Nutritionist Dr. Andrea Del Seppia

Clinical and sports nutrition - Cesena, Forlì, Ravenna and Rimini

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Breastfeeding: breast milk and its benefits

Breastfeeding: breast milk and its benefits

Now universally recognized by all scientific communities as the only food able to fully satisfy the needs of the infant, mother's milk is fundamental for the supply of nutrients and functional factors such as antibodies and hormones: we explore the topic with our nutritionist, Dr. Andrea Del Seppia.

The composition of breast milk is excellent for providing the baby with the right nutrients in quantity and proportions. Thanks to immunoglobulins, lactoferrin, lysozyme and cells of the immune system (macrophages, lymphocytes and neutrophils), it has an "immune" function towards numerous pathogens (viruses and bacteria) and reduces the incidence of food allergies in adulthood. It is a food that is always available, fresh, at the right temperature (body), also valuable for the effectiveness it has on the mother-child bond and on the psychological well-being that arises in both from the practice of breastfeeding. Various scientific studies show that, in addition to the child's good health and proper development, breastfeeding reduces the risk of breast cancer, ovarian cancer, the risk of type 2 diabetes and postpartum depression for the woman.

But what are the characteristics of breast milk? Let's see them together ...

First of all, the composition varies from person to person and from the beginning to the end of the breastfeeding period, adapting to the growth needs of the newborn. For example, the colostrum produced from the first to the fifth day of lactation is richer in proteins and immunoglobulins than transitional milk, secreted from the fifth day of lactation and from mature milk, due to the baby's need to develop tissues and immunity. However, the average composition varies from 0.6 to 1.4% of proteins, from 3 to 8% of fats, from 6.5 to 8% of carbohydrates and contains about 0.2% of salts; the rest is water. On the other hand, artificial breastfeeding can lead to a higher incidence of childhood obesity (type I and II diabetes), less resistance to pathologies and less development. In mothers, non-breastfeeding is associated with an increased incidence of premenopausal breast cancer, ovarian cancer, gestational weight gain, type II diabetes, myocardial infarction and metabolic syndrome.

Let's now pass to the nutritional requirements: according to the LARN (Nutrient and Energy Reference Intake Levels) the energy requirement of the nursing nurse increases with the production of milk ranging from 750 ml / dia to 810 ml / dia, for which will require an increase in caloric intake from 450 to 550 kcal / dia. However, the quantity can vary from woman to woman based on numerous factors such as, for example, age and weight reached at the end of pregnancy by the mother and size of the child.

Speaking of the mother's feeding time during breastfeeding, it is essential to keep in mind that the quality of the food introduced is reflected in the quality of the milk that will be taken by the infant. Therefore, the same recommendations for pregnancy apply. In general, it is recommended to follow a varied and balanced diet consisting of fruit, vegetables and cereals, preferably whole wheat, important sources of dietary fiber. Compared to pregnancy, the caloric intake must be increased: we therefore recommend 4-5 weekly portions of legumes, sources of vegetable protein and dietary fiber, to be alternated with meat, fish, eggs and cheese.

Fish is important for a correct intake of DHA, which is important for the development of brain and retinal structures.

At least 2 portions of fish are recommended, up to 3-4 servings per week, better if small sized blue fish (sardines, anchovies, mackerel) rather than large fish such as tuna and swordfish, accumulators of contaminants (EFSA 2015) . With regard to fats it is preferable to use extra virgin olive oil and essential fatty acids which are mainly found in oil seeds (for example flax, walnut, almond and soy) and blue fish.

Among the micronutrients, particular attention must be paid to calcium, present above all in milk and derivatives; to the iron we find, for example, in legumes; to vitamin B12 that we can find in eggs and fish such as salmon and sardines; folic acid, of which broad-leaf vegetables and vitamin D are rich.

All dried fruit, rich in mono and polyunsaturated fatty acids, could be an excellent snack at least once a day.

It is also important to maintain a high water intake of which an increase of about 700 ml per day is recommended, compared to what is recommended for women who do not breastfeed (2000 ml).

At this point we just have to list the foods to avoid: such as those that can make a bad taste of milk, making it unpleasant to the baby or cause food poisoning. In the first case, onion, parsley, artichokes, broccoli, cabbage and asparagus are contraindicated. In the second case, we advise against the consumption of crustaceans, molluscs, game and raw eggs. Also, if the infant is suffering from gaseous colic, avoid all dairy products, legumes with peel and dried fruit. Always remember that being followed by a specialist in nutrition is the best solution to ensure the right amount of nutrients and in the right amounts for each single mother.

Read the full article on Misura® website

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Link to Dr. Andrea Del Seppia page on the official Misura® website

Misura® is a registered trademark of Colussi S.p.A. The material reported in this article is the property of Colussi, who authorized its publication.

Feeding and glycemic index

Corretta alimentazione e indice glicemico

One of the parameters with which to evaluate the choice of food is surely represented by the glycemic index, that is, the value that measures the speed with which the various foods increase the level of glucose in the blood (glycemia).

Misura's interview with Dr. Andrea Del Seppia

Let's talk about the topic with our nutritionist, Dr. Andrea Del Seppia.

 

Dr. Del Seppia, can you explain to us what is the glycemic index and why is it so important?

First of all, the glycemic index (GI) allows us to classify a food based on its conversion rate into glucose and then into energy. Depending on the speed with which they raise the blood sugar, the various foods are in fact defined "low, medium or high glycemic index". For example, whole grains and legumes have a low GI and are converted slowly into circulating glucose. In this case, the blood sugar level is gradually increasing and, gradually, an amount of insulin is released, the hormone used to reduce excess blood sugar levels, which will make the available sugars available to the cells: these foods provide slow-release and long-term energy.
In contrast, high GI substances such as potatoes, jams or very sugary fruit quickly enter the blood and provide immediate energy in the short term because just as quickly the hormone insulin will reduce the glycemic values.

What are the factors that influence the glycemic index?

The main factors contributing to reduce the GI of a food are the coexistence of fiber, proteins and / or fats within the meal or the food itself. Whole grains such as oats or spelled, rich in dietary fiber, have a lower GI compared to polished rice; the wholemeal pasta, compared to the common semolin pasta, has a lower GI due to the higher fiber and protein content.
In the composition of starches, which are a type of complex carbohydrates, the preponderant presence of amylose (a long linear structure) compared to amylopectin (a branched structure) lowers the GI: for example, corn and potatoes have little amylose and therefore a high GI; lentils, on the other hand, have a lot of amylose and a low GI. In the case of fruit, the degree of ripening affects the IG: normally the unripe has lower values than the very ripe (more sweetish).

Cooking techniques have effects: a prolonged boiling of starchy foods causes an increase in IG. In fact, the pasta cooked for a long time (and therefore more hydrated) will give a quicker glycemic response compared to that given by the pasta left "al dente"; the latter also has the advantage that, being harder, it induces a slower chewing, favouring a sense of satiety.

On the other hand, the IG decreases with toasting bread and cooling carbohydrates: for example, cold pasta, rice and cereal salads or boiled potatoes, if left to cool, have a lower GI than when the same foods are consumed as soon as cooked.

Can the glycemic index allow us to divide food into "good" and "bad"?

This is not a sufficient parameter because it only indicates how fast the blood sugar rises and does not provide any information about the amount of glucides. This value alone does not describe how high the blood glucose peak is, just how fast it is reached. For a more complete evaluation, the concept of glycemic load (CG) was introduced, which takes into account both the quality and quantity of ingested carbohydrates. The CG depends on the portion, while the IG is fixed.

For example, a margherita pizza with wholemeal dough does not have a particularly high GI, however it contains an abundant portion of carbohydrates, so its CG is high. Conversely, the carbohydrates contained in the cooked carrots raise the blood glucose concentration rather quickly, but a carrot contains fewer carbohydrates, so overall it has a low CG.

The concept of CG reflects the importance of not losing sight of the size of the portions and also considering the total caloric intake: simplifying, if there is an excess of calories compared to the requirement, the excess glucose will be converted into adipose tissue (fat deposit).

Corretta alimentazione e indice glicemico

How does the glycemic index of food affect our body?

We have seen that to slow down the absorption of carbohydrates contained in a meal, substances such as fiber, proteins or fats can be added. In practice, it is necessary to be guided by common sense and guidelines: it is not sensible to add excessively fat or to increase excessively the protein portion with the aim of reducing the glycemic index.
Instead, it is advisable to add a good source of fiber to each meal: for example, choosing a wholemeal pasta al dente, to which are added courgettes, an adequate portion of salmon and a tablespoon of extra-virgin olive oil; we will obtain a meal with a low glycemic index, with a gradual release of energy that will give us a sense of prolonged satiety.

Another trick to lower the GI and to increase the sense of satiety is to start the meal with a good portion of seasonal vegetables, cooked or raw.

As for snacks, you can combine the fresh fruit eaten with the skin - which is often edible and rich in fiber, provided it is not treated with harmful products - with a small portion of dried fruit that slows its absorption, or accompany an extract or centrifuged of vegetables and fruit with a couple of wholemeal crackers.

Read the full article on Misura® website

Read the article on Misura® official page

Link to Dr. Andrea Del Seppia page on the official Misura® website
 

Misura® is a registered trademark of Colussi S.p.A. The material reported in this article is the property of Colussi, who authorized its publication.

Folic acid in pregnancy

Folic acid in pregnancy

Folic acid and its properties: from foods that naturally contain it to the importance of taking it before and during pregnancy.

Misura's interview with Dr. Andrea Del Seppia

Let's find out more with our nutritionist Dr. Andrea Del Seppia.

Dr. Del Seppia, what is folic acid?

It is an essential micronutrient that is part of the B vitamins. It is also known as vitamin B9 and more generally it is included in the group of compounds that comes under the name of folate, that is, those compounds that have the basic structure of folic acid and which are naturally present in foods; while the term "folic acid", or pteroilmonoglutammic acid, means the synthesis molecule that we find in food supplements and in so-called "fortified" foods, like some breakfast cereals.

What is its function and why is it so important during pregnancy?

It is essential for the performance of numerous physiological processes of growth, metabolism and cell differentiation. In our body, participates in processes of synthesis of nucleic acids (DNA and RNA), some amino acids (from which proteins) and red blood cells (this last action is carried out in synergy with vitamin B12 and iron).

 

 

How can it be taken and in what quantity?

As for other vitamins, folic acid is an essential nutrient and is not synthesized internally by our body, but must be introduced with daily nutrition. A varied and balanced diet, which provides at least two portions of fresh vegetables and three portions of fruit, can meet the daily demands of folate. However, cases of deficiency are frequent, both due to the lack of stability of the molecule in food and to some wrong food choices. There are, therefore, some cases in which it is necessary to control the intake of folate from the diet and increase the income through food supplements. One of these cases is pregnancy: according to the LARN (Recommended Nutrient Intake Levels), the recommended intake of folic acid for the woman of childbearing age, which includes or does not exclude pregnancy, is 400 mcg / day, starting at least one month before conception, and then taking a quantity equal to 600 mcg / day, at least for the first three months of gestation.
During lactation, the requirement remains increased to 500 mcg / day to compensate for losses due to breastfeeding. There are also "risk" situations for women who have familial congenital malformations, gastro-intestinal or malabsorption pathologies, or who have had a history of repeated miscarriages or fetal problems: in these cases the dosage of folic acid can increase up to 4 -5 mg / dia.

Can you explain better the function of folic acid during pregnancy and the importance of its supplementation, in addition to the risks that may derive from its deficiency ...

The importance of folic acid supplementation for women is due precisely to its important role in the synthesis of proteins, DNA, RNA and blood hemoglobin. A deficiency can lead to the appearance of numerous problems to the fetus, such as premature births, underweight babies, mental retardation and neural tube defects (from which spina bifida, anencephaly and encephalocele). Folic acid intake prior to conception has been shown to reduce the risk of neural tube defects by up to 70%. Unfortunately, it may happen that during the first month of pregnancy, when the heart, stomach and nervous system of the fetus are formed, a woman does not realize she is pregnant. Therefore, it is very important to start taking it right when planning for pregnancy.
The deficiency can also induce some forms of anemia in the mother. To prevent them, often folic acid supplementation is accompanied by iron and vitamin B12, which act in synergy with folic acid for the correct formation of hemoglobin. Vitamin B12, present mainly in foods of animal origin (such as liver, kidneys, fish, eggs, meat and cheese), acts in synergy with folates also in the formation of DNA. A deficiency can in turn induce folate deficiencies.

And what are its major food sources?

Foods naturally richer in folates are broad-leaved vegetables (from the name "folium" derives the term "folate"), such as artichokes, broccoli, asparagus, spinach, lettuce and endive; but we can also find them in abundance in brewer's yeast, in the liver, in legumes (beans, peas and chickpeas), in eggs, oranges, kiwis, strawberries, walnuts and muesli. Fermented milks are also very rich in folate, such as yoghurt and kefir. Furthermore, a recent study has shown that fermented folates rich in folates are able to significantly increase the level of hemoglobin in the blood.

Tell us about the behavior of folate in the kitchen ...

They are present in higher quantities in foods of plant origin, but they are much less stable and digestible than the folates present in foods of animal origin. Folate, in fact, are water-soluble vitamins and therefore easily "washable" with water from food, as well as being sensitive to light and heat. It is estimated that cooking and storage of food can result in losses of 50 to 95% of the molecule.

Some strategies can improve the preservation and stability of folate present in foods. For example, it is advisable to avoid long soaking before cooking the food, especially if the vegetables have been cut very finely. Steaming is recommended over boiling, especially if prolonged. Pressure and microwave cooking are also preferable to prolonged boiling.

In cases where the latter method is still used, it is advisable not to throw away the cooking water, where the folates are released, but to use it for soups or sauces. It is also recommended to use the lid to avoid further losses and salt at the end of cooking. On the other hand, the potato, despite being a food poor in folic acid, maintains its low levels despite a boosted cooking.

The presence of antioxidants (such as ascorbic acid or vitamin C and polyphenols) present in fresh fruits and vegetables (eg orange and kiwi) may limit the degradation of the present folate. It has been seen that the addition of ascorbic acid during cooking can reduce its loss. However, freezing is the most recommended storage method. For vegetables it is better to freeze the whole leaf rather than the chopped plant. Finally, to avoid further leaks of folates, unstable to light, it is advisable to keep the food in the dark.
Folate stability increases in foods of animal origin: the cooking method to be preferred in this case is direct fire, for example, cooking on the grill. The folates present in the liver seem to be among the most resistant to this type of cooking.

A final curiosity: the minced spinach presents more quantity of folates than the whole leaf.

Read the full article on Misura® website

Read the article on Misura® official page

Link to Dr. Andrea Del Seppia page on the official Misura® website
 

Misura® is a registered trademark of Colussi S.p.A. The material reported in this article is the property of Colussi, who authorized its publication.

How to sit at the table with the right “Misura”

Andrea Del Seppia

In a world where nutritional advice is proposed everywhere, it is difficult to distinguish truthful information from misleading information and understand what are the really important elements to follow a balanced diet. Often, the basic notions to have a balanced diet are lacking and this has repercussions on health.

Misura's interview with Dr. Andrea Del Seppia

We elaborate on the topic with our nutritionist, Dr. Andrea Del Seppia

Dott. Del Seppia, nutrition is a complex science and in continuous phase of study, but there are some well-defined and validated cornerstones for some time, is there any talking about it?

Science is not based on opinions, but on reliable data, and also in the dietary field there are evidences that allow to extract generic advice valid for the population, in general. It often happens to see miraculous properties attributed to some exotic fruit or to read that a certain category of food constitutes a "poison" if included in the daily diet. Some foods are particularly protective for our body, while others, if consumed in excess, can be harmful. However, it often happens that you run into extremist statements that can make you lose the global view of what is really important in the context of a balanced diet. If we do not consider the landscape in which it is hired, no food serves as a panacea for every evil.

What does it mean to follow a balanced diet?

Nutrition is not only the tool to meet the daily energy needs, but one of the factors that allow you to live in a good state of health preventing nutritional deficiencies. Adequate nutrition must include all nutrients in the right quantities and should not only consider calories (a merely quantitative measure), but take into account qualitative assessments of food and a good balance of macronutrients.

Eating in a balanced way means eating in a varied, not monotonous way, without unjustified exclusions of certain foods. It also implies a correct satisfaction of the palate, a healthy conviviality, the balance of psychological factors connected to food, without neglecting factors of an economic and organizational nature. A balanced diet is represented by a model that is sustainable in the long term and which concretizes the Greek origin of the word "diet": way of life.

 

What are the cornerstones of proper nutrition?

The levels of reference intake of nutrients and energy for the Italian population (LARN, IV Revision, SINU 2014) provide parameters that allow to formulate healthy indications in the food sector. These guidelines give ranges of values and not fixed values, including a margin that takes into account the variability of each one's needs.

There is no perfect food plan, standardized and ideal for all healthy individuals: it will be up to the nutrition professional to provide a personalized diet based on specific individual conditions. The energy needs depend on the different personal physiological needs (height, physical activity, age, etc.), are expressed in calories and are satisfied by the contribution of macronutrients: carbohydrates, proteins and fats.

Mediterranean diet

Between 45 and 60% of the daily energy needs must be satisfied by the contribution of carbohydrates, often demonized unjustifiably: in reality they are an essential energy source for the proper functioning of our body from the muscles to the brain.

You should prefer whole grains (spelled, barley, wholemeal pasta, wholemeal flour) and pseudocereal (buckwheat, quinoa), legumes and season the common semolina pasta with plenty of vegetables. The consumption of simple sugars, on the other hand, should not provide more than 15% of the total energy supply.

Among sources of simple sugars, it is appropriate to prefer those "essential" foods such as fruit and the recommended portion of dairy products or substitutes, for example a portion of yogurt for breakfast or snack. Dietary fiber is a component of vegetables that we do not digest (therefore it has a caloric intake close to zero) but which, when taken in adequate quantities, performs beneficial actions mainly at the level of the intestine and the sense of satiety. Cooked and / or raw vegetables, fruit, whole grains, legumes and dried fruit guarantee a good supply of fiber: it is necessary to take at least 25 grams a day.

The average daily intake of proteins in the healthy adult can vary between 0.9 and 1.1 grams per kilogram of body weight, to be increased in case of increased needs such as during growth, in pregnancy or in the case of intense physical activity. The protein sources, during the week, should be alternated between fish, legumes (which, in addition to carbohydrates, also contain a good protein content), lean meats, eggs, dairy products, any products derived from soy, lean meats and, in more reduced red meat, processed and salami.

Mediterranean diet

Lipids, or fats, must not provide more than 30% of the daily calories. This percentage should not fall below 20% of total calories in order not to create imbalances. In daily choices we recommend the use of extra virgin olive oil as main seasoning and to limit sources of saturated fats such as butter, cream, sauces rich in fats, palm oil, fatty meats and cheeses. It is necessary to ensure the presence of foods rich in polyunsaturated lipids such as cold water fish or dried fruit, especially walnuts. Also to be fried fries and vegetable margarines.

If you were to recommend a diet in line with these parameters what would it be?

In 2010 the Mediterranean Diet was declared a UNESCO Intangible Cultural Heritage of Humanity. The Mediterranean model does not refer only to what we put in the dish: it is not a series of foods, but a set of "skills, knowledge, rituals, symbols and traditions concerning the cultivation, harvesting, fishing, breeding, conservation, cooking and above all food sharing and consumption "(UNESCO, 2010).

Read the full article on sito Misura® website

Read the article on Misura® official page

Link to Dr. Andrea Del Seppia page on the official Misura® website
 

 

Misura® è un marchio registrato di Colussi S.p.A. Il materiale riportato in questo articolo è di proprietà di Colussi, che ne ha autorizzato la pubblicazione.

Nutrition and well-being

Food as a source of well-being

Clinical and sports nutritionist, Dr. Andrea Del Seppia is responsible for the clinical and diet nutrition service at the Malatesta Novello nursing home in Cesena (accredited private hospital).

When he had not yet graduated in Food Science, Andrea already followed two great passions, sport and healthy eating. Training footballer, hangs the boots to the nail to launch the paths of the Emilian Apennines in the saddle of the mountain-bike and then return to the sea to be conquered by the surf board with which, as soon as the professional commitments allow it, drops in water between the Italian coasts and those of Spain, its second home of adoption.

The interest in eating healthy and natural leads him first to achieve the Bachelor's Degree in Food Science at Alma Mater Studiorum University of Bologna and in 2011 to specialize with the Master's Degree in Food Science and Human Nutrition at the faculty of Medicine and Surgery of the University of Perugia.

As a nutritionist in various clinics, where he deals with the nutritional treatment of all pathologies related to nutrition, he works alongside sports nutritionist to help athletes of different disciplines to maximize sports performance.

Currently, he is in charge of the nutrition area of Perugia Calcio and personal nutritionist of several professional athletes, including the boxer Matteo "Il Giaguaro" Signani, WBA inter-continental champion of middleweight in 2015.
Dr. Andrea Del Seppia is registered in the National Order of Biologists section A.

Andrea Del Seppia

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Misura® is a registered trademark of Colussi S.p.A. All the material shown here is Colussi's property. Colussi S.p.A. authorized the publication of their articles on this website.

Structures where I hold consultations

Province of Forlì - Cesena
  • Casa di Cura Malatesta Novello, Ospedale privato accreditato, Cesena
  • Poliambulatorio IS.M.A.C., Gatteo (FC)
  • Poliambulatorio Arcade, Cesena – Savignano
  • Primus Medical Center Day Hospital Forli
  • Poliambulatorio Omnialab, Forlimpopoli

 

Province of Ravenna
  • Ravenna Medical Center - GVM, Ravenna

Province of Rimini
  • Centro Medico Gelso Sport, Bellaria – Igea
    Marina

  • Clinica Nuova Ricerca - Rimini

Milano - C.so Lodi, 114

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Contacts

Dr. Andrea Del Seppia
47522 Cesena (FC) - Italy
Phone: +39 349 18 24 495 (Italian Line)
VAT ID: 04000540403
Email:

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