The kidneys are important organs that filter waste and maintain our body’s fluid balance. They also release hormones that help to regulate blood pressure at a normal level, and they play an important role in producing red blood cells in our body. Besides that, they are vital in producing the active form of vitamin D which is essential to promote strong and healthy bones.

In this article, we will discuss some common medications that will affect the kidney’s function. It’s important to understand and be aware of which medications may be harmful to the kidneys and precautions shall be taken to protect our kidneys.

Pain Relievers (Non-Steroidal Anti-Inflammatory Drugs-NSAIDs)

Some pain relievers, for example ibuprofen and naproxen, can harm the kidneys if taken frequently or in large doses. These medications relieve pain and help with inflammation.

However, it can be dangerous for those who have existing kidney problems or those who are dehydrated. Thus, we shall not take too much of pain relievers but to take them cautiously according to the dosage recommended by doctors.

Antibiotics

Certain antibiotics can hurt the kidneys through a variety of mechanisms. For example, some antibiotics can block the urine flow by producing crystals that cannot be broken down. Some antibiotics have substances that can damage certain kidney cells when they are excreted from the kidneys. There are also cases where some people develop allergic reactions towards antibiotics that will adversely affect their kidneys.

When antibiotics are used for a short period of time, they are generally safe. The risk of damage to kidneys is increased when antibiotics are used in high dosage or for a prolonged period. So, bear in mind that we should only take antibiotics when prescribed by doctors and we should strictly follow their medical advices.

Diuretics/Water Pills

Diuretics, or water pills, are usually prescribed by doctors to treat high blood pressure and swelling. They work by helping to excrete extra fluid in the body. However, some diuretics, like furosemide, can affect kidney function. This is because sometimes diuretics will dehydrate the body, disturbing the balance of electrolytes in the body and the blood flow to the kidneys which can be bad for the kidneys.

Thus, it is crucial for people taking diuretics to have regular monitoring of kidney function and electrolyte levels.

Contrast Dyes

In many cases, the use of a contrast dye is necessary while carrying out diagnostic tests such as CT scans, angiograms and MRIs to help doctors see certain body tissues or blood vessels better. However, it is important to know that sometimes these dyes can be harmful to the kidneys and will either cause kidney problems, or cause problems in patients with existing kidney disease. Thus, it is important to inform doctors if you have any kidney diseases before undergoing any imaging tests involving contrast dyes.

Antiviral Medications

Some antiviral medications, such as acyclovir and tenofovir, used to treat viral infections, can damage the kidneys. These medications can cause harms to the kidneys or reduce kidney function, especially when taken at high doses or for a long period. Antiviral medications can cause renal failure in many ways such as through crystal deposition in the kidneys as well as causing injury on the renal transporters and renal cells. Thus, it is imperative to have regular monitoring of kidney function if taking these antiviral medications.

Take away messages

While medications can be beneficial, it is crucial to understand the potential risks they pose to the kidneys. Be aware of which medications will affect kidney function and take necessary precautions to protect our kidneys. We shall always take medications according to the recommended dosage so as to reduce the risk of developing medication-related kidney problems and always talk to your doctors if you have any existing kidney diseases.

Reference:

1.    National Kidney Foundation. (n.d.). Pain Medicines (Analgesics). Retrieved from https://www.kidney.org/atoz/content/painmeds_analgesics

2.   American Association of Kidney Patients. (n.d.). Understanding Diuretics. Retrieved from https://aakp.org/dialysis/understanding-diuretics/

3.    Radiological Society of North America. (2020). Contrast Materials. Retrieved from https://www.radiologyinfo.org/en/info.cfm?pg=contrast-ct

4.     National Kidney Foundation. (n.d.). Common Medicines Used for People with Kidney Disease. Retrieved from https://www.kidney.org/atoz/content/medications-kidney-disease

5.     WebMD. (2022). What Meds Might Hurt My Kidneys? Retrieved from https://www.webmd.com/a-to-z-guides/medicine-hurt-kidneys

6.     National Kidney Foundation. (n.d.). Contrast Dye and the Kidneys. Retrieved from https://www.kidney.org/atoz/content/Contrast-Dye-and-Kidneys#:~:text=Contrast dyes are often used,the way they normally should.

7.     National Library of Medicine. (2005). Retrieved from https://pubmed.ncbi.nlm.nih.gov/15861345/#:~:text=Antiviral drugs cause renal failure,epithelial cells of the kidney.

A slipped disc happens when one of the rubbery cushions (discs) that sit between the bones (vertebrae) that stack up spine pushes out from its position. The disc protects the bones by absorbing the shocks from daily activities like walking, lifting, and twisting.

Each disc has two parts: a soft, gelatinous inner portion and a tough outer ring. A slipped disc happens when the inner “jelly” substance pushes through the crack. This is also known as a herniated or prolapsed disc.

Causes

Several factors can contribute to a disc rupture, including:

• Aging – Disc becomes less flexible as people age and becomes more prone to tearing or rupturing
• Gender – Men between the ages of 20 and 50 are most likely to have a slipped disc
• Obesity – Excess body weight causes extra stress on the discs in the lower back
• Occupation – People with physically demanding jobs have a greater risk of back problems
• Sedentary lifestyle – Driving or working at a desk job for long time can increase the risk of a slipped disc
• Smoking – Less oxygen is supplied to the disc and it may lead to rapid degeneration of the discs

Slipped discs can happen anywhere along the spine, but slipped discs most often occur in the lower back or the neck. It’s rare for a slipped disc to be in the mid-back. However, not all slipped discs cause symptoms. Many people will never know that they have slipped a disc.

Slipped disc at the lower back
It’s common for a slipped disc at the lower back to cause “sciatic nerve” pain. This sharp pain usually radiates from the buttock to the leg and sometimes to the foot. Other symptoms of a slipped disc at the lower back include:

• Back pain
• Tingling or numbness in the legs and/or feet
• Muscle weakness

Slipped disc at the neck
Symptoms of a slipped disc at the neck include:

• Pain near or between shoulder blades
• Pain that travels to shoulder, arm and sometimes hand and fingers
• Neck pain, especially in the back and on the sides of the neck
• Pain that increases when bending or turning the neck
• Numbness or tingling in the arms

Treatment

In most cases, slipped discs do not require surgery. With time, the symptoms of a slipped disc will improve in approximately 9 out of 10 people. However, time taken to improve varies, ranging from a few days to a few weeks.

Nonsurgical treatment
Initial treatment for a herniated disc is usually nonsurgical. Nonsurgical treatment may include:

• Applying heat or cold. Initially, cold packs can be used to relieve pain and inflammation. After a few days, might switch to gentle heat to give relief and comfort.
• Rest. Take rest breaks throughout the day but avoid sitting for long periods. Try to avoid activities that worsen the pain.
• Resuming activity slowly. Make sure movements are slow and controlled, especially bending forward and lifting.

Medication

• Nonsteroidal anti-inflammatory drugs (NSAIDs). Anti-inflammatory drugs such as ibuprofen or naproxen can help relieve pain by treating inflammation in the nerves and soft tissues surrounding the disc.
• Neuropathic drugs. These drugs affect nerve impulses to decrease the pain. They include gabapentin (Neurontin), pregabalin (Lyrica), duloxetine (Cymbalta), or venlafaxine (Effexor XR).
• Muscle relaxants. These medications can calm spasms and ease pain. Sedation and dizziness are common side effects.
• Steroid injection. An injection of a cortisone-like medicine into the space around the nerve may provide short-term pain relief by reducing inflammation.

Physical therapy

Strengthening the core—the muscles in the back, abdomen, upper thighs, and buttocks—is an important part of therapy to treat symptoms of a slipped disc. If these muscles are weak, the spine bears more weight. This added pressure could cause instability or worsen an existing spine problem. A physical therapist can recommend a series of exercises for strengthening these core muscle groups, which can improve posture, relieve pressure on the nerves affected by a slipped disc, and alleviate pain.

Surgical treatment

A doctor may recommend surgery if conservative treatment options, such as physical therapy and medications, do not reduce or end the pain altogether. The benefits of surgery should be weighed carefully against its risks. Although a large percentage of patients with herniated discs report significant pain relief after surgery, there is no guarantee that surgery will help.
A patient may be considered a candidate for spinal surgery if:

• Pain limits normal activity or impairs quality of life
• Progressive neurological deficits develop, such as leg weakness and/or numbness
• Loss of normal bowel and bladder functions
• Difficulty standing or walking
• Medication and physical therapy are ineffective
• The patient is in reasonably good health

Complications

Left untreated, a slipped disc may lead to complications such as:

• Worsening symptoms, such as increased pain, numbness or weakness that can affect daily routine
• Loss of bladder control or bowel control, which may lead to incontinence or difficulty urinating
• Saddle anesthesia, where the slipped disc compresses the nerves and leads to loss of sensation in the inner thighs, back of the legs and around the rectum
• Permanent nerve damage, which may lead to permanent weakness or paralysis

Prevention

• Using proper lifting techniques
  Position your feet shoulder-width apart
  Bend your knees and keep your back straight
  Use your legs to lift you up
  Keep the object close to the center of your body

• Practicing good posture
  When standing, keep your shoulders aligned over your hips
  Avoid slouching, especially while sitting at your computer
  Sit with your feet flat on the floor and your knees bent at 90-degree angles

• Exercising regularly
• Focus on workouts that strengthen back and abdomen muscles to support your spine
  Avoid exercises such as squats, sit-ups, and high impact aerobics activities

• Maintain a healthy weight
  Being overweight or obese puts excessive pressure and strain on the back and knees. It also may contribute to poor posture

• Quit smoking
  Smoking deprives healthy tissue of nutrients and oxygen, increasing the risk of developing spinal disc degeneration and osteoporosis. A smoker’s heavy coughing bouts can also increase pressure on the spine

References

1. Cleveland Clinic (2021). Herniated Disk (Slipped, Ruptured or Bulging Disk). Retrieved 10 June 2023, from https://my.clevelandclinic.org/health/diseases/12768-herniated-disk .
2. Mayo Clinic (2022). Herniated disk. Retrieved 10 June 2023, from https://www.mayoclinic.org/diseases-conditions/herniated-disk/symptoms-causes/syc-20354095 .
3. Nall, R. (2017). Slipped (Herniated) Disc. Retrieved 10 June 2023, from https://www.healthline.com/health/herniated-disk .
4. Park, D. K. (2022). Herniated Disk in the Lower Back. Retrieved 10 June 2023, from https://orthoinfo.aaos.org/en/diseases–conditions/herniated-disk-in-the-lower-back/ .
5. Portal Rasmi MyHEALTH (2019). Slipped Disc of Spine. Retrieved 10 June 2023, from http://www.myhealth.gov.my/en/slipped-disc-spine/ .

Aging is an inevitable process that all people experience. The progress of aging depends heavily on diet. Therefore, diet that rich in adequate nutrients and antioxidants play significant roles in delaying skin aging process. They can protect the skin from UV-induced skin aging, fight against oxidative stress, neutralize free radicals and scavenge reactive oxygen species.

Figure 1.0: Comparison of the Changes between Healthy skin and Aging skin.

Table 1.0: Comparison of Young Skin and Aging Skin

Vitamin C (Ascorbic Acid)

Vitamin C is a water-soluble, powerful antioxidant that protects skin from oxidative stress and repairs UV-induced skin aging. Besides, it also promotes the productions of collagen and elastin. This results in decrease in wrinkles, and increase in skin’s elasticity. According to a study conducted by Abdullah et al. (2019), both enzymes lysyl hydroxylase and proyly hydroxylase are crucial in Types I and III Collagen production. They rely on Vitamin C as an essential co-factor. Examples of foods that rich in Vitamin C are kiwi, strawberry, lemon, orange, guava, papaya, green peppers, red peppers, etc.

Vitamin E (Tocopherol)

Vitamin E is a fat-soluble potent antioxidant. It delays skin aging by fighting against oxidative stress and moisturizing the skin. A study from Keen et al. (2016) showed that the skincare products with the range between 2% to 20% of topical Vitamin E are able to minimize lipid peroxidation, thus delaying skin aging. It works by reducing wrinkles and enhancing the stratum corneum’s capacity to retain moisture and promote skin antioxidant protection. Examples of foods that rich in Vitamin E are broccoli, corn oil, sunflower seeds, mango, nuts (almond, hazelnuts and peanuts), etc.

Alpha Lipoic Acid (ALA)

ALA is a very potent antioxidant. ALA and its reduced form Dihydrolipoic Acid play significant roles in producing intracellular antioxidants and removing free radicals (Isaac et al., 2015). Examples of foods and supplements are broccoli, internal organs, potato, red meat, spinach, tomato, ALA supplements, etc.

Astaxanthin

It is a reddish-orange pigment that present in a wide variety of aquatic creatures. Examples included marine fishes, shrimps, crustaceans, etc. It is a potent antioxidant that plays a significant role in delaying skin aging by fighting against oxidative stress. In a study by Tominaga et al. (2017), long-term intake of astaxanthin may prevent age-related skin degeneration and preserve skin disorders resulting from environmental exposure. Examples of foods and supplements are algae, crayfish, krill, shrimp, salmon, trout, yeast, astaxanthin supplements, etc.

Coenzyme Q10 (CoQ10)

It is a well-known free radical scavenger. It helps to neutralizes reactive oxygen species, thus protecting cells from oxidative stress. According to a study conducted by Zhao et al. (2019), CoQ10 are able to shield astrocytes (cells) from UVB-induced oxidative stress by regulating PKA-ERK 1/2 signalling pathway. Examples of foods and supplements are fatty and oily fishes (salmon and tuna), internal organs, soybean, spinach, whole grains, CoQ10 supplements, etc.

Protein

Protein is needed to preserve the firmness, shape and integrity of the skin. Besides, it plays a crucial role in boosting cell regeneration. Diet high in protein promotes collagen production that results in smooth, radiant, moisturized and healthy skin. Examples of foods that rich in protein are lean meats (beef, lamb and pork), poultry (chicken, duck, goose and turkey), egg, fatty fishes, prawn, crab, lobster, mussels, oysters, scallops, tofu, etc.

Collagen Supplement

It helps to improve skin texture, retain moisture, and slow down the aging process. It has a variety of formulations and a broad range of origins like porcine, bovine and marine fishes, etc. In a study conducted by Czajka et al. (2018), oral administration of fish-derived collagen hydrolysate low-molecular-weight collagen peptide (LMWCP) promotes the regeneration of collagen fibers and elastic tissues in the skin. At a dose of 1000 mg once daily, it can significantly improve skin moisture, suppleness and wrinkles.

Water

Water helps our body stays hydrated and revitalized, and assists in maintaining the suppleness of skin. Individuals who drink plenty of water are less likely to get marks, creases compared to those who don’t. This helps to slow skin aging. In a study that conducted by Palma et al. (2015), consuming more than 2 L water daily encourages both superficial and deep hydration of the skin. As a result, skin looks moisturized, younger and healthier.

Conclusion

In conclusion, diet and nutrition that are adequate, balanced, moderate and diversified plays a crucial role in delaying skin aging. Besides, individuals should also consume at least five servings of fruits and vegetables daily, and avoid overconsumption to maintain healthy, radiant skin.

References

1. Abdullah. M & Attia, F.N. 2019. Vitamin C (Ascorbic Acid). In: StatPearls
2. Keen, M.A. & Hassan, I. 2016. Vitamin E in dermatology; Indian Dermatology Online Journal, 7(4):311-315.
3. Tominaga, K., Hongo, N., Fujishita, M., Takahashi, Y & Adachi, Y. 2017. Protective effects of astaxanthin on skin deterioration; Journal of Clinical Biochemistry and Nutrition; 61(1):33-39
4. Zhao, Q., Ma, Y.M., Jing, L., Zheng, T.X., Jiang, H.F., Li, P.A. & Zhang, J.Z. 2019. Coenzyme Q10 Protects Astrocytes from Ultraviolet B-Induced Damage Through Inhibition of ERK 1/2 Pathway Overexpression; Neurochemical Research; 44(7):1755-1763.
5. Isaac, V.L., Chiari-Andréo, B.G., Marto, J.M., Moraes, J.D., Leone, B.A., Corrêa, M.A. & Ribeiro, H.M. 2015. Rheology as a Tool to Predict the Release of Alpha-Lipoic Acid from Emulsions Used for the Prevention of Skin Aging; Biomed Research International.
6. Czajka, A., Kania, E.M., Genovese, L., Corbo, A., Merone, G., Luci, C. & Sibilla, S. 2018. Daily oral supplementation with collagen peptides combined with vitamins and other bioactive compounds improves skin elasticity and has a beneficial effect on joint and general wellbeing; Nutrition Research. 57:97-108.
7. Palma, L., Marques, L.T., Bujan, J. & Rodrigues, L.M. 2015. Dietary water affects human skin hydration and biomechanics. Clinics in Cosmetic Investigation Dermatology. 8, 413

INTRODUCTION

Globally, the popularity of plant-based diets has increased, largely due to its positive impacts for human health and the environment. Plant based diet is when eating habits are largely plant-based or plant-forward emphasized. This diet includes whole grains, legumes, beans, nuts, seeds, and oils in addition to fruits and vegetables (McManus, 2018).

A plant-based diet can help athletes perform better by reducing weight, building slimmer bodies, and enhancing stamina, according to recent studies.  Athletes, who require weight control, speed, and endurance in particular should consider the benefits of practicing plant-based diets. As research indicates, reduction in meat-based foods and an increase in plant-based foods can contribute to a reduction in body fat percentage and, consequently, leaner body mass. Leaner body mass promotes improved athletic performance.

One of the earliest studies on the body composition of American Olympians revealed that they had more lean body mass and a lower body fat percentage than collegiate athletes.  More recent research has been done to look at the body composition of professional athletes.  Although body fat percentage and lean body mass varied by sport in various studies of collegiate athletes, athletes nevertheless had lower overall body fat percentages than other college students (Rizal, 2021).

However, there are few downsides of consuming a plant-based diet. Protein is present in plant-based diets, albeit in lower amounts than in animal-based foods, and they typically include a high concentration of one of the other macronutrients. A chicken breast, for instance, contains 80% protein and 20% fat, while raw chickpeas contain 22% protein and 65% carbohydrates. Plant proteins are more difficult to digest, frequently “incomplete” (lacking essential amino acids), and frequently poor in branched chain amino acids (BCAA), which are crucial for muscle synthesis.

Moreover, the presence of phytic acid reduces the bioavailability of nutrients such as zinc and iron in plant-based food products. Micronutrients such as vitamin B12, iron, calcium and zinc are least available in plant-based food and can be found mainly in animal based food products. The substitutes for these vitamins can only be obtained in supplements in order to fully obtain the benefits among athletes. Deficiency of iron causes anaemia which leads to muscle injury and fatigue during strenuous activities. Calcium inadequacy in a sportsperson causes reduced bone density that further leads to bone fragility (BioSteel US, 2023).

There are several ways to manage a healthy plant-based diet while being an athlete. Vitamin B12 deficiency can be overcome by consuming food rich in that specific nutrient such as nutritional yeast, fortified soy and almond milks. If there is no sufficient source in getting enough iron each day, they can consume more plant sources of the mineral, such as green vegetables, cereals, legumes, nuts, and seeds.

The main iron supply for vegans is non-haem iron, which is less accessible than the haem iron present in animal products. Consuming ascorbic acid (vitamin C) along with an iron-rich meal can, however, increase the bioavailability of non-haem iron. Citrus fruits, bell peppers, strawberries, and kiwifruit are just a few foods that contain vitamin C. In the event that the athlete avoids dairy products, plant sources of calcium include tofu, fortified plant milks and juices, broccoli, and leafy greens like kale. Beans, nuts, seeds, oats, and wheat germ are examples of plant sources of zinc (Harrington, 2020).

CONCLUSION

When it comes down to it, vegan athletes may face some additional dietary difficulties. While it can be challenging for many athletes to achieve nutritional requirements, those who follow a plant-based diet may be more susceptible to nutrient shortages, particularly when it comes to protein and several vitamins and minerals. However, all nutrient needs can be satisfied with careful meal planning, preparation, strategic replacement of animal foods with plant meals of comparable nutritional content, and supplementation. In conclusion, a plant-based diet should at least be given some thought by athletes who want to obtain a competitive edge in all areas of health that can positively affect their performance.

REFERENCES

BioSteel US. (2023). Are Vegan Athletes at a Disadvantage in Pro Sports? [online] Available at: https://biosteel.com/blogs/news/are-vegan-athletes-at-a-disadvantage-in-pro-sports

Harrington, J. (2020, April 22). 5 Tips for Creating a Plant Based Diet for Athletes | CSP Global. CSP Global. https://online.csp.edu/resources/blog/plant-based-diet-for-athletes/

McManus, K. (2018). What is a plant-based diet and why should you try it? [online] Harvard Health Blog. Available at: https://www.health.harvard.edu/blog/what-is-a-plant-based-diet-and-why-should-you-try-it-2018092614760.

Ostfeld, R.J. (2017). Definition of a plant-based diet and overview of this special issue. Journal of geriatric cardiology : JGC, [online] 14(5), p.315. doi:https://doi.org/10.11909/j.issn.1671-5411.2017.05.008.

‌Rizal, E. (2021). Benefits of Plant-Based Diets in Athletic… [online] Berkeley.edu. Available at:https://pha.berkeley.edu/2021/04/11/benefits-of-plant-based-diets-in-athletic-performance/.

What is diabetes?

Diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood glucose. Hyperglycemia also known as high blood sugar is a common effect of uncontrolled diabetes and if continued over time will leads to deterioration of various body’s systems, especially the nerves and blood vessels.

What are the symptoms of diabetic patient?

Symptoms of diabetes may occur suddenly. In type 2 diabetes, the symptoms can be mild and may take years to be noticed. Symptoms of diabetes include:

Over time, diabetes can damage blood vessels in the heart, eyes and kidneys. People with diabetes have a higher risk of health problems including heart attack, stroke and kidney failure. Diabetes can cause permanent vision loss by damaging blood vessels in the eyes. Many people with diabetes develop problems with their feet due to nerve damage and poor blood flow. This can cause foot ulcers and may lead to amputation.

What is Therapeutic Diet?

A therapeutic diet is a meal plan that controls the intake of certain foods or nutrients. It is part of the treatment of a medical condition and are normally prescribed by a physician and planned by a dietician. A therapeutic diet is usually a modification of a regular diet. It is modified or tailored to fit the nutrition needs of a particular person.

Purpose of Therapeutic Diet:

Type of Therapeutic Diet:

Diabetic or calorie-controlled diet (ADA)

These diets control calories, carbohydrates, protein, and fat intake in balanced amounts to meet nutritional needs, control blood sugar levels, and control weight. The purpose of the diet is to keep the patient in good health, to keep blood sugar level within normal level and to keep urine free from sugar. Portion control is used at mealtimes as outlined in ADA “Exchange List for Meal Planning.  The diet planning will be balanced but have restriction on carbohydrates like rice, biscuits, sugar, jams, sweets, honey and sweet potatoes. Most commonly used calorie levels are 1,200, 1,500, 1,800 and 2,000.  Moreover, this diet used healthy fats that come from fish oils, olive oil, nuts, flaxseeds, avocados and high-fiber cereals made from whole grains, fresh fruits and veggies.

What are lifestyle approaches for prevention and management of diabetes?

Exercise

Physical activity is another important part of diabetes management plan. During workout, our muscles use sugar (glucose) for energy. Regular physical activity also helps our body use insulin more efficiently. These factors work together to lower the blood sugar level. The more strenuous the workout, the longer the effect lasts. However, even light activities such as housework, gardening or being on the feet for extended periods can improve blood sugar.

Management of stress

Stress may induce your body to release hormone cortisol which in turn triggers liver to release glucose. Thus, prolonged stress may cause a rise in blood sugar level. Additionally, it may be harder to closely follow usual diabetes management routine if an individual is under a lot of extra pressure. Patient with diabetic should learn relaxation techniques and avoid common stressors. Exercise can often help relieve stress and lower blood sugar level.

Monitoring of blood sugar

Diabetic patients, even healthy individual should monitor blood sugar levels regularly. This action can help everyone to maintain their sugar levels under normal range. Most importantly patient with diabetes should have their sugar levels recorded to ensure that their health is in optimal condition. Otherwise, patient with diabetes might not be aware whether their sugar level is in an acceptable range or have passed a dangerous level.

Take medication on time

Alongside lifestyle modification such as nutrient-dense diet and regular exercise, a person with type 2 diabetes might need to manage their blood sugar levels through medication that was prescribed by a doctor. In order to ensure their blood glucose is always under control, diabetic patient must take precaution to always consume their medication on time.

Conclusion

In conclusion, appropriate diet and lifestyle approach is important in preventing and managing diabetes. Diet which are rich is fibers, low carbohydrates and healthy fats helps in management of normal blood sugar level. Together with this, physically active, good management of stress and regular monitoring of sugar level gives more benefits in the prevention and management of diabetes. So let’s live healthy!!

References

Ghosh, Amrita. (2018). Therapeutic Diet: What We Need to Consider. Bengal Physician Journal. 5. 25-27. 10.5005/jp-journals-10070-5209.

Tarigan, Rinawati. (2022). hubungan gaya hidup dengan terjadinya penyakit diabetes melitus di rsu daerah dr r.m djoelham. Jurnal Keperawatan Priority. 5. 94-102. 10.34012/jukep.v5i1.2105.

Superfood?

In a world constantly on the move, maintaining a healthy body is profound as it could put a halt to everyday requirement including work and social life. Therefore, the choices we make about the food we consume are perhaps the most influential decisions we make daily, as it doesn’t just shape our individual health but also the collective vitality of generations to come. Superfoods, packed with essential nutrients, can play a significant role in promoting health and preventing various diseases. However not a single food can provide all the nutrients, health benefits and energy we need for our body. According to 2015–2020 US Dietary Guidelines, “a healthy eating pattern is combining healthy choices from across all food groups while paying attention to calorie limits.”  This article aims to highlight a list of essential superfoods that should be included in your diet to ensure optimal health and vitality.

List of Superfoods

1. BERRIES

Berries are considered beneficial to our health due to its high antioxidant content, particularly anthocyanin. These compounds have been linked to the abilities that may help protect the body from heart disease and reduce inflammation. Some of the most well-known berries are Strawberries, Blueberries, Blackberries and Cranberries. Cheatham et al. (2023) found that regularly eating blueberries may improve memory and delay age-related cognitive decline. The result proved that the potential consumption of blueberries has supported neural functioning.  Besides, eating berries can also be effective in treating various digestive and immune-related disorders combined with established treatment or therapies (Govers et al., 2018). There is various ways to enjoy berries as it can be part of your breakfast plate, a smoothie or a dessert.  

2. FATTY FISHES

Fatty fishes contain Omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which are essential for cardiovascular health and brain function.  Furthermore, these fatty acids help in reducing inflammation, preventing fat deposited in the arteries, improving blood flow and reducing triglyceride levels (Shahidi & Ambigaipalan, 2018). Our body cannot produce omega 3 fatty acids naturally. Therefore, it must be obtained through diet. Fatty fish such as salmon, sardine and mackerel are excellent sources of omega 3 and it is highly nutritious packed with `healthy fats’, protein, vitamin B, and minerals such as potassium and selenium. It is one of the best source to reduce inflammation and may help reduce the risk of cardiovascular issues (Zivkovic et al. 2011).

!! the serving of fatty fish is limited to one to two servings weekly due to the risk of heavy metal contamination in larger fish.

3. QUINOA

Quinoa is one of the many varieties of whole grain. Whole grains are made up of all three components of the grain. There are numerous varieties, such as whole wheat and whole corn, oats, brown rice and quinoa. Seal (2006) stated that whole grains provide a variety of essential elements such as vitamins, minerals, protein, fiber, and other beneficial plant compounds. Fiber content in whole grains helps to reduce bad cholesterol levels (LDL), blood pressure and aids in weight loss as it can create a feeling of fullness. For instance, Quinoa is a complete protein and is a great alternative to traditional grains. It contains high fiber, vitamins, and minerals, making it a great addition to any balanced diet (Carreiro et al. 2016). A combination of quinoa with high protein food in a daily diet provides you with a variety of health benefits to support your gut health and body weight management.

4. DARK LEAFY VEGETABLES

Dark leafy vegetables are a crucial part in every diet as they are packed with a bunch of nutrients such as vitamins, minerals and fibre. According to Malaysian Food Pyramid 2020, the recommended intakes for vegetables are more than 3 servings in a daily food intake. There are some examples of dark leafy vegetables that you can add in your diet such as Kale. Kale is a nutrient powerhouse, rich in vitamins A, C, and K, as well as calcium and fibre. It contains antioxidants and compounds that may help protect against certain types of cancer (Ortega et al. 2021). Besides, spinach is also one of the vegetables that are often on the list of the healthiest foods. Spinach is filled with nutrients such as vitamins, minerals, and antioxidants. It is also an excellent source of iron and folate, crucial for increasing hemoglobin in blood and preventing anemia symptoms.

5. YOGURT

Yogurt is a superfood that should be included in your healthy diet list.  It is not only diverse, but has numerous health benefits and abundant with nutrients such as protein and calcium. It is a good source of probiotic equipped with detoxifying properties making it ideal for weight loss and beneficial to your skin. Furthermore, yoghurt is packed with healthy bacteria, which can aid digestion, promote gut health and protect from colon cancer (Kim CE et al. 2022). In addition, consumption of dairy products such as yogurt helps in strengthening body’s immunity and prevention from viral infections due to their beneficial effect that has been mainly attributed to its probiotic.

6. SWEET POTATOES

Sweet potatoes scientifically known as Ipomoea batatas, are a versatile and nutritious root vegetable that has captured the palates and hearts of people around the world. With their vibrant colours, rich flavours, and numerous health benefits, sweet potatoes have earned their place not only on dinner plates but also in culinary traditions and discussions about wellness. One of the most striking features of sweet potatoes is their spectrum of colors, which ranges from pale yellows to deep oranges and even purples. This diverse color palette is indicative of the variety of nutrients and antioxidants they contain. The vibrant orange hue, for instance, is a sign of their high beta-carotene content, a precursor to vitamin A that supports vision, immune function, and skin health (Johra FT et al. 2020).

Conclusion

Incorporating a variety of superfoods into your diet can have a profound impact on your overall health and well-being. These nutrient-dense foods provide a wide array of vitamins, minerals, antioxidants, and other beneficial compounds that support various bodily functions and help protect against chronic diseases. By including superfoods like berries, quinoa, fatty fishes, green leafy vegetables, yogurt, and sweet potatoes, you can create a foundation for a balanced and nutritious diet that promotes long-term health. Remember, a diverse and colorful plate is key to reap the full benefits of these incredible superfoods!

References

1. Cheatham CL, Canipe LG 3rd, Millsap G, Stegall JM, Chai SC, Sheppard KW, Lila MA. Six-month intervention with wild blueberries improved speed of processing in mild cognitive decline: a double-blind, placebo-controlled, randomized clinical trial. Nutr Neurosci. 2023 Oct;26(10):1019-1033. doi: 10.1080/1028415X.2022.2117475. Epub 2022 Sep 6. PMID: 36066009.

2. Govers C, Berkel Kasikci M, van der Sluis AA, Mes JJ. Review of the health effects of berries and their phytochemicals on the digestive and immune systems. Nutr Rev. 2018 Jan 1;76(1):29-46. doi: 10.1093/nutrit/nux039. PMID: 29087531.

3. Zivkovic AM, Telis N, German JB, Hammock BD. Dietary omega-3 fatty acids aid in the modulation of inflammation and metabolic health. Calif Agric (Berkeley). 2011 Jul;65(3):106-111. doi: 10.3733/ca.v065n03p106. PMID: 24860193; PMCID: PMC4030645.

4. Shahidi F, Ambigaipalan P. Omega-3 Polyunsaturated Fatty Acids and Their Health Benefits. Annu Rev Food Sci Technol. 2018 Mar 25;9:345-381. doi: 10.1146/annurev-food-111317-095850. PMID: 29350557.

5. Seal CJ. Whole grains and CVD risk. Proc Nutr Soc. 2006 Feb;65(1):24-34. doi: 10.1079/pns2005482. PMID: 16441941.

6. Carreiro AL, Dhillon J, Gordon S, Higgins KA, Jacobs AG, McArthur BM, Redan BW, Rivera RL, Schmidt LR, Mattes RD. The Macronutrients, Appetite, and Energy Intake. Annu Rev Nutr. 2016 Jul 17;36:73-103. doi: 10.1146/annurev-nutr-121415-112624. PMID: 27431364; PMCID: PMC4960974.

7. Ortega-Hernández E, Antunes-Ricardo M, Jacobo-Velázquez DA. Improving the Health-Benefits of Kales (Brassica oleracea L. var. acephala DC) through the Application of Controlled Abiotic Stresses: A Review. Plants (Basel). 2021 Nov 29;10(12):2629. doi: 10.3390/plants10122629. PMID: 34961097; PMCID: PMC8706317.

8. Kim CE, Yoon LS, Michels KB, Tranfield W, Jacobs JP, May FP. The Impact of Prebiotic, Probiotic, and Synbiotic Supplements and Yogurt Consumption on the Risk of Colorectal Neoplasia among Adults: A Systematic Review. Nutrients. 2022 Nov 21;14(22):4937. doi: 10.3390/nu14224937. PMID: 36432622; PMCID: PMC9697560.

9. Johra FT, Bepari AK, Bristy AT, Reza HM. A Mechanistic Review of β-Carotene, Lutein, and Zeaxanthin in Eye Health and Disease. Antioxidants (Basel). 2020 Oct 26;9(11):1046. doi: 10.3390/antiox9111046. PMID: 33114699; PMCID: PMC7692753.

Aging is an inevitable process that all people experience. The progress of aging depends heavily on diet. Therefore, diet that rich in adequate nutrients and antioxidants play significant roles in delaying skin aging process. They can protect the skin from UV-induced skin aging, fight against oxidative stress, neutralize free radicals and scavenge reactive oxygen species.

Figure 1.0: Comparison of the Changes between Healthy skin and Aging skin.

Table 1.0: Comparison of Young Skin and Aging Skin

Vitamin C is a water-soluble, powerful antioxidant that protects skin from oxidative stress and repairs UV-induced skin aging. Besides, it also promotes the productions of collagen and elastin. This results in decrease in wrinkles, and increase in skin’s elasticity. According to a study conducted by Abdullah et al. (2019), both enzymes lysyl hydroxylase and proyly hydroxylase are crucial in Types I and III Collagen production. They rely on Vitamin C as an essential co-factor. Examples of foods that rich in Vitamin C are kiwi, strawberry, lemon, orange, guava, papaya, green peppers, red peppers, etc.

Vitamin E (Tocopherol)

Vitamin E is a fat-soluble potent antioxidant. It delays skin aging by fighting against oxidative stress and moisturizing the skin. A study from Keen et al. (2016) showed that the skincare products with the range between 2% to 20% of topical Vitamin E are able to minimize lipid peroxidation, thus delaying skin aging. It works by reducing wrinkles and enhancing the stratum corneum’s capacity to retain moisture and promote skin antioxidant protection. Examples of foods that rich in Vitamin E are broccoli, corn oil, sunflower seeds, mango, nuts (almond, hazelnuts and peanuts), etc.

Alpha Lipoic Acid (ALA)

ALA is a very potent antioxidant. ALA and its reduced form Dihydrolipoic Acid play significant roles in producing intracellular antioxidants and removing free radicals (Isaac et al., 2015). Examples of foods and supplements are broccoli, internal organs, potato, red meat, spinach, tomato, ALA supplements, etc.

Astaxanthin

It is a reddish-orange pigment that present in a wide variety of aquatic creatures. Examples included marine fishes, shrimps, crustaceans, etc. It is a potent antioxidant that plays a significant role in delaying skin aging by fighting against oxidative stress. In a study by Tominaga et al. (2017), long-term intake of astaxanthin may prevent age-related skin degeneration and preserve skin disorders resulting from environmental exposure. Examples of foods and supplements are algae, crayfish, krill, shrimp, salmon, trout, yeast, astaxanthin supplements, etc.

Coenzyme Q10 (CoQ10)

It is a well-known free radical scavenger. It helps to neutralizes reactive oxygen species, thus protecting cells from oxidative stress. According to a study conducted by Zhao et al. (2019), CoQ10 are able to shield astrocytes (cells) from UVB-induced oxidative stress by regulating PKA-ERK 1/2 signalling pathway. Examples of foods and supplements are fatty and oily fishes (salmon and tuna), internal organs, soybean, spinach, whole grains, CoQ10 supplements, etc.

Protein

Protein is needed to preserve the firmness, shape and integrity of the skin. Besides, it plays a crucial role in boosting cell regeneration. Diet high in protein promotes collagen production that results in smooth, radiant, moisturized and healthy skin. Examples of foods that rich in protein are lean meats (beef, lamb and pork), poultry (chicken, duck, goose and turkey), egg, fatty fishes, prawn, crab, lobster, mussels, oysters, scallops, tofu, etc.

Collagen Supplement

It helps to improve skin texture, retain moisture, and slow down the aging process. It has a variety of formulations and a broad range of origins like porcine, bovine and marine fishes, etc. In a study conducted by Czajka et al. (2018), oral administration of fish-derived collagen hydrolysate low-molecular-weight collagen peptide (LMWCP) promotes the regeneration of collagen fibers and elastic tissues in the skin. At a dose of 1000 mg once daily, it can significantly improve skin moisture, suppleness and wrinkles.

Water

Water helps our body stays hydrated and revitalized, and assists in maintaining the suppleness of skin. Individuals who drink plenty of water are less likely to get marks, creases compared to those who don’t. This helps to slow skin aging. In a study that conducted by Palma et al. (2015), consuming more than 2 L water daily encourages both superficial and deep hydration of the skin. As a result, skin looks moisturized, younger and healthier.

Conclusion

In conclusion, diet and nutrition that are adequate, balanced, moderate and diversified plays a crucial role in delaying skin aging. Besides, individuals should also consume at least five servings of fruits and vegetables daily, and avoid overconsumption to maintain healthy, radiant skin.

References

1. Abdullah. M & Attia, F.N. 2019. Vitamin C (Ascorbic Acid). In: StatPearls
2. Keen, M.A. & Hassan, I. 2016. Vitamin E in dermatology; Indian Dermatology Online Journal, 7(4):311-315.
3. Tominaga, K., Hongo, N., Fujishita, M., Takahashi, Y & Adachi, Y. 2017. Protective effects of astaxanthin on skin deterioration; Journal of Clinical Biochemistry and Nutrition; 61(1):33-39
4. Zhao, Q., Ma, Y.M., Jing, L., Zheng, T.X., Jiang, H.F., Li, P.A. & Zhang, J.Z. 2019. Coenzyme Q10 Protects Astrocytes from Ultraviolet B-Induced Damage Through Inhibition of ERK 1/2 Pathway Overexpression; Neurochemical Research; 44(7):1755-1763.
5. Isaac, V.L., Chiari-Andréo, B.G., Marto, J.M., Moraes, J.D., Leone, B.A., Corrêa, M.A. & Ribeiro, H.M. 2015. Rheology as a Tool to Predict the Release of Alpha-Lipoic Acid from Emulsions Used for the Prevention of Skin Aging; Biomed Research International.
6. Czajka, A., Kania, E.M., Genovese, L., Corbo, A., Merone, G., Luci, C. & Sibilla, S. 2018. Daily oral supplementation with collagen peptides combined with vitamins and other bioactive compounds improves skin elasticity and has a beneficial effect on joint and general wellbeing; Nutrition Research. 57:97-108.
7. Palma, L., Marques, L.T., Bujan, J. & Rodrigues, L.M. 2015. Dietary water affects human skin hydration and biomechanics. Clinics in Cosmetic Investigation Dermatology. 8, 413

Magnesium, one of the abundant minerals in the body, is found naturally in foods, added to food products, available as a dietary supplement, and present in some medicines. Energy synthesis, oxidative phosphorylation, and glycolysis all require magnesium. It is necessary for the production of DNA, RNA, and antioxidant glutathione besides helping in the structural development of bone. Magnesium is also involved in the active transport of calcium and potassium ions across cell membranes, which is important for nerve impulse transmission, muscle contraction, and appropriate heart rhythm.

Magnesium deficiency is not very common in children. However, as more children consume more processed foods, magnesium deficiency is becoming more common nowadays. Magnesium deficiency can also occur in children with digestive disorders such as celiac disease, chronic diarrhea, or type 2 diabetes. Loss of appetite, nausea, vomiting, fatigue, and weakness are the first signs of deficiency in children. When it becomes severe, it may lead to numbness, tingling, and muscle cramps. Magnesium deficiency in children can also cause sadness, difficulties in focusing, insomnia, and anxiety (NIH, 2022).

HEALTH BENEFITS OF MAGNESIUM

Magnesium is one of the important minerals needed for children as it plays a vital part in wide range of enzymatic functions in the body. As the body requires magnesium for numerous biological functions,  its deficiency can have a significant effect. This is especially important for infants, toddlers and teenagers, who rely on these processes to grow and function normally.

Magnesium has a wide range of benefits for children, which include promoting restful sleep. Sleep issues can affect people of any age, but children are more prone to suffer from them. Lack of magnesium are linked to sleeplessness as magnesium is thought to promote and regulate GABA, a neurotransmitter that promotes sleep. Thus, increasing child’s magnesium levels in tiny amount can help to promote sleep (Doherty et al., 2019).

Magnesium also acts as a guide that direct calcium to the bones. Calcium and magnesium work together to promote bone density and growth. Calcium is not effectively absorbed into the bones without magnesium. Furthermore, there is a higher risk of weakened bones if the magnesium level falls too low (Ciosek et al., 2021).

Commonly, children are still unable to manage their emotions and moods, thus taking magnesium can help to create calm and peaceful feeling. It can help to relieve stress and increase children’s mood. As such, magnesium-rich diet is also advised for children with attention-deficit hyperactivity disorder (ADHD) in order to reduce hyperactivity and agitation (Robberecht et al., 2020).

Additionally, magnesium provides constipation relief by working as a natural stool softener. Magnesium aids with bowel movement, which help to soften the stool by increasing water in the intestines. The increase in water stimulates bowel movement, besides softening the stool, making the stool easier to pass (Terri, 2021).

SOURCES OF MAGNESIUM

Magnesium is important for the proper functioning of hundreds of enzymes and aids to promote healthy bones. Deficiency of magnesium might cause development issues in children. Thus, it is important to know what are the best sources to get magnesium from your diet (Patwal, 2023). Magnesium is abundantly present in plant and animal-sourced foods. Green leafy vegetables, legumes, nuts, seeds, and whole grain are all good sources of magnesium. In general, magnesium can be found in foods containing dietary fiber. Magnesium is also added into some breakfast cereals and other fortified foods (NIH, 2022).

Some examples of magnesium-rich foods that can be included in daily diet are soy products, such as tofu, soy milk, and soybeans. Other than that, legumes and seeds also good source of magnesium besides nuts such as almonds and cashews. Consuming almond butter and almond milk can be a good alternative too. Whole grain breads and breakfast cereals can be a good option too as magnesium is also fortified into them. Bananas, potatoes, and dried apricots are some of the sources other than green leafy vegetables, such as avocados and spinach (Golisano Children’s Hospital, 2023).

Healthy foods usually offer all the nutrients needed by our body. However, given today’s children’s eating habits, supplement containing magnesium can be considered to fulfil the daily recommended intake.

RECOMMENDED INTAKE OF MAGNESIUM

The amount of magnesium needed by the body usually depend on the age and sex. For infants aged zero to six months, it is recommended to take 30mg/day, while for infants aged seven to twelve months, it is recommended to take 75mg/day. Children aged between one to three years old, on the other hand, need 80mg/day. While, for those aged four to eight years old need 130mg/day. For adolescent aged nine to thirteen years old, they may need 240mg/day, while for boys and girls aged between fourteen to eighteen years old, need 410mg/day and 360mg/day of magnesium, respectively (RNI, 2017).

CONCLUSION

In conclusion, magnesium serves as an important mineral needed by the body for various functions. It is considered as one of the essential mineral children need for healthy growth and development. In children, magnesium may offer benefits such as to promote sleep, support neurological function, improve mood, and aid in the muscle development. Lack of magnesium in children may lead to fatigue, muscle weakness, irritability, and delayed growth and development. Thus, it is important to take healthy diet in order to make sure magnesium are taken according to the recommendation. When the intake cannot meet the recommendation, magnesium supplements may be a good idea to combat the insufficiency.

REFERENCES

Ciosek, A., Kot, K., Kosik-Bogacka, D., Łanocha-Arendarczyk, N., & Rotter, I. (2021, March 28). The Effects of Calcium, Magnesium, Phosphorus, Fluoride, and Lead on Bone Tissue. Biomolecules; Multidisciplinary Digital Publishing Institute. https://doi.org/10.3390/biom11040506

Doherty, R., Madigan, S. M., Warrington, G. D., & Ellis, J. (2019, April 11). Sleep and Nutrition Interactions: Implications for Athletes. Nutrients; Multidisciplinary Digital Publishing Institute. https://doi.org/10.3390/nu11040822

Golisano Children’s Hospital. (2023). Magnesium-Rich Foods – Pediatric Nutrition. Galisano Children’s Hospital. Retrieved October 7, 2023, from https://www.urmc.rochester.edu/childrens-hospital/nutrition/magnesium-foods.aspx

NIH. (2022, June 2). Magnesium – Fact Sheet for Health Professionals. National Institutes of Health (NIH). Retrieved October 7, 2023, from https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/#:~:text=Magnesium%20is%20a%20cofactor%20in,%2C%20oxidative%20phosphorylation%2C%20and%20glycolysis.

Patwal, S. (2023, July 18). Magnesium For Kids: Importance, Best Sources And Supplements. MomJunction. https://www.momjunction.com/articles/magnesium-rich-foods-for-your-kids_00104129/

Robberecht, H., Verlaet, A. A. J., Breynaert, A., De Bruyne, T., & Hermans, N. (2020, September 27). Magnesium, Iron, Zinc, Copper and Selenium Status in Attention-Deficit/Hyperactivity Disorder (ADHD). Molecules; Multidisciplinary Digital Publishing Institute. https://doi.org/10.3390/molecules25194440

RNI. (2017). Recommended Nutrient Intakes for Malaysia 2017. Ministry of Health (MoH). Retrieved October 7, 2023, from https://hq.moh.gov.my/nutrition/wp-content/uploads/2017/05/FA-Buku-RNI.pdf

Terri. (2021, March). Magnesium for Constipation. Michigan Medicine, University of Michigan. Retrieved October 7, 2023, from https://www.med.umich.edu/1libr/MBCP/Magnesium.pdf

INTRODUCTION

Periods of voluntary moderation from food and drink (i.e., intermittent fasting) has been practiced since earliest ancient times by peoples around the globe. Books on ethnology and religion describe a remarkable variety of fasting forms and practices. Renewed interest in fasting regimens is evidenced by an excess of popular press publications and diet recommendations (Brongers,1997).

Intermittent Fasting vs Calories Restriction

While entering the discussion about intermittent fasting, it is important to understand the difference between caloric restriction and intermittent fasting. Calorie restriction (CR) is a reduction in total caloric intake that does not result in malnutrition. This has consistently been found to result in decreased body weight and increased longevity in many species, including non-human primates. Among overweight humans, short-term CR (6-months) has been shown to significantly improve multiple cardiovascular risk factors, insulin sensitivity, and mitochondrial function. Likely due to these physiological changes, clinical trials indicate CR may have several beneficial effects among overweight adults, in addition to weight loss. However, over the past several decades, obesity intervention trials have revealed that most individuals experience difficulties sustaining daily CR for extended periods of time.

Types of Intermittent Fasting

More studies are needed to evaluate mechanisms, efficacy in humans, target populations, and safety of intermittent fasting. There are numerous intermittent fasting regimens ranging from 12- to 16-hour daily fasts to 5:2 strategy, and it remains uncertain which strategy is the best for cardiovascular health, especially with evidence suggesting that intermittent fasting regimens should follow circadian rhythms. Some of the most common ways are:

The 16:8 method

16:8 intermittent fasting method is a form of time-restricted fasting. It works by allowing consumption of foods during an 8-hour window and avoiding food or fasting for the remaining 16 hours each day. People who follows the 16:8 method abstain from taking food at night and for part of the morning and evening. During the middle of the day, they tend to consume their daily calories (NA, 2020). This method of intermittent fasting can be repeated as often as you’d like or even done once or twice. Finding the right eating and fasting windows for this method might take a few days to figure out, especially if you’re very active or if you wake up hungry for breakfast.

The 5:2 method

This approach to intermittent fasting focuses on capping your calories at 500 for two days a week. During the other five days of the week, you maintain a healthy and normal diet. On fasting days, this approach usually includes a 200-calorie meal and a 300-calorie meal. It’s important to focus on high-fiber and high-protein foods to help fill you up and keep calories low when fasting (menshealth.com, 2019)

The eat-stop-eat method

It’s a method of intermittent fasting which involves two, non-consecutive, 24 hour fasts per week. That means that two days a week, you’ll eat just one meal. Whether that’s breakfast, lunch, or dinner is up to you, and you can vary it as you wish. An example week might look like this:

Benefit of Intermittent Fasting

Help weight loss                                 

Trepanowski et al., 2017, compared the effects of alternate-day fasting vs. daily calorie restriction on weight loss, weight maintenance, and risk indicators for cardiovascular disease. This was a randomized clinical trial of obese adults (18 to 64 years of age; mean body mass index, 34) at a single-centre academic institution in Chicago. Participating individuals were randomized to one of three groups for one year: alternate-day fasting (25% of energy needs on fast days; 125% of energy needs on alternating “feast days”), calorie restriction (75% of energy needs every day), or a no-intervention control. The primary outcome was a change in body weight.

Secondary outcomes were adherence to the dietary intervention and risk indicators for cardiovascular disease. Over the course of 12 months, the control group maintained their weight around the baseline weight, while the alternate-day fasting and daily caloric restriction groups, by 6 months, both exhibited a lowest point in weight 7% below the baseline weight (not significantly different from each other before exhibiting some later weight gain, ending at 12 months approximately 4.5% below starting weight. There was a 38% dropout in the alternate-day fasting group compared to 29% in the daily calorie restriction group and 26% in the control group. Overall, the authors concluded that alternate-day fasting did not improve health beyond calorie restriction.

Help in blood sugar

There are several proposed mechanisms regarding the development of insulin resistance. One prominent theory relates to associations between increased adiposity and subsequent chronic inflammation, leading to the development of insulin resistance in tissues. Intermittent fasting can decrease adiposity and related insulin resistance through reduced caloric intake and metabolic reprogramming. Another hypothesis is that decreased energy intake, such as that achieved through intermittent fasting, will cause a prolonged decrease in insulin production and increased levels of AMPK, which likely plays a role in the improvements in insulin sensitivity and glucose homeostasis.

CONCLUSION

In summary, intermittent fasting has shown positive effects on weight loss, in addition to reducing insulin resistance and favourably shifting the levels of leptin and adiponectin. Pre-clinical and clinical studies have demonstrated that intermittent fasting has a wide range of benefits for many diseases, including obesity, T2DM, and hypertension, and in improving cardiovascular risk factors. One argument against intermittent fasting is that, despite extensive animal data, many clinical trials have failed to show as significant improvements of intermittent fasting over caloric restriction.

REFERENCES

1. Brongers HA. Instruction and Interpretation: Studies in Hebrew Language, Palestinian Archaeology and Biblical Exegesis. Belgium: Brill Academic Pub.; 1997.
2.  Kerndt P.R., Naughton J.L., Driscoll C.E., Loxterkamp D.A. Fasting: The history, pathophysiology and complications. West. J. Med. 1982;137:379–399. 
3.  Moro T, Tinsley G, Bianco A, et al. Effects of eight weeks of timerestricted feeding (16/8) on basal metabolism, maximal strength, body composition, inflammation, and cardiovascular risk factors in resistance-trained males. J Transl Med 2016;14:290
4. Nowosad K., Sujka M. Effect of Various Types of Intermittent Fasting (IF) on Weight Loss and Improvement of Diabetic Parameters in Human. Curr. Nutr. Rep. 2021;10:146–154. doi: 10.1007/s13668-021-00353-5. 
5. https://www.healthline.com/nutrition/16-8-intermittent-fasting
6. https://simple.life/blog/eat-stop-eat-plan/
7. Trepanowski J.F., Kroeger C.M., Barnosky A., Klempel M.C., Bhutani S., Hoddy K.K., Gabel K., Freels S., Rigdon J., Rood J., et al. Effect of Alternate-Day Fasting on Weight Loss, Weight Maintenance, and Cardioprotection Among Metabolically Healthy Obese Adults: A Randomized Clinical Trial. JAMA Intern. Med. 2017;177:930–938. doi: 10.1001/jamainternmed.2017.0936
8. Albosta M., Bakke J. Intermittent fasting: Is there a role in the treatment of diabetes? A review of the literature and guide for primary care physicians. Clin. Diabetes Endocrinol. 2021;7:3. doi: 10.1186/s40842-020-00116-
9. NA (2020), A Guide To 16:8 Intermittent Fasting. https://www.medicalnewstoday.com/articles/324882#summary

Introduction

Magnesium (Mg2+), is an abundant mineral in the body, plays a key role in many essential cellular processes such as:

• intermediary metabolism,
• DNA replication and repair,
• transporting potassium and calcium ions,
• cell proliferation together with signaling transduction

For children, magnesium is crucial as it helps in muscle relaxation and activation of vitamin D and calcium to help keep bones strong. In addition, magnesium plays an important role in helping:

• to regulate heartbeat
• preventing tooth decay and
• supporting the immune system when the body is under stress.

Factors that contribute to magnesium deficiency

Magnesium deficiency can be caused by a variety of circumstances, but the main cause in children is usually a poor diet management.

Magnesium is known to be depleted by stress, strenuous activity, and a diet high in refined sugar and carbs. It’s crucial to note that anxiety and stress affect children too, which causes them to regularly consume a diet high in sugar and refined carbohydrates.

Other than that, factors that can reduce the absorption of magnesium include a low protein diet, a high saturated fat diet, a prevalent western diet which leads to vitamin D deficiency, a lack of sunlight exposure and medications commonly given to children, such as antibiotics, inhaled corticosteroids, antihistamines and antacids (Magnesium: A Vital Nutrient for Children, n.d.).

Symptoms and complications of magnesium deficiency

Symptomatic magnesium deficiency in children is not very common. However, habitually low intakes or excessive losses of magnesium due to certain health conditions, and/or the use of certain medications can lead to magnesium deficiency.

Symptoms of worsened magnesium deficiency can include:

• numbness
• tingling
• muscle spasms or cramps
• severe symptoms related to irregular heartbeats and seizures (Signs and Consequences When Children Lack Magnesium | Vinmec, n.d.).

• Severe magnesium deficiency can result in hypocalcemia or hypokalemia (low serum calcium or potassium levels, respectively) because mineral homeostasis is disrupted.

• A magnesium deficiency can also affect a child’s behavior such as sadness (irritability or hyperactivity), difficulty concentrating, insomnia, and anxiety (“Diet. Ref. Intakes Calcium, Phosphorus, Magnesium, Vitam. D, Fluoride,” 1997).

When a child’s body lacks magnesium, it may affect their growth rate causing them to be underdeveloped in height and have small skeletal muscles. Besides, children with magnesium deficiency often have behavioural disorders such as aggression, depression and anxiety. Children who are deficient in magnesium are more likely to have weak muscles, experience muscle spasms, and are more prone to cramps because magnesium is involved in the process of relaxation of muscles.

Recommended intake of magnesium and source of magnesium

The amount of magnesium the body needs depends on age and gender. Based on the Recommended Nutrient Intake for Malaysia (RNI), the average recommended amount of magnesium per day according to age is as follows:

The Dietary Guidelines for Americans describe a healthy dietary pattern as one that includes a variety of vegetables; fruits; grains (at least half whole grains); fat-free and low-fat milk, yogurt, and cheese; and oils.

Whole grains and dark-green leafy vegetables are good sources of magnesium. Low-fat milk and yogurt contain magnesium as well.

Some ready-to-eat breakfast cereals are fortified with magnesium. Also, dried beans, legumes (such as soybeans, baked beans, lentils, and peanuts) and nuts (such as almonds and cashews) also provide magnesium (Magnesium – Health Professional Fact Sheet, n.d.).

Conclusion

In children, symptomatic magnesium deficiency is uncommon, but it can be triggered by habitual low intake, excessive losses due to specific health conditions, and certain medications. Early signs include loss of appetite, nausea, vomiting, fatigue and weakness. If ignored, these symptoms could become more severe and show up as tingling, numbness, muscle spasms, or even convulsions. This deficit may result in diseases like hypocalcemia or hypokalemia, which disturb the balance of minerals in the body and prevent children from growing and developing their muscles properly.

References

Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. (1997). Dietary Reference Intakes for Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride. https://doi.org/10.17226/5776

Magnesium: A Vital Nutrient for Children. (n.d.). Retrieved September 14, 2023, from https://www.printfriendly.com/p/g/pcGdNy

Magnesium – Health Professional Fact Sheet. (n.d.).

Ministry of Health Malaysia. (2005). Recommended Nutrient Intakes for Malaysia 2005. In Ministry of Health Malaysia.

SARAVANAMUTTO, K. (n.d.). MAGNESIUM DEFICIENCY IN KIDS. https://www.nourishedbeginnings.ca/blog1/magnesium-deficiency-in-kids-what-you-should-know#:~:text=Yes%2C deficiency can also impact,the behaviours above (7)

Signs and consequences when children lack magnesium | Vinmec. (n.d.).