Another believe that juicing is better than eating the whole fruits and vegetables because body can absorb better and let digestive tract rest from digesting fiber. If ones consider blending fruit, that is even better since edible fiber in it makes we feel full, so it promotes satiety(1).

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

Three longitudinal prospective cohort studies found out 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 squeeze for its juice, what left inside the fruit juice are 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 are about the same, which is about 20-26g of sugar per cup (3).

The reasons why fruit juice contain higher sugar content as compared to fresh fruit even when the fruit juice is the 100% fruit juice without the addition of anything else is because of, in order to make the 250ml of orange juice as an example two medium size of orange is needed, and that is only 250ml, since when it is in liquid form people tend to consume it even more thus more no of fruits needed. As the number of fruit increases so does the sugar in it but not the fiber inside, which in returns make it have loads of sugar(1,3,4,7,8)!

According to 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 level when ingested(8).

The similar case goes to smoothies  not only that it has lot of sugar from multiple number of fruits, but  various kind of protein based food like yogurt, milk, almond milk etc that is mixed together with it will increase it calorie as well (4).

High sugar level in both of these drinks make it a high calorie beverages thus poses the same effect like high calorie food, which can lead to weight gain. As we know that, Malaysia is the fattest country in Southeast Asia, one of the contributing factor behind is the lack of knowledge on what can increase weight and what cannot. 

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

Study on the composition of grapefruits with different method of household processing also found out that, composition of antioxidant on blended grapefruit has higher concentration of the beneficial compound as compared to juicing or hand squeezing (5).

However, as for the absorption of beta carotene, study found out that fruit and vegetables juice makes beta carotene absorb better as compared to blending or eating raw fruit. This is due to the fact that fiber hinder the absorption of beta carotene (6).

The takeaway message

Eating raw fruit, juicing and blending all has its pro and cons. What important is always take into account the amount of sugar content and fiber content. All in all make sure that you have balance, nutritious and moderate diet as per suggested by Ministry of Health, eat 3 servings of vegetables/day and 2 servings of fruits/day. Varied the way vegetables and fruit cooked or served and eat 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. 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].

Ramadhan is the month where Muslims around the world fast from dawn to dusk. Healthy Muslims need to fast, begin with the pre-dawn meal called ‘suhoor’ and break the fast at dusk which call ‘iftar’. Apart from Ramadhan, there are many other occasions where other religions around the world are also practicing fasting. The difference is only the method and the do’s and don’ts during the ritual. Since according to World Health Organization (WHO) there is evidence suggests that fasting have positive effects on health (1), there are also people who fast in order to lose weight (E.g: Intermittent fasting) and for health purposes.

What happened to your body during fasting?

During fasting, when no food and drink is consumed, body uses its stored carbohydrate (in the liver and muscles)  provide energy. Once all the calories from foods consumed have been used up, body will use the excess food that we consume in the form triglycerides (fat) to provide us with energy. This is when people usually loss weight.

Our body cannot store water so during fasting the kidneys conserve as much water as possible by reducing the amount lost in urine. However, body cannot avoid losing some water during certain process in the body such as through your skin (perspiration) and when you breathe (2).

Due to all these changes during fasting, we must to make sure that we practice healthy eating during fasting in order to make sure body that our body is able to cope with all this changing process by not losing nutrient needed but instead loss the unwanted fats, sugars, and cholesterol in the body.

4 Tips to eat healthily while fasting in Ramadhan

1.Do not skip ‘suhoor’

This is especially for special groups such as older people, adolescents, pregnant women, nursing mothers and as well as children who choose to fast. The meal for ‘suhoor’ must include vegetables, high fiber food can slow down the empty rates on the stomach and make individuals feel satiety. A serving of carbohydrates such as rice or bread (whole grain product is better) and protein – rich food such as egg or/ and dairy product are also a must.

Since ‘suhoor’ is very early in the morning and mostly people do not bother to cook for long time, thus people opt to fry their food, it is healthier to fry using air fryer where less fat (oil) is used, but apart from frying it is actually recommended to use other cooking method such as steaming or just stir fry since it use less oil.

During ‘suhorr’ also people tend to cook processed food such as sausages, nuggets etc, all these processed food actually contain high salt, it is better to avoid food that is high in salt, cause it will also makes one very thirsty later, thus food such as pickle, processed foods, salted meat and fish products, salty cheese and various types of ready-to-eat foods are best to avoid (1,2).

2. Keep hydrated

Make sure to drink 8 glass of water per day, still. Here is tip on how to drink 8 glass of water in Ramadhan according to Ministry of Health Malaysia (3).

Other than this, you can also increase water intake by consuming hydrating food. Try to add hydrating food such as watermelon, cucumber, tomato and green salad. You must also avoid caffeinated beverages such as coffee, tea and cola, because caffeinated beverages are diuretic (which means it makes one urinate more often when consumed) this will lead to dehydration as well. Soupy food also rich in water thus it is suggested to consume this kind of food when break the fast. During the day of the fasting period, when the temperature is high (E.g: noon) it is important to remain in a cool and shaded place and to avoid the sun (1,2).

3. Break the fast gently

When it is time for break the fast, avoid filling up on greasy foods in the form of cakes and deep-fried savory snacks. It is best to go for dates, fruit or nuts to satisfy your hunger. If you often get caught in the rush hour traffic, consider keeping these preferred choices handy in small containers in your handbag or backpack so you do not have to delay your breaking of fast. This will prevent you from getting overly famished at dinner after the prayers, where you risk overeating and causing indigestion (4).

In Islam also, it is a sunnah habit to consume dates when break the fast;

You may also try to consume date and water to break fast and perform maghrib prayer first, then only begin to eat  heavy meals, just as the suggestion from Ministry of Health Malaysia.

4. Moderation and variation

The changes to eating habits and lack of fluids during the day may cause constipation for some people. When you can eat and drink, consume plenty of high fiber foods, such as wholegrains, high fiber cereals, bran, fruit and vegetables, beans, lentils, dried fruit and nuts alongside plenty of fluids will help to ease constipation. Do some light physical activity, such as going for a walk after iftar or right before iftar in the evening will also helps with the constipation and indigestion after iftar.

While Ramadhan is time for people to reunite however during the pandemic of COVID19 it is best for people to not make a celebratory feast together. Iftar meals are often a time for celebration (of the day that you have successfully refrain yourself from eating and drinking) but it is still important not to go overboard when eating during Ramadan. Consuming a lot of deep fried, creamy and sweet foods may cause you to gain weight during Ramadan. Ramadan can be a good time to make changes to improve the balance of your diet that you can sustain in the longer term.

Be moderate in preparing ‘iftar’ and ‘suhoor’ menu. Moderation is the key when you go for grocery shopping as well. You can also practice ‘suku – suku separuh’ during ‘suhoor’ and ‘iftar’.

References

1. World Health Organization (WHO) (2020). Dietary Recommendation for the month of Ramadhan. http://www.emro.who.int/nutrition/nutrition-infocus/dietary-recommendations-for-the-month-of-ramadan.html (Accessed May 8, 2020)
2. British Nutrition Foundation (n.d). A healthy Ramadhan. https://www.nutrition.org.uk/healthyliving/seasons/ramadan.html?__cf_chl_jschl_tk__=75c06dff67f5c87204c0dc2cdd8343844c35c78f-1588901425-0-ATZP71yUnOxiGwGcgpUyrLmtTJ-b_aVnqESs0dUhbMEwJx2CMSYck_sO8RxelwmxumL_jHJv2_mGOGvWSHlXaS_XwkdLczerYyCCTS6sjsdD9iRqqIt7I_CiM5BqvX8mnxfvPxXSNRGVErKJz0u9Z-jdTIY4PV0TvLNPbbPWNeZ0FpQCI0OKjcEl-s-fgzbwiWzuJ6jfRtpYYwc37XdkKv5wE3APFD-rODoj4wdkXGHByASPcLGaYNiPWa_9x1AS7n4g0TY5EsWp3OHEeCmtpv3c4VZ3rn5QKzrtx788z_k0_J4rluYZx1CbGz3DcFaQIdFXGyIZAPcr2CYlI1MMnmlD-genvQspQrMxHnrOn6Ix2p7QlmZSgD0RKHKOIeG80w (Accessed May 8, 2020)
3. Kementerian Kesihatan Malaysia (KKM). Jabatan Kesihatan Negeri Pulau Pinang. https://web.facebook.com/jknpenang/posts/3729048157168283?_rdc=1&_rdr  (Accessed May 8, 2020).
4. Indra Balaratnam (2018). New Straits Times (NST). Eat Well Healthy Eating for Ramadhan. https://www.nst.com.my/lifestyle/heal/2018/05/367119/eat-well-healthy-eating-tips-ramadan (Accessed May 8, 2020).

Chocolate craving is purely sensory as it has a set of extremely appealing sensory characteristics. The fat in chocolate (cocoa butter) melts at body temperature producing a distinctive and pleasant oral sensation.  Moreover, chocolate also has a very attractive aroma (7).

There are several reasons people crave for chocolate and women tend to desire chocolate much more than men. Chocolate tend to boost your mood as well as to lower your stress level. It also contains some magnesium which women tend to be deficient in and thus this could explain why women seem to crave chocolate more than men. In general, people crave chocolate because it tastes good, it smells good and it feels awesome when it melts in our mouth (7).

The Science Behind Chocolate

Chocolate is a complex mixture which contains over 800 compounds. Dark chocolate, milk chocolate and ruby chocolate being the most recent which are made with varying proportions of chocolate, liquor, cocoa solids, cocoa butter, milk and sugar. Cocoa is a source of flavinoids and alkalinoids (theobromine and phenethylamine) and caffeine which act as stimulants to the central nervous system. It also contains cannabinoids-anandamide which is known to induce a state of happiness (2).

#1 Chocolate, the mood booster (6)!

Chocolate makes you feel happy and relax as it will release feel good neurotransmitters and thus, people often crave chocolate in stressful situation or crave when they are in need of comfort.

Dopamine is released into your brain when you eat chocolate which give you joy and make you happy as well as to lower your stress level. Serotonin allows us to be content, relieve depression and calming anxiety.

#2 Chocolate craving and magnesium deficiency (4)

Unstoppable chocolate craving may indicates magnesium deficiency which is most common in women. Magnesium deficiency may cause symptoms including migraine, irritability, anxiety, extreme fatigue, insomnia and lack of concentration.

So, if you find yourself suffering from these symptoms and crave chocolate it may not just be a sweet tooth you have. Try eating good quality dark chocolate bar or try magnesium supplement to curb those craving that you have.

#3 Chocolate craving and menstrual cycle (8)

Food cravings are one of the symptoms of premenstrual syndrome, also known as  PMS. In general, PMS is caused by hormonal fluctuations and how they affect chemical messengers in the brain, neurotransmitters. Antioxidant, anandamide in chocolate has a calming effect when combined with serotonin and tryptophan. These chemicals can boost your mood and make you feel better during your period.

#4 Antioxidants in chocolate

Dark chocolate rich in minerals such as iron, magnesium, zinc as well as contains several compounds that possess antioxidant properties (flavanols and polyphenols). When comparing the amount of antioxidants of dark chocolate, hot chocolate mix and fruit juices, study found that both dark chocolate and cocoa had a greater antioxidant capacity and greater total flavanols and polyphenols. Decent amounts of antioxidants in dark chocolate may promote healthy blood flow and blood pressure as well as anti-aging (9).

However, we would need to consume large amount of dark chocolate to get enough antioxidants to see the benefits. Milk chocolate often the chocolate of choice and it has negligible antioxidant content, especially for the amount of sugar it contains. Most processed chocolate contains high fructose corn syrup and other additives.

If you are in it for the antioxidants, consume really high quality dark chocolate with minimal sugar. If antioxidants are your priority, consider other foods like organic berries.

Eat It or Leave It (1)?

Most chocolate falls into one of three categories: milk chocolate, dark chocolate or white chocolate. The darkness of chocolate is determined by the proportion of cocoa solids mixed with cocoa butter and sugar. Milk chocolate contains about 10% cocoa liquor that contains both non-fat cocoa solids and cocoa butter compared with a minimum 35% found in dark chocolate. Meanwhile, white chocolate contains only cocoa butter.

The amount of cocoa solid in an important indicator of the amount of dietary flavonoids which are found in fruits and vegetables. Most dark chocolate is high in flavonoids but milk chocolate is usually the chocolate of choice due to it sweet taste (about twice the sugar of dark chocolate). If you enjoy chocolate, choose the high quality dark chocolate with minimal sugar. Eat it in moderation because you like it, not because you think it is good for you.

References

1. American Heart Association. 2019. Are there health benefits from chocolate? Available from https://www.heart.org/en/news/2019/02/12/are-there-health-benefits-from-chocolate [Accessed on 30 April 2020].
2. Chinmayi, T., S. 2019. The Science behind Chocolate Cravings. Research Matters. Available from https://researchmatters.in/sciqs/science-behind-chocolate-cravings [Accessed on 30 April 2020].
3. Corinne, O., O. 2018. Does My Chocolate Craving Mean Anything? Healthline. Available from https://www.healthline.com/health/craving-chocolate#hunger [Accessed on 30 April 2020].
4. Emily, W. 2019. Constantly craving chocolate? Magnesium deficiency could be the reason. BetterYou. Available from https://betteryou.com/health-hub/constantly-craving-chocolate-magnesium-deficiency-could-be-the-reason/ [Accessed on 30 April 2020].
5. Johnson, J. 2017. What causes food cravings? Medical News Today. Available from https://www.medicalnewstoday.com/articles/318441#causes [Accessed on 30 April 2020].
6. Madi, J. 2017. There’s a psychological reason why you crave chocolate all the time. BUSINESS INSIDER. Available from https://www.businessinsider.com/heres-the-reason-why-you-crave-chocolate-2017-7?IR=T [Accessed on 30 April 2020].
7. Paul, R., Elenor, L. and Carn, S. 1991. Chocolate Craving and Liking. Appetite 17: 199-212.
8. Sara, T. 2019. Ack! I need chocolate! The science of PMS food cravings. The Conversation. Available from https://theconversation.com/ack-i-need-chocolate-the-science-of-pms-food-cravings-116341 [Accessed on 30 April 2020].
9. Stephen, J., C., Amy, G., P., Jeffrey, W., H., Mark, K., P., Julie, M., Larry, H., Debra, L., M. 2011. Cacao seeds are a “Super Fruit””: A comparative analysis of various fruit powders and products. Chemistry Central Journal 5(5): 1-6.
10. Susan, Y. 2003. Sugar and Fat: Craving and Aversions. The Journal of Nutrition 133 (3): 835-837.

Setiap tahun Hari Raya Aidilfitri ialah pada 1 Syawal tahun Hijrah. Perayaan tersebut juga dikenali sebagai Hari Raya Puasa atau Hari Raya Fitrah atau Hari lebaran. Hari Raya Aidilfitri merupakan sambutan yang diraikan oleh umat Islam di seluruh dunia setelah berjaya menjalani ibadah puasa sepanjang bulan Ramadhan.

Antara amalam – amalan tradisi yang dilakukan semasa Hari Raya ialah amalan ziarah – menziarahi sanak – saudara dan jiran tetangga. Amalan mengeratkan silaturahim ini sangat digalakkan dalam Islam bagi memohon kemaafan di antara satu sama lain. Akan tetapi oleh kerana Hari Raya Aidilfitri tahun ini ialah pada musim Perintah Kawalan Pergerakan Bersyarat maka, ikutlah saranan untuk beraya dengan selamat dalam kita menjauhi wabak COVID19. Walaupun sesetengah daripada kita ada yang telah mendapat vaksin tetapi masih ramai yang belum, dan sudah divaksin bukan bermakna anda tidak boleh dijangkiti wabak COVID19.

Semasa bulan Ramadhan sebelum ini, ramai di antara kita mengambil kesempatan menurunkan berat badan dan makan secara sihat. Walau bagaimanapun, apabila tiba musim perayaan, kebanyakan kita mengalami penambahan berat badan. Berat badan yang berjaya diturunkan sepanjang 30 hari menjalani ibadah puasa mungkin meningkat semula hanya selepas 15 hari menyambut Hari Raya. Hal ini adalah kerana, hari raya adalah masa untuk menikmati juadah hari raya yang hanya setahun sekali dimasak dan dimakan bersama – sama oleh kerana itu ramai yang mengambil kesempatan ini untuk makan juadah raya tanpa mengira jumlah kalori dan panduan pemakanan sihat (1).

Sebenarnya pemakanan sihat sangat mudah diikut walaupun ketika hari raya. Makan dengan sihat bukan bermaksud kita tidak dapat menikmati juadah hari raya akan tetapi makan dengan kadar yang betul dan dengan cara penyediaan makanan yang lebih sihat. Kita dapat bahagikan amalam pemakanan sihat ketika hari raya kepada dua kategori iaitu semasa penyediaan makanan dan semasa menikmati hidangan hari raya.

7 Tips Sediakan Hidangan Sihat di Hari Raya (1,2,3)

1. Kurangkan gula, minyak dan lemak dalam penyediaan biskut dan kek.

Gunakan ½ atau ¾ daripada kuantiti gula yang biasa digunakan semasa menyediakan biskut dan kek. Jika perlu, gunakan gula gantian bagi mendapatkan biskut atau kek yang sempurna tekstur dan rasanya.

2. Gunakan daging yang telah dibuang lemak atau ayam yang telah dibuang kulit.

3. Kurangkan mensajikan makanan yang bersantan, bergoreng dan berminyak.

4. Gantikan penggunaan santan dengan susu rendah lemak dalam penyediaan rendang dan kuah lontong.

5. Potong ayam atau daging dalam size yang kecil.

6. Gunakan ramuan tinggi serat untuk membuat  biskut dan kuih raya seperti tepung bijirin penuh, oat dan buah prun.

7. Kurangkan penggunaan pewarna tiruan dalam penyediaan kuih-muih, kek dan puding. Sebaliknya gunakan pewarna semulajadi seperti dari sumber daun pandan dan sebagainya.

7 Tips Makan Secara Sihat Di Hari Raya (1,2,3)

1. Makan dalam saiz hidangan atau kuantiti yang kecil.

Pemilihan pinggan yang lebih kecil membantu dalam mengurangkan pengambilan makanan lebih – lebih lagi jika anda makan secara buffet.

2. Pilih makanan yang rendah kalori seperti buah-buahan serta makanan yang kurang minyak, lemak dan santan.

3. Pilih makanan tinggi serat untuk mengelakkan sembelit.

4. Hadkan pengambilan makanan yang manis dan berlemak seperti biskut raya dan dodol.

Anda juga boleh mengehadkan pengambilan kuih-muih atau kek semasa hari raya kepada hanya 5 biji kuih raya sehari dan kurangkan pengambilan makanan manis yang lain.

5. Pilih buah- buahan segar sebagai pencuci mulut.

6. Hadkan pengambilan makanan yang tinggi kandungan garam seperti kerepek

7. Minum air kosong berbanding minuman berperisa, minuman berkarbonat dan minumam yang manis.

Senang bukan? Ikutilah panduan pemakanan sihat semasa hari raya ini, agar usaha anda untuk menurunkan berat badan sepanjang bulan Ramadhan tidak sia – sia. Bagi individu yang mempunyai masalah kesihatan, hari raya bukanlah tiket untuk anda menikmati juadah tanpa mengambil kira faktor kesihatan ya!

Akhir sekali, selamat menyambut Hari Raya Aidilfitri, semoga hari raya ini memberi keceriaan kepada kita semua!

Rujukan

1. Kementerian Kesihatan Malaysia (KKM). Bahagian Pemakanan. Perancangan dan Pemilihan Menu Sihat Rumah Terbuka Aidilfitri. http://nutrition.moh.gov.my/wpcontent/uploads/penerbitan/buku/Menu%20Rumah%20Terbuka%20Hari%2 0Raya%202013.pdf

2. Kementerian Kesihatan Malaysia (KKM). Bahagian Pemakanan. Makan Secara Sihat di Hari Raya. https://www.infosihat.gov.my/index.php/multimedia/bukukecil/item/makan-secara-sihat-di-hari-raya

3. Jabatan Kesihatan Negeri Perak. Kementerian Kesihatan Malaysia (KKM), bahagian Pemakanan. Makan secara sihat di hari raya. http://jknperak.moh.gov.my/v4/index.php/my/arkib-berita/69-informasikesihatan/509-makan-secara-sihat-di-hari-raya.html

Tinjauan Kebangsaan Kesihatan Malaysia atau Nama Inggerisnya, National Health Morbidity Survey Malaysia (NHMS) adalah survei kesihatan yang dibuat setiap empat tahun oleh Kementerian Kesihatan Malaysia (KKM) bertujuan untuk mengenal pasti status kesihatan rakyat Malaysia. Tinjauan ini adalah tinjauan yang melibatkan negeri di seluruh Malaysia.

Tinjauan ini mengkaji beberapa perihal aspek kesihatan yang terpenting seperti penyakit tidak berjangkit yang dialami oleh rakyat Malaysia iaitu obesiti, kencing manis, darah tinggi, dan masalah kolesterol. Ia juga merangkumi aspek pemakanan seperti  pengambilan makanan dan minuman sihat, aspek kesihatan mental, kesihatan seksual dan pengambilan dadah. Selain daripada itu, tinjauan ini juga mengkaji aspek yang melibatkan perkhidmatan kesihatan di Malaysia.

Terdapat beberapa perkara serius menurut hasil dapatan ini iaitu;

1 daripada 2 dewasa di Malaysia adalah obese!

Obese atau obesity adalah masalah lebihan berat badan yang di alami oleh individu, yang berpunca daripada pelbagai faktor. Namun, apa yang lebih membimbangkan adalah, menjadi obese ini sendiri adalah merupakan risiko utama kepada masalah kesihatan seperti kencing manis, darah tinggi, kolesterol, masalah jantung serta masalah kesihatan yang lain – lain lagi.

Jika perkara ini berterusan, bayangkan setiap orang yang anda jumpai separuh daripadanya adalah obese dan mempunyai kencing manis, darah tinggi dan sebagainya!! Menurut kajian ini, inidividu yang mengalami obesity tertinggi adalah wanita iaitu sebanyak 57.6%, kaum india iaitu sebnayak 63% dan dalam kalangan mereka yang berumur 55 – 59 tahun.

Antara lain perkara yang membimbangkan ialah masalah kencing manis dalam kalangan rakyat Malaysia.

1 daripada 5 dewasa mengalami masalah diabetes!

Diabetes atau kencing manis adalah keadaan di mana paras gula dalam darah menjadi tinggi. Hal ini berpunca daripada kekerapan pengambilan makanan yang tidak sihat. Makanan yang tinggi karbohidrat, gula dan lemak dan gaya hidup yang tidak aktif.

Selain daripada peratusan obesity yang semakin meningkat saban hari, yang mengeruhkan keadaan ini juga adalah pengambilan minuman yang manis, menurut tinjauan,sebanyak 53.2% individu di Malaysia minum minuaman manis yang disediakan sendiri setiap hari, 4.2% individu minum minuman berkarbonat setiap hari dan 6.7% individu minum minuam 3 dalam 1 setiap hari.

Menurut tinjauan ini, seramai 3.9 juta dewasa berusia lebih dari 18 tahun menghidapi penyakit kencing manis. Kebanyakkan dari mereka yang berumur 18 – 40 tahun tidak tahu bahawa mereka menghidapi kencing manis.

Antar negeri yang mempunyai prevalen kencing manis yang tinggi adalah Negeri Sembilan (33.2%), Perlis (32.6%), dan Pahang (25.7%).

Antara gejala yang melibatkan masalah kencing manis ialah, keletihan, kerap membuang air kecil, kehausan yang melampau, penurunan berat badan, dan kerap mengalami jangkitan kuman. Sekiranya anda tidak mempunya gejala seperti ini, anda juga boleh melakukan saringan kencing manis jika anda mempunyai berat badan yang berlebihan, BMI melebihi 23 kg/m2 atau ukur lilit pinggang melebihi 80 cm untuk wanita dan 90 cm untuk lelaki.

Kegagalan mengenal pasti masalah kencing manis dengan lebih awal akan menyebabkan komplikasi yang lebih serius di masa akan datang.

4 daripada 10 dewasa mengalami masalah kolesterol

Seramai 8 juta rakyat Malaysia mempunyai masalah tinggi kolesterol, iaitu 4 daripada 10 orang mengalaminya. Bacaan kadar bagi tinggi kolesterol ialah sebanyak 5.2 mmol dan ke atas. Mereka yang berumur 40 – 59 tahun adalah individu yang paling ramai tidak mengetahui bahawa mereka mempunyai tahap kolesterol yang tinggi. Hanya 63% daripada individu yang mempunyai masalah kolesterol yang tinggi Berjaya mengawal tahap kolesterol dengan pengambilan ubat – ubatan.

3 daripada 10 dewasa mengalami  Hipertensi

Hipertensi atau tekanan darah tinggi yang tidak dikawal boleh mengakibatkan serangan jantung, strok dan pelbagai penyakit kardiovaskular yang lain. Bacaan kadar tekanan darah tinggi yang tidak terkawal ialah bacaan yang melebihi 140/ 96 mmHg. Lelaki yang berumur 30 tahun ke bawah adalah mempunyai 3 kali ganda lebih ramai menghidapi hipertensi berbanding wanita. Dalam 6.4 juta rakyat Malaysia yang mengalami hipertensi atau tekanan darah tinggi, hanya separuh yang menyedari bahawa mereka menghidapi penyakit ini.

Kesimpulannya, masalah seperti obesity, kencing manis, darah tinggi dan tinggi kolesterol mempunyai perkaitan rapat antara satu sama lain. Penyakit – penyakit ini membawa komplikasi yang lebih serius dalam jangka masa panjang dan merupakan risiko kepada masalah kardiovaskular yang juga merupakan penyebab kematian nombor satu di Malaysia. Seramai 1.7 juta individu di Malaysia mempunyai tiga faktor risiko manakala seramai 3.4 juta individu di Malaysia mengalami faktor risiko utama.

Bagi mengatasi masalah ini, individu perlu mengawal bacaan tekanan darah iaitu bacaan perlu kurang dari 140/ 90 mmHg. Individu juga perlu mengamalkan diet yang seimbang dan sihat bagi mengekalkan berat badan yang ideal, selalu bersenam dan menghindari rokok dan alkohol.

Rujukan

1. Tinjauan Kebangsaan Kesihatan dan Morbiditi (2009). Penyakit tidak berjangkit, permintaan jagaan kesihatan dan literasi kesihatan. Penemuan Utama, Infografik Booklet. Institut Kesihatan Umum.

2. Tinjauan Kebangsaan Kesihatan dan Morbiditi (2009). Lembaran Fakta. Penyakit tidak berjangkit, permintaan jagaan kesihatan dan literasi kesihatan. Lembaran Fakta. Institut Kesihatan Umum.

3. Portal Rasmi Pendidikan Kesihatan Malaysia (MyHealth) (2016). Kementerian Kesihatan Malaysia. Bagaimana Diabetes dikesan? http://pendidikanpesakit.myhealth.gov.my/bagaimana-diabetes-dikesan/

4. Portas Rasmi Pendidikan Kesihatan Malaysia (MyHealth) (2008). Kementerian Kesihatan Malaysia. Obesity and Overweight. http://pendidikanpesakit.myhealth.gov.my/bagaimana-diabetes-dikesan/

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 

How does it works? 

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.

When food is consumed, an enzyme called insulin converts the glucose in the food into glycogen, which is then stored in the body until it is used again (2).

Meanwhile, when you need energy, the glucagon enzyme in your body will break down the glycogen stored into glucose and use it as energy, or better known as ATP (2).

The Overall pathway.

This is where L- Carnitine plays it role. This is where L- Carnitine comes into play. Mice fed a high-fat diet are able to lower their blood glucose levels when L- Carnitine supplementation is given to the mice, 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 product, L – Carnitines can be found naturally in  food 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).

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).

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).