To secure more insights into this topic, MIMS reaches out to our guest experts—two dietitians, Datin Farah Di Ba Khan from Prince Court Medical Centre (PCMC) and Mr Ng Kar Foo from International Medical University (IMU)—to find out what they have to say.
Coconut oil: The good, the bad and the uglyCoconut oil’s detrimental health effects have been the talk of the town of late. But, our experts believe this is not necessarily breaking news. “That has been going on for the last year or so,” shares Datin Farah. Some of her clients rave about the coconut oil they have been ingesting – claiming it does wonders for their health.
According to Datin Farah, referring to the American Heart Association (AHA) guidelines and what most of the dietitians out there know – coconut oil is a saturated fat. It all depends on the type of coconut oil you’re looking at. “It is never a 100% safe food. They all drink coconut oil for one reason: to lose weight. From my point of view and experience with clients who come in, that is,” she shares. ‘This stems from its ability to keep one full,” adds Datin Farah.
Kar Foo adds that the main component of this oil is medium chain triglycerides (MCT). Hence, while research highlights MCT’s ability to aid in weight loss and increase HDL levels, other vital findings are somehow ignored.
“What we have forgotten to look into is that total cholesterol and LDL levels are also increased; unlike other unsaturated oils, for example olive oil and canola,” he remarks. Thus, he deems unsaturated fats healthier compared to saturated fats.
“Our diet in Malaysia is already so high in fats. Just look at what the majority of us consume first thing in the morning. That’s already a disadvantage in this country,” observes Datin Farah. In her opinion, we should tread with caution. “It is not 100% certified to say it is safe to carry on taking it. Even a cardiologist would say it depends on your daily diet and activity level,” she highlights.
Datin Farah emphasises that “as a dietitian, sometimes, we need to look into how our clients feel. You can tell them it’s a ‘no’; but they might still continue. Therefore, we should explain looking at their blood profile and lipid levels – if a person comes in with high lipids and a strong family history of cardiac disease, I would not advise it.”
“If there is someone who is generally fit – takes care of his or her health and eats well – but, looks at coconut oil for health reasons – I don’t see the point of taking one to two tablespoons of it. If they still want to continue and do not consume high amounts of fat from other foods, then why not? It is very subjective,” she states.
Kar Foo supplements that coconut oil can be consumed as a type of “comfort food”. He advises though, “it may not be wise to take it everyday or to replace your unsaturated oils with it.”
No data from other dietetics associations would wholly advocate for this health fad, claims Datin Farah. Practising caution, she expresses that she “would look at the brand, the type, how its processed and where it is processed.”
Diet plans are not one-size-fits-allIt is difficult to keep up with how many diet plans there are out there. We turn to our experts to give us the lowdown on what works – and what doesn’t.
Listing some notable diets off the top of her head, Datin Farah says the Atkins, Mediterranean, Deakin and Cambridge have been known to be effective. However, she believes this only stands true if followed properly. She finds that most people go on diets to lose weight “but none of them would want to work out because they don’t have time.”
Kar Foo opines that a diet that truly works is any that an individual can practice throughout their lives. “Research shows that low carbohydrates can reduce weight significantly. Some say the Mediterranean diet has been helpful. In the end, we feel that as long as patients can adhere to a diet for a long time, they can reap the benefits,” he explains.
He continues, “Similarly, in my personal experience, some clients find it easy to follow a low carb diet and lose more weight. For clients who opt for a low carb diet, pushing them for a Mediterranean diet will not work.”
Often a time, people lose sight of the potential dangers of diet plans, points out Datin Farah. “If you do it for a short period of time and you incorporate other foods also, then it is fine.” However, in some instances, when they start the diets and see great results, they halt their diet plans due to lack of time or motivation. Subsequently, when their weight creeps back up and they attempt to get back on the plan – “it just doesn’t work because their metabolism has slowed down.”
She also says that with some of these diets, clients could produce more fat cells. “Let’s say you go on the Atkins diet with low carbs – carbs give us the energy to go about our day – and if we don’t have it, we feel sluggish and tired.”
“Proteins don’t give us the energy, (it just helps in) muscle building. So, you produce more ketones and the brain is triggered to produce more fat cells to keep the muscles going,” elaborates Datin Farah. In addition to weight loss, the excess protein causes the kidneys to work harder. “So, you develop high uric acid, high cholesterol and triglyceride levels,” illustrates Datin Farah.
Strong scientific backing for diets that boost overall human body health include the Mediterranean diet and DASH diet, says Kar Foo. “The issue for these two diets in Malaysia is that a lot of food items are very westernised,” he states, “it is challenging to follow in Malaysia.”
Datin Farah says the Atkins diet is one often followed, especially when a surgeon requires a patient to lose weight before a surgery. However, it should be incorporated “with guidance from a dietitian and also with laboratory values to see how they progress,” she adds. A follow-up blood test is also vital and certain deficiencies can be picked up externally – like hair loss, nail changes and bad breath.
Assess motivation levels and balance out portionsIn his line of work, Kar Foo gets creative with the implementation of diet plans. “The most practical way for me is to bring them to a supermarket to directly view the choices available,” he says. To start off with, he often brings patients to the IMU cafeteria. “Our Lower Ground floor covers most of the common food. People learn by direct observation, so it’s better for them. Pamphlet reading somehow doesn’t work so much; I would rather show them,” he justifies.
He adds that it is important to assess the individual’s motivation level. “We are trained for nutritional counselling and from there, we pick up on their characteristics – whether they are willing to change, not ready to change or just thinking about change,” he explains, referencing the Prochaska-Diclemente cycle.
In general, Datin Farah recommends consuming small portions throughout the day. “In that case, the body metabolises all the time so you want to keep it going. It’s like a car having petrol; like an engine running. If you sleep all day, you don’t need that much of calories. That’s why there is a calorie intake difference from a teenager to a senior citizen. So, I would say have smaller portions and cut down on carbs,” she opines. All in all, Datin Farah eloquently simplifies her views in a tagline – “Everything in moderation”. MIMS
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