Friday, December 14, 2007

Don't turn a blind eye to diabetes

From The NST

By Kasmiah Mustapha


Diabetics need regular eye checkups.

Diabetics risk going blind if they do not control their illness, writes KASMIAH MUSTAPHA.

AS symptoms only manifest until it is too late, most diabetics do not know they are at risk of developing other serious illnesses related to their disease.

One such malady is diabetic retinopathy or diabetic eye disease, a highly specific vascular complication of both Type 1 and Type 2 diabetes.

Universiti Sains Malaysia Professor of Medicine Dr Mafauzy Mohamed says the condition, if untreated, will lead to vision deterioration and ultimately, blindness.

"Most diabetics are not aware they can become blind if they do not control their blood sugar level. As diabetes is often diagnosed late, when patients have been suffering from it for four to five years, they could already be at risk of diabetic retinopathy.
The disease is responsible for over 80 per cent of blindness in diabetics. It blinds 25,000 diabetics each year.

Blindness results from damaged blood vessels next to the retina. Swollen, leaking and bleeding capillaries are blocked, cutting off blood and oxygen supply to small sections of the retina.

In a study conducted on the effectiveness of diabetic treatment in local hospitals last year, Dr Mafauzy discovered that 27.3 per cent of the 1,099 patients surveyed suffered from retinopathy.

"One out of 100 of them are already in the early stages of blindness," he said.

Of the number of patients he surveyed, 27 per cent had eye damage, one per cent were blind, 10.8 per cent had eye problems that needed laser treatment, 16 per cent had cataracts, 11.1 per cent had early symptoms that if left untreated can cause serious retinopathy, and 5.4 per cent had advanced eye disease or severe visual impairment.

Dr Mafauzy says almost all diabetics will suffer from some form of eye damage if they do not control their blood sugar level.

"More than 60 per cent of Type 2 diabetic patients had eye diseases."

Besides controlling their blood sugar levels and hypertension, Type 2 diabetics need to go for eye checkups every year. Those with Type 1 diabetes should go for a checkup five years after they have been diagnosed.

Dr Mafauzy says laser treatment is used to prevent the eye from getting worse by repairing leaking and bleeding vessels with cauterisation.

"This treatment is to prevent blindness. It is not to restore vision. If the damage has set in, it is not reversible. Doctors can only prevent it from getting worst. That is why diabetics need to control their condition by eating healthy, exercising and taking their medication."

In a recent sub-study on Fenofibrate Intervention and Event Lowering in Diabetes (Field) it was revealed that fenofibrate, a lipid modifying agent is found to be effective to treat diabetic retinopathy.

With fenofibrate, the use of laser treatment therapy was reduced by 30 per cent. In addition there was also a significant reduction in the progression of the disease.

In the year 2000, there were 940,000 adult diabetics in the country, and it is estimated 2.48 million will suffer from it by 2030.

Diabetes is the sixth leading of death. It is also the leading cause cause of renal failure, new cases of blindness and non-traumatic amputations.

Saturday, December 8, 2007

What comes out of the farm may be something else

From The NST

To enlarge picture (pdf), click here

THAT deep green and crunchy organically grown vegetable sporting a shiny certification logo on its package comes with an assurance.

Loke Siew Foong with a selection of organic foods the company distributes.
Loke Siew Foong with a selection of organic foods the company distributes.
To enlarge picture (pdf), click here
It's a promise that those leaves, beans or gourds were grown at a farm with no nasty pesticides or chemicals, with respect for the earth, and fair treatment for workers.

But, in Malaysia, here's where the official assurance ends - at the farms which produce the organically grown fruits and vegetables.

This is because Malaysia's organic certification scheme covers only the farms, not processors, wholesalers or retailers who get the fresh produce to diners everywhere.

And in the organic way of thinking, that makes the chain incomplete and opens the door to doubt.
Why? Because between farm and store, no one keeps an eye on how those organic greens are handled.

If someone was keeping an eye on things, the requirements would be tough.

Inspectors scrutinise cold rooms to see if strictly organic produce is kept apart from other naturally grown items, how often the room was cleaned and with what, says Loke Siew Foong, who manages organic certified wholesaler Radiant Code.

"They'll have none of that Baygon or Ridsect (insecticide) or even mosquito coils in our stores," says the OAM co-founder.

Everything from lorries that transport the greens to packaging used would also have to be up to scratch.

"The whole idea is that the organic produce doesn't get mixed up with conventionally grown foods."

The certification is also crucial because it doesn't just mean the greens are free of agro-chemicals, explains Gurmit Singh, the executive director of Cetdem.

A certified organic product also gives consumers the assurance that there's been a minimal impact on nature and the produce has been grown in a socially just manner.

"That means no abuse of cheap foreign labour.

"No cutting corners and no cheap alternatives.

"This makes organic farming a demanding business. As a result, initial costs can be high."

Gurmit knows this first hand from Cetdem's own experience with its pioneering organic farm in Sungai Buloh, which the group operated for about a decade.

Often, there were times when Gurmit and his wife, Tan Siew Luang, worked the one-acre farm on their own because no workers were available.

But this level of care and concern is what consumers are really paying for.

How do you know it's organic?

Look for certification

The best assurance is a certification. Look for a logo.

In Malaysia, the Department of Agriculture is the only agency that certifies organic food. It uses the SOM label.

At present, there are only standards to certify organic vegetables and fruits. Retailers should display their certification and customers have a right to ask.

Read the labels

Some products could be certified by an agency in a foreign country like the National Association for Sustainable Agriculture, Australia (Naasa).
Look for the logo that also carries a licence number.
The agencies usually list certified products/companies on their websites. It’s a good way to double-check that no one’s faking a label.

Check out the farm/farmer

Some people buy organic food from farms they know are doing things right, although these may not yet be certified. So visit the source farm if you can. Ask for a recommendation from the store if you aren’t sure.

Trial and error

This isn’t fail-safe but the difference between organic and conventional produce is this:

Fresh organic food very rarely looks the same. It’s not made in a mould. So shapes and sizes are often irregular. A consignment this month will also likely look different from next month’s.

Also it’s full of flavour. It’s very rarely tastes standardised or bland. A tomato should taste like a tomato, not like water.

Tips from the Centre for Environment, Technology and Development Malaysia and Organic Alliance Malaysia.

More Health Tips

The United States FDA defines cosmetics as: "Intended to be applied to the human body for cleansing, beautifying, promoting attractiveness, or altering the appearance without affecting the body’s structure or functions.
The first archaeological evidence of cosmetics usage is found in Ancient Egypt around 4000 BC. The Ancient Greeks and Romans also used cosmetics. The Romans and Egyptians used cosmetics containing mercury and often lead.

In the Western world, the advent of cosmetics was in the Middle Ages, although restricted to use within the upper classes. Cosmetic use was frowned upon at some points in history. For example, in the 1800s, Queen Victoria publicly declared make-up improper. It was viewed as vulgar and acceptable only for use by actors.

By the middle of the 20th century, cosmetics were in widespread use in nearly all societies around the world. Today the cosmetic industry is a big and growing one. One report said that women could use more than 20 make-up products as part of her daily routine. Even the guys are getting into it.

Let us face one fact: Make-up is an entirely unnatural phenomenon. Hence, no cosmetic product can claim to be totally safe. Even those without carcinogens could have ingredients that cause allergy and irritation. Cosmetics may also have ingredients that are supposed to be "safe" simply only there are no safety data for them.

When it comes to looking good, you do not need to make unhealthy choices. If your lifestyle is relatively clean, the use of well-chosen make-up may not add much to your total toxic load.

When buying or using cosmetics, here are some simple tips:


• Start from the inside


"I know the power of make-up," a doctor friend once told me, "I get to see my wife in the morning." The truth is really very simple: true and lasting beauty comes from within. Beauty is deeper than you skin! It starts with a nutritious diet, adequate rest, good sleep, regular exercise and periodic stress-free breaks.


• Study the label


It makes sense, but it bears repeating: Carefully read the labels of the stuff that you are going to put on your face. Don’t rely on claims of ‘all natural’, ‘organic’ or ‘cruelty-free’. These claims are increasingly becoming meaningless. Check for independent third party endorsement and credibility. The true story of the product can only be found in the list of ingredients.


• Natural Products


Look for natural waxes like honey, beeswax and carnauba, plant oils, cocoa butter and more natural powders based on cornstarch, kaolin and silk. Make sure these are the main (if not only) ingredients, and not simply added to pay lip service to the idea of being a "natural" product.


• Beware the price hype


Price is no guarantee. It used to be. Not anymore. Sometimes, the cheaper brands use fewer toxic ingredients, but only the label will tell you for sure. Ask for and about independent tests on done on the products in accredited laboratories.


• Re-read the label every time you buy


Don’t just buy a product because it was safe the last time you looked. By the time you replace your eye shadow or lipstick, it may be made from completely different ingredients. Manufacturers are continually reformulating their products.


• Avoid cosmetics that are pearly, glittery or frosted


To achieve this effect, manufacturers add ingredients such as pure aluminium, mica and even fish scales. Used near the eye, these particles can flake off and cause corneal damage. Ingested aluminium is linked to Alzheimer’s disease.


• Choose lip gloss over lipstick for everyday wear


Conventional lip glosses contain less colour, but are high in phenol, a poisonous substance that is easily absorbed into the delicate tissue of the lips (aided by petrolatum, a petroleum-derived moisturiser along with other wetting agents).


• Seek "safe" colours


In cosmetics terms, a number beginning with "CI75 ..." is considered a "natural" colourant, even though some are highly synthesised. Anything else may be considered suspect. Those beginning with "CI77..." are inorganic substances used as colourings (such as iron oxides, natural carbon, and the more toxic aluminium and barium sulphates).


• No Perfumes. No Sweet


Avoid all perfumed cosmetics. Avoid lip products that taste sweet. Often, these use saccharin (a suspected carcinogen) and phthalic anhydride (made from another suspected carcinogen, naphthalene), an irritant which can cause headaches, nausea, vomiting, diarrhoea and confusion. It has been linked to kidney and brain damage in infants.


• No sunscreens


Make-up is for indoors anyway. Don’t be fooled by claims of natural sunscreens. The only effective sunscreens are synthetic chemi- cals that add to your toxic burden.


• Don’t need to makeup


Sadly, many women wear makeup for the most trivial occasions — shopping for groceries, weekends at home or even for walks in the park. Get used to the way you look without make-up. Give your skin and body a break. If you really must put something, stick to the basics — swipe of carefully chosen mascara and a bit of lipstick or lip gloss is fine for everyday use.

* Datuk Dr Rajen M. is a pharmacist with a doctorate in Holistic Medicine.

Simple Health Tips

The deadly duo — heart disease and diabetes — can be kept at bay making the proper changes to lifestyle, writes DR LIEW YIN MEI.

HEART disease and diabetes are indeed a deadly duo, and people with diabetes are two to four times more likely to develop cardiovascular disease (CVD) than those without diabetes.

This is because those with diabetes usually have associated CVD risk factors: High blood glucose, high blood pressure, abnormal blood fat levels and central obesity.

High blood glucose and high blood pressure levels can damage the inner lining of your blood vessels (arteries), making it easier for cholesterol and other fat substances to accumulate inside the artery walls.

This causes plaques (fatty deposits) to form. These plaques narrow your arteries, restrict blood supply and may also rupture, leading to the formation of blood clots.
If the blood clots travel to other parts of your body and partially or totally block blood flow to an organ, say for example, your heart, you may end up with a heart attack. If a plaque ruptures in the brain, you will suffer a stroke.



HEART DISEASE DOESN’T HAVE TO BE YOUR FATE

While diabetes and heart disease are indeed closely linked, having the former doesn’t mean that you will invariably succumb to the latter.

There are steps you can take to protect your heart and keep it healthy. The key here is good control of your diabetes.

This includes becoming more physically active, reducing excessive body weight and maintaining a healthy body weight and normal blood glucose levels.

In addition, good control of your lipids (blood fats), blood pressure and avoidance of smoking are equally important. What you consume also makes a world of difference.

Highlighted below are some easy-to-follow dietary tips that will help you maintain healthy levels of blood glucose, blood pressure and blood fats (lipids):



Keep blood glucose levels within normal range

Ideally, if you have diabetes, your blood glucose level targets should be between 3.8 and 6.1 mmol/L before meals and less than 7.8 mmol/L two hours after meals. This can be achieved by:

• Eating smaller but more frequent meals. Your body can handle only so much glucose at a time.

• Consuming sensible amounts of complex carbohydrates (e.g. rice, wholemeal or wholegrain bread, noodles and tubers) instead of refined ones at every meal, every day.

• Spacing out the carbohydrate intake evenly throughout the day and have a consistent amount at every meal. Don’t overload on carbohydrate foods (or any other types of foods, for that matter) at any one meal. This helps to avoid a spike in blood glucose.

• Eating more complex carbohydrate foods that contain higher amounts of fibre. There are two types of fibre — soluble and insoluble.

Soluble fibre (such as beta glucan, pectin, etc) can be found in high quantities in oats, barley, legumes and some fruits, like apples. Insoluble fibre is found in fruits, vegetables, seeds and whole grains.

Consume a mix of both types of fibre to make up the recommended total dietary intake of 20-30g per day, of which at least 6g should comprise of soluble fibre.

High fibre foods are digested at a slower rate. This means that glucose is absorbed into the blood stream at a slower rate, leading to a slower rise of blood glucose levels.

• Choosing low glycaemic index (GI) carbohydrate foods. Glycaemic Index (GI) is a measure of how quickly or slowly your body converts carbohydrates in a particular food into glucose and releases it into your bloodstream.

Foods with low-GI include barley, brown rice, specially-formulated bread, pasta (made from durum wheat) and muesli.

• Avoid sugar and highly sweetened food and drinks and go for processed edibles that are low or free of fat and sugar. Sweetened foodstuff causes your blood glucose levels to rise quickly.



Keep your blood pressure down

You should ask your doctor to check your blood pressure at your every visit. People with diabetes should aim for lower blood pressures of 130/80 mmHg or less (irrespective of age).

The following dietary tips may help you achieve your target:

• Too much sodium, a type of mineral that is vital for the healthy functioning of your body (especially the heart, muscles and nerves), can aggravate blood pressure, particularly if you have diabetes and are obese.

Minimise sodium or get rid of it entirely. Try not to add salt, soy sauce or monosodium glutamate (MSG) to your meals. Instead, season your food with natural herbs and spices.

• Avoid processed foods (e.g. sausages and burger patties), preserved foods (pickles, salted eggs and salted fish) and canned foods as these contain too much salt.

• Limit or stay away from alcohol. Alcohol increases blood pressure and makes your heart work harder. If you must drink, the recommendation for men is not more than two standard drinks a day, while women should not exceed one standard drink a day.



Eat right to maintain healthy fat levels

If you have diabetes, it is crucial to maintain healthy fat levels. Keep your total cholesterol level below 5.2 mmol/L.

Your LDL ("bad") cholesterol should be kept lower than 2.6 mmol/L and the HDL ("good") cholesterol higher than 1.03 mmol/L for men and 1.3 mmol/L for women.

You also need to keep your triglyceride level below 1.7mmol/L.

In addition to practising an active lifestyle, here are some diet tips that can help you achieve healthy fat levels:

• Avoid high cholesterol foods which raise LDL cholesterol levels, such as prawns, crabs, oysters, squids, egg yolk and offal (liver, kidney, intestines, brain).

You can eat about two to three eggs a week provided you keep your animal fat intake low.

• Minimise your intake of saturated fats, which tend to boost LDL cholesterol levels.

Saturated fats are found mostly in animal or animal-derived foods, which include whole fat dairy foodstuffs like ghee, lard, full cream milk, butter, cheese and mayonnaise.

Coconut milk should be avoided as they are high in saturated fat.

A healthier alternative would be to use low-fat milk in curries, desserts (cendol, bubur cha cha) and your favourite kuih-muih.

• Love your unsaturated fats. Polyunsaturated fats help lower LDL cholesterol levels but also decreases the HDL ("good") cholesterol levels while monounsaturated fats are neutral.

Monounsaturated fats sources include plant oils such as canola, olive and peanut while polyunsaturated fats are derived from vegetables, plant oils (corn, sunflower, soy) nuts (almonds, hazelnuts) and certain kinds of fish like salmon and tuna.

• Limit your total fat intake by reducing fat from all sources including cooking oils. Watch out also for hidden fats from pastries and cookies.

• Use as little oil as possible when cooking. Instead of deep-frying food, try stir-frying or shallow-frying and experiment with other low-fat cooking methods like steaming, boiling, grilling, baking or roasting.

• Avoid trans fatty acids, which are regularly found in commercially prepared baked goods, margarine, snack foods and processed foods.

Trans fats are damaging to cholesterol levels as they increase the bad LDL cholesterol and lower the good HDL cholesterol. Read food labels to find out if a particular treat contains trans fat.

• Consume more soluble fibre because it helps to lower LDL cholesterol levels in the blood.

Keeping your blood glucose levels, blood pressure, blood fats and body weight within the healthy range is critical for every person who has diabetes.

By following the advice given above, you can effectively reduce your risk of heart disease (as well as other complications of diabetes) and be rewarded with the freedom to enjoy life to the fullest.

Note: Datin Dr Liew is a consultant physician with the Heart Foundation of Malaysia

Friday, December 7, 2007

Cord of Life

The new bind in this cord

By : MANVEET KAUR

Storing a newborn’s umbilical cord as insurance against certain diseases that the child or family may be afflicted with in the future has lead to new services offered by blood banks. MANVEET KAUR speaks to medical specialists who clarify the benefits and limits involved.

Dr Foo Ban Nyen, executive chairman of CellSafe International
BEFORE a baby is born, parents-to-be need to make all sorts of decisions for the benefit of their child’s wellbeing, ranging from what brand diapers to use to which paediatrician to consult.

These days, they are faced with another serious decision, one that may protect their child from a life-threatening illness. The decision: whether or not to take out a “biological insurance” for their children, so to speak.

This type of insurance is essentially a blood sample from the baby’s umbilical cord, which will be cryogenically stored at a blood bank. Cord blood, as it is known, contains stem cells that can be used in transplants to cure leukaemia, lymphoma, anaemia and other blood-diseases and may, someday, treat ailments from diabetes to Alzheimer’s.


According to Benen Foo Ban Nyen, executive chairman of CellSafe International, a private blood bank in the Klang Valley, stem cells are rare and difficult to harvest from the adult body, but they are found abundantly in the baby’s umbilical cord and placenta. “Umbilical cords are often discarded after birth, yet the blood is a rich source for stem cells,” he says.

Foo says there are three main reasons to save a baby’s cord blood: for the child, for family members and for presently undeveloped uses.

“There are well over 70 diseases that have been successfully treated using umbilical cord blood stem cells, and there are many diseases — from Parkinson’s, stroke, heart disease and spinal cord injuries to Alzheimer’s — in promising stages of research and development right now,” says Foo, whose company is one of the three private blood banks in Malaysia, along with StemLife and CyroCord.

As cord blood banking isn’t routine in hospital or home deliveries, you have to choose and plan beforehand. Foo says that it will be collected in a specific kit that parents must order ahead of time from them.

“Taking cord blood is very safe for the mother and baby,” explains Foo. “Collection takes place shortly after birth in both vaginal and cesarean (c-section) deliveries.”

Storing a newborn’s stem cells with a private company means the family has access to the cells whenever needed — as long as the company is in business and the cells are viable. A basic package for cord blood banking at CellSafe costs RM2,000, with an annual fee of RM250. Should you choose to stop paying your fees, your stem cells will be disposed of. A more comprehensive package, like the Platinum package, costs RM5,000.

But it almost seems too simple, doesn’t it? Save a byproduct of the birth process and potentially save a life. In practice, however, umbilical cord use, collection, and storage are still experimental and raise many controversial issues and questions. Should the blood be stored only for potential use by a family member or donated to a public bank? What is the likelihood of a family ever using its own sample?

Another concern is that the long-term viability of cryogenically frozen cord blood has yet to be firmly established.

Still, no one debates that cord blood cells can be lifesaving.

“Cord blood is a proven, effective source of blood-forming stem cells for people with certain diseases,” says haematologist Dr Goh Kim Yen. “It can be used to treat numerous hematologic, metabolic, and immunologic disorders.”

She says that studies have shown success in using cord blood stem cells in allogeneic transplants. Allogeneic transplants mean the tissue comes from a person other than the recipient — either a sibling, another relative, or a non-relative. Conversely, an autologous transplant means the patient uses his own tissue.

However, Dr Goh, who specialises in stem cell transplants, says that if a child develops certain blood diseases, his or her own frozen cord blood may not be the best choice of stem cell to carry out a transplant.

“The cord blood may have the same genetic flaws that caused the disease in the first place, so it may not be the best choice.”

Stem cell transplants are performed in both children and adults, she says.

The larger the size of the person, the more blood-forming stem cells that are needed for a successful transplant. The number of stem cells in a single unit of umbilical cord blood may not be adequate for engraftment in a large sized adult.

The American Academy of Pediatrics (AAP), in its most recent statement, says “private storage of cord blood as “biological insurance” is unwise” unless a family member might need a blood stem cell transplant.

For instance, Dr Goh explains, if someone in your family already has leukaemia, sickle cell anaemia, or other blood disorders, banking could make sense, either for the child or for another family member.

According to most experts, the odds that a child will ever use his or her own stored cord blood are small. A 2005 editorial in the journal Obstetrics and Gynecology states that the chances are about one in 2,700.

Other estimates range widely. Advertising from one private cord blood bank puts the odds at 1 in 27. The American Academy of Pediatrics suggests it’s more like 1 in 200,000.

Indisputably, there are very few documented cases of a child receiving his or her own banked cord blood as treatment. The US Institute of Medicine says that there may only have been as few as 14 of these procedures ever performed. One reason is that the conditions cord blood stem cells could help treat just aren’t that common.

“The diseases in children that we can treat with their own cord blood stem cells are limited,” says Dr Goh.

So the important thing is to make an informed choice. You need to know the benefits and costs of cord blood banking before you make any decisions. Whatever you do, don’t let yourself be pushed into a choice.

“I think it’s fine if a parent makes an informed decision to do this and the decision is entirely a personal one after weighing its pros and cons,” says Dr Goh.

Gym bugs

From The NST

By : KARINA FOO


Use the treadmill up to the time limit, then move on, for variety.

There’s one in every gym, a Mr (or Miss) Inconsiderate. KARINA FOO lists out the profiles.


Have a fun sweating it out, but with consideration for others.
YOU’RE about to use the shoulder press machine but just as you’re adjusting your weights, you spot ‘it’ on the seat: a wet puddle, stain, sweat or some other liquid that didn’t come from you. Gross.

You move to another machine, but there’s a guy curling his biceps and sounding like he’s in labour.

How about migrating to the the free weights area. Oh, the bench is occupied by someone who’s taken up permanent residence, performing never-ending reps.

The cardio machines? The same few people have been at it for what seems like hours (at some gyms, you must queue just to use one).

There are signs imploring users to be considerate, but people seem too busy working out to read them.

Etiquette in the gym is just as important as anywhere else. Have basic consideration for others and for the equipment. Most people, though, seem too caught up in their own exercise world to realise that there are others there too.

You may recognise these familiar characteristics, not just at the gym, but at work, too. Here are a few; take these as gentle reminders to create a better and more comfortable environment for you and everybody else.

THE WWF CONTESTANT

Spotted at: Weights machines or free weights area

Traits: As described above, someone who sounds like he’s going through immense pain. There are also other traits like dropping or throwing the barbell on the floor or swearing loudly when he’s had enough.

These people are usually really nice (and gentle), they just use all their strength on weights and express their “pain” when they’ve reached the maximum limit of what their bodies can take. It’s OK to grunt and swear a little (just as long you don’t share that with the entire gym).

Next time you encounter this, wait for the guy to finish and approach him when he looks relaxed or is taking a long break.

Tell him nicely: “Hi, you’re doing great but I would really appreciate it if you could lower your tone of voice because it is distracting my workout too, thanks.” Don’t accuse him of being a loud-mouthed freak because that might start an unnecessary argument.

THE HUMAN HOSE

Spotted at: Everywhere, but most commonly the cardio sections or during group exercise classes.

Traits: This person either is working out very hard or has lots of sweat glands. It’s a really icky feeling to think you won’t be drenched in only your own perspiration.

They could also be the culprits who leave sweat puddles on the machines. An add-on feature: sometimes they have body odour and (most of the time) don’t have a clue!

Gym towels are provided to wipe sweat off yourself and the equipment. If you’re caught in a “sticky situation”, pick another machine (or move to another one) or go to the other side of the studio.

Or take extreme measures: Be really daring to offer him some deodorant, then tell a white lie by saying you use it too because it’s really good!

THE AMNESIC HERCULES

Spotted at: The free weights area.

Traits: Now this person is strong, his legs can push 150kg effortlessly, but when it comes to putting back the weights, he conveniently forgets!

No, he’s neither amnesic or is suddenly too weak, he’s just being inconsiderate. It is annoying for the next person to see weights still stacked on the machine, without knowing who was responsible. Ask an instructor for help to remove them. And remember, yourself, to put the weights back. It sets a good example and hopefully others will remember and follow suit when they use the weights.

MR/MRS UNIVERSE

Spotted at: Anywhere with mirrors

Traits: These people can be good looking and they want to believe it. They strut their stuff and usually spend eons in front of the mirrors, flexing, comparing muscle size or running their fingers through their cheese-grater abs.

Sure they can be inspiration for a fitter-new-you, but don’t follow in their footsteps thinking that the gym is a runway.

Yes, mirrors are there for you to look at yourself, but when you block other people (those who are really checking their form), then you’re not going to score many favourable points.

Use the changing room mirrors if you want to indulge in self-admiration, and leave the gym mirrors for proper gym work.

THE DURACELL BUNNY

Spotted at: Every machine

Traits: If you could earn a dollar for each rep or each minute this person is at the machine, you’ll make Donald Trump look like a pauper!

This is a hog who tries to forget that others who need to use the machine, too. Most gyms have time limits on the cardio machines (usually 20-25 minutes at a time), but some people think they’re being smart by covering the time monitor with their towel!

When the gym is crowded and you’re nearing the time limit on the treadmill, move to another cardio machine, maybe the elliptical trainer or even an exercise class — it’s also an added bonus because it gives variety to your workout!

THE BOOKWORM

Spotted at: Any place or any other area that obstructs other members.

Traits: He brings a book or magazine, sits on a bench or machine and reads for what seems like the duration of your entire workout.

He could be taking a break between sets, but a ‘break’ isn’t one when it’s more than 10 minutes long and he’s absorbed in features like “How To Satisfy Her” or other articles unrelated to gym time.

It’s OK to have a read between sets but if you’re going to veg out in front of the pages, do it outside, like at the gym reception room or in the changing rooms.

JOHHNY BRAVO/ JESSICA RABBIT

Spotted at: Any place where there are people.

Traits: A man or a woman (but it’s more noticeably the guys) who goes around trying all sorts of ways to chat up the opposite sex.

They could pose as someone trying to ‘correct’ your already correct form (and invades your comfort zone), compliments you endlessly, and just flirts shamelessly. But there are just so many ways they do it and you’ll soon know what they’re trying to do.

While the gym is a great place to socialise, it’s not cool when you’re totally dying during your workout, and someone tries to hit on you.

They also think you’re free to talk or listen to the story of their lives. Just tell them: “Sorry, I can’t talk now, am trying to finish a workout. I’ll see you later.”

It is hard to brush people off, but you do want to get on with your workout. You can always wear an in-your-face shirt which says: “Come this close and you won’t look straight again!”. But no, just be cordial and they’ll understand (hopefully).

BUT IT’S STILL A BOTHER!

IF these people don’t budge when you’ve already told them (nicely), let the gym staff know, by word or a letter. If the gym cares for its members, they’ll take action but if not, maybe it’s time for a change.

But note that in every gym, there will be some people who work you up the wrong way. The deal is to learn how to work out alongside them, agree to something and comply with it.

If everyone co-operates with each other, the gym should be a pleasant place to go to.

Food for friendly bacteria

From The NST

By : Yam Cher Seng

OF late, there’s been a lot of buzz about probiotics in the media. According to an expert panel commissioned by FAO and WHO, probiotics are micro-organisms which, when administered in adequate amounts, confer health benefits on the host. In other words, you can call it friendly bacteria which exert health benefits on the host.

Friendly bacteria adhere to the lining of the intestinal tract and have been shown to colonise and grow in the gastrointestinal tract. Friendly bacteria secrete anti-infective proteins that are harmful to the pathogens. This ultimately improves gut problems such as bloating, flatulence, diarrhoea and constipation, which are caused by imbalance of gut microflora.

Healthcare professionals also have been advising patients who have undergone antibiotic treatment to supplement their diet with probiotics. This is because antibiotics kill off all bacteria, including the good ones. This allows the harmful bacteria to overgrow, resulting in gastrointestinal problems. A healthy dose of probiotics can keep the “bad bug” at bay and improve beneficial intestinal microflora.

Many clinical studies have demonstrated the health benefits of friendly bacteria. Specific strains such as Lactobacillus acidophilus LA-5 and Bifidobacterium lactis BB-12 are well-documented for reducing the incidence of diarrhoea, hard bowel movement (constipation) as well as alleviate lactose intolerance and food allergies. A dose of 1-1.5 billion cfu of these probiotics daily would be beneficial.

Many of you may have heard about probiotics, but how many of you know about prebiotics? In layman’s term, prebiotics is the food for probiotics.
Of all prebiotics, chicory inulin is the most extensively studied. It is a natural prebiotic extracted from chicory root and carries many beneficial effects for the human body. An abundance of scientific evidence from human studies has demonstrated positive results which underlie the health benefits of these probiotic strains and inulin.

On the other hand, studies showed that inulin is beneficial for improving gut health and enhancing absorption of calcium, which is important for stronger bones. Not only is it safe and well-tolerated among children, it is a good supplement after an antibiotic treatment. Administration of antibiotics disturbs the intestinal microflora and supplementing your child with inulin after an antibiotic treatment helps re-establish the homeostasis of the gut microbiota by increasing the levels of lactobacilli and bifidobacteria.

A combination of pre and probiotics, also known as synbiotic, showed that children with oral supplementation of synbiotics experienced significantly fewer sick days compared to those without synbiotic supplementation. Moreover, orally administered synbiotics may enhance vitamins and minerals absorption particularly calcium, boosting bone health by increasing the expression of calcium-binding proteins and solubility of minerals.

These benefits induced by synbiotics contribute to improvement in nutritional status with subsequent enhancement of the immune system, which in turn will improve a child’s performance in the classroom.

The writer is a pharmacist who is actively involved in the dissemination of information on natural healthcare and holistic therapies. For more information, she can be contacted at csyam@streamyx.com.

Secrets to a youthful look

From The NST

STAYING FIT AND FABULOUS: Secrets to a youthful look

By : KARINA FOO


Tom always works out no matter where and when!

Businessman Tom Curtis tells KARINA FOO that regular exercises are not only therapeutic but can also delay significantly the ageing process.

Name: Tom Curtis
Occupation: CEO of Golds Gym Kuala Lumpur (GGKL) and businessman
Age: 52 (No way!!)

HAVE you ever felt that you are bursting with energy?
That feeling is probably rather rare for quite a few over 50 but with regular exercise and a healthy lifestyle, most can experience it too.
Tom Curtis, CEO of Golds Gym Kuala Lumpur (GGKL) is the epitome of one who defies his age and is fitter than many younger to him. When he talks, his eyes light up; he speaks with vibrancy and his actions are sprightly.
“Nah, age doesn’t matter, I’m geared for anything,” says the Englishman who has been living in Malaysia for over 20 years and has travelled extensively. He recently scaled Mount Everest and will probably do it again. He tells us what keeps him on his feet and how you, too, can be fit and fabulous.

How do you maintain your physique and fitness?
I work out in Gold’s Gym every day when I’m in Kuala Lumpur, which is about three-four days a week, and I try to take a few minutes to exercise in the evenings when I’m travelling.
What’s your exercise regime like and how do you squeeze it into your hectic schedule?
I tend to focus on strength training, though more recently while preparing for an expedition to Mt Everest, I added some stepping and treadmill exercises a couple of times a week. I tend to limit my workouts to three or four muscle groups per day, working each major muscle group twice a week at least.
Throw in some use of functional training equipment such as the BOSU and TRX system, popularised by the US Navy Seals, and that just about completes my training regimen.
I’m fortunate that I’m able to work out of an office I’ve set up in GGKL. I handle all my business interests from there, so when things go quiet, which will generally be around 6.30 to 7pm, I just duck into the gym. No fighting with traffic, no time-wasting journey to antagonise me and no excuses to miss my daily workout!

Many people hate the idea of exercising, so tell them what’s the best thing about it?
Breaking out! Unless you’re truly and seriously stretched in your daily life, you wouldn’t understand that, but after a mentally challenging day, there’s nothing like some serious physical action.
The best thing about working out is the direct contrast it provides to the rest of the day. Throwing pieces of iron around is hugely therapeutic after the minutiae of contracts and calculators for the working day!

But are there any obstacles that deter you from working out?
None. I will not be kept from the gym. Once regular exercise becomes an integral part of your daily life, it remains so. That is the key to the successful adoption of a healthy lifestyle.

Aren’t there times when you can’t follow schedule?
Travel can keep me from the gym for three to five days at a time. After three days of not working out, your muscles start to lose their strength. I solve that problem by getting back into the gym as fast as possible after trips, at least for a short workout.

Is there any pressure to keep up or maintain your image in front of others?
Frankly, no. I’m not really an image-conscious person, though obviously, as the public face of the Malaysian franchise of one of the global fitness colossuses, it is important that I make some effort at keeping up a healthy lifestyle and work out regularly.
I do try to make a point of maintaining a strong body and avoid all-night beer binges.

I see you love your food though?
Oh yes, here’s the entire list — nasi lemak... and beef or chicken rendang, nasi dagang, laksa of all varieties, nasi lemak, endless kuih, sotong, goreng pisang, murtabak pisang, fried kuey teow, nasi kandar, nasi campur, nasi padang, nasi kerabu, ayam percik, banana leaf curry, sambal... frankly anything from Malaysia and Thailand. And, oh, did I mention nasi lemak? (Yes, you did, Tom)

How very healthy indeed! But have you always maintained the healthy part of your lifestyle?
Assuming you still want to associate me with a healthy lifestyle after my repetitive references to nasi lemak, I think my healthy lifestyle goes all the way back to my public school days in England.
During those formative years, one was rarely 30 minutes away from some form of exercise. Sports and competition, we were taught relentlessly, was a ‘good thing’, to be maintained throughout one’s life and it has been a cornerstone of my lifestyle since then.
Today, if I’m not working or exercising, I’m watching sports on TV at any and every opportunity.

What is your motivation to working out?
Advancing years and the inability to maintain the same fast and furious pace of yesteryear. It’s heartening that something as simple as regular exercise can help roll back the years and delay significantly the onset of the ageing process.
I want to retain as much freedom and functionality as possible well into my mature years

How do you de-stress?
I don’t suffer from stress. Stress is the result of exposing oneself to various pressures that are beyond your capability and capacity to handle, resulting in under-performance and consequent mental stress.
I like to ensure that I approach life in a light-hearted and relaxed, yet professional manner so as to avoid inducing stress. If I am stressed, I’d relieve it by knocking a speed ball or combination bags around a while and maxing out on some weights.

What would you suggest to someone who wants to get in shape?
Don’t waste another day. Start now and make fitness a part of your lifestyle. If I have a dollar for everyone who told me that they’re too busy to go to a gym three times a week for an hour a time, I’d be a multi-millionaire.
That’s just excuses. Absolutely no-one is too busy to make regular exercise part of their life and the simplest way of making sure you do that is to carve out three dedicated sessions of 90 minutes each at a gym.
Next, don’t give up when it becomes routine or hard! That’s just weakness. Stay with it and make it as much a part of your life routine as Sunday lunch with the family or visits to the supermarket.
It’s a mental hurdle you have to get over, but once you understand just how vital it is to exercise three times a week, then you have a chance of keeping the commitment going.
Fitness doesn’t come in three-month spells, you have to start now and keep going till late into your life. So, if you value your health, life, long-term functionality and love your family, get into the gym.

Then, should we use the media’s portrayal of ‘beautiful bodies’ for inspiration?
I think that the focus on the body beautiful is generally being overdone somewhat, though I’m firmly of the belief that the media focus on a shapely, toned or buffed body is both good for the public and for the fitness industry.
The world is fast-paced, abounding in pollutants, free radicals and pressures of all forms and varieties. Our wellbeing is being attacked from every angle and the most effective single preventive, antidote or solution to those negatives is regular exercise and a healthy, fit and well-prepared body.
The visual element is perhaps somewhat superfluous, but the message conveyed by the media image of the well-kept body serves to influence the public on the need to engage in regular physical exercise for long-term wellbeing.

For bull’s eye vision!

From The NST

ALTERNATIVE MEDICINE:
For bull’s eye vision!

By : Yam Cher Seng

WORLD Sight Day falls on Oct 13 every year. It’s a day to remember how important our eyes are and how we should keep them clear and healthy. Many cases of blindness are a result of common eye disorders.

Typical causes of blindness are age-related macular degeneration (breakdown of the retina affecting central vision), glaucoma (increase in eye pressure that can hurt the retina), cataract (loss of lens transparency) and diabetic retinopathy (breakdown or blockage of the retinal blood vessels in diabetic patients).

Age-related macular degeneration (ARMD) is the leading cause of blindness. It is the most common form of macular disease which affects the central part of the retina. The retina has two parts: the peripheral retina and the macula. If you imagine the retina as a circle with a bull’s eye at the centre, the macula is the bull’s eye: it is very small. The large area of the retina that surrounds the macula and makes up 95 per cent of it is called the peripheral retina.

Age-related macular degeneration usually develops after a person reaches 50 years. It generally involves both eyes, although they may not be affected at the same time, or to the same degree. The condition causes problems reading, seeing small objects and distorted vision. This process can happen quickly or develop over several months. Those with this condition may become very sensitive to light or actually see lights that are not there. There may be some discomfort, although overall the condition is not painful.

Lutein and zeaxanthin are carotenoids found in highest concentration in the macular region of the eyes, where they are believed to help filter out damaging blue light. They act as an antioxidant, protecting the lens, retina and macula against free radical damage. Therefore, anyone who spends a lot of time outdoors exposed to the sun should consider consuming more of these beneficial carotenoids.
Lutein and zeaxanthin are yellow pigments naturally found in high concentrations in egg yolks, corn and yellow fruits, and dark green leafy vegetables (spinach, kale, broccoli).

Recent diet surveys have indicated that consumption of these foods has dropped more than 20 per cent in the two groups at highest risk for age-related macular degeneration (women and the elderly).

When choosing a supplement, be sure to select one that delivers an effective level of lutein (about four to six mg/day). From studies of age-related macular degeneration rates and dietary intake, it appears that diets providing about 6mg of lutein and about 350µg of zeaxanthin per day can reduce its prevalence by nearly half.

Even normal-sighted people who take lutein and zeaxanthin supplements report reduced glare and sharper vision. This can be helpful for anyone exposed to brilliant sunlight or computer screens on a daily basis. Therefore, maintain healthy eyesight from now, because once lost, many functions of the eye cannot be restored.

Take this advice to heart

From The NST

By : KASMIAH MUSTAPHA


Diabetics need to control their sugar intake.

A worldwide study involving five Malaysian hospitals looks at heart and stroke risks for diabetics. KASMIAH MUSTAPHA listens to what the experts have to say.


Chan: “In treating diabetic patients, we had always looked at controlling their blood pressure.”
Khalid advises patients to lead a healthy lifestyle.
PEOPLE with diabetes not only need to monitor their blood sugar levels, but also have to control their blood pressure. A diabetic person with high blood pressure is at higher risk of cardiovascular disease.

Professor Chan Siew Pheng, senior consultant endocrinologist at the University Malaya’s Medical Centre says cardiovascular disease is the main cause of death for people with Type II diabetes.

“The risks of heart attack and stroke are higher for them if they do not control their blood pressure. In addition, the poor control of blood sugar level will cause more complications as it will increase the risk of narrowing of the blood vessels in the heart or brain, causing a heart attack or stroke.”

Chan was speaking at a news conference to announce the results of a worldwide study on the effect of a fixed combination of perindopril and indapamide in controlling blood pressure levels for people withType 2 diabetes.
The advanced trial involved 11,140 patients in 20 countries in Asia, Australasia, Europe and North America.

Five centres in Malaysia were involved: University Malaya Medical Centre, Hospital Universiti Kebangsaan Malaysia, Penang General Hospital, Ipoh General Hospital and Hospital Universiti Sains Malaysia.

Chan, who is the lead investigator for UMMC, says the four-year study found that the fixed combination of perindopril and indapamide had lowered the risk of total mortality by 14 per cent.


It was also found that the combination of the two drugs lowered the risk of cardiovascular death by 18 per cent, reduced major vascular events by nine per cent, total coronary events by 14 per cent and total renal events by 21 per cent.

In Malaysia, the National Health and Morbidity Survey showed an increase in adult diabetes from 6.3 per cent in 1986 to 8.8 per cent in 1996. It was estimated that one in every 10 adult Malaysians is a diabetic.

Globally there are 25 million people with diabetes, most of whom will eventually die or be disabled by the complications of the disease.

The patients selected for the trial were aged 55 and above, and who had a history of macro and micro vascular disease 10 years prior to joining the trial. They also had signs of other risk factors and were either hypertensive or normotensive.

Chan says five years of treatment with the fixed combination of perindopril and indapamide would have prevented one major vascular event among 66 patients, one death among 79 patients, one coronary event among 75 patients and one renal event in 20 patients.

“As Malaysia is involved in the study, the data is relevant to our population. In treating diabetic patients, we had always looked at controlling their blood pressure.”

HUKM consultant cardiologist Professor Datuk Khalid Yusoff says it is important that people with diabetes have better control of their blood sugar level to avoid complications.

“You have to consider that you are at risk of heart, kidney and eye diseases. Always talk to your doctor about the right treatments for you.”

“The most important thing for a diabetic is to exercise and lead a healthy lifestyle. This will help in controlling your condition.”

The advanced trial included four major sub-studies looking at heart and eye functions after intervention, cost-effectiveness and quality of life and genetic factors. The trial was initiated and designed by the investigators and co-sponsored by the George Institute for International Health (Australia), the University of Sydney and pharmaceutical company Servier.

The results of the second part of the trial, that sets out to assess the risks and benefits of intensive glucose lowering, will be announced at the end of the year.

Mind your cells

From The NST

By : KASMIAH MUSTAPHA


A diet with fruits and vegetables will keep the body healthy.

KASMIAH MUSTAPHA speaks to an expert on cellular health about staying healthy and ageing beautifully.

WHAT better way to ensure we live longer and healthier than by taking care of our inner health. And the best way to do this is to keep the cells in our body healthy, by eating proper food with the essential nutrients.

Datuk Dr Harnam Singh, an expert on cellular health, says keeping the cells healthy would prevent the onset of illnesses and diseases. “Cells are the foundation of a healthy body. They need nutrients to ensure the organs in our body function well: if they don’t, it will result in an overall health decline in a person.

“Without cells, the organs and organ systems cannot function and this will of course lead to deterioration of our overall health.”

Dr Harnam says the body has some 100 billion cells that work together to form tissues, organs and organ systems, with each having specific functions. A healthy diet that contains all the essential nutrients is vital to ensure the cells are healthy.
“When we are talking about cellular health, it means we need to take care of our cells. This can be done through eating healthy — eating carbohydrates, proteins and fats in the right proportions, taking vitamins and minerals. And also by leading an active lifestyle.

“In today’s world, 70 per cent of the diseases is because of our lifestyle and only 30 per cent due to our genes. If we have a sedentary lifestyle with bad eating habits, you know that this will cause several health complications.”

If the cells are not supplemented with essential nutrients, it will lead to cellular dysfunction.

Dr Harnam says each cell comprises three main things: mitochondria, chromosomes and genes. “Mitochondria keep the cells working. They are the engines that keep our bodies functioning. To get this engine running we need vitamins and minerals. Mitochondria will take these nutrients, break them down, and create energy for the cells.

“Research has shown that an important factor in ageing is the decay of mitochondria. Experts believe that preventing or reversing mitochondrial dysfunction might reverse the ageing process.

“The body will release free radicals which will get on the cell and damage it. The free radicals can cause the cell to break down and become weak. It will eventually lead to the death of the cells, which will cause havoc to our immune system.

“To protect the cells, we need to take antioxidants such as vitamins C and E. Antioxidants are found to have a role in slowing the ageing process. So it is advisable if you start to take all these supplements.

“Let the food be our medicine and medicine be our food. What we eat, and our lifestyle, are the two pillars of good health.”

Recent studies have shown free radicals to be implicated in the cause of more than 50 diseases including heart disease, various forms of cancer, cataracts, and premature ageing. Antioxidants are intimately involved in the prevention of cellular damage — the common pathway for cancer, ageing, and a variety of diseases.

Saturday, November 17, 2007

Osteoporosis

OSTEOPOROSIS is a disease people often do not know they have until they break a bone.

Bone thinning due to osteoporosis affects millions of people around the world. While 80% of those affected are women, men are also at risk, and the disease can strike at any age.

Osteoporosis literally means “porous bones” and it is a condition characterised by calcium-depleted bones that become fragile and weak.

Between 2-4% of a person’s skeleton is remodelled every year. This means that calcium and other minerals (magnesium, zinc, copper, boron, manganese) leave the bone in a process called resorption and then must be “remodelled” or replaced.

If not prevented or if left untreated, osteoporosis can progress painlessly until a bone breaks. These broken bones, also known as fractures, occur typically in the hip, spine, and wrist.

Any bone can be affected, but of special concern are fractures of the hip and spine. A hip fracture almost always requires hospitalisation and major surgery. It can impair a person’s ability to walk unassisted and may cause prolonged or permanent disability or even death.

Spinal or vertebral fractures also have serious consequences, including loss of height, severe back pain, deformity and so on.

Whether due to poor nutrition or reduced hormone levels with the onset of ageing, the loss of calcium and other minerals from the bone creates tiny holes that make bones weak and brittle, particularly if collagen is lost. This is how osteoporosis develops.

Building and maintaining bone mass is paramount to avoiding osteoporosis. By about age 20, the average woman has acquired 98% of her skeletal mass.

Building strong bones during childhood and adolescence can be the best defence against developing osteoporosis later.

There are five steps, which together, can optimise bone health and help prevent osteoporosis. They are:

Diet: Eating foods rich in calcium, magnesium, zinc, manganese, boron and copper such as milk, broccoli, fish and dark green vegetables.

Weight-bearing and resistance-training exercises: Bones, like muscles, grow stronger when regularly stressed.

A healthy lifestyle with no smoking or excessive alcohol intake.

If you are not meeting the required intake of calcium and other minerals through diet, you should consider taking supplements.

The importance of calcium supplementation has long been recognised in bone health. However, as important as calcium is to bone health, it is found that in the US, only 25% of women with osteoporosis are calcium deficient.

New evidence clearly shows that vitamin D, magnesium, copper, zinc, boron and manganese are also vital for maintaining strong and healthy bone.

These nutrients should all be consumed together for optimal bone metabolism. Even the absence of one nutrient can result in weak bones and osteoporosis.

Calcium plays an important role in maintaining bone. Calcium alone cannot prevent or cure osteoporosis, but it is an important part of an overall prevention or treatment program. The US RDA (recommended daily allowances) for calcium is as follows:

Adults and teenagers – 800 to 1200mg per day.

Pregnant and breast-feeding females – 1200mg per day.

Children four to 10 years of age – 800mg per day.

Children from birth to 3 years of age – 400 to 800mg per day.

Vitamin D helps body absorb calcium. Low levels of vitamin D are common in women, especially the elderly. Deficiencies of vitamin D can lead to calcium deficiencies, leading to soft bones (osteomalacia). Experts recommend a daily intake of between 400 and 800 international units (IU).

Magnesium is essential for both the preservation and mobilisation of calcium in the bone and is required for the utilisation of vitamin D.

Magnesium deficiency is common and is a leading risk factor for osteoporosis. The US RDA for magnesium is 400mg per day.

Manganese is a trace mineral required for the synthesis of connective tissue that form the matrix upon which mineral deposition occurs. The recommended daily intake for manganese is 2mg.

Boron is needed to convert vitamin D into its active form, which explains why boron deficiency affects calcium metabolism and bone formation.

Boron reduces calcium loss from bones. Although there is no official RDA for boron, a dosage of 1.5 to 3.0mg daily is safe and adequate (Murray, 1996).

Zinc supports bone formation by enhancing the action of vitamin D. Zinc helps maintain bone structure and is involved in bone development.

Copper deficiency may lead to abnormal bone deposition. Copper helps form the building blocks of bone.

When shopping for a calcium supplement, do ensure that it also contains the other essential nutrients mentioned above in adequate amounts to support strong and healthy bones.

Prevention of osteoporosis should begin at birth by meeting the human dietary requirements for calcium and other nutrients and should continue thereafter.