Experts Rally to Tackle the Hidden Crisis of Childhood Iron Deficiency Anaemia

WORDS LIM TECK CHOON

A multidisciplinary team of 28 clinicians from Malaysia, Thailand, Laos, Myanmar, Cambodia, and India recently presented an independent expert consensus on the screening and management of iron deficiency anaemia (IDA) in young children across Southeast Asia and India. Their efforts were sponsored by Danone.

The consensus comes in response to the concerning findings of the Iron Strong Study 2023, which highlighted that 1 in 3 Malaysian children are at risk of anaemia.

It presents 12 evidence-based recommendations to guide healthcare practitioners and policymakers in decision making related to screening, prevention and management of IDA in young children.

FEATURED EXPERT
PROFESSOR DR MUHAMMAD YAZID JALALUDIN
Senior Consultant Paediatric Endocrinologist
Faculty of Medicine, Universiti Malaya

Professor Dr Muhammad Yazid Jalaludin tells us: “The release of this expert consensus represents a significant advancement in managing IDA in children. By bringing together leading experts from the region, evidence-based recommendations have been established that can greatly benefit child health.”

A CALL FOR ANNUAL NON-INVASIVE SCREENING FOR YOUNG CHILDREN

According to Professor Dr Muhammad Yazid Jalaludin:

  • Iron deficiency anaemia (IDA) in children is often underdiagnosed because mild cases often show no visible symptoms.
  • However, this undetected deficiency can significantly impact growth and even irreversible consequences on a child’s brain development and future learning abilities.
  • In light of this, the panel of experts has advocated for annual non-invasive anaemia screening for all children aged 1 to 5.
  • The panel also emphasizes the importance of nutritional intervention, particularly the fortification of food and milk to help reduce the risk of IDA in all children.
  • Additionally, the panel calls for more efforts to be made o actively educates parents and caregivers on IDA risks and prevention.
NUTRITIONAL INTERVENTION IS ESSENTIAL
FEATURED EXPERT
PROFESSOR DR HAMID JAN JAN MOHAMED
Professor, Nutrition Programme
School of Health Sciences
Universiti Sains Malaysia

Professor Dr Hamid Jan shares the following:

  • Addressing IDA in children requires a multifaceted approach that combines early detection with comprehensive nutritional interventions.
  • Incorporate a variety of iron-rich foods into a child’s diet. Such foods include lean meats, poultry, beans, and dark leafy vegetables like spinach.
  • Additionally, fortified milk and foods play an important role in ensuring adequate iron intake, especially for children who may have limited access to diverse diets.
  • Pairing iron-rich foods with enhancers like vitamin C-rich foods can significantly improve absorption, making it easier for a child to benefit from their iron intake.
AN ONLINE QUESTIONNAIRE

Following the recommendations in the expert consensus, Danone has introduced the Iron Strong Screening Questionnaire, an online self-assessment tool developed in collaboration with a panel of paediatric and nutrition experts. This questionnaire, available in Bahasa Melayu, allows parents to assess their child’s iron intake based on age and can be found at the Danone website (links open in a new tab).

International SOS Urges Organizations to Take Proactive Measures in Protecting Employee Heart Health

WORDS LIM TECK CHOON

FEATURED EXPERT
DR OLIVIER LO
Group Medical Director, Occupational Health Services
International SOS

As World Heart Day approaches on September 29, International SOS calls upon organizations worldwide to implement proactive measures to safeguard their workforce against cardiovascular disease (CVD).

A CALL FOR ACTION

“Organizations worldwide have a Duty of Care to foster work environments that promote the heart health of their employees,” says Dr Olivier LO, “as this can play a significant role in preventing cardiovascular disease.”

He adds: “With World Heart Day upon us, it is a great reminder of the importance of heart health initiatives at work. Heart disease may significantly impact employers financially through direct costs like healthcare services and medications, as well as indirect costs such as absenteeism and presenteeism.”

“Additionally, there are costs associated with hiring temporary staff or overtime pay to cover absent employees, as well as potential increases in health insurance premiums,” he further elaborates.

SOBERING STATISTICS
  • CVDs remaining the leading cause of death globally, accounting for 17.9 million fatalities annually.
  • Recent data from International SOS reveals a concerning trend:
    • 34.5% increase in cardiovascular health-related assistance requests from 2021 to 2022
    • Further 18% increase from 2022 to 2023
    • 86% of heart-specific ailments were reported in the male population
  • These statistics underscore the growing need for comprehensive cardiovascular health support in the workplace.
7 PROACTIVE MEASURES FOR WORKPLACE CARDIOVASCULAR HEALTH

International SOS recommends the following strategies to mitigate cardiovascular risks among employees:

Measure 1: Create a Heart-Healthy Culture

Foster an environment that prioritizes health and wellbeing.

Measure 2: Encourage Regular Health Screenings

Offer screenings for blood pressure, cholesterol, and other risk factors.

Measure 3: Implement Healthy Eating Initiatives

Provide access to nutritious food options and educate employees on heart-healthy diets.

Measure 4: Promote Regular Physical Activity

Encourage exercise through workplace wellness programs and facilities.

Measure 5: Offer Stress Management Programs

Provide resources to help employees manage stress, a significant CVD risk factor.

Measure 6: Launch Education and Awareness Campaigns

Organize workshops on cardiovascular health to raise awareness.

Measure 7: Support Smoking Cessation

Provide resources for employees who wish to quit smoking, as tobacco use contributes to approximately 17% of all CVD deaths.

New Vaccine Approved to Protect Older Adults from Respiratory Syncytial Virus Disease

WORDS LIM TECK CHOON

AN INTRODUCTION TO RESPIRATORY SYNCYTIAL VIRUS
  • Respiratory syncytial virus (RSV for short) is a common virus that primarily infects the lungs and respiratory tract.
  • It spreads easily through respiratory droplets when an infected person coughs or sneezes.
  • The virus can survive on surfaces for several hours.
  • RSV is highly contagious and can infect almost all children by the time these children are 2 years old.
  • The virus causes cells in the respiratory tract to fuse together, forming large multinucleated cells, which is where it gets its name ‘syncytial’.


An overview of RSV disease. Click on the image to view a larger, clearer version.

For more information on RSV, catch up with Dr Lee Onn Loy in our previous article on this topic.
RSV AND ITS IMPACT ON OLDER ADULTS
FEATURED EXPERT
PROFESSOR DR AHMAD IZUANUDDIN ISMAIL
Deputy Director & Consultant Respiratory Physician
Hospital Al Sultan Abdullah Universiti Teknologi MARA (HASA UiTM)
  • RSV also significantly affects older adults. It is increasingly recognized as a major cause of respiratory illness in older adults, particularly those aged 60 and above.
  • Older adults with pre-existing conditions such as chronic obstructive pulmonary disease (COPD), heart disease, or weakened immune systems face a higher risk of developing severe outcomes from an RSV infection.
  • RSV can also worsen existing health issues, leading to conditions like congestive heart failure and worsening asthma.

“RSV can lead to severe outcomes especially among older adults with co-morbidities such as asthma, COPD and chronic heart failure,” says Professor Dr Ahmad Izuanuddin Ismail. “They also have increased risk of hospitalization following the RSV infection.”

He then elaborates: “It is important for us to protect patients aged 60 and above with co-morbidities. It is time we protect our older adults with underlying health conditions from RSV infection to enable them to lead a good quality of life especially in their golden age. By prioritizing the well-being of older adults, we can collectively foster a healthier and more vibrant society, ultimately enhancing the quality of life for all generations.”

VACCINATION AS A KEY METHOD TO REDUCE THE RISK OF SEVERE COMPLICATIONS
  • Vaccines are available to protect people against RSV.
  • Recently, GlaxoSmithKline Pharmaceutical Sdn Bhd (GSK) announced that their latest RSV vaccine for adults 60 years old or older has been approved in Malaysia.
  • The vaccine is approved based on positive data from a phase III trial, where the vaccine demonstrated high overall vaccine efficacy of 82.6% against lower respiratory tract disease.
  • This vaccine was generally well tolerated with an acceptable safety profile.
  • Some observed adverse events included injection site pain, fatigue, myalgia, and headache. These were typically mild to moderate and lasting within a few days after vaccination.

Following the approval of the vaccine, Dr Alap Gandhi, the Country Medical Director of GlaxoSmithKline Pharmaceutical Sdn Bhd (GSK) Malaysia and Brunei tells us: “Today’s announcement is a major step forward from a public health perspective, as it allows us to deliver an RSV vaccine in Malaysia to protect older adults.”

Reference: GlaxoSmithKline Pharmaceutical Sdn Bhd. (2024, September 25). GSK’s Arexvy is a vaccine approved to protect older adults from respiratory syncytial virus (RSV) disease in Malaysia [Press release, KKLIU 2755 / EXP 17.3.2025].

Warning! Cheap Blood Pressure Meters Rampant in the Market Could Raise Critical Health Emergency!

FEATURED EXPERT
LIM EN NI
Chief Pharmacist
Alpro Pharmacy

In Malaysia, blood pressure monitoring devices are regulated by the Medical Devices Authority (MDA).

Only devices with a Certificate of Approval from MDA can be sold in the market and they are usually priced around RM100 to RM300 per unit.

A VIRAL CONCERN

In a recent viral video, a doctor raised concerns over faulty, low-quality blood pressure meters that are easily purchased online for as low as RM15, which gave inaccurate readings.

This could lead to potential risk of a public health emergency resulting from the dangers of the uncertified health monitoring devices.

Uncertified blood pressure meters often provide inconsistent or incorrect readings, leading to false perceptions of blood pressure levels,

As a result, users may end up making inappropriate adjustments to their medication without proper medical guidance.

PHARMACY CHAIN ISSUES CAUTION TO THE PUBLIC

Alpro Pharmacy cautions the public to be more vigilant when purchasing health monitoring devices, online and offline.

Here are a few ways the public can check if their blood pressure meters are registered:

  1. Verify the registration status of a device on the MDA’s website: https://mdar.mda.gov.my/frontend/web/index.php?r=carian (link opens in a new tab)
  2. Bring your blood pressure meter to a nearby community pharmacy for the pharmacist to have a look.

If a blood pressure monitor had been registered with the MDA, the MDA registration number (“nombor pendaftaran peranti perubatan”) will be displayed on the box. Click on the image for a larger, clearer version. 

TURN TO CERTIFIED EXPERTS AND TRUSTED SOURCES

Alpro urge the public to seek professional advice from certified pharmacists or a medical practitioner prior to adjusting their medication dosage.

Self-diagnosis and straying from medication could put patients at an even higher risk of morbidity from their existing condition.

Similarly, other medical devices, such as blood pressure monitors, glucometers, and pulse oximeters, are also important. Regular check-ups with these devices help us monitor and manage our health conditions effectively.

These devices provide valuable insights into your well-being, allowing timely interventions and more informed discussions with healthcare professionals. Ensure that you purchase them from trusted sources to guarantee accuracy and reliability.

This is a press release from Lim En Ni, the Chief Pharmacist of Alpro Pharmacy. It has been edited for clarity.

Healing Across Genders: The Bald Oncologist Tackles Cultural Norms in Malaysian Cancer Treatment

WORDS LIM TECK CHOON

FEATURED EXPERT
DR MALWINDER SINGH SANDHU
“The Bald Oncologist”
Consultant Clinical Oncologist
Pantai Hospital Kuala Lumpur
Website and Social Media

In the realm of oncology, gender plays a crucial role in shaping caregiving dynamics and communication between patients and healthcare providers. To give us a better understanding of this, Dr Malwinder Singh Sandhu, also known as “The Bald Oncologist”, joins to share some valuable insights into how gender influences caregiving responsibilities and impacts the support needs of patients navigating cancer treatment.

GENDER NORMS AND CANCER COMMUNICATION

Dr Malwinder reveals that, in Malaysia, cultural expectations and gender norms play a crucial role in shaping the way cancer patients communicate with healthcare providers, adhere to treatment plans, and cope with the challenges of the disease. These gender-specific factors have significant implications for both the diagnosis and management of cancer.

MEN WOMEN
  • Expected to be stoic.
  • May downplay symptoms or avoid discussing discomfort, leading to delayed diagnoses and inadequate symptom management.
  • Might feel more comfortable discussing symptoms but may be hesitant to talk about reproductive health, especially with male doctors.
  • Caregiving responsibilities often cause women to prioritize their family over their own health, which can lead to underreporting symptoms.
GENDER-SPECIFIC BARRIERS TO CANCER CARE 

According to Dr Malwinder, gender norms can also present barriers to accessing cancer care,

MEN WOMEN
  • Cultural pressures to remain strong may delay seeking treatment until symptoms are severe.
  • Men may also find it hard to adhere to treatment regimens if they feel it interferes with their work or provider roles.
  • Stigma surrounding certain cancers, like breast and cervical cancer, can cause delays in seeking care.
  • Balancing caregiving duties with their own health needs can also lead to treatment adherence challenges
PSYCHOLOGICAL IMPACT OF CANCER DIAGNOSIS & TREATMENT

“Men and women experience cancer’s psychological toll differently,” Dr Malwinder tells us.

MEN WOMEN
  • Often suppress emotions, internalizing anxiety and fear.
  • This can worsen their mental health, but men are also less likely to seek psychological support due to societal expectations of emotional strength.
  • While women may be more emotionally open, they often worry about becoming a burden on their families.
  • Guilt and anxiety about their family’s future are common psychological challenges.

One way to address these psychological challenges for both men and women is by joining a support group.

  • These groups provide a safe space for patients to share their concerns, gain emotional support, and learn how to cope with their illness from others facing similar experiences.
  • Support groups can help break down gender barriers, encouraging both men and women to open up about their struggles, and ultimately improve their overall mental health.
BODY IMAGE CONCERNS IN CANCER PATIENTS

“Changes in physical appearance from cancer treatments, such as surgery or chemotherapy, can cause body image issues,” says Dr Malwinder. “These concerns are also shaped by gender.”

WOMEN MEN
Physical changes, like hair loss or mastectomies, can severely impact a woman’s sense of identity, exacerbating stress and leading to potential identity crises. While not discussed as openly, men also struggle with body image issues, especially when treatments cause weakness or weight loss, challenging their sense of masculinity
HOW GENDER INFLUENCES OTHER ASPECTS OF CANCER CARE

Dr Malwinder further shares the following information.

MEN WOMEN
  • Treatment adherence and follow-up care. May be less consistent with follow-up appointments, especially if they feel “recovered” enough to resume their responsibilities.
  • Palliative care. Cultural norms of resilience may prevent men from discussing pain, leading to inadequate pain management.
  • Support. Tend to have smaller, less emotionally-focused support networks. Cultural expectations of strength can leave them feeling isolated, with limited community support.
  • Treatment adherence and follow-up care. While balancing family obligations can be a challenge, women are generally more consistent with follow-up care when encouraged by healthcare providers.
  • Palliative care. Women in traditional caregiving roles may prioritize their family’s needs, making them reluctant to seek end-of-life care.
  • Support. Often have wider social networks, supported by family and female friends, and are more likely to seek emotional support from community or religious groups.
DR MALWINDER’S RECOMMENDATIONS TO HEALTHCARE PROVIDERS FOR A MORE GENDER-INCLUSIVE APPROACH TO CANCER CARE
Diagnosis
MEN WOMEN
Oncologists should create a safe environment for men to express vulnerability without judgment. Healthcare providers should encourage women to prioritize their own health over caregiving responsibilities.
Treatment
MEN WOMEN
Treatment plans should accommodate men’s work commitments to improve adherence. Offer support for balancing family care and treatment helps women adhere to their treatment plans.
Follow-up Care
MEN WOMEN
  • Regular check-ins with encouragement to stay consistent in their care are vital.
  • Promote support groups to help deal with emotional and psychological challenges.
  • Support systems that alleviate caregiving burdens can improve treatment adherence.
  • Promote support groups to help deal with emotional and psychological challenges.
Caregiving Support
  1. Acknowledge the different strengths of male and female caregivers.
    • Support programs should cater to the strengths and challenges of both genders.
    • Female caregivers might need respite care and emotional support, while male caregivers could benefit from guidance in providing more emotional care.
  2. Encourage open communication.
    • Open conversations about caregiving and support can break down gender norms.
    • Male caregivers should be encouraged to engage emotionally, while female caregivers should feel empowered to ask for help and set boundaries.
  3. Expand support networks for male patients.
    • Community programs should be developed to help male cancer survivors and caregivers connect.
    • Tailored support groups for men can provide a space to discuss struggles and break cultural barriers.
  4. Establish family support structures.
    • Families should be educated on sharing caregiving responsibilities equally, encouraging sons and male relatives to take on more emotional caregiving roles.
  5. Leverage community and religious groups.
    • Community and religious organizations play a crucial role in providing social support, especially for female patients.
    • Encourage these groups to also support male patients and caregivers as an essential step to extend care networks.

The Hidden Dangers of Dengue: It’s More Than Just a Fever

WORDS LIM TECK CHOON

FEATURED EXPERT
DR SHANTHI RATNAM
Consultant Physician and Intensivist
Thomson Hospital Kota Damansara

Many people think of dengue as a mild illness, but the reality can be far more serious.

Severe dengue often requires hospitalization and can lead to internal bleeding, organ damage, and even death. What’s more, a second infection is more likely to be severe.

However, there’s another aspect of dengue that’s less well-known: post-dengue syndrome. This condition can leave lasting effects long after the initial infection has passed.

BAHWANEE’S LONG ROAD TO RECOVERY

Bahwanee Muthusamy’s experience with dengue fever was the beginning of a challenging journey that has lasted over 6 months.

“This was my second bout of dengue,” Bahwanee recalls. “At first, it seemed like just a mild fever but within a day, I had a terrible headache, vomiting, and diarrhoea. My platelet count dropped dangerously low.”

Bahwanee’s condition quickly became critical, affecting her liver. She spent 2 weeks in the hospital and another 2 months on medical leave.

Even simple tasks like driving or sitting up for long periods were impossible due to nerve compression in her lower back.

WHAT IS POST-DENGUE SYNDROME?

Dr Shanthi Ratnam explains that Bahwanee’s experience is known as post-dengue syndrome (PDS).

“It’s when symptoms of dengue fever persist for more than 6 weeks after the acute phase,” she says. “We’re still learning about how common it is, but some studies suggest it could affect between 18% and 50% of dengue patients.”

Dr Shanthi is an intensivist, a medical practitioner that specializes in the care of critically ill patients, such as those in the intensive care unit or ICU.

PDS can cause a range of symptoms, including:

  • Mild to overwhelming fatigue
  • Muscle and joint pain
  • Swelling of the joints (reactive arthritis)
  • Poor concentration
  • Dizziness

The challenge with PDS is that there’s no specific test to diagnose it. Doctors must rule out other possible causes before concluding that a patient has PDS.

LONG-TERM IMPACT OF PDS

PDS has turned Bahwanee’s life upside down.

“It’s affected everything,” she says. “Simple actions like climbing stairs are now exhausting. I can’t work like I used to. I’m dealing with hormonal issues, hair loss, and a weakened immune system. It’s been a nightmare.”

Dr Shanthi points out that PDS can also take a toll on mental health.

“It can severely affect a person’s quality of life,” she explains. “This is true especially for young, active people. The constant fatigue, pain, and inability to resume normal activities can be depressing.”

WHO IS AT RISK OF PDS?

While anyone can develop PDS, some groups are at higher risk:

  • Elderly patients
  • People with existing health conditions like hypertension, heart disease, obesity, or autoimmune diseases
  • Those who have had dengue before
RECOVERING FROM PDS

For people that are recovering from dengue, Dr Shanthi recommends the following:

  • Get plenty of rest. It is good to get 8 to 10 hours of sleep per night.
  • Eat a balanced diet rich in fruits and vegetables.

She also offers advice for caregivers of the following groups of people.

  • Children. Keep them home from school for a week before gradually resuming normal activities.
  • Older adults. Encourage frequent naps and sufficient nighttime rest.
  • People with diabetes or high blood pressure. Monitor blood pressure closely and consult with a doctor about medication adjustments.
  • People at high risk of bleeding. Watch for warning signs like dark, sticky stools.
GIVEN THE LONG-TERM IMPACT OF DENGUE, PREVENTION IS CRUCIAL

Dr Shanthi emphasizes the need for a comprehensive approach such as:

  • Eliminate mosquito breeding grounds, such as standing water in containers and rain gutters.
  • Consider innovative preventive strategies like the dengue vaccine.
About the Dengue Vaccine

The dengue vaccine, recently approved in Malaysia, is now available in private clinics and hospitals.

It’s given in 2 doses, 3 months apart.

Dr Shanthi recommends it for high-risk groups such as:

  • Elderly people with other health conditions
  • Obese individuals
  • People with high blood pressure, heart disease, or autoimmune conditions
  • People taking medications that can affect their immune system

Even those who have had dengue before, like Bahwanee, can get the vaccine 6 months later for protection against other strains of the dengue virus.

A CALL TO ACTION

Both Dr Shanthi and Bahwanee stress the importance of taking dengue seriously.

“We need to renew our commitment to fight dengue on all fronts,” says Dr Shanthi.

Bahwanee adds: “Dengue is often dismissed as merely a fever but look at what happened to me. I’m so glad there’s a dengue vaccine now because dengue is everywhere, so no one is safe. We need to take it seriously and be proactive to combat this threat together.”

Understanding Mild Cognitive Impairment: Causes, Detection, and Ways to Improve Memory

WORDS PROFESSOR DR TAN MAW PIN

FEATURED EXPERT
PROFESSOR DR TAN MAW PIN
Geriatric Medicine Consultant
Founder and Managing Director of ACT4Health Sdn Bhd
WHAT IS MILD COGNITIVE IMPAIRMENT (MCI)?

Mild cognitive impairment, or MCI, occurs when people notice memory problems that are confirmed by tests, yet they can still manage their daily activities independently.

CAUSES OF MILD COGNITIVE IMPAIRMENT

The most common cause of MCI is Alzheimer’s disease, which also leads to dementia. However, many other factors can contribute to MCI, including:

  • Strokes or cerebrovascular disease
  • Lewy body disease (also linked to Parkinson’s disease)
  • Certain infections
  • Head injuries
  • Vitamin B12 deficiency
  • Side effects of certain medications
  • Imbalances in body chemistry

While some causes of MCI are reversible, others can worsen over time. It’s essential to address these issues early to improve or maintain cognitive function.


Common symptoms of MCI. Click on the image for a larger, clearer version.

HOW MILD COGNITIVE IMPAIRMENT DEVELOPS

MCI occurs when the brain doesn’t work as well as it should due to the various underlying conditions shared earlier.

  • In some cases, like Alzheimer’s or Lewy body disease, abnormal proteins build up in the brain.
  • For those with cerebrovascular disease, stroke damage can often be seen on an MRI.
  • In cases related to infections or vitamin deficiencies, there may not be visible changes in the brain, but chemical imbalances are present.
MILD COGNITIVE IMPAIRMENT IN MALAYSIA
  • In Malaysia, studies show that 1 in 4 people over the age of 60 have mild cognitive impairment.
  • While many improve, 10% to 25% of those with MCI will eventually develop dementia.
  • Older individuals are more likely to have MCI, but it can also affect younger people.
HOW IS MILD COGNITIVE IMPAIRMENT DETECTED?

Detecting MCI can be tricky. Common tests include the Montreal Cognitive Assessment (MoCA), although it has limitations for Malaysians due to cultural and language differences.

A more regionally adapted test, the Visual Cognitive Assessment Test (VCAT), is now being used. VCAT was tested in Malaysia through collaborations with Dr Nagaendran Kandiah and his team when he was working at the National Neurological Institute in Singapore.

These tests are designed to detect mild memory problems and often take longer than traditional dementia screenings. Newer digital tests are also being developed to make detection faster and more accessible.

CAN ONE PREVENT MCI FROM GETTING WORSE?

The good news is that people with MCI can improve their chances of preventing memory decline by making lifestyle changes. Here are some proven methods:

Mental Exercises
  • Engaging the brain through memory exercises, puzzles, and learning new skills can help.
  • Activities like crossword puzzles and recall games are excellent for keeping the mind sharp.
Physical Exercise
  • Regular exercise, which should include strength training, should be done for at least 30 minutes, 5 days a week.
  • Physical activity is crucial for maintaining brain health.
Diet
  • Certain diets, like the Mediterranean or Okinawan diets, have been linked to lower risks of cognitive decline.
  • Consuming oily fish (salmon, mackerel, tuna) at least once a week, along with whole grains, fresh fruits, vegetables, and reducing red meat and fats, is highly recommended.
Social Participation
  • Staying socially active, whether through family, friends, or volunteering, is essential for cognitive health.
  • Volunteering is particularly effective as it provides a sense of purpose and responsibility as well as a morale boost when things are difficult.

Learning New Skills

  • Continuing education, whether learning a new language, picking up a musical instrument, or even pursuing higher education, helps maintain brain function.
  • Many older adults now take postgraduate degrees after retirement to keep their minds active.
  • The University of Third Age, Malaysia (link opens in a new tab) is a good place to get started. This is a programme by the Institute of Gerontology, Universiti Putra Malaysia with the support of our government and the United Nations Population Fund (UNFPA).
IN CONCLUSION

Mild cognitive impairment (MCI) doesn’t have to be a step toward dementia.

By recognizing the signs early, addressing underlying causes, and making lifestyle changes, we can protect our memory and brain health. So, stay proactive by staying active—mentally, physically, and socially!

  • ACT4Health has partnered with A. Menarini and CARiNG Pharmacy to launch the ⁠’Catch Mild Cognitive Impairment Early: Act Now, Remember More’ campaign.
  • This campaign aims to encourage Malaysians to get early screening to address potential MCI issues.
  • At the time of writing, free VCAT screening tests are available at selected CARiNG Pharmacy outlets.

Unboxing the Truth: A Dietitian’s Take on Ultra-Processed Foods

WORDS LIM TECK CHOON

FEATURED EXPERT
GEORGEN THYE
Consultant Dietitian and Coach
Founder of Georgen Cooking
Website | Instagram | Facebook | TikTok | YouTube | Linkedin

In recent years, ultra-processed foods have become a hot topic in the world of nutrition and health. With new studies linking these foods to increased risks of heart disease, diabetes, mental disorders, and even early death, many are left wondering: just how bad are these convenience foods for our health?

To shed light on this complex issue, we sat down with Georgen Thye, a registered dietitian, to unpack the truth about ultra-processed foods. He will offer us some valuable insights to help us make informed choices about our nutrition.

UNDERSTANDING ULTRA-PROCESSED FOODS

First off, Georgen, can you explain what exactly are ultra-processed foods?

Georgen Thye: Ultra-processed foods (UPFs) are products mostly made from substances extracted from foods, such as fats, starches, added sugars, and hydrogenated fats.

  • These foods typically contain numerous additives like preservatives and flavour enhancers, and they have undergone multiple industrial processes.
  • UPFs often contain minimal to no whole food ingredients and are designed to be convenient, have a long shelf life, and taste good.
  • It’s worth noting that UPFs can trigger cravings due to their high sugar content and the way sugar interacts with the brain’s reward pathways, potentially encouraging overeating. In fact, UPFs make up a significant portion of many people’s daily calorie intake in today’s modern diet!

What makes UPFs so ‘ultra’? Can you explain the different levels of food processing?

Georgen Thye: Certainly. While there are various classification systems, we’ll use the NOVA system recognized by the World Health Organization. It breaks foods into four categories:

  1. Unprocessed or minimally processed foods. These are natural foods that have undergone minimal changes, like fresh fruits, vegetables, and milk.
  2. Processed culinary ingredients. These are substances derived from minimally processed foods, such as oils, butter, and salt, used in cooking.
  3. Processed foods. These have undergone some processing to enhance flavour and shelf-life, like canned vegetables, cheese, and freshly baked bread.
  4. Ultra-processed foods. These are heavily modified using industrial processes and often contain little to no whole food components. Examples include sugary snacks, soft drinks, and frozen ready-to-eat meals.
THE GOOD, THE BAD, AND THE ULTRA-PROCESSED

Let’s now address the crux of the issue: should we avoid consuming all ultra-processed foods?

Georgen Thye: It’s not quite fair to say all ultra-processed foods should be entirely avoided.

While many are high in unhealthy fats, sugars, and additives, some can still provide convenience and nutritional benefits in certain contexts.

The key is balance.

  • We should focus on limiting UPFs that are high in added sugars, unhealthy fats, and sodium—like sugary snacks, fast foods, and processed meats.
  • However, some UPFs, such as fortified cereals or plant-based milk alternatives, might still provide valuable nutrients.

It’s also important to differentiate between processed and ultra-processed foods. Processed foods like canned vegetables, canned fish, or whole grain bread often maintain their nutritional value and can play an important role in a healthy diet.

FINDING THE BALANCE IN OUR DIET

Are there any benefits to consuming ultra-processed foods?

Georgen Thye: Ultra-processed foods do offer some benefits, such as convenience, affordability, and a longer shelf life.

They’re quick to prepare, often budget-friendly, and can help reduce food waste.

Processing techniques like pasteurization can also improve food safety by reducing the risk of foodborne illnesses.

From a personal perspective, eating isn’t just about nourishment—it’s also about enjoyment. Sometimes, indulging in a favorite comfort food, which might be ultra-processed, can bring joy and emotional satisfaction.

The key is making informed choices and understanding how much and how often we consume these foods.

What would be your advice on how can we incorporate ultra-processed foods into our diet without negatively affecting our health?

Georgen Thye: It’s unrealistic to completely avoid ultra-processed foods in today’s world.

The key is to limit consumption and be mindful of portion sizes.

  • Prioritize whole foods like fruits, vegetables, and whole grains, letting ultra-processed foods be a smaller part of your intake.
  • Learn to read nutrition labels and understand ingredients to help you make more informed choices. When possible, choose options with lower sugar, salt or sodium, and unhealthy fats.

Remember, eating is also about enjoyment. Having your favorite processed food occasionally is okay—just be mindful of how often and how much you consume. It’s all about finding the right balance for your individual needs and lifestyle.

Unmasking the Shingles Threat: Pain, Prevention, and the Power of Vaccines

WORDS LIM TECK CHOON


An overview of shingles. Click on the image to view a larger, clearer version.

5 ESSENTIAL FACTS ABOUT SHINGLES
  1. Shingles, also known as herpes zoster, is a viral infection that causes a painful skin rash that takes on a pattern known to Malaysians as “snake”.
  2. Chinese superstition held that should the “snake head” meet the “snake tail” as the rash spreads, it will cause death. Of course, this is not true. The rash can be painful, but it is not typically fatal.
  3. The “snake” is actually caused by varicella zoster virus (VZV), the same virus responsible for chickenpox.
  4. What happens is that after a person recovers from chickenpox, the virus still remains in an inactive or dormant state in their nervous system.
  5. Shingles develop when this virus becomes active again or reactivates. This can be common particularly among older adults or those with weakened immune systems.

Reactivation of dormant chickenpox virus can lead to the development of shingles. Click for a larger, clearer version.

THE SYMPTOMS OF SHINGLES
Rash
  • Shingles typically manifests as a painful rash that develops into blisters, often appearing on one side of the body, commonly on the chest, abdomen, or face.
Pain and Emotional Distress
  • The pain can be severe. It is often described as burning, stabbing, or shock-like.
  • The intense pain can lead to significant emotional distress, impacting daily activities and quality of life.
  • Due to the pain, many individuals report difficulties in sleeping, concentrating, and performing routine tasks.
Flu-like Symptoms
  • Many individuals also commonly experience flu-like symptoms such as fever and fatigue.
COMPLICATIONS OF SHINGLES
Post-herpetic Neuralgia (PHN)
  • This is a condition characterized by persistent nerve pain that can last for months or even years after the rash has healed.
  • The risk of developing PHN increases with age.
  • It affects approximately 10-20% of those who contract shingles, particularly in older adults.
Economic and Emotional Impact
  • People with shingles have to face costs associated with medical treatment, lost workdays, and the potential long-term care needed for complications like PHN.
  • The emotional toll and the risk of complications highlight the importance of preventive measures, particularly vaccination.
VACCINATION AGAINST SHINGLES 
  • Vaccination is a highly effective way to prevent shingles and its complications.
  • The recombinant zoster vaccine (RZV) has shown remarkable efficacy in clinical trials.
  • This is a non-live, recombinant subunit adjuvanted vaccine that enhances the immune response, helping the body to fight off the virus before it can reactivate and cause shingles.
  • The vaccine is administered in 2 doses, with the second dose given 2 to 6 months after the first.
  • It provides up to 97% protection against shingles in adults aged 50 and older.
  • Studies indicate that RZV maintains an efficacy rate of over 80% against shingles even several years after receiving the vaccination.
RECOMMENDATIONS FOR THE VACCINE
  • Health authorities recommend that adults aged 50 and over should receive the shingles vaccine, regardless of whether they have had shingles or chickenpox in the past.
  • Additionally, individuals aged 18 and older who are immunocompromised or at increased risk for shingles should also consider vaccination.
  • The optimal time to receive the vaccine is as soon as one reaches the eligible age, as the risk of shingles increases with age.

Reference: GlaxoSmithKline Pharmaceutical Sdn Bhd. (2024, September 10). GSK shingles vaccine now available in Malaysia [Press release, KKLIU 2560 / EXP 29.01.2025].

Reforming Doctors’ Fees Plays Key Role on the Path to Sustainable Healthcare

WORDS DR HARDIP SINGH GENDEH

FEATURED EXPERT
DR HARDIP SINGH GENDEH
Lecturer and Specialist Ear, Nose & Throat Surgeon
Department of Otorhinolaryngology, Head and Neck Surgery
Faculty of Medicine
Universiti Kebangsaan Malaysia

The Malaysian Medical Association (MMA) hosted a pivotal forum titled Fee Schedule: Reforming Doctors’ Remunerations for a Sustainable Healthcare as part of the National MMA Convention & Scientific Congress 2024 and the 64th MMA Annual General Meeting.

The event took place on Saturday, 7 September 2024, in Kuching, Sarawak.

KEY INSIGHTS FROM INDUSTRIAL LEADERS

The forum provided valuable insights into the future direction of the Fee Schedule, focusing on both Schedule 7 and 13.

It saw notable contributions from various stakeholders in the healthcare industry, associations, the Ministry of Health (MOH), and medical professionals. The discussion was moderated by Associate Professor Sanjiv Rampal from IMU University and yours truly from Universiti Kebangsaan Malaysia (UKM).

Panelists included:

  • Dato’ Dr Kalwinder Singh Khaira, representing the MMA
  • Dr Vasu Pillai, also representing the MMA
  • Dr Mohamed Iqbal Hamzah from the Ministry of Health Malaysia (MOH)
  • Datuk Dr Thirunavukarasu Rajoo, representing general practitioners
  • Datuk Dr Kuljit Singh, representing the Association of Private Hospitals of Malaysia (APHM)
  • Dr Gunalan Palari, specialist representative
  • Dr Liew Shan Fap, representing the Society of Private Medical Practitioners Sarawak
CHALLENGES AND PROPOSALS FOR FEE SCHEDULE REFORM

During the forum, Dr Mohamed Iqbal Hamzah, Head of the Medical Practice Division at the Ministry of Health, shared key issues regarding the current Doctors’ Fee Schedule.

The discussion covered the history of fee schedules for private specialists and general practitioners, their benefits and drawbacks, and the need for timely revisions to reflect the changing healthcare landscape.

MMA’S PROPOSALS FOR HARMONIZATION AND TIMELY REVIEWS

The MMA presented two critical recommendations:

  • The harmonization of fee schedules across practices
  • The implementation of a regular, timely review process

Both recommendations are raised to ensure that doctors’ remunerations are fair and up to date.

AUDIENCE ENGAGEMENT RAISES OPPORTUNITIES FOR FUTURE DISCUSSIONS

The interactive forum sparked lively engagement, with questions posed both in person and online.

Bolstered by this response, the MMA expressed its eagerness for more discussions and engagements on this crucial topic in the future.

If you missed the forum, catch up by watching the full session here (link opens in a new tab).