How To Cook Asparagus You’ll Actually Want To Eat

If you don’t like asparagus, it’s possible you just think you don’t.

(It’s also possible you truly hate it, but let’s just give this a try, OK?)

First things first, let’s address the elephant in the room. Asparagus has an unfortunate association with urine, and you may have a hard time getting past that. It’s understandable. In a cruel twist of evolution, asparagus makes all of our pee smell like asparagus, but not all of us can actually detect the scent. Those of us who can might be avoiding the vegetable entirely.

Another reason you might not like asparagus is that people cook it beyond recognition, or, worse, they don’t trim off the woody stalks. This nutritious vegetable deserves better. One serving provides you with 100 percent of your daily vitamin K requirements, and it’s also packed with vitamins A, C, E and B-6, as well as iron, copper, calcium and fiber. It treats you right, so you need to start treating it right.

Here is a guide to help ensure you eat the best asparagus of your life. Heed these tips and forget about all the bad asparagus from your past.

How To Shop For Asparagus

Avoid canned asparagus; fresh tastes infinitely better. Generally, fresh asparagus is available on the West Coast from February to May, and on the East Coast from May to June. The asparagus we find in grocery stores year-round is usually from Peru, and it’s not as good.

Make sure your spears are bright green and have tightly closed tips. (And if you’re cooking with purple or white asparagus, make sure it’s a vivid purple or a bright white.) While you’re at it, check out the root end to make sure it’s not dried out and brown.

You’ll see asparagus ranging from pencil-thin to jumbo-sized, and anywhere in between. The New York Times explains that the “thickness of the asparagus does not indicate its maturity; a thin asparagus spear does not grow into a fat one.” So how do you choose what to buy? Really, it doesn’t matter. But if you’re doing a quick sauté, thin spears will work best, whereas fatter stalks work nicely with cooking methods that apply heat to the vegetable for longer periods of time, such as roasting.

If you stick your asparagus in the crisper drawer, you’re doing it wrong. Treat asparagus like cut flowers and place it in a cup or bowl of water in the fridge, cut-side down. It’ll stay fresh for up to a week this way, if not longer.

How To Prep Asparagus

There’s nothing worse than getting a mouthful of woody asparagus stalks you can’t chew. Follow these steps, and you’ll never end up having to spit your asparagus into your napkin again.

Wash and peel it. Yes, peel it.

Asparagus comes from the ground, so you need to give it a good rinse. If you see any white, woody scales on the outside of your stalk, get out a vegetable peeler and simply peel them away until you reach the soft center.

It’s imperative that you break off the woody part of each stalk. You can do this in one of two ways.

First, you can bend each spear until it breaks easily at a natural snapping point. (Make sure your hands are near the bottom of the spear, or you risk discarding too much.) The disadvantage of this method is that it produces uneven lengths that look sloppy, and you tend to snap off more than you need to.

Alternatively, you can cut your spears with a knife. Note where the woody parts begin, and remove them.

How To Cook Asparagus

For each of the following methods, use a fork to test the doneness of your asparagus. Whether you want it crisp-tender or super soft, it’s up to you.

Roast
Roasting is our favorite way to cook asparagus, as it creates a nice caramelized flavor. With the oven set at 400 degrees Fahrenheit, drizzle olive oil and sprinkle salt on your prepared asparagus. Then bake it on a rimmed cookie sheet. (We like to line our baking sheets with aluminum foil for easy cleanup.) Roast it until crisp-tender, at least 15 minutes. Leave it in longer if you want it to turn nice and brown, around 30 minutes total.

Steam
Steaming is a quick and healthy way to cook asparagus. In a large pot fitted with a steam basket (and water below that), cook the asparagus, covered, until it turns bright green and is crisp-tender. This should take no longer than 3-5 minutes.

Simmer
In a saucepan with about an inch of generously salted water, simmer the asparagus for 2-4 minutes (depending on the size of your stalks) until bright green and crisp-tender. Remove from the pot with tongs and blot dry with a paper towel.

Blanche
This method is best for asparagus that you’ll be serving on a crudité platter with dips, because it allows the asparagus to retain its bright green color and its crunch. In a wide pot, boil a few inches of generously salted water and add your asparagus. Simmer for 1 minute, and then immediately plunge the spears into a bowl of ice water to halt the cooking process. Pat dry with paper towels.

Grill
Grilling produces a similar effect to roasting. Brush the asparagus with olive oil and sprinkle with salt. On a heated grill, lay the spears so that they are perpendicular to the wires on the rack (you don’t want to lose your asparagus to the coals!). Grill for roughly 7-10 minutes.

Sauté
We really only recommend sautéing for thinner stalks of asparagus. Heat a couple tablespoons of olive oil in a sauté pan over medium heat, and cook your prepared asparagus stalks (with a little garlic and salt, if you’d like) for about 5-7 minutes to get a crisp-tender result.

Now take a look at some of our favorite asparagus recipes of all time, and put your new skills to work:

Crimes Against Peeps, From ‘Peepza’ To Pancake-Flavored Chicks

People hate Peeps. Like, they really hate Peeps. But in a cruel twist of fate, people (or Peeple?) who love Peeps are the ones who end up doing the worst things to them every Easter.

Follow us down the dark rabbit hole of the internet for a few examples.

Crime No. 1: Peepza

Peepza is pizza topped with Peeps. It shouldn’t exist, and it definitely shouldn’t be as popular as it has become.

It was born from a joke made by Adam Kuban, the editor of Serious Eats’ now-dormant pizza blog called Slice. Slice published a tongue-in-cheek recipe for Peepza in 2010, but of course the internet gave it a life longer than it ever deserved to have.

Now every Easter, Peepza rears its ugly head and prompts an onslaught of social media reactions. It has become so mainstream, in fact, that even Martha Stewart let Peepza corrupt her pristine palate:

Crime No. 2: Terrible flavors

Some crimes against Peeps are actually committed by the company that makes them. The folks at Peeps have created some controversial flavors like Orange Sherbet Peeps dipped in fudge and Neapolitan Peeps filled with chocolate, which are essentially baby birds that squirt out brown goo when you squeeze them. But it gets worse. There are Party Cake Peeps, Cotton Candy Peeps and, perhaps worst of all, Pancakes & Syrup Peeps.

Crime No. 3: Shooting someone who’s wearing a vest made of Peeps

This one almost qualifies as an actual crime, because there’s a gun involved. Pro shooter Kirsten Joy Weiss, who has a YouTube channel full of trick shots and other gun stunts, made a protective vest out of Peeps in 2016 and then fired at it to see how much damage the treats could take.

Crime No. 4: Burying your Peeps alive

Please don’t make this trifle. It’s just not OK.

Crime No. 5: Eating a food that’s indestructible

An editor at HuffPost left some Peeps on a desk for a year, and almost nothing happened. One week, the Peeps felt a little bit harder, but the next they’d feel a little softer.

And when it comes to tests about Peeps, this was on the unscientific end of the spectrum.

The worst crimes against Peeps are probably yet to be committed. We’ll find new, more upsetting ways to add them to dioramas, art projects and recipes; we’ll continue to impale them with sticks and allow them to ruin Oreos and bottles of wine.

But you can find comfort in the fact that you’re not alone if you want the madness to end:

How Long You Can Keep Leftover Ham?

Now, go eat your leftovers with confidence.

Fresh (uncured) ham, cooked
3-4 days in refrigerator, 3-4 months in freezer

Cured ham, cook-before-eating, after consumer cooks it
3-5 days in refrigerator, 1-2 months in freezer

Spiral-cut hams and leftovers from consumer-cooked hams
3-5 days in refrigerator, 1-2 months in freezer

Country ham, cooked
7 days in refrigerator, 1 month in freezer

Before they go bad, use your leftovers in these delicious recipes:

What To Do With Leftover Ham

Leftover ham can sit in your refrigerator like the giant piece of animal flesh that it is, threatening to emit odors as you wonder how long it’ll last before you have to toss it. Or it can be turned into something delicious if you just get off your keister and put it to good use.

These 25 recipes are all perfectly suited for leftover ham. You can slice it or dice it and toss it into a hearty soup, a creamy pasta dish, a Cobb salad or the world’s most delicious homemade version of a Hot Pocket. Take your pick and get cooking.

You’re Doubling The Glycemic Index Of A Sweet Potato When You Bake It

A baked sweet potato is one of those rare things in life that’s both good for you and intensely satisfying, kind of like watching multi-episode TV crime dramas. In terms of nutrition, a baked sweet potato is high in vitamins A and C, fiber, potassium and iron. Flavor-wise, it’s like dessert and a savory casserole got married and had a baby.

But a baked sweet potato also has twice the glycemic index of a raw sweet potato.

Before you panic, don’t. Baked sweet potatoes’ glycemic index is still not very high, and they’re still recommended as a healthier alternative to white potatoes. However, if you’re diabetic, you need to regulate your insulin levels for any reason or you’re just looking to cut back on sugars, you may want to rethink the way you eat sweet potatoes.

The good news: there are simple ways to prepare sweet potatoes that can produce a dramatically lower GI, compared to baking them.

We’ll show you how to do that, but first, let’s get to the root of this to understand what happens when you eat a baked sweet potato.

What is a glycemic index, and why should we care about it?

A glycemic index (GI) is a way of ranking carbohydrate-containing foods according to their immediate effects on blood sugar levels. Carbs with a low GI (which are considered to be the most diabetic-friendly) are more slowly digested, causing a slower rise in insulin levels, whereas foods with a high GI, such as white bread and table sugar, are quickly digested and make our insulin levels skyrocket.

That means foods with a high GI are also way more likely to make you hangry.

A low GI is defined as 55 and under, intermediate is 56 to 69, and high is 70 and above.

In the case of tubers like potatoes and sweet potatoes, we often overlook their incredible potential to convert from starch to sugar. Sweet potatoes may not be sold in a bakery box, but they still contain chains of glucose like other sugary foods ― the difference is that a sweet potato’s glucose comes packaged in a plant, not in a cookie or cake.

As health journalist Max Lugavere explains in his book Genius Foods, our bodies can turn starch into sugar molecules with ridiculous ease. This conversion process begins even before you swallow your food, when an enzyme in your saliva called amylase begins to break down starch. But your body isn’t the only thing that converts starch to sugar. Cooking does it, too.

How cooking affects a sweet potato

The nutrition facts for raw and baked sweet potatoes can be vastly different. One cup of raw sweet potato may contain 114 calories, 26.8 grams of carbs and 5.6 g sugar, whereas one cup of baked sweet potato may contain 180 calories, 41.4 g carbs and 16.9 g sugar. That’s a big increase in carbs and sugars. But why?

Here’s the scientific explanation: Heat breaks down starch granules, which allows amylopectin and amylose (the two polysaccharides that form starch) to be more readily digested by pancreatic amylase (an enzyme), which turns starch into maltose (a sugar).

Here’s the layperson’s explanation: Heat breaks down the starch in sweet potatoes in a way that allows your body to easily convert that starch into sugar, which spikes your blood sugar levels.

So what does that specifically mean in the case of sweet potatoes?

A study conducted in 2016 subjected 11 types of sweet potatoes to three different cooking methods ― baking, microwaving and steaming ― to determine each method’s effect on the food’s glycemic index. And the differences were notable.

Cooking Treatment Effects On Sugar Profiles And Sweetness of Eleven-Released Sweet Potato Varieties,” published in the Journal of Food Processing & Technology, found that the GI for a raw sweet potato started at 15 and that baking increased it the most (33), microwaving the least (18), and steaming came in somewhere in the middle.

Baking vs. microwaving

The longer a sweet potato is exposed to heat, the study found, the more its GI is likely to increase.

The sweet potatoes were baked in a conventional oven for 60-90 minutes at 180-220°C ― which is much longer than they would be microwaved or steamed. Researchers concluded that the longer cooking time at high temperatures “resulted in the highest sugar formation.”

Baking also employs dry heat, which dehydrates the sweet potato, degrades its starches, concentrates its sugars and therefore increases the sugar content and glycemic index.

Conversely, the microwave exposed the food to heat for the shortest amount of time and increased the sweet potato’s GI the least. The study cited the technique’s “rapid heating mechanism” as being responsible for actually deactivating part of the process that turns starch into sugar.

No matter how you cook a sweet potato, it’s important to note that there are numerous varieties with different GIs. A 2012 study published in The Open Nutrition Journal, titled “Glycemic index of sweet potato as affected by cooking methods,” worked with the popular Beauregard variety, which has a raw GI of 32. The earlier study found that cooking a sweet potato approximately doubles the GI.

Here’s what you can do at home

According to the 2016 findings, if you want sweet potatoes with the lowest GI, you should basically do anything but bake them.

Don’t run off, however, and eat a bunch of sweet potatoes raw. The reason we cook them in the first place is to make them easier to digest. When heating breaks down those starch granules, it prevents you from experiencing certain embarrassing digestive issues.

But you can eat raw sweet potatoes in small quantities without much trouble. And unlike white potatoes, they don’t contain the dangerous enzyme solanine in their raw state.

These are a few ways to cook and enjoy sweet potatoes, in order from lowest GI to highest:

  • If you want to try eating them raw for the lowest GI, toss a handful of grated raw sweet potato into a smoothie or throw it on top of a salad.
  • If you want to try microwaving a sweet potato, follow these directions. It takes 5-10 minutes.
  • It takes a little longer to steam sweet potatoes. Follow these directions to make them in about 20 minutes.
  • Baking takes the longest. Follow these directions and you’ll have baked sweet potatoes in a little over 45 minutes.

Now that everything’s been explained, just remember not to freak out about eating baked sweet potatoes if you don’t have issues with your blood sugar. Even baked sweet potatoes still have a lower GI than a lot of other foods we consider to be healthy, such as instant oatmeal, brown rice, watermelon or rice milk. And they’re still seriously good for you in so many other ways.

Here are some of our favorite ways to cook them:

How To Make Big Batch Cocktails Without Doing Any Math

So you’ve finally mastered the perfect Old-Fashioned recipe (or mojito, or Manhattan, or what have you). You make it for yourself with precision, immaculately balancing the flavors every time, and you revel in the satisfaction of feeling like a bona fide adult.

But what happens when it’s time to make that drink for several people at a party? There’s no way you’re going to spend the entire night at the bar, meticulously mixing one drink at a time.

That’s when you batch your cocktails, mixing them up in big pitchers that’ll serve eight to 10 people. But multiplying your drink recipe by the number of people at your party can get sloppy. Cocktail recipes are often formulated in fractions, calling for 3/4 ounce Cointreau here or an ounce and a half of vodka there. The math is frustrating, and it doesn’t always add up to something that can be easily executed with the measurements on the average jigger.

André and Tenaya Darlington, the sibling authors of the new cocktail book Booze & Vinyl, offer an easier solution, one that miraculously doesn’t involve any math:

Here’s a quick way to turn a recipe into eight servings: substitute ‘cups’ for ounces. You can apply this to any recipe. Simply measure the ingredients into a pitcher. Instead of shaking or stirring on ice, dilute the drink by adding 20 percent water. Chill well before serving.

Hold off on batching citrus drinks until right before guests arrive. Citrus juices lose their freshness quickly, especially when mixed with spirits, so to keep a pitcher of Margaritas zesty, batch out the spirits ahead of time. Then squeeze your citrus right before guests arrive.

It makes sense if you think about it, because there are 8 ounces in a cup.

Now you’re ready to mix up a big batch of cocktails. If you don’t know where to start, the Darlingtons shared their mojito recipe below. Feel free to make a single drink or use their trick and convert the ounces to cups for a big crowd.

Mojito

Born in Havana, Cuba ― although the date and origin are contested and it could be as old as the 1500s ― this classic cocktail gained popularity as a Hemingway favorite after World War II. It has gone on to become one of the most ordered drinks at bars, to the chagrin of many a tired muddler. Simple and refreshing, it is a great drink to serve at parties.

  • 2 ounces white rum
  • 6 mint leaves, plus a sprig
  • 3/4 ounce simple syrup (recipe follows)
  • 3/4 ounce fresh lime juice
  • 2 ounces club soda

In a rocks glass, muddle mint leaves with simple syrup. Add rum and lime juice. Stir. Fill the glass with ice and top with club soda. Garnish with a sprig of mint.

Simple Syrup

  • 1 cup demerara sugar
  • 1 cup water

In a small saucepan over medium heat, combine equal parts sugar and water. Stir until the sugar dissolves. Do not boil. Remove the pan from the heat. Cool. Transfer the liquid to a jar, seal well, and refrigerate for up to a month.

 

Reprinted with permission from Booze and Vinyl, 2018 by André Darlington and Tenaya Darlington, Running Press

 

These Healthy Sweet Potato Brownies Are Magical

Here’s a common baking conundrum: You want to bake brownies, but you dread the temptation of eating the entire batch. Oh, and one other thing: You don’t want to share.

We’ve found a healthy compromise.

In case you didn’t know, Ella Mills is the queen of healthy brownies. She’s the face of the popular U.K.-based blog (which is now verging on an empire) called Deliciously Ella. She famously cooked her way out of illness with a healthy diet she created for herself, and now she shares her recipes with the rest of us.

Her recipe for sweet potato brownies has always been wildly popular, but now she’s topped it with an updated version that’s gooier, sweeter and frosted.

There’s no flour, butter or table sugar in this recipe. Instead, these brownies are made with sweet potatoes, dates, ground almonds, coconut oil and raw cacao powder (as opposed to conventional cocoa powder), all of which are nutritional powerhouses.

Check out the recipe here, and find more like it in Mills’ latest cookbook, Natural Feasts.

My original recipe for sweet potato brownies has been so popular over the last few years, so many of you absolutely love them and make them all the time, but I’ve been feeling for a while that there was a way to make them so much better. I wanted something gooier, richer, more chocolaty and all round more indulgent, and these are the result of that. I promise you’d never know there was any veg in here at all! ―Ella Mills

Note: This recipe uses U.K. measurements, which is why the ingredients are listed in grams, not cups. We suggest weighing your ingredients for baking anyway, so invest in a scale if you don’t already have one.

Overview

Serves: 10
Prep: 20 minutes
Cooking: 50 minutes
Total: 70 minutes
Difficulty: medium

For the brownies

  • 500 grams of sweet potatoes (about 2 medium)
  • 12 medjool dates
  • 6 tablespoons of pure maple syrup
  • 100 grams of ground almonds
  • 2 tablespoons of melted coconut oil
  • a pinch of salt
  • 100 grams of ground oats
  • 6 tablespoons of raw cacao powder

For the icing

  • 2 tablespoons of coconut oil
  • 2 tablespoons of almond butter
  • 1 tablespoon of maple syrup
  • 2 tablespoons of cacao powder

Method

Start by preheating the oven to 350 F on its convection setting, or 400 F if your oven doesn’t have one. Peel the sweet potatoes, then cut them into chunks and place them into a steamer for about 20 minutes, until they become really soft.

Once they begin to fall apart, remove the sweet potatoes and add them to a food processor with the pitted dates.

Put the remaining ingredients into a bowl, and then mix in the sweet potato-date combination. Stir well.

Place into a lined, 9-by-9-inch baking dish and cook for about 45 to 50 minutes, until you can pierce the brownie with a fork and it comes out dry. Remove the tray and allow it to cool for about 10 minutes ― this is really important, as it needs this time to stick together!

While the brownies are cooking, make the icing. Simply melt all the ingredients together and stir well. Place the mixture in the freezer for 15 minutes and then the fridge for another 15 to firm it up a bit.

Remove the brownies from the tray and leave to cool completely before icing ― otherwise your icing will melt! Spread the icing on top, cut into squares, dig in and enjoy!

Rare Disease Advocates Call For Registry

How do you convince the Government that your particular medical problem needs money?

Especially when said medical problem comes under the umbrella of rare diseases.

With non-communicable diseases like diabetes, cardiovascular disease and cancer affecting so many Malaysians – and by extension, taking up much of the Health Ministry’s budget – how do you get any attention for diseases that only affect one in a few thousand people?

Says Hospital Kuala Lumpur’s Paediatric Department head Dr Hishamshah Mohd Ibrahim: “In Malaysia, because we are a higher middle-income country, our emphasis has always been to prioritise healthcare where the needs are most glaring.

“So, in that sense, when we devise our national programme, we tend to put our resources more towards the commoner causes of disease that can result in higher mortality and morbidity.”

He adds that for rare diseases, the small number of cases and few treatment options, with those options that are available being very expensive and not easily accessible, make budgeting for them very challenging.

In the 10 countries Lee has been to as MLDA president, no NGO can come up with sufficient funds to completely cover the treatment for rare disease patients, only the Government has enough resources for that, he says. — Photos: Handout

However, the senior consultant paediatrician and paediatric haematologist-oncologist says: “Rare diseases, being rare in themselves, are very costly if you look at one individual patient, but if you look at the big picture – that they are part of our community – for us to show humanity, we need to handle the less fortunate in our community the best that we can.

“That goes to show our values as human beings, to be empathetic to those who are less fortunate than us.”

He points out that the Government actually provided a specific allocation of RM10mil for rare diseases in the 2018 Budget.

This is an increase over the RM8.5mil allocated annually in the Budget since 2009.

However, according to the Malaysian Lysosomal Diseases Association (MLDA), the average cost of enzyme replacement therapy (ERT) for one patient ranges between RM500,000 and RM1mil a year.

This means that only a limited number of patients can benefit from the annual allocation.

Although rare diseases affect a comparatively small number of people individually, collectively, the number of these patients is significant.

According to the University Malaya Specialist Centre, around 16,500 of the 550,000 Malaysian babies born every year are afflicted with congenital abnormalities, the majority of which are caused by rare diseases.

Says Dr Hishamshah: “I have a lot of positive feeling that the ministry is still going to support rare diseases further, but we need to actually demonstrate that the health dollars that we spend are health dollars that are well spent.

“For that, you actually need to have outcome data, and for that, you’ll actually need to have a very good registry for rare diseases.”

Registry challenges

Rare diseases, registry, Dr Ngu Lock Hock, Star2.com

According to Dr Ngu, there are now better lab facilities for testing rare diseases, better accessibility to treatment, and more clinical geneticists to treat patients, compared to when he first started practising 16 years ago.

A registry is a place where all the official records of something – in this case, rare disease patients – are collated and kept.

According to Dr Hishamshah, there are 32 national disease registries in Malaysia.

As someone who has been involved in the setting up of a few registries himself, Dr Hishamshah recalls suggesting a rare diseases registry about 10 years ago to his then-officemate, consultant paediatrician and geneticist Dr Choy Yew Sing, who was treating patients with rare diseases, but without any specific budget for them.

Says Associate Professor Dr Asrul Ahmal Shafie: “I think, in our current age, what we always need is information.

“And I think this is what is lacking in Malaysia – we cannot describe how big the problem is because no one can actually give the percentage, the right figure, the size of the problem, and even if there is such problem.

“And if let’s say, someone says, ‘I can give you money’, we cannot say how much because we do not know the exact size of the problem.”

The Universiti Sains Malaysia (USM) social and administrative pharmacy lecturer notes that a registry would provide epidemiological data (i.e. the “who, when, where and how” of the disease) and prevalence (number of cases) of each of the rare diseases.

However, there are a number of challenges that face the setting-up of a national rare diseases registry.

“One of the biggest challenges to collecting data is having the people and infrastructure to support the collection,” he says.

Manpower is needed to enter the data accurately, and dedicated software needs to be available to collate the information.

Assoc Prof Asrul adds that a more specific challenge for rare diseases is the lack of ICD-10 coding.

ICD-10 is the 10th, and latest, revision of the World Health Organization’s International Statistical Classification of Diseases and Related Health Problems.

This classification provides an internationally-standardised way of defining and categorising diseases.

However, rare diseases are not properly provided for in the ICD-10. This makes it more difficult to enter data accurately and in a consistent manner for a registry.

Rare diseases, registry, Dr Hishamshah Mohd Ibrahim, Star2.com

Dr Hishamshah says that the health information available from a registry is very important in providing advice to policymakers for healthcare spending.

Hospital Kuala Lumpur Genetics Department Clinical Division deputy head Dr Ngu Lock Hock notes that there are between 6,000 and 7,000 rare diseases, many of which are genetic in origin.

He says: “It’s not to say that the Health Ministry does not have these statistics; at the individual clinics, we do have all these statistics.

“But, as Assoc Prof Asrul highlighted, many of these rare diseases do not have ICD-10 coding, so, a lot of times, they are probably classified as ‘other’ diseases.

“If you look at the health statistics by the Health Ministry, a lot of diseases are ‘congenital’ or ‘other’ conditions.

“These rare diseases are inside there, but you cannot identify them as separate entities.”

The consultant paediatrician and clinical geneticist adds that it is also essential for there to be an accurate diagnosis in the first place.

“That is a challenge for rare diseases.

“Some rare diseases require a very difficult diagnostic pathway – some need difficult and specialised tests to confirm the diagnosis,” he says.

“Because there are so many different types, there is no single doctor who will be familiar with every condition.

“So, if we want to have a registry, it will really need a concentrated effort from every party – not just geneticists, but also paediatricians, cardiologists, ophthalmologists, every discipline.

“Because a patient with a rare disease may not just see a geneticist, they may present to an ophthalmologist or a cardiologist or another specialist,” he adds.

Rare diseases, registry, Dr Asrul Ahmal Shafie, Star2.com

Assoc Prof Asrul (right) says that one of the main problems with setting up a rare diseases registry is the lack of ICD-10 coding, which affects how data on these diseases can be collected. Listening to him is Zabidi, whose son has Sly syndrome (mucopolysaccharidosis VII).

Improvement over the years

However, Dr Ngu notes that things have certainly improved since he first started practising clinical genetics in 2002.

“At that time, we had very little access to all these treatments for rare genetic diseases and to diagnostic facilities.

“But over the last 10 to 15 years, we have slowly built up our capacity in our laboratories in the Health Ministry to diagnose all these rare diseases.

“And for those rare diseases that we do not have tests in the country, the ministry actually provides funding for outsourcing, so we can actually send the test to laboratories overseas,” he says.

For example, when MLDA president Lee Yee Seng’s two daughters were first diagnosed with Pompe disease in 2005, it took two to three months for the test to be sent to Australia and analysed.

Today, Dr Ngu says the test can be done in two weeks locally.

He adds that tests for almost 80 genetic diseases can now be done in Malaysia.

“In terms of treatment, at the time when I joined, it was very difficult to access drugs for these rare diseases and the special milk formula needed to treat rare inborn errors of metabolism.

“But over the years, the Government has provided dedicated funds for these patients.

“And in fact, if you compare to other countries in Asean, we are probably the only country where the patients can come into the clinic, pay RM5 and get all the drugs and special milk they need,” he says.

The number of clinical geneticists in the country have also increased over the years, although the number is still quite small – around a dozen in total.

All of them are based in the Klang Valley, except for two in Hospital USM, Kubang Kerian, Kelantan, according to Dr Ngu.

He shares, however, that the eight geneticists in Hospital Kuala Lumpur frequently provide consultation to other doctors around the country via phone and e-mail, as well as take turns running monthly clinics at the general hospitals in Penang, Johor Bahru, Kuching, and Likas in Sabah.

As Lee says, it is hope that keeps us alive.

Dr Hishamshah, Assoc Prof Asrul, Dr Ngu, Lee and MLDA vice-president Zabidi Ali were speaking at a group dialogue held recently at Hospital Kuala Lumpur, in conjunction with World Rare Disease Day, organised by the biotechnology company Sanofi Genzyme.

Eggs Are Good For You – Even With Cholesterol

For the first time in decades, the latest Dietary Guidelines for Americans no longer recommend that we limit our intake of cholesterol to 300mg a day. (One egg yolk contains about 180mg of cholesterol.)

Instead, these experts tell us to limit saturated fat (eggs are low in this type of fat) and “eat as little dietary cholesterol as possible while consuming a healthy eating pattern”.

In other words, heart health appears to depend less on whether we eat eggs or not and more on the company they keep.

There’s a big difference, for example, between a breakfast of eggs, wholegrain toast, low fat yoghurt and fruit, and one that features eggs, sausage, biscuits and gravy.

Eggs have long scored the highest of all protein foods in quality and digestibility.

Each egg contains all the essential amino acids to build every type of protein our bodies need.

One amino acid is leucine – a powerful stimulant for building muscle tissue.

And eggs are cheap (cheep cheep) compared to most other sources of protein.

Besides protein, eggs are packed with 13 essential nutrients (meaning they are absolutely needed for our bodies to function).

According to the Egg Nutrition Center, eggs are one of very few foods that contain vitamin D naturally.

And these compact nutrition powerhouses also provide choline, a nutrient involved with brain development during pregnancy, plus memory and mood functions as we get older.

And here’s a surprise: Don’t toss the yolks. That’s where most of the nutrients in eggs reside, including vitamin D, choline and antioxidant substances.

Also, more than 40% of the protein in eggs is found in the yolk.

By the way, the colour of the egg does not change the nutrition of this food. Different hens lay different-coloured eggs.

The colour of the yolk, however, depends on the amount of orange and yellow plant pigments in the hen’s diet. – The Monterey County Herald/Tribune News Service

Why One Polyp Becomes Cancerous But Another Doesn’t

Researchers at Mayo Clinic in the United States are closer to answering the question, why does one colon polyp transform to cancer while another seemingly identical polyp does not?

A colon polyp is a small clump of cells that forms on the lining of the colon.

While most colon polyps are harmless, some can develop into colon cancer, which can be fatal if found too late.

“The molecular determinants that distinguish normal, benign polyps from those at risk for becoming cancer are unclear,” says Dr Lisa Boardman, a gastroenterologist at Mayo Clinic.

“In our paper, published in the journal Scientific Reports, we asked the question: Why does one polyp transform to cancer while another, that is clinically and histologically identical, does not?”

To answer this question, Dr Boardman and her colleagues used next-generation sequencing techniques to molecularly characterise and compare colorectal polyps from Mayo Clinic patients that were associated with cancer with those from patients with polyps that were benign.

Next-generation sequencing is sophisticated DNA and RNA sequencing technology that allows researchers to study biological systems at a level never before possible.

Dr Boardman and her colleagues found that polyps adjacent to cancerous tissue exhibited distinct genetic alterations from polyps that remained cancer free.

“By integrating multiple sequencing platforms, we identified a panel of 124 genes that were differentially altered between polyps that were associated with cancer and polyps that did not progress to colorectal cancer,” she says.

“These results serve as a foundational study showing that polyps with and without cancer exhibit distinct molecular signatures.”

Dr Boardman says the ability to identify molecular features that predict whether a polyp will transform to cancer would be a major clinical step in individualising the care of patients with polyps.

She says current guidelines for polyp surveillance are still based only upon polyp size, number, histology and degree of dysplasia.

She adds that there are currently no blood or tissue-based molecular tests used to tailor surveillance intervals for patients with polyps.

Dr Boardman says the ability to determine a polyp’s risk for progression to cancer could have significant benefits for patients and the healthcare system, including reducing costs, reducing risks and improving the use of colonoscopy.

“This study is also the first step in our efforts to establish a pre-cancer biobank at Mayo Clinic, which will support future studies on polyps in order to prolong health by preventing pre-malignancy in the colon.” – Mayo Clinic News Network/Tribune News Service