Is it true that men should take care more of their heart than women because men have a higher risk?

At a younger age, men have a slightly higher risk than women on having a heart issue. It may due to men are usually exposed more to risk factors that burdening the heart, such as smoking, excessive alcohol intake, hypertension, high cholesterol, etc. However, following by aging and post-menopause, women have the same risk as men for a heart issue. Furthermore, people with a genetic history of hypertension, high cholesterol or diabetes should take advance care of their heart, regardless of gender.

Other than EPA and DHA in the supplement capsule, what is the remaining content in the Omega-3 supplement

The active ingredient in the Omega-3 supplement is EPA and DHA. Thus, the quantity of both active ingredients is generally stated on the packaging. On the other hand, the remaining content in the supplement capsule is fatty acid as well but not identified in the content list.

What are omega-3 and omega-6 fatty acids?

Based on dietary guideline for cholesterol, one should not exceed 300mg cholesterol daily, and shall not exceed 200mg if having any risk of cardiovascular diseases.

CoQ10 is a natural component produced in the body. Do healthy people still need to take the supplement?

Our body naturally synthesize CoQ10 and reaches its peak around age 20. Then, the CoQ10 production begins to drop as we age. For example, the CoQ10 concentration of healthy heart left about 68% when reaching the age of 40. By the age of 80, the heart has only about 42% of CoQ10. Furthermore, the CoQ10 from diet is insufficient to replenish our body need. Hence, CoQ10 supplementation is recommended to ensure maintenance of optimal CoQ10 level in the body.

Usually only elderly population be diagnosed with diabetes mellitus. Is this true?

This is not true. All population (regardless age) has the risk on diabetes mellitus. There are a few types of diabetes mellitus – type I, type II and gestation diabetes; where a reduction in the production and/or utilization of insulin causes glucose in the blood unable to be utilize effectively and keep on circulating in the blood stream.

In type I diabetes, the body unable to produce insulin due to the destruction of beta cells in pancrease. Type I diabetes usually is diagnosed in children, and they are required for insulin therapy for survival and maintenance good health.

Most common form of diabetes, accounting for about 90% of incidences. Type 2 diabetes, the pancrease either produce inadequate amount of insulin or the body unable to use the available insulin properly. Type II diabetes usually adults, and is more common in overweight or obese people.

Gestational diabetes is a temporary type of diabetes that develops during pregnancy (gestation). A woman who had gestational diabetes in one pregnancy has a higher risk of developing gestational diabetes in future pregnancies. Gestational diabetes usually reverts to normal after pregnancy, but it increases the risk of type II diabetes in the future.

How important is fish oil for your heart health?

Opt for high potency fish oil produced under intense purification and in reconstituted triglycerides (rTG) form for easy absorption and usage by the body. Let the high strength fish oil be part of your heart health maintenance regime!

What are good fats? How important are good fats to our health?

In fact, our body needs the essential fatty acid like Omega-3 (EPA & DHA) to protect us from heart disease, maintain normal brain and eye function and manage inflammatory conditions.

How to avoid soreness after exercise?
  • Boost your energy level for a rapid recovery
  • Improve muscle endurance to withstand an active lifestyle
  • Provide antioxidant protection for a healthier life
How to improve blood circulation?
  • Incorporate exercises such as jogging, swimming to increase blood-pumping abilities and to improve blood circulation 
  • Include food such as goji berries, garlic, ginkgo into your diet to promote healthy blood flow.
  • Stay away from processed food, saturated fat and trans fat
  • Get a massage to stimulate blood flow
  • Elevate your leg while lying on bed to increase blood circulation
  • Quit smoking 
What are the signs and symptoms of poor blood circulation?
  • Tingling or numbness in any of the extremities 
  • Edema or swelling of lower extremities 
  • Constant extreme fatigue 
What are the factors that affecting our blood circulation?
  • Medical conditions may limit the blood flow 
  • Increased age can cause the circulation to work less effectively compared to youngsters
  • Unhealthy diet can lead to reducing of blood flow to particular part of the body 
  • Smoking may constrain the blood flow properly
What do you know about the blood circulation in our body?

The main component of the blood circulation in our body are the heart, blood and blood vessels. The blood circulation system is important to carry oxygenated blood and nutrients to the body and waste materials away from the body tissues.

Are you getting enough of EPA and DHA?

The National Institutes of Health (NIH) recommended a daily intake of 650mg of DHA+EPA for normal healthy individuals to maintain overall health or cardiovascular care. On the other hand, for individuals with documented coronary heart disease, American Health Association (AHA) recommended a daily intake of 1 gram of EPA +DHA either from fish or supplement. 

What are omega-3 polyunsaturated fatty acids?
  • Omega-3 polyunsaturated fatty acids is a family of fats that are important for health. It can be divided into 3 forms which are alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). 
  • ALA is also known as essential fatty acid. It cannot be produced by the body and must be obtained from food such as leafy green vegetables, nuts, canola oil, flaxseed oil and soy bean oil. 
  • EPA and DHA are long-chain fatty acids that can be made from ALA in our bodies. However, the synthesis of EPA and DHA from ALA might be slow due to rate limiting factors such as aging, stress and unhealthy diet. Hence, the best way to ensure we are taking enough of EPA and DHA is by eating food rich in these fats. Example of good sources of EPA and DHA are oily fish such as salmon, tuna and mackerel. 
What are the food sources of omega-3 fatty acids?
  • Alpha-linolenic acid (ALA), an essential fatty acid, can be obtained from food such as leafy green vegetables, nuts, canola oil, flaxseed oil and soybean oil. 
  • Food sources of Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) include oily fish and seaweed
Are Malaysian population consuming enough of omega-3 fatty acids?

Based on a study conducted in 2010, the dietary levels of omega-3 fatty acids (ALA+EPA+DHA) are very low among the Malaysian Population. Intake of these omega-3 fatty acids was reported to be in the region of 0.22 – 0.28 % kcal, which is below the Malaysian recommended range of 0.30- 1.2% kcal for these omega-3 polyunsaturated fatty acids.

Why should red yeast not be taken/consumed concomitantly with prescription statins?

It is due to the risk of toxic effects and drug interactions would likely increase with ingestion of 2 similar drugs that inhibit HMG-CoA reductase.

What are the active constituents contained in red yeast rice?

Red yeast rice contains a family of 9 different monacolins, all of which have the ability to inhibit HMG-CoA reductase. Other active ingredients in red yeast rice include sterols, isoflavones and monounsaturated fatty acids. 

Which part of body cells contain higher concentration of CoQ10?

Co10 is found abundantly in heart, liver, kidney, brain and muscle cells as those organs require higher energy to function properly.

Does CoQ10 help in improving sports performance?

Yes. CoQ10 can help to improve exercise performance by maximal oxygen consumption, increase the time of exhaustion and reduce fatigue. 

How does our body generate energy to support cellular metabolism?

95% of the energy of the human body are generated in the form of ATP in aerobic cellular respiration with the presence of CoQ10 as cofactor in electron transport chain. Without CoQ10, ATP couldn’t be formed and energy couldn’t be produced effectively

What is the recommended dosage of CoQ10 supplementation?

Presently, there are no established dietary intake recommendations for CoQ10. Some researchers suggest daily doses of 30-200mg of CoQ10 for adults 19 years old and above. For those who are over 60 or on the statin drug, 150mg daily is recommended.

What are the sign and symptoms of CoQ10 depletion?

Statin users may experience symptoms such as fatigue and muscle weakness.

What are the side effects of taking cholesterol-lowering medication such as statin?
  • While reducing cholesterol level, statin at the same time also suppress the production of CoQ10 due to partially shared biosynthetic pathway. Statin usage reduces the CoQ10 level in the body, even as short period as a 2-weeks-statin-exposure.
  • It also depletes Vitamin E and zinc levels.

 

Source:

  • Ghayour-Mobarhan, M., et al, 2008. Investigation of the Effects of Statin Therapy on Serum Vitamin E Status in Patients with Dyslipidemia. Pakistan Journal of Nutrition, 7(4): 561-565
  • Ghayour-Mobarhan, M., et al, 2005. Effect of statin therapy on serum trace element status in dyslipidaemic subjects. J Trace Elem Med Biol,19 (1): 61-67
  • Marcoff, L. and Thompson, P.D., 2007. The Role of Coenzyme Q10 in Statin-Associated Myopathy. J Am Coll. Cardiol. 49:2231–22377
How frequent lipid modifying agents are prescribed in Malaysia?

According to Malaysia Statistics on Medicine 2008, lipid modifying agents, mainly statin drugs, which inhibit the cholesterol production in the human liver, is the 5th most used drugs in Malaysia.

 

Source: Malaysia Statistics on Medicines 2008

Are BiO-LiFE Fish Oil supplement free from dioxin?

We specify the raw material fish oils used in our fish oil capsules. One of the specifications which we have outlined is dioxin. Our products comply with the WHO guidelines for dioxin level.

Are there limits for peroxide value?

Yes, the limits are measured in miliequivalents per kilo (mEq/kg) and generally our fish oils are below 5mEq/kg. The common industrial standard is below 10mEq/kg.

Do you test all the batches of finished capsules for rancidity before releasing them for sale?

Yes, we do. We conduct peroxide value tests. It is generally accepted that the first compounds formed by oxidation of oil are hydro peroxides. Hydro peroxides are assessed by doing peroxide testing.

What is your choice of soft capsule gelatine? The common concerns.

A soft capsule shell is made of gelatine. In the Malaysian market we can find soft capsules encapsulated in bovine, non-animal and fish gelatine. All gelatine is derived from collagen which is the principle protein found in the skin, bone and connective tissues of animals. Bovine gelatine is derived from bones, skin and connective tissues of cattle. Bovine gelatine is by large the widely used source of gelatine in soft capsule shells. Bovine gelatine is more rigid and absorbs less moisture compared to non-animal gelatine or fish gelatine.

This property provides good stability for bovine soft capsules in the highly humid Malaysian ambient condition. However, the safety of bovine capsules raised consumer concerns after the incident of Bovine Spongiform Encephalopathy (BSE) which is also commonly known as mad cow disease. HALAL or not HALAL is also a disturbing concern for some consumers. All of BiO-Life and Efamol range of bovine soft capsules are encapsulated in HALAL certified gelatine and come with a BSE free certificate. Having said that gelatine comes from animals, is there such a thing called vegetable gelatine? The answer is NO.

However, there are many non-animal based ingredients which have similar properties as animal gelatine and can be used for capsule shells. Most BiO-LiFE range of soft capsules carry the trademark “vegicaps” and their source of capsule shell are carrageenan. Carrageenan comes from seaweed and is usually derived from red algae. It is a common ingredient that is used in many milk products like yoghurt or chocolate milk as thickening agent and has no safety concerns. The storage of vegicaps is also critical and it cannot survive harsh heat and moisture conditions like bovine soft capsules. Carrageenan is also a more expensive material compared to bovine gelatin because of its limited availability. Fish gelatine capsules can be considered the most recent entry into the Malaysian market.

Fish gelatine is derived largely from skin and bone of coldwater fish. The properties of a fish gelatine based soft capsule could closely resemble those from bovine gelatine though the odour of fish gelatine is usually stronger than bovine as capsules age. Soft capsules made from fish gelatine are perceived as suitable for some classes of vegetarians (the semi-vegetarians and pescatarians) and also has no HALAL issue. The main disadvantage for fish gelatine is that it is considered as one of the 8 major allergens by some governing regulatory bodies. The United States Food and Drug Authority requires all food products containing fish proteins including fish gelatine to be declared on the labels, failing which the product is considered mislabelled.

My 48-year-old mother has been diagnosed with borderline blood pressure. Doctor said that she does not need medications but care is needed to maintain her blood pressure. Kindly advise.

A holistic approach that combines lifestyle and dietary changes along with nutritional supplements has been found to be effective in maintaining and reducing blood pressure. Your mother should increase intake of fresh fruits and vegetables. The types of dietary fibre that are of greatest value are the water-soluble oat bran, apple pectin and psyllium seeds. It is important to reduce the intake of red meat and dairy products as they are rich in saturated fats which are known to elevate blood pressure.

Studies have revealed that diet high in sodium chloride (table salt) indirectly results in hypertension and thus, it is good to cut down on salt consumption. Include essential fatty acids such as those found in evening primrose oil (omega-6 fatty acids) and marine fish oil (omega-3 fatty acids) in your diet to lower blood cholesterol and blood pressure levels.

A supplement containing antioxidant nutrients namely beta-carotene, vitamins C, E and the mineral zinc will also be helpful in preventing the oxidation of cholesterol on arterial walls, consequently reducing the risk of high blood pressure and atherosclerosis. Lifestyle wise, avoid caffeine intake as it constricts blood vessels, aggravating a hypertensive condition. Exercise regularly (40 minutes a day, 3 times a week) and manage stress properly. Yoga, meditation or sports are examples of relaxation techniques to keep hypertension under control.

I am 50 years old and was shocked to find that my cholesterol reading is high at 7.1mmol/L. I would like to know if there are any other means to reduce cholesterol as I am worried about the side effects of statins.

Today, many people are suffering from high blood cholesterol and it may be caused by a high fat diet, excessive alcohol intake, obesity and certain health conditions such as diabetes and hypothyroidism. Lifestyle changes are the first line treatment for high blood cholesterol. These changes include a low saturated fat and high fiber diet, combined with alcohol reduction, smoking cessation, and regular exercise.

For individuals who are unable or unwilling to take statins, supplementation of red yeast rice and, omega-3 fatty acids from fish and fish oil supplements may be an alternative. Red yeast rice helps to lower cholesterol by inhibiting the activity of the enzyme (HMG-CoA reductase) involved in cholesterol production whereas omega-3 fatty acids have triglyceride-lowering properties.

A recent trial published in the July 2008 issue of Mayo Clinic Proceedings showed that supplementation of red yeast rice and fish oil combined with lifestyle changes reduced LDL (“bad” cholesterol) cholesterol levels by 42.4%, in proportions similar to standard therapy with statin. Do opt for a standardised extract of red yeast rice and a high strength concentrated fish oil supplement that contains 330mg EPA and 220mg DHA for therapeutic effects.

Tips to maintain healthy cholesterol level effectively:

  • Trim all visible fat from meat and poultry.
  • Increase your fiber intake, especially oat fiber. Opt for whole grain when buying bread and cereals.
  • Have regular physical activity, about 30 minutes between 3 and 5 times a week.
My name is Phang and I am 54 years old. What nutrients do we need for general health maintenance? I read a lot about vitamins as well as minerals and being a health-concious person, I would like to know more.

A healthy balanced diet that comprises the 5 main food groups will provide most of the nutrients needed for optimum health. However, in this modern era, one may find it difficult to have nutritious meals daily. This situation leads to dependence on fast foods and processed foods for convenience. Unhealthy diet and lifestyle, undoubtedly can affect the body’s immune system and over time, it will expose us to various health problems. Supplements are an alternative way of getting the necessary nutrients and it is meant to address deficiencies which may result from unhealthy diet or lifestyle.

 

Different individuals require different nutrients depending on diet, lifestyle and health conditions. Spirulina and fish oil are good supplements to start with. Organic spirulina contains various essential nutrients needed by the body namely protein, B vitamins, minerals, chlorophyll and enzymes. The soft and easily digested cell walls make it suitable for elderly who are unable to absorb, assimilate and utilise nutrients efficiently.

On the other hand, fish oil provides omega-3 fatty acid derivatives namely eicosapentaenoic acid (EPA) and docosahexaneoic acid (DHA) important for regulating blood pressure, muscle contractions, blood clotting and inflammation as well as heart health. Last but not least, regular exercise also improves the state of health and quality of life.

I am Sharifah and being the first time mother, I am interested to know what foods I should be feeding my 2-year-old daughter to boost her brain power.

Healthy eating and good nutrition are the foundations of growth and development.

The first few years of life are growing phases for the development of many abilities such as visual centers of the brain and language abilities. Encourage your child to eat a variety of foods to ensure a good balance of nutrients needed for optimum health and development. Fish is a food of excellent nutritional value, providing high quality protein and a wide variety of vitamins and minerals. Children should increase their intake of marine omega-3 fatty acids by eating more fatty fish like salmon, mackerel, tuna and sardines. However, you should also take note that some of these fishes can have high mercury and other heavy metal contents. 

Scientific studies have indicated that three fatty acids namely docosahexaenoic acid (DHA), arachidonic acid (AA) and gamma-linolenic acid (GLA) found in marine fish oil and evening primrose oil are essential to achieve optimal neural development (brains) and visual acuity (eye development). 

DHA is the primary structural component of tissue in the brain and retina of the eye. It is particularly important during the first 2 years of life and early childhood when the brain and eyes are rapidly growing and developing. Meanwhile, AA is required for normal transmission of messenger along nerves and proper memory function. There are a variety of fish oil supplements but it is important to get a formula that provides a combination of DHA, GLA and AA which help in learning ability, concentration and coordination. 

A daily intake of 140-280mg of DHA is beneficial. Apart from that, you may also incorporate organic spirulina 500mg in her diet. Organic spirulina, a blue-green algae, is a rich source of complete protein, vitamins and minerals essential for health. Protein provides the building block for nerves and brain, helps build and repair body tissues as well as is needed for growth and development of children.

There is growing concern that many types of fish contain mercury. How about fish oil supplement?

Mercury is bound to the meat of fish rather than its oils. During fish oil production, fish is cooked to separate the oil from the protein. This is the first step in separating mercury from the oils. Subsequently, distillation of the oil further reduces heavy metals if they are present. Most of BiO-LiFE fish oils go through a molecular distillation process to ensure the high purity of fish oil is achieved through elimination of contaminants.

Is it better to refrigerate the fish oil supplements to control the rancidity?

For the BiO-LiFE range of fish oil, it is not necessary. All BiO-LiFE products use a reputable source of fish oils with very low peroxide value post encapsulation. In addition, all BiO-LiFE products contain synergistic anti-oxidant mixture that keeps the oil in each soft gel from oxidising and turning rancid.

How do you determine rancidity in fish oil?

There would be overly fishy smells, similar to that of fish gone bad.

Is it true that fish oil in the form of triglyseride is better than the synthetic ethyl ester form?

Yes, it is true.

Omega-3 fatty acid supplements in the triglyceride form are closest to the natural form of oils. Numerous studies have shown that the triglyceride structure has a significant influence on the therapeutic effect of fish oil. 

High-quality grade fish oil should be converted from the ethyl ester form to natural triglyceride form during the manufacturing process and before it is marketed to the final users, which are you and me! This is because the ethyl ester form has been demonstrated to be 10-50 times more resistant to the digestive enzyme, lipase than the natural triglyceride form. It also has poor absorption rate. Therefore, consuming a fish oil supplement in the form of natural triglyceride offers substantially 70 per cent better absorption compared to the ethyl ester form. 

 

Ref: Dyerberg, J., Madsen, P., et al (1995) Bioavailability of n-3 Fatty Acid Formulation. Vol, 20 (Prevention and Treatment in Vascular Disease. Pg 217-225)

What is the benefit of taking a double strength fish oil?

(i) Convenience (fewer capsules dosage)

(ii) Improved palatability (lesser fishy burp)

(iii) Better consumer compliance

(iv) Greater cost efficiency which is an added convenience to many with severe conditions

I'm a housewife with three children. Lately, I have been suffering from muscle weakness and fatigue. What could be the causes of my tiredness?

Low energy and muscle weakness could be due to coenzyme Q10 (CoQ10) deficiency, vitamin B deficiencies, age, poor nutrition, prolonged exercise and emotional stress. 

 
CoQ10 deficiency occurs with age. This is probably due to a dietary deficiency in the substrates required to produce CoQ10 or an overall dysfunction of the biochemical mechanisms responsible for CoQ10 synthesis. Thus, CoQ10 supplementation may be beneficial. CoQ10 is one of the essential powerhouse nutrients for the body. It is involved in several key enzymatic steps in the production of energy and also functions as an antioxidant. 
 
Increasing your vitamin B intake may be helpful too. The B vitamins aid in energy production by participating in carbohydrate, protein and fat metabolisms. B vitamins are water-soluble vitamins that are not stored in the body. Therefore, it must be replaced daily through dietary source or supplementation. 
 
Have a well-balanced diet comprising fruits, vegetables, whole grains, seeds and nuts. These quality foods supply nutrients that renew energy. Do avoid chocolate, carbonated drinks, caffeine and highly processed foods. Apart from that, moderate exercise is also advisable. Deep breathing exercises, in particular, are recommended.
I am Kamaruddin, a lecturer in a university. I was prescribed statins by the doctor for high cholesterol levels in the blood and have been taking it consistently. However, at the same time, I often feel lethargy and sleepy.
Statins, the medications used for lowering elevated blood cholesterol levels were prescribed to you based on the high cholesterol profile. Although side effects have been reported, statin is still widely used by cardiovascular patients as it has been proven to lower levels of the “bad” cholesterol, LDL-cholesterol and thus prevent plaque build-up in the arteries. 
 
For your condition, in addition to the statin medication you are taking, coenzyme Q10 (CoQ10) supplementation is highly recommended. Clinical use of statins can be made safer and possibly more effective by the addition of coenzyme Q10. This is because studies have found that even short exposure to statins clearly lowers blood plasma levels of CoQ10. CoQ10 is necessary for ATP production in human metabolism and is an important antioxidant in human oxidation defense systems. 
 
Diet and lifestyle also play an important role in maintaining heart health. Maintaining a healthy body weight by shedding excess visceral fats will reduce your chances of an arterial blockage:
  • Regular exercise strengthens the heart, improves circulation, and lowers blood pressure. 
  • Learn to control stress by adopting new ways to relax such as deep breathing exercises, muscle relaxing techniques, meditation or yoga. 
  • Follow a well-balanced diet low in fats, salt, and cholesterol. Lowering your intake of fat cuts your risk of arterial disease.
  • Quit smoking as this is a key step in managing the arterial disease.

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