The Star Online: Lifestyle: Health
The Star Online: Lifestyle: Health |
| Posted: 10 Aug 2011 03:31 AM PDT When it comes to human health, there is much conjecture and misinterpretation over the role of enzymes. RECENTLY, a couple of mutual friends threw a party to show off the fruit "enzymes" they had made out of an assortment of berries, grapes and dragon fruit. I must admit the grape "enzyme" was the best, especially when taken chilled. A curious reaction took place that caused a little dis-inhibition and flushing. I departed the gathering heaping compliments on the host for serving the next best thing to ice wine. He still insisted it was "enzymes" he created. Some prefer to make "garbage enzymes" from kitchen discards, using the brew for scrubbing floors, washing dishes and insect repellant. Enzymes have many industrial applications, such as in food processing, manufacture of detergents, stain removers, the pharmaceutical industry, bio-fuel conversion – the list goes on. When it comes to human health, there is much conjecture and misinterpretation over the role of enzymes. Touted to be the "life force" of living things, it has been claimed that low levels of enzymes are the root cause of chronic degenerative diseases and ill health, spawning various philosophies like consumption of raw foods, concoction of home cocktails and feeding the ever-expanding supplementation industry. What are enzymes, really? They are specialised proteins manufactured by various parts of different cells, each with a highly specific function. The process of production and replenishment is based on instructions from the genetic blueprint coded in DNA. We therefore make our own enzymes all the time using the right ingredients and raw materials, somewhat different from kitchen chemistry. Sailing across the sea of confusion, enzymes would be better understood if we load them into different boats: digestive enzymes; metabolic enzymes; plant enzymes; systemic enzymes; and enzyme supplements. Digestive enzymes Digestion literally starts in the brain! Thankfully, no digestive enzymes are secreted here, but thought, sight and smell can trigger a flow of saliva, preparing the oral cavity for the reception of food. Subsequent grinding, chomping and blending of morsels with salivary enzymes (amylase) begin their deconstruction into smaller and partially digested particles. The ball of food is swallowed and moved along the gullet by muscular contractions. Upon entry into the cavernous stomach cavity, a flurry of activities occur. Hormones are secreted and acid is produced, activating a powerful enzyme (pepsin) which breaks down proteins. The stomach churns, allowing the acid, enzymes and food to mix well. After about an hour, the stomach starts to empty its contents into the small intestines, where the hive of activities further intensify. Bile from the gallbladder and the enzyme-rich alkaline pancreatic juice flood the intestines. Amylase breaks down carbohydrates from complex long chain sugars (polysaccharides) to double sugars (disaccharides); protease dices the proteins into amino acids and lipase trims fats into fatty acids. The cells lining the intestinal wall produce and release highly specialised enzymes like sucrase, seeking out sucrose and breaking it into glucose and fructose, which can then be absorbed. Other enzymes (disaccharidases) include maltase (glucose-glucose) and lactase (glucose-galactose). In the Asian population, there is a high incidence of lactose intolerance due to lactase deficiency, whereby milk sugar is not broken down and the affected individual experiences bloating, cramps, flatulence and diarrhoea after consuming dairy products. Metabolic enzymes Metabolism is the intriguing set of chemical processes that maintains life. Anyone who tries to gain mastery of all the possible reactions that occur within the human cell risks a challenge to their sanity as there are thousands of reactions, many tightly interwoven to meet a single objective of producing energy. Each reaction is like a dance to music, needing two to tango. When glucose and oxygen comes together, nothing happens, but within the mitochondria in the cells, sparks literally fly, as the glucose is burned for energy with the help of firestarters like vitamins and minerals (co-factors), and enzymes, which fan the speed of burning. Without such rate-limiting control, one would rage with fever after downing a bun! By definition, a metabolic enzyme is a catalyst protein that controls a particular biochemical reaction. In instances of high turnover, the enzyme causing excessive build-up of uric acid from proteins results in gout. Similarly, the increased tendency to turn bad fats into cholesterol induces inflammation of the arteries. On the other hand, when certain enzymes are lacking, there will be a backlog of unwanted metabolites, eg lack of enzymes converting bilirubin to bile salts result in jaundice. One of the commonest enzyme disorders is G6PD deficiency, where abnormal red blood cells self-destruct. Disaster strikes when there is a genetically pre-determined errant enzyme not performing its duty, broiling deep trouble for many born with such "Inborn Errors Of Metabolism", with catastrophic consequences. Plant enzymes Plants, an inherent component of our ecosystem, are also well endowed with their own set of enzymes. The human machine emits carbon dioxide, and plants soak it up for a specific chemical process known as photosynthesis, where light energy combines with carbon dioxide to release oxygen into the atmosphere, simultaneously creating the backbone of carbon atoms to form carbohydrates, proteins and fats. Man and animals feed on plants and each other, propagating the food chain. As "green" as we try to be, humans have no capacity to photosynthesise. Plant enzymes differ from human metabolic enzymes, but nevertheless do have some benefits on human digestion. Plants and their fruits contain various enzymes in different forms and ratios. A banana is a starchy fruit and contains mainly amylase, an enzyme that helps to break down starch into smaller units of sugars. A mango gets sweeter, juicier and more aromatic, compliments of its own enzymes. Avocado has high fat content and necessarily, has greater amounts of lipase. These plant enzymes are mysteriously placed in specific fruits for their own ripening and subsequent breakdown. If we chose to enclose ripe fruits in a jar over a period of time, the sugars become "ethanolised" through fermentation into one of the most enjoyed beverages since ancient times, namely alcohol. As enzymes are destroyed through cooking at high heat, there is much written and talked about consuming food in the raw form. Systemic enzymes Generally, orally taken enzymes (particularly from animal sources) do not tolerate the acidic environment in the stomach, and since they are proteins, many are themselves broken down by our own digestive enzymes. There are a few exceptions and these have found their way into the doctor's dispensary as part of therapy for specific disease states. Papain, an enzyme extract derived from papaya, has specific protein busting (proteolytic) action. A squeeze of raw papaya into the toughest of meats acts as a tenderiser. In medical application, papain has been used to treat tissue swelling from trauma, surgery, inflammation, wound healing and excessive mucous production. Bromelain, derived from pineapples, is used as a commercial tenderiser and is also touted to have anti-inflammatory properties. Serratiopeptidase, sourced from bacteria and the gut of silkworms, possesses mucous reduction effects and is used in respiratory tract inflammation. It is also found to reduce pain in fibrocystic breast congestion. Claims of benefits of systemic enzymes in heart disease and cancer are currently inconclusive. Enzyme supplements There is certainly no doubt that enzymes are pivotal to biochemical reactions that sustain life. With ageing, poor nutrition, environmental stresses and disease states, both metabolic and digestive enzymes do get depleted. The confusion here is that many proponents of enzyme therapy oversimplify matters, claiming that taking a particular enzyme drink or tablet would rejuvenate the enzyme's levels in the body. Metabolic enzymes cannot be replaced by supplementation, full stop! Good nutrition and healthy cells with proper genetic instructions ensure a constant supply of enzymes, as our body manufactures these enzymes from the necessary amino acids. Many people after their 40s complain that they are unable to tolerate their favourite food as well as compared to their youth. With age, digestive enzymes secretion slackens, and foods that are not digested properly and absorbed remain as a substrate for bacterial fermentation. "Indigestion" leads to bloating, burping, heartburn, abdominal cramp, constipation and flatulence, which is almost always offensive. Since the body's digestive system is unable to cope, taking the right digestive enzyme supplement certainly provides not only relief, but restores physiological gut functions. Most enzyme supplements contain amylase (for digestion of starch), protease (proteins), lipase (fats), lactase (dairy) and cellulase (plant fibre). Some manufacturers add in proteolytic enzymes like papain and bromelain, which apart from aiding digestion of proteins, also seeks out inflammation. It is amazing how the myriad of biochemical reactions in our bodies consolidate together; that the bits and pieces fall into place so perfectly on the jigsaw puzzle of life itself. In good health, we should be thankful that all our enzymes are alive and kicking in unison. If for some bizarre reason there is a missing link, the shattering impact of this biological earthquake is beyond comprehension. May you have a good day making those wonderful enzymes ... err, not ethanol! ■ Dr C.S. Foo is a medical practitioner. For further information, e-mail starhealth@thestar.com.my. The views expressed are those of the writer and readers are advised to always consult expert advice before undertaking any changes to their lifestyles. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information. Full Feed Generated by Get Full RSS, sponsored by Used Car Search. |
| Posted: 09 Aug 2011 04:23 PM PDT These three individuals are a source of hope and strength to haemophiliacs. THE people who best understand what a haemophiliac goes through and how he feels would be fellow sufferers. Lin Hsu-Ke, chairman of the Taiwan Haemophilia Society, was 12 years old when he was diagnosed with the condition. At the time, he did not know anything about haemophilia except its name. He soon discovered its impact, however, when his parents curtailed his activities in order to prevent him from getting injured. "They stopped me from doing whatever was fun!" he says in a recent interview at the 3rd Asia Pacific Haemophilia Camp in Taiwan. "I knew then that I could not afford to get hurt." |
| Posted: 09 Aug 2011 04:22 PM PDT A lively, creative bunch of kids at a haemophilia camp proved that the disease is no barrier to leading a full, healthy life. THE children and teenagers at the camp looked and behaved like any other boys. On the surface, no one would have been able to tell them apart from other children and teenagers. Yet, these ones have inherited a blood disorder called haemophilia; the blood lacks a protein – Factor Eight (VIII) or Factor Nine (IX) – and therefore cannot clot properly, leading to spontaneous or prolonged bleeding, especially in the muscles, joints and internal organs. When this happens, ugly bruises develop. This condition, which is also marked by painful and inflamed joints, affects primarily males while the carriers are females. Co-hosted by the Taiwan Haemophilia Society and Bayer HealthCare, the 3rd Asia Pacific Haemophilia Camp was held in Uni-Resort of Mawudu in Hsinchu county, Taiwan, recently. It brought together those affected by the condition, to learn and share about haemophilia, and build friendships with fellow patients. The camp also aimed to motivate, encourage and empower patients and their caregivers. Over 100 participants from Malaysia, Indonesia, Thailand, Taiwan and China attended the camp. Facing the diagnosis How can one tell if a bruise is just a normal bruise or whether it is due to haemophilia? "There are two ways to be diagnosed. If you are born into a family that knows they have haemophilia, your parents are at least a bit prepared for it," says Brian "BJ" Ramsay, a haematology specialist nurse from New Zealand, in an interview at the camp. "If a family has a history of haemophilia, the baby is diagnosed at birth. "In the first year of life, babies don't do an awful lot: they lie still, they're picked up, fed and put down. So the actual bleeding risk is quite low," adds Ramsay. Parents who know the diagnosis from the time of the baby's birth have about a year – before the baby starts crawling and walking – to get used to the diagnosis. "But for those who don't get the diagnosis at birth, and haemophilia is new to them, it is a lot more difficult. When it gets picked up as the baby starts moving around and bruising, it is then that the problem begins," says Ramsay. "Treatment of small children can be difficult. You need specialist doctors and nurses to get venous access. Babies' veins are very small; sometimes it can take two, three, even four attempts to get a needle in. Treatments can be as traumatic as the bleeding. "These parents hit the road running. There's an awful lot to take on at once," he explains. Without treatment, the disease can result in debilitating pain, damaged joints, disability and even early death. Wong Mun Kee knows all too well the grief and heartache of losing a child to haemophilia. Her elder son was only five years old when he suffered a fall, which led to bleeding and subsequently, death. If he had survived, he would be 21 years old today. Wong has other children – two daughters and another son, Lam Weng Hong, 13. Understandably, Wong is very protective of her son, a haemophilia patient. He was diagnosed when he was a baby, after he developed unsightly bruises when learning to crawl and using the bouncinet. She does not allow him to be "too active" but, rather, encourages him to pursue other interests, such as drawing and reading. "He can draw very well. He draws buildings with intricate details," she proudly says at an interview during the camp. "I still keep the drawings which he's done since he was a little boy, when he drew a 'map of the world'." "I want to be an architect when I grow up," says Weng Hong, who has learnt to live with his condition. He experiences discomfort, joint pain and swelling, especially in the ankle. "I feel irritable when this happens," he says. However, he is not about to let life pass him by. "My hobbies are playing games and the piano. My favourite game is 'Angry Birds'," says the lanky boy. He is now at Grade Five for piano. At school, he excels in his favourite subjects, Maths and Science. Weng Hong – who had submitted a poem – and the other camp participants were among the winners of the Live Your Best Life – Haemophilia Or Not! contest launched on World Haemophilia Day, April 17, in the Asia Pacific region. The children demonstrated creativity and originality in their entries, which comprised comic strips, paintings, drawings, poems and music lyrics. The entries also conveyed the hopeful message that one can lead full, healthy lives despite having haemophilia. "Even if they're haemophilic, it doesn't mean that they can't be somebody. Nor does it mean that they're inferior to their friends. They just have to do what they do best, for example, singing, swimming or drawing," says Dr Novie Amelia Chozie in a separate interview. She is a paediatrician with Cipto Mangunkusumo Hospital in Indonesia. "They are perfectly normal children. Only one gene isn't working properly," says Ramsay. Although there is no cure for haemophilia, patients can learn to manage the disorder. Proper diagnosis and treatment are crucial so that they can maintain a high quality of life. Haemophiliacs can enjoy most of the activities that other people do. For the Show And Tell segment on the first night of the camp, some of the participants shone. For instance, Nabil Firdaus Mohd Nazri, 11, had brought his palm-sized skateboard, with which he performed some "stunts". This bright-eyed, active Malaysian boy loves skateboarding, he shared, but since he cannot pursue the sport – which is deemed extra dangerous for haemophiliacs due to its high risk of injury – Nabil has cleverly devised a way of pursuing it, nevertheless. The audience and the emcee, Andy Lee, were baffled. How does one do skate-boarding on the little skateboard? Nabil promptly showed the audience how. He "skateboarded" on it with his fingers! He demonstrated such nimbleness with it, including manoeuvres like flipping, tossing and catching the skateboard with his fingers, which led to Lee dubbing the item a "fingerboard". Another patient, 10-year-old Nelson Jian, wowed the audience with his rendition of Justin Bieber's song, Never Say Never, and Jay Chou's Kua Shi Dai (The Era). The chubby, bespectacled lad from China clearly had natural talent and was quietly confident as well. While aggressive, body-contact sports such as football and rugby should be avoided by haemophiliacs, other sports – like swimming and cycling – are fine. During the camp, the boys had a lot of fun in the swimming pool, doing hydrotherapy exercises under the watchful eye of fellow haemophiliac Hsiao Wei-Chih, as well as Luo Min-Long and Tu Jhih-Wei. Through a series of talks and practical workshops, healthcare professionals equipped patients and caregivers with the necessary skills and knowledge to manage haemophilia, while representatives from various haemophilia societies shared about the progress they had made in raising awareness and the standard of haemophilia care in Asia. The camp also aimed at motivating participants to live life to the fullest. Through the "Asia United Challenge" indoor group games, they had the chance to meet and befriend many other people like themselves, all living with the disorder and making the most of life despite the condition. The campsite was transformed into a hive of activity as participants tackled challenges at each of the six games stations: Lego-building, a musical performance, piecing together a jigsaw puzzle, decorating a giant postcard, designing an outfit and a trivia quiz plus landmark mix-and-match. The kids learned to work as a team in order to complete the tasks. There were more opportunities to kindle new friendships at the campfire dinner on the second night of the camp. The young patients had a hands-on experience making models from recyclable materials during a model-building session organised by the Taiwan Science Centre. Meanwhile, parents and caregivers shared their views and experiences in dialogue forums, thereby drawing strength from, and empowering, one another. They also had sessions with specialist nurse Ramsay, and Dr Young Ji-Hsiung, chief of the oncology-hematology division at Taiwan's Lin-Shin Hospital, on haemophilia care. To deal with any emergencies that might arise, a First Aid area was designated on the camp grounds. Patients could go there for health checks or carry out self-infusion. A nurse was always on hand to assist patients. Ramsay took a workshop to demonstrate how patients can administer injections to themselves. Practice kits were distributed to all the patients, and Ramsay explained the usage of every item in it, then gave clear step-by-step instructions on how to carry out self-infusion. More insightful talks were given on the last day of the camp. Dr Kang Jiunn-Horng from Taipei Medical University Hospital spoke on Joint Effort: How To Care For Your Joints while Su Hsiu-Yueh, from the same hospital, gave a talk on Eating Right. At the end of the camp, patients and caregivers were enlightened on how to manage haemophilia better while members of haemophilia associations gleaned much from the experience of the Taiwan Haemophilia Society in garnering government support for the haemophilia community. Full Feed Generated by Get Full RSS, sponsored by Used Car Search. |
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