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Posted: 05 Jan 2013 04:14 PM PST

Herbal and nutritional therapies for diabetes.

THIS is the third article on fighting diabetes. Diabetes is an impending national disaster and will consume much of our resources if we ignore the threat.

Already, one in five adults are afflicted. And the situation is getting worse.

In the first article, I explained how obese diabetics can reverse or cure their condition by reducing their weight to normal, which may include dieting, exercise, and even bariatric surgery for the morbidly obese after everything else has failed (and after adequate medical, dietary and psychological consultations).

In the second article, I explained how diabetes can be managed by a nutrient-dense, high-fibre, low saturated fat, whole-food (legumes, fruits, vegetables and whole grains) diet combined with exercise and weight loss (if overweight).

I also shared about foods and nutrients that have been shown in scientific studies to improve insulin sensitivity. These include almonds, alpha lipoic acid, chromium, cinnamon, curcumin (turmeric), grapefruit, oatmeal, omega-3 (polyunsaturated fatty acids), vitamins D and K, and others.

Today, I would like to share some herbal and nutritional therapies that may be helpful in diabetes. For those with diabetes who are on drug treatment, these therapies may help them reduce or wean off the drugs. For those whose diabetes control is not good, these therapies may help avoid or delay the increase of drug dosage.

Remember that all drugs have multiple side-effects, while most herbal and nutritional therapies have multiple benefits, that is, even if the treatment fails to improve diabetes, there are other benefits that you can look forward to (eg some of these remedies also help normalise blood pressure).

A caveat: as with most herbal and nutritional therapies, only a few of the therapies mentioned below have undergone scientific studies to validate the claims. Most are based on traditional use, testimonials, and the clinical experience of doctors and other health practitioners I know.

With that disclaimer, and with the knowledge that these remedies are safe after being used for many years by many thousands of people, I advise those who are keen to try these therapies to do so without compromising the monitoring of diabetes (ideally by daily home blood glucose test), and without adjusting their drug doses on their own.

Let your doctor advise on that after seeing the record of your daily blood glucose. If the remedy works, the improvement can be seen as early as within one week, and it is reasonable to decide that it does not work if there are no improvements after one month of consumption.

Malaysia has a rich history of traditional medicines, and there are hundreds of herbal remedies claimed to be effective against diabetes.

I have tested some of these on my patients, and found several herbal teas and herbal juices indeed help in controlling the blood glucose in some patients. However, there are no formal studies to validate the claims made by the manufacturers of these products.

Berries: There are many berry-based fruit juices being sold. These are mostly claimed to be health-enhancing due to the high antioxidant content of berries and the other constituent fruits (eg mangosteen, pomegranate).

Many diabetics who consume these juices for the claimed health benefits also report better control of their diabetes. This has been confirmed by several doctors who have recommended these juices to their diabetic patients.

The most powerful of these berries (in terms of antioxidant power) are maqui, acai, gouji (wolfberry), and blackberries.

Probiotics and prebiotics: Probiotics are "good" or "friendly" bacteria that improve the health of our intestines (mainly the colon), as well as the rest of the body as a result of improved colon health.

These good bacteria actually line our intestines, making sure harmful bacteria don't get through into the body. Some of them also manufacture vitamin B (important for nerve health and managing stress), and help improve calcium absorption.

Prebiotics are food that feed the probiotics. Having abundant prebiotics will help the probiotic population grow. The gut has about 100 trillion bacteria. The percentage of good versus bad bacteria depends on the food and drugs you take.

Some raw foods contain live probiotics (eg yoghurt and other raw fermented foods) and/or prebiotics (eg insoluble fibre found in many fruits and veggies).

Note that cooking kills the probiotics.

Antibiotics kill both good and bad bacteria, so it is important that you replenish your gut probiotics after every course of antibiotics.

Probiotics have been known to give many health benefits – including healthy bowels; improving coeliac disease; preventing asthma, infections and allergies in children; helping in weight loss; improving skin health; and preventing recurrent yeast infections.

Recent studies have shown that probiotics can help prevent/delay type 1 diabetes (study by University of Florida, reported in May 2011 in Future Medicine), and help in the management of type 2 diabetes. Many studies have shown the benefits of probiotics for diabetics, especially the obese ones.

A 2010 multicentre, double-blind, placebo-controlled intervention study on 87 obese subjects found that subjects who consumed yoghurt (containing probiotics) had significantly reduced abdominal fat, body weight, and other factors that indicated the benefits on metabolic disorders such as diabetes.

Thus, it is not surprising that many diabetics report better glucose control if they consume probiotics.

A review in Acta Diabetologica (December 2011) noted that intestinal microbiotica (ie the balance of good versus bad bacteria) is a causal factor in the development of the metabolic disorders such as diabetes. We will definitely see a bigger role for probiotics in mainstream modern medicine.

Already, many paediatricians are recommending milk formulas enriched with probiotics for growing children. There will come a time when probiotics will be officially endorsed as a daily supplement for all, as many of us health enthusiasts are already doing.

I get my probiotics through supplements, as I do not think that the yoghurt, yoghurt drinks, raw tempeh, natto, etc provide enough probiotics unless you consume lots and lots of it, like people of some other countries do as these are part of their usual meals.

Gum Arabic: Gum Arabic is the superstar of prebiotics. For many years, it has been used in the food and beverage industry, but not for its health benefits. It is the ingredient that helps keep the bubbles in your soda drink stable. Without the fizz, half the fun of drinking soda is gone (although drinking soda is certainly not good for health).

Since it is a powerful prebiotic, all the benefits of probiotics mentioned above can be expected from consuming it.

Gum Arabic is mainly produced in the arid lands of Sudan and neighbouring countries. It has been used as traditional medicine for many years, with many known health benefits. It was introduced to me by two friends, who also introduced me to the former Sudanese government minister who is the exporter.

We had a long discussion on the history and benefits of Gum Arabic. The former minister is convinced that it is the "food from heaven" ("Al Manna") mentioned in the Bible and the Quran.

My two friends had gone to Sudan with him to inspect the area that grew the Acacia trees that produced Gum Arabic (much like how latex is produced once the bark of the rubber tree is poked or cut), and to see the manufacturing process.

The gummy product is sourced from two Acacia species (A. senegal and A. seyal) and then processed to powder form. It is consumed after mixing with plain cold water. My two friends are now the importer and CEO respectively of the importing company.

My friends have first-hand knowledge of the benefits of Gum Arabic. One is a medical practitioner who runs a busy clinic. His patients with diabetes showed remarkable improvements after consuming Gum Arabic, including one man who had kidney failure, was on dialysis for many years, and had not produced any urine for the last 10 years.

I also have a good story to tell. My mother (83 years old) has been on hypertensive medicines for many years (not prescribed by me!). She tried Gum Arabic, and after several weeks, her pressure is now normal without any drugs.

However, her blood pressure still goes up when she is stressed, and returns to normal when she is able to rest and forget whatever upsets her. She is now getting my aunties to take it too.

I strongly recommend everyone to try Gum Arabic. There are many benefits that are already known from the prebiotic properties that it has.

However, I suspect that it has many other constituents that are yet to be discovered.

In the next article, I will share yet more nutritional options to prevent and fight diabetes.

In the meantime, do not forget that fighting diabetes (and other chronic diseases) begins with a healthy lifestyle, a healthy diet, sufficient exercise (including building muscles), and maintaining optimum weight. I hope all of you made resolutions to improve your health in 2013. Happy New Year!

> Dr Amir Farid Isahak is a medical specialist who practises holistic, aesthetic and anti-ageing medicine. He is a qigong master and founder of SuperQigong. 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.

The genes of dieting

Posted: 05 Jan 2013 04:13 PM PST

Ongoing research is pointing to the fact that our genes may contain the answers to puzzling questions like why weight gain persists in some people, and why certain diets do not work for some people.

SO much has been said and written about dieting that you could probably fill whole buildings with the amount of information and research revolving around this issue.

People have tried all sorts of diets to lose weight. Some have gone carb-free, some have tried pills, some drink diet shakes, others eat only raw food. Some people are so desperate that they have tried all of the above.

A relatively new concept in dieting is genetic profiling. A few months ago, I wrote about genetic profiling in medicine and how it can be used to predict what diseases a person is susceptible to (Secrets in your DNA, Fit4Life, Oct 28, 2012).

The mapping of the human DNA – known as genomics – has allowed scientists to understand more about how certain genes play a role in the development of diseases.

Genetic profiling tests – now available in Malaysia – can be carried out to identify whether you carry the genetic components of certain diseases, such as certain cancers, heart disease, glaucoma and blood-clotting disorders.

If you have these genetic mutations, you may be at increased risk of developing these conditions, although it is by no means a guaranteed diagnosis.

As I wrote in my article, the benefit of genetic profiling is to enable you to take early action against the development of these diseases, by changing your lifestyle and behaviour to reduce the risk as much as possible.

Fat and genes

What role can genomics play in nutrition, specifically? More research is pointing to the fact that our genes may contain the answers to puzzling questions like why weight gain persists in some people, and why certain diets do not work for some people.

First, we have to look at the idea that obesity may be a genetic condition, as opposed to being caused by an overabundance of calories that are not burned off with physical activity.

In the early 1980s, a scientist called Dr Albert Stunkard of the University of Pennsylvania, United States, conducted an experiment to test the question of nature-vs-nurture when it comes to obesity. He studied a Danish registry of adoptees, which contained detailed information like the names of the adoptees' biological parents, and the heights and weights of the adoptees, their biological parents and their adoptive parents.

Out of the 540 adult adoptees he studied, all were as fat as their biological parents. On the other hand, their weight was not associated with how fat their adoptive parents were.

These findings were given weight by the fact that the subjects had been adopted when they were very young – ranging from the first month to the first year of life – and would have grown up almost entirely within the environment of their adoptive families.

Dr Stunkard was able to show that fatness – among his subjects, at least – was influenced by genetics, not family environment and upbringing.

Other experiments have shown that overweight and obese people fight an uphill battle against their own metabolism when they try to lose weight. It has been shown that even after overweight people lose weight through strict diets, they will regain the weight later.

Scientists have since figured out that the body's metabolism slows down to half its original speed when a person loses weight, causing them to be unable to burn up calories as effectively.

In thin people, on the other hand, the metabolism doubles when they gain weight, and they are unable to stay fat.

If fat is indeed inherited, and if the body's metabolism appears designed to retain fat, as suggested by these findings, does this mean that there is no point in attempting to lose weight at all?

I would certainly disagree with such a view. But a better understanding of the invisible connection between genes and obesity can help overweight people accept that it is more difficult for them to lose weight, and that conventional lifestyle changes may not work for them.

Genetic secrets

Now, the genes may hold even more secrets to help people overcome their weight problems. The science of nutrition and dietetics is combining forces with genomics to gain insights into how different people react to certain elements of their diet, such as certain food and nutrients.

As nutritional genomics (or nutrigenomics) becomes even more advanced, we may eventually be able to tailor dietetic advice to every individual based on his/her genetic profile.

An article in Australia's Sydney Morning Herald in September highlighted the case of a couple who were both overweight and unable to lose weight despite trying to eat healthily. Their dietitian, who uses genetic testing in her practice, found that the wife was sensitive to carbohydrates, according to her genotype, while the husband had a balanced genotype. So a low-carb diet was more suitable for the wife, while the husband just needed calorie modification.

A study published in the New England Journal of Medicine also found that people genetically predisposed to obesity are more likely to gain weight from sugary soft drinks, compared to people without the genetic traits.

Genes predisposing people to obesity also act in the brain to influence eating behaviour, rather than directly influencing metabolism.

At the same time, the brain also has sensors that detect the presence of different macronutrients, and then send messages to the brain about satiety. Because of genetic variations, these sensors may operate differently in different people.

What this means is that obese people are more likely to overeat, and that every individual has a different response to certain macronutrients. Some people become easily full from carbohydrates, while others need protein or fibre to feel satiated.

Such findings are very helpful for people with the genetic susceptibility to obesity, as they can learn to avoid certain foods or macronutrients – or target certain nutrients – with the concrete knowledge that the action is directly linked to information from their genes.

At the end of the day, the fundamental principle of losing weight is to burn off more calories than what you eat. Nutrigenomics cannot change this principle, but it can change the way you approach it, so that you are not trying diets or methods that are just not suitable for your genes.

Nutrigenomics is becoming increasingly popular in Australia, and it is only a matter of time before the practice catches on in Malaysia, where genetic profiling is already available in some clinics.

> Datuk Dr Nor Ashikin Mokhtar is a consultant obstetrician & gynaecologist (FRCOG, UK). For further information, visit www.primanora.com. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader's own medical care. 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.

A personality for fitness

Posted: 05 Jan 2013 04:13 PM PST

Whether you are a social butterfly, a shy guy, or an adrenaline junkie, Fit4Life has compiled a list of different exercises to go with your different personality types as you kickstart your new year's resolution towards attaining better health and fitness.

IT'S a brand new year and you're all psyched about losing those extra kilos you gained during the holidays. Besides, there is no better time to make resolutions towards attaining better health and fitness.

Never mind that you made the same resolution last year (and the year before), this time around you are serious about getting that sculpted Victoria's Secret silhouette, and you're going to do whatever it takes to get there! Naturally, such a quest would entail an arduous exercise regime, which you will follow through, come rain or shine.

But fast forward six months, and there's a 50% chance that you would have given up your new fitness regime, according to the American Council on Exercise. The lack of planning, motivation and boredom, contribute to why people fall off the fitness wagon.

To give you a little boost on your journey towards achieving better mental and physical wellness, Fit4Life has compiled a list of exercises or sports to go with your different personality types.

As exercise makes up an integral part of the health and fitness equation, it is important to engage in regular physical activity to get your heart pumping, your blood flowing, and above all, to stay in tip-top shape all year long!

The Social Butterfly

Social butterflies enjoy attention, and most of the time, these vivacious folks get what they want. Friendly and easygoing by nature, the social butterfly can often be seen flittering from one group to another. Somehow, they just get along with everybody.

Dancing is a cool and interactive way for these sociable creatures to stay healthy and fit. These sparkly personalities will surely enjoy meeting new people from dance classes as well. The best part is, they can even pick up a few moves to impress their family and friends at the numerous parties and social gatherings they will be attending.

Among the long-standing trends in dance fitness is Zumba, a high-octane workout that combines salsa and Latin dance moves. It is usually performed to Latin and world music beats, and is an explosive workout intended to help you get lean. An hour of Zumba burns up to 500-600 calories.

Another staple dance workout you will find in most commercial gyms is Step Aerobics. It uses an elevated platform in its routine. The platform's height can be tailored to suit individual needs by inserting risers under the step.

Also an excellent fat-burner, Step Aerobics burns about 500 calories in an hour. Other benefits of this workout include helping to boost coordination skills, and providing flexibility training to enhance joint movements.

The Adrenaline Junkie

Do you get a kick out of running mile upon mile, week after week? Do you crave the sweaty satisfaction that follows a prolonged bout of physical activity? If your answer is yes, chances are, you are probably an adrenaline junkie.

These restless folks regularly seek out thrilling pursuits or activities to get an adrenaline rush. Runners, in particular, have been known to be addicted to the 'runner's high', a term used to describe the feeling of euphoria that is induced by a vigorous workout.

These adrenaline junkies can take things up a notch by participating in activities like marathon running. Incidentally, the sport is becoming a popular trend in Malaysia, with many websites and blogs now dedicated to documenting all the latest happenings on the local marathon-running scene.

The thing about marathons is that, because it is usually done in droves, you will likely meet other like-minded exercise enthusiasts along the way. As marathoners often train together, this also means that your view about the sport will be wrapped up in nice thoughts about new friends and a hearty protein shake afterwards.

This positive reinforcement will likely promote a sense of heightened self-sufficiency when it comes to maintaining a regular exercise schedule in the long run.

The best part about marathon running? It's FREE. Plus, you will be the proud owner of some serious bragging rights once you complete that ultra-marathon.

Needless to say, there are about as many overweight marathon runners as there are flying pigs. An hour of running burns roughly 500-600 calories. Just make sure you have proper footwear to ensure your runs are comfortable and injury-free.

The Daredevil

A more extreme version of the adrenaline junkie, these daredevils regularly dally with danger in highly-challenging stunts simply for the heck of it. Never mind that they might break a bone or two while attempting some crazy feat.

To satiate their thirst for thrills, the restless daredevil can take on Parkour, a training discipline that uses the human body to get from point A to point B in the most efficient manner possible.

Parkour practitioners, called traceurs, are known for their ability to navigate from rooftop to rooftop, make death-defying jumps with safe landings, and scale-mounting obstacles like walls, fence and boulders.

There is a growing community of Parkour practitioners on the local front. These ballsy folks turn urban environments into training grounds to challenge the limits of their bodies and minds.

However, due to the dangerous nature of Parkour, it is important to consider the risk factors involved in any movement you intend to perform. A novice practitioner should always start small before graduating to a more difficult movement (eg practise jumping off a knee-high ledge before aiming for a waist-high one).

The Homebody

Home is where the heart is for these reserved folk. The homebody prefers their couch to huge venues or social hangouts any day. But just because you love your couch doesn't mean you have to look like a couch potato. Your road to fitness can begin anywhere, even from the centre of your living room.

Contrary to popular belief, you don't have to splurge on a treadmill or an elliptical trainer to get a good workout. Home fitness videos are a nifty alternative for those who do not have access to the gym, or those who simply prefer to exercise at home.

There is an abundance of available home fitness videos to choose from, ranging from dance aerobics to more intense exercise programmes such as Insanity or the P90X. These home-based workouts provide an avenue for the homely to stay healthy.

The only downside to working out alone is that there is no one to watch for your form. Exercises that are done incorrectly can often lead to muscle strains or injury.

Luckily, we now have Lord Google at our fingertips. So be sure to look up any new exercise regimes or movements you are unfamiliar with before you start.

The Shy Guy

Unlike the homebody, while these shy fellows have no problem leaving the house, they clam up whenever they find themselves in a large crowd or among unfamiliar faces.

For the shy and de-conditioned fitness novice, we recommend group fitness classes such as indoor cycling. While there is no real need for verbal interaction in these classes, they create an opportunity for those unacquainted with human contact to mingle and to potentially make new friends.

Such classes promote a sense of togetherness, as fellow participants strive towards the mutual goal of improved health and fitness. Having a lead cycling instructor to guide and cheer you on is also a great motivator.

The good thing about cycling in a comfortable indoor studio is that any risk of getting run over by a truck or being eaten up by a bear (depending on your location) is removed.

In Malaysia, indoor cycling offers a safe respite from the sun, which makes exercising outdoors a rather unappealing prospect for some.

The Kiasu (Competitive) People

A little friendly rivalry can be healthy, especially when you are trying out a new fitness programme. After all, there is nothing like getting a little push from your workout buddies when you feel like throwing in the towel.

For those who enjoy a challenge, we reckon that CrossFit – a strength and conditioning programme that utilises a short-duration, high-intensity protocol – may be just the thing for you.

The programme, aimed at providing "athlete-training" for the masses using constantly varied functional movements, has emerged as a superstar in the fitness world since its beginnings in the 2000s.

For the CrossFit enthusiast, much of the excitement lies in competing to be at the top of the scoreboard at the gym's daily timed workout challenges or WODs (Workouts-of-the-Day) in a perpetual quest to get fitter, faster and stronger.

Obviously, he who trains like an athlete will look like one too. As CrossFit disciples will tell you, you can expect to make significant gains in strength over a short period of time with this gruelling programme.

The downside? Your hands will soon be as callused as a sailor's from performing one too many power-lifting movements like the "clean-and-jerk", swinging heavy kettlebells and doing multiple pull-ups.

The Angry

Whether it is dealing with a rogue boss or a nitpicking in-law, we've all had those moments when we feel our inner-Hulk flare dangerously close to the surface, threatening to burst out of our clothes and to start smashing.

But surely there is a more positive way to deal with anger than to run amok in your boxers. Uncontrolled anger can take a toll on both your health and relationships. Channel your inner-Hulk into martial arts such as muay thai or boxing instead.

Muay thai and angry folks seem almost a match made in anger-management heaven. Besides helping to deal with one's aggression, the sport also hones physical capacities like strength, agility and stamina. The sport's rigorous training also jacks up the body's metabolism and burns off roughly 600-700 calories in a typical one-hour session.

Similarly, boxing also helps build strength, speed and endurance, and is an effective fat-buster, burning over 500 calories an hour when sparring with a partner. Both sports will come in handy if you ever need to save the world from whiny super-villains.

The Clean Freak

While many exercisers take a sweat-soaked shirt as a sign of an effective workout session, others balk at the thought of getting down and dirty. If breaking a sweat isn't your thing, you can still get a good workout while keeping cool with exercises like swimming.

Swimming is a good cardiovascular workout that also has muscle-toning benefits. An easy swim burns roughly 500 calories an hour, while a more vigorous effort can help torch almost 700. Because water is about 800 times denser than air, each movement you make underwater is like a mini resistance workout for your entire body.

Each kick, push and pull that you muster while you swim works the core, hips, arms, shoulders and glutes.

Because you become virtually weightless when submerged underwater, there is little or no impact on the joints when you move. This means that you can swim just about as often as you like without risking injury. You certainly can't say the same for running or CrossFit.

Can't swim? Don't sweat it. Water gyms that utilise underwater gym equipment such as treadmills, bicycles and elliptical trainers are becoming increasingly popular on our shores. The low injury risk from exercising underwater makes the regime suitable even for those unaccustomed to physical activity, or are slightly on the chubby side.

Whatever your preferences, whether you are a raving CrossFitter hell-bent on kicking your competitor's butt or the shy guy who never could find the courage to talk to that cute girl at the gym, it is important to find an exercise regime that you really like doing.

Keep experimenting with different activities until you find something that you really enjoy. You can even try mixing things up for variety. As regular exercise has been proven to help you live longer and better, it only makes sense that you do something that you really like over the life-long course of your fitness journey.

Kredit: www.thestar.com.my

Ahad, 6 Januari 2013

The Star Online: Lifestyle: Health

The Star Online: Lifestyle: Health

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