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YOUR GUIDE TO LIVING WELL

TUESDAY, JUNE 14, 2011

HEALTH POST How city living is taking its toll on asthma sufferers

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Take my breath away

COOK WITH TRUE COLOURS

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WORK OUT WITH SPIRIT >PAGE 8


2 NEWS ASK THE DOCTORS DR FONG YAT-YUK

HEALTH BITES ...................................................... Jeanette Wang jeanette.wang@scmp.com

An apple a day keeps muscles OK Researchers at the University of Iowa, United States, have discovered that a compound found in the fruit’s skin – ursolic acid – may help prevent muscle wasting that can result from ageing and illness. Studies on mice showed that those that received the compound for a number of weeks became leaner and had lower blood levels of glucose, cholesterol and triglycerides. The findings, published in this month’s issue of the journal Cell Metabolism, might lead to the development of new drugs if confirmed in humans, the study’s authors suggest.

Q: Why do I wake up tired even when I’ve had 10 hours’ sleep? Glam it up, gym rats Edgy accents, studded trims, star embellishments and other fashionable features in the new G*POW athletic wear range ensures you’ll always make a smooth transition from gym to cocktail hour. “Throughout my years of training I could never find athletic wear that was comfortable and cutting edge in style,” says the line’s Venezuelan-born designer, Charo Perez Giusti. “I want women in the gym to not only feel sexy and comfortable, but to look it as well.” Check out the collection at Pure Retail IFC from June 23-26. www.gpowathletics.com.

Two triathlons are better than one If you believe that, then the 2XTRI on Sunday, August 28, at Science Park, Sha Tin, could be your thing. Swim 300 metres, cycle 12 kilometres, run 3km, repeat. Prize money will be offered to the first three men and women – HK$3,000, HK$2,000 and HK$1,000 respectively – across the line, as well as medals and prizes for top in age groups. Sign up at www.revolution-asia.com.

Cancer diagnosis: pee and see? Possibly so, say researchers at the University of Edinburgh, Scotland. They have identified key proteins in the urine of advanced cancer patients which suggest that cancers of the gut, stomach and pancreas could be detected much sooner with a simple urine test. In the study, published in the journal Proteomics-Clinical Applications, six particular proteins were found to be present in 98 per cent of the cancer cases, but absent in almost 90 per cent of samples from cancer-free patients. Two of these proteins have been narrowed down for future analysis. Only about 10 per cent of patients with the above-mentioned cancers are still alive five years after diagnosis.

Look before you jump on the barefoot wagon If it ain’t broke, don’t fix it. Runners looking to jump on the barefoot wagon should keep that in mind, according to Professor Stuart Warden, director of research the department of physical therapy at Indiana University, US. Barefoot running is a hot issue as it’s said to promote a lower risk of injury. This, in theory, is because you’re forced to land on the forefoot, which reduces impact forces on the body. If you’re happy running in shoes and don’t suffer repeated injuries, stick with it, is his advice. But injury-plagued runners who haven’t improved through rehabilitation may want to consider a switch. “If you transition to barefoot running slowly, and run correctly … you could decrease the risk of injury over the long term,” Warden says.

A: It is generally supposed that after 10 hours’ “good” sleep, everyone should feel refreshed and energetic. If you still feel tired after 10 hours’ sleep, there are several possible causes. The first issue to be clarified is what tiredness means. Does it mean daytime sleepiness (inability to stay awake and alert during the day, resulting in unintended lapses into drowsiness or sleep, as defined in the International Classification of Sleep Disorders), or just feeling of fatigue without sleepiness? The latter could be due to a body disorder (for example, during a viral infection) or psychiatric disorder (such as depression or an anxiety disorder). Some depressive patients may present with genuine daytime sleepiness rather than insomnia. Obstructive sleep apnoea syndrome is a common cause of sleep disorder, in which patients exhibit symptoms of loud snoring, morning dry mouth and morning headache as well as sleepiness, which happens because of repeated apnoea. In some patients, the daytime sleepiness could be caused by periodic limb movement disorder, which is characterised by repetitive rhythmic movement of the limbs (usually the toes or the ankles) during sleep. In rare cases, narcolepsy could be the cause. Patients present with daytime sleepiness (some describe it as “irresistible”) and cataplexy (attacks of sudden symmetrical muscle weakness precipitated by emotions, but with clear consciousness, lasting for seconds to minutes with spontaneous recovery). A sleep study is needed to accurately diagnose these sleep disorders. Dr Samson Fong Yat-yuk is a psychiatrist and a member of the Hong Kong College of Psychiatrists

APP OF THE WEEK

Count up those as calories as you consume and burn ...................................................... Katie McGregor healthpost@scmp.com Spark People Food and Fitness Tracker – Free Rating 10/10 Absolutely shocking: who would’ve thought that my favourite tipple, a glass of whisky, would cost a massive 270 calories? But the damage was already done as I was updating this iPhone app the following morning. A spin-off from Sparkpeople.com, the No 1 diet and fitness site in the United States, this app is essentially a handy food and exercise diary. When you first install it, you’re asked to key in your weight-loss goal and by when you hope to achieve it. From there, the app calculates how many calories

you can consume and how many you would have to burn each day. On the home screen, you’ll get a summary of how you’re getting on, depicted by two bar charts – one counts down for calories eaten, and another counts up for calories burned. Whisky is just one of more than a million items in Spark People’s extensive food calorie database, many of which are uploaded by users. Every time you eat something, simply search for the food in the database, and its calories are logged into your daily count. Having something unusual? Enter it into the database once and you won’t have to type it again – my rather complex breakfast staple, a green smoothie, is there. Meanwhile, the exercise tracker keeps an eye on working those

The Spark People app has calories for more than a million foods

calories off. Just select your activity from the exercise library, enter your workout duration, and the app will calculate how many calories you’ve burned. To balance the whisky, for example, I knew I needed to cycle at about 20km/h for about 40 minutes. The app packs a few other extras, including an option for customised daily meal plans, fitness programmes, feedback reports (with graphs, no less) and a hydration tracker. Explore them on your own – they’re all free. If you’re looking for motivation to eat better and work out more, this app is for you. There is nothing like seeing that hard-earned 500-calorie deficit wiped out in an instant by a couple of glasses of whisky. That tipple will be for only very special occasions for me henceforth.

There are many possible causes for overtiredness. Photo: Jonathan Wong

> CONTACT US Culture Editor: Janelle Carrigan janelle.carrigan@scmp.com Health Post Editor: Jeanette Wang jeanette.wang@scmp.com General inquiries: healthpost@scmp.com Advertising: tel: 2565 2435; advertising@scmp.com This issue’s advisory panel contributor: Dr Adrian Wu (immunology & allergy)


MEDICAL 3 CASE HISTORY

FROM THE EXPERTS

Nosebleeds lead to doctor’s inquiry

Ancient belief in curative power of music proves solid as rock ...................................................... Dr Richard Lau and his team healthpost@scmp.com

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When 35-year-old Vincent Hui (real name withheld for patient confidentiality reasons) experienced his first nosebleed, an alarming torrent of blood poured from his nose, soaking his shirt. The first nosebleed was soon followed by another, then another. While nosebleeds usually cease within 20 minutes, Hui took up to two hours to staunch each bleeding. Nosebleeds are relatively common and usually not serious. One in seven people may experience a nosebleed at some time in their lives. But the copious amount and extended duration of bleeding in Hui’s case, plus the frequent occurrence, alerted him – and his doctors – that something more serious was afoot. Hui consulted Dr Raymond Liang, director of the Comprehensive Oncology Centre at the Hong Kong Sanatorium and Hospital. Liang noticed that Hui’s limbs suffered unusual bruising, which, together with the excessive bleeding and frequent nosebleeds, indicated that Hui had a bleeding tendency. A bleeding tendency means something in the body’s natural ability to clot has gone awry. The body stops bleeding in three steps – by constricting injured blood vessels, clumping platelets and forming blood clots with the clotting proteins produced in the liver. To diagnose Hui’s condition, Liang had to investigate which of these functions had failed. As Hui was young and otherwise healthy, and not on medication such as steroids or aspirin, Liang quickly ruled out drugs, liver disease, kidney failure, leukaemia and haemophilia as potential causes of abnormal bleeding. He ran a blood test on Hui and found that his clot-forming platelets – thrombocytes – were at a critically low level. This finding pointed to immune thrombocytopenia as the likely culprit. Immune thrombocytopenia is a condition where the body’s immune system – for unknown reasons – attacks platelets, drastically reducing their numbers. Healthy people have 150,000 to 450,000 platelets per microlitre of blood. When the number of platelets drops below 50,000 per microlitre, bleeding problems can occur. When platelet numbers drop to dangerously low levels of fewer than 20,000, spontaneous bleeding, including that in the brain, becomes a potentially deadly threat. Hui had only 10,000 platelets per microlitre of blood. However, as immune thrombocytopenia – like most autoimmune diseases – tend to affect women, Liang could not be

Illustration: Angela Ho

Eileen Aung-Thwin healthpost@scmp.com

certain at first that Hui had the condition, as he did not fit the profile. His medical team swiftly conducted a bone marrow biopsy to see if the low platelet count was a result of reduced platelet production in Hui’s bone marrow, but results showed it was normal. Hui was given an emergency treatment of intravenous immunoglobulin, an antibody-rich blood product, to stave off the suspected immune destruction in his blood. Within 24 hours of its administration, Hui’s platelet count started to climb to normal levels, and the nosebleeds stopped. His positive response to the stopgap treatment (its effects wear off within one to two weeks) confirmed Liang’s suspicions of immune thrombocytopenia, as it is the only disease that responds to intravenous immunoglobulin treatment. With a confirmed diagnosis, Hui was started on a long-term treatment of steroids to suppress his immune system to reduce the destruction of the platelets. However, the steroids gave Hui severe stomach discomfort that required copious amounts of antiulcer treatments to relieve. Yet, when the steroids were reduced, Hui’s platelet count dropped. Liang needed to order repeated treatments of intravenous immunoglobulin to help stabilise Hui’s condition. The doctor observed that it is common for men to respond more poorly to steroid treatment than

women. After four months of unsuccessful steroid treatment, Liang proposed a splenectomy. The spleen is a fist-sized organ in the left side of the abdomen that removes old red blood cells and plays a role in the immune system. But platelets are also trapped and destroyed in the spleen, which Liang describes as the “platelet graveyard”. Removing the spleen would slow down the destruction of the platelets but also expose Hui to a higher risk of infection. However, Liang says the infection risk in adults such as Hui can easily be managed, with fewer side effects than the steroid treatment. Hui would have to be vigilant about infections and keep a steady supply of antibiotics handy, taking them at the first sign of fever. Reluctant to continue grappling with the severe side effects of steroids, Hui agreed to the splenectomy. To prepare for the operation to remove one of his immuneprotective organs, he was given a battery of vaccinations to shore up his body’s defences. The splenectomy was a success, and immediately after the operation, Hui’s platelet count rose to a respectable 100,000 per microlitre. However, although the procedure greatly retarded the rate of platelet destruction, Hui’s immune system was still destroying platelets faster than normal, and his body’s ability to stem bleeding was still weak. So he must still take extra care to avoid any kind of injury.

When we talk about therapeutic tools to treat mental illnesses and improve our well-being, the picture that often comes to mind is a classic Freudian couch or a watch that hypnotises the patient and prompts repressed memories to resurface. In reality, tools and approaches that may help to enhance our psychological health are often not as mysterious as they seem, and some are part of our everyday lives. Listening to a few tunes, for example, can have more benefits than you think. Similar to many other so-called alternative therapies, the use of music as a therapeutic tool has been well documented since ancient times. Egyptian physicians referred to music as medicine for the soul, and included chant therapies as part of their medical practice. Hippocrates, pioneer of Western medicine, also used it to facilitate the healing of his patients. Psychological research into the therapeutic effect of music has provided considerable support to the ancient beliefs. Listening to calm, soothing music has medical benefits such as alleviating the symptoms of depression, improving the gait of stroke victims, reducing anxiety and even lessening pain during dental procedures. The use of music is not limited to clinical settings. Most recently, researchers from the University of Groningen in the Netherlands found that listening to particularly happy or sad music can even change the way we perceive the world. The findings, released in April, showed that people often saw happy faces when they were listening to happy music (and vice versa). A popular belief is that listening to Mozart can make you smarter. Studies, in fact, have found that the benefits of the Austrian composer’s music have more to do with improving the listener’s mood, which in turn affects cognitive performance. Similar effects have been reported in studies in which children listened to familiar play

songs, or even tunes from the pop band Blur. Music characterised by a fast tempo and strong rhythm can also increase energy and induce bodily actions, while studies have found that runners are likely to have a more positive mood and get a 15 per cent endurance boost when listening to music synchronised with their stride rate. A possible reason behind this “miraculous” effect of music may be that the rhythm of the music is reminiscent of the heartbeats of our mothers, which we felt when we were in the womb. The sense of tranquillity in response to calming music of slow rhythms is perhaps associated with the safe, relaxing, and protective environment provided by our mother. Conversely, we may become more alert with a fast rhythm as it may signalise vigilance or danger. Nonetheless, these findings do not mean that a particular musical piece is the sole cure for our psychological problems, or an easy way to run a marathon without training. Musical preference, after all, is highly personal: the feelings that you and your partner may have for a particular song (“our song”, as you may call it) will probably not be the same for another person, or when you hear it again if the relationship ends. Similarly in psychotherapy, there is no quick fix that will work for every case. What is intriguing is that music is a low-cost, easily accessible tool with few side effects to complement or facilitate existing techniques in psychotherapy, as well as our everyday activities. Although it has long been documented in art and literature, scientific research in this area is just beginning, and we can expect more interesting findings. The next time you tune in to your playlist, spend some time experimenting with how it can add more colour to your life. Dr Richard Lau is the director of psychological services at the Whole Person Development Institute, and is a former assistant professor with the faculty of medicine, Chinese University of Hong Kong.

Listening to Mozart’s music may not make you cleverer, but it will certainly improve your mood, researchers say. Photo: AFP


4 COVER STORY

Asthma’s choke hold The number of cases in Hong Kong may be levelling off, but that’s cold comfort to the 400,000 Hongkongers who still wheeze, says Richard Lord

Roadside risk

200

%

Maximum risk increase that roadside residents in other countries develop asthma, say studies cited by Dr Alfred Tam

F

irst, the good news: Hong Kong’s air pollution is not causing the city’s asthma levels to rise. The bad news: it is certainly making life worse for sufferers here. Indoor living conditions are not helping, either, making the fight against Hong Kong’s most common childhood disease – one responsible for 15 per cent of hospital admissions among children – a tough one. Asthma – recurrent attacks of shortness of breath, coughing and wheezing, caused by the inflammation (and hence narrowing) of the airways – affects about 300 million people worldwide, according to the World Health Organisation. Anyone, at any age, can get it, although it tends to be worse in children and young adults. It cannot be cured, but asthmatics can still enjoy a good quality of life through early diagnosis, appropriate treatment and effective continuing monitoring. In Hong Kong, the prevalence of asthma rose steadily from the 1950s to the 90s because of urbanisation and the affluence brought about by Hong Kong’s dramatic economic and population growth during that period. But the incidence of asthma has levelled off recently at about 10 per cent among children and about 5 per cent among adults, or about 400,000 asthmatics in total. This plateau – which still puts the city in the middle-to-high bracket globally – might not tell the whole story, says Dr Alfred Tam Yatcheung, chairman of the Hong Kong Asthma Society. “Although the prevalence has remained more or less the same, patients are becoming younger,” he says. “And the number of admissions in public hospitals is progressively increasing, which may mean we’re treating the same number of people, but their symptoms are more severe.” In most developed countries, Tam says, the rate of asthma deaths is progressively coming down, owing to effective treatment and management of the condition. But it has remained the same here for the past few decades, at an estimated 90 to 100 a year. That translates to a higher death rate relative to the number of sufferers than a country such as the United States, even though asthma is far more prevalent there.

[It] may mean we’re treating the same number of people, but their symptoms are more severe DR ALFRED TAM, CHAIRMAN OF THE HONG KONG ASTHMA SOCIETY

“Air pollution is an important factor. More [asthma] patients are admitted to hospital when air pollution is worse. And if you look at the relationship of roadside pollution with the prevalence of asthma … studies show that in many other countries, living by the roadside has been shown to increase the risk of developing asthma by 60 to 200 per cent,” Tam says. According to the WHO, the fundamental causes of asthma are “not completely understood”, and the condition is “under-diagnosed and under-treated”. Risk factors include genetics, pollution, indoor living conditions and exposure to certain chemicals, medicines and food additives. “Asthma, as we understand it now, is very heterogeneous,” Tam says. “Different mechanisms can result in the same pathology.” Because allergic asthma typically develops in childhood, “how the immune system interacts with conditions during childhood is very important”, says Dr Adrian Wu, specialist in immunology and allergy at Matilda International Hospital. In the US, for example, asthma rates vary depending on when people are born throughout the year; they are slightly higher in pollen season. “It’s the same in Hong Kong: you’re at a higher risk if you have a high rate of exposure to indoor allergens, or if you grow up with smokers,” Wu says. In Chinese medicine, it is believed that asthmatics have deeply harboured phlegm in the lung inherently, says Professor Feng Weibin, a Chinese medicine consultant at Kwong Wah Hospital. “This may be due to heredity, physique and the invasion of the six evils – wind, cold, heat, dampness, dryness and fire.”

Many people in Hong Kong spend much of their time indoors – in conditions that can also worsen the condition. Dust mites are asthmatics’ No 1 indoor enemy – and the city’s hot, wet, humid climate makes sofas, beds, carpets and soft toys perfect breeding grounds for them. Then there are the ubiquitous cockroaches, the second-biggest threat, and pets. “There needs to be more education on indoor pollutant control,” says Dr Wong Wing-ching, associate consultant at the department of medicine and geriatrics at Kwong Wah. “That includes cleaning to limit dust mites, controlling humidity, better ventilation during cooking and keeping pets out of the home – or at least out of the bedroom.” The small size of many Hong Kong flats exacerbates another antagonist: fumes from poorly ventilated gas cookers. And the city’s crowded living conditions also help diseases spread quickly. “Infection is a big problem, especially for small children,” says Tam. “Viruses, in particular, tend to irritate the airways.” The workplace is less of an issue in Hong Kong, mostly because a lot of high-risk industries involving chemicals and plastics have migrated onto the mainland, although Wong says that occupational asthma still goes under-reported in the city. Construction workers, decorators, carpenters and even hairdressers and people who work in food processing are among those potentially at risk. Other factors can include stress, diet and certain medicines. Tam says that many attacks, particularly among children and young people, are triggered by harsh words from a parent, teacher or boss. About 5 per cent of asthmatics are sensitive to sulphites, preservatives used in wine and dried fruit. Also, 10 per cent of asthmatics are sensitive to beta blockers and aspirin. “Always tell your doctor that you’re asthmatic, or it can be very dangerous,” says Dr Simon Ip Kar-shun, respiratory consultant at Hong Kong Baptist Hospital. Asthma can also be induced by exercise – but, taken the right way, exercise can also help sufferers increase their respiratory capacity.

MINIMISE SYMPTOMS • Don’t smoke. • Exercise regularly, as long as your asthma is under control. • Don’t have carpets and soft toys in your home, and reduce the number of soft furnishings. • Use covers on bedding and other furniture to control dust mites. • Don’t keep pets or, if you can’t bear to be without them, at least don’t sleep in the same room with them. • Ensure your home is as dry as possible. • Eat foods containing antioxidants, zinc, selenium, copper and omega-3 fatty acids. • Don’t consume anything containing sulphites unless you know your asthma isn’t triggered by them. • Certain medicines can trigger asthma, so let your doctor know that you’re asthmatic. • If you have an attack, use your inhaler, stay still, sit upright and take plenty of fluids.

“It’s extremely dangerous if you exercise and it’s not under control,” Ip says. “But asthmatics who have their condition under control can do any exercise they like.” But that relies on clean air. Doctors agree that lowering the city’s air pollution would alleviate asthmatics’ suffering. “[It] would do so much to reduce the number of cases, their severity, and the number of deaths,” Tam says. The long-awaited Motor Vehicle Idling Bill, Ip notes, will be a step in the right direction. Other important measures include stopping smoking, improving living and working environments, maintaining a healthy diet, and the prevention and appropriate treatment of respiratory tract infections, Feng says. Tam adds: “There needs to be holistic management that takes in lifestyle factors. The patient, together with the doctor, needs to know the severity of their asthma and if there are trigger factors that make it worse, and then can devise appropriate management treatment.” healthpost@scmp.com


COVER STORY 5


6 FITNESS STEP RIGHT UP: WEEK 4

Core power to you ...................................................... Jeanette Wang jeanette.wang@scmp.com Just chalking up kilometres will not make you a better walker or runner. Core conditioning through simple bodyweight exercises help work the various muscle groups that stabilise the trunk. This will make you less prone to injuries and will improve your ability to maintain good form. Try this circuit from walking coach Freeman Lee Ping-chiu twice a week, for 20 to 30 minutes each time. Do 20 reps for each exercise, unless otherwise stated. Crunch Works: upper abdominals Keep lower back pressed to the ground, hands crossed in front of chest. Exhale, contract abs and lift head and shoulders off the ground. Swan dive Works: back Lie on stomach. Place hands below chest. Lift upper body from the hips. Tighten abs, squeeze shoulder blades together, hold for two counts.

Crunch

Swan dive

Freeman Lee, an accredited International Association of Athletics Federations coach, demonstrates core conditioning exercises that can help strengthen your muscles and make you less prone to injury. Photos: May Tse

TAKING IT ONE STEP AT A TIME Outer thigh lift

Inner thigh lift

Week 4 Mon Walk an easy 30 min Tues Core training Wed Power walk 30 min Thurs Core training Fri Walk an easy 30 min Sat Rest Sun Power walk 30 min Training tip In hot, sunny weather, wear sunscreen, sunglasses (to relax your facial muscles), and a visor or cap to keep the sun off your face. Keep hydrated at all times.

Inner thigh lift Works: inner thigh (adductor) Lie on side, with start position similar to previous exercise, but with upper leg bent and crossed over the bottom leg, with foot flat on floor. Inhale, lift bottom leg, concentrating on pressing up. Exhale, lower to start position. Repeat with other leg. Plank Works: deep abdominals (transversus abdominis) Lie face down in push-up position, using forearms for support, elbows directly under shoulders. Relax shoulders and tuck chin in. Tighten stomach, hold for 30-60 seconds. Side plank Works: obliques Lie on side. Lift body off the ground, using bottom forearm and the side of the bottom foot for support. Contract abs and relax shoulders. Hold for 30-60 seconds.

Plank

Push-up Works: chest, triceps, shoulders Lie face down with hands at shoulder level, palms flat on floor and slightly wider than shoulderwidth apart. Keep feet together. Exhale, straighten arms and push body off the ground without arching the back. Inhale, lower body.

Side plank

Push-up

Outer thigh lift Works: hip, outer thigh (abductor) Lie on side, with body aligned on same plane, using the forearm for support. Pull in abs for stability. Exhale, lift upper leg up and out from hip socket for two counts. Inhale and lower for four counts to start position. Repeat with other leg.

Lunge

Lunge Works: butt, quadriceps (front thigh) and hamstring (back thigh) Slowly step forward with either leg until the shinbone is perpendicular to the ground. Let back leg lower until the knee gently touches the ground. Draw belly button in and keep upper body erect. Return slowly to pre-descent position. Repeat with other leg.


DIET 7 NUTRITION COLOUR YOUR PLATE

Rainbow palette for your palate ......................................................

disease, a University of Manchester report claims.

Elizabeth Snouffer healthpost@scmp.com Pineapple buns or congee with fish balls for breakfast; cha siu bau, claypot rice or egg noodles for lunch; beef with oyster sauce and fried choi sum for dinner. The brown sauces and soups, white grains and dried meats of many Hong Kong dishes have little nutritional value or colour, and cannot sustain an average diet without resulting in detrimental health effects. While these processed foods are big on convenience – easy and gratifyingly quick to prepare and have long shelf lives – they’re also high in sugar and fat. They have been blamed for many metabolic disorders, often providing the basis for a compromised immune system. People cite lack of time, education or availability of wholesome foods as a rationale for poor eating behaviour. Well, here’s a simple way to modify old habits with one easy step: think of your plate as a canvas. Add some colour, such as purple (pomegranate), green (spinach) and a dash of yellow (butternut squash). The overall colour of your plate, the dietary equivalent of an artist’s palette, determines if your diet is nutrient-deprived. Froot Loops don’t count; the colours should be plant-based. Adding a few fresh vegetables or fruit every day will produce many health benefits, including a reduced risk of heart disease, diabetes, cancer and other debilitating illnesses. It’s also one sure way to sustain a healthy body weight or body mass index, a weight-to-height ratio, used as an indicator of obesity or that a person is underweight.

Green: In Italy, a recent study looked at the eating habits of 30,000 women and found that eating at least one daily serving (57 grams) of leafy vegetables, such as raw lettuce or endive, or cooked vegetables like spinach or cabbage, may lower the risk of developing heart disease by 46 per cent. Cruciferous vegetables such as broccoli, cabbage, bak choi and watercress are infused with phytochemicals, which are known for their anti-carcinogenic properties. Eating these veggies three to four times a week may reduce the risk of cancer by as much as 50 per cent.

Eat a rainbow: filling your plate with brightly coloured fruits and vegetables can help keep you fit and healthy “Two plus three is the way,” says the slogan of the Centre for Health Promotion’s campaign to help people eat a healthier diet. That is, two servings of fruit and three of vegetables every day. One serving is typically equal to two ounces (57 grams), or a quarter- or half-cup. But four in five Hongkongers are not meeting that need, according to a survey last year by the Health Department. Dr Kung Kin-hang, senior medical officer for the department’s Central Health Education Unit, says the inadequate intake of necessary vitamins,

minerals, dietary fibre and antioxidants is of “particular concern”. Don’t know where to start? Use this guide to understand how to colour your diet. Orange/Yellow: Results from a new Centre for Disease Control study suggest that high levels of alphacarotene in the blood may reduce the risk of dying from cardiovascular disease, cancer and other causes by up to 39 per cent. The fruits and vegetables that carry the highest level of alpha-

carotene include carrots, squash, pumpkin, sweet potatoes and bell peppers. Citrus fruits such as oranges, lemons and limes are an important source of antioxidants such as ascorbic acid (also known as vitamin C), flavonoids and phenolic compounds. These help maintain a healthy immune system. Purple: Blueberries, blackberries, grapes, purple cabbage, purple onions and eggplant can help ward off diseases including Alzheimer’s, multiple sclerosis and Parkinson’s

Red: The colour that signals strength and passion has similarly vibrant and robust nutrients in fruits and vegetables coloured by pigments called lycopene or anthocyanin. Lycopene is an antioxidant that neutralises free radicals, and anthocyanin offers protection from heart disease. Watermelon, apples, red berries, red grapes, beetroot and pomegranate are all good examples. A good source of lycopene is also found in tomatoes, although better absorption occurs with cooked tomatoes than from raw ones. Red wine also shares in the benefits of these powerful antioxidants. White/Yellow: Onions, white potatoes, cabbage, cauliflower, parsnip, garlic and ginger contain allicin, a compound that helps lower blood cholesterol and blood pressure. Bananas and celery are good sources of potassium, essential for cell function, nerve transmission and normal blood pressure.

RECIPE FOR HEALTH VEGGIE MAKI

Seasonal leaves in a salad roll that is raw power for the body and soul ...................................................... Shima Shimizu healthpost@scmp.com You won’t need cutlery to eat this colourful salad. Done in the style of maki – Japanese for “roll” – it’s especially suited to eating with hands, and is a great grab-and-go, fuss-free meal. Swiss chard, also known as plain chard, is the highlight of the dish in more ways than one. Large and fleshy, it’s what keeps the other vegetables together. Its reddishpurple and yellowish pigments not only add a splash of colour, but are also rich in the phytonutrient betalain, which has antioxidant, anti-inflammatory, anti-cancer and detoxification properties. Chard leaves also contain at least 13 polyphenol antioxidants, including the flavonoids kaempferol, which protects the heart, and syringic acid, which can help regulate blood sugar. The leaves are also packed with vitamins K, A and C.

Chard tastes similar to beets, a mix of sweet and bitter that adds a delicious dimension to this quick dish. Swiss chard is at its best between June and August. I use the organic ones from Homegrown Foods (www.homegrownfoods.com.hk). During the off-season, you could use alternatives such as the ones listed below to ensure you eat only the freshest seasonal ingredients.

For the veggie maki: 4 Swiss chard leaves (or other big leaves such as cabbage, romaine or bak choi) 1 tbs shoyu almond dip 2 nori sheets, cut in half 8 shiso leaves (or basil) ½ carrot, julienned ¼ cabbage, thinly sliced ½ red or yellow pepper, julienned ½ cucumber (or kohlrabi), julienned 8 toothpicks

Veggie maki with shoyu almond dip Serves 2 Ready in 15 minutes

Place a big leaf on a cutting board and spread the shoyu almond dip on it. Place a nori sheet on top, followed by two shiso leaves. Place a quarter of the remaining vegetables near the stem of the big leaf, and start rolling from the stem towards the tip of the leaf. Use a toothpick to keep its shape. Repeat with the remaining big leaves. Cut each roll in half and serve.

For the shoyu almond dip: 1 cup almonds, soaked and dehydrated 1½ tbs soy sauce 1 tsp garlic powder 2 tbs water Place almonds in a food processor and process until they turn into almond butter. Add soy sauce, garlic powder and water and blend well.

Raw food chef Shima Shimizu is the managing director of Sesame Kitchen (www.sesamekitchen.com) and conducts classes and events in Hong Kong and around the region.

Get on a nutrition roll with these colourful veggie maki. Photo: K.Y. Cheng


8 DIET/WELL-BEING

PERSONAL BEST

Zen and the art of body maintenance ...................................................... Tara Patricia healthpost@scmp.com The crowd falls silent. The young man digs deeply into every ounce of his being. This is it: all his years of training, all his sacrifice, come down to this very moment. As the crowd jumps up around him in slow motion, a drop of sweat rolls down his face. He can hear his heart beating. He is one with everything, yet has no distractions. It’s just him and a silent sense of knowing. With focus and a calm spirit, he makes the play. As the crowd watches nervously ... he delivers. We have all seen this situation played out in movies. We have heard athletes talk about “being in the zone”, or say: “Sport clears my mind and I feel alive.” They’re referring to the spiritual side of exercise. Physical movement affects the physical body, but it also affects the mental, emotional and spiritual self. It creates a chemical and emotional shift in the mind-body state, which allows us to clear the mind of clutter and reconnect deeper to our inner spirit, our true essence. Athletes “in the zone” are in a state of meditation, completely focused on the “now”. They have detached from the chaos of the mind and reached a place of complete connection. They have become connected with their true selves, feeding their spirit and allowing the natural process of life to unfold. We fill our schedules with “busyness”, and this chaos has found its way into our minds, creating more and more distractions

from who we truly are meant to be in life. We race around so much that even when we lie down at night, we take time to settle our stillrunning minds. Tapping into the spiritual side of exercise allows you to reclaim your mind, free yourself of distraction and enter into a form of meditation. In this state, you can begin to reap many more benefits than simply losing weight or toning muscle. You will begin to build confidence, increase emotional stability, decrease restlessness and negative thinking, improve focus and clarity,

If you have not treated this body as well as you could have and see the ill effects before you, forgive yourself and bring your mind, body and spirit into harmony. Over time, you will be able to calm and control your thoughts, increase joy and peace of mind, and improve concentration and creativity. How do we embrace this spiritual side of exercise? Simply allow it to unfold. While many of us go into exercise to seek a better physique, you should put it all into perspective. Allow the physical change in your body to be the reward. Look in the mirror. If you have not treated this body as well as you

could have and see the ill effects before you, smile and forgive yourself. Tell your body that you appreciate how hard it has worked for you, even though you may not have always made the best choices for it. If you dislike a part, accept it for what it is. Make the decision right here, right now, to see your physical form as something that deserves your love, and make the appropriate changes. Make the changes because you are honouring yourself and your body, not because you wish to become something different. Then allow the process of exercise to unfold. Give your mind permission to leave the worries of your life behind. Do not get upset with yourself if you find them creeping back in; simply acknowledge them and move on. Focus on your breathing or the warmth of the sun as it shines down on you. Be aware of your body within the space that surrounds you. Notice your breath as it travels through your nose and into your lungs. No matter what exercise you embark on, calm your being and allow your spirit to shine forth. As you begin to allow yourself to enter into and feel the process of the deeper mind-body state during exercise, you will begin to notice the calm, connected feeling spill over into other parts of your day. You will feel less stressed and have a more enthusiastic approach to life. Reconnecting to the spiritual side of exercise will illuminate your day and rekindle your soul. Tara Patricia is the author of The Road You Were Meant to Travel and a speaker in the field of self-transformation. www.tarapatricia.com.

If you aren’t ready for lunch, have a crunch ...................................................... Jeanette Wang jeanette.wang@scmp.com Bear Naked Fit Triple Berry Crunch HK$65 for 340g bag, City’super A handful of these may not seem like much, but this all-natural granola is so dense and chewy that even a quarter-cup serving (120 calories, 23g carbs, 4g protein, 2g fat) will keep you nicely satisfied. With no added oils and less sugar (just 4g) than traditional granola, it doesn’t get much healthier than this. Verdict: A delicious topping for ice cream or yogurt, but gets soggy quickly when combined with milk.

Photos: Edmond So

Illustration: Martin Megino

THE TASTE TEST GRANOLA

Whole Earth Red Fruit Crunch HK$66 for 450g box, City’super Cocoa Krispies was my favourite cereal as a child because it turned plain milk into a chocolatey treat. But if you, like me, have been avoiding it because of its partially hydrogenated vegetable oil and high sugar content, Red Fruit Crunch makes a worthy alternative. Pink organic oat clusters, redcurrants, strawberries and raspberries turn your milk pink with just the right sweetness and a slight tartness. Verdict: Extremely moreish. Great with milk, yogurt or on its own.

Kashi GoLean Crunch HK$53 for 425g box, City’super Some people may write this off as “horse food” purely based on its looks, but don’t judge granola by its colour. The pleasing sweetness and lightness of this one certainly surprised; it reminded me of freshly baked waffles drizzled with maple syrup. Best of all, it stayed crunchy until the last morsel, even when soaked in a big bowl of cold milk. Verdict: With 190 calories, 37g carbs (including 8g fibre), 9g protein and 3g fat per 1 cup serving, it’s now my recovery food of choice after a workout.


2011 06 14 Health Post #4