Strengthen Your Defence Against Illnesses with a Hidden Ally

WORDS ANAS ALMASWARY & PROFESSOR DR SUZANA SHAHAR

FEATURED EXPERTS

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

When we feel a scratchy throat or struggle to breathe, our first thought is usually hospitals. But what if I told
you there’s a simple remedy in your kitchen?

Let’s explore how the anti-inflammatory diet can actually boost our immune system, especially when it comes to respiratory health.

THE TROUBLE WITH PRO-INFLAMMATORY DIETS

Our body’s immune system is like a superhero that fights off infections and heals injuries, and inflammation is its natural power.

But here’s the twist: if not kept in check, inflammation can turn into a villain that causes chronic diseases. Hence, the foods we consume can either be a superhero sidekick or a troublemaker!

A pro-inflammatory diet influences our immune system’s balance in bad way, increasing the inflammation in our body.

Such a diet, measured by the Adapted Dietary Inflammatory Index (ADII), is associated with systemic inflammation and reduced kidney function in older adults. Chronic low-grade inflammation is believed to be one possible pathway linking this dietary pattern to kidney dysfunction.

EXAMPLES TO PRO-INFLAMMATORY FOODS

  • Red and processed meats
  • Refined sugars
  • Fried foods
  • Margarine or shortening
  • Alcohol
  • Sodas

Researchers found that a higher ADII is related to higher levels of C-reactive protein (CRP), a marker of inflammation, and lower estimated glomerular filtration rates (eGFR), an indicator of kidney function.

Hence, a proinflammatory diet can lead to both systemic inflammation and reduced kidney function.

THE BENEFITS OF AN ANTI-INFLAMMATORY DIET

Generally, an anti-inflammatory diet should include sources of low-fat protein, colourful no- starchy carbohydrates, healthy fats like extra virgin olive oil, supplementation of omega 3 fatty acids, and foods rich in polyphenols.

An anti-inflammatory diet keeps insulin levels stable and cuts down on omega 6-fatty acids, which is crucial for beating silent inflammation.

Found in vibrant non-starchy veggies and fruits, polyphenols included in this diet put the brakes on inflammation by targeting a key player called nuclear factor (NF-κB). These polyphenols activate AMP kinase, a central switch controlling metabolism, including blood sugar levels.

The anti-inflammatory diet goes the extra mile by reducing chronic inflammation at the cellular level and tweaking gene expression. The result is lower risk of chronic diseases like obesity, metabolic syndrome, and diabetes.

NUTRIENTS EXAMPLES OF FOODS TIPS
Lean sources of proteins Chicken, fish, or protein-rich vegetarian sources like tofu
or legumes.
Consume approximately the size and thickness of the palm of your
hand.
Colourful carbohydrates Vegetables like broccoli, spinach, carrots, bell peppers; fruits like guava and dragon fruits. Fill two-thirds of your plate with
non-starchy vegetables and
substantial amounts of fruits
These foods will help maintain a
low glycemic load and provide adequate levels of polyphenols.
Healthy fats Vegetable oils. Use in cooking or drizzle over salads and vegetables.
Omega-3 fatty acids Fatty fish such as salmon, mackerel, tuna, and sardines. Avoid deep frying; omega-3 fatty acids will be lost if you do this.

References:

  1. Bikman, B. (2020). Why we get sick: The hidden epidemic at the root of most chronic disease–and how to fight it. BenBella Books.
  2. Eleazu C. O. (2016). The concept of low glycemic index and glycemic load foods as panacea for type 2 diabetes mellitus; prospects, challenges and solutions. African health sciences, 16(2), 468–479. https://doi.org/10.4314/ahs.v16i2.15
  3. Estruch R. (2010). Anti-inflammatory effects of the Mediterranean diet: The experience of the PREDIMED study. The proceedings of the Nutrition Society, 69(3), 333–340. https://doi.org/10.1017/S0029665110001539
  4. Galland L. (2010). Diet and inflammation. Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, 25(6), 634–640. https://doi.org/10.1177/0884533610385703
  5. Grimes, K. (2011). The everything anti-inflammation diet book: The easy-to-follow, scientifically-proven plan to reverse and prevent disease lose weight and increase energy slow signs of aging live pain-free. Simon and Schuster.
  6. Lyons, C. L., & Roche, H. M. (2018). Nutritional Modulation of AMPK-Impact upon Metabolic-Inflammation. International journal of molecular sciences, 19(10), 3092. https://doi.org/10.3390/ijms19103092
  7. O’Neil, A., Shivappa, N., Jacka, F. N., Kotowicz, M. A., Kibbey, K., Hebert, J. R., & Pasco, J. A. (2015). Pro-inflammatory dietary intake as a risk factor for CVD in men: A 5-year longitudinal study. The British journal of nutrition, 114(12), 2074–2082. https://doi.org/10.1017/S0007114515003815
  8. Oprea, E. (2021). The power plate diet: Discover the ultimate anti-inflammatory meals to fat-proof your body and restore your health. Rodale Books.
  9. Rudnicka, E., Suchta, K., Grymowicz, M., Calik-Ksepka, A., Smolarczyk, K., Duszewska, A. M., Smolarczyk, R., & Meczekalski, B. (2021). Chronic low grade inflammation in pathogenesis of PCOS. International journal of molecular sciences, 22(7), 3789. https://doi.org/10.3390/ijms22073789
  10. Sears B. (2015). Anti-inflammatory diets. Journal of the American College of Nutrition, 34 Suppl 1, 14–21. https://doi.org/10.1080/07315724.2015.1080105
  11. Shivappa, N., Bonaccio, M., Hebert, J. R., Di Castelnuovo, A., Costanzo, S., Ruggiero, E., Pounis, G., Donati, M. B., de Gaetano, G., Iacoviello, L., & Moli-sani study Investigators (2018). Association of proinflammatory diet with low-grade inflammation: results from the Moli-sani study. Nutrition (Burbank, Los Angeles County, Calif.), 54, 182–188. https://doi.org/10.1016/j.nut.2018.04.004
  12. Xu, H., Sjögren, P., Ärnlöv, J., Banerjee, T., Cederholm, T., Risérus, U., Lindholm, B., Lind, L., & Carrero, J. J. (2015). A proinflammatory diet is associated with systemic inflammation and reduced kidney function in elderly adults. The journal of nutrition, 145(4), 729–735. https://doi.org/10.3945/jn.114.205187

Mealtime Strategies to Transform the Lives of People with Type 2 Diabetes

WORDS LIYANA TAN ABDULLAH, DR HARVINDER KAUR GILCHARAN SINGH & DR KANIMOLLI ARASU

FEATURED EXPERTS

LIYANA TAN ABDULLAH
BSc Applied Chemistry UM
Student of Master Clinical Nutrition
Universiti Kebangsaan Malaysia
DR HARVINDER KAUR GILCHARAN SINGH
Senior Lecturer
Centre for Community Health Studies (ReaCH) Faculty of Health Sciences
Universiti Kebangsaan Malaysia (UKM)
DR KANIMOLLI ARASU
Dietitian and Senior Lecturer
IMU Division of Nutrition & Dietetics
International Medical University (IMU)

Type 2 diabetes mellitus (T2DM) poses a significant public health challenge in Malaysia, mirroring a global trend of increasing prevalence.

According to the International Diabetes Federation (IDF), there are almost 463 million people suffering from T2DM worldwide. In Malaysia, this chronic condition is on the rise, with approximately 1 in 5 adults living with diabetes according to 2019 National Health and Morbidity Survey.

THE COST OF TREATING T2DM IN MALAYSIA IS INCREASING DAY BY DAY

Globally, total annual cost for treating diabetes in 2022 was estimated to be USD412.9 billion, which include USD306.6 billion for direct medical costs and $106.3 billion for indirect costs attributable to diabetes.

T2DM has a huge socioeconomic implication with an estimated cost of RM 4.38 billion in 2017 to treat T2DM and its complications, according to a report published by the Malaysian Ministry of Health (MOH) and the World Health Organization (WHO).

Additionally, people with T2DM suffer from complications such as heart disease, chronic kidney disease, nerve damage, vision and/or hearing problems, and mental health issues when the disease is poorly managed. Consequently, it leads to poor quality of life among Malaysians living with T2DM.

There is a need for public awareness and caution when managing T2DM. This article aims to provide comprehensive insights of the risk factors associated with T2DM and lifestyle strategies for effective diabetes management.

WHAT IS TYPE 2 DIABETES?

T2DM is a chronic health condition characterized by increased sugar (glucose) levels in the blood.


An overview of T2DM. Click on the image for a larger and clearer version.


Following a meal, our body processes the ingested food, generating sugar, specifically glucose molecules. Glucose molecules are then released into the blood stream.

Concurrently, the pancreas secretes insulin hormone to control and maintain our blood glucose level. Insulin helps our cells to utilize sugars as a source of energy for the body.

In people with T2DM, their body cannot produce sufficient insulin or there is a problem in the effective utilization of insulin. Thus, blood glucose level remains high, causing multiple complications.

RISK FACTORS OF T2DM

Various risk factors, including overweight and obesity, have been identified in association with T2DM.

Overweight and obesity

The mechanisms that link obesity with insulin resistance are still uncertain. However, some studies suggest that people with obesity have fewer insulin receptors, especially in the skeletal muscle, liver and adipose tissue, than lean people.

Excessive weight gain is posited as a potential factor contributing to the impairment of insulin function, possibly linked to the detrimental effects of fat accumulation in tissues such as the muscles and liver.

Other risk factors

Besides obesity, other risk factors for T2DM includes combination of environmental and genetic risk factors. Even though strong correlation between genetic risk factors and T2DM are found in many studies, environmental risk factors remain as crucial in the development of T2DM.

Therefore, specific strategies such as promotion of physical activity, healthy lifestyle and healthy dietary patterns combined with interventions to reduce the rate of obesity could reduce increasing number of T2DM incidences in near future.

MEALTIME STRATEGIES FOR PEOPLE WITH T2DM

Here are some important strategies recommended by Ministry of Health Malaysia.

Portion control is crucial.

People with T2DM are recommended to have:

  • 2 servings of carbohydrates for breakfast.
  • 2 to 3 servings for lunch and dinner, respectively.
  • 1 to 2 servings of snack.

You can use your hand as a visual guide to determine portion sizes of your foods.

NUTRIENTS EXAMPLES SIZE OF 1 PORTION
Carbohydrates Rice The size of your fist.
Protein Tenggiri fish The size of your palm.
Fats Butter The size of the tip of your thumb.
Dietary fibre Green vegetables 2 hands full.

Additionally, you can also adhere to their specific recommended portions by following the Malaysian healthy plate such as the quarter, quarter half concept.


  1. Pick a dinner plate of 9-inch or 23-cm diameter.
  2. Fill half the plate with non-starchy vegetables, such as salad, green beans, broccoli, cauliflower, cabbage, or carrot.
  3. Fill one quarter with a lean protein, such as chicken, fish, turkey, beans, tempeh, tofu, or eggs.
  4. Fill the remaining quarter with carbohydrate-rich foods such as rice, pasta, noodles, corn, or other wholegrains. Note that a cup of milk counts as carbohydrate.
  5. Choose water or a low-calorie drink such as unsweetened fruit juice or tea to go with your meal.
  6. You can also add 2 serving of fruits per day as part of your diet.

Consume high-fibre food such as fresh fruits and vegetables.

Foods containing high amounts of soluble fibres such as apples, citrus fruits, barley, and beans help to prevent sugar spikes as they slow down the digestion process.

However, these foods also contain carbohydrates and thus, you need to watch the portion sizes.

Choose wholegrains instead of simple carbohydrates.
EXAMPLES OF SIMPLE CARBS EXAMPLES OF COMPLEX CARBS
  • White bread
  • White pasta
  • White rice
  • Cakes
  • Cookies
  • Candy
  • Ice cream
  • Non-diet sodas
  • Sugar cereals
  • Sweetened drinks
  • Whole wheat bread
  • Brown rice
  • Starchy vegetables
  • Fruit
  • Beans
  • Lentils
  • Quinoa
  • Oats
  • Sweet potatoes
  • Chia seeds
Avoid or limit intake of foods high in sodium as these foods may lead to high blood pressure.

Examples of high sodium foods include salty snacks, fast food, pickles, and gravies.

Low sodium foods include whole foods such as fresh fruits and vegetables, unsalted foods or snacks, herbs and spices.

Consume healthy fats such as foods rich in unsaturated fatty acids.

Examples of fgood sources of unsaturated fatty acids include fish, nuts and seeds.

Avoid or limit intake foods high in saturated fats such as processed meat, cheese, and fatty meat.

Avoid or limit sugar sweetened beverages such as canned drinks or carbonated drinks.

These beverages add to your total calorie intake and lead to increased blood glucose levels.

People with T2DM can opt for unsweetened coffee or tea.

Avoid or limit alcohol drinks and cigarettes smoking.
Lead an active lifestyle by doing exercises.

Perform moderate-intensity exercises such as cycling less than 20km/hour, water aerobics, mowing the lawn, actively playing with children for 150 minutes per week.

Perform for at least 90 minutes per week vigorous exercise such as race walking, hiking uphill, aerobics, swimming, and cycling uphill.

Additionally, aim for at least 2 sessions per week of muscle strengthening exercises such as push-ups, squats and abdominal crunches.

Consult a healthcare professional on the appropriate types and frequency of exercise. as some individuals may need personalized exercise regime—especially the older adults, elderly and those with chronic conditions.

It is also recommended to check blood glucose levels before engaging in vigorous exercise regimes.

Consume adequate fluids to maintain good hydration status during exercise.

OTHER USEFUL TIPS
Monitoring carbohydrates intake is essential.

A dietitian can provide guidance on estimating carbohydrates intake through techniques such as carbohydrates counting or maintaining a food diary. These approaches enable people with T2DM to understand how different foods impact their blood sugar levels. It is important to pair carbohydrates counting with the blood glucose levels and medication intake.

Always monitor at home the blood sugar level for those who are at risk of hypo- or hyperglycaemia, using a blood glucose meter.

Self-monitoring of blood glucose level is important to ensure blood glucose stays within the recommended levels and it helps to prevent hypo- or hypoglycemia.

It can be done in a fasting state before and/or 2 hours after a meal.

People with T2DM should adhere to anti-diabetic medications dosage intake and insulin injection regimen to help improve blood glucose control.

Always seek guidance from healthcare professionals to manage your diabetes effectively.

Keeping a close watch on overall carbohydrates and sugar consumption remains a fundamental strategy for achieving optimal blood sugar control in people with T2DM.

Besides, people with T2DM should possess awareness and understanding of all the recommendations and guidelines provided by their healthcare professionals.


References:

  1. CPG Secretariat, Health Technology Assessment Section. (2020). Clinical practice guidelines: Management of type 2 diabetes mellitus (6th ed.). Ministry of Health Malaysia. https://www2.moh.gov.my/moh/resources/Penerbitan/CPG/Endocrine/CPG_T2DM_6th_Edition_2020_13042021.pdf
  2. Nasir, B.M., Abd. Aziz A., Abdullah, M.R., & Mohd Noor, N. (2012). Waist height ratio compared to body mass index and waist circumference in relation to glycemic control in Malay type 2 diabetes mellitus patients, Hospital Universiti Sains Malaysia. International journal of collaborative research on internal medicine & public health (IJCRIMPH), 4, 406. https://www.researchgate.net/publication/281629114_Waist_height_ratio_compared_to_body_mass_index_and_waist_circumference_in_relation_to_glycemic_control_in_Malay_type_2_diabetes_mellitus_patients_Hospital_Universiti_Sains_Malaysia
  3. Bener, A., Zirie, M., & Al-Rikabi, A. (2005). Genetics, obesity, and environmental risk factors associated with type 2 diabetes. Croatian medical journal, 46(2), 302–307.
  4. Ganasegeran, K., Hor, C. P., Jamil, M. F. A., Loh, H. C., Noor, J. M., Hamid, N. A., Suppiah, P. D., Abdul Manaf, M. R., Ch’ng, A. S. H., & Looi, I. (2020). A systematic review of the economic burden of type 2 diabetes in Malaysia. International journal of environmental research and public health, 17(16), 5723. https://doi.org/10.3390/ijerph17165723
  5. Gardner, C. D., Trepanowski, J. F., Del Gobbo, L. C., Hauser, M. E., Rigdon, J., Ioannidis, J. P. A., Desai, M., & King, A. C. (2018). Effect of low-fat vs low-carbohydrate diet on 12-month weight loss in overweight adults and the association with genotype pattern or insulin secretion: The DIETFITS randomized clinical trial. JAMA, 319(7), 667–679. https://doi.org/10.1001/jama.2018.0245
  6. Kojta, I., Chacińska, M., & Błachnio-Zabielska, A. (2020). Obesity, bioactive lipids, and adipose tissue inflammation in insulin resistance. Nutrients, 12(5), 1305. https://doi.org/10.3390/nu12051305
  7. Feisul, I. M., Azmi, S., Mohd Rizal, A. M., Zanariah, H., Nik Mahir, N. J., Fatanah, I., Aizuddin, A. N., & Goh, A. (2017). What are the direct medical costs of managing type 2 diabetes mellitus in Malaysia?. The medical journal of Malaysia, 72(5), 271–277.
  8. Shafie, A., & Ng, C.H. (2020). Estimating the costs of managing complications of type 2 diabetes mellitus in Malaysia. Malaysian journal of pharmaceutical sciences, 18, 15-32. 10.21315/mjps2020.18.2.2
  9. Goossens G. H. (2008). The role of adipose tissue dysfunction in the pathogenesis of obesity-related insulin resistance. Physiology & behavior, 94(2), 206–218. https://doi.org/10.1016/j.physbeh.2007.10.010
  10. Parker, E. D., Lin, J., Mahoney, T., Ume, N., Yang, G., Gabbay, R. A., ElSayed, N. A., & Bannuru, R. R. (2024). Economic costs of diabetes in the U.S. in 2022. Diabetes care, 47(1), 26–43. https://doi.org/10.2337/dci23-0085

Tame the IBS Beast: Your Guide to a Happy Gut

WORDS MARAM T.M. BESAISO & DR SHANTHI KRISHNASAMY

FEATURED EXPERTS

MARAM T.M. BESAISO
Master’s Student in Clinical Nutrition
Faculty of Health Sciences
Universiti Kebangsaan Malaysia
DR SHANTHI KRISHNASAMY
Senior Lecturer and Coordinator of the Master of Clinical Nutrition Dietetics Programme
Universiti Kebangsaan Malaysia

Have you ever woken up feeling like your stomach was about to explode? Or experienced that nagging discomfort after eating certain foods? If so, you’re not alone.

Irritable bowel syndrome (IBS), a common gastrointestinal disorder, affects 1 in 10 people worldwide.

UNMASKING IBS: A PERSONAL JOURNEY

My teenage years, already burdened by academic pressure, took a painful turn when I developed IBS.

The unpredictable digestive woes—rumbling stomachs, embarrassing episodes, and constant discomfort—cast a shadow over my social life and amplified my anxieties.

Shame and isolation became my unwelcome companions.

Seeking medical help finally brought the diagnosis: IBS.

While the condition persisted, understanding it became the first step towards managing it.

Now, on the flip side of this journey, I offer my story not for pity, but for hope. To anyone wrestling with IBS, know this: you’re not alone. Let’s navigate this together, sharing strategies, finding support, and reclaiming control. Together, we can turn the tables on IBS and discover a life brimming with delicious possibilities and digestive joys.



An overview of IBS. Click on the image for a larger, clearer version.


NAVIGATING THE COMPLEXITIES OF IBS

This can be a daunting task, as this common gastrointestinal disorder can significantly impact your quality of life.

While not life-threatening, IBS can manifest in a range of distressing symptoms. It is a common condition characterized by frequent tummy troubles, bloating, cramps, and bathroom emergencies.

It not only affects the gut but also causes social anxiety, worry about finding a bathroom, and a decline in productivity due to doctor visits, tests, and medications.

GUT OFFENDERS

Living with IBS means your gut can flip its lid over certain foods. Here are some of my worst offenders.

  • Spicy foods: capsaicin in chili peppers lights up pain receptors in your sensitive gut, leading to gut pain, bloating, and diarrhoea.
  • Caffeine revs up your gut, potentially worsening diarrhoea and anxiety. Plus, it acts like a sneaky thief, steals fluids (causing dehydration) and makes constipation worse.
  • Alcohol, research suggests alcohol disrupts gut barrier integrity, which can worsen IBS symptoms. Also, alcohol disrupts digestion, which may slow down bowel movements and contribute to constipation. It irritates gut, triggering inflammation and worsening discomfort.
LIFESTYLE HACKS TO EMPOWER YOUR LIFE IN SPITE OF IBS

IBS can rumble your confidence and hijack your life. Fear not! Conquer IBS and reclaim your freedom with simple dietary tweaks and lifestyle hacks.

Regularity and consistency are key. To ease your IBS symptoms, eat slowly and regularly in a relaxing environment, and be mindful of how your food affects your gut.

Small and frequent wins. Smaller portions, more often, can be your gastrointestinal allies, embrace bite-sized snacks throughout the day to keep your digestion humming smoothly.

Small changes as a starter. To avoid losing motivation, make gradual changes and observe their effects. This will help you maintain consistency and find what works best for you.

Start recording. Keep a diary of your foods and symptoms as you are making changes, so that you can see what have helped (and haven’t).

Hydration is your hero. Water is your gut’s best friend! Aim for 8 glasses daily.

Caffeine and fizz, the troublemakers. Limit yourself to 3 cups of coffee and/or tea a day and keep the fizzy drinks at bay – your gut will thank you!

Alcohol? Not the best buddy. Moderation is key, so if you do imbibe, choose wisely and drink plenty of water alongside.

Fibre matters but choose wisely. If your IBS involves frequent trips to the loo, steer clear of whole grains, brown rice, bran, and fruit and veggie peels. However, don’t ditch fibre altogether!

To conquer constipation: embrace soluble fibres in moderation. Apples, pears, bananas, flaxseeds, chia seeds, and oats can be your constipation-busting friend.

Sorbitol, the sweet deceiver. If diarrhoea is your IBS partner, avoid the artificial sweetener sorbitol found in sugar‑free sweets, including chewing gum, and drinks, and in some diabetic and slimming products.

Trigger foods. Fatty foods and spices might be it’s not your best choice.

Stress, the IBS enemy. Exercise, meditation, and yoga are your stress-busting maestros, helping your gut find its happy rhythm again.

Sleep. Aim for eight hours of uninterrupted sleep. A well-rested you translates to a well-rested gut, ready to face the day with digestive harmony.

Probiotics: The gut’s new best buds. Consult your doctor about incorporating these into your routine. They’re friendly bacteria, keeping your gut’s ecosystem in balance and preventing IBS from crashing your day

Seek expert guidance. Consult your doctor or a registered dietitian for personalized advice and support.

Remember, IBS is yours to manage, and with these empowering strategies, you can reclaim control, say goodbye to gut chaos, and embrace a life brimming with delicious possibilities and happy digestion!


References:

  1. UK National Institute for Health and Care Excellence (NICE). (2008, February 23). Irritable bowel syndrome in adults: diagnosis and management. https://www.nice.org.uk/guidance/cg61
  2. Werlang, M. E., Palmer, W. C., & Lacy, B. E. (2019). Irritable bowel syndrome and dietary interventions. Gastroenterology & hepatology, 15(1), 16–26.
  3. Koochakpoor, G., Salari-Moghaddam, A., Keshteli, A. H., Esmaillzadeh, A., & Adibi, P. (2021). Association of coffee and caffeine intake with irritable bowel syndrome in adults. Frontiers in nutrition, 8, 632469. https://doi.org/10.3389/fnut.2021.632469

A Dermatologist Addresses 3 Common Misconceptions About Dry Skin

WORDS LIM TECK CHOON

FEATURED EXPERT
DR FELIX YAP BOON BIN
Consultant Dermatologist
Sunway Medical Centre
MISCONCEPTION 1
DRY SKIN IS NOTHING SERIOUS.

Dr Felix Yap Boon Bin points out that this is not always true.

“Lack of water or skin dehydration will cause dry skin to peel, crack, irritate, itch and become sensitive,” he explains. “If we scratch the itch, it may lead to damage of the skin’s epidermis, causing it to become thinner or eventually recede away.”


Our skin consists of three layers: the epidermis, the dermis, and the subcutaneous layer. Click on the image for a larger, clearer version.


“When the epidermis is compromised, germs and dust can penetrate into the second layer of the skin or dermis, causing inflammation, in addition to causing other skin problems, such as eczema and psoriasis,” Dr Felix shares.


A comparison of healthy and dry skin. Click on the image for a larger, clearer version.


What causes dry skin?

Dr Felix says that being under the hot sun for a long period of time can cause dry skin.

Being in an air-conditioned room for long periods of time can also be a factor, as air conditioning can cause the skin to dry.

However, many cases of dry skin are due to genetic factors. “Some individuals are born without a protective skin layer, causing their skin to be easily dehydrated,” Dr Felix says. Therefore, it is possible for someone to develop this condition without spending much time under the sun or air-conditioning.

Additionally, the use of improper skincare products can lead to dry skin. Dr Felix cites the frequent usage of body scrubs or soaps with a higher pH level (pH above 7) as an example.

If you spend much time under the sun or in air-conditioned rooms, Dr Felix recommends, applying moisturizers regularly to ensure that the skin is healthy and has a good level of hydration. “However, if dryness is at a serious level, it is recommended to use medicated moisturizers,” he says.
MISCONCEPTION 2
ANY SKIN MOISTURIZER WILL DO.

Not true. 

“For dry skin types, oil-based moisturizers are more suitable because the oil content will moisturize the skin and reduce itching or peeling,” Dr Felix explains.

He adds: “Individuals with oily skin can choose oil control moisturizers to prevent acne growth.”

For sensitive skin, Dr Felix recommended the use of specialized moisturizers, products without fragrance or chemicals produced by certified medical brands.

Hence, he reminds everyone to identify their own skin type before choosing their skincare products, in order to ensure that these products are suitable for long-term use.

MISCONCEPTION 3
DRINKING A LOT OF WATER AND EATING VEGETABLES REGULARLY CAN HELP THE SKIN STAY HYDRATED

Research has proven that this assumption is inaccurate.

“Lack of water in the body will certainly affect the quality of the skin, but drinking a lot of water at one time does not help the skin to stay hydrated,” Dr Felix elaborates.

“Also, consuming a lot of vegetables does not necessarily help to hydrate the skin. Healthy and hydrated skin requires a balanced diet, which includes a variety of nutrients and not just vegetables,” he adds.

BONUS: DR FELIX’S TIPS TO PROTECT YOUR SKIN

“The water content in our skin will also decrease as we age,” Dr Felix reminds us. “The protective layer will become thinner and its efficiency to trap water will also become lower when we reach between 40 to 50 years old.”

Therefore, he offers some tips to help us take care of our skin in order to avoid skin problems in the future.

  • Sleeping for 7 hours a day and have a consistent bedtime, preferably before 12 midnight.
  • Lead an active lifestyle to improve the immune system. Low immunity can cause skin diseases such as eczema.
  • Use moisturizers before going to bed, especially in rooms with air conditioning.
  • Apply sunscreen before leaving the house.

Experts Explain Why You Should Include Digital Detox into Your 2024 Resolutions

WORDS LIM TECK CHOON

Data from a survey published in 2023 found that the average Malaysian is online 8 hours every day, with almost 3 hours spent on their social media.

On the other hand, some studies suggest that excessive screen time can lead to increased levels of stress and anxiety. This could lead to actual physical illnesses.

So, how can we reconcile the time we spent on social media with the potential repercussions of such a habit?

THE DARK SIDE OF DOOMSCROLLING
FEATURED EXPERT
DR RAVIVARMA RAO PANIRSELVAM
Psychiatrist
Hospital Miri

Psychiatrist Dr Ravivarma Rao Panirselvam tells us: “Harmful social media use is when the user’s day-to-day function is affected, such as at their jobs and other roles in society.”

He further explains that the speed and scale of social media interactions can encourage the need for instant gratification, which is a potentially addictive behaviour.

Hence, the term ‘doomscrolling‘ is coined to describe the act of endlessly scrolling through social media or online platforms, compulsively consuming news.

Certain studies have found that that passively taking in such a high volume of information can actually be harmful to our mental health.

THE FEAR OF FOMO

Unhealthy digital consumption habits can also amplify our regular human emotions and insecurities.

This can be seen in a phenomenon known as ‘fear of missing out‘ or FOMO, which describes the perception that we are missing out on fun experiences, crucial information, and chances to form social connections. FOMO typically arises from the constant comparison of our regular lives to that in other people’s highlight reels.

“Sometimes we as users are not cognizant that content that is posted online is heavily curated and serves a purpose which may be far off from reality,” Dr Ravivarma Rao says.

He explains that there is ample published evidence that social media can affect its users’ self-esteem.

“We tend to compare ourselves to those who are more ‘socially upward’, making us feel bad about ourselves,” he elaborates.

IT’S ALWAYS A GOOD TIME TO GO FOR A DIGITAL DETOX!

The term ‘digital detox‘ means disconnecting ourselves from digital media for a period of time.

The benefit of this detox is that it allows us to experience a ‘mental reset’, to reflect and assess how we are consuming digital content. It gives us the space to regain control of our focus and rediscover the people and things that are truly meaningful to us.

SOME TIPS TO GET THE DETOX GOING
Practice self-regulation.

Avoid impulsive actions, understand why we feel certain emotions, and take our time to respond appropriately.

Within the digital sphere, this means making sure that the digital content we consume match your personal values.

Set our boundaries.

Allocate specific periods of time for checking the news or social media. No peeking at other times!

Start with small breaks between going online, and once we are more used to these breaks, increase the duration of these breaks.

Curate our feeds.

Unfollow or mute social media accounts and pages that consistently share distressing content that make us angry or drive us into FOMO.

Make an in real life or IRL list.

If we find ourselves picking up our phone whenever we are bored or restless, we can make a list of alternative IRL things that we want or need to do.

On the list can be things such as catching up with friends in real life, taking up a new hobby, or doing chores that we have been postponing all this while.

Use this list as a guide on what we can do the next time we feel the urge to check our social media.

DON’T GIVE UP WHEN THE GOING GETS TOUGH
FEATURED EXPERT
MEDIHA MAHMOOD
Chief Executive Officer
The Content Forum
Website

Digital detox can be challenging to do, especially when we’re so used to consuming digital media for long periods of time.

However, we shouldn’t give up so soon. It is common to experience setbacks and ‘relapses’ at first. Each time we slip up, we should evaluate the possible reasons for the setback and take steps to avoid falling into the same situation in the future.

“Cultivating a mindful relationship with our digital world is not just a choice; it’s a responsibility,” asserts Mediha Mahmood, the Chief Executive Officer of the Content Forum. “In an era where our lives unfold both online and offline, the importance of a digital detox cannot be overstated.”

She reiterates the benefits of adopting a healthier digital lifestyle by trying out a digital detox and adopting self-regulation. “Aside from giving you some much needed respite from all the digital noise, unplugging will also help you identify how you can make social media serve you—rather than the other way round,” she points out.


References:

  1. Howe, S. (2023, August 21). Social Media statistics for Malaysia [Updated 2023]. Meltwater. https://www.meltwater.com/en/blog/social-media-statistics-malaysia
  2. Nakshine, V. S., Thute, P., Khatib, M. N., & Sarkar, B. (2022). Increased screen time as a cause of declining physical, psychological health, and sleep patterns: A literary review. Cureus, 14(10), e30051. https://doi.org/10.7759/cureus.30051
  3. McLaughlin, B., Gotlieb, M. R., & Mills, D. J. (2022). Caught in a dangerous world: Problematic news consumption and its relationship to mental and physical ill-being. Health communication, 38(12), 2687–2697. https://doi.org/10.1080/10410236.2022.2106086

Expert Advice for Moms That Are Juggling Breastfeeding and Work

WORDS MAS AMIRAH MOHMAD AZHAR & DR HASLINA ABDUL HAMID

FEATURED EXPERTS

MAS AMIRAH MOHMAD AZHAR
Student of Master’s in Clinical Nutrition
Faculty of Health Sciences
Universiti Kebangsaan Malaysia (UKM)
DR HASLINA ABDUL HAMID
Lecturer and Registered Dietitian Nutritionist
Centre for Community Health Studies (ReaCH)
Faculty of Health Sciences
Universiti Kebangsaan Malaysia (UKM)

Exclusive breastfeeding is recommended for infants from birth until at least 6 months of age.

This is defined as providing an infant with just breast milk—no other foods or liquids.

For the first six months of life, the World Health Organization (WHO) and other health organizations highly advise this practice, as it can contribute to many advantages for both mother and baby.

THE BENEFITS OF BREASTFEEDING

In addition to its balanced nutritional composition, breast milk contains important substances such as immunoglobulin A or Ig A, lactoferrin, cytokines, enzymes, growth factors and leucocytes. These substances provide the baby with protection against infections while also promoting intestinal adaptation and maturation.

Breast milk also contains numerous prebiotic substances such as human milk oligosaccharides (HMO), which support the growth of non-pathogenic probiotic microorganisms, primarily lactobacilli and bifidobacteria, while removing the potentially pathogenic bacteria. This high concentration of HMO is unique to humans, and studies have shown that breastfed infant has a more stable and constant population of oligosaccharides compared with infants fed with formula milk.

Furthermore, the composition of breast milk is unique, as the concentration of both energy and protein in expressed breast milk is highly variable throughout lactation stages, between mothers, and even from the same mother.

Breast milk feeding also has been linked to improved long-term neurocognitive development and cardiovascular health outcomes.

Additionally, numerous studies have demonstrated the effectiveness of breast milk in offering protection even to preterm infants in the Neonatal Intensive Care Unit (NICU).

THE JUGGLE BETWEEN BABY AND BRIEFCASE

For many working mothers, balancing work and breastfeeding can be challenging.

If you’re one of these mothers, you can choose to breastfeed exclusively or partially once you go back to work.

If you choose to exclusively breastfeed, you should express your milk while you’re on your work breaks. You can use this expressed milk to build up a supply for the feeding of your infant by a caregiver while you’re at work or for moments when you face a shortage of breast milk.

TIPS & ADVICE

The following may be useful for working mothers that still wish to breastfeed as well as to support needs of their infants.

Don’t stress yourself out!

While it’s always ideal to aim to complete your breastfeeding journey until 2 years, you and your health matters too.

Studies have shown that the benefits of breast milk on babies are dose-dependent, so the more and the longer you give, the better the beneficial effects are.

With that said, it also means that some breast milk is better than none.

Every drop matter, so while you are trying your best to pump your milk within your capacity, do not be discouraged by the amount. You might get to express more in some days and just a little in other days, and it’s totally fine.

Seek help whenever necessary.

Being a new mother is overwhelming with both love and new responsibilities, so it is very important for you to prioritise your mental and physical well-being.

Also, go for consistent health check-ups and give yourself ample time to rest.

Know your employment policies.

Nowadays, many companies provide reasonable breaks for breastfeeding employees to express breast milk. Certain companies even provide special rooms or areas for pumping the breastmilk, which comes with a refrigerator to store breast milk as well as a wash area. These venues are kept out of sight and away from public or coworker intrusion.

You can request for such an area at your workplace if such a space is not available.

The location to express your breast milk, the number of breaks available for you, and the length of each break likely differ from company to company. You should get a better understanding on your employer’s company’s policy when it comes to expressing breast milk at the workplace. This way, you can incorporate breast milk expression into your work schedule without negatively affecting your work performance or your ability to get enough rest.

You have the right to ask for permission, explain about your timetable routines to express milk, and enquire about any accommodations to improve your ability express milk more conveniently, so don’t hesitate to talk to your supervisor or human resource department.

You can do this early, such as before your delivery date, so that you can transition from your maternity leave to back to work more seamlessly.

Manage your expectations.

Know how much you need to pump, how many sessions you need to spare your time for, and how much breast milk your baby needs.

How much does your baby need? While it is quite difficult to estimate how much a baby receives from direct breastfeeding, Recommended Nutrient Intake for Malaysia 2017 states that:

  • Babies need around 500 to 600 kcal/day during their first year of life.
  • This amount increases to around 900 to 980 kcal/day at the age of 1 to 3 years.

The number of breastfeeding sessions is reduced as the baby ages, but the amount of milk needed by the baby is increased, from 6 to 8 sessions and 60 to 150 ml.

So, the number of pumping sessions and amount of milk needed to be expressed could be tailored to that.

The amount of milk consumed by your baby is usually reduced once you start them on complementary feeding, but they can still be breastfed on demand, with direct breastfeeding done at home.


Estimated daily milk requirements of babies from 0 to 6 months old. Click image for a larger, clearer version.


The recommended nutrient intake for infants from 0 to 3 years old. Click on the image for a larger, clearer version.


Invest in a good breast pump and breast milk storage.

There are many innovations and developments in the design of breast pumps and related accessories.

Hence, before purchasing a breast pump, take time to research by reading reviews or talking to your healthcare about the necessary equipment to meet your breastfeeding needs. You can also opt for trial or rental period to determine whether a breast pump is suitable for you.

Don’t just choose based on design and brand—you must also choose based on your needs also your budget. Local brands are usually more economical while still having comparable good quality to imported brands.

If you have a busy schedule, there are certain brands that offer quiet, wearable, or hands-free option which could accommodate your routine.

You will also need specialised storage bags made specifically to hold breast milk for safe transportation and storage.

  • Look for BPA-free bags that are strong enough to be kept in the freezer or refrigerator.
  • Consider bags with double zipper seal, the ability to stand alone for simple pouring, and a write-on section to record the time and date you expressed the milk.

Also, after each use of the breast pump, you should clean every area that came into contact with your breast milk or breast tissue. It is not always possible to use soap and water, particularly at work when you might not have access to a sink or have limited time. Cleansing wipes prevail for these instances!

Breastfeeding sanitizer spray is another useful consideration for quick or last-minute cleaning.

To make breast pump cleaning easier when you are on the go, make sure the supplies you buy fit compactly inside your pump bag.

Maintain proper hydration.

Have a bottle of water ready every time you pump your breast milk as well as every time you breastfeed your baby.

Water is essential, but it’s especially critical for working breastfeeding moms to stay focused and energised throughout the day.

Studies have shown that consuming more fluids than normal does not result in an increase in milk production. However, drinking too little water can lead to dehydration, which can harm your health and the quality of your breast milk.

Therefore, to ensure that your body is functioning at its best, it is crucial to consume enough fluids as to stay hydrated, which can range from 1.5 to 2.5 litres per day.

Some mothers rely on coffee to stay awake— which makes sense when your baby decided to play at 3 am! —so consuming low to moderate amounts (around 2 to 3 cups per day, or less than 300 mg of caffeine) is still considered acceptable.

Balanced meals are always key!

Recommended Nutrient Intake for Malaysia 2017 recommends that lactating mothers should consume about 2,400 kcal/day in the first 6 months of lactation, which is approximately 500 kcal more than normal adult women (1,800 to 1,900 kcal for a moderately active individual).

For mothers that want to lose some of their pregnancy weight, make sure to have adequate calories and protein according to your needs. Schedule an appointment with a dietitian if you need help to plan your meal.

Make sure to include plenty of fruits and vegetables in your meals as they are a great supply of important vitamins and minerals. Carbohydrates, especially from whole grains, is a great source of energy and fibre that can support the ability to feel full for longer.

Healthy snacking is encouraged in between meals. Go for fruit smoothies, toast, crackers, yogurt, and nuts.

TO SUM THINGS UP

Exclusive breastfeeding is one of the essential components of early childhood nutrition, but every breastfeeding mother’s circumstances are different. Therefore, it’s critical to identify a schedule and strategy that are most effective for you and your baby.

Furthermore, practice self-compassion while you manage this delicate balancing act, and don’t be afraid to seek for help and advice from your loved ones, coworkers, family members, and friends.

What Kind of Sleeping Position Is Best for a Pregnant Mom and Safest for Her Baby? Let’s Find Out!

WORDS LIM TECK CHOON

When it comes to pregnancy, the mom will have to generate enough energy for her well-being and for the growth and development of her baby. This includes eating for two (or more if she is carrying more than one baby!) as well as getting enough sleep to meet the physical demands of pregnancy.

Of course, the mom may have to adopt a different sleeping position during the pregnancy. This brings us to the question of which sleeping position is best when it comes to keeping the baby safe while allowing mom to get the most out of her sleep.

THE ACCEPTED CONVENTIONAL WISDOM OUT THERE

It is generally assumed that sleeping on the left side is better for a pregnant woman, as it’s more comfortable and helps to maintain proper blood flow between the mom and the baby she is carrying. This better blood flow also decreases the chances of swelling around the mom’s ankles and in her legs.

Sleeping on the right side is said to put pressure on the mom’s liver, so many advise a pregnant woman to sleep on her right side only for short naps.

How true are all these assumptions, though?

THE UK NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE (NICE) REVIEWED AVAILABLE EVIDENCE

They stated that the purpose of their review was to determine whether there is any link between the mom’s sleeping position and the incidence of either stillbirth or the baby being born smaller in size than typical normal, healthy babies of the same age (small for gestational age or SGA).

In their findings, published in 2021, they stated that:

There is high quality evidence linking supine going-to-sleep position—that is, the mom sleeps lying on her back—and stillbirth.

NICE noted that the overall incidence of stillbirth is generally low (1 in every 244 births in the UK based on 2018 statistics), but they feel that there is enough evidence for doctors to advise pregnant moms to avoid sleeping in this position.

HOW ABOUT SLEEPING ON THE LEFT SIDE THAT IS GENERALLY SAID TO BE GOOD FOR MOM & BABY? ANY EVIDENCE FOR THAT?

Well, NICE noted that the evidence for this, as well as for sleeping on the right side, ranged from low quality to very low quality. They concluded, therefore, that more research would be needed to look into this matter.

One thing is for sure, though—they noted that sleeping on mom’s back is definitely something to be avoided!

THE TAKE HOME MESSAGE

Pregnancy may also give rise to other sleeping issues, such as problems falling asleep, and special care is often needed for pregnant women that also have obstructive sleep apneoa (OSA) and other health conditions that could affect her sleep or her breathing while she is asleep.

Hence, it’s always sensible for a couple expecting a baby to discuss mom’s sleep matters further with their obstetrician and gynaecologist. They should do this as early as possible—don’t wait for the sleeping issues to arise first!


Reference: National Guideline Alliance (UK). (2021). Maternal sleep position during pregnancy: Antenatal care. National Institute for Health and Care Excellence (NICE). https://www.ncbi.nlm.nih.gov/books/NBK573947/

Can Parkinson’s Disease Be Prevented with the Mediterranean Diet?

WORDS OH YAN TING, DR MUNIRAH ISMAIL & PROFESSOR DATO’ DR ROSLEE RAJIKAN

FEATURED EXPERTS

OH YAN TING
Dietitian and Student of MHSc in Clinical Nutrition
Faculty of Health Sciences
Universiti Kebangsaan Malaysia
DR MUNIRAH ISMAIL (PhD)
Lecturer and Dietitian
Dietetics Program
Centre for Healthy Ageing and Wellness (H-CARE)
Faculty of Health Sciences
Universiti Kebangsaan Malaysia
PROFESSOR DATO’ DR ROSLEE RAJIKAN
Professor in Clinical Nutrition and Dietetics
Centre for Healthy Ageing and Wellness (H-CARE)
Faculty of Health Sciences
Universiti Kebangsaan Malaysia

Parkinson’s disease is a degenerative neurological disorder affecting movement.

It occurs when there is damage to brain cells that results in a reduction of dopamine, a chemical in the brain that controls movement, mood, concentration, and others. A lack of dopamine will result in the brain’s nerves being unable to effectively regulate the activities as mentioned earlier.

Individuals with Parkinson’s disease usually experience motor symptoms such as tremors, slower body movements, limb stiffness, postural instability, and uncoordinated body movements. In addition, they may also suffer from depression, behavioural changes, sleep disorders, constipation as well as smell disorders.

PARKINSON’S DISEASE IN MALAYSIA

To date, approximately 15,000 to 20,000 Malaysians have been diagnosed with Parkinson’s disease, and this number is expected to increase by five times in the year 2040.

CAUSES & CURE

Various factors can contribute to the development of this disease, including genetic predisposition and environmental factors such as diet and physical activity as well as exposure to toxic agents such as heavy metals and pesticides.

Although the cause of Parkinson’s disease is not fully understood, there is evidence to suggest a link between oxidative damage, chronic neuroinflammation, and mitochondrial dysfunction, which can result in the development of this disease.

Currently, there isn’t a cure for Parkinson’s disease. Therefore, preventive measures must be implemented to reduce one’s risk of developing this disease.

NUTRITION & PARKINSON’S DISEASE

Nutrition is one of the environmental factors found to influence one’s risk of developing Parkinson’s disease.

A high intake of vegetables as well as fish and legumes are moderately associated to a reduced risk of Parkinson’s disease.

Meanwhile, high consumption of meat, processed meat, sugary foods, and carbonated drinks is associated to an increased risk.

THE MEDITERRANEAN DIET

The Mediterranean diet is practiced widely in Greece, Spain, and Italy.

Many previous studies found that this diet confers benefits for health and longevity.

It is associated with a reduced risk of type 2 diabetes, heart disease, and stroke.

In addition, the Mediterranean diet is also widely recognized for its role in reducing oxidation and inflammation in the body. Since the onset and progression of Parkinson’s disease involve neuroinflammation and oxidative stress, the Mediterranean diet can therefore play an important role in the prevention of this disease.

Two large cohort studies have shown that a high level of adherence to the Mediterranean diet is associated with a lower risk of Parkinson’s disease. Whereas a lower level of adherence to this diet is associated with an earlier onset of Parkinson’s disease.

In addition, short-term adherence to the Mediterranean diet has also been found to reduce constipation, which is one of the signs and symptoms of Parkinson’s disease.

Characteristics of the Mediterranean diet.

This diet emphasizes the following 4 components:

High intake of fresh fruits and vegetables, as well as whole grains. According to the Greek Dietary Guidelines 1999, it recommends the following:

  • Vegetables: 6 servings a day.
  • Fruits: 3 servings a day.
  • Whole grains: 8 servings a day.

These foods contain high dietary fibre, vitamins, and polyphenols. Vitamins A, C, and E and polyphenols contain antioxidant and anti-inflammatory properties that are likely to reduce the risk of Parkinson’s disease. In addition, the high dietary fibre content can also help to reduce occurrences of constipation.

Consistent use of olive oil. This oil contains monounsaturated fatty acids and polyphenols that can reduce oxidative stress and inflammation.

Consumption of milk, dairy products, potatoes, chicken eggs, fish, nuts, legumes, seeds and red wine in moderation.

  • Milk and dairy products: 2 servings a day.
  • Nuts and legumes: 3 to 4 servings a week.
  • Fish or seafood: 5 to 6 servings a week.
  • Chicken or duck: 4 servings a week.
  • Eggs: 3 servings a week.
  • Red wine: no more than 2 glasses a day for men and 1 glass a day for women.

Foods such as nuts, legumes, fish, chicken, and eggs are important sources of protein for building and repairing body cells and tissues.

For fish, go for deep-sea fish that contain high levels of omega-3 fatty acids. Omega-3 fatty acids can maintain brain function and reduce inflammation and oxidation.

As for red wine, it contains high amounts of polyphenols.

Low intake of red meat, sweet foods, and saturated fat.

  • Red meat: 4 servings a month.
  • Sweet foods: 3 servings a week.

High intake of red meat has been linked to an increased risk of Parkinson’s disease. There are several possibilities that contribute to this. The high haem content in red meat can act as a toxin when this substance is not digested properly. Secondly, the high content of saturated fat in red meat is associated with increased oxidative stress.

RECONCILING THE MEDITERRANEAN DIET WITH OUR MALAYSIAN DIET

Although this diet is practiced by the people in Mediterranean countries that have a different dietary culture from Malaysians, it is possible to include their recommendations into our Malaysian diet.

In fact, there is a high similarity between the Mediterranean Diet Pyramid and the Malaysian Food Pyramid.


Image 1 shows the Mediterranean Diet Pyramid while Image 2 shows the latest Malaysian Food Pyramid. Click on these images for larger, clearer versions.


  • Both the Mediterranean diet and the Malaysian Food Pyramid encourage the consumption of fruits and vegetables, followed by the consumption of various grain products, especially whole grains.
  • In line with the recommendations of the Mediterranean diet, the Malaysian Food Pyramid also recommends the selection of lean meat and the incorporation of plant protein sources such as legumes in a simple daily diet.
  • Both of these pyramids also emphasize limiting the intake of fat, oil, sugar, and salt.

However, a slight difference is that the Mediterranean diet emphasizes the consistent use of olive oil.

The Mediterranean diet also encourages moderate wine consumption, but individuals may make decisions on whether to include this into their diet, based on their own personal religion and beliefs.

HOW TO USE THE MALAYSIAN FOOD PYRAMID AS A FOUNDATION TO INCORPORATE MEDITERRANEAN DIET IN OUR LIVES

One simple way is to follow the Malaysian Healthy Plate concept.


The Malaysian Healthy Plate concept. Click on the image for a larger, clearer version.


  • The first quarter of the plate is allocated for carbohydrate food sources such as rice, bread, grains, and others.
  • The second quarter is allocated for protein sources such as legumes, fish, chicken, and meat.
  • The remaining half is allocated for fresh vegetables and fruits.

The “Suku Suku Separuh” (“Quarter Quarter Half”) concept emphasizes portion control and balanced meals. Following it allows us to adhere to the recommendations of the Malaysian Food Pyramid.

Additionally, the cooking methods used in meal preparation also play a key role in enabling the incorporation of the Mediterranean diet into our Malaysian diet. We can use olive oil in the grilling, baking, and roasting of meat, fish, and vegetables. It can also be used as drizzle for our salads and ulams.


References:

  1. Chu, C., Yu, L., Chen, W., Tian, F., & Zhai, Q. (2021). Dietary patterns affect Parkinson’s disease via the microbiota-gut-brain axis. Trends in food science and technology, 116, 90–101. https://doi.org/10.1016/j.tifs.2021.07.004
  2. Bexci, M.S. & Subramani, R. (2018). Decoding Parkinson’s associated health messages in social media pages by Malaysian service administrators. Malaysian journal of medical research (MJMR), 2(4), 64-72.
    3. Torti, M., Fossati, C., Casali, M., De Pandis, M. F., Grassini, P., Radicati, F. G., Stirpe, P., Vacca, L., Iavicoli, I., Leso, V., Ceppi, M., Bruzzone, M., Bonassi, S., & Stocchi, F. (2020). Effect of family history, occupation and diet on the risk of Parkinson disease: A case-control study. PLoS one, 15(12), e0243612. https://doi.org/10.1371/journal.pone.0243612
  3. Molsberry, S., Bjornevik, K., Hughes, K. C., Healy, B., Schwarzschild, M., & Ascherio, A. (2020). Diet pattern and prodromal features of Parkinson disease. Neurology, 95(15), e2095–e2108. https://doi.org/10.1212/WNL.0000000000010523
  4. Georgiou, A., Demetriou, C. A., Christou, Y. P., Heraclides, A., Leonidou, E., Loukaides, P., Yiasoumi, E., Pantziaris, M., Kleopa, K. A., Papacostas, S. S., Loizidou, M. A., Hadjisavvas, A., & Zamba-Papanicolaou, E. (2019). Genetic and environmental factors contributing to Parkinson’s disease: A case-control study in the Cypriot population. Frontiers in neurology, 10, 1047. https://doi.org/10.3389/fneur.2019.01047
  5. Gao, X., Chen, H., Fung, T. T., Logroscino, G., Schwarzschild, M. A., Hu, F. B., & Ascherio, A. (2007). Prospective study of dietary pattern and risk of Parkinson disease. The American journal of clinical nutrition, 86(5), 1486–1494. https://doi.org/10.1093/ajcn/86.5.1486
  6. Yin, W., Löf, M., Pedersen, N. L., Sandin, S., & Fang, F. (2021). Mediterranean dietary pattern at middle age and risk of Parkinson’s disease: A Swedish cohort study. Movement disorders : official journal of the Movement Disorder Society, 36(1), 255–260. https://doi.org/10.1002/mds.28314
  7. Alcalay, R. N., Gu, Y., Mejia-Santana, H., Cote, L., Marder, K. S., & Scarmeas, N. (2012). The association between Mediterranean diet adherence and Parkinson’s disease. Movement disorders : official journal of the Movement Disorder Society, 27(6), 771–774. https://doi.org/10.1002/mds.24918
  8. Rusch, C., Beke, M., Tucciarone, L., Dixon, K., Nieves, C., Jr, Mai, V., Stiep, T., Tholanikunnel, T., Ramirez-Zamora, A., Hess, C. W., & Langkamp-Henken, B. (2021). Effect of a Mediterranean diet intervention on gastrointestinal function in Parkinson’s disease (the MEDI-PD study): Study protocol for a randomised controlled trial. BMJ open, 11(9), e053336. https://doi.org/10.1136/bmjopen-2021-053336
  9. Rusch, C., Beke, M., Tucciarone, L., Nieves, C., Jr, Ukhanova, M., Tagliamonte, M. S., Mai, V., Suh, J. H., Wang, Y., Chiu, S., Patel, B., Ramirez-Zamora, A., & Langkamp-Henken, B. (2021). Mediterranean diet adherence in people with Parkinson’s disease reduces constipation symptoms and changes fecal microbiota after a 5-week single-arm pilot study. Frontiers in neurology, 12, 794640. https://doi.org/10.3389/fneur.2021.794640
  10. Calder P. C. (2006). n-3 polyunsaturated fatty acids, inflammation, and inflammatory diseases. The American journal of clinical nutrition, 83(6 Suppl), 1505S–1519S. https://doi.org/10.1093/ajcn/83.6.1505S
  11. The Hellenic Health Foundation. (n.d.). Dietary guidelines for adults in Greece. https://www.hhf-greece.gr/hydria-nhns.gr/adultdietarytext_eng.html
  12. Bisaglia, M. (2022). Mediterranean diet and Parkinson’s disease. International journal of molecular sciences, 24(1), 42. https://doi.org/10.3390/ijms24010042
  13. Lange, K. W., Nakamura, Y., Chen, N., Guo, J., Kanaya, S., Lange, K., & Li, S. (2019). Diet and medical foods in Parkinson’s disease. Food science and human wellness, 8(2), 83–95. https://doi.org/10.1016/j.fshw.2019.03.006
  14. Foo Chung, C., Pazim, K., & Mansur, K. (2020). Ageing population: Policies and programmes for older people in Malaysia. Asian journal of research in education and social sciences, 2(2), 92-96.  https://myjms.mohe.gov.my/index.php/ajress/article/view/10227

New Year, Healthier You? An Expert Shares a Health Screening Strategy to Help You Get Started

WORDS LIM TECK CHOON

FEATURED EXPERT
DR MURALITHARAN GANESALINGAM
Head of Department
Obstetrics and Gynaecology
School of Medicine
International Medical University (IMU)
FIRST, LET’S REFLECT: DO YOU NEED HEALTH SCREENING? 

Health screening benefits us, even when we believe and feel that we are healthy.

Dr Muralitharan Ganesalingam tells us: “The goal of screening tests is to detect changes in the body before they become unmanageable. In this way, you have the chance to modify your lifestyle and steer away from a particular illness.”

GO FOR HEALTH SCREENING FROM EARLY ADULTHOOD (SUCH AS WHEN YOU START WORKING) AND DO IT TWICE A YEAR AFTER YOU TURN 45

As Dr Murali puts it:

  • Generally, women between 19-24 years of age are considered to be at the peak of health.
  • From the age of 25, fat begins to accumulate, especially in the hips, thighs and abdomen, while muscle mass deteriorates.
  • From the age of 35, bone mass depletes at a rate of 0.5% to 1% each year.

There will be variations to this trend, as people are difference and hence their bodies age differently too. However, these changes with ageing prompt the recommendation given by Dr Murali, as health screening can help in detecting early the health issues that can arise alongside these changes.

Furthermore, health screening can be helpful in detecting the development of certain diseases that may not show obvious symptoms at the early stage.

PRIORITISE THESE HEALTH SCREENING TESTS
  • Blood pressure to check for hypertension. “This disease, known as the ‘silent killer’, progresses without noticeable symptoms and affects 3 in 10 Malaysians (approximately 6.4 million people), and increases the risk of stroke and heart attack,” explains Dr Murali.
  • Blood count to detect conditions like anaemia. On average, anaemia affects 3 in 10 women aged 15 to 49 years and can cause complications during pregnancy such as miscarriage and premature birth.
  • Blood glucose test to check for diabetes.
  • Body mass index (BMI) to monitor weight gain and help prevent obesity. Dr Murali points out that our national statistics show that 1 in 2 adults are overweight or obese, and 1 in 2 have abdominal obesity, of which women accounted for 54.7% and 64.8% respectively.
  • Lipids test to check for elevated levels of cholesterol, which can lead to heart disease. Around 4 in 10 Malaysians, approximately 8 million people, have raised cholesterol levels, with women being more likely to have higher levels than men. In spite of this, 1 in 4 people are unaware they have high cholesterol.
  • Kidney function and liver profile, as chronic kidney disease affects 1 in 7 Malaysians, and diabetes is a significant risk factor for this disease.

Dr Murali also recommends going for annual eye checks, hearing tests, and dental check-ups as we age.

Just for women
  • Pap smears to check for cervical cancer. “Because we have an efficient screening programme through the use of Pap smears, we have been able to reduce the incidence of cervical cancer substantially,” says Dr Murali. “It is the most significant advancement in the control of cancer, hence annual screening for cervical cancer is something I emphatically encourage.”
  • Breast examinations (see below) to check for breast cancer. Dr Murali points out that it is essential for all women to be disciplined about performing their own breast examinations as well as to go for an annual check by a doctor, who will advise if a mammogram is needed.
  • Bone mineral density scans to detect osteoporosis. Dr Murali explains that one’s bone mineral density decreases with age and the risk of fractures increases, hence postmenopausal women 50 years and older should be screened. “Women aged 65 years and older should be screened at least once a year, according to Malaysian guidelines,” he adds.

An overview of how to perform breast self-examination at home. Click on the image for a larger, clearer version. If you are unsure or you have concerns, you can consult your doctor for more information.


FINAL ADVICE

“It is important for you to speak to your regular doctor about any health concerns and discuss what health screenings may be beneficial for you, based on your age, lifestyle and family history,” Dr Murali emphasizes.

An Expert Spills the Bean on Lactose Intolerance & Your Kids

WORDS LIM TECK CHOON

FEATURED EXPERT
DR ONG SIK YONG
Consultant Paediatric Gastroenterologist and Hepatologist
Sunway Medical Centre

According to Dr Ong Sik Yong, lactose intolerance is a common gastrointestinal condition caused by the inability to digest and absorb dietary lactose.


Lactose intolerance is the result of your small intestine not producing enough of an enzyme called lactase. Lactase helps to break down lactose or milk sugars into simple sugars for absorption by your body.


BLAME IT ON DECLINING LEVELS OF LACTASE

Dr Ong shares that newborns can digest about 1 litre of breast milk every day.

However, the enzyme lactase, which digests lactose, usually declines in levels once the child stops breastfeeding, a circumstance known as lactase non-persistence.

“Approximately 70% of the world population are affected by lactase non-persistence, which causes the condition called primary lactose intolerance,” Dr Ong reveals.

He adds that generally a child shows symptoms of primary lactose intolerance after they turn 5. However, some children may exhibit symptoms as early as 2 years old.

CAN ALSO BE DUE TO OTHER GUT ISSUES

In young children, lactose intolerance may also be caused by underlying gut issues such as:

  • Gut infection.
  • Cow’s milk allergy.
  • Celiac disease.
  • Inflammatory bowel disease.

Dr Ong further shares that sometimes a child may temporarily lose the ability to digest lactose during an episode of acute gastroenteritis. Once the child recovers, however, they can continue to consume milk without further issues.

SYMPTOMS OF LACTOSE INTOLERANCE

“Usually, symptoms begin about 30 minutes to two hours after consumption,” says Dr Ong.

He adds that the common symptoms are:

  • Abdominal discomfort.
  • Bloating.
  • Farting.
  • Diarrhoea.
  • Perianal skin irritations with raw lesions surrounding the anus, due to low faecal pH in the child’s stools.
MANAGING THE DIET OF A LACTOSE INTOLERANT CHILD

Dr Ong advises parents to feed dairy products with naturally lower lactose content to children that show signs of lactose intolerance.

“After a period of limiting food with lactose, the child can consume back small amounts of foods and drinks containing lactose,” he adds.

The child’s symptoms should be observed throughout this trial period and over time, the parents or even the child would be able to tell how much of lactose the child can take.

“Besides that, parents can also consider using lactase enzyme, which can be taken by the child prior to consumption of dairy products to reduce unwanted consequences from consuming lactose,” advises Dr Ong.

NUTRITIONAL CONSIDERATION FOR THE LACTOSE-INTOLERANT CHILD

Milk and other various dairy products are a major source of calcium and vitamin D.

“Hence, it is important to make sure children who has limited dairy product intake to have other non-dairy food which are rich in these nutrients, like fish with soft edible bones, such as salmon and sardines, as well as green leafy vegetables. They may also require calcium or vitamin D supplement for their growing bones,” Dr Ong says.