KUALA LUMPUR: The recovery phase of Malaysia's COVID-19 movement control order (RMCO) will be extended to Dec 31 and tourists will remain barred from entering the country, said Prime Minister Muhyiddin Yassin.
Speaking in a televised address on Friday (Aug 28), the prime minister said even though the number of new cases in the country has fallen, the virus is still raging globally. The RMCO phase was originally scheduled to end on Aug 31.
"I am aware that based on global developments, we will go through a lengthy period before the country can be completely free from the threat of COVID-19," he said.
"For now, the situation is controlled. However, if there is an increase in cases in certain locations, the government will take a targeted approach by implementing enhanced movement control order or targeted movement control order, as previously enforced in several locations."
He added: "This means that the government requires a legal mechanism to continue efforts to curb and control the spread of COVID-19. Hence, for the benefit of you all, the government has decided to extend the recovery movement control order until Dec 31, 2020."
He also emphasised that no individual will be excused from these laws and anyone who breaks the regulations will be punished.
Mr Muhyiddin expressed his support for the Ministry of Health (MOH) to increase the fines for those who break these laws, to twice or thrice the current amounts.
The prime minister also pointed out that the extension will ensure all parties adhere to the standard operating procedures and health protocols that have been outlined.
He added that foreign tourists are still barred from entering Malaysia during this period to prevent the spread of imported cases into the country.
The MCO, first imposed on Mar 18 to control the spread of COVID-19, was previously extended three times until May 12.
It was initially enforced when the number of daily new cases saw an alarming three-figure spike. Under the MCO, domestic and international travel was barred, and people were encouraged to stay at home to break the infection chain.
Subsequently, controls continued to be lifted over time. Daycare centres, hair salons, beauty parlours, open markets and night markets were given the green light to reopen.
Malaysia later entered the RMCO phase from Jun 10, where almost all social, educational, religious and business activities, as well as economic sectors reopened in phases, with standard operating procedures to be adhered to. Interstate travel was also permitted while the country's borders remained closed. The current control order, which began on June 10, was due to expire on Monday.
Four months of efforts seemed to have paid off as Malaysia began to report mostly single-digit increase in daily new cases - and even zero local transmission on a few days - until new clusters emerged.
On the back of 13 new clusters detected during the RMCO phase, Mr Muhyiddin had earlier reminded Malaysians to comply with social distancing rules and warned the public not to be complacent.
On Aug 3, Malaysia's Senior Minister (Security Cluster) Ismail Sabri Yaakob announced that the wearing of face masks was compulsory in crowded public areas, including markets, supermarkets, tourist areas, cinemas and on public transport.
Four Chinese COVID-19 vaccine candidates have started
international phase-3 clinical trials, according to the State Council
joint prevention and control mechanism against COVID-19.
Star-studded study group: Sunway University students studying at the
communal areas on their campus accompanied by cardboard cutouts of
celebrities like Nicol David and Ed Sheeran. — ART CHEN/The Star
Colleges and universities take own initiative to make campus safer
It’s all systems go for the country’s higher education institutions as they wait to welcome students again after face-to-face learning came to a halt when the movement control order (MCO) was announced on March 18.
Both private higher educational institutions (IPTS) and public higher educational institutions (IPTA) have taken the necessary safety precautions and made arrangements for the return of their students.
They are now waiting for the related standard operating procedure (SOP) from the Higher Education Ministry, which is expected to be released soon.
“We have prepared the documents. They are currently pending approval from the Prime Minister’s Office to be released,” a ministry official told The Star yesterday.
Malaysian Association of Private Colleges and Universities (Mapcu) president Datuk Dr Parmjit Singh said its members had taken precautionary measures to maintain the safety standards of its campuses and facilities since the start of the pandemic.
“We are fully prepared to open and are just waiting for an official announcement to see how operations will be managed because so much depends on the ministry’s SOP,” he said in response to Senior Minister Datuk Seri Ismail Sabri Yaakob’s announcement on Wednesday that the National Security Council has approved the ministry’s proposal to reopen the institutions.
Ismail Sabri said the country’s Covid-19 outbreak had stabilised and the reopening of these institutions would include allowing foreign students to return.
National Association of Private Educational Institutions (Napei) president Assoc Prof Elajsolan Mohan said the IPTS had ensured that the learning environment was safe.
“We are ready and are following international best practices because we have many international partners. We already have measures in place. The security and safety of students will continue to be our top priority,” he said, adding that sanitation activities had been carried out.
He said the institutions had been looking forward to resuming classes because they were concerned about some “technologically disadvantaged” students who were unable to access certain online classes due to the lack of Internet connectivity.
Its members will also allow staff to alternate between coming to campus and working from home while students can opt for blended learning (a mixture of face-to-face and online learning).
“One way to ensure crowd control on campus is to let students who have to commute and those in Sabah and Sarawak to use remote learning,” he said.
He added that institutions must address the issue of student assessment resulting from the difference in learning methods over the past four months.
Sunway Education Group’s chief executive officer Elizabeth Lee said students would be returning to the campus in stages this month.
And they will be greeted by some “fun social distancing companions” like Henry Golding, Datuk Lee Chong Wei, Datuk Nicol David, Chef Wan, Ed Sheeran, BTS’ Jungkook, Rowan Atkinson and Jack Ma – in the form of cardboard cutouts.
She said the “social distancing companions” placed on seats around campus would be effective in discouraging people from sitting too close to each other.
“Instead of the usual ‘X’, the cutouts of well-known personalities, which have been placed strategically at communal study areas, double up as fun photo props for students to take selfies with their favourite celebrities.”
Taylor’s University School of Food Studies and Gastronomy head Siti Ramadhaniatun Ismail said all of the the institution’s culinary arts students in semester one and finalyear students were allowed back on campus from Wednesday for their practical classes.
“They need to attend their practical classes to sharpen their practical skills component,” she said.
Universiti Sains Malaysia (USM) acting deputy vice-chancellor (academic and international) Prof Datuk Dr Ahmad Farhan Mohd Sadullah said the varsity had been quiet without students.
“We have precautionary measures in place and these take into account the many possible scenarios involving the movement control order (MCO).
“We have worked diligently to make sure our campus is a safe zone when the pandemic was at its worst.”
USM had initially planned to welcome students back next year, in accordance with the government’s earlier announcement that e-learning would continue until Dec 31.
“We will modify the current SOP to accommodate students who will be returning soon,” he said, adding that crowd control will not be a problem as USM will implement blended learning.
“We are only expecting students to return in early October as USM is almost finishing its second semester – students will soon be enjoying their holidays,” he said.
Universiti Putra Malaysia (UPM) deputy vice-chancellor (academic and international) Prof Dr M. Iqbal Saripan said all its faculties were opened to research and certain final-year students on Wednesday.
He said UPM had implemented a system to track the movement of its staff and students using a QR code.
The “reopening process” will continue in phases until next February.
“Twenty-five percent of our student body is on campus now. We hope that we can increase the number gradually, especially for research students.
“We allow staff, who are in the high-risk group and have small children, to work alternate days from home. But it won’t be a problem if they all choose to come to work.
“Reopening of the higher educational institutions is good news, but we need to ensure international students who are still overseas can access the classes while the borders are still closed.”
Noting that students are eager to return to life on campus, Universiti Kebangsaan Malaysia (UKM) vice-chancellor Prof Datuk Dr Mohd Hamdi Abd Shukor said the existing SOP would be revised once the new advisories and directives are announced.
UKM has been operating at capacity as of June 10.
“Working from home only applies to certain staff who are in high-risk groups or have medical conditions.
“Lectures were offered in sessions and with a limited number of students,” he said.
He added that students who feel uncomfortable returning to campus can continue with online learning.
Universiti Malaysia Sarawak (Unimas) vice-chancellor Prof Datuk Dr Mohamad Kadim Suaidi said final-year students who require facilities such as the laboratory, studio and workshops, as well as students who need to complete industrial training on campus, can already return.
“We are also planning to allow students who lack electrical gadgets and are facing Internet connectivity limitations to return to campus to continue with their lessons using campus facilities.
“However, this needs the ministry’s approval first. If approved, we will observe the SOP strictly whereby there will not be more than 25% of the student body on campus, and facility usage will not exceed 50% of its capacity,” he said in a press release.
He added that the university would monitor students who use the facilities through its “We Care” application, an online application which can track movement in realtime.
“New pre-university students will be allowed to come to campus in stages starting August, while new postgraduate students can start returning in October,” he said. full
The first phase of the reopening of childcare centres will start on June
15 and more will be allowed to open in the next phases. — Filepic
THE Penang government has agreed to allow all 120 registered childcarecentres (taska) to operate in stages, says state welfare and caring society committee chairman Phee Boon Poh.
He said the first phase of the reopening involved 26 centres starting from June 15 and more would be allowed to be open in the next phases.
“Since June 1, the state government and several other agencies, notably Welfare Department, have been conducting surveillance at the taska centres during the conditional movement control order (MCO).
“During the surveillance, the operators’ compliance level of the standard operating procedure (SOP) was scrutinised.
“The detailed reports were sent to me,” he said in a recent statement.
Phee said only nine taska were allowed to open in the state.
There are 15 public taska in the state.
“Overall, the compliance rate is at a satisfactory level.
“The attendance of kids is still at the minimum and the centres operate at 50% of their capacities,” he said.
He said the state government’s intention to allow private taska to operate had to be postponed to June 15 following additional SOP imposed by the Health Ministry on June 1.
He said regulations on matters such as cleanliness, isolation room preparation, sanitisation and prevention of gatherings must be channelled to parents and be taken seriously.
He said this was to ensure that there would be no risk of the virus spreading among children.
In ensuring compliance, taska operators must get the operating permission letter from the state Welfare Department after inspection is complete.
They must ensure that the total capacity of children in their premises does not exceed more than 50%, among other requirements.
.Covid-19 can affect our blood vessels, causing blood to clot more easily, which can result in stroke, heart attack or pulmonary embolism, among other conditions - AFP
Covid-19 can have a wide-ranging effect on many organs in our body
THE last time, you were telling me about many unusual Covid-19 symptoms, such as Covid toes, skin rashes. and loss of smell and taste (From taste to toes, StarHealth, May 31). What about the gut?
Yes. The SARS-CoV-2 virus that causes Covid-19 binds to our lung cells using the cell’s ACE2 (angiotensin-converting enzyme 2) receptor.
This receptor is also present in our intestinal cells.
The theory is that the virus is in our saliva.
When we swallow our saliva, the virus gets into our guts and binds to our intestinal cells using their ACE2 receptors.
Once this happens, we get diarrhoea, nausea and vomiting.
Sometimes, a Covid-19 patient may only experience these symptoms, without any lung problems like a dry cough or difficulty breathing.
Covid-19 patients with gut problems tend to be diagnosed later and have longer infections.
On average, Covid-19 patients have diarrhoea for five days.
Wait, if Covid-19 patients have diarrhoea, does that mean we have to be careful about using toilets then?
Yes. For example, if one of your family members has Covid-19, it might be advisable to allocate one toilet for their use only, or at least allocate one toilet paper roll for their sole use.
You should also disinfect the toilet seat the patient is using after each use and wash your hands.
I have also heard of the kidney being affected?
You are right.
It occurs through the same mechanism; the kidney also carries ACE2 receptors on its cell membranes.
Some studies are finding that as much as one-third of Covid-19 patients admitted to hospital, develop kidney problems, resulting in acute renal (kidney) impairment, or worse, outright acute renal failure. Some patients even require dialysis.
Patients who develop kidney problems are usually the ones who also have the worst lung symptoms.
It may be that the amount of virus in them is very high and/or their immune system is acting up very badly.
When the immune system is heavily provoked, what happens is that it releases a cytokine storm.
The blood vessels are affected and they start to leak fluid.
When there is less fluid going into the kidneys, they do not get enough oxygen and their tubular cells get damaged.
Gosh! What are the other organs Covid-19 affects?
There is also the liver. Once again, this is an organ with cells rich in ACE2 receptors.b
Over half the patients hospitalised for Covid-19 develop some kind of liver impairment.
This is diagnosed by a blood test showing elevated liver enzymes.
Luckily, the liver is not usually affected so badly by Covid-19 that it results in acute liver failure.
The theory for this is that the kidneys may be directly affected by the virus, but the liver is not, and any ill effects on it are more a result of the body’s own cytokine storm.
I really think I don’t want to risk getting Covid-19! Are there any other organs affected?
You are wise. It really is not worth the risk as we can be one of those that are affected very badly.
As for your question, the brain is also affected.
The brain? How?
It has all to do with the ACE2 receptors again.
You see, many blood vessel cells also have these receptors.
As blood vessels are present all over our body, any effects on them are not restricted to a specific organ, like the lung, kidneys and intestines.
So if Covid-19 directly affects the blood vessels of a patient, they will cause blood clots more easily as they are damaged.
In autopsies done on deceased Covid-19 patients, blood clots are apparent throughout many organs in their bodies.
This suggests that many blood vessels and organs are affected by the disease.
Once you have blood clots, you may have complications like stroke where blood clots travel to the arteries of the brain and clog them up.
Doctors have also observed patients with dizziness, confusion, delirium, altered mental state and muscle weakness.
This has to do with the brain getting inflamed.
Wait, when blood clots form in blood vessels, not only a stroke can happen, right? This can also cause a heart attack.
True, blood clots can lead to a heart attack or a pulmonary embolism when a clot gets into your lungs
In fact, Accident and Emergency departments in some hospitals have received patients with heart attacks who turn out to have Covid-19 when they were tested.
Covid-19 can also attack the heart directly by inflaming the heart muscles.
This is known as myocarditis.
It can lead to chest pain, abnormal heart rhythms and heart failure.
There is also a condition called “happy hypoxia”.
This is when a Covid-19 patient has very low levels of oxygen as shown on the monitor, but appears to be breathing more or less normally.
Many doctors have theorised that this condition could be due to blood clotting in the lungs.
DR.Y.L.M
Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, email starhealth@thestar.com.my. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information
Here are nine ways to strengthen your body’s defence system against illnesses through healthy eating and daily habits.
dehydration makes you more susceptible to
falling sick, so ensure that you fill up on fluids, especially if you
are outside under the hot sun.— Filepicb
LATELY, we’ve all been wondering if we are doing enough to keep our bodies strong and warding off illnesses.
One critical way to ensure that you have a fighting chance is to boost your immunity.
The immune system is made up of organs, cells, tissues and processes
that fight against germs and toxins trying to enter our body.
You can bolster your immune system by making good lifestyle and food choices; and you’ll see results by being consistent.
Your body will feel healthier, you’ll have more energy and you’ll spend
less time waiting to see the doctor for a common ailment.
It’s important to note, however, that no matter how strong an immune
system is, you cannot stop bacteria and viruses from entering your body.
In order to avoid contracting a dangerous disease like Covid-19, you
should still practise social distancing, wear a mask and wash your hands
frequently.
So just to be clear, the tips below are not to protect specifically
against Covid-19, but to help you boost your immune strength to fight
off all types of infections.
Get the proper amount of sleep
Adults need an average of seven to eight hours of sleep every night.
Teens need eight to 10 hours, and younger children and infants up to 14 hours of sleep daily.
A lack of sleep or poor quality sleep has been linked to a higher
frequency of falling sick, leading researchers to believe that sleep and
immunity have close ties.
Also, sleeping for longer periods when sick, lets your immune system fight illnesses more effectively so that you heal faster.
In a study involving 164 healthy adults, those who had less than six
hours of sleep per night were more susceptible to colds, compared to
those who had at least six hours of sleep.
To avoid having trouble falling asleep, there are several things you can do:
> Keep your room completely dark, e.g. close the curtains fully, remove any night lights or use a sleep mask.
> Keep your bed time consistent, even during weekends and holidays.
> Exercise regularly, even if it’s just brisk walking for 20 mins a day.
> Limit screen time (TV, phone,
laptop) at least an hour before bed in order to prevent the impact of
blue light from disrupting your circadian rhythm (your body’s natural
wake-sleep cycle).
Eat lots of whole plant foods
Whole plant foods like vegetables, nuts, seeds and fruit are rich in antioxidants, vitamin C and fibre.
Eating more of these nutrientdense foods helps to lower your risk of infections.
This is because the antioxidants in the foods decrease inflammation by battling unstable compounds known as free radicals.
Chronic inflammation has been found to occur more frequently in patients
with heart disease, Alzheimer’s disease and certain cancers, so it’s
important to find effective ways to reduce inflammation.
At the same time, whole plant foods are high in fibre and feed your gut
microbiome (the community of healthy bacteria in your gut).
A robust gut microbiome can improve your immunity and help keep harmful
pathogens from entering your body via your digestive tract.
Additionally, other nutrients found in whole plant foods, like vitamin C, may help to reduce symptoms of the common cold.
Eat foods like papaya, broccoli, spinach, garlic, ginger, bell peppers and kiwi fruit.
Consume healthy fats
Sunflower seeds or kuaci, in this filepic are good source of healthy fats.
Healthy omega-3 fats have anti-inflammatory properties.
These fats could be a key weapon in fighting against illnesses,
considering that chronic inflammation prevents your immune system from
performing at its best.
Healthy fats can be found in foods such as olive oil, salmon, chia seeds, sunflower seeds and almonds.
Olive oil, in particular, is highly anti-inflammatory, and has been
known to decrease the risk of chronic problems like heart disease and
type 2 diabetes.
The anti-inflammatory properties of these healthy fats may be critical
to helping your body fight off harmful disease-causing bacteria and
viruses, so try to get more of it in your diet now.
Have more fermented foods
We are learning that immunity and gut health are intertwined.
Your digestive tract contains beneficial bacteria (probiotics) that you
can increase in amount by eating fermented foods like yoghurt,
sauerkraut, kimchi, kefir and natto.
This may help strengthen your immune system by helping it to identify
harmful microorganisms as a healthy ecosystem of gut bacteria teaches
your immune system how to tell the difference between good bacteria and
bad bacteria (pathogens that cause problems).
In a three-month study in 126 children, those who drank 70ml of
fermented milk every day were found to have less childhood infectious
diseases by about 20%, compared with a control group.
Another study of 152 people infected with a rhinovirus found that those
who supplemented with the probiotic Bifidobacterium animalis had a much
better immune response and lower levels of the virus in their nasal
mucus.
Cut your sugar intake
A high intake of sugar and refined carbohydrates contribute to obesity, heart disease and other conditions that disrupt your
immune system.
According to an observational study in around 1,000 people, obese people
who were administered the flu vaccine were twice as likely to still get
the flu, compared to non-obese individuals who received the vaccine.
Curbing your sugar intake can decrease inflammation and aid weight loss, thus reducing your risk of chronic health conditions.
Strive to keep your added sugar intake to 5% or less of your daily
calories, which is equal to about two tablespoons of sugar for a
2,000-calorie diet.
Throw in some exercise
Moderate exercise can give your immune system a boost.
Studies indicate that even a single session of moderate exercise can
boost the effectiveness of vaccines in people with compromised immune
systems.
By making it a regular routine, moderate exercise helps your immune cells to regenerate often and reduce inflammation.
Some types of exercises you can do include brisk walking, indoor cycling, jogging, swimming and hiking.
Aim for a minimum of 150 minutes of moderate exercise per week.
Drink enough fluids
Dehydration paves the way to making your body susceptible to falling sick.
Without enough water, you may experience headaches and hinder your
physical performance, focus, mood, digestion, and heart and kidney
functions.
Hydration itself doesn’t protect you from germs and viruses, but dehydration increases your susceptibility to illness.
To know that you are drinking enough water regularly, the colour of your urine should be a clear, light yellow.
Plain water is the best option to stay hydrated – it is free of calories, additives and sugar.
You will need more fluids if you exercise a lot, work outside or if the weather is hot.
Keep stress at bay
Reducing anxiety and stress will help to improve immune health.
In the long run, stress increases inflammation and messes with your hormonal balance and immune cell function.
Long-term stress is especially taxing on children, weakening their immune response
Activities that are often recommended to help people manage stress
include exercise, journaling, drawing or painting, meditation, outdoor
walks and other mindfulness practices.
If you feel a need to express how you feel to someone, then seeing a certified counsellor or therapist can help.
Supplement wisely
;
Two things to note about supplements: the first is that they are not a
replacement for a well-rounded diet, and the second is that they don’t
guarantee that you will be free from getting sick.
Some studies however, have found that supplements may fight off viral
infections, or at least give your immune system a helping hand in
staying strong.
If you would like to take supplements, choose wisely.
Here are some vitamins and minerals to consider taking that may help improve your immunity:
> Vitamin E
This vitamin is a powerful antioxidant that helps the body fight off
infection, and is found in foods like nuts, seeds and spinach.
> Zinc
A peer review of 575 people with the common cold, who took more than 75
mg of zinc per day, reduced the duration of their cold by one-third,
compared to those who didn’t take the supplement.
> Vitamin D
A deficiency in this vitamin may increase your chances of getting sick, so supplementing may counteract this effect.
> Vitamin B6
This vitamin is vital to supporting biochemical reactions in the immune system.
Vitamin B6-rich foods include chicken, cold water fish such as salmon and tuna, green vegetables and chickpeas.
The bottom line is that improving your lifestyle and making better
dietary choices can help strengthen your immune system to fight off
harmful pathogens and keep you healthy and well.
By Datuk Dr Nor Ashikin Mokhtar,
who is a consultant obstetrician and
gynaecologist, and a functional medicine practitioner. For further
information, email starhealth@thestar.com.my. The information provided
is for educational and communication purposes only and it should not be
construed as personal medical advice. Information published in this
article is not intended to replace, supplant or augment a consultation
with a health professional regarding the reader’s own medical care. The
Star does not give any warranty on accuracy, completeness,
functionality, usefulness or other assurances as to the content
appearing in this column. The Star disclaims all responsibility for any
losses, damage to property or personal injury suffered directly or
indirectly from reliance
on such information
When muscles shrink
Despite having normal nutrition, many senior citizens actually have low muscle mass, making them more prone to falls and fractures.
MUSCLE loss or sarcopenia is a natural part of ageing and one of the main contributors to musculoskeletal impairments in the elderly.
Photo: 123rf.com
Photo: 123rf.com
Strong muscles support the joints as they help absorb the stress placed on the joints when you move.
Without adequate muscles, the joints take a beating, and can cause the individual to become frail and more likely to suffer from falls and fractures.
The 2018 Malaysian National Health and Morbidity Survey (NHMS) reported that 15% of those aged above 60 had fallen at least once over 12 months.
Half suffered injuries, while one in five were hospitalised.
Even if you are active, it is still possible to have some muscle loss beginning in your 30s.
However, there are steps you can take to slow down or prevent losing muscle.
Missing muscles
According to Asia’s largest clinical study of its kind on nutritional outcomes in the elderly, there was a prevalence of low muscle mass among the elderly, despite them being active, healthy and without any chronic medical illnesses.
The two-part Singaporean study, called Strengthening Health in Elderly through Nutrition (Shield), was jointly carried out by Changi General Hospital (CGH), Sing Health Polyclinics and healthcare company Abbott.
Results from the first phase of the study was published in the Plos One journal last year.
This observational phase looked at 400 healthy individuals in Singapore aged 65 and older.
The results revealed that the prevalence of low muscle mass was higher in females (24.9%) than in males (15.5%), with even adults with normal nutritional status at risk for having lower muscle mass. (See Maintaining muscles during menopause).
Every one-year increase in age over 65 years was associated with 13% higher odds of having low muscle mass.
And 52% of participants had vitamin D insufficiency despite living on an island where sunshine is available the whole year round.
“The majority (93%) of the subjects were fully independent and self-caring in the community.
“All the subjects were living at home and able to walk independently without any walking aids, and were relatively active prior to the study
“Participants were not subjected to any exercise programmes before or during the study.
“We assessed their physical activity level using the PASE (Physical Activity Scale for the Elderly) questionnaire.
“The average PASE score of the study participants was 119.45, similar to the norm of older adults,” says principal investigator Dr Samuel Chew, adjunct associate professor and senior consultant at the geriatric medicine department at CGH.
However, the subjects’ daily diet was not collected in this first part of the study.
A combination of physical activity, which includes weights or resistance training, and a balanced diet with an adequate amount of high-quality protein (e.g. chicken breast, fish, eggs, tofu and other soya products), is essential for good muscle health and function.
However, many seniors don’t embark on strength training programmes and cite difficulty in chewing meats and poultry due to deteriorating teeth, so they avoid eating protein or get little of it in their diets.
Assoc Prof Chew says, “We are unable to comment on the possible reasons for the observed low muscle mass, but from the available literature, there is a measurable decline in muscle mass from the age of 40.
“The decline rate increases by about 8% every 10 years and accelerates after the age of 70 to about 15% every 10 years.
“There are many factors that contribute to this loss in muscle mass, such as changes in hormone and endocrine levels, the loss of connections between the nerves and muscle units with the onset of ageing, acute or chronic illness, and inactivity.
“In addition, those above the age of 65 require more dietary protein in order to stimulate the same amount of muscle protein synthesis as a young person.”
Other factors that may impact elderly diets are:
> The lack of knowledge about good nutrition
> The lack of awareness about the high prevalence of low muscle mass and inadequate levels of micronutrients such as vitamin D
> Poor oral health
> Loss of appetite due to physiological and sensory/taste changes associated with ageing
> Living alone
> Other illnesses
> Use of multiple medications
Get some sunshine
As for the lack of vitamin D, it is apparently common in older adults.
“The results from our study are consistent with previous studies performed in Asia.
“Therefore, while the finding is not unexpected, it still poses a cause for concern.
“Vitamin D is produced in the body naturally when the skin is exposed to sunlight.
“It is also found in dietary sources such as dairy products, oily fish, eggs and mushrooms.
“As such, it is likely that the vitamin D insufficiency is related to a lack of exposure to sunlight and/or insufficient intake of vitamin D-rich food sources,” explains Assoc Prof Chew.
To overcome this deficiency, one method is to get 15 minutes of exposure to outdoor sunlight daily.
He asserts, “It is vital for the activity to take place outdoors, as the component of sunlight that stimulates the production of vitamin D in the human skin does not penetrate glass windows very well.
“However, be mindful of direct overexposure to sunlight, which may result in skin damage and other health complications.”
The Shield study compares to a similar European ageing study that was carried out in Berlin, Germany, where the prevalence of sarcopenia was 24.3%.
“Many factors can affect the results, such as the characteristics of the study participants, methods used to measure muscle mass and cut-off criteria used to define low muscle mass, and participants’ nutritional status.
“The study conducted in Europe included generally healthy community-dwelling older adults who may have had normal nutritional status or were at risk of malnutrition, which is a risk factor for low muscle mass.
“Therefore, the true prevalence of low muscle mass in the general population aged 65 years and above in Singapore is likely going to be higher than the prevalence observed in our study, as they would include individuals who are at risk of malnutrition,” says study co-investigator and Abbott Scientific & Medical Affairs divisional vice-president Dr Low Yen Ling.
While no similar studies have been carried out in Malaysia, it is believed that our elderly could also be having low muscle mass.
Statistics from the Global Burden Disease Study 2010 shows that the lifespan of Singaporean men is 78.8 years, and for women, 83.3 years. So, even with lower muscle mass, women are living longer.
Dr Low reflects: “Biological, behavioural, and environmental factors can all contribute to this topic.
“One possible explanation is that men smoke more often than women.
“Some evidence also suggests that although both men and women are living longer as the burden of infectious diseases falls, such reduction may disproportionally benefit women.
“This is an ongoing effort and researchers are still studying how all these potential factors influence life expectancy and ways to improve longevity.
“What we know is that scientific evidence has shown that low muscle mass is associated with negative outcomes such as higher risk of functional impairment, fractures, complications, and even mortality.”
Less muscles, poorer immunity
Skeletal muscle accounts for about 40% of total body weight and contains at least half of all body proteins.
Data suggests that loss of muscle mass is associated with compromised immunity and infections.
Research in older adults has shown increased markers of inflammation associated with low muscle mass and muscle function.
Immunity is affected if an older adult loses more than 10% of their lean body mass, while a decrease of more than 30% can make them susceptible to pneumonia.
This is probably because muscles produce and release compounds that play an important role in the proliferation, activation and distribution of certain immune cells.
Assoc Prof Chew says, “Hospitalised patients with pneumonia may have poor outcomes, and this is often associated with very low muscle mass and poor nutrition – two factors that are also linked to a weakened immune system.
This is because muscles are a natural reservoir of amino acids, which are required for proper functioning of the immune system.
“Decreased muscle mass, together with the associated loss of physical strength and function, can lead to an impaired recovery from critical illness.
“Infection in an individual with deficient muscle mass causes further inflammation in the body, which can cause further loss of muscle mass and impairment of the immune system, resulting in a vicious cycle that may ultimately result in poor health outcomes.”
To help preserve muscles, Dr Low provides these tips:
> Engage in regular exercise
Aim for at least 150 minutes of moderateintensity exercise a week, and include resistance training to maintain muscles and strength.
> Eat enough protein
Incorporate chicken, seafood, eggs, beans or dairy into your diet, and aim for about 20-30g per meal.
Adults 65 years and above may need up to 50% more protein than younger adults.
To further amp up protein intake, snack on proteins between meals or supplement your diet if needed with protein powders or shakes.
> Follow a balanced diet
Choose a balanced diet full of vegetables, fruits, whole grains, proteins, healthy fats, and key vitamins and minerals like calcium and vitamin D.
> Consider HMB (beta-hydroxy-betamethylbutyrate)
HMB is a metabolite of the essential amino acid leucine and a naturally-occurring compound that has been shown to preserve muscle mass in healthy older adults when taken as a supplement.
While HMB is naturally found in very small amounts in foods such as avocados, grapefruit and catfish, it’s hard to get enough from food sources alone to achieve the desired health benefits.
Having healthy muscles is critical to ensure that the elderly can continue to retain their mobility, strength, energy levels and independence as they age – the Shield study reinforces that.
There is also a correlation between skeletal muscle and bone health – healthy muscles link to healthy bones, but strong bones do not necessarily mean that the muscles are strong.
Dr Low suggests: “It is important to perform early screening to identify those who have low muscle mass, so that appropriate interventions can be implemented.
“Muscle health can be determined by using a handheld dynamometer (to test hand grip), measuring calf circumference or measuring muscle mass using the bioelectrical impedance analysis (BIA).”
The second phase 2 of the Shield study, to be completed this year, will involve 800 elderly participants at risk of being malnourished, who will be placed on oral nutritional supplements.
The aim is to find out how the supplement will affect their nutritional status, and their rates of hospital admission and re-admission.
The signs of muscle loss
Maintaining muscles duringmenopause
NEW European research has found that keeping physically active during menopause could help women maintain muscle mass.
Keeping active during menopause can help maintain a woman’s muscle mass, which is important to staying active and independent.—AFP
Carried out by researchers at the University of Jyväskylä, Finland, the new study looked at 234 women aged 47 to 55, who were followed from perimenopause to early postmenopause, which is the stage after menopause when menstruation has permanently stopped.
The women had their muscle mass measured and hormone levels tested in the perimenopausal state and right after entering postmenopause.
The women were also asked to self-report their physical activity levels and wear an accelerometer for seven days, which is a wearable device that records movement.
The findings, published in the Journal of Clinical Medicine, showed that the average duration of menopausal transition was one-and-ahalf years, although the researchers note that the time it takes to go through menopause is unique for each woman.
For some of the women in the study, it took less than six months, and for others, it took more than three years.
The researchers also found that during this time, the women experienced significant decreases in various measures of muscle mass, with an average of a 1% decrease in muscle mass.
However, women who were more active during the menopausal transition had higher muscle mass before and after menopause, compared to the less active women.
The researchers say this highlights the importance of keeping active during the transition from perimenopause to postmenopause, when the production of oestrogen stops and leads to a decline in muscle mass.
“We already knew that oestrogen has a role in the regulation of muscle properties,” says doctoral student Hanna-Kaarina Juppi.
“By following the hormonal status, measuring many aspects of muscles, and by taking into consideration the simultaneous chronological ageing of women going through menopausal transition, we were able to show that the decrease of muscle mass takes place already in early postmenopause.”
She adds: “The observed change does not seem like much, but what is meaningful is that the decline happens in a short period of time and can have an impact on metabolism, as muscles are important regulators of whole-body metabolism.” – AFP Relaxnews
Physiotherapy for stroke patients is not just about exercises and
movement, but also incorporates technology such as functional electrical
stimulation and virtual reality. — Photos: SUNWAY MEDICAL CENTRE
VELOCITY
Protein shakes have divided nations! Some will be critical of the
singlet toting gym junky’s protein shaker and others will feel inspired
to shake themselves. So should you protein shake?
To shake or not to shake?
One quality scientific review, found protein supplementation with
resistance training to increase muscle mass more than resistance
training alone. Additionally, in conjunction with a healthy diet protein
supplementation can aid in fat loss (1). A further review study found
protein ingestion with resistance training to increase muscle mass,
strength, explosive power and power during endurance based tasks more
than resistance training alone (2). This tells us you should get
shaking!
What, when, how to shake:
If it is an entire protein supplement you are consuming such as whey
powder, then consuming the product within 30 minutes post workout
appears to offer maximal strength and muscle mass benefits (3).
Consuming protein after a workout becomes even more effective when it is
consumed with a high GI carbohydrate like glucose or maltodextrin. Try
adding a spoonful of honey to your shake or buy maltodextrin powder and
add a sprinkle.
Amino acids are the building blocks of proteins and one such amino acid
is Leucine. It appears that protein supplements containing 3-4g per dose
of leucine most optimise the amount of protein effectively used
(synthesised) by the body. Consuming any normal whey protein should
achieve this.
Alternatively, If you consume an isolated amino acid supplement (more
expensive), you’re best taking this pre-workout. Although these are more
expensive than protein supplements and confer no further benefit (3).
China will make its Covid-19 vaccine a global public good when it is ready for application after successful research and clinical trials, a senior Chinese official said.
Finding a cure: An engineer conducting tests on an experimental vaccine for Covid-19 at a laboratory in Beijing
.
Wang Zhigang, minister of science and technology, said at a press conference in Beijing yesterday that international cooperation should be strengthened in vaccine development, clinical trials and application.
Vaccine development should focus on ensuring safety, effectiveness and accessibility, he added.
To date, four inactivated vaccines and one adenovirus vaccine had been approved for clinical trials, said a white paper titled “Fighting Covid-19: China in Action”, which was released by the State Council Information Office yesterday.
While scientists in China and abroad had kept up with mutual developments, China led the world in the development of certain types of vaccines, the white paper said.
A great deal of international cooperation had been carried out so far in terms of vaccine development, according to Wang.
Highlighting the significant role that vaccines had played in human history, Wang said both Chinese scientists and those in other countries were trying to make contributions to building a global community of health for all.
He, however, noted that the development of vaccines is a rigorous and complex procedure, which faces many uncertainties and may take a long period of time.
Wang also said drug research and development had been a priority in the efforts of fighting the pandemic in China since the very start, with more than 160 research institutes and enterprises taking part in various programmes.
Meanwhile, Ma Xiaowei, minister of the National Health Commission, said at the press conference that China would strengthen the building of public health emergency response system as the Covid-19 pandemic had exposed flaws in the country’s medical and public health system.
The country would improve the investment mechanism on public health system so that it would be in a better situation to handle disease prevention and control, he said.
Different levels of disease prevention and control centres would have a clearer definition of their functions, with the Chinese Centre for Disease Control and Prevention making the final decision on scientific research, testing, guidance and pathogenic analysis on epidemic diseases, Ma added.
“Moreover, we will further improve the reporting and warning system of major public health incidents by building public opinion monitoring system, reporting system by medical workers and reporting system on scientific findings,” he said.
There would also be new policies in cultivating more talents in public health and improving their treatment, especially talents in pathogenic detection, epidemiological investigation, laboratory testing and analysis on epidemic situation, he added.
China could have Covid-19 vaccine ‘ready for public use early next year’
Three vaccines developed by Chinese companies and researchers are in their second or third phase of trials. - Reuters
China may have a vaccine against the deadly Covid-19 for emergency use by September and for the general public early next year, a top Chinese public health expert has said..
This is the first time a Chinese official has put an estimate on the timescale for development of a coronavirus vaccine, believed to be the key to containing the global pandemic. The US Food and Drug Administration believes a vaccine in the United States could be at least a year away, and the World Health Organisation (WHO) has said that it could take 12 to 18 months..
Gao Fu, head of the Chinese Centre for Disease Control and Prevention, on Thursday told China Global Television Network, the overseas arm of the state broadcaster, that vaccines currently at phase two or three of clinical trials could be available by the time of a potential second wave of outbreaks. Three Chinese vaccines have completed the first phase of trials.
“We are in the frontline for the vaccine development, and we may have a vaccine ready for emergency use by September,” Gao said. “These newly developed vaccines, which are still under phase two or phase three clinical trials, could be used for some special groups of people, for example health care workers.”.
https://youtu.be/WsUFEd1_bws br />
Gao added that “we may have a vaccine for the healthy population early next year”, but stressed that its feasibility would depend on “progress of our development”..
Unlike influenza – whose frequent mutations must be anticipated by vaccine makers preparing for seasonal outbreaks – Sars-Cov-2, the virus that causes the disease Covid-19, is believed not to mutate as often and is unlikely to become a “new norm” such as seasonal flu, according to virologist Shi Yi, of the Institute of Microbiology, Chinese Academy of Sciences..
“Some experts believe the epidemical new coronavirus will become a norm and spread like the influenza virus... but [we believe] such probability would be relatively low,” Shi told reporters at a regular briefing in Beijing on Thursday. “At present, there is no evidence that the new coronavirus has the same variability as influenza virus.”.
https://youtu.be/8oQM48rToSc
Shi also rejected the possibility of Covid-19 becoming a chronic illness, given that the virus multiplies mainly in patients’ respiratory tracts and no continuous virus carrying has been observed. He added that the same was true of the century’s two other known coronavirus-induced diseases, severe acute respiratory syndrome (Sars) and Middle East respiratory syndrome (Mers)..
As the coronavirus has swept the globe and infected more than 2.7 million people, causing nearly 200,000 deaths, scientists have raced to develop a vaccine to combat the pandemic. By Thursday, six candidates had entered into clinical trials and 77 others were in preclinical studies, according to the WHO..
https://youtu.be/vfL7DzdNl54
Newly added to the group being trialled was a viral vector vaccine developed by a team of researchers from the University of Oxford, which was injected into its first two volunteers on Thursday and was based on a technology used to develop a vaccine for Mers..
The team’s leader, Dr Sarah Gilbert, reportedly expressed hope that 1 million doses would be ready for use by September.
US biotech start-up Moderna started the world’s first coronavirus clinical trial in March, on its mRNA vaccine. Another US company, Inovio Pharmaceuticals, kicked off its first human trial of a DNA vaccine last month..
Three vaccines developed by Chinese companies and researchers have passed their first phase of trials for safety and earlier this month started the second phase, involving hundreds to more than 1,000 volunteers testing their effectiveness and researchers assessing vaccination doses..
https://youtu.be/UEzZ6sZegso
The trio included the Adenovirus-vector vaccine, by Tianjin-based Cansino Biological I and Beijing Institute of Biotechnology, and two inactivated vaccines developed by the Wuhan Institute of Biological Products and Sinovac Research & Development in Beijing..
China has experienced an easing of the Covid-19 epidemic after nearly five months of the outbreak, which was first reported in the central city of Wuhan. It reported only four locally transmitted and two imported cases on Thursday, while the number of patients still under treatment has fallen to below 1,700..
But vaccines under development will require an effective patient population for the third phase of trials, to allow their effectiveness to be tested in an environment where the virus is still prevalent..
Researchers must overcome difficulties such as “vaccine enhancement”, in which a disease is exacerbated in a vaccinated person infected with the actual virus..
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