Pregnancy & Nutrition DIABETES AND PREGNANCY Right communication is key
EXERCISE DURING PREGNANCY Read to know its Importance!
PREGNANCY SCREENING Why is Prenatal Screening Significant?
PRE & POST NUTRITION IN PREGNANCY Adequate Nutrition For Mothers
RECIPE BOOKLET-HEALTHY 365 Would you like to be featured?
PREGNANCY & LOSS Find ways to cope better
JANUARY ISSUE 2022
TEAM EDITOR IN-CHIEF/ BANSARI RAO CO- EDITORS / SONU MISHRA, DR. DVIJ MEHTA WEBSITE / NUTRITIONINSIGHTS.IN CONTRIBUTORS / NIDHI MEHTA / POOJA LAKHANI / SHILPA WAGH / KRUTI SHAH / DR. TEJAL LATHIA / DR. CHINTAN SHAH / LISTEN WORKS / RABIA MISTRY MULLA / NANDITA DHANAKI / POOJA JAGIASI / KOSHA PAREKH / MANALI DESAI / ARTI KOKANE / KHYATI SALHOTRA / COVER PAGE / <A HREF='HTTPS://WWW.FREEPIK.COM/PHOTOS/FOOD'>FOOD PHOTO CREATED BY ONLYYOUQJ - WWW.FREEPIK.COM</A>
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contents nutrition insights | january issue | 2022
06
IMPORTANCE OF PRE & POST PREGNANCY NUTRITION
By Nidhi Mehta
14
GESTATIONAL DIABETES MELLITUS ENDOCRINOLOGIST PERSPECTIVE
By Dr. Tejal Lathia
10
HOME REMEDIAL FOODS DURING PREGNANCY
By Mrs. Shilpa Wagh
08
18
12
By Pooja Lakhani
By Dr. Chintan Shah
By Kruti Shah
28
16
22
SUPPLEMENTATION IN PREGNANCY
TALKING ABOUT PREGNANCY AND DIABETES
By Dr. Tejal Lathia
NEURAL TUBE DEFECTS AND BIRTH DEFECTS
TRIMESTERIC CHANGES IN MOTHER AND IMPORTANT EXAMINATIONS
EXERCISE IN PREGNANCY
MYTHS AND FACTS
By Rabia Mistry
By Dr. Dvij Mehta
20
26
30
By Listen Works
By Pooja Jagiasi
24
29
By Kosha Parekh Manali Desai Arti Kokane Khyati Salhotra
SHARING ABOUT LOSS
FOOD STORY DINK/GOND
By Nandita Dhanaki
NUTRI-TWIST
RESEARCH
RECIPES
EDITOR'S NOTE
WELCOME A very happy new year, readers. We welcome you to the first issue of this year! What better than starting this year on a happy note and talk about something which is associated with happiness, PREGNANCY! Pregnancy is a unique, exciting, and often joyous time in a woman's life, as it highlights the woman's creative and nurturing powers while providing a bridge to the future. Pregnancy can be a life changing experience bringing in excitement and challenges. As rightly said, with great power comes great responsibility, pregnant women must take steps to remain as healthy and wellnourished as they possibly can. They should consider their health care and lifestyle choices so as to best support the health of their future child and their personal wellbeing. With this issue we highlight some important aspects of nutrition and pregnancy, and how certain lifestyle changes can take you and your baby a long, healthy way. Herein we shed light on the importance of pre and post nutrition in pregnancy. We elucidate the importance of right supplementation and significance of exercise in pregnancy. We also shed light on old, forgotten, effective home remedial foods, and fixes to make a mother feel comfortable during her journey of gestation. This issue features articles on various problems associated with pregnancy and talks about coping up with losses, changes undergone during pregnancy, effective communication, prenatal tests and more such wonderful insights. Towards the end, as always, we share some captivating, easy to make, healthy recipes and also give you a chance to feature your recipes and expertise in our upcoming issues! Nutrition Insights is also coming up with a Healthy 365 day-recipe booklet and would love to invite one and all to feature their recipes and be a part of the venture. Hope you enjoy reading this issue! Happy Reading!
NUTRITION INSIGHTS WELCOMES YOU TO
R E C I P E
B O O K L E T
HEALTHY
365
Get a chance to feature your recipe in our upcoming recipe booklet "HEALTHY 365"
A RECIPE BOOKLET FEATURING HEALTHY DELICIOUS RECIPES FOR DAILY HOME-COOKING Contact us to join! Email: recipebooklet.ni@gmail.com Phone: +91-9867299172
IMPORTANCE OF PRE & POST PREGNANCY NUTRITION By - Nidhi Mehta, Pediatric Nutritionist, Consulting Dietician Pregnancy is one of the most important phases in a woman’s life. It lays the foundation to ‘Motherhood’. Nutrition before and during pregnancy is very important as it lays the foundation to the child’s life! It helps the mother have a safe and normal pregnancy. Good nutrition can prevent certain complications like tiredness, hypertension, gestational diabetes, anemia & also can help prevent or manage morning sickness to an extent.
Pre-Pregnancy Diet Care: A lady needs to be careful as soon as she decides to conceive. Certain foods to be included in the diet to ease into pregnancy are- good quality proteins, green leafy vegetables, fresh fruits n veggies, calcium rich foods like milk, sesame seeds; vitamin D a.k.a. sunlight to get that calcium absorbed by the bones. Include good quality grains.
Foods to avoid before & during pregnancy: Refined foods-like maida, breads, pasta Too much sugar or fried foods Processed foods like sauces Packaged foods like chips& wafers Sugary drinks like soda Alcohol & smoking
Pregnancy & Nutrition: Good health & nutrition go hand in hand. Do keep some basic things in mind once you are pregnant. You just need to eat carefully to nourish yourself & the baby growing inside you. Eat simple home cooked foods as much as possible. Some nutrients are more important:
Folic acid: 1st 4 months is very crucial as it is very important in making new cells. Each and every cell being made in the new born will require folate! Include about 50g of green leafy vegetables like coriander, mint, spinach, methi or any local variety everyday. Iron: As a pregnant lady puts on weight, her blood volume increases too! Include iron rice foods like gardencress seeds (haliv), bajra, mothbeans, masoor, raisins, dates, watermelon, meat and such iron rich foods in the diet! These will keep the lady from getting tired! Proteins: Mildly increase the protein intake as the tissues being formed in the new born require proteins! Include natural sources like dals, pulses, nuts like peanuts, coconut, cooked egg, milk & milk products like curd, paneer, buttermilk, meat & fish as per your likings. Fresh fruits & veggies: Include a variety of these; they provide lots of vitamins (esp A, C, B), they provide antioxidants & pigments that protect us & our little one. Good quality fats: These provide the essential energy& fat soluble vitamins -A,D,E, & K. Use cold pressed/ wood pressed filtered oils good quality ghee & butter. Fluids: drink several glasses of water to avoid dehydration.
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FOLATE AND CYANOCOBALAMIN SUPPLEMENTATION IN PREGNANCY - UNVEILING THE SCIENCE BEHIND By- Pooja Lakhani, MSc, RD, CNSC, Clinical Dietitian.
Maternal undernutrition predisposes to a range of unfavourable pregnancy outcomes including early fetal loss, congenital anomalies, poor fetal growth, perinatal morbidity and even mortality. Protein calorie undernutrition continues to be a substantial problem in India. In addition to this, there is an increasing concern regarding micronutrient deficiencies and their impact on maternal and fetal outcomes. Optimal dietary intake and/or supplementation of micronutrients such as iron, vitamin-C, vitamin-D, calcium, vitamin-B12 and folic acid has been associated with positive peri-natal outcomes. In this article, we will focus upon role, benefits, deficiency and dietary sources of Folate or Vitamin-B9 and Cyanocobalamin or Vitamin-B12.
Folic Acid Folic acid supports pregnant woman’s increasing blood volume and growing maternal and fetal tissues. It also plays an important role in cell division and in the synthesis of amino acids and nucleic acids like DNA and is essential for the normal development of spine, brain and skull of the fetus, especially during first four weeks of pregnancy. This is the time when women are often not even aware that they are pregnant. The RDA for Folic acid intake in pregnancy has been revised to 570 micrograms per day, however average daily intake of folic acid remains between 200-300 micrograms through regular vegetarian diet. To bridge this
gap between folate intake and requirements, the American College for Obstetricians and Gynaecologists made following recommendations: Regular consumption of folate rich dietary sources including lentils, black beans, okra, white beans, spinach, salad greens, kidney beans, chickpeas and sunflower seeds. Because many pregnancies are unplanned, all women who could become pregnant should take a multivitamin containing 400 micrograms of folic acid at least 3 months before conception and continue throughout first trimester of pregnancy. Women with history of fetal loss or neural tube defects may need
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Tips for Pregnant Mothers: 01 02 Enjoy this phase of life. Don’t stress yourself by over thinking.
Eat regularly and stick to the timings of the meal each day. Do not overeat.
03
04
Eat simple food. Do not go for spicy, greasy, heavy food items.
Take a walk in fresh air and sunlight in the mornings.
05
06
Include lot of fluids daily.
Include a variety of food items.
07
08
Meditate for some time daily.
Have small frequent light meals.
Fitness is a Super Power for Super Moms to BE! Kruti Shah,CPFE CAPPA CERTIFIED,USA Pre Natal Fitness Care As a new mother you are always concerned with your well-being, because this time it’s not only for you but also for your little one inside. So is exercise really needed during pregnancy? What is fitness during pregnancy? How does it help you and your baby? Does it help only physically? Or also mentally? Let’s explore the world of exercise during pregnancy and post pregnancy.
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Gestational diabetes mellitus – Endocrinologist’s perspective Dr Tejal Lathia, Consultant Endocrinologist Fortis, Apollo and Cloud Nine Hospitals, Navi Mumbai Gestational diabetes is defined as impaired glucose tolerance with onset or first recognition during pregnancy. Its prevalence ranges from 3.8 to 17.9% in different parts of the country. It is difficult to predict any uniform prevalence levels of GDM in India, because of wide differences in living conditions, socioeconomic levels, and dietary habits(1). However, all experts agree that the prevalence of gestational diabetes in increasing at a rapid pace commensurate with the rising rates of obesity, rapid urbanization, limited physical activity, increased accessibility to and consumption of junk food. The specific risks of diabetes in pregnancy include spontaneous abortion, fetal anomalies, preeclampsia, fetal demise, macrosomia, neonatal hypoglycemia, hyperbilirubinemia, and neonatal respiratory distress syndrome, among others. In addition, diabetes in pregnancy may increase the risk of obesity, hypertension, and type 2 diabetes in offspring later in life2). These adverse consequences make it imperative that all women must be screened for gestational diabetes at the first antenatal visit.
Screening must be repeated in the second and third trimester as well especially in high risk women –age more than 35 yrs, overweight, family history of diabetes, previous pregnancy with diabetes or neonatal complications suggestive of diabetes in pregnancy (large baby or intrauterine fetal death)(2). There are several ways to diagnose diabetes during pregnancy, but the IADPSG guidelines based on HAPO study are the best accepted by endocrinologists in India. An oral glucose tolerance test is conducted with 75 gms of glucose in a fasting state and blood is collected in the fasting state and 1,2 hrs after glucose. Values of Fasting > 92 mg/dl, 1 hr > 180 mg/dl and 2 hr > 153 mg/dl are suggestive of GDM. Fortunately, 90% of women can be managed on lifestyle modifications alone. Remaining women need insulin treatment to achieve recommended targets of Fasting blood glucose < 90 mg/dl, 1 hr < 140 mg/dl and 2 hr < 120 mg/dl for optimal pregnancy outcomes. The age-old adage – “prevention is better than cure” holds especially true for GDM. Encouraging young women to maintain a healthy weight and BMI prior to planning pregnancy can help prevent GDM especially women at high risk as enumerated above.
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TRIMESTERIC CHANGES IN MOTHER AND IMPORTANT EXAMINATIONS DR. DVIJ MEHTA A full-term pregnancy lasts around 38-40 weeks and has three trimesters. Trimesters are a period of three months each. In each trimester, the fetus meets specific developmental milestones.
1st Trimester A healthy first trimester is of prime importance to the normal development of the fetus. As the embryo implants itself into the uterine wall, several developments changes take place. It also includes the formation of amniotic sac, placenta, the umbilical cord and all the major body organs and systems of the fetus. During pregnancy, your body will undergo dynamic changes to help nourish and protect your baby. The following is a list of changes and symptoms that may happen during the first trimester: You may experience mood swings like premenstrual syndrome partly due to surges in hormones. This may cause what we call “morning sickness,” which causes nausea and sometimes vomiting. Cardiac volume increases by about 40 to 50 percent from the beginning to the end of the pregnancy intern causing an increase in cardiac output which may cause an increased pulse rate during pregnancy. Mammary glands enlarge due to an increased amount of the hormone’s estrogen and progesterone. Areolas will darken and enlarged and veins become more noticeable on the surface of your breasts. You tend to urinate more often as your uterus is growing and begins to press on your bladder. There might be heartburn, indigestion, constipation, and gas as muscular contractions in the intestines are slowed due to high levels of progesterone. You may also experience tiredness and fatigue due to the physical and emotional demands of the pregnancy.
TESTS Your first prenatal visit is of prime importance. A complete medical history is taken, a physical exam is done, and certain tests and procedures are performed to assess the health of both you and your unborn baby. Your first prenatal visit may include: Personal medical history: Previous and ongoing medical conditions like DM, Hypertension, anemia, allergies and surgeries. Maternal and paternal family medical history, including illnesses, intellectual or developmental disabilities, and genetic disorders. Personal gynecological and obstetrical history, including past pregnancies (miscarriages, stillbirths deliveries, terminations) and menstrual history (length and duration of your menstrual periods) Education: Talking about proper nutrition and expected weight gain in pregnancy, regular exercise, the avoidance of alcohol, drugs and tobacco during pregnancy etc. Pelvic exam: This exam may be done for one or all the following reasons. To note the size and position of the uterus, to determine the age of the fetus, to check the pelvic bone size and structure. Lab tests: 1.Urine tests 2.Blood tests (These are done to determine your blood type, Rh factor) 3.Blood screening tests for infectious disease like German measles ect. Genetic tests and other screening tests: These are done to find inherited diseases and for high-risk patients who have known to or have had a family member with a genetic disease.
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NEURAL TUBE DEFECTS AND BIRTH DEFECTS DR. CHINTAN. G. SHAH CLINICAL ASSOCIATE DIVISION OF PEDIATRIC NEPHROLOGY BAI JERBAI WADIA HOSPITAL FOR CHILDREN, PAREL, MUMBAI.
What are neural tube defects? Neural tube defects (NTDs) are severe birth defects of the central nervous system (Brain and spinal cord) that originate during embryogenesis and result from failure of the morphogenetic process of neural tube closure. Birth defects are health conditions that are present at birth. A baby’s neural tube normally starts out as a tiny, flat ribbon that turns into a tube by the end of the first month of pregnancy. If the tube doesn’t close completely, an NTD can happen. NTDs happen in about 3,000 pregnancies each year in the United States.
This variance likely reflects differing contributions from risk factors such as nutritional status, prevalence of obesity and diabetes, usage of folic acid supplementation and/or fortification, the presence of environmental toxicants, and differing genetic predisposition among ethnic groups. In most populations, there is also a striking gender bias: Anencephaly is more prevalent among females than males. Overall, although studies have identified numerous risk factors, these may account for less than half of NTDs, suggesting that additional genetic and nongenetic factors remain to be identified.
Causes of NTDs NTDs are among the most common birth defects worldwide with a prevalence that varies from 0.5 to more than 10 per 1,000 pregnancies.
Birth defects can be diagnosed during pregnancy or after the baby is born, depending on the specific type of birth defect. During Pregnancy various Prenatal Testing can be done as follows:
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Listen Works is a mental health initiative aiming to normalize conversations about mental health and work towards contributing to an inclusive society. With a team of psychologists, our aim is to provide accessible mental health services to all age groups and populations. We offer both virtual as well as personal mental health support. We are here for you. Contact: +917738485801 Email: listenworks.connect@gmail.com
Sharing about loss During Pregnancy Pregnancy can be life - changing experience, bringing in excitement as well as many challenges that those who are expecting might not be entirely prepared for. They can experience a multitude of feelings from excitement, joy, happiness, worry, fear, disappointment. No one feeling is more acceptable than the other. No one ALWAYS feels positive throughout this journey. For the expectant looking after their emotional health becomes as important as taking care of their physical health during and after they give birth. Mental health is a state of wellbeing where we feel satisfied, connected, and alive. Many things can impact how the individual feels, acts, behaves ranging from their physical health, support systems, stressful life events/circumstances like socioeconomic status, violence and abuse, HIV/Aids, adolescent pregnancy, unplanned pregnancy, substance use, divorce/separation. 1 in 3 to 1 in 5 persons in developing countries, and about 1 in 10 in developed countries, have a significant mental health problem during and after childbirth (WHO, 2008), making it even more important to be vigilant if their discomfort is increasing There may be many pressing questions running through their minds - Will everything turn out to be, okay? Will they become good parents? What if something they do harms the baby? Will they be able to provide for their needs? Are they capable enough to handle this?
Feeling doubtful/anxious/sad is valid.The body goes under numerous changes during and after pregnancy, and pregnancy hormones such as estrogen and progesterone can contribute to a mix of emotional highs and lows. Women ‘s changing body shapes can also impact how they feel internally. Some women may feel comfortable and happy about changes in body weight while others may really feel anxious about not fitting into the portrayal of “perfect pregnant women body contours.” It is important for them to accept and embrace their body. Relationship dynamics between partners changes from being a couple to preparing for parenthood. Some partners can become overprotective, both can become anxious about being a parent, or worry about losing our appeal to our partner. There can also be changes in your sex drive during this period. It is always a good idea to talk about their feelings with each other rather than holding back these conversations, which can bring in distress. Keep a close check on what is happening for you during this time- How have you been feeling? What are these feelings trying to tell you? What are they asking for you to do? Do you feel the need for some more support? Are you finding it difficult to manage yourself? Do you feel the impact of your worries and anxieties growing?
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MYTHS & FACTS
Righting the wrongs of Pregnancy myths! -Rabia Mistry Mulla Pregnancy is such a sensitive phase that even a slightest comment by someone can put the expectant mother into frenzy. And if that expectant female is a first time mother, well, then she definitely starts walking on eggshells, all this to ensure that her baby stays well. Since centuries, myths around pregnancy have spread like wild fire telling the mothers to eat in a certain manner or avoid certain foods without having any scientific backing. In this issue, Nutrition Insights has taken upon them to bust such baseless myths and make the mothers worry less and enjoy their pregnancy more!
Ever heard someone cajole an expectant mother into consuming desi ghee? Well their explanation is that it helps to lubricate the birth passage! Well, desi ghee is undoubtedly good for health but consuming it in larger amounts is only going to cause the mother to gain weight during pregnancy (which she needs to knock off post she delivers). Instead exercise dear mommies; it is more helpful in increasing the flexibility of the pelvic area. Enroll into a good prenatal class to help make the labor short and easy.
This one is slightly controversial but definitely worth pondering over - eating papaya when pregnant leads to miscarrying of the baby Agreed that papaya has protein breaking enzymes called papain, and when consumed in large quantities during the early part of pregnancy can be harmful to the baby. But after the first trimester, a slice of this sweet and vitamin A rich fruit can be consumed without a frown.
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FOOD STORY
All you need to know about Dink/Gond The moment we hear word Gond or Dink the first thing that comes to our mind are ladoo's made from them. When I started collecting information for this article, I came across was a long list of dink/ gond ladoo recipes and how they are beneficial for pregnant and lactating women. Is that all Dink or Gond can be used for? Let’s find out.
N A N D I T A
S
A S S I S T A N T A C T R E C
D H A N A K I D I E T I C I A N
NUTRI-TWIST
Pooja Jagiasi
Nutri -
Mathri - Tea Snack Mathri Recipe is a perfect tea time Indian snack. It is a kind of flaky biscuit from north-west region of India and can be prepared using different flavours and spices. From sweet to savoury to spicy you can make different varieties to cherish with your favourite beverage. Every region has its own variations like some add Rava along with maida or besan with maida and many more. Most common variation is made with maida, rava and fenugreek leaves. You can store them for many days in an air tight container or you can also take away them while traveling or for picnic.
Mathri Recipe:
Traditional
Ingredients Maida: 60 gms Rava: 15 gms Ajwain: 5 gms Black pepper: 5 gms Ghee: 45 gms Salt as per taste Oil-for deep frying: 200ml
Recipe: Firstly, a large bowl take maida and rava. Add pepper, ajwain, salt and ghee. Crumble and mix well making sure to form a moist flour. Now add water as required and knead the dough. Knead to a tight dough adding more water if required. Pinch a ball sized dough and flatten with hand. Prick using a fork to prevent from puffing. Fry the mathri in medium hot oil. Fry on low flame till the mathri floats. This takes approx 1-2 minutes. Now continue to fry on low to medium flame till they turn crispy and golden in colour. Drain off the mathri over kitchen paper to absorb excess oil. Finally, serve mathri with evening chai or store in an airtight container for a month.
From This
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Pregnancy & GDM Dr. Tejal Lathia Pregnancy is a time of great responsibility in a woman’s life as she is almost single handedly responsible for the health of the baby. However, often the responsibility starts much before pregnancy in the planning stage itself. With the current raging syndemic of obesity and diabetes mellitus, more and more women seeking fertility are overweight and living with diabetes already. Many young women also live with polycystic ovarian syndrome which predisposes them again to obesity and prediabetes. As a result, from the medical perspective, much is demanded from young women preparing for pregnancy. Weight loss, better blood sugar soften needing metformin or even multiple injections of insulin to attain a glycosylated haemoglobin level which is safe for pregnancy are imperative. Achieving both these goals requires intensive lifestyle modifications, frequent blood glucose monitoring, regular testing of Hba1c and doctor visits. One of the pain points of the current healthcare scenario is lack of training in communication for healthcare professionals. So, how then do doctors, nurses, nutritionists, physiotherapists communicate the need for intensive lifestyle modifications, ideal weight and blood glucose values to young women planning pregnancy?
Talking about pregnancy and diabetes – be kind! In absence of any formal training in communication we tend to use words, phrases or methods that we see our peers, seniors and teachers use. Also, we tend the remember the worst consequences of uncontrolled blood glucose levels we have seen and our communication emerges from a place of fear and guilt wondering if we could have done more. We forget about the women who did very well - lost weight, followed diet and avoided medications, had healthy babies and uneventful deliveries. As a result, most of the time we communicate about the health situation by talking about the “bad” effects that can happen to the baby if they don’t comply with our advice and attain their goals. Many of our conversations go like –
communication with the person and hold them responsible for adverse outcomes. In a series of focus group discussions conducted with women living with diabetes, some women revealed how they took decisions not to plan pregnancy at all because they were terrified after their interaction with their doctor about diabetes. Some were blamed for adverse outcomes of their babies in spite of doing everything that was recommended. So, should we not explain about possible adverse consequences to spare their feelings? Yes, we must! But the way we communicate the risk is extremely important. The women in our focus group discussion suggested using phrases that convey hope and eschew worst case scenarios.
“If you don’t lose weight, you will get diabetes during the pregnancy”. “If you don’t take care of your diet, you will need insulin” “If you don’t control blood sugars, the baby will have complications”.
“If you are able to lose weight, diabetes in pregnancy can be avoided.” “ If you take a healthy diet, we may be able to avoid insulin." “If we manage the blood sugars well, we can ensure a healthy baby”. “I am there to support you and we can do this together”
If you look closely at the messaging in this communication, using the word “Will have” implies that adverse outcomes are inevitable. We are also laying the onus of the adverse outcome squarely on the young woman’s shoulder. This kind of communication also impacts the interaction of the person with their caregivers who often themselves then use negative
As healthcare professionals our intentions are sterling but how we communicate our intention profoundly impacts how they are perceived by the people we are trying to help and their decisions about their health.
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RECIPE
NUTTY BUTTY PAK KHYATI SALHOTRA CLINICAL NUTRITIONIST
INGREDIENTS Almond Flour- 1 tbsp (15 g) Jowar four- 1 tsp (5 g) Amaranth flour- 1 tsp (5 g) Chopped almonds- 1 tsp (5 g) Halim seeds- 1 tsp (5 g) Sesame seeds- 1 tsp (5 g) Gond (edible gum)- 10 g Rice crisps: 1 tsp (5 g) Jaggery: 1 tbsp (15 g) Ghee: 1 tbsp (15 g) Pinch of ginger powder
PROCEDURE To begin, add 15g ghee and roast 15g almond flour in it for 7-8 minutes. Add and roast 5g of jowar flour and amaranth flour in the same dish for 5 mins Chop 5g of almonds and add it in the flours Similarly add ginger powder, gond (edible gum) and rice crisps in the mixture Cook all of them for 10 mins Cut the jaggery into small pieces and add it to the mixture. Combine all of the ingredients in a mixing bowl until the jaggery melts. Place the mixture on a plate and shape it into a circle. Finally, roast 5g sesame seeds and Halim seeds, then sprinkle on top of the dish (or mix them in) and serve. Optional: To add some variety, drizzle it with dark chocolate.
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