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Showing posts with label nutrition. Show all posts
Showing posts with label nutrition. Show all posts

Tuesday, 7 May 2024

Diversify your protein sources for better nutrition

Protein, an essential nutrient needed by our body, can be found in both animal and plant food sources
One way of increasing your plant-based protein intake is by mixing your protein sources in one meal, e.g. you have dhall and chickpeas, alongside fish, in this dish. — Filepic

When discussing protein in our diets, we often think of animal-based protein sources, such as meat, fish and poultry.

But did you know that protein is also available in foods originating from plants?

In fact, it is essential to include these plant-based protein sources in our diet as part of our healthy eating plan.

Before delving deeper into the topic, we need to understand what protein is and why we need to eat foods containing it.

Apart from carbohydrates and fats, protein is a major nutrient needed by our body to function properly.

It contributes significantly to the growth and maintenance of our body, including the formation of new cells and the repair of old ones.

Additionally, protein serves as the building block for enzymes and hormones, which are key to various biological processes in the body.

It also provides energy when the supply from carbohydrates and fats is insufficient.

As protein is essential for cell growth and repair, adequate intake is important during periods of rapid development, such as during childhood, adolescence, pregnancy and breastfeeding.

In addition, sufficient intake of high-quality protein by the elderly is important to help improve mood, boost resistance against stress and prevent muscle loss.

In the most recent update to the Malaysian Food Pyramid, protein-rich foods are placed on the third level from the base, indicating that they need to be consumed in moderation.

According to this guideline, individuals are advised to incorporate a balanced mix of protein sources into their daily diet.

The Food Pyramid recommends one serving of fish; one to two servings of poultry, meat or eggs; and one serving of plant-based protein foods.

To achieve optimal health, adults are encouraged to aim for approximately one gramme of protein per kilogramme of body weight daily, as per the Malaysian Recommended Nutrient Intake (RNI) of 2017.

This means an individual weighing 70kg should aim for an intake of 70g of protein per day.

Understanding protein sources

As mentioned earlier, protein is not solely sourced from animal-based foods, such as chicken, meat, eggs and fish.

Indeed, protein can also be obtained from plant-based protein foods such as legumes, nuts and soybean products, which are equally nutritious and beneficial for our body.

Hence, incorporating both animal- and plant-based proteins into our daily meals can provide a higher quality of protein to support overall health.

To help us make better dietary choices, let’s learn more about the different sources of protein:

Animal protein

Fishes such as Indian mackerel (ikan kembung), salmon and herring are excellent sources of protein with lower levels of saturated fats compared to meat and poultry.

Additionally, they are rich in omega-3 fatty acids, which are essential for brain development in children.

Shellfish varieties like crabs, lobsters and shrimps offer lean protein with minimal saturated fats and calories, and are high in many micronutrients.

Meat and poultry are complete proteins that contain all the essential amino acids.

They are also high in minerals and vitamins.

The fat content may vary depending on the cuts, with examples of lean options including skinless chicken or turkey breast, and beef or pork tenderloin.

A cost-effective protein source, eggs provide excellent quality protein containing all the essential amino acids.

Additionally, egg yolks are rich source of polyunsaturated fatty acids, which are good fats.

Plant-based protein

Legumes are generally low in fat, high in dietary fibre, and free from saturated fats and cholesterol.Soybean is considered as one of the best complete protein sources and can make a pretty delicious dish, such as this Szechuan mapo tofu. — FilepicSoybean is considered as one of the best complete protein sources and can make a pretty delicious dish, such as this Szechuan mapo tofu. — Filepic

They are also a good source of B-group vitamins and contain phytochemicals and antioxidants.

However, they are incomplete proteins as they are low in some essential amino acids.

Examples of legumes are dhal, lentils, peas, chickpeas and peanuts.

Nuts are nutrient- and energy- dense foods that contain high amounts of protein, healthy fats, phytochemicals and antioxidants.

They are also rich in dietary fibre and various micronutrients.

Examples include almonds, pistachios, chestnuts and hazelnuts.

Soybean is considered as one of the best complete protein sources.

Soybean foods are widely consumed and available in various forms.

They are also rich in protein, dietary fibre, unsaturated fat, vitamins and minerals.

Examples of soybean foods are soymilk, tofu, tempeh and natto.

Increase your plant-based proteins

Here are some practical tips to boost your intake of plant-based proteins:

  • Add legumes to dishes

    Try mixing plant-based proteins and animal proteins in the same dish.

    For example, you can prepare stir-fry shrimps with added tofu or incorporate chickpeas into beef stew.

  • Include legumes daily

    Aim to incorporate a serving of legumes every day as part of your daily protein intake.

    For example, you can have lentil soup with bread for breakfast, instead of toast with kaya.

  • Have a variety of legume dishes

    Prepare different legume dishes to keep your meals exciting and nutritious.

    For example, you can have stir-fry tempeh one day and braised tofu the next.

  • Choose legumes or nuts as snacks

    This is an easy way to increase your plant-based protein intake.

    However, be mindful of portion sizes, especially with nuts, as they are high in calories.

    For example, you can have steamed chickpeas, boiled peas/edamame, roasted almonds or chestnuts for a satisfying and nutritious snack.

Also, follow these simple cooking tips to ensure that you get the essential nutrients needed by your body, while avoiding excessive intake:

  • Choose skinless or lean cuts

    Opt for skinless chicken or duck parts, and lean cuts of beef, lamb or pork, when buying meat or poultry.

    Otherwise, you can also remove the skin or trim excess fat before cooking to reduce saturated fat intake from animal protein.

  • Include plant-based protein foods

    Add plant-based protein foods to your grocery shopping list to diversify your protein options when cooking dishes.

  • Use healthier cooking methods

    Cooking methods can also affect the quality of your protein intake.

    Choose to cook by steaming, stewing, braising, boiling, poaching, grilling, roasting or air-frying.

    Limit deep-frying and breading as these methods will cause the food to soak up more oil during cooking, hence adding more fat and calories to your intake.

  • Limit intake of organ meats

    Organ meats such as the liver, spleen or kidney are nutritious, but also high in cholesterol and saturated fat.

    Consume them in moderation to maintain a balanced diet.

When we have mixed rice for lunch, protein-based dishes are often the star of the meal.

However, most of us tend to choose chicken or meat as the primary protein source.

It is worth noting that dietary guidelines recommend including at least one serving of fish and one serving of plant-based protein as part of our daily protein intake.

This will ensure that we have a variety of protein sources in our diet.

Combining both animal and plant-based proteins in our diet will also provide higher-quality proteins for our body.

So go ahead and try some different protein-based dishes in your menu.

ByTan Ye Ting and Georgen , who are members of the Malaysian Dietitians’ Association (MDA). This article is contributed by Nutrition Month Malaysia (NMM) 2024, an annual community nutrition education initiative jointly organised by the Nutrition Society of Malaysia, MDA and the Malaysian Society of Body Composition. NMM’s annual Food-Fit-Fun Fair will be held in Pavilion Bukit Jalil, Kuala Lumpur, on May 22-26 (2024).

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Related stories:

Soy foods like tofu and tempeh are popular plant-based protein alternatives

Adopting a plant-based diet has multiple benefits

How to get started on a plant-based diet

Nutritional needs according to age

Thursday, 19 January 2023

Here's a diet to help you live a long life

 

The sooner one starts eating healthy, the better, but research shows that even making the appropriate dietary changes in one’s 80s can lead to a longer life. — dpa

 




Humans have sought the fountain of youth and long life for millennia.

For longevity at least, scientists think they’ve found a potent intervention: proper nutrition, which, in contrast to our genetic makeup and certain living conditions, is alterable.

And it appears that not only what and how much we eat is important, but also when.

In an article published in the journal Cell, gerontologists Professor Dr Valter Longo and Dr Rozalyn Anderson examine hundreds of ageing and nutrition studies on simple organisms, laboratory animals and humans, and combine them with their own studies to come up with a “longevity diet”.

Lovers of calorie bombs such as burgers, chips and cola, or comfort foods like white chocolate, will be disappointed.

The two experts link limited calorie intake and periodic fasting to a lower disease risk and longer life expectancy.

Their longevity diet calls for 45%-60% of calories from non-refined complex carbohydrates, 10%-15% from mostly plant-based proteins, and 25%-35% from mostly plant-based fats.

Translated into practical terms, this means: “Lots of legumes, whole grains and vegetables; some fish; no red meat or processed meat and very little white meat; low sugar and refined grains; good levels of nuts and olive oil, and some dark chocolate,” says Prof Longo.

While meat lovers may turn their noses up at the sound of the diet, his recommended “recipes for longevity” include couscous with mixed fish, tomatoes, almonds and garlic; Tuscan bread salad; and pasta with eggplant and tomato sauce topped with ricotta salata, which hardly sound unpalatable.

The longevity diet also calls for restricting eating to an 11-12 hour timeframe daily and a few yearly cycles of five-day fasting-mimicking diets – a low-calorie meal plan developed at the Longevity Institute that’s formulated to simulate the body’s fasting state.

Must be adapted

Prof Longo and Dr Anderson emphasise that their longevity diet should be adapted to individuals based on sex, age, lifestyle, health status and genetics,

This is as no diet is equally suited, say, to a physically fit 20-year-old and a 60-year-old with a metabolic disorder.

People over age 65 may need to increase protein intake to prevent frailty and diseases resulting from reduced bone or muscle mass, or low blood cell counts, they write.

According to German Institute of Human Nutrition Department of Nutrition and Gerontology head Dr Kristina Norman, modifications of this kind are very important.

“It’s often difficult in old age to ingest sufficient protein, too little of which can cause muscle loss and increase the risk of falling and breaking a bone.

“Eating somewhat more meat than generally recommended can therefore be advisable.”

She sees many parallels in the proposed diet with familiar dietary recommendations, e.g. those of the German Nutrition Society (DGE), as well as an eating plan aimed at healthy – and environmentally responsible – nutrition proposed by scientists some time ago.

“Contrary to popular belief, recommendations on healthy eating don’t change every few years – for the most part, they’re highly stable,” she notes.

“The Longo study can be regarded as old hat, but the matter has been reassessed and backed by stronger evidence.”

Never too late

In the view of Dr Bernhard Watzl, former head of Hamburg-based Max Rubner Institute’s Department of Physiology and Biochemistry of Nutrition, which advises Germany’s Federal Ministry of Food and Agriculture on consumer health protection in the nutrition sector, the overarching finding in the Cell review is that the quantity and quality of nutrition are key to long life.

“It’s better to consume too few calories than too many,” he says, adding that “The more demands that are placed on a system, the greater the wear it’s subjected to.”

So it’s important, he says, to keep demands at low levels.

As regards fasting, Dr Watzl is less convinced by the available data than Prof Longo and Dr Anderson are.

“Fasting is only for people unable to limit their calorie intake,” he says.

In such people, temporary abstinence from food can help to resensitise certain receptors in the body.

While he stresses it’s never too late in life to start eating healthily, Dr Watzl says sooner is better than later when it comes to preventing diseases that develop gradually over decades.

Prof Longo cited a Norwegian study that found even 60- to 80-year-olds gained several years in life expectancy when they followed many of the recommendations that are also part of the longevity diet.

The biggest gains, according to the study, came from eating more legumes, whole grains and nuts, and less red and processed meat.

Dr Watzl sees the dietary trend towards more wholemeal bread and muesli positively, but says “too much cheese or sliced sausage is often put on the bread – or white bread is eaten.”

He’s also critical of heavily-processed foods, not only because of the additives, but also the quick nutrient availability, which he says overtaxes metabolism.

ALSO READ: Ultra-processed foods are bad for your mind, heart and life

To optimise their longevity diet, Prof Longo and Dr Anderson advise personalising it in consultation with a nutrition specialist.

They also recommend focusing on smaller, more tolerable changes, rather than large ones that cause major weight loss followed – when the diet is abandoned – by a rapid “yo-yo-like” regain of fat.

“We propose that the longevity diet would be a valuable complement to standard healthcare and that, taken as a preventative measure, it could aid in avoiding morbidity, sustaining health into advanced age,” they write. – By Gisela Gross/dpa 

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Sunday, 1 May 2022

Humans are nutritionally wise; Say goodbye to daily aspirin

  Our food choices may be smarter than previously thought.

 
 


Researchers say our food choices may be influenced by nutritional requirements rather than calories.

PIONEERING research has shed new light on what drives people’s basic food preferences.

The international study, led by the University of Bristol, United Kingdom, set out to re-examine and test the widely-held view that humans evolved to favour energy dense foods and our diets are balanced simply by eating a variety of different foods.

Contrary to this belief, its findings revealed people seem to have “nutritional wisdom,” whereby foods are selected in part to meet our need for vitamins and minerals, and avoid nutritional deficiencies.

Lead author Jeff Brunstrom, professor of experimental psychology, said: “The results of our studies are hugely significant and rather surprising. For the first time in almost a century, we’ve shown humans are more sophisticated in their food choices, and appear to select based on specific micronutrients rather than simply eating everything and getting what they need by default.”

The paper, published in the journal Appetite, gives renewed weight to bold research carried out in the 1930s by an American paediatrician, Dr Clara Davis, who put a group of 15 babies on a diet which allowed them to “self-select”, in other words eat whatever they wanted, from 33 different food items.

While no child ate the same combination of foods, they all achieved and maintained a good state of health, which was taken as evidence of “nutritional wisdom”.

Its findings were later scrutinised and criticised, but replicating Dr Davis’ research was not possible because this form of experimentation on babies would today be considered unethical.

Hence, it has been nearly a century since any scientist has attempted to find evidence for nutritional wisdom in humans – a faculty which has also been found in other animals, such as sheep and rodents.

To overcome these barriers, Prof Brunstrom’s team developed a novel technique which involved measuring preference by showing people images of different fruit and vegetable pairings so their choices could be analysed without putting their health or well-being at risk.

In total 128 adults participated in two experiments.

The first study showed people prefer certain food combinations more than others.

For example apple and banana might be chosen slightly more often than apple and blackberries.

Remarkably, these preferences appear to be predicted by the amounts of micronutrients in a pair and whether their combination provides a balance of different micronutrients.

To confirm this, they ran a second experiment with different foods and ruled out other explanations.

To complement and cross-check these findings, real-world meal combinations as reported in the UK’S National Diet and Nutrition Survey were studied.

Similarly, these data demonstrated people combine meals in a way that increases exposure to micronutrients in their diet.

Specifically, components of popular UK meals e.g. fish and chips or curry and rice, seem to offer a wider range of micronutrients than meal combinations generated randomly, such as chips and curry.

The study is also notable as it features an unusual collaboration – Prof Brunstrom’s co-author is Mark Schatzker, a journalist and author.

In 2018, the two met when Schatzker delivered a talk about his book, The Dorito Effect, which examines how the flavour of whole foods and processed foods has changed, and the implications for health and wellness.

Prof Brunstrom explained: “Mark challenged the view among behavioural nutrition scientists that humans only seek calories in food. He pointed out, for example, that fine wine, rare spices and wild mushrooms are highly sought after but are a poor source of calories.

“This was all very intriguing, so I went to see him at the end and basically said: ‘Great talk, but I think you’re probably wrong. Do you want to test it?’

“That marked the start of this journey, which ultimately suggests I was wrong. Far from being a somewhat simple-minded generalist, as previously believed, humans seem to possess a discerning intelligence when it comes to selecting a nutritious diet.”

Schatzker added: “The research questions the modern food environment – does our cultural fixation with fad diets, which limit or forbid consumption of certain types of foods, disrupt or disturb this dietary ‘intelligence’ in ways we do not understand?”

“Studies have shown animals use flavour as a guide to the vitamins and minerals they require.

“If flavour serves a similar role for humans, then we may be imbuing junk foods such as potato chips and fizzy drinks with a false ‘sheen’ of nutrition by adding flavourings to them.

“In other words, the food industry may be turning our nutritional wisdom against us, making us eat food we would normally avoid, thus contributing to the obesity epidemic.” - The Star Malaysia 

 

Say goodbye to daily aspirin 


Daily aspirin no longer recommended for adults 60 and older

Doctors reverse recommendation on daily aspirin

THIS might be a tough pill to swallow.

People aged 60 and older are no longer recommended to take aspirin medication as a way of avoiding heart disease because of the potential health risks, the United States Preventive Services Task Force (USPSTF) announced last week.

The new stance by the leading task force serves as an update to its 2016 guidance, which said people between 60 and 69 years old with at least a 10% risk of suffering from cardiovascular disease over the next 10 years should view taking low-dose aspirin daily as an “individual” decision.

“Based on new evidence since the 2016 Task Force recommendation, it is now recommended that once people turn 60 years old, they should not consider starting to take aspirin because the risk of bleeding cancels out the benefits of preventing heart disease,” reads the announcement by the USPSTF.

Meanwhile, people aged 40 to 59 with at least a 10% risk of 10-year cardiovascular disease should look at taking daily aspirin as an individual choice, the task force said.

“Daily aspirin use may help prevent heart attacks and strokes in some people, but it can also cause potentially serious harms, such as internal bleeding,” John Wong, a member of the task force, said in a statement.

“It’s important that people who are 40 to 59 years old and don’t have a history of heart disease have a conversation with their clinician to decide together if starting to take aspirin is right for them.”

The new guidelines apply to people who don’t have cardiovascular disease but are at high risk to develop it and haven’t begun taking aspirin each day.

The organisation also notes that about 605,000 people in the US suffer their first heart attack each year on average, while about 610,000 have their first stroke.

Heart disease accounts for more than 25% of deaths in the US, making it the leading cause in the country.

Aspirin is an anti-inflammatory drug that has been used for more than a century. It’s often taken to treat symptoms such as headaches, body aches and other cold-like ailments.

The task force is made up of 16 appointed volunteers who are each considered leaders within a field of health or medicine.- TNS

Friday, 21 January 2022

Malaysian teens are shorter than the rest

 

 

Undernutrition among our adolescents is causing them to be stunted, making them shorter on average than some of our regional neighbours.

` MALAYSIAN teenagers are a short lot – and not because of genetical predisposition.

` One in six local teens are considered stunted at 6-7cm shorter than the World Health Organization’s (WHO’S) standard height reference for adolescents between 10 and 17 years old.

` This is as they are not consuming adequate amounts of the nutrients needed for growth.

` Given that the window for the adolescent growth spurt is very short, yet provides the biggest growth opportunity during our lifetime, this problem of undernutrition needs to be addressed so that our teens can attain their maximum potential height.

` Stunted growth and development caused by undernutrition is common in many regions, especially poorer ones.

` Data from our 2019 National Health and Morbidity Survey (NHMS) showed that one in five Malaysian children aged five and under are stunted.

` This reflects an increasing trend, with 21.8% in 2019 from 17.7% in 2015 and 16.6% in 2011.

` Meanwhile, data from the 2017 NHMS revealed that the adolescent stunting rate was at 8.5%, or one in 12, in the 10- to 17-years-old age group.

` Increased risk of disease

` “This is a high percentage for an upper middle income country like ours.

` “For developed countries, we want to keep this figure below 5%,” comments Universiti Malaya Faculty of Medicine Department of Paediatrics head Professor Dr Muhammad Yazid Jalaludin.

` The average final adult height of Malaysians is 164.7cm for men and 153.3cm for women.

` “If we plot this on the growth chart, we are in the bottom 10th percentile, which means our average height is at the lowest out of 100 countries for both men and women, i.e. we are 8-9cm shorter than the rest.

` “The fact that we are not achieving as much height as other Asian men and women is worrying.

` “We have fallen behind Singapore, Japan and South Korea, although in the 1940s and 1950s, we were around the same height,” he says.

` The average male height is 170.6cm in Singapore, 171.2cm in Japan and 175.3cm in South Korea. For females, it is 160cm in Singapore, 158.8cm in Japan and 162.6cm in South Korea.

` Interestingly, females in South Korea have recorded one of the biggest height increases among the world’s female population over the last century.

` Prof Yazid adds: “Of course, we also have to look at the parents’ height – teens should be plus or minus 8cm from their dad’s or mum’s height.”

` Studies have shown that countries that consume more dairy products and animal proteins have a taller population, compared to countries that rely on rice and wheat, like most Asian countries.

` Some consequences of stunting include poor cognition, poor educational performance at school, lower income and lower economic opportunity.

` And when stunting is accompanied by excessive weight gain later in childhood, the person will develop an increased risk of nutrition-related chronic diseases in adulthood, including obesity, diabetes and heart diseases.

` “A number of them become obese, as when they start to grow older, they get better nutrition and cannot satisfy their hunger, so they eat a lot,” he says.

` However, stunting recovery intervention may enable undernourished children to catch up on height and other developmental markers.

` The crucial years

` Puberty is the time in life when a boy or girl becomes sexually mature.

` This is also when the growth spurt occurs.

` This short period of rapid growth development in children typically lasts around two to three years.

` Prof Yazid explains: “Boys and girls start at different ages.

` “In girls, puberty is when the breasts develop, which can be as early as eight years old, until menarche, i.e. their first period, which is around two or three years after breast development.”

` He adds that the growth spurt usually occurs at the early stage of puberty, so for girls, it occurs around the time of breast development.

` “Once they get their menses, they don’t grow much until the end of the total pubertal period – the gain is only around 2-5cm.

` “During the first two to three years of puberty, most will gain between 17-22cm in height,” he says.

` For boys, puberty begins later, with testicular enlargement that can begin as early as nine to 10 years of age, although it typically occurs around 12 years of age.

` It then takes another two to three years before puberty ends.

` “Only after puberty will boys have a growth spurt and can achieve a 20-25cm height gain.

` “This is when they start having acne, pubic hair, etc

` `

Start them young

Malaysian teens are shorter than the rest

 “They can grow really fast, but to help them grow, we need to intervene immediately and cannot wait until their voice changes,” Prof Yazid points out.

He also notes that nobody usually knows when a boy starts puberty as no one checks for testicular enlargement under normal circumstances.

Only a visit to a paediatric endocrinologist is likely to see their testes size being examined.

Where growth happens

All children have growth plates – areas of smooth, elastic cartilage found at the end of each long bone in the body.

This is where growth takes place. When the bones finish growing, the growth plates close.

Girls generally stop growing and reach their maximum height around the age of 14, and boys, around 16.

Doctors can estimate when growth will be completed by determining a child’s bone age.

They do this by taking an X-ray of the left hand and wrist to see if the growth plates are still open.

The bone age may be different from the child’s actual age.

Prof Yazid says: “Bone age is not the same as chronological age.

“For those that go into early puberty, their bone age may be more advanced than chronological age.

“Height gain should really begin before puberty.

“If the girls are short at the start of puberty, we like to delay puberty, because if they were to start their menses with the height of 130cm, then we cannot do much.

“That’s why it’s important to start nutrition, adequate caloric intake and caloric expenditure from a young age for bone lengthening and thickening, so that the child can gain enough height.”

The adolescent phase contributes to 15-20% of adult height, 45% of adult bone mass increase, and 40-50% of adult weight gain.

Nutritional needs

During early adolescence, children require up to twice or more key nutrients to support accelerated growth and development, compared to a younger child.

These include:

> Calcium – up to 85% increase > Protein – up to 154% increase > Magnesium – up to 200% increase

> Phosphorus – up to 170% increase)

> Zinc – up to 75% increase, and > Vitamin K – up to 133% increase.

Results from the 2017 NHMS showed that:

> 89.4% of adolescents did not meet the required nutritional intake (RNI) for calcium

> 98.8% did not meet the RNI for vitamin D, and

> Over 60% did not meet the RNI for vitamin E.

In addition, the survey found that seven out of 10 adolescents habitually skipped breakfast, while another one in two skipped lunch and dinner.

“I’ve encountered a number of adolescents (13-18 years) who have growth issues; they are underweight so they don’t gain much height.

“At this age, physical activity is important for boys, and if they don’t eat much, they lack energy.

“Three out of four kids also don’t take adequate dairy products,” laments Prof Yazid.

A lack of sleep also affects height.

This is as growth hormones are secreted the most between 10pm to midnight before dropping, then rising a bit between 2am to 4am.

He says: “Most of our adolescents sleep late and have poor quality of sleep, so they don’t get the spurt of growth hormones.

“Another factor is physical activity, which enables the secretion of endorphin and serotonin hormones to make you feel good about yourself. “When you feel good and sleep better, it increases the growth hormone secretions.

“Our adolescents love to sleep late, don’t do regular physical activity and skip meals, so how can they grow well?

“With Covid-19, all kids are equally affected as they don’t do much physical activity and spend more time on gadgets.”

Adolescents should aim to incorporate 30-60 minutes of moderate physical activity daily.

“Walking lazily doesn’t count.

“It’s best to exercise in the evening so they can sleep better at night,” he says.

Parents as role models

Prof Yazid says about half of adolescents perceive that their parents don’t know what they do in their free time.

“What and how you eat matters. “Parents need to try to understand their adolescents’ perspective and look into the kinds of food, timing of their food intake/sleep and exercise patterns.

“It’s better to show than to say, because bugging them doesn’t help when parents themselves don’t lead by example.

“So, when food is put on the table, show them how you would eat it.

“Similarly, exercise with them and sleep early.

“Parents are really the best supporters to encourage their children to do all these,” he says.

In terms of dairy products – which are important for development and bone strength – a number of parents think their children don’t need milk beyond the ages of five or seven, and thus, stop serving it to them.

This is incorrect.

Prof Yazid says: “From dairy products, they can get good nutrients.

“They need at least 600ml of milk a day – 400ml can come from milk and the other 200ml can be obtained from other sources such as cheese or yoghurt.”

When regular meals alone do not meet the increased nutrient requirements for their child’s growth, parents can seek advice from their child’s physician and consider nutritional supplements to help improve nutritional intake during this important growth period.

“The height at the start of puberty is so important to determine the final height.

“If we can reduce stunting rates before the age of five, we can definitely reduce its prevalence among adolescents,” concludes Prof Yazid.

The Star Malaysia 


When parents make mistakes 

 One common parenting mistake is jumping to conclusions about your child’s guilt without even giving them a chance to explain first. — Positive Parenting
 

It may be hard to put aside your pride and apologise to your kids, but it will make you a better parent and show your children good values.


IF you have ever mistakenly raised your voice towards your child or blamed him for something he did not do, you must know how awful that feels like.

Parents commit mistakes too, but as authority figures and role models in the family, they may find it hard to right their wrongs.

Mistakes are bound to happen, whether due to stress, overwork, lack of sleep, poor judgement or carelessness.

However, this is not an excuse to be ignorant or dismissive of one’s missteps.

What we can do is to learn from our mistakes today so that we can be better parents tomorrow.

It may not be easy to overcome our ego and admit our mistake to the kids.

But by role-modelling such behaviour, we can teach our kids (and ourselves) to be better human beings.

Common parenting mistakes


To learn from your mistakes, you will first need to accept that a mistake has been made.

It may occur unintentionally or due to past ignorance.

Here are some common mistakes:

> Breaking promises

You promised to take your daughter to her favourite restaurant after she did well in her test, but you were too busy and ended up not going.

Parents promise all kinds of things to their kids, but it can be hard to fulfil all of the promises made.

> Telling lies

White lies are common for various reasons – as an excuse, to avoid difficult topics, and often, to calm children.

Parents may also tell a lie to another person in front of their kids.

Even if the lie seems harmless, it teaches the kids that it is okay to lie – and this is not okay.

> Jumping to conclusions

Some parents tend to blame or scold their kids without giving them a chance to explain things first.

By assuming that our kids’ past behaviours and choices dictate present and future ones, it limits how we view our kids and can cause us to judge them unfairly.

> Using bad words

Rising anger tends to blind us. You may not realise the bad words being uttered and there is no way to retract them once they are said.

It is bad enough when said to another person, but worse when said to your own kids.

> Comparing and criticising

Constructive comments are okay, but belittling your child, comparing him with others, and criticising his weak spots, all with the intention of “building up his character” are not.

> Too much teasing

Joking, teasing and kidding with your kids are some of the ways to have a laugh and fun with them.

However, you may be taking things too far if they are not laughing.

Even worse is if you press them for not being able to take the joke. > Forgetting things

Having a busy schedule may lead to occasional slip-ups, causing you to forget simple errands (e.g. to pick up your child from tuition), or even important events and dates (e.g. your child’s birthday or school sports day).

> Being hypocritical

Parents are the main role model for their kids.

When parents do not practise what they preach, they risk confusing the kids with conflicting messages.

> Hurting them physically

Parents may accidentally inflict physical harm onto their children, e.g. injuring your daughter’s finger while closing the car door.

Some parents also tend to take out their anger or frustrations on their kids (including yelling, cursing and hitting).

Righting the wrong


After realising that you have made a mistake, what can you do?

> Don’t be too hard on yourself

No parent is perfect, so do not beat yourself up too long for being a “horrible parent”.

Instead, focus on correcting your mistake and finding a solution. >

Admit mistakes and apologise

Once you and your child have calmed down somewhat, gently talk about what you regret and apologise for your mistake.

Ask for a “do over” and try to make things right.



This can be a great opportunity to demonstrate forgiveness and humility to your child. > Reconnect with your child

Let your child express how he feels.

Be open, present and willing to listen and engage with him.

Try to put yourself in his shoes and see (and feel) from his point of view.

This will build empathy and a deeper understanding to reconnect with one another.

> Aim to be better

Focus on self-improvement as a person and parent.

Learn to regulate your own emotions by practising self-compassion and learning to stay centred whenever there is a crisis in your household.

Loving your child starts with loving yourself.

It is part of human nature to make mistakes.

In our lifetime, we will (or should) exchange apologies and forgiveness countless times, including as a parent.

The important thing is to acknowledge that a mistake has been made and to learn from it, make amends, reconcile and gradually develop to be a better parent and individual.

-
Alexius Cheang is a behavioural psychologist. This article is courtesy of the Malaysian Paediatric Association’s Positive Parenting programme in collaboration with expert partners. For further information, please email starhealth@ thestar.com.my. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information. 

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Malaysian teens are shorter than the rest

 

 

Undernutrition among our adolescents is causing them to be stunted, making them shorter on average than some of our regional neighbours.

` MALAYSIAN teenagers are a short lot – and not because of genetical predisposition.

` One in six local teens are considered stunted at 6-7cm shorter than the World Health Organization’s (WHO’S) standard height reference for adolescents between 10 and 17 years old.

` This is as they are not consuming adequate amounts of the nutrients needed for growth.

` Given that the window for the adolescent growth spurt is very short, yet provides the biggest growth opportunity during our lifetime, this problem of undernutrition needs to be addressed so that our teens can attain their maximum potential height.

` Stunted growth and development caused by undernutrition is common in many regions, especially poorer ones.

` Data from our 2019 National Health and Morbidity Survey (NHMS) showed that one in five Malaysian children aged five and under are stunted.

` This reflects an increasing trend, with 21.8% in 2019 from 17.7% in 2015 and 16.6% in 2011.

` Meanwhile, data from the 2017 NHMS revealed that the adolescent stunting rate was at 8.5%, or one in 12, in the 10- to 17-years-old age group.

` Increased risk of disease

` “This is a high percentage for an upper middle income country like ours.

` “For developed countries, we want to keep this figure below 5%,” comments Universiti Malaya Faculty of Medicine Department of Paediatrics head Professor Dr Muhammad Yazid Jalaludin.

` The average final adult height of Malaysians is 164.7cm for men and 153.3cm for women.

` “If we plot this on the growth chart, we are in the bottom 10th percentile, which means our average height is at the lowest out of 100 countries for both men and women, i.e. we are 8-9cm shorter than the rest.

` “The fact that we are not achieving as much height as other Asian men and women is worrying.

` “We have fallen behind Singapore, Japan and South Korea, although in the 1940s and 1950s, we were around the same height,” he says.

` The average male height is 170.6cm in Singapore, 171.2cm in Japan and 175.3cm in South Korea. For females, it is 160cm in Singapore, 158.8cm in Japan and 162.6cm in South Korea.

` Interestingly, females in South Korea have recorded one of the biggest height increases among the world’s female population over the last century.

` Prof Yazid adds: “Of course, we also have to look at the parents’ height – teens should be plus or minus 8cm from their dad’s or mum’s height.”

` Studies have shown that countries that consume more dairy products and animal proteins have a taller population, compared to countries that rely on rice and wheat, like most Asian countries.

` Some consequences of stunting include poor cognition, poor educational performance at school, lower income and lower economic opportunity.

` And when stunting is accompanied by excessive weight gain later in childhood, the person will develop an increased risk of nutrition-related chronic diseases in adulthood, including obesity, diabetes and heart diseases.

` “A number of them become obese, as when they start to grow older, they get better nutrition and cannot satisfy their hunger, so they eat a lot,” he says.

` However, stunting recovery intervention may enable undernourished children to catch up on height and other developmental markers.

` The crucial years

` Puberty is the time in life when a boy or girl becomes sexually mature.

` This is also when the growth spurt occurs.

` This short period of rapid growth development in children typically lasts around two to three years.

` Prof Yazid explains: “Boys and girls start at different ages.

` “In girls, puberty is when the breasts develop, which can be as early as eight years old, until menarche, i.e. their first period, which is around two or three years after breast development.”

` He adds that the growth spurt usually occurs at the early stage of puberty, so for girls, it occurs around the time of breast development.

` “Once they get their menses, they don’t grow much until the end of the total pubertal period – the gain is only around 2-5cm.

` “During the first two to three years of puberty, most will gain between 17-22cm in height,” he says.

` For boys, puberty begins later, with testicular enlargement that can begin as early as nine to 10 years of age, although it typically occurs around 12 years of age.

` It then takes another two to three years before puberty ends.

` “Only after puberty will boys have a growth spurt and can achieve a 20-25cm height gain.

` “This is when they start having acne, pubic hair, etc

` `

Start them young

Malaysian teens are shorter than the rest

 “They can grow really fast, but to help them grow, we need to intervene immediately and cannot wait until their voice changes,” Prof Yazid points out.

He also notes that nobody usually knows when a boy starts puberty as no one checks for testicular enlargement under normal circumstances.

Only a visit to a paediatric endocrinologist is likely to see their testes size being examined.

Where growth happens

All children have growth plates – areas of smooth, elastic cartilage found at the end of each long bone in the body.

This is where growth takes place. When the bones finish growing, the growth plates close.

Girls generally stop growing and reach their maximum height around the age of 14, and boys, around 16.

Doctors can estimate when growth will be completed by determining a child’s bone age.

They do this by taking an X-ray of the left hand and wrist to see if the growth plates are still open.

The bone age may be different from the child’s actual age.

Prof Yazid says: “Bone age is not the same as chronological age.

“For those that go into early puberty, their bone age may be more advanced than chronological age.

“Height gain should really begin before puberty.

“If the girls are short at the start of puberty, we like to delay puberty, because if they were to start their menses with the height of 130cm, then we cannot do much.

“That’s why it’s important to start nutrition, adequate caloric intake and caloric expenditure from a young age for bone lengthening and thickening, so that the child can gain enough height.”

The adolescent phase contributes to 15-20% of adult height, 45% of adult bone mass increase, and 40-50% of adult weight gain.

Nutritional needs

During early adolescence, children require up to twice or more key nutrients to support accelerated growth and development, compared to a younger child.

These include:

> Calcium – up to 85% increase > Protein – up to 154% increase > Magnesium – up to 200% increase

> Phosphorus – up to 170% increase)

> Zinc – up to 75% increase, and > Vitamin K – up to 133% increase.

Results from the 2017 NHMS showed that:

> 89.4% of adolescents did not meet the required nutritional intake (RNI) for calcium

> 98.8% did not meet the RNI for vitamin D, and

> Over 60% did not meet the RNI for vitamin E.

In addition, the survey found that seven out of 10 adolescents habitually skipped breakfast, while another one in two skipped lunch and dinner.

“I’ve encountered a number of adolescents (13-18 years) who have growth issues; they are underweight so they don’t gain much height.

“At this age, physical activity is important for boys, and if they don’t eat much, they lack energy.

“Three out of four kids also don’t take adequate dairy products,” laments Prof Yazid.

A lack of sleep also affects height.

This is as growth hormones are secreted the most between 10pm to midnight before dropping, then rising a bit between 2am to 4am.

He says: “Most of our adolescents sleep late and have poor quality of sleep, so they don’t get the spurt of growth hormones.

“Another factor is physical activity, which enables the secretion of endorphin and serotonin hormones to make you feel good about yourself. “When you feel good and sleep better, it increases the growth hormone secretions.

“Our adolescents love to sleep late, don’t do regular physical activity and skip meals, so how can they grow well?

“With Covid-19, all kids are equally affected as they don’t do much physical activity and spend more time on gadgets.”

Adolescents should aim to incorporate 30-60 minutes of moderate physical activity daily.

“Walking lazily doesn’t count.

“It’s best to exercise in the evening so they can sleep better at night,” he says.

Parents as role models

Prof Yazid says about half of adolescents perceive that their parents don’t know what they do in their free time.

“What and how you eat matters. “Parents need to try to understand their adolescents’ perspective and look into the kinds of food, timing of their food intake/sleep and exercise patterns.

“It’s better to show than to say, because bugging them doesn’t help when parents themselves don’t lead by example.

“So, when food is put on the table, show them how you would eat it.

“Similarly, exercise with them and sleep early.

“Parents are really the best supporters to encourage their children to do all these,” he says.

In terms of dairy products – which are important for development and bone strength – a number of parents think their children don’t need milk beyond the ages of five or seven, and thus, stop serving it to them.

This is incorrect.

Prof Yazid says: “From dairy products, they can get good nutrients.

“They need at least 600ml of milk a day – 400ml can come from milk and the other 200ml can be obtained from other sources such as cheese or yoghurt.”

When regular meals alone do not meet the increased nutrient requirements for their child’s growth, parents can seek advice from their child’s physician and consider nutritional supplements to help improve nutritional intake during this important growth period.

“The height at the start of puberty is so important to determine the final height.

“If we can reduce stunting rates before the age of five, we can definitely reduce its prevalence among adolescents,” concludes Prof Yazid.

The Star Malaysia 


When parents make mistakes 

 One common parenting mistake is jumping to conclusions about your child’s guilt without even giving them a chance to explain first. — Positive Parenting
 

It may be hard to put aside your pride and apologise to your kids, but it will make you a better parent and show your children good values.


IF you have ever mistakenly raised your voice towards your child or blamed him for something he did not do, you must know how awful that feels like.

Parents commit mistakes too, but as authority figures and role models in the family, they may find it hard to right their wrongs.

Mistakes are bound to happen, whether due to stress, overwork, lack of sleep, poor judgement or carelessness.

However, this is not an excuse to be ignorant or dismissive of one’s missteps.

What we can do is to learn from our mistakes today so that we can be better parents tomorrow.

It may not be easy to overcome our ego and admit our mistake to the kids.

But by role-modelling such behaviour, we can teach our kids (and ourselves) to be better human beings.

Common parenting mistakes


To learn from your mistakes, you will first need to accept that a mistake has been made.

It may occur unintentionally or due to past ignorance.

Here are some common mistakes:

> Breaking promises

You promised to take your daughter to her favourite restaurant after she did well in her test, but you were too busy and ended up not going.

Parents promise all kinds of things to their kids, but it can be hard to fulfil all of the promises made.

> Telling lies

White lies are common for various reasons – as an excuse, to avoid difficult topics, and often, to calm children.

Parents may also tell a lie to another person in front of their kids.

Even if the lie seems harmless, it teaches the kids that it is okay to lie – and this is not okay.

> Jumping to conclusions

Some parents tend to blame or scold their kids without giving them a chance to explain things first.

By assuming that our kids’ past behaviours and choices dictate present and future ones, it limits how we view our kids and can cause us to judge them unfairly.

> Using bad words

Rising anger tends to blind us. You may not realise the bad words being uttered and there is no way to retract them once they are said.

It is bad enough when said to another person, but worse when said to your own kids.

> Comparing and criticising

Constructive comments are okay, but belittling your child, comparing him with others, and criticising his weak spots, all with the intention of “building up his character” are not.

> Too much teasing

Joking, teasing and kidding with your kids are some of the ways to have a laugh and fun with them.

However, you may be taking things too far if they are not laughing.

Even worse is if you press them for not being able to take the joke. > Forgetting things

Having a busy schedule may lead to occasional slip-ups, causing you to forget simple errands (e.g. to pick up your child from tuition), or even important events and dates (e.g. your child’s birthday or school sports day).

> Being hypocritical

Parents are the main role model for their kids.

When parents do not practise what they preach, they risk confusing the kids with conflicting messages.

> Hurting them physically

Parents may accidentally inflict physical harm onto their children, e.g. injuring your daughter’s finger while closing the car door.

Some parents also tend to take out their anger or frustrations on their kids (including yelling, cursing and hitting).

Righting the wrong


After realising that you have made a mistake, what can you do?

> Don’t be too hard on yourself

No parent is perfect, so do not beat yourself up too long for being a “horrible parent”.

Instead, focus on correcting your mistake and finding a solution. >

Admit mistakes and apologise

Once you and your child have calmed down somewhat, gently talk about what you regret and apologise for your mistake.

Ask for a “do over” and try to make things right.



This can be a great opportunity to demonstrate forgiveness and humility to your child. > Reconnect with your child

Let your child express how he feels.

Be open, present and willing to listen and engage with him.

Try to put yourself in his shoes and see (and feel) from his point of view.

This will build empathy and a deeper understanding to reconnect with one another.

> Aim to be better

Focus on self-improvement as a person and parent.

Learn to regulate your own emotions by practising self-compassion and learning to stay centred whenever there is a crisis in your household.

Loving your child starts with loving yourself.

It is part of human nature to make mistakes.

In our lifetime, we will (or should) exchange apologies and forgiveness countless times, including as a parent.

The important thing is to acknowledge that a mistake has been made and to learn from it, make amends, reconcile and gradually develop to be a better parent and individual.

-
Alexius Cheang is a behavioural psychologist. This article is courtesy of the Malaysian Paediatric Association’s Positive Parenting programme in collaboration with expert partners. For further information, please email starhealth@ thestar.com.my. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information. 

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