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.

A Tips-Filled Bumper Article to Help You Sleep Better Featuring Four Experts

WORDS LIM TECK CHOON

FEATURED EXPERT
CELESTE LAU
Chief Dietitian
Sunway Medical Centre
ADD MAGNESIUM-RICH FOODS IN YOUR DIET

“Magnesium plays a crucial role in various bodily functions, such as muscle and nerve operation, protein synthesis, glycolysis, and blood pressure regulation,” says Celeste Lau.

She explains further that this mineral aids in the conversion of protein into chemicals that induce sleepiness, promote muscle relaxation, and maintain gamma-aminobutyric acid (GABA), a neurotransmitter responsible for promoting restfulness.

You should consume between 100 and 350 mg of magnesium daily for optimal sleep support.

Celeste recommends adding sources of magnesium such as walnuts, almonds, flaxseeds, salmon, and mackerel into your meals. It is recommended to consume between 100-350mg of magnesium daily for optimal sleep support.

“Additionally, refrain from consuming a heavy meal in the evening. It is recommended to have dinner 2 to 3 hours prior to your bedtime,” she adds.

FEATURED EXPERT
MICHELLE CHONG HUI YEE
Clinical Psychologist
Sunway Medical Centre
PRACTICE RESTFULNESS

Michelle Chong explains that restfulness is a deliberate act of nurturing yourself—physically, mentally, and emotionally.

It is characterized by a feeling of peacefulness and contentment, often accompanied by a sense of relief from stress, worries, tension, or fatigue.

Mentally, restfulness means quieting the mind, letting go of worries, and embracing a sense of mental stillness.

  • Learn to embrace mindfulness and relaxation techniques.
  • Grounding yourself in the present moment. This heightened awareness allows you to detach from worries about the past and anxieties regarding the future as well as to foster a sense of presence that can alleviate stress and enhance your awareness of immediate experiences.
  • Practice deep breathing exercises and progressive muscle relaxation (PMR) methods to heighten your body awareness and release muscle tension, focusing on achieving a state of ‘physical rest’.
  • Prioritize relaxation techniques that calm the mind before bedtime. “Activities such as mindfulness meditation and journaling can effectively declutter the mind and reduce stress hormones, creating a more seamless transition into sleep,” Michelle says.
FEATURED EXPERT
DR NURUL YAQEEN
Consultant Respiratory, Sleep & Internal Medicine Physician
Sunway Medical Centre Velocity
START SLEEPTIME RITUALS 
  • “Do not use your bed as an office to answer calls, respond to emails and avoid watching television in bed,” advises Dr Nurul Yaqeen.
  • Instead, reserve your bed for sleep. Remove electronic devices (televisions, computers, smartphones, etc), from the bedroom.
  • Try to start a sleep ritual as rituals help signal the body and mind that it is time to sleep. Some suggestions from Dr Nurul Yaqeen are drinking a glass of warm milk, taking a bath, or listening to calming music to unwind before bed.
  • “There is also the 10-3-2-1 method to help you rest better at night,” she says, “which is no caffeine 10 hours before bed, no food or alcohol 3 hours before bed, no work 2 hours before bed, and no screen time 1 hour before bed.” 
FEATURED EXPERT
Effendy Nadzri
Interior Designer
ENDO
Website
GET THE AMBIENCE RIGHT
  • “Keep your room cool at night,” says Effendy Nadzri. “The ideal temperature in the bedroom should be between 20º and 23º Celsius.”
  • If you have an air conditioner at home, he recommends switching it on at night to signal to your body that it is time for sleep.
  • Set the perfect ambience with dimmable or mood lighting to enhance your bedroom space and create the desired mood for a restful evening before you retire to sleep.
  • “You may want to have aromatherapy or essential oils that can help you relax at night,” Effendy adds.

 

Tuberculosis Cases Are Rising in Malaysia. An Expert Shares What You Should Know & Do About This

WORDS LIM TECK CHOON

FEATURED EXPERT
DR ROSMADI ISMAIL
Consultant Interventional Pulmonologist and Internal Medicine Specialist
Sunway Medical Centre

Quite recently, our Minister of Health Dr Zaliha Mustafa revealed at the United Nations General Assembly High-Level Meeting that there was a concerning increase of 17% in tuberculosis cases in 2022 compared to 2021, along with a 12% increase in tuberculosis-related deaths during that time period.

In light of this development, Dr Rosmadi Ismail shares his thoughts with us about tuberculosis, its detection, treatment, and prevention.

Tuberculosis is an infectious disease that is caused by the bacteria Mycobacterium tuberculosis (MTB) infecting the lungs as well as certain other parts of the body.

An overview of the symptoms and preventive measures of tuberculosis. Click on the image for a larger, clearer view.

IS DETECTION OF TUBERCULOSIS GETTING BETTER?

Dr Rosmadi reveals that there are several innovative techniques currently undergoing clinical trials in a few countries.

These techniques, which include biosensing technologies and nano-diagnostics, promise quicker and more accurate results.

He shares: “Ongoing research focuses on innovative methods like computer-aided detection (CAD) through artificial intelligence, aerosol capture technologies, and antigen-based skin tests. They are poised to revolutionise TB diagnosis, enhancing efficiency and effectiveness in the future.”

In Malaysia, there are diverse methods employed to ensure accurate and timely detection of tuberculosis, such as:

  • Sputum smear microscopy, typically the first test for tuberculosis.
  • Culture and sensitivity testing to diagnose tuberculosis.
  • Nucleic acid amplification tests (NAATs) to facilitate the identification of tuberculosis cases.
  • Chest radiography and clinical tests like the Tuberculin Skin Test (TST) to confirming the infection.
TREATMENT OF TUBERCULOSIS

Treatment of tuberculosis in Malaysia follows the World Health Organization guidelines, which is the global standard.

Dr Rosmadi tells us, “The standard treatment for drug-susceptible tuberculosis in Malaysia involves a combination of four drugs administered for a duration of 6 to 8 months.”

Treatment utilizes the Directly Observed Treatment (DOT) strategy, which sees the patients receiving close supervision from healthcare workers to ensure that they complete their medication intake.

Currently, there are no new medications or treatments that show superior results over current ones when it comes to treating tuberculosis. Dr Rosmadi notes that treatment for drug-resistant TB involves a distinct medication regimen and extended treatment duration.

“This tailored approach has proven effective even in cases of drug-resistant TB, reinforcing our commitment to comprehensive patient care,” he says.

DR ROSMADI’S TUBERCULOSIS TIPS 
  • Stay clear of crowded places. It’s best to avoid crowds, especially if they’re poorly ventilated.
  • If you’re experiencing a persistent cough, fever, or unexpected weight loss, seek medical help promptly. This will help you get better and stop the disease from spreading.
  • Get checked if you’re at risk. If you have a weak immune system or have been around people with tuberculosis, consider getting tested. It’s a simple step that can catch the disease early if exposed.
  • If you’re diagnosed with tuberculosis, completing your treatment is essential. P
  • Preventive measures such as wearing a mask, covering your mouth and nose when you cough or sneeze, and disposing of tissues properly can help protect yourself and those around you.
  • If your job puts you in contact with many people, wear the proper protective gear as an added layer of safety.
  • Think about getting vaccinated. The current vaccine, Bacillus Calmette Guérin (BCG), offers partial protection to infants and young children against severe forms of tuberculosis. It doesn’t protect adolescents and adults that are the primary carriers of the tuberculosis bacteria, but it could help in the long run.

A Physician Explains How You Can Have a Safe and Happy Vacation with the Kids

WORDS LIM TECK CHOON

FEATURED EXPERT
DR NUR ELAYNI BORHAN
Consultant Emergency Physician
Sunway Medical Centre
BEFORE YOU LEAVE THE HOUSE

Make sure that you have at hand essentials such as the following:

  • Paracetamol for fever or pain
  • Oral rehydration solution for dehydration due to diarrhoea
  • Cough and cold medications
  • Inhalers if your children have asthma
  • Antiseptic wipes
  • Band-aids, adhesive tapes, and gauze for wound care
  • Thermometer
  • Your child’s existing medications, if any

“I would also advise to bring some topical medication such as antiseptic cream, mentholated or medicated topical ointment – anything you’re used to, from home,” Dr Nur Elayni Borhan adds. “You know your own children, so bring the things that you know would benefit them. Try to avoid bringing things that are new to them.”

WATCH WHAT YOUR KIDS ARE EATING!

Diarrhoea and vomiting are among the most common illnesses that affect children while they are on holiday.

Dr Elayni advises parents to ensure that their children are taught to follow safe food and water precautions.

Her other tips are:

  • Frequently wash hands to prevent foodborne and waterborne illnesses.
  • If you are breastfeeding your child, continue to breastfeed during the vacation.
  • Make sure that vaccinations for the whole family are up to date, as there is generally a higher risk for most vaccine-preventable diseases when travelling.

If your child—or any other family member—develops diarrhoea, Dr Elayni recommends consuming plenty of fluids.

“Oral rehydration solution may be used to prevent dehydration, especially if the child is also vomiting,” she further adds. “If your child appears to be dehydrated and/or has a fever or bloody stools, seek medical attention immediately.”

IF YOUR CHILD HAS AN ALLERGY

Dr Elayni says, “Planning ahead is the key to making your trip safe and enjoyable.”

  • Always stay alert, take every necessary precaution, and carry all essential medications.
  • Bring a medical kit with your child’s medications, including their epinephrine pen. Do this no matter how near or short the trip is.
  • Not everyone can understand English or Bahasa Melayu, so get information about your child’s allergy translated to the native language of your destination. Written information about your child’s allergies, for example, can be very useful when ordering food for your child.
  • Take note of the allergy policies of the airline and at the hotels you will be staying at. Every airline or hotel is different, and they need advance notice to make accommodations.
  • Research restaurants or grocery stores at your destination that would carry products safe for your child.
OTHER USEFUL TIPS
If your child suffers from motion sickness:
  • Keep them hydrated.
  • Let them eat and drink in small amounts regularly instead of having heavy meals.
  • Avoid letting them read or us screen devices while traveling in a vehicle. Instead, encourage them to sleep or engage in conversations with other family members.
If your child experiences uncomfortable pressure in the ear:
  • Encourage them to swallow their saliva. Younger children can breastfeed or suck on a thumb while older children can suck on lozenges or chew gum to equalize the pressure,

General tips for a fun and safe vacation:

  • Bring along your child’s comfort toy or blankie.
  • If your child has an existing chronic condition, consult a doctor before traveling to destinations with different climates and altitudes. You may need to take special precautions, such as dressing your child appropriately for colder destinations and apply sunscreen at hotter destinations.
  • Discourage your children from swimming in non-chlorinated bodies of water (rivers, ponds, lakes, etc), as there is a risk of your child swallowing contaminated water.
  • Pack safe snacks and meals in case there are no appropriate restaurants for your child.
  • Identify important healthcare facilities at your destination. You can also seek advice on available local medical services from hotels or tour company representatives.
  • Include your child in any travel insurance policies bought for the trip, which should include medical repatriation if necessary.

Georgen Thye Explains the Differences between Various Milks in the Market

WORDS GEORGEN THYE

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

Milk comes in various forms, and it’s important to know the differences, including how they’re processed in the factory, and their nutrition content. Let’s break down the variations:

UHT MILK

Ultra-high temperature (UHT) milk is heat-treated to extend shelf life.

It undergoes pasteurization at an ultra-high temperature, a process to kill harmful bacteria, and is packed in a sterile environment.

It’s convenient and doesn’t require refrigeration until opened.

However, some nutrients may be reduced during the manufacturing process.

FULL CREAM MILK

This milk contains the highest fat content, approximately 3.25–3.5% fat, giving it a rich, creamy flavour.

It also goes through pasteurization and is homogenized to ensure an even distribution of fat.

LOW FAT MILK

Low fat milk first undergoes pasteurization, similar to full cream milk.

Then, it undergoes a skimming process to remove much of the fat, reducing its overall fat content to around 1–2%.

It’s still homogenized, ensuring a consistent texture while providing essential nutrients with reduced fat.

FRESH MILK

Straight from the farm to your fridge, fresh milk is minimally processed to preserve its natural flavour and nutrients.

It typically undergoes pasteurization but minimal homogenization, keeping it close to its farm-fresh state and containing around 3.25–3.5% fat.

FLAVOURED MILK

Whether it’s chocolate or strawberry, flavoured milk adds a tasty spin to regular milk.

However, be cautious of added sugars, which can increase calorie levels.

Choose options with lower sugar content and enjoy in moderation.

Note that despite its sweetness, flavored milk still provides essential nutrients like calcium and protein.

WHICH MILK IS RIGHT FOR YOU?

Your milk choice depends on your goals and taste.

Low-fat is great for reducing fat and sugar.

Fresh milk is minimally processed and ideal for those who love its natural taste.

Enjoy flavoured milk in moderation, choosing lower-sugar options.

Regardless of your pick, milk is rich in vital nutrients like calcium and protein for good health so enjoy!

15 Facts & Tips That Moms & Dads Should Know When It Comes to Dengue & Their Kids

WORDS LIM TECK CHOON

FEATURED EXPERT
DR YONG JUNINA FADZIL
Consultant Paediatrician and Paediatric Cardiologist
Klinik Pakar Kanak-Kanak Junina
FOR PARENTS WITH BABIES BELOW 6 MONTHS OF AGE
  1. According to Dr Yong Junina, young babies with dengue may not show specific symptoms—they may not even exhibit fever.
  2. Furthermore, fever is also a symptom of many other childhood illnesses. Thus, even when a child has fever, it can be challenging for a doctor to identify the exact cause of the fever.
  3. Also, a child’s condition may worsen quickly if left untreated.
  4. Hence, Dr Yong Junina advises parents with a child of under 6 months of age to promptly seek medical attention when their child appears unwell.
FOR PARENTS OF SLIGHTLY OLDER CHILDREN
  1. “Older children may still experience difficulties in communicating their conditions to their parents,” Dr Yong Junina shares.
  2. Generally, unwell children tend to consume less fluids, and severe dengue can cause fluid leakage from blood vessels, resulting in reduced urine output. Dehydration, regardless of the cause, can be perilous, especially in young children.
  3. Hence, bring the child to see a doctor promptly when they show such signs of being unwell.
SOME POSSIBLE SIGNS THAT A CHILD MAY HAVE DENGUE
  • Lethargy.
  • Body ache.
  • Pain behind the eyes.
  • Headaches.
  • Parents can check whether their child’s hands and feet feel cold. They can also press on the child’s fingertips to observe how quickly the fingertips regain their normal colour.
HOW DENGUE AMONG YOUNG CHILDREN IS TREATED
  1. Dr Yong Junina tells us that young children are more likely to develop severe dengue and related complications, such as dengue shock syndrome.
  2. Dengue shock syndrome is the result of dengue-causing viruses triggering a chain of reactions that cause one’s blood vessels to leak. Eventually, the person experiences sudden drop in blood pressure, internal bleeding, and even organ failure. This is a serious medical emergency that can lead to death if not treated quickly!
  3. Dr Yong points out that children with severe dengue will need to be admitted into the hospital. There, they will undergo repeated blood tests and possibly be put on drip.
  4. “Throughout all this, parents would need to stay with them, affecting their work and ability to care for the rest of the family,” she says. “Among daily wage earners, the loss of income would be significant.”
PROTECTING YOUR CHILD FROM DENGUE
  1. “There is no preventive method that is 100% effective,” says Dr Yong Junina. Hence, it is important for parents to practice vigilance.
  2. Keep the house free of potential mosquito breeding grounds by ensuring there is no stagnant water.
    • Aedes mosquitoes, the ones responsible for infecting us with dengue, breed in clean water, so make sure pails are covered and use larvicide in any places that water may collect in.
    • Remember to check aquariums and containers of aquatic pets (such as terrapins), receptacles for catching residual water from plants and dishracks, and containers of water-based plants such as money plants and hydroponics.
  3. Keep windows closed at dawn and dusk, as these moments are when the Aedes mosquitoes are more active, and sleep with long-sleeved clothing.
  4. Use mosquito repellents. There is a wide range of products available, including chemical-free products infused with lemongrass.

A Dietitian Exposes 3 Common Misconceptions about Detox Diets & Products

WORDS GEORGEN THYE

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

It’s a common belief that detox diets and products can cleanse your body of toxins, but let’s unravel the truth.

MYTH 1: DETOXING CLEARS YOUR TOXINS

Fact: Your body has its own built-in detox system. Your liver, kidneys, and digestive system work around the clock to eliminate waste and toxins.


An overview of the detox system of our body. Click on the image for a larger, clearer version.

MYTH 2: DETOX DIETS ARE EFFECTIVE

Fact: Most detox diets are restrictive and low in essential nutrients. They may lead to temporary weight loss, but it’s mostly water weight, not toxins.

MYTH 3: DETOX PRODUCTS WORK MIRACLES

Fact: Detox teas, supplements, and wraps often lack scientific evidence and can have side effects. They’re not a magic solution.

SO, HOW CAN YOU SUPPORT YOUR BODY’S NATURAL DETOX PROCESSES?

Eat a balanced diet, stay hydrated, and get enough sleep. Your body has the detox game covered!

LOOKING FOR AUTHENTIC DIETARY FACTS & ADVICE?

Visit Georgen’s social media, links above, for more fun educational advice, facts, and more.

Drop him a note if you are interested in his services:

  • Corporate Wellness Programme
  • Health Talks
  • Cooking Workshop
  • Virtual Diet Consultations

A Dermatologist Shares Essential Skincare Tips for People with Diabetes

WORDS DR GAN TECK SHENG

FEATURED EXPERT
DR GAN TECK SHENG
Consultant Dermatologist
Tung Shin Hospital

The stakes are high when it comes to diabetes management.

High blood sugar is not just a number; it affects various bodily components, including your skin.

For many, a skin problem serves as an early warning sign of diabetes. Those elevated glucose levels are often the culprits behind the dry, itchy skin.

But here is the lifestyle twist–many individuals living with diabetes are not aware of the vital role that proper skin care plays. It is not just about administering insulin and watching your diet; it is about a comprehensive approach to well-being that includes your skin.

GENERAL SKIN CARE
Use gentle cleanser when bathing or showering.
  • Avoid bar soaps as they strip away natural oils and disrupt skin barrier function.
  • Also avoid cleansers that contain perfumes and harsh detergents as they may cause irritation and redness to the skin. Instead, use gentle cleansers to help maintain hydration and prevent skin dryness.
Bathe or shower the right way.
  • Use lukewarm water as hot water strips away natural oils and damages the skin.
  • Keep your baths or showers short, ideally no longer than 10 minutes.
Dry your skin carefully.
  • After a bath or shower, dry your skin with gentle pats.
  • Remember to dry the skin between your toes, armpits and other skin folds. Intertrigo—rashes and inflammation caused by skin-to-skin friction—occurs more easily in warm moist environments.
Apply moisturizer every day.
  • Keep your skin moisturized and prevent cracks that lead to infection.
  • Pick a hypoallergenic, fragrance-free moisturizing cream or ointment.
  • Apply after bathing or when your skin is dry or itchy.
FOOT CARE
Check your feet daily.
  • First, dry your feet carefully.
  • Make sure to check between your toes and your feet for rashes, cuts, sores, or any other changes to the skin.
  • Use a mirror if you cannot see your soles.
Wear shoes that fit well.
  • Always wear shoes and socks to avoid injury.
  • Wear closed, well-fitting shoes with cushioned sole.
  • Check if there is any object or pebble inside your shoes before putting them on.
Treat dry, cracked heels.
  • Apply urea cream on dry, cracked hills every day before getting into bed. This will help in preventing the development of non-healing sores and serious skin infections.
Take care of your toenails.
  • Keep your toenails short and trim them straight across.
  • Gently smooth any sharp edges with a nail file.
  • Do not let the sides of your toenails grow into the skin.
See a doctor for treatment of corns and calluses on your feet.
  • Do not remove corns or calluses with sharp objects. Any skin injury on the feet may increase the risk of ulcers and infection, especially patients with diabetic neuropathy.
  • Be cautious when using over-the-counter products, as these products may irritate your skin.
Treat all wounds immediately.
  • Wash wounds with antiseptic and water.
  • Only apply antibiotic cream if recommended by your doctor.
  • Cover the wound with an adhesive bandage.
  • Perform daily dressing to help your skin heal.
SEE A DOCTOR IF YOU EXPERIENCE ANY OF THE FOLLOWING
  • Reddish and swollen skin.
  • Pain or tenderness.
  • Honey-coloured crusts.
  • Change in the colour and temperature of your feet.
  • Wound that is weeping or leaking pus.
  • Thickened or discoloured nails.