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I'm A Clinical Dietician With A Master’s In Human Nutrition And Food Science, AMA!

Posted by

Veronica Cavallini profile picture
Veronica Cavallini
VIP 13 days & 17h ago


Hello, DxD community! I’m Veronica Cavallini, a clinical dietitian in Singapore! I’ll be replying to all your comments on Wednesday, 13 March 2019, at 5:00 PM.

Background:

I have a Master’s degree in Human Nutrition and Food Science, and have 9 years of experience within the field. I have a special interest in the treatment of gastrointestinal conditions.

As an Italian, I love fresh and healthy foods, but I also indulge occasionally with a slice of pizza. 

Leave a comment below to ask me anything related to diet, nutrition and weight loss, e.g.:

  • What is a healthy diet
  • How to lose or gain weight in a healthy way
  • Nutrition and gastrointestinal issues
  • Nutrition and other medical conditions such as diabetes, hypertension, PCOS, food allergies and intolerances
  • Recommended diet during pregnancy and breastfeeding
  • Eating disorders
  • Nutrition in general
#Diet & Nutrition
Comments (42)
Xin Tian  profile picture
Xin Tian
VIP 7 days & 9h ago

Hi everyone, I'm Xin Tian, DxD's content editor. I'll be moderating this AMA. Veronica will be coming on live on 13 March 2019, from 5:00pm to 6:00pm to answer all your questions. Feel free to start leaving your questions and comments for her below!

Hi Veronica, thanks for joining us in this AMA session! 

I understand that you are a clinical dietician and nutritional consultant in Singapore. Many people have ideas about what a healthy diet is or know that they can do something to eat more healthfully. But not everyone thinks of getting outside help on eating well. So here are some of my questions to start this AMA:

1. What is your role as a nutritional consultant, and what do patients in Singapore come to see you for?

2. Who should see a nutritional consultant?

3. It's said that short-term dieting usually doesn't work. Is slow weight loss through dieting over a long period of time (months or years) more effective to keep the weight off? 

Hi Xin Tian,

Thank you for the questions!

1- As a nutritional consultant I usually guide patients into better eating habits not only for a weight management purposes, but to achieve optimal health. I usually help to develop healthy eating plans based on their eating habits and their nutritional requirements. I usually see a variety of patients with different health conditions like diabetes, hypertension, high blood cholesterol, autoimmune diseases, gastrointestinal diseases, PCOS, allergies and food intolerances, eating disorders and weight management.

2- People who want to improve their health status (for example weight management and other medical conditions), people who wants to change their diet for ethical reasons, or people who just want to be more healthy.

3- Usually I see patients obtaining more results with a slow weight loss through dieting over a long period of time in a combination with regular exercise. What I do not like about short and extreme diet is that people starve for few months and after that they go back to their usual food habits, gaining all the kg they have lost. This usually happens because the body goes into starvation mode, the metabolism slows down in an attempt to burn as little energy as possible to keep you alive, thus it is then easier to store extra body fat the moment you start eating again. We need to learn how to eat healthy and follow something reasonable for the rest of our life, not only for a few months.

On the other hand, there are some particular conditions where an aggressive diet for a short period of time is suggested. For example, for people with severe obesity and comorbidities such as diabetes, cardiovascular diseases, hypertension, respiratory conditions, metabolic disorders, or who are going to have bariatric surgery may be advised to take an aggressive diet to reduce possible complications during surgery.


Xin Tian  profile picture
Xin Tian
VIP 5 days & 23h ago

Thank you so much Veronica for answering the DoctorXDentist community's questions on food, diet, and gastrointestinal health during our AMA!

To learn more about Veronica, do visit her profile from Andrea's Digestive, Colon, Liver, and Gallbladder Clinic.

Wishing all of you the best of health and much eating well to come!

Thank you very much!! 
Yvonne
8 days & 0h ago

Hi, I would like to know if eating fresh fruit before bedtime is a bad idea because of too much sugar intake? Thank you!

Hi Yvonne, 

Thank you very much for your question! I usually recommend to avoid having anything right before bed time as it can disrupts your sleep. Eating fruits right before going to bed can release high amount of sugar, causing spike in energy, when your body should be preparing to slow down and rest. Of course if you decide to snack before bed time, keep it healthy avoiding fruit canned in sugary syrup, fruit juices and fruit with high sugar content. The best option could be a small serving of raspberry, blackberry, strawberries or some vegetables stick.

Also, another thing I always ask to my patients is why they feel the cravings after dinner. How many times I had food during the day? Did I eat a balanced meal during dinner? Did I have enough vegetable during my dinner? Is the needs of food real or I’m only bored? Depending on the answers there are few tips we can use in order to avoid or reduce cravings.

May
8 days & 0h ago

Hi Veronica! I’m interested in eating sustainably because I know this planet cannot support us eating steaks and ribs the way some people in the West do!

If I switch to a vegetarian diet, do I need to take supplements for certain minerals?

What do I need to make sure I get enough protein from non-meat protein sources?

Thank you!

Hi May, 

Thank you very much for your questions! 

1- I think that before you do any change in your foods habits you should check with your GP if the level of your vitamins and mineral is in the good range. After that, you can correct deficiencies if any, and change your diet to a vegetarian, based on your actual health condition. After you start the diet, in my opinion, it is advisable to do regular check-ups with your GP who knows you and your medical history.


2- Depending on which type of diet you choose, you can choose different types of food. For example:

- Lacto-Ovo vegetarian: you can use eggs, low fat milk and dairy, legumes (beans, lentils, peas, chickpeas, etc..), seaweed, tofu and tempeh, sprouts, nuts, seeds, grains (especially quinoa, spelt and buckwheat because they contain more protein) and vegetables milk.

- Ovo vegetarian: you can use eggs, legumes (beans, lentils, peas, chickpeas, etc..), seaweed, tofu and tempeh, sprouts, nuts, seeds, grains (especially quinoa, spelt and buckwheat) and vegetables milk.

- Lacto vegetarian: you can use low fat milk and dairy, legumes (beans, lentils, peas, chickpeas, etc..), seaweed, tofu and tempeh, sprouts, nuts, seeds, grains (especially quinoa, spelt and buckwheat) and vegetables milk.

- Vegan: you can use legumes (beans, lentils, peas, chickpeas, etc..), seaweed, tofu and tempeh, sprouts, nuts, seeds, grains (especially quinoa, spelt and buckwheat) and vegetables milk.

- Pescatarian: you can use fish and seafood, eggs, low fat milk and dairy, legumes (beans, lentils, peas, chickpeas, etc..), seaweed, tofu and tempeh, sprouts, nuts, seeds, grains (especially quinoa, spelt and buckwheat) and vegetables milk.

Also remember that animal proteins contains all the essential amino acids in the correct proportions, hence they are considered of high biological value, while the vegetable ones can have an incomplete amino acids profile. For this reason the combination of grains and legumes in the same dish (eg. rice and lentils) represents the good substitute of a slice of meat, as grains contains a good doses of the essential amino acids missing in the legumes and vice versa.




Danielle
8 days & 0h ago

Hi Veronica, thanks for answering these questions!

I snack on non-salted and non-sugared nuts a lot. Is there such a thing as eating too many nuts?

Is it true that having one cup of coffee a day is good for brain health too? I am female if that helps. Thank you!

Hi Danielle, 

Thank you very much for your questions! 

1-Eating nuts as part of a healthy diet is good for our health especially because nuts may protect from cardiovascular diseases and other health conditions. Nuts contain good fats, fibre, vitamins, AND plant sterols, they are easy to pack when you are on the go, and they are considered as a good snack to eat between meals. One drawback to nuts is that they are high in calories, so it is important to limit portions. Moreover, while a normal portion can hold you over until dinner, a few more handfuls can ruin your appetite.

Another thing is that nuts and seeds are not easy to be digested, so if you suffer from IBS or other gastrointestinal conditions, they may trigger symptoms such as bloating and discomfort. A portion of nuts is usually 30g (a small, cupped handful) which is about 175kcal.

2- Studies have shown that coffee may have health benefits protecting against type 2 diabetes, Parkinson's disease, and liver disease, including liver cancer. Coffee also seems to improve cognitive function and mental health, for example decreasing the risk of depression. However, there are some side effects which varies by individual and their ability to metabolize caffeine. If you are not a coffee drinker, you do not need to start, but if you like to enjoy coffee, keep in mind that the Mayo Clinic suggests a limit of around 400mg of caffeine per day, which is about 4 cups of brewed coffee.


Chong
8 days & 0h ago

Hello! I've got a friend on Facebook who is on a liquid fast (no food, just water, sparkling water, and tea, with a drop of lemon sometimes, and apple cider vinegar) for three weeks so far and counting. Yes, he's still alive. I know this sounds weird but it's true.

He claims that it is helping him with his health and weight loss. What is the science behind this (if it is accurate)?

Is this something healthy or is it more dangerous than it is beneficial? Thank you!

Hi Chong, 

Thank you for your questions!

1-Some studies have shown that a short period of fasting (24-72 hours) or intermittent fasting may have some health benefits such as:

promoting blood sugar control by reducing insulin resistance;
decreasing inflammation;
improving blood pressure, triglycerides, and cholesterol levels;
improving brain function and preventing neurodegenerative disorders;
aiding weight loss;
and delaying aging and extending longevity.

However, further studies are needed to understand how fasting may impact in all these conditions and in general health status.

2- In my opinion, a long period of fasting like this, unless necessary due to other medical reasons and suggested by a doctor, is very unhealthy. I strongly discourage this practice for such a long period of time for many reasons:

- You can have more loss of muscle instead of fat. Furthermore when you start fasting, your body goes into a conservation mode, burning calories more slowly.

- You can have different side effects: headache, dizziness, low glucose level, fatigue, and muscle aches. Prolonged fasting can lead you to have anemia, irregular heartbeat, liver and kidney problems, and vitamin and mineral deficiencies.  

It is a big no-no for me!

Anonymous
6 days & 9h ago

Hi Veronica! 

Are lactose intolerance and milk allergy the same? 

Thank you! 

Jade 

Dear Jade, 

Thank you very much for your question!

There is a bit of confusion regarding intolerances and allergies. Lactose intolerance and milk allergy are not the same. 

Lactose intolerance is caused by not having enough of the enzyme lactase, which is needed to break down lactose in single unit of sugar, glucose and galactose, which they can be absorbed in the small intestine. If this process is not happening, the lactose goes in the colon where is fermented by the bacteria. The bacterial fermentation of lactose produces gas and increases gut transit time and intracolonic pressure, resulting in one or many symptoms such as bloating, diarrhea, and flatulence. This condition can be easily detected using the breath test. This test make use of gut bacteria’s ability to digest unabsorbed sugars and convert these to hydrogen, which is then absorbed into the blood and can be measured in exhaled breath.

A food allergy occurs when a person's immune system reacts to substances (proteins) in the food that are harmless for most people. The exposure to the allergen can trigger signs and symptoms such as digestive problems, hives or swollen airways. In some people, a food allergy can cause severe symptoms or even a life-threatening reaction known as anaphylaxis. To detect allergies the most accurate test is the skin prick test.


Sohee
6 days & 9h ago

Hello! I would like to know how you think about flexitarianism? :)

Hi Shoee, 

Thank you for your question!

The flexitarian diet is a new concept of vegetarian diet, that gives you more flexibility combining vegetable proteins with animal proteins few times a week. I think that the flexitarian diet should be a good compromise between people who usually eat animal proteins including meat and vegetarians or strict vegans. Having few times per week more variety of animal foods will increase the daily intake of different vitamins and mineral which may be lacking in the vegetarian or strict vegan diet. If you're thinking about changing to a flexitarian diet, I would advise to follow few tips:

• eat at least five portions of fruit and vegetables a day;

• include wholegrain at least in one of your main meal;

• include different source of iron that may be lacking due to a low intake of red meat. Good sources include dark green, leafy vegetables such as spinach, cabbage, kale and broccoli;

• use vitamin C from food to increase the absorption of iron from vegetables sources. You can have a small glass (150ml) of fresh squeezed orange juice or a lemon sauce as a dressing, or salad items like sweet peppers, lamb's lettuce and tomatoes with meals;

• use few times a week animal protein like salmon, eggs, low fat dairy and chicken;

• reduce the anti-nutrients in the legumes with a long soaking, changing constantly the water and when possible removing the skin after cooking.



Anonymous
6 days & 7h ago
Dear dietitian Veronica,

What type of foods would you advise patients with acid refluxes to eat? Thank you! 

Hi, 

Thank for your question!

Recent studies shows that a Mediterranean diet can help in reducing reflux medications, giving a lot of extra benefit on reflux and gastritis. I always recommend to follow an healthy diet (mediterranean style) giving extra tips:

• Avoid large meals and do not have meals and snacks in 2-3 hours before bedtime

• Limit or avoid (depending on individual tolerance) foods or beverages such as:

- Alcohol, carbonated beverages, soft drinks, coffee, black tea, citrus fruits or citrus juices (do not take them at empty stomach)

- mint, spices such as chilli pepper or curry, garlic and spring onion

- foods rich in fats (fried food, butter, cream, fat sauces such as mayonnaise, gravies, fat meats, processed meat, margarine)

- tomato and tomato based products  

- chocolate and sweets 

Moreover..

• if you smoke, please quit smoking .

• Eat slowly and chew well your food.

• Avoid wearing very tight clothing, or belt.

• If you suffer from night-time reflux is advisable to slightly raise the headboard of the bed and avoid snacks before bedtime.


Anonymous
5 days & 14h ago
Wow thank you Veronica for the detailed ans! Will take note and share with my family!
:) Hope this can help!! 

Of course if you have reflux since long time and you have never had a visit with a gastroenterologist, I strongly recommend you to go for a check. Also, please remember that stress play and important role in triggering all the symptoms so if you are stressed you might consider to go for some meditation sessions or yoga classes. Combining medication, stress management and food you can for sure relieve the symptoms. 

Anonymous
6 days & 5h ago

Hello! Do you have any tips on portion control?

Ulfa

Dear Ulfa, 

Thank you very much for your question!

Please find below a few tips on portion control:

• Before and during meals, drink water to fill up your stomach.

• Start your meal with a big portion of vegetables, you can feel full faster and control your subsequent food intake. This can also allow you to better control your blood sugar level during meals, and avoiding cravings.

• To get an idea of how much carbs, protein, fats, and veggies to have in a meal, use the plate or palm rule. If you use the plate, choose a small one so you do not overeat. Divide the plate into half a plate of low-starch vegetables, a quarter plate of protein, and a quarter plate of complex carbs, with one or two tablespoons of healthy fats.

• Use the same bowls and plates.

• Do not eat from a bag or a box.

• Chew your food properly before swallowing and eat in a relaxed atmosphere.

• Eat slowly.


Pino
6 days & 4h ago
Hello Veronica..what’s your view on cold cuts? Are they considered unhealthy? 

Dear Pino, 

Thanks for your question!

Cold cuts are considered processed meat and they should be avoid because they are unhealthy. All these foods usually are loaded with salt, sugars, and preservatives such as nitrates and nitrites. These are considered potentially dangerous substances because in an acid environment (for example in the stomach) they are transformed into nitrosamines, compounds considered carcinogenic. Furthermore, nitrites bind the hemoglobin reducing the transport of the oxygen to the tissues.

Selecia
8 days & 0h ago

Hello! I am currently in my 40s. What foods are good for brain health and preventing conditions such as Alzheimer’s, Parkinson’s, etc? 


Dear Selecia, 

Thank you very much for your question! 

I usually recommend to have a healthy lifestyle doing regular exercise and following a healthy diet. Foods you may have regularly are fruits, vegetables, wholegrains, and legumes because they contain a high amount of vitamins and antioxidants which may help your body during the oxidation precesses. Also, they are loaded with fibre which contributes to intestinal health by selecting good and bad bacteria (gut-brain connection).

Have plenty of extra virgin olive oil, avocado, nuts, seeds, and oily fish (salmon, tuna, trout, mackerel, and sardines) because they contain good fats which have proven health benefits in reducing inflammation and reducing the risk of cognitive impairment and Alzheimer’s disease. Furthermore, it is very important to reduce intake of sugar as well as saturated and trans fats.

Anonymous
6 days & 7h ago

Hello! Which are the foods do I need to avoid if I have high uric acid?

Thanks!

Hi, 

Thank you for your question!

Usually people with high levels of uric acid have to follow a low purine diet. You should follow these guidelines, but it is always recommended to see a dietitian to help you with the new diet plan: 

• avoid red beef, pork, bacon, lamb, and minced meat ;

• avoid internal organs: such as kidney, liver, intestines, meat gravies, meat extracts, fish roe, tongue, and brains among others;

• avoid broth made from red meat; 

• avoid alcoholic beverages;

• avoid foods that are made with a significant amount of yeast such as beer and bread;

• some vegetables may increase uric acid levels: such as beans, lentils, spinach, avocado, peas, and mushrooms;

• certain seafood to be avoided includes: sardines, mussels, scallops, herring, mackerel, shrimps and anchovies, sushi, crabs, and oysters;

• full cream dairy products with high fats have to be avoided: including whole cream milk, cream, and sour cream ;

• simple carbohydrates such as sugar and all the foods that may contain it like sweets, deserts , cakes, etc..;

• coffee, cocoa, chocolate, and even black tea has to be reduced.

Anonymous
6 days & 6h ago

Hi Veronica! 

Should I drink alcohol sometimes during pregnancy?

Thank you very much! 

Anne 

Dear Anne, 

Thanks for your question. 

Although the majority of doctors recommend to avoid alcohol during pregnancy, some others say that occasional light drinking is unlikely to cause problems while you are expecting. Since the potential effects of small amounts of alcohol on a developing baby are not well understood, I would recommend to avoid any unnecessary risks for the baby.

What I usually recommend to all my patients is a healthy alternative of Spritz made with: red orange juice without sugar, grated ginger, black peppercorns, and 1/2 teaspoon of agave syrup.

Joao
6 days & 4h ago
What’s your favourite food in Singapore? 

Hi Joao, 

Thank you for your question!

There are different foods I like of this multicultural country, but what I like the most is the Indian food. Once in a while, I like to indulge with butter chicken, aloo gobi ,and dosa :)

Cheryl
6 days & 2h ago

What is SIBO and how can I test for this condition? I always have bloating and gas and a friend recommended me to do the test. If The result will be positive, which diet I should follow?

Dear Cheryl, 

Thank you for your question! 

SIBO stands for Small Intestinal Bacterial Overgrowth. It is a syndrome caused by an increased number of bacteria in the small intestine that usually live in the colon. When bacteria overpopulate in the small intestine, you might not be able to absorb nutrients from your food. This bacterial imbalance in the gut can cause bloating, diarrhea, maldigestion, reflux and pain. The test available in the market to detect this condition is the breath test, which usually is performed in gastroenterologist clinics, hospitals or specialist centres. If the outcome is a positive result, you should consult your doctor to understand which therapy you should follow and a dietitian specialised in the use of a Low FODMAP diet.

Dianny
6 days & 2h ago


Dear Veronica, sorry for my late question! Do you think I can eat 1/2 avocado every day?

Thank you! 

Dear Dianny, 

Thank you very much for your question!

To be honest without knowing your medical history it is not easy to say. Generally, if you do not have any medical condition which requires a fat intake restriction, you can have it without problems. Avocado is a very nutritious food packed with fibre, vitamins, antioxidants, and good fats! I usually use it in the smoothies or on toast or in the salad or I use it a lot as ingredient to create a healthier version of chocolate cream.

Sunitha
6 days & 1h ago

Dear Veronica, I suffer from constipation, do you have any tips?

Dear Sunitha, 

Thanks for your question!

If you have chronic constipation you should go to a gastroenterologist first and then you can do some changes in your diet. Please remember that, at this stage, you do not have to eat a lot of nuts or wholegrain products because instead of helping, they can aggravate the condition. Usually soluble fibre from food and supplements is recommended. But again, go to a gastroenterologist and let him or her advise you which fibre supplement suits for your needs. Generally to ease constipation, beside a balanced diet tailored on patient needs, I usually recommend to try homemade water prunes. 

Sandy
6 days & 1h ago

I often feel bloating and gas, which are the foods that I need to reduce? What can help me to improve my digestion?

Dear Sandy, 

Thank you for the questions! Of course, if you are always bloated and you feel gassy, you should consult a gastroenterologist, then you can see a dietitian regarding the diet modifications. I attached below few advice.

Food that is often related to bloating:

  • Generally vegetables are very healthy, but some of them may cause extra gas and should be taken in moderation: all legumes (beans, peas, lentils, etc..),cabbage, cauliflower, broccoli, bean sprouts, Brussel sprouts, asparagus, onion, garlic.
  • Fruits: grapes, pears, mango, cherries, water melon.
  • All processed food, fast food, carbonated beverages and soft drinks can increase indigestion and gas.
  • Oily and fried food, curry.
  • Artificial sweeteners and all the food or drinks which contain them.
  • In some people, especially those lactose intolerant, fresh milk and fresh cream can cause a lot of gas and cramps. You can try to shift to lactose-free milk and dairy which should result in less discomfort. 
  • Reduce sugar and all the foods which contain it like cakes, deserts, sweet drinks, etc..

To improve your digestion you can try with apple, papaya, ginger, camomile and oats. Always remember to reduce/avoid fried and oily food, artificial sweeteners, processed foods, curry and spices, coffee, black tea, garlic, spring onion and citrus fruits, because those can increase acid reflux episodes.

Joan
5 days & 4h ago



Hi Veronica, I’ve totally removed carbs from my diet because an health coach recommend me to do it in order to clean my body from toxins. I’m not feeling good and I would like something more sustainable and not so aggressive. What do you think?

Dear Joan, 

Thank you very much for your question! 

First of all I recommend you to see a dietitian and if you want to be sure about their credentials, please go to the SNDA website where you can find the list of all the accredited dietitians and nutritionists in Singapore.

Second, carbohydrates as opposed to what many people nowadays say, are not the main culprit of all the diseases in the world. They are the only substrate that doesn't produce any waste product during the digestion. Also, if your problem was gluten related, now that you are avoiding all the carbs, you cannot be tested for celiac. You have to be exposed again to gluten and do the proper test later. 

Of course I do not know your medical history and which symptoms you were presenting when you met the health coach, but what I can say is that you also have to listen to your body. If you are not feeling good this is a clear sign that you can do something less aggressive. 

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