healthy bones - 3 july 2016

7/25/2019 Healthy Bones - 3 July 2016

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SUNDAY STAR, 3 JULY 2016

special

HEALTHY BONES


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healthy bonesSUNDAY STAR,

3 JULY 2016

Livingstrong longerNE health is often overlooked byny Malaysians. It usually doesbecome a concern until an

ury occurs or bone healtheriorates with old age.

Although bones are tough buthtweight structures, they areen susceptible to injuries andar-and-tear such as bonectures.

However, bones have the abilityepair and mend themselves.

e recovery period of a fracturepends on the severity of themage and if necessary, surgicalervention is necessary to aid inper healing.

Bones are also prone toorders and diseases that oftenur in later stages of life, but

me bone issues may presentmselves at a much younger age.f these bone diseases are leftreated for an extended periodime, the effects can berimental and cause a host ofer health problems. Some of thest common bone-relatedeases among Malaysians areeoporosis and arthritis.

agile bonesOsteoporosis is defined as aletal disorder where bones loseical density and become fragile.atients suffering from

eoporosis are prone to seriousne fractures and injuries that result in poor healing order patients with disabilities.

According to the Health Ministry,causes of osteoporosis can beken down to primary andondary classifications. Primaryssification includes women whove reached menopause, old aged idiopathic causes. These aremost common causes of

eoporosis.

n the secondary classification,eoporosis is caused bydocrine disorders (diseasessed by the dysfunction ofans that produce hormones inbody) such as Cushingsdrome and hypogonadism, side

effects of certain drugs and chronicdiseases such as renal failure andliver cirrhosis.

Individuals diagnosed withanorexia nervosa or certain typesof leukaemia or have undergonegastric bypass surgical proceduresare also at risk of osteoporosis.

Osteoporosis also affectsindividuals who have beendiagnosed with osteogenesisimperfecta (OI) or brittle bone

disease.OI is an incredibly rare disorder

that occurs in six to seven out ofevery 100,000 individuals. Peoplewith OI are constantly prone tofractures due to defective or thelack of type 1 collagen in theirbones.

For the most part, osteoporosis isa silent disease and is not usuallydiagnosed until a bone injury orfracture.

However, some commonsymptoms of osteoporosis includeback pain, loss of height, lowtrauma fracture and increasingdorsal kyphosis, known asDowagers hump or hunching.

Osteoporosis can be diagnosed

through an X-ray test known as thebone mineral density test, whichmeasures how much calcium andother minerals are packed into asegment of a bone.

Creaky hinges

Arthritis is another commonbone and joint issue faced bymany. It is usually categorised asthe inflammation of the jointstructures such as bone andcartilage.

There are many types of arthritisbut, according to the ArthritisFoundation Malaysia (AFM), thetwo most prevalent arthritisincidences in Malaysia are

osteoarthritis (OA) and rheumatoidarthritis (RA).

OA is a degenerative form ofarthritis that is common amongthe older population. OA can bedefined as joint failure and is causeby repeated damage of the joint

Characteristics OsteoarthritisRheumatoid arthritis

Age at whichcondition manifests

30 to 50 years of age but may alsoexhibit later in life

Begins later in life

Speed of onset Relatively rapid over weeks to months Slow and worsens over the years

Joint symptoms Joints are painful, swollen and stiff Joints ache and are sensitive, but havelittle or no swelling

Duration of stiffness Stiffness occurs in the morningsand lasts more than an hour

Stiffness occurs in the mornings, end of the dayor after periods of activity and lasts less thanan hour

Presence of symptomsaffecting the wholebody (systemic)

Feeling of fatigue and being ill Symptoms only focused on affected joints

Pattern of jointsthat are affected

Affects small and large joints on bothsides of the body in a symmetricalpattern pain in both hands, bothwrists or elbows, or balls of the feet

Symptoms begin on one side of the body andmay spread to the other side. Symptoms begingradually and are limited to one set of jointssuch as joints closest to the fingernails, largerweight-bearing joints (knees and hips) or the spine

difiable and non-modifiable risk factors for osteoporosis. (Source: Clinicalde on Management of Osteoporosis 2012, Ministry of Health Malaysia)

The differences between osteoarthritis (OA) and rheumatoid arthritis (RA).

where the cartilage whichprovides a cushion for weight

bearing around the joints degenerates and exposes the bonysurfaces of the joint-ends of thebones to direct pressure.

OA is usually described as acutepain at the joints and sometimesassociated with stiffness. Patientswith OA will often find it difficultto keep their stability whenmoving. The pain for OA can varyfor no apparent reason there maybe good days and bad days.

OA commonly occurs around thehands between elbows, wrists andfingers, and in the knees and hips.Unlike osteoporosis, OA is easier todiagnose due to the symptomsbeing easier to recognise.

Patients who experience joint

pain for more than six monthsshould consult a doctor. Thoroughphysical and X-ray examinationsshould be sufficient for doctors tomake a diagnosis if the symptomsare a result of OA or some otherdisorder.

RA exhibits different symptomscompared to OA. According to theAFM, RA is a common form ofarthritis and affects about five in1,000 Malaysians.

RA is a result of inflammation ofthe synovium a membrane

surrounding joints that contains alubricant called synovial liquid.The synovium is also enclosed in ahard outer layer known as thecapsule.

The inflammation exhibitssymptoms such as redness,swelling and pain. Redness iscaused by increased blood flowwhile swelling and pain is causedby local nerve irritation due to theinflammation chemicals and thestretching of the capsule.

Inflammation is the bodysnatural reaction to arrest aninfection by foreign bodies suchas bacteria.

Healthcare experts are stillstudying the reasons an

inflammation reaction is set off onsome of the bodys local tissuessuch as the joints that exhibit RA.

Continuous inflammation tocartilage, bones and other jointligaments can cause irreversibledamage. It is because of thisreaction that RA is classified as anautoimmune disease.

RA is most prevalent amongindividuals aged between 30 and50, where women are more

commonly affected by the diseasethan men. Unfortunately, there is

no fixed pattern of the severity ofRA in different individuals. Theeffects of RA vary from person toperson, where some individualsmay suffer more extensive damageto their joints while others exhibitmild symptoms.

Pain and discomfort in joints dueto RA are not continuous; theymight flare up at intermittentperiods, but there are no knownobvious triggers for these flare-ups.

Early detection of RA is key tobetter recovery outcomes. Eventhough there is no specific test todiagnose RA, doctors performseveral tests and examinations tocome up with a clinical diagnosisfor it.

Doctors will usually call for ablood test that will detect traces ofinflammation and the rheumatoidfactor blood protein that isprevalent in 70% of people withRA.

In addition to this, an X-rayexamination will also be carriedout to identify damage to the jointscaused by inflammation in RA.

> SEE NEXT PAGE

Non-modifiable Modifiable

Advancing age

Genetic predisposition

Female gender

Premature menopause ( three units per day)

Excessive caffeine intake (> three drinks per day)

Low body weight (BMI


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SUNDAY STAR,3 JULY 2016

healthy bones 3

Prevention is better than intervention> FROM PREVIOUS PAGE

Though osteoporosis andarthritis are diseases that aremore common among olderindividuals, necessaryprecautions taken at a youngerage can help delay if notcompletely prevent thesediseases.

According to Dr GopinathMathavan, consultantorthopaedic and trauma surgeonat Oriental Melaka StraitsMedical Centre, to achieveoptimal bone mass by the timean individual reaches his latetwenties, it is important to instilhealthy nutritional and lifestyle

habits with adequate physicalactivities from a young age.

Building a childs bone bankis very much like saving for theireducation. Parents play a crucialrole in building their childs bonebank. Parents should inculcatethe practice of eating a balancediet with their children, he says.

To build strong and healthybones, children should getadequate dietary supplementfrom foods that are rich incalcium and vitamin D, whichaids the body in calciumabsorption. Some examples offood that are rich in thesenutrients are milk, soy, cheese,salmon and yoghurt.

Another growing concernamong the young is the lack ofphysical activity, especially withthe emergence of digital gadgets.Hence, children these days aredrawn to a sedentary lifestylewith minimum physical activity.

Being physically active meansspending less time sitting andmore time on their feet. The bestphysical exercises that are idealfor bone health are weight-bearing activities such asrunning, soccer, hiking,basketball and gymnastics,says Dr Gopinath.

Even as adults, bone health iscrucial to avoid premature onsetof osteoporosis and arthritis.

Necessary lifestyle modificationsalso need to be done to ensurelong-term bone health.

Minimising bone loss canbe achieved by ensuring themodifiable risk factors such aslack of nutrition, physicalinactivity, smoking and alcoholabuse are avoided, saysDr Gopinath.

Continuous focus on abalanced diet and engagementin physical activity is importantto ensure optimum bonehealth to reduce boneloss and strengthenjoints as well.

Always discuss and

consult with a healthcarephysician about taking the rightsupplements to improve bonehealth, in case of a reducedintake of necessary sources ofbone nutrition in your diet.

However, specialconsideration must be takenwhen pursuing extreme physicalactivities and sports.

Most bone injuries and stresson the joints that could lead tofuture injuries occur during aphysical activity.

This affects athletes whoundergo advanced training toregular individuals who straintheir bones in gyms due to poortechnique and posture.

Hence, it is important toalways consult with a certifiedexpert such as a coach or atrainer when engaging in suchactivities.

Schedule annualappointments with yourphysician to check your bonesand keep a firm eye onsymptoms that cause discomfortand need immediate medicalattention. In most cases,untreated bone diseases worsenover time.

Managing weight is alsocrucial to bone health.Individuals are advised tomaintain a target body massindex (BMI) of between 18.2 and

22.9 for both males and females.Individuals with a higher BMI

risk straining their weight-bearing joints such as their hipsand knees while individualswith a BMI that is lower than18.2 are at risk of developingosteoporosis due to malnutrition.

Living but not limited

Patients with osteoporosis areadvised to not engage in heavyphysical activity or contactsports. Physicians will focus onhelping to strengthen bonesthrough diet and dietarysupplements.

A daily 30-minute brisk walk

is a simple and low-impactphysical activity patients withosteoporosis and arthritis cancarry out to not only stay activebut also exercise joints andstrengthen bones.

Patients with OA areencouraged to exercise andusually a consultantphysiotherapist will advise onspecial exercise techniques tostrengthen thigh muscles.

For RA patients, exercise isimportant as well but

special care must betaken to reduceimpact on the joints.

Warm-up routinesand gentle stretches

Hope for arthritis

Arthritis Foundation Malaysia(AFM) offers support andassistance for patients witharthritis.

One way it does so is byproviding funds for jointprostheses procedures, which cancost between RM10,000 andRM20,000.

A lot of these procedures arebeyond the financial scope ofmost Malaysians. We provideassistance either in part or in fullbased on the internal assessmentcommittees consideration,

says Assoc Prof Dr SargunanSockalingam, consultantrheumatologist and president ofAFM.

AFM also aids in the

management of arthritis inMalaysia through publicprogrammes, where healthcareprofessionals who specialise in thetreatment of arthritis speak inpublic forums and seminars anddisseminate advice to the public.

These healthcare professionalswork with us on a voluntary basis.AFM is a platform where patients,their relatives, and anyoneinterested in arthritis can meetexperts in the treatment andmanagement of the disease.

Some of our members who are

healthcare professionals in variousfields also suffer from arthritis.They bring an interestingperspective to the disease and howto manage it, says Dr Sargunan.

are great ways for RA patients tostay active.

RA patients are also advised toinvest in appropriate shoes toreduce shock and impact to jointswhen exercising.

As a whole, swimming is agreat activity for patients withosteoporosis or arthritis as itconditions bone and muscle withminimal impact on joints and riskof contact injury.

The appropriate precautionand management of bothosteoporosis and arthritis beginwith the awareness of thediseases and how they affect anindividual.

It is important to start taking

care of bones and joints at anearly age to sustain the health ofyour bones for later in life.Regularly consult physicians andmake the necessary modificationsto ensure long-term bone health.

Foods such asmilk, cheese andsalmon are richin calcium andvitamin D, whichcontribute tobone health.


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healthy bonesSUNDAY STAR,3 JULY 2016

Sole

confdentRNS and calluses are areas of thick hardn that can sometimes form on the outerges of your toes, ball of the foot and backhe heel.

Caused by excessive pressure or friction,se thickened areas of skin can result incomfort and even pain with every step.

With the PediSoft Express Electronic Foote by Guardian, you can forget about theseoblems once and for all as it helps removegh, lifeless skin and calluses, leaving youh a soft and gentle sole.

Buffing your feet has never been morenvenient and easy, thanks to PediSofts

advanced buffing mechanism that operatesat 2,350 revolutions per minute.

Powered by two AA batteries, theelectronic foot file comes to life with asimple touch of a button.

Slide the safe and easy-to-use powerbutton to get rid of hard dry skin, and havebeautiful and smooth feet in just threeminutes.

Designed to provide you with acomfortable grip and to avoid anyunfortunate mishap, the foot file isergonomically shaped with a slim-fit handle.

In addition to the foot file, a cover andmini brush are included in every PediSoftExpress Electronic Foot File package andyou can choose between two types of roller

heads to suit the condition of your skin.Use the coarse mineral roller head forstubborn, hard and dry skin areas or switchto the regular mineral roller if you havenormal to slightly hard, dry skin.

Head to the nearest Guardian pharmacyand take a PediSoft Express Electronic FootFile home with you for only RM89.90.

nThis article is brought to you by yourpartner in health, Guardian Health andBeauty Sdn Bhd.

e PediSoftExpress

ElectronicFoot File

andlacementer heads.

An adequate intake of calcium will ensure thatyour bones stay strong.

Staying ft with K2

ENTISTS now recognise thenefits of vitamin K2 for bone andart health. It is essential for theny processes in the body,luding maintenance of theleton.nsufficient vitamin K2 in

ur diet may lead to weakernes and an increased risk ofctures.cientists have been studying the

ationship between vitamin K2d bone health, investigating howamin K2 supplements mayprove bone health in someople.The research, published inteoporosis Internationalin 2013,died women who have beenough menopause this group isst at risk of developingeoporosis and sufferingctures.

A study published in Yonsei

dical Journalin 2013 shows thatamin K2 supplements:lSlow down the rate of boneakening after menopauselIncrease bone strength andy decrease the number ofctures in women witheoporosislMay boost the effectiveness ofeoporosis medications

Vitamin K2 plays a central rolecalcium metabolism, the mainneral found in bones.Vitamin K2 activates thecium-binding activity ofo proteins called matrix Gla

protein (MGP) and osteocalcin,which help to build and maintainbones.

Osteocalcin is the protein thatbinds to the calcium in our bodyand converts it to bone tissue. It isreleased around soft, growingbones where it binds with calciumto add to the layers of bone tissuebeing made.

Osteocalcin only works if it isfirst activated by vitamin K2,making it a major player in

bone health.While vitamin K2 contributes

calcium to the bones, it also keepsit out of the hearts arterial vessels,which could have potentiallyled to arterial hardening orcalcification, increasing the risk ofcardiovascular disease.

The vitamin K-dependent MGPregulates this potentially fatalcalcium accumulation.

A 2004 study on the relationshipbetween dietary intake of

menaquinone and reduced risk ofcoronary hear disease undertakenby Erasmus Medical CenterRotterdam, among others, foundthat those who had the highestintake of vitamin K2 were 52%less likely to develop calcificationof the arteries and had a 57%lower risk of dying from heartdisease over a seven- to 10-yearperiod.

A similar 2009 study of 16,057women published in theNutrition,

Metabolism and CardiovascularDiseasesjournal found thatparticipants with the highest intakeof vitamin K2 had a much lowerrisk of heart disease.

For every 10g of K2 theyconsumed per day, the risk of heartdisease was reduced by 9%.

Ensure that you get plenty ofvitamin K2 if you are consumingcalcium and vitamin D for yourbones to achieve their synergisticeffects.

Calcium is linked to good bonehealth and vitamin D3, a naturalform of vitamin D, helps your bodyabsorb calcium while vitamin K2directs the calcium to yourskeleton.

Without the help of vitamin K2,the calcium that vitamin D3 helpsabsorb might work against you bybuilding up in your coronaryarteries rather than your bones.

Thus, calcium taken togetherwith vitamin D3 and vitamin K2may be the necessary solution forhealthy bones.

For patients receiving oralanticoagulant treatment, it isrecommended that they do nottake vitamin K2 supplementswithout consulting their medicaldoctor.

This article is brought to you byVitamode and Caring Pharmacy.

nFor more information,call 1300 800 228 or [email protected].

Keep your bones strong with vitamin K2, which works synergistically with calcium and vitamin D3.

ForestallingosteoporosisOSTEOPOROSIS can strike at any age andaffects both men and women. According tothe International Osteoporosis Foundation,globally, one in three women and one in fivemen over the age of 50 will experienceosteoporotic fractures during their lifetime.

Many are not aware that osteoporosis isrobbing them of their bone mass until afracture occurs, most commonly at the hip,spine or wrist. It can lead to chronic pain,

reduced mobility, disability or even death.Bones are living tissues that constantly

undergo remodelling. During childhood andadolescence, bones are formed faster thanare broken down, so there is a net increase inbone mass.

Bone mass continues to increase until itreaches its maximum strength and density inones thirties.

Then, with advancing age, bonebreakdown slowly overtakes bone formation,resulting in gradual bone loss. As the bonesbecome more porous, osteoporosis is likely tooccur.

You are at a higher risk if you are awoman, aged over 50, menopausal or have afamily history of osteoporosis.

An inactive lifestyle, heavy smoking,excessive alcohol consumption, poor diet and

insufficient calcium intake can also increaseyour risk of osteoporotic fractures.Osteoporosis is preventable with proper

nutrition and lifestyle habits. Calcium is thekey nutrient for optimum bone growth andmaintenance.

The recommended nutrient intake ofcalcium is 800mg to 1,000mg per day forMalaysian adults, which many fall short of intheir daily diet.

You can get adequate calcium intake byeating a variety of calcium-rich foods and

complementing them with calciumsupplements. Essential co-factors are alsorequired to help your body better absorband use calcium.

Magnesium plays an important role inpreventing unabsorbed calcium fromdepositing in arteries, joints and tendons orforming kidney stones. On the other hand,vitamin D facilitates calcium absorption andpromotes bone formation.

Boron is increasingly recognised as a keytrace mineral for bone growth. It helpsactivate vitamin D, which in turn improvescalcium absorption from the small intestine,facilitates calcium deposition into the bonesand reduces urinary excretion of calcium.

It also helps increase joint comfort andflexibility. A good source of boron is

FruiteX-B, a patented plant-based form ofboron with remarkable bioavailability.Keeping your bones strong and healthy

well into your golden years needs more thanjust calcium. Supply your body with all thebone-building nutrients it needs so you canenjoy an active, vibrant life.

This article is brought to you byVitaHealth.

nFor more information, call 1800 183 288.


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healthy bones 5

Averting sports injuriesTHE most common sports-relatedinjuries that doctors see areknee and ankle injuries, saysDr Thirukumaran Subramaniam,resident consultant orthopaedicand trauma surgeon at MahkotaMedical Centre.

In Malaysia, people generallydevelop ankle sprains, shoulderstrains or a tear of the anteriorcruciate ligament (ACL a ligamentin the knee joint) while playingfootball, futsal and badminton.

It comes down to poorpreparation. Basically, people donot warm up properly, do not haveproper training and their musclesand joints have lost the ability to

endure strenuous exercise, saysDr Thirukumaran.

These are weekend warriors,who do little or no exercise duringthe week and then try to performstrenuous activities during theweekend. Because their bodies arenot used to the strain, this can leadto traumatic injuries in the joints,he continues.

What to do

Sometimes, sports injuries arebeyond your control. However, it ispossible to prevent the mostcommon types of sports injuries

from occurring, especially thosethat are caused because we are notproperly conditioned for theactivity.

The best thing is to know yourlimit do not unduly strain yourjoints and muscles. This willminimise injuries caused byoveruse. You should learn torecognise when to stop. A goodindication is when you feel tired.

It is also very important towarm up before playing sports.This increases your blood flow tothe muscles and makes you moreflexible, says Dr Thirukumaran.

Another injury-prevention factorthat many people are not aware of

is the use of appropriate gear.Protective gear such as shin and

elbow pads can, of course, preventinjuries, but it is also important towear proper shoes and use goodequipment.

Shoes that are made for thespecific game will offer your anklessupport, grip the ground so thatfalls are minimised, and minimiseinjuries to your toes and ankles insports such as football and futsal.

Treatment

Most sports injuries 80% to90% do not require surgery.

Instead, the PRICE method oftreatment is used.

PRICE stands for protection, rest,ice, compression and elevation;these are the most importantprinciples for a speedy recovery.

Protection simply meansprotecting the injured area fromfurther trauma by using a sling,bandage, splint or other types ofprotection.

Next, you have to rest theinjured joint so that it can healand recover naturally withoutunnecessary movement.

An ice pack can be applied to theinjured area to reduce swellingand pain.

Once the ice pack is removed,compression should be applied tothe injured area. This also helps tominimise swelling.

Elevation of the injured area isimportant immediately after theinjury occurs to reduce the bloodflow to the injured area andfurther reduce swelling.

PRICE is the main method oftreatment for sports injuries.Sometimes, however, six to eightweeks of rehabilitation is required,depending on the severity of theinjury, says Dr Thirukumaran.

Dr Thirukumaran Subramaniam,resident consultant orthopaedic andtrauma surgeon at Mahkota Medical

Centre.

Keeping ft

Maintaining bone health comesdown to a good diet andreasonable amount of exercise.

If you are older, feel you are notflexible or have less energy, chooselow-impact exercises such as yogaor tai chi, says Dr Thirukumaran.

He reiterates the importance ofwarming up and using propermethods and equipment whenexercising. Regular exercise willminimise injuries and keep you fitand healthy for longer.

nFor more information,call 06-285 2999.


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healthy bonesSUNDAY STAR,

3 JULY 2016

Hygiene and

balanced dietCATED on the right sideder your rib cage, the liver issecond largest organ in yourdy.As the liver functions to remove

mful substances from yourod and process your daily

nsumption into nourishment forur body to use, it is crucial top your liver healthy and takecautionary steps to stave off

er diseases.Among the more common livereases are hepatitis A, B and Ct can cause the liver to swell

d perform inefficiently.While the best way to prevent

hepatitis A virus is bycination, it is advisable toways wash your hands with soapd warm water after using thehroom or before preparing anding food.

Both hepatitis B and C viruses also lead to cirrhosis, which isscarring of the liver caused by

ntinuous, long-term livermage.rotect yourself by avoiding

direct contact with infectedblood and ensuring you donot share personal itemssuch as toothbrushes andrazors with people who have thedisease.

Limiting foods that have highiron content and salt will also helpto reduce your chances ofdeveloping hepatitis B.

As there is no vaccine toprevent the hepatitis C virus,seek immediate medical attentionif you are exposed to blood orneedles.

In addition to hepatitis A, B andC, another cause for liver swelling

and cirrhosis is fatty liver disease,which is the build-up of fat in livercells.

Make sure you limit your intakeof high-calorie foods and insteadhave a daily diet with high-fibrefoods such as oats, wheat bran,wholegrain and fruits.

nThis article is brought to you byyour partner in health, GuardianHealth and Beauty Sdn Bhd.

JUST because your liver canrepair itself and create newhealthy tissue, it should not betaken for granted.

Follow these three generalsteps to ensure your liver is

functioning at its best:

Maintain a healthy lifestyleand dietlExercise regularlylHave a diet comprising

food from all food groups.Opt for more food rich in fibresuch as fruits, vegetables,wholegrains and beans, andhave a sufficient source of

protein every daylDrink six to eight glasses of

water dailylChoose organic vegetables

as they contain less pesticidesand chemicalsl

Maximise your intake offruits and vegetables with highsulphur content such asbroccoli, cabbage, cauliflower,garlic and onionslFollow a steady eating

regime to maintain your weight,an important aspect of livercarelLimit your intake of salt

and food high in salt

lConsult your doctor on therecommended amount ofprotein you should consume

Avoid overexposure to toxins(breathing or touching)l

Limit your contact withcleaning and aerosol products,insecticides and cigarettes

Limit alcohol consumptionlToo much alcohol can

damage and destroy liver cellslProlonged and

overconsumption of liquor cancause the liver to perform lessefficiently and cause cirrhosis

Keeping healthy

Ensure your liver performsefficiently by maintaining ahealthy lifestyle thatincludes regular exercise.


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SUNDAY STAR,

3 JULY 2016

healthy bones 7

Nourishment for all agesAS the most abundant mineral inour body, calcium is important forthe maintenance of healthy bones.

The daily intake of calciumrecommended by the HealthMinistry is 800mg per day foradults and 1,000mg per day foradolescents and adults above 50years old.

As bone mass peaks duringadolescence, it is important toensure adolescents recommendedcalcium intake is met.

As for adults, calcium isimportant to fight against the onsetof osteoporosis.

Bone nutrition

There are a number of nutrientsthat help the body use calciumefficiently to maintain bone health.

Over the years, various studieshave shown that magnesium helpswith calcium absorption andretention in the body.

Vitamin D plays an importantrole in regulating calcium in thebody while vitamin K worksclosely with calcium to form strongbones.

How do we get all thesenutrients in our daily diet? Milk isnot only a main source of calcium

but also other importantminerals and vitamins thathelp in maintaining bonehealth.

Benets of goatsmilk

Goats milk naturallycontains high calcium justthree glasses of milk canprovide about 90% of anadults reference intake ofcalcium based on theEuropean Unionsregulations.

Your other sources of

calcium should be foodssuch as dark greenvegetables and nuts tomake up for the dailyrequirement.

An interesting propertyof goats milk is theglobules of fats, which areeasy to digest in theintestine while the proteinforms a softer curd. Thisunique property helps indigestive health and comfort.

A 1996 study by the University ofTampere suggests that the highcalcium content in goats milkhelps lower blood pressure.

Moreover, as goats milknaturally has lower cholesterolthan other types of milk, it is agood alternative for those whowant to watch their cholesterollevels.

Goats milk containshigher levels of magnesiumthat is vital in maintaininghealthy bones. It alsocontains higher vitamins Dand K, which help inregulating calcium andformation of bones in thebody.

Now that we know thegoodness in goats milk,how do we ensure that it iseasily available for ourbodys uptake?

Goats milk containscasein phosphopeptides,which increase solubility

and absorption of mineralssuch as calcium,magnesium, iron and zinc.

Karihome goats milk isproduced by Dairy GoatCo-operative in NewZealand, which is naturallyblessed with green pasturesand enforces strictregulations to ensurequality products areexported.

Dairy Goat Co-operative suppliesgoats milk to various markets suchas the United Kingdom, France,Spain, Hong Kong, Singapore andChina.

Karihome goats milk is availablein Malaysia and is locallydistributed by Orient Europharma(M) Sdn Bhd, which is a subsidiaryof Orient Europharma Pte Ltd fromTaiwan.

Karihome is available in allranges to cater to different agegroups.

Children can benefit fromKarihome Growing-Up Formula,which is suitable for one- tothree-year-olds while childrenabove four years old can enjoyKarihome Pre-School Formula.

Karihome Goat Whole MilkPowder is available for adults.

Rich in nutrition that helps inchildrens and adults physicaldevelopment, goats milkcomplements our daily diet for themaintenance of good health.

Goats milk is highly nutritious asit contains essential vitamins andminerals for the maintenance ofnot only healthy bones but ahealthy you. It is an ideal food forthe whole family to enjoy.

This article is brought to you byOrient Europharma.



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healthy bones 9

Fixing ailing joints

MINIMALLY invasive (keyhole)surgery uses a few small incisionsrather than one large incision andhas been associated with betteroutcomes than open surgery,including reduced risk of surgicalsite infections and less post-operation pain, which translate tofaster recovery time and shorterhospital stay.

Total knee replacement

Arthritis of the joints is verycommon in Malaysia and ofteninvolves the knees.

The goal for treatment is torelieve pain and improve quality oflife.

When my patient complains ofsevere knee pain, I know that it ishard if not impossible for them toperform their daily activities.Medications and walking support

are often used first but when theireffectiveness has reached a limit,knee replacement surgery canbecome the answer, says Dr LimLi Aik, consultant orthopaedic andtrauma surgeon at Oriental MelakaStraits Medical Centre.

Total knee replacement surgery(TKR) is a safe and effectiveprocedure to relieve pain, restorelimb alignment with good range ofmotion and improve overallquality of life.

This procedure involvesremoving all diseased portions ofbone and tissue on the ends andreplacing them with metal and

high-density polyethyleneimplants.

These implants create a newjoint that approximates theanatomical and physiologicalfunction of a human knee joint.

In most cases, the replacementknee can last for about 15 to 20years.

The overall success of TKRdepends on appropriate patientselection, proper implant choice,meticulous and appropriate

surgical technique and post-surgery rehabilitation, saysDr Lim.

The availability of computer-assisted navigation in TKR surgeryhelps orthopaedic surgeonsachieve proper soft tissue balance,correction to within one to twodegrees of the neutral mechanicalaxis and minimal or zero errorduring the implant placement,says Dr Lim.

With the combination of

navigation technology andminimally invasive surgicaltechnique, this advancement hasresulted in better post-operationresults.

Patients can move the day aftertheir surgery and can usually bedischarged four days after theprocedure.

Early mobilisation reduceshospital stay by reducing therisk of post-operationcomplications such as deepvein thrombosis and this ispsychologically empowering forthe patient, which translates toimproved results duringrehabilitation after the operation.

Joint arthroscopy

Arthroscopy is a surgicalprocedure where the surgeonuses specialised cameras andequipment to diagnose and treata variety of joint problemsthrough just a small incision inthe skin.

Arthroscopy can only beundertaken after obtaining acomplete medical history andexamination of the affected joint,often supplemented by furtherinvestigations such as X-rays orMRI scans.

Following this, a decision willbe made whether or not to proceedwith surgery, says Dr GopinathMathavan, consultant orthopaedicand trauma surgeon at OrientalMelaka Straits Medical Centre.

Common problems within thejoint that can be dealt with usingarthroscopic methods include:lSynovitis (inflammation of the

joint lining)lDamaged joint surfaceslLoose fragments of bone or

cartilagelBone spurs or impingementlLigament reconstruction

procedures

Arthroscopy is generally safeand can often be performed as aday procedure. Because of thesmaller incision needed, there isless discomfort and risk, whichallows for quicker recovery. Mostpatients can return to work andresume sporting activity as earlyas two to six weeks post-surgery,says Dr Gopinath.

Furthermore, complicationsfrom arthroscopy are rare.These include pain, infectionand swelling of the joints.


Dr Gopinath Mathavan.Dr Lim Li Aik.


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0 healthy bonesSUNDAY STAR,

3 JULY 2016

Dietary sources of calcium and vitamin D are essential in ensuring bettercalcium balance and reduced bone loss.

Feel young, move well

OD movement is essential tointain an active lifestyle.althy bones, joints and muscleswell as good nutrition areential for good flexibility,ture, balance, stamina and

ength.Bone is dynamic living materialnsisting of minerals (mainlycium and phosphate), collagend small amounts of otherteins, cells and water.

Bones are in a state of constantmodelling where new bone isposited and older bone ismoved. However, it happens less

ciently in adult men andmen and this results in boness loss, causing osteoporosis andreasing the risk of fractures.

Healthy joints are also integral toying mobile. Specialisedtilage called hyaline cartilage

ds and protects the ends of

nes, absorbing shock anducing friction to ensure smooth

nt movement.Cartilage is an active, growingue that requires continuouseneration to provide thetection and strength that jointsuire.

Cartilage is subject to continuouseneration through theakdown and formationcesses, which are in a state of

uilibrium. If imbalanced, thisl lead to loss of cartilage.

An overactive lifestyle, high-pact sports and ageing can alsoar down joint cartilage, leading

to joint discomfort, cartilagedegeneration, and loss of jointmobility and flexibility, which leadto osteoarthritis.

A physically active lifestyle hasbeen shown to provide benefits ina number of areas associated withmusculoskeletal health and qualityof life, including improved boneand muscle strength, reduced riskof falls and fractures, increased

energy and stamina, protectionagainst osteoarthritis and painrelief.

Calcium is essential for bonehealth as it is one of the mainbone-forming minerals and 99% ofthe bodys calcium resides in boneas reservoir to maintain bloodcalcium levels.

When dietary intakes orintestinal absorption of calcium are

too low to maintain blood calciumlevels at the correct level,parathyroid hormone (PTH) isreleased by the parathyroid glands.

PTH stimulates bone resorptionor breakdown to release calciumand this may lead to a loss of bonemass.

An increase in calcium intakecan lead to better calcium balance,increased bone gain during growthperiods, reduced bone loss in laterlife and reduced risk of fractures.

Vitamin D is a fat-solublevitamin that is crucial for bonehealth. However, there are veryfew foods that contain vitamin Dand hence the main source comes

from what the body makes on theskin from sun exposure.

Vitamin Ds main function in thebody is to increase the efficiency ofcalcium absorption and maintainlevels of calcium in the blood.

It does this by enhancing theability of the gut to absorb calciumfrom diet. When calcium intake islow, vitamin D and PTH stimulatethe breakdown of bone torelease calcium to maintain bloodcalcium level.

Vitamin D also supports calciumabsorption by stimulating theproduction of a transport proteincalled calbindin, which actively

transports calcium from the gutinto the bloodstream. When thebody has the right amount ofvitamin D, up to 40% of dietarycalcium is absorbed.

When a diet is supplementedwith vitamin D and calcium in theelderly, there is a decrease in boneloss and fracture.

Furthermore, vitaminD-fortified foods may play a usefuland cost-effective role in improvingthe vitamin D status of targetpopulation groups.

Anlene contains the MoveMaxnutrition bundle, a combination ofnutrients that work together tohelp care for the health of your

bones, joints and muscles, whichsupport your overall movement asyou age so you can move like youfeel young again.

Anlene MoveMaxs blend ofnutrients that includes calcium,vitamin D, magnesium, zinc,protein, B-vitamins, collagen,vitamin C and vitamin E.

This article is brought to you byAnlene.

nFor more information, call1800 883 122 (Monday to Fridayfrom 8.30am to 5.30pm) or [email protected].


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healthy bones 11

Over time, this causes our bonesto grow weaker and this may leadto osteoporosis. Osteoporosis is aprogressive bone disease that ischaracterised by a decrease inbone mass and density that leadsto an increased risk of fractures.

Postmenopausal women aremost vulnerable to osteoporosis.Although loss of oestrogen is theprimary reason for this, poorlifelong calcium and vitamin Dintake as well as lack of exerciseplay a role in the development ofosteoporosis.

Men are also at risk, althoughthey usually get affected later inlife than women. This means that it

is important for men to keep trackof their calcium intake as well.

Marigold HL Low Fat Milk isMalaysias favourite milk since1988 and is the No.1 PasteurisedLow Fat Milk in Malaysia tilltoday.

Marigold HL Low Fat Milkhas also been awarded theprestigious Putra BrandAwards 2015 The PeoplesChoice in the category ofBeverage Dairy.

With every glass ofMarigold HL Low Fat Milk,you will enjoy nutritiousgoodness of wholesome

delicious milk. This milk has 25%more calcium compared toordinary milk and is fortified withvitamin D for better calciumabsorption.

It also contains 56% moreprotein compared to ordinary milkand is fortified with eight essentialvitamins A, B1, B3, B6, B12, C, Eand folic acid giving you all thenutrients needed to stay healthyand active.

Marigold HL Low Fat Milk is lowin fat and lactose. It has 74% lessfat compared to ordinary milk,which keeps you healthy, slim andtrim and has 75% less lactosecompared to ordinary milk, which

eases your digestive system and issuitable for people who are lactoseintolerant.

A BALANCED diet along withregular exercise helps optimise

bone health at all ages andreduce the risk of osteoporosis.The benefits of a healthy dietfor bones are:lChildren and adolescents

build maximum peak bonemasslAdults maintain healthy

bones and avoid prematurebone losslSeniors sustain mobility

and independence

The health and strength ofour bones rely on a balanced

diet and steady stream of

nutrients, most importantlycalcium and vitamin D.Calcium is a mineral that people

need to build and maintain strongbones and teeth. It is alsoimportant for other physicalfunctions such as muscle controland blood circulation.

Calcium is not made in the body.It must be absorbed from the foodswe eat. To effectively absorbcalcium from food, our bodiesneed vitamin D.

If we do not have enoughcalcium in our diet to keepfunctioning, calcium is removedfrom its storage in the bones.

People who are lactose-intolerant may experiencedigestive discomfort such as gas,bloating and diarrhoea withordinary milk.

For those who are concernedwith high cholesterol levels,Marigold HL Low Fat Milk withPlant Sterols helps lowercholesterol levels.

Plant sterols work by blockingcholesterol absorption by yourbody. Include two glasses ofMarigold HL Low Fat Milk withPlant Sterols (with 1.6g of plantsterol esters) daily as part of abalanced diet that includes regularconsumption of fruits and

vegetables as well as exercise tohelp maintain cholesterol levels ata healthy range.

Marigold HL Low Fat Milk isavailable in plain, chocolate and

strawberry flavours.

nFor more information, visitwww.marigold.com.my.

Milk for nutritional value

Obtain adequatecalcium andnutrients withMarigold HL LowFat Milk.

Excercise anda balanceddiet help topreventosteoporosis.


12/12

2 healthy bonesSUNDAY STAR,

3 JULY 2016

U may notice that peoplewadays often suffer fromhritis, especially osteoarthritis,ich typically attacks hands,ees, hips and the spine.Osteoarthritis is a common jointease that results from wear andr on the cartilage that protectsd cushions your joints.While many think that thisppens only to the elderly, itects younger adults as well.Apart from the natural ageing

cess, the progressivegeneration of cartilage cancaused by repeated motion,ich increases friction when

nes at the joints rub against

h other.This leads to breakdown oftilage, bony change of joints,erioration of tendons andments, and various degrees ofammation of the joint lining.ymptoms of osteoarthritis varym person to person and includen, stiffness, tenderness and losslexibility.

There is no cure foreoarthritis. The goal ofatment is to ease the pain,intain mobility and slow thegression of joint deterioration.

Over-the-counter medicationsh as non-steroidal anti-

inflammatory drugs or aspirin areusually prescribed to treat paincaused by osteoarthritis.

Nevertheless, long-termmedication might cause sideeffects and put you at risk ofnumerous health complications.

Glucosamine and chondroitinare slow but effective compoundsthat are studied extensively toprevent the degradation ofcartilage.

Glucosamine and chondroitinare natural components found incartilage. In a healthy joint,cartilage serves as a cushionbetween bones to facilitate themovement.

It is a flexible connective tissuethat allows the bones to glide overeach other smoothly with littlefriction during physical activitiessuch as walking or exercising.

However, repetitive straining ofthe joints can cause the cartilage towear down prematurely. Hence,glucosamine and chondroitin playimportant roles in promoting jointhealth.

Glucosamine is a type of aminosugar normally produced by thebody and is the precursor forproduction of glycosaminoglycan(GAG), a fundamental buildingblock of cartilage.

It aids in stimulating theformation of collagen andproteoglycans, which serve as jointlubricant to provide smooth andlow-friction movements.

Due to its powerful effect oncartilage metabolism, glucosamineis capable of repairing damaged oreroded cartilage to prevent furtherdeterioration.

Meanwhile, chondroitin is themost abundant GAG in cartilage.Being a natural compound incartilage, chondroitin acts like awater magnet, absorbing waterinto connective tissues andproviding shock absorption.

This helps to promote water

retention and suppleness tomaintain nourishment andlubrication in the cartilage.

Moreover, chondroitin helps toprotect cartilage from prematurebreakdown by inhibiting thedestructive enzymes activity.

As we age, producing sufficientglucosamine becomes morechallenging and this causes thecartilage to start deteriorating,resulting in stiffness and painfuljoints.

Therefore, supplementation ofglucosamine and chondroitin canbe used to manage osteoarthritis.

A well-known clinical study, the

Glucosamine/chondroitinArthritisIntervention Trial(Gait), was conductedin the United States toinvestigate the efficacyand safety of glucosamineand chondroitin as atreatment for kneeosteoarthritis.

The study, publishedin theNew EnglandJournal of Medicinein 2006, revealedthat a combinationof 500mgglucosamine and

400mg chondroitinthree times daily boostseffectiveness in treating moderate-to-severe knee pain related toosteoarthritis.

The Study on OsteoarthritisProgression Prevention (Stopp)was also carried out to establishthe efficacy of chondroitin astreatment for osteoarthritis.

The study, published inArthritisand Rheumatismin 2009,demonstrated that long-termsupplementation with chondroitinsulphate (800mg daily) canimprove symptoms and delayjoint structure degradation in

individuals with osteoarthritis.Physical activities such as

walking and exercising puttremendous stress on yourcartilage.

Accumulation of these acutestrain injuries over time can leadto the degenerative disease ofjoints, so it is important to act now.

This article is brought to you byBiO-LiFE Marketing Sdn Bhd.

nFor more information,call 03-7882 8888 or [email protected].

Treating osteoarthritisSupplementyour body withglucosamineand chondroitinto manageosteoarthritis.

Wholesome eatsBUILDING healthy bones and joints beginswith getting much-needed nutrients fromvarious food sources to prevent disorderssuch as osteoporosis and arthritis.

Here are some easy-to-find andcost-friendly food sources that are rich innutrients to build healthier bones and joints.lMilk Milk has always been associated

with building strong bones and jointsespecially among children and teenagersbecause it is one of the best sources ofcalcium and vitamin D. Milk is also rich inother nutrients such as potassium,magnesium, riboflavin, phosphorus and

vitamins D and B12, which are keycomponents in building healthy bones. Otherdairy products such as yoghurt and cheesealso have the same nutrients as milk andmake excellent alternatives for milk.

lSoy Soy is a great alternative forpeople who are looking for dairy substitutes.Soy and tofu are great sources of calcium aswell as other plant-based nutrients such asisoflavones. Soy has been shown to have apositive impact in preventing osteoporosis.Last year, a research team led by theUniversity of Hull in the United Kingdomfound that women on a soy diet withisoflavones had a lower rate of bone loss,which reduces the risk of osteoporosis.

lDark green vegetables Dairy and soy

products are not the only sources of calciumthat can supplement your bodys needs tobuild strong bones. Dark, leafy vegetablessuch as mustard greens, bak choy, Chinesecabbage, spinach and turnip greens haveadequate amounts of calcium to meet dietaryneeds. One cup of turnip greens hasapproximately 197mg of calcium. Dark greenvegetables are also great in preventingosteoporosis as they are rich in vitamin K.

l Prunes Prunes are known to contain

necessary dietary fibre for good digestionbut a 2013 study has discovered that it alsobenefits your bones. The results of the studypublished in theBritish Journal of Nutritionshowed that women who ate prunes hadsignificantly higher bone mineral density inthe ulna (one of two long bones in theforearm) and spine. Hence, due to their highcontent in calcium and vitamin D, eatingprunes can help to lower the rate of bonemineral loss in older individuals.

lSardines Although sardines aremostly known for their benefits in

maintaining a healthy brain as they are richin DHA and omega fatty acids, they are alsopacked with calcium and vitamin D. Theycan provide as much calcium and vitamin Das milk and dairy products in a singleserving. Sardines can be eaten from the canas a quick fix or incorporated into salads,fried rice and sandwiches. The omega fattyacids in sardines are also good forpreventing inflammation in joints.

Soy is analternativesource ofcalcium for

individualswho cannotconsumedairyproducts.

healthy bones - 3 july 2016

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