BFM 89.9 Interviews

Dato’ Dr Rajen M. says, emphasising the basis for supplements. The natural health advocate and columnist states that the need for supplements is increasing with the intake of fast food, processed food, stored food, GM food and chemical-laced food.

According to Dr Rajen, this is never an issue 100 or 200 years ago, when normal food provides for the body’s nutritional needs. Today, much of the nutrition that the body needs is lost when food is being heat treated or radiated.

The body therefore needs dietary supplement to make up for the loss. The need for dietary supplements – addition to nutrition – is validated by various clinical studies and trials around the world. However, Dr Rajen states that the idea of dietary supplement has not always been accepted by the general public.

Many are aware of the debate that is surrounding the supplement business. Even something as widely accepted now as folic acid was dismissed in the 50s, he says.

“Today, a gynae would recommend that to a pregnant woman because we have proven beyond a shadow of doubt that adding folic acid to the diet would get good development of the spine of a child.”

Dr Rajen also cited calcium and fish oil as among the supplements that had to take the long and winding road before they became acceptable to the public.

Citing the GISSI-Prevenzione trial in Italy and Europe involving 11,000 patients who had one heart attack and therefore had very high risk of a second heart attack, Dr Rajen explains that the research arm with patients that were given fish oil had a 45% reduction of a second heart attack.

“One single supplement!” he says, “I would think that even a drug would not work as well in preventing heart attack. And it is so safe, so natural, has no side effects – long term, and therefore you can see that even today the fastest growing segment in the world in terms of supplement is fish oil.

Fish oil, 10 years ago or 15 years ago was pooh-poohed. Today, the American Heart Association recommends this to particularly males over the age of 40 as a supplement.”

The idea of supplements only giving us expensive urine has also cropped up. “Well, I have a different take on this,” he says. “I’d rather have expensive urine than sick urine.”

“A person whose urine is lacking the basic material, which means that the food that they’ve eaten is not enough, every cell is starved, every tissue and organ is starved and you get cheap, sick urine. So I think expensive urine is not necessarily a bad thing, if you look at it from a proper context.”

When it comes to the need for dietary supplement, Dr Rajen says that it could start at a very young age all the way to the elderly. The need comes in different forms depending on one’s lifestyle – children, pregnant and nursing mothers, sportsmen, and those recovering from ailments or surgery.

“Supplements will become and is already a fact of life for a lot of people.”

There have been a lot of studies done all over the world on the consumption of supplements. The studies revealed that people who are more educated and have more disposable income tend to use more dietary supplements.

An interesting finding is that women tend to purchase more supplement.

“Eight out of ten times buyers of supplements at pharmacies are women, who buy for themselves, for their husbands and for their kids,”

Dr Rajen says.

“So it’s almost a proactive response to life – modern living, fast-paced living; processed foods, fast foods, stored foods, old foods, preserved foods, stale foods – all kinds of different foods we get are nowhere as ideal as they were, pristine as 100 years ago or 200 years ago.”

Dr Rajen cautions that dietary supplements are not meant to replace our diet.

“You still need your calories, you still need the protein, carbohydrates and the fats.”

Using an analogy of a car, he explains that a supplement is an additive to make the car work better, not to replace the fuel.

“You need them both, and more and more so today.”

Addressing the confusion between supplements and drugs, Dr Rajen says that a drug is a synthetic substance that produces a benefit, but there is a side effect. Supplements, on the other hand, are natural and do not have side effects, as they work with the body and the system.

Due to the nature of supplements, a person can decide on taking certain supplements on his own. However, if a person has disease process and is on a treatment for it, Dr Rajen says it is best to consult a doctor or health professional before deciding on a supplement.

The same rules apply to supplements as they do to any other products. With the massive market, the average consumer is spoilt for choice. Dr Rajen advises consumers to exercise caution in buying supplements.

“You would like to be able to look for it in a pharmacy, not at pasar malam, and this gives you some professionalism.

Dr Rajen says.

And then if you’re looking at supplements, you want it to be natural, you want it to be food-based; for example, if you’re taking calcium look for milk calcium, which is well established; (and) you want to be dealing with a company with reputation.”

Other pointers shared include how consumers should ensure that the product is sourced properly, and there is clinical evidence and certification. They should also look out for whether it is organic, toxin-free, and if the company makes any effort in guaranteeing or delivering the quality.

“When there is a massive choice, it becomes a commodity, and consumers then have difficulty in choosing a product either in terms of quality or in terms of weeding out the substandard products.”

Commenting on the future of the supplements market, Dr Rajen says that he sees it going in three ways: more savvy manufacturers that result in more concentrated and synergistically combined products; the idea of predictive medicine due to technological advances; and personalised medicine that calls for specific supplements.

“We’re going towards stem cells, and stem cells will be the future supplements. So we’ll put you on stem cells, and we’ll navigate the stem cells with the right kind of nutrients,” he adds.

Dr Rajen's Blog

Generations of fish oil

Relating the changes, Dr Rajen explains the focus of every stage or what he refers to as “generation” of fish oil that is developed as a health supplement.

In developing the first generation of fish oil, the whole process was about extracting and filtering the oil from the fish.

The development of the second generation of fish oil, which is widely available in the market, was about the concentration of fish oil in every capsule.

For the third generation, which is the most recent development, the focus is on the concentration of fish oil in the blood.

The key here, as emphasised by Dr Rajen, is absorption. “You want to make sure it’s in your body tissue.” This brings us to MOPL – marine omega-3 phospholipids – the form of phospholipids found in marine organisms.

The basics

What is omega-3? Dr Rajen explains, “Omega-3s are a long-chain carbon and only nature can make them. And the longer the chain, the better.” The long chains and double bonds of the EPA and DHA improve electrical conductivity, he says.

“So they can get to all the tissues, tissues that have high need for electrical conductivity: the brain, the eyes, the retina, and the heart, and maybe to some extent the liver. The other thing is that they are phospholipids. Phospholipids are actually the molecules of life, particularly for the liver, they help the liver, they feed the liver.”

Phospholipids

Phospholipids are the key building blocks of cellular membranes. Omega-3 phospholipids usually found in human breast milk are also found in fish roe.

Dr Rajen points out that the difference between the typical second generation fish oil that is harvested from fish and the third generation oil that is obtained from the roe is its phospholipids content, which makes it highly absorbable.

This is what sets Pristin MOPL fish oil from the second generation fish oil. The unique phospholipids structure in MOPL, as Dr Rajen describes, “allows them to enter the membrane because they can dissolve in water as well as oil.”

It also delivers DHA-to-EPA ratio of 3:1, which is the same omega-3 ratio found in human breast milk. Dr Rajen describes it as a “very high form of nutrition” and “the most potent form of DHA on the planet”.

The benefits of MOPL

Apart from the high absorption rate, lies in the synergistic EPA:DHA ratio which could be absorbed by the brain, eyes and heart. It is even beneficial for conditions such as skin psoriasis. While it is an auto-immune disease, the MOPL helps in managing or treating the symptoms.

Additionally, the familiar fishy smell is no longer part of the package. According to Dr Rajen, due to its high absorption rate, MOPL fish oil is fully absorbed by the tissues and therefore will not be present in the stools.

Dosage and cost effectiveness

With MOPL, a smaller dosage of one to two capsules is sufficient for one’s daily nutritional supplement needs, therefore it is more cost effective compared to the previous generations of fish oil.

The recommended daily intake for the first generation of fish oil is four to six capsules, while the second generation of fish oil should be taken two to three capsules daily in order to fulfil the minimum omega-3 requirement as well as to combat inflammation and heart disease.

“I think that this is such a simple, cheap, economical way of preventing or reducing the impact of that in a 20-year time frame,” says Dr Rajen. He recommends Pristin MOPL particularly to those above 40 even if there are no symptoms of health problems such as blood pressure.

Scientific and economic proof

The case of the fish oil’s cost effectiveness had also been presented in a study carried out in the US, where the cost of consuming omega-3 as a supplement was compared to that of placing a defibrillator in every home.

The latter was found to reduce death from heart attacks by 2%, while the cheaper alternative of providing the supplement was found to reduce the deaths by 6%.

Personalising supplements based on individual needs is possible with tests, although at this point these are not available locally. Dr Rajen says a DNA test can be done to decide on an individual’s need for omega-3.

Essential

At the same time, he stresses that omega-3 is an essential fatty acid (EFA) that must be taken in one’s diet as it is not produced by the body.

MOPL fish oil is a popular choice in developed countries and it is sold all over Europe, Canada, the US, Australia and New Zealand.

Launched in Asia two months ago, the latest PRISTIN MOPL is sourced from a reputable supplier, Norwegian company Arctic Nutrition, which according to Dr Rajen is the world leader in the marine omega phospholipids market.

With a complete end-to-end supply chain, the company has a patented process that allows it to deliver high quality, high purity, and highly absorbable fish oil. Arctic Nutrition has also ensured that the herring roe, from which the MOPL fish oil is sourced, is sustainably harvested and tested for its nutritional qualities.

Now in Malaysian pharmacies

Available in pharmacies, Pristin MOPL has been in Malaysia for 12 years. Its presence in the local supplement market has been strengthened by the fact that the trademarked brand has been audited by AC Nielsen and named the number one high-strength fish oil for six consecutive years.

While the health prospects are looking good with the availability of a potent form of nutritional supplement such as Pristin MOPL, Dr Rajen cautions consumers not to be reckless. “You still could drop dead from a heart attack.”

“We know that health is holistic, you need many different implements of that: food is one, nutrition is the other.” These, he says, are in addition to resting or sleeping, de-stressing, exercising, and making sure that the heart gets the right amount of work, which he describes as “absolutely critical”.

Pristin official website

Where do they come from?

Before ending up in our gut, these good bacteria are acquired from our environment starting from the birth process all through our growing and living years. According to Dr Rajen, the first probiotics come from the birth canal and the mother’s nipples.

As we grow, the good bacteria are picked up from our surrounding and food – basically everything we touch and consume – and over time, these will build up to be a colony of bacteria that is synergistic with our system.

Outside the gut, the bacteria exist on the skin, nose, and mouth. Dr Rajen explains that they thrive anywhere in the body where there is a close interface with a living part of the body.

Maintaining the balance

Probiotics make up 10-15% of the bacteria in our gut, and they help to keep the balance in the ecosystem. Ideally, the balance can be maintained naturally, but as Dr Rajen puts it, we live in a modern world where we take antibiotics, chlorine and sugary drink, among others, that make other bacteria thrive and upset the balance.

The consequences of not maintaining the balance can be seen both immediately and in the long term. The immediate effect can be quite obvious, where we could have an upset stomach, constipation or diarrhoea. In the long run, it could affect our immune system and we could be prone to allergies and infections.

Functions

“They’re obviously put there by nature over time from birth and have evolved with us, grown with us, and as a result play a myriad of different functions: from just digestion, immunity, cleansing, detoxification, preventing disease, and basically guarding the gut.”

“We also know they help digest food, they ferment and cause the production of certain amino acids, they break down vitamins,” Dr Rajen says about the functions of the probiotics.

Interestingly, Dr Rajen notes that we probably know what is happening in the universe more than what is happening in our gut. This could mean that there may be other functions served by these probiotics in addition to what we already know.

Good bacteria beyond natural food

Probiotics is not only found in natural food. As Dr Rajen previously mentioned, our modern life in a less than pristine environment has resulted in our intakes of antibiotics and other substances that inhibit probiotics. Due to this, there is a need for probiotics in dietary supplements.

Dr Rajen says that although some might argue that they do not need probiotics, he contends that it is not possible unless we live in a pristine environment and take pristine food. The food we take affect the gut bacteria, hence the need for probiotics in supplements.

Are they viable?

While supplements may provide a convenient way of getting probiotics to ensure gut health, there is a concern about whether these probiotics can actually survive and thrive. Dr Rajen points out that although there is a focus on CFU – colony-forming units – there is no analysis on how many of them are actually alive.

Another concern is how probiotics from foreign countries could thrive in our gut. Thirty to 40 years ago, the notion of having probiotics imported from Europe, Australia, Canada, Finland, or Japan was conceived.

However, Dr Rajen says the idea is not a viable one, as local probiotics are better adapted to our diets. The different mix of food that we take could be detrimental to the foreign probiotics, he says, for example, food with preservatives or high intake of sugar would kill gut bacteria.

“The whole trick with probiotics is that you want them to survive in your gut. It’s not like other supplements where they’re digested and thrown away.” Dr Rajen says that the good bacteria must enter the stomach environment where they must be kept alive in order to perform their functions.

Lacto-5

In view of the viability of local probiotics that are better suited to our local diets, Holista Colltech, in collaboration with Melaka Biotech, has developed Lacto-5 as a supplement. Since the local strains adapt better to our diets, they could provide optimum protection to our intestines.

Employing the same technology used in sperm banks, the locally derived probiotics are lyophilised, which allows them to be kept suspended without refrigeration until they are brought back to life in the right environment.

The local strains of probiotics in Lacto-5 are suspended at the time of consumption and come alive upon entering the intestines, where they would thrive and perform their functions.

According to Dr Rajen, studies have been carried out in collaboration with a biotech company in India to prove that the local probiotics can actually survive, ferment, multiply and eventually passed in the stools – alive and active – proving that the probiotics taken do not end up as dead bacteria.

Visit www.lacto5.com for more information on Lacto-5.

Citing the largest study carried out in Malaysia called the Asian Osteoporosis Study, he says 44.8% of all hip surgeries in the country involve Chinese ladies over the age of 60. The remaining 45% include Chinese men and Chinese ladies below the age of 60, Indian and Malay men and ladies and those from other ethnicities.

Prevention

Prevention is possible, according to Dr Rajen. He outlines three ways for the prevention of osteoporosis, which includes eating right, getting enough sunlight, and exercising.

Eating habit is important to ensure that we get the much-needed calcium from natural food sources. Eggs, spinach and anchovies are among the calcium-rich food sources that could naturally provide for our calcium needs.

Something as simple as sunlight can tremendously help in keeping the calcium levels up. Sunlight helps the body in making vitamin D, which enhances the absorption of calcium. Dr Rajen shares that in natural food sources, calcium, magnesium and phosphorus, which are required for healthy bones, always come with vitamin D.

In terms of exercises, Dr Rajen recommends weight-bearing exercises to enhance bone strength. He recommends crawling and arching the back, as

“this forces strain on the bone, and the strain will cause the bone to pull in the calcium, magnesium and phosphorus which it needs to keep good bone density.”

Calcium needs and absorption

Osteoporosis is always linked to calcium, and Dr Rajen says we need between 1,000 milligrams to 1,500 milligrams daily. It also depends on gender and how much calcium we already have stored in our body. The lesser calcium we have, the more our body needs it.

It should be noted that calcium intake does not guarantee absorption. Poor digestion, for one, could hinder calcium absorption.

“That’s the reason why as we age, we all tend to lose calcium,” Dr Rajen says.

The lack of sun, consuming certain food that would not bind calcium, and taking drugs that could remove calcium from our system could potentially reduce our calcium levels. Dr Rajen also adds that lack of bone activity could also result in the bones not pulling in calcium.

The myth

A myth surrounding calcium is that it is believed that taking too much calcium could result in an overdose or renal stones. Touching on the myth, Dr Rajen explains that our body understands calcium so well that it will expel the excess, so there is no possibility of an overdose or the formation of kidney stones.

To illustrate this, he says babies do not get renal stones regardless of their calcium intake in milk. He explains renal stones are more common in older people due to the lack of calcium, and this happens because the body is trying to hold back the calcium.

Of course, in this case, Dr Rajen is talking about natural calcium.

Calcium in supplements

Not everyone could get adequate calcium supply from their daily intake of natural food sources, so the best way to provide for our bodily needs is by taking calcium supplements. The best calcium supplement should come from natural sources.

MOO® Plus calcium supplement from Holista, for example, is sourced from milk and has the right ratio of minerals and vitamin D to provide for the body’s calcium needs. According to Dr Rajen, milk is the best source of calcium. “So it’s a very, very positive source.” It is also clinically proven to increase bone density.

However, not all supplements are sourced from milk or natural sources. Consumers should therefore be cautious when purchasing calcium supplement to ensure that the calcium that enters their system is absorbable.

Choosing the right supplement

Calcium supplements come in different forms and sources. In choosing the right calcium supplement, we should look into how much we could absorb, Dr Rajen says, instead of the price. This brings us back to the natural calcium sources.

To check the source, Dr Rajen recommends checking the packaging. “Most calcium supplements are made of calcium carbonate, and calcium carbonate is very poorly absorbed. And calcium carbonate is not real food; it is limestone, it is chalk.”

He says that it is important that we get the calcium from real food source and that most of the supplements available in the market are sourced from calcium carbonate or calcium citrate.

“Look for milk minerals, they’re the best way to get calcium. And make sure that it has vitamin D as well.”

Getting advice

The best person to recommend or prescribe supplements to the end user, according to Dr Rajen, is the pharmacist. This is because a pharmacist is trained on disease process, supplements and nutritionals, side effects, and drug interactions.

Not dismissing the importance of consulting a doctor, Dr Rajen says the doctor is the point of call for diseases and it would be best to consider the points of view from both the doctor and the pharmacist.

Dr Rajen, who has been involved in various pharmaceutical initiatives, says that the awareness on traditional medicine has been on the rise among pharmacists around the world. Pharmacy schools have been putting more emphasis on complementary, traditional, and phytomedicine or nutritional medicine.

Visit Official MOO® Milk Calcium website