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Showing posts with label high blood pressure. Show all posts
Showing posts with label high blood pressure. Show all posts

Friday, 27 June 2025

Go easy on durian, say experts ; Time ripe to grow durian dynasty

 

(From left) Mohammad Taufik Saidon, Muhamad Hafiz Azizan and Mohd Iszuan Ismail from Alor Setar enjoying the King of Fruits at Anjung Indah in Balik Pulau, Penang. — ZHAFARAN NASIB/The Star

IT IS durian season again, but over-indulging in the King of Fruits can pose a serious risk to our health.

Universiti Sains Malaysia (USM) family medicine specialist Dr Mastura Mohd Sopian said those with diabetes, heart disease, kidney problems or high blood pressure should not binge eat.

“To enjoy the nutritional benefits of durian safely, limit intake to no more than two medium-sized pieces per day, or about 80g,” she said.

Eating too much durian could have a negative impact on blood sugar levels, she noted.

“Bingeing on durian may cause discomfort and disrupt normal metabolic functions.

“For those with chronic conditions, durian should only be consumed in small amounts, occasionally or not at all,” she added.

Dr Mastura said certain foods should be avoided when eating durian, which contains carbohydrates, vitamins and minerals.

“These include spicy dishes, caffeine, carbonated drinks, sweet fruits, desserts, soft drinks and sugar-sweetened beverages.

“Consuming these alongside durian can cause digestive discomfort and increase health risks,” she said.

“Durian also has a ‘heaty’ effect, though reactions may vary among individuals,” said Dr Mastura.

Penang Health Department nutritionist Zuhaida Harun said that like any other fruit, durian should be eaten according to the recommended serving size.

“One serving of durian is two to three pieces.

“It is high in calories and natural sugar.

“For people with diabetes, it can cause a dangerous spike in blood sugar,” she said.

Zuhaida said high consumption of durian could significantly increase a person’s overall calorie intake.

“Sometimes, bingeing can also lead to other health issues such as bloating, indigestion or feeling overheated,” she said, adding that moderation applied to all foods.

Penang health committee chairman Daniel Gooi reminded the public to practise moderation when enjoying durian, especially during the current peak season, to avoid potential health risks.

“Overindulgence, particularly in hot weather, can lead to discomfort such as a sore throat, dehydration or digestive problems,” he said.

“Drink plenty of water and exercise self-control to fully appreciate the fruit without experiencing adverse effects,” Gooi advised.

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Time ripe to grow durian dynasty

Smells like success: Durians on display at a stall in SS2, Petaling Jaya. — ART CHEN/The Star

PETALING JAYA: In the world of durians, Malaysia’s Musang King may reign supreme but a new wave of contenders is emerging.

From the creamy Black Thorn and Red Prawn to the sweet Hajah Hasmah, the government is championing lesser-known premium varieties to capture growing international demand.

Other established types like Sultan and Tekka are also seeing interest, offering the fruit at a more accessible price and broadening Malaysia’s footprint in the global durian market.

Agriculture Department director-­general Datuk Nor Sam Alwi said Musang King and Bukit Merah are the main varieties recommended for export due to their rich, creamy texture and strong flavour but efforts are under way to highlight other premium types such as Black Thorn, Red Prawn and Hajah Hasmah.

“These varieties are being evaluated for future certification and export readiness, based on their potential in terms of taste, texture, shelf life and suitability for long-distance shipping,” she told The Star.

Nor Sam said that Chinese nationals, in particular, are willing to pay premium prices for these varieties.

As such, she said the department is working towards registe­ring durian varieties grown in Malaysia, conduct agronomic assessments and ensure compliance with the phytosanitary requirements of importing countri

“This includes pest disinfestation methods such as vapour heat treatment, traceability systems and farm export certification schemes,” she said.

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These efforts, she said, were in line with the department’s goal of diversifying Malaysia’s durian varieties in the global market, strengthening the competitiveness of the national durian industry and maximising its export value.

The Malaysian Agricultural Research and Development Institute (Mardi) has found that there is a growing appetite for a wider range of flavours among durian enthusiasts.

“Consumers are becoming more adventurous. They are seeking out unique taste profiles. We are also seeing renewed interest in older, established clones such as D24 and Tekka, which are more affordable and offer classic durian characteristics,” it said in a statement.

Mardi said regional favourites and specific kampung durians with distinctive traits are gaining popularity, too.

On the export front, Mardi said it is focusing on developing new hybrids for domestic and global markets.

Its MDUR series (a hybrid durian clone developed by Mardi), in particular, has shown promise.

“One of the main highlights is MDUR 88 (D190), a hybrid of D10 and D24.

“It is golden yellow, slightly sticky and creamy with a flavour that many compare favourably to Musang King.”

In view of its quality, Mardi said the Agriculture and Food Security Ministry is promoting MDUR 88 for export.

“MDUR 88 has recently been rebranded as ‘MARDI Super 88’ (MS88),” it said.

Mardi is also working on other hybrids, such as MDUR 78 (D188) and MDUR 79 (D189), which offer improved yields and greater resistance to diseases like root borers and stem canker.

The institute also highlighted its broader breeding initiatives, noting that its second hybridisation programme, launched in the late 1980s, involved crosses between 10 different varieties.

Several promising hybrids from this programme are now in the final stages of assessment and are expected to be introduced under the 13th Malaysia Plan.

Mardi’s third set of hybrids is undergoing evaluation and assessment.

The institute is optimistic about the potential of these new hybrids.

“While Musang King and Black Thorn continue to set the benchmark in terms of market presence and price, we believe that our own developed hybrids, particularly MDUR 88, have the characteristics and quality to compete in the international market,” it said.

Federal Agricultural Marketing Authority (Fama) director-general Abdul Rashid Bahri said that in addition to Musang King, premium varieties including D24, Black Thorn, IOI and D9 have been sent for assessments to ensure they meet phytosanitary and quality compliance for targeted export markets like China.

“Fama is also working to expand market access beyond China and Hong Kong to countries such as the United Kingdom, Canada, the United Arab Emirates, Australia and the Netherlands,” he said.

Abdul Rashid said that strategic initiatives include participation in trade fairs, digital marketplace partnerships, in-store promotions and collaborative awareness programmes with the Malaysian embassies.

“To strengthen Malaysia’s competitive edge and credibility in premium markets, the ministry is also enhancing the national branding of agricultural produce through Malaysia’s Best, a certification that assures quality and safety for both domestic and international standards,” he said.

In 2023, Malaysia exported 54,374 tonnes of durians, valued at RM1.51bil, with China accounting for more than 45.7% of the total export.

Abdul Rashid said the volume is expected to increase following China’s approval for fresh durian imports.

“Fama will continue to work with industry stakeholders to monitor market trends, optimise logistics, and scale up capacity to meet growing international demand,” he said.

Malaysia’s durian cultivation area has been steadily expanding in recent years, with data from the Agriculture Department showing an increase from 70,286ha in 2019 to a projected 92,129ha in 2024.

Durian production followed suit, rising from 390,635 tonnes in 2020 to a projected 568,852 tonnes this year, despite some fluctuations due to weather and cost challenges.

The increase has been driven largely by global demand especially for premium varieties.

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Wednesday, 9 November 2022

Not the best for weight

 Although BMI is widely used as a measure of weight, it is not very accurate and can lead to the mistreatment of obesity and eating disorders.

Measuring a person’s waistline might give a better representation of their health than their bmi, as those with abdominal obesity are prone to developing certain chronic medical conditions. — Photos: TNS

 

BMI in Adults: Is Yours Healthy, and if Not, How Can You Lose ...

PEOPLE who seek medical treatment for obesity or an eating disorder do so with the hope their insurance plan will pay for part of it.

But whether it’s covered or not often comes down to a measure invented almost 200 years ago by a Belgian mathematician as part of his quest to use statistics to define the “average man”.

That work, done in the 1830s by Adolphe Quetelet, appealed to life insurance companies, which created “ideal” weight tables after the turn of the century.

By the 1970s and 1980s, the measurement, now dubbed body mass index (BMI), was adopted to screen for, and track, obesity.

Now it’s everywhere, using an equation – essentially a ratio of mass to height – to categorise patients as overweight, underweight or at a “healthy weight”.

It’s appealingly simple, with a scale that designates adults who score between 18.5 and 24.9 as within a healthy range.

But critics – and they are widespread these days – say it was never meant as a health diagnostic tool.

“BMI does not come from science or medicine,” said Dr Fatima Stanford, an obesity medicine specialist and equity director of the endocrine division at Massachusetts General Hospital in the United States. 

She and other experts said BMI can be useful in tracking population-wide weight trends, but it falls short by failing to account for differences among ethnic groups, and it can mislabel some people, including athletes, as overweight or obese because it does not distinguish between muscle mass and fat.

Still, BMI has become a standard tool to determine who is most at risk of the health consequences of excess weight – and who qualifies for often-expensive treatments.

Cut-offs for coverage

Despite the heavy debate surrounding BMI, the consensus is that people who are overweight or obese are at greater risk for a host of health problems, including diabetes, liver problems, osteoarthritis, high blood pressure, sleep apnoea and cardiovascular problems.

The BMI measure is commonly included in the prescribing directions for weight-loss drugs.

Some of the newest and most effective drugs, such as semaglutide, limit use to patients who have a BMI of 30 or higher – the obesity threshold – or a lower level of 27, if the patient has at least one weightrelated medical condition, such as diabetes.

Doctors can prescribe the medications to patients who don’t meet those label requirements, but insurers might not cover any of the cost.

While most insurers cover some forms of bariatric surgery for weight loss, they might require a patient to have a BMI of at least 35, along with other health conditions, such as high blood pressure or diabetes, to qualify.

With medications, it can be even trickier.

US national health insurance programme Medicare, for example, does not cover most prescription weight-loss drugs, although it will cover behavioural health treatments and obesity screening. Coverage for weightloss medications varies among private insurance plans.

“It’s very frustrating because everything we do in obesity medicine is based on these cut-offs,” said Dr Stanford.

Over and under

Critics say that BMI can err on both ends of the scale, mistakenly labelling some larger people as unhealthy and people who weigh less as healthy, even if they need medical treatment.

For eating disorders, insurers often use BMI to make coverage decisions and can limit treatment to only those who rank as underweight, missing others who need help, said Serena Nangia.

Nangia is the communications director for Project Heal, a US non-profit organisation that helps patients get treatment, whether they are uninsured or have been denied care through their insurance plan. 

“Because there’s such a focus on BMI numbers, we are missing people who could have gotten help earlier, even if they are at a medium BMI,” she said.

“If they are not underweight, they are not taken seriously, and their behaviours are overlooked.” 

Dr Stanford said she too often battles insurance companies over who qualifies for overweight treatment based on BMI definitions, especially some of the newer, pricier weight-loss medications, which can cost more than US$1,500 (RM7,114.50) a month.

“I’ve had patients doing well on medication and their BMI gets below a certain level, and then the insurance company wants to take them off the medication,” she said, adding she challenges those decisions.

“Sometimes I win, sometimes I lose.”

Not accurate for health

While perhaps useful as a screening tool, BMI alone is not a good arbiter of health, said Dr Stanford and many other experts.

“The health of a person with a BMI of 29 might be worse than one with a 50 if that person with the 29 has high cholesterol, diabetes, sleep apnoea, or a laundry list of things,” said Dr Stanford, “while the person with a 50 just has high blood pressure.

“Which one is sicker? I would say the person with more metabolic disease.”

Additionally, BMI can overestimate obesity for tall people and underestimate it for short ones, experts say.

And it does not account for gender and ethnic differences.

Case in point: “Black women who are between 31 and 33 BMI tend to have better health status even at that above-30 level” than other women and men, Dr Stanford said.

Meanwhile, several studies, including the long-running Nurses’ Health Study, found that Asian people had a greater risk of developing diabetes as they gained weight, compared with whites and certain ethnic groups.

As a result, countries such as China and Japan have set lower BMI overweight and obesity thresholds for people of Asian descent.

Other measurements

Experts generally agree that BMI should not be the only measure to assess patients’ health and weight.

“It does have limitations,” said David Creel, a psychologist and registered dietitian at Cleveland Clinic’s Bariatric and Metabolic Institute.

“It doesn’t tell us anything about the difference between muscle and fat weight,” he said, noting that many athletes might score in the overweight category, or even land in the obesity range due to muscle bulk.

Instead of relying on BMI, physicians and patients should consider other factors in the weight equation.

One is being aware of where weight is distributed.

Studies have shown that health risks increase if a person carries excess weight in the midsection.

“If someone has thick legs and most of their weight is in the lower body, it’s not nearly as harmful as if they have it around their midsection, especially their organs,” he said.

Dr Stanford agreed, saying midsection weight “is a much better proxy for health than BMI itself”, with the potential for developing conditions like fatty liver disease or diabetes “directly correlated with waist size”.

Patients and their doctors can use a simple tool to assess this risk: the tape measure.

Measuring just above the hipbone, women should stay at 35 inches or less, and men at 40 inches or less, researchers advise.

New ways to define and diagnose obesity are in the works, including a panel of international experts convened by the prestigious Lancet Commission, said Dr Stanford, a member of the group.

Any new criteria ultimately approved might not only help inform physicians and patients, but also affect insurance coverage and public health interventions.

She has also studied a way to recalibrate BMI to reflect gender and ethnic differences.

It incorporates various groups’ risk factors for conditions such as diabetes, high blood pressure and high cholesterol.

Based on her research, she said, the BMI cut-off would trend lower for men, as well as Hispanic and white women.

It would shift to slightly higher cut-offs for Black women.

(Hispanic people can be of any race or combination of races.)

“We do not plan to eliminate the BMI, but we plan to devise other strategies to evaluate the health associated with weight status,” she said. – Kaiser Health News/tribune News Service

Although BMI is widely used as a measure of weight, it is not very accurate and can lead to the mistreatment of obesity and eating disorders.

Kaiser Health News (KHN) is a US national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programmes at Kaiser Family Foundation (KFF). KFF is an endowed non-profit organisation providing information on health issues to the US. 

-The Star Malaysia By JULIE APPLEBY 

 

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