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Diabetes – What should I eat?

 

Living with diabetes does not have to mean feeling deprived. People can learn to balance meals and make healthy food choices while still including the foods they enjoy. Both sugary and starchy carbohydrates can raise blood sugar levels, but people can choose to include these foods in the right portions as part of a balanced meal plan.

1. Green leafy vegetable

Green leafy vegetables are packed full of essential vitamins, minerals, and nutrients. They also have minimal impact on blood sugar levels. They are also low in digestible carbs, or carbs absorbed by the body, so they will not significantly affect blood sugar levels.

Leafy greens, including spinach and kale, are a key plant-based source of potassium, vitamin A, and calcium. They also provide protein and fiber.

Some researchers say that eating green leafy vegetables is helpful for people with diabetes due to their high antioxidant content and starch-digesting enzymes.

2. Whole Grains


Whole grains contain high levels of fiber and more nutrients than refined white grains. Eating a diet high in fiber is important for people with diabetes because fiber slows down the digestion process. Slower absorption of nutrients helps keep blood sugar levels stable.

Whole wheat and whole grains are lower on the glycemic index (GI) scale than white bread and rice. This means that they have less of an impact on blood sugar.

Good examples of whole grains to include in the diet are:

  • brown rice
  • whole-grain bread
  • whole-grain pasta
  • buckwheat
  • quinoa

People can swap white bread or white pasta for whole-grain options.

According to a recent study, it is shown that consuming 4 servings of whole grains per day can reduce the risk of developing pre-diabetes by up to 30%. Meanwhile, other research shows that if people consume whole grains daily, they also experience less inflammation, in return lowering the odds of developing insulin resistance, high blood pressure, and heart disease.

3. Fatty Fish


Some people consider fatty fish to be one of the healthiest foods on the planet.

Salmon, sardines, herring, anchovies, and mackerel are great sources of the omega-3 fatty acids DHA and EPA, which have major benefits for heart health.

Getting enough of these fats on a regular basis is especially important for people with diabetes, who have an increased risk for heart disease and stroke.

DHA and EPA protect the cells that line your blood vessels, reduce markers of inflammation, and may help improve the way your arteries function

Research indicates that people who eat fatty fish regularly have a lower risk for acute coronary syndromes, like heart attacks, and are less likely to die from heart disease

Studies show that eating fatty fish may also help regulate your blood sugar.

A study in 68 adults with overweight and obesity found that participants who consumed fatty fish had significant improvements in post-meal blood sugar levels, compared with participants who consumed lean fish.

Fish is also a great source of high-quality protein, which helps you feel full and helps stabilize blood sugar levels. For the vegetarian option, people can eat seaweed, such as kelp and spirulina, as plant-based alternative sources of these fatty acids.

4. Beans

Beans are cheap, nutritious, and super healthy.

Beans are a type of legume-rich in B vitamins, beneficial minerals (calcium, potassium, and magnesium), and fiber.

They also have a low glycemic index, which is important for managing diabetes.

Also, beans may help people manage their blood sugar levels. They are a complex carbohydrate, so the body digests them slower than it does other carbohydrates.

Eating beans can also help with weight loss and could help regulate a person’s blood pressure and cholesterol.

In a study involving more than 3,000 participants at high risk for cardiovascular disease, those who had a higher consumption of legumes had a 35 percent reduced chance of developing type 2 diabetes.

5. Nuts


Nuts are another excellent addition to the diet. Like fish, nuts contain healthy fatty acids that help keep the heart-healthy.

Walnuts are especially high in omega-3 fatty acids called alpha-lipoic acid (ALA). Like other omega-3s, ALA is important for good heart health.

Walnuts also provide key nutrients, such as protein, vitamin B-6, magnesium, and iron.

People with diabetes may have a higher risk of heart disease or stroke, so it is important to get these fatty acids through the diet.

A 2019 study involving over 16,000 participants with type 2 diabetes found that eating tree nuts — such as walnuts, almonds, hazelnuts, and pistachios — lowered their risk of heart disease and death.

Research also indicates that nuts can improve blood glucose levels.

A study in subjects with type 2 diabetes found that consumption of walnut oil daily improved blood glucose levels.

This finding is important because people with type 2 diabetes often have elevated levels of insulin, which are linked to obesity.

6. Probiotics

                                                                            
                                      Probiotics are the helpful bacteria that live in the human gut and improve digestion and overall health.

Some research from 2011 suggested that eating probiotic yogurt could improve cholesterol levels in people with type 2 diabetes. This could help lower the risk of heart disease.

One review study suggested that consuming probiotic foods may reduce inflammation and oxidative stress, as well as increase insulin sensitivity.

People can choose a natural yogurt, such as Greek yogurt, with no added sugar. A probiotic yogurt will contain live and active cultures called Lactobacillus or Bifidobacterium.

A long-term study involving health data from over 100,000 participants found that a daily serving of yogurt was linked to an 18 percent lower risk of developing type 2 diabetes.

It may also help you lose weight if that is a personal goal.

Studies show yogurt and other dairy foods may lead to weight loss and improved body composition in people with type 2 diabetes.

The high levels of calcium, protein, and a special type of fat called conjugated linolic acid (CLA) found in yogurt may help reduce your appetite, making it easier to resist unhealthy foods.

What is more, Greek yogurt contains only 6–8 grams of carbs per serving, which is lower than conventional yogurt.

It is also higher in protein, which may promote weight loss by reducing appetite and decreasing calorie intake.

The Bottom Line

People with diabetes can work with their healthcare professionals to devise a personal nutrition plan.

Eating a healthful, balanced diet including the foods listed above can help people with diabetes manage their condition and prevent complications by:

  • controlling their blood sugar levels
  • lowering inflammation
  • lowering the risk of heart disease
  • increasing antioxidant activity
  • reducing the risk of kidney disease

When diabetes is not managed, it increases your risk for several serious diseases.

Just remember, although these foods may help manage blood sugar, the most important factor in healthy blood sugar management is following an overall nutritious, balanced diet.

Diabetes


What is Diabetes?

You may have heard that diabetes is a silent killer, because it takes away your life, parts by parts. The prevalence of diabetes has became worse as the year goes by as a recent survey from Health Ministry showed that nearly one in five Malaysian adults, or 18.3%, has diabetes.

Diabetes is a health disorder in when our body does not produce enough or respond normally to insulin, resulting in a buildup of extra sugar in our bloodstream.

What is Insulin?

Insulin is a type of hormone released from the pancreas that regulates the amount of glucose in the blood by helping the glucose to move from the blood into the cells.

Types of Diabetes

 Type 1 DiabetesType 2 Diabetes
What is happening?Caused by autoimmune disease when the pancreas produces too little or no insulinPancreas produces insulin, but the body doesn’t respond normally to the insulin produced.
Age of onsetChildhoodAdulthood
Risk  factorNo known cause, and there is no way to reverse or cure it. Not associated with excess body weight, some affected patients might even be underweight.Commonly associated with poor lifestyle and diet, such as excess body weight, age, physical inactivity, race and ethnicity, family history and poor control of blood lipid profile.
ManagementRequired insulin therapyCan be managed by lifestyle modification such as diet and exercise if diagnosed early. Medication can be prescribed by doctor.
Cure and preventionCannot be preventedCan be prevented by lifestyle changes

Diabetes Diagnosis

Pancreas is a gland located behind the stomach in the upper left abdomen. Pancreas will release insulin as sugar metabolism. Insulin plays an important role in keeping blood glucose level within a healthy normal range. Thus, some tests can be conducted to check whether you are diabetic. Following tests are available at pharmacy:-

  1. Glycosylated Hemoglobin (HbA1C) measures your average blood glucose level for the past 3 months. It measures how much of glucose attached to your Hb (hemoglobin) as our Hb only lives for about 3 months. This test is shown to have higher sensitivity of identifying risk of diabetes. Reduction of HbA1C significantly reduces diabetes complications. HbA1C should always be less than 6.5%.
  2. Fasting Plasma Glucose (FPG) measures blood glucose level after fasting for at least 8 hours. It is usually done in the morning without breakfast; only plain water is allowed. Fasting glucose level should be below 5.6 mmol/L.
  3. Random Plasma Glucose (RPG) measures the blood glucose level at anytime of the day. RPG should be less than 8.0 mmol/L.

Symptoms of Diabetes


Sources: Accu-chek.co.uk/sign and symptoms of diabetes

The common term to remember is The 3 P’s of Diabetes, which is

  1. Increased hunger (Polyphagia) – The feeling of hunger that is not easily satisfied.
  2. Increased thirst (Polydipsia) – most likely as a result of frequent urination.
  3. Frequent urination (Polyuria) – result  from increased renal activity as kidneys need to filter out excess sugar in the blood.

Furthermore, diabetes also comes with other symptoms such as tired/fatigue, nausea, numbness and tingling of hand and feet, blurred vision, sudden weight lost, sexual problem and slow healing of wound.

Complications of diabetes

Complications of diabetes are the most worrying part in diabetes as the symptoms will develop gradually. Over time, uncontrolled blood glucose level results in the higher risk to get the complications. Eventually, it may disable and even life threatening.  

  1. Nerve Damage (Diabetic neuropathy) – High blood sugar can injure the wall of tiny blood capillaries that nourish your nerves throughout your body. It can cause pain, numbness, burning or tingling sensation, especially on your legs. When one nerve is damaged, it is gradually spread to multiple neurons.  Thus cause alteration of functional organ in body can result in problem such as nausea, vomiting, constipation or diarrhea. For men, glucose damage the nerve which blood supply to penis, thus cause erectile dysfunction.
  • Kidney Damage (Diabetic Nephropathy)- Diabetes can damage your kidney due to kidney need to consistently wash away the glucose in your bloodstreams. The damaged kidney become leaky and let protein enter to your urine. It can progress to irreversible end-stage kidney diseases or kidney failure. This may require dialysis or kidney transplant on later stage.
  • Eye Damage (Diabetic Retinopathy)- Diabetes damage the small capillaries in your retina, cause it to break down (hemorrhage), which potentially cause vision loss or blindness. It also increases risk of developing other eyes problem such as glaucoma and cataracts. 
  • Cardiovascular disease – if you have diabetes, you are more risk to heart disease, including chest pain (angina), heart attack and narrowing of arteries (arteriosclerosis) and even stroke.  
  • Diabetic foot– Nerve damage to feet increases various foot complications. Infection from cuts and blister often occur due to poor wound healing. Diabetes may cause you more susceptible to skin problem, which will worsen the condition. Left untreated, this infection may require amputations.

Lifestyle Modification

  1. Low GI ( Glycemic Index) food– The amount and type of carbohydrate consumed will affect the blood glucose level after meals. We can plan a meal with low GI food. GI tells us a how quickly a food raise our blood glucose. GI is ranged from 0 to 100, tested by pure glucose. GI with less than 55 is considered low and it is useful to help manage glucose level. Some diabetic nutritional drink can be used as a meal replacement for diabetic individual. Other than that, good sources of carbohydrate include fruits, vegetables, whole grains, legumes can be added. Increase fiber intake and whole grain food helps in increasing insulin sensitivity and thus overcome insulin resistance. You should also get good vitamins and minerals from healthy and balance diet.
  • Artificial Sweetener– Diabetic individual should limit or avoid sugar sweetened beverages. It is a good start to swap sugary drink, energy drink, fruit juice into water, plain milk, tea and coffee. You may always try out low or zero-calories artificial sweetener as substitutes to control your blood glucose level. 
  • Cut down alcohol intake– Alcohol is high in calories that will spike up your glucose level.  It should be limited to1 drink per day (women) and less than 2 drink per day (men).
  • Eat less salt and processed food – Salt and processed food can increase risk of hypertension, which later leads to cardiovascular disease. Sodium intake should be less than 1 teaspoon per day. You can change your diet to omega-3 rich fatty acid food. EPA and DHA have beneficial effect on preventing heart disease.
  • Quit smoking– Smoker are likely to develop diabetes compare to non-smoker. Nicotine replacement therapy can be considered to make it easier to quit. The faster you quit, the faster the body start to heal.
  • Exercise regularly– being more physically active help to control your diabetes. When our muscles work, they take in glucose from the blood, liver and muscle. It improves cardiovascular risk, improve muscle strength, and contribute to weight loss.
  • Weight Management– You should be able to find out your Body Mass Index (BMI). Body Mass Index is a simple calculation using a person’s height and weight. The formula is BMI = kg/m2 where kg is a person’s weight in kilograms and m2 is their height in metres squared. A BMI of 25.0 or more is overweight, while the healthy range is 18.5 to 24.9. BMI applies to most adults 18-65 years. In addition to BMI, other physical measurements, such as body fat percentage, distribution of body fat and waist circumference, are important methods of assessing overweight and obesity. Modest weight loss of 10% over 6 months may improve glucose level responds.
  • Foot care – People with diabetes are prone to have skin infections, including bacterial and fungal infection. Performing daily foot inspection and care is very important in avoiding serious foot complications. It is also necessary to perform regular checking of wound or infection that does not heal. With proper foot care, it is estimated that as half of the foot and leg amputation can be prevented.

References

  1. American Diabetes Association. (n.d.). Understanding A1C: Diagnosis. https://www.diabetes.org/a1c/diagnosis
  2. Carbohydrates and the glycaemic index. (2020, March 16). Betterhealth. Retrieved July 24, 2021, from https://www.betterhealth.vic.gov.au/health/healthyliving/carbohydrates-and-the-glycaemic-index#bhc-content
  3. Diabetes Mellitus. (n.d.). MIMS. Retrieved July 24, 2021, from https://specialty.mims.com/diabetes%20mellitus/patient%20education
  4. Diabetes Signs. (2019, January 15). Diabetes.co.uk. Retrieved July 23, 2021, from https://www.diabetes.co.uk/The-big-three-diabetes-signs-and-symptoms.html
  5. Diabetes. (2020, October 30). Mayoclinic. Retrieved July 23, 2021, from https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444
  6. Dionardo, M. J. (2021, May 15). 6 Lifestyle Changes to Control Your Diabetes. WebMD. https://www.webmd.com/diabetes/diabetes-lifestyle-tips
  7. Ministry of Health Malaysia. (2020). Clinical practice guidelines: Management Of Type 2 Diabetes Mellitus (6th ed.). Retrieved from https://www.moh.gov.my/

Amalan Pemakanan Yang Sihat Di Bulan Puasa

Puasa Ramadan ertinya menahan diri daripada makan dan minum serta segala perbuatan yang boleh membatalkan puasa, mulai dari terbit fajar sehinggalah terbenam matahari pada bulan Ramadan.


Pada bulan Ramadan, umat Islam akan menahan lapar dan dahaga lebih daripada 12 jam sehari. Oleh itu, mereka yang berpuasa perlu menggunakan dua waktu makan yang dibenarkan sehari iaitu sahur dan iftar dengan sebaik mungkin.

Penghidratan adalah salah satu risiko yang dihadapi semasa berpuasa kerana cuaca yang panas dan lembap. Ramai yang mengalami sakit kepala dan masalah untuk menumpukan perhatian semasa berpuasa. Tabiat pemakanan yang berbeza dalam 30 hari berpuasa boleh mengakibatkan pelbagai masalah penghadaman, sakti gastrik dan sembelit. Ketidakhadaman juga boleh berlaku akibat makan terlalu banyak daripada biasa semasa berbuka.

Namun begitu, daripada menambahkan jumlah makanan semasa berbuka atau sahur, lebih baik bagi anda memilih jenis dan kualiti makanan yang sesuai dimakan supaya kesan-kesan negatif berpuasa di bulan Ramadan boleh dielakkan.
Mari lihat jenis makanan yang sesuai dimakan sewaktu sahur dan berbuka untuk meningkatkan tenaga anda.


1) Kekalkan Hidrasi dengan Makanan yang Mempunyai Kandungan Air yang Tinggi

Selain daripada minum air kosong, anda boleh mengambil makanan yang tinggi dengan kandungan air seperti tembikai merah, timun, tomato dan strawberi.
Elakkan minuman yang mengandungi kafein seperti kopi dan teh kerana kafein boleh menambah pembuangan air kencing dan menyebabkan air dalam badan kita kurang.


2) Makanan Tinggi Protein

Makanan tinggi protein boleh membantu anda kurang penat sepanjang hari. Protein mengambil masa lebih lama untuk hadam dan anda akan merasa kenyang untuk tempoh masa yang panjang. Telur, keju, ayam dan daging adalah pilihan yang baik.
Susu tepung seperti MK Nutrasure dan Ensure Gold Liquid sesuai untuk diambil semasa bulan puasa kerana kandungan protein yang lebih tinggi berbanding susu tepung yang lain.


3) Makanan yang Tinggi Kandungan Kanji dan Serat

Makanan berserat tinggi boleh membantu mengawal ketidakhadaman dan pedih ulu hati. Anda boleh cuba oat, bijirin tinggi serat dan roti gandum penuh kerana ia boleh membantu anda merasa kenyang untuk tempoh masa yang lebih panjang.
Karbohidrat kompleks dalam makanan berkanji seperti nasi perang, dan kentang adalah pilihan yang bagus untuk tenaga dan mampu meningkatkan tumpuan. 

4) Penghadaman yang Lancar dengan Buah-buahan dan Sayur-sayuran

Untuk mengatasi masalah sembelit, kurangkan pengambilan makanan yang berlemak, bergoreng dan pedas sewaktu sahur. Anda boleh meningkatkan pengambilan buah-buahan dan sayur-sayuran kerana ia kaya dengan serat dan boleh mengelakkan sembelit. Amalkan brokoli, sayur bayam, keledek, lentil dalam pemakanan.


5) Pilih Lemak dan Minyak yang Sesuai

Lemak yang baik memainkan peranan yang penting dalam diet seimbang. Makanan yang kaya dengan lemak sihat seperti salmon, zaitun dan kacang-kacang boleh dirangkumi dalam pemakanan anda. Selain itu, minyak yang digunakan untuk memasak juga sangat penting. Anda boleh menggunakan minyak kepala dara, minyak dedak beras dan lain-lain.


6) Berbuka Puasa dengan Kurma

Kurma secara tradisinya dimakan pada permulaan iftar kerana ia mengandungi gula semula jadi, serat dan mineral. Selain itu, kurma mudah dicerna, menjadikannya sumber tenaga dan nutrien yang cepat bagi individu yang berpuasa.

7) Supplemen

Selain pemakanan yang sihat, supplemen dan minuman sihat adalah sumber vitamin dan mineral yang bagus.
Individu yang mempunyai masalah gastrik atau ketidakhadaman boleh mengambil probiotik untuk mengurangkan senak dan kembung yang disebabkan oleh perubahan tabiat makan secara tiba-tiba. Probiotik boleh membantu menyeimbangkan semula mikroflora normal dalam sistem pencernaan dan megurangkan risiko gastrik.

Susu tepung seperti MK Glucerwin, MK Colostrum, Ensure Gold Liquid, Glucerna membekalkan nutrisi yang lengkap dan membekalkan makro- dan micro-nutrien yang diperlukan oleh badan kita. Susu tepung adalah pilihan alternatif yang sesuai untuk Muslim yang berpuasa sebagai makanan penggantian pada waktu sahur atau iftar.

Bagi individu yang tidak gemar susu tepung atau minuman sihat, multivitamin adalah pilihan terbaik semasa bulan puasa. Multivitamin bukan hanya membekalkan vitamin dan mineral yang lengkap, ia juga membantu membekalkan tenaga untuk badan kita sepanjang tempoh
berpuasa. Oleh itu, multivitamin adalah penting pada bulan puasa untuk menambahkan balik vitamin dan mineral yang diperlukan untuk seharian.

Perlu diingatkan bahawa kesederhanaan adalah kunci untuk pemakanan sihat. Selain itu, kita juga harus mengamalkan pergerakan fizikal yang aktif, contohnya, dengan berjalan-jalan atau berjoging setiap hari. Pemakanan yang sihat adalah penting dan harus diamalkan selalu bukan sahaja pada bulan puasa! Dengan ini, kami mengucapkan selamat berpuasa kepada semua orang!

Intermittent Fasting


Intermittent fasting is a dietary approach that involves interspacing planned periods of fasting with regular eating. It is an eating pattern that cycle between periods of eating and    fasting. It focuses more on when to eat rather than what to eat.

Intermittent fasting works by prolonging the period when the body has burned through the calories consumed from the last meal and begins to burn fat. The body will use up its sugar stores and starts to burn fat after hours of fasting, this process is known as metabolic switching.

Benefits of Intermittent Fasting

Help Lose Weight and Visceral Fat

Intermittent fasting can support hormone function to facilitate weight loss. Lower insulin levels, higher Human Growth Hormone (HGH) levels, and increased amounts of noradrenaline can assist in the breakdown of body fat and facilitate its use for energy. Because of this, fasting actually increases the body metabolic rate and eventually help to burn more calories. According to a 2014 review of the scientific literature, intermittent fasting can cause weight loss of 3–8% over 3–24 weeks.

Lowering risk for Type II Diabetes

Intermittent fasting has been shown to have major benefits for insulin resistance, leading to an impressive reduction in blood sugar levels. In human studies on intermittent fasting, fasting blood sugar has been reduced by 3–6% over the course of 8–12 weeks in people with prediabetes. Fasting insulin has been reduced by 20–31%.

Beneficial for Heart Health

Intermittent fasting improves heart health by controlling the risk factors that lead to heart diseases. The risk factors include blood sugar levels, blood pressures, cholesterol levels and inflammatory markers.

Improve Sleep

Research suggests that intermittent fasting may improve sleeping quality by reinforcing the circadian rhythms.

Types of Intermittent Fasting

Time-Restricted Fasting (16/8 method)

The 16/8 method involves choosing of an eating window (about 8 hours) everyday and fast during the remaining 16 hours. It is also known as the Leangains protocol and can be very simple as we only have to skip our breakfast and not eating anything after dinner.

The easiest way to practice 16/8 method is to choose a 16-hours fasting period which include the time we spent sleeping. For example:

  • 9 a.m. to 5 p.m.
  • 10 a.m. to 6 p.m.
  • 12 a.m. to 8 p.m.

Fast Diet (5:2 method)

It involves eating normal diet 5 days a week and restricting the calorie intake to 500 – 600 in the other 2 days. During the fast, the calorie intake is limited to 500 for women and 600 for men respectively.

For example, we may have normal diet every day of the week except Friday and Saturday. For those 2 days, we can eat 2 or 3 small meals with total calories not exceeding the limit.

Eat Stop Eat

Following this method, one has to practice a 24-hours fast once or twice per week. Important tip here is to eat responsibly after the fast. Eating responsibly refers to eating normal diet where we don’t binge because we just fasted, but we also don’t restrict ourselves with an extreme diet (eating more or less than we need).

For example, if we finish our dinner at 7p.m., then the next meal should be on 7.pm. the next day. By this, we have completed a 24-hours fast. Water, coffee, and zero-calories beverages are allowed during this period to help with the fast.

This method may be difficult for many people to follow. However, we can start with 14 hours fast and slowly increase to 24 hours.

Alternate Day Fasting

There are several different versions of this method. Some of them allow 500 calories (about 25% of calorie need) during the fast and eat normally during the non-fasting days. A full fast every other day can be rather extreme and is not recommended to beginners.

Fasting Tips

  1. Drink cinnamon tea during the fast to help suppress the appetite.
  2. Exercise just before or during the eating window.
  3. Meditation during the fasting period to pass the hunger pangs.
  4. Practice balance and healthy diet.
  5. Always check with your primary care provider before starting any restrictive eating plan.

Who Should Avoid Intermittent Fasting

  1. Teenagers under 18 years old.
  2. Pregnant or breastfeeding women.
  3. People with diabetes mellitus.
  4. People with eating disorders such as anorexia.

References

  1. Mosley M, Spencer M. The FastDiet: Lose Weight, Stay Healthy, and Live Longer with the Simple Secret of Intermittent Fasting. Atria Books. 2013
  2. Williams KV, Mullen ML, Kelley DE, Wing RR. The effect of short periods of caloric restriction on weight loss and glycemic control in type 2 diabetes. Diabetes Care. 1998;21:2–8.
  3. Varady KA, Bhutani S, Klempel MC, et al. Alternate day fasting for weight loss in normal weight and overweight subjects: a randomized controlled trial. Nutr J. 2013;12:146.
  4. LeCheminant JD, Christenson E, Bailey BW, Tucker LA. Restricting night-time eating reduces daily energy intake in healthy young men: a short-term cross-over study. Br J Nutr. 2013;110:2108–2113.
  5. Ekmekcioglu C, Touitou Y. Chronobiological aspects of food intake and metabolism and their relevance on energy balance and weight regulation. Obesity Reviews. 2011;12:14– 25.

Superfood


Superfood is a term that is commonly used to describe foods that offers multiple health benefits through its nutrient contents, beyond providing energy. Consumption of these foods is linked with disease prevention and improved quality of life.

The idea of superfoods offers longevity and vitality has long been described in various cultures. Recent findings on essential fatty acids, dietary fibers, essential micronutrients and antioxidants make them the main substances related to superfoods.

Superfood such as Omega-3 and Omega-6 fatty acids must be obtained in diet as the human body does not produce them naturally. Better known types of omega-3 fatty acids, Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are mainly associated with benefits for the heart. They reduce inflammation, improve blood flow, prevent formation of fat deposit in blood vessel, and reduce triglyceride levels. Consuming a diet enriched with EPA and DHA can lead to less frequent and milder headache in patients with migraine, while moderate intakes may also delay cognitive function decline in elderly men. Some studies suggest that dietary interventions combined with pharmacological treatments might have an additive benefit in prevention of such condition.

Micronutrients are vitamins and minerals which are consumed in small quantities but are nonetheless essential for physical and mental development. There is a long list of essential micronutrients, however the ones that are particularly deficient in diets include iron, zinc, calcium, iodine, vitamin A, B-vitamins, and vitamin C. Effects of these micronutrient deficiency includes night blindness, eyesight problems, anemia and stunted growth.

Some superfoods confer benefit to digestive health via dietary fibers. These includes soluble fibers (inulin) and non-digestible carbohydrates (oligosaccharides), better known as prebiotics that helps nourish microflora in the intestines. Insoluble fibers help with bowel movement, reduces risk of intestinal diseases and helps in weight control.

Phytochemicals found in plants provide their colors and characteristic smell. There are multiple different types of known phytochemicals which includes tannins, flavonoids, and saponins. These chemicals are produced by plants for their own benefit and do not have nutritional value for human. Yet, they have been found to provide multiple health benefits via antioxidant properties, hailed for preventing cancer, protecting cells from damage, and reducing signs of ageing.

Goji

One popular example of superfood would be the Goji berry, originating from China. Also known commonly as Wolfberry, they contain phytochemicals zeaxanthin dan carotene which are important in maintaining healthy eyesight. They can be taken as part of the diet, providing energy through complex sugar and protein contents. Carbohydrates betaine, cerebroside, beta-sitosterol in Goji berry help counter nerve damage in neurodegenerative diseases and protect the eyes from glaucoma –both are important especially in ageing populations.

Wholegrain

A lot of wholegrains have also been discussed to have superfood property. An analysis of more than 3000 middle- and older-aged American adults over years indicates taking more whole grains in diet may protect against heart disease. Person who ate at least 3 servings of whole grains daily had smaller increases in blood sugar levels, blood pressure, and waist size compared with persons who ate less than one-half serving per day.

An excellent example of super grain is Quinoa. It provides a rich supply of protein, dietary fibers, several B vitamins, dietary minerals, magnesium, phosphorus, and manganese. Quinoa seeds also have low glycemic index, it provides energy source in small, lasting amount, which makes it a good staple food item. Raw quinoa seeds provide polyphenols at a higher level compared to many fruits and vegetables. Polyphenols are known to have powerful anti-inflammatory benefits for the body, and it is believed that they could help to reduce the risk of some cancers, cardiovascular disease and other illnesses too. Indigestible carbohydrate fibres called oligosaccharides found in the grain act as prebiotic, they provide nutrients for intestinal microflora.

Pumpkin

Pumpkin, a fruit that is more nutritionally similar to vegetables, is a filling, nutrient-dense food with multiple health benefit. It’s very high in antioxidants, such as alpha-carotene, beta-carotene and beta-cryptoxanthin. These can neutralize free radicals, stopping them from damaging human cells. High content of vitamins A, C, and E, iron and folate help strengthen immunity. Pumpkins’ high vitamin A, lutein and zeaxanthin contents can protect the eyes against sight loss, which becomes more common with age. Pumpkin is also a good source of fiber and helps suppress appetite. It has mildly diuretic property, eating a lot of pumpkin may induce a “water pill”-like reaction, increasing the amount of water and salt the body expels through urine. This is particularly beneficial for people concerned with their blood pressure.

Beetroot

The beetroot is the taproot portion of a beet plant, one of several cultivated varieties of Beta vulgaris. Beetroot had been used as part of traditional remedy for multiple health benefits, particularly relating to blood and heart health. Studies have shown that beetroot juice can modestly help reduce blood pressure. Beetroot can be eaten raw, used for juice extraction, baked or boiled. Polyphenols and dietary fiber in red beetroot juice helps diminish blood cholesterol level by stimulating excretion of cholesterol in intestines. It has also been studied to stop weight gain and reduce cholesterol in obese individuals. Beetroot is rich in soluble dietary fiber that provide moderate increase in blood sugar level post-meal, and especially beneficial in pre-diabetic.  Regular consumption as part of diet also appears to positively influence physiological response to exercise. Therefore, beet root is an especially valuable super food for people concerned with their body weight and cardiovascular risks.

Although a lot of superfoods are from plant origin, fatty fishes are one of the exceptions. They provide essential proteins not commonly found in plants, which the human body use for energy production, growth, and repair. Fatty fishes found in cold water such as salmon, trout, and sardines contain higher level of omega-3 fatty acids compared to their warm-water counterparts. These benefits are however offset by risk of heavy metal contamination in larger fish. Thus, it is only recommended to take one to two servings of the fish weekly.

To get the best result from superfoods, is it best to consume them raw, cooked, or processed? The answer depends on which superfood one is referring to. In general, taking them as closely to their natural form is preferable to retain its nutrients. Juicing of beetroots, natural drying of goji berries, and removing the outermost shell of quinoa helps improve palatability and ease consumption. However, excessive consumption beyond dietary recommendation exposes to other risks. Red beet root, for example, accumulates oxalic acid responsible for causing kidney stones. Larger fatty fish may also have heavy metal content in their muscle tissue and may adversely affect some populations proportionately. In these cases, taking pre-processed food or supplements focusing on their benefit may be the wiser choice.

Most of the studies that display theoretical health benefits of these food products would use extracts in laboratory. In experimental studies, the method to gain the extract themselves are usually more vigorous than is possible in human digestive system. Therefore, a lot of the supporting studies may overestimate or underestimate the actual health benefit when we consume the food as part of our diet.

It is also important to note that phytochemical content may vary among species, cultivation method, and food handling prior to consumption. The magnitude of potential risks that may be associated with phytochemicals is still unclear, especially when taken in large doses as supplements. These extracted substances may have possible side effects or may interact with other substances in the body, e.g., medications. There are only few documented cases suggesting that certain phytochemicals may also be harmful. For instance, some studies have shown that overdosing on beta-carotene may increase the risk of lung cancer in smokers. Therefore, you should always speak to your healthcare provider before taking phytochemical supplements. Taking it as functional food in moderation is probably safer in the long run.

To quote the 2021 Dietary Guidance to Improve Cardiovascular Health scientific statement, developed under chair of the American Heart Association’s writing group, one can improve cardiovascular health and reduce cardiovascular risk with an emphasis on dietary patterns and food-based guidance beyond naming individual foods or nutrients. It is important to first emphasize on balanced diet, and to take superfoods strategically to enrich our nutrient consumption.

References

  1. Quinoa – Wikipedia [Internet]. En.wikipedia.org. 2022 [cited 18 April 2022]. Available from: https://en.wikipedia.org/wiki/Quinoa
  2. 9 Super Grains With Health Benefits You Need to Try [Internet]. HubPages. 2022 [cited 18 April 2022]. Available from: https://discover.hubpages.com/health/Super-Grains-Your-Guide-To-The-Newest-Hollywood-Superfoods
  3. Superfoods or Superhype? [Internet]. The Nutrition Source. 2022 [cited 18 April 2022]. Available from: https://www.hsph.harvard.edu/nutritionsource/superfoods/
  4. Barsby J, Cowley J, Leemaqz S, Grieger J, McKeating D, Perkins A et al. Nutritional properties of selected superfood extracts and their potential health benefits. PeerJ. 2021;9:e12525.
  5. The Role of Proteins, Fats and Carbohydrates in Our Diet and Health [Internet]. Healthpedian.org. 2022 [cited 18 April 2022]. Available from: https://www.healthpedian.org/the-role-of-proteins-fats-and-carbohydrates-in-our-diet-and-health/
  6. Omega-3-enriched diet cuts headache days | Latest news for Doctors, Nurses and Pharmacists | Pharmacy [Internet]. MIMS News. 2022 [cited 4 April 2022]. Available from: https://specialty.mims.com/topic/omega-3-enriched-diet-cuts-headache-days-in-migraine-
  7. Kendall C, Esfahani A, Jenkins D. The link between dietary fibre and human health. Food Hydrocolloids. 2010;24(1):42-48.
  8. Ritchie H, Roser M. Micronutrient Deficiency [Internet]. Our World in Data. 2022 [cited 3 February 2022]. Available from: https://ourworldindata.org/micronutrient-deficiency?utm_medium=syndication&utm_source=scribd#hidden-hunger-index
  9. Goji berries a potential arsenal against age-related macular degeneration | Latest news for Doctors, Nurses and Pharmacists | Multidisciplinary [Internet]. MIMS News. 2022 [cited 18 April 2022]. Available from: https://specialty.mims.com/topic/goji-berries-a-potential-arsenal-against-age-related-macular-degeneration?channel=multi-specialty&utm_medium=email&_hsmi=202393192&_hsenc=p2ANqtz-9bZXdq_h6_uBQH5DFoIcHXH-iS6Za-A0TknP3rGbXfJvYHIX78OtHoVU4MvlP-E88nUmrjbXdxANrUdkqdI0dmHTgCVQ&utm_content=202393192&utm_source=hs_email
  10. Phytochemicals and their Potential Health Benefits [Internet]. Healthpedian.org. 2022 [cited 18 April 2022]. Available from: https://www.healthpedian.org/phytochemicals-and-their-potential-health-benefits/
  11. Sawicki C, Jacques P, Lichtenstein A, Rogers G, Ma J, Saltzman E et al. Whole- and Refined-Grain Consumption and Longitudinal Changes in Cardiometabolic Risk Factors in the Framingham Offspring Cohort. The Journal of Nutrition. 2021;151(9):2790-2799.
  12. Barsby J, Cowley J, Leemaqz S, Grieger J, McKeating D, Perkins A et al. Nutritional properties of selected superfood extracts and their potential health benefits. PeerJ. 2021;9:e12525.
  13. Saravanan V, Manokaran S. Physico-chemical studies and evaluation of diuretic activity of <i>Cucurbita maxima</i>. Bangladesh Journal of Pharmacology. 2012;7(4).
  14. Beetroot – Wikipedia [Internet]. En.wikipedia.org. 2022 [cited 18 April 2022]. Available from: https://en.wikipedia.org/wiki/Beetroot
  15. Siervo M, Lara J, Ogbonmwan I, Mathers J. Inorganic Nitrate and Beetroot Juice Supplementation Reduces Blood Pressure in Adults: A Systematic Review and Meta-Analysis. The Journal of Nutrition. 2013;143(6):818-826.
  16. Vega C. What Is a Heart-Healthy Diet? American Heart Association Weighs in With New Dietary Recommendations. Presentation presented at; 2021; Medscape.org.

SACHA INCHI OIL: NUTRITIONAL CONTENT & ITS HEALTH BENEFIT


According to National Health and Morbidity Survey (NHMS 2019), about 1.7 million individuals in Malaysia are at risk of suffering from 3Hs, namely hypertension, hyperlipidemia (high cholesterol) and hyperglycemia (diabetes) which leads to cardiovascular disease. It is well known that cardiovascular disease is the leading cause of death in Malaysia.

Plukenetia volubilis L. (family Euphorbiaceae), commonly known as Sacha Inchi, Inca peanut or mountain peanut has been adopted as a food source due to its high nutritional value and potential benefits for human health. Sacha Inchi is used as a traditional remedy and in recent years has been introduced to cosmetics and dietary supplementation markets successfully.

Content of Sacha Inchi

Medicinal applications of Sacha Inchi have been discussed for a variety of diseases. Besides its cholesterol and blood pressure lowering properties, it is presumed that Sacha Inchi may promotes health improvements in diabetic, arthritis, cancers (breast cancer, prostate carcinoma) and in certain cases of psychological disorders patients. Due to its recognized high content of essential fatty acids, phenolic compounds and vitamin E, Sacha Inchi provides antioxidant properties, hypolipidemic, immunomodulation and emollient activity, as well as capacity to remove heavy metals from aqueous solutions.

Sacha inchi has been known to be rich in unsaturated fatty acids. Its seed contains:

  1. Polyunsaturated fatty acids like α-linolenic (ALA) and linoleic (LA), bases of ω-3 and -6, respectively, γ- and δ-tocopherols,
  2. Natural forms of vitamin E, known for its antioxi­dant activity and antitumor potential.

Essential fatty acids in the form of omega 3 and omega 6 contained in sacha inchi oil are 50.5% and 34.1% respectively, while the protein content in Sacha Inchi is 22-30%. These biomolecules are involved in immune functions, where it helps in mediating inflamma­tory response. Intake of omega-3 fatty acids from other sources is widely used to lower high blood triglyceride levels which positively influence blood flow and blood clotting.  In this context, Sacha Inchi oil has been assumed to be an alternative to fish oil.

Studies on Sacha Inchi

Gonzales et al. conducted a study for four months on 15 males and 15 females without the history of hyperlipidaemia or any other disease likely to affect lipid me­tabolism showed that the permanent consumption of sacha inchi oil for four consecutive months showed 10 % increase in plasma HDL level. Other study also stated that consumption of 50 g of sacha inchi can significantly lower triglyceride levels. Although sacha inchi oil may have an unpleasant taste, it is believed that over time it can be accepted by consumers. Commercial sacha inchi oil is classified as extra virgin oil or virgin oil and has low oxidative stability thus should not be consumed hot.

Polyunsaturated fatty acids of Sacha Inchi is the main component that contributed to its beneficial function in variety of processes such as regulation of the inflammatory immune response, blood pres­sure, re­duction of triglyceride levels in the circulation, prevention of neurodegenerative and neuropsychiatric disorder, main­tenance of memory and visual function. Supplementation of yoghurt with sacha inchi seeds has been studied recently, revealing an increase of the levels of ALA and LA of 25- and 50-fold respectively, from an average PUFA content of 3.60 to 81.51% in the modified product compared to the control.

It is considered that fatty acids with higher fraction of PUFA in sacha inchi are beneficial to human health due to their antiatherogenic, antithrombogenic and hypocholester­olemic effects, besides having a high nutritional value.

Sources of sacha inci

Sources of sacha inchi can be varies in these modern days. Various brands has marketed sacha inchi in form of oil and softgels. Some people would simply enjoy sacha inchi by roasting the seed or mix with other nuts for snacking.

Example: Sacha inchi in form of softgel
Example: Sacha inchi in form of oil
Example: Sacha inchi seeds

References

  1. Cárdenas DM, Gómez Rave LJ, Soto JA. Biological Activity of Sacha Inchi (Plukenetia volubilis Linneo) and Potential Uses in Human Health: A Review. Food Technol Biotechnol. 2021 Sep;59(3):253-266.
  2. Gonzales GF, Gonzales C. A randomized, double-blind pla­cebo-controlled study on acceptability, safety and efficacy of oral administration of sacha inchi oil (Plukenetia volubilis L.) in adult human subjectsFood Chem Toxicol. 2014;65: 168–76.
  3. Hanssen, H.-P. and Schmitz-Hübsch, M. (2011) Nuts and Seeds in Health and Disease Prevention, Chapter 117 – Sacha Inchi (Plukenetia volubilis L.) Nut Oil and Its Therapeutic and Nutritional Uses. Academic Press. Available at: https://doi.org/10.1016/B978-0-12-375688-6.10117-3 (Accessed: April 14, 2023).

IS CAFFEINE GOOD FOR OUR HEALTH?


In this era of globalization, most people make caffeine their loyal company day in, day out to stay alert while working. Caffeine is also well-known among adolescents and young adults to burn the midnight oil or during their café hunting endeavors.

WHAT IS CAFFEINE?

Caffeine is a natural stimulant that is widely consumed all over the world. It mainly stimulates  our brain by blocking the effects of neurotransmitter adenosine that cause sleepiness and fatigue. As a result, it helps us to stay awake and prevent exhaustion.

Caffeine is usually found in plants including tea leaves and cocoa beans. There are also synthetically formed caffeine that has been added in some food, drinks, tablets  and supplements. Therefore, try to avoid these caffeinated foods and drinks six hours prior to sleep to prevent trouble sleeping.

(Saimaiti et al. 2022)

As we all know, consumption of caffeine has often been related to sleep problems, increased case of heart palpitations and anxiety. Nonetheless, research found that it also has various health benefits.

BENEFITS OF CAFFEINE

·         Improves alertness and psychological health

A study reported that caffeine may improve alertness and decrease fatigue. Besides, caffeine has been linked to decrease risk of depression and suicide (Walter, 2022).

·         Boost metabolism and burn fat

Due to caffeine’s ability to stimulate the central nervous system, it may aid in boosting metabolism and promote fat burning. However, these effects are likely to remain small over the long term (Tabrizi et al. 2019). Another study also found that caffeine may decrease appetite which can slightly help in reducing weight gain (Walter, 2022).

·         Enhance exercise performance

It is reported that small amount of caffeine consumed before exercise can possibly show an acute increase in exercise performance (Diaz-Lara et al. 2022).

·         Reduced risk of chronic illnesses

Several studies reported that regular consumption of caffeine may decrease the risk of developing type 2 diabetes, endometrial cancer, liver cancer, gall-stones and gall-bladder cancers (Walter, 2022).

Note: The health benefits of caffeine are influenced by the amount of caffeine intake and physical condition of the consumer as well.

SIDE EFFECTS OF CAFFEINE

Excess consumption of caffeine is substantially associated with various side effects on our health.


(Walter 2022)

Caffeine may also interact with calcium and iron absorption that may lead to calcium and iron deficiency. Besides, it can interact with some medications causing it to limit the effectiveness of certain medications. Thus, medications and caffeinated food and drinks should be taken separately.

Note: Caffeine affects individual differently. Some individual may experience the symptoms above with a small intake of caffeine within short period of time and vice versa.

RECOMMENDED DOSAGE

It is considered safe for healthy adults to consume 400 mg of caffeine a day (FDA 2018).

As for pregnant women, you are advised to limit your caffeine intake ( 200 mg per day) as it can easily cross the placenta which results in increased risk of miscarriage  and low birth weight.

A moderate amount of caffeine for Individual A may feel like a high dose for Individual B. In conclusion, every individual has different caffeine tolerance.

THE TAKEAWAY

Moderation is the key. Consume caffeine in moderation (400mg caffeine per day) so that you can enjoy the health benefits of caffeine without incurring it negative impact. You may also consider other ways to stay energized throughout the day by getting 7-8 hours of sleep per night and exercise regularly. If you have trouble staying awake and frequently feel tired, consult a doctor/physician for further assistance.

REFERENCES

Diaz-Lara, J., Grgic, J., Detanico, D., Botella, J., Jiménez, S. L. & Del Coso, J. 2022. Effects of acute caffeine intake on combat sports performance: A systematic review and meta-analysis. Critical Reviews in Food Science and Nutrition: 1-16.

FDA. 2018. How much caffeine is too much? https://www.fda.gov/consumers- updates/spilling-beans-how-much-caffeine-too-much [3 May 2023].

Saimaiti, A., Zhou, D.D., Li, J., Xiong, R.G., Gan, R.Y., Huang, S.Y., Shang, A., Zhao, C.N., Li, H.Y. & Li, H.B. 2022. Dietary sources, health benefits, and risks of caffeine. Critical Reviews in Food Science and Nutrition: 1-19.

Saleem, A. R., Iftikhar, R., Kazmi, S. M. A. & Majeed, A. 2022. Effects of caffeine on mood, memory and attention. Pakistan Journal of Medical & Health Sciences 16(10): 541- 541.

Tabrizi, R., Saneei, P., Lankarani, K. B., Akbari, M., Kolahdooz, F., Esmaillzadeh, A., Nadi- Ravandi, S., Mazoochi, M. & Asemi, Z. 2019. The effects of caffeine intake on weight loss: a systematic review and dos-response meta-analysis of randomized controlled trials. Critical Reviews in Food Science and Nutrition 59(16): 2688-2696.

Walter, K. 2022. Caffeine and health. JAMA 327(7): 693-693.

Diabetic Foot Ulcer

INTRODUCTION

Diabetic foot is one of the most devastating complications of diabetes, which is defined as infection, ulceration or destruction of tissues at the foot. It is usually the result of poor glycemic control, underlying nerve damage, peripheral vascular disease, or poor foot care.

According to World Health Organization, the global prevalence of diabetes among adults of > 18 years old has risen from 4.8% in 1980 to 8.5% in the year of 2014. As the numbers of newly diagnosed diabetics increase yearly, the incidences of foot ulcer also increase.

ETIOLOGY

The etiology of diabetic foot ulcer is multifactorial, however the common underlying causes are:

  1. Poor blood sugar control
  2. Formation of calluses
  3. Foot deformities
  4. Improper foot care
  5. Underlying nerve damage / poor blood circulation of lower limbs
  6. Dry skin

PRESENTATION OF THE WOUND

  1. Well defined wound
  2. Punch out-look
  3. Surrounding skin will often be calloused
  4. Depth of wound typically depending on the thickness of callous
Callus

The most common cause of ulceration is due to repetitive mechanical forces of gait, which lead to callus (pre-ulcerative lesion). When the callus becomes too thick, the callus will press on the soft tissues underneath which eventually lead to ulceration.

A layer of whitish, macerated, moist tissue found under the surface of the callus indicates that the foot is close to ulceration, and urgent removal of the callus is necessary.

Figure 1 showing diabetic ulcer revealed underneath of callus.

TREATMENT

PHARMACOLOGICAL TREATMENT

Oral Analgesic

Simple pain killer ( e.g. paracetamol or NSAIDs) should be considered in mild and moderate pain in diabetic foot ulcer patient.

  • Topical antibiotic

Topical antibiotics are used to treat infected wound or to further prevent infection in uninfected wound.

  • Oral Antibiotic

Oral antibiotic will be prescribed by physician when there are systemic symptoms of infection in diabetic foot ulcer patient.

NON PHARMACOLOGICAL TREATMENT

Wound care

Wound care is important in management of diabetic foot. There are different types of wound dressing which helps in reduce symptom, provide wound protection and improve wound healing. It has 3 important steps in diabetic wound management:

  1. Debridement

Debridement is a process of removing debris and surrounding callus that will slow down wound healing and causes infection.

  • Offloading

Offloading is the process of redistribution the pressure off the wound to the entire weight-bearing surface of the foot. It can be achieved by either wearing temporary footwear until ulcer heal or wearing pressure-relief devices

Mechanical loading of feet during daily activities, e.g. walking or standing which exposes pressure on plantar surface causing compression and shear stress. This pressure and stress will be aggravated by foot deformities ( e.g. hammer and claw toes) which are very common in diabetic patients. Therefore patients are advised on using footwear that fits, protects and accommodates the shape of feet (with socks). Patient who are at moderate or high-risk are usually prescribed with footwear with removable cast boots to decrease the pressure on affected area. It has to ensure that it fits, protects and supports the foot.


Figure 3 shows example of removable cast boots for patient with diabetic foot ulcer.

c. Appropriate wound dressing

  • Dry wound needs topical application that add moisture to the wound
  • Diabetic wound with heavy exudates needs a dressing to absorb moisture.
  • Dressings need to be changed at least daily in order to apply clean wound covering & monitor infected wound.

Supplementation

Vitamin B12

Vitamin B12, which is also known as cobalamin is vital for proper functioning and development of nervous system. Nerve damage with symptoms of pain, tingling, numbness and loss of sensation is often associated with Vitamin B12 deficiency.

Metformin, which is one of the diabetic agent commonly used for diabetic patient has confirmed that its long term use has contributed to vitamin B12 deficiency in patient with diabetic disease. Metformin has been reported to lead to malabsorption of vitamin B12. Therefore, diabetic patient who is taking metformin is encouraged to consume vitamin B12 through diet or supplement. This is to prevent development of nerve damage which eventually leads to foot ulcer.

PREVENTION

Patients who are at high risk of developing diabetic foot ulcer need to know the basic care of foot, callus and nail, this should be done regularly to prevent foot problems. Diabetic foot prevention can be done by:

  • Lifestyle modification
    • Having good glycemic and blood pressure control by taking medication, follow diet plan, exercise regularly, and monitor blood sugar regularly through HbA1c test is important to reduce the incidence of diabetic foot ulcer and subsequent risk of amputation.
  • Smoke cessation
    • Do not smoke as it reduce blood flow in feet.
  • Take good care of feet hygiene by washing them daily with mild soap. Use only lukewarm (below 37°C) and not hot water. Do not soak feet as it can cause dry skin.
  • Use moisturizer daily to keep dry skin from itching or cracking. But do not moisturize between the toes as it could risk an infection to occur
  • Cut toenails carefully after washing and drying the feet. Do not cut nails too short as this could lead to ingrown toenails.
  • No self-treat corns or calluses.
  • Wear clean and dry socks which are not too tight and are light coloured. Socks with extra cushioning, no elastic top, higher than ankle, made from fibers material are preferred.
  • Never walk barefoot indoors or outdoors.
  • Put feet up when sitting to ensure good blood circulation. Keep the blood flowing to feet by wiggling toes and moving ankles for five minutes, 2 – 3 times a day. Don’t cross legs for long periods of time.
  • Seek for treatment if there is presence of pain, noticeably red or discolored areas, discharge, bad smell, ulcer, blister or if feeling generally unwell with difficulty controlling blood sugar level

REFERENCE

  1. Ministry of Health Malaysia. Clinical practice guideline: Management of diabetic foot. 2nd ed. Ministry of Health Malaysia. http://www.moh.gov.my/. 2018.
  2. Edmonds ME, Foster AV. ABC of wound healing: Diabetic foot ulcers. BMJ. 2006 May 1;332(Suppl S5).
  3. MIMS Malaysia. Infectious Disease: Diabetic Foot Infection. https://specialty.mims.com/diabetic%20foot%20infection/signs%20and%20symptoms?channel=infectious-diseases.
  4. Badedi M, Darraj H, Hummadi A, Solan Y, Zakri I, Khawaji A, Daghreeri M, Budaydi A. Vitamin b12 deficiency and foot ulcers in type 2 diabetes mellitus: A case–control study. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. 2019 Dec 6:2589-96.

Nutrition for Elderly

Aging is a biological process measured by temporal continuity, heterogeneity on cellular, somatic and molecular level, and, the ability of being modulated. It is a process characterized by social, physical and physiology of human beings. National Policy on Older Persons stated that people aged 60 years and above are categorized as elderly but it varies globally depends on the percentage in the country. Aging process causes various physical and cognitive changes thus stresses on proper nutrition intake to achieve successful aging. Bad dietary habits among elderly will lead to various chronic diseases such as type II diabetes, atherosclerosis, coronary heart disease and malnutrition. Besides, decrease in food intake results in nutrient deficiencies and cause problems such as loss of bone density and muscle mass plus functional decline. This proves that nutrient intake in elderly plays an important role to maintain a healthy body.

Generally, energy requirement for elderly will be lower than young adults as their energy expenditure decreases due to their health condition. Elderly are advised to meet their energy requirement through a healthy diet.

IMPORTANT NUTRITIONS FOR ELDERLY

1. Protein

Why a high protein diet isn't just for people who work out

Protein is a macronutrient used to build up muscle, replenish body fluid and help metabolism process in the form of enzymes and hormones. Older persons are exposed to protein malnutrition and declining fat free mass thus making it compulsory for them to consume 1.2 to 2g of protein per day. Declinations of fat free mass which cause weakness in skeletal muscle commonly occur among elderly. Besides elderly, people who undergo weight training and regularly maintain their fitness are well associated to this kind of problem. Sufficient protein intake can be fulfilled by consuming milk products, egg, meat, fish and chicken as well as pulses and nuts. However, it is advisable to consume eggs, whole milk, and fatty meats sparingly as they are also rich sources of fat and cholesterol.

Protein food Vectors & Illustrations for Free Download | Freepik

2. Fiber

High-Fiber Diet: Good for the Gut, Good for Your Overall Health -  University Health News

Fiber is an indigestible carbohydrate which cannot be broken down into sugar molecules. It can help to relieve constipation and lower blood cholesterol level among elderly. Fiber slows down sugar absorption in the body and helps keep hunger at bay. It is recommended to consume approximately 25-30g of fiber daily in our diet. Elderly needs to consume fruits and vegetables in their meal in order get all the benefits from them.  Green leafy vegetables are rich in iron hence favorable for elderly that suffers from anemia while yellow and orange fruits are rich in beta-carotene, an antioxidant agent that helps scavenge free radicals.

3. Carbohydrate

Best Carbohydrates Foods for Athletes & its impact on performance – Know  here

Carbohydrates are mostly found in starches, sugar and fibers. Carbohydrates are converted to glucose and help to generate energy to the body by supporting bodily function on daily basis. Elderly are required to consume approximately 130g of carbohydrate daily in their diet. In general, elderly suffers low sense of taste and smell and chewing difficulties thus affecting their appetite. This encourages them to choose food that is easier to digest such as carbohydrate-rich food. Carbohydrate intake in elderly should be monitored and restricted especially on sugar intake and refined cereals in diets. Unhealthy food choice can be substituted with fiber rich foods such as fruits, whole cereal, vegetables and other complex carbohydrate that digest slower thus helps in regulating blood sugar level.

Is Chocolate Milk A Complex Carb | Nunu Chocolates

4. Fat

Other than source of energy, fat helps to add palatability and is required for synthesis of fat soluble vitamins such as vitamin A, D, E and K. Fat has numerous benefits and according to World Health Organization 2022, there is no need to restrict its consumption except for people who are overweight and obese. Nevertheless, saturated fats intake should be minimized and not exceed 8% of total energy intake while recommended fat consumption is between 20-30% from daily calorie intake. Fats that are advisable to consume are particularly unsaturated fats such as omega-3 and omega-6 fatty acids that are usually found in fish, soy canola seed and oil, seaweed and green leaves. Both of these omegas help to regulate blood pressure and slow down inflammatory responses. Fats such as butter, ghee and refined oils should be taken moderately while fried foods, pastries and fatty meat should be avoided for elderly.

Different types of fats

5. Calcium & Vitamin D

Osteoporosis and bone problems are usually associated with older people due to their lack of calcium and vitamin D intake. People aged 70 are recommended to consume at least 600 IU of vitamin D (up to 1000 IU/day) and 1200 mg of calcium per day. It can be obtained from calcium-rich food such as milk and milk products namely cottage cheese and curd, green leafy vegetables, and sesame seeds. Vitamin D is also important for elderly as it helps in calcium absorption. It is mostly found in flesh of fatty fish including salmon, tuna, and mackerel.

High Calcium Foods | Non-Dairy Foods High in Calcium

DIET SUGGESTIONS

1. Okinawan Diet

Okinawan diet is a diet that contains 30% of sugar and 15% of grains in dietary intake. It contains approximately 30% of green and yellow vegetables and sweet potato is used to replace rice. This kind of diet are claimed to have low level of saturated fat and glycemic index and is able to help reduce risk of cardiovascular disease, some cancers, and other chronic diseases.

Food for Thought - The Okinawan Diet – Okinawa Hai

2. Mediterranean Diet

Mediterranean diet is a traditional diet from Greece that focus on consumption of plant based foods such as olive oil, legumes, unrefined cereals, fruits and vegetables. Fish, seafood, dairy and poultry are included in moderate while red meat and sweets are consumed occasionally. This type of diet are more focused on olive oil as it is monounsaturated fat that can help lower total cholesterol and low density lipoprotein (LDL).

Benefits of the Mediterranean Diet - Grain Foods Foundation

THE BOTTOM LINE

Aging individual generally experience extra health problems and tends to have high dependency to certain medication compared to others. This indirectly affects their health and nutritional intake. Majority of elderly are shown to face common disorders like osteopenia, type II diabetes, malnutrition, cognitive decline and nutritional deficiencies. Balance nutrition and adequate intake of nutrients following a health standard may help to prevent above problems in elderly. Suitable dietary plan and recommended nutritional intake should be emphasized among older people to improve their geriatric health and decrease the prevalence of chronic disease.

REFERENCES

  1. Kaur, D., Rasane, P., Singh, J., Kaur, S., Kumar, V., Mahato, D. K. & Kumar, S. (2019). Nutritional interventions for elderly and considerations for the development of geriatric foods. Current aging            science12(1), 15-27.
  2. Masoro, E. J., & Austad, S. N. (Eds.). (2010). Handbook of the Biology of Aging. Academic press. 
  3. Nieves, J. W. (2003). Calcium, vitamin D, and nutrition in elderly adults. Clinics in geriatric medicine19(2), 321-335.
  4. Roseland, J. M., Phillips, K. M., Patterson, K. Y., Pehrsson, P. R., & Taylor, C. L. (2018). Vitamin   D in foods: An evolution of knowledge. In Vitamin D (pp. 41-77). Academic Press.
  5. Willcox, D. C., Willcox, B. J., Todoriki, H., & Suzuki, M. (2009). The Okinawan diet: health implications of a low-calorie, nutrient-dense, antioxidant-rich dietary pattern low in glycemic load. Journal of the American College of Nutrition28(sup4), 500S-516S.

IS KETO DIET A GOOD PRACTICE OR NOT?

Keto Diet: What is Ketogenic Diet? - Public Health Notes

INTRODUCTION

In recent years, there are variety of diets that has been introduced to current society each with their own benefits, pros and cons towards body health. Ketogenic diet is a part of diet that has been practiced by most individuals. Ketogenic diet also known as keto diet is a type of diet that involves consumption of high amount of fat, moderate amount of protein and very few carbs. Keto diet recommended that 75% of calories come from fat, 20% from protein and 5% from carbohydrate sources. Mainly, keto diet restricts carbohydrate intake to less than 25 to 50 grams per day.

Easy Foundations to Start Strong on the Ketogenic Diet

Some guidelines of food sources in keto diet:

The Keto Diet Is Popular, but Is It Healthy? | Methodist Health System |  Omaha, Council Bluffs, Fremont

HOW DOES KETO DIET WORKS?

In normal conditions, our body especially brain and nervous system use glucose (a form of sugar) that come from carbohydrate sources as their primary source of energy.

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Keto diet on the other hand uses fat or ketones (acids produced in the liver) as the primary source of energy. By practicing keto diet, our body received low amount of glucose thus sugar is depleted and cannot be used as the main energy source. Hence, our body system changes the usual energy supply of sugar to fat as well as ketones. This phase is known as ketosis, in which body system depends on fat as well as ketones as its key power source.

What is Ketosis. Is it Healthy & How Can I use it to Get Rid of

BENEFITS OF KETOGENIC DIET

1. Treat difficult-to-control epilepsy in children

A study showed that children suffering from epilepsy who practice keto diet had reduced episode of seizures similar to those who were on medications. This decrease in seizures episodes is due to the brain utilizing ketone bodies as energy (Li & Heber, 2020).

2. Promoting weight loss

Another study showed that keto diet stimulates weight loss for short-term period by reducing the calories intake through higher consumption of fat and protein which aids to enhance satiety (Alharbi & Al-Sowayan, 2020).

3. Control blood glucose in patients with pre-diabetes and type 2 diabetes

Patients with pre-diabetes and diabetes who followed this diet for three months observed a change in their blood glucose through an improved Hba1c result (O’Neill & Raggi, 2020)

POTENTIAL RISKS AND SIDE EFFECTS OF KETOGENIC DIET

  • Some study showed that there was a phenomenon known as Keto Flu which exhibit symptoms such as drowsiness, fatigue, nausea, poor breathing, poor concentration, indigestion, insomnia and depression. This phenomenon will last for a week causing the body to lose fat and experience drastic weight loss.
  • Besides, keto diet lacks in fiber and some important nutrients such as calcium, magnesium, potassium, vitamin A and B.
  • Also, keto diet enhances the process of ketosis that will use fat and elevate amount of ketones in the body. Continuous usage of ketones and its increase will cause blood to become acidic and harmful to the body.
  • Furthermore, it can increase the level of LDL in the blood due to high intake of saturated fats in the diet.

KETOGENIC DIET IN LONG TERM

  • By restricting macronutrients such as carbohydrates, protein or fat in long term, our body will experience craving that may lead us to give up the diet.
  • After an individual decided to stop practicing keto diet and start eating normally, they will likely consume foods they were restricting before double the normal amount hence causing weight rebound or drastic increase of body weight.
  • Moreover, by consuming higher fat content in keto diet, our body are no longer sensitive towards insulin due to the low amount of carbohydrate that normally stimulate insulin production for the conversion of glucose in the body. Thus, it is not suitable for diabetic patients especially for those who are on insulin injection due to high risk of hypoglycemic episode.

THE BOTTOM LINE

Keto diet generally works only for short-term period. Though it provides some benefits momentarily, we also need to consider the consequences that might happen after we stop practicing it. Diets that had restriction of certain macronutrients do not provide adequate and balance nutrients to our body thus will cause health problems and might prove hard to practice. Our body needs complete nutrients namely carbohydrate, protein, fat, vitamin, mineral and fibers to function efficiently. Therefore, diet consisting of balance, and adequate nutrients is more encouraged so that it can be practice consistently.

REFERENCES

Alharbi, A., & Al-Sowayan, N. S. (2020). The Effect of Ketogenic-Diet on Health. Food and Nutrition Sciences11(04), 301–313. https://doi.org/10.4236/fns.2020.114022

Li, Z., & Heber, D. (2020). Ketogenic Diets. JAMA – Journal of the American Medical Association323(4), 386. https://doi.org/10.1001/jama.2019.18408

O’Neill, B., & Raggi, P. (2020). The ketogenic diet: Pros and cons. Atherosclerosis292, 119–126. https://doi.org/10.1016/j.atherosclerosis.2019.11.021

PLANT BASED DIET: IMPLICATIONS ON HEALTH AND EXERCISE PERFORMANCE IN ATHLETES

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/.

DIETARY GUIDELINES FOR LACTOSE INTOLERANTS

INTRODUCTION

Lactose is a sugar naturally found in milk and dairy products. Lactose needs to be broken down into glucose and galactose in the intestine by an enzyme called lactase. Approximately 65% of people across the globe are unable to digest lactose and categorized as lactose intolerant. It occurs due to insufficiency or absence of lactase enzyme to break down lactose in the gut. Consequently, the undigested lactose that passes through the colon may cause several symptoms such as bloating, abdominal pain, diarrhea and constipation which create discomfort to the body. There are several types of lactose intolerance:

Primary lactose intolerantSecondary lactose intolerance
Congenital
-Present at birth and mostly a rare case
Damage/injury within the intestine due to gastroenteritis
Delayed (adult form)
-Developed around the age of 20 years old
Bowel diseases such as celiac disease
Bowel surgery

Lactose intolerance is a common disorder and can be controlled by limiting food that contains lactose. The amount of lactose an individual can tolerate varies from person to person. Some might need to adjust the type, amount and timing of the food while some left with no option but to completely eliminate lactose in their dietary intake.

To highlight, most lactose-containing food such as cow’s milk and dairy products are the nutrient powerhouse to our bodies because they supply calcium, phosphorus, choline, vitamin B12 and high-quality protein. Avoidance of these food groups can lead to imbalanced nutrition intake and it is associated with poor bone health. Thus, dietary approach is the best way to counter nutritional deficiency caused by lactose intolerance.

DIETARY GUIDELINE

Choose lactose-free products

Lactose-free products are safe to consume as lactose is already pre-digested at the production level, thus it can provide an identical amount of nutrients as normal milk or dairy products. For example, lactose-free milk, cheese and yoghurt drink.

Additionally, lactose-free products are also available in formula milk to accommodate lactose intolerance among babies and toddlers.

Choose plant-based products

Milk alternatives from plant-based sources such as fortified soy milk, almond milk and oat milk can be the best substitute to cow’s milk. Plus, it is a healthier choice as well as plant-based foods are cholesterol-free!

Yoghurt

Most yogurts are considerably harmless to lactose intolerants. Few studies reported that despite their lactose content, yogurts contain live organisms (probiotics) such as β-galactosidase that are able to hydrolyze lactose and facilitate its absorption inside the intestine.

Check the food label

Lactose intolerants are advised to meticulously check food labels as some ingredients are hidden lactose which possibly causes unintended symptoms later. Baked goods, ice creams, cake mixes, butter, margarine, breakfast cereals and chocolates are typically lactose-based. Food ingredients that indicate lactose content are:

  • Milk sugar
  • Whey or whey protein concentrate
  • Curds
  • Cream
  • Condensed milk
  • Goats milk
  • Butter
  • Buttermilk
  • Evaporated milk
  • Malted milk

In addition, ingredient names that look alike to lactose such as lactic acid, lactate and lactalbumin are unrelated to lactose hence it is safe to consume.

BOTTOM LINE

All in all, people with lactose intolerants can enjoy vast sources of food as long as it is lactose-free or has reduced-lactose content. Adherence to this dietary guideline is highly recommended to prevent unwanted symptoms and to ensure balanced nutrition is well-supplied daily despite some food limitations.

REFERENCES

  1. Lactose intolerance. Retrieved from, http://www.myhealth.gov.my/en/lactose-intolerance/
  2. Facioni, M.S., Raspini, B., Pivari, F. et al. (2020). Nutritional management of lactose intolerance: the importance of diet and food labelling. J Transl Med 18, 260. https://doi.org/10.1186/s12967-020-02429-2
  3. Ajmera, R. (2023). Lactose-free diet: food to eat and avoid. Retrieved from, https://www.healthline.com/nutrition/lactose-free-diet

DIET AND LIFESTYLE APPROACHES FOR PREVENTION AND MANAGEMENT OF DIABETES

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.

6 SUPERFOOD LISTS THAT YOU SHOULD ADD TO YOUR DIET!

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
One Major Side Effect of Eating Berries, Says Science — Eat This Not That

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.  

  1. 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.

  1. QUINOA
Health Benefits of Quinoa, The Andean Gluten-Free Grain Variety

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.

  1. DARK LEAFY VEGETABLES
Health Benefits of Dark Leafy Green 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.

  1. YOGURT
Homemade Flavored Yogurt Recipe

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.

  1. SWEET POTATOES
Now in Season: Buying, Storing, and Preparing Sweet Potatoes Properly |  Stories | Kitchen Stories

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

AMAZING HEALTH BENEFITS AND SOURCES OF MAGNESIUM FOR CHILDREN INTAKE

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

INTERMITTENT FASTING DIET PLAN FOR WEIGHT LOSS

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).