On 5 October 2023, the Faculty of Medicine of Universiti Kebangsaan Malaysia (UKM) conferred the Distinguished Alumni award to Dr Zaliha Mustafa, our Minister of Health.
This conferment was in acknowledgment and celebration of Dr Zaliha’s accomplishments and successes as the Minister of Health. Notably, she is the first female Minister of Health of Malaysia.
CELEBRATING THE PRESENT & CONTEMPLATING THE FUTURE
Upon receiving the title, Dr Zaliha shares: “I would like to express my utmost appreciation to UKM, especially the Faculty of Medicine, for bestowing upon me the Distinguished Alumni award. Indeed, I’m very proud of having the privilege to receive my education in the faculty.”
The conferment ceremony was also graced by the presence of Professor Emeritus Dato’ Dr Mohamad Abd Razak, the Chairman of the UKM Board of Directors.
He delivered a talk entitled ‘Reformasi Sistem Kesihatan yang Kalis Masa Hadapan’ (Reformation of a Future-Proof Healthcare System), which touches on relevant health issues that affect the way in which societies in this country would confront the challenges of the future.
Professor Emeritus Dato’ Dr Mohamad Abd Razak also shared his experiences as a student in the faculty around 1983 to 1989. “There are far more advances in technology and methodology today to provide optimal benefits to students,” he said.
Additionally, Dr. Zaliha took the opportunity to officiate the Space for Distinguished Alumni at the Faculty of Medicine of UKM.
A SPACE TO CELEBRATE THE LEGACY OF UKM’S DISTINGUISHED ALUMNI
The Space for Distinguished Alumni is set up by UKM to honour the accomplishments of the Distinguished Alumni of UKM.
A multimedia display is set up in this space to commemorate these accomplishments with visitors.
Aside from Dr Zaliha, the other Distinguished Alumni are Tan Sri Dato’ Seri Dr Noor Hisham Abdullah (2020), Datuk Dr Rohaizat Yon (2021), and Professor Emeritus Dato’ Dr. Lokman Saim (2022).
On 4 September 2023, the Pertubuhan Kumpulan Sokongan Ibu Bapa Dan Bayi Pramatang Malaysia (BPM) and the Galen Centre for Health and Social Policy partnered to organize a media roundtable called Taking a Closer Look at RSV.
RSV is short for respiratory syncytial virus, one of the most prevalent viruses that infect the respiratory system of mostly children below 3.
FEATURED EXPERT
ASSOCIATE PROFESSOR DR ADLI ALI
Head of Clinical Immunology
UKM Children’s Specialist Hospital
“RSV is a disease that has been around for a long time, yet the number of cases is still high. The actual burden of the disease is not known from the economic impact on the healthcare system which includes admission costs, utilization of respiratory supports, as well the economic and social impact on the family of patients. Therefore, prevention is very important in addressing the further progression of the disease in the country.”
FEATURED EXPERT AZRUL ABDUL KHALIB
Founder and Chief Executive Officer
Galen Centre for Health and Social Policy
“With the varied guidelines on prevention, we need to prioritize and respond with more urgency to RSV which can have a life-long impact. Parents, caregivers and the community at large need to understand the severity of the disease, how it can affect the future of our nation and what can be done to address them immediately.”
Azrul also called for more streamlined guidelines for RSV prevention and to ensure the channels for parents to seek support and financial aid for their children are made more accessible.
Furthermore, increased availability of preventive options would help reduce mortality and save children’s lives.
Parent Nur Suhana sharing her personal experience caring for her child Shafiq Rizqi who was born premature, and her experience in dealing with the RSV infection.
Parent Nursyahirah shared the challenges in caring for her child Wan Nur Afeeya who was born prematurely at 25 weeks.
Wan Nur Afeeya who was born prematurely at 25 weeks, was infected with RSV this year.
Norazleena Yaha, founder of Pertubuhan Kumpulan Sokongan Ibu Bapa Dan Bayi Pramatang Malaysia (BPM) spoke about how the organisation help parents access the available financial support to purchase the vaccines.
Associate Professor Dr. Adli Ali, Head of Immunology and Rheumatology Services, UKM Children's Specialist Hospital
Associate Professor Dr Choo Yao Mun, Consultant Neonatologist and Paediatrician, University of Malaya Medical Centre
Azrul Abdul Khalib, Founder and Chief Executive Officer of the Galen Centre for Health and Social Policy
WORDS AINUL SYAFIQAH MOHD AZAHARI & DR NUR HANA HAMZAID
FEATURED EXPERTS
AINUL SYAFIQAH MOHD AZAHARI
Nutritionist and Student of Master’s in Clinical Nutrition
Faculty of Health Sciences
Universiti Kebangsaan Malaysia (UKM)
DR NUR HANA HAMZAID
Senior Lecturer
Center for Rehabilitation & Special Needs Studies (iCaRehab)
Faculty of Health Sciences
Universiti Kebangsaan Malaysia (UKM)
Autism spectrum disorder (ASD), also known as autism, is a developmental disability caused by neurodevelopmental disorders that affect how the brain functions and alter the development of the nervous system.
As a result, someone with autism typically experiences difficulties in their social, cognitive, and emotional functioning.
Among the main characteristics of people with autism are significant social communication and behavioural challenges that can be seen as early as when they are 18 months old.
Additionally, people with autism would also exhibit a high degree of repetitive behavioural patterns.
AUTISM CAN GIVE RISE OF PROBLEMS AFFECTING THE CHILD’S GASTROINTESTINAL SYSTEM
These problems, called gastrointestinal issues (GI), are common among with children with autism.
A 2019 review of 13 studies found out that 80% of children with autism experience gastrointestinal issues.
These children typically experience:
Constipation
Diarrhoea
Abdominal bloating
Abdominal pain
The same review also found out that there is an association between poor gut health and the children’s behavioural response, due to the impaired function of the gut and disruptions to the population of bacteria in the gut (the gut microbiome).
ISSUES IN THE GUT CAN CAUSE THE CHILD WITH AUTISM TO ACCEPT ONLY A SMALL SELECTION OF FOODS
The affected gut-brain axis results in neurological imbalance that gives rise to the child’s tendency toward repetitive behaviour and sensitivity.
This repetitive behaviour can restrict the variety of foods accepted by the child, or food selectivity, based on their taste and sensory requirements. A hypersensitive child with autism, for instance, usually prefer foods with less texture and milder tastes, while a hyposensitive child with autism—one with lower-than-normal sensitivity to sensory input—may prefer instead foods with more textures and stronger tastes.
THESE ISSUES CAN PUT A CHILD WITH AUTISM AT RISK OF NUTRITIONAL DEFICIENCY
Food selectivity as well as gut issues in children with autism can put their nutritional status at stake. Here are some common issues related to this.
Reduced absorption efficiency of nutrients in the gut during digestion
This is due to abnormalities in gut functions.
Reduced digestion of carbohydrates
Some studies mentioned that children with autism lack the enzymes needed for a better carbohydrate digestion.
Preference for carbohydrate-rich and often sweet foods
One 2004 study found out that children with autism prefer foods high in carbohydrates, which are generally sweet, while commonly rejecting foods that are bitter and sour. High consumption of carbohydrate-rich foods can impact the child’s glucose tolerance and sensitivity, which over time would lead to overweight and obesity, diabetes, and dental caries.
Food selectivitykeeps children with autism from obtaining the types and amounts of nutrients to meet their daily nutritional intake
Rejection of certain tastes and food textures may restrict the child from obtaining essential micronutrients such as vitamin D, vitamin B12, vitamin C, calcium, and zinc.
The child may also have a lower consumption of dairy products.
Furthermore, parents of some children with autism put these children under dietary restrictions protocols, such as casein- and/or gluten-free diets. However, to date there is no evidence that these dietary restrictions can improve the child’s behavioural and gastrointestinal issues. On the other hand, it is likely that such dietary restrictions only further narrow the window of opportunity for proper nutrient intake.
HOW TO PROVIDE OPTIMAL NUTRITION & CARE TO A CHILD WITH AUTISM
Providing optimal care to a child with autism involves a multidisciplinary team, which comprises of paediatricians, psychiatrists, occupational therapists, speech-language therapists, dietitians, and social workers.
The paediatrician and psychiatrists work to recognize the early symptoms of and conduct assessments for autism.
Occupational therapists evaluate the current developmental levels of emotional self- regulation and participation in social interactions.
Speech-language therapists provide interventions to help the child improve their communication skills.
Dietitians consult with carer or the child themselves to understand the child’s dietary and eating behaviours, in order to identify the child’s food aversion and/or nutritional deficiencies and to advise the child’s carers on how to best manage these issues.
Social workers link parents and families with agencies and autism-related community programmes.
HOW PARENTS CAN MANAGE THE FOOD SELECTIVITY OF A CHILD WITH AUTISM
Explore various food textures and tastes
A hyposensitive child requires more triggers in order to stimulate their senses, so offer crunchy and chewy foods with strong aromas. Use herbs and spices, instead of salt and sugar, to enhance the flavours of these foods.
For hypersensitive children, introduce softer, mushier foods with less intense flavours such as porridge, yoghurt, and mashed foods. Parents and caregivers should also incorporate desensitization techniques into playtime and other activities with these children outside of eating time.
Roleplay with the child during mealtimes
For example, pretend to be a cook or feed the child’s favourite toy. You can also use the foods that your child likes and accepts to spin a story about other foods that your child may also enjoy.
Such imaginative games can help switch on the child’s imaginative skills, make mealtimes for enjoyable, and reduce the child’s reluctance to eat.
Food challenge
For example, if your child accepts a certain sauces, dips, or gravy, try dipping new foods into them to get your child to try these foods.
Food chaining
Food chaining helps to encourage a child with food selectivity to try new foods.
If your child like apple sauce, for example, you can try introducing the apple fruit into their meals.
Food chaining involves trial and error, and parents/caregivers may experience some degree of frustration when the child rejects the new foods that are introduced into their meals.
However, be patient and don’t give up! Perseverance and consistency are essential when it comes to success in helping a child with autism to adopt healthier eating habits.
References:
Lefter, R., Ciobica, A., Timofte, D., Stanciu, C., & Trifan, A. (2019). A descriptive review on the prevalence of gastrointestinal disturbances and their multiple associations in autism spectrum disorder. Medicina (Kaunas, Lithuania), 56(1), 11. https://doi.org/10.3390/medicina56010011
Narzisi, A., Masi, G., & Grossi, E. (2021). Nutrition and autism spectrum disorder: Between false myths and real research-based opportunities. Nutrients, 13(6), 2068. https://doi.org/10.3390/nu13062068
Schreck, K. A., Williams, K., & Smith, A. F. (2004). A comparison of eating behaviors between children with and without autism. Journal of autism and developmental disorders, 34(4), 433–438. https://doi.org/10.1023/b:jadd.0000037419.78531.86
Williams, B. L., Hornig, M., Buie, T., Bauman, M. L., Cho Paik, M., Wick, I., Bennett, A., Jabado, O., Hirschberg, D. L., & Lipkin, W. I. (2011). Impaired carbohydrate digestion and transport and mucosal dysbiosis in the intestines of children with autism and gastrointestinal disturbances. PloS one, 6(9), e24585. https://doi.org/10.1371/journal.pone.0024585
Zeidan, J., Fombonne, E., Scorah, J., Ibrahim, A., Durkin, M. S., Saxena, S., Yusuf, A., Shih, A., & Elsabbagh, M. (2022). Global prevalence of autism: A systematic review update. Autism research : official journal of the International Society for Autism Research, 15(5), 778–790. https://doi.org/10.1002/aur.2696
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.
LEE JIE YEE
Dietitian and Student of Master’s in Clinical Nutrition
Faculty of Health Sciences
Universiti Kebangsaan Malaysia (UKM)
DR HASLINA ABDUL HAMID
Lecturer & Registered Dietitian and Nutritionist
Dietetics Programme
Centre for Community Health Studies (ReaCH)
Faculty of Health Sciences
Universiti Kebangsaan Malaysia (UKM)
DO YOU KNOW?
Your brain is always working hard 24/7.
It takes charge of almost every daily activity—your movement, body temperature, hunger, memory, and thoughts.
It can also affect your moods, emotions, and eventually your mental health.
HOW YOUR FOOD INTAKE CAN AFFECT YOUR MOODS & BRAIN
Choosing the right food is important not only for physical health, as what the common nutrition research shows, but also for your mind.
Well-balanced, nutritious foods help your bodies (and brains) to function well
As a matter of fact, the brain accounts for about 20% of your total daily energy requirements. From macronutrients (carbohydrates, proteins, and fats) to micronutrients (the vitamins and minerals), all of these play a role in brain health and function.
A healthy diet promotes a healthy gut, which communicates with the brain through what is known as the gut-brain axis
In our gut, billions of microbiota profoundly affect this gut-brain relationship.
Don’t underestimate these tiny little organisms, as they take charge of producing mood-regulating chemical substances, namely serotonin and dopamine.
Serotonin and dopamine, our body’s natural ‘feel-good’ neurotransmitters, help us to regulate emotions, sleep, and appetite. They are connected to our brain’s reward system and help to produce a happy sensation.
Since more than 90% of serotonin resides in the gut, taking good care of our stomach with food can transmit a happy signal to our brain.
Too happy isn’t always good, though! Don’t get too carried away with comfort foods
In stress-inducing situations, people tend to reach for comfort foods. However, these foods are usually high in fats and sugars, which makes them addictive. Yes indeed, the sugar is creating a surge of dopamine and a short boost of happiness.
However, other than contributing an exceeding amount of calories, these comfort foods also lacks essential nutrients such as omega-3 and vitamin B fatty acids and vitamin D, which are beneficial for your nervous system that regulates emotions.
Besides, high consumption of these calorie-dense foods might result in obesity, which is known to stimulate proinflammatory status—a plausible way to increase depression risk.
WHAT ARE THE BEST TYPES OF DIET TO IMPROVE YOUR MENTAL WELL-BEING?
Studies found that following a healthy eating pattern is associated with better stress management, improved sleep quality, increased concentration, and better mental well-being in general.
However, an emerging field of research known as nutrition psychiatry looks into a more specific relationship between diet and mental health. A few types of diet have been identified to be likely helpful for mental well-being.
Mediterranean diet
The Mediterranean diet emphasizes fruits, vegetables, whole grains, nuts, legumes, and healthy fats (such as olive oil) while limiting dairy products, red meat, alcohol, and processed foods.
The reason why the Mediterranean diet is beneficial to mental health could be due to its anti-inflammatory effects of the food components and the high content of antioxidants.
This diet might be relatively helpful in reducing the risk of depression as well as improving cognitive function.
If you are already dealing with depression, the depressive symptoms might reduce over time while preventing its remission.
The Mediterranean diet is also rich in selenium, tryptophan, omega-3, and vitamin D, which can help to improve sleep quality.
DASH diet
The DASH diet is a dietary approach that initially was designed to reduce blood pressure.
Same as the Mediterranean diet, the DASH diet is also rich in whole grains, vegetables, fruits, and other low-fat products such as fish, poultry, and beans. Try to limit high saturated fat food such as fatty meat and tropical oil.
The DASH diet emphasizes choosing food that is high in protein, fiber, potassium, calcium, and magnesium while cutting down those high in saturated fats and sodium.
Following a DASH diet could help to reduce symptoms of depression, anxiety, and stress. Additionally, nutrients that can be found in the DASH diet, such as vitamin B, omega-3 fatty acids, and antioxidants, are linked to brain function and mental well-being.
MIND diet
The MIND diet is the combination of Mediterranean diet and DASH diet, which also emphasizes the intake of natural plant-based foods and limits on animal and high-fat food.
However, leafy green vegetables and berries are exclusively focused.
Similar to the Mediterranean diet and DASH diet, the MIND diet could be helpful in reducing depression risk and psychological distress due to its high concentration of antioxidants.
Psychological stress and eating habits are closely related. It doesn’t matter which diet plan you want to choose, the key is to eat a healthy and balanced diet in appropriate portion sizes.
However, bear in mind that nutrition is just one factor among many that could impact mental health. Don’t just rely on changing your diet—you should seek advice from a mental health professional for personalized treatment for your mental issues.
The survey is now closed. All parties involved would like to express their gratitude to everyone that participated in the study.
FEATURED EXPERT ASSOCIATE PROFESSOR DR ERWIN J KHOO
Consultant Paediatrician & Head of Paediatrics Department
International Medical University (IMU)
IT CAN BE CHALLENGING FOR A PARENT TO DETERMINE FACTS FROM FICTION WHEN IT COMES TO NEWS ON SOCIAL MEDIA
Netizens who are vaccine hesitant have an alarming footprint on social media. In a vicious cycle, their hesitance is likely to be fueled by health (mis)information obtained from a variety of sources, including news media such as the Internet and social media platforms.
As access to technology has improved, social media has attained global penetration. In contrast to traditional media, social media allow individuals to rapidly create and share content globally without editorial oversight. Users may self-select content streams, contributing to ideological isolation. As such, there are considerable public health concerns.
These worries may be magnified in the face of the ongoing COVID-19 pandemic. As the development and subsequent deployment of more vaccines are expected to play a critical role in downstream emerging pandemic control efforts, social media will remain a powerful tool. Most concerning is how (mis)information and (un)substantiated reports on its platforms will threaten to erode public confidence even well before the release of any scientific evidence.
It is not readily evident why social media is so disproportionately successful in promoting vaccine hesitancy as opposed to uptake. Social media users may represent a skewed population sample with baseline misperceptions regarding the benefits and side effects of vaccination whilst simultaneously lacking familiarity with the consequences of vaccine-preventable disease. Moreover, when evaluating the risks and benefits of vaccination in general, the risks may be overestimated and may seem more immediate, and tangible as compared to the more abstract potential benefits of disease prevention.
IF YOU ARE A PARENT WITH A CHILD UNDER 18, PLEASE SPEND 15 MINUTES TO HELP US BETTER UNDERSTAND THE SITUATION
SOcial MEdia on HesitAncy in Vaccine E-survey or in short, SOMEHAVE, is a multinational collaborative study between International Medical University (IMU), the Singapore’s National University Health System (NUHS), National University of Malaysia (UKM) and Universiti Malaya (UM)
The study uses unidentified e-survey for parents with the aim of seeking the impact of social media on vaccine hesitancy.
For the English survey form, please click here (link opens in a new tab).
For the Bahasa Malaysia version, please click here (link also opens in a new tab).
AINUL SYAFIQAH MOHD AZAHARI
DR NUR HANA HAMZAID
VOON SUK CHEN
DR FATIN HANANI MAZRI
FEATURED EXPERT
LEE JIE YEE
DR HASLINA ABDUL HAMID
FEATURED EXPERT