Globally, it is estimated that 100 million men have ED problems, but even with such a figure, ED is considered a taboo topic to discuss because it is considered an embarrassment, and people do not want to seek medical help for it. It is not taboo to discuss ED because it is a health issue. Sexual well-being is one component of overall health, and as we age, our bodies do not function as well as they used to, which is why ED is common in men aged 40 and older.

ED can be caused by a variety of factors, including physical, psychological, and social factors. Physical factors such as heart disease, atherosclerosis, high blood pressure, diabetes, high cholesterol, obesity, Parkinson's disease, multiple sclerosis, liver or kidney problems, Peyronie's disease, and alcoholism are common among older men. These medical conditions typically affect the nerves and blood vessels that control erections, which explains why people with such conditions are more likely to develop ED. Psychological factors can also contribute to ED. Worry about being unable to achieve or maintain an erection, as well as prolonged emotional distress related to economic, professional, social issues, relationship conflicts, and depression can all distract a man of any age from becoming aroused. 

Stendra (avanafil), Viagra (sildenafil), Cialis (tadalafil), and Levitra or Staxyn (vardenafil) are some of the most commonly prescribed erectile dysfunction treatments. Aside from medication, lifestyle changes such as exercise, healthy eating, stress management, and adequate sleep will also aid in the treatment of this condition.

According to the study, not all types of exercise help with ED; exercise such as cycling might not be helpful for ED, according to the National Health Service, UK; however, weight-bearing exercise can increase the natural production of testosterone, which is a significant factor in erectile strength and sex drive. Apart from weight-bearing exercise, kegel exercises, which improve your pelvic floor, yoga, and aerobic exercise, which are targeted to improve stamina and overall fitness, also help. In general, exercise will improve sexual health as it improves blood circulation, hormone regulation, stamina, and endurance, thus improving sex drive and erection problems.

Apart from exercise, nutrition also plays an important role in ED. A study found that men with a 42-inch waist are 50% more likely developing ED than men with a 32-inch waist. Also, being obese increases men's risk of getting vascular diseases and diabetes, which contributes to ED. Reduce or stop smoking, and consuming alcohol has also shown tremendous positive effects on ED problems. Smoking for a long time affects the vascular health; it causes the blood supply to the penis to become restricted due to blockage or narrowing of the arteries, thus causing the erection problem. While, as for the consumption of alcohol, it suppresses the central nervous system that is responsible for releasing nitric oxide (a chemical that is responsible for producing and maintaining an erection), which is why the more men drink alcohol, the more likely they are to have an ED problem.

In conclusion, talk to your doctor regarding your condition. You might think that your condition is too petty to discuss, but by letting your doctor know about it, it gives a different perspective to your whole treatment plan.

References

1. Everyday Health (n.d). Naturqal Treatment for Erectile Dysfunction. https://www.everydayhealth.com/pictures/lifestyle-changes-natural-treatments-erectile-dysfunction/ (Accessed on March 2, 2021).
2. Healthline (n.d). Erection Problems. https://www.healthline.com/health/erection-problems (Accessed on March 2, 2021).
3. Medical News Today (n.d). Erectile Dysfunction. https://www.medicalnewstoday.com/articles/5702 (Accessed on March 2, 2021).
4. National Health Service, United Kingdom. Erectile Dysfunction. https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/ (Accessed on March 2, 2021).
5. National Institute of Health (NIH), National Institute of Diabetes, Digestive, and Kidney Disease (NIDDK). Symptoms & Causes of Erectile Dysfunction. https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/symptoms-causes (Accessed on March 2, 2021).
6. Mayo Clinic. Erectile Dysfunction. https://www.mayoclinic.org/diseases-conditions/erectile-dysfunction/symptoms-causes/syc-20355776 (Accessed on March 2, 2021).
7. Everything you need to know about ED. https://www.healthline.com/health/erectile-dysfunction#symptoms (Accessed on March 2, 2021).

Oyster supplementation (1, 2, 3)

When it comes to oyster supplementation, people always thought that it came from its shell and not the meat, but the truth is, it comes from its creamy flesh meat!

The creamy flesh of oysters is cleaned and depurated. It is then processed and made into capsules, powder, and tablets. This is actually good news for those who cannot consume slimy, meaty food and thus can take it in tablet or capsule form.

Many people have started to consume oysters for their known ability to increase testosterone levels in men. It is also well known for its benefits in supporting men’s reproductive health as it contains a high level of zinc.

Since oysters are high in zinc, oyster extraction supplementation is highly recommended for those who are deficient in this nutrient. This is a very important nutrient that can help your immune system and improve your body’s metabolism as well. 

Zinc is a trace mineral that is essential for various body functions, such as protein synthesis, collagen formation, wound healing, and healthy immune function. Apart from that, it is also needed to support prostate and reproductive health, especially for males. Individuals who have digestive disorders such as Celiac Disease and Chron’s Disease and/or are on a vegan diet are at higher risk of being zinc deficient and thus require zinc supplementation. 

Zinc deficiency can lead to fatigue, impaired senses of taste and smell, poor appetite, slow wound healing, poor immunity, and hair loss as well. 

What do the study's findings say? (4,5)

In 2003, a study in Japan used oysters, which contain a significant amount of zinc, to investigate whether they could improve the reproductive health of mice. This study was conducted on three groups of mice, where the first group was supplemented with a diet rich in zinc from oysters, the second group was supplemented with zinc from zinc carbonate, and the third group was fed a diet deficient in zinc.

This study found that mice supplemented with zinc either from oyster extraction or zinc carbonate had improved serum levels of zinc, improved sperm motility and maturation, increased successful pregnancy rates, increased maternal weight gain, increased the number of live fetuses, increased fetal body weight, and had better embryonic development as compared to mice fed a diet deficient in zinc. Thus, this study suggested that oyster extraction is a useful supplement that can prevent reproductive defects from zinc deficiency, and the bioavailability of zinc may be identical to zinc carbonate.

Another recent study that was conducted in 2018 with regards to men’s reproductive health and oysters is the review article that concluded that zinc is vital in men’s reproductive health since the adequacy of zinc content in seminal plasma is needed for men’s germination, normal sperm function, and fertilization. The review also noted that seminal fluid deficiency causes infertility, and many studies prove the association of the seminal plasma zinc concentration with the physiology and pathogenesis of sperm and its quality. The study also indicates that men who are smokers have a higher possibility of becoming infertile, as the toxin in cigarettes can lead to oxidative stress that can hinder the efficacy of seminal fluid and sperm parameters.

In conclusion

To date, there has been no meta-analysis or systematic study with regards to oysters specifically and men’s reproductive health. However, randomised controlled trials and review articles from a few studies, such as the two above, are able to portray that zinc deficiency may hinder sperm quality and fertility in men. Since oysters have a significant amount of zinc, they can be used to treat or prevent men’s reproductive health problems. Furthermore, the study also noted that the content of taurine and glycogen will also help alleviate this problem.

References

1. Men’s Health Online Magazine. Take This Supplement to Improve you Sex Life. https://www.menshealth.com.au/oyster-and-zinc-supplement-improves-sex-health (Accessed on August 13, 2020).
2. Men’s Health Online Magazine. Oyster Nutrition Facts. https://www.menshealth.com/nutrition/a19527227/oysters-nutrition-facts/ (Accessed on August 13, 2020).
3. Are Oysters Good for you? Benefits and Danger. https://www.healthline.com/nutrition/oysters#1 (Accessed on August 13, 2020).

Benign Prostatic Hyperplasia (BPH) is a condition in which the prostate is enlarged but not cancerous. It is also known by a few other names, such as benign prostatic obstruction, benign prostatic hypertrophy, and enlargement of the prostate. According to the National Health Morbidity Survey Malaysia (NHMS), 16% of Malaysian men over the age of 40 suffer from this problem. The signs and symptoms of this problem usually worsen as men get older, which is why the NHMS reported that the percentage of men with symptomatic BPH increased from 10% among 40-year-old men to 33% among 75-year-old men.

Among the signs and symptoms of this problem are:

• Frequent or urgent urinating problem.
• Increased frequency of urination at night (nocturia).
• Difficulty starting urination
• A weak or interrupted urine stream.
• Dribbling at the end of urination
• Urine incontinence
• Pain after ejaculation or during urination
• Unusual urine colour or smell
• Inability to completely empty the bladder.

Most of these symptoms usually come from a blocked urethra or an overworked bladder from trying to pass the urine through the blockage in the bladder. For BPH, the size of the prostate does not necessarily indicate the severity of the problem; men can have a greatly enlarged prostate with little blockage and a few symptoms or a minimally enlarged prostate with greater blockage and more symptoms.

The cause of this condition is rather poorly understood, but there are probably two reasons for this, according to scientists. First, throughout their lives, men produce testosterone (male hormone) and a small amount of oestrogen (female hormone), but as men age, the amount of active testosterone decreases, leaving a higher proportion of oestrogen, which promotes prostate cell growth, hence the enlargement of the prostate. Second, it is due to the dihydrotestosterone (DHT) hormone, which plays roles in prostate development and growth. As men get older, they continue to produce and accumulate high levels of DHT in the prostate, which encourages prostate cells to continue growing. This is also theorised because men who do not produce DHT do not develop BPH.

 There are various treatments that can help with BPH, depending on the individual's severity and condition. Discuss your condition with your healthcare professionals so they may suggest a better treatment plan for you. The treatment plan usually involves lifestyle modifications such as:Urinating as soon as you feel the urge

•  Go to the bathroom to urinate, even when you don’t feel the urge.

• avoiding over-the-counter decongestants or antihistamine medications, which can make it harder for the bladder to empty.

• Avoid alcohol and caffeine, especially in the hours after dinner.

• Reduce your stress level, as nervousness can increase the frequency of urination.

• Exercise regularly, as a lack of exercise can aggravate your symptoms.

• Learn and practise Kegel exercises to strengthen your pelvic muscles.

• Keep warm, since being cold can make symptoms worse. 

As for the treatment from healthcare professionals, its usually includes prescription of medication (alpha blockers, alpha reductase inhibitors, etc.), minimally invasive procedures (transurethral needle ablation, high intensity focus ultrasound, prostatic stent insertion), and surgery (laser surgery, open prostatectomy, transurethral incision of the prostate (TUIP). Bottom line: talk to your doctor regarding your condition. No matter how insignificant you may think things that occur to you are, they might actually be a symptom of a disease.

References

1. Mayo Clinic. Benign Prostatic Hyperplasia (BPH). https://www.mayoclinic.org/diseases-conditions/benign-prostatic-hyperplasia/symptoms-causes/syc-20370087 (Accessed on Feb 25, 2021).

2. National Institute of Health (NIH). National Institute of Diabetes and Digestive and Kidney Diseases. Benign Prostatic Hyperplasia (BPH). https://www.niddk.nih.gov/health-information/urologic-diseases/prostate-problems/prostate-enlargement-benign-prostatic-hyperplasia (Accessed on Feb 25, 2021).

3. What do you want to know about enlarged prostate? https://www.healthline.com/health/enlarged-prostate (Accessed on Feb 25, 2021).

4. Ministry of Health Malaysia (MOH). National Health Morbidity Survey (NHMS) (2018) Infographic Booklet  

To answer this, it really is a very tricky one. There are always two sides to a story when it comes to this. One believes that juicing is unhealthy than eating whole fruits due to the loss of fibre throughout the process, which makes fructose (sugar in fruit) absorb even quicker as compared to when it is combined with fibre, thus making it less healthy (1).

Another belief is that juicing is better than eating whole fruits and vegetables because the body can absorb them better and let the digestive tract rest from digesting fibre. If one considers blending fruit, that is even better since the edible fibre in it makes us feel full, so it promotes satiety (1).

So should we consider juicing, blending, or just eating raw fruits and vegetables?

Three longitudinal prospective cohort studies found that greater consumption of fruits such as blueberries, grapes, apples, bananas, and grapefruit reduced the risk of type 2 diabetes, while greater consumption of fruit juice was associated with an increased risk of type 2 diabetes (2).

When fruit is squeezed for its juice, what is left inside is basically sugar, vitamins, and antioxidants such as carotenoids, etc.; thus, it is healthier in this aspect as compared to frizzy drinks (3). However, the amount of sugar inside both of these drinks is about the same, which is about 20–26 g of sugar per cup (3).

The reason why fruit juice contains a higher sugar content as compared to fresh fruit even when it is 100% fruit juice without the addition of anything else is because, for example, in order to make 250 ml of orange juice, two medium-sized oranges are needed, and that is only 250 ml. Since when it is in liquid form, people tend to consume it even more, thus more fruits are needed. As the number of fruits increases, so does the sugar in them, but not the fibre inside, which in turn makes them have loads of sugar (1, 3, 4, 7, 8).

According to the Singapore Health Promotion Board, many people may think that naturally occurring sugar is healthier than added sugar, but actually there is no chemical difference between the two, and they have the same impact on blood sugar levels when ingested (8).

The same case goes to smoothies, not only because they have a lot of sugar from a large number of fruits, but also because various protein-based foods like yoghurt, milk, almond milk, etc. that are mixed together with them will increase their calories as well (4).

The high sugar levels in both of these drinks make them high-calorie beverages and thus pose the same effect as high-calorie food, which can lead to weight gain. As we know, Malaysia is the fattest country in Southeast Asia, and one of the contributing factors is a lack of knowledge on what can increase weight and what cannot.

Weight gain is linked to many health problems, such as heart diseases, metabolic syndrome, cancer, bone and joint problems, kidney problems, etc. (3).

A study on the composition of grapefruits with different methods of household processing also found out that the composition of antioxidants in blended grapefruit has a higher concentration of the beneficial compound as compared to juicing or hand squeezing (5).

However, as for the absorption of beta carotene, a study found that fruit and vegetable juice makes beta carotene absorb better as compared to blending or eating raw fruit. This is due to the fact that fibre hinders the absorption of beta-carotene (6).

The takeaway message

Eating raw fruit, juicing, and blending all have their pros and cons. What is important is to always take into account the amount of sugar and fibre content. All in all, make sure that you have a balanced, nutritious, and moderate diet as suggested by the Ministry of Health: eat 3 servings of vegetables per day and 2 servings of fruits per day. Vary the way vegetables and fruit are cooked or served and eat them in moderation.

References

1. Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/expert-answers/juicing/faq-20058020

2. MurakiIsao, ImamuraFumiaki, Manson JoAnn E, Hu Frank B, Willett Walter C, van Dam Rob M et al. Fruit consumption and risk of type 2 diabetes: results from three prospective longitudinal cohort studies BMJ 2013; 347 :f5001. https://www.bmj.com/content/347/bmj.f5001

3. Healthline (n.d). Is Fruit Juice is as Unhealthy as Sugary Soda? https://www.healthline.com/nutrition/fruit-juice-vs-soda#sugar-content

4. Healthline (n.d). Juicing vs Blending: Which one is better for me? https://www.healthline.com/health/food-nutrition/juicing-vs-blending

5. Ram M Uckoo1, Guddadarangavvanahally K Jayaprakasha, V M Balasubramaniam, Bhimanagouda S Patil. Grapefruit (Citrus Paradisi Macfad) Phytochemicals Composition Is Modulated by Household Processing Techniques.

6. Julia K Kolodziejczyk1, Shirley W Flatt, Loki Natarajan, Ruth Patterson, John P Pierce, Gregory J Norman. Associations of Soluble Fiber, Whole Fruits/Vegetables, and Juice With Plasma Beta-carotene Concentrations in a Free-Living Population of Breast Cancer Survivors. Women Health 52(8). DOI: 10.1080/03630242.2012.728189

7. How many orange does it take to make a cup of orange juice? (n.d). https://www.eatdifferentrd.com/blog/2016/8/12/how-many-oranges-does-it-take-to-make-a-cup-of-oj

8. Chanel News Asia (CNA) International (2019). That cup of fresh fruit juice could contain as much sugar as a soft drink. https://www.channelnewsasia.com/news/singapore/fruit-juice-sugar-diabetes-health-risks-soft-drink-11708652

“Eat more vegetables and fruits to get your fiber!” You may have heard these words. But what is fiber, really? How it works to improve our health? Let us take a closer look on it!

Fiber is a type of carbohydrate that our body cannot digest undigested. Though most carbohydrates are broken down into sugar molecules but fiber cannot be broken down into sugar and thus it will pass through our body. These carbohydrates often considered beneficial in which mostly come from fruits, vegetables and legumes (1, 3, 6).

Soluble fiber

Dissolves in water; absorb water to form a gel like substance that slow the digestion and cause you to feel full. They have been shown to decrease cholesterol and lower blood glucose. Common source of soluble fiber includes beans, oat bran, fruits and vegetables. It is also found in pysllium, a common fiber supplement.

Insoluble fiber

Does not dissolve in water; Increase fecal bulk and appear to help food pass more quickly through the digestive tract so it can be of benefit to those who struggle with constipation and irregular stools.

 Facts About Fiber (3,4)

#1 Fiber aids in achieving healthy weight.

#2 Fiber fight diseases. It appears to reduce risk of developing various health conditions including heart disease, diabetes, constipation and breast cancer.

#3 Fiber helps to lower cholesterol.

#4 Fiber helps to regulate blood glucose.

#5 Recommended dietary fiber intake per day for all age group is 20-30g/day. However, if a person is not currently eating enough of fiber, he or she should increase his or her fiber intake slowly  to avoid gas and bloating.

#6 More fiber needs more water. When eating a high fiber diet, be sure to drink at least eight or more glasses of water every day.

#7 Fiber aids in improving digestion by increasing stool bulk and regularity. A high-fiber diet may help reduce the risk of hemorrhoids and diverticulitis.

#8 Too much fiber is a bad thing. You may experience abdominal cramping, bloating, gas, constipation and even diarrhea.

#9 Fruit and vegetable peels are rich in several nutrients including fiber. Eating unpeeled fruits and vegetables keep you feel full longer due to its high fiber content. However, certain fruit and vegetable peels may be hard to consume or simply inedible. These peels are best removed and not eaten.

#10 Fruits and vegetable juice has less fiber than whole fruits and vegetable. This is because the skin is removed and thus it is more healthful to eat whole fruit and vegetable.

#11 Fiber cannot be cooked out.

Tips to Increase fiber intake (5,7)

Consume products that have whole grain listed as the first ingredients, high fiber content and low fat and sugar content.

Replace white rice, bread and pasta with brown rice and whole grain products.

Include legumes in your diet (beans, dried peas and lentils)

Eat unpeeled whole fruit and vegetables not juice.

Snack on fruits and vegetables

Take a fiber supplement (e.g psyllium)

In conclusion,

Fiber is an important dietary substance to your diet. This is because high fiber foods are also good sources of vitamins, mineral and antioxidants which offer many health benefits. Therefore, as one of the key ingredients to healthy eating, fiber is something you cannot skip.

References

1. Cleveland Clinic. 2019. Improving Your Health With Fiber. Available from https://my.clevelandclinic.org/health/articles/14400-improving-your-health-with-fiber [Accessed on 23 April 2020].
2. Danielle, D. 2018. How much fiber is too much. Medical New Today. Available from https://www.medicalnewstoday.com/articles/321286#treatment [Accessed on 23 April 2020].
3. Harvard University School of Public Health. (n.d.). Fiber. Available from https://www.hsph.harvard.edu/nutritionsource/carbohydrates/fiber/ [Accessed on 23 April 2020].
4. Karin, L. 2016. 45 Interesting Facts about FIber. Fact Retriever. Available from https://www.factretriever.com/fiber-facts [Accessed on 23 April 2020].
5. Kerri, A., J. 2016. 16 Easy Ways to Eat More Fiber. Healthline. Available from https://www.healthline.com/nutrition/16-ways-to-eat-more-fiber [Accessed on 23 April 2020].
6. Mayo Clinic. 2018. Dietary fiber: Essential for a healthy diet. Available from https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/fiber/art-20043983 [Accessed on 23 April 2020].
7. My Health Ministry of Health. 2012. SERAT DAN KAWALAN DIABETES. Available from http://www.myhealth.gov.my/serat-dan-kawalan-diabetes/ [Accessed on 23 April 2020].

Blood glucose is the primary source of energy, and it is derived from the food that we eat. To convert this energy from food that we consume to cells, our bodies require a hormone called insulin, which is produced in the pancreas. With the help of this insulin hormone, energy from food is then converted into cells. When the body is unable to produce enough or any insulin, or when insulin is not used effectively, glucose or sugar remains in the blood and does not reach the cells (2).

Too much glucose in the blood can cause health problems over time. Although there is no cure for diabetes, individuals can take steps to manage their diabetes and stay healthy. Diabetes complications include cardiovascular disease, diabetes neuropathy (nerve damage), nephropathy (kidney damage), retinopathy (eye damage), and many others.

In this article, we will concentrate on the complication of nerve damage, also known as neuropathy. Excess sugar can cause damage to the walls of the tiny blood vessels (capillaries) that nourish nerves, particularly in the legs. This can cause tingling, numbness, burning, or pain, which usually starts at the tips of the toes or fingers and spreads upward. If left untreated, the individual may lose all feeling in the affected limbs (4).

Many studies are being conducted in an effort to reduce the risk of diabetic neuropathy complications, one of which is the use of Alpha Lipoic Acid (ALA). ALA is a type of antioxidant found in a variety of foods, but in very small amounts. Foods containing it include spinach, broccoli, yams, tomatoes, potatoes, carrots, beets, and rice bran. Whereas in animal-based food, the heart, liver, and kidney have higher concentrations of lipoic acid (LA) (5).

Lipoic acid (LA) can be synthesized by the human body in the liver. LA or ALA performs functions such as glucose and lipid metabolism, anti-inflammation, antioxidant property that can be used to regenerate other antioxidants, protein repair, and metal ion chelation. ALA, on the other hand, increases insulin sensitivity in people with diabetes (6).

As an antioxidant, ALA or LA aids in the fight against free radicals or oxidative stress caused by three pathways in the body of people with diabetes mellitus: mitochondrial, enzymatic, and non-enzymatic. Concerning the function of ALA in diabetes, several clinical trials have discovered that ALA may increase insulin sensitivity and help to reduce blood sugar and lipid levels.

There are two detailed studies involving this, in which ALA is administered for two weeks to 22 patients and improvements in fasting and average glucose levels, insulin sensitivity, LDL and HDL, and total cholesterol are seen, but the study is too short to measure the HBa1C level. So, another study related to this is the one that administered ALA orally to 74 patients for 4 weeks and discovered improvements in insulin resistance and fasting glucose (7).

Regarding the sole function of ALA on diabetic neuropathy, it is a possible alternative treatment for diabetic neuropathy. Diabetes causes neuropathy, or nerve damage, which is a permanent and common complication. However, ALA can help to alleviate the symptoms (8).

There are two types of neuropathy, the first of which is peripheral neuropathy, which most commonly occurs in the feet and legs but can also sometimes occur in the hands and arms. It can also cause numbness or the inability to feel changes in temperature, tingling or burning sensations, muscle weakness, a loss of balance, foot problems including ulcers or infections, sharp pain, or cramps. Whereas autonomic neuropathy can affect your autonomic nervous system, such as your heart, bladder, lungs, stomach, and intestines, this includes difficulty swallowing, constipation or uncontrollable diarrhea, bladder problems, erectile dysfunction, a decrease or increase in sweating, sharp drops in blood pressure, and many more (8).

In conclusion, studies show that ALA is able to help alleviate the symptoms of diabetes and diabetic neuropathy. However, the right management of diabetes, such as the intake of its medication, such as metformin, and diet control, together with physical activity, must be done side by side.

References

1. National Institute if Diabetes, Digestive and Kidney Disease (NIDDK). United States Department of Health and Human Services. What is Diabetes? https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes#:~:text=Diabetes%20is%20a%20disease%20that,to%20be%20used%20for%20energy. (Accessed on June 16, 2020).
2. National Diabetes Institute of Malaysia (NADI). https://www.diabetesmalaysia.com.my/article.php?aid=8#:~:text=Your%20target%20blood%20glucose%20levels,in%20the%20last%203%20months. (Accessed on June 16, 2020).
3. Clinical Practice Guideline (CPG) for Management of Diabetes Mellitus Type 2. 5th Ministry of Health Malaysia (MOH). https://www.moh.gov.my/moh/resources/Penerbitan/CPG/Endocrine/3b.pdf (Accessed on June 16, 2020).
4. Mayo Clinic. Diabetes. https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444 (Accessed on June 16, 2020).
5. Alpha Lipoic Acid Supplement. https://www.webmd.com/diabetes/supplement-guide-alpha-lipoic-acid (Accesed on June 16, 2020).
6. Saeid Golbidi, Mohammad Badran and Ismail Laher. Diabetes and Alpha Lipoic Acid (2011). Frontiers in Pharmacology. Journal of Pharmacology.NCBI. DOI 10.3389/fphar.2011.00069
7. Diabetes Action. Alpha Lipoic Acid. https://diabetesaction.org/article-alpha-lipoic-acid#:~:text=While%20most%20of%20the%20research,of%20oxidative%20stress%20and%20inflammation. (Accessed on June 16, 2020).
8. Alpha Lipoic Acid (ALA) and Diabetic Neuropathy. https://www.healthline.com/health/alpha-lipoic-acid-and-diabetes (Accessed on June 16, 2020).

Durian or ‘King of fruit’ is a well-known fruit for its smell. Anthony Bourdain, the late renowned food critic describes durian as “It smelled like you buried someone holding a big wheel of Stilton (cheese) in his arms, then dug him few weeks later” (1). That is to describe how horrible the smell of durian is, but to certain people who like to eat durian the smell of durian to them is heaven!

Durian actually has more than 30 species but the one that people usually eat are about 8 species only, due to its exotic nature, people have started to commercialized durian even to the international level. The most common durian being exported and widely consumed is Durio Zibethinus (2).

Due to its popularity, people started to questioning about durian health benefits, whether it is good or bad for health? Unlike apple, orange, guava and many other common fruits where people always equate it to “an apple a day keeps the doctor away” which means, consuming all these fruits are going to make you healthier, since it is packed full with nutrients that is good for body. For durian, the opinion regarding its health effect is mixing, some people say that it is good for health and can even be used to alleviate infertility or PCOS, Polycystic Ovarian Syndrome  and some people say that it is heaty thus cannot be consumed too much etc. (3).

In general, durian is considered a safe fruit to eat just like any other fruit, but since durian has high calorie value, thus it is not advisable to consume in large amount unlike other fruits. Look at the infographic below to understand, calorie in durian in comparison with other fruits (4).

Here is the calorie of durian per seeds, surprisingly eating  5 seeds of durian is equivalent to a bowl of rice! ANDDDD IF A DURIAN CONSISTS OF 15 SEEDS IT IS EQUIVALENT TO 3 BOWL OF RICE! Thus, the recommended intake of durian is only 2-3 seeds, which is equivalent to about per serving of fruits or 90 kcal.

Though, it is crystal clear here that it is safe to eat durian within recommended amount, but there are people who should be even more cautious in consuming durian, that is people who are obese, people who have diabetes and people who have kidney problem. As for people who are obese and diabetes, it is due to its high calorie, high carbohydrate and high fats value thus should be extra careful on the consumption of durian. Whereas for people with kidney problem or undergoing dialysis, due to high potassium content in durian and it is difficult for their body to excrete potassium, thus, they must avoid eating TOO MUCH durian at all cost (4)!

Apart from its high calorie content durian has many benefits as well. It has high antioxidant effect, which makes it a potent fruit to fight against cancer. Durian contains high vitamins, nutrients and organic chemicals that function as antioxidant. All these antioxidants are vital in scavenging the free radicals, that potentially mutated and becoming cancer cells. Which is why it is very important to consume food that is high in antioxidant. It also contains high vitamin C, vitamin B complex and vitamin E, as well as phytonutrients that battle cancerous cells (2).

Durian also, is found to helps in maintaining healthy bones due to its high potassium content. It can help in alleviating depression and sleeping problem, for it contain tryptophan – a natural sleep-inducing compound, that can increase level of serotonin and melatonin for better sleep and emotion management. Durian also contain high fibre which can aids in digestion and helps in infertility for it has high estrogen hormone for conceiving (2).

Albeit durian has many health benefits, when it comes to its consumption with other foods and beverages such as alcohol, it is said that it can interfere with liver function. In detail, durian contain sulphur-containing volatiles which can inhibit the enzyme aldehyde dehydrogenase (enzyme that helps in process alcohol), thus explaining why consuming durian together with alcohol is a deadly mixed (4).

As for the consumption of durian with paracetamol, there is no study on human has been conducted, so far. But there is study on lab rat regarding this. The study shows that, rat that receive paracetamol and durian gives sign of hypothermic effect (significant drop in temperature) thus explain that the two mixture is toxic. However, the mechanism of toxicity is still unknown. To be safe, it is not safe to consume durian together with paracetamol (5).

In conclusion, for people who does not have any health concerns, consume durian within the recommended intake and consume it in moderation, is very much advisable. While for those who have health concerns, eat durian very minimally, it is advisable to eat other types of fruit that have lower calorie count as compared to durian, but since it is in the season thus consume it very minimally with caution towards calorie intake from other food types as well is recommended.

References

1. The Star. Benefits of eating durian? Its rich in antioxidant but its fattening (2019). https://www.thestar.com.my/lifestyle/health/2019/09/10/eating-durian-healthy-or-not/ (Accessed on June 17, 2020). 
2. Tan M.C & Shyamala A. (2018). Exploring the Nutritional Content and Benefits of Durian (Durio Zibethinus). Institute of Bioproduct Development, Universiti Teknologi Mara. https://www.utm.my/ibd/project/exploring-the-nutritional-contents-and-benefits-of-durian-durio zibethinus/#:~:text=Durian%20is%20widely%20celebrated%20for,and%20protect%20against%20cardiovascular%20diseases. (Accessed on June 17, 2020). 
3. Reshma M. Ansari (2016). Potential Use of Durian Fruit (Durio Zibenthinus linn) as an Adjunct to treat Infertility in Polycystic Ovarian Synrdome (PCOS). PubMed. https://pubmed.ncbi.nlm.nih.gov/26778225/ (Accessed on June 17, 2020). 
4. International Medical University (IMU). Can A Durian A Day Keep the Doctor Away? http://imunews.imu.edu.my/people/can-a-durian-a-day-keep-the-doctor-away/ (Accessed on June 17, 2020).
5. A. Chua., H. Nurhaslina., S.H. Gan. (2008). Hyperthermic Effect of Durio Zibethinnus and Its Interaction with Paracetamol. https://pubmed.ncbi.nlm.nih.gov/19271022/#:~:text=Because%20durian%20(Durio%20zibethinus)%2C,a%20risk%20of%20toxic%20effects 

L-Carnitine is an amino acid that the body produces. L-carnitine assists the body in converting fat into energy. In other words, L-carnitine aids the body's energy production. L-carnitine is essential for heart and brain function, muscle movement, and a variety of other processes in the body (1).

How does it work? 

Many studies have found that L-carnitine can improve insulin sensitivity. It improves insulin sensitivity, allowing the body to convert food into energy. Here's a general overview of how food is converted into energy or fat in the body.

Glycogen is created when food is consumed and stored in the body until it is needed again (2). Insulin is an enzyme that converts the glucose in the food into glycogen.

The Overall pathway

This is where L-carnitine plays its role. Mice fed a high-fat diet are able to lower their blood glucose levels when L-carnitine supplementation is given to them, as opposed to mice fed a high-fat diet without the supplement (3).

Another human study found the same result, which is that L-carnitine supplementation reduces insulin resistance and improves insulin sensitivity. The study also suggests that current diabetes patient management, which includes diet modification, medication administration, and physical activities, may be improved in the future with the consumption of supplements such as L-Carnitine (4). The study also suggests that consuming 3g of L-carnitine per day may improve diabetes symptoms, but this must be accompanied by medical professional consultation (4). However, some studies suggest that L-carnitine consumption may have some side effects, so the safe consumption level is less than 2g/day.

Due to the possibility that the general public might mistake it for a "magic pill" that would allow diabetes patients to eat whatever they wanted after taking it. The answer is no! A diabetes patient must still adhere to the diabetes diet, physical activity, and diabetes medication, but because diabetes is a progressive disease where the condition can worsen progressively, all actions, including supplement intake, may slow its progression (4).

Where can L-carnitine be found?

Apart from supplemented products, L-carnitines can be found naturally in foods such as beef and fish.

Beef: 81 mg/ 3 ounces

Pork: 24 mg/ 3 ounces

Fish: 5 mg/ 3 ounces

Chicken: 3 mg/ 3 ounces

Milk: 8 mg/ 3 ounces

References

1. WebMD. L – Carnitine. https://www.webmd.com/vitamins/ai/ingredientmono-1026/l-carnitine (Accessed on July 13, 2020).

2. Feedback Loop of Insulin and Glucagon. https://www.biologycorner.com/2017/08/22/feedback-loops-insulin-andglucagon/ (Accessed on July 13, 2020).

3. Randall L. Mynat (2009). Carnitine and Type 2 Diabetes. NCBI. PMC Journal. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5707127(Accessed on July 13, 2020). 

4. Mingroe, Graco et al., (1999). L- carnitine Improves Glucose Disposal in Type 2 Diabetes Patient.  https://pubmed.ncbi.nlm.nih.gov/10067662/#:~:text=Conclusions%3A%20L%2Dcarnitine%20constant%20infusion,also%20observed%20in%20normal%20subjects (Accessed on July 13, 2020).

5. Healthline. L – Carnitine: Benefits, Sides Effects, Sources and Dosage.https://www.healthline.com/nutrition/l-carnitine (Accessed on July 13,2020).

Diabetes is a type of chronic disease; it occurs when the glucose level in the blood is higher than normal. It is one of the leading causes of heart problems as well. In Malaysia, according to the National Health Morbidity Survey (NHMS) 2019, there are about 3.9 million people aged 18 years and older who have diabetes. Diabetes affects one out of every five adults, and the prevalence is higher in states such as Negeri Sembilan (33.2%), Perlis (32.6%), and Pahang (25.7%). The prevalence of people who have undiagnosed diabetes in Malaysia is high as well; undiagnosed diabetes occurs when people have never checked their blood glucose level in their entire life or check it rarely (1).

To understand diabetes better, it occurs when the pancreas in the body does not produce enough insulin anymore, or when the insulin is not working well anymore. Insulin is needed in order to transport glucose from the blood vessels to cells and tissues. When insulin is insufficient, glucose cannot be transported to the intended organ, thus causing a high glucose level in the blood vessels and causing damage to the organ and tissue that do not get sufficient glucose to function, and also causing damage to the blood vessels that are exposed to a high glucose level (2).

There are various complications due to diabetes, such as kidney problems, heart problems, diabetic food disease, nerve problems, and eye problems. A nerve problem is when a diabetic person starts to feel tingling and numbness in their peripherals (legs and hands), which is commonly referred to as diabetic neuropathy. Diabetic foot disease, or gangrene, occurs when a diabetic person is exposed to a wound. It must be handled with care since it can be dangerous to the extent of amputation. Eyes problem or diabetes retinopathy is the one that can lead to blindness, that we are going to discuss in detail in this article (2,3).

Diabetes retinopathy is the condition in which the retina is damaged, and it is a diabetic complication. When the glucose level in the blood is high, it causes a blockage in the blood vessels, causing the blood vessels to rupture easily. thus causing impaired vision and blindness (2, 3).

In the early stages, there are no significant symptoms associated with this problem; however, as things get more serious, people will experience seeing floaters or black dots in their vision. They will then start to experience obscure vision, night blindness, and diplopia (seeing a double image) (2, 3).

Risk factor to this problem includes those who have been diagnosed with diabetic in the long time (more than 5 years), those who have poor control of blood glucose level, cholesterol level, blood pressure level and low haemoglobin. Those who have gestational diabetes are also at high risk of getting diabetes retinopathy (2, 3).

There are two types of diabetic retinopathy (2,4);

Non – Proliferative Diabetic Retinopathy

Non-proliferative diabetic retinopathy (NPDR) is the early stage of the disease, in which symptoms will be mild or non-existent. In NPDR, the blood vessels in the retina are weakened. Tiny bulges in the blood vessels, called microaneurysms, may leak fluid into the retina. This leakage may lead to swelling of the macula.

Proliferative Diabetic Retinopathy

The more advanced form of the disease is proliferative diabetic retinopathy (PDR). Circulation issues deprive the retina of oxygen at this stage. As a result, new, vulnerable blood vessels can form in the retina and the vitreous, the gel-like fluid that fills the back of the eye. Blood from the new blood vessels may leak into the vitreous, clouding vision.

In order to prevent diabetic retinopathy from occurring, it is recommended for individuals with diabetes to control their blood sugar level, control their blood pressure level, stop smoking, regularly exercise, and maintain their ideal weight. Apart from these, people with diabetes may as well conduct yearly eye screenings. Eye screening for diabetics will be conducted using a fundus non-mydriatic camera, where an image of the eyes will be captured. Optometrist, eyes doctor, or eye specialist will then grade the image to see whether the eye's codition is normal or abnormal. Bleeding and swelling in the retina, an abnormal optic disk, a torn retina, and other abnormal conditions are examples of abnormal conditions. 

References

1. National Health Morbidity Survey (NHMS) 2019. Institute Kesihatan Umum (IKU), Kementerian Kesihatan Malaysia.
2. Fatanah Ismail. Diabetes Mellitus (2008). MyHealth Portal. Kementerian Kesihatan Malaysia. http://www.myhealth.gov.my/en/diabetes-mellitus-3/ (Accessed on August 21, 2020).
3. Ainayanti Adnan. Diabetis: Mesti Jalani Pemeriksaan Mata (2016). MyHealth Portal. Kementerian Kesihatan Malaysia. http://www.myhealth.gov.my/diabetes-mesti-jalani-pemeriksaan-mata/ (Accessed on August 21, 2020).
4. Diabetic Retinopathy (n.d). American Optometric Association (AOA). https://www.aoa.org/healthy-eyes/eye-and-vision-conditions/diabetic-retinopathy?sso=y (Accessed on August 21, 2020).

Fiber is a type of carbohydrate that our body is unable to digest. Though most carbohydrates are broken down into sugar molecules, fiber cannot be broken down into sugar molecules, and instead it passes through the body undigested. Fiber helps regulate sugars in the body and helps keep hunger and blood sugar in check.

Children and adults need at least 20 to 30 grammes of fiber per day for good health. It can be obtained by consuming a diet rich in whole grains, vegetables, legumes, nuts, and fruits.

There are two types of fiber: soluble fiber and insoluble fibre.

• Soluble fiber is a type of fiber that dissolves in water and can help lower glucose levels and blood cholesterol levels. Foods with soluble fiber include oatmeal, nuts, beans, lentils, apples, and blueberries.

• Insoluble fiber is a type of fiber that does not dissolve in water. It can help food move through the digestive system, promoting regularity and helping to prevent constipation. Foods with insoluble fibers are wheat, whole wheat bread, whole grain couscous, brown rice, legumes, carrots, cucumbers, and tomatoes.

There are various studies confirming that consumption of a diet high in fiber helps to make the overall body function healthier.

Heart Health

In a Harvard study with over 40, 000 male health professionals, researchers found that consumption of a high-fiber diet reduced the risk of getting coronary heart disease by 40%. Another study conducted by Harvard among female nurses also found similar findings: a high-fiber diet lowers the risk of metabolic syndrome (a combination factor of heart disease and diabetes). These factors are high blood pressure, high insulin levels, excess weight, a high triglyceride level, and a low HDL level (good cholesterol level).

Eat Healthy Food

It is commonly assumed that the health of your eyes is unrelated to what you consume, but the truth is that it is. Consuming nutrient-dense foods will allow you to maintain good health, thereby avoiding complications that may arise in your eyes as a result of your health complications.

As part of a healthy diet, choose foods high in antioxidants, such as vitamins A and C, which have been shown to benefit eye health. Foods high in vitamins A and C include green leafy vegetables and foods with bright colours like orange and red. It also contains carotenoid, which is beneficial to the eyes. Carotenoid is an antioxidant found in plants that are brightly coloured, such as red, orange, yellow, and green. Aside from that, it can act as a cancer-fighting agent. Carotenoid works in the macular (the most sensitive part of the retina responsible for vision production and colour perception).

Lutein and zeaxhantin are types of carotenoids.

Inadequate antioxidant intake, alcohol consumption, or saturated fat consumption may result in free-radical reactions that harm the macula. High-fat diets can also cause deposits in the arteries that restrict blood flow. Because of the small size of the blood vessels that feed the eyes, they are especially sensitive to this.

Exercise regularly

By exercise regularly, body will have lower risk of getting various kind of metabolic disease such as diabetes, kidney problem and heart problem, thus lower the risk of getting complication that can impair eyes function. Example of metabolic disease that can impair eyes directly is, diabetes, which in the later stage can cause diabetic retinopathy. The condition where blood vessels of the light-sensitive tissue at the back of the eye (retina) is damaged. At first, it may cause no symptoms or mild blurry vision, eventually it can cause blindness.

Wear sunglasses

The American Academy of Opthalmology (AAO) encourages people to protect their eyes from the sun's harmful UV rays. Sunglasses are more than just a fashion statement; they are also a wise and healthy choice. Long-term sun exposure without adequate protection can increase the risk of eye disease such as cataract, macular degeneration, eye growth, and a rare form of eye cancer.

While short-term exposure can also damage the eyes. Sun reflecting off water can cause a painful sunburn on the front part of the eye, called photokeratitis. It causes redness, blurry vision, sensitivity to bright light, and in rare cases, even temporary vision loss.

The good news is that prevention is simple: Wear sunglasses that block 99 to 100 percent of both UVA and UVB radiation.

Quit smoking

Smoking is not only bad for your lungs. It can hurt your eyes, as well. Smoking increases your risk of eye diseases like macular degeneration and cataracts.

Eye care in conclusion

People usually take their eyesight and health for granted; it was only when we began to lose the ability that we began to take it seriously. Start taking care of your eyes now by doing the above. If you are constantly looking at a screen, you can also give your eyes a break every 20 minutes by looking 20 feet away for 20 seconds. If you have a family history of eye problems, schedule a comprehensive dilate eye exam on a regular basis. If you wear contact lenses, make sure to disinfect them and replace them on a regular basis. Also, remember to wash your hands before touching your eyes or face

References

• National Institute of Health (NIH). National Eye Institute (NEI) (July 2020). Keep your eyes healthy. https://www.nei.nih.gov/learn-about-eye-health/healthy-vision/keep-your-eyes-healthy (Accessed on July 28, 2020).
• Bausch + Lomb. Healthy Eyes. https://www.bausch.com/vision-and-age/20s-and-30s-eyes/healthy-eyes (Accessed on July 28, 2020)
• All About Vision. How carotenoid can keep your eyes healthy. https://www.allaboutvision.com/nutrition/carotenoids.htm#:~:text=According%20to%20nutrition%20research%2C%20an,macular%20degeneration%20later%20in%20life. (Accessed on July 28, 2020).
• Mayo Clinic. Diabetic Retinopathy. https://www.mayoclinic.org/diseases-conditions/diabetic-retinopathy/symptoms-causes/syc-20371611#:~:text=Diabetic%20retinopathy%20(die%2Duh%2D,or%20only%20mild%20vision%20problems. (Accessed on July 28, 2020)
• American Academy of Opthalmology. Sunglasses your prescription for eye health. https://www.aao.org/newsroom/news-releases/detail/sunglasses-your-prescription-eye-health (Accessed on July 28, 2020).

In this fast-changing world that we are in today, people want things to be done quick and always ready! People use various kind of devices and gadgets to speed up process of doing work. Initially, computer was built not for the sake of email and doing work, but it is actually to calculate and tabulate census for United States of America population since the population has grown bigger, it was started with a machine sort of punch card machine in 1880, where due to this the government save about $5 million in order to tabulate the census. From that sort of punch card machine, Alan Turing then presents another universal machine which capable of computing anything that is computable, the central concept of modern computer today is based on his ideas. Few years later, in 1939 Hewlet – Packard is founded by David Packard and Bill Hewlett in California, until today the computer that we are using is evolve from time to time, to the small smartphone on our hands that is capable of doing so many thing just like the bulky desktop (1).

All these technologies make us even more connected to devices like smartphone to connect with other people or to get things done. From paying bills, to designing, networking, sales, work, presentation, you name it all must be done using laptop, computer, smart phone, and the devices. The fact is everyone everyday is looking at the screen for long time, when the recommended hour to look at the screen is only 2 hours per day (2).

Why screening is bad for eyes?

White light that we see from sun and electronic devices is a combination from red, orange, yellow, green, blue, indigo, and violet light. Each of these lights has different energy and wavelength. Rays on red have longer wavelength and less energy, while the blue rays have shorter wavelength and more energy. Light that looks white can have a large blue component, which can expose the eye to a higher amount of wavelength from the blue end spectrum (3).

Sun also have this blue light, but blue light exposure from screen is small compared to exposure from sun, thus why makes it bad for eyes. Furthermore, screen exposure has closer proximity to eyes and the time spent looking at screen is longer than at the sun (3,4).

Almost all visible blue light penetrates the eyes through cornea, lens and reaches the retina, due to this, it makes eyes prematurely aging.

Blue light from computer screens and digital devices can decrease contrast leading to digital eyestrain. Fatigue, dry eyes, bad lighting, or how you sit in front of the computer can cause eyestrain. Symptoms of eyestrain include sore or irritated eyes and difficulty focusing. Apart from that, studies also suggested that continued exposure to blue light over time could lead to damaged retina cells. This condition can cause problems like age-related macular degeneration (4).

Macular degeneration is the result of photoreceptor cell death in the retina. The function of the photoreceptor cells is to capture visual images and signal them to the brain using a molecule called retinal. Retinal, which is produced by the eye, is triggered by blue light and causes various chemical reactions. These reactions within the eye can be poisonous to the photoreceptor cell molecules rendering them damaged. When these photoreceptor cells die, there’s no regeneration (4).

What can we do?

With the current work requirements where most of work and stuff need to be accomplished through the usage of electronic devices thus screening is very much essential, makes it even harder to take care eyes from the screen. No! There are actually ways to take care of your eyes still, apart from consume food that is high with antioxidants and vitamins that can improve eyesight condition you may also try and practice the tips below (5)!