Why Did the Ministry of Health Ban Pei Pa Koa-Flavoured Ice Cream? A Pharmacist Explains

WORDS LIM TECK CHOON

FEATURED EXPERT
LIM EN NI
Chief Pharmacist and Director of Engagement
Alpro Pharmacy

On 30 July 2024, the Ministry of Health announced a ban on the selling of Pei Pa Koa-flavoured ice cream in an ice cream chain store.

The official reason cited for this ban was that mixing Pei Pa Koa—a cough syrup that is marketed as an over-the-counter traditional medicine—with food products is an act prohibited under Section 13B(2) of the Food Act 1983.

WHAT IS THE PROBLEM WITH USING THE COUGH MIXTURE AS AN ICE CREAM FLAVOURING?

According to Lim En Ni, unregulated consumption of this cough mixture can be harmful especially to pregnant women and young children.

This is because Pei Pa Koa contains licorice (甘草) that can bring about the following health issues.

Fluid Retention and Hypertension

Licorice contains glycyrrhizin, a substance that resembles the structure of the hormone aldosterone and, when it is in the body, mimics the function of aldosterone.

As a result, high levels of glycyrrhizin can lead to fluid retention, hypertension, and an imbalance of electrolytes in the body.

Blood Pressure Issues

Glycyrrhizin can cause an increase in blood pressure by reducing potassium levels and increasing sodium levels in the body.

In pregnant women, high blood pressure can lead to complications such as preeclampsia.

Preterm Labour Risk

Lim En Ni points out that some studies suggest that consuming large amounts of licorice during pregnancy may increase the risk of preterm labour by increasing production of prostaglandin, a hormone-like compound that is involved in triggering labour.

Baby Developmental Issues

There is evidence suggesting that excessive licorice consumption during pregnancy might affect the cognitive development of the child. It has been associated with lower intelligence and behavioral problems in children.

THE TAKE-AWAY MESSAGE

While over-the-counter medications are readily accessible, they should not be taken lightly—and definitely should not be used as flavouring for foods and beverages!

  • Always exercise caution and read labels carefully before use.
  • For optimal safety, consult a pharmacist or doctor prior to taking any new medication, even those available without prescription.

The above two simple precautions can help prevent adverse reactions and ensure the most appropriate treatment for your condition.

Healthy Ageing Through Post-Retirement Employment: A Path to Active Living

WORDS LEE YIN LAN

FEATURED EXPERT
LEE YIN LAN
Lecturer
School of Accounting and Finance
Taylor’s Business School

As life expectancy increases, the concept of retirement is evolving. Healthy ageing has become a crucial focus for individuals and societies alike. This article explores how employment after retirement can contribute to healthy ageing, discussing both the benefits and challenges of this approach.

THE CHALLENGE OF HEALTHY AGEING IN RETIREMENT

Malaysia is transitioning into an ageing society, with the Department of Statistics reporting an average lifespan of 74.8 years in 2023.

The extended lifespan presents challenges. A 60-year-old retiree in Malaysia must support themselves for nearly 15 additional years, potentially straining public resources for medical and welfare aid.

Over the past decade, government expenditure on pensions and gratuities has averaged RM14.8 billion annually, reaching RM32.01 billion last year.

Projections suggest this figure could escalate to RM46.36 billion by 2030 and a staggering RM120 billion by 2040.

Retirement, a significant life transition, prompts reflection on how to embrace active ageing practices and maximize this phase of life. Many retirees are now considering continued employment as a strategy for healthy ageing and financial stability.

BENEFITS OF POST-RETIREMENT EMPLOYMENT FOR HEALTHY AGEING

Faced with a rapidly ageing population, encouraging seniors to supplement their incomes through active employment is emerging as a viable solution. This approach not only eases the financial burden but also contributes significantly to healthy ageing.

Countries with substantial ageing populations, such as Japan, Singapore, and Germany, actively promote post-retirement employment through tailored programmes. These initiatives stem from the belief that remaining active in the labour market yields multiple benefits for healthy ageing.

  • Maintaining good physical and mental condition
  • Fostering social connections
  • Enhancing individual financial security
  • Contributing to overall health and happiness

Research supports the positive impact of post-retirement employment on healthy ageing.

Studies across various countries have linked later-life employment to reduced risks of dementia and lower mortality rates from conditions often exacerbated by social isolation, such as strokes and heart disease.

A 2021 study by University of St Andrews scholars, published in a leading health journal, found that delaying retirement until 67 or older can reduce cognitive decline by up to 34% compared to earlier retirees. This finding underscores the importance of extended workforce participation in promoting healthy ageing and cognitive well-being.

ADDRESSING THE CHALLENGES OF RETIREE EMPLOYMENT

Despite the benefits, retirees may encounter challenges such as age discrimination and skills mismatch when re-entering the workforce.

Older workers often face bias from employers who favour younger candidates, viewing them as more adaptable and tech-savvy.

Additionally, older employees may be unfairly labelled as stubborn or resistant to change due to their extensive and longstanding experience.

Retirees

To address these challenges, retirees should proactively update their skills to align with current industry demands and tailor their resumes to highlight relevant experience.

Leveraging professional networks can also provide valuable job opportunities. Removing age identifiers from resumes, such as graduation dates, can help combat age discrimination, while adopting a modern resume format enhances competitiveness in the job market.

Employers

Employers can further contribute to creating an age-friendly workplace, offering flexible options such as remote work or part-time hours for older employees, while also implementing health programmes like screenings and fitness classes to support their well-being and boost productivity.

Additionally, using age-neutral recruitment and promotion practices ensures decisions are based on skills and qualifications, promoting fairness and inclusivity for all employees.

IN CONCLUSION

While ageing has traditionally been associated with declining productivity and viewed as a burden on society, this perception is evolving. With advancements in healthcare and a culture of lifelong learning, it is now recognized that individuals can maintain productivity and contribute to society well into their later years. Therefore, middle-aged and older adults approaching retirement or who already retired may consider exploring opportunities for continued engagement and fulfilment in the latter stages of life.

References:

  1. Department of Statistics Malaysia. (n.d.). Life Expectancy. OpenDOSM.
    https://open.dosm.gov.my/dashboard/life-expectancy
  2. Kivimäki, M., Walker, K. A., Pentti, J., Nyberg, S. T., Mars, N., Vahtera, J., Suominen, S. B., Lallukka, T., Rahkonen, O., Pietiläinen, O., Koskinen, A., Väänänen, A., Kalsi, J. K., Goldberg, M., Zins, M., Alfredsson, L., Westerholm, P. J. M., Knutsson, A., Theorell, T., Ervasti, J., … Lindbohm, J. V. (2021). Cognitive stimulation in the workplace, plasma proteins, and risk of dementia: three analyses of population cohort studies. BMJ (Clinical research ed.), 374, n1804. https://doi.org/10.1136/bmj.n1804
  3. Hale, J. M., Bijlsma, M. J., & Lorenti, A. (2021b). Does postponing retirement affect cognitive function? A counterfactual experiment to disentangle life course risk factors. SSM – population health, 15, 100855. https://doi.org/10.1016/j.ssmph.2021.100855

Gut Health Revolution: How Probiotics Could Be a Key to Weight Loss

WORDS LIYANA TAN ABDULLAH & DR NURUL HUDA RAZALLI

FEATURED EXPERTS

LIYANA TAN ABDULLAH
BSc Applied Chemistry UM
Student of Master Clinical Nutrition
Universiti Kebangsaan Malaysia
DR NURUL HUDA RAZALLI
Senior Lecturer
Dietetic Programme
Centre for Healthy Ageing and Wellness (H-CARE)
Faculty of Health Sciences
Universiti Kebangsaan Malaysia (UKM)
GETTING TO KNOW PROBIOTICS BETTER
  • Probiotics are live bacteria and yeasts that are beneficial for your health, especially your digestive system. Often referred to as ‘good’ or ‘helpful’ bacteria, they help keep your gut healthy.
  • Probiotics are naturally found in your body, but they can also be ingested through certain foods and supplements.
  • Probiotic products contain selective, beneficial types of microbes to add to the populations already living in your body.
  • They are crucial in maintaining a balanced gut microbiota, the community of microorganisms living in the intestines. The human gut is home to trillions of bacteria, a complex ecosystem that plays a vital role in digesting food, synthesizing nutrients, and defending against pathogens. Probiotics contribute to this ecosystem by enhancing its function and restoring its natural balance when it has been disrupted.
  • Some studies suggest that certain probiotics may aid in weight loss by influencing metabolism and fat storage.
PROBIOTIC PRODUCTS IN THE MARKET
  • Many probiotics are oral supplements designed to be ingested into your gastrointestinal tract.
  • Others are topical products that you can apply to your skin or to the mucous membranes inside your body cavities, like your nose or genitals. These are all places where beneficial microbes commonly live.
  • You can also obtain probiotics from your natural food. Yes, tempeh, yogurt, kefir, kimchi, sourdough bread, and other usually fermented foods are probiotic-rich.
THE LINK BETWEEN PROBIOTICS & OBESITY

Variation in the composition of the gut microbiota results in health deterioration due to the mechanisms they employ to maintain appropriate homeostasis, including immune system modification, metabolic signaling, endocrine signaling, neuronal signaling, and epigenetics.

The condition is closely linked to various metabolic disorders, including elevated cholesterol levels, type 2 diabetes, heart and vascular diseases, and osteoporosis.

Consequently, addressing obesity through prevention and treatment is crucial, more so with the integration of innovative scientific approaches and technologies like artificial intelligence.

Probiotics, regarded by the WHO and FAO in 2002 as beneficial live microorganisms that confer health benefits when consumed in adequate amounts, are a testament to this.

They positively affect the host by establishing themselves within the human body and altering the microbial composition at specific sites. By modulating the mucosal and systemic immune functions or adjusting the intestinal microbiota balance, they facilitate nutrient absorption and intestinal health, offering health-promoting effects whether as single or mixed microorganisms with a defined composition.

The connection between gut health and obesity has become a focal point of modern medical research. Studies suggest that the composition of gut microbiota in obese individuals differs significantly from that of healthy individuals, indicating a potential link between gut microbes and obesity.

Probiotics interact with the host through pattern recognition receptors in intestinal cells, such as Toll-like receptors, and these can play multiple roles in the individual’s body.

The mechanisms of action of probiotics associated with obesity control may be modulation of endogenous microbiota functions that affect interaction with the host, competitive exclusion of pathogens, improved epithelial barrier function and other innate immune responses, modulation of fat absorption and excretion, reduced endotoxemia and inflammation, and modulation of numerous genes involved in hepatic lipogenesis or lipolysis in adipose tissue.

Gut Microbiota and Body Weight Regulation

Research shows that certain strains of gut bacteria are more prevalent in individuals who are obese compared to those who are not. These bacteria may influence weight by affecting the body’s metabolism, increasing energy extraction from food, and altering the way fat is stored in the body.

Probiotics and Weight Loss

Research indicates that specific probiotic strains could be effective for weight loss in obese individuals.

Some studies have found that introducing specific probiotic strains such as Hafnia alvei can help reduce body weight and body mass index (BMI) in obese individuals.

Probiotics may aid weight loss by improving the balance of the gut microbiota, reducing inflammation, and influencing hormones and proteins related to appetite and fat storage.

Prebiotics and Synergistic Effects

Prebiotics, non-digestible fibers that feed beneficial gut bacteria, can also play a role in managing obesity. When combined with probiotics, prebiotics can enhance the growth and activity of healthy gut bacteria, leading to improved gut health and potentially contributing to weight loss.

HOW CAN OUR GUT MICROBIOTA BECOME UNBALANCED?
External Factors

Diet, drug intake, and lifestyle habits—smoking, alcohol intake, and disrupted sleeping habits—which can easily influence the bacterial communities in the gut.

Bacterial Metabolites from the Gut

These metabolites, such as SCFAs, gamma-aminobutyric acid (GABA), and tryptophan, have a substantial influence on the regulation of the gut-brain axis.

For example, even a short-term (5-days) consumption of diets composed entirely of animal or plant products alters the microbial community structure, affecting microbial gene expression among individuals.

Fermentable dietary fibre, prebiotics, and probiotic-based diets contribute to the proliferation of SCFA-producing bacteria, which might influence gut-brain communication and brain function directly or indirectly through immune, endocrine, vagal, and other humoral pathways.

THE CHALLENGES IN USING DIET AS A MEANS TO ACHIEVE & MAINTAIN BALANCED GUT MICROBIOTA

Firstly, individual variability plays a significant role. The gut microbiota is highly personal and can be influenced by genetics, age, diet, lifestyle, and even antibiotic use.

This variability means that what works for one person may not work for another, making personalized nutrition and probiotic supplementation strategies necessary.

Furthermore, modern lifestyles and diets often work against the maintenance of a healthy gut microbiota. Processed foods, high sugar consumption, and the overuse of antibiotics can disrupt the delicate balance of gut bacteria, making it difficult to restore or maintain a healthy gut environment.

Additionally, stress and lack of sleep can also negatively affect gut health, adding another layer of complexity to managing gut microbiota.

Lastly, the current regulatory environment regarding probiotics and dietary supplements can be a challenge for consumers. The market is flooded with products claiming to support gut health, but not all of these products are effective or safe. The lack of stringent regulation and standardized testing protocols makes it challenging for individuals to make informed choices about the probiotics and prebiotics they choose to incorporate into their diets.

WHAT CAN WE DO TO MAINTAIN A HEALTHY GUT MICROBIOTA?

Beyond diet and supplementation, holistic approaches that encompass emotional well-being and physical activities play a crucial role in maintaining a balanced gut microbiota.

Healthy Food and Physical Activities

Use the Malaysian Healthy Plate as simple yet effective guide to help you balance your meals on a 10-inch plate.

Imagine dividing your plate into 4 parts.

  • One quarter is dedicated to carbohydrates like rice, noodles, bread, grains, or tubers, ensuring you have the energy to power through your day.
  • The next quarter is reserved for proteins such as fish, poultry, meat, or legumes, supporting muscle repair and growth.
  • The remaining half is where colourful vegetables and fruits come in, flooding your body with essential vitamins, minerals, and fiber.
Healthy Emotional Well-being
  • Practice activites that promote emotional well-being, such as mindfulness, meditation, adequate sleep, and stress management techniques.

Through a comprehensive approach that includes healthy eating, exercise, and stress reduction, individuals can support their gut microbiota’s balance, thereby enhancing their overall health and well-being.

References:

  1. Coradduzza, D., Sedda, S., Cruciani, S., De Miglio, M. R., Ventura, C., Nivoli, A., & Maioli, M. (2023). Age-related cognitive decline, focus on microbiome: A systematic review and meta-analysis. International journal of molecular sciences, 24(4), 3756. https://doi.org/10.3390/ijms24043756
  2. Dalile, B., Van Oudenhove, L., Vervliet, B., & Verbeke, K. (2019). The role of short-chain fatty acids in microbiota-gut-brain communication. Nature reviews gastroenterology & hepatology, 16(8), 461-478. https://doi.org/10.1038/s41575-019-0157-3
  3. Déchelotte, P., Breton, J., Trotin-Picolo, C., Grube, B., Erlenbeck, C., Bothe, G., Fetissov, S. O., & Lambert, G. (2021). The probiotic strain H. alvei HA4597® improves weight loss in overweight subjects under moderate hypocaloric diet: A proof-of-concept, multicenter randomized, double-blind placebo-controlled study. Nutrients, 13(6), 1902. https://doi.org/10.3390/nu13061902
  4. Jokela, M., Virtanen, M., Batty, G. D., & Kivimäki, M. (2016). Inflammation and specific symptoms of depression. JAMA Psychiatry, 73(1), 87-88. https://doi.org/10.1001/jamapsychiatry.2015.1977
  5. Luoto, R., Kalliomäki, M., Laitinen, K., & Isolauri, E. (2010). The impact of perinatal probiotic intervention on the development of overweight and obesity: Follow-up study from birth to 10 years. International journal of obesity, 34(10), 1531-1537. https://doi.org/10.1038/ijo.2010.50
  6. National Center for Complementary and Integrative Health. (2019, August). Probiotics: What you need to know. https://www.nccih.nih.gov/health/probiotics-what-you-need-to-know
  7. Zhang, J., Mu, J., Li, X., & Zhao, X. (2022). Relationship between probiotics and obesity: A review of recent research. Food science and technology, 42, e47621. https://doi.org/10.1590/fst.47621

Has Malaysia Bent the Curve in the Fight Against Hepatitis B & C?

WORDS LIM TECK CHOON

FEATURED EXPERT
DR PHILIP PANG BOON CHEONG
Consultant Gastroenterologist and Hepatologist
Subang Jaya Medical Centre
A QUICK OVERVIEW OF HEPATITIS B & C
Hepatitis B
  • It’s a viral infection that attacks the liver.
  • It’s caused by the hepatitis B virus (HBV)
  • Can be acute (short-term) or chronic (long-term).
  • Transmitted through blood, semen, and other body fluids.
  • Currently, there is no cure available.
  • Vaccination provides a greater degree of protection against HBV infection.
Hepatitis C
  • It’s also a viral liver infection.
  • It’s caused by the hepatitis C virus (HCV).
  • It often becomes chronic or long-term.
  • Primarily transmitted through blood-to-blood contact.
  • No vaccine available, but treatable with direct-acting antiviral medications (97% cure rate).
WHY IS THERE A FIGHT AGAINST HEPATITIS B & C?

Dr Philip Pang reveals the following:

  • Hepatitis B and C are considered silent killers because they are often undiagnosed until health complications arise.
  • These diseases progress while undetected to cause severe liver damage and even cancer.

“Viral hepatitis is preventable and treatable. Thus, it is crucial that effective intervention measures are put in place,” Dr Pang shares.

HOW DO WE FIGHT AGAINST THESE TWO FORMS OF HEPATITIS?
  • 3 doses of the hepatitis B vaccine are administered to all newborns before they turn 1.
  • “The Ministry of Health (MOH) has also implemented targeted health screenings for high-risk populations including pregnant women and those with family history,” says Dr Pang.
  • Wider access to affordable direct-acting antivirals has led to a significant drop in chronic hepatitis C cases.
  • The Ministry of Health has also developed the National Strategic Plan for Hepatitis B and C (NSPHBC) 2019-2023 with the aim of eliminating hepatitis B and C by 2030. This comprehensive plan outlines a structured approach to prevention, diagnosis, treatment, and care to combat viral hepatitis.
HOW ARE WE DOING THUS FAR?
  • Statistics show that in Malaysia, an estimated 1.1% of the population is infected with hepatitis B virus in 2017, and 2.5% with hepatitis C virus in 2019.
  • Viral hepatitis is the seventh most common cause of mortality in our country.
  • 94% of deaths from chronic hepatitis B and C infections are caused by cirrhosis (severe scarring of the liver) and liver cancer.
THE DRIVE FOR GREATER PREVENTION OF HEPATITIS B

Hepatitis B is not curable at the moment, although early diagnosis can allow for proper measures to be taken so that individuals with this disease can still lead a fairly active and productive life.

However, many individuals with hepatitis B are unaware of their status and often go undiagnosed.

“An individual with hepatitis B is like having a neighbour who lives together in harmony, but you don’t know when your neighbour would one day go crazy,” Dr Pang tells us.

He goes on to say: “If we can fight hepatitis B in this generation, we are well on our way to eliminating it by 2030. Yet, we are far from achieving this goal. More needs to be done to raise public awareness about hepatitis B transmission, prevention methods, and the importance of vaccination.”

Pregnant Moms

The lack of symptoms can lead to pregnant mothers being unaware that they have hepatitis B, which increases the risk of mother-to-child transmission.

Routine blood tests during pregnancy can help identify these cases.

“Early detection allows for proper management, Pregnant mothers may be given antivirals and newborns given an immunoglobulin injection, specifically hepatitis B immunoglobulin, within 24 hours after birth” Dr Pang says.

For the newborn, the immunoglobulin injection provides a temporary protection against hepatitis B infection until the baby’s own immune system can develop immunity through vaccination.

People Living with Hepatitis B

Dr Pang recommends that individuals with hepatitis B should see their doctors once a year and undergo a routine blood test, which monitors their viral load.

Those who are 40 years old and above and present with symptoms should see their doctors more often, every six months, and undergo liver cancer surveillance.

Consider Hepatitis Vaccination and Stay Safe
  • Vaccination is key for improving our protection against hepatitis A and B.
  • Practice safe sex and good hygiene are vital.
  • Avoid sharing needles and personal care items.
  • Ensure safe practices during procedures that involve needles, such acupuncture or tattooing.

Uncovering the Secret Connection Between Hormones and Your Weight

WORDS ANAS ALMASWARY & PROFESSOR DR SUZANA SHAHAR

FEATURED EXPERTS

ANAS ALMASWARY
Master’s Student in Clinical Nutrition
Faculty of Health Sciences
Universiti Kebangsaan Malaysia (UKM)
PROFESSOR DR SUZANA SHAHAR
Dietetic Program
Centre for Healthy Aging and Wellness
Faculty of Health Sciences
Universiti Kebangsaan Malaysia (UKM)

Are you tired of struggling with weight loss or weight gain despite your best efforts at diet and exercise? Do you find yourself constantly wondering why your body refuses to cooperate, leaving you feeling frustrated and defeated?

HOW HORMONES IMPACT YOUR WEIGHT

Hormones regulate our activity in many ways, not just as simple ‘on and off’ switches that determine if we feel like exercising.

They also influence weight gain and loss by controlling energy intake, appetite, and metabolic balance.

Ghrelin

A hormone produced mainly in the gut, ghrelin has been implicated in the regulation of food intake and meal frequency as well as energy balance.

High levels of ghrelin before meals and during fasting act to stimulate appetite by signaling hunger.

The levels of this hormone revert back to normal values after meals, to help regulate appetite and satiety.

Leptin

When you are overweight, your levels of leptin go up to tell your brain you have plenty of energy.

However, people with obesity can develop a resistance to leptin. Even when their leptin levels increase, their brain no longer recognizes the satiety signal, and they continue to overeat.

Weight loss helps to improve leptin sensitivity, making it easier to lose weight.

Insulin

This is another hormone associated with weight management.

It regulates blood sugar levels after meals, and is influenced by how often and what you eat.

Endurance exercises increase insulin sensitivity. This allows the body to better process carbohydrates and store less fat.

Thyroid hormones

Moreover, thyroid hormones (T4 and T3) also help to regulate your metabolism.

If your thyroid hormone levels lower, such as due to an underactive thyroid or hypothyroidism, your digestive system may act at a slower pace, bringing about weight gain.

When your thyroid is overactive (hyperthyroidism), your metabolism speeds up, and you may lose weight.

Cortisol

The stress hormone cortisol has also been shown to play a role in weight control and affects eating behavior by increasing motivation and consumption of junk foods.

Likewise, chronically stressed people may prefer more energy-dense comfort foods, leading to weight gain over time.

KNOWLEDGE LEADS TO UNDERSTANDING

It is important to understand how hormones like ghrelin, leptin, insulin, thyroid hormones, and cortisol interact with lifestyle behaviors such as diet, exercise, sleep, and stress.

This understanding enables the design of personalized weight control strategies. These strategies can help correct hormonal imbalances and support long-term, successful weight manage.

YOU MAY HAVE HORMONAL IMBALANCE & SHOULD SEE A DOCTOR IF YOU:
  • Experience unusual weight gain or loss.
  • Develop increased sensitivity to cold or heat.
  • Have Increased thirst and urination.
  • Experience insomnia or have difficulties in sleeping.
  • Have irregular or heavy periods, missed periods, or painful periods.
  • Experience mood changes such mood swings, anxiety, depression.
  • Experience fatigue or low energy.
  • Are infertile or have difficulties in getting pregnant.
HOW OTHER FACTORS CAN LEAD TO HORMONE IMBALANCES

Several factors can cause hormone imbalances, including genetics, lifestyle choices, stress and anxiety levels, sleep patterns, and diet.

The balance of these factors can affect the hormonal control of ghrelin, cortisol, insulin, GLP-1, and leptin, which are important for appetite control and body weight balance.

For instance, increased psychological stress can affect hormone levels such as cortisol and ghrelin, changing eating behaviors.

Additionally, lack of sleep, poor dietary habits, and a sedentary lifestyle can contribute to hormonal imbalances, which may compromise weight control and metabolism.

Overall, a combination of genetic predisposition and environmental influences can lead to hormonal imbalances, potentially contributing to issues like obesity and difficulties in weight control.

NATURAL STRATEGIES FOR BALANCING YOUR HORMONES
  1. Increasing your water intake
  2. Adjust the macronutrient composition of meals.
  3. Eat more frequent smaller meals with moderate proteins and limited fats.
  4. Ensure that you have adequate sleep
  5. Take steps to reduce stress levels
  6. Incorporate at least 30 minutes of exercise a day into your daily routine.

Addressing these lifestyle factors and their impact on hormone levels can help many people achieve better hormonal balance and support effective weight control

Additionally, working with a team of professionals, including physicians, psychologists, dietitians, nutritionists, and exercise physiologists, for personalized strategies can further enhance hormonal balance and overall weight management.

References:

  1. Monalisa, R. (2015). Role of leptin in obesity. Research journal of pharmacy and technology, 8(8), 1073-1076. http://dx.doi.org/10.5958/0974-360X.2015.00185.7
  2. Schwarz, N. A., Rigby, B. R., La Bounty, P., Shelmadine, B., & Bowden, R. G. (2011). A review of weight control strategies and their effects on the regulation of hormonal balance. Journal of nutrition and metabolism, 2011, 237932. https://doi.org/10.1155/2011/237932
  3. Severo, J. S., Morais, J. B. S., de Freitas, T. E. C., Andrade, A. L. P., Feitosa, M. M., Fontenelle, L. C., de Oliveira, A. R. S., Cruz, K. J. C., & do Nascimento Marreiro, D. (2019). The role of zinc in thyroid hrmones metabolism. International journal for vitamin and nutrition research. Internationale Zeitschrift fur Vitamin- und Ernahrungsforschung. Journal international de vitaminologie et de nutrition, 89(1-2), 80–88. https://doi.org/10.1024/0300-9831/a000262
  4. Treasure, N.-O., Johnkennedy, N., Chinyere, O., Amarachi, I. P., & Chioma, N. (2022). The perspective of hormonal imbalance in humans: A review. Acta Scientific Clinical Case Reports, 3(11). https://www.researchgate.net/publication/368720563_Acta_Scientific_Clinical_Case_Reports_The_Perspective_of_Hormonal_Imbalance_in_Humans_A_Review_Case_Report

Concerned about Food Additives & Food Safety? You Should Read This!

WORDS TI MEI JUN & DR NURUL HUDA RAZALLI

FEATURED EXPERTS

TI MEI JUN
Student of Master Clinical Nutrition
Faculty of Health Sciences
Universiti Kebangsaan Malaysia (UKM)
DR NURUL HUDA RAZALLI
Senior Lecturer
Dietetic Programme
Centre for Healthy Ageing and Wellness (H-CARE)
Faculty of Health Sciences
Universiti Kebangsaan Malaysia (UKM)

More than 200 diseases, ranging from cancer to diarrhoea, are brought on by contaminated food that contains dangerous bacteria, viruses, parasites or chemical.

Malaysia had an incidence of 60 cases of food and water borne disease per 100,000 people, with 56% being food poisoning.

Hence, food safety is crucial to ensure that food, when prepared or consumed in accordance with its intended usage, would not harm consumers.

4 FACTS THAT WE SHOULD KNOW ABOUT FOOD ADDITIVES
  1. According to Codex Alimentarius Commission—also known as the ‘Food Code’ published by the Food and Agriculture Organization of the United Nations (FAO) and World Health Organization—any substance that is not typically used as an ingredient in food or consumed as food on its own is considered a food additives, regardless of its nutritional value.
  2. Food additives are added to processed foods to serve several functions, most prominently the prevention of food spoilage, improvements in flavour or texture and other desired qualities, and the provision of certain colours and flavours.
  3. Food additives are applied in the production and processing of almost all food types.
  4. Only specific foods may have food additives added to them, and only to the extent allowed by the Food Regulations of 1985.
EXAMPLES OF COMMON FOOD ADDITIVES
Soybean To maintain food consistency
Beet A colouring agent
Tartazine A colouring agent
Aspartame An artificial sweetener
Monosodium glutamate (MSG) A flavour enhancer
Lecithin Thickening and stabilizing agent
Guar gum Thickening and stabilizing agent
Benzoic acid A preservative
Sorbic acid A preservative
5 TIPS FOR CONSUMERS TO REDUCE EXPOSURE TO HARMFUL ADDITIVES
  1. People with allergies or sensitivity to certain food ingredients should closely read labels when shopping for processed foods.
  2. Buy fresh and whole food to minimize exposure of food additives and contaminants.
  3. Proper storage and handling of food materials are crucial to prevent contamination. Wash and peel foods, such as apples and eggs, to remove dirt and pesticides.
  4. Purchase food from stalls that demonstrate good hygiene practices, such as covering and properly packaging their food.
  5. Buy food that is prepared fresh upon ordering, rather than food that was cooked earlier and not maintained at the appropriate temperature.

References:

  1.  Halim, N. R. A., Mutalib, S. A., Ghani, M. A., & Hashim, H. (2024). Food safety regulations implementation and their impact on food security level in Malaysia: A review. International food research journal, 31(1), 20-31. https://doi.org/10.47836/ifrj.31.1.02
  2. Laganà, P., Avventuroso, E., Romano, G., Gioffré, M. E., Patanè, P., Parisi, S., Moscato, U., & Delia, S. (2017). The Codex Alimentarius and the European legislation on food additives. In P. Laganà, E. Avventuroso, G. Romano, M. E. Gioffré, P. Patanè, S. Parisi, U. Moscato, & S. Delia (Eds.), Chemistry and hygiene of food additives (pp. 23-32). Springer International Publishing.
  3. Lalani, A., Pouyani, N., Askari, A., Tavajohi, S., Akbari, S., & Jafarzadeh, E. (2024). Food additives, benefits, and side effects: A review article. Journal of chemical health risks, 1(1), 1. https://doi.org/10.22034/jchr.2023.1967340.1619
  4. Liang, X. (2023). Impact of food additives in ultra-processed food on human health. Theoretical and natural science, 6, 437-444. http://dx.doi.org/10.54254/2753-8818/6/20230321
  5. Ukwo, S., Udo, I., & Ndaeyo, N. (2022). Food additives: Overview of related safety concerns. Food science & nutrition research, 5(1), 1-10. http://dx.doi.org/10.33425/2641-4295.1052

Let’s Talk about HPV with a Doctor

WORDS DR RAHIMAH RAHIM

FEATURED EXPERT
DR RAHIMAH RAHIM
Medical Doctor
Klinik Amaya
Question 1
WHAT IS HPV?

The human papilloma virus or HPV is a very common virus transmitted through skin-to-skin contact, including sexual activity.

Most HPV infections do not cause any symptoms and can clear up on their own.

However, some strains can lead to serious health issues like genital warts and cancers, particularly cervical cancer.

The risk of HPV infection increases with certain behaviors such as having multiple sexual partners, engaging in unprotected sex, and smoking.

How HPV infects human cells. Click on the image for a larger, clearer version.

Question 2
IF HPV INFECTION CAN SHOW NO SYMPTOMS, WHAT CAN WE DO TO FIND OUT WHETHER WE HAVE BEEN INFECTED?

Screening for HPV is vital because it helps detect abnormal cell changes early, before they have the chance to progress into cancer.

Cervical screening, which includes HPV testing, is essential for identifying high-risk HPV strains.

High-risk HPV strains can lead to abnormal cell changes in the cervix, which, if left untreated, may progress to cancer. Hence, early detection through HPV testing allows for close monitoring and timely intervention, preventing the development of cervical cancer. This proactive approach is essential in maintaining women’s health and well-being.

Question 3
CAN YOU TELL US ABOUT THE HPV VACCINE?

The HPV vaccine is the most effective way to prevent HPV infections and the associated cancers.

It is safe, effective, and recommended for both males and females starting at age 9.

The vaccine is administered as a series of shots and provides protection against several high-risk HPV strains.

Vaccination, combined with safe sex practices, using condoms or dental dams, and limiting the number of sexual partners, greatly reduces the risk of HPV transmission.

Question 4
WHAT ARE THE TREATMENT OPTIONS AVAILABLE FOR PEOPLE WITH HPV?

Healthcare providers can offer comprehensive guidance on screening, diagnosis, and treatment options for those affected by HPV infections.

This includes regular monitoring for abnormal cell changes, treatment for genital warts, and appropriate interventions for any pre-cancerous conditions.

Digital health solutions can be leveraged to enhance our approach in managing HPV. These solutions facilitate seamless patient-doctor interactions, enabling us to schedule and conduct HPV screenings efficiently. Patients can conveniently access consultations and receive timely reminders for screenings, which are crucial for early detection. This technology not only streamlines our workflow but also empowers patients to take proactive steps in their healthcare journey.

For further information, individuals can consult with healthcare professionals. Our goal is to provide comprehensive care and support to those affected by or at risk of HPV.

 

Men, Don’t Ignore This: A Consultant Endocrinologist’s Diabetes Advice That Could Improve Your Quality of Life

WORDS DR RADHAMANI RAJAKUMAR

FEATURED EXPERT
DR RADHAMANI RAJAKUMAR
Consultant Internal Medicine Physician and Endocrinologist
Columbia Asia Hospital – Bukit Rimau
Sobering Fact 1
MEN FACE NEARLY DOUBLE THE RISK OF DEVELOPING TYPE 2 DIABETES COMPARED TO WOMEN

Globally, an estimated 17.7 million more men than women grapple with diabetes mellitus.

This disparity extends to urological complications, with both genders equally susceptible once diabetes sets in. Over half of individuals with type 2 diabetes, regardless of gender, will experience urological complications.

Sobering Fact 2
UROLOGICAL DISEASES MARKEDLY INCREASED IN PREVALENCE WITH ADVANCING AGE & DURATION OF DIABETES

This marked increase is seen with advancing age of 50 years old and above and of diabetes duration of more than 10 years.

YOU MAY HAVE DIABETES & SHOULD CONSULT A DOCTOR IF YOU HAVE:

  • Lower urinary tract symptoms (LUTS, see below)
  • Erectile dysfunction and reduced libido
  • Fever and painful urination suggestive of urinary tract infection
  • Genital thrush (see below)
  • Overactive bladder (frequent urination, frequent nighttime urination, urine leakage, or incontinence)
Sobering Fact 3
MORE THAN 50% OF MEN WITH DIABETES EXPERIENCE BLADDER DYSFUNCTION

They develop lower urinary tract symptoms (LUTS) such as urinary urgency, frequency, nocturia (waking up at night to urinate), and incontinence due to diminished bladder sensation and/or poor contractility.

They are also at higher risk of developing bladder infections, called cystitis, and bladder cancer.

In men, lower urinary tract symptoms are common age-related complaints that are often attributed to benign prostatic hyperplasia (BPH), especially after the age of 50.

Why do these men develop lower urinary tract symptoms?

The effect of diabetes on the development or presence of lower urinary tract symptoms and benign prostatic hyperplasia remains controversial.

Some studies suggested that diabetes increases prostate size consistent with benign prostatic hyperplasia.

Other studies reported conflicting results that diabetes increases the risk of lower urinary tract symptoms due to bladder dysfunction rather than an increase in prostate volume.

Sobering Fact 4
35% TO 45% OF MEN WITH DIABETES EXPERIENCE ERECTILE DYSFUNCTION

The prevalence of erectile dysfunction is 3 times more common compared to men without type 2 diabetes.

However, the treatment for erectile dysfunction depends on the cause. It’s important to discuss the problem with your doctor. Often the answers to a few simple questions will help to determine if the problem is physical or psychological.

Sobering Fact 5
MEN WITH DIABETES COMMONLY EXPERIENCE ERECTILE URINARY TRACT INFECTION

Urinary tract infection (UTI) can occur anywhere in the urinary tract, including the bladder, urethra, ureters, or kidneys.

It typically involves bacteria entering the urinary system, leading to symptoms such as frequent and painful urination, cloudy or bloody urine, and strong-smelling urine.

Sobering Fact 6
MEN WITH DIABETES CAN DEVELOP REPEATED CASES OF GENITAL THRUSH

Genital thrush is a fungal yeast infection linked to excess sugar in the blood getting passed in the urine.

Because yeast thrives on sugar, it is more likely to grow on the penis of a man with diabetes.

YOU MAY HAVE GENITAL THRUSH & SHOULD CONSULT A DOCTOR IF YOU HAVE:

  • Redness, swelling, and itching around the head of the penis
  • Your penis has an unpleasant odour
  • A white, lumpy appearance to the skin of the penis
  • Soreness and discomfort during sexual activity
Sobering Fact 7
UROLOGICAL COMPLICATIONS, IN PARTICULAR SEXUAL DYSFUNCTION, CAN LEAD TO PSYCHOSOCIAL DISORDERS AND RELATIONSHIP DISHARMONY

While these complications are generally not life-threatening, they pose significant mental distress and limitations in daily functioning, thus decreasing one’s quality of life.

Furthermore, men living with type 2 diabetes may experience stress, anxiety, or depression related to the daily demands of diabetes management, fear of complications, or concerns about the future.

These emotional struggles can affect mood, behaviour, and interpersonal interactions.

Sobering Fact 8
HEALTH SCREENINGS ARE KEY TO MANAGING DIABETES

Health screenings provide valuable insights and early detection of potential complications.

By undergoing regular health screenings, diabetic men can also actively manage their condition, prevent complications, and improve their overall quality of life by addressing potential health issues early and effectively.

BEST APPROACHES FOR DIABETES MANAGEMENT

  • Adhere to and monitor your medications
  • Keep up with medical appointments and health check-ups
  • Eat a healthy and balanced diet
  • Maintain a healthy weight
  • Perform regular physical activity
  • Manage stress and seek mental health support
  • Aim for sufficient sleep duration
  • Limit alcohol consumption and quit smoking

Two Experts Explain Why Coaching in Palliative Care Is Necessary for the Wellbeing of Our Population

WORDS DR JESRINA ANN XAVIER & DR LIEW KEAN YEW

FEATURED EXPERTS

DR JESRINA ANN XAVIER
Senior Lecturer
School of Management & Marketing
Faculty of Business & Law
Taylor’s University
DR LIEW KEAN YEW
Palliative Care Specialist
Hospital Ampang
INTRODUCING PALLIATIVE CARE
  • Palliative care is specialized medical care for people living with serious illnesses.
  • It aims to improve the quality of life for patients and their families associated with life-threatening illnesses.
  • Palliative care services were first offered in Malaysia in 1995, and they are gradually being included in the standard healthcare system.
RISING NEED OF PALLIATIVE CARE
  • The need for palliative care is on an upward trend all over the world due to the ageing population and the rising burden of chronic diseases.
  • In Malaysia, the proportion of palliative care needs to deaths hovered at 71% in the observed years. By 2030, it is observed that the growth for palliative care specifically will increase to 240%.
  • Sarawak, Perak, Johor, Selangor, and Kedah will become the top five Malaysian states with the highest needs in 2030.
COACHING IN PALLIATIVE CARE
  • Coaching in palliative care refers to the practice of providing support, guidance, and education to individuals facing terminal or life-threatening illnesses, as well as their families and caregivers.
  • It aims to improve quality of life by early detection and treatment of pain and symptoms.
  • It also enables patients and their families to take an active role in choosing how they will be treated, reclaiming a sense of control over their lives.
THE BENEFITS OF COACHING IN PALLIATIVE CARE
Improved Communication and Expression Skills
  • Anthony Grant, a revered psychologist, informs that coaching can be considered an emerging cross-disciplinary occupation, with the main goals being to improve performance, enhance well-being, and support organizational and individual change.
  • Palliative care coaching adopts a comprehensive strategy, acknowledging that every person’s experience with illness is distinct and multifaceted.
  • Coaching helps individuals develop their communication skills and express their needs, preferences, and concerns more effectively.
  • It can lead to increased satisfaction in care outcomes.
Assists in Enhancing Patient Wellbeing 

Through a coping mechanism, palliative care coaching assists patients and their families through goal setting, problem-solving, and symptom management.

Empowers Patients and Their Loved Ones to Make Informed Decisions
  • Making decisions about treatment options, advance care planning, and end-of-life care is rather challenging when undergoing treatments.
  • By providing information, the clarification of options, and assistance in weighing the advantages and disadvantages of various possibilities, coaching makes it easier for patients to advocate for their rights and choices.
Providing Patient-Centered Care
  • Coaches can deliver patient-centered care that respects people’s cultural backgrounds, attitudes, and beliefs.
  • Palliative care coaching helps patients, families, and healthcare professionals coordinate and collaborate, which promotes continuity of treatment to achieve shared objectives.