Making vital choices
IT is no secret that Malaysians love our food. Not only have we made the act of eating somewhat of a cultural pastime and widely accepted medium for social or business activities, the wide selection of cuisines available has become a point of pride to the nation that we enthusiastically introduce it to foreigners and tourists.
Looking beyond the mouthwatering delicacies, trendy eateries and endless lists of online food blogs, there is unfortunately a deep underlying social problem that continues to grow unnoticed.
As many of Malaysians’ favourite foods contain rich and processed ingredients, a large number of the population fails to realise or ignore that their daily diet can greatly affect gut health and, in the long term, cause additional health problems.
Poor gut health as a result of bad dietary choices is a global problem and this is the reason the World Gastroenterology Organisation named diet and the gut as the theme for this year’s World Digestive Health Day that takes place every May 29.
The unknown risks
According to Dr Tee E Siong, president of the Nutrition Society of Malaysia and council member of Digestive Health Malaysia, “Inappropriate dietary habits have adverse effects on gut health – the most common problems are heartburn ( indigestion felt as a burning sensation in the chest), tummy pain, diarrhoea and constipation.
“An unhealthy gut can lead to more serious diseases such as gastroesophageal reflux, irritable bowel syndrome ( IBS), indigestion or colorectal cancer ( development of cancer from the colon or rectum),” says Dr Tee.
“Gut diseases may include inflammatory bowel disease, bowel and liver cancers, and an unhealthy gut may lead to other problems that can affect mental health,” says Prof Dr Lee Yeong Yeh, professor of medicine and consultant in gastroenterology, hepatology and internal medicine at Universiti Sains Malaysia.
Prof Lee is also a committee member of the Malaysian Society of Gastroenterology & Hepatology, steering committee member of the World Digestive Health Day 2016 and a member of the Young Scientist Network of Academy of Sciences of Malaysia.
He continues to add skin diseases, celiac disease ( difficulty in digesting food due to hypersensitivity to gluten) and diabetes mellitus into the mix of possible diseases linked with poor gut health.
Based on the figures released by the Health Ministry ( MOH) and National Cancer Registry of Malaysia, it is undeniable that the current dietary habits of Malaysians are a matter of concern.
In Health Facts 2015, the latest report by the MOH on the general state of health among Malaysians, diseases linked to poor digestive health are the sixth principal cause of death in Malaysia.
Furthermore, MOH in 2014 recorded diseases of the digestive system as the seventh principal cause of hospitalisation in government hospitals and the sixth principal cause of death in both public and private hospitals.
The National Cancer Registry recorded colorectal cancer as the second most common form of cancer affecting Malaysians, with up to 3,000 new cases reported every year.
You are what you eat
Dr Tee believes poor dietary habits are the major cause of obesity in the country and the main reason for the high prevalence of diabetes, cardiovascular disease and certain forms of cancer.
He adds that people are simply eating too much and frequently and urges people not to constantly consume overly large serving sizes.
Malaysians really should be aware of the main ingredients in their favourite dishes and how consuming large amounts can affect general health as there are countless health campaigns and notices regarding the dangers of consuming foods excessive in fat, oil, santan ( coconut milk), sugar, salt and preservatives.
In an article written by Prof Lee and published in The Star last month titled “From Fat to Cancer”, people link obesity to heart diseases, diabetes and strokes but many are unaware that obesity also affects the bowels.
Prof Lee says there are various foods that may cause symptoms in susceptible individuals and that eating processed food and meat may lead to bowel cancers.
“Fatty food can slow stomach emptying and cause a feeling of fullness while foods containing FODMAPs ( an abbreviation for a collection of molecules found in foods that can be poorly absorbed by people) can cause bloating, especially in patients with IBS,” says Prof Lee.
Practising self- discipline
Dr Tee stresses that maintaining a healthy gut is not difficult, as you will just have to be disciplined in maintaining a healthy eating pattern.
“Have a balanced diet that includes a wide variety of foods from each of the main food groups – and eat moderate amounts.
“Limit the intake of foods high in fats, oil, sugar and salt and include more plant foods such as legumes. This will help you obtain enough dietary fibre, which is important for good gut health,” says Dr Tee.
He also recommends consuming food containing ingredients that can promote good bacteria in the gut such as fermented soy products, cultured milk and drinks, as well as yoghurt as they are a good source of probiotics.
As stress can have a negative effect on gut health, both Dr Tee and Prof Lee advise people to conduct regular exercise on top of healthier dietary habits to maintain a healthy gut.
Speaking on the myriad of diet fads that are heavily promoted in the market, both doctors say it is difficult to ascertain if commercial diets have any beneficial or negative effects in the long run, and more research has to be carried out within this area.
However, Dr Tee stresses, “You have to remember that there is no magic bullet or short cut to keeping fit or maintaining a healthy body weight.
“It requires a long- term programme of adopting a balanced diet and physically active life. While this may not sound exciting, it is the only proven safe way to maintain a healthy body weight.”
Both Dr Tee and Prof Lee agree that the awareness level on the seriousness of gut diseases is still low.
“Many Malaysians tend to ignore their bowel complaints and seek medical advice relatively late. They are also quite reluctant to change their diet,” says Prof Lee.
“The public must not delay seeking medical advice if they encounter signs such as prolonged abdominal pain, gastrointestinal bleeding that form black or tarry stools, changes in bowel habits, unintended weight loss and the persistent feeling of nausea or vomiting,” says Dr Tee.
Given the number of colorectal cancer cases, hospitalisation, and other diseases linked to poor digestive health in Malaysia, more needs to be done on the part of the Government and health authorities.
The authorities must take the initiative to reach out to the public and find new ways in which they can highlight the importance of such a vital issue to all levels of society.
Dr Tee says that diseases related to the gut can be prevented by having knowledge of the various diseases and causes. Recognition of symptoms is also important so that people can seek timely professional advice.
Malaysians need to take responsibility for their health and learn the consequences of their dietary habits. While it is alright to indulge from time to time, what you choose to consume every day will determine your overall well- being in the long run.