be harmful to the fetus.
• Alcoholic beverages and caffeine should be consumed in very limited quantities.

Yiannis Kerimis

Clinical Dietitian

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Weight Loss Mistakes

A large percentage of people are quite switched on about healthy eating, while for some the fight for weight loss never stops. Some are experimenting on their own while others follow the advice of experts, sometimes successfully and sometimes with not such good results, to acquire the silhouette of their dreams.

What are the factors and the nutritional mistakes being made that hinder the success of achieving that desired weight loss?

Mistake # 1: Excessive consumption of «light» products

When a product says that it is « light» it mean that it has 30% fewer calories than the equivalent product which is complete. It may have fewer calories but that does not mean that there are no calories and it should be consumed in moderation. In some cases the consumer buys ‘low fat’ products or products indicating 0% that may actually be low in fat but are high in sugar or otherwise may not have much sugar but are high in fat.

Mistake # 2: Whatever is healthy has no calories

A big mistake many make is that they consume products that are healthy without considering quantities or calories. The most common occurrence when one follows a healthy eating plan is the excessive consumption of fruit. Fruit is on the one hand rich in vitamins and fiber and should be consumed on a daily basis but it has natural sugars and calories. For example: 1 large fruit has 100 calories and if someone eats 4-5 pieces of fruit daily they have automatically consumed about 400-500 calories. Another big mistake is eating seeds like linseed / sunflower seeds / pine nuts which are nutritiously healthy but also very rich in calories.

Mistake # 3: Wholegrain products have fewer calories than similar refined products

Wholegrain products have exactly the same calories as the corresponding products that are refined and thus should not be consumed in larger quantities. The only difference is that whole grains have more nutrients such as minerals and fiber and maintain a healthier balance of blood glucose levels

Mistake # 4: Anything in liquid form has few calories.

Another false impression that many have. Soft drinks and alcohol are high in calories and do not provide any nutrients. Also, although olive oil is a source of good fats for the health of the heart it does not cease from being from a family of fats and contains 120 calories per tablespoon. Finally, a glass of fruit juice contains twice and three times more calories than eating a small piece of fruit.

Mistake # 5: All salads are low in calories.

A salad will actually contain a few calories if the base is vegetables. But when ingredients such as fruit, nuts, seeds, cheese, and so on, are added to the salad the caloric value can exceed 500-600 calories; therefore pay attention to the addition of too many ingredients. The same error can also be made with our main meals when including the addition of several supporting foods like bread, olives, juice, cheese, etc. It increases the caloric value of our main dish extensively.

In conclusion, when someone tries to lose weight and has not achieved the expected loss they should pay attention to any mistakes that can be made; monitoring the quantity and type of food they are eating.  A food can be healthy but it still has calories.

Sometimes reaching a desired weight, even when following a healthy and balanced diet can be hindered by a slow metabolic rate which is being affected by age, past strict diets etc. An increase in physical exercise helps in boosting the metabolism. If this does not help then a blood test is advised to see if any hormonal imbalances like thyroid inactivity are the cause.

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Nuts & Health

Dry nuts are rich in nutrients such as antioxidants, unsaturated fats and natural fibre so they should be consumed regularly in small amounts due to the high calorie amount. The main nuts which are rich in antioxidants and promote the general health of the organism are:

Walnuts contain omega- 3 fats and are rich in phenols and linolenic acid, antioxidants which react against harmful nutrients in the organism. The phenols in connection with the omega-3 fats act as a protector to the health of the heart.

Almonds are rich in unsaturated fat, nutrients and vitamin E which act as a strong antioxidant and it helps reduce the risk of cancer and anti ageing; and it also protects the heart. Almonds are a good source of calcium and help the strengthening of bones which helps in turn to adjust the pressure of the arteries.

Hazelnuts are rich in dissolvable nutrients and promote the regularity of the intestine but also it is rich in manganese, nutrients which take part in the metabolism of the hydrate of carbon and fat and it is constitutive and it is found in a lot of enzymes.

Pistachios contain vitamins from the group B (especially niacin and folic acid) and natural sterols which according to scientific research they control and keep low the cholesterol levels in the blood. Pistachios are also a good source of protein. 1/3 cup of pistachios contains 25% approximately of a demanded daily amount of protein needed for the organism.

In conclusion, nuts have heart protection and cancer protection qualities and they must be absorbed regularly as part of a balanced diet.

They are rich in nutrition, so large amounts should not be taken because they contain a lot of calories (160 -180 calories in 30 gr) they can cause weight gain.  Nuts should be consumed without any additional confectionary ingredients such as chocolate covering or salt because these ingredients will rule out the positive effects of the nuts.

Yiannis Kerimis MSc RD

Clinical Dietitian

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Ways to increase metabolism

Energy and the caloric requirements of each individual are dependent on four different aspects. The metabolic requirements of each individual are affected by the daily physical activity, the movements made subconsciously, the thermogenic effect of food (i.e. the energy needed for digesting food) and the basal metabolism.

The definition of basal metabolism can be described as the body’s chemical reactions that are designed for its smooth functioning. These reactions are responsible for a large number of functions in the body such as the cell metabolism, the maintenance of body temperature, the smooth function of the gastrointestinal tract, the glands and many other. In order for these chemical reactions to be accomplished the human body requires energy and the measure to count energy is called calorie. The higher the intensity of these chemical reactions is the more calories are required.

Metabolism in the human body is influenced by several factors. Men in general have increased basal metabolism than women and thus they achieve easier weight loss.  Also, men usually have a higher percentage of muscle tissue than women. Increase in muscle tissue and also weight gain in general leads to the increase of the basal metabolism. Also, the age of an individual can be another factor affecting basal metabolism. During growth energy and metabolic needs are increased, while after the age of 20 metabolism begins to decrease by 1-2% per decade. Besides the sex, age, weight gain, muscle mass, etc metabolism is influenced by various hormonal disorders. Poor functions in the thyroid gland, which has the effect of reducing a hormone called thyroxin, reduces metabolism by 40% while in a state of hyperthyroidism metabolism can be increased by 80%. Other factors that increase metabolism and energy needs are pregnancy and breastfeeding, increased body temperature (i.e. fever), cold climate, caffeine intake and some catabolic diseases and injuries.

Metabolism increases mainly in two ways: by exercising and by following a correct diet. Physical exercise helps to burn more calories and causes an increase in muscle tissue which also increases metabolism and energy needs.  When talking of nutrition it is suggested to reduce fat and simple carbohydrates (i.e. sugar) and avoid or reduce the consumption of sweets, fried foods and processed meat. Food consumed should mainly consist of vegetables, fruits, complex carbohydrates (whole grains, oatmeal, etc.) and protein (fish, chicken, etc). Surveys suggest that protein increases metabolism by 40%. It is advised not to skip meals during the day as the consumption of 5-6 meals daily increases metabolism. When following a weight loss diet one must be patient and not reduce excessively calories consumed as this will have a negative impact on the metabolism in the long run.  Finally, consumption of plenty water is advised in order to increase metabolism, hydration and detoxification of the body.

The way of measuring basal metabolism is achieved by using indirect calorimetry. The method of inducing one to indirect calorimetry is by lying down comfortably and wearing a mask which is connected to a special apparatus that measures combustion accomplished in the body according to the proportion of oxygen inhaled and carbon dioxide exhaled.

Yiannis Kerimis MSc RD

Clinical Dietitian

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Child Obesity

Child obesity is considered a major problem of our contemporary society. It is becoming common for children and teenagers to develop health problems, such as type II diabetes and hypercholesterolemia, which usually appears in adulthood. Childhood obesity is due to the influence of various factors such as heredity, family and social circle influences and last but not least the psychology of the child.
Children have a 50% chance of becoming obese if one of the parents is obese while the chances are increased if both parents are obese. Obesity can also be influenced by the fact that when a child lives in an environment unsuitable for outdoor games it is natural to find some forms of entertainment that promote physical inactivity such as television, computers, video games, etc. Accumulation of unwanted weight in children is also linked to the replacement of certain emotions with food. Many parents tend to reward their children with food.  Usually, a child is given sweets or is rewarded with a meal in a fast food restaurant when it performs well in a school project with the result of linking food with positive feelings.  Eventually food becomes an action related to positive emotions and later in adulthood overeating subconsciously sooths them when they are struggling to overcome a stressful situation or a negative emotion.

Childhood obesity can be treated with a proper diet, exercise and emotional support.  Overweight children should not be encouraged to follow grueling diets as this might influence their natural and biological growth in a negative manner.  It is a real challenge to stabilize a child’s weight in harmony with their increasing height during growth. In some severe cases of obesity weight loss should not exceed the amount of 2.2-4.4 pounds per month. With the help of an expert, a child should follow a balanced diet containing a combination of all food groups.

Scientific researches suggest that when a nutritionally balanced breakfast becomes a part of a child’s routine, children have less chances of becoming overweight. Children should also consume two main meals and two snacks that are nutritionally rich such as yogurt with fruit. Soft drinks or concentrated fruit juices should be replaced with fresh juices and water. Vegetables should always be a part of a main meal and when parents are accustomed to consuming vegetables children will eventually imitate them. Parents should also discover which vegetables are more likeable to their children and present them in an attractive way. Children over the age of 2-3 years can consume dairy products reduced in fat (semi-skimmed) as they contain the exact same vitamins as the full fat ones.

The combination of a balanced diet with physical exercise such as cycling, swimming or team sports guarantees a child’s good physical condition and a body weight that is close to their ideal.

In addition to promoting a balanced diet and exercise, parents should provide emotional support to their children. When a child is overweight parents should approach it in a diplomatic way and explain in a polite but yet comprehensive manner why the child has to pay attention to its nutritional intake and offer some examples.  When speaking to children in need of a diet change, parents should avoid adjectives such as “fat” or “obese”.

Food should never be associated with emotion thus rewarding or punishing a child should not be supported with food.  For example, many parents promise to reward their children with ice cream if they do well in their school exams or threaten them not to give ice cream if they do not eat their vegetables first. Ice cream in this case is used as a reward (positive emotion) and vegetables as something oppressive (negative emotion).

Parents have to realize that children imitate them in general and food consumption is not an exception. When parents follow a well balanced diet then children will follow and learn how to adopt a healthy way of eating.

In conclusion, one can say that children that follow a well balanced diet combined with exercise and adequate emotional support will have a healthy and natural growth and will maintain their ideal weight for their height.

Yiannis Kerimis MSc RD

Clinical Dietitian

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Vegetarian Diet Recommendations

Vegetarianism is the practice of following a diet deficient in meat, poultry, seafood and animal products. In some cases vegetarians may add eggs, milk and even seafood to their diets. In the last decades there is a general trend towards adopting this kind of lifestyle.
There are plenty of benefits in following a vegetarian diet. Vegetarians usually consume increased quantities of antioxidant vitamins such as vitamins C and E which contain anti-cancer and anti-aging properties.  Also, vegetarians consume lots of fiber which is responsible for the balance of blood sugar levels and blood lipids and at the same time it promotes the health of the gastrointestinal track.  People who adopt vegetarianism usually have good lipid levels (cholesterol, triglycerides) and low body weight with a reduced risk of developing heart disease, cancer and diabetes.

Although vegetarianism offers many health benefits, strict vegetarians (vegans) may be deficient in nutrients such as protein, iron, B complex vitamins and calcium.

Protein found in animal products is considered biologically complete as it provides all the amino acids that contribute towards the make of protein. On the contrary, protein found in plants, with the exception of soy protein, is often deficient in certain amino acids and not absorbed by the body as it should. Legumes are a good source of protein but are lacking some amino acids that can be found in forms of carbohydrates such as rice, potatoes, pasta and nuts.  In order for the body to be provided with complete protein the combination of legumes and carbohydrates it’s highly recommended. Good combinations of such foods are lentils with rice, vegetables with pasta, chick peas with potatoes etc.

Iron is absorbed easier by the body when it originates from animal products rather than plants. Food sources rich in iron that come from plants are dried fruits, breakfast cereals, nuts, dark green vegetables (i.e spinach) and seeds. To increase iron absorption by the body, vitamin C should be added to the diet. For example, meals should be accompanied by a glass of orange juice.

A vegetarian diet may also be deficient in B complex vitamins such as B12 and folic acid. Both vitamins are related to the healthy development of red blood cells.  Good sources of folic acid are dark green leafy vegetables, oranges, legumes, bananas, etc. Vitamin B12 is mainly found in animal products and it is less common to trace it in plants, with the exception of soy, therefore vegetarians may need to take supplements to maintain good health.

Last, vegans (= vegetarians who do not consume dairy products or seafood products like salmon and sardines) may have low levels of calcium in their body. Vegetarian sources of calcium are almonds, sesame, tofu (soybean products), dried figs and broccoli.

Yiannis Kerimis MSc RD (USA)

Clinical Dietitian

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