The Star Online: Lifestyle: Health
The Star Online: Lifestyle: Health |
| Posted: 28 Sep 2011 02:41 AM PDT Cardiovascular diseases remain the world's main killers, claiming about 17 to 18 million lives each year. Heart Foundation of Malaysia (Yayasan Jantung Negara) director Datuk Dr Khoo Kah Lin shares his views on the matter on the eve of World Heart Day tomorrow. IT has been repeatedly said that the heart is an extremely vital organ. Can you put this into perspective? The human heart is really the most amazing organ in the body. It beats even before you are born into this world, continuing to do so until you take your last breath. For as long as you are alive, your heart is hard at work. There is no other muscle in your body that works in such an astonishing way. The human heart is tasked with pumping oxygen-rich blood and nutrients to the whole body. The heart's other function is also to "carry away" your body's waste products such as carbon dioxide, from the tissues. The heart is "connected" to every part of the body through blood vessels. Despite the importance of our heart, it is often the most neglected organ in our body, as the rising prevalence of heart disease in the nation illustrates. Also, after a heart attack, the damage done to your heart is irreparable. As such, it is of utmost importance that we prevent heart disease well before it strikes. This can be done if we eliminate the risk factors of heart disease, and this has to begin from childhood itself. Isn't heart disease a problem for older people? How do young children fit into the picture? It's really not accurate to say that heart disease only afflicts the older age group. Heart disease can be caused by multiple factors, called risk factors, which in fact begin building up right from childhood. I have personally heard that even children as young as two can already have developed risk factors for heart disease. In my opinion, the true problem lies in the fact that the perception of heart disease has not evolved. In Malaysia, heart disease has been the number one killer for the past three decades. Before we can understand heart disease, we need to go to the root of the matter – the risk factors. The key is that heart disease is largely preventable, if only parents cultivate a healthy lifestyle in their children from young. You said that heart disease is largely preventable, if tackled early on in life. Can you elaborate a bit more? Yes, prevention of heart disease from childhood is what I wish to stress upon. I term this loosely as the "modifiable risk factor", which largely co-relates to the diet and lifestyle of the child. Under the umbrella of modifiable risk factor, we have five separate and equally important issues to deal with: high cholesterol levels, obesity, diabetes, high blood pressure and of course, a sedentary lifestyle. Most people will not contest that fast food consumption, frequent dining outs and being a couch potato profoundly affect the growing child. In fact, the more we move away from consuming a "natural" diet, the worse the outlook is in terms of heart disease. Well, the notion of change makes people uncomfortable. So, instead of dwelling on change, why not instil the habit of healthy living in the child right from the start? Healthy living does not mean creating a good food vs bad food list. Neither does it mean adhering to a vegan diet or bland and tasteless foods. That is rather unrealistic to ask for. I task it upon the parents and caregivers, not to control their children and dictate their life completely, but to be a good role model and provide proper guidance to the young to live and eat healthily. Of course, to err is human, and I am not saying that as a parent, you should be perfect. Neither am I asking parents to mould a Stepford child. A child will always be a child and it is in fact wrong to deny your child her "childhood" indulgences totally, as suppressing a child's desires too much will result in unhealthy emotional growth. How exactly can parents influence those modifiable risk factors? To answer your question, allow me to elaborate on each of the modifiable risk factor in turn, and how parents can actually make a difference to all of it. High blood pressure Also known as hypertension, it often has no symptoms. You will not know that you are suffering from it unless you check your pressure regularly. High blood pressure increases your heart's workload, causing the heart muscle to be enlarged as it forces your heart to work harder than necessary. This would increase the risk of a heart attack or heart failure, as in the long run, this causes the heart muscle to weaken and work less effectively. High blood pressure can be easily controlled by limiting daily salt intake. Try cultivating healthier habits by avoiding foods such as processed food, fast food, or even try to limit eating out. Home-cooked meals are always healthier and more nutritious. According to the Malaysian Dietary Guidelines 2010, salt intake should not exceed 5gm (or one teaspoon) a day. High cholesterol Cholesterol is a waxy substance and is needed by the body to perform its primary functions. In fact, your liver produces almost 75% of your body's cholesterol (also known as endogenous cholesterol) and the balance comes from the food you eat (dietary cholesterol). It is important to understand the two different types of cholesterol – the good and the bad cholesterol. > HDL-cholesterol (high-density lipoprotein): The "good" cholesterol is needed by your body to carry cholesterol away from cells back to the liver, where it is then broken down and passed out as waste products. Generally, high HDL-cholesterol levels may protect you from heart disease. Research has shown that regular physical activity can increase your levels of HDL-C. > LDL-cholesterol (low-density lipoproteins): The "bad" cholesterol causes an accumulation of "deposits" on the artery walls, leading to blockage in the blood vessel (known as atherosclerosis). Progressive atherosclerosis with deposition of the LDL cholesterol in the walls of the arteries causes a build-up known as plaque. When the plaque ruptures, this causes a formation of blood clot, which then obstructs blood flow to the heart, and this causes a heart attack. > Triglycerides: This is a form of fat made in the body, brought on by obesity/overweight problems, lack of exercise, smoking and excessive alcohol consumption. High levels of triglycerides, especially in conjunction with low HDL cholesterol levels, also predispose to coronary heart disease. To control high cholesterol, it is important to note that cholesterol comes mainly from animal products. Limit your children's consumption of cholesterol-rich food or saturated and trans fats, which increase the amount of bad cholesterol in your body. Consume oil sparingly, and always opt for healthier options such as fat-free products or rapeseed oil. Diabetes Diabetes is generally known as the mother of all diseases and is often linked to a host of other diseases that fast-tracks individuals to suffer from heart disease. It is reported by the American Heart Association that heart disease and stroke are the main causes of death and disability among people with type 2 diabetes. In fact, 65% of people with diabetes die from some form of heart disease or stroke. Contrary to popular belief, diabetes also affects the young. In fact, in Malaysia, children as young as 10 years old have been diagnosed with type 2 diabetes. Diabetes amongst adults and children can be easily managed by controlling sugar intake from young. It is advised that sugar intake should not exceed 50g daily (Malaysian Dietary Guidelines 2010). Obesity Approximately 43% of Malaysians are either overweight or obese, an increase of a staggering 250% over a 10-year period from 1996, according to the National Health and Morbidity Survey III (2006). Obesity is simply defined as having excess body fat. It is generally caused by consuming more calories than your body can burn up. Nowadays, kids generally are more prone to obesity as they spend most of their time in front of their computers, being a couch potato or consuming too much unhealthy snacks or foods. According to a study conducted by Segal and Sanchez (2001), after an obese child reaches six years of age, the probability the obesity will persist into adulthood exceeds 50%, and 70% to 80% of obese adolescents will remain so as adults. According to the WHO, an estimated 17.6 million children under five are overweight. Sedentary lifestyle Essentially, our children lack much needed exercise. According to a study reported in Business Week, children spend almost eight hours daily watching TV, playing video games or surfing the Internet. How often do we see kids running around in the playground or in the park these days? Parents should try to encourage regular physical activity amongst family members. It is not only good for everyone's heart-health, but encourages bonding among the family members too. As the saying goes, a family that plays together stays together. For children with parents who suffer from heart diseases, physical activity is even more crucial. By exercising, you can increase your levels of HDL-C (good cholesterol) and also eliminate other risk factors such as obesity and high blood pressure. Recent research has argued that genes play a large part too, especially when it comes to heart disease. Any comments on that? I will answer that question with another question: what is the standard of proof of that statement? Has it been proven beyond reasonable doubt that genes will lead to heart disease, or are we talking about it on the balance of probabilities? According to the Framingham Heart Study published in the May 2004 issue of the Journal of the American Medical Association, it was found that having one parent with premature heart or vascular disease can double or even triple one's risk of premature heart disease. If both parents had premature heart disease, a daughter would have three times the risk, and a son, twice the risk. Well, I am not denying that heart disease is a condition that can be passed down from generation to generation. But one word of caution here – even though you may have inherited such genes, that does not mean that it is cast in stone that you WILL suffer from heart disease. Which means that this case is not proven beyond reasonable doubt. Hereditary factors simply predispose you and make you more vulnerable to heart disease. It is risk factors like these that are beyond our control that should motivate us to get our act together and start instilling heart-healthy habits amongst our children. There are still the modifiable risk factors which play a larger role in preventing heart disease, even if hereditary predisposition is a factor. That is why I repeatedly tell my patients to take extra care of their children's lifestyle and diet habits, to reduce the likelihood that heart disease will become a vicious cycle. There is a saying that goes: hereditary loads the gun, environment pulls the trigger. You have emphasised the link between parents and their children. What about the role of families as a whole in collectively reducing their risks of heart disease? How important is that? There is a Latin quote: non est vivere sed valere vita est, which simply means, life is not about being alive, but being well. Think about it this way: we all have our respective roles to play in society. In my family, I am a father and a husband. Of course, I pray for a long life so that I can be with my family, but at the same time, I need to be well to be that loving father and husband. As I have mentioned earlier, genetically, you can be predisposed to heart disease. It is reported that in Malaysia, children as young as seven years old suffer from high cholesterol. Heart-healthy initiatives at home aren't as hard as what we may think. Start by having family time together at parks, walking the dog, or even going for a family sporting event. Show your child that if you can do it, so can they. The prevalence of overweight children has jumped from 2% (NHMS II, 1996) to 5.4% (NHMS III, 2006). According to the Journal of the American Heart Association, studies have confirmed that when children learn and practise heart healthy eating habits, it can significantly reduce their heart disease risk later in life. Can you tell us what are some of the activities championed by the Heart Foundation towards reducing the prevalence of heart diseases in our country? The Heart Foundation has been actively involved in conducting road shows all over the country. These road shows, or YJM Heart Weeks, are held in shopping malls and we offer free health checks and advice by experts. YJM is also actively involved in educating Malaysians on heart diseases; specifically on the major risk factors, through educational press articles in major newspapers or magazines. YJM also collaborates with the private sector to conduct educational community-based programmes. The most recent one we undertook was the Quaker Make Malaysia Heart Healthy campaign. – Lee Mei Chieng Related Stories: |
| Posted: 28 Sep 2011 12:36 AM PDT Vitamins are essential organic compounds required by the body to regulate tissue growth and metabolism. MY parents are always asking me to take my vitamins. When I enter any pharmacy, I also notice a lot of vitamin counters. Why are vitamins so important? The word vitamin historically came from the term "vital amine" back in 1912. A scientist called Funk was describing a discovery that a certain "amine" extracted from rice polishings could prevent beriberi. Therefore, he thought that particular amine was "vital". There are altogether 13 vitamins. They are essential organic compounds needed by the body to regulate metabolism, cell and tissue growth, help enzymes function, and basically allow you to carry on living healthily. They are named vitamins A, C, D, E, K and the whole host of B vitamins (thiamine, riboflavin, niacin, pantothenic acid, biotin, vitamin B6, vitamin B12 and folate). You can actually get all your vitamins from the foods you eat, assuming you eat a normal diet consisting of meat, vegetables, and carbohydrates. Your body can make vitamins D and K. Vitamins A, D, E and K are fat-soluble, while the rest are water-soluble. If you are vegetarian, you may need to take a vitamin B12 supplement. How do you know if you are deficient in a certain vitamin type? There are certain symptoms associated with the deficiency. For example, vitamin A is needed for vision (especially night vision and dark adaptation), immune response, bone growth, reproduction, and the maintenance of the surface lining of cells. Therefore, if you have vitamin A deficiency, you will find it difficult to visually adjust to the dark. You can't drive at night. Your skin, hair and fingernails will be dry, lustreless, cracked, and easily broken, and you get infections very easily. Then, as it gets worse, you get night blindness. You may even become totally blind. If you eat a normal balanced diet, it is not "easy" to get vitamin A deficiency. Yet, vitamin A deficiency affects one third of the world's children under five. These children live in Africa and South-East Asia. More than half a million children die every year because of vitamin A deficiency, and another half a million become blind. What about vitamin B deficiency? How would we recognise it? We may suffer vitamin B complex deficiencies because we are taking too much processed foods (instead of natural foods) and refined sugar, and experience excessive stress. The vitamin B family is responsible for the wellbeing of our cells, transmission of our nerve impulses, muscular contraction, digestion, brain function, thought processes and energy production. Therefore, if you are deficient, you can have heart palpitations, irregular heartbeat, indigestion, and the feeling of exhaustion all the time. Mental problems may start to crowd in. You may have paranoia – the fear that something bad will happen to you at any time. You may feel nervous, easily agitated and frustrated. You can't sleep. You feel restless all the time. You may even have tingling in your hands and feet. What about vitamin B12 deficiency? Why do vegetarians get it? In general, vegetarians lack adequate intake of vitamin B12. It is only present in animal products like eggs, meat or milk. If you are a vegetarian who can take eggs and milk, all is well and good. But if not, you have to take supplements. There is also another reason for vitamin B12 deficiency. There is such a thing called an intrinsic factor, which is produced by our stomach cells. The intrinsic factor helps the absorption of vitamin B12. So, if anything were to affect the stomach, such as serious, atrophic gastritis, this intrinsic factor cannot be produced. Vitamin B12 is also absorbed in the latter parts of the small intestine, called the terminal ileum. If anything were to happen to the terminal ileum, such as if we had surgery, vitamin B12 cannot be absorbed. Bacterial overgrowth in the small intestine can also cause this deficiency. How will I be able to tell if I have vitamin B12 deficiency? You may get pernicious anaemia. This is a very "interesting disease" characterised by three symptoms: > Megaloblastic anaemia – this is a type of anaemia which has a lot of early red cells called promegaloblasts. They can be seen under the microscope. > Gastrointestinal symptoms like nausea, diarrhoea, and belching. > Neurological symptoms like being unable to sense deep touch, pressure and vibration, and a persistent tingling. Mental disorders can occur. Vitamin B12 deficiency can be very serious and cause permanent brain damage if you don't correct it. Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health advice, computers and entertainment. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information. |
| Posted: 27 Sep 2011 08:19 PM PDT LIKE many Malaysians, I love food. The notion of "self-control" or "moderation" evaded my understanding, and I never once thought that I might one day be affected by heart disease due to my unhealthy lifestyle habits. Most of the time, I felt sluggish and I would be breathless after climbing the flight of stairs in my home. One day, I happened to read an article on heart disease, and boy, was I shocked to discover that I was a walking time-bomb for heart disease. I then made a quick Google search about heart disease. The link I stumbled upon was the Quaker Heart-Health Test. I answered a few questions and waited with bated breath. Then came the shock. I was at "high risk" of developing heart disease. I quickly applied to be part of the Quaker challenge. My prayers were answered. I received a call to inform me that I was selected to participate in the Quaker Smart Heart Challenge. But before I could officially join the challenge, I was sent for a blood test. I did suspect that the results would not be optimistic, and I was right. I was diagnosed with high blood cholesterol. I knew I had to do something quickly to reduce my cholesterol levels if I wanted to avoid a heart attack. No harm giving the challenge my all, I figured. It was after all, just for 30 days. I strived to adjust my dietary and lifestyle habits. Two bowls of oatmeal, daily, for 30 days, plus various lifestyle changes, including regular physical activity. First week into my oat meal diet, my perception remained unchanged – it was bland and I strongly contemplated giving up. But, the experts who were monitoring my progress on a daily basis were my source of guidance and motivation. I filled up a daily log sheet on my meals and physical activity and I was given feedback and tips on what I was doing right and areas that I could further improve. I learned more creative ways to eat my oats and began loving it. My family members felt the difference in me and I knew I had made the right choice. My energy levels did not fall even as the day progressed. Even my friends and family members asked what was my secret. I just smiled and told them my experience with the Quaker Smart Heart Challenge. Then, the 30 days were up. The moment of truth dawned as I went for my second blood test to see if my efforts during the 30 days made a difference. However, something in me felt reassured that somehow, things would be different. I was right. I had won the war. I managed to reduce my total cholesterol levels by a staggering 33% in just 30 days! As the saying goes, let him who would move the world, first move himself. Building heart-health is a lifelong effort, but I know I must have a strong heart to keep my family fit for life. – Normala Nordin Related Stories: |
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