Category: Nutrition

Sugar is an inseparable ingredient in the food we consume. However, too much sugar is not ideal for our health and teeth. Hence, sugar substitutes continue to entice consumers. Generally, any sweeteners other than the regular table sugar are considered as sugar substitutes. Table 1 shows several types of sugar substitutes available currently.

Note: ADI= Acceptable daily intake established by the U.S. Food and Drug Administration.

Although Aspartame provides 4 kcal/g, the amount of Aspartame used in food and drinks is so little that its calorie contribution is negligible.

Health benefits

Dental care

Sugar substitutes, unlike sugar, do not promote the development of dental caries. The microflora of dental plaque produces little or no decay-promoting acid in reaction to sugar substitutes.

Weight loss

Most sugar substitutes are lower in calories than sugar is. Substituting regular sugar (4 kcal/ g) with other sugar subsitutes (lower in calories than regular sugar) allows individuals to consume the same food they normally would, with a lower calorie intake. For instance, most of the generally used sugar alcohols provide lower calories, as follows:

• Erythritol 0.2 kcal/g
• Isomalt 2.0 kcal/g
• Lactitol 2.0 kcal/g
• Maltitol 2.1 kcal/g
• Mannitol 1.6 kcal/g
• Sorbitol 2.6 kcal/g
• Xylitol 2.4 kcal/g

Diabetes mellitus

Most sugar substitutes are metabolised more slowly, allowing blood sugar levels to stabilised over time. Hence, they may be beneficial for patients with diabetes mellitus.

In conclusion, sugar substitutes should be used only in moderation. Sugar substitutes, as their name implies, are simply to substitute one addiction (regular sugar) with another. That being said, you may train your taste buds to enjoy less sweet food over time. By progressively reducing the quantity of sugar you consume, you may alter the way your taste buds perceive food. For instance, you may cut down the quantity of sugar in your morning coffee or tea, from 1 teaspoon to ½ teaspoon.

References:

Manfred Kroger, Kathleen Meister and Ruth Kava. (2006). Low calorie sweeteners and other sugar substitutes: A review of the safety issues. Comprehensive Reviews in Food Science and Food Safety, Vol. 5, 35-47.

Kritida R. Tandel. (2011). Sugar substitutes: Health controversies over perceived benefits. J Pharmacol Pharmacother., 2(4), 236-243.

U.S. Food and Drug Administration. (2001). Agency response letter. GRAS Notice No. GRN 000045. 5 Oct. Rockville, Md.: USFDA.

McNutt K. (2000). What clients need to know about sugar replacers? J Am Diet Assoc., 100, 466-469.

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Words Lim Teck Choon 
 

Edna Loh

Accredited Practising Dietitian (Aus)
Unicare Pharmacy (Petaling Jaya)

Broccoli, cauliflower, and brussels sprouts are just some of the vegetables that fall under the Cruciferae family. Hence, the greens in this family are often referred to as cruciferous vegetables. Aside from those already mentioned, other cruciferous greens that often grace our dinner table include kai lan, bok choy, broccoli sprouts, cabbage, choy sum and wasabi (the plant, not the sauce).  

Edna Loh, an accredited practising dietitian, explains that these plants are rich in sulforaphane, a substance that is increasingly found to be more beneficial to our health than we initially suspected.

Down with the Cancer Risk?

Sulforaphane plays a role in regulating a gene called nuclear factor erythroid 2-related factor 2 (Nrf2). This gene allows for the production of signalling proteins (cytokines) that are involved in suppressing carcinogenic substances.

There have been several studies demonstrating the likelihood of sulforaphane in reducing the risk of cervical, bladder and prostate cancers. A large population study even found that there is a 39% reduction in risk of bladder cancer in participants who consumed two or more servings of broccoli compared to those who ate fewer than 1 serving per week.

Reduces Inflammation of Joints and Cardiovascular System

Some studies proposed that sulforaphane can help block the production of a signal protein, called interleukin 1 beta (IL-1), which when released will trigger inflammation. Therefore, it can be beneficial to add sulforaphane as a dietary component in combination with ongoing treatments for painful inflammatory conditions such as spinal cord or joint injuries.

Improved Detoxification by the Liver

Sulforaphane may help speed up the detoxification of potentially dangerous substances (drugs, pesticides, etc) by the liver, likely by stimulating the activity of liver enzymes that are responsible for the detoxification process.

Protects Our Cells Against Damage

Furthermore, research suggests that this helpful substance can activate 200 other genes to produce proteins that will improve the defence of our cells against damage by free radicals. If you may recall, free radicals are thought to be one of the possible risk factors for cancer. By protecting our cells from free radicals, sulforaphane helps to ensure the normal, healthy functioning of these cells.
 

GETTING THE GOODNESS

Here is the tricky part: even if you include cruciferous vegetables in your diet, sulforaphane is very sensitive to heat, and can spoil (denature) as a result of heat. Most studies recommend that you eat these vegetables raw.

Now, don’t make that face. If you’re not keen on the taste of raw vegetables, Edna Loh recommends the following to still get the most out of cooked cruciferous vegetables.

1. Wash and then chop up the vegetables. Leave them aside for 30 to 45 minutes. This will allow the moisture on the vegetables to activate an enzyme (myrosinase) in these greens, which will lead to the formation of more sulforaphane.
2. Steam the vegetables for no more than 3 minutes at 60-100°C.
3. If you wish to boil broccoli or other cruciferous vegetables, add some mustard seeds to intensify sulforaphane formation.
    

What about Supplements?

Sulforaphane supplements are available in the market. They can cost quite a bit because the technology to process this compound without causing heat to spoil it can be expensive. However, they may benefit certain groups of people such as those at high risk of cancer due to family history.

If you are keen to know more about these supplements or whether they may be of benefit to you, you can discuss this matter further with your pharmacist or doctor.

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Did you know that heart disease is the leading cause of death in the US? In 2016, 35% of all deaths in Malaysia were due to heart disease or stroke. We all read about what’s healthy and what’s not, but sometimes marketing gimmicks, labels and pre-existing notions make us eat food that may actually be harming our bodies. Senior Cardiologist Dr Ramasami Nandakumar highlights the top unhealthy foods for your heart and what to eat instead.

1. FOODS HIGH IN SALT

You already know foods like chips or crisps pack a lot of salt, but you need to be aware of how much they raise blood pressure, making you susceptible to heart disease. Chips are laden with saturated fat and salt, and both are terrible for your heart. There are also several foods that we almost don’t expect to be high in salt. Premade soups, canned vegetables, and off-the- shelf sauces are some of the worst culprits. The solution lies in reading labels and eating fresh – more work in the kitchen, but so worth it! As I always say – be smart. Be label smart.

2. CURED MEAT

If you have been watching What the Health on Netflix you already know where this is going! The sausages and cold cuts we eat are laden with nitrates and salt. Nitrates can increase your risk of cancer and salt is a known contributor to hypertension and heart disease. You can, of course, treat yourself with the occasional hot dog or hamburger. When you eat about 50 grams of processed meat every day which is the equivalent of one hot dog or four bacon strips, your risk of developing colorectal cancer increases by 18%. Avoid red meat and processed meat and include skinless poultry (chicken or duck), lean meat, oily fish (salmon, sardines or tuna), beans and lentils for your fill of protein.

3. SUGAR AND ITS HIDDEN FORMS

While we often strive to not eat sugar in the form of chocolates and candy, there’s plenty of it in that soda you are sipping too. Whilst there are many obvious foods like pastries, white rice and sweet sauces, breakfast cereals and fruit juices also pack a lot of sugar. We all like our can of soda or soft drink with our food, but that could have approximately 10 or 11 teaspoons of sugar which exceeds the American Heart Association recommendations for consumption of sugar (6 teaspoons for women and 9 for men). Try to include whole grains and fibre in your diet and be aware of foods that have high glycaemic index. You’ve probably heard it before, but be conscious of portion sizes, read labels and snack on fruit or nuts when that urge to eat sugar strikes. And yes, think again before you open that can of soda.

4. FRIED FOOD

Love that bucket of fried chicken? Your heart is urging you to stop eating it along with those samosas, fries and pub-style calamari. The carbs can spike your sugar levels and the added fat and salt is doing your heart no favours. Do consider healthy snacks such as nuts or seeds but if you really crave those crisps then baked is reasonable. Moderate consumption and preparation methods are key to maintaining a balanced nutritious diet.

5. BLENDED COFFEE

Saying goodbye to our regular cup at the coffee shop sounds too harsh, cruel even. Most of my patients hate having to do away with their regular coffee. But even if you skip the cream, the syrup, sugar and other toppings can increase your blood sugar and blood pressure levels and that is a total disaster for your heart health. My advise is to not skip your cuppa entirely, just have it black or with milk and stay away from the added sugar. I actually prefer gourmet, well-sourced coffee ie, Ethiopian, Sumatra or the Kenyan – with no add ons! HT

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WORDS PANK JIT SIN

Dr Chang recently came to Kuala Lumpur to speak about ginseng. Dr Chang spent his life researching ginseng and its curative properties and is considered the foremost authority on the herb.

The famed traditional Chinese medicine (TCM) herb known as ginseng is the dried root of plants belonging to the Panax ginseng, which is a testament to its potency and versatility in TCM. Panax is derived from the Greek word pana which means all and axos which means cure. Ginseng is thought to be derived from the mandarin ren shen which loosely translates to human heart, as the forked roots of the plant resemble a human effigy.

Ginseng as a general term incorporates P. ginseng, P. quinquefolius and P. notoginseng (grown in Yunnan and Kwangshi). However, the type most commonly used in Malaysia is P. ginseng. 

While it is supposed to be a herb associated with TCM, ginseng is the fourth most purchased herb in the US, falling behind Echinaceae, ginkgo and garlic. This is reflective of its acceptance in the US market and its ubiquity in supplement formulation.

Why is it so expensive?

We all know ginseng is pricey. Sometimes we’re inclined to think its prices have been purposely manipulated to be so exorbitant. However, that’s not necessarily true as ginseng takes many years to grow. In fact, a good quality root takes 7 years and more to grow. The shortest harvesting time is 4 years. In the interim from planting to harvesting, many things could happen and the risk of losing the crop to pest or weather conditions increase over time. Another factor contributing to the slow harvest time is the temperature and altitude at which ginseng grows.

Harvesting of ginseng is also a very resource heavy endeavour as the crop can’t simply be pulled, collected and sent for sale. The plant section above ground must be chopped off but not entirely as the neck (the portion linking the leaves to the roots) should be left intact. The roots, which is the desired part, are then collected. At this point, the collectors must be careful not the damage the roots as intact, aesthetically pleasing shapes can fetch higher prices. The fine roots surrounding the main rhizome should also ideally be kept intact. After collection, the roots are then aged in a cool, dry area for some weeks to ‘cure’ it. Ginseng was cured using extreme heat previously, but this technique is no longer being practiced.

In Korea, ginseng is also categorized into red, white and oriental ginseng based on its processing method. All ginseng starts off as white. Red ginseng requires at least 6-year-old roots to be steamed at 90 ^oC to 98^oC to turn the starch into a stable gelatin form. Then, the roots are dried either mechanically or in the sun. The resulting drying process turns the roots a reddish colour. According to Chang, red Korean ginseng is further subdivided into five categories—Heaven, Earth, Good, Cut and Tail, in order of decreasing price. Regardless of the aesthetic nature of the roots, they are all equally potent, said Chang. In general, most studies pertaining to ginseng and its effects are based on red ginseng.

What makes ginseng so potent?

The active ingredients responsible for ginseng’s curative properties are ginsenosides, which are a class of triterpene saponins extracted primarily from the roots of plants from the Panax genus. As ginsenosides are a broad class of compounds, it is difficult to pinpoint the exact mechanism for each component. The compounds have a wide range of action including:

1. 1. as a central nervous system stimulant and antifatigue agent, which is basically like coffee but without the ‘crash.’ Ginseng is also associated with improved memory.

1. 1. as a cardiac tonic, as it can increase heart muscle contraction and increasing the blood pumped. Mind you, this effect can also interact with heart medication, so it is best to check with your doctor should you want to start on ginseng supplementation.

1. 1. Lowering blood sugar levels: no particular mechanism has been attributed but because of its blood sugar lowering effects, ginseng should be taken with caution by persons who are on diabetes medication.

1. 1. Improving immunity, as ginsenosides and ginseng polysaccharides help to regulate different types of immune cells. In doing so, these compounds also help to reduce inflammation and bacterial infections.

1. 1. Antitumour effect: components of ginsenosides known as Rh1 and Rh2 were found to be toxic to tumour cell lines and this was demonstrated in animal studies. In Taiwan, where liver cancer is a major cancer, existing research points to ginseng’s ability to kill cancer cells and to prevent the spread of the disease.   

1. Anti-ageing effect: the compounds found in ginseng are found to be potent antioxidants and reduce oxidative stress in animal models. Oxidative stress is thought to be responsible for the ageing process. Thus, by decreasing oxidative stress, it leads to an increase in lifespan. This has been demonstrated in fruit flies, nematodes and mice.

What’s in my red ginseng?

The list is quite comprehensive and here is what you are consuming with each portion of ginseng.

Ginsenosides, carbohydrates, acetylenic compounds, amino acid and ginseng peptides, trace elements, vitamins, organic acids and esters, nitrides, plant sterols and flavones.

As it is a natural supplement, the components are rarely extracted in isolation and they work synergistically together.

How should I consume my ginseng?

Well, the obvious and most common way is by making a soup or stew out of it. This dilutes the bitter-sweet taste of ginseng and adds more flavour to the dish. Popular tonifying Korean and Chinese dishes feature ginseng in their recipes.

Dried ginseng can also be sliced, where they can be placed under the tongue for it to slowly be absorbed. It can also be powdered and placed into capsules for easy consumption. They can also be placed into sachets and drank as tea. One of the newer available forms of ginseng is a dark liquid, essentially ginseng extract in liquid form. It can be mixed in water and drunk immediately or taken on its own, almost like chicken essence.

Now you know all you need to know about ginseng and its benefits. HT

References:

1.  https://extension.psu.edu/history-and-cultivation-of-ginseng#section-8
2. Petkov W. (1959). Pharmacological studies of the drug Panax ginseng. Arzneim.–Forsch;9:305–311.
3. Yeo H., et al. (2012). J Ginseng Res.;36(2):190–197.
4. Luo J.Z., Luo L. (2009). Ginseng on Hyperglycemia: Effects and Mechanisms. Evid Based Complement Alternat Med.;6(4):423–427.
5. Kang S., Min H. (2012). Ginseng, the ‘Immunity Boost’: The Effects of Panax ginseng on Immune System. J Ginseng Res.;36(4):354–368.
6. Baek K., et al. (2017). Comparison of anticancer activities of Korean Red Ginseng-derived fractions. J Ginseng Res.;41(3):386–391.
7. Yang Y., et al. (2017). Ginseng: An Nonnegligible Natural Remedy for Healthy Aging. Aging Dis.;8(6):708–720.

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WORDS PANK JIT SIN

Hello, folks!

It’s your friendly neighbour- hood durian fanatic. You may recall from the Note from the Team in the August issue that there was a picture of yours truly in a truck filled with durian.

I recall in my (much) younger days, when my father used to bring back a car boot full of durians every week when the fruit was in season. We’d have durian for breakfast, dinner and lunch. It is always a good time for durian. In my family, there’s not a single soul who would say no to durian. Unfortunately, this fruit happens to be quite divisive. You’ll have people at both ends of the spec- trum—people who love (we need a stronger word than this) and those who abhor it (like some colleagues, who can’t even tolerate a whiff of this fruit from heaven). Of course, there are others who can tolerate the smell but will not eat it. Whichever one you are, there’s no harm in learning more about the amazing fruit.

DURIAN DURIAN!

The scientific name for the regular durian is Durio zibethinus. As one can guess, the genus gets its name from the Malay word for thorn—duri. The entire genus Durio has about 30 members but only nine produce edible fruits.1 The other species are usually sold as wild durian or forest durian. Some of the more well-known ones are Durio oxleyanus (the dalit and sukang of Borneo which also exist in Peninsular Malaysia), Durio lowianus (durian daun), Durio testudinarum (durian kura-kura), Durio grandiflorus (durian hantu) and Durio kutejensis (lukak).

We probably know durian is a nutrient-dense fruit. The US Department of Agriculture (USDA) registers durian’s calorie content at 147 kcal (kilocalorie) per 100 g.3 In comparison, pineapple only has 61 kcal while apples have 54 kcal per 100 g. Among fruits, durian has a decent amount of fats at 5.33 g per 100 g of fruit. The fats found in durian are considered good fats as they are monounsaturated healthy fats. Additionally, durian does not contain any cholesterol. Whatever rumours you’ve heard about durian being high in cholesterol is just the figment of someone’s imagination.⁴

Durian has relatively high potassium content, thus making it great at replenishing lost electrolytes. I guess if you get lost in the jungle and are tired and hungry, and chance upon wild durians, make sure to eat it as it will probably keep you alive while waiting for help to arrive. Apart from potassium, durian has a healthy dose of vitamin C and various other B vitamins. For those with diabetes, a small portion of durian will not mess with your sugar levels much. According to a study which compared four common fruits— papaya, pineapple, watermelon, and durian—durian had the lowest glycaemic index (GI). GI is a measure of how fast the food item is converted into basic sugar in the body. In fact, durian has a GI similar to rolled oats, and thus does not cause a sudden spike in blood sugar levels.5,6 However, the total calorie content of durian is still high, therefore, persons with diabetes should only take small portions at any one time. According to the Malaysian Dietitians’ Association, the recommended intake of fruits for adults is 2-3 servings daily and 1 serving of durian is 2 medium seeds.⁷

WHY DO I FEEL ‘HEATY’ AFTER CONSUMING DURIAN?

Heatiness, which is a uniquely Asian concept, refers to any food that causes a sensation of heat. These usually encompass energy dense and spicy foods. While it is difficult to explain this sensation in scientific terms, scientists in Japan tried to explain the term ‘heaty food’ by terming them as ‘thermogenesis- inducing’ or heat- producing foods.⁸

Indeed, when tested on mice, durian did elicit an increase in body temperature. The scientists attribute the increase in body temperature to sulphur- containing compounds found in the pulp of durian which activate sensors in the body to produce more heat.⁸

THE MANY FACES OF DURIAN

Our traditional foods incorporate durian in a variety of ways. First is the tempoyak durian, which is fermented durian. Tempoyak is surprisingly easy to process and just requires scraping the pulp of durian and mixing it with some salt, and then keeping it in a container at room temperature. The pulp is considered fermented when it starts to smell rancid. In the days before refrigeration, fermentation was one way to store excess food. Another traditional durian product is the dodol durian, which actually consists of caramelized sugar, durian, glutinous rice flour, and coconut milk. In recent years, durian has been incorporated in more food products. We can now get durian in almost everything—biscuits, pastries, ice cream, cendol, fritters, and lempok.

In 2018, a local makeup company introduced durian-scented cosmetics range including eyeliner and lipstick. We’re not sure how well received it was but HealthToday did get a sample to test out and it was rather mild.

HOW DO I CHOOSE THE BEST DURIANS?

Considering we should only eat durians in moderation, I’m guessing we all want to have only the best. There are three very simple ways to check from the outside of the fruit. First is to hold the durian in both hands and give it a firm shake. There should be some hollow shaking inside. This means the fruit is fully ripe and the flesh is dry, allowing the fruit pods to dislodge from the carapace. The second is to run your fingernails across the thorns lightly and to ‘feel’ the vibrations coming from the fruit. It should sound hollow, which again reflects the ripeness of the fruit. Finally, look at the fruit stalk. It should be green and firm on the first day. If the fruit is already more than a day old, the stalk will shrink and turn brown.

The ‘quality’ of fruits produced by a plant depends on many factors. First is the amount of nutrients the plant receives. Adequate fertilizer is necessary for fruit formation. Similarly, adequate water is important as any stress faced by the plant will affect its flowering phase. Next is the soil, which is very much dependent on the location. Not all soils are suitable for durian farming but in general, most durians are planted on freshly cleared forests, which tend to be very fertile. HT

Durian can be an acquired taste for people not raised in Southeast Asia. Here’s a link to a comprehensive review by Jared Rydelek of weirdexplorer.com.

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We’ve all experienced a bad hair day at some point in our lives – we’re only human, after all. However, there are some people who are plagued with it all too often. If that includes you, you’ll know exactly what I’m talking about. You wake up every morning, hoping that today will finally be the day when your hair will no longer be dry and brittle.

But, as always, it never actually happens. Your hair still gets tangled up in knots, which are becoming increasingly difficult to brush out. Adding to your concern, the strands of hair between the bristles of your hairbrush seem to be growing in number. And let’s not forget your horrendous spilt ends!

Hairy solutions

Having dry, frizzy hair can be a nightmare. After all, everyone wants their ‘crowning glory’ to actually be glorious – and lacklustre, damaged hair just doesn’t cut it. So, here’s a rundown of some tried-and-tested tips to restore much-needed moisture and shine to your locks!

Go nuts on coconuts!

Coconut oil, to be exact. As coconut oil contains compounds small enough to penetrate the hair’s core, applying just half-a-teaspoon to your hair can work wonders. Rub the oil through the mid-lengths and ends of your hair before wrapping it in cling film and leave it for 30 minutes. Then, rinse off the oil with water and baby shampoo.

Love your hair

Don’t put your hair through more than it can bear. While heat-styling is great for creating polished hairstyles, too much of it can damage your hair. Traditional wet-roller setting is a more hair-friendly alternative. Even if you do go for heat-styling, always opt for the lowest heat setting and use heat protection sprays.

Watch the weather

Our hot weather can spell trouble for dry locks. But while you can’t do something about where you live, you can do something about your hair. Wear a hat and use special sun-protection hair products if your locks are exposed to prolonged sunlight and heat.

Condition with mayonnaise

Aside from being a great sandwich spread, mayonnaise makes for a fantastic hair conditioner. Firstly, wet your hair with warm water. Next, massage a generous amount of mayonnaise on your hair and scalp before covering with a plastic bag. After half-an-hour, rinse off the mayonnaise with water and shampoo.

The hair diet

Hair care isn’t merely about picking out the right shampoo and conditioner; it also involves eating healthy. Consume more oily fish like salmon and mackerel as they are rich in omega-3 fatty acids, which are necessary for maintaining scalp health. Also, vegetables and whole-grain foods are great sources of zinc, iron and vitamins – nutrients essential for boosting healthy tresses.

References:

LiveStrong. Available at www.livestrong.com

WebMD. Available at www.webmd.com

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