SUNDAY STAR, 4 JUNE 2017

DIGESTIVE HEALTH & YOU

Core
strength
Keeping your digestive
system strong and
healthy works with
what you eat, your
lifestyle and regular
medical check-ups.
Look inside to learn
more about keeping
your gut healthy.
2 Digestive Health & You
By IAN JEROME LEONG
VERY often, people who are
experiencing stomach cramps,
fatigue and fever may brush off the
whole ordeal and assume the cause
for such symptoms to be a mere
stomach bug.
However, when the intense
pain persists and other symptoms
include watery or bloody stools,
reduced appetite and weight loss,
there is a possibility that you have
inflammatory bowel disease (IBD).
IBD was the focus of last weeks
World Digestive Health Day, an
annual initiative by the World
Gastroenterology Organisation
(WGO) to increase the general
awareness of specific digestive
disorders, including their related
Punch to the gut
research, prevention and therapy.
This years campaign was aimed
at providing gastroenterologists,
patients, healthcare providers
and the general public with the
relevant basic and clinical
knowledge surrounding IBD.
A crucial factor about IBD is
that there is still a lack of
understanding or information
about the diseases manner of
development inside the human
body within the medical fraternity.
Scientists and doctors have yet to
pinpoint the definite causes of IBD
and the medications currently
prescribed to IBD patients are
mere therapies to dampen the
aberrant immune response or
suppress the inflammation.
The good news is that the
number of IBD cases remains
relatively low in Malaysia and
there are therapies available.
However, this does not
mean that Malaysians should
take the disease lightly as it
can greatly impede daily life
by causing water and salt
loss, anaemia, dehydration,
severe weight loss and
possibly life-threatening
complications in the long run.
Understanding the
threat
IBD can be separated into two
main disease categories
Crohns disease (CD) that affects
the colon and ulcerative colitis
(UC) that can affect any part of the
digestive system.
SUNDAY STAR, 4 JUNE 2017
Persistant stomach cramps,
reduced appetite and weight
loss could signal more than
a stomach bug.
The good news is
that the number of
IBD cases remains
relatively low in
Malaysia and there are
therapies available.
Both conditions have
overlapping and distinct clinical
and pathological features that are a
result of an abnormal
immunological response whereby
the patients white blood cells and
other inflammatory cells attack the
gastrointestinal tract, leading to
prolonged, uncontrolled
inflammation and ulceration.
In severe cases, IBD is
particularly debilitating and
greatly restricts ones daily life,
says Prof Dr Lee Yeong Yeh,
professor of medicine and
consultant of gastroenterology at Malaysias Young Scientist determine if therapies proven to be
Universiti Sains Malaysia. Network, says the common effective in one population will be
Although the symptoms in symptoms include abdominal pain, comparably effective in another.
milder cases may subside, they can watery or bloody stools, fever, Another challenge will be to
recur and progress to become
more severe if left untreated.
weight loss and feeling easily tired
while less common ones include
facilitate access to novel expensive
therapies in lesser privileged
Severe cases may require joint and skin problems. countries.
specialised treatment in the form World Digestive Health Day 2017 Though the cause of IBD is
of biologics managed by a chair Dr Charles Bernstein wrote in unknown, genetic and
gastroenterologist. Those of higher his introduction of IBD on WGOs environmental factors are believed
severity may need surgery. website: The pathogenesis of IBD to play a role in triggering the
Prof Lee, who also holds the is incompletely understood. As IBD disease.
position of science leadership chair is increasingly a worldwide
of the Academy of Sciences disease, one challenge will be to > TURN TO PAGE 4
SUNDAY STAR, 4 JUNE 2017 3
4 Digestive Health & You
Mitigating the risk
> FROM PAGE 2
According to a 2015 article titled
Management of IBD in Malaysia
published in the IBD Research
journal, the prevalence of
inflammatory bowel disease (IBD),
ulcerative colitis (UC) and Crohn's
disease (CD) in the country was at
9.24, 6.67 and 2.17 per 100,000
persons respectively.
Hence, the estimated number
of people with IBD in Malaysia is
between 2,000 and 3,000, with a
larger number of cases among the
Indian ethnic community and the
majority of all patients falling
below the age of 30.
While it is good that many
people do not live with IBD in
Malaysia, this in itself can be
discouraging for patients.
The journal article states that
there is a lack of experience in the
use of biologics to treat IBD,
leading to the overuse of steroids.
In addition, it claims that
surgical expertise is limited as
there are few colorectal surgeons
with specific IBD training or
experience.
Worse still is when patients of
IBD require surgery but exhibit
side effects of long-term steroid use
and nutritional deficiencies,
further compromising surgical
success.
These findings mirror another
2015 article, Chronic attacks on the
bowel, which states that due to the
infrequent number of IBD cases in
the country, some diagnoses were
delayed by doctors or, worse,
mistaken for other conditions such
as irritable bowel syndrome,
haemorrhoids or even cancer due
Fifteen per cent
of patients with
UC in the United
Kingdom were
unable to work
after five to 10 years
living with the
disease while patients
with moderate to
severe UC faced a 30%
increased risk of work
impairment compared
to those without.
to the overlapping symptoms.
Prof Lee agrees that awareness
of the disease is generally low
among healthcare providers and
IBD can be difficult to distinguish
from cancers based on symptoms
alone.
However, he adds, Subsequent
investigations including
colonoscopy should be able to
differentiate between IBD and
cancer, and if there is suspicion of
either condition, it is best to refer
to a gastroenterologist or specialist
in bowel disorders.
Defusing the situation
In the United Kingdom where
the prevalence of IBD is much
SUNDAY STAR, 4 JUNE 2017
higher affecting roughly 240,000 increased risk of work impairment While the awareness of IBD may
people or 400 patients per 100,000 compared to those without. still be low in Malaysia, the
of the population the IBD One would be forgiven for Malaysian medical field is starting
Standards Group (a UK group wondering if Malaysia too will face to pay more attention to
made up of various digestive, such a dire situation, given the understanding the disease.
paediatric and gastroenterology rising number of IBD cases locally The establishment of an IBD
associations and societies) reported and how the situation can take a interest group, Persatuan Crohn
that up to 85% of IBD patients toll on an already stressed national dan Kolitis Malaysia, as well as
required hospitalisation and up to healthcare system. collaborations with international
70% of patients with CD required Fortunately, Malaysias IBD agencies such as the European
surgery within five years of numbers are still among the lowest Crohns and Colitis Organisation
diagnosis. globally. In addition, Prof Lee and Asian Organization for
Fifteen per cent of patients with believes that Malaysia has the right Crohns & Colitis are steps in the
UC in the UK were unable to work
after five to 10 years living with
therapies in place, whether
through biologics or surgery.
right direction, but the medical
fraternity also needs to ensure
the disease while patients with However, patients need to have the Malaysia continues to have a
moderate to severe UC faced a 30% right diagnosis early. control of the situation.
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SUNDAY STAR, 4 JUNE 2017 Digestive Health & You 5

Your friendly bacteria probiotics

PROBIOTICS, as defined by the
Food and Agriculture Organization Probiotics may
positively change
of the United Nations (FAO) and
Biogrow Probiotics
World Health Organization (WHO),
contains stable
are live microorganisms which,
when administered in adequate microencapsulated the intestinal flora,
amounts, confer a health benefit probiotic strains that
can withstand the inhibit the growth
of bad bacteria
on the host.
The interest in probiotics has harsh environment
of your guts.
been growing in the past few years
due to their potential health (pathogenic),
benefits on humans.
Various studies have
promote better
demonstrated that probiotics may digestion, enhance
positively change the intestinal
flora, inhibit the growth of bad immune function
bacteria (pathogenic), promote
better digestion, enhance immune
as well as alleviate
function as well as alleviate stomach upset.
stomach upset.

Choosing the right

probiotics
Nowadays, it is easy for
consumers to get probiotic
supplements from pharmacies.
However, how do we know if we
are taking the right probiotics that
truly benefit our guts?
According to Expert Panel of the
United Nations and WHO, a
probiotic should meet the criteria
below to be truly termed as
probiotic:
l Clinically identified strains
(eg. Lacidophilus Rosell-52)
l Safety assessment
l Clinical efficacy evidence
l Shelf-stable formulation
The determination and
confirmation of strain identity is
the key. Many consumers may not
be aware that the benefits and
properties of certain probiotics are
strain-specific.
For example, general
L.acidophilus may not work the
same as L. acidophilus Rosell-52.
Therefore, a clinically identified
probiotic strain is a must because it
assures consumers of the safety
and quality of this particular strain
of probiotics.
Are your probiotics getting
through?
Besides probiotic strains, it is
also crucial to choose probiotics
that are able to withstand gastric
acid, bile acid and attach strongly
to your intestinal lining in order to
exert beneficial effects.
However, it would be difficult
for certain probiotics to get
through this harsh environment
without proper technology.
Hence, experts have provided
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This technology protects probiotics
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thermal shock up to 50C, thus
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probiotics during the intestinal
transit and their quality.
According to a scientific study,
microencapsulated probiotics are
five times more efficient than
the same uncoated strains in
terms of gut colonisation and
the amount of bacteria detected
in faeces.
The survival of probiotics is of
utmost importance because only
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benefits to us, not the dead ones.
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It consists of three different
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6 Digestive Health & You
HAVING pioneered the journey towards
wellness for decades, Vitagen is a brand
synonymous to better digestion.
As the nations No.1 and first cultured milk
drink, Vitagen celebrates 40 years of
digestive care expertise through its launch
of a public awareness campaign that stresses
the significance of gut health to ones overall
well-being.
Spotlight on good gut health
Highlighting the five signs of and five steps
to good gut health, the campaign speaks
directly to consumers, guiding them through
the essentials of leading a healthy, balanced
lifestyle.
Touting three core messages our
immunity starts from our gut, gut health
affects mental clarity and our gut impacts
our mood the campaign focuses on the
digestive system and its everyday influence
on our lives.
This campaign follows a string of other
initiatives in Vitagens long-term efforts to
champion gut health.
As a pioneer in sponsoring programmes
to facilitate the promotion of digestive care,
Vitagen collaborated with Digestive Health
Malaysia (DHM) and the Nutrition Society of
Malaysia (NSM) to launch the Good Gut
Health Awareness (GGHA) campaign last
year.
Fortifying Vitagens brand value of being
the good gut expert, the GGHA campaign
featured extensive research on live, good
bacteria and their beneficial effects in
rebalancing gut flora, thus reinforcing the
message a better gut begins with a bottle
of Vitagen.
Vitagens commitment to educating
Malaysians about gut health can best be
exemplified when it stepped up to become
the sole sponsor for the first World Digestive
Health Day in Malaysia in 2009. Today, it
continues to play a pivotal role and remains
an active sponsor annually.
Last month, Vitagen hosted its first
World Digestive Health Day event with the
support of DHM and NSM.
Part of the success of these campaigns
lies in the efficacy of the product itself.
Containing billions of live, good bacteria,
Vitagen aids in the absorption of nutrients
from food, stimulating a stronger immune
system.
Vitagen is available in the Vitagen Regular, Vitagen Less Sugar and Vitagen Collagen Less Sugar variants to cater to different tastes and needs.
Championing the cause
It also assists in suppressing the growth of
harmful bacteria, thus reducing the risk of
intestinal disturbances for optimal digestive
health.
Catered to all
Vitagen is available in a few variants.
Vitagen Regular comes in a line-up of real
fruit flavours, including apple, grape, orange
and the signature LB flavour.
Each bottle contains billions of good
bacteria, 0% fat and no preservatives,
making it a good daily supplement for all.
For those opting for lower sugar intake,
there is Vitagen Less Sugar.
Besides contributing to better digestion
and stronger immunity, Vitagen Collagen
Less Sugar helps replenish the bodys
collagen level, aiding in the maintenance
of a youthful complexion as well as
counteracting the wear and tear of bodily
joints.
Just like the other variants, it contains
billions of good bacteria as well as dietary
prebiotic fibre, vitamin C and marine
collagen peptides.
Beyond every measure, our gut health
is fundamental to defining our overall
well-being.
Having the awareness and an
understanding of what it means to be
healthy as we take active steps to get there
marks only the beginning of our journey
towards building a healthier nation.
Better digestion and a stronger immune
A watery situation
LIVING in Malaysia means every day can be
a gastronomic adventure. Many individuals,
especially those living in urban areas, rely
on hawker stalls and restaurants to get most
of their meals.
Although tasty and convenient, eating out
all the time exposes one to a higher risk of
food poisoning, which can prove to be
dangerous and even fatal if immediate
medical attention is not sought.
Food poisoning occurs when
contaminated food is consumed. The food
could be contaminated through contact with
faecal matter during handling or prepared
with contaminated ingredients and/or water.
The two most common types of bacteria
responsible for food poisoning are
Escherichia coli and Staphylococcus aureus.
Other types of bacteria that cause severe
food poisoning symptoms include
Salmonella, Shigella, cholera and
Campylobacter enteritis.
Food poisoning occurs in the gut, mainly
the small and large intestines. The virulent
bacteria produce harmful toxins that elicit
inflammation in the bowel system.
Inflammation leads to symptoms such as
abdominal cramps, fever and chills, nausea,
vomiting and diarrhoea. Bloody diarrhoea
and feeling weak are more serious
symptoms of food poisoning.
Doctors often diagnose and treat food
poisoning based on patients description of
symptoms and stool texture as well as a
physical examination of the abdomen. If
there is a reported outbreak of a certain
infection, doctors may prescribe a stool test
to identify the bacteria.
Severe cases involving haemorrhage may
warrant a sigmoidoscopy where a thin
hollow tube with a camera is inserted
SUNDAY STAR, 4 JUNE 2017
Vitagen assists in
suppressing the growth
of harmful bacteria,
thus reducing the risk of
intestinal disturbances for
optimal digestive health.
system begin with Vitagen.
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or visit www.vitagen.com.my.
through the rectum to identify sources of
bleeding or infection.
The most common treatment option for
food poisoning is ensuring that a patient
does not experience dehydration from
excessive loss of fluids. This includes
managing diarrhoea as well as controlling
the nausea and vomiting.
Patients may be prescribed oral
rehydration mixtures to replenish fluids and
minerals lost through diarrhoea and
vomiting. If necessary, they may also be
given antibiotics to stop the infection.
Under extreme circumstances of
dehydration, the doctor may admit a patient
to a hospital so that he may receive
intravenous (IV) saline fluid restoration and
medication.
Infants, pregnant women and the elderly
tend to manifest more serious symptoms of
food poisoning. Therefore, close attention
must be paid to their symptoms and
treatment.
In terms of diet, it is recommended that
patients with food poisoning cease the
consumption of solid foods until they have
been rehydrated and stopped vomiting and
experiencing diarrhoea.
Once they feel better, they can try
consuming foods such as crackers, toasts,
banana, clear soups, decaffeinated tea and
porridge.
It may take some time to be on their feet
again, so they should not rush into
consuming dairy, high-fat and spicy foods
upon recovery.
Patients require plenty of rest and should
take the day off their duties to regain
strength. With proper treatment, they
should recover from food poisoning within
12 to 48 hours.
SUNDAY STAR, 4 JUNE 2017 Digestive Health & You 7

For a healthy gut

PREBIOTICS are a source of food for
probiotics to grow, multiply and survive in
the gut. Prebiotics are fibres that cannot be
absorbed or broken down by the body and
therefore serve as a great food source for
probiotics.
Prebiotics by nature do not stimulate the
growth of bad bacteria or other pathogens.
The official definition of prebiotics is non-
digestible food ingredients that beneficially
affect the host by selectively stimulating the
growth and/or activity of one or a limited
number of bacteria in the colon, which can
improve host health.
Prebiotics occur naturally in our diet and
can be found in garlic, onions, asparagus and
bananas. However, one may have to eat
large quantities of these foods to have a
bifidogenic effect that is to increase the
levels of friendly bacteria in our intestines.
For this reason, many people find it easier
to take a prebiotic supplement or a
combination probiotic and prebiotic
supplement (called a symbiotic) to ensure
they are feeding their levels of friendly
bacteria.
Common prebiotics include
fructooligosaccharide (FOS),
galactooligosaccharide (GOS), inulin and
lactulose.
What are probiotics?
According to the World Health
Organization, probiotics are live
microorganisms which when administered
in adequate amounts confer a health benefit
on the host.
Probiotics support digestive health by
producing specific enzymes needed in the
digestion of food and aiding the breakdown
of food substances. Probiotics also improve
the absorption of vitamins and minerals into
the bloodstream.
Probiotics support immunity by
stimulating the bodys natural defences and
lining the intestines with a protective layer
of friendly bacteria that bars pathogenic
substances in the gut from harming the
body.
As two-thirds of the bodys immune
system is managed in the gut, it may be
important to keep ones probiotic levels high.
How to choose a good probiotics
supplement?
Many people believe that the best
probiotic supplement is the one with the
most bacteria in it, which are measured in
colony-forming units (CFUs).
However, research to date has shown that
it is not the total number of bacteria in a
product that is important, it is the number of
different strains of bacteria it includes.
Because the different strains of probiotic
bacteria have slightly different functions and
are concentrated in various places along the
digestive tract, probiotic supplements that
MAL11080010XC
friendly bacteria that bars
contain multiple strains tend to be more
effective overall than products containing an
extremely high concentration of just one or
two strains.
How is Nutriforte Lactoghurt
beneficial?
No two probiotics formulae produce the
same results. The benefits observed clinically
among probiotics vary according to the
manner in which those bacteria are
prepared and protected, and according to
the strains used.
Nutriforte Lactoghurt contains FOS, which
provides a synergistic effect to promote
healthy gut.
It uses a dual-coated technology called
Duolac to ensure the bacteria reach the
Probiotics support
immunity by stimulating
the bodys natural
defences and lining
the intestines with
a protective layer of
pathogenic substances in
the gut from harming the
body.
intestines alive and in good condition to
exert their action. This dual-coated
technology is patented in the European
Union, Japan and South Korea.
Besides this, Nutriforte Lactoghurt
contains five different strains and is tested
initially and at the end of shelf life to ensure
that all strains survive together until the
time of expiry.
This product is developed by Cell Biotech,
a Danish-Korean bio-venture enterprise that
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Lactoghurt is available at all leading
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KKLIU No.0903/2016

Understanding fibre content

ACCORDING to the Malaysian Dietary
Guidelines, the recommended daily intake of
total fibre for Malaysians is 20g to 30g per
day.
However, Malaysian Journal of Nutrition
reported that more than half of Malaysian
adults consume only about 13g to 15g
of dietary fibre per day, indicating a
fibre-deficient diet among adults.
Dietary fibre content is usually listed
on a food label as total fibre, which is a
combination of soluble fibre and insoluble
fibre.
Both types have distinctive health benefits.
It is important to select the right dietary
fibre to deliver the desired health benefits.
Products that are made of natural oat bran
such as oat bran powder and crispy oat
cereals contain high amounts of the soluble
fibre known as oat beta-glucans.
A daily intake of 3g oat beta-glucan has
been extensively studied and documented
for cholesterol-lowering and blood
glucose-regulating benefits.
According to the European Food Safety
Authority (EFSA), the ingestion of insoluble
fibre improves bowel function by increasing
bulk in stool and bowel regularity.
The Health Ministry states that the gut
health benefit is achieved when a food
product contains at least 6% of oat fibre or
3g of total fibre in a single serving.
Therefore, it is imperative for consumers
to find out from the product label how much
of total fibre (including oat beta-glucans) a
serving of the food can deliver, along with
known amounts of carbohydrate or sugar
content and total caloric intake.
Biogrow Oat BG22 Oat Bran Powder and
Oat BG22 Crispy Cereal contain high
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Both are made of natural ingredients
Swedish oat bran. They are free of artificial
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Two scoops or sachets (18g) of oat bran
powder or one packet (30g) of crispy cereal
daily provides 3g oat beta-glucan (soluble
fibre).
High in total fibre and low in glycaemic
index (GI), both the oat bran powder and
cereal offer soluble and insoluble fibre with
at least 22% total fibre content. They have
been tested in the laboratory to be low in GI
and suitable for diabetics.
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8 Digestive Health & You SUNDAY STAR, 4 JUNE 2017

HAVING a balanced diet is, as we all know,

key to good health but Muslims must pay
greater attention to what and how they
consume food during Ramadan especially as
their bodies adjust to the new routine.

Even though fasting is an annual

obligation, it is a concern when Muslims
start to pick up unhealthy eating habits
during the non-fasting hours.
The food and drinks consumed during the
non-fasting hours can greatly affect ones
mental and physical abilities the following
day. As it is a month-long fast, healthy eating
habits must not be forgotten.

Eating in order
Among the things that people may do
wrong is deciding to skip sahur.
Skipping the morning meal out of
convenience, desiring more sleep or simply
because one does not feel hungry early in
the morning may not sound like a big deal
but it is important that people consume a
decent amount of food as it will provide
them with the energy and fluids required to
last the day.
A complete meal with the right nutrients,
fibre and roughage will help prevent people
Moderate food consumption is important when fasting to ensure the body is still sufficiently nourished.

Eating in moderation
from feeling lethargic or weak as they go
about their daily activities.
After spending the entire day without food
or drink, it is then natural to want to quickly
satiate one's hunger and quench one's thirst
but it is advisable for one to eat in
moderation to avoid problems such as
indigestion, regurgitation and heartburn.
Prof Dr Lee Yeong Yeh, science leadership considerable amounts of oil, sugar, coconut Prof Lee says, Some people may find

A complete meal with

chair of Young Scientist Network of the
Academy of Sciences Malaysia, says, Eating
too quickly often ends up with excessive
eating, worsening indigestion and more
severe acid reflux.
He also suggests that people who have had
stomach surgery, in particular, must avoid
eating too quickly.
Considering the intake
Many of Malaysias tastiest dishes have
milk, fat and salt, not to mention artificial
flavouring, sodium and preservatives.
It is no surprise then that high
consumption of such foods coupled with
long hours of inactivity can put people at
risk of gaining weight.
People need to monitor their food intake
to ensure they eat everything in moderation.
It is important to cut down on fried chicken,
French fries and other fried foods as these
foods are high sources of saturated fat and
calories.
dishes rich in oil and coconut milk to cause
abdominal discomfort, indigestion, gas and
reflux.
He shares that patients with underlying
heart disease, diabetes mellitus and
hypertension may also find their diseases
worsening when consuming large amounts
of such foods during Ramadan.
Prof Lee, who is also professor of medicine
and consultant of gastroenterology at
Universiti Sains Malaysia, adds, Some
people may find processed foods to cause
abdominal discomfort, indigestion, gas and
reflux as well. In more severe cases, they
lead to the possibility of food poisoning,
causing diarrhoea, vomiting and fever.
Keep properly hydrated
Many individuals do not drink enough
fluids during the non-fasting window, which
can cause dehydration and even constipation
during the day.
Relying heavily on caffeinated drinks such
as colas, energy drinks, tea and coffee,
however, will further dehydrate the body.
While breaking fast, drinks and desserts
such as rose syrup, air bandung, cendol and
colourful kuih-muih are sweet to the taste
and can be refreshing but these treats are
also sources of empty calories that will add
some unwanted kilogrammes to your
weight.
People need to consume such treats
moderately. As a better alternative, you can
the right nutrients, fibre
and roughage will help
prevent people from
feeling lethargic or weak
as they go about their
daily activities.
consume coconut water to quench your
thirst and remain hydrated.
Another way to keep hydrated is to
consume more fruits. Whether consumed
whole, as fresh juice or a slushy, fruits
provide high amounts of vitamins, minerals
and dietary fibre that are important for the
body and also a good way to detoxify the
digestive system.
Granted, there are many tasty and
delicious delicacies to feast upon in Malaysia.
However, many of these dishes should not
be a staple in any diet, particularly for those
who are fasting this month.
Fortunately, there are countless
alternatives available that can provide the
right nutritional requirements to last the
day. One simply has to be more mindful of
his or her daily intake.