Overcome the Obesity

Hi Friends when is the last time you did proper exercise? Most of us in IT industry especially get glued to our desktops-laptops-notebooks & missing out on little essentials of life. How about a refreshing walk in the outside? New studies have shown that an hour long regular walk proves to be a boon for those fighting the fat. Scientists have proven that regular walks can reduce the influence of genes which are considered to cause obesity, by down-regulating the gene expression. This conclusion was reached after a recent study which involved ten thousand people with a genetic predisposition to obesity. It was conducted by the Department of Nutrition at Harvard School of Public Health in Boston, USA.

Dr.Qibin Qi, a lead researcher of study said that regular walks could reduce the BMI by half. In contrast those who get stuck to the sofa watching TV/surfing net for up to four hours a day may have their genetic risk of obesity increase by 50%. Walking not only reduces your risk of obesity, it has lot of other health benefits including strong toned muscles, healthy heart, better stamina and cheerful disposition.

Keep Walking, Keep Walking…..

by Dr. Pramod G. Bagali

Eat, but love thyself

Life these days is blessed for most,

in Malaysia even more,
the variety of food to choose
we live to eat, ah bliss!
Workouts and exercises, not a routine,
sedentary lifestyle, obesity a norm.
 

It is then no surprise,
Non-communicable diseases are on the raise.
Non-communicable? Uh?
Diseases of long duration with slow progression,
Heart disease, stroke, cancer, diabetes, to name a few.
 

Steam, poach, grill, roast,
styles highly recommended,
deep frying, barbequing to be avoided.
Unsaturated fats are advocated
for cholesterol lowering.
 

Start by changing what you consume
Lean meat to the minimum, poultry and fish at moderate
A little bit of buttermilk, yogurt, cheese for dairy intake.
Fruits and vegetables, greens and coloured
Broccoli, spinach, carrots, tomatoes
Apricots, melon, peaches, berries
Spices and herbs, nuts and seeds,
Cloves, coriander, ginger, thyme,
Hazelnuts, walnuts, almond and sunflower seeds
With anti-inflammatory, antioxidants properties.
 

Whole-wheat, brown rice, cereal, oatmeal
foods with low glycemic load,
Nasi lemak, roti canai, teh tarik
and junk foods should be off limits.
Forget not your fluids
but not from soft, carbonated beverages,
small quantity of sugar and sodium
are acceptable
as it is not cool being diabetic or hypertensive.

Limit your intake to your needs,

Female, 1900; male, 2400 calories.

Include some movement in your idle lifestyle,

Five times a week; 30 minutes a day,

Mixture of endurance, strength, flexibility, agility regimes,

wonders you'd see.

What is then left to live for, you ask?

Healthy heart, healthy mind,

your future, your decision,

Moderation is the key!

~Jagdish Kaur Chahil~

Wonder Food – Fresh Vegetables and Berries?

How often do you eat (1) fresh vegetables; (2) fresh fruits; (3) fresh or frozen berries?

If your answer is ‘‘daily or several times a day’’ for at least two of these three questions, then you are on the right track towards combating heart disease.

There were many interesting research and development in the area of the Therapeutics LifeStyle Changes and how it affects the genes in the past few years. In October last year, big title such as “Raw vegetables and fruit 'counteract heart risk genes'” and “Fruit and veg 'stops inherited gene' that causes heart attacks” made its way to the headlines at BBC news (1) and NHS website (2). These articles described about a study conducted by McGill University, Canada, published in medical journal Public Library of Science (PLoS) Medicine (3) and gained a lot of public attention.

Back to the Basics: Combating Heart Risk Genes with Raw Vegetables and Fruits

The study by Ron. Do et. al. investigated the effects of diet towards the risk of heart attack of 3820 patients who possessed certain risk of genetic predisposition towards heart diseases. The study subjects were extracted from 5 ethnicities- Europeans, South Asians, Chinese, Latin Americans and Arabs, whom had had a non fatal heart attack. The main analysis was separated into 2 parts. Firstly, the effect of 4 genetic variations in a region of the chromosome called 9p21 on the risk of heart attack. And secondly, how does this risk influenced by smoking, activity level and diet.

The diet focus on 19 food items which were grouped into three dietary categories:

1.    Oriental (soy sauce, tofu, pickled foods, green leafy vegetables, eggs and low sugar),

2.    Western (eggs, meats, fried and salty foods, sugar, nuts and desserts)

3.    Prudent (raw vegetables, fruits, green leafy vegetables, nuts, desserts and dairy products).

Here comes the interesting part, the result shows that all the four genetic variations increased the risk of heart attack by about a fifth, with South Asians at the highest risk among all other ethnicity (The application of this study to the general population is likely to be high as about 50% of the ethnic groups tested carried one of the four risk variants). The risk was further affected by whether or not the study subject had a prudent diet pattern and which specific genetic variation he possessed.  For example, those with rs2383206 (4) variant (which increases the risk of the heart disease), but ate a good diet in fruit (such as berries) and raw vegetable, had the same risk as those without the risk variant.

However, the study shows that effect of these four genetic variations on the risk of heart attack was not influenced by physical activity level or smoking.

What Does This Means to You?

To put it in a layman term, some of us are born with inherent risk towards certain diseases such as heart disease. This inherent risk is in the form of genetic variations i.e. change/s in genetic sequences which is quite impossible to be altered / treated in today’s clinical settings. However, this does not spell doom for the person. Various studies had shown that lifestyle, diet and environmental factors can help to reverse or stop the effect of these genetic variations.

To believe that our health is predetermined because we are “born this way” is out-dated (except for those with rare monogenic disease). We may not know how much of what we are is determined by DNA (Nature) or by the external factors such as lifestyle and environment (Nurture), but we do know that both play a part. Knowing how your genes may impact your health can help you to pro-actively plan to intervene and to manage the health risk. And this involves simple steps of ordering an appropriate genetic test to determine the risk of disease predisposition, and subsequently adopt a healthy lifestyle which can be tailored according to the risk level.  

In short, Therapeutic Lifestyle Changes (TLC) is definitely not a rocket science, a simple action such as to consume fresh vegetable and berries everyday helps to keep heart disease away!

(1)    http://www.bbc.co.uk/news/health-15254471

(2)    http://www.nhs.uk/news/2011/10October/Pages/fruit-vegetables-counter-heart-risk.aspx

(3)    http://www.plosmedicine.org/article/info%3Adoi/10.1371/journal.pmed.1001106

(4)    http://snpedia.com/index.php/Rs2383206

Submitted by Susan Ong Su Ming, Product Portfolio Manager

The Preventive Approach: Therapeutic Lifestyle Changes

There are many genetic screenings available in the market today which allow individual to screen for genetic predisposition towards certain diseases such as breast cancer and colorectal cancer. Have you ever wonder what would you do if the genetic test result turns out to be positive?

Many will freak out or go into depression mode. However, having a genetic predisposition is not the end of the story. Except for some rare genetic disease, genetic alone does not condemn you to disease nor determines your fate. 

Lifestyle disease such as heart disease is multifactorial in its nature. Apart from genetic predisposition, factors such as not smoking, eating a healthy diet or regular exercise may delay or offset the expression of the disease.  Many studies had showed that although the genotype (which bearing the risk allele) cannot be changed, the expression of the gene can be influenced by the external factors such as diet and environment. Recently, a researcher named Ornish D. has conducted a study to analyze the effects of Therapeutic Life Style Changes (TLC) at genetic level [1] (PMID: 18559852). It was revealed that through adoption of good diet plan and exercise regime, the genes which involves in Cancer causation were “switched off” whereas the genes which offer protection towards cancer were “switched on”. 

What is TLC?

Therapeutic Lifestyle Changes (TLC) was first introduced in the Third Report of the National Cholesterol Education Program (NCEP)’s Adult Treatment Panel (ATP) III guidelines, 2002 [2]. It was highly recommended by various health organizations such as American Diabetes Association, American Heart Association, and The Obesity Society. This therapeutic strategy includes specific dietary regime (TLC diet), weight management, and increased physical activity, targeting at obese person at risk for type 2 diabetes and/or coronary heart disease. TLC is not something new. Previously it was referred as lifestyle intervention, lifestyle therapy, or lifestyle medicine. In short, it is a patient-centered or personalized approach for disease management, reduction, and prevention, which incorporates diet and nutritional recommendations, regular exercise, adequate rest, and stress management for lifestyle-related conditions.

A major component of TLC is diet. The cumulative effect of the TLC diet components can reduce low density lipoprotein by 25-30% which is similar to the effect of drug therapy [2]. The following table describes the TLC diet. 

Table 3. Dietary Recommendations for TLC Diet [3]
Component	TLC Diet	Food Sources
Total fat	25-35% of total calories*
Saturated fat	<7% total calories	Animal-based foods, including whole-fat dairy products (milk, cream, butter, cheese), fatty meats such as beef and pork. Some vegetable-based foods such as coconut, palm, and palm kernel oils also contain relatively high levels of saturated fats.
Polyunsaturated fat	Up to 10% of total calories	The two primary types of polyunsaturated fats are omega-6 and omega-3 fats. Omega-6 fats are found in nuts, seeds, and vegetables oils such as sunflower, canola, safflower, corn, and soybean oils. Plant sources of omega-3 fats (-linolenic) include canola oil, soybean oil flaxseed, and English walnuts.
Monounsaturated fat	Up to 20% of total calories	Oils including olive, canola, and peanut oil.
Trans fat	Lower intake	Foods containing or prepared with partially hydrogenated vegetable oils, including stick margarine, pastries, fried foods, french fries, and pastries. Naturally occurring trans fats are also found in milk, butter, and meats.
Carbohydrate**	50-60% of total calories
Dietary fiber	20-30 grams per day
Protein	15-25% of total calories
Cholesterol	<200 mg/day	Foods of animal origin. Highest amounts are found in liver and egg yolks. Moderate amounts are found in full-fat dairy products, some seafood (shrimp and lobster), and fish (salmon and sardines)
Sodium	<2,300 mg/day
Dietary options
Plant sterols/stanols	Add up to 2 grams per day
Soluble fiber	Increase 5-10 grams per day
Fish (fatty fish)	Include in weekly eating plan

In conclusion, TLC is not a rocket science; it is simply a pro-active way of managing one’s health in an informed and scientific manner. With some discipline, you will be well on the way to adopting a healthy lifestyle and reducing your risk for chronic disease.

In the subsequent articles, there will be highlights of 2 famous gurus of TLC. Please stay tuned!

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[1] http://www.ncbi.nlm.nih.gov/pubmed/18559852

[2] http://www.nhlbi.nih.gov/guidelines/cholesterol/atp3full.pdf

[3] Can Lifestyle Modifications Using Therapeutic Lifestyle Changes (TLC) Reduce Weight and the Risk for Chronic Disease? Research to Practice Series, No. 7, National Centre for Chronic Disease Prevention and Health Promotion, Division of Nutrition, Physical Activity and Obesity

by Susan Ong, Manager, Product Portfolio