Most of us have heard it by now: the 2019 National Health and Morbidity Survey from our Ministry of Health revealed that more than half of Malaysians are overweight or obese. Given that type 2 diabetes is closely linked to overweight and obesity, it’s therefore not surprising that the prevalence of this chronic disease in this country is high—the highest in Asia, in fact!
Furthermore, there is a misconception that, for people with diabetes, eating healthily means giving up all the foods and beverages they used to enjoy. This is not true, that the key to a healthy, balanced diet for people with diabetes lies with keeping count of one’s carb and calorie intake, so that these are within the recommended amount for the person.
Recognizing the prevalence of type 2 diabetes and the need to empower Malaysians with this condition to prepare healthy, diabetes-friendly meals that they will enjoy, Alpro Pharmacy together with sugO35, a personalized diabetes care service provider, has prepared a series of recipe books for people with diabetes.
Last November, Teroka FUN Resipi Diabetik was released in conjunction with World Diabetes Day.
This is the second volume in the series, following the first volume, U-Turn Diabetic the Fun Way.
“One of the most frequently asked questions from our diabetic patients is ‘What can I eat?’,” dietitian Chua Kai Jia shares with us.
5 GREAT THINGS ABOUT TEROKA FUN RESIPI DIABETIK
It contains 25 diabetes-friendly recipes utilizing common ingredients used in Malaysian dishes. Each ingredient gets a chapter of its own, with fun facts and nutritional information about these ingredients.
These recipes are prepared by nutritionists and dietitians.
These dishes will appeal to Malaysians of all races, and they are also affordable to prepare and tasty to eat—proof that someone with diabetes can still enjoy delicious meals as long as they pay attention to what and how much they eat.
Chua shares that this book will be useful to people with diabetes and their loved ones when it comes to adhering to a healthy, well-balanced (and tasty!) diet while keeping their blood glucose levels within a healthy range.
The content is in Bahasa Malaysia and Chinese, making it accessible to a large majority of Malaysians.
HOW TO GET YOUR COPY
Digital You can sign-up to get your free copies of the 2 recipe books using the links below. All links open in a new tab.
The first volume is out of print. Volume 2, Teroka FUN Resipi Diabetik, is still available, however, for RM59.90. You can obtain a copy here (link opens in a new tab).
HealthToday is not associated with Alpro Pharmacy and sugO35. This article is presented for information purpose only, as we believe that these books can be of use to readers. We do not get any income from downloads or purchases through the links on this page.
LIM CHAIN YIN
SEA Nutrition Lead
TIP 1 Portion Out Your Snack
Be sure to pace yourself throughout the equal halves.
Once you’ve decided what you want to eat, portion it out. This can help you slow down, so that you enjoy your snack.
Check in with yourself to see if you’re full and satisfied before having another portion.
To keep tabs on how much you eat, always check the serving size per package on the label and put your snack in a bowl or on a plate.
TIP 2 Alter Your Choices
If you’re watching the game late at night, you might have a craving for something to eat. Remember that your body works harder when it’s sleeping, so try to snack on something light that will give you energy to keep going, but won’t make it hard for your body to digest.
TIP 3 Enjoy Every Bite
Snacking while engaging in other activities—in this case, watching the game—can easily lead to unconsciously eating more than you should.
Take a moment during the interval to savour your snack with all of your senses. To fully enjoy your snacking experience, pay attention to the smell, taste, texture, shape, and colour of your food.
Take small bites and chew slowly and be sure to finish one bite before starting the next.
TIP 4 Put Your Snacks Out of Reach
When watching a game in your living room, make sure your snacks are beyond arm’s reach. That way, you will be less likely to keep going back for more and inadvertently grab more than you need.
TIP 5 Drink Water, Lots of It!
Your brain tends to trick you into wanting to snack more, but you might just be thirsty. So, drink a glass of water and wait for a couple of minutes before deciding whether or not you’re hungry.
Snacking mindfully is a simple way to tune into your body’s needs. It can be practised by anyone, anywhere, and at any age. It is a great habit in cultivating a positive relationship with food by making deliberate and conscious choices to promote your well-being as well as keeping a balanced lifestyle. But habits take time to build and change, so taking small steps is a good way to start out!
Every woman’s body is unique. Therefore, the question of the ‘right option’ or ‘best option’ is something that each and every woman has to figure out on her own.
For example, mothers that breastfeed often experience rapid weight loss and may benefit from an increased intake of certain nutrients or supplements. Women that gave birth via caesarean section may need a longer time to recover. Existing health issues and lifestyle variables also need to be considered.
If you are interested to find out more about the topics discussed below, you should discuss the matter further with your doctor.
Postpartum weight loss averages about 4.5 to 5.5 kg in the first 6 weeks. Women often return to their pre-pregnancy weight within a year, though this time frame varies depending on how much weight was gained during their pregnancy.
Breastfeeding aids in weight loss since it consumes extra calories, resulting in a natural weight loss for many women.
Breastfeeding women should pay special attention to their diets at this time.
While experiencing weight loss after giving birth may seem like a good idea, doing so too quickly will actually hinder healing!
POST-PREGNANCY DIETARY RECOMMENDATIONS
Dietary recommendations should include a variety of fresh produce, whole grains, lean proteins, and healthy fats.
Breastfeeding mothers, in particular, should drink a lot of water (6-10 glasses daily). Try to stay away from sodas and other sugary drinks.
Meanwhile, for moms that had a C-section, they should focus on eating foods that are high in protein. Avoid junk foods and take vitamin supplements, especially if they are nursing.
Vitamin and mineral supplements are crucial for moms during and after pregnancy.
This is because nutrients such as calcium, iron, vitamin D, folic acid, zinc, and more are normally redirected from the mother’s bloodstream to the developing infant.
Furthermore, the delivery process as well as breastfeeding depletes the body of essential vitamins.
Hence, postnatal supplements such as calcium, vitamin D, B vitamins, docosahexaenoic acid (DHA), magnesium, selenium, iodine, and choline may be helpful in replenishing nutrients that were used up during pregnancy and after childbirth.
Regular exercise after childbirth will help strengthen and tone your muscles while increasing your energy levels and making you feel less weary.
It also aids in the loss of excess weight.
During the first 6 weeks, the uterus returns to its pre-pregnancy size, and some women may feel uterine cramping and discharge.
However, mothers are recommended to gradually resume their exercise habits, starting with less strenuous activities during the first few weeks after giving birth.
A few days after delivery, you can start doing gentle abdominal and pelvic floor exercises if they don’t cause you any pain.
Try to proceed at your own pace—you can gradually increase the duration and tempo of your workout of over time.
Swimming, cycling, yoga, pilates, mild weight training, and low-impact aerobics are all good alternatives after the first few weeks.
The Malaysian Meteorological Department (MetMalaysia) recently announced that Malaysia will experience continuous heavy rainfall from mid-November, leading to probable major flash floods in several states, and the monsoon season will last until early next year.
We would like to outline several precautionary measures for residents in flood-prone areas, from a community pharmacist’s point of view, to proactively mitigate flood damages ahead of the period and in the aftermath.
BEFORE A FLOOD
Closely monitor your surroundings and stay up to date on weather forecasts and warnings
Assemble disaster supplies, including long-term medications and first aid kits in water-proof bags in case of evacuation.
People, especially the elderly, with chronic diseases, are advised to visit their nearest pharmacy and bring along with their chronic medications, in order to keep a record in the pharmacy and have an up-to-date medication list; this will be useful should one lose the hard-copy of their prescription and face difficulties in retrieving their medication
AFTER A FLOOD
Due to poor sanitation and hygiene in flood areas, there is a high risk of flood-borne diseases such as leptospirosis, cholera, and dengue fever. Keep an eye out for general symptoms such as fever, headache, diarrhoea, muscle aches, and vomiting. In the case of any such symptoms, please visit the nearest healthcare centres immediately.
Alpro Pharmacy and DOC2US have launched the Life-saving Medication Care Programme, which provides a one-time supply of medications for up to 7 days for free. Those with contaminated or lost chronic disease medications can visit an Alpro Pharmacy outlet and speak to the pharmacist for more details. Note that a police report copy of the flooding is required for verification purposes.
DR LOW LEE LEE
Infectious Disease Physician
Sultanah Bahiyah Hospital
FUNGI: OUR FRIENDS & FOES (IT’S COMPLICATED)
Fungi are found naturally in our environment. There are many different types of fungi, over 2 million species however about 600 fungi have caused diseases.
Invasive fungal infections typically manifest as a severe and aggressive form of the disease, leading to corresponding to high prevalence and death rates if left untreated.
These infections include invasive mold infections.
INVASIVE MOLD INFECTIONS AT A GLANCE
Usually caused by Aspergillus (giving rise to invasive aspergillosis) but can also be caused by other rarer molds such as Mucormycetes (giving rise to mucormycosis).
These molds produce spores; most of us encounter these spores every day without getting ill, but people with compromised immune systems may develop complications as a result of these spores.
Despite invasive aspergillosis and mucormycosis being relatively uncommon, invasive mold infections are often life threatening. If left untreated, the mortality rates can reach 100%!
Various parts of the world reported superinfections of invasive aspergillosis and mucormycosis in patients with COVID-19, which are associated with increased risk of death. COVID-19 likely increases the risk for fungal infections because it weakens the immune system or due to certain therapies used for treatment such as steroids.
There are no specific symptoms, as symptoms can vary depending on the type of infection. This makes diagnosis an infection a challenging and sometimes complicated task!
Invasive aspergillosis is uncommon and occurs primarily in immunocompromised people.
Commonly seen in people that have undergone stem cell and other organ transplants (especially lung transplant), as well as in patients with blood-related cancers such as acute leukemia.
Typically affects the lungs, but it can also spread to other parts of the body.
Mucormycosis is rare and estimated to affect approximately 10,000 cases worldwide, barring India. If India is included the numbers rise to 910,000 cases annually!
Typically occurs in the sinuses of the nose or lungs; however it can spread to the brain and other organs as well.
COMMON SYMPTOMS OF A POSSIBLE INVASIVE MOLD INFECTION
Typical pneumonia symptoms including fever, chest pain, cough, coughing up blood, and shortness of breath
Sinus infection, which may be painful
Pain, tenderness, swelling and pressure around the eyes, cheeks, nose or forehead
One-sided facial swelling
Nasal or sinus congestion
Black lesions on nasal bridge
HOW TO REDUCE YOUR RISK OF AN INVASIVE MOLD INFECTION
When performing activities that involve close contact with soil and dust, such as yard work or gardening, take care to wear shoes, long pants, and long-sleeved shirts
Whenever possible, avoid dusty areas like construction or excavation sites; wear a N95 mask when you have to visit these areas
Keep your house dry and mold-free
Avoid staying in a moldy home (even while it is being cleaned)
With Deepavali being around the corner, the thought of delicious, mouth watering dishes comes to mind for most Malaysians.
Be it the sweet delicacies or the main dishes, festive food is known to be a crowd favourite. It is during festive seasons, that most people let go of their healthy eating habits and indulge in more than their usual food portion. Because, who doesn’t love their mutton curry, chicken varuval or pineapple tarts?
However, the brunt of all the overindulging comes about after the festive season. You might start seeing some extra pounds in your weight and perhaps even spikes in your blood sugar level from all that over indulging. So, why not make your festive season this time a little healthier by following some of my simple tips below.
PREPARE YOUR OWN DISHES & SWEETS
This allows you to modify the recipe to make it a healthier version, such as by reducing the amount of ghee or oil used in the original recipe.
Alternatively, you may also switch from ghee, which contains high amount of saturated fats, to vegetable oil, which contains unsaturated fats and is hence more friendly for your heart health.
You can also reduce the amount of sugar or condensed milk by half from the original recipe for the sweet items. This method helps to reduce the overall calorie of the food items.
PRACTICE PORTION CONTROL
While it can be hard to resist the mouth watering festive food, it is still important to practice portion control.
When it comes to your favourite festive food like jalebi, kesari, pineapple tarts or muruku, practice sharing these food items with family or friends.
You can also practice portion control by limiting to only 1-2 pieces of these food items onto your plate, so that you avoid over indulging, more so if you have multiple houses to visit!
Another trick is to avoid eating cookies straight out of the cookie jars, as this usually causes one to lose track of how much they have eaten.
KEEP AWAY FROM SUGARY DRINKS
Sugary drinks like cordials or packet drinks are commonly served at open houses. However, these drinks are just loaded with sugar without providing your body with any nutrients.
Hence, it is advisable to limit your intake of sugar sweetened beverages to no more than 1 to 2 servings per day.
It is very easy to over consume these sugary drinks as you go about visiting from one house to the other or even while catching up with family and friends. Hence, for those hosting open houses this year, some healthier options to consider would be lower-calorie drinks. Great examples that are also simple to prepare are:
Ginger lemonade, with half the sugar from the original recipe
Infused water; you can always replace plain water with sparkling water for that extra fizziness in the drink
And for those visiting, if there is no other option of lower-calorie drinks, opt for plain water!
Mindful eating helps you to listen to your body for hunger and satiety cues. This is important as it prevents you from mindless eating that adds up to your daily calorie intake.
Over-indulging is common, especially if you are busy catching up with family and friends, and unknowingly end up eating more than you need to. Hence, check in with yourself to identify your hunger and satiety cues is helpful.
Always remember to stop eating before you feel full, as your brain takes 20-30 minutes to register the feeling of fullness.
APPLY THE MALAYSIAN HEALTHY PLATE PRINCIPLES
It is always back to basics when it comes to eating healthily during festive season. The Malaysian Healthy Plate concept encourages the suku-suku-separuh (quarter-quarter-half) method, which helps to ensure a balanced meal with less sugar, salt and fat intake.
This concept simply means filling:
¼ of your plate with grains (preferably whole grains)
¼ of your plate with low fat protein sources (chicken, fish, mutton, eggs, prawns)
½ of your plate with vegetables
HOW YOU CAN PRACTICE THE HEALTHY PLATE CONCEPT DURING DEEPAVALI
Grains: Idli (2 small pieces)
Protein sources: Chicken varuval (1 palm-sized lean chicken)
Vegetables: Stir-fried cabbage with turmeric (2 handfuls of veggies)
Grains: Thosai (1 piece)
Protein sources: Mutton Curry (4 matchbox-sized pieces of lean mutton)
Vegetables: Stir-fried bhindi masala (2 handfuls of veggies)
Grains: Jeera rice (2 to 3 flat rice scoops)
Protein sources: Chicken peratal (1 palm-sized lean chicken)
Vegetables: Stir-fried bittergourd with turmeric (2 handfuls of veggies)
The bottom line is, you can definitely enjoy the festive food that usually comes about only once a year. However, the key is to practice moderation when consuming them. That way, you get to enjoy the good food and yet not have to deal with untoward health problems after the festive season is over!
DR LIM YIN SEAR
Senior Lecturer of Paediatrics
School of Medicine
Faculty of Health and Medical Sciences
DR MAHFUZAH MOHAMED
Guest Lecturer of Paediatrics
School of Medicine
Faculty of Health and Medical Sciences
NEW NORMAL LEADS TO NEW ‘CULTURE SHOCK’ FOR A CHILD’S IMMUNE SYSTEM
For the duration of the COVID-19 pandemic, children were predominantly confined to their home and as a result, were less exposed to common bacteria and viruses. This will render younger children’s immune system to develop poorly.
From March 2022 onwards, as life seemed to make its way back to normality, children started to attend school, enrichment classes, and sports activities again.
This has led to many young kids falling ill with diseases such as influenza, hand-foot-and-mouth disease, and lung infections. An elevated frequency of visits to the doctor has worried many parents that their children may have weakened immune system (we say that these children are then immunocompromised).
ARE CHILDREN REALLY MORE PRONE TO INFECTIONS POST-PANDEMIC?
Currently, there is no scientific data to show that children are more prone to infections after the pandemic.
HOWEVER, THERE ARE CERTAIN FACTORS THAT CAN INDIRECTLY UP THE RISK OF INFECTIONS IN CHILDREN
A briefing by UNICEF on the impact of COVID-19 on children has shown that the prevalence of unhealthy diets such as snacking has increased. This may be due to a lack of easy access to fresh food and financial constraints, possibly leading to childhood obesity and malnourishment.
Additionally, a sedentary lifestyle and the lack of exercise could contribute to childhood obesity, escalating vulnerability to infections.
Another major issue that arose during the MCO period was the disruption of essential health services including childhood immunisations. In a recent WHO pulse survey, 90% of countries reported disruptions to routine immunisations. Immunisations are of utmost importance for preventing certain infectious diseases.
Another important issue that needs to be taken seriously is the mental health of children and their caretakers. The Adverse Childhood experience (ACE) study showed that adverse childhood experiences in categories of abuse, household challenges, and neglect are not only associated with worse mental health outcomes, but also with chronic health conditions such as diabetes, heart disease, chronic obstructive pulmonary disease, liver disease, and cancer.
POSSIBLE SIGNS THAT YOUR CHILD MAY HAVE A WEAK IMMUNE SYSTEM
Frequent and recurrent pneumonia, bronchitis, sinus infections, ear infections, meningitis, or skin infections
Inflammation and infection of internal organs
Blood disorders, such as low platelet count or anaemia
Digestive problems, such as cramping, loss of appetite, nausea, and diarrhoea
Delayed growth and development
Autoimmune disorders, such as lupus, rheumatoid arthritis, or type 1 diabetes
TOO CLEAN ISN’T ALWAYS GOOD
Some parents go to the extreme to create a “super clean” environment to protect their children and forbid the children to play or touch anything or anyone that has not been sanitised. This isn’t necessarily a good thing, and here’s why.
In the early years, our immune system is a blank canvas. Although infectious disease is a legitimate cause for concern, and a certain level of cleanliness is necessary, children need to develop an immunity to common pathogens.
Overprotecting children from germs is detrimental to their development. Therefore, parents need to balance between a clean environment rather than a sterile environment.
HOW ABOUT HAND-WASHING AND SANITISING?
Studies have shown that soap and water are better equipped to remove more germs from one’s hand than hand sanitiser does.
However, it is still recommended to use hand sanitisers when washing with soap is not an option.
LET’S TALK ABOUT VITAMIN D
Generally speaking, children with a balanced diet and outdoor activities would attain the daily requirement of nutrients.
A minimum of 400 IU (10 µg/day) of vitamin D is recommended for children and adolescents, especially among exclusively breastfed infants and all children and adolescents who are not routinely exposed to sunlight.
Vitamin D supplementation is only recommended to those who are unable to obtain an adequate amount of vitamin D from their diet or have inadequate exposure to sunlight.
Care should be taken while consuming vitamin D supplementation. A daily vitamin D intake of 2,000 IU or more puts one at risk of vitamin D toxicity. The signs and symptoms of toxicity include headache, a metallic taste in one’s mouth, pancreatitis, nausea, and vomiting.
PROFESSOR CHIN BEEK YOKE
School of Health Sciences
International Medical University
Superbug is a term coined to describe multi-drug resistant bacteria.
Medications that are usually effective on them, such as antibiotics, just don’t work as effectively anymore. “These are bacteria that circumvent the effects of antibiotics and proliferate or multiply uncontrollably in the host,” explains Professor Chin Beek Yoke.
EVERY BACTERIAL SPECIES CAN BE A SUPERBUG
Any species of bacteria can develop a resistance to antibiotics and become a superbug.
“Bacteria are very smart. They will mutate to overcome antibiotics. Once bacteria has the resistance gene in them, they can duplicate and combine with different species of bacteria. That’s how bacteria propagate their multi-drug resistance in nature,” Prof Chin shares.
WE HAVE A ROLE IN CREATING SUPERBUGS
According to Prof Chin, a key reason why superbugs are prevalent is the unnecessary and over-prescription of antibiotics.
GOOD HABITS TO ADOPT
Take antibiotics only when necessary. Diseases that are not caused by bacteria do not require antibiotics!
Complete your full course of antibiotics—finish all the antibiotics your doctor gave you. Don’t stop just because you think you are feeling better.
Avoid using unapproved or black market antibiotics that are not at full strength and do not work as effectively as genuine ones
IMPROPER DISPOSAL OF ANTIBIOTICS MAY ALSO PLAY A ROLE
People tend to dispose of antibiotics incorrectly, and this can be a problem.
“We pour it down the drain, or throw it into the trash. The excess antibiotics then get into our ecosystem, in the soil, or may end up in rivers and water bodies,” says Prof Chin.
GOOD HABIT TO ADOPT
The correct way to dispose of the extra antibiotics is to bring them to your nearest pharmacy. Many pharmacies are equipped to dispose of extra medicines in the appropriate manner.
THEN THERE’S THE ISSUE OF ANTIBIOTICS IN ANIMAL AND FISH FEED…
Another cause is the use of antibiotics in feed for domestic animals or fish. When humans consume the meat from these animals and fish, they also consume the residual antibiotics present in these products.
This unintended consumption of antibiotics may modify the bacterial environment in our bodies and render us susceptible to future bacterial infections.
GOOD HABIT TO ADOPT
Purchase foods that are obtained from sources that are free of antibiotics.
HOW TO MINIMIZE POSSIBLE CONTACT WITH SUPERBUGS
Multidrug resistant bacteria are everywhere, but we can do a few things to reduce coming in contact with them.
PRACTICE GOOD HYGIENE
Wipe surfaces and clean items that come into our household
Wash all fruits and vegetables after purchase, before storage, and before cooking. This will prevent the bacteria from propagating
If you wish to try fruits from stalls and supermarkets in order to ‘test before buying’, wipe them first with a wet wipe
Wear shoes and socks when travelling in areas where contaminated soil or water is prevalent
DON’T PANIC TOO MUCH ABOUT COMING IN CONTACT WITH SUPERBUGS, HOWEVER!
Prof Chin explains that having them on your skin alone doesn’t mean that you will become infected and suffer.
“Your skin is a very good protective organ,” she says. “Bacteria or pathogens can only enter when there is a cut. So, if you don’t have a cut or laceration, you will be fine. Just make sure to wash your hands and feet or any exposed areas.”
The same goes for the times when you ingest bacteria. “You will usually have enough stomach acid to kill these superbugs, and most of the time you have enough innate immune cells in your body to fight them off,” she explains.
However, people with health conditions that weaken their immune system should take precautions to reduce their odds of contracting bacterial infections; they should consult their doctor on the best ways to do this.
ARE YOU DISPOSING YOUR UNWANTED OR UNUSED MEDICINES CORRECTLY?
If you gather all these medications and dump them into the trash bin, you’re not exactly doing it properly.
SO, HOW SHOULD YOU DO IT?
Well, the best way to dispose of unwanted or unused meds is to drop them off at a proper facility—a facility that is equipped to dispose of these medications in a manner that will not cause possible harm to other people as well as the environment.
HMM, WHERE IS THE NEAREST FACILITY TO DO THIS, THEN?
Well, as of the time of writing, there is a convenient drop-off point for all your unused and unwanted medications: the nearest CARiNG Pharmacy outlet.
This is made possible through the Do It Right programme, a collaboration between the Faculty of Pharmacy of Universiti Malaya and the pharmacy retail chain.
CARiNG Pharmacy outlets will operate as a drop-off point for these medications, which will then be transported to Kualiti Alam Incineration Centre for further processing and proper disposal.
“Unwanted medicines left at home are a safety issue. Over 10,205 people required hospitalization because of medicine poisonings across Malaysia. Unwanted medicines in homes pose a health hazard especially to children,” Loo Jooi Leng, the Marketing Director of CARiNG Pharmacy, says to us in order to explain the rationale of this programme.
YES, YOU CAN NOW DROP OFF YOUR UNUSED & EXPIRED MEDS AT ANY CARiNG OUTLET
Read the labels of the medicines in your cabinet and check which are expired and no longer needed.
Remove the expired or unwanted medicines from your cabinet and place them into a bag.
Return the bag to any CARiNG Pharmacy near you and their staff will place it in a secure bin for safe disposal.