FEATURED EXPERT
LEE JIE YEE
Dietitian and Student of Master’s in Clinical Nutrition
Faculty of Health Sciences
Universiti Kebangsaan Malaysia (UKM)
Over-restricting calories has become a concerning weight-loss trend in today’s society, driven by the impact of social media and influencers.
These influencers on social media promise a speedy weight loss by extreme dieting and severely restricting the amounts of calories consumed. These extreme strategies usually lure people who want to lose weight quickly to achieve their desired body shape.
But do these strategies really deliver the magical results you once believed in?
3 REASONS WHY EATING TOO FEW CALORIES CAN UNDERMINE YOUE EFFORTS TO LOSE WEIGHT
Reason 1 THE YOYO EFFECT
A successful weight loss is defined as when an individual voluntarily loses weight and keeps the weight loss for 1 year or more.
Unfortunately, most individuals fail to maintain their weight due to the yoyo effect.
Like the toy that inspires its name, the yoyo effect is a kind of weight loss phenomenon that goes up and down just like a yoyo.
Imagine that a long holiday is approaching. You think, “Beach vacay, I should get in shape!” You start a new diet, and the weight starts to come off.
But then, you get tired of the restrictive diet and bounce back to your old eating habits: desserts, fried foods, snacks…
Eventually, the kilos that you have lost start to creep back on, and you’re back where you started. You struggle to fit into your pants and decide to diet again.
This, the yoyo effect, is like a rollercoaster for your weight, but not a fun one.
Reason 2 YOUR BODY’S METABOLIC RATE GOES LOWER
Extremely cutting down on calories is basically subjecting your body to a starvation state.
Starvation is essentially a prolonged deprivation of nutrition—a state that our bodies naturally perceive as an existential threat to our survival.
To ensure that the body’s energy storage is used efficiently, the body will slow down its metabolism rate.
A lowered metabolism also delays other processes such as fatty acid oxidation, which makes weight loss harder.
Reason 3 YOUR MUSCLES BREAK DOWN AND YOUR HORMONES ARE AFFECTED TOO!
While people aiming for weight loss usually strive to increase muscle mass and reduce fat, this aftermath might not be appealing to you.
Similar to the mechanism above, our body needs to provide sufficient energy for survival during starvation.
Therefore, when the glucose reservoir is depleted, this is where our muscles start to break down to provide us with the energy we need.
This could lead to severe muscle loss as well as hormonal changes, which could affect our mood or menstrual cycle.
SO, WHAT SHOULD YOU DO INSTEAD TO LOSE WEIGHT?
It is important to keep in mind that a long-term weight loss journey should be slow, steady, and determined.
A reasonable calorie deficit targeting 500 to 1,000 kcal would allow one to lose 0.5 to 1 kg per week.
Do seek advice from a nutritionist or dietitian for an effective and personalized weight loss regime.
References:
Contreras, R. E., Schriever, S. C., & Pfluger, P. T. (2019). Physiological and epigenetic features of yoyo dieting and weight control. Frontiers in genetics, 10, 1015. https://doi.org/10.3389/fgene.2019.01015
Farhana, A., & Rehman, A. (2023). Metabolic consequences of weight reduction. In StatPearls. StatPearls Publishing.
Olson, B., Marks, D. L., & Grossberg, A. J. (2020). Diverging metabolic programmes and behaviours during states of starvation, protein malnutrition, and cachexia. Journal of cachexia, sarcopenia and muscle, 11(6), 1429–1446. https://doi.org/10.1002/jcsm.12630
VOON SUK CHEN
Nutritionist and Student of Master’s in Clinical Nutrition
Universiti Kebangsaan Malaysia (UKM)
DR FATIN HANANI MAZRI
Lecturer of Dietetic Programme
School of Healthcare Sciences
Universiti Kebangsaan Malaysia (UKM)
When it comes to managing one’s weight, most people tend to think about watching their calories. But do you know that the timing of your sleep and meals is just as important?
Your body follow a natural rhythm that controls all sorts of stuff happening inside you. It’s time to uncover the secrets of your body clock and how they can help you keep your weight in check.
WHY TIMING MATTERS
Have you ever wondered why you consistently feel sleepy as night approaches and your stomach starts growling around the same time each day?
It’s all thanks to your body’s internal clock, known as circadian rhythm.
Our internal clock
The term ‘circadian’ originates from ‘circa’ meaning ‘cycle’ and ‘diem’ meaning ‘day.
It represents the daily oscillation of various molecular, physiological and behavioural processes, including the sleep-wake cycle.
This helps to induce and promote sleep, ensuring that your sleep patterns align with the 24-hour day-night cycle.
How does the internal clock work?
Your internal body clock synchronizes with the day-night cycle through light signals.
During the day, it receives light signals, like sunlight, through retina receptors in your eyes. This stimulates metabolism and physiological processes that promote wakefulness.
As night falls, the body clock detects weaker light stimuli, triggering night-time activities and inducing sleepiness, aided by the release of melatonin.
By aligning your circadian rhythms with the day-night cycle, your internal clock ensures sufficient rest for daytime productivity.
How the internal clock affects our eating-fasting cycle
The eating-fasting cycle is also orchestrated by the internal body clock.
During the daytime, digestive system is optimized for efficient nutrient absorption and energy utilization, while hunger hormones are regulated to promote appetite and energy intake.
Whereas at night, your physiology is geared towards rest, and your digestive system slows down.
Ideally, based on the internal clock, you are meant to be physically active and eating during the day, and sleeping and fasting at night.
However, your internal body clock cycle can be disrupted by erratic 24-hour day-night activities, such as:
The modernization of our lives.
Exposure to artificial light around the clock.
High calorie food being accessible 24-hours.
This disruption can have adverse effects on your efforts to maintain our health, which includes weight management.
THE LINK BETWEEN THE TIMING OF OUR SLEEP & EATING AND OBESITY
Sleep-wake and eating-fasting cycles are 2 vital physiological and behavioural activities that are regulated by internal body clock, and they influence one another.
Staying up late can lead to late-night snacks and weight gain
Eating closer to bedtime, when your internal body clock is telling us that it’s rest time, it can mess with the normal rhythm of internal body clock and eventually promote weight gain.
Picture this: you had dinner at 7.00 pm, and you’re still awake at 1.00 am. That’s a long stretch to feel hungry and be tempted to snack. Staying up late gives you a large window of opportunity to eat, especially if there’s a big gap until bedtime.
Those late-night munchies can easily lead to unwanted weight gain.
Eating 2 to 3 hours before bedtime can lead to weight gain
Your internal body clock will stimulate the production of melatonin, a hormone that make you feel sleepy, 2 to 3 hours prior to usual bedtime.
Eating close to the onset of melatonin production has been associated with insulin resistance as well as greater body fat percent and waist circumference.
Eating more later in the day can lead to more weight gain
Several studies reported that your body burns less calorie (diet-induced thermogenesis, DIT) during dinner compared to breakfast.
The decrease in DIT reflects a reduction in energy expenditure from digestion, absorption, and metabolism of the nutrients ingested.
Therefore, if you eat more of calories towards later in the day, you are more likely to gain more weight compared to those that eat earlier in the day.
Lack of sleep can make us hungry and eat more than we should
Not getting enough sleep due to late sleep can mess with important hunger hormones like leptin and ghrelin, which can leave you feeling hungrier and more likely to overeat.
On top of that, it affects your brain’s ability to make healthy choices and control cravings.
Studies have shown that sleep-deprived individuals have poor food choices, and they tend to go for high calorie and unhealthy foods.
5 WAYS TO ALIGN YOUR BEHAVIOURS WITH YOUR INTERNAL CLOCK & OPTIMIZE YOUR WEIGHT MANAGEMENT EFFORTS
Sleep early. Don’t let late nights tempt you into reaching for those late-night snacks. Aim for an early bedtime, ideally aligning with the natural day-night cycle.
Have an adequate amount of sleep. The National Sleep Foundation and the Sleep Health Foundation recommend 7 to 9 hours of sleep for adults.
Maintain a consistent sleep schedule. Stick to a routine, even on weekends, to keep your circadian rhythm on track and promote better sleep quality.
Have regular meals and avoid late-night eating. Establish regular mealtimes and try to avoid eating close to bedtime. Give yourself at least a three-hour gap between your last meal and sleep.
Eat more calories earlier in the day. Follow the age-old wisdom of “eat breakfast like a king, lunch like a prince, and dine like a pauper.” Focus on consuming a substantial portion of your daily caloric intake during breakfast and lunch.
Aligning your sleep and eating patterns with circadian rhythms is important for effective weight management. So, the next time you find yourself struggling with your weight, remember that it’s not just about calories.
Take a moment to listen to your body’s natural rhythm, prioritize adequate and quality sleep, stick to consistent sleep and meal schedules, and avoid late-night eating.
These small adjustments can help maintain a healthy weight and achieve a healthier you. Your body and waistline will thank you for it!
References:
Al Khatib, H. K., Harding, S. V., Darzi, J., & Pot, G. K. (2017). The effects of partial sleep deprivation on energy balance: a systematic review and meta-analysis. European journal of clinical nutrition, 71(5), 614–624. https://doi.org/10.1038/ejcn.2016.201
Bacaro, V., Ballesio, A., Cerolini, S., Vacca, M., Poggiogalle, E., Donini, L. M., Lucidi, F., & Lombardo, C. (2020). Sleep duration and obesity in adulthood: An updated systematic review and meta-analysis. Obesity research & clinical practice, 14(4), 301–309. https://doi.org/10.1016/j.orcp.2020.03.004
Boege, H. L., Bhatti, M. Z., & St-Onge, M. P. (2021). Circadian rhythms and meal timing: impact on energy balance and body weight. Current opinion in biotechnology,70, 1–6. https://doi.org/10.1016/j.copbio.2020.08.009
Chaput, J. P., McHill, A. W., Cox, R. C., Broussard, J. L., Dutil, C., da Costa, B. G. G., Sampasa-Kanyinga, H., & Wright, K. P., Jr (2023). The role of insufficient sleep and circadian misalignment in obesity. Nature reviews. Endocrinology, 19(2), 82–97. https://doi.org/10.1038/s41574-022-00747-7
Dashti, H. S., Gómez-Abellán, P., Qian, J., Esteban, A., Morales, E., Scheer, F. A. J. L., & Garaulet, M. (2021). Late eating is associated with cardiometabolic risk traits, obesogenic behaviors, and impaired weight loss. The American journal of clinical nutrition, 113(1), 154–161. https://doi.org/10.1093/ajcn/nqaa264
Mazri, F. H., Manaf, Z. A., Shahar, S., Mat Ludin, A. F., & Abdul Basir, S. M. (2022). Development and evaluation of integrated chrono-nutrition weight reduction program among overweight/obese with morning and evening chronotypes. International journal of environmental research and public health, 19(8), 4469. https://doi.org/10.3390/ijerph19084469
Richter, J., Herzog, N., Janka, S., Baumann, T., Kistenmacher, A., & Oltmanns, K. M. (2020). Twice as high diet-induced thermogenesis after breakfast vs dinner on high-calorie as well as low-calorie meals. The Journal of clinical endocrinology and metabolism, 105(3), dgz311. https://doi.org/10.1210/clinem/dgz311
FEATURED EXPERT DR NIZAR ABDUL MAJEED KUTTY
Senior Lecturer
Department of Physiotherapy
Universiti Tunku Abdul Rahman (UTAR)
People with diabetes are living longer now, which is incredibly exciting. Still, they are vulnerable to accelerated muscle loss or sarcopenia, an often-overlooked condition that occurs in people with type 2 diabetes.
MUSCLE LOSS IS NORMAL WHEN WE AGE
It is normal for individuals to lose 3% to 8% of their muscle mass per decade beginning at age 30, and the rate of decline is even higher after the about age 60. Muscle strength declines even more rapidly; at a rate of 3% to 4% per year in men and 2.5% to 3% per year in women by the age of 75.
HOWEVER, PEOPLE WITH TYPE 2 DIABETES ARE LIKELY TO EXPERIENCE ACCELERATED MUSCLE LOSS OR SARCOPENIA
While some muscle loss is typical, sarcopenia refers to a condition of accelerated muscle loss.
An overview of sarcopenia compared to healthy muscle mass. Click on the image to get a larger, clearer version.
Earlier definitions of sarcopenia focused exclusively on loss of muscle mass as the key determinant of the condition, but more recent definitions have recognized that muscle strength and function are equally important for predicting adverse outcomes.
Thus, newer definitions for sarcopenia have included low walking speed and grip strength alongside low muscle mass.
Sarcopenia is associated with an increased risk of falls, functional decline, frailty, and mortality.
THE LINK BETWEEN SARCOPENIA AND TYPE 2 DIABETES
The link is well established.
In a study of Korean adults, 15.7% of participants with diabetes were found to have sarcopenia, compared with just 6.9% of participants without diabetes.
A later study led by the same author, also in Korea, produced similar findings: in a sample of 414 adults aged 65 or older, participants with type 2 diabetes had significantly lower muscle mass.
A link between low muscle mass and diabetes has been found in several other populations as well.
Multiple studies have also linked diabetes to reduced muscle strength. The effect sizes were smaller in women, but the trend was the same for both genders.
This association between sarcopenia and diabetes has led some researchers to argue that sarcopenia is probably one of the underlying mechanisms that explains the reduced functional ability and mobility that is often seen in older patients with type 2 diabetes.
HOW TYPE 2 DIABETES LEADS TO SARCOPENIA
While diabetes accelerates the process of muscle loss, the mechanisms aren’t yet thoroughly understood.
The presence of insulin resistance, which is the key feature of type 2 diabetes, appears to be a major pathway.
Inability to make new proteins at a rapid pace to replace muscles that have been degraded naturally
One of the key roles of insulin is to drive nutrients, such as glucose, from the blood into skeletal muscle tissues and stimulate protein synthesis.
In type 2 diabetes, however, insulin signaling is impaired; insulin is not able to effectively drive glucose into the muscle tissues, and the muscles cannot synthesize new protein rapidly enough to keep pace with natural muscle degradation.
Decreased function of mitochondria
The mitochondrion is the ‘energy plant’ structure in most cells of the body.
Individuals with diabetes frequently have decreased mitochondrial function, which appears to contribute to the impairment of muscle function.
Type 2 diabetes can damage the nerves outside of the brain and spinal cord, usually at the hands and feet (peripheral neuropathy)
Diabetes can promote sarcopenia via peripheral neuropathy. This condition can affect nerves that control proper muscle contraction.
Approximately 30% to 50% of diabetes mellitus patients experience peripheral neuropathy, and the condition has been shown to be an independent risk factor for sarcopenia in individuals with diabetes.
Other possible factors?
Still, other factors also may play a role in causing muscle loss in the context of diabetes.
Thus, a wide variety of factors likely contribute to the connection between diabetes and sarcopenia. Some data suggest that these varying mechanisms come into play even in individuals who are comparatively young or who are comparatively early in the disease process.
CAN LOWERING BLOOD GLUCOSE HELP PREVENT MUSCLE LOSS?
The growing body of research on the connection between diabetes and sarcopenia has raised an important question of whether lowering blood glucose help preserve muscle mass.
There’s currently little research on that question, but diabetes medications that control blood glucose levels likely do have a role to play in treating and preventing muscle loss among older adults with diabetes.
However, key clinical trials on which clinical management guidelines for blood glucose have been based on unfortunately often exclude the participation of older adults, so there’s no way to know at present.
Hence, future research is needed to better understand the effects of glucose-lowering on muscle mass in older adults.
THE ROLE OF EXERCISE
While diabetes medications may have a role to play in lowering blood glucose and in staving off muscle loss, no medication is as beneficial for treating sarcopenia as physical activity.
Physical activity is always recommended to promote fat loss and maintain muscle mass, both of which can improve glucose levels in people with type 2 diabetes.
This recommendation applies equally to both younger and older adults.
Researchers especially recommend muscle strengthening exercise and resistance activities.
Progressive resistance training is the proven method for the prevention and improvement of sarcopenia.
Resistance exercises in more detail
Resistance training doesn’t require more than your own body weight.
Using resistance to engage the muscles causes a surge in growth-promoting hormones that signal the body to produce more muscle tissues.
Not only do these signals encourage the growth of new muscle tissue, but they also help to reinforce existing muscle tissues by making them stronger.
Some body weight resistance exercises that you can try include:
Push-ups; try an easier version with your knees on the ground, if you need to.
Planks.
Squats.
Lunges.
With progressive resistance training, you need to exercise your muscles against an increasing external force 2 to 3 times a week for at least 8 to 12 weeks.
This is progressive, meaning that the number of repetitions, sets, or load should be increased gradually over time based on your capabilities and progress.
As the resistance exercises programme develops, more advanced resistance exercises that can be done include barbells, kettlebells, and medicine balls or floor-based exercises.
In terms of exercise order, the American College of Sports Medicine (ACSM) recommends multi-joint exercises to be performed before single-joint exercises for a particular muscle group, and that within each session the larger muscle groups be exercised before smaller muscle groups.
As older adults with sarcopenia are also likely to be at an increased risk for falls and display reduced cardiorespiratory fitness, exercise programmes for them often involve a combination of exercise modes that includes resistance exercises, balance training and aerobic training.
For older adults with sarcopenia
Consider:
Walking around the block 4 to 5 times.
Do some weight lifting.
Sit on and get up from a chair as fast as possible and do this 10 times in a row and getting up ten times in a row as fast as possible.
If you are not used to being physically active, or you have health conditions that can affect your ability to exercise, consider consulting a physiotherapist or a personal trainer to advice. They can help you develop an exercise programme tailored to your needs, health status, and personal enjoyment.
Data from a recent study conducted by Singaporean researchers suggests that multivitamin supplements that contain folic acid and iodine may be beneficial to women that are planning and hoping to conceive a child.
WHAT THE STUDY DID
The investigators interviewed 908 women between 18 and 45 years old that were trying to conceive. These women were enrolled in the Singapore PREconception Study of long-Term maternal and child Outcomes (S-PRESTO).
As an aside, S-PRESTO is a large-scale study on the effects of nutrition, lifestyle, and maternal mood prior to and during pregnancy on the effects of the baby’s genetic materials and the presence clinically important outcomes of the pregnancy. This study is beyond the scope of this article, though!
Back to this study, the investigators were interested in 2 things:
Fecundity, or the measure of the chances of successful pregnancy
Time to pregnancy, or the time between the first moment when the woman tries to conceive and the time of successful conception
WHAT THE INVESTIGATORS FOUND
Multivitamins containing folic acid and iodine improve the success rate of having a baby when compared to those that do not take these supplements.
These multivitamins also are linked to shorter time to pregnancy.
Vitamins D and E do not show any significant improvements to pregnancy success rate and time to pregnancy.
On the other hand, consumption of evening primrose oil is linked to lower pregnancy success rate and slightly longer time to pregnancy, compared to those that do not take this supplement.
WHY FOLIC ACID?
Folic acid, or vitamin B9, plays a role in breaking down and reducing the levels of an amino acid called homocysteine in the body.
High levels of homocysteine can cause effects that can affect fertility, such as increasing the ageing rate of a woman’s eggs and triggering the death of trophoblasts, which are cells of the outer layer of the developing embryo that helps it to attach to the woman’s endometrium for further development, protect the embryo, and eventually form the placenta.
Hence, by reducing the effects of high levels of homocysteine, folic acid can help improve the chances of a successful pregnancy.
HOW ABOUT IODINE?
Past tests on animals suggested that iodine can help improve the regulation of ovulation, increase the odds of a successful fertilization of an egg by a sperm cell following sexual intercourse, and promote successful implantation of the fertilized egg into the endometrium of the woman for further development.
Iodine also plays an important role in the development of nerve and brain cells of the foetus.
HOWEVER, SOME POINTS TO NOTE BEFORE YOU RUSH TO THE PHARMACY!
The investigators noted that more research is needed before we can make any conclusive statements about the effects of folic acid and iodine on one’s hopes of a successful pregnancy.
For example, their study did not measure the exact amounts of these nutrients that will work best on a woman hoping to conceive, and more research would be needed to determine whether their results can be replicated.
However, they believed that women trying to conceive could potentially benefit from taking multivitamin supplements containing these two nutrients, when this is also done in conjunction with other beneficial lifestyle modifications such as being physically active and cutting down on smoking and alcohol intake.
Reference: Ku, C. W., Ku, C. O., Tay, L. P. C., Xing, H. K., Cheung, Y. B., Godfrey, K. M., Colega, M. T., Teo, C., Tan, K. M. L., Chong, Y. S., Shek, L. P., Tan, K. H., Chan, S. Y., Lim, S. X., Chong, M. F., Yap, F., Chan, J. K. Y., & Loy, S. L. (2022). Dietary supplement intake and fecundability in a Singapore preconception cohort study. Nutrients, 14(23), 5110. https://doi.org/10.3390/nu14235110
FEATURED EXPERT CHUA KAI JIA
Dietitian
Alpro Pharmacy
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.
Print
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.
FEATURED EXPERT LIM CHAIN YIN
SEA Nutrition Lead
Mondelēz International
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 practiced 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!
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.
Tip 1
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.
Tip 2
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.
Tip 3
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!
Tip 4
EAT MINDFULLY
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.
Tip 5
APPLY THE MALAYSIAN HEALTHY PLATE PRINCIPLES
The Malaysian Healthy Eating Plate. Click on the image to view a larger version.
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
Example 1
Grains: Idli (2 small pieces)
Protein sources: Chicken varuval (1 palm-sized lean chicken)
Vegetables: Stir-fried cabbage with turmeric (2 handfuls of veggies)
Example 2
Grains: Thosai (1 piece)
Protein sources: Mutton Curry (4 matchbox-sized pieces of lean mutton)
Vegetables: Stir-fried bhindi masala (2 handfuls of veggies)
Example 3
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
Taylor’s University
DR MAHFUZAH MOHAMED
Guest Lecturer of Paediatrics
School of Medicine
Faculty of Health and Medical Sciences
Taylor’s University
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.
The lower levels of alpha-S1-casein protein in goat’s milk explain its easier digestibility and hypoallergenic properties.
The casein protein in goat’s milk also results in a smaller and softer curd formation in the stomach, which can be more easily digested by stomach enzymes compared to the harder curd formed by cow’s milk.
Goat’s milk has more medium-chain fatty acids than cow’s milk, which has more long-chain fatty acids. Long chain fatty acids are harder to digest, because they require bile salts from the liver as well as pancreatic enzymes to break them down before they can be absorbed by the intestine. On the other hand, medium chain fatty acids in goat’s milk do not require pancreatic enzymes to be broken down; they are more readily absorbed into the blood stream.
MORE CALCIUM, VITAMIN A & PROBIOTICS THAN COW’S MILK
1 cup of goat’s milk contains 327 mg of calcium, while 1 cup of cow’s milk contains 276 mg of calcium. That equates to 51 mg more calcium in goat’s milk. However, this does not mean you have to switch to goat’s milk for that extra calcium. One is still able to achieve their calcium requirement through other calcium-rich foods like yoghurt, cheese, and some vegetables like spinach, bok choy, and broccoli in addition to milk intake.
1 cup of goat’s milk contains 483 IU of Vitamin A while 1 cup of cow’s milk contains 114 IU. Vitamin A is essential for good vision, growth, fetal development, and a healthy immune system.
Goat’s milk contains a higher amount of prebiotics (oligosaccharides) compared to cow’s milk, which encourages the growth and proliferation of beneficial bacteria in the gut.
HOWEVER, SOME CAVEATS OF NOTE
Goat’s milk may not be suitable for people that are lactose intolerant as it still contains lactose. Some people find goat’s milk slightly easier to digest than cow’s milk, but other people may not have the same reaction. If you are lactose intolerant or have milk allergies and want to give goat’s milk a try, do consult your doctor beforehand.
Children above the age of 1 year can safely drink pasteurised goat’s milk, provided they do not have any allergy issues. Raw, unpasteurized goat’s milk is not encouraged as it may contain bacteria that can cause serious illness among children.
Children diagnosed with cow’s milk protein allergy (CMPA) are not recommended to consume goat’s milk or goat’s milk formulas. This is because there is evidence that this milk may still cause allergy reactions in children with CMPA, due to cross reactivity with cow’s milk.
Goat’s milk has more calories per serving, when compared to whole cow’s milk. This is due to the higher fat content in goat’s milk (10 g per serving) compared to 8 g per serving in cow’s milk. So, if you’re watching your weight, you may want to consider low fat cow’s milk or skim milk, especially if you drink more than 2 cups of milk per day.
HOW ABOUT SHEEP’S MILK?
IT’S ALSO EASIER TO DIGEST, COMPARED TO COW’S MILK
Based on a recent study in New Zealand, the protein in sheep’s milk is also more readily digested as compared to cow’s milk, which may be the reason it is better tolerated by adults that are unable to tolerate cow’s milk.
MORE CALCIUM, ZINC & PROTEIN THAN COW’S MILK
Sheep’s milk contains as much as 35% more calcium in 1 serving (1 cup) as compared to cow’s milk. Calcium is an essential mineral for strong bones and teeth, and is one of the important minerals in the prevention of osteoporosis.
Sheep’s milk contains a higher amount of zinc as compared to cow’s milk. Zinc is important for cell growth and division, wound healing, and supporting a healthy immune system.
Sheep’s milk is a high-protein beverage, containing 7 grams more protein per serving than cow’s milk. Protein plays an important role in the building and repairing of tissues and muscles as well as for a healthy immune system.
HOWEVER, SOME CAVEATS OF NOTE
Pasteurized sheep’s milk is fine for children after the age of 1 year, provided that they do not have allergy issues.
Children diagnosed with cow’s milk protein allergy (CMPA) are not recommended to consume sheep’s milk or sheep’s milk formulas. Just like with goat’s milk, there is evidence that sheep’s milk may still cause allergy reactions in children with CMPA, due to cross reactivity with cow’s milk.
Sheep’s milk has more calories per serving, when compared to whole cow’s milk. This is due to the higher fat content (17 g per serving) compared to 8 g per serving in cow’s milk. So, if you’re watching your weight, you may want to consider low fat cow’s milk or skim milk, especially if you drink more than 2 cups of milk per day.
SHEEP’S MILK VS GOAT’S MILK: IS ONE BETTER THAN THE OTHER?
Looking at the data and evidence that we have, there isn’t one “best milk” out of the cow’s milk, sheep’s milk, or goat’s milk.
All three types of milk have their pros and cons, and it really depends on the specific reason you choose a particular type of milk.
Barring any intolerance or allergy issues, it is absolutely okay to choose the milk that you like the most in terms of taste as well as your health status.
Malaysian Paediatric Association and Malaysian Society of Allergy and Immunology. (2012). Guidelines for the management of cow’s milk children 2012 (CMPA in children). https://www.allergymsai.org/pdf/guideline-cows-milk.pdf
The University Malaya Medical, Business, Computing and Software Engineering teams have launched a free app, called Age Plus.
“The main objective of the project is to develop a health management application for users to self-manage their health,” shares Associate Professor Dr Mumtaz Begum Mustafa, the creator of the Age Plus app.
WHAT DOES THE APP CURRENTLY PROVIDE?
LIFESTYLE
Provides visualization patterns of your daily activities as well as personalized recommendations for a healthier lifestyle
Information on healthy foods
Calorie calculator to help you plan healthy meals
Seat goals for and track your water intake, caffeine consumption, sleep, and exercise
PERSONAL MEDICAL DETAILS
Useful for managing medical information such as medication and consultation detail
Record and keep tab on your medications
Record and keep track of your medical appointments
Find nearby hospitals
HEALTH MANAGEMENT
Improve awareness on disease-related conditions among older persons.
Get useful advice and tips on health-related matters
AGE PLUS IS USER-FRIENDLY
Dr Mumtaz explains that the app boasts design solutions to improve its usability especially among older persons. Features of the app that reflect this include:
Increased action time and reduction of multiple tasks
FEATURED EXPERT
VOON SUK CHEN
DR FATIN HANANI MAZRI
FEATURED EXPERT
DR LIM YIN SEAR
