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YOUR GUIDE TO LIVING WELL

TUESDAY, JULY 17, 2012

Who dares swims Open-water swimming is taking off in Hong Kong >PAGE 6

HOW BEE POLLEN COULD POSE A DEADLY HAZARD

EATING THE AFTERBIRTH: WEIRD OR WONDERFUL?

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2 NEWS APP OF THE WEEK

HEALTH BITES

This diet knows taste matters

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...................................................... Katie McGregor healthpost@scmp.com South Beach Diet HK$15 Rating: 8/10 As I logged on to the app for the first time, the photo of what looked like a delicious bowl of prawn laksa immediately set my stomach rumbling. Surely an app designed to help you lose weight should not make you feel hungrier than before. The South Beach Diet is not new and has proven to be effective. The concept is that you will lose weight if you eat foods that are light to moderate in calories but satisfy your hunger: “You don’t have to count calories, but calories do count.” The first phase lasts just 14 days and the literature suggests that you might lose as much as 4.5kg, which is just about right to fit in with my holiday plans. On logging on to the app, you must register and then provide your vital statistics. The app suggested an “ideal weight” for me, one I considered unreasonably low but if losing weight is this easy, perhaps it’s reasonable. The app provides a list of things you can eat in each phase, and in phase 1, cheese, chicken, dairy, nuts, greens and coconut milk are included. Foods to avoid: bread, bran cereal, brown rice, some fruit, champagne and carrots. Like all good weight-loss apps, this comes with a journal in which you can log your exercise and food consumption and keep an eye on your daily calorie goal. Add food from a list of recommended meals, add custom foods or scan a barcode.

Ideally, you should be keeping things simple and adding items from your recommended meal plan. The plan comprises five meals a day and includes such items as Asian turkey meatballs in lettuce, creamy broccoli soup and even a funky chilled espresso custard. All recipes come with a photograph, ingredient list and preparation instructions. It sounds satisfying, but it’s a logistical nightmare because all of this and more might be on a single day’s meal plan. And that is where they have you; by becoming a paid subscriber and logging on to the website, you can customise your meal plan, choose from even more recipes, create a shopping list and even get advice from a nutritionist. So I paid HK$38 for a seven-day subscription. Be warned: the subscription will auto-renew until you cancel it by logging on to your iTunes account.

ASK THE DOCTORS DR ANTHONY LUKE Q: When I lift weights, I get soreness, specifically around my biceps. Is there something wrong with my technique? How can I avoid this? A: Biceps tendinitis is a very common problem for weightlifters. Sometimes the problem lies in technique, for anatomical reasons or from lifting too much or too often. Make sure to lift with good technique and proper posture, and incorporate rest days between workouts. Working on eccentric exercises is also useful for weightlifters. For example, when the biceps contracts, the elbow bends. When the elbow is extending, the biceps muscle is contracted but lengthening. The latter is essentially the contraction of the biceps, and is usually the type of motion that injures muscles and tendons. Working on exercises that target this is a very important part of training that can protect muscles and tendons from injury. Dr Anthony Luke is an associate professor of clinical orthopaedic surgery at the University of California, San Francisco. Reprinted with permission of the American College of Sports Medicine’s ACSM Fit Society Page

> CONTACT US Deputy Culture Editor: Choong Tet Sieu tetsieu.choong@scmp.com Health Post Editor: Jeanette Wang jeanette.wang@scmp.com General inquiries: healthpost@scmp.com Advertising: tel: 2565 2435; e-mail advertising@scmp.com Printed and published by South China Morning Post Publishers Ltd, Morning Post Centre, 22 Dai Fat Street, Tai Po Industrial Estate, Tai Po, Hong Kong. Tel: 2680 8888

Jeanette Wang jeanette.wang@scmp.com Make time by giving time There are never enough hours in a day for most Hongkongers. But experts from business schools at Yale, Harvard and the University of Pennsylvania offer a solution: volunteer your time. It sounds counter-intuitive, but giving time away may actually increase our sense of unhurried leisure. Across four experiments, the researchers found that people’s subjective sense of having time, called “time affluence”, can be increased. Compared with wasting time, spending time on oneself and even gaining a windfall of “free” time, spending time on others increased feelings of time affluence. UPenn Professor Cassie Mogilner says this is because giving away time boosts one’s sense of personal competence and efficiency, which stretches out time in our minds.

Programmed to gain weight Not entirely surprisingly, children who watch more television are fatter and less physically fit, a recent study has found. Researchers at the University of Montreal and the affiliated Sainte-Justine Mother and Child University Hospital in Canada looked at the television-watching habits of children aged between 21⁄2 and 41⁄2, and found that those who spent more time in front of the box had larger waist sizes and poorer athletic performance. The study, published in the International Journal of Behavioral Nutrition and Physical Activity, found that children watched an average of 8.8 hours per week at age 21⁄2, rising by an average of six hours by age 41⁄2. Each additional hour that they watched television compared with two years earlier corresponded to an increase in their waist size of slightly less than half a millimetre, and also resulted in them being able to manage about 3.3mm less in a standing long jump.

The whites of their thighs That fake golden summer tan is getting harder to achieve. Restrictions on indoor tanning, which studies suggest is linked to skin cancer, appear to have increased in several countries since 2003, according to a study published in the Archives of Dermatology. The number of countries with nationwide indoor tanning laws restricting those 18 years or younger increased from two (France and Brazil) in 2003 to 11 last year. The additional countries were all in Europe: Spain, Portugal, Germany, Austria, Belgium, England, Wales, Northern Ireland and Scotland. Dr Mary Pawlak, of the Colorado School of Public Health, and colleagues conducted a web-based internet search of access to indoor tanning and compiled the legislation. “Additional countries and states are developing indoor tanning restrictions or making their existing legislation more restrictive,” the authors say. Exposure to ultraviolet radiation – whether from the sun or artificial sources such as sunlamps used in tanning beds – increases the risk of skin cancer, according to the US National Cancer Institute.

Cancer therapy may be your cup of tea The latest potential cancer treatment involves a very rare substance and a very common one: gold and tea. Scientists at the University of Missouri have found a way of targeting certain cancers, involving gold nanoparticles and a compound found in tea leaves, that might become a less harmful alternative to chemotherapy. When used to treat prostate cancer, the researchers found, the tea compound is attracted to tumour cells, helping to deliver to the site of the tumour the radioactive gold nanoparticles, which can destroy the cells. The scientists’ study, published in the Proceedings of the National Academy of Sciences, found that unlike current treatments, the technique was also effective against aggressive forms of the disease that can spread to other parts of the body. It can be used in smaller doses than chemotherapy, which can have toxic effects on organs and bodily functions; nanoparticles of the appropriate size are injected in just a couple of sites compared with the hundreds used now, and are more likely to remain at the tumour site, thanks to the tea compound.


MEDICAL 3 QUIZ

HEALTHY LIVING

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How we do like to be beside the seaside

Jeanette Wang jeanette.wang@scmp.com It may not seem to have a nose, but a mosquito has an extraordinary sense of smell, which gives it the uncanny ability to find and bite us. Zainulabeuddin Syed, a mosquito biologist with the University of Notre Dame’s Eck Institute for Global Health in the US, studies olfaction in mosquitoes and other insects. An understanding of what leads mosquitoes to feed on humans can play an important role in developing more effective mosquito and disease control. A large part of a mosquito’s brain is devoted to smell. Only female mosquitoes feed on blood, which they use to produce eggs. And they find their meals through smell. Culex mosquitoes, for example – which transmit West Nile virus, an emerging infectious disease, and other life-threatening illnesses – can detect minute concentrations of nonanal, a chemical substance given off by humans. They detect it via receptor neurons on their antennae. Birds, the main hosts of mosquitoes and a prime source of West Nile virus, also emit nonanal. Syed is also researching the role that plants – and how they smell – play in mosquito behaviour. A deeper understanding of the role of the chemicals produced by plants and how mosquitoes select plants to obtain their energy sources can lead to better control and elimination strategies. As for mosquito repellent, Syed says DEET (N, N-Diethyl-metatoluamide) is effective. But rather than mask odours that attract mosquitoes, the insects smell DEET and avoid it. In many areas of the world, mosquito control is a matter of life and death. In Africa, malaria claims a victim every 30 seconds. A better

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

Female mosquitoes feed on blood, using it to produce eggs. Photo: NYT understanding of the role that smell plays in mosquito behaviour can offer important clues that may lead to new control strategies. Test your knowledge of mosquitoes here. 1. Which of these diseases is not carried by mosquitoes? a. Japanese encephalitis b. Dengue fever c. HIV 2. The itchy red bumps from mosquito bites are caused by a. its sharp mouth parts b. allergic reaction to pollen carried on its legs c. an allergic reaction to its saliva 3. How many species of mosquito are there? a. 2,000 b. 3,500 c. 5,000 4. Is there anywhere in the world that’s mosquito free? a. yes, in deserts b. yes, in the Arctic Circle c. no, they are everywhere Answers: 1. c; 2. c; 3. b; 4. a (mosquitoes breed in stagnant water; a desert doesn’t have water)

DIETING

Write it down and shed more ...................................................... Jeanette Wang jeanette.wang@scmp.com When it comes to dieting, studies show that how much you eat is more important than what you eat. To prove this, researchers in Seattle, Washington studied 123 overweight-to-obese, sedentary women aged 50 to 75. The team at Fred Hutchinson Cancer Research Centre concluded that post-menopausal women who want to lose weight should keep a food journal. They should also avoid skipping meals and eating out – especially at lunchtime. “It is difficult to make changes to your diet when you are not paying close attention to what you are eating,” says Dr Anne McTiernan, director of the centre’s prevention centre. Study participants were given the following tips for keeping a food journal: • Be honest – record everything that you eat • Be accurate – measure portions, read labels • Be complete – include details such

as how the food was prepared, and any toppings or condiments • Be consistent – always carry your food diary with you or use a diettracking app on your smartphone Study participants were randomly assigned to one of two groups: diet only and exercise plus diet. They filled out questionnaires to assess dietary intake, eatingrelated weight-control strategies, self-monitoring behaviour and meal patterns. They were also asked to complete a 120-item food frequency questionnaire to assess dietary change throughout the study. At the end of the study all participants lost an average of 10 per cent of their starting weight, which was the goal of the intervention. Women who kept food journals consistently lost about 2.7kg more than those who did not. Those who reported not skipping meals lost an extra 3.6kg compared to women who did. Those who ate out less frequently lost on average 2.3kg more than those who ate lunch out at least once a week. The results of the study were published last week in the Journal of the Academy of Nutrition and Dietetics.

Making a choice between a home in Mid-Levels or the south side? Findings from a new study might help sway your decision. Researchers from the European Centre for Environment and Human Health at Peninsula College of Medicine and Dentistry revealed yesterday that people living near the coast tend to enjoy better health than those living inland. Lead author of the study, Dr Ben Wheeler, says: “We know that people usually have a good time when they go to the beach, but there is strikingly little evidence of how spending time at the coast can affect health and well-being. By analysing data for the whole population, our research suggests there is a positive effect, although this type of study cannot prove cause and effect.” The researchers used data from the 2001 census for England, which involved more than 48 million people. The results show that on average, populations living by the sea report higher rates of good health than similar populations living inland. The link between good health and proximity to the sea was also found to be

Research suggests that seaside living is good for you. Photo: Bloomberg strongest in the most economically deprived communities. The authors were keen to point out that although this effect is relatively small, when applied to the whole population the effects on public health could be substantial. Along with other studies, the results of this work suggest that access to “good” environments may have a role in reducing inequality in health between the wealthiest and poorest members of society. Another recent study conducted by

the centre in collaboration with Natural England found that visits to the coast left people feeling calmer, more relaxed and more revitalised than visits to city parks or countryside. One reason those living in coastal communities may attain better physical health could be due to the stress relief offered by spending time near the sea. So for those who can’t live by the sea, perhaps making frequent visits to the beach this summer could put you in better health.


4 MEDICAL

CASE HISTORY

Shock to the system ......................................................

Illustrati on: Ang ela

Bee pollen supplements have been touted as nature’s perfect food. Bee pollen, or bee bread, is said to be full of minerals, enzymes and amino acids that can increase one’s energy, boost the immune system and fight signs of ageing. It is a compound made by bees from the pollen they collect and is used to feed the hive. Advocates claim these supplements can do everything from boost fertility and help weight loss to ease migraines and ulcers. But bee pollen supplements also carry a known – but infrequently advertised – risk of a severe and potentially deadly allergic reaction called anaphylaxis, a complication that 30-year-old Jessica Smith (whose name has been changed for patient confidentiality reasons) discovered the hard way. Perhaps persuaded by the promises of glowing health benefits, Smith bought a bottle of bee pollen supplement, along with omega 3-6-9 oil and vitamin D3. But her hopes of better health turned into a nightmare within 10 minutes of taking her second dose. Smith first felt a strange tingling sensation in her mouth and throat, which was followed by the alarming sensation that her throat was closing up. Her eyelids and lips swelled, she could not swallow and broke out in hives. Smith’s breathing grew shallow as she gasped for breath, and she started feeling light-headed and weak. Common allergic reactions are localised in one part of the body such as the respiratory system, which results in sneezing and a runny nose, or the skin, where a rash might break out. But an anaphylactic reaction to an allergen is a whole-body reaction involving multiple organ systems. Smith’s body overreacted to an allergen and released chemicals that were causing her symptoms. Without timely treatment, she could have died. Smith called an ambulance and was taken to hospital. It was immediately evident to doctors that she was suffering a severe anaphylactic reaction. According to allergist and clinical immunologist Dr Gordon Sussman of St Michael’s Hospital in Toronto, there are four grades of anaphylactic reaction.

Ho

Eileen Aung-Thwin healthpost@scmp.com

Her eyelids swelled, she was unable to swallow, she broke out in hives, and started to feel faint and light-headed

Grade one is a mild reaction that involves one organ system; grade two involves more than one system; with grade three there is tightness in the throat; and in the most severe, grade four, the patient suffers breathing difficulty. Emergency room doctors gave Smith an injection of epinephrine (adrenaline), which is the standard treatment for anaphylaxis to help open her airways, reduce swelling and improve blood circulation. She was also given antihistamines. Her body responded

quickly to the medication, and within 10 minutes her symptoms were under control. There was a risk that she could suffer a relapse, so she was admitted for observation for the next eight hours. When she was discharged, she was referred to Sussman to uncover the allergen that had almost cost her life. Sussman investigated Smith’s medical history. Smith reported that she had seasonal allergies, and would suffer red, itchy eyes, runny nose, sneezing and post-nasal

drips during summer, in particular. She had no known allergies to food, drugs, latex or insect venom (common triggers for anaphylaxis). Given that Smith had taken her new supplements immediately prior to the onset of the anaphylactic reaction, they were the primary suspect. Because those substances were not part of standard allergy tests, Sussman had to prepare special extracts from the supplements to test Smith for the allergy. Smith’s skin prick test, in which a tiny amount of a suspected allergen is put under the skin, showed a strong reaction to the supplement and Timothy grass, a common species of grass. There was no reaction to the omega oil or the vitamin D3 supplement. Sussman says Smith’s pre-existing allergies may have made her more susceptible to an anaphylactic reaction, although there are many factors that can contribute to a severe reaction to an allergen. Moreover, its severity can vary with each exposure. Hence, it is difficult to predict who might suffer anaphylaxis and when. He also explained that Smith probably did not have an immediate reaction to the first dose because her immune system needed initial exposure to the substance to arm itself against it. Although she was told to stop taking the supplement, it was unlikely she would have to avoid all bee products. Sussman also suggested that she carry an epinephrine auto-injector with her in the event of another anaphylactic reaction in future. But as long as she avoids her known allergens, it is likely she will be able to avoid another severe allergic reaction. Anaphylactic reactions to pollen are not new; similar cases have been reported in medical literature, and Sussman himself has seen other such cases. While pollen presents a risk for a severe allergic reaction, the risk is not very great, says Sussman. Nevertheless, it pays to be aware that supplements can trigger unwanted responses in the body. If you notice a tingling sensation or other unusual symptoms after ingesting a new food, stop taking the substance immediately and consult a doctor, he advises.


HEALTH 5 TRADITIONAL CHINESE MEDICINE

The Tao of the brain ...................................................... Elizabeth Snouffer healthpost@scmp.com Scientists studying a form of Chinese mindfulness meditation have confirmed and expanded their findings on the positive effects of the technique in subjects who regularly practise it. Called integrative body-mind training (IBMT), the technique was adapted from traditional Chinese medicine in the 1990s by professor Tang Yi-yuan, one of the lead scientists in the study. Today, it is said to be practised by thousands of people in China. In 2010, research led by Tang, a visiting research professor at the University of Oregon, and Michael Posner, a professor of psychology there, first reported changes in structural efficiency of white matter in the brain that can be related to positive behavioural changes in 45 participating students practising the technique regularly for a month. Cerebral white matter is an essential component of the human brain. It contains fibre pathways that facilitate the distributed neural circuits that contribute to sensor and motor function, intellect and the emotions. The pair’s new study, published last month in the Proceedings of the National Academy of Sciences, came from additional scrutiny of the 2010 study and another that involved 68 undergraduate students at China’s Dalian University of Technology. The researchers revisited data obtained from using an MRI technique known as diffusion tensor imaging. They found that after a month, or about 11 hours of IMBT, subjects had improved mood changes that coincided with increased axonal density – more brain-signaling connections – and an expansion of myelin, the

protective fatty tissue that surrounds the axons, in the brain’s anterior cingulate region. Deficits in activation of the anterior cingulate cortex have been associated with attention deficit disorder, dementia, depression, schizophrenia and other disorders. This dynamic pattern of white matter change involving the anterior cingulate cortex, a part of the brain network related to self-regulation, could provide a means for intervention to improve or prevent mental disorders, say the scientists. IBMT is a combination of ancient techniques taken from traditional Chinese martial arts, Taoism and Confucianism, and uses the principles of yin and yang, and the theory of the five elements. The meditative state is achieved through training involving relaxation of various muscle groups over the face, head, shoulders, arms, legs, chest, back and abdomen, guided by a qualified tutor and audio CD. Tang has years of experience in the field. He started learning high-

IBMT is a combination of ancient techniques taken from traditional martial arts, Taoism and Confucianism

Tang (left) and Posner proved the effectiveness of the meditation techniques

level consciousness training from a variety of Chinese masters when he was just six years old. He believes that IBMT is quickly achieved once learned, but can be difficult initially because it is an “effortless practice.” It requires participants to let go of themselves to attain a high level of balance through mind, body and environment. Tang and Posner have done a series of studies on IBMT since 2006. “In our studies, almost all IBMT participants feel energised with a sense of positive emotions after training, and the effects are longlasting,” says Tang, who is now the director of Texas Tech University’s Neuroimaging Institute. In a paper in 2007, 40 Chinese undergraduate students were given five days of IBMT training for 20 minutes a day prior to a mental maths test. The control group was given a 20-minute session of normal relaxation training, similar to yoga. The experimental group had lower levels of the stress hormone cortisol, anxiety, depression, anger and fatigue than the relaxation control group. In 2009, Tang and his Chinese colleagues found that IBMT subjects in China had increased blood flow in the right anterior cingulate cortex after receiving training for 20 minutes a day over five days. Compared with the relaxation group, IBMT subjects also had lower heart rates and skin conductance responses, increased belly breathing amplitude and decreased chest respiration rates. The results of this new study made the scientists “very excited”, says Tang, because all of the other training exercises, such as workingmemory training or computerbased training have shown only to change myelination. “We believe these changes may be reflective of the time of training

involved in IBMT. We found a different pattern of neural plasticity induced by the training.” “This study gives us a much more detailed picture of what it is that is actually changing,” says Posner. “We did confirm the exact locations of the white-matter changes that we had found previously. “And now we show that both myelination and axon density are improving. The order of changes we found may be similar to changes found during brain development in early childhood, allowing a new way to reveal how such changes might influence emotional and cognitive development.” Posner became interested in IBMT after a 2005 meeting with Tang, who proposed they collaborate. “Even normal people can become more efficient,” says Posner. “It’s really about enhancing conductivity of messages from one part of the brain to another.” Tang has worked with some patients suffering with depression with good results, and Posner is working on a study with people who are addicted to tobacco. At present, there are no qualified IBMT coaches available for consumer training worldwide, but that’s about to change in the next 12 to 18 months. Tang plans to open centres in New York, Europe and around the Hong Kong region. He is also publishing an English book and CD for US consumers and a Chinese version which targets university professors on the mainland. Coaching is a key component for the future. “You can’t teach a person how to swim with a manual, and it’s the same with IBMT,” says Tang. “A student really requires hands-on guidance.” For more information (in Chinese), go to yi-yuan.net


6 COVER STORY

Current infatu

Open-water swimming is not as scary or difficult as it seems, and it’s growing in popularity, writes Rache

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lizabeth MacDonald finds it boring to just do laps in the pool – “always following the black line”. While the 32-year-old lawyer still trains up to four times a week in the pool, her passion is swimming in open water. “I love the different elements that the sea offers,” she says. “It’s very relaxing.” MacDonald is not alone. Since a 10-kilometre open-water swimming race was added to the Beijing Olympics in 2008, it has become one of the world’s fastest-growing sports. Needing little more than a swimsuit, goggles and some easy-tomaster skills, it’s easy to see why open-water swimming is catching on. The sea provides more freedom than a pool, says Olivier Courret, 39, director of a sporting goods company. “When you are swimming in the ocean, there are no walls. You can swim for kilometres and nothing is there to stop you.” Being surrounded by water, with more than 250 islands to explore, and a climate in which it’s possible to swim comfortably for most of the year, Hong Kong offers

the perfect playground for openwater swimming. It is these elements that led long-time Hong Kong residents Ian Polson, 67, and Lloyd McBean, 60, both originally from Australia, to start swimming in Hong Kong’s waters several years ago. They recognised each other on the podiums of local swimming races and became regular training buddies. Swimming at Repulse Bay on Saturday afternoons became an integral part of their week. But it was not long before they noticed several other swimmers training at the same time. So Polson, a barrister, and McBean, a swimming coach, joined forces and made the training sessions a regular event, open to all, and the Open Water Swimmers of Hong Kong (OWSHK) was born. It’s an informal association of Hong Kong’s open-water swimming aficionados. Regulars, not-so-regulars and new members, ranging from 13 to 68 years old, meet year round on Saturday afternoons at Repulse Bay. The group of swimmers – more than 40 during summer and 20 or so during off-peak times – meet at 2pm. Once in the water, the group

Members of the Open Water Swimmers of Hong Kong train in Repulse Bay (above and right). Photos: Edward Wong splits into two, based on ability. The stronger swimmers will swim three kilometres or more for over an hour to nearby islands and beaches, while the less confident group swims closer to the beach for about 1.5 kilometres. There is no cost to participate in

It’s a totally different mind game in the sea. You can start wondering what’s down there, but that keeps it interesting ELIZABETH MacDONALD

the training sessions; they are fuelled by Polson and McBean’s shared passion. So popular are the OWSHK group and Hong Kong’s water offerings that Jose Pinto, 39, who works for The Venetian in Macau, takes the 45-minute ferry ride to Hong Kong at least once a month to swim. He enjoys the social aspects of the friendly group and the time swimming around Hong Kong’s beaches. “It’s a different way to see the city,” he says. Swimming in the open water also offers more of a challenge than poolswimming. “It’s a totally different mind game when you are in the sea,” says MacDonald. “You can start wondering what’s down there, but that keeps it interesting.” While many Hongkongers avoid


COVER STORY 7

uation l Jacqueline the open water because they fear what may be lurking in the depths, swimmers should not be concerned. Despite a potential shark sighting off Stanley beach in late June, seasoned Hong Kong open-water swimmer Doug Woodring has never seen a shark in Hong Kong’s waters. A 46-year-old California native and Hong Kong resident for 28 years, he is the co-creator of well-known open swimming races, the Shek O Challenge, a 2.2kilometre swim, and The Clean Half, a 14.5-kilometre swim from Stanley to Deep Water Bay, which can be swum in relay teams or solo. The Shek O race has been running for eight years and the Stanley race for six. During all of his time in openwater swimming, Woodring says: “There have been no documented attacks during open-water races.” According to Polson, the biggest irritations in the water are the odd jellyfish or plastic bag. He also believes there is a misconception about Hong Kong’s water pollution. “It is not as bad as many people think,” he says. While heavy rainfall may affect the water quality, the water towards the south of Hong Kong Island and up north of Hong Kong is beautiful and refreshing most of the time, says Polson. Even the water in Victoria Harbour has become the setting for open-water swimming. After a 33-year hiatus due to pollution levels and increased harbour activity, Hong Kong’s famous cross-harbour swim was reintroduced last year. This year, the swim, renamed the New World Harbour Race, will take place on October 21 and be open to 1,500 participants – a 50 per cent increase from last year. Apart from confident swimming skills, swimmers need to be able to navigate in the open water. Easy, according to Courret: “You pop your head out of the water every once in a while and take reference points.” To avoid water traffic and other hazards, such as jet skis, McBean and Polson require that OWSHK

swimmers wear brightly coloured swim caps and stay in groups. “Then you’re just like one big fish going through the water,” says Courret. Open-water swimmers should also be prepared to contend with wilder elements, such as choppy water, wind and currents. “But that’s when it gets really fun,” says MacDonald. Once swimmers have the skills down pat, they can explore some of Hong Kong’s many races. Popular races among novice and experienced swimmers alike include Revolution Asia’s Summer Ocean Swim Series, sponsored by Garmin and Sportsworld, and their Tribal Splash ’n’ Dash Aquathon Series, which combines short running distances with swimming. Nerida Rigg, 35, a triathlete, started the races after moving from Australia eight years ago. The swims,

from 1.4 to two kilometres, take most competitors only 30 minutes to complete and are achievable with minimal training. “Our lifeguards stay out there until the last person crosses the line,” Rigg says. And it’s never too late to get involved. The greatest number of participants in Rigg’s races comes from the 35- to 44-year-old category, she says. With low impact on the body and the ability to control your speed, exertion and distance, it suits those looking for a serious workout, or just a leisurely swim to cool down. So, if you’re suffering during Hong Kong’s hot, humid summer, perhaps it’s time to leap into the water. Rigg’s advice for anyone wanting to give the sport a try is not to be afraid. “It’s not as scary as you think; just give it a go.” healthpost@scmp.com

OPEN SEASON • Open Water Swimmers of Hong Kong (owshk.org) • 2XU Open Water Swim Series: Middle Island Challenge – July 28 (3.4 kilometres) and Pier to Pier Invitational – September 24 (five kilometres) (owshk.org) • Garmin SportsWorld Summer Ocean Series South Bay on August 19; Repulse Bay on September 2; and Deep Water Bay on September 30 (revolution-asia.com) • Clean Half 14.5 kilometres, October 6 (thecleanhalf.com) • New World Cross Harbour Race 1.5 kilometres, October 21 (hkharbourrace.com)


8 HEALTH

Placenta s Some women say it’s beneficial, but eating your own afterbirth isn’t for the squeamish, writes Jennifer Huang

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hen Mina Bregman was having her third child, she had already decided she was going to eat the placenta after childbirth. It would not be the first time she had eaten her own afterbirth. Following her second pregnancy, the midwife dehydrated Bregman’s placenta, processed it at a low temperature and ground it into powder form for consumption. But this time, it would be a little different. The placenta is an organ that develops in the womb during pregnancy to deliver nutrients to the fetus. Believed by some to provide health benefits, the practice of placentophagy, or ingesting afterbirth, is well outside of the mainstream but has become a trend worldwide in recent years. In March, actress January Jones told People magazine that she ate her own placenta in the form of capsules after becoming a first-time mum, adding that the practice is “not witchcrafty”. Those with a more conventional outlook may find the idea difficult to stomach. “Every time I give birth, my family always wonders what crazy things I’m going to do to shock them,” says Bregman. At the time, she was living in the Netherlands where home births assisted by midwives are fairly common. After a smooth delivery, Bregman’s doula, Rachel Hopkins, placed the placenta into a pan and brought it to the kitchen where a scalpel, a cutting board

Photo: Corbis


HEALTH 9

smoothie, anyone? sterilised in an autoclave and plastic bags had been set aside for the postnatal preparation. Hopkins assessed the health of the placenta by checking the colour, texture and size. She examined the flow of the tree-like veins and checked for evidence of clots or infections. Satisfied, she carefully cleaned the organ and divided it into ten pieces, reserving one portion for the day’s use and storing the rest in the kitchen freezer. With the help of Bregman’s fiveyear-old daughter, Hopkins mixed the reserved placenta with coconut water and frozen strawberries in the blender to make a special smoothie. “I swear that it didn’t taste like placenta. It’s like a frozen daiquiri,” says Bregman. She felt that it was a positive experience and credits the smoothies for her smooth recovery from a pelvic condition that developed post pregnancy. She adds: “I did find that my emotions were more on an even keel. I didn’t have the depression dip that you usually do after day five. Also, I noticed that my milk came in sooner.” A recent study conducted by Mark Kristal, professor at State University of New York, Buffalo, revealed that placentophagy has medical benefits in non-human mammals. One notable finding is the way in which eating the placenta can amplify the painkilling effect of naturally occurring endorphins released during labour and delivery. “The placenta contains a molecule that enhances opiate processes that go on at the time,” says Kristal. The afterbirth functions as a natural mechanism to keep the female from pumping out too much endorphins. “[Placentophagy] gives more of an opiate effect without more opiates,” says Kristal. “It works with the female’s own endorphins without any opiates from outside.” The analgesic effect is true for non-pregnant females and even males. Kristal thinks this will have applications for pain management and addiction recovery.

It also sheds some light on why almost all non-human mammals eat their own afterbirth. But Kristal stresses that his research is specific to non-human mammals. He cautions against using these results to make a case for human placentophagy. Yet, it is precisely because it occurs in nature that women like Bregman believe that ingesting afterbirth is a healthy practice. She says: “It made sense to me because animals do it and there is a lot of nutritional value.” “When you consume placenta it’s bio-identical material. It’s your child’s unique material, your own and your husband’s,” says Hopkins, who studied the uses of the placenta with German midwife Cornelia Enning. “This is a form of hormone replacement, in effect, and helps those with a history of postpartum depression, weakness and anaemia following pregnancy.” With her knowledge of nutrition, Hopkins developed her recipe for raw placenta smoothies. In the past eight years, she’s helped 56 people and trained a dozen midwives and maternity nurses. She received all of her referrals by word of mouth. “I’m happy and fortunate to have someone like Rachel,” says Bregman. “Even though I’m not prone to postpartum depression, with each subsequent pregnancy my body gets so depleted. It’s hard for your body to build a baby.” Part of the challenge is not only persuading clients to keep an open mind but also getting full co-operation from family members. “A woman needs to have full support of the family,” says Hopkins. “It is taboo for some people. But I’ve never had anyone regret it

Some animals eat their own young, but that doesn’t justify humans doing it PROFESSOR MARK KRISTAL

or act up because when the family members have seen someone they love go through postnatal depression before, they are relieved to see her flourishing.” Her husband, a vegan, prepared Hopkins’s placenta after she gave birth to their second child. “I felt the effects immediately,” she says of her experience. “I drank it within a minute and immediately asked for more. I got up and wanted to take a shower until the midwife showed up and told me to get back into bed. I felt great.” “There is something about [placenta] that when it hits your tongue, your body wants it,” Hopkins says. “It’s heavily laden with hormones. It’s a massive vitamin and mineral bomb.” Kristal regards such accounts with scepticism: “Most accounts are anecdotal. The [new mothers] have a positive response no matter how much they take or when they take it. This raises issue that it might be a placebo.” He says it’s difficult to substantiate these health claims because it’s hard to find control subjects or even identify conditions such as postnatal depression. “In non-humans, there really is no equivalent to postnatal depression,” he says. “In humans, it’s such a nebulous concept that it’s difficult to deal with.” Other medical experts claim that such an approach to medicine has its own limitations. “[Western medicine] considers efficacy in terms of hormones, blood cells, immunity,” says Jiang Xiajiang, professional consultant of Chinese medicine at Chinese University. “Traditional Chinese medicine doesn’t think in those terms. Although ancient doctors did not know this kind of science, they were knowledgeable about the efficacy of using the placenta in medicine.” Eating the human placenta is an ancient practice in Chinese medicine, according to Jiang. Called zi he che, the uses are varied but the placenta is taken primarily to tonify the kidney system, revitalise the blood or to treat issues triggered by a

deficiency in the kidney system. It can treat a range of gynaecological ailments, says Jiang, such as female infertility, amenorrhea, or premature menopause, as well as improve milk production. It is also used to treat asthma, allergies, underdevelopment in young children, and impotence and sterility in men. After the placenta is processed to make medicine, it can come in many forms: pills, powder and injections. Commonly prescribed in powder form, it is generally boiled in combination with other ingredients to make a soup. “There are people who eat placenta raw, mostly on the mainland and not in Hong Kong,” says Jiang. “Hospitals would have to provide it right after the birth, which is unlikely to happen in Hong Kong.” Although Jiang has never prescribed raw placenta for her patients, she says cooking fresh afterbirth into foods is still done in parts of China. “They would first flush out the blood vessels to clean them thoroughly and braise [the placenta] in huangjiu [a grain wine] to cook out the gaminess,” she says. “Once it shrinks to about palm size, they just wrap it in dumplings to eat the way you would pork or another kind of meat. The taste is virtually undetectable because it has the flavour of meat. And a lot of times the sick person may not even know they’re eating it.” Traditional use of placenta has changed with greater safety controls, concerns about hygiene, a gradual shift in perception and lack of supply. Placentophagy poses certain risks especially if the pregnant mother has an infectious disease such as hepatitis. Jiang explains, because the Chinese government now restricts the sale of human placenta, the parts used for Chinese medicine in Hong Kong tend to come from animal sources such as pigs, cows, sheep or horses. “Eating your own placenta is easy, economical and clean,” says Kathryn of her own experience. “It’s better than [taking] horse hormones.” Kathryn requested to keep her

surname private owing to the sensitivity of her family towards the subject. She first encountered the consumption of the placenta while studying at the Chengdu College of Chinese Medicine in the early 1990s. She says: “[If] animal body parts should be appropriate for humans as a tonic, it makes sense that eating your own body part isn’t strange.” When she gave birth to her first child, Kathryn was living in a small town in Mexico. “My husband tried to separate the umbilical from placenta. It was very bloody and he was making a mess,” she says. “We kept it in the refrigerator after we cleaned it and then cooked it in an interesting dish. It was basically five-spice stew over rice. We also cooked it with curry.” “Giving birth takes so much from your health, according to Chinese medicine,” says Kathryn. “It’s a great drain on a female’s jing.” (Jing is a medical concept referring to a person’s essence and is a fundamental determinant of the body’s constitution.) But she says she felt no change after eating the placenta. “My take is what contributes to your general health is a combination of several factors,” Kathryn says. “You can’t isolate one thing and say that’s the determining factor.” Kristal says he’s always been sceptical about reports from women praising the benefits of eating their own placenta. “It is much more efficient and medically sound to treat women with hormones than for them to eat a placenta,” says Kristal. He says behind it all is a “back to nature idea that we’re animals and, if they do it, we should do it. Some animals eat their own young, but that doesn’t justify humans doing it.” Hopkins, on the other hand, points out that the benefits of using human and animal placentas are now being explored in cosmetics and the health supplement industry. Rather than distancing ourselves from the source of our medicine, we should accept it, she says. healthpost@scmp.com


10 FITNESS HEALTHY GOURMET

SPORTS NUTRITION

Eat your aches away ...................................................... Sasha Gonzales healthpost@scmp.com

Train your brain and your body will follow ...................................................... Andrea Oschetti healthpost@scmp.com Last week, we kicked off this column by focusing on flavour, one of four principles that sum up my approach to healthy cooking. The goal when I cook is to bring out the food’s natural flavours by respecting ingredients with light cooking techniques. To that end, I served up a simple-to-prepare yet complex-tasting buckwheat lasagne recipe to demonstrate this philosophy. My second principle of healthy eating is mindfulness. To counter the stress generated by daily life in bustling Hong Kong, which can over-stimulate our senses, we must try to find a space where we are aware of our thoughts, physical sensations and emotions. In relation to food, mindfulness means being aware of what we eat, by experiencing what we put in our mouths fully and with all of our senses. And the attention you put into what you eat is what makes all the difference. We also need to get in touch with our body and learn what it naturally likes, by providing it with simple and healthy food. Our body has memory: it takes just a week of healthy eating for it to crave food that serves our

Our body has memory: it takes just a week of healthy eating for it to crave food that serves our well-being

well-being. Below is a light, tasty and well-balanced summer recipe that I am sure you will want to try over and over again. Crunchy avocado balls with Italian energy salad Ingredients 4 ripe avocados 1 carrot 1 celery stem 50 grams sun-dried tomatoes 20 grams olives 40 grams sliced almonds 1 bunch of chives Juice of 2 lemons 1 tbsp oil Some lettuce, grilled zucchini, pine nuts, shallots, oil and lime juice • Peel the avocados, sprinkle them with lemon juice and cut into cubes. • Finely cut the carrot, celery, and chives. • Dice the olives and sun-dried tomatoes. • Mix the ingredients with oil, salt and pepper and mould into four balls. • Toast the almonds for four minutes at 180 degrees Celsius. • Coat the avocado balls with almonds. • Serve with a lettuce salad mixed with grilled zucchini, pine nuts, shallots and a vinaigrette of oil and lime juice. Healthy Gourmet is a recipe column by private chef Andrea Oschetti that runs in Health Post each week. He can be reached at andrea@fioreblu.com

When Hippocrates, the father of Western medicine, said “let food be thy medicine and medicine be thy food”, he was referring to food’s intrinsic ability to nourish the body and to prevent and treat ailments. His idea is not new, of course. Humans have long been aware of the health benefits of natural foods. Before the advent of modern medicine, cultures relied on native herbs, spices, fruits and plants to restore physical strength, heal wounds and cure illnesses. Even today, food is still regarded as a natural remedy in many parts of the world. In India, for example, the sour tamarind fruit is used to reduce fever and arthritis pain, while in China, herbs, roots and animal parts are believed to treat everything from infertility to insomnia. If you are an athlete or participate in vigorous physical activities, it’s no secret that food can be a powerful ally when it comes to performing at your peak. Carbohydrates and fats provide sustaining energy, protein aids in muscle building and repair, water prevents dehydration, and minerals such as iron – which can be obtained from meat and green leafy vegetables – transport oxygen to your tissues. Many people experience muscle soreness after strenuous exercise, and this is due to a variety of factors. According to Lisa Middleton, a sports dietitian and fitness consultant at Sports Dietitians Australia, most muscle soreness is related to damage caused during exercise. “The higher intensity or longer duration of exercise, the more likely muscle damage and subsequent soreness will occur,” she says. “Often, beginners at a particular exercise will experience more muscle soreness than if the muscle is conditioned for that activity. But if the muscle is pushed beyond its capabilities, as in progressive resistance training, then muscle damage and soreness will occur.” This is where what you eat can make a significant difference to how you feel. Says Middleton: “Muscle damage is important for muscle conditioning, but if appropriate nutrition is not achieved, then this muscle damage will not be repaired as effectively, and increased muscle soreness will result.” If there is no acute injury, this discomfort or pain in the muscles after physical activity (also known as delayed onset muscle soreness) can be caused by dehydration, low levels of sodium, potassium, calcium or magnesium, or lactic acid build-up. Dr Benita Perch, a naturopathic physician from the Integrated Medicine Institute, adds that elevated temperature, too, can damage the structural element in the muscle, resulting in muscle soreness. It helps to know there are several

natural foods that can help prevent and relieve muscle soreness. In addition to good-quality protein such as lean meats, fish, eggs and soy products, nutritionists recommend foods that have an anti-inflammatory effect. Ginger and turmeric are well-known anti-inflammatory agents, but if you cannot take spicy foods, a host of other options exists. According to Perch, tart cherry juice contains phenolic compounds, including flavonoids and anthocyanins, which have an antiinflammatory action. “In a study, 20 marathon runners were assigned to drink either tart cherry juice or a placebo for five days prior to and for 48 hours after a marathon run,” she says. “Those who drank the cherry juice in place of their regular sports drink reported significantly less post-race muscle soreness.” Omega-3 fatty acids (particularly EPA and DHA), found in oily fish, flaxseeds and walnuts, are also natural anti-inflammatories,

If appropriate nutrition is not achieved, muscle damage will not be repaired as effectively LISA MIDDLETON, SPORTS DIETITIAN AND FITNESS CONSULTANT

Perch adds. Daily consumption of these foods prevents the build-up of inflammation and hence, muscle damage. Daphne Wu, a freelance dietitian for Life Enrich Training and Consulting Centre, explains how antioxidant-rich berries can help with muscle soreness, too. “Antioxidants prevent muscle damage that has been caused by the depletion of free radicals,” she says. Bananas and coconut water are also recommended as they contain potassium, which can alleviate muscle cramps, while lemon verbena is a natural anti-spasmodic and can ease spasms from over-exertion. Dehydration is not directly related to muscle soreness, but muscle cramping is associated with dehydration, electrolyte imbalance and fatigue, Wu adds. So it is important to stay hydrated before, during and after exercise, as dehydration can lead to muscle weakness and increase the risk of injury and muscle damage. And in the past decade, low-fat chocolate milk was singled out for improving recovery and exercise performance, says Wu. Although these foods can relieve the discomfort of muscle soreness after exercise, there is no miracle food to prevent the problem, which is why dietitians recommend eating a healthy, balanced diet that is rich in whole foods, and staying well hydrated, especially when the body is not used to exercising. It is also important to provide sufficient time for muscle repair. A good training regimen should be enhanced with sufficient rest, says Wu. “You can replenish your energy reserves and delay fatigue during exercise with the foods you eat, but only sufficient rest can improve your recovery and prepare your muscles for the next round of exercise.”


WELL-BEING 11 THE TASTE TEST GERMAN RYE BREAD ...................................................... Jeanette Wang jeanette.wang@scmp.com

Delba 5 Grain Bread HK$17 for 250 grams, ThreeSixty This all-natural, preservative-free loaf is made mainly from rye, with added wheat, barley, oats and millet. Most rye breads are traditionally made with a sourdough starter and have a very long baking period, hence they tend to be dark-coloured and taste malty and slightly sour. Verdict: grainy and crumbly; thinly sliced as it’s so dry and dense that it’s best savoured in small amounts.

Peter Duncan believes that fitness goals are just as important as professional goals. Photo: Nora Tam

FIT & FAB

We can work it out ...................................................... Rachel Jacqueline healthpost@scmp.com Peter Duncan’s greatest achievement has not been leading the international design firm, Hassell, through exponential growth in China, or the design and delivery of high-profile projects. It has been the construction of a healthy life and leading the way for others. Duncan, who heads Hassell’s China practice and is chairman of the international organisation, has extended his personal ethos to the rest of the company. When redesigning the company’s Shanghai office, Duncan included a dedicated spin cycle studio and offers free instructor-led classes for employees. “At seven o’clock every night the music goes on and everyone goes for a spin,” says Duncan. “It’s a way to get people more enthused and has a great impact on the workplace.” The company has also sponsored employees in Hong Kong and the mainland to participate in the Great Wall Marathon since 2008, which is taken up by about a fifth of its employees. “Our employees love to exercise and train together,” says Duncan. “It’s a great way to connect people.” The 51-year-old father of two finds time in his busy schedule to train at least 10 times a week: running, cycling, swimming and weight training. Even though he travels up to half

Chinese cities are very polluted and present an extreme working and living environment. With training, I have developed more strength, balance and resilience of the time and entertains often, he eats well and hasn’t touched a drop of alcohol in years. For Duncan, it’s not just about keeping in shape, but developing a mind and body that can withstand the pressures of managing a flourishing business in China. “Chinese cities are very polluted and present an extreme working and living environment. With training, I find I have developed more strength, balance and resilience.” Australian-born Duncan has spent the past 22 years living in Hong Kong and Shanghai. He says that traditional Chinese principles of good health, good food, exercise and natural medicine – as well as a culture of hardiness – have had an influence on his approach.

Why have you made health and fitness a focus in your workplace? I believe sport and fitness give us a strong sense of balance. Since working in China, I have found that projects are large, complicated and demanding. I could just work and work. But I got to a point where I realised that I couldn’t maintain that pace; it wasn’t sustainable. I needed something to give me the strength to continue. For me, being fit and healthy makes me more resilient. What’s the most surprising feedback you’ve received on your approach to health in the workplace? It has come from our clients. They see the value in nurturing people’s health. Ten years ago, business in China was geared towards indulgent activities such as banquets and karaoke. Being recognised and associated with a different path reinforces a point of difference in the culture of our practice, which I think is really important. What led to your current philosophy on health and work/life balance? Progressively, I found that I no longer enjoyed the distraction that indulgence created. I believe it inherently diminishes our capacity for good work. I found that it was more important to be focused on developing the business and doing good work, which takes enormous effort. As demands increased, I realised I could not take that level of load without change.

Do you have a fitness goal for 2012? I’m doing the Phuket triathlon in November. We have professional goals and I think fitness goals are just as important. But when I compete, it is for the process and sense of achievement, rather than the competition. How do you fit it all in? You just do. I’m up early – usually by 6.30am. And I’m usually in bed by 10.30pm. It’s not difficult. I get out every morning before work and usually fit in a session after work, too. My travel schedule often disrupts my routine, but that’s when I find that the running helps, especially with the jet lag. Where is your favourite place to run? I love to run when I travel – it’s a great way to see a city. And I’m lucky as I always manage to find somewhere pretty in every place that I’ve been. I love running in Chinese cities as they change so quickly; being able to explore a city with a morning run is a wonderful way to start the day. But if I had to choose one place it would be Hangzhou – it has a beautiful lake, hills and incredible wetland areas. Do you think your healthy approach to life has aided your success? Definitely. I think it has had a lot to do with it. For me, it is also something that I value in an employee. I think leading a healthy, balanced life really says something about a person.

Mestemacher Rye Bread with Muesli HK$29.90 for 500 grams, Gourmet Freshly ground whole rye grains are combined with sultanas, hazelnuts, sunflower seeds and linseed to make a high-fibre, high-energy loaf. Packs 8.4 grams of fibre per 100 grams. Verdict: chewy, nutty and slightly sweet; good toasted and spread with butter or honey.

Pema Whole Grain Bread HK$35 for 500 grams, City’super This 10-pack offers six varieties – rye bread, with sunflower seed, with flaxseed, special bread (fibre-rich), fitness bread (with oats) and for children (with wheatgerm and honey). Verdict: the individually wrapped portions are great for snacking – each 50-gram portion has only about 85 calories and 1.5 grams of fat. The children’s flavour is moist, soft and lacks the off-putting strong rye taste.

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