Hoping for a Baby? These Multivitamins May Increase Your Odds of Success!

WORDS LIM TECK CHOON

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:

  1. Fecundity, or the measure of the chances of successful pregnancy
  2. 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
  1. Multivitamins containing folic acid and iodine improve the success rate of having a baby when compared to those that do not take these supplements.
  2. These multivitamins also are linked to shorter time to pregnancy.
  3. Vitamins D and E do not show any significant improvements to pregnancy success rate and time to pregnancy.
  4. 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

Healthy Meals Are Still Tasty for People with Diabetes, Thanks to This Book

WORDS LIM TECK CHOON

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
  1. 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.
  2. These recipes are prepared by nutritionists and dietitians.
  3. 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.
  4. 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.
  5. 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.

Read This Before You Reach for Your Snacks This FIFA World Cup Season

WORDS LIM CHAIN YIN

LIM CHAIN YIN
SEA Nutrition Lead
Mondelēz International
TIP 1
Portion Out Your Snack
  1. Be sure to pace yourself throughout the equal halves.
  2. Once you’ve decided what you want to eat, portion it out. This can help you slow down, so that you enjoy your snack.
  3. Check in with yourself to see if you’re full and satisfied before having another portion.
  4. 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.

  1. 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.
  2. 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!

5 Ways to Eat Healthily and Merrily During Deepavali

WORDS GURSHARON KAUR GILL

GURSHARON KAUR GILL
Dietitian

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!

Children More Vulnerable to Infections During These Post-Pandemic Times?

WORDS DR LIM YIN SEAR & DR MAHFUZAH MOHAMED

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.

Sheep’s Milk vs Goat’s Milk: Is One Better Than the Other?

WORDS GURSHARON KAUR GILL

GURSHARON KAUR GILL
Dietitian
IS GOAT’S MILK THE G.O.A.T?
EASIER TO DIGEST, COMPARED TO COW’S MILK
  • 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.

References:

  1. Alberta Health Services (2022, April). Nutrition guideline: Healthy infants and young children—milk. https://www.albertahealthservices.ca/assets/info/nutrition/if-nfs-ng-healthy-infants-other-milks-fluids-milk.pdf
  2. 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
  3. Metzger, M. (2022, July 22). Goat milk versus cow milk: A comparison. Michigan State University Extension Sheep & Goats. https://www.canr.msu.edu/news/goat-milk-versus-cow-milk-a-comparison

Free Age Plus App Helps Older Persons Self-Manage Their Own Health

WORDS LIM TECK CHOON

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
  • Simplified in-app navigation/navigation assistance
  • User-friendly interfaces
  • Voice-response technology, with information dissemination through speech
  • Big buttons and simple, static menus

Age Plus is now available for free for Android phone users. Visit this link (link opens in a new tab) to download the app.