Dr Matin Mellor Abdullah

Fasting in the holy month of Ramadan is an important pillar of Islam that encourages prayer, self-discipline, and spiritual reflection. While all Muslims who are mukallaf (have reached puberty and are of sound mind) are required to fast from sunrise to sunset, exemptions are made for several categories, including those who are ill, receiving treatment, or recovering from serious illness, injury, or surgery.

“While those who are ill or receiving treatment for a serious illness are exempt, many faithful feel the spiritual need to do so.” – Dr Mellor”

In spite of this, the desire to participate in this spiritual journey is strong and many cancer patients still wish to proceed with fasting. The question is, should they?

Dr Mellor advises a pragmatic approach that treads a cautious line between practicality, safety and spirituality.

“Many patients I see are open with me about their intention to fast. While I can advise them on medical matters, there are no official guidelines available hence I also advise them to speak to their ustaz so they can have clarity and peace of mind about their spiritual obligations,” he said.

When it comes to their health, these are things every cancer patient should consider if they wish to fast this Ramadan.

1. Every cancer patient is on a different point in their treatment journey.

“For patients who have already undergone treatment or are in maintenance, there should be no impediment to fasting. However, those who are currently undergoing investigations may find it challenging due to the required tests, and those in the midst of receiving therapy may need to make adjustments to their medication schedule,” explained Dr Mellor.

Furthermore, Dr Mellor said those who are receiving curative treatment may wish to forgo fasting and adhere to their planned treatment schedule to maximize their chance of cure, while patients receiving palliative treatment may temporarily defer treatment and resume after Ramadan.

However, each patient must be evaluated on a case-by-case basis, he stresses, with due consideration for the patient’s health and wellbeing.

2. There are different types of treatment, and every cancer patient tolerates treatment differently.

Patients with cancer may be receiving radiotherapy, chemotherapy, or targeted therapy, and each of them are associated with a different range of side effects, with some patients being more affected than others.

To cite an example, Dr Mellor said, “Chemotherapy remains the mainstay of cancer treatment, and it is common for patients to feel unwell for a few days or even up to a week. Side effects can include loss of appetite, feeling weak, developing mouth ulcers, and gastrointestinal discomfort like diarrhoea or gastritis. Sometimes, the side effects are so severe that medications are necessary to control the nausea or diarrhoea. Because of these factors, the individual ability to tolerate both treatment and fasting differs from patient to patient.”

3. Treatment schedules can be adjusted, with medical supervision.

“If you wish to fast while on treatment, be sure to discuss this with your doctor first so we can advise you on adjusting medication schedules and address any concerns,” said Dr Mellor.

Treatment options vary according to the type of cancer, its location and stage, he explained.

– Oral medication. These may include oral chemotherapy and medications to manage nausea and pain, which are usually taken twice daily and can be timed for sahur and iftar.
– Hormone therapy. These are usually taken once daily and patients who are already familiar with the side effects may adjust the timing so that nausea medications may be taken if needed. Among patients who have received several cycles of treatment, familiarity with its side effects may make it possible to plan their fasting accordingly.
– Radiotherapy and nuclear medicine procedures. These are administered at the hospital and may be scheduled accordingly, based on availability and your doctor’s advice.

4. Prioritise your wellbeing.

“Many patients try to fast with good intentions but are unable to complete it, which can be disappointing. I would advise patients to refrain from fasting if they are recovering from surgery or who are nutrient-deficient as the body may not be able to tolerate fasting under such circumstances,” said Dr Mellor.

For those fasting, he advises being careful to get sufficient hydration and to eat a balanced diet that is rich in fruits, vegetables and protein so they get the nutrition they need.

At the end of the day, said Dr Mellor, “It is a deeply personal decision, and I remind all my patients that it is also important to recognise their body’s limits – there is no medication for tiredness and sometimes, your body just needs rest and recovery so reflect deeply on your decision, speak to your doctor, listen to your body and act accordingly.”

Yet health experts say that not all resolutions are equal – some lead to better outcomes than others. Some common goals can even backfire – causing stress, injury, or demotivation. Understanding which resolutions support long-term well-being, and which ones tend to fail can help individuals make choices that fit both their bodies and their cultural realities.

Public health experts across Asia increasingly encourage realistic, incremental change. Dr. Takeshi Kasai, former WHO Regional Director for the Western Pacific, has repeatedly stressed that small, sustained actions create more lasting health benefits than short-term efforts.

Wellness resolutions work best when they fit daily life, cultural food patterns, and available resources. Rather than chasing perfection in January, health professionals suggest focusing on habits that can be repeated all throughout the year. In other words, the most effective resolution may be choosing progress over pressure, and building health one ordinary day at a time.

OG resolutions that never go out of style

1. Eating more whole, traditional foods

Rather than extreme diets, nutrition researchers consistently point to balanced eating patterns. The World Health Organization (WHO) recommends diets rich in vegetables, fruits, whole grains, and legumes, while limiting ultra-processed foods high in salt, sugar, and saturated fat.

In many Asian countries, traditional diets already align with these guidelines. Meals centered on rice, vegetables, fish, tofu, fermented foods, and soups can support heart and metabolic health when portions are managed. A 2019 study published in The Lancet linked diets high in processed foods to increased risk of cardiovascular disease across multiple Asian populations. Shifting back toward home-cooked meals is often more effective than adopting imported diet trends.

2. Committing to regular, moderate physical activity

The WHO advises adults to engage in at least 150 minutes of moderate-intensity physical activity per week. Brisk walking, cycling, household chores, or traditional movement practices such as tai chi and yoga all count. Public health experts note that consistency matters more than intensity. In densely populated Asian cities where gym access may be limited, walking and stair use remain practical options. A large-scale study in The British Journal of Sports Medicine found that even small increases in daily movement lowered mortality risk.

3. Prioritizing sleep

As a highly urbanized region, Asia places strong value on hard work, which often comes at the expense of adequate rest and sleep. Sleep deprivation has become a growing issue in many Asian countries due to long commutes, shift work, and screen exposure. The Asian Sleep Research Society reports that adults in East and Southeast Asia often sleep less than the recommended seven hours per night. Improving sleep routines, such as setting consistent bedtimes, reducing late-night screen use, and limiting caffeine, has been linked to better mental health, immune function, and weight regulation.

4. Managing stress through simple, low-cost practices

Stress-related disorders are rising across Asia, according to WHO regional data. Instead of costly retreats or apps, experts often recommend daily habits such as breathing exercises, prayer or meditation, journaling, and regular social connection. A meta-analysis in JAMA Internal Medicine found that mindfulness-based practices reduced anxiety and depression symptoms across diverse cultural settings, including Asian populations.

5. Scheduling preventive health checkups

In many Asian countries, people seek medical care only when symptoms become severe. Health authorities, including the Asian Development Bank, have urged earlier screening for hypertension, diabetes, and certain cancers. Simple resolutions such as annual blood pressure checks or routine blood tests can help detect conditions before complications arise.

Common resolutions that may cause harm than good

1. Extreme weight loss goals

Rapid weight loss resolutions, often promoted online, can lead to nutrient deficiencies, muscle loss, and rebound weight gain. The WHO warns that very low-calorie diets without medical supervision may increase health risks. Research in Obesity Reviews shows that most people who pursue aggressive weight loss regain the weight within one to two years, often with added metabolic strain.

2. Eliminating entire food groups

Resolutions that ban carbohydrates, fats, or staple foods like rice may not be sustainable in Asian contexts. Carbohydrates remain a key energy source in many traditional diets. Nutrition experts from the Harvard T.H. Chan School of Public Health note that dietary quality matters more than macronutrient elimination. Removing culturally central foods can also lead to social stress and poor adherence.

3. Exercising daily without rest

Daily high-intensity workouts may sound disciplined, but sports medicine specialists caution against insufficient recovery. Overtraining increases the risk of injury, hormonal imbalance, and burnout. The American College of Sports Medicine recommends rest days and gradual progression, especially for beginners.

4. Relying on supplements instead of food

The supplement market in Asia has grown rapidly, yet evidence for many products remains limited. WHO guidelines state that most people can meet nutrient needs through food, except in specific medical cases. A review in The BMJ found little benefit from routine vitamin supplementation for preventing chronic disease in the general population.

5. Setting vague or socially driven goals

Resolutions such as “be healthier” or “look better” often lack clear direction. Psychologists note that goals tied to appearance or social pressure are less likely to last than those linked to daily habits or personal values. A study in Health Psychology found that behavior-based goals, such as walking after dinner had higher success rates than outcome-based goals like weight targets.

By Dr Malar Santhi Santherasegapan MD CSMU (Ukr), MBA in Healthcare Management – HONS (UTM), PDAM (IIWAM), IES (London)

In recent years, gut health has emerged as a central focus of wellness, with probiotics, fiber-rich foods and fermented products becoming everyday staples. Amid this attention, one common ingredient in Malaysian kitchens has been largely overlooked: palm oil. New research shows that, when sourced responsibly and used appropriately, especially in its red or unrefined form, palm oil may play a valuable role in supporting gut health, aiding nutrient absorption and contributing to overall wellness.

Nutritional strengths of red palm oil

Red palm oil, or RPO, is nutritionally remarkable because it is rich in fat soluble bioactive compounds, including carotenoids, which convert to vitamin A, as well as the two main forms of vitamin E like tocotrienols and tocopherols, and other antioxidants.

Oil Palm (Photo by Craig/Wikimedia)

According to a 2025 review article, these bioactive compounds, especially tocotrienols, have strong antioxidant and anti-inflammatory properties that help reduce oxidative stress and cellular damage. Another recent review confirms that palm cooking oil, when consumed as part of a balanced diet, can support heart health, protect the brain and improve absorption of fat-soluble vitamins.

Beyond its antioxidant and heart health benefits, the nutritional profile of RPO supports essential bodily functions. Vitamin A promotes healthy vision and immune function. Vitamin E protects cells. Fat soluble vitamins in general need dietary fat for optimal absorption, which palm oil can provide.

New evidence red palm olein and the gut microbiome

New evidence from a recent study by the Malaysia Palm Oil Board (MPOB) titled Red palm olein biscuit supplementation modulates gut microbiota in vitamin A deficient rural Malaysian schoolchildren: a randomized controlled trial highlights the link between red palm oil and gut health. In this double-blind trial, 328 primary school children aged eight to twelve from rural areas, all vitamin A deficient, were given biscuits enriched with red palm olein over six months, four days per week.

Compared with children receiving control biscuits with regular palm olein, those consuming RPO enriched biscuits had a notable increase in beneficial gut bacteria, including Anaerostipes, UCG 010 and Lachnospiraceae NK4A136 group.

The researchers also observed improvements in micronutrient status, including higher levels of provitamin A carotenoids, vitamin E and better hematological parameters such as packed cell volume and mean corpuscular volume. Children in the RPO group also showed amore stable and cohesive gut microbial network, indicating improved microbial interactions.

The study concluded that six-month supplementation with RPO-enriched biscuits can positively modulate the gut microbiota of vitamin A deficient children, increase beneficial bacterial populations and improve nutrient and hematological status.

Rebalancing the narrative moderation and context

Palm oil, like any dietary fat, is not a superfood on its own. Concerns about saturated fat remain relevant, especially in diets already high in calories, processed foods or frequent deep frying. Experts agree that red palm oil is most beneficial when consumed as part of a balanced diet.

Much of the negative perception of palm oil comes from outdated assumptions that all saturated fats are harmful, or that the antioxidant rich components in RPO do not matter. Malaysian regulatory and consumer advocacy organizations have publicly countered these stigmas, noting that typical palm oil consumption is not harmful and that it remains trans-fat free and cholesterol free.

A call for sustainable informed consumption and more research

Malaysia continues to lead global research into palm oil nutrition, including its bioactive compounds and health effects. The Malaysian Palm Oil Board and other scientific bodies can help promote an evidence-based understanding of palm oil’s benefits and limitations. For the average Malaysian, whether preparing Nasi Lemak for breakfast, cooking sambal for dinner or frying snacks for guests, red palm oil can be embraced as a nutrient rich and culturally significant oil that, when used as part of a balanced diet, supports gut health, micronutrient sufficiency and general well-being.

There remains a need for more large-scale, long-term clinical studies, especially on gut microbiome modulation in adults, metabolic outcomes and interactions with Malaysian dietary patterns.

In the meantime, it is time to reset the palm oil narrative, not as a threat, but as an under appreciated ally, especially for a Malaysian diet rich in tradition and flavor.

Here are the three most common health risks to watch out for during the holidays, according to recent studies. These include elevated stress and its impact on mental and physical health, increased risk of cardiac events, including heart attacks and “holiday heart syndrome,” and a surge in respiratory virus transmissions.

Stress and mental health

The holiday season can be a particularly stressful time for many. In 2025, 41% of U.S. adults expected more holiday-related stress than the previous year, a sharp rise from 28% in 2024 and 29% in 2023, according to a recent APA Healthy Minds Poll. Stress tends to affect younger adults the most, with nearly half (49%) of those aged 18 to 34 reporting elevated stress, compared to just 27% of adults over 65.

A 2024 Holiday Stress Survey by Sleepopolis found that this surge in stress can take a toll on mental health: 37.5% of respondents said their mental well-being worsens during the holidays, while only 12.6% felt an improvement. Persistent stress may contribute to serious health problems such as high blood pressure, weakened immunity, and depression. Financial pressures remain a leading cause, affecting 37.4% of adults, down from 48% the year before, yet only 35% actually plan and budget for holiday spending. Other common stressors include family dynamics (16.7%) and disrupted routines (8.3%).

Interestingly, some studies show a slight easing in anxiety and depression: in 2024, 36% of adults reported higher anxiety (declining from 52% in 2023) and 28% reported higher depression (dropping from 41% in 2023). Still, a survey by the telemedicine platform Sesame found that 62% of Americans feel moderately to extremely stressed during the holidays. Social interactions themselves can add to the strain. Sesame’s survey highlighted that nearly 60% of Americans worry about politically charged conversations at gatherings.

With this year’s heightened geopolitical and economic tensions, it’s more important than ever to steer holiday conversations toward light and cheerful topics, keeping in tune with the spirit of the season.

Cardiac events

Preparations during holiday celebrations can indeed be stressful, and this is also the time of year when many indulge in high-salt, high-sugar, and high-fat foods without guilt. It is no surprise, then, that the holiday season is linked to a notable rise in cardiac events, including heart attacks and “holiday heart syndrome.” Research cited by the American Heart Association (AHA) in the Circulation journal consistently shows that heart attacks peak on Christmas Day, the day after Christmas, and New Year’s Day. According to the AHA, cardiac mortality is higher around these holidays than at any other time, with heart attack deaths rising by 37% on Christmas Eve, peaking at 10 p.m., and most commonly affecting people over 75 or those with pre-existing conditions.

Several factors contribute to the holiday rise in cardiac events. Stress from planning, travel, and family dynamics can raise blood pressure and heart rate, according to Dr. Sarah Spelsberg in her 2024 UNC Health article. Overindulgence in salty, sugary, and fatty foods strains the heart, especially in those with pre-existing conditions. Excessive alcohol can cause dehydration, disrupt heart rhythms, and trigger “holiday heart syndrome”, most commonly atrial fibrillation (AFib), with more than two drinks in four hours increasing AFib risk over 3.5 times.

Colder temperatures also pose a risk by constricting blood vessels, raising blood pressure, and forcing the heart to work harder. Activities such as shoveling snow can further amplify these dangers. Finally, delayed medical care during the holidays, whether due to attributing symptoms to stress or overeating, or avoiding disruptions to festivities, can worsen outcomes for those experiencing cardiac events.

Respiratory virus transmission

It is no coincidence that the Covid -19 surge in 2019 followed the Chinese New Year and other celebrations at the time. Generally, the holiday season brings increased social contact, indoor gatherings, minimal social distancing, dry air, and sometimes shared food—all conditions conducive to the spread of respiratory viruses. Inadequate immunization may also contribute to rising respiratory cases.

The U.S. Centers for Disease Control and Prevention (CDC) recommends staying up to date with all recommended immunizations. Other strategies advised by the CDC include practicing good hygiene, such as regular handwashing and cleaning frequently touched surfaces; ensuring clean air in areas where people live and work; taking precautions when sick by staying home and avoiding contact with others; and seeking medical care as needed. Additionally, wearing masks, maintaining physical distancing, and, most importantly, keeping one’s immunity strong help prevent the spread of respiratory illnesses.

Resource person: Dr. Noor Zehan Abdul Rahim, Consultant Paediatrician and Paediatric Respiratory Specialist, Sunway Medical Centre, Malaysia

In Malaysia, where urban living and vibrant cityscapes define daily life, an unsettling trend is emerging – an increase in childhood allergies. What was once considered a minor nuisance has become a significant health concern, with triggers ranging from dust mites to severe food reactions. According to estimates, one in five Malaysian children may develop allergies [1], a situation that urges parents to pay more attention on, understand, manage, and prevent these conditions.

“Allergies are more than just sneezes or skin rashes, they can deeply affect a child’s quality of life,” shares Dr. Noor Zehan Abdul Rahim. “Urban living exposes children to higher allergens like dust mites, smoke, and pollution. While parents can’t control everything, they can take steps to make their homes safer havens.”

Most common allergens affecting Malaysian children

1. Dust mites are the most common triggers for respiratory allergies in Malaysia. They thrive in humid conditions and hide in bedding, carpets, and soft furnishings.
2. Pet dander is another major culprit. “Even hypoallergenic pets can still provoke reactions in sensitive children,” explains Dr. Noor Zehan.
3. Food allergens, though less common than in Western countries, can include reactions to peanuts, shellfish, and milk.
4. Pollen and mould also pose challenges, particularly in damp urban areas.

Recognising symptoms

Allergy symptoms can vary and typically appear between 2 to 3 years of age, although food allergies may develop as early as 6 months, while respiratory allergies, such as hay fever, often emerge around 5 or 6 years old.

Respiratory triggers can cause sneezing, coughing, wheezing, or nasal congestion. Allergic rhinitis, the most common childhood allergy [2], is characterised by sneezing, a runny nose, and nasal blockage. Skin reactions like rashes or eczema may signal environmental or dietary causes, while vomiting or diarrhoea can indicate food allergies.

“Parents should watch for recurring symptoms,” advises Dr. Noor Zehan. “If a child frequently reacts after eating certain foods or being in specific environments, it’s worth investigating further.” She recommends keeping a symptom diary to help identify patterns and triggers.

Related: Flu on the rise: How Asia is managing a widespread seasonal threat

Ignoring allergies can have lasting effects

The risks of untreated allergies go far beyond temporary discomfort. Persistent allergic rhinitis can lead to chronic sinusitis or asthma, which disrupt a child’s sleep, focus, and everyday activities.

Alarmingly, asthma rates in Malaysian children have surged, from 6.4% to 9.4% among 6 – 7-year-olds and from 9% to 13% among 13 – 14-year-olds [3].

“Asthma triggered by untreated allergies can be life-altering if not properly managed,” warns Dr. Noor Zehan. “It’s heartbreaking to see children struggle with something that can often be prevented or controlled.”

What parents can do

While allergies can feel overwhelming, Dr Noor Zehan outlines simple but effective steps parents can take to reduce allergen exposure and manage symptoms that can make a big difference, including:

1. Clean and declutter: Use dust-mite-proof covers and vacuum regularly with HEPA filters.
2. Eliminate smoke exposure: Even particles on clothes can aggravate allergies.
3. Manage pet allergens: Keep pets out of bedrooms, and in severe cases, consider rehoming.
4. Introduce allergenic foods carefully: Under medical guidance, introduce foods like peanuts or eggs between 4 and 6 months, but avoid whole peanuts to prevent choking.
5. Choose air purifiers wisely: Avoid fragrances or chemicals that irritate sensitive airways.

Truths and fallacies on allergy

Misconceptions about allergies persist, including the belief that children will naturally outgrow them. “While some do, many allergies persist into adulthood, impacting the quality of life if not managed properly,” explains Dr Noor Zehan.

Another myth is that avoiding triggers like cold drinks can prevent respiratory issues. “With proper management, children with asthma or allergic rhinitis can enjoy normal activities without unnecessary restrictions,” she reassures.

Parents may also worry about inhaler dependency, but Dr. Noor Zehan dispels this fear. “Inhalers are not addictive. They are life-changing tools that help children breathe freely and thrive. As conditions improve, reliance on medication can be gradually reduced,” she explains.

Exposure to different environments for immunity building

The pandemic has also influenced allergy trends. Lockdowns temporarily reduced children’s exposure to infections, easing respiratory symptoms, but limited opportunities for immunity-building. “Reduced exposure meant children missed out on essential immunity-building, leaving them more vulnerable post-COVID,” explains Dr. Noor Zehan.

She also encourages parents to strike a balance. “Gradually reintroduce your child to diverse environments while maintaining good hygiene. This helps rebuild their defences and allows you to identify potential allergens.”

Managing childhood allergies requires teamwork between parents and healthcare providers. Regular check-ups with a paediatrician are essential for early detection and treatment. “The early years are crucial for long-term health,” emphasises Dr. Noor Zehan. “Stay informed, take action, and don’t hesitate to seek medical advice. Every step you take now will help your child live a healthier, happier life.”

References:

1 Subramaniam, S. (2014, November 29). Allergies and what we need to know about them. Scientific Malaysian Magazine. Retrieved from Scientific Malaysian Allergies and What We Need to Know About Them | Scientific Malaysian Magazine

2 Subramaniam, S. (2014, November 29). Allergies and what we need to know about them. Scientific Malaysian Magazine. Retrieved from Scientific Malaysian Allergies and What We Need to Know About Them | Scientific Malaysian Magazine

3 Dinglasan, J. L., Tang, L. Y., Chong, M. C., & Al Raimi, A. M. (2022). Asthma prevalence and the relationship between level of knowledge and quality of life among asthmatic schoolchildren in Malaysia. Saudi Medical Journal, 43(1), 113-116. https://doi.org/10.15537/smj.2022.43.1.20210211

Chocolates are rich in B vitamins, along with other nutrients such as magnesium, iron, and antioxidants that support brain function, mood regulation, and overall well-being.

But more than chocolates, B vitamins, specifically B1 or Thiamine (or Thiamin) is also present in foods [1] including meats such as pork, fish, whole grains beans, lentils, green peas, sunflower seeds and yoghurt. It is also added to breads, cereals, and baby formulas.

Cooking and processing reduce thiamine levels. Bread retains 70–80% of its original vitamin content, pasteurization cuts milk’s thiamine by up to 20%, and unenriched white rice has only a tenth of that in brown rice. Alcohol and folate deficiency further hinder absorption.

Thiamine and the brain

The brain’s high dependence on mitochondrial ATP production makes it especially vulnerable to thiamine deficiency. This risk is heightened during periods of rapid growth such as infancy and childhood, when inadequate intake or genetic defects can lead to deficiency.

Thiamine deficiency has been linked to a wide spectrum of symptoms ranging from confusion, memory loss, and sleep disturbances to severe neurological and cardiac conditions including encephalopathy, ataxia, heart failure, and muscle wasting, according to authors of the study, “Neurological, Psychiatric, and Biochemical Aspects of Thiamine Deficiency in Children and Adults (Frontiers in Psychiatry)”. [2]

How the body absorbs and uses Thiamine

Thiamine is absorbed in the small intestine through active transport at normal dietary levels and by passive diffusion when consumed in higher doses. Most of the thiamine found in food occurs in phosphorylated forms that are converted into free thiamine by intestinal enzymes before absorption.

The vitamin is stored mainly in the liver, skeletal muscles, heart, brain, and kidneys, with total body reserves estimated at 25 to 50 mg. About 80% of this stored thiamine exists as thiamine diphosphate (TDP), its active form, which acts as a cofactor for enzymes that support glucose, amino acid, and lipid metabolism.

How much should we take?

The Recommended Dietary Allowance (RDA) for men ages 19 and older is 1.2 mg daily, and for women in the same age range 1.1 mg daily. For pregnancy and lactation, the amount increases to 1.4 mg daily. Meanwhile, a tolerable Upper Intake Level (UL) is the maximum daily dose unlikely to cause adverse side effects in the general population. There is no UL for thiamin due to a lack of reports showing negative effects from high thiamin intakes. [3]

Vitamin B1 in cognitive health and Alzheimer’s

A small clinical trial led by Dr. Gary E. Gibson’s team at the Burke Neurological Institute, in collaboration with physicians at Burke Rehabilitation Hospital, found that benfotiamine—a compound that raises vitamin B1 levels—appears safe and may help improve cognitive function in people with mild cognitive impairment and early Alzheimer’s disease.

The yearlong study, published in the Journal of Alzheimer’s Disease [4], examined benfotiamine’s ability to increase blood thiamine concentrations. Higher vitamin B1 levels are thought to enhance the brain’s use of glucose, a key factor in maintaining cognitive performance.

Alzheimer’s affects one person in the United States every 65 seconds, with cases projected to grow from over five million to 14 million by 2050. Prior research indicates that reduced brain glucose metabolism may occur decades before memory loss begins.

Funded by the National Institutes of Health and the Alzheimer’s Drug Discovery Foundation, the study provides early evidence supporting further research on benfotiamine as a potential treatment to slow or prevent cognitive decline in Alzheimer’s disease.

In the same vein, a national clinical study [5] evaluating benfotiamine, a synthetic form of thiamine (vitamin B1), as a potential treatment for mild cognitive impairment (MCI) and early Alzheimer’s disease (AD), has been conducted, with the University of Iowa taking part. The Phase 2 trial, known as BenfoTeam, will assess whether benfotiamine can help preserve or improve memory, thinking, and daily functioning. Nearly 50 sites across US had participated, with funding from the National Institute on Aging under the National Institutes of Health.

Professor Delwyn Miller of the UI Carver College of Medicine said Alzheimer’s affects nearly seven million Americans and remains the fifth leading cause of death among people over 65. He noted that existing treatments provide limited benefits and can be difficult to access. Miller said benfotiamine presents a credible, affordable, and safe approach worth testing in this larger study.

The BenfoTeam study has evaluated whether increasing blood thiamine levels can delay cognitive decline in people aged 50 to 89 with mild memory issues or dementia due to AD. Recruitment efforts focus on underrepresented groups, including Hispanic and Black communities, which face higher rates of the disease.

Previous pilot studies found benfotiamine to be safe and well tolerated, with slower cognitive decline than placebo. Those findings supported the launch of this larger, 18-month randomized, double-blind, placebo-controlled trial involving 406 participants across 50 US sites.

Sources

1.https://nutritionsource.hsph.harvard.edu/vitamin-b1/

2.https://pmc.ncbi.nlm.nih.gov/articles/PMC6459027/

3.https://nutritionsource.hsph.harvard.edu/vitamin-b1/

4.https://burke.weill.cornell.edu/gibson-lab/impact/news-articles/new-data-suggests-raising-vitamin-b1-levels-very-high-helps-people

5. https://medicine.uiowa.edu/news/2024/09/university-iowa-health-care-evaluating-synthetic-version-vitamin-b1-treatment

Leaner weight, lower health risks in midlife

A recent study published in JAMA Network Open on weight loss in Midlife has examined the long-term effects of sustained weight reduction in midlife, looking beyond the well-established reduction in diabetes risk.

The research followed 23,149 adults between the ages of 40 and 50 from three cohorts: the Whitehall II study in the UK (1985–1988), the Helsinki Businessmen Study in Finland (1964–1973), and the Finnish Public Sector study (2000). Participants were tracked for 12 to 35 years and classified into four groups based on body mass index (BMI): those who maintained a healthy weight, those who reduced their BMI from overweight to healthy, those who gained weight from healthy to overweight, and those who remained overweight.

The study found that individuals who lost weight from the overweight range into a healthy range during midlife and maintained it had a lower risk of developing chronic diseases and a reduced risk of death from all causes compared to those who stayed overweight. Importantly, these benefits extended beyond the lowered risk of type 2 diabetes, indicating that sustained weight loss offers broader protective effects on long-term health. While achieving and maintaining weight loss through lifestyle changes in midlife can be challenging, the findings suggest that doing so can significantly improve overall health outcomes over the course of decades.

Heart health and intermittent fasting

A new study published in The BMJ suggests that intermittent fasting can be just as effective as traditional calorie-restricted diets for weight loss and improving cardiometabolic health, with alternate day fasting showing the greatest benefit.

The research, led by Zhila Semnani-Azad of Harvard T.H. Chan School of Public Health, is the largest systematic review to date on intermittent fasting and analyzed 99 clinical trials involving more than 6,500 participants. Most participants had an average body mass index of 31, with nearly 90% already managing health conditions.

The study compared intermittent fasting diets, including alternate day fasting, time-restricted eating such as the 16:8 method, and whole day fasting such as the 5:2 plan, with calorie-restricted and unrestricted diets.

Results showed that both intermittent fasting and calorie restriction led to meaningful weight loss and better health outcomes compared with unrestricted eating, but alternate day fasting produced superior results. Participants on this plan lost on average 1.3 kg more than those on traditional calorie-restricted diets and showed additional improvements in waist circumference, cholesterol and triglyceride levels, and c-reactive protein, an inflammation marker linked to chronic disease.

These findings highlight the potential of weight loss through intermittent fasting to improve not only body weight but also markers of heart and metabolic health. While the researchers caution that most clinical trials were short-term, lasting less than 24 weeks, they say the evidence points to fasting as a promising option for people seeking effective ways to manage obesity and related health risks. At the same time, they stress that fasting is not for everyone and that individuals should consult with healthcare providers to ensure it suits their medical history, lifestyle, and long-term sustainability.

New evidence of cellular-level benefits of weight Loss in obesity

Scientists have produced the first detailed characterization of how weight loss changes human fat tissue by analyzing hundreds of thousands of cells. The study published in Nature, revealed a number of beneficial effects, including the clearing of damaged, ageing cells and an increased metabolism of harmful fats.
Researchers say these findings provide new insights into how weight loss improves health at the molecular level and could eventually guide the development of therapies for diseases such as type 2 diabetes.

The research compared fat tissue samples from people with severe obesity, defined as a BMI over 35, who underwent bariatric surgery, with samples from healthy-weight individuals. For the weight loss group, fat was analyzed during surgery and again more than five months later, when participants had lost an average of 25 kg.

By studying gene expression in more than 170,000 fat cells from 70 individuals, scientists discovered that weight loss unexpectedly triggers the breakdown and recycling of lipids, a process that may help burn energy and reverse the harmful accumulation of fats in organs like the liver and pancreas. While further research is needed to confirm whether this lipid recycling directly contributes to health improvements, it may help explain why weight loss often leads to remission of type 2 diabetes.

The team also observed that weight loss cleared out senescent cells, which are ageing and damaged cells that build up in tissues, cause inflammation, and impair proper function. Removing these cells may play a role in reducing obesity-related complications. However, the study also found that certain effects of obesity on the immune system were not fully reversed, as inflammatory immune cells infiltrating fat tissue persisted even after significant weight loss. This type of immune memory, researchers warn, could have harmful consequences if weight is regained.

According to Dr. William Scott of the MRC Laboratory of Medical Sciences and Imperial College London, who led the study, these results provide a detailed map of the mechanisms driving the health benefits of weight loss at the cellular level.

Fat tissue, he explained, influences much more than weight itself, playing roles in blood sugar regulation, body temperature, hormone balance, and reproductive health. The researchers hope that knowledge gained from this work will contribute to more effective treatments for diabetes and other conditions linked to excess body fat. The study was funded by the Medical Research Council, Diabetes UK, and Wellcome.

Modest diet change improves pregnancy health

A new study published in Nature Medicine has found that a reduced-calorie diet in late pregnancy is safe for women with gestational diabetes who are overweight or obese, and offers meaningful health benefits for both mother and baby.

The research, led by Professor Claire Meek at the Universities of Leicester and Cambridge, showed that women who followed a 1,200-calorie nutritionally balanced diet from 29 weeks of pregnancy were less likely to require insulin treatment compared with those on a standard 2,000-calorie plan.

Researchers estimate that adopting this approach nationally could help up to 13,000 women with gestational diabetes each year avoid insulin use.

Apart from lowering the need for insulin, modest weight loss of around 3kg in the third trimester was linked to improved blood sugar and blood pressure, as well as a 48% lower risk of delivering a large baby, a factor tied to safer births and reduced risk of obesity and type 2 diabetes in childhood.

These benefits continued after pregnancy, with women maintaining better blood sugar control for at least three months postnatally. Since gestational diabetes raises the risk of type 2 diabetes tenfold, the findings suggest that modest weight loss in late pregnancy could play an important role in protecting long-term health for both mothers and their children.

1. Hiking and nature walks

Hiking is huge in places like South Korea, where nearly two-thirds of the population hit the trails at least once a year, and about a third do it monthly. It’s not just a trend—it’s a lifestyle that spans generations, with even older adults lacing up their sneakers for some fresh air and movement. As a solid cardio workout, hiking helps with heart health, lowers the risk of serious illnesses like stroke and type 2 diabetes, and boosts mental wellness by cutting down stress, anxiety, and negative vibes through nature exposure. On a global scale, mountain trekking brings in up to 20% of tourism revenue, showing it’s not just good for your body but also the economy. When done responsibly, it supports environmental conservation and helps local communities thrive. Best part? In many Asian countries, hiking trails and nature parks are just a quick trip from the city and often free or super cheap to access—making it one of the most low-cost, high-reward activities out there.

Suggested spots to explore: Mount Kinabalu (Malaysia), Mount Agung (Indonesia), Tilicho Lake (Nepal), Mount Shosha(Japan), Hang Son Doong (Vietnam)

2. Walking and jogging in parks

In cities like Singapore, it’s totally normal to have a park just a short walk from home—less than 10 minutes away for most people. According to studies, about 76% of urban residents say they use parks at least once a month, and 63% get active there, whether it’s walking, jogging, or just moving around. Regular time spent in these spaces is linked with better well-being, from feeling less stressed to building social connections and staying physically fit. Studies even show that the more time you spend walking or jogging in parks, the better your wellness scores get. Interestingly, it’s not just about how close a park is on a map. If people feel like a park is easy to reach, they’re more likely to actually use it. This shows how city design and perception go hand in hand. In many parts of Asia, smart urban planning that mixes walkability, nearby green zones, and public spaces helps people stay active without spending much.

Suggested spots to explore: Southern Ridges trail (Singapore), Minoo Park (Japan), Karanji Lake Nature Park (India), Pawa Mangrove Nature Park (Philippines), Lumphini Park (Thailand), MacRitchie Reservoir (Singapore)

3. Cycling trail adventures

Cycling is having its moment in cities like Tokyo and other Asian hubs, where dedicated bike lanes and urban routes make it easy to ride for fun or as a way to get around. Most cycling trips cover anywhere from 2 to 10 kilometers, which fits perfectly into daily routines. In cities where biking is more popular, there’s a pretty balanced mix of riders across ages and genders—including kids and older adults. But in places where cycling isn’t as common, women and seniors tend to be underrepresented. As for health perks, cycling helps boost heart health, build muscle, and support mental wellness, all while being easy on the budget. Touring by bike in Southeast Asia can be especially low-cost, with daily expenses sometimes staying under US$100 for both food and lodging. Total steal!

Suggested spots to explore: Rizal Park (Philippines), Taitung Ocean Mountain Bikeway (Taiwan), Geylang Park Connector (Singapore), Tsukuba Rinrin Road (Japan)

4. Home cooking with local ingredients

In places like Japan and Vietnam, a big chunk of the population – say, it’s up to 71% in Vietnam—regularly cooks at home, helping keep meals healthier and more mindful. Young adults living with family tend to eat better when meals are homemade, usually with more veggies and grains and less unhealthy fats. It also saves serious cash. A home-cooked meal can cost as little as US$5 per serving, way cheaper than dining out. Plus, the more confident and motivated you are in the kitchen, the more likely you are to keep up the habit. Healthy, tasty, and easy on the wallet!

Suggested spots to explore: Cai Rang Floating Market (Vietnam), Cicada Market (Thailand), Jimbaran Fish Market (Indonesia), Bac Ha Market (Vietnam), La Trinidad Strawberry Farm (Philippines)

5. Gardening and urban farming

Urban gardening is gaining serious traction in cities like Taipei, where nearly 27% of people take part in family or community-based agriculture. In some areas, more than half of city residents are involved in some form of urban farming. Beyond just growing plants, the activity boosts physical movement, supports mental health, and helps build stronger neighborhood vibes. Hanging out at community gardens adds extra mental health perks that go beyond exercise alone. On a bigger scale, it supports food security, cuts down carbon footprints, and can even open up side income when backed by local programs like those in Singapore, Japan, and China. Start-up costs can be a bit much, but shared spaces and skill-sharing models make it way more doable for most people. Green gains all the way!

Suggested spots to explore: Forest Research Institute (Malaysia), Sothy’s Pepper Farm (Laos), Tropical Spice Garden (Malaysia)

6. Birdwatching and nature observation

Birdwatching is catching on across Asia as a chill, low-cost hobby that gets people out into parks, forests, and even city corners with a bit of greenery. It’s easy to get into—no fancy gear or major time commitment needed—and it’s open to all age groups. Spending time watching birds or just observing nature helps lower stress, improves focus, and supports mental wellness by boosting calm and connection. Whether you’re out solo or tagging along with friends, it’s a simple way to unplug and feel better, without spending much at all.

Suggested spots to explore: Prek Toal Sanctuary (Cambodia), Penang National Park (Malaysia), Phnom Tamao Wildlife Rescue Centre (Cambodia), Payah Indah Wetlands (Malaysia), La Mesa Eco Park (Philippines), Rajah Sikatuna National Park (Philippines)

7. Meditation and spirituality practices

In countries like India, Sri Lanka, and Thailand, meditation is part of everyday life for many, with nearly half of adults practicing at least once a week. It’s deeply rooted in culture and widely embraced across all age groups. Meditation is known to ease stress, reduce anxiety, and lift mood while also boosting focus and emotional resilience. It doesn’t cost much to get started and works whether you’re doing it solo or with a group. With minimal expenses and solid mental health benefits, it’s a go-to for staying grounded and calming the mind.

Suggested spots to explore: San Agustin Church-Manila (Philippines), Phuoc An Hoi Quan Pagoda (Vietnam), Wat Xieng Thong (Laos), Mahabodhi Temple complex (India)

8. Exploring cultural and natural heritage sites on foot

Asia is packed with culture, with over 220 UNESCO World Heritage sites across the region. Many of these spots are easy to reach and can be explored on foot, often with little to no entry fee. Walking through these areas offers more than just exercise—the mix of movement, history, and scenery boosts heart health, builds strength, and lifts your mood. Since a lot of these sites are close to towns and cities, it’s a smart way to get some steps in while soaking up the local vibe. History plus health? Win-win.

Suggested spots to explore: Kamphaeng Phet Historical Park (Thailand), Himeji Castle (Jaoan), Temple of Literature (Vietnam), Bayon (Cambodia), Shwedagon Paya (Myanmar), Mae Fah Luang Art & Culture Park (Thailand).

Dr Chang Kok Chun / Thomas Chua Wei Yeh

Text-neck syndrome: bad posture from tech habits

From classroom to office, the everyday habit of looking down at screens are making Malaysians suffering from text neck syndrome, a preventable condition causing long-term neck and shoulder pain, and threatening the neurological function.

With an average screen time of eight hours and 17 minutes daily, Malaysians now rank among the highest digital device users in Asia, according to Dr Chang Kok Chun, Consultant Orthopaedic, Trauma and Spine Surgeon at Sunway Medical Centre Velocity (SMCV). This will result in ‘text neck syndrome,’ a relatively new condition that has emerged, especially post-pandemic with noticeable rise in cases among teenagers and young adults.

This growing health issue is a repetitive stress injury caused by prolonged forward head posture while looking down at screens. When someone develops text neck, the muscles and joints in the neck undergo continuous strain due to poor posture. Over time, this causes muscle and joint fatigue, discomfort, and if left untreated, may even result in structural damage.

Risk from high digital usage

Malaysia’s high digital consumption, particularly among the younger population, is a significant contributor to the rise of text neck syndrome. The country records the third-highest TikTok usage in Southeast Asia, with an average watch of 121 videos a day2. Combined with long hours at desks or classroom, and the lack of ergonomic awareness, this creates the perfect situation for postural strain.

One of the most common postural issues we see is “Forward Head Posture,” says SMCV’s Physiotherapist and Manager of Rehabilitation Medicine Services, Thomas Chua Wei Yeh. Misalignment occurs when one tilts the head forward by 45 degrees which increases the load on the cervical spine from only 5 to 22 kg. This adds over 1,000 hours of strain on an average user’s spine in just a year, which can lead to symptoms such as neck and shoulders pain, headaches, dizziness, spinal nerve irritation resulting in tingling sensation of the hands and even early degenerative arthritis of the neck.

“Younger patients are more at risk, mainly due to their frequent and prolonged use of smartphones, tablets, and laptops,” Dr Chang notes. He adds, “Text neck is now both an occupational hazard for office workers and a lifestyle-related issue for those who are constantly glued to their devices.”

Check workspace ergonomics

Poor workplace ergonomics further compounds the issue, as many endure long hours at non-conducive desk setups. This prolonged strain is increasingly linked to higher rates of sick leave in corporate environments, reduced productivity, and declining workplace performance. The Ministry of Health reports that 67% of Malaysians experience neck pain at some point in their lives, making it the second most common musculoskeletal complaint in the country, yet many dismisses the discomfort as temporary or stress related.

Signs to watch out for

The early signs of text neck syndrome are often overlooked or mis-attributed to stress or poor sleep. Symptoms may include persistent neck or upper back stiffness, headaches that begin at the base of the skull, tingling or numbness in the hands and fingers, dizziness or poor balance, difficulty concentrating, eye strain and general fatigue.

“Neck pain is one of the most commonly recognised symptoms, but referred pain to the shoulders and upper back is often missed,” says Dr Chang. He urges Malaysians to pay closer attention to the pain they are feeling and avoid ignoring it to prevent other health complications that could arise from text neck syndrome.

Take it seriously

If left un-managed, text neck syndrome can lead to a series of musculoskeletal and neurological complications, including herniated discs, frozen shoulder, or reduced lung capacity from prolonged hunching. In more advanced cases, compressed cervical nerves may disrupt neural blood flow and nerve signals. Other symptoms that might occur includesblurry vision, brain fog, dizziness and difficulty concentrating

“The pain will initially provoke protective muscle spasm, which would show in X-ray as straightening of the spine,” Dr Chang explains. “If ignored, this can lead to premature degeneration of the spine, including thinning of the disc between two segments of vertebrae, and the development of bone spurs and facet joint arthritis over time, which is also known as cervical spondylosis (wear and tear of the joint and discs in the neck).

He further warns that this irreversible condition may cause nerve or spinal cord compression, leading to radiating pain, numbness or pins and needles sensation in the arms, forearms and hands. In severe cases, it can cause weakness and paralysis in both the upper and lower limbs. Persistent pain does not only affect one physically, but it can take a toll on mental health and overall wellbeing. As discomfort lingers, it can interfere with daily routines and diminish quality of life. Over time, individuals may experience reduced productivity, increased irritability or helplessness, especially when relief feels out of reach.

Text neck syndrome has evolved from a mild postural issue into a serious and preventable health concern, driven by Malaysia’s increasing reliance on digital devices and poor ergonomic habits. While simple changes in posture and screen time habits can reduce the risk. As a result, prolonged strain often goes unchecked, leading to chronic pain, spinal degeneration, and in some cases, irreversible nerve and spinal cord damage. Awareness and sustainable habits such as proper posture, ergonomic setups and regular intermittent neck relaxation exercise, Malaysians can take meaningful steps to reduce the risks of text neck and preserve their spinal health in the digital age.

Prevention and recovery

Managing text neck syndrome typically involves a combination of physiotherapy, lifestyle changes and, in some cases, medication. Dr Chang stresses that the best investment lies in consistent ergonomic practices through reducing screen time, using proper posture and incorporating regular neck relaxation exercises throughout the day.

Thomas adds that physiotherapy plays a critical role in both recovery and prevention. “We use manual therapy, postural retraining and targeted exercises to relieve tension, build strength, and restore proper alignment,” he explains. While most patients begin to notice improvement within three to six sessions, those with more severe conditions may require a longer treatment plan to achieve lasting results.

Treatment plans are tailored to each individual’s lifestyle and physical demands. “For students, we focus on limiting continuous screen time, encouraging posture-friendly reading habits, and optimising backpack use to avoid unnecessary strain on the neck and upper back,” says Thomas. Meanwhile, prioritising ergonomic workstation and integrating mobility breaks such as stretching routines is recommended for office workers to reduce muscular fatigue and joint stress.

Progress is tracked through a combination of clinical assessments and patient-reported outcomes. “We assess range of motion to evaluate cervical and thoracic spine mobility, and test muscle strength in key postural areas,” Thomas explains. “Postural analysis helps us monitor alignment changes over time, while pain scales and functional questionnaires offer insights into daily performance and comfort levels.” He adds that improvements such as reduced reliance on pain medication or greater tolerance for daily tasks are also important indicators of recovery.

He also cautions against movements that worsen symptoms particularly during recovery, such as abdominal crunches, overhead lifting or prolonged typing with a flexed neck. “Rest helps reduce immediate pain, but movement, postural correction, and strengthening are key to long-term recovery.”

While many are aware of the risks, Dr Chang acknowledges that consistent application remains a significant challenge. “Everyone understands the cause and consequences of text neck syndrome, but bad habits are hard to break, and heavy workload compels us to neglect proper neck and spine care.” Still, he encourages all to start making positive changes, one step at a time, as lasting habits are built upon.

Resources:

https://www.electronicshub.org/the-average-screen-time-and-usage-by-country-in-2024/

https://multimedia.scmp.com/lifestyle/article/2183329/text-neck/index.html

https://www.physio-pedia.com/Text_Neck

https://www.malaymail.com/

https://moh.gov.my/index.php

By Dr Abdul Razak Hussin, Consultant Orthopaedic and Sports Surgeon,  Ara Damansara Medical Centre (ADMC)

Who is at risk?

Knee injuries can affect anyone, not just athletes. Whether you run, play sports on weekends, or hike, a sudden twist or misstep can cause serious damage. The most commonly injured knee structures are the anterior cruciate ligament (ACL) and the meniscus, a C-shaped cartilage that cushions the joint.

Despite this, many ignore knee pain, assuming it will heal on its own. Unfortunately, untreated ACL or meniscus injuries can lead to instability, chronic pain, and early arthritis.

How do these injuries occur?

Knee injuries result from either direct impact (e.g., a football tackle) or sudden, non-contact movements (e.g., twisting while the foot remains planted). Many individuals report hearing a distinct “pop” at the time of injury, followed by swelling and pain. In severe cases, the knee becomes unstable, making movement difficult.

Mild injuries may allow continued activity, but without treatment, symptoms often worsen over time.

Do you need surgery?

Treatment depends on the severity of the injury. Mild cases may improve with physiotherapy and strengthening exercises, while severe ACL and meniscus tears often require surgery.

Doctors typically use X-rays to rule out fractures and MRIs to assess ligament and cartilage damage. If left untreated, a damaged ACL or meniscus can cause ongoing instability, especially during activities like descending stairs or walking on uneven surfaces. This can further damage the meniscus and cartilage, leading to persistent pain and arthritis.

What happens during surgery?

ACL reconstruction replaces the torn ligament with a tendon graft, usually from the hamstring or patellar tendon. Meniscus treatment varies based on severity—doctors aim to repair it when possible, but in cases of extensive damage, a partial meniscectomy may be necessary.

After surgery, most patients start walking with crutches almost immediately. Those undergoing meniscus repair may need to limit weight-bearing activities for proper healing. A knee brace is typically required for about six weeks.

Recovery and rehabilitation

Recovery takes time, and returning to high-impact sports should only be considered after a full year to allow proper healing. Post-surgical rehabilitation is crucial, with modern advancements like bioactive scaffolds, platelet-rich plasma (PRP), and robot-assisted therapy improving outcomes.

Emerging treatments, including stem cell therapy and virtual reality rehabilitation, also enhance recovery and make physiotherapy more engaging.

Early intervention matters

Persistent knee pain, swelling, and instability should never be ignored. Seeking medical attention early can prevent further damage and improve recovery outcomes.

While knee injuries can be accidental, understanding their causes and symptoms allows individuals to seek timely treatment. The goal is to restore function, prevent complications, and help patients return to daily activities pain-free.