Demystifying childhood eczema

Sunday May 25, 2014

Demystifying childhood eczema

Statistics show that an estimated one in five children in Malaysia suffer from eczema. - Filepic

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In this first of four articles on atopic eczema, we explore some of the most common misconceptions people have of the condition – many of which are barriers to timely and effective treatment.

Twenty years ago, atopic eczema – a type of inflammation of the skin that is associated with the immune system – is a condition that was almost unheard of in children.

However, statistics over the past decade show that it has been on the rise, paralleling urbanisation and improvement of general hygiene standards.

Today, statistics show that an estimated one in five children in Malaysia have it.

This phenomenon may be caused by an immature immune system in children, a system that does not have the chance to mature due to a lack of exposure to potential allergens, says paediatric dermatologist Dr Leong Kin Fon.

Although the condition is now common among children, it is frequently misunderstood by parents and caregivers.

One of the most common myths is that atopic eczema is caused by a single factor.

This belief has sent many parents and caregivers on a wild goose chase to find and remove that elusive single causative factor, just to find the condition recurring even after spending a fortune on tests and treatments.

Here are some of the more common misconceptions people have of the condition.

Myth #1: There is a single cause for atopic eczema.

Atopic eczema is a multifactorial condition that is a result of the interaction between genetic and environmental factors.

Children and young adults with eczema are usually genetically predisposed to having dry skin because of a hyperactive immune system. The condition usually occurs within the first five years of a child’s life.

These factors can be aggravated by multiple environmental factors such as the weather, stress, food, bacteria, and irritants such as harsh cleansing agents and dustmites, says Dr Leong.

The combination of precipitating factors is unique in each individual, even with children from the same family who are living under one roof.

Myth #2: Atopic eczema would not recur if it is already treated.

There is no known cure for eczema, and it will recur if a child or young adult is exposed to factors that trigger the inflammation of the skin.

While treatment by a general practitioner or a dermatologist is usually needed after a flare-up occurs, the condition can be managed to prevent or minimise the severity and frequency of future flare-ups.

Myth #3: Atopic eczema only occurs in dry environments.

Atopic eczema also occurs in hot and humid environments, particularly when there’s sweating. This is because sweat could irritate the skin if it is not washed away quickly.

Changes in temperature as a child or young adult moves from a hot and humid environment to a cold and dry environment could also exacerbate symptoms for those living with atopic eczema.

Myth #4: The condition will occur in the same way every time.

The triggering factors for atopic eczema can change in an individual as he or she grows older.

For instance, a baby’s atopic eczema is more likely to be due to food allergies and exposure to harsh cleaning detergents or extremes of weather.

In comparison, a teenager and young adult’s eczema may more likely be caused by stress or exposure to contact allergens in skin care products or perfume.

Myth #5: There is one single medication or treatment that could cure atopic eczema.

There is no magic bullet or medicine for atopic eczema.

Mild eczema can be treated and managed with a suitable moisturizer and cleanser, as well as the avoidance of extreme weather (too hot and humid or too cold and dry).

Patients can also be taught to avoid scratching the skin when it itches by lightly tapping or massaging the itchy patch.

More severe forms of eczema may require the appropriate use of antibiotics, antiseptics and steroids for a limited period only.

Treatments can range from a few days to a few months, depending on the age of the patient and the severity of the flare-up.

Myth #6: There is nothing much I can do about eczema except to will it away.

About 65% of those with atopic eczema will find their condition less symptomatic after they reach 15 years old, while the rest may live with the condition for much longer, says Dr Leong.

However, when parents and those living with atopic eczema are empowered with the knowledge to manage the condition, atopic eczema can be controlled with certain lifestyle habits and suitable moisturisers and skin cleansers.

Habits such as keeping the skin clean and moist, as well as avoiding extremely hot or cold weather, could go a long way towards keeping eczema at bay.

This article is courtesy of Beiersdorf.

http://www.thestar.com.my/Lifestyle/Health/2014/05/25/Demystifying-childhood-eczema/

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The mighty mussel

Sunday May 25, 2014

Historical records show that the native Maoris living along the coast of New Zealand did not suffer from joint problems or arthritis owing to their diet of fresh, raw New Zealand Green Lipped Mussel. – Filepic

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An extract of the New Zealand Green Lipped Mussel inhibits joint ageing enzymes that can potentially destroy joint cartilage and lead to arthritis.

THOSE who suffer from joint complaints not only have a problem with diminishing cartilage in their joints. There is also a problem arising from a biochemical imbalance.

One of the key causal agents of this imbalance is joint ageing enzymes (scientifically known as Matrix Metalloproteinases or MMPs) in the joints.

All of us have certain levels of joint ageing enzymes in the joints, which exist normally in a balanced state.

Joint problems manifest when the levels of these enzymes increase too much, resulting in joints breaking down faster than they can re-built.

Although the affected joint will try to repair itself, it often fails because of persisting high levels of the enzymes.

It doesn’t stop there. Joint damage further provokes the immune system to trigger inflammatory responses, which lead to inflamed, swollen and painful joints.

Prolonged inflammation eventually leads to the formation of bone spurs, resulting in limited joint movement and pain.

However, nature has provided a solution to rectify this in the form of a marine denizen from New Zealand.

Historical records show that the native Maoris living along the coast of New Zealand did not suffer from joint problems or arthritis owing to their diet of fresh, raw New Zealand Green Lipped Mussel.

It was not until the 1970s that an extract from this mussel was developed, and it has been a boon to many people suffering from arthritis.

Initially, it was not known how this extract works. However, advancements in biotechnology in the past 10 years has enabled scientists to understand how the extract works – it’s a natural joint ageing enzyme inhibitor that can correct the imbalance of the enzymes in the joint.

When levels of these enzymes are controlled, it allows for the joints to repair and “clean-up” areas of damaged joint surfaces, including bone spurs.

The extract also has antioxidant properties, and demonstrates several significant anti-inflammatory actions, including preventing immune cells from indiscriminately attacking our joints.

Although there is no cure for arthritis, it is possible to control the condition. Joint preservation is key to man’s functional longevity. The extract in effect helps slow arthritis from progressing through controlling the joint ageing enzymes at all joints, be it the knees, shoulders, neck, back or fingers.

The extract works differently from glucosamine in aiding joint repair. Glucosamine is linked to a supply of raw ingredients for joint cells to utilise to repair damaged cartilage (i.e. food for joint cartilage) and does not have any effect on joint ageing enzymes.

Just as arthritis doesn’t develop overnight, the process of restoring joints will also take time, especially if the process involves tackling the root of the problem.

A landmark study lead by Kendall, Lawson and Hurley in 2000 showed that the mussel extract has a 70% success rate for reducing arthritis pain. However, those who take it need to undergo a course of at least three months before effects are felt.

The mussel extract is not a painkiller. Hence, those who consume it stll need to take painkillers initially before the benefits kick in.

An additional benefit of the extract is its stomach-protecting properties. It helps protect the stomach when taken together with painkillers, leading to a reduction in gastric lesions by more than 50%.

In the long run, when joint ageing enzymes are in balance, those with arthritic pain may find that they need not rely on their painkillers any more.

With a research history of 40 years, the extract is probably one of the most enduring joint products in the world today, testament of its quality, safety and effectiveness.

In 2005, the Australian Centre for Complementary Research and Education (ACCMER) awarded the extract the Ideal Anti-Arthritic Agent accolade. It is used in more than 25 countries worldwide and is now available in Malaysia.

http://www.thestar.com.my/Lifestyle/Health/2014/05/25/The-mighty-mussel/

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Salt: How low should you go?

Monday August 18, 2014

BY GENE EMERY

High salt is bad, but is less good? Researchers are divided. - Filepic

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While most scientists agree that high sodium intake is bad, new studies spark debate on further decreasing salt intake.

In one study that looked at death and heart disease, researchers found that extremely low-salt diets may not be as beneficial as many experts believe, and might even pose a hazard.

Another study, focusing on blood pressure effects, found that people with a moderate salt intake didn't benefit from reducing their consumption as much as people in the high-salt group.

“Previously it was believed that the lower you go the better. What these studies show collectively is that there is an optimal level, and lower is not necessarily better,” says Dr Andrew Mente of McMaster University in Hamilton, Ontario, chief author of the blood pressure study.

Salt is everywhere, in condiments such as your favourite kicap. It makes sense to know where your sodium is coming from. – Filepic

On the other hand, a third international study supports the conventional wisdom that there’s a direct link between less salt and better health. This study found no evidence that extremely low levels of sodium are dangerous.

One thing the three studies agree on is that too much salt is bad for you. High amounts contribute to high blood pressure, stroke, heart attack, kidney problems and heart failure.

That third study concluded that high salt intake was responsible for 1.65 million heart disease deaths worldwide in 2010.

“These are staggering numbers when you actually think about it,” says Dr Elliott Antman, president of the American Heart Association.

Worldwide, daily consumption is usually 3-6g of sodium, which translates to 7.5-15g of salt. That’s well above the limit of 1.5-2.4g of sodium each day recommend by the World Health Organization and other organisations.

“Even at 4g per day, we found half a million deaths per year,” says chief author Dr Dariush Mozaffarian, dean of the Friedman School of Nutrition Science and Policy at Tufts University. Mozaffarian says his analysis uncovered no danger at low levels or below, and he argued that even Mente’s blood pressure study showed no risk there.

However, Mente says the relationship seems to be more complicated than previously thought, and the health benefits of lowering salt intake don’t fall at the same place for everyone.

Experts are divided on how low salt intake should go and if that has an impact of health. – Filepic

“If people are eating a very high level of sodium and they reduce their intake, you get a large reduction in blood pressure,” he says. “But if you’re eating a moderate level of sodium and you reduce it to a lower level, you’re not really getting much in return as far as blood pressure reduction is concerned.”

The most dramatic evidence was the study that looked at the link between sodium intake and death, heart attacks and strokes using urine samples to estimate sodium consumption.

Led by Mente’s colleague at McMaster, Dr Martin O’Donnell, it found that consuming less than 3g of sodium per day increased the risk of death or major cardiovascular events by 27% compared to people who consumed 4-6g daily. The optimum sodium level was 3-6g per day. “Both higher and lower levels of estimated sodium excretion were associated with increased risk,” the O’Donnell team concluded.

That study shows “there are unintended consequences of going lower” adds Mente.

Currently only about 1% of people worldwide “were consuming less than 2g per day,” he says. “What we’re recommending right now is what almost nobody around the world eats, apart from maybe a few hunter-gatherer societies. We’re making recommendations where the human experience is extremely sparse. These findings strongly question our current recommendation.”

A sprinkle here, a dash there, scientists do agree that the current sodium intake is too high. – Filepic

Mozaffarian disagrees. Both the O’Donnell and Mente studies derived their results from the same research project, known as the PURE study.

“When you have a single study like the PURE study, that’s one study in the context of many,” says Dr Mozaffarian. Some have suggested a risk for very-low salt intake while others have not.

Not only does the weight of the evidence suggest that there is no risk in aggressive salt reduction, Mozaffarian says, “You don’t have any plausible biology to explain why you’d get a small increase in risk with low sodium intake.”

There’s another reason for scepticism. The PURE study assessed sodium consumption based on a single urine sample collected each morning. Antman called that a “very unreliable method” for measuring salt intake.

“The gold standard is 24-hour urine collection, and they didn't use it. And even then your sodium intake may vary a lot from day to day,” he says.

“The bottom line is, the American Heart Association’s position has not changed in response to the PURE paper,” says Antman, a cardiovascular expert at Brigham and Women’s Hospital in Boston. The association recommends less that 1.5 grams of sodium daily.

Nonetheless, Dr Suzanne Oparil of the University of Alabama at Birmingham contends in a journal editorial that, “Both high and low levels of sodium excretion may be associated with an increased risk of death and cardiovascular-disease outcomes and (the tests suggest) that increasing the urinary potassium excretion counterbalances the adverse effect of high sodium excretion.”

That idea should be confirmed in a large study, she said, but “in the absence of such a trial, the results argue against reduction of dietary sodium as an isolated public health recommendation.”

“The big picture is that high sodium is bad and should be reversed, and there’s just some controversy over how low you should go,” said Mozaffarian.

“Whether it should be 2g or 1.5g or 2.5g per day, that’s all theory,” he says. “Right now it’s close to 4g per day. Let’s get it down below 3, and then we can argue how low it should go. But right now it’s clearly way too high.” – Reuters

At the end of the day, the point to remember is that excess salt is not good for health.

http://www.thestar.com.my/Lifestyle/Health/2014/08/18/Salt-how-low-should-you-go/

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