Category: Nutrition

Most of us recognize that we should be cutting down on fats. However, do we realize that it is even more crucial to try substituting the saturated fat we consume with unsaturated fat?

We need some fat in our daily diet as fat assists the body to absorb some vitamins. In addition, it is a good source of energy and the essential fatty acids that our body cannot produce on its own.

However, consuming a lot of fat may lead to a higher energy intake than is required, making us more likely to gain weight. Hence, if we want to eat healthily and have an ideal body weight, opt for lower fat alternatives whenever possible. Although it is crucial to reduce fat consumption, we also have to consider the types of fat we are consuming. We should be cutting down on foods that are high in saturated fat or trans fat, and substitute them with unsaturated fat instead.

Know the fats

Consuming too much saturated fat may raise blood cholesterol levels, which increases the chance of developing heart disease. Saturated fats such as butter, lard, ghee, full cream dairy products and coconut milk should be consumed minimally.

 Trans fat can raise blood cholesterol levels, just like saturated fats. In fact, the effects of trans fat may be worse than that of saturated fat. Trans fats are frequently found in biscuits, cakes, hard margarine and frozen processed food.

Therefore, unsaturated fats may be a better choice. Substituting saturated fats with unsaturated fats may reduce blood cholesterol levels and provide us with the essential fatty acids that our body requires. For instance, the unsaturated fats found in oily fish may help reduce the risk of heart disease. Sources of unsaturated fats include oily fish, nuts and seeds, olive oil, sunflower oil and vegetable oils. However, these oils are not suitable for deep fat frying due to their low smoking point and chemical composition.

How much is too much?

If we wish to cut down on fat, we may compare the labels of different brands of similar food products and choose those with less fat and less saturated fat. Use the following as a guide to understand whether a food is low or high in fat or saturated fat.

Foods with fat/saturated fat content between the high and low values stated in the table above are considered to have medium fat/saturated fat content.

Other ways to trim the fat

Remember, the amount of a particular food we consume affects the amount of fat we will get from it. Below are some ways to help us cut down on fats, particularly saturated fat:

• Measure cooking oil using tablespoons instead of pouring it straight from the container.
• Use unsaturated oils such as olive oil, sunflower oil instead of lard, butter or ghee in cooking.
• Choose lean meat and trim off any visible fat.
• Bake, grill or steam instead of frying so you do not have to add any extra fat.
• When you are choosing food products, compare the labels so you can select those with less saturated fat or less total fat.
• Select dairy products with lower fat content whenever possible such as skimmed milk, lower fat cheeses or reduced fat yogurt.
• When you are preparing sandwiches, avoid any butter or fat spread if the filling is adequately moist. When fat spread is used, opt for low-fat varieties. Choose one that is soft, straight from the fridge so that it can be spread thinly.

References:

National Institutes of Health. (2001). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood cholesterol in Adults (Adult Treatment Panel III).Circulation; 106: 3143.

Albert, C.M. et al. (2002). Blood levels of long-chain n-3 fatty acids and the risk of sudden death. New England Journal of Medicine; 346: 1113-1118.

Siscovick, D.S. et al. (1995). Dietary intake and cell membrane levels of long-chain n-3 polyunsaturated fatty acids and the risk of primary cardiac arrest. JAMA; 274: 1363-1367.

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Have you heard of Hedera helix? That’s the scientific name for the plant which you may know as the common ivy, English ivy or European ivy. Ivy is a flowering plant found in the Araliaceae family that can be seen clinging on house walls and tree trunks around Europe and Western Asia.

It is widely known that ivy leaf causes itch when we touch it. However, dried ivy leaf extract is safe and tolerated well among children and adults.

Father Knows Best

The medicinal properties of ivy were supposedly made famous by the Father of Medicine, Hippocrates. Over the centuries, ivy has been used to prevent hangovers from alcohol; as an anaesthetic due to its germ-killing (antiseptic) properties; to reduce swelling of the brain and feet, and even to treat bleeding and gut infection which causes bloody diarrhoea (dysentery).

The Ivy Today

Scientific studies have now shown ivy extract to contain antimicrobial properties, anti-inflammatory and antispasmodic actions, in addition to mucus-thinning properties. In a nutshell, ivy extract helps us breathe properly when we are down with a cold or flu as well as bothersome coughs that go on and on.

What’s in the Ivy?

The two main chemical groups in ivy that have been researched many times are triterpenoid saponins and flavonoids. Triterpenoid saponins have antiviral properties; Flavonoids function as antioxidants and help to bind and remove toxins from our body. Flavonoids also have anti-inflammatory actions besides the ability to modulate the enzyme pathways in our body.

Ivy is Good for Coughs and More

Ivy extract helps to relax the lungs’ bronchial muscle, especially in people who are down with cold or flu and having bouts of coughing. Even in those having asthma attacks, ivy extract can help them breathe easier. Ivy also makes thick and sticky mucus become more liquid. Mucus which is more liquid can be coughed up and gotten rid of easily.

Studies have shown ivy extract to weaken many strains of bacteria, the yeast Candida albicans and flu virus. This helps people to recover from infections faster.

It is really not surprising that ivy extracts can be found as active ingredients in medications for cough. It is truly a plant that deserves a league of its own!

References: 1. Clinicians Research Based. Available at: www.clinicians.co.nz 2. Lutsenko Y, et al. (2010). Hedera helix as a medicinal plant. Herba Polonica.; 56(1):83-96 3. Schmidt M, et al. (2012). Suitability of ivy extract for the treatment of paediatric cough. Phytother Res.;26 (12):1942-1947 4. Simoes CM, et al. (1999). Mechanism of antiviral activity of triterpenoid saponins. Phytother Res.; 13(4):323-328 5. The International Plant Names Index. Available at: ipni.org

6. Uddin G, et al. (2011). Preliminary Phytochemical Screening and Antimicrobial Activity of Hedera Helix L. Middle-East Journal of Scientific Research.; 8(1):198-202.

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Dr Tee E Siong may not be a household name in Malaysia, but to those on the local nutrition scene, he is well-known for his passionate advocacy of better eating habits. He was a founding member of the Nutrition Society of Malaysia (NSM) and has served as its President for the last 19 years. He was also involved in several key initiatives of the Ministry of Health Malaysia to improve the nutritional status of Malaysians. Furthermore, several newspapers seek his views on various current nutrition issues in the country. He is a regular contributor to major newspapers such as The Star.

June 9th, 2015 marked another milestone in Dr Tee’s long list of distinguished accomplishments – the day saw the official launch of his first published book, Malaysian Diet: the Plain Truth. On that special occasion, we sat down with Dr Tee for a little chat on his life, his book, and, of course, his thoughts on the food Malaysians love to eat.

HT: Dr Tee, congratulations on your book! It has been a long time coming, hasn’t it?

TES: I am truly pleased that I have managed to complete the book. It is something I have wanted to do for some years, but I never got around to doing it until two years ago. I am glad that it is finally out! I must thank UM Press for this opportunity to collaborate in publishing this book, and realizing my plan!

HT: What is this book about?

TES: As the title suggests, it’s about our diet, the Malaysian diet. We always hear that our favourite food, such as nasi lemak and roti canai, are unhealthy, but this is not necessarily true. It does not mean that we should stop eating them altogether. My book shares with readers on how we can eat our favourite food and remain healthy.

All it takes is some adjustments to our dietary habits. For example, by preparing healthier versions of our favourite dish (which is sometimes as easy as cutting down on the amount of oil, salt or sugar used as well as adding more vegetables) and watching the portion size, delicious Malaysian dishes such as nasi lemak need not be considered “guilty” (or even dangerous!) pleasures.

My book also contains science-based advice as well as common sense for Malaysians wishing to adopt a generally healthier approach to food. Readers looking for honest, unbiased information on phytonutrients, for example, or dietary tips to improve their health can find such information and more in my book.

HT: What inspired you to write the book?

TES: It is the years of working in public health, mostly through the NSM that inspired me to write this book. It is like putting together my thoughts and experiences over the past 3 decades into a book. It is also due to recognizing that the prevalence of nutritional problems is still high, I feel that more reading materials for the public on this matter is needed. I want to reach out to the people. I believe that we must continue to empower the people with the right knowledge, while making the environment more health friendly.

I often ask myself: after decades of promoting healthy eating and active living amongst the population, why is the prevalence of non-communicable diseases (such as diabetes and heart diseases) not declining? Are the health authorities and NSM wasting their time doing these activities? Are we not getting to the people with our messages?

I would like to believe that all the information disseminated over the years have contributed towards increasing the awareness of the people on the importance of healthy lifestyle to prevent nutritional problems. However, in many cases, the knowledge gained has not been translated into behaviour change and positive actions. There are also people who are aware, but do not see the urgency in changing their lifestyle practices.

What it all means is we need to work further in reaching out to the people. We need to use strategies and approaches that appeal to the public. We have more work to do.

This is where I feel my book can make a contribution. There are indeed numerous nutrition books in bookshops, but mostly by foreign experts, foreign writers. I want to give people a book, written in an easy enough language (and yet maintaining a professional approach), in a language and style that will appeal to the local public. It is based on the local scenario that people can relate to. The book does not promise magic bullets; neither does it prohibit people from enjoying eating. Instead, it encourages them to eat in a wise manner; to be disciplined.

HT: Your book advocates heavily for the “always reliable” method of balanced meals and regular exercise to maintain weight and health, unlike other books which may emphasize singly on special diets, weight loss supplements, and other methods. In your opinion, what are the advantages of balanced meals and regular exercises compared to those methods?

TES: Very simple. My approach is based on what mainstream nutrition science believes is the way. It is based on science. It is not so “fashionable”, not so exciting, but it is evidence-based approaches adopted by government authorities the world over and the international health organisations.
Other methods may promise quick or “magic bullet” solutions, but to date, there is nothing as sustainable and effective as the “old-fashioned” way. My book shows you how this can be achieved in a way that allows you to still enjoy your favourite food.

HT: How would you respond to people who claim that your advice – watch what you eat, exercise regularly – is too “hard” to follow because they are too busy?

TES: My advice is actually not hard to follow. It’s a matter of being disciplined. I think what is required, firstly, is for the individual to have the belief that healthy eating and active living are key to a healthy life.

Everyone wants to be healthy to enjoy the wealth he has accumulated. But not everyone believes in the importance of healthy eating and active living. Some people take it for granted that they will be healthy; there is no need to do anything. Some people take on a healthy lifestyle only when there are signs of ill health such as chest pain, sugar in urine, etc.

Hence, we must first convince the individual that healthy eating and active living are very important. Once that is done, it becomes not hard to practise this lifestyle. These practices become ingrained in the lifestyle. One just hates salty foods, sugary drinks and fatty foods. One feels uncomfortable not exercising or being physically active.

Healthy eating doesn’t mean one has to give up all the “goodies” of Malaysian cuisine. I concluded in my book that it is possible to adopt a healthier makan culture and yet enjoy the goodness of Malaysian cuisines. We just need to be conscious of what we eat, and be clever about how we eat. I am not asking everyone to calculate every calorie and every gram of fat in their meals. It is not necessary to do that. What one needs are only some simple knowledge of the nutrient content of the foods and some simple adjustments to the daily meals.

HT: Very nicely put, Dr Tee. Let’s get back to your book. Please share with us the journey to publication. How did you conduct your research, and who supported you along the way?

TES: It has taken me quite a while to finish the writing of this book! My schedule is still rather tight, being involved in numerous activities, besides NSM projects.  

Fortunately, there is no real need to do a lot of “research”. The book is sort-of an accumulation of thoughts and experiences I have had for 3 decades. I do include some data on health statistics, but these are not difficult to come by, with my involvement in current activities.

My daughter, Tee Shiao Eek helped me to write the chapters. She is an experienced journalist who has been writing on health matters for many years. She has helped me put some of the scientific facts in a more reader-friendly format.

HT: The book is in English. Do you have plans to translate it into other languages?

TES: I am in discussion with UM Press (the publisher) on translating the book into Bahasa Malaysia. We want to see how the English copy is being received before we do that.

Malaysian Diet: The Plain Truth by Dr Tee E Siong is available at RM26 in all major bookstores. You can also order a copy fromwww.umpress.com.my.

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Overly thin individuals may be the envy of those who struggle to shed extra pounds. While being underweight seems more desirable than being overweight, being underweight has its risks.

Hefty consequences

Those overly thin individuals are at risk of infection (due to easily compromised and weak immune system), hair loss, low muscle mass and unstable hormonal regulation. In addition, underweight individuals are also prone to osteoporosis and anaemia due to the disrupt intake or absorption of important nutrients. Furthermore, underweight women are at risk of amenorrhea (the absence of menstruation) and probable pregnancy complications.

Despite the obesity epidemic escalating at an alarming rate, there is a proportion of the population that is underweight. According to the World Health Organization, the prevalence of underweight (body mass index <18.5 kg/m2) among Malaysian adults was 8.3%.

Lifting the curtain

There is a plethora of causes why individuals may become underweight. Hence, there are as many treatment plans as there are causes. No one size fits all. There is no magic bullet. A treatment plan should be tailored according to each individual. Being underweight, whether body weight is lost purposefully or not, can result from both psychological and physiological factors.

Physical causes of underweight include genetics and illness. Individuals with “lean genes” may have a higher basal metabolic rate, but should be cautious of extreme body weight loss. Body weight loss of more than 2% of total body weight in one week; 5% in one month; 7.5% in three months; and 10% in six months will put an individual at a high risk of becoming underweight.

That aside, some attacks of flu may lead to unintentional weight loss; and some medications may suppress appetite or cause weight loss. Patients should consult their pharmacist if they have recently began a new medication and are now experiencing otherwise unintentional weight loss. Apart from that, some medical conditions do foster underweight, such as hyperthyroidism, diabetes, tuberculosis, HIV/AIDS and cancer.

Many people who are under a lot of stress may experience weight loss due to nausea or a lack of appetite. In addition, individuals suffering from depression frequently experience reduced appetite and unintentional weight loss. For these cases, consultation from a counsellor or psychologist should be sought as well as intervention from a dietitian.

Tackling the issue

The analogous between underweight and overweight continues in treatment plans. Successful weight gain, like successful weight loss, originates from the pairing of a structured diet plan with regular physical activity. The key to gaining weight is to take in more calories than you use.

First of all, there is a need to determine a healthy weight target (body mass index between 18.5 kg/m2 and 24.9 kg/m2) and proceed from that starting point by increasing calorie intake. An extra 500 to 1,000 calories per day is recommended, for a weight gain of 0.5 to 1 kg per week. Similar to weight loss, realistic goals are crucial for proper weight gain. In addition, most of us may find it surprising that weight gain depends equally on physical activity, in order to build and maintain lean tissue. Furthermore, a side benefit of a physically active lifestyle is an increased appetite, which may initiate a positive cyclical effect.

Tipping the scales in a positive direction originates from selecting foods that are calorie-dense but at the same time, still beneficial. Although fast food and unrestricted desserts appear like a miraculous quick fix, nutritious food with protein, vitamins and minerals should be emphasized; instead of mere calories from processed sugars and saturated fats.

Integrating extra calories into a routine diet is often beneficial. For instance, replacing water with milk in oatmeal may add approximately hundreds of calories more conveniently than changing to foods that you may not usually consume. In addition, milk will also add calcium and protein on top of the extra calories.

Smart snacking between main meals also plays a crucial role in weight gain, such as nuts or yogurt can add calories, vitamins and minerals. Furthermore, the weight gain plan may be coupled with polymeric formulae/ nourishing fluids.

Being able to consume anything without noticeable consequences is a fallacy— even underweight individuals have to be aware of fat and sugar intake. Poor dietary choices may lead to illnesses such as heart disease or stroke, irrespective of body weight. Consult your dietitian if you need professional help in dealing with the difficulties of gaining weight!

References:

Institute for Public Health. (2011). The fourth national health and morbidity survey (NHMS IV). Kuala Lumpur: Ministry of Health Malaysia.

World Health Organization. (1998). Preventing and managing the global epidemic. Report on a WHO Consultation on Obesity. Geneva: World Health Organization.

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The origins of Ginkgo

Ginkgo biloba, also known as the Maidenhair tree, Kew tree or Japanese Silver Apricot tree, is one of the oldest surviving species of tree. The tree is considered to be a “living fossil”, as it survived through major extinction events. Ginkgo trees have very unique properties; they are capable of growing more than 130 feet and can live for over 1000 years.

Ginkgo owes its name to a traveller named Kaempfer who proposed it in 1712. This name was adopted by Linnaeus, the founder of the binomial nomenclature system. He added the species name “biloba” to indicate that the wedge-shaped lamina of the leaf had 2 divergent segments or lobes. Hence, the botanical name of the herb, Ginkgo biloba Linn.

Claimed uses of Ginkgo

In traditional Chinese medicine, the seeds of the ginkgo tree are sometimes used for treating cough, asthma, bronchitis, urinary and digestion disorders. The most widely used part of the Ginkgo tree are its leaves. It is one of the most researched herbs in the world and is gaining recognition as a brain stimulant that enhances memory because of its beneficial effects on the vascular or circulatory system.

It also acts as a powerful antioxidant and may help control the transformation of cholesterol to plaque (fatty deposits associated with the hardening of arteries causing atherosclerosis, as well as relaxing constricted blood vessels.

Due to its positive effects on blood circulation, ginkgo is found to be a candidate of choice for treatment of diabetic peripheral vascular disease, haemorrhoids, stroke, Raynaud’s Syndrome (a blood vessel disorder) and varicose veins. It has also been used in the treatment of eye and ear disorders, as the improved blood circulation to the eye can slow down any retinal damage. In some clinical tests, it was found to have improved hearing loss in the elderly.

Furthermore, the positive circulatory effects can relieve disorders affecting the extremities like cold hands and feet and chronic arterial blockage.  According to the Institute for Natural Products Research, Ginkgo has also been claimed to soothe bladder irritation and prevent bed-wetting, treat gonorrhoea and intestinal worms and improve sexual energy.

What does Ginkgo contain?

The herb Ginkgo contains mainly 2 groups of phytoconstituents, namely flavonoids and terpene lactones – including ginkgolides A, B, C, bilobalide, kaempferol and quercetin. These phytoconstituents help to control and regulate imbalances in the body, thereby controlling damage to the body and brain.

How does Ginkgo work?

The effects of Ginkgo can be attributed to an increased blood and oxygen flow to the brain, regulating the release of neurotransmitters. The result of improved blood flow to the brain is improved mental performance and memory.

Does Ginkgo have any negative effects?

Ginkgo should be considered with caution when being taken with medications for co-existing diseases, especially when consumed concomitantly with other herbs that can increase bleeding like ginger, garlic, and ginseng. Its safety for use during pregnancy and lactation lack sufficient scientific evidence and hence should be avoided.

How is ginkgo available for consumption?

The extracts of the ginkgo are formulated as capsule, soft gel, tea and liquid extract dosage forms. The dosing of these may vary depending on the preparation. Medical website MedicineNet.com recommended the dosage of 120 – 240 mg per day in divided doses, 2 to 3 times a day for dementia; and 120 – 160 mg per day in divided doses, 2 to 3 times a day for vertigo and tinnitus.

What does the future hold?

With more scientific studies to support its claims, coupled with advances in medical technology, we can witness further findings to prove the quality, efficacy and safety of ginkgo across a wider population database. We can expect newer products using more potent standardised extracts containing the active phytoconstituents to enhance the effects with fewer side-effects.

References:

Cambridge University Press. Available at www.cambridge.org

Missouri Botanical Garden. Available at www.missouribotanicalgarden.org

International Organisation of Palaeobotany. Available at www.palaeobotany.org

 Cleveland Clinic. Available at www.clevelandclinicmeded.com

Jiang X, et. al. (2005). Effect of ginkgo and ginger on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects; Br. J. Clin. Pharmacol.; 59(4); 425-432.

Drugs.com. Available at www.drugs.com

About Health. Available at www.altmedicine.about.com

MedicineNet.com. Available at www.medicinenet.com

 Herb Wisdom. Available at  www.herbwisdom.com

WebMD. Available at www.webmd.com

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Let’s play a little game. The item is a herb that is commonly used in cooking. It is white,bulb-like in shape and produces a strong distinctive flavour once peeled or cooked. While some may find its smell fragrant, others may find it repulsive.  Still can’t guess what it is? It is GARLIC!

Garlic (Allium sativum) has beenknown for its medicinal and culinary uses ever since ancient times. It is available in its original form, in powder or as supplements. But, what makes garlic great for us? Let’s discover why.  

#1: Garlic is packed with minerals and vitamins

Do you know garlic contains minerals and vitamins that can be good for your health?  According to Self Nutrition Data, taking up to 3 cloves of garlic (~9g) per day can provide you with 5% of vitamin C. Vitamin C is essential for the growth and maintenance of body tissues. It is also an antioxidant that can prevent damage caused by free radicals in the body. 

Three cloves of garlic a day can also provide you with 6% of vitamin B6. This vitamin is essential for various bodily processes such as maintaining normal nerve function, production of red blood cells and antibodies. Garlic is also low in saturated fats and a source of essential minerals such as calcium, manganese and selenium.

#2: Garlic contains allicin

Allicin is one of the active constituents of garlic and to produce this, the garlic has to be crushed or chopped.  Allicin is found to display antibacterial, antifungal, antiparasitic and antiviral properties against certain strains of viruses, which can be beneficial in preventing diseases.

#3:  Garlic extracts can be a source of antioxidant

Free radicals present in the body can damage the endothelial cells, which can in turn contribute to aging and diseases such as cardiovascular, neurodegenerative and inflammatory disorders. But aged garlic extracts (AGE) may be able to counter this. AGE are extracts taken from fresh garlic that have been aged for a period of time. It is shown to be able to protect our endothelial cells from free radicals. That aside, AGE also plays a role in preventing loss of brain function.

References:

Ankri, S., & Mirelman, D. (1999). Antimicrobial properties of allicin from garlic. Microbes and Infection; 1(2): 125-129

Borek, C. (2001). Antioxidant health effects of aged garlic extract. The Journal of Nutrition; doi: 1010S-1015S

Live Strong. Available from www.livestrong.com

Medline Plus. Available from www.nlm.nih.gov

SELF Nutrition Data. Available from www.nutritiondata.self.com

University of Maryland Medical Center. Available from www.umm.edu

Wei, Z., & Lau, B.H.S. (1998). Garlic inhibits free radical generation and augments antioxidant enzyme activity in vascular endothelial cells. Nutrition Research; 18(1): 61-70

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