What you could be eating in future is changing rapidly
Walk into any supermarket or café and take a look at the food advertisements. No longer are they merely “tasty” or “filling”, rather, the labels promise things like gut health, brain support, energy balance or anti-inflammatory nutrition. Smoothies contain probiotics; snack bars stress protein and fibre; drinks are said to encourage calm, focus or immunity. The change indicates a deeper change in the way people perceive food. Food is now understood increasingly as more than nourishment; it’s a way to improve health or prevent illness. Improvements in nutritional science, a better understanding of chronic diseases and a growing anxiety about longevity are driving what and why people eat. Several fascinating food and health trends have developed and will probably resonate in kitchens and restaurants around the world, knocking grocery aisles out of place. The age of personalised nutrition For decades, dietary advice appeared fairly constant – shake off fat, eat a greater proportion of vegetables and minimise sugar. However, scientists already know that people react in very different ways to the same foods. One person’s meal might trigger a significant surge in blood sugar levels, for another, almost nothing. This understanding has fuelled one of the largest trends in modern nutrition: personal diets. Advancements in technology today are facilitating better food choices related to the biology of each individual. For example, continuous glucose monitors (CGMs) allow users to observe how their blood sugar levels are responding in real time after meals in various foods. Microbiome testing supplies answers to the trillions of microbes living in the gut, which is an important area of digestion and metabolism. And these tools help people design diets that will make a remarkable difference to their bodies. An experimenter might find out that rice increases glucose but quinoa doesn’t or that some fibres help with digestive health. Data is the future of nutrition as more people are transitioning toward precision nutrition by choosing foods based on how their own body responds. Attention on the gut Inside the digestive tract is an abundant environment of microbes that help consume food, manufacture vitamins, assist with immune function or improve the mood. Scientists are discovering that these microbes are closely linked to obesity, diabetes and weight gain, as well as with mental health. This awareness of gut health has fuelled interest in foods that support good gut bacteria. Fermented foods, such as yogurt, kefir, kimchi and kombucha have moved from specialty products to mainstream staples. In this context, nutrition experts emphasise the significance of prebiotic fibres, which are found in many foods – onions, garlic, oats, legumes, bananas, etc. Polyphenol-rich foods – berries, olive oil, green tea and dark chocolate – have been catching on too, as they favour the growth of good microbes at all levels. But the message is clear: a healthy gut ecosystem could be among the pillars of overall well-being. A third vital theme in today’s food landscape relates to the rise of functional foods i.e. foods that provide concrete health benefits above and beyond nutritional requirements. Today’s consumers need to manage their health and eat foods that satisfy certain goals. Some are looking for more focus, mental clarity, improved immunity or digestion, or better metabolic regulation. Supermarket shelves are filled to the brim with foods and drinks, which are loaded with probiotics, collagen, adaptogenic herbs, omega-3 fatty acids and plant polyphenols. In fact, grocery stores have turned into something of a wellness clinic. Studies show dark chocolate can improve cardiovascular health and may be linked to a reduced risk of heart disease over time.— dpa Eating for longevity Longevity has become a worldwide health goal. With such life expectancy, most people don’t simply want to keep living longer; rather they want to be fit and healthy enough to fit into old age, and then some. Studying places called Blue Zones – sites where people live longer than a century – scientists have found certain dietary habits associated with long life. These diets tend to focus on whole foods, vegetables, legumes, nuts, olive oil and moderate fish. This is similar to the Mediterranean diet, which has long been believed to lower heart disease risks, metabolic problems and memory loss. Many of these longevity-fuelled diets also prioritise high-antioxidant or anti-inflammatory foods – berries, leafy greens, green tea and extra virgin olive oil. The longevity approach is more about sustainable practices compared to one-size-fits-all diets – easy, nutrient-dense foods that promote long-term health. The protein revolution There is an increasing emphasis on protein, another major trend in contemporary dietary trends, especiallly among athletes and bodybuilders. Now, it is an omnipresent nutrient sought by just about anyone – from harried business executives to older adults concerned about muscle-strength maintenance. Sarcopenia, the progressive loss of muscle mass from ageing, is becoming more obvious. Proteins enhance both muscle mass preservation and metabolism, and are associated with better physical function. Food manufacturers have gotten on board and protein is now found in breakfast cereals, snack bars and coffee drinks as well as desserts. Peas, lentils and chickpeas prepared from plant-based proteins are on the rise, and fermented plant proteins are becoming more digestible. Collagen-based products promoted for joint, skin and connective tissue health are also heavily promoted. Hence, protein is now one of the most powerful, transformative nutrients fuelling modern food innovation. Shift in metabolic health focus A lot of nutrition trends are currently rising, and much of them have metabolic health as the underlying concern. Rates of obesity, type 2 diabetes and fatty liver disease have surged worldwide. As awareness of these diseases has increased, the public is becoming concerned about how diets may impact our blood sugar and energy supplies. This adjustment has contributed to a heightened curiosity about foods that may help in controlling glucose. Diets that emphasise healthy fats, whole grains and balanced protein and vegetables are gaining popularity. Consumers are also consuming less processed foods and added sugars. The goal is not excessive dieting but rather maintaining steady energy and metabolic balance throughout the The post What you could be eating in future is changing rapidly first appeared on Primanora Medical Centre. The post What you could be eating in future is changing rapidly appeared first on Primanora Medical Centre.
Walk into any supermarket or café and take a look at the food advertisements. No longer are they merely “tasty” or “filling”, rather, the labels promise things like gut health, brain support, energy balance or anti-inflammatory nutrition. Smoothies contain probiotics; snack bars stress protein and fibre; drinks are said to encourage calm, focus or immunity. The change indicates a deeper change in the way people perceive food. Food is now understood increasingly as more than nourishment; it’s a way to improve health or prevent illness. Improvements in nutritional science, a better understanding of chronic diseases and a growing anxiety about longevity are driving what and why people eat. Several fascinating food and health trends have developed and will probably resonate in kitchens and restaurants around the world, knocking grocery aisles out of place. The age of personalised nutrition For decades, dietary advice appeared fairly constant – shake off fat, eat a greater proportion of vegetables and minimise sugar. However, scientists already know that people react in very different ways to the same foods. One person’s meal might trigger a significant surge in blood sugar levels, for another, almost nothing. This understanding has fuelled one of the largest trends in modern nutrition: personal diets. Advancements in technology today are facilitating better food choices related to the biology of each individual. For example, continuous glucose monitors (CGMs) allow users to observe how their blood sugar levels are responding in real time after meals in various foods. Microbiome testing supplies answers to the trillions of microbes living in the gut, which is an important area of digestion and metabolism. And these tools help people design diets that will make a remarkable difference to their bodies. An experimenter might find out that rice increases glucose but quinoa doesn’t or that some fibres help with digestive health. Data is the future of nutrition as more people are transitioning toward precision nutrition by choosing foods based on how their own body responds. Attention on the gut Inside the digestive tract is an abundant environment of microbes that help consume food, manufacture vitamins, assist with immune function or improve the mood. Scientists are discovering that these microbes are closely linked to obesity, diabetes and weight gain, as well as with mental health. This awareness of gut health has fuelled interest in foods that support good gut bacteria. Fermented foods, such as yogurt, kefir, kimchi and kombucha have moved from specialty products to mainstream staples. In this context, nutrition experts emphasise the significance of prebiotic fibres, which are found in many foods – onions, garlic, oats, legumes, bananas, etc. Polyphenol-rich foods – berries, olive oil, green tea and dark chocolate – have been catching on too, as they favour the growth of good microbes at all levels. But the message is clear: a healthy gut ecosystem could be among the pillars of overall well-being. A third vital theme in today’s food landscape relates to the rise of functional foods i.e. foods that provide concrete health benefits above and beyond nutritional requirements. Today’s consumers need to manage their health and eat foods that satisfy certain goals. Some are looking for more focus, mental clarity, improved immunity or digestion, or better metabolic regulation. Supermarket shelves are filled to the brim with foods and drinks, which are loaded with probiotics, collagen, adaptogenic herbs, omega-3 fatty acids and plant polyphenols. In fact, grocery stores have turned into something of a wellness clinic. <img fetchpriority="high" decoding="async" width="1024" height="676" src="https://primanora.com/wp-content/uploads/2026/04/07-1024x676.jpg" alt="" class="wp-image-27779" srcset="https://primanora.com/wp-content/uploads/2026/04/07-1024x676.jpg 1024w, https://primanora.com/wp-content/uploads/2026/04/07-300x198.jpg 300w, https://primanora.com/wp-content/uploads/2026/04/07-768x507.jpg 768w, https://primanora.com/wp-content/uploads/2026/04/07.jpg 1240w" sizes="(max-width: 1024px) 100vw, 1024px" /> Studies show dark chocolate can improve cardiovascular health and may be linked to a reduced risk of heart disease over time.— dpa Eating for longevity Longevity has become a worldwide health goal. With such life expectancy, most people don’t simply want to keep living longer; rather they want to be fit and healthy enough to fit into old age, and then some. Studying places called Blue Zones – sites where people live longer than a century – scientists have found certain dietary habits associated with long life. These diets tend to focus on whole foods, vegetables, legumes, nuts, olive oil and moderate fish. This is similar to the Mediterranean diet, which has long been believed to lower heart disease risks, metabolic problems and memory loss. Many of these longevity-fuelled diets also prioritise high-antioxidant or anti-inflammatory foods – berries, leafy greens, green tea and extra virgin olive oil. The longevity approach is more about sustainable practices compared to one-size-fits-all diets – easy, nutrient-dense foods that promote long-term health. The protein revolution There is an increasing emphasis on protein, another major trend in contemporary dietary trends, especiallly among athletes and bodybuilders. Now, it is an omnipresent nutrient sought by just about anyone – from harried business executives to older adults concerned about muscle-strength maintenance. Sarcopenia, the progressive loss of muscle mass from ageing, is becoming more obvious. Proteins enhance both muscle mass preservation and metabolism, and are associated with better physical function. Food manufacturers have gotten on board and protein is now found in breakfast cereals, snack bars and coffee drinks as well as desserts. Peas, lentils and chickpeas prepared from plant-based proteins are on the rise, and fermented plant proteins are becoming more digestible. Collagen-based products promoted for joint, skin and connective tissue health are also heavily promoted. Hence, protein is now one of the most powerful, transformative nutrients fuelling modern food innovation. Shift in metabolic health focus A lot of nutrition trends are currently rising, and much of them have metabolic health as the underlying concern. Rates of obesity, type 2 diabetes and fatty liver disease have surged worldwide. As awareness of these diseases has increased, the public is becoming concerned about how diets may impact our blood sugar and energy supplies. This adjustment has contributed to a heightened curiosity about foods that may help in controlling glucose. Diets that emphasise healthy fats, whole grains and balanced protein and vegetables are gaining popularity. Consumers are also consuming less processed foods and added sugars. The goal is not excessive dieting but rather maintaining steady energy and metabolic balance throughout the day. Food and mental well-being Another trend that increasingly gets scientific attention is the link between food and one’s mental health. Researchers have established a tight connection between the gut and the brain called the gut-brain axis. The signals coursing between these systems determine one’s mood and stress responses and cognitive function. Some nutrients appear to be particularly important for brain health. Omega-3 fatty acids in fatty fish, magnesium in leafy greens and nuts and B vitamins in whole grains support neurological functions. That’s why foods associated with mental health e,g, dark chocolate, fermented foods, nuts, seeds and fatty fish, are marketed as part of a brain-healthy diet. At a time when stress and burnout are all too commonplace, nutrition is taking root as part of the mental health puzzle. Anti-inflammatory eating Inflammation is a trendy topic in food conversations. A natural immune response (known as inflammation), but chronic low-grade inflammation has been linked to a range of diseases and disorders, including cardiovascular disease, diabetes and arthritis. They have also generated curiosity about foods believed to aid in controlling inflammation in the body. Ingredients such as turmeric, ginger, berries, olive oil and fatty fish are often promoted for their anti-inflammatory activity. They are abundant in antioxidants and omega-3 fats that ought to prevent cell damage. The bottom line: A diet rich in whole, nutrient-rich foods supports the body‘s natural defenses. Sustainability on the plate Food choices need to change – not stop – based on your health. But now an increasing number of people begin to consider how their diets affect the world. Environmental concerns are driving interest in the cause of sustainable eating – from plant-forward diets and responsibly sourced seafood to foods grown under regenerative agriculture. Fewer kinds of food thrown away, products made within communities and sourced from those communities – are also part of a more conscious-eating approach. Food is more than a means of satiating hunger – it’s increasingly seen as a foundation for long-term health. Remember, what we eat today influences what health we have tomorrow. By Datuk Dr Nor Ashikin Mokhtar Published in Star Newspaper, 20 Apr 2026 The post What you could be eating in future is changing rapidly first appeared on Primanora Medical Centre. The post What you could be eating in future is changing rapidly appeared first on Primanora Medical Centre.
Why nitric oxide is important for our health
Many of the chronic health challenges we face as adults in Malaysia now – like high blood pressure, diabetes, heart disease, fatigue, brain fog and sexual health conditions – are often treated as separate problems. But from a health and long-term perspective of functional medicine and ageing, these problems that can apparently be separated from one another often seem to have a common denominator: declining blood vessel health. Central to this process is the naturally-occurring molecule nitric oxide, which is responsible for circulation, metabolism, immune balance and healthy ageing. Nitric oxide is a gas formed in the body that relaxes and widens the channels of blood vessels within the body – a process called vasodilation. This basic action helps to ensure that oxygen and nutrients are delivered to all tissues in the body. Even in very small amounts, nitric oxide has a huge impact on health. It is typically considered in functional medicine to be a marker of vascular age as healthy blood vessels are crucial for determining how well the body functions over time. Here is why nitric oxide matters to our health: > Heart disease and high blood pressure Heart disease remains a major cause of death in Malaysia. Many people assume that high blood pressure or heart disease are just a consequence of advancing age or genetic fate. In fact, one major contributor to these conditions is endothelial dysfunction, in which the lining of a blood vessel loses its ability to produce adequate nitric oxide. When nitric oxide levels are low, our blood vessels become stiff and inflamed, causing the heart to work harder and blood pressure to eventually rise. The longer this goes on, the more likely you are to experience complications like heart attack and stroke. > Diabetes and metabolic syndrome Nitric oxide also contributes to metabolic health, which has become an increasingly serious issue in Malaysia. A sufficient level of nitric oxide assists in increasing cellular insulin sensitivity and aiding glucose to enter the muscles more effectively. With decreased production of nitric oxide, insulin resistance and the occurrence of type 2 diabetes increases. This vascular-metabolic connection explains why people with diabetes are at much higher risk for heart disease, and why the health of blood vessels is critical in long-term diabetes management. > Ageing brains Nitric oxide is crucial for brain health and cognitive longevity. Reduced availability of nitric oxide is associated with impaired cerebral blood flow and a greater risk of neurodegenerative diseases, like Alzheimer’s disease. The brain is exceptionally sensitive to changes in blood flow, and even small decreases in circulation can threaten memory, concentration and mental clarity. From a lifelong perspective, sustaining healthy blood flow to the brain is the most critical means of preserving cognitive function and independence in old age. > Energy and stamina Nitric oxide is closely related to a person’s energy level and physical stamina. A lot of middle-aged and elder Malaysians say that they are easily fatigued, have low exercise resistance or take longer to recover after playing sports. Although such symptoms are frequently ascribed to ageing, they often indicate diminished nitric oxide generation instead. When blood vessels do not dilate properly, muscles get less oxygen for activity, leading to mild tiredness and slower recovery. Supporting pathways through nitric oxide helps to preserve mobility, strength and vitality – key elements of healthy ageing. > Sexual health Another important insight into nitric oxide status comes from sexual health. Early indicators of the ageing of the vascular system often occur in men via erectile dysfunction and women via impaired sexual responsiveness. Nitric oxide is critical for genital blood flow and normal sexual function, so trouble in that area often shows up years before more significant cardiovascular symptoms come about. Thus, sexual health in functional medicine is conceptualised not just as an individual problem, but also as a window into overall cardiovascular and metabolic health. > Living longer Nitric oxide production naturally decreases with age due to several key factors. Sadly, Malaysia’s modern lifestyle aspects – i.e. physical inactivity, consumption of refined carbohydrates and ultra-process-ed foods, chronic stress, poor sleep, smoking, and chronic metabolic disease – only exacerbate this decline. When the amount of nitric oxide drops, blood vessels become stiffer, inflammation rises and the body’s capacity for coping with stress decreases. This accelerates biological ageing and raises the risk of various chronic diseases. From a functional medicine and longevity standpoint, the idea is to not just treat disease once it starts, but also preserve nitric oxide levels over the course of a lifetime by promoting early and consistent production. It requires that the body’s natural nitric oxide pathways be supported by lifestyle and nutritional approaches, rather than relying only on drugs for the treatment of late stage disease. Some examples of nitrate-containing vegetables in Malaysia include: These vegetables help to fuel the nitrate to nitrite to nitric oxide pathway, which depends on healthful oral bacteria. This pathway may be blocked by excessive use of antiseptic mouthwash. Regular physical activity, adequate sleep, stress management and so on are also important to reduce chronic inflammation and oxidative stress, which quickly destroy nitric oxide and decrease blood vessel function. > Ageing healthily Nitric oxide, in the context of healthy ageing, is much more than a cardiovascular molecule. It says everything about health as a healthy circulatory system serves all organs in the body. Sufficient nitric oxide is related to higher energy metabolism, higher cognitive function, better metabolic control, healthier sexual function and resilience with ageing. By boosting nitric oxide production, people aren’t just adding years to life, but are maximising the quality of those years. Clinically, nitric oxide provides a valuable model of why many co-existing chronic diseases are often clustered in the same individual. High blood pressure, diabetes, fatigue, erectile dysfunction and cognitive complaints are often treated independent of one another, but tend to stem from the same underlying problem: vascular dysfunction with a reduced availability of nitric oxide. In a clinical setting, signs such as low exercise tolerance, chronic fatigue or sexual dysfunction should not The post Why nitric oxide is important for our health first appeared on Primanora Medical Centre. The post Why nitric oxide is important for our health appeared first on Primanora Medical Centre.
Many of the chronic health challenges we face as adults in Malaysia now – like high blood pressure, diabetes, heart disease, fatigue, brain fog and sexual health conditions – are often treated as separate problems. But from a health and long-term perspective of functional medicine and ageing, these problems that can apparently be separated from one another often seem to have a common denominator: declining blood vessel health. Central to this process is the naturally-occurring molecule nitric oxide, which is responsible for circulation, metabolism, immune balance and healthy ageing. Nitric oxide is a gas formed in the body that relaxes and widens the channels of blood vessels within the body – a process called vasodilation. This basic action helps to ensure that oxygen and nutrients are delivered to all tissues in the body. Even in very small amounts, nitric oxide has a huge impact on health. It is typically considered in functional medicine to be a marker of vascular age as healthy blood vessels are crucial for determining how well the body functions over time. Here is why nitric oxide matters to our health: > Heart disease and high blood pressure Heart disease remains a major cause of death in Malaysia. Many people assume that high blood pressure or heart disease are just a consequence of advancing age or genetic fate. In fact, one major contributor to these conditions is endothelial dysfunction, in which the lining of a blood vessel loses its ability to produce adequate nitric oxide. When nitric oxide levels are low, our blood vessels become stiff and inflamed, causing the heart to work harder and blood pressure to eventually rise. The longer this goes on, the more likely you are to experience complications like heart attack and stroke. > Diabetes and metabolic syndrome Nitric oxide also contributes to metabolic health, which has become an increasingly serious issue in Malaysia. A sufficient level of nitric oxide assists in increasing cellular insulin sensitivity and aiding glucose to enter the muscles more effectively. With decreased production of nitric oxide, insulin resistance and the occurrence of type 2 diabetes increases. This vascular-metabolic connection explains why people with diabetes are at much higher risk for heart disease, and why the health of blood vessels is critical in long-term diabetes management. > Ageing brains Nitric oxide is crucial for brain health and cognitive longevity. Reduced availability of nitric oxide is associated with impaired cerebral blood flow and a greater risk of neurodegenerative diseases, like Alzheimer’s disease. The brain is exceptionally sensitive to changes in blood flow, and even small decreases in circulation can threaten memory, concentration and mental clarity. From a lifelong perspective, sustaining healthy blood flow to the brain is the most critical means of preserving cognitive function and independence in old age. > Energy and stamina Nitric oxide is closely related to a person’s energy level and physical stamina. A lot of middle-aged and elder Malaysians say that they are easily fatigued, have low exercise resistance or take longer to recover after playing sports. Although such symptoms are frequently ascribed to ageing, they often indicate diminished nitric oxide generation instead. When blood vessels do not dilate properly, muscles get less oxygen for activity, leading to mild tiredness and slower recovery. Supporting pathways through nitric oxide helps to preserve mobility, strength and vitality – key elements of healthy ageing. > Sexual health Another important insight into nitric oxide status comes from sexual health. Early indicators of the ageing of the vascular system often occur in men via erectile dysfunction and women via impaired sexual responsiveness. Nitric oxide is critical for genital blood flow and normal sexual function, so trouble in that area often shows up years before more significant cardiovascular symptoms come about. Thus, sexual health in functional medicine is conceptualised not just as an individual problem, but also as a window into overall cardiovascular and metabolic health. > Living longer Nitric oxide production naturally decreases with age due to several key factors. Sadly, Malaysia’s modern lifestyle aspects – i.e. physical inactivity, consumption of refined carbohydrates and ultra-process-ed foods, chronic stress, poor sleep, smoking, and chronic metabolic disease – only exacerbate this decline. When the amount of nitric oxide drops, blood vessels become stiffer, inflammation rises and the body’s capacity for coping with stress decreases. This accelerates biological ageing and raises the risk of various chronic diseases. From a functional medicine and longevity standpoint, the idea is to not just treat disease once it starts, but also preserve nitric oxide levels over the course of a lifetime by promoting early and consistent production. It requires that the body’s natural nitric oxide pathways be supported by lifestyle and nutritional approaches, rather than relying only on drugs for the treatment of late stage disease. Some examples of nitrate-containing vegetables in Malaysia include: Spinach (bayam) Water spinach (kangkung) Mustard greens (sawi) Lettuce Beetroot Ulam-ulam (pegaga, selom, daun ketumbar). These vegetables help to fuel the nitrate to nitrite to nitric oxide pathway, which depends on healthful oral bacteria. This pathway may be blocked by excessive use of antiseptic mouthwash. Regular physical activity, adequate sleep, stress management and so on are also important to reduce chronic inflammation and oxidative stress, which quickly destroy nitric oxide and decrease blood vessel function. > Ageing healthily Nitric oxide, in the context of healthy ageing, is much more than a cardiovascular molecule. It says everything about health as a healthy circulatory system serves all organs in the body. Sufficient nitric oxide is related to higher energy metabolism, higher cognitive function, better metabolic control, healthier sexual function and resilience with ageing. By boosting nitric oxide production, people aren’t just adding years to life, but are maximising the quality of those years. Clinically, nitric oxide provides a valuable model of why many co-existing chronic diseases are often clustered in the same individual. High blood pressure, diabetes, fatigue, erectile dysfunction and cognitive complaints are often treated independent of one another, but tend to stem from the same underlying problem: vascular dysfunction with a reduced availability of nitric oxide. In a clinical setting, signs such as low exercise tolerance, chronic fatigue or sexual dysfunction should not be dismissed as standard ageing. These findings are frequently early indicators of compromised endothelial function and increased risk of cardiometabolic disease. Early intervention in nitric oxide pathways can help clinicians to prevent irreversible damage before it happens. Do note however, that functional medicine does not replace medical treatment; it is an answer to root causes, not a substitute for clinical care. Medications are often needed when necessary and life-saving, but improved long-term health happens when lifestyle problems, nutrition, metabolic state, sleep and stress are treated in parallel with pharmacological treatment. Providing interventions to support nitric oxide production and utilisation by vascular systems provide an opportunity to enhance vascular resilience and potentially reduce the burden of future disease. For patients, the real message is empowerment. The many factors that affect nitric oxide – physical activity, diet, gut and oral health, sleep quality and stress – can be changed. Even modest and consistent changes can lead to significant improvements in circulation, vitality and overall health. Preserving nitric oxide is ultimately about protecting the body’s internal highways that connect oxygen, nutrients and signals to every cell. When these are kept open and flexible, the body ages more slowly, recovers more efficiently and stays in use for longer. This is what longevity-led, preventive care is about. By Datuk Dr Nor Ashikin Mokhtar Published in Star Newspaper, 06 Apr 2026 The post Why nitric oxide is important for our health first appeared on Primanora Medical Centre. The post Why nitric oxide is important for our health appeared first on Primanora Medical Centre.
When your bile forms stones in the gallbladder
Gallstones are a common health issue here in Malaysia that are occurring more and more frequently. Routine ultrasound scans – often done as part of an annual medical check-up – can identify gallstones for many. But this condition is typically only identified after the person experiences discomfort (including pain in the upper abdomen), bloating, nausea and a feeling of heaviness after eating. For some Malaysians, gallstones stay silent for years without causing harm. For others, they cause repetitive bouts of pain, which can interfere with daily life and induce anxiety. Knowing why gallstones develop and why it is occurring more frequently can help us manage them in a safer, more enduring way. When bile becomes ‘thick’ he gallbladder is a small, pear-shaped organ located below the liver. Its primary job is to store bile, which is a digestive fluid produced by the liver. Bile is crucial for the breakdown of fat, converting fats into vitamins and aiding bowel activity. Under healthy conditions, the bile is liquid. However, trouble arises if it becomes too concentrated or “thick”. In these cases, the bile can coalesce into small solid pieces, which over time, may turn into fine, brittle stones. Most gallstones are cholesterol stones, formed when the bile is too cholesterol-rich. A smaller percentage of gallstones are pigment stones, which are more associated with liver- or blood-related causes. Gallstones vary widely in size, from as small as a grain of sand to large enough to block the bile ducts. In cases of blockage, patients can develop more severe symptoms, leading to more serious complications. Related factors The increasing occurrence of gallstones in Malaysia mirrors worldwide changes in lifestyle and diet over the past three decades. Our metabolic health has shifted as we increasingly consume refined carbohydrates, sugar-sweetened beverages and processed food – and eat out regularly. Meanwhile, contemporary work practices tend to lead to long hours of sitting still, relatively little physical activity and a more sedentary lifestyle than ever before. Chronic stress also compounds the stress burden by disrupting digestion and the natural flow of the gut. These patterns contribute to heightened rates of obesity, insulin resistance, type 2 diabetes, fatty liver disease and polycystic ovary syndrome (PCOS) – conditions highly implicated in gallstone risk. Obesity raises the risk because weight gain is associated with less contraction of the gallbladder. When the gallbladder fails to empty effectively, the bile sits longer and goes stagnant, stimulating concentration and stone formation. People affected by insulin resistance often have increased insulin production to compensate for the body becoming resistant to its effects. This metabolic setting adds to the percentage of cholesterol going into bile, thus increasing the risk for cholesterol stones. Irregular eating patterns, like skipping meals, eating late at night, and cycling between overeating and restrictive dieting, can also damage gallbladder function. This is as the gallbladder relies on regular contractions to efficiently drain bile. Rapid fat loss caused by aggressive dieting also brings more cholesterol into bile, in addition to causing the gallbladder to drain with less frequency. These factors create a good environment for gallstone formation. Similarly, hormonal variations, such as increased oestrogen states, also serve to inflate bile with cholesterol and decrease gallbladder contractions. This can occur in women with PCOS, perimenopause, menopause, high oestrogen levels, low SHBG (sex hormone-binding globulin), or those treated with hormonal therapies or who are pregnant. The gallbladder’s hormone-related responses explain the higher occurrence of gallstone formation during certain stages of life for women. Preventive approaches Dietary habits should be re-evaluated to effectively manage gallstones. While some contend that removing fats completely is required, low-fat diets that are too restrictive can actually worsen gallstone conditions. Inadequate fat leads to bile going into stagnation, which further increases the chances of stone formation. Healthy fats are also essential for the contraction of the gallbladder and the release of bile. A balanced intake of healthful fats, i.e. olive oil, coconut oil, ghee, avocados and fatty fish (e.g. sardines, mackerel), is essential for gallbladder functioning. Balance is important: too much greasy food can worsen symptoms, while totally eliminating fat can be detrimental to gallbladder health. A diet high in fibre promotes bile health as it reduces cholesterol and helps with digestion. Good sources of fibre include water spinach (kangkung), mustard greens (sawi), broccoli, cabbage, long beans, papaya, guava, apples and berries. Whole grains (e.g. oats, brown rice) and legumes are good for digestion. Frequent bowel movements are needed to avoid reabsorbing bile and gallstones, and to decrease the risk of bile-borne diseases. Traditional Malaysian foods such as bitter gourd, turmeric, ginger and pegaga aid in digestion and bile flow, compatible with the principles of functional medicine. It’s just as essential to restrict the types of foods that may increase your chances of getting a gallstone. Sugary drinks, such as soft drinks and sweetened teas, are known to negatively affect blood sugar and insulin levels. Eating too many sweets, pastries and fried foods can make insulin resistance even worse and may contribute to the formation of gallstones. Consuming less highly-processed food may minimise inflammation and metabolic stress. For women with hormonal imbalances, promoting the excretion of oestrogen by taking the following could help lower their risk of gallstones: Some harmful gut bacteria produce an enzyme known as glucuronidase, which promotes the reabsorption, rather than the excretion, of oestrogen. This recycled oestrogen might worsen bile thickening. To help improve gut health and prevent this: Frequent bowel movements are essential as constipation can cause reabsorption of bile and hormones instead of their removal. Promoting gut health with high-fibre foods, fermented foods such as yoghurt and kefir, and tempeh, while also treating issues like constipation and bloating, provide additional support for good gallbladder function. Manage it right For many Malaysians who have stable gallstones (either incidentally or presenting only with small, occasional symptoms), the strategies above that can help with metabolic health, digestion and bile flow can be both practical and empowering. However, it is crucial to seek medical care in certain cases, The post When your bile forms stones in the gallbladder first appeared on Primanora Medical Centre. The post When your bile forms stones in the gallbladder appeared first on Primanora Medical Centre.
Gallstones are a common health issue here in Malaysia that are occurring more and more frequently. Routine ultrasound scans – often done as part of an annual medical check-up – can identify gallstones for many. But this condition is typically only identified after the person experiences discomfort (including pain in the upper abdomen), bloating, nausea and a feeling of heaviness after eating. For some Malaysians, gallstones stay silent for years without causing harm. For others, they cause repetitive bouts of pain, which can interfere with daily life and induce anxiety. Knowing why gallstones develop and why it is occurring more frequently can help us manage them in a safer, more enduring way. When bile becomes ‘thick’ he gallbladder is a small, pear-shaped organ located below the liver. Its primary job is to store bile, which is a digestive fluid produced by the liver. Bile is crucial for the breakdown of fat, converting fats into vitamins and aiding bowel activity. Under healthy conditions, the bile is liquid. However, trouble arises if it becomes too concentrated or “thick”. In these cases, the bile can coalesce into small solid pieces, which over time, may turn into fine, brittle stones. Most gallstones are cholesterol stones, formed when the bile is too cholesterol-rich. A smaller percentage of gallstones are pigment stones, which are more associated with liver- or blood-related causes. Gallstones vary widely in size, from as small as a grain of sand to large enough to block the bile ducts. In cases of blockage, patients can develop more severe symptoms, leading to more serious complications. Related factors The increasing occurrence of gallstones in Malaysia mirrors worldwide changes in lifestyle and diet over the past three decades. Our metabolic health has shifted as we increasingly consume refined carbohydrates, sugar-sweetened beverages and processed food – and eat out regularly. Meanwhile, contemporary work practices tend to lead to long hours of sitting still, relatively little physical activity and a more sedentary lifestyle than ever before. Chronic stress also compounds the stress burden by disrupting digestion and the natural flow of the gut. These patterns contribute to heightened rates of obesity, insulin resistance, type 2 diabetes, fatty liver disease and polycystic ovary syndrome (PCOS) – conditions highly implicated in gallstone risk. Obesity raises the risk because weight gain is associated with less contraction of the gallbladder. When the gallbladder fails to empty effectively, the bile sits longer and goes stagnant, stimulating concentration and stone formation. People affected by insulin resistance often have increased insulin production to compensate for the body becoming resistant to its effects. This metabolic setting adds to the percentage of cholesterol going into bile, thus increasing the risk for cholesterol stones. Irregular eating patterns, like skipping meals, eating late at night, and cycling between overeating and restrictive dieting, can also damage gallbladder function. This is as the gallbladder relies on regular contractions to efficiently drain bile. Rapid fat loss caused by aggressive dieting also brings more cholesterol into bile, in addition to causing the gallbladder to drain with less frequency. These factors create a good environment for gallstone formation. Similarly, hormonal variations, such as increased oestrogen states, also serve to inflate bile with cholesterol and decrease gallbladder contractions. This can occur in women with PCOS, perimenopause, menopause, high oestrogen levels, low SHBG (sex hormone-binding globulin), or those treated with hormonal therapies or who are pregnant. The gallbladder’s hormone-related responses explain the higher occurrence of gallstone formation during certain stages of life for women. Preventive approaches Dietary habits should be re-evaluated to effectively manage gallstones. While some contend that removing fats completely is required, low-fat diets that are too restrictive can actually worsen gallstone conditions. Inadequate fat leads to bile going into stagnation, which further increases the chances of stone formation. Healthy fats are also essential for the contraction of the gallbladder and the release of bile. A balanced intake of healthful fats, i.e. olive oil, coconut oil, ghee, avocados and fatty fish (e.g. sardines, mackerel), is essential for gallbladder functioning. Balance is important: too much greasy food can worsen symptoms, while totally eliminating fat can be detrimental to gallbladder health. A diet high in fibre promotes bile health as it reduces cholesterol and helps with digestion. Good sources of fibre include water spinach (kangkung), mustard greens (sawi), broccoli, cabbage, long beans, papaya, guava, apples and berries. Whole grains (e.g. oats, brown rice) and legumes are good for digestion. Frequent bowel movements are needed to avoid reabsorbing bile and gallstones, and to decrease the risk of bile-borne diseases. Traditional Malaysian foods such as bitter gourd, turmeric, ginger and pegaga aid in digestion and bile flow, compatible with the principles of functional medicine. It’s just as essential to restrict the types of foods that may increase your chances of getting a gallstone. Sugary drinks, such as soft drinks and sweetened teas, are known to negatively affect blood sugar and insulin levels. Eating too many sweets, pastries and fried foods can make insulin resistance even worse and may contribute to the formation of gallstones. Consuming less highly-processed food may minimise inflammation and metabolic stress. For women with hormonal imbalances, promoting the excretion of oestrogen by taking the following could help lower their risk of gallstones: DIM (diindolylmethane) – helps to normalise the metabolism of oestrogen; however, it should be avoided during pregnancy or if oestrogen levels are very low, unless under the supervision of a healthcare professional. Calcium – inhibits the reabsorption of oestrogen within the gastrointestinal system B-complex vitamins – helps with liver detoxification and methylation, thus supporting overall liver metabolism, which helps increase SHBG. Some harmful gut bacteria produce an enzyme known as glucuronidase, which promotes the reabsorption, rather than the excretion, of oestrogen. This recycled oestrogen might worsen bile thickening. To help improve gut health and prevent this: Include probiotics of multiple strains in your diet. Talk mild prebiotic fibres, e.g. 5-10g of partially hydrolysed guar gum (PHGG) or acacia fibre daily. Frequent bowel movements are essential as constipation can cause reabsorption of bile and hormones instead of their removal. Promoting gut health with high-fibre foods, fermented foods such as yoghurt and kefir, and tempeh, while also treating issues like constipation and bloating, provide additional support for good gallbladder function. Manage it right For many Malaysians who have stable gallstones (either incidentally or presenting only with small, occasional symptoms), the strategies above that can help with metabolic health, digestion and bile flow can be both practical and empowering. However, it is crucial to seek medical care in certain cases, especially when the signs of duct obstruction or infection are evident. Severe or recurring right-upper abdominal pain, fever, jaundice, frequent vomiting or worsening symptoms must never be treated independently and should require prompt medical assistance. By Datuk Dr Nor Ashikin Mokhtar Published in Star Newspaper, 09 Mar 2026 The post When your bile forms stones in the gallbladder first appeared on Primanora Medical Centre. The post When your bile forms stones in the gallbladder appeared first on Primanora Medical Centre.
Knowing when it is necessary to take supplements
Discussion about supplements is a popular topic. A stroll across a pharmacy, clinic or healthcare establishment will find you faced with a stacked shelf of vitamins, minerals, herbs and nutritional powders. This ubiquitous availability tends to bring up a critical and reasonable question in the public’s mind: if we eat well enough, why then do doctors and healthcare professionals prescribe supplements? The solution is not found in health fads, or on sales campaigns, but exists within modern living, evolving dietary patterns, the escalating burden of chronic disease and chronic medication adherence. Supplements are not meant to replace food and the traditional diets that Malaysians take pride in. Nutrient deficiencies do not occur only in people who eat poorly or live in extreme conditions; they are increasingly common even among individuals who appear well-nourished. Malaysia is frequently referred to as a country rich in food, due to abundant produce but modern eating habits have changed significantly over the past few decades. Rapid urbanisation, long working hours, shift work and easy access to convenience foods – all these have changed what and how we eat. Fast and highly processed items, sugary sweets and fried foods, as well as large portions of refined carbohydrates now serve an increasingly important role in urban dining patterns. These foods provide enough calories and are satiating in nature, but they usually lack important micronutrients. National local surveys found that adults fail to meet the recommended intakes of calcium, iron (especially women) and many vitamins, despite consuming adequate, or even high, calories. This leads to a paradox in which one may seem well-fed or even overweight but be functionally malnourished. These deficiencies may not lead to illness over the long term but over time are associated with fatigue, lower immunity, bad bone health and increased risk of chronic disease. Impaired absorption and changing lifestyles The gastrointestinal system is crucial for the absorption of nutrients. Various conditions, including irritable bowel syndrome, inflammatory bowel disease, coeliac disease, low stomach acid and prior gastrointestinal surgeries, can hinder the uptake of vitamins and minerals. Additionally, even without a formal diagnosis, elements such as chronic stress, alcohol intake, and frequent antibiotic usage can compromise gut integrity and disturb the balance of the microbiome, thereby diminishing nutrient availability. Modern lifestyles place extra demands on nutritional health. Chronic stress, often faced by urban professionals and those working shifts, has been linked to an increased requirement for various nutrients, particularly magnesium and B vitamins. Inadequate sleep can disrupt hormonal balance and nutrient utilisation. Alcohol consumption hinders the absorption and metabolism of B vitamins, zinc and magnesium, whereas smoking amplifies oxidative stress and reduces levels of vitamin C and antioxidants. Together, these elements contribute to a gradual and unnoticed decline in nutrient levels, frequently occurring well before any laboratory indicators become evident. Increased physiological demands Various life stages such as pregnancy, breastfeeding, adolescence, menopause and ageing require increased nutrient intake. In these scenarios, relying solely on dietary consumption may not suffice to fulfil these heightened requirements, making supplementation a viable and evidence-supported option. Expectant and nursing mothers need to increase their intake of iron, folate, iodine, calcium and vitamin D to preserve maternal well-being and facilitate the growth of the foetus or infant. Factors like chronic stress, infections, inflammation and significant physical or mental exertion further increase the turnover of nutrients. Older adults, due to age-related digestive changes, are often prescribed multiple long-term medications, which must be taken cautiously to ensure adequate nutrient absorption. The metabolic demands for these individuals are heightened as many also have chronic health issues such as hypertension, diabetes and heart disease, hence require medications that can disrupt the body’s nutrient balance. An overlooked problem Perhaps one of the most clinically significant yet often overlooked causes of nutrient deficiencies is the prolonged use of medications. These drug-induced nutrient deficiencies (DIND) arise when drugs disrupt the processes of digestion, absorption, metabolism, transport or excretion of essential nutrients. This does not suggest that medications are detrimental or unnecessary; in fact, many are crucial for effective disease management. However, neglecting to consider their nutritional impacts can undermine treatment efficacy and overall health. To counteract deficiencies resulting from medication use, supplements are advised, which is particularly important in Malaysia, where chronic conditions such as diabetes and heart disease are widespread. The high prevalence of diabetes often necessitates long-term medication, potentially leading to unintended malnutrition and associated public health concerns. DIND can occur as medications impede nutrient absorption or metabolism, frequently going unnoticed since symptoms like fatigue or cognitive issues are commonly attributed to ageing or stress instead of nutrient shortages. Common medications Proton pump inhibitors e.g. omeprazole and pantoprazole are widely used for gastric pain, acid reflux and ulcer disease. By reducing stomach acid, these drugs reduce symptoms and encourage healing, but stomach acid also plays a key role in the absorption of critical nutrients. Persistent application of proton pump inhibitors has been linked with impaired absorption of vitamin B12, magnesium, calcium and iron in the long term. This could lead to anaemia, nerve symptoms, muscle cramps and a higher risk of fractures over time, especially in elderly people. Metformin, which is the most prescribed drug of choice for type 2 diabetes, is another well-established example. Long-term use of metformin has been well-established to decrease vitamin B12 absorption, leading to fatigue, tingling or numbness in the hands and feet, memory and concentration problems, and further peripheral neuropathy. Vitamin B12 is not regularly monitored or supplemented, which leads to symptoms attributed solely to diabetes itself, and leaves the deficiency untreated. Statins, often prescribed to lower cholesterol and the risk of cardiovascular diseases, present nutritional problems too. Such medicines suppress cholesterol production by blocking a metabolic pathway that also produces coenzyme Q10, a key ingredient for the formation of energy in muscular cells. Lower levels of coenzyme Q10 can give rise to muscle pain, weakness and fatigue – effects that can also cause people to stop their medications without medical guidance. The use of hormonal contraceptives utilised by The post Knowing when it is necessary to take supplements first appeared on Primanora Medical Centre. The post Knowing when it is necessary to take supplements appeared first on Primanora Medical Centre.
Discussion about supplements is a popular topic. A stroll across a pharmacy, clinic or healthcare establishment will find you faced with a stacked shelf of vitamins, minerals, herbs and nutritional powders. This ubiquitous availability tends to bring up a critical and reasonable question in the public’s mind: if we eat well enough, why then do doctors and healthcare professionals prescribe supplements? The solution is not found in health fads, or on sales campaigns, but exists within modern living, evolving dietary patterns, the escalating burden of chronic disease and chronic medication adherence. Supplements are not meant to replace food and the traditional diets that Malaysians take pride in. Nutrient deficiencies do not occur only in people who eat poorly or live in extreme conditions; they are increasingly common even among individuals who appear well-nourished. Malaysia is frequently referred to as a country rich in food, due to abundant produce but modern eating habits have changed significantly over the past few decades. Rapid urbanisation, long working hours, shift work and easy access to convenience foods – all these have changed what and how we eat. Fast and highly processed items, sugary sweets and fried foods, as well as large portions of refined carbohydrates now serve an increasingly important role in urban dining patterns. These foods provide enough calories and are satiating in nature, but they usually lack important micronutrients. National local surveys found that adults fail to meet the recommended intakes of calcium, iron (especially women) and many vitamins, despite consuming adequate, or even high, calories. This leads to a paradox in which one may seem well-fed or even overweight but be functionally malnourished. These deficiencies may not lead to illness over the long term but over time are associated with fatigue, lower immunity, bad bone health and increased risk of chronic disease. Impaired absorption and changing lifestyles The gastrointestinal system is crucial for the absorption of nutrients. Various conditions, including irritable bowel syndrome, inflammatory bowel disease, coeliac disease, low stomach acid and prior gastrointestinal surgeries, can hinder the uptake of vitamins and minerals. Additionally, even without a formal diagnosis, elements such as chronic stress, alcohol intake, and frequent antibiotic usage can compromise gut integrity and disturb the balance of the microbiome, thereby diminishing nutrient availability. Modern lifestyles place extra demands on nutritional health. Chronic stress, often faced by urban professionals and those working shifts, has been linked to an increased requirement for various nutrients, particularly magnesium and B vitamins. Inadequate sleep can disrupt hormonal balance and nutrient utilisation. Alcohol consumption hinders the absorption and metabolism of B vitamins, zinc and magnesium, whereas smoking amplifies oxidative stress and reduces levels of vitamin C and antioxidants. Together, these elements contribute to a gradual and unnoticed decline in nutrient levels, frequently occurring well before any laboratory indicators become evident. Increased physiological demands Various life stages such as pregnancy, breastfeeding, adolescence, menopause and ageing require increased nutrient intake. In these scenarios, relying solely on dietary consumption may not suffice to fulfil these heightened requirements, making supplementation a viable and evidence-supported option. Expectant and nursing mothers need to increase their intake of iron, folate, iodine, calcium and vitamin D to preserve maternal well-being and facilitate the growth of the foetus or infant. Factors like chronic stress, infections, inflammation and significant physical or mental exertion further increase the turnover of nutrients. Older adults, due to age-related digestive changes, are often prescribed multiple long-term medications, which must be taken cautiously to ensure adequate nutrient absorption. The metabolic demands for these individuals are heightened as many also have chronic health issues such as hypertension, diabetes and heart disease, hence require medications that can disrupt the body’s nutrient balance. An overlooked problem Perhaps one of the most clinically significant yet often overlooked causes of nutrient deficiencies is the prolonged use of medications. These drug-induced nutrient deficiencies (DIND) arise when drugs disrupt the processes of digestion, absorption, metabolism, transport or excretion of essential nutrients. This does not suggest that medications are detrimental or unnecessary; in fact, many are crucial for effective disease management. However, neglecting to consider their nutritional impacts can undermine treatment efficacy and overall health. To counteract deficiencies resulting from medication use, supplements are advised, which is particularly important in Malaysia, where chronic conditions such as diabetes and heart disease are widespread. The high prevalence of diabetes often necessitates long-term medication, potentially leading to unintended malnutrition and associated public health concerns. DIND can occur as medications impede nutrient absorption or metabolism, frequently going unnoticed since symptoms like fatigue or cognitive issues are commonly attributed to ageing or stress instead of nutrient shortages. Common medications Proton pump inhibitors e.g. omeprazole and pantoprazole are widely used for gastric pain, acid reflux and ulcer disease. By reducing stomach acid, these drugs reduce symptoms and encourage healing, but stomach acid also plays a key role in the absorption of critical nutrients. Persistent application of proton pump inhibitors has been linked with impaired absorption of vitamin B12, magnesium, calcium and iron in the long term. This could lead to anaemia, nerve symptoms, muscle cramps and a higher risk of fractures over time, especially in elderly people. Metformin, which is the most prescribed drug of choice for type 2 diabetes, is another well-established example. Long-term use of metformin has been well-established to decrease vitamin B12 absorption, leading to fatigue, tingling or numbness in the hands and feet, memory and concentration problems, and further peripheral neuropathy. Vitamin B12 is not regularly monitored or supplemented, which leads to symptoms attributed solely to diabetes itself, and leaves the deficiency untreated. Statins, often prescribed to lower cholesterol and the risk of cardiovascular diseases, present nutritional problems too. Such medicines suppress cholesterol production by blocking a metabolic pathway that also produces coenzyme Q10, a key ingredient for the formation of energy in muscular cells. Lower levels of coenzyme Q10 can give rise to muscle pain, weakness and fatigue – effects that can also cause people to stop their medications without medical guidance. The use of hormonal contraceptives utilised by women, has been linked to lower levels of several nutrients such as vitamin B6, vitamin B12, folate, magnesium and zinc. Not all users are affected but chronic use may affect mood, energy level and tolerance for stress in high-risk individuals. Diuretics, which are the medications commonly used for conditions including hypertension and heart disease, raise urinary potassium, magnesium and zinc losses. Deficiencies in these nutrients are observed as muscle cramps, weakness or abnormal heart rates, especially among elderly patients. Corticosteroids, like prednisolone, which are administered against asthma and immune-mediated diseases, inflammation or inflammatory disease disrupt the metabolism of calcium and vitamin D, leading to calcium deficiency and bone-wasting. Osteoporosis is becoming a growing problem among older Malaysians. Meanwhile, the prolonged or frequent use of antibiotics can disturb the gut microbiome, which is essential for the synthesis of various vitamins, such as vitamin K and several B vitamins. This imbalance, known as dysbiosis, may negatively affect digestion, immune system functionality, and the absorption of nutrients even after the completion of antibiotic treatment.DIND are frequently observed yet frequently go unrecognised in clinical settings, despite their widespread nature. The symptoms associated with these deficiencies are often vague, routine blood tests may yield normal results, and the onset of deficiencies progresses gradually. Additionally, consultations with healthcare providers tend to focus on disease management rather than evaluating nutritional health. As a result, numerous individuals experience persistent symptoms that could be alleviated and prevented through proper nutritional intake. The role of supplementation Supplementation, when applied correctly, serves as a strategy for correction and prevention rather than a substitute for evidence-based medicine. Its objective is to restore physiological equilibrium, assist metabolic processes, mitigate the long-term impacts of diseases and the side effects of medications. It is crucial that supplementation is tailored to the individual, taking into account clinical evaluations, medication history, dietary habits and when necessary, laboratory assessments. In short, supplements are not lavish goods but serve as protective or corrective tools, especially for people with chronic diseases. Supplementation should be subject to regular review and used alongside, not replace medical treatment and a healthy diet When used wisely and correctly, supplements help support the body so that medical treatments can work more effectively and overall health is preserved. By Datuk Dr Nor Ashikin Mokhtar Published in Star Newspaper, 23 Feb 2026 The post Knowing when it is necessary to take supplements first appeared on Primanora Medical Centre. The post Knowing when it is necessary to take supplements appeared first on Primanora Medical Centre.
Things that are quietly harming our hearts
Heart health is fundamental to overall well-being and long-term survival. The heart functions as the body’s main engine, pumping blood that delivers oxygen and nutrients to every organ, tissue and cell. When the heart is healthy, it supports physical activity, mental clarity, emotional balance and resilience against illness. In Malaysia, heart disease remains the leading cause of death, affecting people across all ethnicities, income groups and ages. Conditions such as coronary artery disease, hypertension (high blood pressure), heart failure and stroke continue to rise, not only among older adults, but increasingly among younger Malaysians. Poor heart health reduces quality of life, limits productivity and shortens life expectancy, often silently and gradually. As Malaysians navigate urban living, demanding work schedules, family responsibilities and digital dependence, many heart health threats go unnoticed. This column aims to shed light on the hidden habits and household factors that may be harming heart health in Malaysia. By increasing awareness of these influences, readers can take practical, achievable steps to protect their hearts and build healthier lifestyles. In our daily environment In today’s Malaysian society, many people spend 10 to 15 hours a day sitting at office desks, in cars stuck in traffic, in front of screens or relaxing on sofas after long workdays. This sedentary pattern is one of the strongest contributors to heart disease. Prolonged sitting slows metabolism, promotes weight gain, raises blood pressure, increases blood sugar levels and worsens cholesterol profiles. Even individuals who exercise occasionally may still be at risk if most of their day is spent inactive. Simple lifestyle adjustments can help counteract this: Incorporating movement into daily routines is more sustainable than relying only on occasional gym sessions. Stress is also an integral part of contemporary Malaysian life. Financial commitments, heavy traffic, workplace demands, caregiving duties and academic pressures all contribute to ongoing stress, which can significantly affect heart health. A tense home environment – marked by persistent noise, clutter, unresolved tensions or inadequate rest – can keep the body in a prolonged “fight-or-flight” mode. This state triggers continuous release of stress hormones such as cortisol and adrenaline, leading to sustained increases in heart rate and blood pressure. Over time, these changes place strain on blood vessels and raise the risk of heart disease. Cultivating a more calming home environment can greatly support heart health. Simple, but effective, measures include: A calm and supportive home nurtures not only emotional balance, but also long-term heart health and resilience. Sleep is frequently compromised in Malaysian homes due to extended working hours, prolonged screen time at night, shift work schedules and various social obligations. However, inadequate sleep quality and insufficient rest are significantly associated with heart diseases. Disrupted sleep patterns and ongoing lack of sleep heighten the likelihood of developing: Enhancing sleep hygiene is crucial. This encompasses: Quality sleep should not be viewed as an indulgence; it is fundamental to maintaining heart health. Household factors Food selections are among the most significant factors affecting heart health. In Malaysia, numerous families depend on processed foods, takeout options and sugary drinks largely due to convenience and hectic lifestyles. Consumption of items rich in saturated fats, trans fats, sugars, and sodium – such as fried snacks, instant noodles, fast food items, pastries, sweetened beverages and processed meats –heightens the likelihood of obesity, as well as elevated blood pressure and cholesterol levels. Moreover, easy access to unhealthy snacks promotes mindless consumption. Implementing minor adjustments within one’s environment can lead to substantial improvements, including: When prepared with care, traditional Malaysian cuisine has the potential to support heart health by prioritising vegetables, legumes, fish and whole foods. Many individuals in Malaysia might not realise that their household environments could expose them to harmful elements detrimental to heart health. Common household items such as cleaning agents, air fresheners, insect repellents and certain types of furniture can emit volatile organic compounds (VOCs) into the indoor atmosphere. Extended exposure to these indoor pollutants is linked with increased inflammation, oxidative stress and respiratory challenges – all of which elevate the risk for heart issues. The quality of indoor air may also be compromised by factors such as: To mitigate these risks effectively, practical measures include: Maintaining clean air is essential for supporting both lung function and heart health. A disorganised home not only appears messy, but also elevates mental stress. The presence of visual disorder can lead to persistent feelings of being overwhelmed, anxiety and restlessness, which in turn may impact heart health negatively. Moreover, clutter inhibits movement and physical activity by making environments feel confined and unwelcoming. Engaging in regular decluttering contributes to: Maintaining a tidy and organised living environment fosters emotional stability, as well as promotes heart health. Harmful lifestyle choices Smoking remains one of the most damaging habits for heart health in Malaysia. Tobacco chemicals damage blood vessels, reduce oxygen delivery, increase clot formation and raise blood pressure. Quitting smoking leads to rapid and significant improvements in heart health, regardless of age. Alcohol consumption, particularly when excessive, also increases the risk of hypertension, irregular heart rhythms and heart muscle damage. Moderation is essential, and for many individuals, reducing or avoiding alcohol altogether is the safest option. The growing reliance on technology, extended commute times and sedentary office work have notably diminished daily levels of physical activity. Engaging in regular movement is essential for sustaining healthy blood pressure, cholesterol and glucose levels. Aiming for a minimum of 150 minutes of moderate exercise each week is advisable; this can encompass activities such as brisk walking, cycling, swimming or exercises performed at home. For seniors, chair exercises are highly beneficial for improving overall strength, mobility, balance and general health. Simple movements can be performed safely while seated or using a chair for support, making them especially suitable for older adults or those with limited mobility. When done consistently, chair exercises improve circulation, better heart health, posture and confidence. A significant number of Malaysians tend to pursue medical attention only when they experience symptoms. However, heart diseases frequently progress quietly over an extended The post Things that are quietly harming our hearts first appeared on Primanora Medical Centre. The post Things that are quietly harming our hearts appeared first on Primanora Medical Centre.
Heart health is fundamental to overall well-being and long-term survival. The heart functions as the body’s main engine, pumping blood that delivers oxygen and nutrients to every organ, tissue and cell. When the heart is healthy, it supports physical activity, mental clarity, emotional balance and resilience against illness. In Malaysia, heart disease remains the leading cause of death, affecting people across all ethnicities, income groups and ages. Conditions such as coronary artery disease, hypertension (high blood pressure), heart failure and stroke continue to rise, not only among older adults, but increasingly among younger Malaysians. Poor heart health reduces quality of life, limits productivity and shortens life expectancy, often silently and gradually. As Malaysians navigate urban living, demanding work schedules, family responsibilities and digital dependence, many heart health threats go unnoticed. This column aims to shed light on the hidden habits and household factors that may be harming heart health in Malaysia. By increasing awareness of these influences, readers can take practical, achievable steps to protect their hearts and build healthier lifestyles. In our daily environment In today’s Malaysian society, many people spend 10 to 15 hours a day sitting at office desks, in cars stuck in traffic, in front of screens or relaxing on sofas after long workdays. This sedentary pattern is one of the strongest contributors to heart disease. Prolonged sitting slows metabolism, promotes weight gain, raises blood pressure, increases blood sugar levels and worsens cholesterol profiles. Even individuals who exercise occasionally may still be at risk if most of their day is spent inactive. Simple lifestyle adjustments can help counteract this: Standing or walking for a few minutes every hour Taking short walks after meals Using stairs instead of lifts Incorporating daily movement such as brisk walking in the neighbourhood, tai chi or light home exercises. Incorporating movement into daily routines is more sustainable than relying only on occasional gym sessions. Stress is also an integral part of contemporary Malaysian life. Financial commitments, heavy traffic, workplace demands, caregiving duties and academic pressures all contribute to ongoing stress, which can significantly affect heart health. A tense home environment – marked by persistent noise, clutter, unresolved tensions or inadequate rest – can keep the body in a prolonged “fight-or-flight” mode. This state triggers continuous release of stress hormones such as cortisol and adrenaline, leading to sustained increases in heart rate and blood pressure. Over time, these changes place strain on blood vessels and raise the risk of heart disease. Cultivating a more calming home environment can greatly support heart health. Simple, but effective, measures include: Setting aside screen-free periods Practising mindfulness, relaxation or prayer Promoting open and respectful family communication Minimising clutter and excessive noise Creating clear boundaries between work and rest. A calm and supportive home nurtures not only emotional balance, but also long-term heart health and resilience. Sleep is frequently compromised in Malaysian homes due to extended working hours, prolonged screen time at night, shift work schedules and various social obligations. However, inadequate sleep quality and insufficient rest are significantly associated with heart diseases. Disrupted sleep patterns and ongoing lack of sleep heighten the likelihood of developing: Hypertension Obesity Type 2 diabetes Inflammation, and Hormonal imbalances. Enhancing sleep hygiene is crucial. This encompasses: Adhering to a regular sleeping routine Limiting exposure to screens prior to bedtime Creating a cool, dark and quiet environment for slumber Steering clear of substantial meals and caffeine intake late in the evening. Quality sleep should not be viewed as an indulgence; it is fundamental to maintaining heart health. Household factors Food selections are among the most significant factors affecting heart health. In Malaysia, numerous families depend on processed foods, takeout options and sugary drinks largely due to convenience and hectic lifestyles. Consumption of items rich in saturated fats, trans fats, sugars, and sodium – such as fried snacks, instant noodles, fast food items, pastries, sweetened beverages and processed meats –heightens the likelihood of obesity, as well as elevated blood pressure and cholesterol levels. Moreover, easy access to unhealthy snacks promotes mindless consumption. Implementing minor adjustments within one’s environment can lead to substantial improvements, including: Making fruits visible and readily available Preparing uncomplicated home-cooked dishes Limiting sugary beverages, especially at home Opting for healthier cooking techniques such as steaming، grilling or stir-frying with minimal oil. When prepared with care, traditional Malaysian cuisine has the potential to support heart health by prioritising vegetables, legumes, fish and whole foods. Many individuals in Malaysia might not realise that their household environments could expose them to harmful elements detrimental to heart health. Common household items such as cleaning agents, air fresheners, insect repellents and certain types of furniture can emit volatile organic compounds (VOCs) into the indoor atmosphere. Extended exposure to these indoor pollutants is linked with increased inflammation, oxidative stress and respiratory challenges – all of which elevate the risk for heart issues. The quality of indoor air may also be compromised by factors such as: Accumulation of dust and mould Pet dander Inadequate ventilation Seasonal haze impacting interior air quality. To mitigate these risks effectively, practical measures include: Opting for natural or low-toxicity cleaning products Enhancing ventilation within living spaces Regularly cleaning surfaces to minimise dust and mould accumulation Utilising air purifiers during periods of haze. Maintaining clean air is essential for supporting both lung function and heart health. A disorganised home not only appears messy, but also elevates mental stress. The presence of visual disorder can lead to persistent feelings of being overwhelmed, anxiety and restlessness, which in turn may impact heart health negatively. Moreover, clutter inhibits movement and physical activity by making environments feel confined and unwelcoming. Engaging in regular decluttering contributes to: Decreased levels of stress Enhanced focus and tranquility Increased motivation for movement and exercise Improved sleep quality. Maintaining a tidy and organised living environment fosters emotional stability, as well as promotes heart health. Harmful lifestyle choices Smoking remains one of the most damaging habits for heart health in Malaysia. Tobacco chemicals damage blood vessels, reduce oxygen delivery, increase clot formation and raise blood pressure. Quitting smoking leads to rapid and significant improvements in heart health, regardless of age. Alcohol consumption, particularly when excessive, also increases the risk of hypertension, irregular heart rhythms and heart muscle damage. Moderation is essential, and for many individuals, reducing or avoiding alcohol altogether is the safest option. The growing reliance on technology, extended commute times and sedentary office work have notably diminished daily levels of physical activity. Engaging in regular movement is essential for sustaining healthy blood pressure, cholesterol and glucose levels. Aiming for a minimum of 150 minutes of moderate exercise each week is advisable; this can encompass activities such as brisk walking, cycling, swimming or exercises performed at home. For seniors, chair exercises are highly beneficial for improving overall strength, mobility, balance and general health. Simple movements can be performed safely while seated or using a chair for support, making them especially suitable for older adults or those with limited mobility. When done consistently, chair exercises improve circulation, better heart health, posture and confidence. A significant number of Malaysians tend to pursue medical attention only when they experience symptoms. However, heart diseases frequently progress quietly over an extended period. Consistent health screenings are crucial for the early identification of: Hypertension Elevated cholesterol levels Diabetes Obesity and associated metabolic risks. Regular check-ups facilitate prompt intervention, provide lifestyle recommendations and ensure referrals as needed. Engaging in preventive care not only saves lives, but also lessens the likelihood of long-term complications. Call to action Heart disease does not arise from a singular cause; rather, it is influenced by an array of daily habits, home settings and lifestyle decisions. Now is the opportune moment to initiate change.Evaluate your domestic environment and everyday activities critically.Make a commitment to implement practical and sustainable changes over time. When necessary or advisable, seek support from healthcare professionals.By cultivating healthier lifestyles and optimising living spaces, Malaysians have the potential to safeguard their heart’s well-being and improve overall life quality one step at a time. By Datuk Dr Nor Ashikin Mokhtar Published in Star Newspaper, 09 Feb 2026 The post Things that are quietly harming our hearts first appeared on Primanora Medical Centre. The post Things that are quietly harming our hearts appeared first on Primanora Medical Centre.
Unseen factors that influence our weight
For numerous Malaysians, the journey towards weight loss can feel like an endless battle. Efforts may include reducing rice consumption, skipping breakfast, taking evening walks, or even enrolling in a gym. You might see some initial success in losing a few kilogrammes and feel a sense of accomplishment, only to find the weight returning unexpectedly – sometimes even exceeding your previous measurements. This cycle can lead to feelings of exhaustion, frustration and disappointment. Many individuals begin to internalise negative beliefs about themselves, thinking they are lazy, weak or lack discipline. However, the reality is this: If losing weight was merely a matter of willpower alone, we wouldn’t be witnessing a continuous rise in obesity rates among Malaysians each year. The underlying issue does not stem from laziness; rather, it is rooted in the misconceptions we have been taught regarding weight management. We have been led to believe that weight loss relies solely on eating less and exercising more. If this were entirely accurate, then anyone who adhered to these principles would achieve lasting slimness. Yet, many people adhere strictly to diets without seeing significant results; some even experience further weight gain. This perspective is where a functional approach becomes essential. The functional approach redefines weight gain as a biological imbalance, rather than a personal failure. Instead of assigning blame to individuals, it examines the phy­­siological processes occurring within the body. Understanding weight beyond diet While diet plays an important role in weight management, it does not encompass the entire scenario. Factors such as hormonal balance, sleep quality, stress levels, gut health, inflammation status and daily lifestyle habits also have a significant influence on your body weight. Although food intake and physical activity are valuable tools for managing weight-loss efforts, effectively addressing internal imbalances is also crucial; otherwise, these tools often prove ineffective. In Malaysia specifically, many individuals engage in dieting practices that are deemed “correct”, but they may still face challenges due to dysfunctional hormones, poor sleep patterns, high stress levels or impaired metabolism – all contributing factors that lead the body to retain fat. Let’s explore some significant hidden issues impacting weight loss efforts. The impact of sugar and insulin A major reason behind weight struggles for many Malaysians lies in elevated blood sugar levels, coupled with insulin resistance. To put it simply: insulin is the hormone responsible for regulating how your body processes sugar. When consuming carbohydrates – whether they are complex like rice or simple like sugary snacks and beverages – sugar enters your bloodstream and insulin works to transport that sugar into cells for energy use. However, frequent high sugar consumption causes cells to become unresponsive to insulin – a condition known as insulin resistance. When this occurs: Thus, individuals who frequ­­ently consume drinks like bubble tea or sweetened iced coffee struggle with maintaining their desired weight despite limited food intake because their bodies remain locked in fat storage mode. Functional approaches prioritise stabilising blood sugar as a foundational step. Without addressing this issue first, no subsequent plan will yield effective results. The role of stress Stress extends beyond mental strain; it significantly alters hormonal functions within your body. Under stressful conditions, cortisol – a hormone vital for survival – is released, prompting fat storage as an adaptive response, particularly around the abdominal region. In Malaysia, chronic stress can be caused by: Persistently elevated cortisol levels result in: Many resort to increased exercise intensity or severe dietary restrictions to try to lose weight, all while blaming themselves. Yet, they often lack guidance on effective stress reduction strategies. Functional approaches incorporate methods such as: Weight loss becomes more manageable when individuals’ nervous systems regain feelings of safety and stability again. The influence of gut health Many Malaysians find it surprising that gut health directly correlates with weight regulation. However, the stomach and intestines play critical roles by influencing: Individuals experiencing gut-related issues may commonly suffer from symptoms such as: Gut damage frequently arises from factors such as: When inflammation persists within the gut, fat retention occurs as a protective mechanism employed by our bodies against perceived threats. Functional approaches prioritise repairing gut health before pursuing aggressive weight-loss tactics. The importance of sleep If you tend toward late nights that result in feeling tired upon waking, or scrolling through devices at bedtime while grappling with stress, your quest for a healthy body weight will likely falter. Poor quality sleep contributes significantly by: Those who experience inadequate rest tend toward increased cravings, especially for sugary foods. This could lead them unknowingly towards larger portion sizes, resulting in unnoticed weight gains over time. In Malaysia, late-night activities fuelled by work commitments, social media usage and supper traditions contribute heavily towards insufficient sleep cycles. A comprehensive functional plan should always include strategies aimed at restoring good sleep patterns as the lack thereof contributes directly to the inability to achieve sustainable results when it comes to overall well-being. Change of hormones with age Countless Malaysians reminisce about how they could easily maintain slimmer silhouettes in their 20s, stating things like: “I used to be able to eat anything without gaining weight.” Yet, life transitions introduce several changes including pregnancy, menopause or andropause for men, thyroid disorders, chronic illnesses, and burnout. These alterations disrupt hormonal equilibrium, resulting in stagnation. Previously effective methods fail to produce desired outcomes any more, leaving those affected seeking new solutions outside traditional approaches that may no longer apply under current circumstances faced today. A functional lens evaluates aspects such as: Instead of relegating discussions concerning ageing to accep­­tance statements proclaiming “this is normal”, functional medicine prompts inquiry into whether there is any assistance that can help individual bodies re­­store optimal functioning once again. By Datuk Dr Nor Ashikin MokhtarPublished in Star Newspaper, 26 Jan 2026 The post Unseen factors that influence our weight first appeared on Primanora Medical Centre. The post Unseen factors that influence our weight appeared first on Primanora Medical Centre.
For numerous Malaysians, the journey towards weight loss can feel like an endless battle. Efforts may include reducing rice consumption, skipping breakfast, taking evening walks, or even enrolling in a gym. You might see some initial success in losing a few kilogrammes and feel a sense of accomplishment, only to find the weight returning unexpectedly – sometimes even exceeding your previous measurements. This cycle can lead to feelings of exhaustion, frustration and disappointment. Many individuals begin to internalise negative beliefs about themselves, thinking they are lazy, weak or lack discipline. However, the reality is this: If losing weight was merely a matter of willpower alone, we wouldn’t be witnessing a continuous rise in obesity rates among Malaysians each year. The underlying issue does not stem from laziness; rather, it is rooted in the misconceptions we have been taught regarding weight management. We have been led to believe that weight loss relies solely on eating less and exercising more. If this were entirely accurate, then anyone who adhered to these principles would achieve lasting slimness. Yet, many people adhere strictly to diets without seeing significant results; some even experience further weight gain. This perspective is where a functional approach becomes essential. The functional approach redefines weight gain as a biological imbalance, rather than a personal failure. Instead of assigning blame to individuals, it examines the phy­­siological processes occurring within the body. Understanding weight beyond diet While diet plays an important role in weight management, it does not encompass the entire scenario. Factors such as hormonal balance, sleep quality, stress levels, gut health, inflammation status and daily lifestyle habits also have a significant influence on your body weight. Although food intake and physical activity are valuable tools for managing weight-loss efforts, effectively addressing internal imbalances is also crucial; otherwise, these tools often prove ineffective. In Malaysia specifically, many individuals engage in dieting practices that are deemed “correct”, but they may still face challenges due to dysfunctional hormones, poor sleep patterns, high stress levels or impaired metabolism – all contributing factors that lead the body to retain fat. Let’s explore some significant hidden issues impacting weight loss efforts. The impact of sugar and insulin A major reason behind weight struggles for many Malaysians lies in elevated blood sugar levels, coupled with insulin resistance. To put it simply: insulin is the hormone responsible for regulating how your body processes sugar. When consuming carbohydrates – whether they are complex like rice or simple like sugary snacks and beverages – sugar enters your bloodstream and insulin works to transport that sugar into cells for energy use. However, frequent high sugar consumption causes cells to become unresponsive to insulin – a condition known as insulin resistance. When this occurs: Blood sugar levels rise Fat accumulates instead of burning Hunger intensifies Cravings amplify Energy diminishes Weight increases. Thus, individuals who frequ­­ently consume drinks like bubble tea or sweetened iced coffee struggle with maintaining their desired weight despite limited food intake because their bodies remain locked in fat storage mode. Functional approaches prioritise stabilising blood sugar as a foundational step. Without addressing this issue first, no subsequent plan will yield effective results. <img decoding="async" width="1024" height="676" src="https://primanora.com/wp-content/uploads/2026/02/02-1024x676.jpg" alt="" class="wp-image-27743" srcset="https://primanora.com/wp-content/uploads/2026/02/02-1024x676.jpg 1024w, https://primanora.com/wp-content/uploads/2026/02/02-300x198.jpg 300w, https://primanora.com/wp-content/uploads/2026/02/02-768x507.jpg 768w, https://primanora.com/wp-content/uploads/2026/02/02.jpg 1240w" sizes="(max-width: 1024px) 100vw, 1024px" /> Bad eating habits like midnight snacking or giving in to food cravings could actually be influenced by insulin resistance and chronic stress. — dpa The role of stress Stress extends beyond mental strain; it significantly alters hormonal functions within your body. Under stressful conditions, cortisol – a hormone vital for survival – is released, prompting fat storage as an adaptive response, particularly around the abdominal region. In Malaysia, chronic stress can be caused by: Extended working hours Traffic congestion Financial burdens Family obligations Digital device overuse Inadequate sleep. Persistently elevated cortisol levels result in: Slowed fat metabolism Muscle degradation Heightened sugar cravings Decreased sleep quality Mental fatigue. Many resort to increased exercise intensity or severe dietary restrictions to try to lose weight, all while blaming themselves. Yet, they often lack guidance on effective stress reduction strategies. Functional approaches incorporate methods such as: Enhancing sleep hygiene Practising breathing exercises Cutting back on caffeine intake Addressing work-life balance Training nervous system resilience. Weight loss becomes more manageable when individuals’ nervous systems regain feelings of safety and stability again. The influence of gut health Many Malaysians find it surprising that gut health directly correlates with weight regulation. However, the stomach and intestines play critical roles by influencing: Hormones associated with hunger Signals related to cravings Enzymes responsible for fat storage Pathways involved with inflammation. Individuals experiencing gut-related issues may commonly suffer from symptoms such as: Bloating Constipation Acid reflux Food sensitivities Post-meal fatigue. Gut damage frequently arises from factors such as: Excessive consumption of processed foods Overuse of antibiotics Inadequate fibre intake Irregular eating patterns High sugar diets. When inflammation persists within the gut, fat retention occurs as a protective mechanism employed by our bodies against perceived threats. Functional approaches prioritise repairing gut health before pursuing aggressive weight-loss tactics. The importance of sleep If you tend toward late nights that result in feeling tired upon waking, or scrolling through devices at bedtime while grappling with stress, your quest for a healthy body weight will likely falter. Poor quality sleep contributes significantly by: Heightening hunger hormone production Diminishing satiety signals Elevating cortisol levels Slowing metabolic function Worsening insulin sensitivity. Those who experience inadequate rest tend toward increased cravings, especially for sugary foods. This could lead them unknowingly towards larger portion sizes, resulting in unnoticed weight gains over time. In Malaysia, late-night activities fuelled by work commitments, social media usage and supper traditions contribute heavily towards insufficient sleep cycles. A comprehensive functional plan should always include strategies aimed at restoring good sleep patterns as the lack thereof contributes directly to the inability to achieve sustainable results when it comes to overall well-being. Change of hormones with age Countless Malaysians reminisce about how they could easily maintain slimmer silhouettes in their 20s, stating things like: “I used to be able to eat anything without gaining weight.” Yet, life transitions introduce several changes including pregnancy, menopause or andropause for men, thyroid disorders, chronic illnesses, and burnout. These alterations disrupt hormonal equilibrium, resulting in stagnation. Previously effective methods fail to produce desired outcomes any more, leaving those affected seeking new solutions outside traditional approaches that may no longer apply under current circumstances faced today. A functional lens evaluates aspects such as: Thyroid functionality Oestrogen proportions Testosterone quantities Cortisol cycles Polycystic ovarian syndrome (PCOS) features. Instead of relegating discussions concerning ageing to accep­­tance statements proclaiming “this is normal”, functional medicine prompts inquiry into whether there is any assistance that can help individual bodies re­­store optimal functioning once again. By Datuk Dr Nor Ashikin Mokhtar Published in Star Newspaper, 26 Jan 2026 The post Unseen factors that influence our weight first appeared on Primanora Medical Centre. The post Unseen factors that influence our weight appeared first on Primanora Medical Centre.
Why your weight changes throughout the day
Many might feel astonished or frustrated when their body weight appears to shift from morning to night, up to over a kilogramme at a time. That daily variation is a regular part of life and should not be read as a sign of genuine fat gain or fat loss. In fact, the majority of short-term weight changes have nothing to do with body fat at all. Your weight changes throughout the day because the body keeps losing and gaining non-fat weight like food, water, waste and glycogen (sugars that act as energy reserves). This understanding of the scale allows you to more accurately interpret the numbers, which can lessen the stress or discouragement you may experience. Eating and drinking Every time you eat or drink, your body weight increases instantly – not because you’ve gained any body fat, but because mass has now physically entered your body. For example: With a 500ml bottle of water weighing nearly 0.5kg, a full meal comprising both food and water may weigh between 0.5kg and 1.5kg, depending on the quantity of food eaten. Even small snacks can add significantly to your weight. This extra weight remains until the digestion process is completed and the waste is eliminated. During digestion, nutrients are absorbed by the body for use, and excess fluid and waste are excreted through urine, stool, sweat and breathing. So the scale represents what’s within your body at the moment, not what’s been stored as fat. Water retention Water is an ever-changing resource. Your body is constantly altering how much water it retains, depending on your diet, hormones, activity and surrounding environment. Factors that cause water weight changes include: Waste removal Your weight decreases when your body gets rid of waste products. Urination might lose you as much as 1kg of weight daily. Bowel movements typically shed 200-500g of weight from your body. Water is also lost when you sweat and breathe. This is why people tend to weigh the least in the morning after they use the toilet, and before eating or drinking. Glycogen storage Short-term weight is significantly impacted by carbohydrate intake, primarily via glycogen storage. When you eat more carbohydrates, your glycogen levels rise as excess carbohydrates are broken down into sugar in the form of glycogen for storage. As 1g of glycogen typically binds with 3-4g of water, this also results in more water being stored, thus increasing your weight. When you cut down on carbohydrates, your body releases glycogen to make up for the lower levels of sugar in the body. This also results in the water bound to glycogen being released, thus, causing your weight to drop. This is why low carbohydrate diets often result in quick initial weight loss, but this loss is largely due to water, not fat. Exercise effects In the short term, exercise removes body fluid, rather than body fat. After exercise, your weight may decrease due to sweating, but also rise from the fluids you consume to rehydrate. Sore muscles also retain water as a part of the healing process, which can cause a rise in your weight post-exercise. All this is normal and short-term, and does not translate to permanent weight gain. Hormonal influence A number of hormones regulate fluid balance and metabolism. These include: Analysing the scale properly Your reading of the scale can vary based on the following: Even tiny differences like weighing with your shoes on or with heavy clothing, can change readings in a major way. Evening weight is generally greater than morning weight, because the body stores food, fluid and waste throughout the day. To measure your weight more accurately: Other ways you can track your weight loss progress are: Fat loss vs water loss A gradual reduction in body fat is typically slower than the rapid loss of water weight. While fat loss results in a leaner and more toned physique, water loss leads to a flatter or deflated appearance. Unlike fat loss, which tends to remain stable, water loss can rebound quickly after it occurs. The impact of diet on fat loss is indirect, whereas it has a direct influence on water weight. Changes in weight due to fat loss are generally small and steady over time, while fluctuations from water loss can be sudden and substantial. People often experience a plateau at some point during their weight-loss journey. This occurs when internal progress continues, but the scale doesn’t reflect it. Common reasons include: How to overcome plateaus: Look to the long term Your body is not a machine that evolves in a straight line. It undergoes daily changes influenced by factors such as food intake, hydration levels, digestion, hormones and physical activity. These day-to-day fluctuations are not caused by fat gain. Real fat change occurs over a period of time. For example, about 0.5kg of fat constitutes about 3,500 calories. No way can you gain or lose fat in significant amounts overnight! The number displayed on the scale represents more than just fat; it signifies the ongoing processes within your body. Understanding this perspective shifts the scale from being a source of anxiety to becoming an invaluable resource. By Datuk Dr Nor Ashikin MokhtarPublished in Star Newspaper, 12 Jan 2026 The post Why your weight changes throughout the day first appeared on Primanora Medical Centre. The post Why your weight changes throughout the day appeared first on Primanora Medical Centre.
Many might feel astonished or frustrated when their body weight appears to shift from morning to night, up to over a kilogramme at a time. That daily variation is a regular part of life and should not be read as a sign of genuine fat gain or fat loss. In fact, the majority of short-term weight changes have nothing to do with body fat at all. Your weight changes throughout the day because the body keeps losing and gaining non-fat weight like food, water, waste and glycogen (sugars that act as energy reserves). This understanding of the scale allows you to more accurately interpret the numbers, which can lessen the stress or discouragement you may experience. Eating and drinking Every time you eat or drink, your body weight increases instantly – not because you’ve gained any body fat, but because mass has now physically entered your body. For example: With a 500ml bottle of water weighing nearly 0.5kg, a full meal comprising both food and water may weigh between 0.5kg and 1.5kg, depending on the quantity of food eaten. Even small snacks can add significantly to your weight. This extra weight remains until the digestion process is completed and the waste is eliminated. During digestion, nutrients are absorbed by the body for use, and excess fluid and waste are excreted through urine, stool, sweat and breathing. So the scale represents what’s within your body at the moment, not what’s been stored as fat. Water retention Water is an ever-changing resource. Your body is constantly altering how much water it retains, depending on your diet, hormones, activity and surrounding environment. Factors that cause water weight changes include: Salt intake Fluid balance needs salt.High-sodium foods encourage the body to hold or retain water to maintain fluid balance.A salty meal can result in bloating and a temporary weight gain the next day. Carbohydrates Carbs are kept in glycogen form in the muscles and liver in the body.One gramme of glycogen contains approximately three to four grammes of water.Carbohydrate intake will increase water retention and reduce water release. Hormones Hormonal changes, especially during the menstrual cycle for women, can influence fluid balance drastically.Numerous women experience bloating and put on weight right before their period. Stress and poor sleep High levels of stress hormones (notably cortisol) promote water retention and bloating in the abdomen. Heat and physical activity Sweating in hot weather and during exercise can also cause fluid loss, which can lead to a temporary drop in scale weight. Waste removal Your weight decreases when your body gets rid of waste products. Urination might lose you as much as 1kg of weight daily. Bowel movements typically shed 200-500g of weight from your body. Water is also lost when you sweat and breathe. This is why people tend to weigh the least in the morning after they use the toilet, and before eating or drinking. Glycogen storage Short-term weight is significantly impacted by carbohydrate intake, primarily via glycogen storage. When you eat more carbohydrates, your glycogen levels rise as excess carbohydrates are broken down into sugar in the form of glycogen for storage. As 1g of glycogen typically binds with 3-4g of water, this also results in more water being stored, thus increasing your weight. When you cut down on carbohydrates, your body releases glycogen to make up for the lower levels of sugar in the body. This also results in the water bound to glycogen being released, thus, causing your weight to drop. This is why low carbohydrate diets often result in quick initial weight loss, but this loss is largely due to water, not fat. Exercise effects In the short term, exercise removes body fluid, rather than body fat. After exercise, your weight may decrease due to sweating, but also rise from the fluids you consume to rehydrate. Sore muscles also retain water as a part of the healing process, which can cause a rise in your weight post-exercise. All this is normal and short-term, and does not translate to permanent weight gain. Hormonal influence A number of hormones regulate fluid balance and metabolism. These include: Oestrogen and progesterone For women, hormonal changes before menstruation often result in the retention of fluids.This causes bloating and temporary increases on the scale of 1-3kg. Insulin High-carbohydrate or sugar-heavy meals increase insulin, which results in the increase of sodium and water retention. Cortisol (stress hormone) Chronic stress will lead to water retention, bloating and blood sugar spikes that lead to an increase in insulin, which adds to sodium and water retention. Aldosterone This hormone maintains sodium and potassium levels in the body.Elevated levels lead to fluid retention. Analysing the scale properly Your reading of the scale can vary based on the following: Time of day Clothing worn Food and drink consumption Hydration status. Even tiny differences like weighing with your shoes on or with heavy clothing, can change readings in a major way. Evening weight is generally greater than morning weight, because the body stores food, fluid and waste throughout the day. To measure your weight more accurately: Weigh yourself daily at the same time Use the scale after using the restroom Weight yourself before consuming any food or drink Wear minimal clothing during weighing Always use the same scale in a consistent location. Other ways you can track your weight loss progress are: Utilising weekly averages Assessing waist and hip measurements Capturing monthly photographs Observing energy levels and how your clothes fit. Fat loss vs water loss A gradual reduction in body fat is typically slower than the rapid loss of water weight. While fat loss results in a leaner and more toned physique, water loss leads to a flatter or deflated appearance. Unlike fat loss, which tends to remain stable, water loss can rebound quickly after it occurs. The impact of diet on fat loss is indirect, whereas it has a direct influence on water weight. Changes in weight due to fat loss are generally small and steady over time, while fluctuations from water loss can be sudden and substantial. People often experience a plateau at some point during their weight-loss journey. This occurs when internal progress continues, but the scale doesn’t reflect it. Common reasons include: Water retention masking fat loss Muscle inflammation from exercise (which causes water retention) Digestive weight due to fibre changes. Metabolic adaptation. How to overcome plateaus: Improve sleep Increase protein intake Reduce excess sodium Track weekly averages Change how hard you work out Avoid excessive calorie restriction. Look to the long term Your body is not a machine that evolves in a straight line. It undergoes daily changes influenced by factors such as food intake, hydration levels, digestion, hormones and physical activity. These day-to-day fluctuations are not caused by fat gain. Real fat change occurs over a period of time. For example, about 0.5kg of fat constitutes about 3,500 calories. No way can you gain or lose fat in significant amounts overnight! The number displayed on the scale represents more than just fat; it signifies the ongoing processes within your body. Understanding this perspective shifts the scale from being a source of anxiety to becoming an invaluable resource. By Datuk Dr Nor Ashikin Mokhtar Published in Star Newspaper, 12 Jan 2026 The post Why your weight changes throughout the day first appeared on Primanora Medical Centre. The post Why your weight changes throughout the day appeared first on Primanora Medical Centre.
How peptides can help in overall wellness
In recent years, peptides have become a popular topic in wellness, anti-ageing medicine, sports recovery and regenerative health. You may see them promoted for boosting metabolism, helping the body heal faster, improving skin quality, sharpening focus, or even supporting longevity. With so many bold claims circulating online, it can be difficult to know what is true and what is simply marketing. To make informed decisions, it helps to understand what peptides really are, how they work, and whether they are safe for you to use. What exactly are peptides? Although they sound scientific and complicated, peptides are actually something your body uses every single day, quietly and naturally. To understand them, it helps to think of the body as a busy city that never sleeps. In this city, thousands of messages are being delivered every second, e.g. reminders to heal a muscle, instructions to calm inflammation, signals that you’re full, and even requests to repair the skin. Peptides are some of the tiny messengers responsible for carrying these important instructions. Scientifically, they’re made of short chains of amino acids – the same building blocks that make up proteins. But unlike large, complex proteins, peptides are much smaller. They are usually made of two to 50 amino acids, and are nimble and incredibly efficient. They are like the text messages of the body: short, specific and delivered exactly where they need to go. Your body makes hundreds of different peptides naturally in almost every part of our biological system. They help with critical functions such as: > Hormone activity – like insulin regulation > Nerve communication – helping the brain send signals > Cell-to-cell messaging – guiding processes like healing > Immune responses – influencing how the body protects itself > Tissue repair and growth – supporting recovery and regeneration. Because peptides are involved in so many essential processes, researchers have explored how specific peptides can be used to enhance health or treat certain conditions. Instead of forcing the body to do something unnatural, these peptides gently help the body do what it is designed to do – just more effectively. How do peptides work? Think of each peptide as having its own “identity card”. Its specific sequence of amino acids allows it to interact with a particular receptor in the body, much like a key fitting into a lock. Once it connects, it can trigger a targeted response. Depending on the peptide, these responses may include: > Encouraging the body to release growth hormone > Supporting collagen production for healthier skin > Improving fat metabolism > Calming inflammation > Speeding up wound or tissue healing > Improving cellular energy production. Because peptides can act in precise, predictable ways, they are becoming increasingly popular in personalised medicine. Many people use them to support recovery, energy, appearance or overall wellness. Are they safe to use? Some peptides, like insulin or semaglutide, have been researched thoroughly and approved for medical use. Others are newer and still being studied. The biggest safety concern actually comes from where the peptide is sourced. Medical-grade peptides are made in controlled environments and checked for purity. Cheap peptides bought from websites, gyms or influencers may contain contaminants, incorrect doses, or sometimes nothing active at all. This is why medical supervision is non-negotiable. A trained practitioner ensures that the peptide chosen is suitable for your body, your health history and your goals. They also monitor your progress and make sure the dosage and method of use are correct. Without this, even the safest peptides can become risky. Peptides also aren’t suitable for everyone. People with active cancer, severe organ disease or certain hormonal problems might need to avoid them. Pregnant or breastfeeding individuals should also steer clear unless specifically advised they can take them. Types of peptides Peptides are often grouped by the benefits they provide, and one of the most popular categories is weight and metabolism peptides. Many people who struggle with their weight often feel like their hunger controls them, not the other way around. Hormones influence appetite, cravings, and how much fat the body stores or burns. Peptides such as semaglutide and tirzepatide help by supporting these hormonal pathways to reduce appetite and cravings, and improve insulin sensitivity. When hunger decreases, cravings become manageable and metabolism improves, weight loss stops feeling like an uphill battle. These peptides work best when paired with reasonable lifestyle changes that are easier to maintain, instead of taking peptides only. This combination makes weight loss feel more natural, steady, and achievable. Skin and anti-ageing peptides make up another large group. Collagen loss is one of the earliest signs of ageing: the skin becomes thinner, less elastic and more prone to fine lines. Peptides like collagen peptides and GHK-Cu can help by stimulating new collagen production, increasing hydration, improving skin texture and supporting a more youthful appearance. Some work at the surface level, while others work deeper, promoting cell regeneration, and even supporting better sleep, which is when the skin does most of its repair work. People who use skin peptides often notice smoother skin, better moisture retention, and a brighter, healthier look. While good skincare and sun protection remain essential, peptides provide an internal foundation for healthier ageing. Finally, brain and mood-support peptides offer gentle support for mental clarity, focus and emotional balance. Modern life can be overwhelming, and stress, poor sleep and mental fatigue can affect how we function day to day. Peptides like Selank and Semax help regulate brain chemicals related to calmness, motivation and cognitive performance. Unlike stimulants, which push the brain into overdrive, these peptides support natural brain chemistry. Users often describe clearer thinking, less anxiety and better focus. They are especially helpful for people dealing with stress, burnout, or general “brain fog”. Working with the body Peptides are not magic, but they are powerful tools that can work with the body. When used correctly – with proper guidance, quality assurance and personalised medical oversight – peptides can support healthier weight management, better skin and clearer The post How peptides can help in overall wellness first appeared on Primanora Medical Centre. The post How peptides can help in overall wellness appeared first on Primanora Medical Centre.
In recent years, peptides have become a popular topic in wellness, anti-ageing medicine, sports recovery and regenerative health. You may see them promoted for boosting metabolism, helping the body heal faster, improving skin quality, sharpening focus, or even supporting longevity. With so many bold claims circulating online, it can be difficult to know what is true and what is simply marketing. To make informed decisions, it helps to understand what peptides really are, how they work, and whether they are safe for you to use. What exactly are peptides? Although they sound scientific and complicated, peptides are actually something your body uses every single day, quietly and naturally. To understand them, it helps to think of the body as a busy city that never sleeps. In this city, thousands of messages are being delivered every second, e.g. reminders to heal a muscle, instructions to calm inflammation, signals that you’re full, and even requests to repair the skin. Peptides are some of the tiny messengers responsible for carrying these important instructions. Scientifically, they’re made of short chains of amino acids – the same building blocks that make up proteins. But unlike large, complex proteins, peptides are much smaller. They are usually made of two to 50 amino acids, and are nimble and incredibly efficient. They are like the text messages of the body: short, specific and delivered exactly where they need to go. Your body makes hundreds of different peptides naturally in almost every part of our biological system. They help with critical functions such as: > Hormone activity – like insulin regulation > Nerve communication – helping the brain send signals > Cell-to-cell messaging – guiding processes like healing > Immune responses – influencing how the body protects itself > Tissue repair and growth – supporting recovery and regeneration. Because peptides are involved in so many essential processes, researchers have explored how specific peptides can be used to enhance health or treat certain conditions. Instead of forcing the body to do something unnatural, these peptides gently help the body do what it is designed to do – just more effectively. How do peptides work? Think of each peptide as having its own “identity card”. Its specific sequence of amino acids allows it to interact with a particular receptor in the body, much like a key fitting into a lock. Once it connects, it can trigger a targeted response. Depending on the peptide, these responses may include: > Encouraging the body to release growth hormone > Supporting collagen production for healthier skin > Improving fat metabolism > Calming inflammation > Speeding up wound or tissue healing > Improving cellular energy production. Because peptides can act in precise, predictable ways, they are becoming increasingly popular in personalised medicine. Many people use them to support recovery, energy, appearance or overall wellness. Are they safe to use? Some peptides, like insulin or semaglutide, have been researched thoroughly and approved for medical use. Others are newer and still being studied. The biggest safety concern actually comes from where the peptide is sourced. Medical-grade peptides are made in controlled environments and checked for purity. Cheap peptides bought from websites, gyms or influencers may contain contaminants, incorrect doses, or sometimes nothing active at all. This is why medical supervision is non-negotiable. A trained practitioner ensures that the peptide chosen is suitable for your body, your health history and your goals. They also monitor your progress and make sure the dosage and method of use are correct. Without this, even the safest peptides can become risky. Peptides also aren’t suitable for everyone. People with active cancer, severe organ disease or certain hormonal problems might need to avoid them. Pregnant or breastfeeding individuals should also steer clear unless specifically advised they can take them. Types of peptides <img decoding="async" width="848" height="565" src="https://primanora.com/wp-content/uploads/2026/01/3690546.jpg" alt="" class="wp-image-27732" srcset="https://primanora.com/wp-content/uploads/2026/01/3690546.jpg 848w, https://primanora.com/wp-content/uploads/2026/01/3690546-300x200.jpg 300w, https://primanora.com/wp-content/uploads/2026/01/3690546-768x512.jpg 768w" sizes="(max-width: 848px) 100vw, 848px" /> Peptides are often grouped by the benefits they provide, and one of the most popular categories is weight and metabolism peptides. Many people who struggle with their weight often feel like their hunger controls them, not the other way around. Hormones influence appetite, cravings, and how much fat the body stores or burns. Peptides such as semaglutide and tirzepatide help by supporting these hormonal pathways to reduce appetite and cravings, and improve insulin sensitivity. When hunger decreases, cravings become manageable and metabolism improves, weight loss stops feeling like an uphill battle. These peptides work best when paired with reasonable lifestyle changes that are easier to maintain, instead of taking peptides only. This combination makes weight loss feel more natural, steady, and achievable. Skin and anti-ageing peptides make up another large group. Collagen loss is one of the earliest signs of ageing: the skin becomes thinner, less elastic and more prone to fine lines. Peptides like collagen peptides and GHK-Cu can help by stimulating new collagen production, increasing hydration, improving skin texture and supporting a more youthful appearance. Some work at the surface level, while others work deeper, promoting cell regeneration, and even supporting better sleep, which is when the skin does most of its repair work. People who use skin peptides often notice smoother skin, better moisture retention, and a brighter, healthier look. While good skincare and sun protection remain essential, peptides provide an internal foundation for healthier ageing. Finally, brain and mood-support peptides offer gentle support for mental clarity, focus and emotional balance. Modern life can be overwhelming, and stress, poor sleep and mental fatigue can affect how we function day to day. Peptides like Selank and Semax help regulate brain chemicals related to calmness, motivation and cognitive performance. Unlike stimulants, which push the brain into overdrive, these peptides support natural brain chemistry. Users often describe clearer thinking, less anxiety and better focus. They are especially helpful for people dealing with stress, burnout, or general “brain fog”. Working with the body Peptides are not magic, but they are powerful tools that can work with the body. When used correctly – with proper guidance, quality assurance and personalised medical oversight – peptides can support healthier weight management, better skin and clearer thinking. They offer a modern way to help the body do what it wants to do naturally, but with a little more strength, balance and precision. As research grows, we will likely see more peptides becoming officially approved and widely used. Until then, the safest path is to work with qualified medical professionals who can guide you based on evidence, safety and your unique health needs. By Datuk Dr Nor Ashikin Mokhtar Published in Star Newspaper, 29 Dec 2025 The post How peptides can help in overall wellness first appeared on Primanora Medical Centre. The post How peptides can help in overall wellness appeared first on Primanora Medical Centre.
Breathing: Use your nose, not your mouth
Breathing is something we do about 20,000 times a day, often without giving it a second thought. Yet, this simple act has a powerful influence on our health, energy, sleep, and even mood. What many people don’t realise is that how we breathe matters just as much as how much we breathe. Our bodies are designed for nasal breathing, not mouth breathing. The nose is far more than a hole in the face; it’s an advanced filtering, humidifying and oxygen-optimising system. It prepares the air before it reaches your lungs and ensures every breath supports your body in the best way possible. In contrast, breathing through the mouth may seem harmless, but over time, it can affect your sleep, oral health, energy levels, and even your facial structure. Let’s take a closer look at why the nose is nature’s preferred pathway for breathing, and what happens when we neglect it. A built-in air filter Think of your nose as your body’s first line of defence. Inside the nasal passages are tiny hairs called cilia and a thin layer of mucus, which, together, act like a natural filter. As air passes through, dust, pollen, bacteria and other airborne particles get trapped and prevented from entering your lungs. When you breathe through your mouth, you skip this vital step. Unfiltered air flows straight into your throat and lungs, bringing in irritants and microbes that can cause infections or worsen allergies. Over time, this can lead to more sore throats, coughing and respiratory discomfort. Climate control Beyond filtering, your nose also acts as a climate control system for your breath. As air travels through your nasal passages, it is warmed, moistened and gently regulated before reaching the lungs. This matters more than most people realise. The lungs are delicate organs that function best when the air is warm and humid. Breathing cold, dry air through the mouth can irritate the airways, causing coughing, or even mild inflammation, especially in people with asthma or sensitive lungs.Nasal breathing also helps prevent that “scratchy throat” or dryness you feel after sleeping with your mouth open. Nitric oxide production One of the nose’s most fascinating secrets is that it produces a small, but mighty, molecule called nitric oxide (NO). This gas mixes with the air you inhale and plays a crucial role in improving oxygen delivery throughout the body. Nitric oxide helps to open up blood vessels, allowing oxygen to circulate more efficiently. It also has antibacterial and antiviral properties, which means it helps fight off germs even before they reach the lungs. When you breathe through your mouth, you lose this benefit entirely. Mouth breathing not only bypasses nitric oxide, but also often leads to shallow, fast breathing, which reduces your oxygen efficiency. The result is a body that may still feel tired, foggy or anxious, even when you’re technically breathing “enough”. Calming down If you’ve ever been told to “take a deep breath” when you’re stressed, then know that there’s science behind that advice, especially if that deep breath is through your nose. Nasal breathing naturally slows down your breathing rate and activates the parasympathetic nervous system, which helps calm the body and mind. Mouth breathing, on the other hand, often triggers the sympathetic (“fight or flight”) response, which can make you feel tense or anxious. Over time, chronic mouth breathing can actually keep your body in a mild state of stress, contributing to fatigue, poor focus, and even higher blood pressure. This is why practices such as yoga, meditation and tai chi place so much emphasis on nasal breathing – it’s not just about oxygen, but also about restoring balance to the nervous system. Promoting better sleep How you breathe during the day affects how you sleep at night. People who breathe through their noses tend to sleep more soundly, because nasal breathing supports proper airflow and prevents airway collapse. Mouth breathing during sleep often leads to snoring, dry mouth and poor oxygen levels. You may wake up tired, groggy or with a sore throat. Over time, it can even increase the risk of sleep apnoea, a condition where breathing repeatedly stops and starts during the night. Encouraging nasal breathing – sometimes with the help of posture adjustments, nasal sprays or gentle breathing exercises – can make a huge difference in sleep quality and overall energy. It’s one of the simplest, most natural ways to wake up feeling refreshed. Maintaining oral health Your mouth is meant for eating and speaking, not breathing. When you breathe through your mouth, it dries out your saliva, which is essential for neutralising acids and washing away bacteria. A dry mouth becomes a breeding ground for bad breath, tooth decay, gum disease, and even mouth ulcers. In children, chronic mouth breathing can interfere with jaw and facial development, leading to a longer, narrower face and misaligned teeth – what dentists sometimes call a “mouth breather’s face”. Nasal breathing keeps the mouth closed and moist, maintaining the right balance of bacteria and protecting your teeth and gums in the long term. Better sports performance Whether you’re an athlete or just someone who likes to stay active, nasal breathing can help you perform better and recover faster. When you breathe through your nose, you take slower, deeper breaths, which improves oxygen delivery to your muscles and helps you maintain endurance. In contrast, mouth breathing tends to make you breathe too fast, lowering carbon dioxide levels and reducing oxygen uptake. That’s why mouth breathers often feel fatigued or dizzy during workouts. Many endurance athletes now train themselves to breathe through their noses as much as possible – even during intense exercise – to improve stamina, focus and recovery time. A forced habit Sometimes, people resort to mouth breathing because of underlying issues, e.g. nasal congestion, allergies, sinus infections, or structural problems such as a deviated septum or enlarged tonsils. While mouth breathing might provide temporary relief, it’s important to identify and treat the root cause. Persistent mouth breathing can worsen the The post Breathing: Use your nose, not your mouth first appeared on Primanora Medical Centre. The post Breathing: Use your nose, not your mouth appeared first on Primanora Medical Centre.
Breathing is something we do about 20,000 times a day, often without giving it a second thought. Yet, this simple act has a powerful influence on our health, energy, sleep, and even mood. What many people don’t realise is that how we breathe matters just as much as how much we breathe. Our bodies are designed for nasal breathing, not mouth breathing. The nose is far more than a hole in the face; it’s an advanced filtering, humidifying and oxygen-optimising system. It prepares the air before it reaches your lungs and ensures every breath supports your body in the best way possible. In contrast, breathing through the mouth may seem harmless, but over time, it can affect your sleep, oral health, energy levels, and even your facial structure. Let’s take a closer look at why the nose is nature’s preferred pathway for breathing, and what happens when we neglect it. A built-in air filter Think of your nose as your body’s first line of defence. Inside the nasal passages are tiny hairs called cilia and a thin layer of mucus, which, together, act like a natural filter. As air passes through, dust, pollen, bacteria and other airborne particles get trapped and prevented from entering your lungs. When you breathe through your mouth, you skip this vital step. Unfiltered air flows straight into your throat and lungs, bringing in irritants and microbes that can cause infections or worsen allergies. Over time, this can lead to more sore throats, coughing and respiratory discomfort. Climate control Beyond filtering, your nose also acts as a climate control system for your breath. As air travels through your nasal passages, it is warmed, moistened and gently regulated before reaching the lungs. This matters more than most people realise. The lungs are delicate organs that function best when the air is warm and humid. Breathing cold, dry air through the mouth can irritate the airways, causing coughing, or even mild inflammation, especially in people with asthma or sensitive lungs.Nasal breathing also helps prevent that “scratchy throat” or dryness you feel after sleeping with your mouth open. Nitric oxide production One of the nose’s most fascinating secrets is that it produces a small, but mighty, molecule called nitric oxide (NO). This gas mixes with the air you inhale and plays a crucial role in improving oxygen delivery throughout the body. Nitric oxide helps to open up blood vessels, allowing oxygen to circulate more efficiently. It also has antibacterial and antiviral properties, which means it helps fight off germs even before they reach the lungs. When you breathe through your mouth, you lose this benefit entirely. Mouth breathing not only bypasses nitric oxide, but also often leads to shallow, fast breathing, which reduces your oxygen efficiency. The result is a body that may still feel tired, foggy or anxious, even when you’re technically breathing “enough”. Calming down If you’ve ever been told to “take a deep breath” when you’re stressed, then know that there’s science behind that advice, especially if that deep breath is through your nose. Nasal breathing naturally slows down your breathing rate and activates the parasympathetic nervous system, which helps calm the body and mind. Mouth breathing, on the other hand, often triggers the sympathetic (“fight or flight”) response, which can make you feel tense or anxious. Over time, chronic mouth breathing can actually keep your body in a mild state of stress, contributing to fatigue, poor focus, and even higher blood pressure. This is why practices such as yoga, meditation and tai chi place so much emphasis on nasal breathing – it’s not just about oxygen, but also about restoring balance to the nervous system. Promoting better sleep How you breathe during the day affects how you sleep at night. People who breathe through their noses tend to sleep more soundly, because nasal breathing supports proper airflow and prevents airway collapse. Mouth breathing during sleep often leads to snoring, dry mouth and poor oxygen levels. You may wake up tired, groggy or with a sore throat. Over time, it can even increase the risk of sleep apnoea, a condition where breathing repeatedly stops and starts during the night. Encouraging nasal breathing – sometimes with the help of posture adjustments, nasal sprays or gentle breathing exercises – can make a huge difference in sleep quality and overall energy. It’s one of the simplest, most natural ways to wake up feeling refreshed. Maintaining oral health Your mouth is meant for eating and speaking, not breathing. When you breathe through your mouth, it dries out your saliva, which is essential for neutralising acids and washing away bacteria. A dry mouth becomes a breeding ground for bad breath, tooth decay, gum disease, and even mouth ulcers. In children, chronic mouth breathing can interfere with jaw and facial development, leading to a longer, narrower face and misaligned teeth – what dentists sometimes call a “mouth breather’s face”. Nasal breathing keeps the mouth closed and moist, maintaining the right balance of bacteria and protecting your teeth and gums in the long term. Better sports performance Whether you’re an athlete or just someone who likes to stay active, nasal breathing can help you perform better and recover faster. When you breathe through your nose, you take slower, deeper breaths, which improves oxygen delivery to your muscles and helps you maintain endurance. In contrast, mouth breathing tends to make you breathe too fast, lowering carbon dioxide levels and reducing oxygen uptake. That’s why mouth breathers often feel fatigued or dizzy during workouts. Many endurance athletes now train themselves to breathe through their noses as much as possible – even during intense exercise – to improve stamina, focus and recovery time. A forced habit Sometimes, people resort to mouth breathing because of underlying issues, e.g. nasal congestion, allergies, sinus infections, or structural problems such as a deviated septum or enlarged tonsils. While mouth breathing might provide temporary relief, it’s important to identify and treat the root cause. Persistent mouth breathing can worsen the problem over time, leading to chronic congestion, poor sleep and fatigue. Simple solutions like saline rinses, allergy management, nasal decongestants or breathing retraining therapy can often restore healthy nasal breathing and improve overall quality of life. Breathing naturally again The good news is that it’s never too late to retrain bad breathing habits. Simply paying attention to your breath throughout the day, especially during times of stress, rest or physical activity, can make a noticeable difference. Start by consciously keeping your mouth closed and inhaling slowly through your nose. You can also practise slow nasal breathing exercises, where you inhale for four counts, exhale for six, and pause briefly before the next breath. Over time, your body adapts and nasal breathing becomes second nature again. If you find it difficult to breathe through your nose due to congestion, seek advice from a healthcare professional. Treating sinus issues, allergies or nasal obstruction can restore natural breathing. Breathing through your nose isn’t just a small habit; it’s a foundation for good health. Mouth breathing, though sometimes unavoidable, is best reserved for short-term situations like intense exercise or temporary congestion. When it becomes a habit, it can disrupt sleep, oral health, and even emotional balance. By simply closing your mouth and letting your nose do its job, you can improve your energy, sleep, focus, comfort, appearance, long-term health and well-being in profound ways – one mindful breath at a time. By Datuk Dr Nor Ashikin Mokhtar Published in Star Newspaper, 15 Dec 2025 The post Breathing: Use your nose, not your mouth first appeared on Primanora Medical Centre. The post Breathing: Use your nose, not your mouth appeared first on Primanora Medical Centre.
Tackling the many factors influencing teen vaping
Vaping has gained popularity among adolescents for various reasons, including that it is seen as a safer alternative to smoking. This perception is misleading as both activities pose serious health risks, with vaping potentially being more harmful for young people.Adolescents are in a key developmental phase, making them particularly vulnerable to the harmful substances in vaping products. While vaping devices do away with the tar and smoke of traditional cigarettes, they still deliver nicotine and toxic chemicals, including dangerous heavy metals like cadmium. What is equally worrying is that individuals frequently lack awareness regarding the contents of illicit vape liquids, which may include harmful solvents, heavy metals or psychoactive substances. Inhaling these components can lead to: Vapes are intended (by law) solely for use with nicotine or non-nicotine flavoured liquids. However, unregulated products may include illegal substances such as tetrahydrocannabinol (THC, an active component of cannabis, also known as ganja), methamphetamine (also known as meth or speed) or synthetic cannabinoids (components of cannabis), particularly those that are sold online or smuggled into the country. Vape cartridges tainted with sedatives (especially etomidate) and opioids have also been reported – these formulations are illegal. The normalisation of vaping in social settings, fuelled by targeted marketing and peer influence, exacerbates the issue, often overshadowing the risks associated with vaping. Health risks While often seen as a safer alternative to smoking, vaping poses significant dangers, especially for developing young users. Key health concerns include: > Respiratory issues While marketed as cleaner than cigarettes, e-cigarette aerosols contain harmful ultrafine particles that can damage lungs. Evali is a serious respiratory condition caused by the use of e-cigarettes or vaping devices. Common symptoms include difficulty breathing, persistent cough and chest discomfort. This illness is mainly associated with the presence of vitamin E acetate in certain THC-infused vaping products. Other potential diseases include chronic bronchitis, asthma exacerbations and bronchiolitis obliterans (popcorn lung) due to diacetyl exposure. More immediately, inhaling these substances can irritate the airways, causing coughing, wheezing and shortness of breath. Some may also experience diarrhoea, nausea, vomiting, abdominal pain, fever, chills and a rapid heartbeat. > Brain development Adolescence is a critical period for brain development, affecting decision-making and impulse control. Nicotine exposure from vaping disrupts this process and can lead to lasting cognitive impairments. Early nicotine exposure also heightens the risk of future addiction to other substances. > Addiction Both vaping and smoking pose addiction risks, but vaping may have a higher potential for adolescents. Vaping products often contain higher nicotine concentrations than traditional cigarettes. The rapid absorption of nicotine can lead to quicker addiction due to frequent dopamine spikes. Vaping devices, available in interesting designs with appealing liquid flavours, attract young users and encourage habitual use. The more adolescents vape, the more normalised it becomes among this group, thus encouraging even more adolescents to pick up the habit and be exposed to the risk of addiction. Toxic substances Cadmium is commonly found in vaping device components like batteries and coils, where it could potentially leach into aerosols when e-liquids are heated. Some flavoured e-liquids may also contain cadmium due to lack of safety measures during manufacturing or quality control of ingredients. Cadmium exposure can severely impact adolescent health. It is a known carcinogen linked to kidney damage, bone fragility and cardiovascular (heart) issues. Even low exposure can disrupt the endocrine system, causing hormonal imbalances that affect growth and development. Inhalation of cadmium aerosols intensifies these risks, leading to both acute and chronic health problems. The developing brain is vulnerable to neurotoxins like cadmium, potentially causing learning disabilities and behavioural issues. Chronic health conditions may arise from cumulative exposure through vaping, often only surfacing years later. Social and psychological impacts Adolescents face substantial peer pressure in a culture where vaping is glamourised via social media. Many view it as a socially acceptable alternative to smoking, leading to experimentation to fit in. This normalisation complicates their ability to recognise the potential dangers of vaping. Vaping is also linked to increased rates of anxiety, depression and other mental health issues. The nicotine in vaping products can intensify these feelings, creating a cycle where individuals rely on vaping for emotional regulation. This can hinder the development of healthier coping strategies, leaving adolescents vulnerable to mental health challenges. Marketing strategies by vaping companies significantly influence adolescent vaping. Bright colours, enticing flavours and targeted ads create a brand image linking vaping to fun and rebellion. This marketing approach not only attracts youth, but also downplays the risks, leading to increased experimentation and potential addiction. Prevention strategies The dangers of vaping, especially compared to smoking, require urgent attention. Parents, educators and healthcare providers must engage in discussions about vaping risks. Awareness and education can combat the glamourised perception of vaping among peers, empowering youth with knowledge about addiction and health hazards. Understanding the social and psychological factors driving adolescent vaping is crucial. Collaborative prevention strategies, including education and policy changes, are needed to reduce youth vaping rates. Many countries that once allowed vaping, like Thailand and India, have prohibited vaping after public health concerns grew. Since 2014, Thailand has enforced a stringent prohibition on the importation, sale and possession of e-cigarettes and related items. The government has heightened its enforcement against illegal vaping activities, issuing specific advisories aimed at tourists. India enacted a comprehensive ban on vaping through the Prohibition of Electronic Cigarettes Act of 2019. This legislation encompasses all facets of e-cigarette usage and is applicable to everyone, including international visitors. Meanwhile, Singapore took a “better safe than sorry” approach. Their Health Ministry and Health Sciences Authority concluded that vapes do not serve as a safe substitute for traditional smoking; hence, vaping has been banned. Taking vaping seriously Malaysia should take the issue of vaping seriously because of: > Rising youth uptake worldwide Many countries report rapid increases in adolescent vaping, especially with multiple available liquid flavours and social media making these devices appealing. > Unknown long-term harms Vaping is newer than smoking, so long-term consequences (including respiratory, cardiovascular and neurodevelopmental) are still being The post Tackling the many factors influencing teen vaping first appeared on Primanora Medical Centre. The post Tackling the many factors influencing teen vaping appeared first on Primanora Medical Centre.
Vaping has gained popularity among adolescents for various reasons, including that it is seen as a safer alternative to smoking. This perception is misleading as both activities pose serious health risks, with vaping potentially being more harmful for young people.Adolescents are in a key developmental phase, making them particularly vulnerable to the harmful substances in vaping products. While vaping devices do away with the tar and smoke of traditional cigarettes, they still deliver nicotine and toxic chemicals, including dangerous heavy metals like cadmium. What is equally worrying is that individuals frequently lack awareness regarding the contents of illicit vape liquids, which may include harmful solvents, heavy metals or psychoactive substances. Inhaling these components can lead to: Serious lung damage (i.e. e-cigarette or vaping use-associated lung injury, or Evali) Loss of consciousness Addiction Organ damage. Vapes are intended (by law) solely for use with nicotine or non-nicotine flavoured liquids. However, unregulated products may include illegal substances such as tetrahydrocannabinol (THC, an active component of cannabis, also known as ganja), methamphetamine (also known as meth or speed) or synthetic cannabinoids (components of cannabis), particularly those that are sold online or smuggled into the country. Vape cartridges tainted with sedatives (especially etomidate) and opioids have also been reported – these formulations are illegal. The normalisation of vaping in social settings, fuelled by targeted marketing and peer influence, exacerbates the issue, often overshadowing the risks associated with vaping. Health risks While often seen as a safer alternative to smoking, vaping poses significant dangers, especially for developing young users. Key health concerns include: > Respiratory issues While marketed as cleaner than cigarettes, e-cigarette aerosols contain harmful ultrafine particles that can damage lungs. Evali is a serious respiratory condition caused by the use of e-cigarettes or vaping devices. Common symptoms include difficulty breathing, persistent cough and chest discomfort. This illness is mainly associated with the presence of vitamin E acetate in certain THC-infused vaping products. Other potential diseases include chronic bronchitis, asthma exacerbations and bronchiolitis obliterans (popcorn lung) due to diacetyl exposure. More immediately, inhaling these substances can irritate the airways, causing coughing, wheezing and shortness of breath. Some may also experience diarrhoea, nausea, vomiting, abdominal pain, fever, chills and a rapid heartbeat. > Brain development Adolescence is a critical period for brain development, affecting decision-making and impulse control. Nicotine exposure from vaping disrupts this process and can lead to lasting cognitive impairments. Early nicotine exposure also heightens the risk of future addiction to other substances. > Addiction Both vaping and smoking pose addiction risks, but vaping may have a higher potential for adolescents. Vaping products often contain higher nicotine concentrations than traditional cigarettes. The rapid absorption of nicotine can lead to quicker addiction due to frequent dopamine spikes. Vaping devices, available in interesting designs with appealing liquid flavours, attract young users and encourage habitual use. The more adolescents vape, the more normalised it becomes among this group, thus encouraging even more adolescents to pick up the habit and be exposed to the risk of addiction. Toxic substances Cadmium is commonly found in vaping device components like batteries and coils, where it could potentially leach into aerosols when e-liquids are heated. Some flavoured e-liquids may also contain cadmium due to lack of safety measures during manufacturing or quality control of ingredients. Cadmium exposure can severely impact adolescent health. It is a known carcinogen linked to kidney damage, bone fragility and cardiovascular (heart) issues. Even low exposure can disrupt the endocrine system, causing hormonal imbalances that affect growth and development. Inhalation of cadmium aerosols intensifies these risks, leading to both acute and chronic health problems. The developing brain is vulnerable to neurotoxins like cadmium, potentially causing learning disabilities and behavioural issues. Chronic health conditions may arise from cumulative exposure through vaping, often only surfacing years later. Social and psychological impacts Adolescents face substantial peer pressure in a culture where vaping is glamourised via social media. Many view it as a socially acceptable alternative to smoking, leading to experimentation to fit in. This normalisation complicates their ability to recognise the potential dangers of vaping. Vaping is also linked to increased rates of anxiety, depression and other mental health issues. The nicotine in vaping products can intensify these feelings, creating a cycle where individuals rely on vaping for emotional regulation. This can hinder the development of healthier coping strategies, leaving adolescents vulnerable to mental health challenges. Marketing strategies by vaping companies significantly influence adolescent vaping. Bright colours, enticing flavours and targeted ads create a brand image linking vaping to fun and rebellion. This marketing approach not only attracts youth, but also downplays the risks, leading to increased experimentation and potential addiction. Prevention strategies The dangers of vaping, especially compared to smoking, require urgent attention. Parents, educators and healthcare providers must engage in discussions about vaping risks. Awareness and education can combat the glamourised perception of vaping among peers, empowering youth with knowledge about addiction and health hazards. Understanding the social and psychological factors driving adolescent vaping is crucial. Collaborative prevention strategies, including education and policy changes, are needed to reduce youth vaping rates. Many countries that once allowed vaping, like Thailand and India, have prohibited vaping after public health concerns grew. Since 2014, Thailand has enforced a stringent prohibition on the importation, sale and possession of e-cigarettes and related items. The government has heightened its enforcement against illegal vaping activities, issuing specific advisories aimed at tourists. India enacted a comprehensive ban on vaping through the Prohibition of Electronic Cigarettes Act of 2019. This legislation encompasses all facets of e-cigarette usage and is applicable to everyone, including international visitors. Meanwhile, Singapore took a “better safe than sorry” approach. Their Health Ministry and Health Sciences Authority concluded that vapes do not serve as a safe substitute for traditional smoking; hence, vaping has been banned. Taking vaping seriously Malaysia should take the issue of vaping seriously because of: > Rising youth uptake worldwide Many countries report rapid increases in adolescent vaping, especially with multiple available liquid flavours and social media making these devices appealing. > Unknown long-term harms Vaping is newer than smoking, so long-term consequences (including respiratory, cardiovascular and neurodevelopmental) are still being studied. > Gateway and dual-use risk Some evidence shows that vaping can lead to nicotine addiction and possible transition to traditional cigarettes, or worse, dual use of vapes and cigarettes. > Illicit market and adulteration risk Banned or poorly regulated markets can produce contaminated cartridges (with illicit substances like THC and synthetic cannabinoids, as well as other adulterants) and unsafe hardware (e.g. batteries). If Malaysia’s priority is youth protection and prevention of a new nicotine generation, then we need to move quickly with precautionary measures like flavour bans, age/advertising restrictions and online sales bans, while building suitable regulatory systems. If regulated vaping is proven to reduce smoking without youth uptake, then we can consider a tightly-controlled medical/pharmacy pathway for adult smokers to help them transition to a less harmful method of nicotine intake. In short, we mustn’t delay protective measures and out policies should be designed to be adaptive. Addressing vaping-related issues is vital for adolescent health. By promoting awareness and implementing effective prevention measures, we can ensure healthier futures for our young people. By Datuk Dr Nor Ashikin Mokhtar Published in Star Newspaper, 01 Dec 2025 The post Tackling the many factors influencing teen vaping first appeared on Primanora Medical Centre. The post Tackling the many factors influencing teen vaping appeared first on Primanora Medical Centre.