Jom banyakkan pahala di bulan ramadhan.

Assalamualaikum,

(Kali ini rasa nak menulis dalam Bahasa Malaysia sahaja. Penat speaking london :p)
Terasa sangat dekat aura Ramadhan. Tahun ini saya akan berpuasa sebagai seorang ibu dan seorang isteri. Saya dapat rasakan cabaran berpuasa nanti kerana saya masih menyusukan si kecil Husna Zahra saya. Walaubagaimanapun, saya tak mahu jadikan ini satu alasan. Kenapa? Bulan Ramdhan ini bulan yang sgt2 mulia, entah boleh atau tidak saya berjumpa tahun depan. jadi jom pulun habis-habis bulan ini.

"Madam, macam mana kita nak banyakkan pahala di bulan Ramdhan ni ya? Dahla kita kekurangan tenaga, lapar, dari pagi sampai petang kelas, malam kadang2 terawikh pun terlepas"

" Banyak sangat pahala yang Allah berikan pada bulan mulia ni. Kita tahu bulan ni, semua pintu neraka ditutup, pintu syurga dibuka seluas-luasnya. Jadi, sekecil2 kebaikan kita buat, contohnya kita mengelak daripada memijak semut; hatta itupun Allah kurniakan pahala"

"Penat? Memang penat anak2. Tapi tahu tak, orang yang berpuasa ni sebenarnya sangat kuat. Saya teringat  pada masa zaman peperangan Badar di mana peperangan ini terjadi pada 2 Ramadhan. Peperangan ini memperlihatkan kemenangan besar umat Islam yang hanya bejumlah 300 orang jika dibandingkan dengan tentera musyirikin seramai 1000 orang. Hebatkan. Kenapa hebat?"

"Kerana mujahidin dahulu MENDIDIK hati mereka untuk menang kerana Allah"

" Begitu juga dengan kita, jangan jadikan alasan tidak larat untuk tidak bertadarus, bersedekah, dan membuat kebaikan yg lain. Nak PALING MUDAH? SHARE doa, zikir, himpunan nasihat di FB.Ini secara tak langsung kita dapat pahala free mengingatkan rakan2, bahkan kita secara tak langsung mengingatkan diri kita sendiri. hebatkan? "

MAKAN ATAU MELANTAK?



Hoho, terjadi pada sesiapa sahaja, bukan sebab kita lapar, tapi menjurus kepada RAMBANG MATA melihat makanan. Baiklah, menyentuh bab pemakanan (al-maklumlah mengajar nutrition) di bulan puasa, konsepnya sama sahaja. MAKANAN KENA SEIMBANG. Perlu seimbangkan pengambilan Karbohodrat, protein dan Lemak. Senang sahaja, ikut sunnah Nabi kita, as RULES to FOLLOW:

1. Berbuka dengan tamar dan air. Kalau takda tamar, memadai dengan buah-buahan. kenapa? Kerana apabila kita berpuasa seharian, tubuh kekurangan sumber tenaga ringkas yg datangnya daripada karbohidrat (glukosa, sukrosa). Therefore, immediate energy production is needed.
2. Selepas solat maghrib, bolehlah menikmati makanan dalam kuantiti yang banyak sedikit. JANGAN BANYAK SGT macam ULAR SAWA. Memadai dengan rasa kenyang (bukan kenyang melampau) kerana kita perlu untuk bersolat Isyak dan terawikh. 
3. Selepas terawikh, bolehla mengambil makanan snek, tidak terlalu berat (contoh: bubur kacang, buah2, kuih). Kalau kita makan terlalu berat sebelum tidur, ini akan membebankan perut. Banyak tenaga akan digunakan utk proses penghadaman, bukan untuk proses pemulihan. 
4. Jangan lupa banyakkan minum air, lebih2 lagi untuk ibu yang menyusu (3 litre sehari)

Bulan puasa ni sebenarnya melatih nafsu kita, dan seharusnya memberi rehat pada tubuh. Akan tetapi sebaliknya berlaku. Kalau teringin sangat hendak membeli makanan di bazar, boleh. Tapi pilihla yang BERSIH, BERKHASIAT (tidak banyak minyak). Lagi nikmat jika kita sama2 dapat menyediakan juadah berbuka, lagi rapat silaturrahim.

JOM SAMA-SAMA MEMERIAHKAN BULAN RAMADAHAN INI 

Supplemen yang boleh membantu ketika puasa. Semoga dapat memperbanyakkan ibadah di bulan mulia ini

Masyita

" Yang baik itu dari Allah, yang kurang itu dari saya"

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Monthly Bluessss- When that month come (part 2)

Assalamualikum,

Welcome back and thank you for your patience; waiting this part two to publish. Sangat sibuk juga, prepare lab activity for nutrition untuk student FIST (Baru tahu semalam kena handle lab nutrition). Jangan ikut perangai ini ya anak-anak. Baiklah, previous post , we have discussed the physiology of menstrual pain (or scientifically what we called dysmenorrheoa (hoh... berbelit lidah). We also have listed few treatment that can be used (medically and home-based treatments).

Ok... As promised before, saya akan discussed berkenaan evening primrose oil dan borage oil in treating dysmenorrheoa. Have you ever seen evening primrose flower? Fuuhh.subhanallah, ia sangat cantik.

The flower is yellow. The oil is extracted from the SEED.










Ok, now the borage oil. Hardly people in Malaysia I believe heard about this plant. This is how the borage oil looks like:

Cantikkan? It has blue,white or indigo flowers. Similar to evening primrose, the oil is extracted from the seed. Numerous studies have found that either primrose or borage are high in GLA, essential fatty acid of omega 6. Borage have the HIGHEST content.

" GLA tu apa madam?"

"GLA itu singkatan daripada gamma linolenic acid, an omega 6- fatty acids yang terhasil drp linoleic acid yg terdapat dlm tumbuhan spt primrose and borage (in seed) and egg yolk. Ok, linoleic fatty acid tu mcm saya dah ajar is polyunsaturated fatty acid, also known essential fatty acids yg sgt diperlukan tubuh. omega-6 and omega 3 are examples of essential fatty acids"

"Madam, saya confuse, GLA is one of omega-6 kan. Apa kebaikannya daripada derivatives omega-6 yg lain?"

"There are several different types of omega-6 fatty acids. Most omega-6 fatty acids are consumed in the diet from vegetable oils as linoleic acid (LA).  

Jangan confuse ye dengan alpha -linolenic acid [ALA] (ALA ialah omega-3 fatty acid). 

Linoleic acid is converted to gamma-linolenic acid (GLA) in the 

body and then further broken down to arachidonic acid (AA). AA is found abundantly in meat.

Excess amounts of LA and AA are unhealthy because they promote inflammation leading to the diseases like heart disease, asthma, arthritis , depression and cancer.

However, GLA may actually reduce inflammation. Much of the GLA taken as a supplement is not converted to AA, but rather to a substance called dihomogamma-linolenic acid (DGLA).DGLA competes with AA and prevents the negative inflammatory effects that AA cause in the body. In addition, DGLA becomes part of prostaglandins that reduce inflammation.

Walaubagaimanapun, dinasihatkan untuk mendapatkan nutrien seperti zink, Vitamin C , Vit B3 dan Vitamin B6 untuk membantu penukaran GLA kepada DGLA rather than AA. Oleh itu, pemakanan seimbang adalah perlu di sini." 

"Oh... camtu ye madam. DGLA ni become parts of prostaglandin to reduce inflammatory. Tapi macammana GLA reduce the menstrual cramp symptom ye? Sebab sebvelum ni kita belajar the pain from the menses is due to prostaglandin?"

" Ha... bagus pun awk ingat fakta itu. Tu tandanya awk tak tidur dalam kelas saya, hoho... Baiklah, memang betul, research shown that pain during menstrual might be due to prostaglandin.  From my research, protaglandin ini ada 3 jenis : 

1. PGE1 and PGE3 (Good prostaglandin that promotes anti inflammation and reduce contraction )
2. PGE 2(bad prostaglandin that promotes inflammation and contraction---> Byk terhasil daripada AA)

"Jadi keyword di sini adalah : SEIMBANG. Anda kena pastikan jika anda amibil makanan yang kaya dengan omega-6, consume it moderately. Selain daripada itu, complementary from other nutrients such as magnesium, zinc, calcium citrate, vitamin E and C, B6 and B12 may help in reducing the symmptoms". Figure below show the production of Good and bad prostaglandin. 

Source: Glenville (2001)

Ok harapnya anda faham kenapa GLA itu perlu bukan sahaja untuk reduce mentrual cramp, but ia bertindak juga sebagai anti-inflammatory. Tetapi kena ingat, GLA adalah TIDAK SESUAI untuk: 

1. Wanita mengandung
2. Individual who suffer from seizures (sawan)
3. Sesetengah ubat juga memberi kesan jika dimakan bersama GLA: ceftazidime, chemotherapy, cyclosporine, NSAIDs  and Phenothiazines for schizophrenia

References: 

1. Dr Marilyn Glenville PhD. (2001) ‘The Natural Health Handbook For Women’, Piatkus Publishers Limited: London.
2. Ehrlich, S.D. (2012) ' Menstrual Pain"University of Maryland Medical Centre [online] (Available at: http://umm.edu/health/medical/altmed/condition/menstrual-pain) 

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Monthly Bluessss- When that month come (part 1)

Ok.. read the post carefully " When the month come" .. .. During this period, some of the ladies might suffer from pre-menstrual syndrom (PMS). Masih ingat masa kita dulu (eh... para wanita saje ye), bila saja masa itu tiba, kelakuan kitapun berubah (ada yang jadi garang, sedih, happy tak semena-mena) and the guys would labeled us " Dia tengah PMS la tu". .. Baiklah, buka buku nota and I shall discuss with you how this pain occured.

Jom kita belajar anatomy uterus dahulu:

If we look at the figure above, the uterus shape is more like an inverted pear. It is a muscular organ, located between bladder and rectum. Baiklah, if we observed the female reproductive organ, uterus play an important roles in nourishing and house the fertilised egg until the unborn fetus is ready to be delivered. besides that, the uterus is responsible for several reproductive functions, including menses, labor, and delivery. 

" Madam, uterus tu besar mana ye? Saya pelik macam mana uterus boleh mengembang begitu besar ketika waktu hamil"

"There is no definite size of a normal uterus, it is depending on the hormonal levels in the body. Untuk remaja perempuan biasanya size uterus ialah 35mm (length) 10 mm (diameter), whilst the women uterus is roughly a size of a woman fist (8x6x4cm). Kecilkan? Tapi Maha Kuasa Allah, Dia jadikan rahim ibu itu rumah perlindungan yang sgt selesa untuk bayi yang belum lahir. Jadi anda semua kena jaga rahim yang penat menanggung pengembangan dari sebesar buah pear sehingga menjadi buah tembikai"

(Med-health.com, 2013 [online])

Ok,anda semua dah tahu anatomy uterus (atau dengan nama lain rahim). Since the major function of the uterus is to house the fertilised egg (released from ovary), jadinya setiap bulan akan berlakunya pendarahan dari uterus (this is what we called menses: haid). Menses happen when a young girl have reached her puberty (age 10-14 years). Haid berlaku apabila telur yang matang dikeluarkan oleh ovari (setiap bulan), melalui tiub fallopian terus ke uterus. Pada masa ini, dinding uterus sgt tebal dan kaya dengan darah (sebagai persediaan untuk tempelan telur yang telah disenyawakan). Jika telur tersebut tidak disenyawakan, dinding uterus akan gugur sebagai darah haid. Figure below was captured on a real-time during the ovulation process. (Masyaallah, lihatlah sekecil-kecil telur dikeluarkan ovari, membesar sebagai fetus)

" Tapi madam, apa yang membuatkan proses haid itu sakit? Bukankah darah sepatutnya turun seperti cecair?kadang-kadang rasa mcm nak guling-guling je...."

"Haa.... itu baru sakit menses ye, belum sakit bersalin. Sakit bersalin kata orang tua-tua adalah 10x ganda sakit dari sakit period. Tapi jangan sebab takutkan sakit awk tak nak mengandung pula. Pahala sakit bersalin itu sama dengan berjihad fi sabilillah. Baiklah, I will explain the condition in the next para"

Muscle cramp around the abdomen and lower body part is due to the contraction of muscular wall . Keadaan ini menyebabkan salur darah di bahagian uterus ditekan dan the blood supply is temporarily cut- off.  Without oxygen, the tissues in your womb release chemicals (prostaglandin) that trigger pain in your body (NHS, 2012)

" Hooo, jadinya madam how to reduce the pain?"

"Take a warm bath, massage, heat apply around your tummy and exercise. Itu semua anda boleh buat. But some General practitioner may prescribe medication like painkillers, NSAIDs etc."

"Saya pernah terdengar ambil evening primrose oil (EPO) can reduce the pain. Is that true?"

Ha.... satu isu yang byk menimbulkan kontroversi tentang penggunaan evening primrose. It is true that to few cases, evening primrose oil helps with pre-menstrual symptoms (PMS). TIDAK hanya EPO, salah satu tumbuhan yang dapat membantu mengurangkan PMS adalah borage oil. Kedua-dua tumbuhan ini (Evening primrose and borage) kaya dengan essential fatty accid-->  gamma linolenic  acid (GLA). Need to know how these active compound helps with PMS and muscle cramp? KITA TUNGGU THE PART TWO. (nak cerita kat sini panjang pulak). I am hoping this post light up the physiological process of menstrual. 

REFERENCES:

1. MD-Health.com (updated July 2013) [online] (Available at: http://www.md-health.com/Uterus-Size.html)
2. NHS (2012) Painful period (dysmenorrhoea) (Reviewed 16 July 2012) [online] (Available at: http://www.nhs.uk/Conditions/Periods-painful/Pages/Introduction.aspx) 

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What are the relationship among Alfafa, B complex, protein with milk production? (part.2)

Phewwww.... Masih ingat all the points which we have discussed on the nutritional need for lactation. Haa... sila jawab quiz di bawah (during this time, selalu dengar students merungut "Ala, madam, ngape mengejut" "Ala.... saya tak study" "Madam tak bgtau pun") ---> hoho.. dah nama pun quiz.. kalau tak ada quiz, macam mana saya nak tahu awk faham ke tidak? :)

1. What are the minerals that are increased during lactation?
2. Why lactating mother need to increase their water intake?
3. How many kcalaries is expected to be used by a lactating mother?

[6 marks]

Hoho... siap markah lagi.. Baiklah.. please answer all the questions above. Should there be any questions (regardless the quiz) you are free to ask me. Ok... let us continue with this second part. I have been observed the trend of shaklee purchase for milk booster as most of them would buy the ESP (energising soy protein), alfafa, B-complex, multi vitamin (vita-lea). From previous post, I have really emphasised that for individuals who are strictly in a healthy diet regime, don't worry. You may not need dietary supplement. But as most of us (uhuk uhuk... including me) are sometime might neglect in our daily food consumption, supplement might offer a huge help. But BEAR IN MIND, before taking any supplements:

(Source: Gina et al., 2013)

Alhamdulillah, as far as I concerned, Shaklee is safe and made from natural ingredients. Alright then, back to what we called a milk-booster supplement. Sejujurnya, saya kurang bersetuju dengan penggunaan perkataan ini untuk dietary supplement. As the concept of dietary supplement to 'add' to a basic healthy diet and lifestyle, or to a prescription medication to treat medical condition . A herbal supplement or vitamin regimen on its own will not necessarily cure or treat your condition or heath problem. It’s also important to remember that not all supplements are beneficial, especially when taken in toxic doses or combined with other medications (Gina et al., 2013). Jadi, anda sebagai pengguna jgn mudah terpengaruh dgn perkataan  begitu. Kita belajar dulu apa kepentingan setiap nutrien yg terkandung dalam produk suplemen kesihatan. Ambil contoh simple package : ESP, Alfafa ,vitamin B complex and vita-lea (from shaklee). How these micro/micro nutrients HELP you during lactation. 

ESP: Produce from non (GMO) soya beans (Apa itu non GMO: ia bermaksud kacang soya yg digunakan tidak melalui mana-mana perubahan ciri-ciri genetik makanan). As noted, soy protein has low glycemix index (ok, indeks glisemik ini adalah pengukuran berapa cepat glukos dihasilkan di dalam darah selepas sahaja mengambil sesuatu makanan ).  Since protein acts as messenger that trigger hormone excretion (example oxytocin, insulin), consuming ESP may help those actions (oxytocin and prolactin excretion)

But madam, bukankah protein dari tumbuhan itu tidak lengkap (complete protein) berbanding dengan protein haiwan? 

Memang betul. Disebabkan protein tumbuhan tidak lengkap, penambahan 9 asid amino penting telah dibuat dalam produk shaklee. 

Alfafa : Alfalfa is a storehouse of nutrients. Its tap root reaches down as deep as six meters, searching out nutrients and minerals from deposits in the soil, while its leaves gather large amounts of chlorophyll through the natural process of photosynthesis. Alfafa during lactation provide a wide range of vitamins and minerals: vitamins A, C and E as well as calcium, potassium, phosphorus and iron of which required for milk production.

Vitamin B- complex: Vitamin Bs  assist in energy production (B1, B2, Niacin, biotin, panthotenic  and B6); reduce confusion & depression (nerve health); and DNA and new cell synthesis. This is important as more energy is required during lactation and milk production.

Habis tu, apa bezanya B-complex shaklee dgn jenama yang lain?

Shaklee B-complex are high-bioavailability (kadar serapan yang tinggi) kerana asid folik di pasaran adalah bersifat sintetik dan tidak mudah diserap oleh tubuh. Since vitamin B are water-soluble (larut air), it is easily excreted through urine. Therefore, shaklee provided more than 100% of vitamin B to compensate the loss.

Vita - lea: This multivitamin are extracted from plants and provide 12 vitamins and 7 minerals that are important for the body. Yang paling unik, the tablet is coated with spirulina, of which it helps in absoprtion and water soluble. Vita-lea may help vegan lactating mother that may lack specific nutrients. 

Phewww.... ok...Harapnya post ini mudah difahami. Not to promote, but to educate the consumer of why they need such nutrient during their lactation.. Any inquiries on the product or questions regarding nutrition and lactation, feel free to ask in the comment box. 

p/s: I have been used shaklee product during my lactation period. Praise to Allah, it helps me a lot with my energy level. But remember, itu semua dari Allah. Don't be based on supplements only, makanan seimbang kena juga jaga. :)

Yang baik itu dari Allah, yang lemah itu dari diri saya sendiri....

References:

1. Whitney E & Rolfes S.R (2011) Understanding nutrition 12 ed. , Wadswotrh: Belmont
2. Gina Kemp, M.A., Lawrence Robinson, and Jeanne Segal (2013) Dietary supplements: the smart use of vitamins and supplements [online] [Available at: http://www.helpguide.org/life/supplements_dietary_nutritional_herbal.htm]

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What are the relationship among Alfafa, B complex, protein with milk production? (part.1)

Jumuaah Al Barakah. Saya suka Jumaat, it is not because the next day is the weekend, but each time the Friday approached, I feel the serenity. Tak percaya? Have you ever opened your window, or take a brisk walk on Friday morning, you feel different from the other days.. As Allah have chosen Friday as the "Leader of the days", I wish to remind myself to recite Al-kahfi. Why Al - Kahfi on Friday? This is what the prophet do every Friday. I would like to share the secrets of Al-Kahfi, shared from our relative muslim (click the link).

Alhamdulilah.. Today we shall learn on the production of milk (chewaahhh.. dah jd lecturer pula dlm blog). It is important for us (including the man/husband) to at least know the basic anatomy and physiology of the breast. IT IS NOT IMPOSSIBLE FOR EVERY MOTHER TO BREASTFEED HER CHILD/CHILDREN. There are some reasons that I've heard from others that they 've tried, but failed. Tak apa ummi, jgn putus asa. Allah telah pilih ummi semua utk susukan anak. Kalau anda berusaha tapi tak berhasil juga, insyaallah.. yakin bahawa Allah ada sebab utk itu juga. Interestingly, I have came cross this article of why the milk came in late. (You may want to refer to this link). Baiklah, let us see the anatomy of breast:

Alamak madam, scientific sgt namenye... (well, I always have this complaint from my student. My reply: Awk belajar dlm bidang medicine, HARUSSSSS hafal name mak nenek ni sume :p) Ok2... focus... what you can see from the above figure is that the breast is major made from the fat tissue. And if you can see clearly the duct or what we call the milk gland. This is where the milk is secreted. Ajaibnya Allah ciptakan breast ibu ni sensitif pada hisapan. When the baby suck, the small receptors in the nipple is triggered sending a signal to hypothalamus (erkkkk.... apekah itu? Hypothalamus is a region in your brain that coordinate autonomic nervous system and activity of pituitary). hah, lepas saje signal diterima oleh hypothalamus, hypothalamus akan mengarahkan PIH (Pitutitary induced hormon) untuk remberskan DUA jenis hormon lactation: Prolactin and Oxytocin. Prolactin produce milk/milk secretion, tetapi yang meghasilkan let-down reflex itu adalah oxytocin (err.... madam, let-down reflex tu ape ye? Haa... bile awk dah kwin, ade anak nak menyusu... once your child latch, awk akan rasa mcm pengecutan otot around your aerola.. that is let-down reflex. Hoho... tgk muke student sorang yg perempuan, sume dah blushing.. oowww.. come one ladies, let the guys hear too, at least boleh support wife to breastfeed). Summary of the physiology spt dlm gmbarajah di bawah:

Ok... mcm biase kalau dah mengajar nutrition for lactating mother, when I asked the student what are the nutritional needs for lactating mother, almost 80% say Calcium. Hoho.. salah anak2.... But why mdam? Isn't it when you feed your child, most of the calcium loss from the milk? Yes. memang betul.. calcium easily loss from the milk production, tapi bila calcium in the blood drops, it will ask the bone to donate the calcium. Supplementation of Calcium during this stages does not or should I say contribute only a little. Itulah sebabnye, kalo plan nak anak, make sure your calcium restore full ye..

Ok, back to the nutritional needs of the lactating  mother. Breastfeed mother needs more: liquid, energy, protein, CHO, fatty acid, B6, B12, folate, Vitamin A, C and E. hoho.. kasi besarkan sikit. All these macro and micronutrients are increasing during lacatation.

1. ENERGY , PROTEIN, CHO and FATTY ACIDS:  Tahukah anda lactated women need 1800kcal per day for successful lactation? Fuhhh... untuk menghasilkan susu, it requires more energy. Patutla saya cepat lapaaarrrrrrrrrr. These energy come from protein, CHO and fatty acids. CHO requires a lo to replace the glucose that is used to make lactose in milk.  Bayangkan, jika anda menyusukan anak sehari, anda kehilangan sebanyak 1800 kcal. Pehwwww..... Boleh jaga badan gitu... (p/s: bergantung juga pada metabolic rate dan aktiviti fizikal ye)
2. B6, B12, folate, vitamin A,C and E: What's with these vitamins? Vitamin ini semua terkandung didalam susu ibu. Jadi, untuk menggantikan kehilangan vitamin tersebut, extra requirements are needed. 
3. WATER: There is a MISCONCEPTION of which a lactating mother who drinks more water produce milk. This is untrue, whereby an adequate of water intake is needed to avoid dehydration. Make sure you have a glass of water/juices right after your nurses.

WHAT WILL HAPPEN IF MY NUTRIENTS ARE INADEQUATE?  WILL IT AFFECT MY MILK PRODUCTION?

ANSWER: YES, NUTRITIONAL INADEQUACIES WILL REDUCE THE QUANTITY OF MILK, NOT THE QUALITY.

Therefore please ensure you have nutrient-dense food, do not skip any meals and eat healthily.....

Next part, Insyaallah,I shall discuss on the dietary supplement requirement for lactating mothers which include alfafa, protein beverage and B-complex...wee... stay tuned.

Yang baik itu dari Allah, yang lemah itu dari diri saya sendiri....

References:

1. Whitney E & Rolfes S.R (2011) Understanding nutrition 12 ed. , Wadswotrh: Belmont
2. FAO, Energy requirement of lactation, FAO corporate document repository [Available at: http://www.fao.org/docrep/007/y5686e/y5686e0b.htm]

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