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

WORDS PROFESSOR DR TAN MAW PIN

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

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

CAUSES OF MILD COGNITIVE IMPAIRMENT

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

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

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


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

HOW MILD COGNITIVE IMPAIRMENT DEVELOPS

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

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

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

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

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

CAN ONE PREVENT MCI FROM GETTING WORSE?

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

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

Learning New Skills

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

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

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

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

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

WORDS LIM TECK CHOON

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

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

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

UNDERSTANDING ULTRA-PROCESSED FOODS

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

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

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

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

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

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

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

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

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

The key is balance.

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

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

FINDING THE BALANCE IN OUR DIET

Are there any benefits to consuming ultra-processed foods?

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

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

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

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

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

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

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

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

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

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

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

WORDS LIM TECK CHOON


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

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

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

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

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

Weighing the Facts of Malaysia’s Battle Against Obesogenic Environments

WORDS UMI ATIKAH MOHD HASHIM & ASSOCIATE PROFESSOR DR ZAHARA ABDUL MANAF

FEATURED EXPERTS

UMI ATIKAH BT MOHD HASHIM
BSc Nutrition and Community Health UPM
Student of Master Clinical Nutrition
Universiti Kebangsaan Malaysia
ASSOCIATE PROFESSOR DR ZAHARA ABDUL MANAF
Senior Lecturer
Centre for Healthy Ageing and Wellness (H-CARE)
Faculty of Health Sciences
Universiti Kebangsaan Malaysia

The Malaysian lifestyle has been undergoing changes over time. With improved socio-economic conditions, Malaysians tend to consume more food today than they did previously. Excessive intake of high-calorie foods combined with little daily physical activity has led to increased numbers of overweight and obese people in the population.

Malaysia has the second highest in the number of overweight and obese people in the Southeast Asian region. Furthermore, the rate of increase in overweight and obese individuals in Malaysia was found to be the highest in the region. Since the percentage of overweight and obese people increased consistently from 2010 to 2014, there is a high possibility that this trend will continue in the coming years.

The root of this issue lies not just in personal choices but in what experts term an “obesogenic environment.”

WHAT IS AN OBESOGENIC ENVIRONMENT?

An obesogenic environment is characterized by conditions that promote obesity among populations.

In Malaysia, this includes a combination of the following factors.

  • Readily available high-calorie foods, exacerbated by the proliferation of fast-food outlets and online food delivery service.
  • Notable scarcity of outlets offering fresh and nutritious foods in urban areas that makes healthy eating more challenging and often more expensive, steering individuals towards less healthy but more accessible and affordable options.
  • Sedentary lifestyle. Increased screen time, whether for work, education, or leisure, reduces the time spent on physical activities. The convenience of smartphones and other devices has made it easier for individuals to order food online, play video games, or consume digital content for hours, thereby limiting physical movement.
  • Urban planning that discourages physical activity. Urban infrastructure often lacks safe, accessible spaces for physical exercise, further contributing to sedentary behavior. Parks and recreational facilities are often too few or inadequately maintained, especially in lower-income areas.
  • Social and economic pressures. People in lower socioeconomic brackets may prioritize cheaper food options, which are often processed and high in calories, due to budget constraints. Furthermore, individuals working multiple jobs or long hours may have less time and energy to prepare healthy meals or engage in physical exercise.
  • Cultural factors. Food plays a significant role in Malaysian culture, with social events often centered around eating. The emphasis on food abundance can sometimes overshadow the importance of food quality.
IMPLICATIONS FOR THE PEOPLE AND THE NATION

The implications of this obesogenic landscape are profound, impacting not only the physical health of individuals but also the nation’s healthcare system.

  • Public health crisis. Rising obesity rates increase the prevalence of non-communicable diseases (NCDs) such as diabetes, heart disease, and certain cancers, straining the healthcare system.
  • Economic burden. The rise in obesity-related diseases, such as diabetes, hypertension, and heart disease, places an increased burden on healthcare resources.
  • Social and emotional toll. Obesity can lead to psychological issues, including low self-esteem and depression, affecting individuals’ quality of life and productivity. Furthermore, obese people often encounter stigma and discrimination.
TACKLING THE CHALLENGE OF OBESOGENIC ENVIRONMENT WITH A MULTIFACETED APPROACH

Addressing the challenge of obesogenic environments requires a broad, collaborative approach that involves public policy changes, community engagement, and individual action.

  • Enhance urban planning and infrastructure. Prioritize the development of pedestrian-friendly infrastructure, safe cycling paths, and more green spaces within urban areas.
  • Improve economic accessibility to healthy foods. Implement policies aimed at reducing the cost of fresh produce and healthy goods while potentially taxing high-calorie, nutrient-poor foods.
  • Promote cultural shift towards healthy living. Launch public health campaigns that educate about healthy eating and celebrate it as part of the national culture.
  • Leverage technology for health promotion. Harness technology to encourage physical activity and healthy eating through apps and virtual services.
  • Strengthen public health policies. Implement comprehensive policies that tackle the availability and marketing of unhealthy food options, especially those aimed at children.
  • Launch education and public awareness campaigns. Encourage employers to create wellness programmes that promote physical activity and healthy eating. Invest in educational programmes that start from early childhood and extend into adulthood to build lifelong habits of healthy eating and regular physical activity.
  • Improve access to healthcare and nutritional guidance. Ensure individuals have access to regular health check-ups and consultations with nutritionists and dietitians to help prevent and manage obesity.

The battle against obesogenic environments in Malaysia is complex, involving an intricate web of societal, economic, and individual factors. However, by understanding these challenges and adopting a collective approach to address them, Malaysia can pave the way toward a healthier future. It requires commitment from all sectors of society—from government and industry to schools and families—to create an environment where healthy choices are easy, affordable, and valued.

Probiotics: Gut-Friendly Allies or Overhyped Foes?

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

Probiotics are living organisms that confer health advantages when ingested or used on the body and can be discovered in various sources.

These include fermented foods like yoghurt, as well as dietary supplements.

While some may think that probiotics are only beneficial for gut health or specific conditions like diarrhoea, the research delves deeper to reveal that they are crucial for our overall well-being, extending from gut health to the immune system and beyond.

THE BENEFITS OF PROBIOTICS
  • Eases digestion by breaking down complex carbohydrates, dietary fibres, and certain sugars that our bodies can’t digest on their own.
  • Produce short-chain fatty acids (SCFAs) that nourish gut cells and contribute to overall gut health.
  • Compete with harmful bacteria, thus preventing these harmful bacteria from causing digestive issues like diarrhoea, constipation, irritable bowel syndrome, and inflammatory bowel diseases.
  • Contribute to immunity and may have anti-cancer properties.
  • There is growing evidence that probiotics positively impact eczema management in children and reduce the risk of urinary tract infections, particularly among women.

However, ongoing research continues to explore their effects, especially in healthy individuals, and further investigation is needed to provide a clearer understanding.

IF YOU ARE INTERESTING IN TAKING PROBIOTICS, HERE IS HOW YOU CAN CHOOSE THE RIGHT ONE FOR YOU

The market for probiotic supplements has expanded significantly, offering various forms such as tablets, pills, chewable gummies, liquids, powders, and fortified foods. These options cater to different age groups and vary in price and claimed health benefits.

According to pharmacists, the powder form is popular due to its ease of consumption as it can be easily mixed with food.

When planning to purchase probiotics, consider the following factors:

Look at the CFU

Ensure that it contains living and active microorganisms. The potency of probiotics is measured in colony-forming units (CFU), and a higher CFU count often indicates a more potent product.

Consider the Type of Probiotic Strains Present

Various probiotic strains are like a squad of superheroes, each with unique power to tackle different health issues.

Mixing and matching probiotics, especially Lactobacilli and Bifidobacteria, can be the secret weapon against eczema in tiny tots. In addition, when calming down inflammation in urinary tract infections, trust Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 to save the day. (Anukam et al .2009).

Remember, there’s no one-size-fits-all hero here. Every health concern might need its special probiotic warrior or a dream team. So, grab your cape and give these friendly bacteria a whirl for 12 weeks to see if they’re your perfect sidekicks.

Probiotics in Foods May be a More Affordable Option 

Probiotic supplements can be expensive.

Those on a tight budget can still obtain probiotics through natural sources. Consider incorporating yoghurt, kefir, sauerkraut, miso, sourdough bread, kimchi, tempeh, kombucha and pickles into your diet.

DON’T JUST RELY ON SUPPLEMENTATION, HOWEVER!

The debate over whether to obtain probiotics from food or supplements remains controversial.

Some argue that a healthy, balanced diet rich in probiotic foods is sufficient for most individuals. To support the growth of beneficial gut bacteria, consider consuming foods that promote their proliferation.

However, while incorporating these nutritious whole foods into your diet is beneficial, they should not be seen as a cure-all for all health conditions.

Last but not least, a holistic approach to health, including a balanced diet and lifestyle modifications, should be your primary focus.

References:

  1. Anukam, K. C., Hayes, K., Summers, K., & Reid, G. (2009). Probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 may help downregulate TNF-Alpha, IL-6, IL-8, IL-10 and IL-12 (p70) in the neurogenic bladder of spinal cord injured patient with urinary tract infections: a two-case study. Advances in urology, 2009, 680363. https://doi.org/10.1155/2009/680363
  2. Garzon Mora, N., & Jaramillo, A. P. (2024). Effectiveness of probiotics in patients with constipation: A systematic review and meta-analysis. Cureus, 16(1), e52013. https://doi.org/10.7759/cureus.52013
  3. Hemarajata, P., & Versalovic, J. (2013). Effects of probiotics on gut microbiota: mechanisms of intestinal immunomodulation and neuromodulation. Therapeutic advances in gastroenterology, 6(1), 39–51. https://doi.org/10.1177/1756283X12459294
  4. McFarland, L. V., & Goh, S. (2019). Are probiotics and prebiotics effective in the prevention of travellers’ diarrhea: A systematic review and meta-analysis. Travel medicine and infectious disease, 27, 11–19. https://doi.org/10.1016/j.tmaid.2018.09.007
  5. Tsai, Y. T., Cheng, P. C., & Pan, T. M. (2012). The immunomodulatory effects of lactic acid bacteria for improving immune functions and benefits. Applied microbiology and biotechnology, 96(4), 853–862. https://doi.org/10.1007/s00253-012-4407-3
  6. Vasant, D. H., Paine, P. A., Black, C. J., Houghton, L. A., Everitt, H. A., Corsetti, M., Agrawal, A., Aziz, I., Farmer, A. D., Eugenicos, M. P., Moss-Morris, R., Yiannakou, Y., & Ford, A. C. (2021). British Society of Gastroenterology guidelines on the management of irritable bowel syndrome. Gut, 70(7), 1214–1240. https://doi.org/10.1136/gutjnl-2021-324598
  7. Zuccotti, G., Meneghin, F., Aceti, A., Barone, G., Callegari, M. L., Di Mauro, A., Fantini, M. P., Gori, D., Indrio, F., Maggio, L., Morelli, L., Corvaglia, L., & Italian Society of Neonatology (2015). Probiotics for prevention of atopic diseases in infants: systematic review and meta-analysis. Allergy, 70(11), 1356–1371. https://doi.org/10.1111/all.12700

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

WORDS TI MEI JUN & DR NURUL HUDA RAZALLI

FEATURED EXPERTS

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

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

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

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

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

References:

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

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

WORDS DR RADHAMANI RAJAKUMAR

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

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

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

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

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

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

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

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

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

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

Why do these men develop lower urinary tract symptoms?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Sobering Fact 8
HEALTH SCREENINGS ARE KEY TO MANAGING DIABETES

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

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

BEST APPROACHES FOR DIABETES MANAGEMENT

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

Experts Highlight the Urgent Need for Blood Donation in Malaysia and What We Can Do about This

WORDS DR FARZANA RIZWAN & DR IMAM SHAIK

FEATURED EXPERTS

DR FARZANA RIZWAN
Senior Lecturer
School of Medicine
Faculty of Health & Medical Sciences
Taylor’s University		 DR IMAM SHAIK
Senior Lecturer
School of Medicine
Faculty of Health & Medical Sciences
Taylor’s University

Blood transfusion is a lifesaving medical intervention for patients undergoing complex surgeries, experiencing blood loss due to trauma or childbirth, suffering from chronic illnesses and blood disorders, and even during cancer management.

VOLUNTARY BLOOD DONATION PROGRAMMES ARE CRUCIAL FOR MAINTAINING A SAFE AND ADEQUATE SUPPLY OF BLOOD AND BLOOD PRODUCTS
  • That said, currently only 2.2 % of Malaysians donate blood in a year, compared to 3.5–5% in the developed countries.
  • The pre-pandemic blood donation rate was 22.8 donors per 1,000 people, which declined to 19.7 to 22.5 donors per 1,000 population between 2020 and 2022.
  • However, the demand of blood and blood products has increased due to a rise in motor vehicle accidents and the increase in the number of transfusion-dependent patients.

According to our Health Minister Datuk Seri Dr Dzulkefly Ahmad, the country needs more blood donors to maintain a ‘safe zone’ of blood stock to meet the nation’s daily demand of at least 2,000 blood bags.

The Ministry of Health targets 35 to 40 donors per 1,000 population by 2030.

HOW CAN WE ACHIEVE THIS TARGET?
  • Young people 17 years old and above are urged to come forward to help achieve this goal.
  • The community needs to choose the right direction, have a positive mindset, and move away from the myths and negative perception surrounding blood donation.
  • Seek guidance from the good practices that are in place in other countries. For example, we can focus more on ‘targeted recruitment’ to obtain donations from specific ethnic groups if there are certain blood groups that are difficult to find in others.
  • Adopt innovative methods of education and engagement of young students to promote school-, college-, and university-based blood donation drives.
  • The use of mobile apps to facilitate online bookings, reminders, re-scheduling, and appointment cancellation systems provides convenience to the community. The use of mobile technology in tracking the donor eligibility and getting donor feedback would be helpful to make blood donation experience more pleasant and smooth.
DO YOU KNOW THAT DONATING BLOOD CAN ALSO BE GOOD FOR YOUR HEALTH?
  • Improves blood circulation to your tissues and organs.
  • Maintains iron balance—the difference between the amount of iron taken up by the body and the amount lost—in the body.
  • Reduces the risk of hardening and narrowing of the arteries from the accumulation of iron in the artery walls.
  • Reduces the risk of heart attack by reducing arterial blockages.
  • Reduces excessive iron in the blood and decreases the risk of certain cancers. Iron is a source of cancer-causing free radicals, which can damage cells and alter their functions.
  • A therapeutic phlebotomy—a procedure to reduce the excessive iron and number of red blood cells in the body—for individuals with blood diseases such as hereditary hemochromatosis, polycythemia vera, and other rare conditions.

Additionally, there are many medical privileges offered to donors in Malaysia, such as free outpatient treatment and hepatitis B vaccination, among others.

BECOMING A BLOOD DONOR IS A SIMPLE WAY TO CONTRIBUTE TO YOUR COMMUNITY

Check with local hospitals or blood donation centers to find out where and when you can donate your blood.

Reimagining Your Retirement with Entrepreneurship in Your Golden Years

WORDS PROFESSOR DR CHONG WEI YING

FEATURED EXPERT
PROFESSOR DR CHONG WEI YING
Deputy Director
Active Ageing Impact Lab
Taylor’s University.

The word “retirement” conjures images of endless days of relaxation, hobbies pursued at leisure, and perhaps occasional travel. However, this traditional view of retirement is rapidly evolving.

RETIREMENT IS JUST THE BEGINNING OF A NEW PHASE OF LIFE

Today, retirement is increasingly perceived not as an end but as a beginning—a phase of life during which individuals can leverage their decades of experience, skills honed over a lifetime, and a wealth of knowledge to contribute to society in meaningful ways.

The appeal of entrepreneurship has never been greater to individuals, attracting those who desire greater autonomy, choices, and possibilities for unlimited growth in their golden years.

WHY ENTREPRENEURSHIP?

The reasons for this shift are manifold.

Longer lifespan. For one, a longer lifespan has prompted individuals to redefine retirement. With the accumulated resources, such as financial savings and extensive professional networks, individuals might want to expand their activities to include continued work in some capacity, engaging in lifelong learning, pursuing new hobbies, or even starting new businesses after retirement.

Greater access to digital media. Additionally, the advent of the digital era has made access to information, resources, and networks easier than ever for individuals to start businesses from the comfort of their homes.

New goals. Individuals are encouraged to remain engaged, mentally alert, and physically active during their retirement years. Launching a business can offer a renewed sense of purpose, providing a compelling reason to greet each morning with enthusiasm and a goal to work towards. It embodies the pursuit of continued growth, learning, and self-challenge.

Leaving a legacy. In certain cases, embarking on entrepreneurship in later life serves as a powerful means to impart wisdom to the younger generations. This exchange across ages not only narrows the divide between the young and the elderly but also cultivates a culture of ongoing learning and cooperation. Embracing an entrepreneurial spirit in one’s retirement years not only enhances personal fulfilment but also benefits the economy and society at large through job creation, innovation stimulation, and economic growth.

IGNITING YOUR ENTREPRENEURIAL SPIRIT

Before deciding to jump into a business and get caught up in the excitement, it’s crucial to adopt a sober view of potential problems. You first must ask some questions early that might mitigate or prevent potential problems and avoid unnecessary grief.

Here are some practical questions designed to help you determine if starting a business during your golden years is the right decision for you:

  1. Do I have the skills and strengths required to start and manage a new business, or is it primarily seen as a hobby? How does this interest align with the practical aspects of running a business?
  2. Am I financially stable enough to start a business without jeopardizing my retirement savings? What funding options do I have in place?
  3. Do I have the physical and mental stamina required to start and manage a new business? How might this impact my health and lifestyle?
  4. How comfortable am I with taking risks at this stage in my life? Am I prepared for the possibility of failure
  5. Am I looking to build something that leaves a legacy, or am I interested in a venture that meets immediate goals? Who can provide advice and assistance?
  6. How can I leverage my professional and personal connections for support and growth opportunities? Who can be my mentor in the entrepreneurial journey?
  7. Is there a real demand for the product or service I plan to offer? How saturated is the market?
  8. Are there any cost-effective business models that can lower the business risk? How can these models significantly reduce financial exposure and operational risks?
  9. What is my exit strategy if the business doesn’t go as planned? How will this impact my future and finances?
  10. What are the legal implications of my business structure (for example: sole proprietorship, partnership, corporation), and how does it affect my liability and tax obligations? How do I ensure that my business practices comply with stated laws?

As you approach your golden years, it is you that will make the crucial decisions about whether to have a phase of relaxation or a stage for active participation, personal fulfilment, and societal contribution. Starting a business will not only transform your life but also enrich society, showcasing the untapped potential of your later years.

MADSA Calls for More Efforts to Safeguard Dietary Supplements in Malaysia

WORDS DR RAJENDRAN MANICKAVASAGAM

FEATURED EXPERT
DR RAJENDRAN MANICKAVASAGAM
Malaysian Dietary Supplement Association (MADSA)

Since the onset of COVID-19, Malaysians have been taking extra care of their health.

In fact, there has been a steady demand for dietary supplements propelled by this new collective awareness towards our overall wellbeing.

However, recent price hikes have raised the average living costs in Malaysia. For some, they may have to cut back on added expenses, which includes dietary supplements.

This situation opens doors for devious, illegal activities to take place within the market, especially through e-commerce websites where counterfeit supplements are sold at absurdly low prices.

For instance, a single joint support supplement may cost RM120 to RM180 at pharmacies, but some unscrupulous sellers offer the same product for only RM38.

Additionally, certain platforms and sellers may take advantage of unassuming consumers by offering attractive discounts and vouchers, further expanding this perpetual market of deceit in terms of people’s health and wellbeing.

VERY CHEAP SUPPLEMENTS: WHAT’S THE CATCH?

The allure of a good bargain can be extremely compelling, especially when one only needs to pay a fraction of the original price. However, the consequences of purchasing from unverified vendors or websites can be severe.

Counterfeits

A multitude of these sellers often operate without the necessary quality control measures.

Without proper scrutiny, these unscrupulous vendors can easily pass off fake supplements as genuine, putting consumers at risk of ingesting unknown and possibly harmful substances.

These products also may not follow proper standards of procedures, leading to higher chances of improper handling and contamination.

Effects on the Local Supplement Market

In addition to the health risks, these unverified sources also undermine the integrity of Malaysia’s legitimate nutritional supplements market, which is valued at USD $644.88 million in 2023.

Certified brands are finding it increasingly harder to earn customers’ trust who have been victims to disingenuous sellers.

THE NEED FOR REGULATORY RECOGNITION TO PROTECT CONSUMERS

In spite of these malicious activities, Malaysia upholds strict laws and regulations to govern the manufacturing and labelling of dietary supplements.

This includes mandatory registration of documented evidence and stringent timelines for health supplements. While some counterfeit products may slip through the cracks, the Ministry of Health, via the National Pharmaceutical Regulatory Agency (NPRA), has laid out various safeguarding measures to help consumers identify the legitimacy of a product.

The Ministry of Health has also mandated that all certified health supplements must be marked with the holographic sticker called the FarmaTag, which is extremely hard for counterfeit producers to replicate. The sticker also includes an MOH-issued QR Code, a gradient design, and holographic serial and pin numbers.

Additionally, the Health Ministry has released a mobile app called FarmaChecker to help consumers confirm a product’s certification status online by scanning its QR code or typing in its serial number.

At the same time, the NPRA continues to ensure the safety and efficacy of dietary supplements, mandating safety data for supplements with new or innovative ingredients. Similarly, the Malaysian Dietary Supplement Association (MADSA) has also worked hand-in-hand with the government to promote and increase awareness of health supplements and its benefits to all Malaysians.

With the collective effort by both the government and consumers alike, we can work towards a future where all our nutritional supplements are safeguarded from the unethical practices of counterfeit producers.

By being mindful of the sources of our purchases, especially when the products involve our health and wellbeing, we can nurture a safe and healthy supplements market in Malaysia.

After all, bargaining our health for cheaper costs will never be worth the price.

MADSA CALLS MALAYSIANS TO BE VIGILANT

MADSA advises Malaysian consumers to always make sure that online supplements have been registered by the NPRA.

Check if the product has an MAL number, which verifies that it has been approved by the NPRA.

If the product that’s delivered doesn’t have such identification, return and request for a refund and report this matter to the Ministry of Health.