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Posted: 02 Mar 2013 04:30 PM PST

What did you have for breakfast today - a hearty dose of Nasi Lemak with fried chicken, completed with Teh Tarik? Or perhaps a much-needed steaming cup of coffee to go with the morning paper?

For some people, it is a norm to skip breakfast in the morning for an extra 10 minutes of snooze time or to beat the traffic jam. For those who do have breakfast, you'll have to admit that we are spoilt for choice when it comes to the selection of food we can have to start our day.

The question is, are you eating right for the right start to your day?

While bread or cereal may seem to be a convenient option, they are high in carbohydrate and may lead to elevated blood sugar levels which drop quickly and leave you feeling hungry and drained. Research have showed that a breakfast high in protein helps with stabilising blood sugar and prevents hunger for a number of hours.

According to the Malaysian Food Guide, Food Pyramid and Food Composition, breakfast should account for 30% of our protein intake – which translates to approximately 21 grams. While there are many types of food we can consume to meet the 21 grams of protein intake for breakfast, we have to also be mindful not to take in too much calories and fats, which may lead to obesity.

Each person's protein needs depend on several factors such as age, size, physical condition, and the level of physical activity. Nutritionists use a standard method to estimate a person's minimum protein requirement daily, which is to multiply a person's body weight (kg) with 0.8, as the recommended dietary allowance (RDA) in the US for protein is 0.8 grams per kilograms of body weight of adults.

Take a typical Malaysian breakfast for instance. According to Nutriweb Malaysia 2000-2012 Database of Nutrient Composition of Malaysia Food, three pieces of Roti Canai can provide you with 21 grams of protein for your first meal of the day, but that also comes with 31 grams of fat, and 136.5 grams of carbohydrate. Likewise, in order to have 21 grams of protein, you will need to have 2.2 packets of Nasi Lemak, but provides you with 28.8 grams of fat and 128 grams of carbohydrate.

Understanding the importance of a high-protein breakfast, leading direct selling company Amway have introduced its NUTRILITE™ All Plant Protein Powder to help you boost your protein intake and get a right start for the day. With 2.5 scoops of NUTRILITE All Plant Protein that can be mixed with any of your favourite beverages or food, it is an easy and convenient breakfast option that can help you achieve the needed 21 grams of protein, with only 1.3 grams of fat and 0.8 grams of carbohydrate.

"Certified Halal, lactose-free and safe for vegetarians, the NUTRILITE All Plant Protein Powder caters to many people as it has no cholesterol and contains only minimal fat content and nine essential amino acids to aid the body's digestion," said Dr. Gene Maly, Senior NUTRILITE Research Scientist.

"This complete, nutritious alternative to meat and dairy products is suitable for those seeking a lean source of protein in their diets, with its naturally sourced with a unique tri-blend of soy, wheat and pea," Maly added. "It is a boost to your diet to load up your day's essentials, giving you an energized start in the morning."

Energize your day and start it right with NUTRILITE All Plant Protein Powder, available through Amway Distributors nationwide and at the 20 Amway Shops located in Petaling Jaya, Seremban, Kuala Terengganu, Kota Bharu, Batu Pahat, Bintulu, Penang, Klang, Wangsa Maju, Mentakab, Taiping, Malacca, Segamat, Brunei, Alor Setar, Kuantan, Nusa Bestari, Seberang Perai, Sibu, and Ipoh. For more information on NUTRILITE All Plant Protein Powder, log on to http://www.amway.my/nutrition/nutrilite/energise-your-day or call Amway at (03) 7946 2800.

*Source: Nutriweb Malaysia 2000-2012 Database of Nutrient Composition of Malaysia Food

This article is brought to you by Amway.

The youth hormone

Posted: 02 Mar 2013 03:41 PM PST

Human growth hormone maintains the health of many organ systems, and also acts as a biomarker of ageing.

THIS is the second article on hormones that are important for good health. In the first installment (Hormones for health, Fit4life, Feb 17), I wrote about insulin, testosterone, oestrogen and progesterone. I also explained about bio-identical hormones.

Today, I will share about the most important hormone in anti-ageing (maintaining our health and youthfulness) – human growth hormone (HGH).

HGH, DHEA (dihydroepiandrosterone) and pregnenolone are hormones and pro-hormones (ie hormone precursors) which maintain the health of many organ systems, and also act as biomarkers of ageing.

Their levels in the blood peak in early adulthood (around age 20-25 years) and then decline steadily as we age. The current level and rate of decline influences our overall health, as they influence many organs.

The level and rate of decline may be determined by genetic factors, lifestyle, diet, exercise and weight. They can further be modified by supplementation and medical therapy. I call them the "youth hormones".

Of these, HGH is the most important.

The sex hormones are also youth hormones. Testosterone is a reliable bio-marker for men (if the blood sample is taken in the morning), but estradiol is not a reliable bio-marker due to its marked (menstrual) cyclical variation, although the trend (if tests are done on the same day of the cycle, usually at the end of the third week, in a woman with regular cycles) may be useful. After menopause, when there is no menstrual cycle, the level becomes a reliable indicator.

For post-menopausal women out there: most of you probably do not know that your estradiol (the main oestrogen) level is probably even lower than that of the average man of the same age who is not fit and healthy (and most men above 50 are in this category).

These men tend to have higher estradiol levels than they should (which is not good for them), in contrast to menopausal women who have lower levels required for good health.

If your estradiol level is even lower than a man's, how can you expect to be healthy, feminine and sexy?

Human growth hormone

HGH is the "master" hormone of the body. As the name implies, it is crucial for growth in children. Children who are HGH-deficient will become stunted, while those who have excess HGH (usually due to a pituitary gland tumour) will become "giants".

All the world's tallest men and women recorded in the Guinness Book of World Records were likely to have suffered from this problem (acromegaly). They have a myriad of health problems and do not live long.

What we are concerned here is the role of HGH in healthy ageing. After age 25, HGH levels decline by about 13% every decade in the average person (more in the unhealthy, and less in the fit and healthy).

This means that you will have about 50% left by the age of 60.

Since HGH, as the master hormone, directly or indirectly (through increasing the production of many growth factors) influences all the organ systems, its decline is responsible for most of the signs and symptoms of ageing.

The decline in the level of oestrogen after menopause only accelerates the ageing process, which has been going on for at least three decades previously (mainly due to the HGH decline).

The different tissues and organs age at different rates. For example, while most women are wary of their bones becoming brittle (osteopenia/osteoporosis) after menopause, the bone density (and strength) actually starts to decline from about age 35 onwards, about 15 years before menopause, while their hearts usually become unhealthy only after 50 (because oestrogens are excellent protectors of the heart).

Since many men enter andropause even earlier than age 50 (if low testosterone levels are used as the criteria), their accelerated ageing also starts earlier.

In 1990, the New England Journal of Medicine published a landmark study by Rudman and colleagues on the effects of HGH (injection therapy) on men above 60 years old (NEJM July 5, 1990). They reported improvements in body composition (less fat, more muscle), strength, exercise tolerance and wellbeing in the subjects tested.

Although it was a small study, this in fact started the anti-ageing revolution. Since then, there have been over 20,000 studies on HGH. Some of the benefits of having healthy levels of HGH shown in these studies include slower senescence (ageing), reduced adiposity (body fat composition), improved blood lipids, reduced blood homocysteine (a marker of inflammation and heart disease risk), reduced atherosclerosis, improved heart function, improved diabetes, increased lean body mass, improved exercise tolerance, improved immune system, better quality of life, better sleep, less fatigue, better sexual function, improvement from depression and anxiety, improved memory, improvement from memory loss in Alzheimer's, improved rheumatism and fibromyalgia, improved osteoporosis, and many other benefits (references available on request).

Controversies

However, there are some controversies. Naturally high IGF1 (insulin-like growth factor 1, which is the marker for HGH in the blood) has been associated with some cancers (eg breast and prostate), but a causal relationship has not been established.

The higher IGF1 levels have not been shown to be the cause of the cancers, and instead, could be due to the cancer, as cancer cells are known to produce many growth factors to sustain their growth and spread.

In people with acromegaly, HGH production is 10-100 times more than normal. Yet, overall they do not have more cancers (although they have slightly more colon cancers than others). So it is more likely that in cancer patients, the high IGF1 levels is due to the cancer itself.

Another controversy is that HGH can worsen diabetes. IGF1 levels increase with HGH. Insulin-like growth factors have glucose-lowering effects like insulin, and improve insulin-sensitivity. Thus, more studies show improvement in diabetes rather than worsening.

The controversy arises because diabetes occurs more in HGH-treated children, and in those with acromegaly. There are other explanations for these.

There is no doubt that having healthy levels of HGH means better health, and those with severely low levels need treatment. What is controversial is whether those with lower levels within the "normal" range when tested (and have any of the parameters mentioned above which can be improved by HGH) should be interfered at all; and whether high HGH levels predispose to cancer (see above).

The answer is simple – if you want better health and you have low HGH, you can try to improve its level and feel the benefits yourself. Make sure your doctor explains to you all the pros and cons, including possible side-effects (eg edema, which only happens if you take excess doses in the injection form).

If you don't get any benefit after three to six months, then you can stop. If you are convinced of the benefits (especially if there are measurable improvements in your weight, body composition, and obvious improvements in your skin texture), then you can continue.

How to improve HGH levels

There are natural ways to improve your HGH level. The best ways are:

● Make sure you have sufficient deep sleep (six to seven hours of good sleep), and go to sleep not later than midnight because the HGH is released in spurts at about 2-3am (peak spurt) and again at about 5am, provided you are in deep sleep. Those who are chronically sleep-deprived, and those who work shifts, therefore miss on these spurts.

● Have a healthy nutrient-dense, high-protein, low-calorie diet. HGH is a peptide hormone and requires amino-acids for its production. Avoid caffeinated and milk products, alcohol and the empty calories in cakes and cookies.

● Intense exercise, which must include muscle-building (weights and/or resistance) training.

● Maintain a lean body (body fat below 20% for men and below 25% for women).

There are also supplements that can improve natural HGH secretion. These are called "secretagogues" and contain the component amino-acids which also act as HGH secretion-boosters. They are available in powder form (most effective) or tablet/capsules.

There are also sublingual sprays which contain homeopathic formulas or even HGH encapsulated in patented "delivery systems" to allow for its absorption (HGH is a large peptide which cannot be absorbed when taken orally). However, the effectiveness of these formulations has not been scientifically validated.

Then there are also supplements which provide the growth factors (including IGF1) directly instead of inducing HGH secretion, which then increase the growth factors production in the body.

Medical therapy by HGH injection is given only to children and older people with proven deficiencies after appropriate tests are done. These patients must be strictly monitored by their doctors.

The older patients may first try supplementation, and switch to injections only if these fail. For the majority, injections are not necessary.

The dangers and side-effects of overdosing only apply to those getting HGH injections. You need not worry about getting any side-effects if you are taking supplements to improve your HGH levels, which is why you can continue these for as long as you like if you get the benefits, while your doctor monitors your IGF1 level at suitable intervals.

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.

De-caf that pregnancy

Posted: 02 Mar 2013 03:39 PM PST

Myths and facts about caffeine intake during pregnancy.

THE ongoing debate about whether coffee can be consumed during pregnancy continues. For a long time, coffee, tea and other caffeinated drinks have been feared by pregnant women as being harmful to their unborn babies.

The scientific evidence on the safety of caffeine consumption has varied, although the most recent authoritative statement from the American College of Obstetricians and Gynecologists recommends that caffeine intake during pregnancy should not exceed two cups of coffee per day.

Similarly, I advise my patients to avoid caffeine beverages, if they can, or to limit their intake to the recommended amount. Most women tend to err on the side of caution, by avoiding caffeine altogether.

In this column, I will look at the available evidence so far and help readers make an informed decision that best suits their lifestyle.

Careful with caffeine

We have a love-hate relationship with coffee and other caffeinated drinks, such as tea, chocolate and soda. Many of us rely on the stimulant to provide a wake-me-up, whether first thing in the morning or late in a drowsy afternoon.

Taken within reasonable limits, caffeine can improve mental alertness, by stimulating the central nervous system, heart, muscles and the centres that control blood pressure. Caffeine also has a diuretic effect, in that it increases urine flow.

While some studies have suggested that the antioxidants in caffeine have healthful properties, most conventional wisdom also says that we should moderate our daily caffeine consumption.

Obviously, too much stimulation to our system can be unhealthy, as those of us who have had six cups of coffee a day can testify to.

During pregnancy, consumption of caffeine should be even more strictly regulated, as caffeine has a different impact on the baby in the womb. For instance, caffeine consumption is strongly correlated with smoking, which is known to increase the risk of premature birth and low birth weight.

The current recommendation by the World Health Organization (WHO) is that pregnant women should not take more than 300mg of caffeine per day. Some countries, like the US, have set their own limits of 200mg, which is roughly equivalent to less than a single cup of coffee from a cafe.

Caffeine and low birth weight

There is good reason to constantly evaluate the recommendation for caffeine consumption among pregnant women, as research is always discovering new links between caffeine and pregnancy outcomes.

Currently, some new evidence points to a higher risk of low birth weight among pregnant women who consume caffeine during pregnancy.

In a study published in BMC Medicine in February, the Norwegian Institute of Public Health tracked data from 60,000 pregnancies collected over 10 years. They looked at information about mother's diet and birth details, particularly their intake of all sources of caffeine, including coffee, tea, sodas and food with cocoa (such as is found in desserts and chocolate),

The researchers found that caffeine was not associated with premature birth, but there appeared to be a link with low birth weight. They found that if the baby was expected to weigh 3.6kg at birth (average weight), every 100mg of caffeine consumed by the mother per day reduced the newborn's weight by 21-28g. Low birth weight babies are at higher risk of short- and long-term health problems.

Different sources of caffeine also had varying effects on the pregnancy and the newborn. For instance, caffeine from all sources increased the duration of the pregnancy by five hours for every 100mg consumed by the mother per day.

However, caffeine from coffee further increased pregnancy duration to eight hours for every 100mg consumed.

This suggests that it is not just caffeine itself that causes this effect, but another substance in coffee that exaggerates it.

Too young for caffeine

The mechanism of how caffeine affects the unborn baby is still unclear, although it is no surprise that whatever a mother eats or drinks, it will pass through the placenta to her baby in the womb.

While a small amount of caffeine may not have any effect on us, it is different for the unborn baby. The baby's metabolism is still maturing and cannot fully digest the caffeine that passes into its system.

Furthermore, as caffeine is a stimulant, it is bound to cause the baby to be more active than usual. Pregnant mothers will notice that their babies move around more after they have had caffeine, causing them some discomfort.

Many women also fear that drinking coffee will cause them to suffer a miscarriage. The jury is still out on this, as there is no conclusive evidence in either direction. One study in 2008 published in the American Journal of Obstetrics and Gynecology found that women who consume 200mg or more of caffeine daily were twice as likely to suffer a miscarriage, compared to women who did not consume any caffeine.

However, in the same year, another study published in the Epidemiology journal showed that women who drank between 200 and 350mg of coffee per day had no increased risk of miscarriage.

Animal studies have also suggested that caffeine can cause birth defects, premature birth, infertility and other reproductive problems. Whether these effects similarly translate to humans is less certain.

Ultimately, women have to make the decision for themselves. If abstinence is not possible, then moderation is key. Women also have to be aware that they could consume caffeine not only from coffee, but also from tea, cola and other soda drinks (including energy drinks), chocolate and even some over-the-counter medications, such as painkillers.

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.

Kredit: www.thestar.com.my

Ahad, 3 Mac 2013

The Star Online: Lifestyle: Health

The Star Online: Lifestyle: Health

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