by Dr. Richard Chan Tze Ming – Consultant Interventional Cardiologist & Internal Medicine Physician and Dr. Lim Eu Jack – Consultant Emergency Physician at Sunway Medical Centre, Sunway City

According to the National Health and Morbidity Survey (NHMS) 2023, over 33% or 7.6 million Malaysians are living with high cholesterol levels¹. Cardiovascular disease remains the leading cause of death among Malaysian men, responsible for 17.6% of deaths among Malaysian men in 2025².

A silent cardiac crisis is increasingly impacting men in their 20s and 30s, only to be diagnosed after a heart attack, stroke or a blood test.

“Heart problems are no longer just an ‘uncle’s disease’. We’re seeing more young adults come in numbers,” said Dr. Richard Chan Tze Ming, Consultant Interventional Cardiologist and Internal Medicine Physician at Sunway Medical Centre, Sunway City (SMC).

Dr. Lim Eu Jack, Consultant Emergency Physician at SMC said, “The youngest I’ve seen with serious heart attack were in their early 30. There are also a significant number of men who discover they had high blood pressure or undiagnosed diabetes only after they arrive in the emergency room with chest pain or a heart attack,” he says.

Why Young Men should pay attention to High Cholesterol and more
At the centre of many of these cases there is high cholesterol. Dr. Richard notes that a condition called dyslipidemia, or abnormal blood lipid levels, can affect anyone regardless of age. Studies have also found that familial hypercholesterolemia (FH) affects about 1 in 100 people or 320,000 Malaysians, which is higher than global averages³.

Dr. Richard also pointed out that while diet can account for some of your total cholesterol levels, genetics is also an important cause. “Some people are genetically wired to produce more bad cholesterol, even if they exercise and eat clean. That’s why we see patients who hardly eat oily food but still end up with high cholesterol,” he said.

Dr. Jack also said, “High cholesterol is very common, but it’s not usually detected in the ER because it requires fasting and isn’t routinely tested in emergencies. High blood pressure tops the list of undiagnosed conditions. Diabetes is also frequently undiagnosed until complications set in. These conditions are often silent for years, which is why regular health screening is so important,” he says.

Lifestyle and bad habits make it worse, health screening is key
While genes play a role, lifestyle is worsening the problem in young men, putting them at risk of early heart disease.

“Even after exercising, many young people head to mamak stalls or fast-food outlets. Processed food, reused cooking oil, and trans fats all increase LDL cholesterol,” said Dr. Richard.

“Many men ignore early signs like chest discomfort, fatigue, or breathlessness often blaming gastric issues or tiredness. With risk factors like smoking, poor diet, and family history, delaying help can be fatal. Smoking, in particular, is the most significant risk factor we see among younger patients with heart diseases,” said Dr. Jack.

Both doctors stress that it starts with awareness and simple action. “A blood test and blood pressure check can quickly reveal issues like high cholesterol, diabetes, or hypertension. Knowing your numbers is the first step to taking control. These are modifiable risk factors, and if managed early, we can prevent serious complications like heart attacks and strokes,” says Dr. Jack.

“Don’t wait until you have symptoms. Cholesterol is silent. If you have a family history, are overweight, or smoke, you should be screened as early as your 20s,” adds Dr. Richard.

For those with very high cholesterol, lifestyle changes alone may not be enough. Medications are often required to bring it down to safer levels.

“I always tell patients, don’t deprive yourself. Eat in moderation. A healthy lifestyle must be sustainable. If you go too strict, you’ll rebound and overeat later,” advises Dr. Richard.

¹ Institute for Public Health. (2024). National Health and Morbidity Survey (NHMS) 2023: Non-communicable Diseases and Healthcare Demand – Key Findings. National Institutes of Health, Ministry of Health Malaysia. Retrieved from https://iku.gov.my/nhms-2023

² https://v2.dosm.gov.my/portal-main/release-content/statistics-on-causes-of-death-malaysia-2024

³ Chua, Y., Razman, A., Ramli, A., Kasim, N., & Nawawi, H. (2021). Familial Hypercholesterolaemia in the Malaysian Community: Prevalence, Under-Detection and Under-Treatment. Journal of Atherosclerosis and Thrombosis, 28, 1095 – 1107. https://doi.org/10.5551/jat.57026

Understanding Metabolic Syndrome
Metabolic syndrome is a serious health condition that affects people from all walks of life, especially in countries where obesity and sedentary lifestyles are increasing at an alarming rate. It refers to a cluster of interconnected risk factors that, when present together, substantially increase the likelihood of developing chronic diseases such as type 2 diabetes, cardiovascular disease, stroke, and non-alcoholic fatty liver disease.

The five key risk factors that define metabolic syndrome are¹:

• Abdominal obesity (waist circumference ≥90cm in Asian men or ≥80 cm in Asian women; waist measurement not needed if BMI >30 kg/m²)
• High triglycerides (≥1.7 mmol/L or currently taking medication for elevated triglycerides)
• Low HDL cholesterol (<1.03 mmol/L in men, <1.29 mmol/L in women or currently on treatment)
• Elevated blood pressure (≥130/85 mmHg or on antihypertensive treatment)
• Elevated fasting blood glucose (includes insulin resistance, impaired fasting glucose, impaired glucose tolerance, or on treatment)

A person is diagnosed with metabolic syndrome if they meet three or more of these criteria.

Why You Should Care
Metabolic syndrome significantly increases the risk of long-term health problems. What makes it especially dangerous is its silent progression. Many individuals have no symptoms and remain unaware of the dangers until they experience a major health event, such as a heart attack or stroke. You might feel fine and look fine, but your body could be struggling internally.

Targeting the Core: Why Abdominal Fat Deserves Attention
Central obesity plays a pivotal role in metabolic syndrome. Visceral fat — the fat stored deep inside the abdomen around vital organs — is metabolically active and harmful¹. It releases cytokines and pro-inflammatory hormones that disrupt insulin regulation, blood pressure, and lipid metabolism¹. As a result, a normal weight does not always mean a healthy body — people with hidden visceral fat can still face serious health risks.

Abdominal fat is more than a cosmetic issue — it’s a key contributor to metabolic problems, particularly insulin resistance. Insulin resistance impairs the ability of cells to absorb glucose, leading to high blood sugar levels and forcing the pancreas to produce more insulin to compensate¹. Over time, this overwork can exhaust the pancreas’ beta cells, eventually leading to type 2 diabetes.

Are You Unknowingly at Risk?
Anyone can develop metabolic syndrome. While the risk increases with age, it’s no longer just a problem for older adults. Alarmingly, more cases are now being seen in young adults and even teenagers — largely due to poor lifestyle habits².

You’re more likely to develop metabolic syndrome if you have:

• A family history of type 2 diabetes, high blood pressure, or heart disease
• A sedentary lifestyle (not enough physical activity)
• An unhealthy diet high in calories, sugar, saturated fat, or processed food
• Excess abdominal fat (visceral obesity)

Spotting the Red Flags
Early detection is crucial. Raising awareness about regular health check-ups is essential. These check-ups should include waist circumference, blood pressure, and fasting blood tests to measure glucose and cholesterol levels.

Many people with metabolic syndrome don’t show symptoms, which makes regular screening even more important. Everyone should be encouraged to monitor key health indicators: waist size, blood pressure, blood sugar, and cholesterol. Don’t wait for symptoms — prevention starts with action.

From Risk to Recovery: A Practical Approach
Metabolic syndrome can often be reversed in its early stages through sustained lifestyle changes, especially when it hasn’t yet led to severe complications.

Here are simple, non-medication-based steps to manage and possibly reverse metabolic syndrome:

1. Maintain a Healthy Weight
   Even a modest weight loss of 5–10% of your body weight can improve blood pressure, cholesterol, and insulin sensitivity.
2. Adopt a Balanced Diet
   Eat more fruits, vegetables, whole grains, and lean proteins to support overall health; reduce sugary drinks, refined carbs, processed snacks, and fried foods to improve metabolic balance; and choose natural, unprocessed foods whenever possible to minimise hidden sugars and unhealthy fats.
3. Exercise Regularly
   Aim for at least 150 minutes of exercise per week. Walking, cycling, swimming, and strength training are all helpful. Physical activity burns visceral fat and improves insulin function.
4. Sleep Well
   Lack of quality sleep disrupts hormone balance, raises cortisol levels, and worsens insulin resistance — all of which are linked to weight gain. Individuals should aim for 7–9 hours of restful sleep each night.
5. Manage Stress
   Chronic stress raises cortisol, which increases fat storage and disrupts blood sugar levels. Relaxation techniques like deep breathing and yoga can help restore balance.

In some cases, medication may be needed to better control blood pressure, blood sugar, or cholesterol. However, it’s important to remember that medication supports — but does not replace — lifestyle changes. A combined approach is key to reducing long-term health risks.

It’s also important to work closely with a healthcare provider to create a personalised health plan that suits your lifestyle and needs.

Final Thoughts
Metabolic syndrome may be common and serious, but it is also largely preventable — and often reversible with timely changes in your lifestyle. Raising awareness is just the start. Taking consistent action is what truly protects your health.

Make your health a priority — now and always.

¹ International Diabetes Federation. The IDF consensus worldwide definition of the metabolic syndrome [internet]. Brussels: IDF; 2006 [cited 2025 Jun 27]. Available from: https://IDF.org/media/uploads/2023/05/attachments-30.pdf

² Al-Hamad D, Raman V. Metabolic syndrome in children and adolescents. Transl Pediatr. 2017 Oct;6(4):397–407. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5682379/

Dr. Fang Li Chen

Consultant Physician

MD (UNIMAS), MRCP (UK)

Dr. Fang possesses a strong passion for internal medicines and demonstrates comprehensive expertise in a broad spectrum of medical and surgical pathologies. Her keen clinical acumen has consistently contributed to accurate diagnoses and effective patient management. Beyond clinical care, Dr. Fang is deeply committed to advancing patient well-being. She actively empowers individuals to take ownership of their health through evidence-based lifestyle interventions, stress management strategies and appropriate pharmacological treatments.

by Dr. Tan Jin Aun – Consultant Orthopaedic & Spine Surgeon and Dr. Deepak A/L Ajit Singh – Consultant Orthopaedic Surgeon (Spine Surgery and Interventional Pain Management)

When people talk about leadership strength, they usually mean qualities such as resilience, vision, or discipline. Yet for senior executives, policymakers, and business leaders, strength also has a literal dimension. The spine is not simply a biological structure. It is the central column that supports the physical demands of leadership, from long flights and boardroom hours to the continuous pace of decision-making.

Spinal health often becomes a concern only when pain begins to interfere with performance. In our years of treating leaders, the same pattern appears repeatedly. The drive that fuels success frequently comes at the expense of personal well-being. Hours spent in static postures, frequent travel, high stress, and irregular exercise gradually accumulate, leading to back and neck conditions that may begin as minor discomfort but eventually affect both health and performance.

The consequences extend beyond physical pain. Research consistently identifies musculoskeletal disorders, particularly those involving the spine, as leading causes of lost workdays among professionals over 40. Pain not only limits movement but also reduces energy, slows decision-making, and disrupts sleep. Over time, these effects erode the clarity, stamina, and focus that leaders rely on. In Malaysia, spinal disorders remain one of the most common causes of workplace absence, with implications that affect not just the individual but also teams, departments, and organisational outcomes.

By the time symptoms are disruptive enough to require treatment, the underlying problem has often been present for months or even years. The encouraging reality is that many of these conditions are preventable or manageable if detected and addressed early.

The most effective leaders take the same approach to their health as they do to their organisations: regular monitoring, timely adjustments, and preventive action. For the spine, this can be as simple as reviewing office ergonomics, incorporating short breaks for movement during meetings, or practising stretches that counteract the strain of prolonged sitting. Most importantly, it involves undergoing periodic spine health screenings, a structural audit that can identify issues before they become serious.

The comparison is clear. The spine is the body’s core infrastructure. Just as no company can operate without monitoring its essential systems, no leader should expect their spine to perform indefinitely without care. A healthy spine not only prevents pain but also sustains posture, energy, and concentration, all of which form the physical foundation for effective leadership.

Standing tall is more than a figure of speech. It reflects the structure that supports you in every sense. Prioritising spinal health is not indulgence; it is a strategic investment. In the long game of business and governance, one of the greatest assets a leader can protect is the one that allows them to stay upright and perform at their best.

by Dr. Mohamad Imran bin Idris – Consultant Neurologist

Dementia isn’t just forgetfulness—it’s about slowly losing the essence of who you are. In Malaysia, this silent epidemic is growing faster than most realise, driven by an ageing population and widespread chronic illnesses like diabetes and high blood pressure. Globally, dementia affects more than 55 million people, and the World Health Organization (WHO) predicts this number will reach 78 million by 2030. Local studies suggest over 200,000 Malaysians are living with dementia, and the figure is likely underestimated due to low awareness and limited screening.

Consultant Neurologist at Sunway Medical Centre, Sunway City, Dr. Mohamad Imran bin Idris, explained that while slower memory and reduced mental agility can come with age, dementia is different. “The hallmark of dementia isn’t just forgetfulness,” he said. “It is when thinking skills interfere with daily life—language, judgement, even recognising familiar faces. That is when it is time to get help.”

Vascular dementia caused by impaired blood flow to the brain, often after a stroke or due to chronic conditions like high blood pressure, is very common in Malaysia.

Conditions such as hypertension, high cholesterol, smoking and diabetes are key contributors to vascular dementia, he said.

“We’ve seen people in their 40s and even 30s developing early signs after strokes or years of unmanaged chronic illness,” Dr. Mohamad Imran shared. The damage builds silently over decades; when symptoms show, the brain may already be severely affected.

While diet and exercise are known brain boosters, one often overlooked factor is sleep. “Poor sleep affects brain health more than we realise,” said Dr. Mohamad Imran.

Socialising also plays a powerful role. Talking with friends, engaging in conversation — these spontaneous, unpredictable interactions challenge the brain and help preserve cognitive function, he explained. “Repetitive digital games may feel mentally stimulating but offer little long-term benefit. The brain needs novelty,” he said.

While dementia has long been seen as a hopeless diagnosis, science is now catching up. “Two years ago, I’d have said nothing can be done,” Dr. Mohamad Imran said. “But now we have medicines that can slow its progression. We’re entering a new era of treatment.”

Screening tools—from digital cognitive assessments to blood tests that detect early brain changes—are becoming more accessible.

His advice is to start thinking seriously about brain health at the age of 40s and 50s. “Control your blood pressure, stay socially engaged, sleep well, and eat a balanced diet.