Vitamin B12 deficiency

Vitamin B12 deficiency is one of the most common vitamin or minerals deficiency affecting vast majority of population. It can occur at any age but is more common in elderly above the age of 50. Signs and symptoms of vitamin B12 deficiency are;

  • Numbness
  • Tingling or pins and needles sensation in hands and feet
  • Shortness of breath
  • Paleness
  • Nervousness
  • Severe joint pain.

In extreme cases the vitamin B12 deficiency could lead to

  • Memory loss
  • Depression
  • Paranoia and delusions
  • Loss of smell and taste

In order to understand the causes and treatment of Vitamin B 12 deficiency clearly , it is essential to understand the role of vitamins b12 in human body , how much it is required and food sources.

Functions of vitamin B12

Vitamin B12 also called cobalamin is one of the water soluble vitamins . It is especially important for the maintenance of healthy nerve cells . It helps in the synthesis of DNA, RNA, and red blood cells. Vitamin B12 along with folic acid produce a compound called S-adenosylmethionine which plays an important part in immune system and helps to regulate brain chemicals effecting mood such serotonin, dopamine and melatonin. Vitamin B12 also works with other B vitamin to control blood levels of amino acids and homocysteine.

Recommended dietary allowance

The recommended intake of vitamin b12 are provided in dietary reference intake (DRI) for adults and average intake for infants. The RDA of vitamin B12 is expressed in microgram.


0-6 months 0.4 mcg

7-12 months. 0.5 mcg


1-3 years 0.9 mcg

4-8 years. 1.2 mcg

Males and females

9-13 years 1.8 mcg

<14 years. 2.4 mcg

Pregnancy. 2.6 mcg

Lactation. 2.8 mcg

Food sources

Human body is unable to produce vitamin B12 so it must be supplied through diet in sufficient amount in order to avoid deficiency. Vitamin B12 is found in the tissues of animals and is therefore present in food from animal sources including liver, kidneys, Muscle meat, poultry, fish, milk and milk products and eggs. It is not present in fruits and vegetables so people on vegetarian or vegan diets are more susceptible to vitamin b12 deficiency. There are many commercially available breakfast cereals that are fortified with B12 in order to ensure bioavailability of this vitamin to particular group.

Causes of vitamin B12 deficiency

Vitamin B12 deficiency is more prevalent in older people . The major cause of B12 deficiency in older adults is due the lack of inteensic factor, a protein which ia required for the absorption of vitamin B12 from food . This type vitamin B12 deficency is called pernicious anaemia and is more common in;

  • Adults over 60
  • Women
  • And people with postive family history of autoimmune disorders.

Common causes of vitamin b12 deficiency include

  • A strict vegan diet
  • Gastric ulcers
  • Thining of stomach lining
  • Intestinal surgery
  • Medications
  • Digestive disorders

The infants born to vegetarian pregnant mothers are more succeptible to vitamin B12 deficiency.


The treatement of vitamin B12 deficiency include nutritional intervention along with proper supplementation. A person on strict vegetarian diet or vegan diet are recommended to use B12 supplements daily between meals. Also commercially available vitamin b12 fortified cereals ,soya and yeast products can be used instead of the normal ones to ensure sufficient intake of vitamin B12.

For individuals not on any diet restrictions it is essential to include liver, milk, eggs and fish in diet frequently because it carries a good supply of vitamin B12 and other important nutrients.

Treating common cold and cough with diet

Cold and cough are the contagious and the most common ailment people normally suffer several times throughout the year. Usually over the counter medications are offered to the patients suffering from cold and cough, but these medicines doesn’t really cure the symptoms just offer temporary relief. There are several ingredients in our pantry which can help to ease the symptoms of cold and cough. Cold and cough lasts for two weeks and after that time period it automatically clears up.

Signs and symptoms

Common signs and symptoms of cold are

  • Sore throat
  • Runny nose
  • Fatigue
  • Sneezing
  • Coughing
  • Fever and chills , if the cold is caused by bacterial infections

Food to relieve cold and cough symptoms

Cold and cough symptoms usually subsides in a week or two without any medicines. Healthy food and drinks are especially important in order to ensure quick recovery from the symptoms.

Drink plenty of fluids

Drinking plenty of fluids is extremely important to remove mucus and to prevent dehydration accompanied by fever during bacterial infections. An adult should take at least 2 litres of water in cold and cough. Many hot drink are especially helpful in sore throat and also helps to reduce chest congestion. Fluids which are proved to be helpful are;

  • Lemon and honey in warm water
  • Chicken broth and chicken soup
  • Herbal tea with ginger and cinnamon
  • Fresh turmeric boiled in milk


Antioxidants plays a vital tole in the prevention and treatment of common cold and cough. The antioxidants found in food helps to fight against free radicals which can cause damage to parts of cells by a process of oxidation. Studies reveals that antioxidants found in most fruits and vegetables helps to boost immune system and relieve cold and cough symptoms . It also helps to shorten the duration of these ailments. Some of the antioxidants rich foods which are found to be effective in old and cough includes

  • Ginger
  • Honey
  • Garlic
  • Chilli pepper
  • Vitamin C
  • Selenium
  • Zinc

Omega 3 fatty acids

The benefits of omega 3 have been widely discussed for boosting immune system and reducing inflammation throughout the body. Numerous studies advise that daily use of fish oil capsules helps to prevent cold in winter season. Rich sources of omega 3s are

  • Fatty fish
  • Flaxseeds
  • Chia seeds
  • Walnuts

Foods to avoid

There are numerous foods which causes discomfort in cold and cough and also delay the recovery

  • Caffeinated beverages causes dehydration.
  • Deep Fried food releases an airborne irritant which trigger coughing
  • Processed foods are high in sugars, salts , and low quality fats which tend to worsen the symptoms.
  • Tobacco is the leading cause of chronic bronchitis in individuals.
  • Fruits such as banana, oranges and mango increases phlegm production and trigger cough.


Ulcers affects millions of people each year. A peptic ulcer more commonly referred as a stomach ulcer is the lesion on the lining of stomach ,small intestine or oesophagus. Ulcers commonly occurs as a result of microbial or chemical abnormalities that in-turns disrupts the mucosal integrity.

Types of peptic ulcers

There are two common types of peptic ulcers

Gastric ulcer: The lesions that form in the lining of stomach are called gastric ulcers.

Duodenal ulcers: when the peptic ulcer develops in the first part of your gastrointestinal tract or duodenum , it is called duodenal ulcer.

Causes of peptic ulcers

Normally malfunctioning of more than one mechanism result in ulcers to develop. The most common factors that results in erosion of stomach or duodenum lining are;

  • Helicobacter pylori , a bacteria which causes infection in the stomach .
  • Frequent use of aspirin or other NSAIDs inflamed the lining of stomach and intestine and increases the risk of developing ulcers.
  • Stress ulcers which occurs as result of trauma, burns, renal failure or radiation therapy.
  • Smoking also aggravate peptic ulcers symptoms especially in patients who are infected with H.pylori.


The symptoms and intensity of symptoms in peptic ulcers depends upon the location and type of sores. One of the most common symptom of peptic ulcer is the intense pain in the middle of the stomach. Other symptoms include rapid weight loss, nausea, vomiting, heartburn, acid reflux, dark coloured stools, bloating and anorexia.

Diet managementin peptic ulcer

Nutritional care along with proper medication is extremely important in the treatment and prevention of peptic ulcers. The primary goal for diet management is to reduce the pain and the intensity of symptoms and to prevent excessive weight loss.

Following are some dietary recommendations for individuals suffering with peptic ulcers

  • Diet rich in fiber is advisable for patients with peptic ulcers. The fiber is believed to neutralise the concentration of bile acids in stomach and regulate bowel movement.
  • Regular intake of yogurt is very effective as it contains probiotics which tend to suppress the infections caused by bacteria H.pylori in peptic ulcer patients.
  • Persons suffering from peptic ulcers are advised to avoid specific spices such as black pepper and red chillies as it cause superficial erosion on the mucosal lining.
  • Protein foods temporarily buffer or neutralise acid secretions and are important for healing of the wounds. Apt for proteins present in eggs and white meat as it takes less time to digest because of the low fat content .Remove skin before cooking and chew thoroughly in order to avoid discomfort caused by larger particles to the lesions.
  • Caffeine found in tea and coffee stimulates acid secretion and cause discomfort and increase inflammation . Tea and coffee should be completely avoided.
  • Avoid larger meals at bedtime to reduce acid secretion at night time.
  • Fruit juices and soft drinks causes inflammation in discomfort in some patients suffering from mouth or oesophageal ulcers and should be taken with caution.
  • The use of antioxidants, omega 3 fatty acid are also found to beneficial in peptic ulcers caused by bacterial infections.

Olives and Olive oil

The olives are the small, bitter taste fruit formed from the ovary of the olive flower of the tree olea europea. They are found abundantly in countries of the Mediterranean coast including Portugal , southern Asia, east China , Saudi Arabia , Argentina, Norfolk Island, California and Bermuda.

Olives because of its bitter taste are unable to eat straight from the tree. They are usually first soaked in brine for couple of months and then used in savoury dishes and snacks. Olive oil is made by pressing whole olives. Olive oil is commonly used in cooking , salad dressings as well as for hair and skin care. Olives can be picked up to make oil or pickled when they are unripe and green. The oil made from unripe fresh fruit is called extra virgin oil. Olives when left on tree turned purplish black . In either ways olives can’t be eaten fresh.

Nutrition facts of Olive

Olives are the low calories food used in savoury dishes and salads. 100 grams of canned or pickled olive contains;

  • 145 calories
  • 3.8 grams carbohydrates
  • 15.3 grams fat
  • 3.3 grams fiber
  • 1,556 milligrams sodium
  • 3.8 milligrams vitamin E
  • 393 IU vitamin A
  • 0.1 milligram copper
  • 52 milligrams calcium
  • 0.5 milligram iron
  • 11 milligrams magnesium

Health benefits of olives

  • Rich in monounsaturated fatty acids

Olives are rich in fats . Almost 74 % of which are oleic acid , which is a type of monounsaturated fatty acids. Monounsaturated fatty acids are linked with several health benefits which includes;

  • Decrease in inflammation and relieves pain
  • Reduce risk of heart diseases by lowering the level of bad cholesterol in blood
  • Anti cancer properties . Studies reveal, those who consume Mediterranean diet with large amount of olives have lower risks of developing cancer and tumours.
  • Reduces the risk of type 2 diabetes and obesity

  • Antioxidant properties

Olives are rich in antioxidants vitamin E , selenium and zinc as well as phytonutrient oleuropein. Oleuropein is exclusively found in olives which helps to decrease oxidation of LDL . It also helps to protect oxygen related damage to nerve cells, increases the level of glutathione in blood. Glutathione is an important anti oxidant that is capable of preventing damage to the nerve cells caused by free radicals. The vitamin E content of olive is more in green olives and tend to decrease with ripening.Therefore the extra virgin olive oil made from fresh olives have the maximum amount of vitamin E , which itself is a powerful antioxidant.

Olive Oil

Olive oil provide variety of health benefits, if consumed on regular basis. They are rich source of monounsaturated fatty acids and contains 0 percent of sodium . They are rich in antioxidants especially beneficial polyphenols which gets lost during processing whole olives in brine. The oleuropein content is more in olive oil than olives which gives the characteristic bitter taste to fresh olives.

How to use olive oil in foods

  • Olive oil makes an excellent salad dressing when mixed with lemon, salt and pepper.
  • Vegetables can be sautéed in olive oil and added in rice ,pasta and noodles.
  • Polish meat, chicken, fish and kebabs before grilling to give extra flavour to your savoury.
  • Make a tasty hummus by mixing boiled chick peas , lemon, garlic, olive oil, salt , pepper and cumin in grinder.
  • Toast your bread with chopped garlic and olive oil to make a delicious garlic bread.


Malnutrition is the condition in which individuals are unable to get enough nutrition from the food they eat. It usually results from consuming a diet in which nutrients are either not much or more than the required amounts that causes health problems. The two common terms that refers to malnutrition are;

  • Under nutrition- include stunting, underweight, micronutrients deficiencies, anaemias
  • Overweight, obesity resulting in metabolic disorders ( heart diseases, diabetes, hypertension etc).

Malnutrition is a common problem worldwide. According to WHO 1.9 billion people worldwide are overweight and 462 million are underweight. 29% of women of reproductive age are suffering from micronutrient deficiency anaemias. 41 million children under the age of 5 are overweight, whereas 159 million are stunted ( low height fir age)/and 50 million are wasted ( low weight for height).


Undernutrition is the insufficient intake of energy and nutrients in order to meet body needs to maintain good health. It is the broad term which covers both protein energy malnutrition and micronutrients deficiencies. Sometimes the word malnutrition is used as a synonym of undernutrition. The most vulnerable group that are susceptible to undernutrition are older adults, women of childbearing age, and children under the age the 5.

Common signs and symptoms of undernutrition are

  • Tiredness and fatigue
  • Longer healing time for wounds
  • Weight loss and loss of muscle, body fats and body tissues
  • Shivering or feeling cold
  • Hair loss
  • Lack of concentration and difficulties in carrying out daily activities
  • Body pain
  • Breathlessness in extreme cases
  • Delayed growth in children, lack of growth both physically and intellectually.

Causes of undernutrition

There are various reason which results in undernutrition ,some of them are environmental while other may occur as a results of medical or health problems. This includes

  • Socio-economic problems which results in inability to buy foods and sometimes also results in inappropriate selection of foods.
  • Poor maternal health and anaemia results in low birth weight infants.
  • Little or no breastfeeding is the major cause of undernutrition specially in developing countries which lead to stunted growth.
  • Isolation and inability to prepare and shop for meals is the primary cause of malnutrition amongst elderly in developed countries.
  • Low intake as a result of mental or physical problems such as anorexia, schizophrenia, bulimia and dementia.
  • Digestive disorders such as ulcers, crohn’s diseases, frequent onset of diarrhoea and vomiting results in poor absorption of nutrients.

Dietary management for the prevention of undernutrition

The treatment of malnutrition depends upon finding the underlying cause of malnourishment and then treating it accordingly. However both medical and nutrition therapy is extremely important for the prevention as well as treatment of malnutrition. There are different strategies for different age groups and health conditions, some of which are discussed below;

malnutrition in children

Malnutrition is the most common problem in infants and toddlers under the age of five. For the prevention malnutrition in young children it is always essential to follow some of the important points . Some of them are;

  • Exclusive breast feeding to six months of age. Gradual introduction to solid foods along with breast feeding till two years of age.
  • Regular height and weight check ups with health practitioners to rule out any signs of stunting and wasting.
  • Frequent small meals and gradual introduction of protein rich foods after six months of age.
  • Treatment of any underlying health problems and regular health checkups by health practitioners.

Malnutrition in pregnancy and lactation

Maternal malnutrition is the major reason for miscarriages and growth retardation in children . Caloric and nutrients supplementation is extremely important to reduce miscarriages and incidence of low birth weight. Below are some key points to keep in mind if your are trying to conceive, pregnant or lactating;

  • Regular folic acid supplementation is required in first trimester to prevent neural tube defects.
  • Iron supplementation after first trimester throughout pregnancy to prevent iron deficiency anaemia.
  • Regular intake of milk and dairy products throughout pregnancy to prevent osteoporosis in later life.
  • Regular checkups with doctors and health practitioners.

Malnutrition in elderly

Malnutrition is very common in old age which contributes to decline in health, reduced physical activities , weight loss and mortality. Some of the factors which helps to prevent malnutrition and increase the quality of living in later life are;

  • Providing a healthy and friendly environment at meal times.
  • Frequent small meals in order to prevent indigestion.
  • High energy foods and drinks to undernourished elderly including egg nog, fish, fruits and vegetables.

Overweight and obesity

One of the most common and widely discussed form of malnutrition is overweight and obesity. The root cause of overweight and obesity is the consumption of high energy foods and lack of physical activities. Eating a healthy diet with regular exercise is important to maintain a normal weight and to prevent from diseases which occurs as a result of excess weight gain.


Dietician daily

Snacking is generally a term used for eating something between meals. It is normally is associated with eating high fat crisps, biscuits or other bakery products. But it is not true . The snacking can be a healthy habit and may provide certain health benefits if proper choices about the kind and quantity of food can be made. It gives body the energy and nutrients it requires to perform functions throughout the day.
Normally there are 6 -7 hours gap between each meals, and going for a longer period of time without food may lowers blood sugar levels of some individuals and cause irritability in their systems. So sometimes in certain situations it is essential to break the gap by eating or drinking in order to satisfy hunger and keeping the blood sugar level normal.

Tips for healthy snacking.

  • Foods normally referred as snacks such as crisps, french fries…

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Effects of high sodium intake

Dietician daily

Sodium is an important mineral needed by the body to work properly by controlling blood pressure and blood volume. It is also essential for the proper functioning of nerves and muscles in the body.

Recommended intake

The recommended daily intake of sodium for different age groups is as follows Average sodium intake of a healthy adult should not exceed the maximum recommendation of 2300mg/day. However the average daily intake of sodium in a normal diet is far more than this.

Sources of sodium

The main source of sodium comes from the normal table salt, which is the main ingredient of every savoury. 1 tsp of table salt provide 2300 mg of sodium. Other sources of sodium include

  • Natural sources such as meats , fishes, dairy and eggs.
  • Foods in which salt is added during preparations and processing such as cheese, processed meats, tomatoes, salad dressings bread and cookies.
  • Fast foods…

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Low carbohydrate diet….myths and facts

Low carbohydrates, high protein or high fat diet are getting popular these days for weight loss. Some examples of these diets include paleo, Atkins and ketogenic diets. But are these diets really healthy?

Common questions which comes in the mind of an ordinary man are;

  • Are these diets really effective for losing weight?
  • Are there any long term consequences of these diets regarding general health.
  • Does the weight loss after these diets is long term or one gains weight soon after switching to routine diet.

To get the answer to all these questions we need to know the importance of each macro nutrients, their functions in body and their sources. The brief introduction to these macronutrients is illustrated in the table below;

According to USDA the general dietary requirements of carbohydrates for a normal healthy adult is 45-65% of the total calories. The requirements of proteins is 10-35% and of fat is 25-40% of the total calories.

Science behind these weight loss plans

All these diets , Paleo, Atkins and ketogenic focuses on limiting carbohydrates to less than 20 grams per day. According to these diets advocates, it initiates the process of ketosis . The carbohydrates after absorption is converted into glucose which is then transported via blood to all parts of the body as a source of energy required in different functions. The excess glucose is stored in the form of glycogen in liver. The remaining glucose is then converted in fats and is stored in adipose tissues. During fasting state when the body is not provided with sufficient glucose the body uses glycogen stores for energy. Once the glycogen stores are depleted, the fats stored in adipose tissues are used up by the body for energy.

The aim of these diets are to restrict calories from carbohydrates sources which would eventually results is burning of stored form of fats and thus results in weight loss. However the success of these diets vary among individuals.

Advantages and disadvantages of different diets

Atkins diet:

The Atkins diet was first promoted by Dr Robert Atkins in 1972. The diet promotes high proteins and saturated fats intake and limit carbohydrates consumption to less than 20 grams in a day. The main reason of weight loss is that the food low in carbohydrates are less palatable and one ends up in eating less calories. It encourages to eat fats and proteins like :

  • Meat
  • Poultry
  • Seafood
  • Butter
  • Eggs
  • Oils
  • Cheese

It restrict foods such as

  • Breads
  • Rice
  • Potatoes
  • Chips
  • Cookies
  • Candies


  • Promote rapid weight loss.
  • Fancy diet which enables individuals to consume variety of meat products and fatty foods.


  • Diet is very restrictive in nature.
  • Diet is high in saturated fats and is not advisable for patients with positive family history of heart diseases.
  • This diet can cause nervousness , bad breath ,nausea and headaches.
  • High proteins diet place additional burden on kidneys and increases the risk of developing kidney diseases.
  • Atkins diet offers less vitamins and minerals which eventually leads to nutritional deficiency.

Paleo diet

This diet was developed by Loren Cordain , a phd researcher in late seventies. This diet suggests eating all the foods available to people in prehistoric era . It includes meats,fish, nuts, leafy greens, vegetables and seeds. And restrict foods such as grains, dairy, processed and high sugar foods.


  • People tend to lose weight because of limited food choices.
  • Improved satiety due to high fat and protein intake.
  • Improved iron levels due to high intake of red meats.


  • The portion size of the food is not clearly specified, which end up in eating more than required proportions of foods.
  • The diet is quite expensive.
  • Not suitable for people who are vegetarian.
  • This diet end up in developing calcium deficiency because of dairy restrictions.
  • Not suitable for athletes and may result in hypoglycaemia.

ketogenic diet

For detailed review visit Ketogenic diet .

Practical recommendations to lose weight

  • An overall caloric restriction along with exercise is the best way to lose weight. Restrict your calories to 1000 or 1200 calories.
  • Avoid eating refined grains such as white bread, rice and pasta and eat whole grains. Increase fiber intake as it increases the feeling of fullness.
  • Limit high fat, high sugar and processed foods.
  • Drink plenty of water.
  • Fill half of your plate with fruits and vegetables.


Aliya Waqas