A survey finds that the number of young adult Malaysians having sex has doubled since 2016, but their knowledge is shockingly lacking.
MALAYSIAN youth are a curious bunch, but they are still pretty ignorant when it comes to many sexual health matters.
Despite a twofold increase in youth engaging in sexual intercourse over the past six years (from 18.8% to 35.4%), a third do not know a woman can get pregnant the first time she has sex or during her period, and over one in five (22%) believe that mosquitoes can transmit sexually-transmitted infections (STIS)!
As a generation that is online most of the time and is exposed to much sexual content in pop culture, it’s not really surprising that 60% learnt about sex from online articles or watching movies and videos, while 62% had sex for the first time at the age of 22 or younger.
These were some of the findings of the second nationwide Sexual Health and Intimate Wellness Survey 2022 conducted by Durex Malaysia.
The online survey carried out from April to May involved 1,089 Malaysians between the ages of 18 and 30.
The first such survey was done in 2016 and the latest results continue to astound experts.
For example, 23% of the respondents think HIV (human immunodeficiency virus) can be transmitted through a toilet seat, which is an increase from 10% in 2016.
And even though 40% of youths felt pressured to have sex, almost half (42%) did not use a condom or other forms of birth control, which led to one out of 20 women experiencing an unwanted pregnancy.
Space to learn needed
Growing peer pressure to have premarital sex plays a major role in sexual and reproductive health-related decision-making among youths.
Since sexuality education is still considered a sensitive topic here, our youths are struggling to find a space to talk openly and find the right answers.
“When our parents asked our grandparents about sex, they didn’t know how to answer, and similarly, our parents don’t know how to answer their kids.
“So, how can they have conversations about sex when they themselves are unsure about many things?” asks counsellor and sex therapist Chan Fun Shin.
He adds that most youth are embarrassed or uncomfortable saying the words vagina or penis.
“Role-play with your friend by saying those words to start a conversation about sex.
“Eventually, you will get more relaxed and more exposed to what safe sex is,” he advises.
Adds Soroptimist International Club of Petaling Jaya’s SPOT (Soroptimist Puberty Organising Toolkit) Community Project founder Siti Aishah Hassan Hasri: “We suffer a lot of communication ‘fuzziness’ in Malaysia.
“We don’t even want to say the word penis; instead we say ‘pipi saya gatal’ and people who receive the information might think you are referring to your cheek!”
One result of this lack of proper communication about sex from trusted authorities is that many people turn to alternate sources of information about the topic.
As mentioned earlier, 60% of Malaysian youth turn to online articles, movies and videos to today’s younger generation don’t accept “yes” or “no” answers; they want to know why and how, especially when it comes to the birds and the bees. — tns learn about sex.
Nearly half (48%) turn to pornography.
Even more concerning is that one in three believe that the sex shown in pornography is normal.
“Although pornography tends to be viewed in a bad light, I think it plays a significant role in educating the youth concerning sex,” says engineering student Sharvendran Selvan, 22.
He adds though that: “It is a no-brainer that the sexual activity shown in pornography is beyond normal human capability and far from the reality.
“However, it is in our youths’ hands whether they take it positively as a mere source of knowledge, or negatively by implementing everything that they have seen.”
On the other hand, linguistics student Priya*, 23, opines: “Pornography is not the right place to learn about sex as they practice unprotected and unhygienic sex, and could potentially be a bad influence on youths.”
Allowing questions
Siti Aishah shares that: “When we speak with young people, we have to train our peer advocates so that they can speak in the same language and the same mannerisms or acronyms.
“Our main goal is to remove the hypersexualisation from the word sex and everything that comes under it.”
Established in 2015, SPOT uses carefully-designed modules to equip girls of all ages with the confidence and resilience to make informed decisions regarding their well-being.
“I have 13- and 14-year-olds asking me about sending nude pictures or if size matters in bed.
“It’s not because they want to have sex, but because they are curious.
“We want to be able to talk about gender and sex very openly and respectfully.
“Our business is providing safe spaces for young people to have conversations surrounding sex and sexuality,” she says.
Linguistics student Arung*, 22, believes that youth are very conscious of our judgemental society, as well as overall public opinion. She says: “In a country like Malaysia, where sex-related topics are still considered taboo in many places, it is hard not to be judged by the public and this is what prevents youths from seeking help.”
She thinks that sex-related concerns among youth should be addressed via proper sex education in schools, as well as via social media.
“The government should provide a proper platform for the youth where they can learn accurate information, especially as taboos about sex mean this topic is not addressed enough among our people.”
She adds: “It is a well-known fact that youths are constantly on social media such as Tiktok and Instagram.
“Thus, addressing and normalising topics related to sex on such platforms would be efficient and effective.”
Language student Wong*, 22, agrees, suggesting a platform on social media that is easily accessible and where youth can anonymously post questions.
“As youth nowadays are very timid, regularly organising an anonymous Q&A (question and answer) session with professionals would help in clearing their doubts,” she says.
To form a strong, long-lasting bond, intimacy is a key ingredient – it’s what human beings crave in order to create a safe, loving and happy relationship.
Why and how ?
Siti Aishah says: “We are all born as sensual creatures and have emotional, physical, mental and physiological needs that have to be fulfilled in order for us to grow.
Discussing the survey results, as well as issues pertaining sexual health, during the events were (from left), Chan, Tengku Aira, Siti Aishah, Gan and Arwin - REVATHI MURUGAPPAN/The Star
Over one in five youths falsely believe that HIV can be transmitted through a toilet seat. — 123rf.com
“Our young people must understand that it is OK to be sensual, but they must know what is safe and unsafe.
“When people share their experiences, there are always a lot of questions, so these conversations must begin.
“We are working together with other groups to encourage a positive attitude towards sexual and reproductive health, as well as personal and social development.”
She says sexuality education in a culturally- and developmentally-appropriate manner is key to equipping young people with the knowledge to prevent STIS, sexual-related issues and unplanned pregnancies.
A different generation
According to content creator and social activist Arwin Kumar, the youth of today want answers to everything.
“In the past, saying yes and no works, youth listened, but the current generation does not want to listen to a yes or no, they want to listen to why and how.
“Our responsibility should be more than putting a full stop to the topic, but to expand our understanding to help young people make their own decisions.
“We live in a stubborn generation that wants to be independent.
“They hear a lot, but they don’t necessarily listen.
“It is a challenge to deal with them, so we have to try different strategies.”
Indeed, we need a holistic approach in educating our young people.
“On every level, sexual health education is a shared effort – from government agencies, ngos, corporations, down to individuals.
“We want our youths to have a positive view of their bodies and sexuality, and to break the taboo factor when it comes to sexual health,” says United nations Population Fund (UNFPA), Malaysia, programme analyst Tengku Aira Tengku Razif.
After the first survey, which revealed our youth had many sexual misconceptions and wrong perceptions, Durex partnered up with the Women’s Aid Organisation (WAO) and the Federation of Reproductive Health Associations, Malaysia (FRHAM), to reach out to hundreds of young people to correct their false perceptions.
Obviously, it wasn’t enough. “We decided it was timely to conduct another survey, and again, we’ve gotten a few key insights – although we were quite shocked so many were engaging in sex!
“But then again, they all have to go through the phase all adults have gone through.
“The key phrase is learning how to respect themselves,” comments Durex Malaysia marketing manager Jerome Gan.
Based on the insights gained through the 2022 survey, Durex launched the #COMETOGETHER campaign last week.
It is aimed at having more open conversations surrounding the taboo topic of sex.
The company hopes to help Malaysian youths reduce the gaps in their sexual knowledge, equip them with accurate information and guide them to making better and more informed decisions around their sexual activities.
*not their real names
ALTHOUGH
60% of Malaysian youths perceive sex to be pleasurable, two out of five
continue to have sex despite it not being pleasurable, according to the
2022 Sexual Health and Intimate Wellness Survey.And one in four found
their first sexual
Liver Health: 4 Worst Damaging Habits- Thomas DeLauer… http://www.ThomasDeLauer.com for all your business, health, and fitness answers. The number one over the counter medication responsible for wrecking our livers is acetaminophen. Join Celebrity Trainer, Author & Organic Foods Expert, Thomas DeLauer to find out what other habits may be contributing to the health and function of our livers. Learn how the liver plays a big role in our metabolism, how we burn fat, how we get into shape, and detoxification.
1) Too much self-medication:
One of the main functions of the liver is to break down substances that we take by mouth, including medications, herbs and supplements. This process usually takes place efficiently and without causing any harm. When new medications are developed, they are extensively tested to make sure they are safe before being approved for general use. Acetaminophen, when used as directed, is extremely safe even for people with liver disease. However, taking too much acetaminophen at once, or taking a high dose of acetaminophen continuously over several days can cause damage to the liver.
How it Damages the Liver: A dose of Tylenol is absorbed by the gastrointestinal system and released into the bloodstream, where it alleviates pain and symptoms of fever. The liver filters the blood, which is responsible for metabolizing Tylenol into compounds that can be excreted by the body. About 90% is metabolized into harmless substances and excreted in the urine by the kidneys. Another 2% is removed without being metabolized. Between 5-10% is metabolized into a toxic compound called N-acetyl-p-benzoquinoeimine (NAPQI). Normally, the liver can safely remove NAPQI by combining it with gluthathione and converting it into a water-soluble product that is excreted in bile. However, after an overdose, the liver does not have enough gluthathione to combine with the NAPQI. Excess amounts of the toxic chemical cause rapid cell death, necrosis, tissue damage, and potentially deadly acute liver failure. (1,2,3)
2) Alcohol abuse:
The liver can only handle a certain amount of alcohol at any given time, so if you drink more than the liver can deal with by drinking too quickly, or drinking too much, your liver cells struggle to process it. When alcohol reaches the liver, it produces a toxic enzyme called acetaldehyde, which can damage liver cells and cause permanent scarring.
3) Smoking:
Though cigarette smoke does not directly come into contact with the liver, it does indirectly affect the liver. The chemicals in cigarette smoke eventually make their way to the liver. These chemicals cause oxidative stress on the liver, which leads to damage to the liver cells and fibrosis. Oxidative stress is involved in the aging of all the organs of the body. Oxidation produces free radicals that damage the cells of the body.
4) Lack of Sleep:
If you want to keep your body — and particularly your liver – in good condition, it is important that you get enough sleep. During sleep, the body repairs and renews its cells, so lack of sleep will interfere with that. In turn, if the liver cannot repair and renew itself as you sleep, it can’t function properly when you’re awake. A study published in the Journal of Anatomy found that sleep deprivation can cause oxidative stress to the liver. It was found that livers weren’t processing fat efficiently and instead allowed fat to accumulate (which proves that the body cannot function well without a properly working liver) (8)
8) Sleep deprivation predisposes liver to oxidative stress and phospholipid damage: a quantitative molecular imaging study. (n.d.). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/arti...
Why Healthy Liver Function is Essential to Maintain a Balanced Life
The liver is extraordinary! Responsible for over 500 functions, it's important that the liver is needed for overall health and wellbeing.
The liver function is quite extraordinary. The liver is made up of 2 lobes and is located on top of the stomach. As the “Commanding General” of the body, it is also the largest solid organ with over 500 important functions. To name a few liver functions, it regulates chemical levels in the blood, excretes bile, promotes healthy absorption and digestion, and ensures good circulation of qi, our vital energy.
As we can see, it’s imperative that the liver functions properly for overall health and wellness in the body. We share more about liver functions, what happens when issues arise, and herbal remedies to help maintain optimal health.
What is the Function of the Liver?
One vital liver function is to regulate the distribution of our life force for organs nourishment.
Most people know the liver as one of our vital organs. While it’s true from the perspective of modern anatomy, the liver has a vast basis of functions that affect the other organs. Let’s take a look at the different liver functions based on Western medicine and Traditional Chinese Medicine (TCM).
Liver function in Western medicine
There are many things that our liver does on the daily basis. It’s considered the largest organ and gland inside the human body. Interestingly, it’s the only organ that can regrow and replace its tissue.
Inside a liver, there are hundreds of tasks on progress every single day. But mostly, here are five major functions of the liver, based on its anatomical structure.
Production of bile
Made of mainly bilirubin, cholesterol, and bile acids, bile is essential for our digestion. It breaks down fats into fatty acids and turns ammonia, which is poisonous, into the urine.
Regulation of blood levels
The liver helps to regulate our blood of amino acids, regulates our blood for proper clotting and healing, helps to clear the body of drugs or harmful substances, and helps to store resist infections by removing bacteria from the bloodstream.
Conversion of excessive glucose
The liver converts excessive glucose (sugar) into glycogen. This is used for storage that can be converted back for energy and additional glucose.
Clearance of bilirubin
Our liver also works to ensure that we don’t have excessive bilirubin from our red blood cells. Having this condition makes our eyes and skin yellow.
Stores vitamins and minerals
The liver also stores vitamins A, D, E, K, and B12. The liver is also the storage center of iron and copper.
Liver function in TCM
In TCM, the liver is one of the five Zang organs with one primary function: to store and distribute jing (essence) and qi. Rather than referring to liver in anatomy, TCM regards liver as a part of a complex web connecting multiple systems and organs. TCM sees liver functions as essential in four main areas.
Beyond its anatomical concept, our liver is a part of a complex web connecting multiple systems and organs. According to TCM, the main liver function is to control the movement of qi that sustains the organs and tissues of the body.
TCM sees liver function as essential in four main areas:
Distribution of qi
Regulation of digestive system
Management of emotional health
Modulation of the female reproductive system
The balance of qi in our liver will ensure the proper functioning of other organs inside the body. Therefore, we all need a healthy liver to function and thrive.
Problems with Poor Liver Function
In today’s fast-paced society, people who struggle to achieve work-life balance may be more susceptible to poor liver function and imbalances. Here are some problems that can arise with liver issues.
Liver disease
Western perspective: According to the Centers for Disease Control and Prevention, liver disease, also called hepatic disease, affects 4.5 million Americans. The result of substance abuse, obesity, autoimmune diseases, cancer, or viruses such as hepatitis can lead to the disruption of the liver. This is very serious that can lead to a life-threatening condition called cirrhosis. Over time and if untreated can lead to hepatic encephalopathy, esophageal varices, abdominal ascites, liver failure, or liver cancer.
Issues with the liver can also be genetic such as Hemochromatosis, Wilson’s Disease, and Alpha 1 Antitrypsin Deficiency. Hemochromatosis is signified as an iron disorder where the body absorbs too much iron from the food you eat; whereas Alpha 1 Antitrypsin Deficiency is the lack of a certain enzyme, and Wilson’s Disease prevents the body from removing copper in the liver.
Early awareness and a healthy lifestyle — such as limiting alcohol intake, adapting to a healthy diet, and doing regular exercises — are essential to keep the liver functioning properly. Some symptoms to look out for include yellowish and/or itchy skin, swelling of the body, excessive tiredness, pale stool, dark urine, or a loss of appetite, to name a few symptoms. Seek guidance from your doctor who can further assess your symptoms.
TCM perspective: TCM regards the liver as an army general of our body that regulates the movement of ‘qi’ to all organ systems. That’s why any imbalances in the liver can affect the activities of other organs and cause many health issues.
Digestive system disorders
Stomach issues can be related to problems with the liver.
Western perspective: During the early onset of liver diseases like cirrhosis, a person may experience appetite loss. This can make them lose more weight. According to a 2014 study, around 80% of liver cirrhosis patients are having at least one symptom of gastrointestinal diseases (GI). The symptoms include abdominal pain, bloating, diarrhea, belching, and constipation — leading to malnutrition. The causes could be raised toxin levels and insulin resistance due to problems in liver function.
TCM perspective: From a TCM perspective, a disrupted balance in the liver, spleen, stomach, and gall bladder causes digestive system disorders. As a result, people who are prone to qi imbalances are likely to present with various symptoms, such as belching, heartburn, a poor appetite, and a thin white- or yellow-colored tongue coating.
TCM uses a classical formula known as 柴胡舒肝散 (Chai Hu Shu Gan San) to treat imbalances in the stomach and liver. It consists of several ingredients that work in tandem to regulate stomach and liver imbalances. The most basic ingredients of this formula are licorice root, bupleurum, bitter orange, aged tangerine peel, nutgrass galingale rhizome, Sichuan lovage root, and peony root.
Combining Toosendan fruits and Corydalis rhizome with this formula can relieve pain by improving the effect on liver qi. Meanwhile, adding decocted inula flower and hematite — the natural mineral form of iron oxide — can promote better downward movement of qi and relieve the counterflow.
Physical and emotional disordersWestern perspective: Liver dysfunction can be hard to diagnose since there are almost no visible symptoms early on. However, as the liver function becomes more impaired, it will cause physiological changes like an electrolyte imbalance and portal hypertension. In turn, patients will start experiencing physical and emotional symptoms. These include muscle cramps, breathlessness, itchy skin, trouble sleeping, depression, andanxiety.
TCM perspective: Our emotional and physical health are interconnected. For example, excessive anger or irritability is linked to various ailments. This includes dizziness, headaches, dry mouth, and redness of the face and eyes.
Similarly, TCM also believes that emotional imbalances can act as both the symptoms and causes of physical problems. Liver imbalances, specifically, link to anger, irritability, and mental health conditions such as sleeplessness, ddepression,and chronic stress.
A sleep formula known as Suan Zao Ren Tang is especially effective in treating insomnia. Sour jujube seeds — one of the ingredients of this classic formula — is particularly beneficial for improving sleep quality. It works by calming the mind, preventing excessive sweating, nourishing the liver, and soothing the nerves .
Women’s health disorders with the liver
A healthy liver means more energy, regulated periods, and less PMS symptoms. You are ready to face more adventures.
Western perspective: As a part of the endocrine system, liver dysfunction can impact hormonal balance. In women, chronic liver disease may cause amenorrhea (missing periods) and infertility. This can be triggered by low testosterone along with high estrogen and prolactin levels.
TCM perspective: An unbalanced liver can cause irregular periods, premenstrual syndrome (PMS), mood disorders, fatigue, fever and/or chills, abdominal pain, growth of benign masses in the uterus called fibroids, and early menopause..
Another important role of the liver is the storing of blood as well as regulate blood volume in the body. During rest, blood requirement in organs and structures is less and excess blood is channeled to the liver for storage. When there is activity, demand for blood increases and the liver transports blood to the respective organs to meet these needs. In the case of liver blood deficiency, organs fail to receive adequate nourishment which can result in symptoms such as giddiness, weakness in limbs, insomnia, and scanty periods in women or even amenorrhea. When blood cannot be stored in the liver effectively, the circulation of blood becomes unpredictable, leading to either bleeding from the orifices or heavy menstruation in females.
Visual disorders
Western perspective: Eye and visual issues can also be connected to liver disorders. Conditions such as Xanthelasma signified by a yellowish bubble on the eyelid, jaundice, cataracts, or Wilson’s disease may suggest a disrupted liver function.
The liver is also responsible for the production and storage of vitamin A. Because of this, problems in the liver can cause nyctalopia — an inability to see clearly in dim light or at night — and dry eye disease.
TCM perspective: Every organ has an association with a sense organ. The liver is most closely linked to the health of our eyes. Any unpleasant signs of the eyes can therefore be used to assess the health status of the liver. TCM believes that liver blood can travel upwards to nourish eye structures and gives the eyes capacity to see. A deficiency in liver blood may lead to eye issues such as blurred vision, myopia and eye floaters. On the other hand, excess liver heat can manifest in symptoms like red and bloodshot eyes, painful eyes which may be accompanied by a burning sensation.
A herbal tonic prepared using goji berries can nourish the liver, thus help improve your vision. It also improves circulation and strengthens your immune system.
How to Maintain a Healthy Liver
Several cubes of dried poria mushrooms on a copper plate
Poria mushroom is one of the many TCM ingredients that can boost liver health.
A healthy liver function is essential for your overall well-being. Maintaining a healthy lifestyle is important for the body as well as the liver. This includes regular exercise, moderate-to-no drinking or drug use, practicing safe sex, and eating healthy foods. A diet rich in green tea, vegetables, legumes, whole grains, nuts, oats, fatty fish, and limited salt, sugar, saturated fats, and refined carbs is important for liver health.
A classic formula called ‘Free and Easy Wanderer (Xiao Yao San)‘ contains eight ingredients. They are bupleurum, peppermint, Chinese Angelica, ginger root, licorice root, Poria mushrooms, white atractylode, and white peony roots. Xiao Yao San is a classical TCM formula that soothes the liver, strengthens the spleen and nourishes blood. It clears “liver stagnation” which contribute to stress, mood swings, pain, irritability, constipation, abdominal upset, premenstrual syndrome (PMS), and irregular periods.
Supplementation can help to enhance the healthy liver, such as Wild Yunzhi Powder and LLiva Max, containing medicinal fungus, stout camphor fungus (niu chang chih). These formulations can also improve the body’s resistance to disease, promote vitality, and enhance the respiratory system. According to studies conducted on mice, antrodia cinnamomea, has been widely to treat diseases such as liver disease, drug and food intoxication, diarrhea, and certain cancers.
Many issues that arise with the liver are preventable or reversible. However, if you are experiencing any symptoms related to imbalances in the liver, you should seek the advice of a doctor or TCM practitioner. These professionals can assess your situation and prescribe remedies for your specific issues.
Why Healthy Liver Function is Essential to Maintain a Balanced Life https://www.allthingshealth.com/en-us/general-health/digestive-health/healthy-liver-function/
Functional foods do more than just provide energy and nutrients; they also promote optimal health and help reduce the risk of lifestyle-related chronic diseases.
EVERYONE needs to eat – some more than others.
There are so many food choices that picking something healthy may not always be on our mind.
“Let’s say you don’t have a nutritional background – it can be daunting to navigate what’s good and what’s not good.
“With this pandemic, I have noticed from friends, family and colleagues that the majority of us have become more health conscious.
“Covid-19 has put a different perspective on our health and we’re definitely putting more thought into what we eat.
“Functional foods and ingredients are becoming popular,” says Goh Peen Ern, dietitian and Beneo Asia Pacific’s manager of nutrition communication.
Functional foods are ingredients that offer health benefits that extend beyond their nutritional value (i.e. calories and nutrients).
The simplest examples include whole foods such as nuts, seeds, grains, fruits and vegetables. Foods that have been fortified, enriched or enhanced with nutrients, phytochemicals or botanicals, as well as dietary supplements, also fall within the realm of functional foods.
The concept was believed to have originated in Japan in the 1980s when Japanese government agencies started approving foods with proven benefits in an effort to better the health of its general population.
Advances in technology have helped to identify which ingredients would enhance the nutritional value of foods.
Nutritional ingredients are generally perceived as safe, and this assumption of safety has often been used for branding purposes.
Because consumers are aware of nutritional benefits and consider food safety important, food and beverage producers are positioning their products to reflect the health advantages that their ingredients offer.
Carbs: Good or bad?
While functional ingredients can help promote better health, there are still certain factors about us that are not modifiable, e.g. genetics, family history and age.
Goh says: “The good news is that nutrition is one of the most powerful tools that can modify and improve our health.
“In Asian cultures, food is also used as medicine.”
Healthier eating for all
Many think Carbohydrate as bad, but we should not forget that they are essential for brain functions such as thinking. memory and learning, among others.
She gives carbohydrates as an example: “Carbohydrates have been getting a lot of bad rap and people think it is the source of all ailments, but remember that the human body and brain’s main source of energy is from carbohydrates that have been broken down into glucose.
“All health bodies promote eating carbohydrates, which should comprise around 50% of our caloric intake.”
Just like fats, the quality of carbohydrates differs and not all are created the same.
With the number of diabetics in the country and region, choosing the right type of carbohydrate is important in achieving long-term metabolic health.
Fast-release carbohydrates, or high glycaemic index (GI) foods, release glucose into the bloodstream rapidly, causing a spike in blood sugar levels.
These include breads, cereals, sugars, fruits and some starchy vegetables.
A constant high blood glucose level will cause damage to organs such as the eyes, heart and kidneys.
However, fast-release carbohydrates are extremely beneficial when eaten after exercising, as the rapid rise in blood sugar is critical for restoring glycogen – i.e. the sugars stored for energy – in the muscles and liver.
Slow-release, or low GI, carbohydrates foods provide a slower and more sustained release of energy.
These include most vegetables, whole grains, seeds, nuts, beans, peas and legumes.
If you choose foods with slow-release carbohydrates for your meals throughout the day, you’ll have energy for an extended period of time.
Asian body type
Sugar is not necessarily the culprit leading to diabetes.
“About 60% of diabetics live in Asia.
“We have a higher risk of type 2 diabetes compared to Caucasians due to our genetic makeup.
“Asians appear to have a distinct ‘thin-outside-fat-inside’ (TOFI) characteristic phenotype.
“We wear small or medium size clothes, but inside we are ‘fatty’.
“If we do a body scan, our belly fat is much higher compared to Caucasians with the same body mass index (BMI),” says Goh.
Even if our BMI is lower than our Caucasian counterparts, we actually have a higher risk of developing diabetes.
She adds: “Abdominal fat is the worst kind to have as high levels of it is associated with increased inflammation – if the fat is on your arms, it is fine.
“So, Asian waistlines are actually bigger.
“We can’t change that, but we can change our diets by eating slow-release carbohydrates to reduce the risk of getting diabetes.
“Instead of going on a rollercoaster ride, let the blood sugar climb up the hill gently.”
Goh used to work as a dietitian in a hospital, but realised she was only helping the sick.
So, to prevent a larger group of people from getting sick and filling up hospital beds, she moved on to the food industry.
“The food industry is like an ecosystem consisting of companies that manufacture the end product and companies that produce the ingredients.
“If you look at the finished product sold in supermarkets and read the ingredient list that says sugar, it doesn’t mean the manufacturer has its own sugar plantation.
“They may be sourcing it from elsewhere and adding it to the product,” she explains.
Sugar substitute
Extracted from the sugar beet plant, isomaltulose ia a low GI ingredient composed of glucose and fructose, which can be used as sugar substitute
A good slow-release alternative sweetener is isomaltulose, which is extracted from the sugar beet plant that is grown in the Palatinate region in Germany.
Goh says: “This is a functional ingredient that is a fully-digestible, slow-release carbohydrate, which comes in powder form and has been used to replace the sugar in food and beverage products.”
Isomaltulose is fully, yet slowly, digested and absorbed, resulting in a lower blood glucose rise and less insulin release in the body when consumed.
“Unlike high-intensity sweeteners such as saccharine, isomaltulose has half the sweetness of table sugar.
“If I’m using a lot of brain work or playing sports, I need carbohydrates, and drinks containing isomaltulose are an excellent choice.
“Food manufacturers can use this as an ingredient in their products,” she says.
This low GI ingredient is already the number one sugar substitute in hard-boiled candies worldwide.
It can also be used as a bulk sweetener in confectionery, baked goods, cereals, dairy products, sports nutrition products and special nutrition products and so on.
Goh cites the example of canned herbal tea – people want it to be both tasty and healthy, meaning that they don’t want sugar in it.
However, when the manufacturer takes out the sugar, the tea will become unpalatable.
“The manufacturer has to put back something to get a better-tasting tea, so they can put in isomaltulose, which tastes really nice and is not as sweet.
“Many people also don’t check the sugar content and think if the product is not so sweet, it is healthier!” says Goh.
Another functional ingredient with plenty of benefits is chicory root fibre (a prebiotic), which comes from the chicory plant.
Prebiotics are non-digestible dietary fibres that promote the growth of beneficial microorganisms in the intestine.
Unlike probiotics, prebiotics are non-living organisms and aid the intestinal bacteria to flourish.
Chicory root fibre is derived from the chicory plant, which belongs to the dandelion family (and looks like radish), and is primarily composed of inulin.
Inulin is extracted from chicory root through a gentle hot water diffusion process, similar to the process used to extract sugar from beets.
The first step consists of obtaining a liquid concentrate from the chicory root.
This juice will then be refined into fibre in liquid or powder form.
Goh explains: “Back then, companies making cereal and nut bars used sugar syrup to bind the bar together, but now, some manufacturers have started using the liquid version to bind the ingredients so that the product is healthier.
“The chicory root fibre has plenty of healthy benefits and has been linked to improved blood sugar control and digestive health as it selectively increases the good gut microbiome.
“With isomaltoluse, it is slowly broken down by the body, but chicory root fibre is considered a prebiotic, so it is not broken down in the body and doesn’t affect blood sugar.”
In food packaging, some manufacturers will list the item as “having prebiotics” or a “sustained energy product”.
“What you can do is look at the ingredient list to see if it contains any functional ingredients.
“Food companies will usually use generic names, e.g. oligofructose, fructo-oligosaccharides (FOS), galacto-oligosaccharides (GOS), plant sterols, isomaltulose, beta glucan, etc.
“These functional ingredients are not just for diabetics, but for everyone to keep themselves healthy.
“And no, these ingredients are not sold to individuals, but to food manufacturing companies,” she says.
Prioritise food intake
To lead a healthy life, Goh ranks nutrition as top of the priority list, followed by exercise, adequate sleep and controlling stress.
She points out: “If you do the first three things right, then the fourth is not a problem.”
When it comes to the affordability factor, Goh says not all foods with functional ingredients are expensive.
“Maintaining good health is not expensive.
“If you cannot afford these foods, go for home brands, cook your meals with lots of onion and garlic, choose lean meats for protein, and eat your fruit and veggies, but make sure they are rainbow-coloured.”
There are those who think eating healthy once in a while is good enough.
“Health eating is a daily thing!” Goh emphasises.
“It’s not only reserved for special occasions.
“You should be eating healthy 80% of the time and the 20% remaining, you can indulge in junk food, fast food, chocolates, etc – why not?
“In the end, it boils down to habit.
“If you’re eating healthy, it’s very hard to undo.
“If your habit is not so healthy, put your mind to it and consciously eat healthy again and again – you can change your habits.
“Just do one thing consistently until it becomes a habit two or three months later, then work on another thing,” she advises.
More importantly, you have to eat to feel good.
She says: “You can try it yourself, eat junk food one day and healthy food the next, and observe the difference.
Benefits of salt substitutes
Dietary salt substitutes can help lower the risk of heart attacks, stroke and death in those with high blood pressure.
DIETARY salt substitutes lower the risk of heart attack, stroke and death from all causes and cardiovascular (heart) disease, finds a pooled data analysis of the available evidence.
Published online in the journal Heart, the beneficial effects of these substitutes are likely to apply to people all around the world, say the researchers.
Cardiovascular disease is the leading cause of death worldwide, and high blood pressure is a major risk for an early death.
A diet high in sodium and low in potassium is known to drive up blood pressure.
Around 1.28 billion people around the world have high blood pressure, although more than half of these are undiagnosed, say the researchers.
Salt substitutes, in which a proportion of sodium chloride (Nacl) is replaced with potassium chloride (KCL), are known to help lower blood pressure.
A recently published large study from China, called the Salt Substitute and Stroke Study (SSASS), found that salt substitutes cut the risk of heart attacks, stroke, and early death.
But it was unclear whether these benefits would apply to other parts of the world.
In a bid to shed light on this, the researchers trawled research databases looking for randomised clinical trials published up to the end of August 2021, which reported on the effects of a salt substitute on blood pressure, cardiovascular health and early death.
Blood pressure, which is measured in mmhg, is made up of two numbers: systolic, which is the higher number that indicates the force at which the heart pumps blood around the body, and diastolic, which is the lower number that indicates arterial pressure when the heart is filling with blood.
They pooled the results of 21 relevant international clinical trials involving nearly 30,000 people, carried out in Europe, the Western-pacific region, the Americas and South-east Asia.
The study periods lasted from one month to five years.
The proportion of sodium chloride in the salt substitutes varied from 33% to 75%; the proportion of potassium ranged from 25% to 65%.
The pooled data analysis showed that salt substitutes lowered blood pressure in all the participants.
The overall reduction in systolic blood pressure was 4.61mmhg and the overall reduction in diastolic blood pressure was 1.61mmhg.
Reductions in blood pressure seemed to be consistent, irrespective of geography, age, sex, history of high blood pressure, weight (body mass index or BMI), baseline blood pressure, and baseline levels of urinary sodium and potassium.
And each 10% lower proportion of sodium chloride in the salt substitute was associated with a 1.53mmhg greater fall in systolic blood pressure and a 0.95mmhg greater fall in diastolic blood pressure.
There was no evidence that higher dietary potassium was associated with any health harms.
A pooled data analysis of the results of five of these trials involving more than 24,000 participants showed that salt substitutes lowered the risks of early death from any cause by 11%, from cardiovascular disease by 13%, and the risks of heart attack or stroke by 11%.
The researchers acknowledge certain limitations to their findings, including that the studies in the pooled data analysis varied in design and that there were relatively few data for people who didn’t have high blood pressure.
But they nevertheless highlight that their findings echo those of the SSASS – the largest ever trial of a potassium-enriched salt substitute to date.
“Since blood pressure lowering is the mechanism by which salt substitutes confer their cardiovascular protection, the observed consistent blood pressure reductions make a strong case for generalisability of the cardiovascular protective effect observed in the SSASS, both outside of China and beyond,” they write.
“These findings are unlikely to reflect the play of chance and support the adoption of salt substitutes in clinical practice and public health policy as a strategy to reduce dietary sodium intake, increase dietary potassium intake, lower blood pressure and prevent major cardiovascular events,” they conclude.
