Underweight Nutrition

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Coming to Israel in 1978 from the USA, I began working at the Zefat Rivka Ziv hospital as it’s first head nutritionist. To my dismay, there were no nutritional supplements in Israel, so I decided to develop one. The result was the first step towards reaching “Halvah Shake!” I mixed milk, egg powder, and sugar in a blender in the hospital’s kitchen and began feeding patients with appetite loss by mouth and via tube feeding. We also fed hungry, hospitalized soldiers who were brought in during the first Galilee war. I designed this initial formulation with the best quality proteins, and it was important to me that it should also taste good. It was a formulation designed by a nutritionist who knew what patients need, not by a businessman or a food technologist. It was accepted willingly by the patients, and they got better!

We moved to Jerusalem, and I eventually began working in the surgery department at Hadassah Medical Center, Ein Karem. Later, I worked as the head nutritionist at Hadassah, Mount Scopus. No one was interested in my formula, as they now had imported canned nutritional supplements, which they assumed were better. This was the situation until I began working at the Neve Simcha Geriatric Hospital in 1988. The budget-conscious administration did not want to pay for canned, imported nutritional supplements. I was broken. How could I help the patients? Many were protein-calorie malnourished, and they often suffered from pressure sores and appetite loss. It was at this time that I had a very important conversation with our medical director (who would later become my close friend, ProfessorTzvi Dwolatzky, presently head gerontologist at Rambam Hospital, Haifa.) I told him about the formula I had developed in Zefat. He replied, “Yaakov, sit in your office and see if it needs some improvement. Start using it here, and keep records of the data. I think this is going to be something big.” I decided that it needed more fat, so I added techina (sesame spread) which mixes with water and is a good-tasting choice. It went over great with the patients, and we were on our way.

The data I recorded included weight, height, blood tests, diagnoses and type of formula – milkshake, pudding, or tube feeding. This continued for many years. In 1966, a close friend, Aviva Epstein, previous head dietitian at Rambam Hospital, came to visit me at Neve Simcha. We were professional colleagues from my Zefat days, when I had often visited her at Rambam, which was relatively nearby in the Galilee. She and her husband, Professor Leon Epstein, who was then the director of Social Medicine at Hadassah, Ein Karem, had decided that I should present my work on the formula at the 12th International Congress of Dietetics at Manila, Philippines. Not having left Israel for eighteen years, I was shocked. But, these were my close friends, and Dr. Dwolatzky agreed with them. So, I applied, was accepted, and made the long trip to the Philippines to present my findings. It was very well accepted, and the the experience was very encouraging. Fours years later, I again presented a sub-study on the use of the formula with diabetic patients at the 13th International Congress of Dietetics at Edinburgh, Scotland (2000.)

I presented my findings in Israel at the 15th meeting of the Israel Gerontological Society in 2003 , at the 2nd World Conference on Jewish Social and Medical Services in 2004, and again at the 16th meeting of the Israel Gerontological Society in 2005.

I went on to publish two studies in prestigious medical journals:

“Is It Possible to Increase Weight and Maintain Protein Status of Debilitated Elderly Residents of Nursing Homes?”  

Journal of Gerontology, Medical Sciences, 2005, vol. 60A, no. 878-881

Yaakov Levinson, Professor Tzvi Dwolatzky, Aviva Epstein, Bella Adler, Professor Leon Epstein  The editor cited in his acceptance letter, “Thank you for your excellent contribution to our journal.”

“Successful Use of a Sucrose-Containing Enteral Formula in Diabetic Nursing Home Elderly” 

Diabetes Care, 2006, vol.29, no.3, p.698-7000

Yaakov Levinson, Professor Tzvi Dwolatzky, Aviva Epstein, Bella Adler, Professor Leon Epstein


                         ASSETS OF THE FORMULA

                              Superior protein quality from multiple protein sources

                       Powdered product to prevent protein breakdown from liquid storage

                   Healthy fat sources – rich in monounsaturated oils, no hardened or trans fats

                             Contains antioxidants – sesamine, sesamoline, and selenium

                                                                      No soy

                                                No preservatives – no artificial color

                                                                   Great taste

                                                            Mehadrin kashrut

                                   Published research base with long-term clinical trial


Our Patients Say

During the last few weeks of my mother’s life, when she could no longer swallow, the Halvah Pudding “melted in her mouth” allowing her to obtain the nutrition she needed.. 

We have no words to thank you for your wondrous advice on the Halvah Pudding for our mother.

 I am almost in a state of malnutrition …This Halvah Shake saved me. It is very, very tasty. It saved my life. I warmly recommend it to all who need it.