Anna Hoo Clinic

5 signs that you might have chronic inflammation. What you can do to reduce the inflammation?

2022-05-07T15:26:00.000+08:00

What is Chronic Inflammation?

Inflammation refers to your body’s process of fighting against things that harm it such as infections, injuries and toxins to heal itself. When something damages your cells, your body releases antibodies that trigger response from your immune system. Chronic inflammation happens when this response leaving your body in a constant state of alert. Over time, chronic inflammation may have negative impact on your tissues and organs. If goes untreated, it can lead to a host of other issues especially in the heart and brain.

5 Signs of Chronic Inflammation

Acute inflammation often causes noticeable symptoms like pain, redness or swelling. But chronic inflammation symptoms are usually much more subtle. Chronic inflammation has likely been going on for a long time before you realize it’s happening.

Below are 5 common signs that someone may have a chronic inflammatory condition:

1. Body Pain

Body pain such as muscles aches, joint pain, stiffness of lower back is commonly caused by increased systemic inflammation. When inflammatory cytokines are elevated in body, they can attack muscle and joint in redness, swelling and pain.

2. Skin rashes

Skin rashes such as eczema or psoriasis are inflammatory skin conditions by symptoms of redness, rough and flaky skin. Both are linked to hypersensitivity of immune system. Patient with these conditions is more likely to have more inflammatory mast cells which trigger skin rashes to surface.

3. Low energy

Constantly feeling fatigue despite getting sufficient sleep at night is another sign of chronic inflammation. When body is chronically inflamed your immune system remains active and continues to work overtime to regulate its response. Chronic inflammation increases the requirement of cellular energy to deplete the fuel your body need to feel fully energized.

4. Poor digestion

Common digestive problems such as bloating, abdominal pain, constipation, diarrhea may also suggest an issue with inflammation. Chronic inflammation can contribute to leaky gut syndrome which can cause bacteria and toxins to leak through the intestinal wall into the rest of body. Leaky gut issue may contribute to digestive symptoms including irregular bowel movements and bloating.

5. Difficulty losing weight or weight gain

Under inflammatory condition, immune system being attacked, the body released cytokines that interfere with body’s insulin response. When body becomes resistant to insulin, the pancreas releases more insulin which trigger body to store more fat in the abdominal region. High visceral fat is also linked to heart disease, diabetes and cancer.

Other common signs of chronic inflammation also including mood disturbance, water retention, hair loss, migraine, dry eyes, nasal allergies, muscle weakness and insomnia. If you want to optimize your current and future health, you can do so by understanding signs of inflammation in the body.

What can you do to reduce inflammation?

There are wide range of factors that contribute to inflammation, it’s clear that reducing inflammation in the body should be a multi-faceted approach.

- Reduce your intake of inflammatory foods such as processed foods, fried foods, fast food, refined carbohydrates, gluten, sugar and alcohol.

- Avoid food that are sensitive to body which need IgG food allergens test to figure out.

- Eating a variety healthy diet with anti-inflammatory foods.

- Exercising regularly and getting plenty of sleep.

- Reduce exposure to chemical, smoking or exposure to second-hand smoke.

- Adopt good stress management techniques such as mindfulness meditation or yoga.

- Using nutritional supplements such as omega-3, vitamin D as suggested by healthcare provider according to your body needs.

Chronic inflammation can increase the risk of serious diseases if goes untreated. Following lower-inflammation diet, supplements and medication, good stress management, exercise may help reduce risk of living with chronic inflammation. But before making any lifestyle changes, it’s always best to consult with healthcare provider. Take note if you have symptoms of chronic inflammation, please do not hesitate to visit our healthcare provider for consultation, early treatment can help to manage your condition better before it have serious impact on your health. With the guidance of our wellness team, we can assist you better in adopting an anti-inflammatory diet and lifestyle.

Nutritionist, Lara ANNA HOO CLINIC

References:

1. Healthline. 2022. What is Chronic Inflammation (and How to Treat It). [online] Available at: https://www.healthline.com/health/chronic-inflammation

2. WebMD. 2022. Signs of Chronic Inflammation You May Not Expect. [online] Available at: https://www.webmd.com/arthritis/ss/slideshow-signs-chronic-inflammation-unexpected

3. Pahwa, R., Goyal, A. and Jialal, I., 2022. Chronic Inflammation. [online] Ncbi.nlm.nih.gov. Available at: https://www.ncbi.nlm.nih.gov/books/NBK493173/

4. Medicalnewstoday.com. 2022. Inflammation: Types, symptoms, causes, and treatment. [online] Available at: https://www.medicalnewstoday.com/articles/248423#_noHeaderPrefixedContent

5. Verywell Health. 2022. 11 Atypical Signs of Chronic Inflammation. [online] Available at: https://www.verywellhealth.com/11-atypical-signs-of-chronic-inflammation-5075765

What is the difference between Acute Inflammation vs Chronic Inflammation?

2022-04-13T17:12:00.007+08:00

How chronic inflammation can affect your health in the long run.

As destructive as inflammation may sound, inflammation is a crucial part of the body’s defence mechanism that is vital to health. It protects against harmful stimuli and plays a role in the healing process. On the flip side, prolonged inflammation is the cause that leads to detrimental effects. The key difference is the type of inflammation.

There are two main types of inflammation: ACUTE and CHRONIC.

Acute Inflammation

Acute inflammation is caused by an injury, infection or exposure to substance such as cuts, irritants or dust. In response to these harmful pathogens or tissue injury, the immune system triggers a few reactions which are characterized by 5 key signs:

Pain: May occur continuously or only upon touch

Redness: Due to an increase in blood supply to the area
Loss of function: Difficulty moving a joint, breathing, sensing smell
Swelling: Edema can develop if fluid builds up.
Heat: Increased blood flow may leave the affected area warm to the touch

These signs may not always be present but instead, a person may feel tired, generally unwell and have a fever. Acute inflammation starts rapidly and usually subsides within a few days to weeks upon recovery.

Chronic Inflammation

In contrast, chronic inflammation is a silent menace that develops slowly over a long term and can continue for months to years.

Causes of chronic inflammation include:

Sensitivity: Chronic inflammation happens when the body senses something that should not be there. Hypersensitivity to an external trigger can result in an allergy, whether to foods, or external substances such as dust or chemicals

Exposure to chemical irritants: Long term, low level exposure to chemical irritants such as cigarette smoke and industrial waste.

Autoimmune disorders: The immune system mistakenly attacks normal healthy tissue, as in psoriasis, Type 1 Diabetes and rheumatoid arthritis.

Persistent acute inflammation: In cases where a person does not fully recover from acute inflammation, chronic inflammation occurs.

Poor lifestyle habits: Obesity, poor diet, alcohol consumption, smoking, stress, low sex hormones, poor sleep quality are risk factors of chronic inflammation.

Long-term Effects

Furthermore, chronic inflammation is often insidious as it usually begins with no injury or illness present, making it hard to detect in the initial phase. Common signs and symptoms include pain, fatigue, insomnia, weight gain, mood disorders, gastrointestinal issues such as constipation, diarrhea, frequent infections.

In the long run, symptoms may worsen. In fact, chronic inflammation can be a major threat to health and longevity. It is a major contributor to diseases affecting all parts of the human body including:

Cardiovascular disease

Cancer
Diabetes
Autoimmune disease: Systemic Lupus Erythematosus, Rheumatoid Arthritis, Psoriasis
Allergic asthma
Alzheimer’s disease

Chronic kidney disease
Inflammatory bowel disease

Keep Inflammation under Control

Hence, the key to living a healthy and long life is by ensuring that inflammation in the body is kept under control. To do so, we must ensure that we minimize exposure to the causative factors, adopt healthy, balanced lifestyle habits, and conduct regular health screening.

Whether you find yourself at a high risk of chronic inflammation, are experiencing symptoms of chronic inflammation, or simply health conscious, visit your healthcare provider today for a comprehensive assessment on chronic inflammation.

By Nutritionist, ZUANNE

Anna Hoo Clinic

Reference

Pahwa, R., Goyal, A., Bansal, P., & Jialal, I. (2018). Chronic inflammation.

Chen L, Deng H, Cui H, et al. Inflammatory responses and inflammation-associated diseases in organs. Oncotarget. 2017;9(6):7204-7218. Published 2017 Dec 14. doi:10.18632/oncotarget.23208

Health line Understanding and Managing Chronic Inflammation Available from: https://www.healthline.com/health/chronic-inflammation

Furman, D., Campisi, J., Verdin, E., Carrera-Bastos, P., Targ, S., Franceschi, C., ... & Slavich, G. M. (2019). Chronic inflammation in the etiology of disease across the life span. Nature medicine, 25(12), 1822-1832.

Choosing Good Fats to Replace Bad Fats in your Diet

2022-02-18T18:30:00.003+08:00

What are dietary fats?

Think all fat is bad for you? This article gives you an idea about dietary fat, including how to choose good fats over bad fats in your diet.

Fat is a type of nutrient, just like protein and carbohydrates. Your body needs some fat for energy, to absorb vitamins and to protect your heart and brain health. There is a myth that eating fat will cause weight gain, raise cholesterol and lead to a myriad of health problems, however not all fat is the same. In fact, healthy fats play an important role in helping you manage your moods, fight fatigue and control your weight.

By understanding the difference between good and bad fats and how to include more healthy fat in your diet, you can improve how well you think and feel, boost your energy, and even trim your waistline.

Good Fats vs Bad Fats

Since fat is an important part of a healthy diet, rather than adopting a low-fat diet, it’s more important to focus on eating more beneficial “good” fats and limiting harmful “bad” fats.

Unhealthy or “Bad” Fats

1. Trans Fat

Small amounts of naturally trans fats can be found in meat and dairy products but it is artificial trans fats that are considered dangerous. This is the worst type of fat since it not only raises bad LDL cholesterol but also lowers good HDL levels. Artificial trans fats can also create inflammation, which is linked to heart disease, stroke, and other chronic conditions and contributes to insulin resistance, which increases your risk of developing Type 2 diabetes.

Primary food sources include:

- Commercially-baked pastries, cookies, doughnuts, cakes, pizza

- Packaged snack foods (crackers, chips)

- Stick margarine, vegetable shortening

- Fried foods (French fries, fried chicken, chicken nuggets)

- Anything containing hydrogenated or partially hydrogenated vegetable oil

2. Saturated Fat

While not as harmful as trans fat, saturated fat can raise bad LDL cholesterol and can negatively impact heart health, so it’s best consumed in moderation. While there’s no need to avoid all saturated fat from your diet, it is recommended limiting it to 10% of your daily calories.

Primary food sources include:

- Red meat (beef, lamb, pork)

- Chicken skin, lard

- Whole-fat dairy products (milk, cream, ice cream, butter)

- Tropical oils (coconut oil, palm oil)

Healthy or “Good” Fats

1. Unsaturated Fats

Monounsaturated fats and polyunsaturated fats are known as the “good fats” as they are good for your heart, cholesterol, and your overall health. Adding more of these healthy fats to your diet may also help to make you feel more satisfied after a meal, reducing hunger and thus promoting weight loss.

Monosaturated fat - food sources include:

Olive oil, canola oil, avocados, tree nuts (almonds, peanuts, macadamia, hazelnuts, cashews)

Polyunsaturated fat - food sources include:

Sunflower, sesame, pumpkin seeds, flaxseed, walnuts, fatty fish (salmon, tuna, mackerel)

2. Omega-3 Fatty Acids

Omega-3 fatty acids are type of polyunsaturated fat and are especially beneficial to your health. There are different types of omega-3s: EPA and DHA are found in fish and algae and have the most health benefits, while ALA comes from plants and is a less potent form of omega-3.

Research has shown that a diet rich in omega-3s may help to prevent and reduce symptoms of depression, protect against memory loss and dementia, reduce the risk of heart disease, stroke, and cancer, reduce inflammation, joint pain and balance your mood.

Best Food Sources of Omega-3s

Fish sources: Salmon, Mackerel, Trout, Herring, Tuna, Sardines, Anchovies

Vegetarian sources: Sacha inchi seeds, Chia seeds, Algae, Flaxseeds, Walnuts, Canola

Tips for Adding More Healthy Fats to your Diet

Eat omega-3 fats every day – choose fatty fish and plant sources
Cook with olive oil – rather than butter, margarine or lard
Take sacha inchi oil – good plant-based source for omega 3-6-9
Add chia seed into diet – drinking water, smoothies, salad, pudding
Eat avocados – Snack, cook, bake to add nutritious and healthy fats
Be nutty – Munch on a small handful of unsalted nuts and seeds
Dress your own salad – create healthy dressings with olive oil

In summary, be smart about the amount and type of fat you choose. Choosing foods rich in healthier unsaturated fat instead of foods high in saturated fat, not in addition to them. It is important to note that a person’s total diet or overall eating pattern is the most important factor for disease prevention. A varied diet is more beneficial to good health than concentrating on individual foods.

Lara, Nutritionist Anna Hoo Clinic

References:

1. https://www.medicalnewstoday.com/articles/307811#potential-health-risks-of-consuming-salmon

2. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/fat/art-20045550

3. https://www.healthline.com/nutrition/10-super-healthy-high-fat-foods

4. https://www.webmd.com/diet/ss/slideshow-healthy-fat-foods

5. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/fats/4-ways-to-get-good-fats-infographic

What is visceral fat? The 3 major causes and ways to reduce it.

2022-02-11T15:45:00.000+08:00

What is visceral fat? The 3 major causes and ways to reduce it.

Think maintaining low body fat is important simply to maintain an attractive outlook?

While subcutaneous fat (the layer of fat that can be seen and pinched) is a hindrance, it’s the fat that you cannot see that is more worrisome. Visceral fat lies within the abdominal cavity and wraps around the internal organs including liver, stomach, intestines and pancreas.

While it’s hard to judge how much visceral fat a person has, a protruding belly and large waist are two signs. For accurate assessment, bioelectrical impedance machines can measure the amount of visceral fat in a person.

Having too many visceral fat cells poses a serious health problem as they produce inflammatory markers. Over time, long-lasting inflammation leads to higher risk of chronic diseases including heart disease, Type 2 diabetes, stroke and cancer.

3 Major Causes of Visceral Fat

1. Diet

A poor diet consisting of processed foods contribute to the buildup of visceral fat. Processed foods such as fast food, ready-to-eat meals, and baked confectionary are usually high in trans-fat, sugar and calories, while being low in essential nutrients, all of which contribute to fat increase. Besides that, a higher consumption of added sugar is linked to increased visceral fat. Fructose, a form of sugar that is mostly found in sweetened beverages, baked confectionary and fast food gets converted into fat by the liver, which ends up increasing visceral fat storage.

2. Sedentary Lifestyle

Fat gets stored when we consume more calories than we use. With poor diet control, having too little physical activity amplifies fat accumulation in the body. As the total body fat increases, visceral fat increases as well, as visceral body fat makes up an estimated 10% of total body fat in the body.

3. Stress

Stress encourages the body to store excess visceral fat. When under stress, the body produces a hormone called cortisol. While cortisol is important in regulating the body’s processes and response to stress, excessive amounts increase visceral fat storage. Furthermore, stress encourages emotional overeating of empty calories, which further worsens visceral fat accumulation.

Fortunately, lifestyle adjustments can be made to lose existing visceral fat.

1. Balanced, Whole-foods Diet

To keep daily calorie intake under control and to reduce intake of added sugars and trans-fats, focus on a whole foods diet consisting of plenty of vegetables and fruits, ample protein and complex carbohydrates in moderation. At the same time, limit intake of processed foods. Consuming vegetables and fruits will also increase soluble fiber intake, which lowers risk of visceral fat. Increasing soluble fiber intake by 10 grams daily may reduce the risk of visceral fat gain by up to 3.7%. Soluble fiber helps by increasing gut bacteria diversity for a healthy gut, as well as by increasing sense of satiety, which ultimately reduces total calorie intake. Aim for meal proportions of 50% vegetables and fruits, 30% protein, and 20% complex carbohydrates.

2. Keep moving

Moderate to high intensity form of cardio exercises such as biking, tennis, hiking or running are especially effective in losing visceral fat.

To kick start, aim for 150 minutes of cardio exercises per week.

3. Get a good night’s sleep

Lack of sleep is linked to higher levels of visceral fat. In fact, increasing sleep duration from less than 6 hours a day to at least 7 hours has been shown to reduce visceral fat gain by around 26%.

Aim for at least 7 hours of sleep daily. For a well-rested sleep, dim the lights and reduce screen time on electronic devices before heading to bed.

4. Keep stress under control

Focus on managing stress levels by spending time on a hobby, practicing deep breathing and meditation, and seeking support from family and friends.

Zuanne, Nutritionist
Anna Hoo Clinic

Reference

1. How to reduce visceral body fat (hidden fat). (2022). Retrieved 7 January 2022, from https://www.healthdirect.gov.au/how-to-reduce-visceral-body-fat-hidden-fat

2. Hairston, K. G., Vitolins, M. Z., Norris, J. M., Anderson, A. M., Hanley, A. J., & Wagenknecht, L. E. (2012). Lifestyle factors and 5‐year abdominal fat accumulation in a minority cohort: the IRAS family study. Obesity, 20(2), 421-427.

3. Parikh, S., Pollock, N. K., Bhagatwala, J., Guo, D. H., Gutin, B., Zhu, H., & Dong, Y. (2012). Adolescent fiber consumption is associated with visceral fat and inflammatory markers. The journal of clinical endocrinology & metabolism, 97(8), E1451-E1457.

4. Magee L, Hale L. Longitudinal associations between sleep duration and subsequent weight gain: a systematic review. Sleep Med Rev 2012;16:231–241.

5. Chaput, J. P., Bouchard, C., & Tremblay, A. (2014). Change in sleep duration and visceral fat accumulation over 6 years in adults. Obesity, 22(5), E9-E12.

6. Drapeau, V., Therrien, F., Richard, D., & Tremblay, A. (2003). Is visceral obesity a physiological adaptation to stress?. Panminerva medica, 45(3), 189-196.

4 Ways to Lose Fat Without Losing Muscles

2022-01-13T13:20:00.002+08:00

1. Balance between aerobic exercise and core training [2]

Aerobic exercise improves cardiovascular capability, which expands the endurance of the body to burn excess calories (fats) in limited amounts of oxygen. The beneficial threads of aerobic exercise are to increase the overall physique and prevent metabolic syndrome such as obesity, diabetes mellitus and cardiovascular diseases etc. Despite the beneficial impacts given by aerobic exercise, one must also focus on core muscle training in order to increase the muscle build up in the body. Core training allows one to focus on training a particular part of muscles and joints together, where it could tone up a desired body composition. A balanced training between aerobic exercise and core training is effective in building up a healthy and balanced body.

2. Sufficient nutrient intakes for muscle building [1]

Providing the body essential nutrients to support and generate normal metabolism rate is as important compared with exercising. Many people underestimate how much they eat, which easily leads to overeating while creating a positive energy balance. On the other hand, very-low-calorie-diets are not necessary or recommended by nutrition experts, but in order to lose fat, a modest calorie deficit is required, which means burning more calories than food consumptions, but not so many that the body becomes starved of energy.

3. Healthy sleep habits [3]

Despite dietary advice and physical activity schedules, a healthy sleeping habit is another factor where many overlook. Some of the crucial process for muscle growth happen during sleep, especially the stage of deep sleep (non-REM sleep). The growth hormone for muscle will be produced for tissue growth and muscle repair. The muscles relax during sleep, where it helps to relieve tension and is able to reduce pain. In sufficient sleep/ unhealthy sleep habits in the long term can disrupt the repairing process and gradually leads to chronic pain and fatigue. Furthermore, a lack of sleep lowers the insulin sensitivity, where the glycogen may not be replenished adequately. As a result, one is less likely to be trained as strenuously and frequently as they could, while the risk of diabetes increases simultaneously.

4. Only maintain moderate calorie deficits [4]

Losing body fats requires a moderate calorie deficit, which includes a restriction to large amounts of refined carbohydrates, reducing fat consumptions and modest increase of lean protein intake. Muscle building demands a sufficient amount of proteins to prepare the body into an energy fueling state. Maintaining healthy body weight ensures the body has sufficient sources of energy to create an anabolic environment to encourage muscle growths.

Angel, Nutritionist
Anna Hoo Clinic

References:

1. Bagchi, D., Nair, S. and Sen, C.K. eds., 2018. Nutrition and enhanced sports performance: muscle building, endurance, and strength. Academic Press.

2. Barakat, C., Pearson, J., Escalante, G., Campbell, B. and De Souza, E.O., 2020. Body Recomposition: Can Trained Individuals Build Muscle and Lose Fat at the Same Time?. Strength & Conditioning Journal, 42(5), pp.7-21.

3. Martin, T., Arnal, P.J., Hoffman, M.D. and Millet, G.Y., 2018. Sleep habits and strategies of ultramarathon runners. Plos one, 13(5), p.e0194705.

4. Schoenfeld, B.J. and Aragon, A.A., 2018. How much protein can the body use in a single meal for muscle-building? Implications for daily protein distribution. Journal of the International Society of Sports Nutrition, 15(1), pp.1-6

Heavy Metal Toxicity

2021-12-08T16:45:00.000+08:00

The industrial activities of the last century have caused massive increases in human exposure to heavy metals. Mercury, lead, chromium, cadmium, and arsenic have been the most common heavy metals that induced human poisonings [2]. The bioaccumulation of these heavy metals leads to diverse toxic effects to different tissues and organs, where it disrupts cellular activities such as cellular growth, damage-repairing processes, apoptosis and cell differentiation [2]. Acute or chronic poisonings may occur following exposure through the environment like water, air, and food [4].

The comparison of the mechanisms of action of heavy metals demonstrates similar pathways with essential minerals to induce toxicity in humans which includes ROS generation, compromising antioxidant defence, enzyme deactivation, and oxidative stress [2,3]. Some toxic metals including chromium, cadmium, and arsenic can cause genomic instability [3]. Induction of oxidative stress following the defects in DNA repair and DNA damage by the three metals have been considered as the cause of their carcinogenicity [6]. Several acute and chronic toxic effects of heavy metals may affect different organs and systems in the body. Gastrointestinal and kidney dysfunction, neurological disorders, skin lesions, vascular damage, immune system dysfunction, birth defects, and cancer are examples of the complications of heavy metals toxic effects [3].

Mercury (Hg)

Elemental mercury is liquid at room temperature and can be readily evaporated to produce vapor. It is found in air, water and soil in 3 forms: elemental or metallic mercury (Hg0), inorganic mercury (Hg+, Hg2+), and organic mercury (commonly methyl or ethyl mercury) [4]. Mercury vapor is more hazardous than the liquid form of mercury. Organic mercury compounds such as methyl mercury (Me-Hg) or ethyl mercury (Et-Hg) are more hazardous than the inorganic compounds. Inhaling large amounts of mercury vapor where there are mercury spills due to container breakage can be fatal [7].

Mercury compounds have many applications in the mining process. For example the extraction of gold and industrial processes. In lamp producing factories, Hg is used in the production of fluorescent light bulbs. Me-Hg and Et-Hg were used as fungicides to protect agricultural crops against infections [4]. In addition, Hg had been used in the medicinal industry, however it had been replaced with safer pharmaceutical drugs to prevent hazardous events [7]. Some examples are the diuretics chlormerodrin, merbaphen, and mercurophylline and phenylmercury nitrate (disinfectant) [1].

Lead (Pb)

Lead is a catastrophic environmental pollutant which has high toxic effects to various body organs. Even though Pb can be absorbed from the skin, it is mostly absorbed from respiratory and digestive systems [5]. Pb is highly toxic which has adverse effects on the neurological, biological, and cognitive functions in the bodies. Chronic Pb exposure can lead to various disorders in the nervous system, respiratory tract, urinary, and cardiovascular system due to immune-modulation, oxidative, and inflammatory mechanisms [10]. Furthermore, Pb could disrupt the balance of the free-radical and antioxidant activities and promote chronic inflammation in many organs. Exposure to Pb can alter physiological functions and leads to different chronic diseases in later life [5].

Anemia may develop with Pb poisoning via the inhibition of ferrochelatase and δ-aminolevulinic acid dehydratase (ALAD), two enzymes involved in heme biosynthesis [4]. Several antioxidant molecules may have alterations due to Pb exposure and subsequent oxidative stress. Pb has high affinity to the antioxidant molecules which it competes to bind to the antioxidative enzymes and thus decreases the ability of antioxidant defense [4]. The antioxidant functions to detoxifying free radicals could be affected due to Pb exposure. Pb can promote oxidative damage in different organs via direct effect on membrane lipid peroxidation and reducing antioxidant parameters [1].

Chromium (Cr)

Chromium is commonly found in the earth’s crust and seawater. It is a naturally occurring heavy metal in industrial processes. Cr has multiple oxidation states ranging from −2 to + 6, in which the trivalent and hexavalent forms are the most stable forms. Cr (VI) is related to a series of diseases and pathologies while Cr (III) is required in trace amounts for natural lipid and protein metabolism and also as a cofactor for insulin action [3]. Based on the International Agency for Research on Cancer (IARC) report (2018), hexavalent chromium has been classified as a group I occupational carcinogen [6]. The primary route of exposure for non-occupational human populations occurs via ingestion of chromium containing food and water or dermal contact with products containing chromium [6]. Moreover, refractory, metallurgic, and chemical industries release a large amount of Cr into soil, ground water, and air which put humans, animals, and marine life at risk [6]. Cr can cause various diseases via bioaccumulation in the human body which includes dermal, renal, neurological, and GI diseases to the promotion of tumor growth including in different organs [10].

Cadmium (Cd)

Cadmium occurs naturally in soil and minerals such as sulfide, sulfate, carbonate, chloride, and hydroxide salts as well as in water. High Cd level in water, air, and soil is linked with industrial activities which could be a significant human exposure to Cd, thus the ingestion of Cd contaminated food is one of the major exposure [10]. Moreover, cigarette smoking is also connected as one of the factors of Cd exposure, which is capable of elevating Cd concentrations in blood and urine [3]. Presence of Cd in contaminated water could disturb the necessary mechanisms in the body, potentially resulting in acute or chronic diseases [2,3]. Cd is classified by the International Agency for Research on Cancer (IARC) as carcinogenic to humans (Group 1) [6]. Occupational exposure to Cd may occur in alloy, battery, and glass production and in electroplating industries. Due to the importance of the subject, Cd level in the air is routinely monitored in some countries [2]. Unlike low GI absorption, Cd is more efficiently taken from the lungs via inhalation of industrial dust. Acute or chronic inhalation of Cd in industrial areas might lead to renal tubular dysfunction and lung injuries. Cd blood concentration in smokers is almost twice higher than that of non-smokers [2].

Arsenic (As)

Arsenic as a harmful heavy metal is one of the main risk factors for public health. Sources of As exposure are occupational or via the contaminated food and water. It has a long history of use, either as a metalloid substance or as a medicinal product [7]. As is present as a contaminant in food, water, and the environment. Arsenic exists in the forms of metalloid (As0), inorganic (As3+ and As5+), organic, and arsine (AsH3). The order of increasing toxicity of As compounds is defined as organic arsenicals < As0 < inorganic species (As5+ < As3+) < arsine [8,9]. Primary As absorption is from the small intestine, followed by skin contact and inhalation. Following distribution to many tissues and organs in the body including the lungs, heart, kidneys, liver, muscles, and neural tissue, As is metabolized to monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA) in which the latter is the predominant form in the urinary excretion of As [8].

Acute and chronic As toxicity is related to the dysfunctions of numerous vital enzymes. Similar to the other heavy metals, As can inhibit sulfhydryl groups containing enzymes which leads to their dysfunction [9]. Moreover, As inhibits the pyruvate dehydrogenase by binding to the lipoic acid moiety of the enzyme. Pyruvate dehydrogenase inactivation can block the Krebs cycle and inhibits oxidative phosphorylation. As a result, ATP production decreases, resulting in cell damage [7]. Furthermore, the damage of capillary endothelium by As increases vascular permeability, leading to vasodilation and circulatory collapse [7].

To avoid heavy metal exposure:

Always wash the foods before consumption in order to remove the chemicals such as pesticides and fungicides.
Check the functionality of the water filter regularly.
Eat a variety of nutritious foods.
Consume supplements that help to remove heavy metals from the body
Take wholesome and natural foods that help to remove heavy metals from the body such as cilantro, chlorella, garlic, lemon water, etc.

Angel, Nutritionist
ANNA HOO CLINIC

References:

Dadpour, B., et al. (2016). Clinical and laboratory findings of lead hepatotoxicity in the workers of a car battery manufacturing factory. Iranian J. Toxicol. 10 (2), 1–6.

Engwa, G. A. et al. (2019) ‘10.5772@Intechopen.82511.Pdf’, Mechanism and Health Effects of Heavy Metal Toxicity in Humans, p. 23.

Gorini, F., et al. (2014). The role of heavy metal pollution in neurobehavioral disorders: a focus on autism. Rev. J. Autism Dev. Disord. 1 (4), 354–372. doi:10.1007/s40489-014-0028-3

Kianoush, S., et al. (2015). Recent advances in the clinical management of lead poisoning. Acta Med. Iran 53, 327–336.

Kim, T. H., et al. (2020). Exposure assessment and safe intake guidelines for heavy metals in consumed fishery products in the Republic of Korea. Environ. Sci. Pollut. Res. Int., 27, 33042–33051. doi:10.1007/s11356-020-09624-0

Koedrith, P., et al. (2013). Toxicogenomic approaches for understanding molecular mechanisms of heavy metal mutagenicity and carcinogenicity. Int. J. Hyg. Environ. Health 216 (5), 587–598. doi:10.1016/j.ijheh.2013.02.010

Lee, M.-R., et al. (2017). Blood mercury concentrations are associated with decline in liver function in an elderly population: a panel study. Environ. Health 16 (1), 17. doi:10.1186/s12940-017-0228-2

Li, L., and Chen, F. (2016). Oxidative stress, epigenetics, and cancer stem cells in arsenic carcinogenesis and prevention. Curr. Pharmacol. Rep. 2 (2), 57–63. doi:10.1007/s40495-016-0049-y

Liaw, J., et al. (2008). Increased childhood liver cancer mortality and arsenic in drinking water in northern Chile. Cancer Epidemiol. Biomarkers Prev. 17 (8), 1982–1987. doi:10.1158/1055-9965.epi-07-2816

Lin, X., et al. (2018). Connecting gastrointestinal cancer risk to cadmium and lead exposure in the Chaoshan population of Southeast China. Environ. Sci. Pollut. Res. Int. 25 (18), 17611–17619. doi:10.1007/s11356-018-1914-5

Sugar-Free – Is there more behind the label?

2021-12-04T18:58:00.004+08:00

It’s no surprise that we automatically reach for the “sugar-free” food or beverage on the shelf in a bid to be healthier. But before that, read on to understand the true meaning behind the term “sugar-free” and learn to make informed choices.

What are sugar substitutes?

Any form of sweetener that is used to replace table sugar (sucrose) can be termed as a sugar substitute. These sugar substitutes can be classified into two categories – natural & artificial sweetener.

· Natural sweeteners

These sugar substitutes are often promoted as healthier options, but often undergo processing and refining as well. Common natural sweeteners include:

- Coconut sugar

- Honey

- Molasses

- Maple syrup

- Palm sugar

While these natural sweeteners are touted as healthy due to the additional nutrient content, they contain the same amount of calories and are absorbed the same way as regular sugar, hence raising blood sugar levels. Hence. intake of these sweeteners should be considered the same as table sugar.

· Low-calorie sweeteners

These sugar substitutes are usually derived from plants. While the sweetness receptors on our taste buds recognize these sweeteners as sweet-tasting, they are not broken down and are absorbed by our body differently as compared to sugar, due to the different structure. Hence, these sweeteners provide a sweet taste with much less calories, and without negative consequences on blood sugar levels.

While these sweeteners do contain calories, they are usually labelled as “zero-calorie” because they provide intense sweetness with usage at just a small amount of negligible calories.

Popular non-nutritive sweeteners include:

- Erythritol

- Allulose

- Monk fruit sweetener

- Xylitol

- Stevia

While low-calorie sugar substitutes are beneficial for weight management and diabetics as they are low in calories and do not raise blood sugar levels, studies have raised possible health concerns:

1. Increased Appetite & Cravings for Sugar

Regularly consuming sweetened food products, even if they have been substituted with sugar substitute, may increase appetite and cravings for sweet foods in general. Increased consumption of these foods may also displace intake of natural foods, which are lower in calories and nutrient-dense. In the long run, frequent intake can lead to weight gain and malnutrition.

2. Gut Health

Maintain a healthy gut by having the right balance of good and bad bacteria composition is key towards optimal physical and mental health. The composition of gut bacteria varies by individual and is affected by lifestyle habits. Sugar substitutes have been found to reduce the composition of beneficial bacteria. In some studies, sugar substitutes also disrupted the gut bacteria balance and caused poorer blood sugar control among consumers.

Moderation and Shopping Smart is Key:

Sugar substitutes are beneficial if you are trying to gradually reduce sugar intake and manage weight. However, it is important to generally reduce sweetness levels of foods and minimize consumption of both sugar and sugar substitutes. Instead, whole foods such as fruits, vegetables, grains and protein should be the basis of your diet as well, rather than processed foods.

At the same time, read food labels carefully and understand the meaning behind it:

- No sugar or sugar-free: The product does not contain sugar, but may contain natural or artificial sweeteners and sugar alcohol.

- No added sugar: No extra sugar was added during processing. However, the original source might have contained sugar (for example: fructose in fruit juice). Sugar substitutes may have also been added.

Zuanne, Nutritionist
Anna Hoo Clinic

Reference:

1. Ma, J., Bellon, M., Wishart, J. M., Young, R., Blackshaw, L. A., Jones, K. L., ... & Rayner, C. K. (2009). Effect of the artificial sweetener, sucralose, on gastric emptying and incretin hormone release in healthy subjects. American Journal of Physiology-Gastrointestinal and Liver Physiology, 296(4), G735-G739.

2. Ford, H. E., Peters, V., Martin, N. M., Sleeth, M. L., Ghatei, M. A., Frost, G. S., & Bloom, S. R. (2011). Effects of oral ingestion of sucralose on gut hormone response and appetite in healthy normal-weight subjects. European journal of clinical nutrition, 65(4), 508-513.

3. Yang, Q. (2010). Gain weight by “going diet?” Artificial sweeteners and the neurobiology of sugar cravings: Neuroscience 2010. The Yale journal of biology and medicine, 83(2), 101.

4. Suez, J., Korem, T., Zeevi, D., Zilberman-Schapira, G., Thaiss, C. A., Maza, O., ... & Elinav, E. (2014). Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature, 514(7521), 181-186.

Probiotics & Prebiotics – What’s the Difference?

2021-09-22T17:11:00.000+08:00

Probiotics and prebiotics have been the center of discussion for years now when we talk about a healthy digestive system. But before you jump onto the bandwagon of including probiotics or prebiotics into your regime, read on to learn more about the different roles of these two.

Having a healthy gut not only ensures a healthy digestive system but impacts physical and mental health, as many important health functions occur in the gut. The complex community of bacteria in the gut manufactures vitamins and produces short chain fatty acids which strengthen the immune system.

One key indicator of having a healthy gut is through having the right balance of good and bad bacteria. This balance is easily disturbed as the gut is highly sensitive to our lifestyle habits such as chronic stress, poor diet, long term medication usage, tobacco and alcohol consumption.

This is where probiotics and prebiotics come in handy.

1. Probiotics

Probiotics refer to the group of “good” bacteria that provide health benefits when ingested. The most common probiotic bacteria that have been widely studied are Lactobacillus and Bifidobacterium.

Source of Probiotics

Fermented foods such as yogurt, tempeh, kimchi, sauerkraut.
Supplement form

Benefits

Different probiotics have been found to address different health conditions, which is why most supplements combine a few species in a product. At the same time, it is essential to select the right probiotic that addresses your health concern.

Studies have found the beneficial effects of probiotics including:
Alleviating digestive disorders including bloating, constipation, diarrhea and gas
Reducing inflammation – the hallmark of diseases
Enhance immune function to protect against infections
Reduce symptoms of anxiety and depression
Aid in weight management

2. Prebiotics

On the other hand, prebiotics refer to a group of carbohydrates that the human body cannot digest. However, these non-digestible carbohydrates serve as a food source for the gut’s healthy bacteria. Prebiotics selectively stimulate the growth of good bacteria in the gut, especially the Lactobacilli and Bifidobacteria group, which in turn provide the health benefits associated with these bacteria.

Source of Prebiotics

Fruits, vegetables and whole grains such as apples, bananas, berries, legumes, peas, flaxseed, green vegetables.
Added to food products especially baby formula and yogurt. These are usually labelled as “fortified with galactooligosaccharides, fructooligosaccharides, oligofructose, chicory fiber, or inulin”.
Supplement form

Benefits

There are plenty of ongoing research to understand the full effects of prebiotics on gut health. Prebiotics have been shown to:

Support growth of probiotics
Improve calcium absorption
Fermented by gut bacteria to product short-chain fatty acids, which improves gut integrity and prevents Leaky Gut syndrome, which leads to inflammation in the body.

In summary, probiotics themselves are the “good” live bacteria, while prebiotics are the foods for these bacteria. Hence, introducing probiotics and prebiotics can help ensure that you have the right balance of microflora in the gut for optimal health.

To introduce probiotics and prebiotics, practise a balanced diet that is abundant with a variety of high fiber fruits and vegetables. Fermented foods are a great option as well. At the same time, limit foods that are high in sugar and are processed, as these stimulate growth of bad bacteria in the gut, which ultimately affects the balance, regardless of how much probiotics you’re taking,

For supplements, select a supplement that contains both probiotics and prebiotics. However, it is best to speak to your healthcare provider to guide you in selecting the right supplement that addresses your needs as not all probiotics work the same way, and certain forms may not be suitable for those who are lactose intolerant or with yeast (Candida) overgrowth.

Reference

1. Bischoff, S. C. (2011). 'Gut health': a new objective in medicine? BMC medicine, 9(1), 1-14.

2. Quigley, E. M. (2013). Gut bacteria in health and disease. Gastroenterology & hepatology, 9(9), 560.

3. Whisner, C. M., & Castillo, L. F. (2018). Prebiotics, bone and mineral metabolism. Calcified Tissue International, 102(4), 443-479.

4. Slavin, J. (2013). Fiber and prebiotics: mechanisms and health benefits. Nutrients, 5(4), 1417-1435.

5. Esgalhado, M., Kemp, J. A., Damasceno, N. R., Fouque, D., & Mafra, D. (2017). Short-chain fatty acids: A link between prebiotics and microbiota in chronic kidney disease. Future microbiology, 12(15), 1413-1425.

By Nutritionist

Zuanne
Anna Hoo Clinic

八个提高免疫力的建议

2021-09-18T16:00:00.002+08:00

传染疾病流行，免疫系统为我们抵御各种病毒、细菌等微生物的感染。不管什么病毒袭来，强大的免疫系统便是人体抵抗病毒感染的第一道防线。

那么，什么是免疫力？怎样增强免疫力呢？

免疫力是指人体免疫系统抵抗有害微生物和疾病的能力。我们的免疫系统极为复杂，包括免疫器官、免疫细胞、以及免疫分子等。大家都知道增强免疫力就可以提高我们的抵抗力，听起来很有道理，但是事实上却不容易。

首先，免疫系统不是一个简单的器官,不仅组织庞大、成员众多，而是一个极其复杂精密又相互调节的系统。其次，对于免疫反应的复杂性和相互作用，我们还有许多未知的东西，免疫细胞并不是越多越好，免疫反应也不是越强越好。免疫系统要发挥良好的作用，需要系统各部分之间的数量和功能上的平衡与和谐，而不仅仅是加强某一项。

提高免疫力没有神药，保持身体的整体健康是根本。保障有强力健康的免疫系统，除了我们无法控制的遗传因素之外，最重要的是坚持健康的生活方式。尽量避免不健康的环境和习惯，这样身体的每个部分包括免疫系统的功能自然会更好。

近日，哈佛大学的专家们给出了提高免疫力的八个建议。

01 营养均衡的健康饮食

就像任何战斗部队都需要供给一样，免疫系统作为身体的自卫军需要优质而有规律的营养供应。均衡而健康营养的饮食很重要。科学家们早就意识到生活贫困和营养不良的人更容易得传染病。老年人的饮食营养和免疫力低下之间也存在着相关性。老年人往往吃得少，饮食多样性也不够。许多研究发现，与年轻人相比，老年人不仅更容易患上传染病而且死亡率最高。即便在富裕国家，一种被称为“微量营养素营养不良”的情况也普遍存在。“微量营养素营养不良”是指缺乏某些必需的维生素和微量矿物质。这些微量营养素必须从饮食或食物补充剂中获得。对于食物摄入不足或者缺乏某些营养素的人群，食物补充剂可能会有帮助。

02 保持健康的体重

如何知道你的体重是否在健康范围？测量身体质量指数Body Mass Index (BMI) 简单易行。BMI的计算方法是将成人的体重(以公斤) 除以身高 (以米为单位)的平方。亚洲人的评估标准是：健康的BMI范围为18.5至22.9；23.0-27.4 属于超重；超过27.5属于肥胖。研究显示拥有健康的BMI，尤其是在理想范围内的人，死于疾病的风险较低。

03 经常锻炼

运动改善心血管健康，降低血压，帮助控制体重，并预防各种疾病。但这是否有助于自然增强免疫系统并维系免疫系统的健康呢？就像健康饮食一样，运动可以促进整体健康，从而促进免疫系统的健康。它还可以直接通过促进血液循环，使免疫细胞和免疫因子更流畅地达到全身各处，更有效地发挥其保护作用。

04 保证充足的睡眠

睡眠是身体休息并恢复生机的时候。虽然每个人需要的睡眠时间不一样，但通常都需要7-9个小时的优质睡眠。少熬夜早休息，是增强人体免疫功能很重要的生活习惯。

05 减轻压力

现代医学已认识到身心之间的紧密联系。各种各样的疾病，从胃部不适到心脏病，都可能与情绪或压力有关。科学家正积极研究压力与免疫功能之间的关系，尤其是长期压力状态对人体免疫功能的影响。适当缓解压力有助于整体健康，也会助于促进免疫系统的功能。

06 少吸烟，少喝酒

吸烟不仅增加患癌风险，还会损害人体免疫系统。对吸烟的人群来说，如果希望健康，最需要做的事就是戒烟。

07 坚持良好的卫生习惯

保持良好的卫生习惯包括经常洗手、不吃生肉、分餐制、用公筷等，以避免微生物感染。

08 按时接种疫苗

按时接种疫苗。疫苗可激发免疫系统，在病毒感染之前帮助我们的身体做好准备。

结论：

防疫期间，我们得靠自己提升自身免疫力，对自己的健康自律。以上的专家建议供大家做个参考。与其服用各种神药，通过均衡的饮食和健康的生活方式自然增强免疫系统会更好。愿大家齐心抗疫，早日战胜病毒！

Anna Hoo Clinic

Lara 营养师

文献参考：

https://www.health.harvard.edu/staying-healthy/how-to-boost-your-immune-system

What is Cholesterol?

2021-09-15T16:57:00.005+08:00

Most of us are aware that high cholesterol has become one of the common metabolic syndromes which contributes to health risks such as heart attack and stroke. As we age, cholesterol levels might increase with the triggers from environmental factors such as food, stress, and a sedentary lifestyle. A routine blood test and adjustment of lifestyle help to reverse the illness. Unfortunately most of the time it is not been taken seriously because high cholesterol does not manifest symptoms.

What is Cholesterol?

Cholesterol is a soft fatty substance mainly produced in the liver and also found in animal-derived food. Not all types of cholesterol are bad for your health. Cholesterol in the blood is carried by a protein transporter called a lipoprotein. High-density lipoprotein (HDL) is known as “good” cholesterol which supports heart health while Low-density lipoprotein (LDL) is known as “bad” cholesterol which deteriorates our health.

Functions of cholesterol and side effects of high LDL cholesterol.

Cholesterol assists in the production of vital substances such as hormones, bile acids, and vitamin D in our body. It is also a building block for human tissues which helps to maintain the integrity and fluidity of the cell membranes. Hence, it is important for the body to produce cholesterol for optimum cell functioning. The problem starts when over-production of cholesterol or overconsumption of fatty food leads to high LDL cholesterol in the blood.

Excess LDL cholesterol joins with fats and other materials to build up in the inner wall of blood vessels creating plaque. The plaque causes narrowing of the blood vessel and blocks blood from flowing normally. The risk of heart attack and stroke occurs when the plagues break loose and block the flow of blood and oxygen to the heart and brain tissues respectively. To avoid such incidents to happen, it is recommended to keep the LDL and HDL cholesterol levels in the normal range. Unlike LDL cholesterol, HDL cholesterol promotes cardiovascular health by removing the “bad” cholesterol from the blood vessel and eliminate it through the liver.

Possible triggers and prevention of Hypercholesterolemia.

1) Genetics

High cholesterol can be inherited but it depends on the lifestyle which makes it to be treatable.

2) Diet

A poor diet with a high intake of processed food, fast food, fried food, and an excessive amount of animal products may increase the cholesterol level.

Food high in cholesterol includes internal organs, egg yolk, fish roe, squid, and cuttlefish. Limit intake of dairy products, meat, and poultry as it is a moderately high cholesterol food. Choose food with less or no cholesterol such as vegetables, fruits, beans, and fish. Consume food high in healthy fats such as olives, avocado, salmon, tuna, chia seed, flaxseed, nuts, and sacha inchi oil to increase good cholesterol HDL.

Watch out of the food labels with “cholesterol-free” because most of the time this processed food may not contain cholesterol but rich in Trans fat and saturated fat which may trigger the liver to produce cholesterol in the body. Check on the nutritional labelling and ingredient list for a better understanding of the fat intake.

3) Lack of exercise

Inactiveness causes an increase in LDL cholesterol therefore recommended to do 30 minutes of cardio exercises 5 days a week. Active lifestyle promotes the production of HDL cholesterol. Being overweight or obese also impacts your cholesterol levels.

4) Smoking and alcohol drinking

Cigarette smoking and alcohol contribute to inflammation and triggers cholesterol deposits in the blood vessels. Smoking also reduces the “good” cholesterol HDL in the blood and on the other hand, drinking alcohol may increase triglyceride production. Therefore quit smoking and limit alcohol intake may help to reverse and prevent hypercholesterolemia.

5) Stress and sleep

High-stress level spikes the cortisol hormone production which eventually causes the body to demand to make more cholesterol. Hence, relieve stress through activities such as exercise, meditation and also catch up with your sleep. Sleeping early and a minimum of 7 hours of sleep may stimulate the body’s healing and recovery process.

In conclusion, high cholesterol condition matters and it is a reversible condition with a healthy lifestyle practice. Therefore when it comes to cholesterol, follow 3C key points which are CHECK, CHANGE, and CONTROL.

By Nutritionist

Moga
Anna Hoo Clinic

REFERENCES

Zampelas.A* and Magriplis.E. New Insights into Cholesterol Functions: A Friend or an Enemy? Nutrients. 2019 Jul; 11(7): 1645.

American Heart Association. 2020. Understanding & Managing Cholesterol. https://www.heart.org/en/health-topics/cholesterol/hdl-good-ldl-bad-cholesterol-and-triglycerides

Omega-6 : Omega-3’s Counterpart

2021-09-11T17:19:00.001+08:00

Omega-6 Fatty Acids

While we’re probably familiar about the importance of Omega-3 fatty acids by now, there is another form of polyunsaturated fatty acid – or ‘good fat’, that complements Omega-3 and is just as vital for health, which is Omega-6.

What are Omega-6 Fatty Acids?

Just like Omega-3s, Omega-6 fatty acids are essential fatty acids, which means that we need to obtain them through food intake.

Omega-6 fatty acids play a role in providing energy, stimulating skin and hair growth, maintaining bone health, regulating metabolism and have been shown to treat symptoms of chronic diseases.

At the same time, Omega-6 fatty acids produce eicosanoids which play an important role in the immune system by fighting cell damage and regulating pain. However, too much of a good thing raises a concern as excessive pro-inflammatory eicosanoids increase the risk of inflammation.

In that case, do we actually need Omega-6?

Yes, based on the Malaysia Recommended Nutrient Intake 2017, Omega-6 intake is recommended at 3-7% of our total energy intake.

The increased risk of inflammation associated with Omega-6 isn’t due to Omega-6 fatty itself, but rather, due to the imbalance in intake of Omega 6 & Omega-3 (the anti-inflammatory fatty acid) characterized by our diet today, which involves low intake of Omega-3 but high intake of not only Omega-6, but also saturated fat and trans fat.

Hence, consuming a balanced amount of Omega-6 and Omega-3 plays the deciding factor towards reaping the benefits of both types of fat. The recommended healthy ratios of Omega-6 to Omega-3 intake are between 1-to-1 and 4-to-1.

To put into perspective, diet of the human hunter–gatherer population in the Paleolithic period, which included large amounts of both Omega-6 and Omega-3 in meat, plants, fish, nuts and berries presented a balanced ratio of 1-2:1, which made a significant contribution to human evolution by influencing and allowing cognitive development.

In contrast, the Omega-6/Omega-3 ratio of the typical Malaysian diet today is about 10:1, while Western diets have a much higher ratio of 15:1.

Benefits of Omega-6

· Heart Health

When Omega-6 fatty acids are used to replace saturated fat (which is usually found in red meat, butter, coconut oil and dairy), there is a reduced risk of cardiovascular disease. Heart disease has been the leading cause of death in Malaysia for more than a decade, due to high prevalence of risk factors including obesity, smoking, high cholesterol, hypertension and diabetes, which is interrelated with nutrition as well.

· Diabetes

Gamma linolenic acid, a form of Omega-6, has been shown to reduce symptoms of nerve pain in type 1 and type 2 diabetes patients. Furthermore, it has been shown that those who had higher levels of omega-6 fatty acid in the form of linolenic acid were 35% less likely to develop type 2 diabetes.

How to Achieve a Balanced Ratio of Omega 6 & Omega 3

· Rotate between different protein sources by substituting meat intake with fish, beans and pulses, which are lower in saturated fat, but higher in Omega 3 & 6.

· In cooking or baking, swap butter and lard (which are high in saturated fat) with oils such as olive oil or avocado oil.

· Select oils which are low in saturated fat, and contains a balanced amount of Omega 6 to Omega 3 ratio. Examples include:

o Sacha inchi oil: 1: 1.3 Omega 6 to Omega 3 ratio

o Flaxseed oil: 1: 3 Omega 6 to Omega 3 ratio

o Chia seed oil: 1: 3 Omega 6 to Omega 3 ratio

· Limit deep fried foods, commercial baked goods, and processed foods which are high in trans fats.

By Nutritionist

Zuanne
Anna Hoo Clinic

References :

1. Ministry of Health Malaysia. (2017). Recommended Nutrient Intake for Malaysia. Kuala Lumpur.

2. Simopoulos AP. The importance of the ratio of omega-6/omega-3 essential fatty acids. Biomed Pharmacother. 2002 Oct;56(8):365-79. doi: 10.1016/s0753-3322(02)00253-6. PMID: 12442909.

3. Farvid, M. S., Ding, M., Pan, A., Sun, Q., Chiuve, S. E., Steffen, L. M., ... & Hu, F. B. (2014). Dietary linoleic acid and risk of coronary heart disease: a systematic review and meta-analysis of prospective cohort studies. Circulation, 130(18), 1568-1578.

4. Ministry of Health Malaysia. (2017). Clinical Practice Guidelines on Primary & Secondary Prevention of Cardiovascular Disease 2017. Malaysia. Retrieved from https://www.moh.gov.my/moh/resources/Penerbitan/CPG/CARDIOVASCULAR/3.pdf

5. Wu, J. H., Marklund, M., Imamura, F., Tintle, N., Korat, A. V. A., De Goede, J., ... & for Heart, C. (2017). Omega-6 fatty acid biomarkers and incident type 2 diabetes: pooled analysis of individual-level data for 39 740 adults from 20 prospective cohort studies. The lancet Diabetes & endocrinology, 5(12), 965-974.

Nutrients You Need To Prevent Cutaneous Aging

2021-07-31T17:04:00.004+08:00

Cutaneous aging is an aging process that involves both biological aging and extrinsic aging due to inflammations, pollutions, toxins exposure, poor nutrition, and sunlight. Cutaneous aging results in the degrading of skin features and results in wrinkling, loss of elasticity, laxity, pigmentation, and rough-textured appearance.

The skin is the largest and visible organ, it shows obvious signs of aging. When skin ages naturally it results in thin, dry skin, fine wrinkles, and gradual dermal atrophy. However, with induced skin aging through environmental challenges, the skin may exhibit coarse wrinkles, loss of elasticity, laxity, pigmentation, and rough-textured appearance.

To get a young and beautiful appearance, we can slow down skin aging and helps to recover skin damages through nutrients which has antioxidant and anti-inflammatory effects.

1) Vitamin C

Food source: citrus fruits, kiwi, bell pepper, berries, currant, guava, broccoli, and spinach

Increases collagen synthesis in the skin
Lightening of skin pigmentation
UV sun protection

2) Vitamin E

Food source: Sunflower seed, hazelnut, avocado, squash, tomato, mango, almond, and kiwi

Work with vitamin C to protect skin damage from UV light
Prevent skin aging by inhibiting lipid peroxidation

3) Carotenoid

Food source: Cantaloupe, mangoes, papaya, carrots, sweet potatoes, spinach, and pumpkin

Reduction of sunburn
Protect against skin cancer

4) Vitamin D3

Source: Fatty fish like salmon, and, egg yolks

Contributes to skin cell growth, repair, and metabolism
Destroy free radicals that can cause premature aging

5) Polyphenols

Source: Cocoa powder, berries, olives, flaxseed, nuts, green tea, herbs, and spices

Inhibiting collagen degradation and increase collagen synthesis
Reduce skin inflammations

6) Proteins

Source: Fish, chicken, beef, lamb, pork, peas, dark green leafy vegetables, and broccoli

Repair of skin tissues
Provides collagen and elastin for skin firmness and elasticity

7) Water

Maintain skin internal balance and tissue function
Prevent skin dryness

8) Fatty acids (Omega 3)

Source: Salmon, olive oil, flaxseed, walnut, chia seed, and, sacha inchi oil

Promotes skin regeneration
Prevent serious skin diseases

9) Co-enzyme Q 10

Source: Meat, fish, broccoli, pistachios, lentils, soybean, cabbage, and, organ meat

Promote skin cells to repair
Reduce sun damage

Factors trigger skin aging

High trans-fat intake
High sugar and baked goods intake
Processed food
Alcohol intake
Smoking
Poor sleeping habit

By Nutritionist

Moga
Anna Hoo Clinic

References

Cao.C, Xiao.Z, Wu.Y and Ge.C. 2020. Diet and Skin Aging—From the Perspective of Food Nutrition. Nutrients. 2020 Mar; 12(3): 870.

Zhang. S and Duan. E. 2018. Fighting against Skin Aging. Cell Transplant. 2018 May; 27(5): 729–738.

Cho. S. 2014. The Role of Functional Foods in Cutaneous Anti-aging. J Lifestyle Med. 2014 Mar; 4(1): 8–16.

PROTEIN

2021-06-23T15:11:00.001+08:00

What is protein?

Protein is a part of our cells and tissues in the body which is made up of amino acid blocks. Protein is the most essential component for energy, bone density, enzyme production, hormone production, tissue formation, and muscle growth. Our body skeletal muscles contain approximately 75% water, 20% protein, 1–10% fat, and 1% glycogen. There are two types of amino acids which are essential amino acids and non-essential amino acids. Essential amino acids are the protein blocks our body cannot produce and can be sourced out from food while non-essential amino acids can be produced by our body.

Our body needs a complete protein which contains all the 9 types of essential amino acids to repair and grow. Food with complete protein is animal-based such as beef, fish, poultry, eggs, dairies, pea, and soy. Certain plant-based proteins such as lentils, nuts, seeds, vegetables, and whole grains may not have the complete essential amino acids that our body needs. Therefore it is important to have a balanced diet especially when you are a vegetarian. Protein supplements such as branched-chain amino acid (BCAA) and pea protein powder can be helpful in gaining muscle mass while on an exercise regime.

How much protein is enough?

The protein requirement of an adult is based on the body mass. The minimum requirement for a healthy adult to prevent lean body mass loss is about 0.8g protein per kg body mass. However, recommended protein intake for physically active adults is between 1.2-2.0g protein per kg body mass.

Muscle gain happens when the protein synthesis is higher than the protein breakdown while muscle loss happens when the protein synthesis is lesser than protein breakdown. Hence it is important to take sufficient protein in every meals and do exercise to build skeletal muscles.

Below is the list of common food and the protein content:

One large egg has 6 grams of protein
100 grams of beef has about 26 grams of protein
100 grams chicken breast has about 31 grams of protein
One cup of dried beans has about 16 grams of protein
One container (170g) of Greek yogurt has about 17 grams of protein
One cup of broccoli has about 3 grams of protein
1 cashew has about 5 grams of protein
100 grams salmon has about 22 grams of protein
One cup of lentils has about 18 grams of protein
30 grams of pea protein powder has about 25 grams of protein

By Nutritionist Moga
ANNA HOO CLINIC

Reference

Carbone J.W and Pasiakos S.M, 2019. Dietary Protein and Muscle Mass: Translating Science to Application and Health Benefit. Nutrients. 2019 May; 11(5): 1136.

Cataldo D, and Blair M. 2015. Protein intake for optimal muscle maintenance. American College of Sports Medicine.

高“盐值”对人体健康的危害

2021-06-09T16:39:00.002+08:00

“盐” 是我们日常饮食中必不可少的调味品。盐也是人体中必不可少的物质，它能调节人体内水份均衡的分布，维持细胞内外液渗透压。一说到高血压患者的饮食，很多人首先想到的是要 “少吃盐” 。其实盐背后的 “钠” 才是高血压发病的重要危险因素。钠的摄入对人体健康的影响不容小觑，它是人体保持血浆容量、酸碱平衡、神经脉传导和正常细胞功能不可或缺的元素。若钠摄入量过低，会发生食欲不振，四肢无力，疲惫虚弱，晕眩等现象；但是过量摄入则会增加罹患高血压、心脑血管疾病等的风险。

钠盐摄入过量导致的健康问题：

1. 高血压 - 钠盐与血压的水平是成正相关的，吃得越咸，人体钠摄入量越多，血压水平就越高。

2. 心血管疾病 - 人体内的钠量过多，会造成体内水滞留，导致血管内压力升高，阻力增大，照成心脏负荷加重，长期容易引发心脏肿大、心衰等疾病，增加动脉硬化的风险。

3. 加快肾脏老化 - 饮食中的盐分95%是由肾脏代谢排出的，如果过多的钠摄入，无疑会加重肾脏的负担。肾脏长期处于高滤过的超负荷工作状态，肾脏老化的速度就会加快，容易引发肾病。

4. 水肿 - 当过量摄入食盐，钠在体内含量过高引起血容量增加，体内组织间液增加。为了维持平衡，体内会锁住更多的水分来稀释这些盐分。体内积水增多就会出现水肿，肾脏的负荷也会加大。

合理的食盐摄入量？

世界卫生组织WHO规定建议健康成人每日食盐摄入量是少于5克（一茶匙）。马来西亚饮食治疗师协会也建议健康人群每日摄入低于2000毫克的钠（一茶匙食盐的量）；美国心脏协会指南则建议高血压患者每天最多摄入1500毫克的钠。

常见的高钠食物：

主食(1份)：咖喱面(2456mg), 槟城叻沙(2281mg), 炒面(2224mg), 炒粿条(1704mg), 炒饭(1465mg), 鸡饭(1287mg)

加工食品(每100克)：罐头浓缩汤料(20000mg), 快熟面(2000mg)，加工肉类如咸肉香肠火腿培根(>1500mg)

调味品(每100克)：鸡精(18864mg), 味精(8160mg), 辣椒酱(8027mg), 豆瓣酱(6012mg), 酱油(5757mg), 咸鸭蛋(2706mg), 花生酱(2340mg)

低钠食品：每100克食物中的钠含量低于100mg

中钠食品：每100克食物中的钠含量介于100-600mg之间

高纳食品：每100克食物中的钠含量超过600mg

健康饮食建议：

1. 限制每日食盐摄入量，确保这一点的好方法是避免加工食品，减少使用高钠含量的调味料，选择用天然香料取代来烹调食物。

2. 避免摄入过多的酱料比如水果上的酸梅粉，沙拉里的沙拉酱，还有加在其他食物里的酱油和番茄酱等。

3. 选择新鲜的蔬菜，水果，肉类，鱼类，海鲜。可选择富含高钾的食物包括：豆类，坚果，蔬菜(菠菜，花椰菜，南瓜等)，水果(木瓜，柑橘等)。

随着人们生活方式的改变，在外用餐或者点外卖也越来越频繁。餐馆的食物普遍重口味，同样加工食品也是以高盐含量居多。高盐饮食正不知不觉中危害着大家的健康。对于很多慢性疾病来说，改变生活饮食方式是第一步。我们能做的就是在平日生活中尽量降低盐的摄入量，保持健康的饮食、生活习惯，守护好自己的健康。

Lara 营养师
Anna Hoo Clinic

OMEGA 3 - WHAT ARE THE BENEFITS?

2021-05-19T16:47:00.000+08:00

Good Fat

Fat. Despite the bad rep it gets for adding inches to our waistline and bringing along a myriad of health problems, our body still requires fat as a source of energy, to absorb nutrients as well as to protect our vital organs.

The key difference is the type of fat we’re consuming. All the negative health consequences that fat has been blamed for are partly due to consumption of “bad” fats, such as trans fats and saturated fats, which are commonly found in deep fried foods, processed foods and confectionary.

In contrast, “good” fats such as unsaturated fatty acids and Omega-3 fatty acids, have the opposite effect.

With so many types of fats to learn about, Omega-3 fatty acids probably need no further introduction, so let’s start off with a better understanding of omega-3s!

What are Omega-3s?

Omega-3s are a form of unsaturated fatty acid which can be broken down into different types, mainly: Alpha-Linolenic Acid (ALA), Eicosapentaenoic Acid (EPA), and Docosahexaenoic Acid (DHA).

The main difference between these types of Omega-3? ALA is found mainly in plant oils such as flaxseed, soybean and canola oils, while EPA and DHA are found in fish, algae and seafood.

While the human body can convert some ALA into EPA and then DHA, the small amounts produced calls for recommendations to obtain EPA and DHA directly from foods.

Benefits of Omega-3

- Heart Health

Omega-3 fatty acids protect the heart against diseases by:

1. Lowering triglyceride levels in the blood.

2. Lowering blood pressure in patients.

3. Preventing harmful blood clots from forming, thus reducing risk of stroke and heart attack.

4. Preventing plaque formation which harden the arteries and restrict blood flow.

- Eye Health

DHA is a major structural component of the retina of the eyes. Getting enough omega-3 reduces risk of macular degeneration, a condition which can cause permanent eye damage and blindness.

- Brain Health

Omega-3s are vital for brain health throughout the lifespan – whether during birth or at old age. Omega-3s ensure proper growth and development in infants. Furthermore, sufficient omega-3 intake during pregnancy is linked to reduced risk of development delay, higher intelligence and fewer behavioral problems in the child.

At the same time, studies have found that higher omega-3 intake decreases age-related mental decline and reduces risk of Alzheimer’s disease among the elderly.

- Anti-inflammatory

Long term inflammation in the body negatively impacts the tissues and organs, and may play a role in the onset of illnesses such as cancer, heart disease and asthma. Consistent studies have shown that Omega-3s reduce the production of substances that are linked to inflammation in the body.

How much Omega-3 do I need daily?

Our Omega-3 requirements vary considerably depending on our age, sex, lifestyle and health status, with higher intake required for people with underlying health condition.

The National Institute of Health currently recommends 1.6g of ALA for males and 1.1g for females while there are currently no specific recommendations for EPA and DHA. However, the American Heart Association recommends an intake of combined EPA and DHA at 1.0g daily for patients with cardiovascular disease.

Hence, to ensure optimal intake of Omega-3 fatty acids, it is important to consume a balanced diet that includes a variety of fatty fish such as mackerel, herring, sardine and salmon for EPA and DHA, as well as plant-based omega-3 sources including flaxseed, walnuts, sacha inchi and their oils for ALA.

Handy tips to ensure adequate omega-3 intake from foods:

· Aim for a serving of fatty fish (mackerel, seabass, sardines) at least twice a week.

· Snack on plant based sources such as seaweed, edamame, walnuts.

· Incorporate 2 tablespoons of omega-3 rich oils such as flaxseed oil or sacha inchi oil to salads or as part of your daily morning drink.

However, Omega-3s aren’t the only important “good fats”. Keep reading to learn more.

Nutritionist Zuanne
Anna Hoo Clinic

Source

1. Calder, P. C. (2010). Omega-3 fatty acids and inflammatory processes. Nutrients, 2(3), 355-374.

2. Kris-Etherton, P. M., Harris, W. S., & Appel, L. J. (2003). Omega-3 fatty acids and cardiovascular disease: new recommendations from the American Heart Association. Arteriosclerosis, thrombosis, and vascular biology, 23(2), 151-152.

3. https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/fats-and-cholesterol/types-of-fat/omega-3-fats/

4. https://ods.od.nih.gov/factsheets/Omega3FattyAcids-HealthProfessional/

关于痛风您了解多少?

2021-05-05T16:41:00.006+08:00

痛风并不罕见，你认识的人中多多少少都听过患有痛风的朋友或者亲人。其实很多人对痛风的了解并不全面，大概知道是尿酸高。今天这篇文章就让你了解关于痛风的那些事。

什么是痛风？

痛风是一种慢性疾病，其特征是由于关节和尿道中尿酸钠晶体发炎引起的剧烈疼痛和肿胀的反复发作。痛风倾向于发生在下肢的关节，大约一半的人最初的症状出现在大脚趾，但是脚背，脚踝，脚跟，腕部，肘部，手指和掌指关节也可能受到影响。尿酸晶体的沉积可能会导致关节变形，疼痛通常从晚上开始，并足以使人从睡眠中醒来。

嘌呤是存在于人体所有组织和许多食物中的一组化学物质。我们的身体在不断地加工嘌呤，分解嘌呤，回收利用或去除副产物。当肾脏不能有效排出尿酸或者身体里尿酸过多的时候，则会引起尿酸浓度增高，久而久之在一定的条件下产生晶体聚集在体内。

痛风的诱发因素

肥胖症
其他慢性疾病：高血压、高血脂、糖尿病、肾衰竭
家族病史
大量高嘌呤食物摄入、大量饮酒
药物（低剂量阿司匹林以及一些降血压药物如利尿剂）
手术、感染或创伤后发作

如何预防痛风？

在治疗的同时，控制饮食中摄入的嘌呤和果糖，戒酒也是必要的。预防痛风发作可以通过降低风险因素开始。

限制高嘌呤食物的摄入。避免过量食用海鲜，内脏等高嘌呤食物。下面会具体来讲关于影响尿酸的食物或成分。

戒酒。酒精增加嘌呤产生，降低嘌呤排出，特别是啤酒增加外源性嘌呤摄入。有痛风的患者戒酒是关键。

喝足够的水分。每日最少需要喝2.5-3L的白开水。脱水容易让尿酸浓度进一步增高。

健康减肥。避免快速减肥，每周减0.5kg的速度算是合理。

保护肾脏功能。肾在排泄尿酸上的作用密不可分，以上的几点都有助于我们保护肾功能，控制好血糖也是对肾脏健康非常重要。

影响尿酸的食物或成份

限制食用高嘌呤的食物：动物肝脏，脱水的食物（鱼干，肉干，豆干，蘑菇干，因为脱水后嘌呤比例变高），红肉，海鲜（贝壳类和小鱼干），酒精（尤其是啤酒）。另外目前并没有有力的证据指出高嘌呤的蔬菜类增加尿酸风险。

每天的嘌呤摄入量：<400mg/d（相当于每天食用<200g（生重）左右瘦肉类，基本不会超过这个量）。

果糖尿酸是果糖(Fructose)代谢的产物之一，研究上有充分证据表明果糖会增加血液中的尿酸水平。其他可升高尿酸的食物成分：山梨糖醇(Sorbitol)、蔗糖(Sucrose)、乳酸盐(Lactate)。

总结重点：

高尿酸血症不一定会痛风，痛风一定有高尿酸血症
高尿酸是由于体内尿酸产生过高或者排泄下降或者两者皆有
痛风患者如果肥胖，建议减肥，但是不宜过快
痛风患者需要戒酒，饮酒增加尿酸产生同时降低尿酸排出
限制高嘌呤动物来源，高嘌呤植物来源无需过分限制
痛风患者需要限制果糖摄入
控制高血压，控制高血脂，保护肾功能
可补充维生素C帮助降低尿酸
单纯高尿酸血症（未发生痛风）不推荐服药作为预防方式
痛风发作以后，遵医嘱服用降尿酸药物

营养师 Lara
Anna Hoo Clinic

参考文献：

1. All About Gout – Harvard Health. https://www.health.harvard.edu/newsletter_article/all-about-gout

2. The interplay between diet, urate transporters and the risk for gout and hyperuricemia: current and future directions. https://www.ncbi.nlm.nih.gov/pubmed/23253231?dopt=AbstractPlus

3. Risk factors for gout and prevention: a systematic review of the literature. https://www.ncbi.nlm.nih.gov/pubmed/21285714?dopt=AbstractPlus

4. Diet and gout-what is the role of purines? https://onlinelibrary.wiley.com/doi/abs/10.1111/nbu.12205

5. Total Purine and Purine Base Content of Common Foodstuffs for Facilitating Nutritional Therapy for Gout and Hyperuricemia. https://www.jstage.jst.go.jp/article/bpb/37/5/37_b13-00967/_html/-char/en

6. Fructose-Rich Beverages and the Risk of Gout in Women. http://www.ncbi.nlm.nih.gov/pubmed/21068145?dopt=Abstract

What is dietary fiber?

2021-04-21T16:46:00.000+08:00

Fiber

Eat more fiber to prevent constipation. We’ve probably heard this many times now and it is true. But did you know that fiber provides a myriad of other health benefits as well?

What is dietary fiber?

Unlike other types of carbohydrate that are digested in the body to provide energy, dietary fiber are carbohydrates that do not get broken down and digested. Instead, fiber passes through the stomach, small intestine and out of the body intact. Fret not though, these fibers are still useful to us despite it!

Types of Fiber

There are two types of fiber, both of which are beneficial to our health.

Soluble fiber dissolves in water to form a gel-like substance. Commonly found in peas, beans, psyllium, oats, apples and citrus fruits, soluble fiber helps to lower cholesterol levels and regulate blood sugar levels.

Insoluble fiber does not dissolve in water and adds bulk to stool, which leads to softer and more regular bowels to prevent constipation. Legumes, beans, potatoes, carrots and berries are a good source of insoluble fiber.

Health Benefits

- Heart: Individuals who consume higher amounts of fiber reported lower risk of cardiovascular disease. Fiber reduces total cholesterol and low-density lipoprotein (LDL) – also known as the ‘bad cholesterol’.

- Gut Health: Some forms of dietary fibers including inulin, fructo-oligosaccharides (FOS) and galacto-oligosaccharides (GOS) gut serve as prebiotics. Prebiotics stimulate the growth of good bacteria that help maintain a healthy digestive tract by improving gut barrier function and immunity.

- Blood sugar control: Fiber slows down the digestion and absorption of sugar in the body, hence reducing spikes in blood sugar levels. Research has shown that Type 2 diabetics who consumed a high fiber diet experienced 28% reduction in fasting glucose levels.

- Weight management: Fiber helps us keep full longer as it slows down the speed of food passing through the stomach to the rest of the digestive tract. Foods that are high in fiber are often lower in calories as well. Studies have shown that individuals who increased their dietary fiber intake increased weight loss and had better adherence to diet.

Tips to increase fiber intake

Based on the Malaysian Recommended Nutrient Intake 2017, adults are recommended to consume at least 20g-30g of dietary fiber daily. Adopt these tips to help you meet your fiber intake:

Include a variety of fruits and vegetables to get the best of both insoluble and soluble fibers
Choose whole foods over processed foods, which have most of the fibers removed
Eat whole fruits instead of fruit juices
Select whole grain versions of foods such as brown rice over white rice.
Incorporate legumes such as peas, beans and lentils into your meals as a side dish or by adding into soups.

By Zuanne, Nutritionist
Anna Hoo Clinic

Reference:

1. Threapleton, D. E., Greenwood, D. C., Evans, C. E., Cleghorn, C. L., Nykjaer, C., Woodhead, C., ... & Burley, V. J. (2013). Dietary fibre intake and risk of cardiovascular disease: systematic review and meta-analysis. Bmj, 347.

2. McRae, M. P. (2017). Dietary fiber is beneficial for the prevention of cardiovascular disease: an umbrella review of meta-analyses. Journal of chiropractic medicine, 16(4), 289-299.

3. Myhrstad, M. C., Tunsjø, H., Charnock, C., & Telle-Hansen, V. H. (2020). Dietary fiber, gut microbiota, and metabolic regulation—Status in human randomized trials. Nutrients, 12(3), 859.

Slavin, J. (2013). Fiber and prebiotics: mechanisms and health benefits. Nutrients, 5(4), 1417-1435.

SLEEP : What Happens If We Do Not Get Enought Sleep?

2021-04-17T16:24:00.001+08:00

Make sleep your priority

Just like food and water, sleep is also very important for survival. Sleep is the natural remedy for the body to repair, heal and recover. Some of the benefits of getting full night’s sleep are good mood, increased learning and focus, increased energy, improve memory, prevent weight gain, strengthen heart function, and boost the immune system.

Healthy sleep includes adequate duration, good quality, right timing, and the absence of sleep disorders. According to the National Sleep Foundation, an adult aged 18 years old and above should sleep about 7 to 9 hours a day. Appropriate sleeping time is when our body naturally starts to produce a sleep hormone called melatonin around 9 pm. Hence going to bed late at midnight might not be the ideal practice to have a proper sleep.

What happens if we do not get enough sleep at night?

Daytime fatigue
Daytime sleepiness
Mood swings
Poor concentration
Headache/Migraine

Health Risk with chronic insufficient sleep

People with a lack of sleep may have a higher risk of health issues such as heart disease, kidney disease, high blood pressure, diabetes, stroke, and obesity. Poor sleep has also shown to worsen gastrointestinal disease. Disrupted or fragmented sleep may affect emotion, metabolism, hormone regulation, and gene expression. Prolonged insomnia also leads to higher mortality.

Factors of unhealthy sleep routine

Some of the factors come from our own negligence such as high caffeine intake, heavy dinner, high sugar intake at night, physical inactiveness, binge-watching drama, and exposure to blue LED lights. These factors can be overcome with self-discipline and proper time management. Other factors include high stress, depression, hormonal changes, change of environment, change of work shift, and sleep-related disorders.

How to promote a healthy sleeping pattern?

Sleep Right Timing

7-9 hours of sleep for adults
Recommended bedtime 10 pm
Recommended wake-up time 6 am
Avoid afternoon naps

Relaxing bedtime activities

Reading
Meditation/prayers
Listening to relaxing music
Avoid electronics before bed

Comfort sleeping

Room temperature – between 18-20°C
Free from noise
Free from light
Comfortable mattress and pillows

Waking up in between or trouble to sleep?

Avoid alcohol and smoking prior to bedtime
Exercise during the day time
Light meals for dinner – reduce carbs/sugars before bedtime
Avoid fluid intake 1 hour before bedtime
Avoid spicy food and caffeine before bedtime
Record your sleep pattern and speak to our Doctor about it

Make sleep a priority as it is important for both your mental health and physical health. Starts to plan the day and has the self-discipline to follow the right sleep routine. Most importantly, avoid trading your sleep with any types of activities.

By Nutritionist Moga
Anna Hoo Clinic

References

Lichtenstein, GR. The Importance of Sleep. Gastroenterol Hepatol (N Y). 2015 Dec; 11(12): 790

为什么少吃肉，血脂还是高？

2021-04-14T16:40:00.000+08:00

随着我国高血脂患者人数不断上涨，很多人也意识到了高脂饮食的危害，转而追求清淡的饮食，甚至是全素食。然而，有些人明明没吃肉，血脂还是居高不下；即便餐餐吃素，血脂也降不下来…

人体血脂水平主要由血液中的脂肪成分含量来决定，包括胆固醇、甘油三酯、磷脂以及游离脂肪酸。而根据分析，容易发生代谢异常引发高血脂的主要是：总胆固醇(Total Cholesterol)、甘油三酯 (Triglyceride)、高密度脂蛋白(HDL Cholesterol)、低密度脂蛋白(LDL Cholesterol)以及极低密度脂蛋白(VLDL Cholesterol)。

这几种成分，有些容易受到饮食影响，而有些易受到基础代谢异常的影响。由此可见，不能将所有高血脂问题归结为饮食不当；而一些看似合理的饮食习惯，也可能影响到血脂的稳定。

1. 不吃肉却多吃主食

人体每一刻都在消耗能量，而脂肪是其中主要能量来源，如果不吃肉，脂肪摄入不足，就会产生强烈的饥饿感，促使人们从别的食物中补充，首选就是主食。主食多为精制米面，含大量淀粉，可经过消化转变为葡萄糖，多余的葡萄糖又会在肝脏中转化为甘油三酯，升高血脂；且葡萄糖的消化速度较快，饱腹感比脂肪弱，容易多吃。摄入过多主食很容易导致肥胖，当体重增加后，人体对于脂肪的代谢能力也会降低。

2. 坚果摄入超标

核桃、腰果、花生等常见坚果虽然富含不饱和脂肪酸，对人体有益，但不饱和脂肪酸毕竟是脂肪成分，也需要肝脏来代谢。如果每天都食用大量坚果，容易导致脂肪酸和胆固醇摄入超标，破坏原本的饱和脂肪酸与不饱和脂肪酸的平衡，降低人体脂肪代谢效率。因此适量食用坚果有助于调节血脂，但超量食用坚果反而易有高血脂。另外，炒或煎炸后的坚果零食含油、盐、糖较多，长期食用不利于降脂，也要少吃或避免。

3. 肌肉太少脂肪太多

肌肉一般占体重的30%~50%，可以通过将葡萄糖氧化分解为能量，提供人体日常活动所需。当人们肌肉较多时，胰岛素较为敏感，对葡萄糖的利用率较高，从而对食物中的脂肪需求降低；但如果肌肉不足，消化不及时的葡萄糖就容易积压在肝脏内，削弱肝功能，也拖慢了对甘油三酯和胆固醇的代谢效率，可能让血脂、血糖都不断升高。

4. 睡眠不足压力过大

由人体脑垂体前叶分泌的生长激素能促进蛋白质合成，影响脂肪代谢和体重增减。生长激素在夜间睡眠期间分泌较多，特别是晚上10点到凌晨2点和早上5点到7点。长期睡眠不足、压力过大者，生长激素分泌水平下降，容易让脂肪代谢功能紊乱，造成血脂水平居高不下，尤其是患有慢性基础性代谢疾病的中老年人。

一些高血脂患者尝试进行全素食饮食，但有降脂效果并不理想，为什么呢？其实原因在于缺乏优质的肉类，容易导致人体缺乏某些重要的营养元素。

1. 缺乏维生素B群

维生素B群是人体内糖类、脂肪、蛋白质等代谢不可缺少的物质，它们主要存在于蛋、奶、鱼和动物肝脏中。某些常年素食者因为饮食结构不完整，肉食摄入过少，可能导致维生素B群缺乏，造成脂肪代谢紊乱，从而患上高血脂症。

2. 缺乏蛋白质

肉类食物中含有大量蛋白质，且人体消化吸收率较高，完全不吃肉容易导致蛋白质摄入不足，载脂蛋白的合成原料不足，以致于人体代谢脂肪的效率降低。载脂蛋白对于高脂血症、心脑血管疾病等的产生和发展都有重要影响。

3. 缺乏不饱和脂肪酸

不饱和脂肪酸能有效地控制人体血脂的浓度，降低血液中对人体有害的胆固醇和甘油三脂，并提高对人体有益的高密度脂蛋白的含量。然而不吃肉，全素食，也会相应减少不饱和脂肪酸的摄入，这反而不利于控制血脂水平。

其实，降血脂不等于不能吃肉，肉吃对了更能帮你保持血脂健康。根据马来西亚膳食指南建议，每日应吃适量的鱼、禽、肉、蛋、豆类等蛋白质食物。马来西亚卫生部也推出“健康餐盘” 作为人们日常膳食的营养指南。健康餐盘的概念为摄取半盘的膳食纤维如蔬菜水果、四分之一的蛋白质和四分之一的全谷类碳水化合物。这项概念强调全面性的多元化饮食和均衡的营养。这样既能保证一定的肉类脂肪摄入，又可以通过蔬菜中的膳食纤维和维生素来调节脂肪酸与胆固醇的吸收量，保持血脂平稳。

Lara营养师
Anna Hoo Clinic

参考文献：

1. 马来西亚卫生部的营养摄取建议 http://nutrition.moh.gov.my/wp-content/uploads/2017/05/FA-Buku-RNI.pdf

2. 马来西亚成年人士的膳食脂肪及纤维摄取：当以 “西方国指标” 作为饮食计划目标所衍生的问题和影响 http://nutriweb.org.my/mjn/publication/03-2/e.pdf

3.食品营养国家协调委员会。马来西亚饮食指南。吉隆坡: 马来西亚卫生部；2005年 https://scholar.google.com/scholar_lookup?title=Malaysian+Dietary+Guidelines&publication_year=2005&

4. 健康饮食，世界卫生组织 https://www.who.int/news-room/fact-sheets/detail/healthy-diet

关节退化发炎，更需要肌⾁

2021-03-24T17:33:00.000+08:00

增肌从来就不是⼀件简单的事情，更何况是膝盖有退化性关节炎的病⼈。

65岁的她，双腿的膝盖都有退化性关节炎的问题，膝盖的疼痛不由⾃主的让她减少活动，她认为是膝盖动太多了，所以要多休息，连平⽇早上的晨⾛都停掉了。可是，膝盖的疼痛却仿佛变严重了，⽽⼀段⽇⼦后，发现膝盖周围的肌⾁都开始萎缩了。

膝盖的问题我们就请她的⻣科医⽣为她把关照顾，⽽我们就以我们诊所的脉冲电磁感应场疗程为她改善情况：磁波刺激肌⾁的⽣⻓(Magnetic Muscle stimulation)，电磁感应场改善关节疼痛与复原。

由于她需要⼈载送过来诊所，所以原定⼀星期两次的疗程变得⼀星期⼀次。居家我们就教导她如何开始深蹲，不过刚开始肌⾁软弱的关系，我们从她坐着椅⼦，拉着扶⼿站起来开始练习，⼀步⼀步慢慢的增强肌⾁的⼒量。饮⻝也是关键，建议她吃⾜量的蛋⽩质，然后避免⼀些会造成身体慢性发炎的⻝物，提供身体⾜够的原料，以增加肌⾁量。

照⽚是她的肌⾁量增⻓，每⼀个星期都有进展。⽽今天，当仪器放在⼤腿肌⾁上的时候，她很开⼼的告诉我们：你们看，我的⼤腿肌⾁收缩着，把⼩腿拉上来了。疼痛改善良多，现在早上重新晨⾛，吃⾜够的营养，整个⼈的⽓⾊都不⼀样了。

⼈体关节⽼化，当缺乏⾜够的肌⾁及肌⼒，就⽆法分担关节承受的压⼒，如此⼀来就增加关节负担，甚⾄造成关节磨损及发炎产⽣。⾯對膝蓋的退化，現在醫界認為最有效的⾯對⽅式，是要減少久坐，控制體重，並做⼀些加強肌⼒的運動訓練，再配合藥物⽌痛。

Dr. William Hoo
Anna Hoo Clinic

Ref :

StarFormer® TightWave® | Fotona
TESLA Stym - Iskra Medical
Preventive Effects of Repetitive Peripheral Magnetic Stimulation on Muscle Atrophy in the Paretic Lower Limb of Acute Stroke Patients: A Pilot Study (nih.gov)
Magnetic stimulation device speeds up muscle healing The Engineer

LACTOSE INTOLERANCE

2021-03-10T17:13:00.000+08:00

Ever wondered why you experience stomach discomfort after consuming milk or dairy products?

Fret not, an estimated 65% of the population endures the same struggle due to lactose intolerance – a condition that is more common than you think.

What is Lactose Intolerance?

Lactose intolerance is a condition in which an individual experiences digestive discomfort after consuming lactose, a form of carbohydrate that is primarily found in milk and milk products.

A lactose intolerant individual does not make lactase, an enzyme that is required to digest and break down lactose into simple sugars glucose and galactose, which can then be absorbed into the blood. Instead, undigested lactose moves through the gut, where it is fermented by bacteria – leading to digestive discomfort such as:

· Bloating

· Stomach cramps

· Gas

· Diarrhea

· Nausea

· Vomiting

These symptoms usually develop within 30 minutes to 2 hours after consumption, with the severity depending on how much lactose an individual consumes and can tolerate.

Causes of Lactose Intolerance

Our body naturally produces lactase during infancy in order to digest milk but gradually decreases production over time to a sufficient amount that allows us to consume small amounts of dairy in the typical diet. However, there are 3 causes of lactose intolerance.

1. Primary

The most common form is caused by a sharp decrease in lactase production that persists into adulthood. It may be partially caused by genes as studies have shown how lactose intolerance is more common among Asians and Africans as compared to Europeans and Americans.

2.Secondary

Decrease in lactase production due to inflammation in the intestine due to illness or injury such as coeliac disease, Crohn’s disease, chemotherapy or long course of antibiotics. Lactase production may be restored if the underlying illness is treated.

3.Congenital

In rare cases, a genetic disorder leads to congenital lactose intolerance, which affects newborn babies who produce very little or no lactase.

Treatment for Lactose Intolerance

While there is no treatment available to produce more lactase enzyme, symptoms can be controlled by removing milk and dairy products from the diet. It is also important to read food labels to identify any source of dairy in the ingredient list.

What foods contain lactose?

Lactose is found in dairy products including Cow’s milk, cheese, ice cream, yogurt and butter.

Other foods that could contain lactose due to added dairy products include:

Creamy sauces
Biscuits
Cakes and bread
Breakfast cereal
Instant meals
Potato chips

Read through the product ingredient list and watch out for the following terms:

Milk, Whey, Casein, Curds, Cheese, Milk Solids, Milk byproducts.

Besides that, look out for the statement “may contain milk”.

Alternatives to Dairy

To most people, dairy products are an important source of calcium, protein, and Vitamins A and D. Hence, it is important to obtain these nutrients from other food sources when eliminating dairy. Some food alternatives for these nutrients include:

1. Calcium: Sardine, dark leafy greens, nuts and seeds, beans, broccoli

2. Vitamin A: Carrots, broccoli, sweet potatoes, pumpkin, papaya, mango

3. Vitamin D: Exposure to natural sunlight, fatty fish such as salmon, tuna and mackerel.

By Nutritionist Zuanne
Anna Hoo Clinic

Source

https://www.niddk.nih.gov/health-information/digestive-diseases/lactose-intolerance

https://www.medicalnewstoday.com/articles/180120

https://www.nhs.uk/conditions/lactose-intolerance/

https://medlineplus.gov/genetics/condition/lactose-intolerance/

WEIGHT LOSS AND HEALTH BENEFITS WITH INTERMITTENT FASTING

2021-03-06T17:39:00.001+08:00

WHAT IS INTERMITTENT FASTING (IMF)?

Intermittent Fasting is getting its popularity among health-conscious individual due to its positive outcomes. Intermittent Fasting is not a diet but is an eating pattern that has various timing scheduled between the period of fasting and eating. The common methods of intermittent fasting include the 16/8 method, 5:2 method and alternate day fasting. The method that highly recommended is the 16/8 method also known as time-restricted feeding,

Time-restricted feeding referring to an eating period of 8 hours and a fasting period of 16 hours. There is no calorie restriction during the eating window, however, eating the right food plays an important role in the best outcome. This method can be done on daily basis. It is the most popular one and highly recommended as it easy and safe to follow for beginners.

WEIGHT LOSS AND HEALTH BENEFITS WITH IMF

Practising intermittent fasting helps in burning excess body fat hence leads to weight reduction. A normal eating pattern causes your body to use glucose (sugar) as the source of energy whereas by doing IMF, the body shift from utilising glucose to fat to burn for energy. Over time this causes the body to shed excess body fats and reduce weight.

A hormone called Insulin will be released by the body with sugar present in the blood. Frequent meal intake spikes and crashes insulin level which over time may lead to insulin resistance and conversion of excess sugar into fat. IMF practise having been proved to regulate the blood sugar level by preventing spike of insulin level. In a study, individuals with diabetes that practised 16/8 IMF for two weeks have seen a significant reduction in sugar level and weight loss.

Fasting helps in promoting good cholesterol HDL and decreased bad cholesterol LDL and triglyceride. Research has been shown to inhibit the formation of atherosclerotic plaque hence reduce the risk of heart disease. A 2019 clinical trial showed that patients with metabolic syndrome who fasted overnight for 14 hours experienced a significant reduction in blood pressure, total body fat, and waist circumference.

An unhealthy eating lifestyle and a very highly-stressful lifestyle contributes to increased inflammation. In the journal Rejuvenation Research, alternate-day fasting helped reduce markers of oxidative stress. With the reduction of oxidative stress, it is proven fasting may help to reduce inflammation and prevent chronic diseases such as diabetes, heart disease, obesity, and cancer.

PRACTISING INTERMITTENT FASTING

What to eat and how to start the IMF?

During 16 hours of fasting, it is not recommended to eat any food but drinking zero-calorie beverages such as green tea, black coffee, or water is acceptable. Always remember hydration is crucial in weight management.

Eating is typically focusing on healthier and balanced foods for a better outcome. For weight management, it is important to control the portion of carbohydrate to prevent conversion of sugar to fat. Therefore the recommended portion for carbohydrate is 20% of your plate while protein makes up 30% and vegetables 50%. Protein is essential in your diet to prevent muscle loss. It is best to choose whole food instead of processed food to reduce toxin accumulation and prevent inflammation.

Beginners may start IMF with 12 hours fasting and gradually increase to 16 hours when the body is ready. Going straight from feasting all day long to 16-hour fasting can be really shocking for your body.

Contraindications

Although the IMF is beneficial, it may not be suitable for everyone. Some group of people may need to avoid practising IMF:

• Children and teenagers

• Pregnant and lactating mother

• Hypoglycaemia/Low blood sugar level and Diabetes Type 1

• Malnutrition and eating disorders

• Inflammatory bowel disease

Last but not least, IMF can be a part of our healthy lifestyle routine but then again with proper monitoring, this eating pattern is considered safe and may give you the expected outcomes. To ensure this eating pattern is suitable for you, you may talk to our doctors and nutritionist at ANNA HOO CLINIC.

By Nutritionist Moga
ANNA HOO CLINIC

关于喝水的那些事

2021-03-03T17:49:00.000+08:00

喝水的重要性

“多喝水”是生活中最常说的叮嘱。的确，水是一种对人体非常重要的营养物质，水分占到机体重量的70%。水的功能特别多，可调节体温、促进各种营养物质的吸收、促进新陈代谢以及帮助运输营养物质和排泄。如果少喝一次两次可能看不出危害，但如果长时间缺水就会给身体带来不小的麻烦。

多喝水对身体有哪些好处

促进肠道代谢，帮助排便，从而预防便秘等肠道问题。
有助于减少患结石问题的风险。
降低血液粘稠度，血栓问题的患病风险。
加速尿酸的排出，避免尿酸在体内堆积，预防高尿酸、痛风等问题。
餐前适当饮水，有助于促进身体新成代谢。
有利于维持健康体温和体内的散热。

怎样判断自己“缺水了”？

首先，您可以通过关注“尿液的颜色”来判断自己是否缺水。正常尿液的颜色是透明白色或者略带黄色，如果颜色有明显加深，则说明需要补水了。当人体内的水分随着汗液大量流失，身体会出现一定程度的疲劳和精神萎靡状态。其他缺水症状如口渴、嘴唇干裂、头晕，这时就需要及时给身体补水了。

什么时间喝水更合适？

喝水，时间并没有“刻意的限定”，它应该平均分配在一天当中的每一个时间段，隔一段时间补充水分。千万不要等到口干舌燥才开始喝水，那是您已经进入轻度脱水了，希望大家可根据自身情况妥善调节补水时间。

另外，有些时间段建议大家能够补充水分。清晨起床后喝一杯水，帮助身体补充睡眠状态下机体代谢所失去的水分。同时，早晨是一天中人体血液黏稠度最高的时候，饮水可降低血液粘稠度，促进血液循环。饭前半小时喝水，有利于吃饭时充分地分泌胃液，帮助消化。两餐之间适量喝水，可助于冲洗黏附着胃肠内壁食物消化的残留物，达到预防肠道疾病的效果。

生理需水量

一般，体重1kg大约需要40ml的水，以一个体重60kg的成年人来说，一天的基本喝水量就是2400ml。考量其他影响身体排水的因素（如流汗、呼吸、排尿等），人体一天正常喝水量应落在2500至3000ml，如果本身容易流汗或工作场合闷热者，每日喝水可提升至3500ml。另外，要根据自己的身体状况控制喝水量，还要看天气，天气热，出汗多，就要多喝水；如果运动量大也要适当补充水分。

健康饮水小贴士

· 养成外出时随身携带一瓶水的习惯，随时补充水分。

· 用餐前先喝水，有助于减少总热量摄入。

· 新鲜白开水最佳，用白开水替代果汁，碳酸饮料，能量饮料等。

· 饮水少量多次更利于吸收，每次喝水量200-250ml小口慢喝，不给身体过分增加压力。

多喝水，您收获的将不仅仅是“解渴”，还会有很多好处。

健康饮水，正确饮水，坚持饮水，您的生活会因为饮水而变得更加幸福。

营养师
Nutritionist

Lara
Anna Hoo Clinic

References:

1. The Nutrition Source. 2021. Water. [online] Available at: https://www.hsph.harvard.edu/nutritionsource/water/

2. Centers for Disease Control and Prevention. 2021. Water and Healthier Drinks. [online] Available at: https://www.cdc.gov/healthyweight/healthy_eating/water-and-healthier-drinks.html

3. NHS, UK. 2021. Dehydration. [online] Available at: https://www.nhs.uk/conditions/dehydration/

SUGAR - The differences of Natural Sugar and Added Sugar

2021-02-20T17:08:00.002+08:00

Sugar

While you’ve probably heard enough about how we need to avoid sugar , the sweet substance also serves as a quick source of energy and is technically impossible to avoid completely. Hence, it’s important to first realize that 2 types of sugars exist- natural sugar and added sugar - as well as understand the differences between these two.

Natural sugars are found in unprocessed whole foods including fruits, vegetables, dairy and starches and come together as a package with vitamins, minerals and nutrients to provide a sustainable source of energy.

In contrast, the real concern arises with added sugars which refers to any form of sugar that is added to food or beverages during processing or preparation. Added sugars are easily absorbed into the bloodstream and are linked to several diseases. These added sugars can take on a myriad of identities as brown sugar, palm sugar, corn syrup, honey, molasses, high fructose corn syrup, and sugar molecules ending in “ose” such as glucose, sucrose, maltose.

Why should we reduce intake of added sugars?

Excessive intake of added sugars provides little to no benefits and can be detrimental to our health from several aspects.

- Gut health
Processed carbohydrates and added sugars trigger the growth of harmful gut bacteria and promotes an inflammatory microbiota which in turn negatively impacts our health, including the immune system, skin, heart, hormone levels, and body’s ability to absorb nutrients.

- Weight gain
Foods containing added sugars not only tend to be higher in calories, but also tend to be more palatable, which encourage people to consume more of the food. Hence, an increased overall calorie intake can lead to weight gain in the long run.

- Heart health
Excessive sugar intake not only increases the likelihood of being obese and developing type 2 diabetes but have also been shown to increase blood pressure and LDL cholesterol levels, all of which are risk factors for heart disease.

- Skin health
A diet high in sugar contributes to the production of advanced glycation end products (AGEs), which are compounds that damage collagen and elastic, causing the skin to age prematurely. At the same time, a study among 2,300 teenagers demonstrated that frequent consumption of added sugars led to 30% greater risk of developing acne.

Tips to reduce sugar intake:

1. Say no to liquid sugar.

Avoid sweetened beverages including sodas, smoothies, and bubble tea which are a prime source of extra calories that not only contributes to weight gain but also provides very little nutritional benefits. Studies also indicate that liquid carbohydrates are less satiating than solid food form, causing us to feel hungry even after consuming a full serving of beverage.

2. Read food labels

Before you judge the sugar content in foods based on sweetness levels alone, think again! Research suggests that about 75% of packaged foods in supermarkets contain added sweeteners. This includes salad dressings, breakfast cereals, yogurt and canned food.

- Scan the ingredient list for added sugars. Keywords to look out for are “syrup”, “sweetener”, “honey”, “nectar” and words that end with “ose”.

- Select sugar free or low sugar products.

3. Make healthier swaps

- Opt for fresh whole fruits instead of fruit juice & smoothies.

- Opt for whole foods instead of processed foods.

- Have a fruit for snack of dessert instead of a sweet confection

- Prepare a homemade version of sauces, dressings & desserts where you can control the amount of sugar that goes into the food.

By Nutritionist Zuanne
Anna Hoo Clinic

1. Satokari R. High intake of sugar and the balance between pro-and anti-inflammatory gut bacteria.
2. Te Morenga LA, Howatson AJ, Jones RM, Mann J. Dietary sugars and cardiometabolic risk: systematic review and meta-analyses of randomized controlled trials of the effects on blood pressure and lipids. The American journal of clinical nutrition. 2014 Jul 1;100(1):65-79.
3. DiNicolantonio JJ, Lucan SC, O’Keefe JH. The evidence for saturated fat and for sugar related to coronary heart disease. Progress in cardiovascular diseases. 2016 Mar 1;58(5):464-72.
4. Aragno M, Mastrocola R. Dietary sugars and endogenous formation of advanced glycation endproducts: emerging mechanisms of disease. Nutrients. 2017 Apr;9(4):385.
5. Ng SW, Slining MM, Popkin BM. Use of caloric and noncaloric sweeteners in US consumer packaged foods, 2005-2009. Journal of the Academy of Nutrition and Dietetics. 2012 Nov 1;112(11):1828-34.
6. Pan A, Hu FB. Effects of carbohydrates on satiety: differences between liquid and solid food. Curr Opin Clin Nutr Metab Care. 2011; 14:385-90.
7. Ng SW, Slining MM, Popkin BM. Use of caloric and noncaloric sweeteners in US consumer packaged foods, 2005-2009. Journal of the Academy of Nutrition and Dietetics. 2012 Nov 1;112(11):1828-34.

GLUTEN INTOLERANCE - What is Gluten?

2021-02-11T17:10:00.002+08:00

What is Gluten?

Gluten is a complex protein consist of gliadin and glutenin which mainly found in grains. It is an excellent binding agent in food processing and commonly used as additives in most of the processed food. According to gluten property studies, it acts as a binder, holding food together and adding a “stretchy” quality.

However, gluten is resistant to digestive enzymes in the digestive tract. The undigested particles may cross the intestinal barrier and stimulates allergic responses. In addition, components like agglutinin and exorphins in gluten grains induce the damage of intestinal lining which leads to Leaky Gut Syndrome. The damage in the small intestine may cause gastrointestinal symptoms and malabsorption.

Gluten Intolerance and symptoms.

Gluten intolerance conditions include Celiac Disease (CD), and Wheat Allergy (WA). On the other hand, non-celiac gluten sensitivity (NCGS) is also known as gluten intolerance reported in people with no Celiac Disease and Wheat Allergy. The typical symptoms of gluten intolerance are:

· Nausea	Tiredness
· Constipation	Headache
· Bloating	Fibromyalgia-like joint or muscle pain
· Abdominal pain	Leg or arm numbness
· Diarrhoea	Foggy mind
· Irregular bowel movements	Dermatitis or skin rash

The only known treatment for gluten intolerance is a lifelong, strict gluten-free diet.

Gluten food.

Grains are the world’s stable food due to their accessibility, affordability, and longer shelf life. Not all grains contain gluten, therefore a right choice of gluten-free diet is more beneficial for our health.

Main gluten grains are wheat, barley, rye, malt, spelt, triticale, and oats. According to gluten studies, similar protein of gliadins exist as avenins in oats are also referred to as “gluten.”

Examples of processed food that contains gluten are cereals, pasta, noodles, bread, cakes, pastries, biscuits, alcohol, dressings, processed meat, vegetarian meat, sauces, seasoning, marinades, soups, and confectionery.

Gluten-free food includes fresh food such as vegetables, fruits, meats, fish, and poultry. Gluten-free grains or starch includes corn, rice, potatoes, tapioca, quinoa, millet, amaranth, arrowroot, and buckwheat. However, it is suggested to eat these grains in their natural form instead of the processed form such as gluten-free flour, gluten-free pasta, gluten-free biscuits or cakes.

The Benefit of choosing a Gluten-free diet (GFD).

Other than improving gastrointestinal health and immune system, a gluten-free diet also helps in

ü Weight Loss

A study was conducted on people who avoid gluten without any gluten-related diseases found was associated with a decrease in weight over 1 year, lower waist circumference, and higher-high density lipoprotein (HDL-good cholesterol) levels compared to the general population.

ü Insulin Resistance

A gluten-free diet improves insulin sensitivity through the suppression of the inflammatory profile according to a gluten-free diet study.

ü Endometriosis and Chronic Pelvic Pain

Studies claimed an improvement in pain scores after implementation of a gluten-free diet for 6 and 12 months, respectively.

ü Fibromyalgia

Patients on the gluten-free diet and hypocaloric diet for 24 weeks resulted in symptom improvement for both gluten-sensitive and fibromyalgia symptoms.

ü Autism

Children's Hospitals and Clinics of Minnesota reports that a gluten-free diet does seem to help with improvement in behavior, social skills, and learning in children with autism.

ü Epilepsy

In a study conducted in 2016, 6 out of 7 patients with celiac disease had their seizures completely under control and were able to discontinue antiepileptic medications after 5 months on the gluten-free diet.

ü Last not least, while on a gluten-free diet we tend to avoid the intake of processed food which has a positive impact on improving our overall health.

By Nutritionist Moga
Anna Hoo Clinic

References:

Biesiekierski JR, Iven J. Non‐coeliac gluten sensitivity: piecing the puzzle together. United European Gastroenterol J 2015; 3: 160– 165.

Biesiekierski JR. What is Gluten?. Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd 2017

Roszkowska A, Pawlicka M, Mroczek A, Bałabuszek K. Iwanicka BN. Non-Celiac Gluten Sensitivity: A Review. Medicina (Kaunas). 2019 Jun; 55(6): 222.

Niland B., MD and Brooks D. Cash, MD. Health Benefits and Adverse Effects of a Gluten-Free Diet in Non–Celiac Disease Patients. Gastroenterol Hepatol (N Y). 2018 Feb; 14(2): 82–91.

Soaresab FLP, Matosob RO, Teixeirab LG, Menezesc Z, Pereiraab SS, Alvesb AC,…..Leiteb JIA. Gluten-free diet reduces adiposity, inflammation and insulin resistance associated with the induction of PPAR-alpha and PPAR-gamma expression. JNB Volume 24, Issue 6, June 2013, Pages 1105-1111

https://www.hsph.harvard.edu/nutritionsource/gluten