Sleep .......... Are we getting enough?

Travelling across time zones really messed up my normal sleeping pattern. But, come to think of it, I think I sleep better now compared to before, it is just that the timing is a bit off. Like sleeping early and waking up at 5, then falling asleep again at 8 and waking up at 10. But in terms of hours of sleep and quality of sleep, I think it has improved a lot since my last trip. The main focus is quality of sleep and getting that crucial 7.5 hours daily.

I was a victim of poor sleep hygiene like most workaholic city dwellers are. Plus, the intensity and demands of work previously when I was in the hospital were certainly not feasible. Imagine working from 7am to 5pm the next day. Yes, my houseman days in GHKL were super, the time we spent in the hospital was phenomenal. But we loved our job and our patients so much, most didn't even complain. We took it as part of the training to make us become more apt and precise in our decisions despite being under physical and mental duress. 

However, despite not being on-call anymore for the past couple of years, I found that I had a hard time switching off at night, and I wake up considerably easy. Turning off my phone was becoming an anxiety to me, and my late onset insomnia did not improve. I would wake up in the middle of the night and lie in my bed staring at the ceiling for hours unable to go back to sleep, only to doze off a few minutes before my alarm clock went off. It was draining my energy and causing my focus and concentration to wane. To some extent, I was getting a bit more depresses and irritable.

Many of us do not realise how sleep deprivation affects the body. Some people come to me and brag about sleeping for only 3-4 hours a day and able to function normally. (Are you sure?) Some people think its normal but many studies on human behaviour and sleep have shown that chronically sleeping less than 6 hours a day is detrimental not only to your physical health, but affects you mentally, emotionally and socially. 

So why is it important to get that good night sleep?

1) It affects your mood. 

    Lack of sleep causes irritability, lack of motivation, anxiety and depression.

2) Lack of Sleep makes people more prone to accidents.

    It is one of the leading cause of automobile accidents and occupational hazards.

3) It affects your intelligence and memory.

    Lack of sleep makes you forget things, and reduces your mental alertness to up to 32% if

    sleep deprived to less than 6 hours a day of sleep. It stunts creativity. It affects

    concentration, understanding, rationale thinking and problem solving processes.

4) It affects your sex drive.

    Studies have shown that lack of sleep reduces libido in both man and women. In fact, some studies also shows low levels of testosterone secretion in men deprived of sleep.

     

5) Lack of sleep ages your skin faster.

    Apparently beauty sleeps are not just an excuse to sleep early. People who are deprived of

   sleep for a couple of days have sallow skin and puffy eyes. Chronic sleep loss affects the skin worst    causing dark eye circles, formation of fine wrinkles and dull skin. Lack of sleep causes increase in      cortisol hormone levels that is also involved in the breaking down of collagen. 

6) Losing Sleep can cause you to gain weight.

  Most people believe that sleeping can cause you to be fat but actually the reverse is true.                Depriving yourself of sleep makes you gain more weight. A few studies conducted showed    that  people who lack sleep tend to consume more especially in the awkward hours thus  exceeding the  daily caloric requirements leading to weight gain. This was because lack of    sleep reduces the  secretion of leptin (your satiety hormone) and increases the production of  ghrelin (hunger hormone)  making people who sleep less than 6 hours a day experiencing  more hunger. The worst part is, lack  of sleep makes you crave for high fat and high sugary  foods. I think most people can relate to this.

7) Lack of sleep increases mortality risk.

  If you want to live longer, you should sleep more. As a hyperactive teenager, my dad use to  tell me  this. He wasn't too far from the truth. Studies have linked lack of sleep (i.e. sleeping  less than 6    hours a day) to be associated with increased risk of death to twice the risk  especially cardiovascular.

8) Sleep deprivation is associated to a lot of serious medical problems.

 There are many medical problems related to chronic sleep deprivation:

 a) Hypertension and high blood pressure

 b) Heart disease

 c) Heart Failure

 d) Irregular heart beats - arrythmias

 e) Stroke

 f) Obesity

 g) Diabetes

 h) Depression & other mood disorders

 i) Attention Deficit Disorder

9) It affects relationships.

  If your partner has sleeping issues and is deprived of sleep chronically, long term it will be a challenge for the you to cope especially when he or she has reduce mental performance,  less energy, low mood, lacking of motivation, low libido etc. In fact, he or she may start  influencing you to have reduced sleeping hours leading to your own problems. Your partner's sleep disturbances may disrupt your own sleep too.

​​

 

How much sleep should we have in 24 hours?

Most studies agree that an adult between 18-64 years old should try to get 7-9 hours of quality sleep everyday. Here is a beautiful chart courtesy of the National Sleep Foundation on different age groups and sleep recommendations.

​​

 

 

So, if you are sleeping less than the recommended hours, you better start deciding on trying to make more time for sleep. Some people have difficulty in falling to sleep or staying asleep. Others feel like they can sleep but does not have enough good deep sleep and keep waking up. Some people have sleep apnoea issues that causes them to have bad quality of sleep. Some people grind their teeth at night or wake up with muscle cramps. Although it may seem to be common, you should take to your health provider about any sleep disturbances you are experiencing because there are treatments available.

For more information or if you have any questions on sleep, please email to drmmclinic@gmail.com. 

Weight Loss Program that Works

Everyone wants to look good all the time. Everyone wants the perfect body. However, with all the different types of genetic make-ups and environmental influences, not all of us a born with that perfect silhouette. It came to the point that people take for granted the excess weight and obesity that is becoming a plague among us due to the modern sedentary lifestyle and our highly processed food diet that causes more of the unnecessary nutrients to be absorbed and stored.

I use to be really big. But growing up in a society where food was a culture, you do not realize how big you really are until you manage to lose the excess weight. Over past 4 years I have been experimenting and undergoing so many different types of diets from Atkins to blood group diet to soup diet and although a lot of them do give initial results, I do not find a long term benefit until I came across HCG diet. The HCG diet involves injecting the 125 units of the HCG hormone everyday for the period of the course and eating only 500 calories a day of only fiber and protein. There is a strict carbo restriction, strict exercise restriction and if done properly would allow fat loss without sagging.

It was not an easy protocol to follow. The first time I did it, I survived, 10 days before I felt like eating my shoes. And due to starvation, I was eating more and thus gained an additional 4 kg. Then I stopped and did more research ont he protocol and then realized, it was actually an internal manipulation of our own insulin and fat metabolism pathways. So I went through the protocol and started to follow it properly. I found that, after the 2 loading days, the HCG amount would have been sufficient to curb hunger as long as I kept my insulin level plateau down and no spikes. I also realized, you have to follow the eating times strictly initially until your brain gets the idea of the whole diet (usually after the first week) and then you can modify according to your lifestyle. But perhaps the most important component is the maintenance period where you stop injecting and go on 1000 calories of the similar diet, where the 1st stage strictly, and in the second stage starch is introduced. I also experimented on fasting and on exercise and on shorter protocols to cater busy people like me. Personally, I think that at least once in your lifetime, you should do a complete 40 day program and 80 day maintenance program in order to maintain all the weight loss and silhoutte. 

So now, after 4 years of tweaking, I guess our protocol is complete and more comprehensive. I really believe it benefits everyone who are not contraindicated to use HCG. It is perhaps the safest diet in the world as the hormone leaves the body completely after 72 hours.

Benefits of Our HCG Detox Program:

1. You get to choose between 3 durations of the program, i.e. 10, 23 or 40 days. You can even start low and add on by just adding onto the cost. 

2. There is real time consultation via sms/whasapp or email if you need to ask about what to eat or any restriction or if you need rest days. We are pretty responsive to all our HCG patients as part of the service.

3. We do not provide food for HCG because we want you to learn how to eat clean on your own. However, we do provide dining out options for really busy people.

4. Weight loss usually depends on your initial size and fat content. A person with more percentage of fat tends to lose faster and more compared to a skinnier person. Weight also depends on the size of your skeletal muscles hence why men find the weight loss to be more if they were gymming before.

5. We do not allow exercise during this program except for special instances where you are already in a regime or if a certain area of fat is being targeted then we will prescribe the type of exercise we allow.

6. If followed properly, you should lose 500gms every day for the first week, then 300gms, then 100-200 grams. 

7. The most obvious change will be your silhoutte. Some people do not lose much weight but the cellulites reduce and the silhoutte improves. The good news is, this will continue even up to 6 months after initial program or more if exercise regime introduced pertaining that the program and maintenance was done correctly and you don't suddenly start to binge eat.

8. 90% of our patients who succeeded realized that they have a much lesser craving towards sugars and are more conscious about healthy eating.

9. It trains your brain to be self-conscious about what you put into your mouth, the amount of additional sugars in drinks or foods and it is a good start for people thinking of changing their lifestyle into a more healthier one.

10. It regulates menstrual cycles for most ladies with erratic cycles because it does influence the LH/FSH pathways.

11. You don't sag on this diet, because you lose fat content not protein nor muscle. Hence the protein requirement of 100 gms per meal is important.

12. Saying all this, you can still enjoy a glass of wine, or your nasi lemak sometimes after you have completely finished the whole program and maintenance without fear of regaining the same size again. Even if your weight starts to go up, we can also advise you on how to bring it down.

People also ask me isn't 500 calories too little to consume in a day? Well, in the absence of any insulin spike in the body, the HCG hormone acts as a catabolic hormone to fats where it moves out fats and burn them as fuel thus producing between 2000-3000 calories a day. So if you eat more than 500, and do not expense the calories, it will restore as fats, or the metabolism will act by reducing the amount of fats burnt. The best part is that it acts on the excess fat areas i.e. chin, arms, tummy and later thighs as usually the thighs are your physiological fat storages. 

Before I ever tried this diet I was ranging around 86kg. After the second one (the first failed), I dropped down to 78 but went back up to 82 because I didn't follow the maintenance properly. Then subsequently i did 40 days and dropped from 84 to 72. Again the maintenance was not followed well, but I just gained to 76. I tweaked the protocol so many times and I got smaller and smaller. The last time I did a proper HCG course was last January where from 72 I dropped down to 63 and now maintained around 65. It has been a year actually and I feel like going on again just as my yearly detox. The best part maybe was the fact that from an XL size 14, now, I wear dresses size 0-4.

Don't believe me. Here are two pictures of me in Bali taken in 2008 and 2016. 

​​

​​

For more information or enquiries concerning our programs feel free to contact us at drmmclinic@gmail.com or whatsapp to +60123301585.

Exercise is a must - Even if you don't have time.

Recently, my good friend gave me a 3 month free pass to use a gym. Despite not being a gym person, I thought I'd give it a try. The gym was near my office, but getting there was already a 15 minute aerobic cardio exercise from walking. This was good, since I needed to warm up before getting started. The first machine they normally put you on is a thread mill, and yes, it was the same for me too. Then after that they got a PT to guide me (or rather try to close PT training sessions sales). It kinda pissed me off a bit, since the PT was suppose to show you how to use machines but he was busy making me do 3 laps of butterfly jumps and then tell me I have bad stamina when the chick next to me can't even complete 1 lap. So in a way, I was pretty discouraged to go to the gym, since I know that they are just trying to make you buy more and more packages to sign up. Whatever, I still have my 3 months pass, so I don't really give a hoot to what they want to think or say.

Regardless, exercise is a crucial must in our daily lives. Yes you got me right, it has to be daily. But it doesn't mean you have to jog every single day. There are many types of exercises you need to understand and plan them according to target.

1. Cardiorespiratory work out

This is the most common work out everybody does because it is perceived as the most important. It can be anything from running to jogging, or brisk walking to dancing, aerobics, swimming. Regardless, most professionals agree that 30-45 minutes a day is enough and can help reduce a lot of heart related problems such as reduce risk for coronary artery disease, hypertension, diabetes, lipid levels etc. I would normally recommend doing some cardio workout before targeted exercises as it helps to improve your blood circulation, muscles are more prepared and warmed up so it reduces injury. But if you have existing problems like back pain, obesity, joint pains - you should start with low level exercises like walking first before jogging or running. When is the best time to exercise? When you can slot a time of 30 minutes of no disturbance of the routine. An exercise is only effective if you do it continuously for at least 10 minutes at a time. 

2. Body strength and composition exercises.

One of the most interesting things I learnt during my previous anti-aging conferences was that in order to maintain weight you need to lift weights. So I decided to follow this technique and bought myself some dumbbells. And sure enough, I did notice my weight maintaining better despite my lack of running around. So I decided to read more and understand why. The main reason is that if you have a lot of muscle bulk, you burn more energy in your sleep maintaining them compared to if you didn't. The problem when you are obese or overweight, most of the muscles are mixed with too much fat, and fat is a storage organ, so you don't really burn that much calories with them. Now, when we go on a starving diet, our protein stores in our muscles are the first to go hence leading to smaller muscle mass thus why the weight doesn't go down. That is why a lot of diets nowadays preach on a higher protein consumption, more fiber and no refined carbs for a better weight loss result. Another new thing I learnt was that sudden usage of energy for example short sprinting exercises burns more energy and brown fat compared to a 60 minute cardio. So for people like me, who persistently have a V/Q mismatch or poor respiratory endurance, 5-10 minutes sprinting in between my regular jog benefits more in terms of fat loss, compared to trying to sustain 45 minutes of running that would exhaust me more. As for heart rate, although most people believe that you cannot exceed 80% or your max heart rate as it can cause problems, this is not entirely true. High velocity sprinting causes your heart rate to jump even higher than the so-called maximum heart rate level, and studies have shown that it is safe in short outbursts.

3. Flexibility exercises

When I was younger, we use to have this game where we would try to flex our body backward all the way and walk. It was so much fun then. Flexibility exercises are important to maintain the elasticity of the joints and avoid injuries especially in sudden movements. How to stretch? Basically it needs to involve the muscles in each group i.e. extensors or flexors. Still gibberish? Try Yoga or Pilates - these involve a lot of stretching exercise in the routine that is done in stages. Other simple stretch methods are the stretch exercises we use to learn in school during PE (If we did). Or when you learn martial arts or dancing half of the routine are flexible exercises. I normally do stretching exercises after all the cardio and sprinting as the joints are already warmed from the 2 other work outs. Otherwise, I do it on my bed before getting up :).

Basically you need to have a mixture of all three types for a complete work out. There are many forms of exercise to choose from besides the typical treadmill so choose one you are most comfortable and happy with. Other benefits of exercise also includes:

1. Reduce risk of cardiovascular diseases. Even if you already have cardiovascular disease it helps to improve it.

2. Reduces risk for diabetes by increasing insulin sensitivity and improving glucose metabolism. So even if you already have diabetes, it helps. This is also true for resistance exercises, not just the normal aerobic.

3. Reduces hypertension - this is true for aerobic exercises. High intense exercises have not shown much effect.

4. Reduces blood TG, Cholesterol and LDL. This is true when you burn 1000-2000 calories a week usually from constant aerobic or sprint exercises.

5. Reduces risk of stroke due to all above.

6. Reduces risk of colon, breast, lung and multiple myeloma cancers with 30-60 minutes of moderate to high impact exercise daily.

7. Reduces osteoporosis. Lunge exercises and medium impact exercises stimulate bone growth.

8. Improves muscle health and reduces sarcopenia. Sarcopenia is the age-related muscle wasting that we see in elderly people. In some it occurs faster than others. Regular exercise helps maintain muscle masses thus reduces sarcopenia.

9. Maintains body composition and reduces obesity.

10. Reduces Arthritis.

11. Reduces stress. This is only true when you make the exercise fun. Like I said, there are many forms of exercise you can choose from.

12. Improves mood.

13. Reduces Depression and anxiety due to the improvement of mood and reduction of stress.

14. Improves self-esteem. When you exercise and feel good about it, reduces stress and elevates your mood, your self-esteem improves. Plus the multiple health benefits and the figure benefits would definitely boost the inner you.

For busy people like me, there are studies on people who do exercises only on weekends or once or twice a week and it does shows improvement and benefits. So even if you are strung out during most the week, at least take a day off to do some exercise. The recommended is to burn at least 1000 calories a week and this would give you a reduced risk of 20% of dying prematurely. 

Like I always tell my patients during aesthetic consultations, Doing something is always better than doing nothing. So even if you do not get an optimum exercise routine, at least doing some exercise would benefit.