“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)!

The good news is that nutrition can prevent this from happening! A varied and balanced diet can help to prevent many diseases, including blindness. Many studies have found that consuming antioxidants, also known as cancer fighting agents, can help prevent vision loss. Antioxidants are compounds that aid in the scavenging of free radicals that can cause cell mutation and cancer.

Since many of these antioxidants are found in plant-based diets such as vegetables and fruits, one mechanism for this is said to be due to the prevention of other chronic diseases such as hypertension and diabetes, lowering the risk of vision loss. Lutein and zeaxanthin, vitamin A, omega 3, and vitamin C are all antioxidants that have been linked to vision health (2). 

Lutein and zeaxanthin are members of the carotenoid family, which is a well-known antioxidant for eye health. Apart from being found in green leafy vegetables like spinach, it can also be found in yellowish, orange-red plant-based foods like capsicum. In nature, lutein and zeaxanthin appear to absorb excess light energy to protect plants from overexposure to sunlight, particularly high-energy light rays known as blue light. While in the human body, lutein and zeaxanthin are abundant in the macula of the human eye, the name 'macula lutea' is derived from lutein, which means yellow spot.

The National Eyes Institute (NEI) conducted research on lutein, zeaxanthin, and the effect of carotenoids supplement taking in May 2013. It is the second largest eye- disease research study, namely, AREDS2. The purpose of this study was to see how nutrients, such as lutein and zeaxanthin, affected the prevention of AMD and other age-related eye diseases. For five years, participants in this study were given 10 mg of lutein and 2 mg of zeaxanthin every day. The use of daily antioxidant supplementation reduces the risk of progressive Age-related-Macular Degeneration (AMD) by 25% among those with early and intermediate macular degeneration, according to this study. However, it is unclear whether it can aid in the prevention of cataracts and their complications.

Vitamin A is another common antioxidant for the eyes. Night blindness is commonly caused by a lack of vitamin A. Vitamin A functions as photoreceptors, where it aids in the maintenance of light-sensing cells in the eyes. It's found in animal-based foods like dairy and egg yolk.

Omega 3 Fatty Acids (1,2)

EPA and DHA, which are derived from omega-3 fatty acids, are essential not only for brain development during infancy, but also for vision health. A study of people with dry eyes found that taking EPA and DHA supplements daily for three months significantly reduced dry eye symptoms by increasing tear fluid production (lacrimal fluid). Oily fish is a good source of EPA and DHA, and microalgae supplements are also available.

Vitamin E (1,3)

Vitamin E is a fat-soluble vitamin that protects fatty acids from oxidation. Because the retina contains a high concentration of fatty acids, adequate vitamin E intake is essential for good eye health. A study that supplemented 7 mg of vitamins E found that it can reduce the risk of age-related cataracts by 6%. However, a randomized controlled study discovered that vitamin E supplementation does not slow or prevent the progression of people who already have eye problems. Almonds, sunflower seeds, and flaxseed oil are good sources of vitamin E.

Vitamin C (1,3)

Vitamin C is commonly consumed for skin purposes, but since many studies have discovered that vitamin C is an important antioxidant for eye health as well, many supplements are now beginning to incorporate vitamin c rich sources in eye supplementation. It's a good thing because it gives you two effects in one!

Zinc (1,3)

Zinc is abundant in the eyes. It functions as a transporter for vitamin A, which is later involved in the formation of visual pigments in the retina known as melanin. As a result, zinc deficiency has been linked to night blindness. Oysters are a natural dietary resource high in zinc that is also beneficial to men's health!

In conclusion

Taking care of your vision health entails more than just avoiding screens and wearing sunglasses when you go outside. It is also what you put inside your body. Again, healthy eating is important for overall health, including vision!

References

• All About Vision. Lutein and Zeaxanthin. Eye and vision benefits. https://www.allaboutvision.com/nutrition/lutein.htm (Accessed on Aug, 26, 2020).American

• Optometric Association (AOA). Diet and Nutrition. Adding Powerful Antioxidants in your diet. https://www.aoa.org/healthy-eyes/caring-for-your-eyes/diet-and-nutrition?sso=y (Accessed on Aug, 26, 2020)

• 8 Nutrients that will optimize your eye health. https://www.healthline.com/nutrition/8-nutrients-for-eyes. (Accessed on Aug 26, 2020)

There are many factors influencing skin condition, but in this post, we are going to share on tips on how to make your skin glow!

As much as smoking is bad to your lung so does it to your skin

Cigarette smoke contain many harmful substances to our body, as we know. However as for the skin, it releases carbon monoxide which displace oxygen in your skin and nicotine which reduce blood flow which will make skin dry and discolored. Smoking also triggers the destruction of collagen in the skin hence skin loss its elasticity and produce wrinkles and fine lines! 

When you are younger and a smoker you cannot really see the difference but as you get older, the damage on your appearance will be obvious and you will be looking older as compared to your actual age (1).

Sunscreen is a must

Malaysia is a humid and warm country all year long; thus, wearing sunscreen is a must! Sunscreen helps protect skin from premature ageing like wrinkles, fine lines, and hyperpigmentation. Studies show that people who are under 55 years old and wear sunscreen regularly can lower their risk of premature ageing by 24% as compared to those who wear sunscreen occasionally or not at all.

If you are a newbie looking for sunscreen, look for sunscreen with at least SPF 30 (Sun Protecting Factor) and choose sunscreen according to your skin type, such as aqua sunscreen, which is meant for dry skin, etc. You also must apply sunscreen every 2 hours or after exercise. Sunscreen should also be applied at least 30 minutes before going out, as it requires time to be absorbed by the skin and activated in order to protect your skin (2). 

Move, Move, Move

We know that exercising regularly can keep our bodies fit and healthy, but did you know that it can also keep your skin healthy?

Exercise increases blood circulation and flow throughout the body, hence making your skin radiant and glowing. Pssttt…you can kill twoi birds with one stone by doing this; you can keep your body lean while also getting healthy skin! (3)

Keep your body hydrated

Our skin is exposed to various conditions: cold due to the air conditioner, warm due to the water, etc., so drinking plenty of water will make our skin condition better. Everybody is born with a particular skin type, whether it is dry, oily, or a combination; however, all these surrounding factors and age factor can change skin condition as well (4, 5).

In order to see whether your skin is dry, try to pinch it in an area and see whether it has a wrinkle on it after your pinch or whether it bounces back after your pinch, which is an indicator for well-hydrated skin. Wrinkles and less bouncy skin are indicators of dry skin; it can also sometimes be seen based on your urine colour if it is too concentrated, meaning your body does not get a sufficient amount of water (4, 5).

Lifestyle changes can reverse this; drink at least 8 glasses of water per day. Limiting the intake of alcohol and drinking less caffeinated drinks like coffee and tea can improve the dry skin condition (4).

Face and manage your stress. 

We used to believe that suppressing our feelings and emotions was better for everyone, including ourselves. However, that is not always the case; we have to deal with it and manage it. Talk to someone if you have a problem; share it with someone that you trust. Think positive.

Pick up some hobbies, distract yourself from overthinking about it, and slowly find solutions. Doing outdoor activities can help calm a person if their mind is too saturated with a lot of stuff, or spending time alone can de-clutter their mind and create more space. Cleaning can sometimes make you a lot happier and help you think better about the solution to your problem.

Established a skincare routine

Skin care is essential for keeping skin in good condition. A good skin care routine will improve skin condition, but only if the products used are of high quality.First, you have to find out your skin type. Normal skin, dry skin, oily skin, and combination skin are the four skin types.

To determine your skin type, start by washing your face and then waiting an hour. After it’s been an hour, dab your forehead and nose with a tissue and check to see if any oil has rubbed off. If it did, it’s a sign that you have oily skin. If there isn’t any oil but your face feels dry and tight, you may have dry skin (4,5).

Once you have figured out your skin type, find the right product for it. The common one should have cleanser, moisturizer, toner, sunscreen, exfoliator, and makeup removal. Start with cleansing your face at least twice per day. If you need to exfoliate your skin at least twice a week, this is a good time to remove all of the dead cells, dirt, and blemishes on your face (5).

Once you have done these, your skin is now ready to absorb all the good nutrients from your skincare, so now is the time for you to apply toner and moisturizer. Toner and moisturiser are good for hydrating the skin. After that, the skin is completely moisturized.You can now apply sunscreen.After sunscreen, it is time for you to wear makeup. If you are wearing make-up, make sure to thoroughly clean it at the end of the day using make-up removal and start your nighttime skin care routine as per daytime (5).

The only difference between a daytime and nighttime skincare routine is that moisturiser used on the skin is encouraged to be applied thickly at night so that the skin is not dry in the morning!

There are also people who want to give extra care and a boost to their skin; they can try to use serum. Serum is a product that is very concentrated with good vitamins for the skin, like vitamin A, C, and E. It’s usually used to fade scars or add more vitamins to the skin. However, the correct order of using skincare products is important; if not, skin cannot absorb the nutrients that the product has, and it will just go to waste (5).

Diet vs skin condition

 As much as sugary food is bad for your waistline, so is it for your skin! Acne and breakouts can be exacerbated by sugary foods.Sugar and foods high on the glycemic index (meaning foods that, once ingested, convert quickly into glucose and cause your body’s insulin levels to elevate) lead to a burst of inflammation that goes throughout your entire body (6).

Vitamin C

Vitamin C is a very common vitamin used to make skin become radiant and glow. Vitamin C-rich foods are often used to boost skin conditions. Fruits like guava are really rich with vitamin C; it even has twice the content of vitamin C in an orange!

However, if one is a picky eater, it is also best to actually consume a vitamin C supplement rather than apply it topically (topical application). On the market, there are many types of vitamin C supplements. Most of it has really high vitamin C content, such as 500 mg or 1000 mg. However, according to the RNI (recommended nutrient intake), our body only needs about 70 mg of vitamin C, so the higher dosage of the vitamin will just be excreted through urine.

On the supplement ingredients list, you can see whether the supplement is made from natural or synthetic ingredients.Synthetic vitamin C is called ascorbic acid; it usually irritates the stomach and has a higher dosage of vitamin C as compared to vitamin C that is derived from natural fruits like berries, guavas, oranges, etc.

Synthetic vitamin C or ascorbic acid is also usually coloured with food colouring to make the supplement look as if it has a high content of vitamin C. If you notice that your soluble vitamin C supplement stains your glass of water after being diluted in it, there is a high probability that the supplement that you are taking has food colouring in it.

So be wise in choosing your vitamin C supplements. In order to make your skin glow, know how to find good vitamin C. Remember,  it has to be derived from a natural source with no coloring, and the content of the vitamin C does not need to be too high!

References

1. Health (May, 15 2012). 15 Ways Smoking Ruins you Skin. https://www.health.com/condition/smoking/15-ways-smoking-ruins-your-looks
2. Skin Cancer Foundation (June, 2019). All about Sunscreen, Why you need it and how it works for you?. https://www.skincancer.org/skin-cancer-prevention/sun-protection/sunscreen/
3. WebMD (n.d). Exercise for Healthy Skin. https://www.webmd.com/skin-problems-and-treatments/acne/features/exercise#
4. Healthline March, 2, 2018). Is My Skin Dehydrated? https://www.healthline.com/health/dehydrated-skin
5. Kari Molvar. The New York Times (n.d). How to Build a Skincare Routine. https://www.nytimes.com/guides/tmagazine/skincare-routine
6. Forbes (n.d). Does Eating Sugar really Caue Acne? https://www.forbes.com/sites/quora/2017/01/20/does-eating-sugar-really-cause-acne/#14aa38515af4

The word collagen comes from the Greek word "kola,” which means glue, and that is basically the function of collagen, which is to hold protein and/or non-protein substances together. As an example, in the skin, the function of collagen is to hold all the skin structure together. Collagen is one of the major building blocks for many parts of the body, including bones, skin, tendons, and ligaments. It accounts for about one-third of the body's protein composition. It is also found in many other body parts, including blood vessels, corneas, and teeth.

Types of collagen

There are various types of collagen, but the main types are type I, type II, type III, and type IV.

Type I: Most of your body’s collagen is made of type I. It is a densely packed fibre that provides structure to skin, bones, tendons, fibrous cartilage, connective tissue, and teeth.

Type II: This type is made of more loosely packed fibres and is found in elastic cartilage, which cushions the joints.

Type III: This type supports the structure of muscles, organs, and arteries.

Type IV: This type helps with filtration and is found in the layers of your skin.

Collagen in Skin: Do We Need It?

Our body can produce its own collagen; however, the production of collagen gradually declined as we aged, which explains that among the signs of ageing are wrinkles, which come from skin that is less elastic, less supple, and unfirm.

Researchers also revealed that women lose collagen faster than men, causing women’s skin to age faster than men. Apart from gender, nutrition, and recreational drugs, environmental stress such as sun exposure, exposure to toxins such as pollutants, and cigarette smoke can also affect the level of collagen in the body.
 

Our skin is one of the largest organs in our bodies. It is our body's main defense organ against external insults such as radiation, ultraviolet rays, pathogenic microorganisms (bad bacteria), and mechanical and chemical stress (1). The condition of the skin or the skin barrier is greatly supported by the foods that we eat, whether we like it or not. There are foods that can benefit your skin and foods that can harm your skin. The foods listed below can either make or break your skin!

Omega-3-rich foods

The term "good fat" usually refers to omega-3 fatty acids. It regulates skin oil production, improves hydration balance, controls breakouts, and reduces signs of ageing. Furthermore, when applied topically, it can help soften rough, dry skin and soothe irritation and dermatitis. Omega-3-rich foods can improve skin composition by balancing its inflammatory response to sun damage, as well as improve sensitive skin condition by making it less dehydrated and dry.

Fish is high in Omega 3 fatty acids. Specifically, fish oil. As a result, if an individual does not consume fish at all or prefers not to consume fish, it is recommended that they take Omega 3 and 6 supplements for their heart health. Omega-3-rich fish include mackerel, tuna, sardine and anchovies, salmon, and herring. Freshwater fish rich in omega 3 are also available in Malaysia, including catfish (ikan keli), patin fish, and terubok fish.

Aside from that, certain plant-based foods, such as spinach (bayam), mustard leaf (sawi), and 'salad roket,' contain high levels of omega 3. There are also omega-3-rich oils that can be used in cooking, such as canola oil. Also, if you want to improve the health of your skin, instead of snacking on chips or other unhealthy foods, try eating walnuts, which are high in omega 3.

Antioxidant and vitamin-rich foods

Plant-based foods, such as vegetables and fruits, are typically high in antioxidants and vitamins. Fruits and vegetables high in vitamins like C, E, and A are known as skin best friends.' All of these vitamins work in the same way when they engulf free radicals or reactive oxygen species (ROS). Free radicals can be produced naturally in the body, or as a result of UV radiation exposure, among other things. In other words, it is something that happens to everyone. As a result, it is critical to consume foods high in vitamins and antioxidants to combat all of the problems caused by free radical formation.

The Malaysian Ministry of Health recommends eating two servings of fruits and three servings of vegetables per day. The cupped hand size is used to determine vegetable serving size. As a result, 2 cupped hand size equals 2 servings. While the serving size for fruit varies depending on the type of fruit, 1 serving is equivalent to 1 fruit for medium-sized fruit such as apple, pear, and orange, while larger fruit is dependent on the normal cut sized. To simplify things, if you eat two apples, two pear, two bananas, or two oranges per day, you've already met the daily serving requirement.

Guava, orange, and lemon are examples of vitamin C-rich foods. Did you know that guava has twice the vitamin C content of an orange of the same size? Consuming 2 servings of guava or 1 small guava already meets your daily vitamin C requirement (75mg).

The placenta is an organ that connects the foetus to the mother. It transfers oxygen and nutrients to the foetus and removes foetal waste products to the mother. When the baby is born, the placenta will also be discharged from the mother’s body. There has been a growing interest in placenta extraction as it is said to have high nutritional value. The nutritional substance includes cytokines, hormones, bioactive peptides, enzymes, growth factors, vitamins, and minerals.

Culturally, humans rarely consume placenta, but recently there has been growing interest in consuming placenta, be it from humans or animals. Mammals have been consuming placenta since years ago; it is called placentophagia, while in humans it is called placentophagy. The placenta could be served raw, cooked, or encapsulated and taken as a supplement as it contains various nutritional benefits.

Rave on this started when many Hollywood celebrities started using placenta therapy as part of their skincare routine treatment. Celebrities like Kim Kardashian, Victoria Beckham, and even male celebrities like Harry Styles from One Direction have said they have been using this for their skin to get baby-soft skin.

Placenta consumption in Malaysia.

In Malaysia, it is rare for people to consume raw placenta. Usually, it comes in health supplement form and is derived from deer or sheep. Hence, as it is in health supplement form, any products containing placenta extract in a pharmaceutical dosage will require to be registered with the Drug Control Authority (DCA) before they are sold or used in Malaysia.

Benefits of placenta consumption.

Findings from research reported that nutrients that are delivered via the placenta could be retained even after the process of delivering the baby. The research also stated that the placenta contains collagen, elastin, laminin, and vitamins such as B1, B2, B3, B4, B5, B6, B7, and B12. All these vitamins, better known as B complex vitamins, play roles in cell metabolism, cell division, cell development, and energy production.

Due to this aspect as well, it is said that it gives a lot of benefits to skin health. Placenta is even used in clinical settings, such as for burn injuries and wound healing. In one study, researchers compared the efficacy of topical placental extract dressings versus povidone iodine dressings in diabetic wounds in a variety of patients. Placenta wound dressings could significantly accelerate the rate of wound healing when compared to povidone-iodine dressings as they contained amino acids, vitamins, and nucleotides, which accelerated wound healing recovery by seven to ten days.

Due to all these effects, many skincare products have recently incorporated placenta, be it from sheep or deer, in their skincare or supplement products.

Caution with regard to placenta in the supplement

When it comes to placenta consumption as a health supplement, it is evaluated based on its safety of use and product quality. To be safe, sheep placenta products must be hormone-free. Because placenta typically contains hormones such as testosterone, oestrogen, and progesterone, being hormone-free is much more important for a placenta-based supplement. To confirm whether the products you are considering or consuming have been notified by the Ministry of Health, you can conduct an online product search on the National Pharmaceutical Registration Agency (NPRA). However, if the product is not listed in the DCA, it is not recommended that you consume it because its safety and quality have not been evaluated, and it may pose a health risk.

References

1. Ministry of Health (MOH). MyHealth Portal. Sheep Placenta. http://www.myhealth.gov.my/en/sheep-placenta/ (Accessed on January 13, 2021)
2. Pan, S. Y., Chan, M. K., Wong, M. B., Klokol, D., & Chernykh, V. (2017). Placental Therapy: An insight to their biological and therapeutic properties. blood, 4(11), 12.

But, what if it is not in good condition? Is it hormonal in nature? Is it related to food? Is it hereditary? Is it any of these?

Yes, it is indeed all of these!

Skin that appears younger is closely related to lifestyle and genetics. According to research, there is a gene in the human body that controls our skin condition. Have you ever wondered why certain people of similar age but different appearances appear younger than their actual age while others appear older? The study by dermatologist professor Alexa B. Kimball from Harvard revealed that this has something to do with gene expressions.

According to the study, people with rapid gene expression speed up the skin-repairing process when exposed to external or internal stress, which is why they can maintain younger-looking skin. It has also been observed that some people who appear young have rapid gene expression that mimics those who are younger than their chronological age. According to the professor, the skin appears younger because it behaved younger (1)!

To elaborate, the one described above is known as intrinsic skin ageing, and it represents chronological ageing, with the same pattern affecting all internal organs. Extrinsic skin ageing, also known as aged skin, is caused by external factors such as environmental influence, particularly chronic sun exposure and ultraviolet (UV) irradiation, but also smoking, pollution, sleep deprivation, and poor nutrition. As a result, when it comes to skin, the best way to avoid harm is to avoid all of these extrinsic factors (1).

A study that compared sun-exposed skin (face and forearm) to sun-protected skin (buttock) among women aged 20 to 70 years old discovered that ultraviolet (UV) exposure is a major driver and accelerator of skin ageing. Although sun exposure without any skin protection, such as sunscreen, is harmful to the skin, there is a recommended amount of time spent outdoors without sunscreen so that UVB from the sun can activate vitamin D3 in the skin. The recommended exposure time is 5 - 30 minutes between 10 a.m. and 3 p.m., at least twice a week, to the face, arms, legs, or back (2). In Malaysia, where the weather is sunny all year, excessive sun exposure can cause skin damage. As a result, if one of your 2021 resolutions is to avoid sun damage, you should start wearing sunscreen religiously!

Apart from smoking and pollution, which can both cause skin damage, sleep deprivation can also cause skin to appear older. Sleep serves as a reset button for our entire health, including our skin. During sleep, the blood flow to the skin increases, and the organ rebuilds collagen and repairs UV damage, reducing wrinkles and age spots. According to research, sleep deprivation affects wound healing, collagen growth, skin hydration, and skin texture. Inflammation is also higher in sleep-deprived individuals, causing acne outbreaks, eczema, psoriasis, and sin allergies. To combat this, health experts recommend 7 to 9 hours of beauty sleep per day to achieve fluffy baby skin (3,4)!

Poor nutrition is also a major contributor to the appearance of older skin, and the worst culprit of all is sugar! Glycation is the process by which sugar interacts with skin. Younger-looking skin is always associated with firm and elastic skin, which refers to the cross-linking structure of skin fibres. This structure can repair itself naturally; however, when sugar is consumed, the glycation process renders the structure and renders the skin unable to remodel into its original structure. As a result, the youthful skin condition has vanished! This explain, sugar consumption is not only bad for metabolic conditions like diabetes mellitus, but also for skin conditions.

To summarise, the skin is the largest and most delicate organ; it may appear strong and capable of withstanding all of the external and internal harm that we inflict on it, but it, too, requires pampering. A good skincare routine will help with its condition, but it also requires good food, hydration, and sleep to keep everything in check and balance!

References

1. Beth Israel Deaconess Medical Center. (2017, November 28). Expression of certain genes may be key to more youthful looking skin: Certain gene expression patterns identified in women who appear younger than their chronologic age. ScienceDaily. Retrieved January 18, 2021 from sciencedaily.com/releases/2017/11/171128102918.htm
2. Ministry of Health Malaysia (MOH). MyHealth Portal. Vitamin D and sunlight. http://www.myhealth.gov.my/en/vitamin-d-and-sunlight-2/
3. Kahan V, Andersen ML, Tomimori J, Tufik S. Can poor sleep affect skin integrity? Med Hypotheses. 2010 Dec;75(6):535-7. doi: 10.1016/j.mehy.2010.07.018. Epub 2010 Aug 1. PMID: 20678867.
4. 6 Ways to Maximize Your Beauty Sleep for #wokeuplikethis skin. https://www.healthline.com/health/beauty-skin-care/beauty-sleep (Accessed on January 19, 2021).
5. Danby, F. W. (2010). Nutrition and aging skin: sugar and glycation. Clinics in dermatology, 28(4), 409-411.

Vitamin C can be said to be the most popular micronutrient of all. It serves various functions, from immune health to skin health. As of late, many skin care products have incorporated vitamin C as one of the ingredients, or it stands alone in skincare products. Many studies found that topical application of vitamin C showed positive skin changes in improving skin complexion, improving skin hydration, fading out hyperpigmentation, and reducing the appearance of under-eye circles.

But, according to the study, there are various hindrances to the absorption of vitamin C applied topically, such as skin pH, penetration of vitamin C into skin layers, oxidation due to exposure to harsh environments before the skincare is even applied to the skin, and many more.

Which is why people started to dig? What about the consumption of vitamin C? Will it help with skin health even better?

A study on the roles of vitamin C in skin found that the consumption of vitamin C helps with skin health via various pathways.

1.  The promotion of collagen formation

Vitamin C acts as a co-factor for the proline and lysine hydroxylase enzymes that stabilise the collagen structure in skin. In the skin, collagen formation is carried out mostly in the dermis; it requires the enzyme lysine hydroxylase to form collagen, which is dependent on vitamin C. Which is why consumption of a sufficient amount of vitamin C helps with intact-looking skin due to the formation of collagen.

2.  The ability to scavenge free radicals and dispose of toxic oxidants

Another important role of vitamin C is that it acts as a potent antioxidant, which can neutralise and remove oxidants from environmental pollutants and after exposure to ultraviolet (UV) radiation. But most intervention studies are carried out to see the effect or prevention of the damage using a cocktail of other ingredients as well (such as glutathione and vitamin E). Which is why it is said that vitamin C is particularly effective when it is used in conjunction with vitamin E.

3.  Inhibition of melanogenesis

Vitamin C and its derivates, including the weak one (magnesium phosphate ascorbyl derivatives), have been shown to treat skin hyperpigmentation in conditions such as melisma, better known as age spots. This is due to the fact that it has been shown that it reduces melanin synthesis in the skin by interfering with the action of tyrosinase (the rate-limiting enzyme in the production of melanin).

These are all pathways through which vitamin C could help with skin health. During the course of life, the skin is exposed to various challenges that affect its structure, function, and appearance, including:

1. Ageing: loss of elasticity and wrinkle formation

2. Exposure to elements leading to discoloration, dryness, and accelerated wrinkles.

3. Chemical insults such as soaps, hair dyes, and detergents

4. Direct injury, such as wounding or bleeding.

With all the factors from internal and external being addressed, it is thought that it can make things clear that the consumption of vitamin C is able to help with the prevention of further skin damage but at the same time must limit or reduce external factors that cause harm to skin; after all, prevention is better than cure, right?

Apart from this, 16 studies that investigate the consumption of vitamin C supplements or foods show that it improves skin appearance by improving skin elasticity, facial wrinkling, roughness, and discoloration.

Another double-blind nutrition intervention using cocktails of supplementation such as that high in antioxidants such as 10mg trans resveratrol, 60 mcg selenium, 10 mg vitamin E, and 50 mg vitamin C in papaya extraction among populations between 40 and 65 years old shows improved skin surface, brown spots, evenness, moisture, and elasticity after 90 days of supplementation.

Based on all these data, the study stated that the efficacy of consumption of vitamin C is better at improving skin health as compared to topical application only. As the efficacy of topical application is based on the prior skin condition. In one study, it was suggested that when the health status is already optimal, meaning there is enough vitamin C, the topical application of vitamin C will not be absorbed into the skin. Hence, ‘beauty from the inside" via nutrition may be more effective than topical application.

References

1. Pullar, J. M., Carr, A. C., & Vissers, M. (2017). The Roles of Vitamin C in Skin Health. Nutrients, 9(8), 866. https://doi.org/10.3390/nu9080866.

2. Radiance by WebMD. Benefits of Vitamin For Your Skin Health. https://www.webmd.com/beauty/ss/slideshow-benefits-of-vitamin-c-for-skin (Retrieved on May 3rd, 2021).

3. 11 Reasons to add vitamin C serum to your skincare routine. https://www.healthline.com/health/beauty-skin-care/vitamin-c-serum-benefits#how-to-use (Retrieved on May 3rd, 2021).