Tuesday, November 23, 2010

Malaysian Dietary Guidelines 2010

Malaysians like to eat. This is best illustrated by our daily greeting of "have you eaten?". At the same time, we are suffering from various diseases as a result of inappropraite eating habits. Therefore, this guideline is timely and should serve as our dietary guide.

Key message 1: Eat a variety of foods within your recommended intake
Recommendations
1. Choose your daily food intake from a combination of foods based on the Malaysian Food Pyramid.

2. Choose your daily food intake according to the serving size recommended.
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Key message 2: Maintain body weight in a healthy range
Recommendations
1. Maintain body weight in a healthy range by balancing calorie intake with physical activity.
2. Weigh yourself regularly, at least once a week.
3. If you are an adult, prevent gradual weight gain over time.
4. If overweight, aim for a slow and steady weight loss.
5. If underweight, increase energy intake as recommended.

Key message 3: Be physically active everyday
Recommendations
1. Be active every day in as many ways as you can.
2. Accumulate at least 30 minutes of moderate intensity physical activity on at least five to six days a week, preferably daily.
3. Participate in activities that increase flexibility, strength, and endurance of the muscles, as frequent as two to three times a week.
4. Limit physical inactivity and sedentary habits.
Overweight/obese
To lose weight, a total of more than 30 minutes a day of moderate intensity physical activity is recommended, whilst approximately 45 to 60 minutes per day of moderate intensity physical activity is required to prevent the transition from overweight to obesity.
For weight control and for preventing weight gain or regain among formerly obese individuals, a total of 60 to 90 minutes a day of moderate intensity activity or lesser amount of vigorous activity is recommended.

Key message 4: Eat adequate amount of rice, other cereal products (preferably whole grain), and tubers
Recommendations
1. Consume at least four servings of cereal foods daily.
2. Choose at least half of your grain products from whole grains.
3. Choose cereal products that are high in fibre, low in fat, sugar and salt.

Key message 5: Eat plenty of fruits and vegetables everyday
Recommendations
1. Eat a variety of fruits everyday.
2. Eat a variety of vegetables everyday.
3. Eat at least five servings of fruits and vegetables everyday.

Key message 6: Consume moderate amounts of fish, meat, poultry, egg, legumes, and nuts
Recommendations
I. Consume fish more frequently, if possible daily.
2. Consume meat, poultry, and egg moderately.
3. Practise healthier cooking methods for fish, meat poultry, and egg dishes.
4. Choose meat and poultry that are low in fat and cholesterol.
5. Consume legumes daily.
6. Include nuts and seeds in weekly diet.

Key message 7: Consume adequate amounts of milk and milk products
Recommendations
1. Consume milk and milk products everyday.
2. Replace sweetened condensed milk and sweetened condensed-filled milk with unsweetened liquid or powdered milk.

Key message 8: Limit intake of foods high in fats and minimise fats and oils in food preparation
Recommendations
1. Limit the intake of unsaturated fats to less than 10% of total daily calorie intake.
2. Increase the intake of unsaturated fats monounsaturated fatty acids (MUFA) and polyunsaturated fatty acids (PUFA).
3. Limit the intake of foods with high cholesterol.
4. Limit foods containing trans fatty acids (TFAs).
5. Minimise the use of fat in food preparation in order to keep total daily fat intake between 20% to 30% energy.
6. When eating out, choose low-fat foods.

Key message 9: Choose and prepare foods with less salt and sauces
Recommendations
1. Limit salt intake to one teaspoon a day.
2. Reduce consumption of highly salted foods and condiments.

Key message 10: Consume foods and beverages low in sugar
Recommendations
1. Eat foods low in sugar.
2. Drink beverages low in sugar.

Key message 11: Drink plenty of water daily
Recommendations
1. Drink six to eight glasses of plain water daily.
2. Maintain fluid intake from other food sources.
3. Avoid alcoholic beverages.

Key message 12: Practise exclusive breastfeeding from birth until six months and continue to breastfeed until two years of age
Recommendations
1. Prepare for breastfeeding during pregnancy.
2. Initiate breastfeeding within one hour of birth.
3. Breastfeed frequently and on demand.
4. Give only breast milk to baby below six months with no additional fluid or food.
5. Continue to give babies breast milk even if the baby is not with the mother.
6. Introduce complementary foods to baby beginning at six months of age.
7. Lactating mothers should get plenty of rest, adequate food and drink to maintain health.
8. Husbands and family members should provide full support to lactating mothers.

Key message 13: Consume safe and clean foods and beverages
Recommendations
1. Choose safe and clean foods and beverages.
2. Store foods appropriately.
3. Prepare foods hygienically.
4. Cook foods thoroughly.
5. Hold foods appropriately.
6. When eating out, choose safe and clean premises.

Key message 14: Make effective use of nutrition information on food labels
Recommendations
1. Use Nutrition Information Panel (NIP) as a guide in making food choices.
2. Make use of nutrition claims wisely.
3. Educate children on the use of NIP.

Thursday, November 4, 2010

States take on Pertussis as Disease Cases Resurge Around the Nation

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In US, it was reported that pertussis disease has increased recently:

States take on Pertussis as Disease Cases Resurge Around the Nation
Reports of pertussis have reached startling numbers in communities around the nation in recent months, leading to renewed attention to the common infectious disease.
Despite the resurgence, public health workers caution that such outbreaks are not unexpected and should serve as important immunization reminders.
Vaccination is the most effective way of disease prevention, second only to hand washing. Yet, we occasionally take the vaccination lightly as some diseases are rarely reported nowadays. In fact, the vaccination is the tool that help us to fight against smallpox, polio and many others. So, we should adhere to the recommended vaccination schedule to safeguard the best interest of children.

Wednesday, November 3, 2010

Oral Diosmectite is effective in Children with Acute Watery Diarrhoea

We are in the era of evidence-based medicine. The treatmen to diseases should be based on the best available scientific evidence. I would like to share this clinical study with you for the following reasons:
  • This is a study done in Malaysia (and Peru) -- suit to our local context
  • This adresses the common childhood problem -- diarrhoea

Oral Diosmectite Reduces Stool Output and Diarrhea Duration in Children With Acute Watery Diarrhea

"These results show that diosmectite significantly decreased stool output in children with acute watery diarrhea, especially those who were rotavirus-positive."

I read the prescription literature and it states "not recommended in childeren below 6 in accordance to Malaysia's Drug Control Authority".
However, the above study involved children from 0 to 36 months old. No adverse side effects were noted. In the past, there are many off-label prescription done for the children among the doctors in Malaysia. With this study results, we can safely administer this drug to the suffering children.
The only problem with this medicine is it has no pleasant taste. You can help your babies by mixing it with a semi-liquid food, broth, stewed, fruit, puree, etc.