More Malaysians are keeping awake till late to indulge in what is becoming a top national pastime – tucking it in at 24-hour eating joints.

Yes, we are practically eating round-the-clock. If you are still not convinced, take a look at the goings-on at mamak shops close to and way past midnight.

These shops have sprouted up all over the country to satisfy the cravings of Malaysians who are gorging on calorie-packed late night meals with hardly a care – and getting obese in the process.

Statistics show that the prevalence of obesity among Malaysian adults increased by a staggering 250% over a 10-year period from 1996 while the number of overweight has increased by 70%.

The National Health and Morbidity Survey in 2006 showed that two out of every five adults or 43%, were either overweight or obese and an alarming situation where the number of obese adults had more than tripled over a decade, from 4% in 1996 to 14% in 2006.

Besides that, about 38% of youngsters aged between 12 and 18 were classified as overweight.

A recent survey involving 10,000 students showed that 24% of those aged between six and 12 were either overweight or obese.

Health Minister Datuk Seri Liow Tiong Lai is obviously a very worried man, with more Malaysians at risk of being seriously ill due to uncontrollable eating.

“It has to change ... an unbalanced diet and eating late at night,’’ he cautioned. “In the past, we used to have two meals. These days, we are eating five to six times daily with late-night suppers at mamak stalls,’’ he said after launching the Malaysian Council for Obesity Prevention (MCOM) here yesterday.

MCOM, which comprises 13 professional bodies and NGOs, was set up to help the government counter the problem of obesity in the country.

The minister, an avowed vegetarian, spoke of another worrying trend – meat is fast becoming a staple-diet here. A diet rich in red meat causes high cholesterol which leads to cardio-vascular disease.

“Available data on the prevalence of overweight and obesity indicates that the problem we face may be more serious than those in other countries of the region,” he added.

Being overweight and obese, he said, would lead to chronic diseases such as diabetes, high blood pressure, heart disease and even cancer.

According to statistics, 14.9% and 43% of Malaysians aged above 30 suffer from diabetes and hypertension respectively, with 20.7% of adults over 18 suffering from high cholesterol.

Liow said 300 nutritionists would be employed to serve at government clinics nationwide to help tackle obesity problems by creating awareness on the dangers of unhealthy eating.

Malaysian Council for Obesity Prevention (MCOM) president Jong Koi Chong echoed the minister’s concerns, saying the unhealthy eating trend was becoming a major problem.

“Our metabolic rate is very low at night making it easy for fat to accumulate in the body.

"Most 24-hour restaurants serve food that is high in fat, calories and cholesterol. Sadly, more of our young are picking up bad eating habits from adults,’’ he added.

Gaya hidup, trend pemakanan, sikap dan pengaruh persekitaran sekarang mendorong gejala berat badan atau obesiti yang semakin ketara. Obesiti memberi kesan negatif kepada kesihatan tubuh. Ia dikaitkan dengan pakej penyakit kronik, iaitu darah tinggi, kencing manis, sakit buah pinggang dan jantung selain menjejaskan sistem reproduksi.

Jumlah penduduk yang mengalami obesiti juga semakin meningkat. Jika gejala ini tidak dibendung, struktur masyarakat akan semakin lemah kerana sebahagian besar komponen muda mengalami obesiti sekali gus tidak aktif kerana berpenyakit. Obesiti mesti ditangani segera sebelum majoriti rakyat negara ini mengalaminya. Justeru, perlu ada tindakan bersepadu agensi dan kementerian untuk memberi panduan kepada rakyat mengenai disiplin pemakanan serta keperluan melakukan aktiviti riadah untuk mengekalkan berat badan ideal. Memandangkan pemakanan adalah asas kehidupan yang sihat, proses mendidik rakyat mengenainya mesti membabitkan sistem pendidikan di semua peringkat. Kementerian Kesihatan mesti mempelopori tindakan ini. Perlu ada segmen pemakanan dalam mata pelajaran yang difikirkan sesuai di sekolah.

Kemudian, kementerian menggembleng pelbagai media massa, multimedia dan media sosial untuk menyebarkan panduan pemakanan seimbang kepada orang ramai. Program menggalakkan senaman, mengutamakan diet seimbang dan kempen menurunkan berat badan mesti disemarakkan. Ilmu keibubapaan juga perlu diserapkan dengan galakan dan fakta kebaikan menyediakan sendiri makanan untuk keluarga di rumah. Perlu juga disebarkan silibus mengenai diet dan penyediaan makanan secara sihat untuk dijadikan panduan. Menangani obesiti memerlukan panduan dan dorongan pakar. Obesiti sangat kompleks dan hanya panduan pakar mampu menghuraikan permasalahan itu.

Apabila Kementerian Kesihatan menyebut ada kira-kira 300 pakar pemakanan akan ditempatkan di klinik kerajaan terpilih secara berperingkat untuk memberi kaunseling berhubung obesiti, ia adalah tindakan yang benar-benar serius mahu menangani gejala berkenaan. Kesungguhan kerajaan melihat rakyat sihat turut dibuktikan dengan penubuhan Majlis Cegah Obesiti Malaysia (Mcom), Sabtu lalu. Majlis itu dianggotai 13 anggota persatuan yang akan membantu kerajaan menangani masalah obesiti sambil menyebarkan penerangan dan maklumat serta meningkatkan kesedaran umum mengenai gaya hidup sihat termasuk aspek pemakanan.

Kemahiran memberi kaunseling mengenai obesiti dan gaya hidup sihat juga mesti disebarkan kepada lebih ramai individu termasuk guru, persatuan, kelab, badan bukan kerajaan mahupun organisasi pekerjaan supaya penyampaiannya lebih menyeluruh. Susulan lain hasil penubuhan Mcom ialah keperluan mewujudkan garis panduan dalam industri makanan dan minuman yang selama ini ada produknya menyumbang kepada obesiti. Jelas, obesiti ada kaitan dengan pelbagai perkara dan semua ini perlu ditangani dengan bijak tetapi tegas dan berhemah.

Subsidi gula akan ditarik balik secara berperingkat sebagai salah satu usaha kerajaan membangkitkan kesedaran rakyat tentang masalah kesihatan akibat pengambilan berlebihan bahan itu.

Timbalan Menteri Perdagangan Dalam Negeri, Koperasi dan Kepenggunaan Datuk Tan Lian Hoe berkata bagaimanapun kerajaan akan memastikan kenaikan harga gula selepas itu berlaku secara minimum.

"Saya harap apabila pihak kerajaan menarik subsidi gula secara berperingkat, rakyat dapat menerimanya kerana kita buat demi untuk menjaga kesihatan rakyat sebagai pengguna," katanya kepada pemberita selepas melancarkan kempen Kurangkan Pengambilan Gula dan Peranan Koperasi, di sini Rabu.

Bagaimanapun katanya, setakat ini kerajaan belum berhasrat untuk menaikkan harga bahan itu.

"Kita akan kira kosnya, kalau nak kurangkan subsidi pun tidak akan bebankan rakyat," katanya.

Mengulas lanjut, beliau berkata tahun ini kerajaan membelanjakan RM1.008 bilion untuk subsidi gula atau 80 sen setiap kilo bagi memastikan harga bahan itu kekal pada RM1.65 sekilogram.

Dalam ucapannya sebelum itu Tan berkata hasil penjimatan subsidi itu akan diguna untuk projek pembangunan rakyat selaras dengan gagasan 1Malaysia.

Tan juga memetik laporan Pertubuhan Kesihatan Sedunia yang antara lain menyatakan jumlah pesakit diabetes di negara ini dijangka meningkat kepada 2.5 juta orang menjelang 2030, berbanding 1.2 juta sekarang.

Justeru kata Tan, sewajarnya rakyat Malaysia mula mengamalkan gaya hidup sihat yang bukan saja dapat membentuk minda cerdas tetapi juga badan cergas sekali gus berupaya meningkatkan produktiviti.

People with diabetes who undergo cancer surgery are more likely to die in the month following their operations than those who have cancer but not diabetes, an analysis by Johns Hopkins researchers suggests.

The study, to be published in the April issue of the journal Diabetes Care, finds that newly diagnosed cancer patients -- particularly those with colorectal or esophageal tumors -- who also have Type 2 diabetes have a 50 percent greater risk of death following surgery, reports China's Xinhua news agency.

Roughly 20 million Americans -- about seven percent of the population -- are believed to have diabetes and the numbers continue to grow.

"Diabetic patients, their oncologists and their surgeons should be aware of the increased risk when they have cancer surgery," says Hsin-Chieh "Jessica" Yeh, assistant professor of general internal medicine and epidemiology at the Johns Hopkins University School of Medicine, and one of the study's leaders.

"Care of diabetes before, during and after surgery is very important. It should be part of the preoperative discussion."

"When people are diagnosed with cancer, the focus often is exclusively on cancer, and diabetes management may be forgotten," Yeh said, adding that this research suggests the need to keep a dual focus.

The risk picture presented by Yeh and her colleagues emerged from a systematic review and meta-analysis of 15 previously published medical studies that included information about diabetes status and mortality among patients after cancer surgery. The size of the studies ranged from 70 patients to 32,621 patients, with a median of 427 patients.

Yeh says the analysis could not say why cancer patients with diabetes are at greater risk of death after surgery.

One culprit could be infection; diabetes is a well-established risk factor for infection and infection-related mortality in the general population, and any surgery can increase the risk of infections.

Another cause may be cardiovascular compromise. Diabetes raises the risk of atherosclerosis and is a strong predictor of heart attack and death from cardiovascular disease.

"The ultimate question of whether better diabetes management in people with cancer increases their survival after surgery can't be answered by this study," she says. "More research will be needed to figure this out."

Yeh says the Johns Hopkins study is part of a growing volume of research under way at the intersection of diabetes and cancer, two leading causes of death in the United States.

Diabetes appears to increase risk for some types of cancer, and risk factors such as physical inactivity, unhealthy lifestyles and obesity are believed to be shared by both diseases.

Women who eat diets heavy in certain carbohydrates may be at greater risk of coronary heart disease, according to researchers.

A study of over 47,000 Italian adults found that women alone whose diets contained a lot of bread, pizza and rice doubled their heart disease risk.

These foods have a high glycaemic index (GI), meaning they release energy and raise blood sugar quickly.

The findings are published in Archives of Internal Medicine.

The experts say much more research is needed to understand why these high GI foods, rather than carbohydrates per se, appear to pose a risk - and why the risk applies to women and not men.

Low GI carbohydrates, such as pasta, which release energy and raise blood sugar far slower, showed no such link with heart disease.

Glycaemic index

The doctors who produced the report studied 15,171 men and 32,578 women who completed dietary questionnaires over many years.

This allowed the researchers to calculate overall carbohydrate intakes as well as the average glycaemic index of the foods eaten and the glycaemic loads of the diets.

The glycaemic index (GI) is a measure of how much a food raises blood glucose levels compared with the same amount of glucose or white bread.

The glycaemic load is calculated based on the glycaemic index of a given food and also on the total amount of carbohydrates it contains.

After seven years, 463 participants had developed coronary heart disease.

The researchers found that the women whose diet had the highest glycaemic load had more than double the risk of heart disease compared with those women with the lowest glycaemic load.

The authors concluded: "Thus, a high consumption of carbohydrates from high-glycaemic index foods, rather than the overall quantity of carbohydrates consumed, appears to influence the risk of developing coronary heart disease."

The researchers believe that a high-glycaemic diet may dampen 'good' cholesterol levels in women more than in men.

But further research is needed to verify the absence of a link between high-glucose foods and cardiovascular disease in men, says the study.

Victoria Taylor, senior heart health dietician at the The British Heart Foundation, said that for women, choosing lower GI foods could be useful in helping them to reduce their risk of coronary heart disease.

She said: "They could try broadening the types of bread and cereals they eat to include granary, rye or oat; including more beans, pulses; and accompanying meals with a good helping of fruit and vegetables."

PRIVATE eye specialists in Sarawak have fixed their consultation fee at RM30 to make it affordable for diabetic patients to have their eyes checked yearly.

Sarawak Society for the Blind (SSB) Prevention of Blindness Sub-Committee chairman Dr Dennis Kong said the discounted fee, introduced under the Sarawak Diabetic Eyes Screening Programme, excluded treatment costs.

He said the society started the programme recently in collaboration with the Society of Private Medical Practitioners to create awareness among diabetic pa-tients on the importance of annual eye checks in preventing blindness.

“About 55% of the country’s diabetic patients have never had an eye examination,” he said.

“To be entitled to the discount at private clinics, patients have to see their family doctors who will refer them to eye specialists in Kuching, Sibu, Bintulu and Miri,” he told a press conference in Kuching yesterday. Dr Kong said a survey in 2006 showed that the prevalence of diabetes mellitus in Malaysia was on the rise.

“Prevalence of the disease in those more than 30 years in age was 6.3% in 1986, 8.3% in 1996 and 14.9% in 2006,” he said.

However, early detection and treatment and a healthy lifestyle could prevent loss of vision.

Meanwhile, SSB president Datuk Dr Hsiung Kwo Yeun urged the blind and those with impaired vision to register with the society so that they would be entitled to state welfare benefits.

To date, about 3,000 people have registered with SSB. Earlier, SSB donated a personal computer and printer to the Sarawak General Hospital Eye Clinic.

It will be used by ophthalmologists at the clinic to send statistical reports regularly to the National Eye Data Centre (NED) in Kuala Lumpur for research and study.

The reports involve diabetic eye diseases, refractive error in children and incidences of glaucoma, cataract and other eye diseases in Sarawak which will be entered into the NED database.

Seramai 300 pakar pemakanan akan ditempatkan di klinik kerajaan terpilih secara berperingkat-peringkat bagi memberi kaunseling kepada masyarakat berhubung cara pemakanan dan gaya hidup yang sihat sekaligus mengelakkan obesiti.

Menteri Kesihatan Datuk Seri Liow Tiong Lai berkata bagi tahun ini seramai 51 pakar pemakanan akan mula ditempatkan di klinik yang dikenalpasti dan selebihnya akan dihantar secara berperingkat-peringkat.

"Ini juga sebagai langkah untuk menaik taraf klinik kerajaan, tidak ketinggalan juga klinik-klinik 1Malaysia," katanya kepada pemberita selepas merasmikan Majlis Cegah Obesiti Malaysia (Mcom) di Pusat Konvensyen Kuala Lumpur (KlCC) di sini pada Sabtu.

Mcom yang dianggotai 13 anggota persatuan berperanan membantu kerajaan menangani masalah obesiti serta memberi kesedaran kepada masyarakat mengenai cara gaya hidup yang sihat.

Beliau berkata inisiatif membekalkan pakar pemakanan di klinik-klinik terpilih daripada 802 klinik kerajaan di seluruh negara diharap dapat membendung peratusan masalah berat badan dan obesiti di kalangan rakyat Malaysia yang menunjukkan peningkatan sebanyak 70 peratus pada tahun 2006 berbanding 10 tahun sebelum itu.

Liow berkata antara punca utama peningkatan ketara itu adalah disebabkan faktor makanan dan perubahan gaya hidup.

"Jika dahulu, orang makan dua kali sehari tapi sekarang orang makan sehingga lima kali sehari, dengan makan pada tengah malam di kedai-kedai mamak.

"Kanak-kanak hari ini juga tidak lagi bermain di luar tetapi hanya bermain 'playstation' di rumah, ia juga mendorong kepada faktor masalah itu dalam jangka masa panjang," katanya.

Some of the leading cereals contain more sugar than cakes, doughnuts and ice cream, research shows.

Kellogg's Crunchy Nut Cornflakes and Coco Pops as well as Weetabix Minis Chocolate Crisp were among those that had the highest sugar content.

While others, including Shreddies and Special K, still had more than some cakes, mySupermarket.co.uk found.

But cereal manufacturers said the products still only accounted for a fraction of average sugar intake.

The food and grocery comparison website gathered data on the sugar content of leading cereal brands and compared them to some of the nation's favourite snacks and deserts.

They found a jam doughnut had 8.6g of sugar, while a scoop of vanilla ice cream had 10g and Vienetta ice cream cake 11g per slice.
Not all cereals had more sugar per serving than those products, but most had more than a slice of McVities chocolate cake, which contains 5.4g.

Jonny Steel, a spokesman for mySupermarket.co.uk said: "Consumers can end up thinking they are choosing a healthy cereal, often because some sound healthy or simply look healthy because of how they are marketed.

"Yet, as with any product bought, shoppers need to make sure they read the nutritional information on the packet to understand the content."

He also warned salt levels were also higher than expected.

But the Association of Cereal Food Manufacturers said: "Breakfast cereals contribute less than 5% salt and sugar to an average day's diet and are packed full of vitamins, minerals and fibre.

"British breakfast cereals are also the best food category in Europe for providing nutrition information on pack, so people can make educated choices about what they want to buy and eat."

A spokeswoman for Kellogg's said: "Breakfast cereals are low in fat, low calorie and are a good source of vitamins, minerals, and fibre. They are also the primary source of some nutrients such as iron for children in the UK."

Please go to the original article to get the table of sugar content for various cereals.

THERE is an emerging global epidemic of childhood obesity which can increase the risk of cardiovascular diseases and diabetes in later life. It can be attributed to a myriad of causes such as increased physical inactivity, socio-environmental changes and changes in the dietary patterns of children.

With regard to dietary patterns, I would like to highlight the effects of canteen food.

Our children are in school for five to six hours a day and maybe longer with additional extracurricular activities. The only place they can obtain food or drinks is the school canteen.

How many of us have checked these canteens for the availability of healthy food choices?

Unhealthy foods would be those with a high content of saturated fats, meals containing highly processed or simple carbohydrates and overcooked vegetables. Cordials and other drinks high in sugar are easily available.

On the other hand, is cold drinking water easily available? It need not be expensive bottled water but just water fountains.

Children are active by nature and it has been shown that small frequent snacks best satiate them.

We should pay more attention to what is being served in our school canteens. There should be more offerings of healthy food choices which generally have less sugar, less salt, high fibre and wholemeal alternatives.

We should pay more attention to the diet of our children. If childhood obesity increases, the nation will suffer a rise in diabetes complications and cardiovascular diseases in the coming decades.

ALL drinks containing sugar will from now on be barred from functions officiated by Assistant Minister in the Chief Minister’s Department Datuk Daud Abdul Rahman.

Daud took this stand yesterday in support of a government campaign to reduce sugar intake since December last year.

He reasoned that since food itself had some sugar content, it would be best to eliminate sugar in drinks and requested that organisers of his functions would abide by this.

“I do not put sugar in my drinks when I’m at home so I have developed taste buds that are sensitive to sweetness so much so that when I attend functions, I find it hard to consume drinks there,” he said when launching a two-day sugar intake reduction campaign for Kuching city at Choicemall Ria Semariang here.

He hoped that other government functions would follow suit to inculcate the habit among the people.

A participant of the campaign, Robert Jimbai, 49, lauded the minister’s move to promote sugar intake reduction in society, saying that he had not come across many top figures making such a strong stand.

He said the campaign was timely as the rate of illness because of sugar intake was rising among the people.

“I just checked my sugar level and lucky for me, I’m still in the safe zone but this does not mean that I can just eat anything how. The scary part is that, the disease is picking up fast among the young,” he told StarMetro.

The father of three, who is a civil servant, said his family was also cutting down on their sugar intake as he did not want his children’s health to deteriorate.

Meanwhile, Daud said the World Health Organisation had found that a person only needed eight to ten teaspoons of sugar daily but Malaysians were consuming on average of 26 teaspoons.

He pointed out that sugar was one of the contributing causes to 60 different types of illnesses namely diabetes, cardiovascular diseases and kidney failure.

He revealed that by the end of this year, 1.3 million Malaysians could have diabetes. As it is, he said Malaysia ranked number four among Asian countries in terms of diabetes cases.

“Malaysians are used to taking so much sugar that they have developed a taste for it and the amount they take is not even necessary in their daily diet. So if they slowly cut down on sugar, they would eventually find sweet food or drink unpalatable,” he said.

The campaign yesterday featured had basic health screening and several booths offering health products and services.

The campaign was organised by the State Domestic Trade, Cooperative and Consumerism Office in support of the Kuching Consumer Movement and the State Health Department.

HEART disease is a common problem for people with kidney disease, said Health Ministry senior adviser and head of nephrology services Dr Ghazali Ahmad.

Those with kidney disease were at high risk of developing hardening of the arteries resulting in heart attacks, heart failure and strokes.

“Kidney disease somehow speeds up heart disease well before it has ravaged the kidneys. And perhaps not surprising, kidney patients may die of heart disease over a period of time,” said Dr Ghazali during the health screening conducted by the Hospital Kuala Lumpur in conjunction with this year’s World Kidney Day 2010 last Friday at The Mall.

He said kidney disease accelerated heart disease to the point before needing dialysis or transplantation.

“Hypertension (high blood pressure) and diabetes are major risk factors for chronic kidney disease and heart disease,” said Dr Ghazali.

He added that 55% of patients in Malaysia who experienced kidney failure started of by having diabetes.

Over time, these changes will damage the filtering units in our kidneys and will slowly lose their function. Vital nutrients will be lost in the urine and waste products will start to collect in the blood, and if the kidney damage is left untreated, the kidneys may fail as a result.

“Kidney-failure patients needed to undergo costly haemodialysis treatment regularly until suitable kidneys are available,” said Dr Ghazali.

“As such. I advise the public to go for regular medical checks if they have signs of diabetes.”

The salt intake by Malaysians is 25% higher than that set by the World Health Organisation, said Health Minister Datuk Seri Liow Tiong Lai.

He said the Malaysian Dietary Guidelines 2010 stated that the salt intake should not exceed one teaspoon or 5gm a day, which is equivalent to 2,000mg of natrium a day.

“However, the Food Intake Among Malaysian Adults Research 2002/2003 study stated that the natrium intake for adults is 2,575mg a day,” he said at a campaign on reducing sugar intake here yesterday.

Liow said Malaysians should make amends as high salt consumption was closely related to high blood pressure.

“The National Health and Morbidity Survey III (2006) found that the prevalence of hypertension among Malaysian adults is 43%,” he said.

Liow added that in Malaysia, labelling was not required for nitrate as the focus of nutritional labelling catered only to four key nutrients - energy, protein, carbohydrate and fats.

“However, we do monitor the contents in processed food and encourage manufacturers to produce low-salt food,” he said, adding that canned luncheon meat and sardines had high salt content.

“We urge the public to take more fresh food instead,” he added.

On sugar intake, Liow said obese adults increased from 4.4% in 1996 to 14% in 2006.

“Studies also showed that the prevalence of diabetes among those above 30 years old has increased from 8.3% in 1996 to 14.9% in 2006,” he added.

US researchers have found a link between male obesity and low testosterone levels, reports China's Xinhua news agency citing a research.

A research conducted by University at Buffalo (UB) endocrinologists showed that 40% of obese participants involved in the Hypogonadism in Males (HIM) study had lower-than- normal testosterone readings.

The percentage rose to 50% among obese men with diabetes, according to the study appearing online on Monday in the journal Diabetes Care.

The study also revealed that as body mass index, (BMI) a relationship of weight-to-height, increased, testosterone levels fell.

Obesity has long been known as a condition linked to heart disease and diabetes, but this is the largest analysis of the association between obesity and low testosterone, and the first to compare prevalence of low testosterone with obesity and diabetes separately and together.

The study showed that obesity and diabetes might exert independent influences on testosterone concentrations.

"The effect of diabetes on lowering testosterone levels was similar to that of a weight gain of approximately 20 pounds," said Sandeep Dhindsa, an endocrinology specialist in the UB Department of Medicine and first author of the study.

"In view of the fact that almost one-third of the US is obese, these observations have profound pathophysiological, clinical, epidemiological and public health implications."

The HIM study was conducted from November 2003 to February 2004 in 95 primary care practices throughout the US.

The study involved 2,165 men 45 years or older who provided blood samples for analysis of testosterone concentrations.

Belly fat is bad news – it not only looks bad, its very detrimental to general health.

AS if worrying about your hips and thighs your entire adult life wasn’t bad enough, you’ve recently noticed that your belly is getting bigger as well.

As a result, it’s getting harder to button your jeans and an unsightly bulge appears above the top of your pants – sometimes unkindly referred to as the “muffin top”.

You always thought that the dreaded “beer belly” or “spare tyre” only developed in men, so why is this happening to you now?

While it is true that men are more prone to developing an apple-shaped body – where the abdomen grows larger – women will also start to develop it after menopause. Looks aside, this accumulation of belly fat is bad for your health. So it’s time to fight the battle of the bulge with a strict diet and exercise routine.

It will be tempting to just rush out and buy bigger clothes, but it will not solve your problem.

Age, hormones, and genes

Belly fat increases as you get older, especially after menopause. This is because your body’s metabolism will slow down with age, causing the amount of fat in your body to increase.

Unfortunately, women tend to gain more fat with age compared to men. Part of this may have to do with hormones. Menopause brings on hormonal changes that affect the way your body breaks down fat and where the fat is stored.

Menopause causes the distribution of body fat to change, so that is why you find less fat on your arms, legs, and hips, and more on your abdomen.

Don’t blame it all on hormones though as genes may have something to do with it as well. Some women inherit a tendency to gain weight in their midsection because their mothers were like that, and their mother’s mother before them.

Don’t forget that as you get older, you are also physically slowing down. You become more sedentary and move a lot less. When you use less energy, your body stores it as fat.

It’s the fat inside that counts

Even if your weight doesn’t seem to be increasing, it doesn’t mean you can rest easy. Abdominal fat can increase without overall weight gain because the fat in other areas of your body is decreasing.

The mirror alone isn’t a good gauge of belly fat either. The really “bad” fat is not the “love handles” that you can grab with your hands – it’s the fat that you can’t see that you should be worried about. This is known as the visceral fat, which is deeper within the abdomen and surrounds the abdominal organs. This type of fat is linked to higher risk of heart disease, breast cancer, diabetes, metabolic syndrome, gallbladder problems, high blood pressure, and colorectal cancer.

Scientists have discovered why this type of fat is so dangerous – it is because the abdominal fat cells are not just lying dormant, waiting to be used as energy. These cells are active and produce substances that can affect your health.

For instance, it has been found that some of these fat cells produce hormones that promote insulin resistance, increasing the risk of diabetes; other fat cells produce the oestrogen hormone after menopause, increasing the risk of breast cancer.

Measuring your midriff

As I mentioned earlier, you may gain abdominal fat without gaining weight. So measurements of your weight or even your body mass index (BMI) are not accurate ways of monitoring your belly fat.

The simplest method to gauge your internal fat deposits is actually to just measure your waist. Waist measurement must be done correctly with a measuring tape – you cannot just use your pants measurement to assume that it reflects your girth.

Place the measuring tape directly on your skin (if you are wearing clothes, make sure it is a light layer of clothing). The measurement should be taken halfway between your lowest rib and the top of your hip bone, at about the level of your belly button. Breathe normally and do not suck in your stomach. Make sure the tape is firm, but do not pull it so tight that it squeezes your skin.

A reading of more than 80cm (for women) and more than 94cm (for men) means that there is an unhealthy build-up of abdominal fat in the body, which increases the risk of chronic diseases.

Belly fat, off!

So, what can you do to get rid of this awful belly fat? Fortunately, this type of fat can be burned off with a regular exercise routine and a healthy diet.

Cardio workouts are some of the best ways to lose the tummy, as they help you to burn fat calories.

Strength training is also very important, but sometimes overlooked by people who want to lose weight. Strength training with weights is effective in helping you lose belly fat because it helps you to build muscles, which burns more calories.

One of the best exercises is swimming, which burns calories as well as builds and tones muscles. Walking or jogging (outdoors or on a treadmill) also works. Remember, strolling is not exercising – you have to work up a sweat by increasing your speed or incline.

In your daily workout, start with stretching and weight training first, and save the cardio workouts for the last, to avoid injuries.

Diet tips to burn belly fat

There is no secret diet that can help you magically make that belly bulge vanish. The same wisdom for healthy living applies here – a balanced diet, with a variety of foods, is the key to maintaining a healthy waistline.

Here are some tips to help you practise healthy eating and really see the results.

Watch what you eat, literally. There are lots of hidden calories in our meals, which we do not notice, especially when we are eating out. You may have ordered a salad, but the rich, creamy dressing piles on more calories than expected. Ask for a salad with dressing on the side, or with a balsamic vinegar dressing that has fewer calories.

Read nutrition labels on the food items that you buy. Compare the amount of calories, sugars and fats on different products. Choose products that use polyunsaturated fats, instead of saturated fats. Once you start becoming aware of these labels, you will be able to make wiser choices.

Do not skip meals. Eat at fixed times and do not snack between meals. If you find yourself getting too hungry between meals, eat smaller and more frequent meals. But make sure that the amounts of food during each meal are less, or else you will be packing it on!

Drinking tea and coffee may seem harmless, but not when each cup is accompanied by sugar and cream/milk. Cream and two cubes of sugar with your coffee or tea is almost equivalent to a slice of chocolate cake! If you need to have that hot drink, cut down on your sugar and cream.

Eat more complex carbohydrates (like wholegrains, beans, lentils, brown rice and root vegetables), as they are broken down into glucose more slowly than simple carbohydrates and thus provide a gradual steady stream of energy throughout the day.

Fad diets are tempting, especially if you’re trying to lose a lot of weight rapidly. But these diets are called “fads” for a reason – they are only popular for a while because they don’t work over the long-term!

Ultimately, it is willpower and discipline that will get you through a healthy diet and a strict exercise routine. At the other end, a slimmer you awaits!

Eating processed meat such as sausages increases the likelihood of heart disease, while red meat does not seem to be as harmful, a study suggests.

A Harvard University team which looked at studies involving over one million people found just 50g of processed meat a day also raised the risk of diabetes.

But there was no such risk from eating even twice as much unprocessed meat, such as beef, lamb or pork.

This was despite the fact the two forms of meat have a similar fat content.

Writing in the journal Circulation, the researchers speculated that given the similar quantities of cholesterol and saturated fats, the difference may be explained by the salt and preservatives added to processed meats.

This is defined as any meat preserved by smoking, curing or salting and includes bacon, sausages, salami and other luncheon meats.
Salt can increase blood pressure in some people, a key risk factor for heart disease.

In animal experiments, nitrate preservatives can promote atherosclerosis and reduce glucose tolerance, which can in turn lead to heart problems and diabetes.

Similar lifestyle

The team from Harvard School of Public Health looked at 20 studies involving more than one million participants from 10 countries.

On average, each 50g serving of processed meat per day - the equivalent of a sausage or a couple of rashers of bacon - was associated with a 42% higher chance of developing coronary heart disease and a 19% higher risk of diabetes.

"Although cause-and-effect cannot be proven by these types of long-term observational studies, all of these studies adjusted for other risk factors," said Renata Micha, lead author.

"Also, the lifestyle factors associated with eating unprocessed meats and processed meats were similar, but only processed meats were linked to higher risk."

Victoria Taylor, senior heart health dietician at the British Heart Foundation, said: "If you like red meat, this can still be included as part of a balanced heart-healthy diet.

"Go for lean cuts and aim to cook from scratch using healthier cooking methods like grilling or baking. If you need to add flavour, then try using fresh and dried herbs, spices and chillies instead of salt."

A spokesman for BPEX, which represents pork producers, insisted processed meats could form part of a balanced diet.

He suggested further research was needed before any dietary recommendations could be made.

"Various studies indicate that high consumption of processed meat can be indicative of an overall poorly balanced diet: therefore it could be other aspects of the diet that are contributing to the increase in risk," he added.

Curry lovers are being warned about the high levels of salt in the dish.

Research by Consensus Action on Salt and Health (Cash) showed the salt content in some dishes was more than the daily recommended limit.

The campaign group warned with side-dishes, such as naan bread and chutney, salt levels could be even higher - but some healthier options were found too.

Nearly 800 products in supermarkets, independent shops and takeaways were analysed during the research.

The recommended maximum intake of salt is 6g a day.

But the researchers found one chicken tikka masala takeaway had 6.8g per portion, while curries on sale at Iceland also had more than the daily limit.

'Worrying'

Even rice was found to be fairly high with one brand containing 1.4g per portion and naan bread having 3.2g.

Katharine Jenner, from Cash, said: "A regular curry night is becoming a British institution, making these high salt levels extremely worrying.
"This survey shows salt can be hidden behind all the spices and chilli in your curry, even in side dishes and sauces.

"Add to this the lack of clear labelling on packaging in takeaway restaurants and it makes it very hard for consumers to choose a healthy option."

But Cash said if people shopped around they could find lower salt options.

Both the Co-operative's Healthy Living Rogan Josh and Weightwatcher's Korma had just 0.5g per portion.

A spokesman for Iceland said it had been working with suppliers to reduce salt levels.

"We have achieved reduction in salt levels over the last number of years in most product areas bringing the majority of them into line with the Food Standards Agency targets."

Julian Hunt, of the Food and Drink Federation, added: "UK food manufacturers are leading the world on changing the recipes of their products - including cooking sauces and ready meals - to contain less salt."

HEALTHY eating habits should be instilled in children from young to prevent obesity and lifestyle diseases, Semariang assemblywoman Sharifah Hasidah Sayeed Aman Ghazali said.

She said although a study in 2006 showed that only 6.1 per cent of children aged one to 18 in Sarawak were obese, parents should not be complacent but should ensure that their children were eating healthy and nutritious food.

“While people now enjoy better living standards in line with the state’s development, chronic diseases related to nutrition such as obesity, diabetes, hypertension and heart ailments are also on the rise.

“Good nutrition must begin at an early age so that children can grow in good physical and mental health,” she said.

Speaking at the launch of the state-level Nutrition Month Malaysia at SK Encik Buyong in Kuching, Hasidah said good eating habits not only meant consuming nutritious food but also eating sufficient amounts.

“This will ensure that children get enough nutrition and not eat too much or too little, which can affect their health,” she said.

She added that healthy eating should be complemented with a healthy and active lifestyle.

“Children should be encouraged to play games and be active. They will not only become healthy but will have fun at the same time,” she said.

Earlier, State Health director Dr Zulkifli Jantan said Nutrition Month Malaysia was held every April to promote healthy eating habits.

He said this year’s event was themed “Healthy Children, Healthier Nation - Start Young” to create awareness among youngsters and their parents on the importance of good nutrition.

Various activities held in conjunction with the event included a public speaking competition, health and nutrition talks, healthy cooking demonstration and health quiz for students.

ABOUT 40% of the 220 people who registered for the free prosthesis programme had their limbs amputated due to diabetes complications, said Chee Hoon Khor Moral Uplifting Society deputy president Datuk Ooi Soo Hing.

He said the number was worrying as many people nowadays did not know the dire consequences of diabetes.

“It is important to make lifestyle changes and watch one’s diet. It is important for one to avoid sugary food and eat healthy food,” said Ooi during a press conference at the society’s premises on Saturday.

He said this after receiving 500kg of ring tabs from Pulau Tikus assemblyman Koay Teng Hai’s service team, New Century Lions Club of Penang Island and Region 1 Leo Club.

Besides the tabs, Koay also donated RM5,000 from his constituency’s allocation to the programme.

The tabs would be given to the Prosthesis Foundation under the patronage of the Princess Mother of Thailand.

The foundation is sending 110 members including 10 doctors, technicians and administrative staff members to the society’s premises on Macalister Road, Penang, to see if the registered amputees could be fitted with artificial legs for free.

The tabs, which will be melted, are important parts for artificial legs.

Ooi said a kilogram of ring tabs from aluminium cans could be used to make two artificial legs, adding that each artificial leg costs between RM3,000 and RM4,000.

The six-day programme, to start this Sunday, is the second held since 2007 when the team made 190 artificial legs for 177 people.

Ooi added that Penang Chief Minister Lim Guan Eng was expected to open the programme at 9am on that day.

For people with diabetes, having too much glucose (sugar) in their blood for a long time can cause some serious complications, including foot problems. The two main concerns are diabetic neuropathy and peripheral vascular disease.

MedicineNet.com explains about Diabetes and Foot Problems in a Pictures Slideshow, which you can view from this link www.medicinenet.com

Obvious choices of fruit and vegetables are not necessarily the healthiest, say researchers.

According to US experts, making simple swaps like eating sweet potatoes instead of carrots and papaya rather than oranges could make a difference.

Foods, like raspberries, watercress and kale, are richer in phytonutrients which may help prevent disease, they told a US meeting.

UK nutritionists said a balanced diet is essential to good health.

The British Nutrition Foundation warned that relying on eating a few select food types to boost health was ill-advised and said there was no such thing as a "superfood".

Experts recommend five portions a day of fruit and veg in a healthy diet.

Plant foods are known to contain "phytonutrient" chemicals that can protect the heart and arteries and prevent cancers.

But the most popular varieties may not be the best, according to US researchers.

They analysed data from US health surveys of people's dietary habits to look at the most common sources of phytonutrients.

They found that for 10 of the 14 phytonutrients studied, a single food type accounted for two-thirds or more of an individual's consumption, regardless of how much fruit and veg they ate overall.

Carrots were the most common source of beta-carotene, oranges and orange juice the most common source of beta-cryptoxanthin, spinach the most common source of lutein/zeaxanthin, strawberries the most common source of ellagic acid and mustard the biggest provider of isothiocyanates.

However, for each of these phytonutrients there was a richer food source available.

Richer foods

Switching from carrots to sweet potatoes would nearly double beta-carotene intake, say the researchers.

Similarly papaya contains 15 times more beta-cryptoxanthin than oranges, while kale has three times more lutein/zeaxanthin than spinach.

Raspberries have three times more ellagic acid than strawberries and one cup of watercress contains as much isothiocyanate as four teaspoonfuls of mustard.

Study leader Keith Randolph, who is a technology strategist for the supplement company Nutrilite, said: "These data highlight the importance of not only the quantity but also the significant impact the quality and variety of the fruits and vegetables you eat can have on your health."

Dr Emma Williams of the British Nutrition Foundation said: "They are right that some foods are richer sources of phytonutrients.

"But at the end of the day, to be healthy you need to make sure you have a varied and balanced diet.

"No one food can give you everything you need."

The findings were presented at the 2010 Experimental Biology conference in Anaheim, California.

Health ministers, alarmed at the growing number of obese children, agreed on Thursday to try to reduce children's consumption of junk food and soft drinks by asking member states to restrict advertising and marketing.

"Childhood obesity is increasing globally now. The rate of increase in the developing world is greatest because of a rapid change in diet and physical activity patterns," Timothy Armstrong of WHO's department of chronic disease and health promotion told Reuters.

An estimated 42 million children under the age of five are overweight, 35 million of them in developing countries, according to the WHO. Overweight is one category below obese.

"The risks presented by unhealthy diets start in childhood and build up throughout life," the WHO guidelines say.

Armstrong credited the United States with ringing the alarm bell. "The global attention to child obesity has changed significantly, with the new U.S. administration taking it on as a major issue."

U.S. Surgeon-General Regina Benjamin endorsed the plan at the WHO's annual ministerial meeting.

"The set of recommendations on marketing of food and non-alcoholic beverages to children should play a significant role in helping member states promote healthier patterns of eating as part of efforts to reduce the growing epidemic of childhood obesity," Benjamin said in a speech.

"This is a priority for the Obama administration, in particular for the First Lady, who has raised awareness of childhood obesity and the importance of healthy eating."

Michelle Obama this month unveiled a 70-point plan for reducing childhood obesity within a generation, including a call for marketing healthier food, but stopping short of recommending regulatory action or a federal tax on sugary sodas.

The U.S. Centres for Disease Control and Prevention say two thirds of American adults and 15 percent of American children are overweight or obese.

"Since 1980, our obesity rates have doubled for adults and tripled for children," Benjamin told a news briefing on Tuesday. "The problem is even worse for blacks, Hispanics and native American children."

The WHO recommendations include limiting children's exposure to television advertising and making schools and playgrounds free from all forms of marketing of junk food and sugary drinks.

The global recommendations on marketing of foods and non-alcoholic beverages to children are guidelines to the 193 member states of the World Health Organisation (WHO).

Diets containing large amounts of fat, sugar or salt contribute to chronic diseases such as diabetes, heart disease and cancers, which cause 60 percent of all deaths worldwide, the United Nations agency says.

WHO adopted a global strategy on diet and physical activity in 2004, a year after clinching a treaty controlling tobacco.

On Thursday, ministers also agreed to curb binge drinking and other growing forms of excessive alcohol use through higher taxes on alcoholic drinks and tighter marketing regulations.

With 43.11 per cent of the Malaysian population being overweight or obese, it’s no surprise that there is an obesity clinic at Putrajaya Hospital, writes ANNIE FREEDA CRUEZ

FAZLI (not real name) was a chubby and cute toddler. Now, he’s grown - and fat.

“I was always hungry so I kept eating. I was the fattest in my class,” he bemoaned. He was always ridiculed by his friends for being obese, and for not being able to keep up with them when walking or taking part in physical activities. He was 220kg at age 22.

“My movements were restricted as I could not sit in a bus comfortably and I had difficulty getting in and out of taxis,” he said. He also suffered obesity-related health problems, so Fazli sought help. Doctors at a government hospital in one of the northern states referred him to Putrajaya Hospital’s Obesity Clinic two years ago.

He arrived in an ambulance and consultant endocrinologist Dr Masni Mohamad was entrusted with the task of helping him. “I had to assess him thoroughly on his first visit, which included evaluation of potential obesity-related diseases within history, physical examinations and laboratory tests. I had to get his weight history, and his eating and activity behaviour besides searching for trigger factors, including medications,” said Dr Masni, one of the pioneers at the clinic which opened in 2005 for just once a month.

However, when the team of six multi-disciplinary doctors realised that obesity was a real problem, they opened the clinic twice a month and the hospital started getting referrals from all over the country.

The team comprises Dr Zanariah Hussein, head of endocrine unit in Malaysia/Putrajaya Hospital, Dr Nurain Mohd Noor and Dr Masni, consultant endocrinologists, and three other specialists training to be endocrinologists. The others in the team are two bariatric surgeons, dietitians, and rehabilitation and support group experts.

Dr Masni, who was urged to join the obesity clinic by her former boss, Dr Norshinah Kamaruddin, said: “Initially, I was not keen but now I feel happy that I am championing the cause.” “I also categorise a patient’s habitual physical activities such as during leisure, travel, work and exercise,” she said. She also compiles data on the family history on obesity, diabetes, hypertension, dyslipidemia, CVS disease, obesity-related cancer, thyroid disease and does a psychological status evaluation such as a patient’s self image, mental health and screens for eating disorders before embarking on treatment.

“The patient must be ready physically and mentally to undergo the weight loss programme,” she says.

Besides surgery, Fazli was put on a diet and physical exercise regime and finally started to lose weight. He is now 120kg and is still working hard to lose more weight. The incidence of being overweight and obesity is rising globally, affecting virtually all ages and socioeconomic groups. In 2006, the National Health & Morbidity Survey revealed that 29 per cent of adult Malaysians were overweight (BMI > 25 kgm-2) and 14 per cent were obese (BMI >30 kgm-2). In fact, two in five adult Malaysians are either overweight or obese. Obesity is a major risk factor for chronic diseases including type 2 diabetes, hypertension, cardiovascular disease, stroke and certain types of cancer. All these may reduce the quality of life and increase the risk of premature death.

Putrajaya Hospital only accepts patients who are > 40 BMI and many of those in the management and treatment group also have co-morbid health conditions. The hospital has also set up an obesity support group comprising mainly patients who share their experiences, problems and achievements with others or newcomers.

“This group actually has lots of fun interacting and sharing their experiences,” said Dr Masni. The hospital holds its clinic for obesity patients in the first and third Tuesdays of the month from 2pm to 5pm.

Dr Masni is one of the speakers at the 5th Malaysian Conference On Healthy Ageing. She will highlight not only the problems related to obesity but also the ways we can overcome them.

Obese persons with BMI > 40 or those having BMI > 35 with co-morbidities are recommended to go for bariatric surgery if they fail multiple non-surgical methods to reduce weight such as self-directed dieting, nutritional counselling by a dietitian, appropriate exercise and commercial or hospital-based weight loss programmes. Bariatric surgery is currently available in Hospital Putrajaya and some private hospitals. Essentially, this surgical method reduces the size of the stomach and creates intestinal malabsorption, enabling obese persons to lose a significant amount of weight. It results in long-lasting weight loss and eliminates or improves most of the obesity-related medical complications. It helps them to either overcome or control diabetes mellitus, sleep apnea, hypercholesterolemia and gout and 80-90 per cent of hypertension and fatty liver problems. Bariatric surgery patients are managed by a multi-disciplinary team, which includes surgeons, endocrinologists, anesthesiologists, dietitians, nurses, psychiatrists, and physiotherapists.

Dr Masni says a low calorie diet (LCD) of 1,200-1,600 Kcal/day, is recommended for weight loss in overweight and obese persons. “Reducing fat (25-30 per cent of energy) is part of the LCD to reduce calories. We normally have a meal replacement therapy to achieve the LCD by recommending patients to take nutrient-rich formula, vitamin and mineral fortification,” she added. When patients are put on very low calorie diet, then it is done under close supervision, although it’s not usually recommended.

Eat to live, not live to eat WHEN it comes to obesity, women are worse off than men and many of them suffer from diabetes and hypertension.

Most of the women are aged between 40 and 59 years and factors that contribute to their being overweight and obese include genetic reasons, a sedentary lifestyle, medication and, in most cases, food.

“While it used to be eat to live in the past, it’s now live to eat,” says consultant endocrinologist Dr Masni Mohamad.

What Malaysians do not realise is that when you are overweight and obese, you face many health problems.

Her advice is to go running, swimming, cycling and taking part in aerobic activities. These can last from 30 to 60 minutes.

She said poor lifestyle activities are also a contributing factor. Lots of people prefer to take the lift and escalator instead of walking up the stairs and they park their cars near their destinations so that they don’t have to walk.

“Instead of driving, walk or run to do your errands, stand instead of sit and get up to turn off TV instead of using the remote control. Little exercises can go a long way to help maintain an ideal body weight,” she adds.

She also says we should not skip the three daily meals but we should avoid snacking in between meals and drinking sweet or carbonated drinks. We should also eat plenty of vegetables and fruit with some fish or meat and a little rice.

Dr Masni said soups, congee and high fibre food such as oats are good for those who want to lose weight.

We know that a high salt intake contributes to high blood pressure but according to a new study, sugar is just as guilty.

REMEMBER when you were told to cut the salt to reduce the high blood pressure? Well, now you’ll need to take another piece of advice from a hot new study that has found its way into the Archives Of Internal Medicine, one of the world’s leading medical journals. Cut the sugar as well. In fact, you can also cut refined carbohydrates like rice, bread and pasta

According to this study, if you have high blood pressure (hypertension), a low carb diet is a better way to control it than drugs. In a study of 146 people who were hypertensive and overweight, nearly half were able to stop or decrease their blood pressure medication after going on a low-carbohydrate diet. Systolic blood pressure dropped dramatically, researchers discovered. By comparison, only 21 per cent of those who were taking the weight-loss drug orlistat reported a similar drop in blood pressure. Sugar High Did you know that in the United States the average American has increased his/her consumption of sugar from 12kg to more than 65kg a year in the last three decades? That’s an eye-opener to just how much of a problem it really is. No doubt an increase in the sugar content of foods we consider healthy may have contributed to this trend.

The Daily Mail recently reported that foods with traditionally healthy appeal now contain twice as much sugar compared to 30 years ago! As sugar is cheap, abundant and a great stimulator of the tongue, it is now added liberally to everything. Before 1887, cardiovascular disease was almost unheard of and, as a point of interest, an average person consumed only 2.2kg of sugar every year. Instead of a luxury, it has now become a necessity.

Now consider the Eskimos. They have a diet abundant in saturated fat but cardiovascular disease was unheard of until they were introduced to a western diet of coke and sugar. This increase in sugar and high blood pressure is surely linked and is not due to their fat consumption. That is something for us to consider when we are being told to cut down on our saturated fats.

Have you heard of the glycemic index? It is an index of foods and how they affect blood-glucose levels. The higher the number given to any food, the higher its glucose levels. This increase in glucose stimulates the pancreas to secrete more insulin to lower blood-sugar levels. When insulin is increased it will cause the storing of more fat, so you will see a quick rise in weight and an increased triglyceride level, both known to help cause cardiovascular disease.

The chart lists examples of foods from the glycermic index that have a high count and a lower count, which will alert you to avoid these foods if possible.

As you probably know, people suffering from diabetes are usually suffering from high blood pressure also. See my page about diabetes and high blood pressure. If you go to the Glycemic Index you can find out which foods are low in glucose.

The problem your body has in dealing with excess sugar will eventually result in the cells becoming insulin resistant because too much insulin is toxic. If that happens, it leads to other systems in the body malfunctioning.

Insulin helps store magnesium which is needed to relax muscles. When your cells become insulin resistant, the magnesium can’t be stored, muscles constrict, high blood pressure results.

Insulin also has a part to play in sodium and water retention so when too much is in the blood it leads to high blood pressure.

Another reason linking sugar and high blood pressure is how your body absorbs carbohydrates (sugars). Complex carbohydrates are absorbed more slowly than refined carbohydrates so the blood-sugar levels do not rise quickly. Refined carbohydrates, however, need minerals and vitamins to metabolise them into the system and will leach them from your bones and other organs where vital micro-nutrients are stored, leaving you mineral deficient. Minerals such as potassium are not stored and are vital in regulating blood pressure so if you are lacking, it must have an effect on your blood pressure. Eating refined sugars also starts a vicious cycle where fatty acid and cholesterol metabolism is obstructed, causing more trigycerides and cholesterol.

Another study, published recently in the online issue of The Journal Of The American Medical Association, reported that added sugars could be a contributing factor in the development of cardiovascular disease. Sugars or sweeteners are added to food during manufacturing to increase palatability, yet they have no nutritional value. There’s been a 50 per cent jump in added sugar consumption in the past 30 years.

This study shows that reducing added sugar consumption equates to 23 per cent higher HDL-C levels (good cholesterol), eight to 10 per cent lower triglyceride levels and six per cent lower LDL-C levels (bad cholesterol).

If you have a sweet tooth, start training it to be satisfied with less sugar. The craving for sugar is not permanent and will diminish as you eat less. It is the answer to sugar and high blood pressure problems. If you do eat lots of sugar and sugary foods, eliminating it will perhaps be the end of your high blood pressure. Only your tongue wants the sugar. The rest of you does not need it. Reign your tongue in.

The nation's largest nutrition education initiative, Nutrition Month Malaysia (NMM), aims to uplift the health status of primary school children, by reaching out to families in their recent 'Healthy Children, Healthier Nation – Start Young' Carnival.

NMM celebrates its ninth anniversary at Mid Valley Exhibition Centre with the launch of Smart Nutrition for Your Growing, Active Kids Guidebook in conjunction with a family carnival.

Nutrition Month Malaysia steering committee chairman Dr Tee E Siong unveiled the guidebook together with Malaysian Association of the Study of Obesity president Professor Dr Mohd Ismail Noor and the Malaysian Dietitians’ Association honorary assistant secretary Indra Balaratnam.

Speaking at the opening of the carnival, Dr Tee said that the carnival with the theme Healthy Children, Healthier Nation Start Young, was a platform for them to inform parents to start equipping themselves with nutrition knowledge and start empowering their children.

According to Dr Tee, NMM had set aside a three-year plan focusing on child nutrition due to the importance of improving nutritional status of Malaysian children.

The first phase covering pre-school children was launched and implemented last year.

This year’s phase will focus on primary school children and the three-year plan will be wrapped up next year with nutrition issues faced by secondary school children.

Dr Tee said that the carnival aimed to reach out to parents and children to increase their awareness on the importance of healthy lifestyle through its fun educational activities.

It also allowed parents to interact with nutritionists and dietitians to gain further knowledge and know-how to set the stage for their young ones to grow and develop healthily.

“There is actually a small window of opportunity to cultivate healthy eating habits and these years are the perfect time for caring parents to start instilling healthy eating habits in their young children.

“The sooner you do so, the higher your child’s chances of making wise food choices in school and throughout his life,” he added.

The carnival showcases informative, fun-filled activities for the family, including free screenings for Body Mass Index (BMI), blood pressure, blood cholesterol, blood glucose and body fat.

Children were taught nutrition basics in a fun interactive way through games and activities at NutriActive Corner.

The Smart Nutrition for Your Growing, Active Kids Guidebook which was given away for free during the free screening sessions.

The guidebook serves as an informative publication that aims to empower parents by providing them with simple basic knowledge about nutrition; meal planning; healthy cooking as well as healthy eating guides including the new Malaysian Food Pyramid.

A growing body of research shows that a lack of exposure to nature is the culprit in rising obesity, depression and attention disorders in children.

It was otherwise a typical day at the Chinese primary school, but after a massive thunderstorm, a kingfisher flew into eight-year-old Bryn Chen Ann Howes’ classroom. All the kids shrieked and dove for cover.

Howes dashed to catch the bird and held it up for the class to see.

“This is the Oriental Dwarf Kingfisher, and it’s migrated all the way from China,” he commentated to his peers.

However, Howes’ teacher brushed him off and told him to release the bird. He was crestfallen. Howes is an anomaly amongst his peers, a generation plugged into Nintendo games and PlayStations or glued to cable TV.

A 2002 British study reported that eight-year-olds could identify Pokémon characters far more easily than they could name “otter, beetle and oak tree.” The World Heart Federation reports that two-thirds of children worldwide are insufficiently active for their health. These kids double their risk of becoming fat and developing heart and other chronic diseases.

In the past decade, the number of obese children has increased by two to five times in developed countries and almost four times in developing countries.

A growing number of studies are finding links between children’s relationship with the natural environment and how nature can potentially influence children’s health. American writer cum journalist Richard Louv’s award-winning book Last Child in the Woods — Saving Our Children from Nature-Deficit Disorder sparked off an international debate about children’s relationship with nature.

In his book, Louv coined the term “nature-deficit disorder” to talk about how children’s disconnect from the environment can lead to physical and emotional illnesses. Research has shown that children function better cognitively and emotionally in “green environments”; have more creative play in “green areas” and develop better interpersonal relationships and have a more positive attitude to school.

Studies also suggest that nature experiences can help children with attention-deficit disorder.

Closer to home, numerous studies have revealed the link between obesity, diet and sedentary lifestyles. A 2004 study of adolescents aged 12 to 17 found that 19% of Malaysian teenagers are overweight. But to date, no study has been done on the effects of nature on a child’s development.

“This connection between children and nature sounds very New Age and green,” says consultant child psychiatrist Dr Toh Chin Lee of Selayang Hospital.

Moulded by nature

Children like Howes, who cavort outdoors, are very distinct from TV/PlayStation-obsessed kids. Howes’ idea of fun is to look for insects under stones, hunt for dragonflies and beetles, and then identify them all. He brings along his own bug box, butterfly net and flash light during outdoor jaunts.

“We could’ve been in the shopping malls, playing on swings and slides or at home, playing toy cars with Bryn. Instead, we showed him frogs and butterflies, allowed him to touch them and basically just exposed him to nature since he was a baby,” says John Howes, Bryn’s father.

In Louv’s book, he talks about the difference between the constructively bored mind and a negatively numbed mind. Constructively bored kids will eventually let their imagination take flight and find something to amuse themselves whilst the numbed mind gets bored even with a truckload of toys.

“Bryn is very observant and interested in everything around him,” says Howes, 47, an ecologist.

Once while waiting for the school bus, Bryn spotted mayfly larvae in the garden. He put them in a pot so he could watch them hatch later. Because of his love for nature, he’s fostered a passion for reading.

“For years, he’s been looking at pictures in the encyclopedia of animals that I bought,” says the senior Howes, an ardent birder since he was five. “Now that he’s discovered the power of reading, he consumes everything, especially if he can learn more about aphids and beetles.”

Young Howes’ favourite TV programmes? Animal Planet, Discovery Channel or National Geographic Channel. At school, he’s the de facto “naturalist guide”, leading his four or five friends on nature walks during recess.

“In the last six years, I’ve learned an incredible amount of information about insects, and it’s all because of Bryn,” confesses Howes senior, who is from Wales.

“We’d be buying books on insects or searching for information on the Internet together,” says Bryn’s mom, Ting Lan Chiee, a former environmental journalist from Sabak Bernam.

The choices parents make

If parents can pull their kids away from video games or TV, or at least impose a time limit, they can nurture their child’s constructive boredom. The Howes have had friends ask them: “Where do you take the kids, and how do you know where to take them?”

“First things first: You’ve got to quit worrying about the kids too much. They’re pretty hardy. Bryn has taken some falls and got bitten by bugs and harmless snakes, but he’s fine,” advises Howes.

“Find a safe place to go — for example a stream or pond in a park where it’s easy to supervise the kids and there’s lots to see and find. And get over the paranoia of exposing your kids to the sun, mosquitoes and rain.”

Some parents are reluctant to take their kids outdoors because they aren’t familiar with nature or know very little. But as Rachel Carson, the founder of Modern Environmental Movement, once said, “It’s not half so important to know as to feel when introducing a young child to the natural world.”

“You have to let the child feel, see, hear and smell, then he’ll be able to understand what’s happening around him,” says Gonthong Lourdesamy, mother of two boys, Aloysius, seven and Alexavier, four.

Originally from Thailand, Gonthong and her Malaysian husband, Ben, are outdoor lovers. Their kids were exposed to nature as babies.

“Children are naturally curious and plucky. They’ll touch anything and ask lots of questions,” says Gonthong, 41, an environmental educator.

The family frequently goes on trips to Fraser Hills or Janda Baik, or occasionally takes a camping trip to Taman Negara.

“When they pick up a millipede, they’ll ask: What do they eat? Where do they live? They’ll start to process what they learn.”

The boys’ outdoor exposure has shaped their attitude towards nature.

“Once Aloysius told his younger brother off — ‘You shouldn’t use so much paper. They have to cut trees to make paper. Remember, trees are good for animals and rivers’,” Gonthong recalls.

Aloysius can also explain the rain cycle to his peers while Alexavier’s great at putting two and two together.

“He has a reason for everything that happens,” say Gonthong.

“Once he saw an army of ants filing past, and he said, ‘The ants are looking for food’.

“I asked, ‘Why do you say that?’ He replied, ‘Because they are going to the kitchen. We go to the kitchen when we’re hungry’!”

Of course, the boys aren’t impervious to their peers’ influences. When they visit a friend’s house, they do enjoy the PlayStation.

“I don’t want them to be completely cut off from other kids. When they ask if we could buy a PlayStation, I’d explain that if we buy the games, we won’t have time and money to go outdoors. Which would they prefer?”

Nature in your backyard

But before you stock up on Coleman camping gear and plan that ultimate outdoor trip, start in your backyard, like Alicia Ling Horsley has done. The mother to Cian, three, Katelin, five and Bern, seven, allows her kids to romp in the garden.

“The kids wade in our garden pond, feed the chickens, look for ‘fairies’, bathe the dogs or just count ladybugs,” says Ling, 31, who runs a pet boutique business and a cat-boarding facility.

“Sometimes, they climb the long-suffering mulberry tree and pretend to be the Navi from Avatar. Their current pursuit is catching and observing the insects and spiders.”

Ling doesn’t need to keep an eagle eye on her kids. They have learned to tell what’s safe and not.

“I think being given the opportunity to use their bodies fully is one of the best things I can offer my children. Climbing, swinging, running barefoot — this is childhood. They value nature and want to care for her. They don’t yearn for material things so much. Getting a new plant cutting to propagate is as much fun as a toy-building set,” she says

The children get their dose of TV only on weekends in the morning, when Horsley wants to spend time with their father. Though the kids are home-schooled, they get to hang out with other kids through play dates, gymnastics and rock-climbing.

An early start

It’s never too early to inculcate a love for nature in a child, as Cindy Chen and her husband, Lim Teck Wyn, have discovered. Way before she could utter “Mummy”, Cerys, the couple’s daughter was tramping in the woods with her tree-hugging parents.

“My husband and I grew up with lots of nature around us, and it’s important that our daughter share this passion,” says Chen, 31.

The couple run an environmental consultancy firm.

At home, the Lims introduced Cerys to their plants, jumping spiders and maggots from their compost. Since they don’t own a TV, the Lims observe the antics of birds and monkeys outside their balcony in the leafy suburbs of Ampang. Outings to nearby parks or streams and long trips to Endau Rompin and Danum Valley are their idea of fun.

“Cerys gets very excited looking through the binoculars for birds and loves to munch on wild berries during forest walks,” says Chen.

Now 3½ years old, their daughter can rattle off the names of mammals and reptiles and identify some birds and monkeys.

“She has an amazing memory! Months after a trip, she’d talk about what we did, what we saw, who we went with and details that I hadn’t noticed like a funny-shaped stone in the river,” says the proud mother.

“Each time we walk to the car or bicycle, Cerys will find dead or live insects, make a comment or ask us not to step on them.”

So is Cerys a Bindi Irwin in the making, and will Bryn join the ranks of Edward O. Wilson, the world-renowned scientist and insect expert?

“It doesn’t matter if Bryn becomes a computer geek or ends up as an animation artist,” Howes shrugs. “As parents, we give opportunities and stimulation to the kids. It’s up to them how they use it later on. But I’d hope that throughout his life, he’ll retain some interest in the environment and be useful to the human race.

“Too many families waste resources and have too many kids without thinking about what their kids are contributing to the future,” says Howes.

There are good alternatives for refined sugar that can be used in cooking.

WE have all been told that too much sugar in our diet can lead to a myriad of health problems such as diabetes, high blood pressure and stroke. As such, the recurring controversy surrounding the supply of sugar, although a major inconvenience to food operators and retailers, may be a good thing from a health point of view. After all, despite its wide usage in the food and beverage industry, sugar basically has no nutritious value.

Sugar is an informal term for a class of edible crystalline substances, mainly sucrose, lactose, and fructose, characterised by a sweet flavour. Its consumption varies from country to country, and Brazil is known to have the highest per capita production while India has the highest per country consumption.

According to the United States’ Centers for Disease Control and Prevention, people should limit their consumption of sugar and sugar-sweetened beverages.

The World Health Organisation (WHO) and the Malaysia Diet Guidelines both recommend that sugar intake a day should not exceed 50g.

According to the Consumers Association of Penang, Malaysians consume an average of 26 teaspoons of sugar a day (one teaspoon of granulated sugar = 4g).

The 2006 National Health and Morbidity Survey revealed that 29.1% of adults in Malaysia were overweight and 14% obese. In 1996, only 16% were overweight and 4% obese. High intake of sugar has been identified as one of the factors behind the increase in incidence of overweight and obesity in this country.

Apart from obesity, which can lead to more physical complications, too much sugar in one’s diet can cause tooth decay, unstable blood glucose levels and other diseases.

How to reduce sugar intake:

● Cut down on sugary soft drinks. Sodas and most sweetened carbonated drinks are loaded with sugar and calories. Diet colas are no better as artificial sweeteners can do more harm than good. Opt for fresh fruit juices instead. ● Avoid sweetened breakfast cereals. One serving of frosted flakes contains 14g of sugar. Choose oatmeal, natural yoghurt or smoothies sweetened with fresh fruit or frozen berries.

● Choose whole grains. Carbohydrates turn into sugar in your body. Try to avoid white bread and refined white flour and instead go for brown rice, brown pasta and whole grain bread.

● Eat food without added sugars. Processed food and baked goods are the biggest culprits for containing a lot of added sugars. Eat more salads, fruits and vegetables and season your food with more herbs and spices instead.

Healthy substitutes

Natural Raw Honey

Processed honey has little to no health benefits. Go for the organic or raw version. It is actually a delicious alternative to white sugar. Raw honey has amazing health benefits such as anti-oxidant, anti-bacterial and anti-fungal properties. As it is sweeter than sugar, you don’t have to use too much. Many alternative healthcare practitioners consider honey a superfood and a remedy for many health ailments. Honey can also promote better blood sugar control.

Honey can be used in salad dressings, baking and some savoury dishes.

Organic Maple Syrup

Basically, maple syrup is a sweetener made from the concentrated sap of the sugar maple or black maple tree. Produced mainly in north-eastern north America, maple syrup has a sweet earthy taste, is low in calories and has a higher concentration of minerals compared to other types of sugar. It is also an excellent source of manganese and zinc. Manganese and zinc that are found in maple syrup are important as anti-oxidant defences and energy production components. One ounce of maple syrup supplies 22% of the daily value of manganese.

Maple syrup is graded based on its quality and characteristic. Grade A maple syrup can be divided into light amber, medium amber and dark amber colours. The lighter the colour, the more subtle the flavour. Grade B maple syrup is usually used for cooking because of its distinctive taste.

As a sweetener, maple syrup can be used as ingredients in, among others, baked beans, candied sweet potatoes, winter squash, cakes, pies, breads, fudge and other candy, milkshakes, tea and coffee. To most Malaysians, however, maple syrup is more popular as a topping for pancakes.

In high-risk adults with type 2 diabetes, researchers have found that two therapies may slow the progression of diabetic retinopathy, an eye disease that is the leading cause of vision loss in working-age Americans.

Intensive blood sugar control reduced the progression of diabetic retinopathy compared with standard blood sugar control and combination lipid therapy with a fibrate and statin also reduced disease progression compared with statin therapy alone. However, intensive blood pressure control provided no additional benefit to patients compared with standard blood pressure control.

Results of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Eye Study, supported by the National Institutes of Health, are published online June 29 in the New England Journal of Medicine (NEJM) and will be presented June 29 at the 70th Scientific Sessions of the American Diabetes Association.

"The ACCORD Eye Study clearly indicates that intensive glycemic control and fibrate treatment added to statin therapy separately reduce the progression of diabetic retinopathy," said Emily Chew, M.D., chair of the Eye Study and chief of the Clinical Trials Branch of the Division of Epidemiology and Clinical Applications at the National Eye Institute (NEI). "The main ACCORD findings showed that fibrate treatment added to statin therapy is safe for patients like those involved in the study. However, intensive blood sugar control to near normal glucose levels increased the risk of death and severe low blood sugar, so patients and their doctors must take these potential risks into account when implementing a diabetes treatment plan."

The ACCORD study was a landmark clinical trial that included 10,251 adults with type 2 diabetes who were at especially high risk for heart attack, stroke or cardiovascular death. The study evaluated three intensive strategies compared with standard treatments for lowering cardiovascular risks associated with diabetes.

Intensive treatments included control of blood sugar to near normal levels, control of blood pressure to normal levels, and combination treatment of multiple blood lipids with fenofibrate and simvastatin compared to standard treatment with simvastatin alone. Fenofibrate treatment lowers triglycerides and raises the "good" high density lipoprotein (HDL) cholesterol levels, while simvastatin lowers the "bad" low density lipoprotein (LDL) cholesterol levels. All participants were enrolled in the blood sugar trial and in either the blood pressure or lipid trial.

The ACCORD Eye Study involved a subset of 2,856 participants. Researchers analyzed the effects of the treatment strategies on blood vessels in the eye by identifying diabetic retinopathy progression over four years. Diabetic retinopathy is a disease in which blood vessels in the eye’s light-sensitive retinal tissue are damaged by diabetes. Blood vessels can begin to leak, causing swelling in the retina, and abnormal new blood vessels can develop, both causing vision loss. In the study, disease progression was identified through retinal photographs that indicated blood vessel changes or by the need for laser or eye surgery to treat abnormal blood vessels.

Compared with standard blood sugar control, intensive control decreased the progression of diabetic retinopathy by about one-third, from 10.4 percent to 7.3 percent, over four years. Participants in the intensive control group had a median blood sugar level of 6.4 percent hemoglobin A1c—a level close to values in people without diabetes. The standard blood sugar control group maintained a median level of 7.5 percent.

"Previous clinical trials have shown the beneficial effects of intensive blood sugar control on slowing the progression of diabetic retinopathy in people with type 1 diabetes or newly diagnosed type 2 diabetes," said NEI director Paul A. Sieving M.D., Ph.D. "The ACCORD Eye Study expands these findings to a larger population of adults who had type 2 diabetes for an average of 10 years, and demonstrates that the eye benefits from the reduction of glucose below previously established levels."

In addition, compared with simvastatin treatment alone, combination lipid therapy with fenofibrate plus simvastatin also reduced disease progression by about one-third, from 10.2 percent to 6.5 percent, over four years. No prior clinical trial has shown that the combination of fenofibrate and simvastatin reduces diabetic eye disease progression.

There were no differences in diabetic retinopathy progression among participants treated to an intensive systolic blood pressure (top number in a reading) target of less than 120 mm Hg compared with those treated to a standard target of less than 140 mm Hg.

In the main ACCORD study, none of the three treatment strategies resulted in a significant decrease in the combined rate of heart attack, stroke or cardiovascular death compared with standard treatments. However, over about three-and-a-half years of follow up, participants in the intensive blood sugar group had a 22 percent higher risk of death (5.0 percent versus 4.0 percent) and a three times higher risk of seriously low blood sugar (10.5 percent versus 3.5 percent) compared with participants in the standard blood sugar control group.

The ACCORD study began in 2001, and participants were treated and monitored for an average of five years. Results of the blood sugar clinical trial were reported in 2008, when the intensive blood sugar therapy was stopped 18 months early due to an increased risk of death in that treatment group compared with the standard blood sugar control group. Findings from the blood pressure and lipid clinical trials appeared in the April 29, 2010 edition of NEJM.

"A key question in the main ACCORD study was whether intensive glucose control, previously demonstrated to reduce risk of microvascular disease — including eye problems — in diabetes, would reduce large vessel disease that causes problems like heart attacks. Investigators are continuing to evaluate the risks and benefits of the treatment strategies in these high-risk patients with type 2 diabetes," said Susan B. Shurin, M.D., acting director of the National Heart, Lung, and Blood Institute, the primary sponsor of the ACCORD study. "Clinicians should individualize treatment for each patient to prevent complications, also incorporating information about conditions such as cardiovascular or visual problems. Lifestyle interventions, including physical activity, weight loss and healthy diets, can improve diabetes control and reduce onset of diabetes."

The National Heart, Lung, and Blood Institute is the primary sponsor of ACCORD, with additional funding and scientific expertise contributed by the National Institute of Diabetes and Digestive and Kidney Diseases. The ACCORD Eye Study was supported by the National Eye Institute. Another component of the National Institutes of Health — the National Institute on Aging — and the Centers for Disease Control and Prevention support additional substudies. The following companies provided study medications, equipment, or supplies: Abbott Laboratories, Amylin Pharmaceuticals, AstraZeneca Pharmaceuticals LP, Bayer HealthCare LLC, Closer Healthcare Inc., GlaxoSmithKline Pharmaceuticals, Kin Pharmaceuticals Inc., Merck & Co. Inc., Novartis Pharmaceuticals Inc., Novo Nordisk Inc., Omron Healthcare Inc., Sanof Aventis U.S., and Takeda Pharmaceuticals Inc.

The National Eye Institute, part of the National Institutes of Health, leads the federal government’s research on the visual system and eye diseases. NEI supports basic and clinical science programs that result in the development of sight saving treatments.

Part of the NIH, the National Heart, Lung, and Blood Institute (NHLBI) plans, conducts, and supports research related to the causes, prevention, diagnosis, and treatment of heart, blood vessel, lung, and blood diseases; and sleep disorders. The Institute also administers national health education campaigns on women and heart disease, healthy weight for children, and other topics.

The National Institute of Diabetes and Digestive and Kidney Diseases, part of NIH, conducts and supports basic and
clinical research and research training on some of the most common, severe and disabling conditions affecting American The Institute's research interests include: diabetes and other endocrine and metabolic diseases; digestive diseases, nutrition, and obesity; and kidney, urologic and hematologic diseases.

The National Institutes of Health (NIH) — The Nation's Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases.

This press release was contributed by Solvay Pharmaceuticals now Abbott.

Please download the full press release below.

Download NIH ACCORD EYE Press Release (2).pdf (English - pdf) File size=37 Kb