U The Caribbean Health Digest - Issue 31

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OCT DEC 2015


TT$35.00 US$5.99



The risks and benefits. Is it a quick fix for weight loss?

Fitness Devices Do they really work? Congenital Heart Disease Condition developed even before you’re born. Chataigne or Breadnut Not just good in Caribbean curries but high in fibre. uhealthdigest.com


Sherine Mungal Stuart Fraser


Eidetic Publishing

Editorial Director

Sherine Mungal

Managing Editor

Roslyn Carrington


Roslyn Carrington Michelle Ash Maia Hibben Carol Quash Candida Khan Dixie-Ann Dickson David Fenton Dr. Gillian Henry

Our Intention candles are hand-poured purposefully crafted to inspire your senses. We use blends of only one hundred percent pure therapeutic essential oils in combinations that have been researched and proven to soothe, calm and relax. Assembled using all natural soy wax which are free for all toxins and wicks constructed from natural, cotton threads and contains no lead, zinc or other metals.

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Healing Blend Lavender • Eucalyptus • Sage Purify your mind and body with the healing candle. The essential oils of lavender and refreshing eucalyptus soothe the body while reducing physical and mental fatigue. Combined with sage, the “sacred herb,” anxiety can be relieved and euphoria can ensue. Detoxify, energize and release what doesn’t serve you any longer. Prosperity Blend Cinnamon • Bergamot • Petitgrain The prosperity candle will release negativity to create and receive abundance with the aromatic blend of cinnamon, bergamot and petitgrain essential oils. This spicy blend is grounding and powerful to welcome success and a sense of stability. Inspiration Blend Lavender • Spearmint • White Spruce Restore yourself to a place of restoration and calmness with the cooling floral blend found in the inspiration candle. Combined with the essential oil of spearmint, this candle will revatilize your mind and body while increasing your energy and mental clarity. Let your creativity flow and be inspired.

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Gratitude Blend White Spruce • Rosewood A comforting blend of white spruce and rosewood essentials oils. The gratitude candle is a great gesture of giving thanks to someone special or to light when one wants to honor their blessings in their own life. Take a few moments every day to feel what you are most grateful for and it will shift your energy immediately to a place of peace and joy.

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Medical Advisory

Stuart Fraser Eidetic Cindy Singh Lorraine Biran shutterstock iStockPhoto Dr. Neil Singh


Healthy Blend Eucalyptus • Basil • Lemongrass These inviting smells of basil and refreshing orange will delight your sense of health and well-being. Feel confident in your healthy decisions in life to stay energized and focused with this invigorating blend of neroli, basil and lemongrass essential oils. Clarity Blend Litsea Cubeba • Peppermint The cleansing fragrance of this clarity candle will clear your mind while stimulating and energizing your mood. The essential oil of litsea cubeba, combined with refreshing peppermint oil will increase your concentration and help uncover solutions in times of fatigue or stress.

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This information is of a general nature only and is not intended as a substitute for professional health advice and no person should act in reliance on any statement contained in the information provided and at all times should obtain s p e c i f i c a d v i c e f ro m a h e a l t h professional. Eidetic Publishing has made reasonable efforts to ensure that the health information contained herein is accurate and up to date. To the extent permitted by law, Eidetic Publishing, their employees, agents and advertisers accept no liability

(even if negligent) for any injury, loss or damage caused by reliance on any part of this information. U also contains information supplied by third parties. This information is identified with the name of the source and has been chosen for publication because we believe it to be reliable. To the extent permitted by law, Eidetic Publishing, their employees, agents and advertisers accept no liability (even if negligent) for any injury, loss or damage caused by reliance on any part of this information.

U The Caribbean Health Digest is published 4 times a year by Eidetic Publishing, Gaston Court, Gaston Street, Lange Park, Chaguanas, Trinidad & Tobago. Distribution is handled by Eidetic Limited.

Entire contents are copyright. Reproduction in part or whole is prohibited. Eidetic Publishing is in no way affiliated with companies or products covered in U. Produced and printed in Trinidad & Tobago.

12 Choosing the Right Oil With the many different varieties of cooking oils on the supermarket shelves, the options make it more and more difficult to choose which is best for us. Nutritionist Michelle Ash dissects the options and shares her expert advice on how to choose a healthy cooking oil.

30 The Truth about Carbohydrates The basics about how carbohydrates can affect your health and performance. Nutritionist Candida Khan breaks it down; the good, the bad, and the not-so-ugly truth about carbohydrates.

36 Blood Poisoning 16 Liposuction Why should we diet and exercise to lose fat when we can just do liposuction? Maia Hibben discusses the benefits and risks associated with the procedure; read more on our feature article and see if this may be a good option for you.

22 Astigmatism This is perhaps one of the most misunderstood vision problems; for starters it’s called astigmatism, and not “stigmatism” as many of us may have thought. Dixie-Ann Dixon, our newest addition to the U writing team, explores and tells all in this article.

24 Congenital Heart Disease Developing heart disease as adults is life-threatening and traumatic for most, but when one is born with a heart condition or birth defect, it is referred to as congenital heart disease, and can be even more alarming, especially for the families. Dr. Gillian Henry, Paediatric Cardiologist, shares her knowledge on the subject.

David Fenton, BBC Health Correspondent, looks at blood poisoning or sepsis, a condition that affects over 100,000 people in the UK each year. He also looks at the causes, symptoms and treatment options.

40 Chataigne With its conspicuous name and stunning appearance, this prickly fruit has more than looks going for it. The chataigne is packed with vitamins and minerals, and is also an excellent source of fibre, the full list of which is discussed in this article.

42 Tracking the Effectiveness of Fitness Devices Health and fitness data tracking devices are everywhere; some are quite visible and others are worn more discretely. Fashion statement or not, surely these devices have some benefit. Carol Quash reveals all here.

Did you know that U The Caribbean Health Digest is perhaps the only Health and Wellness publication of its kind dedicated to Caribbean people? Well, when we launched in 2008 it was, and unless stuff is happening that we don’t know about, then we can safely say we are still the one and only. So go ahead, feel privileged to be a part of something so unique, ‘cause right about now we would like to take a bow for the great work our team continues to do. We’ve been modest for far too long, but when we listen to the rave reviews we continue to receive, we have to accept them with pride. Season’s greetings to you, our dear readers; as we come to the end of yet another year we reflect on all things accomplished, and focus on all things yet to be achieved. We take this opportunity to once again sing praises to our loyal advertisers for making it all possible, as well as our writers, editors, and of course our printers. Most importantly, we thank our dedicated staff at eidetic for the exceptional work you continue to do, even in the most challenging circumstances. God’s blessings to you all for a happy and healthy holiday season, and a New Year filled with prosperity and abundance.






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Oils are an important source of energy, provide essential fatty acids, and act as carriers for the fat-soluble vitamins (such as Vitamins A, D and E). Fat provides the most concentrated form of energy — 9 calories per gram — compared to carbohydrates and proteins, which each provide 4 calories per gram. Humans can manufacture fat from carbohydrates as long as there is excess consumption of calories. When this happens, excess calories are stored as fat. However, some essential fatty acids cannot be made by the body, and must be gotten from food. Various oils and fats have different properties and thus have different uses in the kitchen. Each type of oil performs best within a certain range of temperatures, for the purposes of roasting, stewing/braising, sautéing or frying. Some are more suitable for high heat cooking, while others have intense flavours that are best enjoyed by simply drizzling directly onto food.

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Effects of overheating oil and the “smoke point” The smoke point refers to how much heat oil can take before it begins to smoke. When oil smokes, noxious fumes are produced, indicating that the oil is starting to break down. Free radicals are formed, as well as harmful compounds that are unhealthy to breathe. Every oil has a different smoke point. Very high temperature cooking, for example frying, requires an oil with a high smoke point. For the healthiest approach, don’t use any oil that has gone beyond its smoke point, and avoid frying often. Heating oil above 375°F can lead to the formation of a particularly harmful compound known as HNE (chemical name: 4-hydroxy-2-trans-nonenal). HNE increases the risk of chronic conditions, particularly cardiovascular disease and brain or neuro-degenerative diseases such as Alzheimer’s and Parkinson’s diseases. The longer or more frequently oil is heated, the more HNE it contains. It’s best not to re-heat used oil. This is one good reason to reduce intake of fried foods, and to avoid regularly eating at fast food restaurants, which are notorious for reusing old oil. Avoiding French fries is also a good idea, since other cancer-inducing compounds called acrylamides are formed when this food is being fried at a high temperatures.

Cooking methods and recommended oils For high-heat cooking (360°–460°F), such as frying, searing, grilling, stir-frying, or roasting, the following oils can be used: canola, avocado, palm, or coconut. All have a high smoke point. For medium-heat cooking (280°–350°F), such as gentle sautéing, stewing, baking, or braising, canola, coconut, sesame, peanut, and olive oils can be used.

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No direct heat oils (225°F) are used for nutritional benefits and are often high in heart-healthy omega-3 fatty acids. For maximum flavour,

choose unfiltered extra virgin olive oil, unrefined or toasted nut and seed oils, e.g., flaxseed, wheat germ. These have the lowest smoke points due to their fragile chemical structures, but have richer, more robust flavours. Enjoyed best when poured directly onto a salad or finished dish, or blended to make salad dressing.

Types of fatty acids Fatty acids are the building blocks of a fat molecule. When choosing cooking oil, it’s best to know the type of fatty acid it contains and how heart healthy it is. There are 4 main types of fatty acids: monounsaturated, polyunsaturated, saturated and trans fats. Each has a different chemical composition. Monounsaturated Monounsaturated fats (like olive, canola and avocado) are at the heart of the highly popular Mediterranean diet. These types of fats promote healthy cardiovascular function. They lower total cholesterol and “bad” LDL cholesterol and increase “good” HDL cholesterol. Polyunsaturated Polyunsaturated fats include “essential” omega-3, omega-6 and omega-9 fatty acids. These play an integral role in several areas — from strengthening our cell structure to reducing the risk of heart attack and stroke. In countries where omega-3 fat intake is high, death from cardiovascular disease is low. About 80% of the North American diet is deficient in omega-3. To off-set this imbalance, omega-3 consumption should become a major focus, rather than omega-6 and omega-9. The ratio of omega-6 to omega-3 fats is very important. The average ratio in North American diets is 10:1, whereas a ratio of 5:1 is advised. This balance can be achieved by eating a diet rich in fish, leafy green vegetables, nuts and seeds. Oils highest in omega-3 fatty acids include flaxseed and fish oil. Polyunsaturated fats generally lower total cholesterol and LDL cholesterol.


Saturated Contrary to popular belief, all saturated fats should not be considered “bad fats.” There are two main types of saturated fats: animal-based like lard; and plant-based such as coconut and palm oils. Most of what is consumed from popular fast food chain restaurants are artery-clogging, “long-chain” saturated fats, derived from animal products. But plant-based saturated fats are made up of “short- and medium-chain” fatty acids, mostly used for energy by the body — the reason oils like coconut are popular with athletes. Saturated fats are more stable, able to withstand higher temperatures. They do not easily become rancid. Animal-based saturated fats raise total blood cholesterol as well as “bad” LDL cholesterol. Trans Fats Trans fats are often artificially made. They are formed during hydrogenation, a chemical process whereby cellular chains of fats are artificially altered to create a more solid, stable substance. The result is a fat that is virtually impossible for our bodies to break down. These fats raise LDL cholesterol and decrease HDL cholesterol.

Recommendations for fat (based on WHO guidelines) Total fat: 15–30% of daily energy (33–66 g for a 2,000 kcal diet) Fatty acids: Saturated: maximum 10% of daily energy (less than 22 g for a 2,000 kcal diet) Polyunsaturated: 6–10% of daily energy (12–22 g for a 2,000 kcal diet) Omega-6 Polyunsaturated: 5–8% (10–16 g for a 2,000 kcal diet) Omega-3 Polyunsaturated: 1–2% (2–4 g for a 2,000 kcal diet) Trans fats: less than 1% of daily energy (less than 2g for a 2,000 kcal diet)



How to choose a healthy cooking oil Most cooking oils consist of a variety of these fat types; no oil can be considered the “perfect” oil. A heart-healthy cooking oil should contain higher amounts of monounsaturated and polyunsaturated fatty acids; (especially omega-3); minimal animal-based saturated fatty acids; minimal trans-fatty acids; lower omega-6 to omega-3 ratios. Taking into account these guidelines, and also individual oil uses and smoke points, as long as only small amounts of fats and oils are used in cooking and preparation, it would be fine to use a variety of any of the following: peanut, flax seed, olive, palm, coconut, avocado, sesame, rapeseed oil (canola), hazelnut oil, walnut.

Dispelling the myths about coconut oil Coconut oil has been an integral part of the diet in many tropical countries. It is highly resistant to heat and spoilage, and therefore very stable. However, there has been much disagreement in the scientific community about whether it has the potential to promote high blood cholesterol and heart disease. Some country consumption patterns provide evidence of the health-protective benefits of coconut oil. In the Philippines, in regions where coconut oil is the main fat consumed, very low rates of cardiovascular disease are observed. There is great need for reliable scientific studies to be conducted on the health benefits of coconut oil, as it is very relevant to the Caribbean and East Asian countries.

Storing cooking oil Nut and seed oils in particular are best kept in the fridge and used promptly. The polyunsaturated fats can quickly turn rancid, with a characteristic, unpleasant odour. Best to throw it out.

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WHAT IS LIPOSUCTION? Liposuction, also known as liposculpture or suction-assisted lipectomy, is a cosmetic surgery that removes body fat. It is most commonly performed on troublesome fatty areas such as the tummy, thighs, arms and buttocks – although it can also be carried out on other areas such as the neck and face, too. Unlike some cosmetic surgeries, which are performed to treat specific health problems or to treat persons who have had disfiguring accidents, liposuction is a purely aesthetic procedure.

THE PROCEDURE Commonly, the treatment area is marked on the body part with a pen, and sometimes the area is photographed so the results of the operation can be compared with how you looked before surgery. Most liposuction operations take between one and three hours, and are performed under general anaesthetic. There are now several different methods of liposuction available.


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The surgeon starts by preparing the area that the fat is to be removed from. This usually involves injecting the area with a mixture of anaesthetic, salt solution and a medication called epinephrine. This helps to reduce blood loss, bruising and swelling. In some cases, preparation may also involve breaking down the fat cells in the treatment area so they are easier to remove.

usually do not require any stitches, healing by themselves and becoming unnoticeable over time.

LASER LIPOSUCTION Laser liposuction is sometimes also referred to as the “smart-lipo” method. It is a considerably less invasive procedure, which means there are fewer recovery problems and a faster recovery time. As its name suggests, laser lipo uses a fine laser fibre, which is directed through the cannula, which liquefies the fat, thus avoiding the need to use pressure to dislodge fat cells, which often leads to increased bruising and swelling in the treated area. This method is often used on smaller, more delicate areas, such as the face or knees.

VASER LIPOSUCTION This is another minimally invasive method of liposuction, and is a form of ultrasonic-assisted liposuction. It differs from laser liposuction in two key ways. Firstly, unlike the laser procedure, VASER can be performed on both small and large areas of fat, and secondly, instead of using a fibre optic to liquefy the fat, it uses ultrasound. VASER stands for ‘Vibration Amplification of Sound Energy at Resonance’ and works by using a specialist probe which pulses sound energy into the fatty area. It leaves essential fat cells, which our bodies need, but breaks down the rest, while causing minimal tissue and cell damage to the surrounding area. It is considered to be an incredibly accurate method of liposuction and reportedly removes 3 times as much fat than laser lipo and other forms of ultrasonic-assisted liposuction.

The surgeon then makes a small cut in the skin of the area to be treated. If it's a large area, several cuts may have to be made. A tube called a microcannula, which is attached to a specialist vacuum machine, is then inserted into the cut. The tube is passed back and forth within the treatment area to loosen the fat and suck it out.


When the fat has been sucked out, the surgeon drains any excess fluid and blood using small drainage tubes. This may have to be done several times after the procedure. The small incisions

SAFELipo is a form of liposculpture that has a method unlike any other form of liposuction and is considered by many as the future of liposculpture. It follows a three-step process: separation – fat




THE BENEFITS aspiration – fat equalization. First the fat is separated from itself, the blood vessels and nerves, using specialist probes. It’s then removed using low-level suction, which is less aggressive than other methods. Then the remaining fatty tissue is equalised – meaning it is smoothed out and well contoured. This method claims to be able to produce the best contouring results, with limited irregularities in the smoothness of the body after recovery.

RECOVERY After most liposuction procedures, the treated area will be bandaged and stitched. Recovery times will vary depending on the area worked on, the extent of the work, and the duration of treatment. If a general anaesthetic was used, then an overnight stay in hospital is to be expected. Recovery can vary depending on the level of treatment, the method used and the individual, but it can take as long as 6 months to see the full results.

THE RISKS As with all types of surgery, liposuction carries a number of risks, including: • Bruising • Swelling • Infection • Scarring • Irregularities (lumpy and uneven results after the fat has been removed) • Numbness in the treated area • Pigmentation changes More serious risks can include: • Thrombosis (blood clot) • Pulmonary oedema (fluid in the lungs) • Pulmonary embolism (blockage in the lungs caused by a blood clot) • Internal bleeding • Damage to internal organs • Post-op infections • Excessive bleeding

Liposuction can be a great way to shape, tone and contour specific areas of the body. The body won’t replace the fat cells removed from these areas, so each method of liposuction can deliver a long-lasting change to your body shape. Methods are improving all the time, reducing the treatment and recovery time – but unfortunately NOT the cost!

THINGS TO CONSIDER Having any kind of cosmetic surgery, including liposuction, is a major decision. It can be expensive, time consuming, and the results can't always be guaranteed. It is something that requires a great amount of thought and thorough research. Ask yourself why you really want to have cosmetic surgery. It is a good idea to discuss your plans and other options with your doctor before going ahead with treatment. Make sure you are fully informed! Liposuction is usually only recommended if you've tried changing your lifestyle but this hasn't helped. If you decide to have liposuction, be absolutely sure about your reasons for wanting to have it. It is important that the surgeon and other healthcare professionals carrying out the procedure are fully qualified and experienced and based in a reputable clinic or hospital.

SO...IS IT A QUICK FIX FOR WEIGHT LOSS? Most plastic surgeons and related organisations state that liposuction should not be considered a weight loss method, and that its results are about contouring as opposed to weight reduction – and therefore, it is not to be considered as a treatment for obesity. In fact, it is not an effective procedure for people who are overweight – generally it works best on people who are relatively fit and healthy. It is also commonly thought to help remove cellulite and reduce the appearance of stretch marks – sadly this is just a myth! Yet, for some people, liposuction might be a suitable procedure, and help them adjust their body in exactly the way they want — helping to boost self-esteem — and therefore the risks may be, to them, justifiable. 19 | u





ave you ever wondered why you squint while reading, staring at the computer, or watching the television? Is it usually followed by a headache? Then you should check your eyes, because you may have astigmatism. As defined by Gary Heiting, OD, on All About Vision.com, astigmatism is a refractive error, meaning it is not an eye disease or eye health problem; it's simply a problem with how the eye focuses light. In an eye with astigmatism, light fails to come to a single focus on the retina to produce clear vision. Instead, multiple focus points occur, either in front of the retina or behind it (or both). Sometimes you squint your eyes so regularly that you are not even aware or mindful of your actions. This may lead to complacency in that you are taking for granted what may become a full-fledged problem over time, as your “quick fix squint” temporarily alleviates your vision problem. Particular attention should be paid to children aged 13 years and under, who may be unaware or unable to effectively articulate that they are having vision problems and its possible link to astigmatism.

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Naftali Bastein, Optician/Contact Lens Practitioner of Look Opticians, explains that if

astigmatism is left uncorrected in the 0–13 (plastic years) age group, they can develop a condition called Amblyopia. “This is a condition where the eyes and the brain fail to develop a good relationship, because the brain will eventually “learn” to see blurry images with amblyopic eye.” The brain will not appreciate what a clear stimulus is, Bastien adds. He notes that this is a critical stage as it represents the early stages of life where your eyes and brain are developing a relationship. The United States National Eye Institute further explains that Amblyopia is a medical term used when vision in one of the eyes is reduced. The eye itself looks normal, but it is not being used normally because the brain is favouring the other eye. This condition is also called lazy eye. Interestingly, if astigmatism is detected and left uncorrected in persons over the age of 13 years, they will experience symptoms such as eyestrain and headaches, especially after prolonged visual tasks. Dry eyes, Bastein notes, is

another symptom, which develops after long concentrated periods where the blink rate decreases, resulting in dryness of the eyes. The person who has astigmatism can see, but with very little to no detail. In an effort to identify details, the person has to work the eyes very hard all day, which causes ocular stress, which triggers the headaches. Eighty percent of patients he sees on a daily basis have astigmatism. It is a very common eye condition, which affects both distances (near and far sightedness). He emphasizes, “This is why eye examinations are very important.” Bastein advises that those who engage in heavy use of the eyes all day, and persons over 60 years who have a family history of glaucoma and diabetes, should have eye examinations once a year, as opposed to others, who usually test every two years. Heiting further cited that the cause of astigmatism is an irregularly shaped cornea. Instead of the cornea having a


symmetrically round shape (like a baseball), it is shaped more like a football, with one meridian being significantly more curved than the meridian perpendicular to it. (To understand what meridians are, think of the front of the eye like the face of a clock. A line connecting the 12 and 6 is one meridian; a line connecting the 3 and 9 is another.) The steepest and flattest meridians of an eye with astigmatism are called the principal meridians.


Heiting outlines three primary types of astigmatism: MYOPIC ASTIGMATISM One or both principal meridians of the eye are near-sighted. (If both meridians are near-sighted, they are myopic in differing degrees.) HYPEROPIC ASTIGMATISM One or both principal meridians are farsighted. (If both are farsighted, they are hyperopic in differing degrees.)

MIXED ASTIGMATISM One principal meridian is near-sighted, and the other is farsighted. Astigmatism also is classified as regular or irregular. In regular astigmatism, the principal meridians are 90 degrees apart (perpendicular to each other). In irregular astigmatism, the principal meridians are not perpendicular. Most astigmatism is regular corneal astigmatism, which gives the front surface of the eye that football shape.



while manually introducing a series of lenses between the light and your eye. This test is called retinoscopy.” He says though many eye doctors continue to perform retinoscopy, this manual procedure has been replaced or supplemented in many eye care practices with automated instruments that provide a faster preliminary test for astigmatism and other refractive errors. Astigmatism, like near-sightedness and far-sightedness, usually can be corrected with eyeglasses, contact lenses or refractive surgery.

Irregular astigmatism can result from an eye injury that has caused scarring on the cornea, from certain types of eye surgery or from keratoconus, a disease that causes a gradual thinning of the cornea. Heiting explains that astigmatism is detected during a routine eye exam with the same instruments and techniques used for the detection of near-sightedness and far-sightedness. “An eye doctor can estimate the amount of astigmatism you have by shining a light into your eye

The axis of astigmatism in eyeglass and contact lens prescriptions describes the location of the flatter principal meridian of the eye, using the above 180-degree rotary scale. (All About Vision.com)

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Director, Pediatric Cardiology Fellowship Training New York University School of Medicine




What Is It? The word congenital means “existing at birth”. Of all the birth defects in humans, heart defects are the most common. These defects occur in about eight or nine of every thousand newborn babies around the world. That is almost one percent of all live newborn infants. Some defects are very mild and there may be no outward symptoms or signs, and the abnormality may not affect a person’s life or quality of life for many years, or ever, perhaps. In other cases, however, the defect is significant enough that the infant may become ill immediately after birth or in the first few months or years of life.

Why Does It Happen? The heart defect occurs in very early pregnancy because of an error in formation of the heart or the blood vessels attached to it. In most cases, the cause of the error is unknown, but there are a few risk factors that have been identified. There are some genetic conditions that affect many parts of the body, including the heart. Down syndrome is the best known of these. In fact, almost half of babies with Down syndrome have heart disease. Having a family member, especially a parent, sister or brother, with a congenital heart defect increases the likelihood of heart defects in a child. Heavy use of certain drugs or medications, including seizure or acne medications, during early pregnancy can increase the risk of certain types of heart defects in the baby. Severe alcohol abuse and infection with rubella (German measles) during pregnancy has also been shown to result in heart defects in some infants. Family stress or hardship, even during pregnancy, has not been shown to cause heart defects.

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How Can You Tell? The signs and symptoms in the child are related to the type of the defect, as well as its severity. Some common findings that might be noted by parents include shortness of breath, poor feeding or growth in infants, repeated lung infections or blue tinge of the skin and lips, called cyanosis. It is important to remember that that many of these findings may also be found in other types of illness, such as lung disease. Often, the abnormal flow in the heart can cause a sound called a murmur, which can be heard by a doctor or a nurse using a stethoscope.

In some types of congenital defects, it may be possible to treat the abnormality without open heart surgery. A specially trained interventional paediatric cardiologist can place special types of thin tubes (catheters) in the blood vessels in the leg or neck, which can be guided into the heart to deliver special devices that may close certain types of holes or reduce some types of obstruction.

The murmur by itself is not a disease, and, in fact, most murmurs in normal, well children, are innocent murmurs. However, a specialist paediatric cardiologist can often determine if a particular murmur is a sign of heart disease.

Some defects, however, are more complex, causing the infant to be very ill early in life, even immediately after birth. Many of these defects, rather than causing excess flow to the lungs, allow too little flow to the lungs, resulting in cyanosis due to lack of oxygen.

Once there is a suspicion of a defect, further tests such as an electrocardiogram (called ECG) and echocardiogram (an ultrasound of the heart) will need to be done to confirm the type and the severity. In some cases, additional tests may be required, including cardiac catheterization, CT scans or Holter monitor.

The surgery for these children may be more complicated, and most will require very close follow up throughout life, and repeated surgical and interventional procedures.

How Is It Treated?

One important area in the ongoing care of these children is their dental health. Poor dental care and multiple cavities can put children with heart disease at risk for infections which can dangerously affect their hearts.

Some of the defects are simple or minor conditions that need no special treatment, such as a small hole between left and right sides of the heart that may close on its own.

What Are The Consequences Of Having A Congenital Heart Defect?

Other children may require only a single surgery or procedure and follow up with their specialist thereafter. One such defect is called a ventricular septal defect, or VSD. This is the most common defect seen in children. It is essentially a hole in the muscle between the left and right sides of the heart and results in excess blood passing through the child’s lung. Some medications are available which may help the heart work better while the child awaits surgical procedure. If the defect causes excess fluid to build up in the lungs, a child may be given a diuretic or “water pill” to help get rid of this extra fluid by urination. Another common medication, digoxin, may be used to help the heart pump more efficiently. Another medication to relax the blood

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vessels may make it easier for the heart to pump. The medications do not “cure” or reverse the defect, but rather, help the body to deal with the effects of the abnormal flow. The true treatment is the surgical procedure to close the hole.

Most children with minor defects, including those requiring surgical repair, can be expected to have normal exercise capacity and can participate in school and sporting activities like other children. Paediatric cardiologists no longer routinely restrict children from school gym and sporting activities as most can participate very safely, and this can improve the child’s quality of life. There have been so many improvements over the years in the care of children with congenital heart defects that there are now more adults living with congenital heart disease than children. Although these adults will continue to require specialized follow up with a paediatric cardiologist or a specialist in adult congenital heart disease, most can enjoy very good quality of life with full participation in family, social and sporting activities.

Ten things about Heart defects range in severity from simple problems, such as "holes" between chambers of the heart, to very severe malformations, such as the complete absence of one or more chambers or valves. Most causes of CHDs are unknown. Only 15–20% of all CHDs are related to known genetic conditions. Most CHDs are thought to be caused by a combination of genes and other risk factors, such as environmental exposures and maternal conditions. Because the heart is formed so early in pregnancy, the damage may occur before most women know they are pregnant. Environmental exposures that may be related to the risk of having a CHD include the mother’s diet and certain chemicals and medications. Maternal diabetes is a recognized cause of CHDs. Maternal obesity, smoking, and some infections also may raise the risk of having a baby with a CHD. Preventing these risk factors before a pregnancy is crucial.

A baby’s risk of having a CHD is increased by three times if the mother, father, or sibling has a CHD. There are about 15 different types of congenital heart defects that a child could have. Some children have multiple types of congenital heart defects when they are born. Fifty percent of children born with CHD do not live to adulthood. Overall mortality has significantly declined over the past few decades. For example, in the 1960s and 1970s, the risk of dying following congenital heart surgery was about 30 percent, and today it is around 5 percent. Successful treatment requires highly specialized care. Severe congenital heart disease requires extensive financial resources, both in and out of the hospital.

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When we want to lose weight, we tend to think that carbohydrates are our enemies, but we are quite wrong. Carbohydrates are the main source of fuel for our bodies. Just like a car needs gas to move, we need carbohydrates to function. We cannot survive without them. Let us look deeper into the topic of carbohydrates.

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WHAT ARE CARBOHYDRATES? Carbohydrates can be defined as a large group of organic compounds that are obtained from the diet. Basically, this is a major part of the food we eat. Our body needs this nutrient in huge amounts and therefore carbohydrates can be referred to as a macronutrient. When the body breaks down carbohydrates, the sugar glucose is released. Examples of carbohydrates include bread, rice, noodles, doughnuts, cookies, yam and macaroni. When looking at the Six Caribbean Food groups, Staples are our main source of carbohydrates, but we can also get carbohydrates from the Legumes, Fruits and Vegetables groups.

WHY DO WE NEED CARBOHYDRATES? Carbohydrates are very important in the diet. They are our main source of energy. Carbohydrates come from the foods we eat. They are essential for the central nervous system, brain and functioning of the body. Carbohydrates help with vitamin and mineral absorption in the body. They add sweetness to our food and are used in the food industry in production of food items.


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It is true that the intake of

carbohydrates is dependent on each individual. If we are looking at the percentage of our daily intake of food, 45–60% should be carbohydrates. According to the FAO and WHO, “Energy balance can be maintained by consuming a diet containing at least 55% total energy from carbohydrate from various sources and engaging in regular physical activity.” It can be recommended that with every main meal during the day, there must be an item that comes from the Staples group.

TYPES OF CARBOHYDRATES There are two main types of carbohydrates. They can be referred to as the “good” and “bad” carbohydrates. This includes refined carbohydrates and complex carbohydrates. You may have heard these terms already, but let us explore these two different groups. Refined carbohydrates are those that spike blood glucose or sugar levels quickly. These can be considered the unhealthy carbohydrate sources. Foods that are refined are highly processed and are broken down or digested easily by the body. Weight gain, diabetes and heart disease are just a few health risks that can be associated with a diet high in refined carbohydrates. This is supported by Harvard College. Complex carbohydrates can be considered as healthy sources of energy. They are normally minimally processed. Foods that are rich sources of complex

carbohydrates are promoted and they should make up most of your diet. They contain more dietary fibre, which has been shown to reduce the risk for many health issues such as cancer. Complex carbohydrates also keep your sugar levels under control.

SOURCES OF CARBOHYDRATES Refined Carbohydrates • White bread • Sugar • Potato chips • Pastries • White flour • White rice • Pretzels • Maple syrup • Cookies • White crackers • White macaroni Complex Carbohydrates • Whole wheat or grain bread • Yam • Eddoes • Breadfruit • Whole wheat flour • Whole grain rice • Oats • Sweet potato • Corn • Whole grain crackers • Whole wheat macaroni

HOW DOES A DIET LOW IN CARBOHYDRATES AFFECT YOUR BODY? Sometimes, carbohydrates are associated with weight gain and therefore if persons want to lose weight, they tend to try and cut carbohydrates out of their diet for results. Without the right


amount of carbohydrate intake, the body would need to get energy from other sources. The result can be a breakdown of the protein stores in the body. There will also be excess salt and water loss. We still need energy to survive, therefore protein breakdown will provide energy after carbohydrate stores have been depleted. Low-carbohydrate diets can lead to bone mineral loss, a rise in cholesterol levels, and ketone production. This ketone production is a response to a low-carbohydrate diet and can be found as the normal response to starvation in the body. This is formed by the use of fat as a source of energy. If ketoacidosis occurs, this means that levels of toxicity in the body increases. The risks include: Ketone production leads to an increase in fat in the blood. Bad cholesterol levels increase, heightening the risk for heart disease and stroke. Bone mineral loss can lead to osteoporosis, where bones can become weak and brittle.

WAYS TO INCORPORATE COMPLEX CARBOHYDRATES IN THE DIET Buy whole grain foods. When visiting the grocery, supermarket or any place where you buy food items, try to limit the purchases of refined foods and increase the complex carbohydrate food items in your

trolley. Sometimes it is better to buy the items raw and prepare them at home. In this way, you would have better control of how your meals are prepared. Read labels. When choosing packaged food items, it is important to note the dietary fibre content of these carbohydrate foods. Once you see a label on the item, look at the nutrition facts section. You will see a breakdown of the nutrients that the item has, for example: fat, carbohydrate, sugar, protein content and many more. When looking at the dietary fibre content, it is recommended that you should buy items with a ‘Daily Value’ percent (DV%) of over 5%. Under 5% means that the dietary fibre content is very low, between 5 to 20% means that the dietary fibre content is medium and over 20% means that the dietary fibre content is high. The more dietary fibre content the better. The added dietary fibre helps to reduce blood glucose spikes and makes the food item healthier to consume. When compared to refined foods, their dietary fibre content is very low or negligible.



wheat bread that you are toasting. Remember to read the label for the dietary fibre content. Breakfast is important since it was found that skipping meals contributed to weight gain. The reason for this is because you tend to eat much more for your next meal, or you tend to eat foods that are high in refined carbohydrates due to cravings. Keeping sugar levels steady helps with weight control. Snack on whole grain foods. Eating food items in between your main meals is considered snacking. Complex carbohydrates are healthy snacking options. Examples include whole wheat crackers. Snacking is important, since this helps to control blood sugar levels and also increases metabolism, which helps with weight control. Carbohydrates are not the enemy. It is your choice that matters. Making healthy carbohydrate choices is the aim. Find the right carbohydrates to eat; do not try to avoid them altogether.

Begin your first meal with whole grains. The first meal to start off the day is breakfast. This is the most important meal of the day because it is the first time that you will fuel your body after sleep for the activities ahead. Start off your day by choosing the right carbohydrates. Options include having whole grain cereal with low sugar content, or hot oats. You can even have toast, just ensure that it is whole

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At first, Ian felt a bit unwell, and then very quickly he thought that he was going to die. He began to sweat profusely, his heart started racing and his legs were so weak he could barely stand. By the time he called for an ambulance he genuinely thought he was having a heart attack. Ten minutes later he was blue-lighted into hospital.

But there was nothing wrong with Ian's heart. In fact, he was suffering from a condition that affects 100,000 people in the UK every year and which — although serious — is very difficult to diagnose and is often missed, even by the most experienced of health care professionals. Ian had blood poisoning, medically known as sepsis.

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Sepsis is a potentially life-threatening condition that can happen to anyone, although it's most common in the elderly, in the very young, and among those with suppressed immune systems, like some patients on cancer treatments.


It happens when bacteria get into the bloodstream and begin to overwhelm the body's natural defences. If untreated it can very quickly spread to vital organs and cause septic shock, in which the body begins to shut down. Every year, 37,000 people in the UK die from blood poisoning, and a thousand of those will be children. In Trinidad and Tobago, according to the Global Health Observatory, about 3% of children under 5 die each year from neonatal sepsis (Figures from 2010), a much reduced figure on previous years. At its height in 2003 the figure was around 9%. Clearly any death from sepsis, let alone a child's, is a terrible thing, but what can be done to prevent it? The problem for doctors is that the early symptoms of blood poisoning, although alarming, can look very much like a harmless infection or any one of a number of other conditions. Sepsis is a great mimic — and spotting it isn't always easy. Dr Luke Hodgson, who works at an intensive care unit at a large hospital in Southern England, said some patients with blood poisoning, especially otherwise healthy adults, are often fooled into thinking that they're not really ill at all, and that what they have is just a 'bug' which will pass. “The problem is they think it's the flu or a virus and it just keeps getting worse and worse,” he said. “Often by the time we see them they are quite a long way down the road and in a serious condition.” Even in hospital it can be difficult to diagnose properly, but

Dr Hodgson's team are now using a special electronic system to flag up the possibility of blood poisoning and to help reduce the number of deaths. It was this early warning system that helped doctors to correctly diagnose Ian's sepsis, and probably saved his life. This is how it works. Each patient's vital signs are recorded electronically. Often there is no single sign that identifies blood poisoning, so what this system looks for is a collection of indicators. A patient's heart rate, pulse, oxygen levels, etc. are all given a score — and if, when the numbers are added up, that score is 5 or over, then the medical staff get an immediate alert to check for sepsis. Niki Anderton is the clinical nurse specialist behind the scheme at St Richard’s Hospital in Chichester. She said it works well because it's quick, easy to use and flags up an immediate concern. And in a busy Emergency Department or ward, that could make all the difference. Children, of course, are especially difficult to diagnose because often they can't explain the symptoms they are feeling. And, let's face it, children are often falling ill with bugs and fevers. Dr Ron Daniels, an NHS intensive care consultant and Chief Executive of the UK Sepsis Trust, told me: 'We need to act on sepsis, now. Blood poisoning affects about 10,000 children a year in the UK and about a thousand of those will die. We estimate, from our research, that if we can get the basics of care right then we can save a child every single day.



“The trouble is, sepsis is not easy to spot. It's not like diagnosing a heart attack where people come in complaining of chest pain. Sepsis is a great mimic. It's caused by pneumonia, by water infections and by skin infections, so people can present with a variety of symptoms. “Awareness is the number one thing — parents need to know what to look for and feel empowered to get help from healthcare professionals.” Now, for the first time, new guidelines have been issued to all healthcare professionals, warning of the danger signs. These tell parents and doctors to be on the lookout for any child who: 1) is abnormally cold to the touch, 2) looks mottled or bluish or has a very pale skin, 3) has a rash that does not fade when pressed, 4) is breathing very fast, 5) is having fits or convulsions, 6) is very lethargic or difficult to wake up. One or more of these symptoms could indicate a patient who is critically ill with sepsis and medical help should be sought. The good news is that caught early sepsis can be treated very effectively with antibiotics (if it's a bacterial infection). These are usually administered within an hour of diagnosis. As is so often the case in medicine, speed is of the essence. Spotting a practiced mimic like sepsis, which seems to hide behind a welter of contradictory symptoms, is never going to be easy, but knowing the danger signs should at least give parents — and health professionals — a head start. And that may be all it takes to save a life.

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Caribbean people love bread in all its forms, from hot hops to butter bread, sada, coconut bake and “float”. It’s filling, nutritious, and easily available. But there are other staples that were once so popular and so reliable for the supporting role they played alongside our meat and veggies that they were also deemed worthy of the “bread” title, such as breadfruit and the breadnut, known in Trinidad and Tobago as chataigne.


HE HISTORY OF CHATAIGNE Many of our favourite dishes have their roots in our chequered and often painful past as Caribbean people. The chataigne is no different. It was valued by indigenous peoples not just for its food, but also because it attracted game animals such as deer and wild pigs, which feed on fallen fruit. It was favoured as a cheap and nutritious way to feed slaves, and even after that dark period in our history ended, its omnipresence in forests and backyards, and quick and easy means of preparation, have kept it popular.

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THE CHATAIGNE TREE The name “chataigne” is closely related to the French “chatain”, meaning chestnut, and, indeed, it is extremely similar in texture and taste, albeit unrelated. The chataigne, Latin name Artocarpus camansi, can be considered a breadfruit with seeds. It is popular in Indonesia, the Philippines and other Pacific territories, and, of course, the Caribbean and Latin America.

Trees enjoy being near to water, and can bear several hundred fruit per year — much to everyone’s delight. THE CHATAIGNE FRUIT The fruit are almost as large as a basketball, roundish, and green. Inside, cushioned by an edible white pulp, are as many as 150 seeds, each in its own shell. The immature shell is soft and green, and when it is at this stage, the entire peeled fruit, pulp and all, is often curried and served with roti and many Indian side dishes. Once mature, the covering of the seeds become hard and dark brown, again, harkening to their nickname of “chestnut”. Inside, the nut is covered by a thin, edible, papery membrane similar to onion skin. These seeds are removed from the pulp and boiled in salted water until they soften. They can then be cracked with the hands and teeth, and enjoyed as a snack or as a side dish. It tastes a bit like a European chestnut, or a sweet potato.


In some cultures the seeds are sliced, roasted or eaten whole, ground into pastes or flours, or processed for their oil. NUTRITIONAL VALUE Unsurprisingly, chataigne are highly nutritious. As the “bread” reference suggests, it’s a good source of energy, providing over 40% of our daily requirement of carbohydrates per cup. Similar to many peas, beans and legumes, chataigne is an excellent source of protein: almost 30% of our daily requirement. No wonder it is so favoured by vegans and vegetarians, and is almost a non-negotiable presence on feast tables at religious festivals such as Divali, which are strictly meatless. But here’s where it gets interesting: chataigne is an excellent source of fibre. In fact, it offers an incredible 95% of our daily requirement of this food component, which is so essential for good digestive health. Remember, too, that fibre is also at the vanguard in our battle against cholesterol and its related medical risks, such as heart disease. Fibre also keeps you feeling full longer, a boon for those who are watching their weight. As previously mentioned, it does produce a high-quality oil, although it’s generally not known for this in Trinidad and Tobago. Like all non-animal sources of oils, it is cholesterol-free. Chataigne provides vitamins, minerals and anti-oxidants aplenty, especially sodium and potassium, (at 4% and 92% of our daily value per cup, respectively.) You’ll also find it a good source of vitamins A, C, and B6; calcium, thiamine, magnesium, zinc, iron, riboflavin, niacin, phosphorus, pantothenic acid, and copper — a jaw-dropping 198% DV of this last metal. CHATAIGNE AND FLATULENCE One undesirable side effect for which chataigne has become notorious is flatulence, which has led to its many naughty nicknames. In truth, this characteristic is shared by many varieties of peas and beans, which contain complex sugars that we are ill equipped to digest. In the absence of the necessary enzymes, these sugars can ferment in the lower intestine, resulting on bloating, cramping and intestinal gas. (With beans, soaking thoroughly tends to minimise the problem.)



Local wisdom says this negative fallout is less when you use chataigne seeds that are very fresh, in which the little nub at the tip has not yet turned black. Or, as any chataigne lovers do … just enjoy it in private! HEALTH BENEFITS OF CHATAIGNE • Vitamin C, an antioxidant, helps strengthen the immune system. • The manganese it contains helps regulate blood sugar. • Calcium builds healthy bones and helps blood to clot. • Magnesium and potassium help support calcium in strengthening bones and preventing bone loss. Potassium also helps regulate blood pressure. • A high iron content helps prevent anaemia. • The high copper content helps support thyroid function. • The fibre is great for bowel health and preventing constipation. • The vitamin A is good for the eyes and helps prevent night blindness.

CURRIED CHATAIGNE Naturally, you can enjoy your chataigne boiled in heavily salted water, but if you’re feeling adventurous, why not try this recipe for curried chataigne? INGREDIENTS 2 medium chataigne (breadnut) or 3 small

1/2 teaspoon turmeric powder

1 medium onion, chopped

2 Tablespoons green seasoning

2 pimento peppers, chopped 4 cloves garlic, chopped

3/4 cup coconut milk powder (about 75g) or 1 cup coconut milk

3 Tablespoons curry

2 Tablespoons coconut oil

1 teaspoon geera powder

1 1/2 teaspoon salt

1 teaspoon amchar masala

Water DIRECTIONS Step 1 - Rub a bit of oil on your hands. This will prevent your hands from getting sticky. Peel off the thick outer skin. Cut into quarters and remove the heart. Separate the seeds from the flesh. Chop the chataigne flesh finely. Remove the skin from the seed. Place in a large bowl of water and wash. Step 2 - Mix the curry, masala, green seasoning, geera, and turmeric with 4 tablespoons water. Heat oil and sauté garlic, pimento peppers and onion. Add the curry mixture and allow to reduce to an almost sticky paste. Step 3 - Add the chataigne. Coat evenly with the curry. Add salt to taste. Mix the coconut powder in 1 cup of water (or add pure coconut milk). Add to chataigne and simmer for 1 minute. Step 4 - Pressure cook for 6 – 8 minutes. * Recipe courtesy simplytrinicoooking.com

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Comes in three wrist sizes and offers more accurate feedback on your activity and calorific burn because of its use of continuous heart rate monitoring. It counts steps, does heart rate tracking of workouts, and resting heart rate monitoring. The OLED screen shows your daily stats, and caller ID from your smartphone. Can be used by beginners and communities.

Succeeded the Vivofit, and is a smart watch and activity tracker rolled into one. Tracks steps and sleep, and monitors heart rate. Smart watch notifications are given through vibrations, and has a curved OLED screen.

JAWBONE UP2 Comfortable and attractive; does activity tagging and sleep monitoring, and has a smart alarm.

JAWBONE UP3 Tracking your sleep has never been more in-depth. The UP3 easily monitors the body's bpm, temperature, rate of respiration and galvanic skin response. It also provides statistics on REM and light and deep sleep, and heart rate while resting, and counts your steps.

MOOV NOW While most tracking devices are worn on the wrist, the Moov Now is worn around the leg, kept in place by a clip and strap. People who participate in advanced sports use it because it produces data on actionable running, cycling and swimming. Can track steps and sleep, and be paired with a smartphone.

GARMIN VIVOFIT 2 Compatible with food app MyFitnessPal, and is a great choice for weight loss. Keeps a check on steps, sleep, bpm, and activity counting, and has a Move bar that gives reminders to get up and move around.


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Not that attractive, but blends fitness and sports features with reliable notifications. GPS accurately tracks running, cycling and swimming with live pace and distances. Also does golf tracking and notifications. The dull screen is one of its downsides, as is its inadequate sleep tracking ability.

SWAROVSKI SHINE Created for bling lovers. Users have a variety of accessories to choose from. The trackers are cleverly concealed behind the Swarovski crystals, but for users who run, cycle or swim, the device comes with standard sports straps too. Also used to track sleep, steps and calories.

MISFIT FLASH Comes in an array of popping colours, with the same technology as the Shine. Tracks steps and sleep, is waterproof, and has a long battery life.

MONDAINE HELVETICA NO.1 SMART Probably the most stylish device available; can easily become an inherent part of your daily ensembles. Yet its fitness tracking aspects were not compromised. It keeps check on sleep and steps and has a long battery life.

WITHINGS ACTIVITÉ Packs step counting, distance checking, calorie counting and sleep tracking into a Swiss-made analogue watch that looks good too. Its sports strap makes it suitable for the pool and intense workouts, and comes with an alarm.

XIAOMI MI BAND This affordable made-in-China device offers checks on steps, sleep, smart alarms and incoming call alerts.

MICROSOFT BAND More than a fitness tracker, it’s compatible with iPhone, Android, or Windows phones. In addition to tracking calories, sleep, and steps, it also sends email and call notifications, calendar alerts, and social media updates. It has GPS mapping, continuous heart-rate monitoring, workout coaching, and sensors that measure the sun's intensity.




BUT DO THEY WORK? But for all the hype about these devices, the question remains: do they really work? As with everything else, what may work for some people may not work for others, because it all depends on the outcome you expect as an individual.

more accurately, features continuous heart rate monitoring, performs automatic sleep tracking, includes basic smartphone notification features, and is complemented by a mature and motivating app with support for third-party integration.

A test conducted by Forbes Magazine reveals that the Fitbit Charge HR was so far the best device to track activity and exercise. "According to our tests—which included 60 hours of research and ten days of real-world testing—the Charge HR is more accurate at counting steps than most other wrist-worn trackers, and works seamlessly with Fitbit's popular social ecosystem.

"The Charge HR features a band similar to a wristwatch. Battery life is a good four to five days. The Charge HR offers a more complete package than any other currently available tracker.

"It has continuous heart rate monitoring for both resting and active use, automatically activated sleep tracking with vibrating alarms, and a legible OLED screen with caller ID. Unique among trackers in this price range, the Charge HR uses a strap modelled after a traditional watch band, which means it won't fall off accidentally," Forbes says. Ideally, the best tracker would be waterproof, stay on the wrist, sync wirelessly with other devices, have a legible screen and long battery life, and have a comprehensive app support. It would also be accurate in tracking steps, sleep quality, altitude and pulse rate. Since there was not a single tracker that currently has all the aforementioned features, researchers surveyed over 600 people to find out which features were of utmost importance. Based on the feedback, they sought the opinions of reputable online fitness tracking writers and tested the devices these writers recommended. "We wore all these devices simultaneously and recorded results of activity over five days. We also tested the wrist-based trackers against hip-mounted ones for accuracy, as clip-on models tend to be significantly more accurate. After collecting comparative data, we tested each tracker individually, along with its accompanying apps/software. "The Fitbit Charge HR wristband does the best of job delivering the features and activity information that matter most. It counts daily steps and flights of stairs

"One criticism is that, as with most wrist trackers, the Charge HR struggles to deliver accurate heart rate data during active exercise. If you want the most accurate readings during exercise, a chest strap is the way to go. Still, it's the fitness tracker most people will be happiest with." But what if circumstances prevent you from obtaining a Charge HR and you have to consider a runner-up? "Get the normal (non HR) Charge. You'll lose the HR's superior strap design and heart-rate tracking, but you'll get the same options for syncing data with your smartphone or computer, great Fitbit software/app, legible LED display, and motivational features, for a lower price," Forbes advises. For serious runners and cyclists, or those whose activities mandate a waterproof tracker, Garmin's Vivosmart wrist band, which isn't as accurate at tracking steps, but excels at workout tracking, may be their best bet. It communicates with cycling sensors and heart-rate monitors to log their data, and is safe to use in the pool, shower, and ocean. "It's also a good option for people who'd like some smart watch features (such as notifications and music-playback control) but don't really care about third-party app support." If you prefer a clip design that gives better step accuracy and reserves your wrist for an actual watch, the Forbes researchers recommend the Fitbit One. "A clip tracker is also a better option for those who participate in contact sports. It’s one of the few trackers that doesn't require a smartphone—it can even be synced directly with a computer via Bluetooth."

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THE NEXT U January to March


Pigeon Peas, can be found in almost every Caribbean kitchen ... but did you know the health benefits? Worried About Your Child's Weight? A practical guide on how you can control it. A Fig is not a Fig Learn more about the real fig and the benefits of this sweet treat.

Article submission guidelines U strives to provide informative, educational articles emphasizing health and lifestyle in the Caribbean. We select articles that will appeal to our Caribbean audience that are uplifting, informative and pertinent to health and wellness. Policies You must submit only original and unpublished work. By submitting to us, you are giving U permission to publish your work both in a single issue and in any future publications that feature items from U. This may include compilation works, web page summaries of the magazine, etc. Although we are retaining the right to use your work, we do not take complete ownership of it. This means that if we publish your work in U, you retain the right to submit the work to other publications. All articles are accepted on speculation. Publication of any article cannot be guaranteed. U reserves the right to edit all copy.

Specifics All accepted articles will be accompanied by the byline and monetary compensation as set out in our writers’ contract. Letters to the editor We encourage Letters to the Editor commenting on recent articles published in our magazine. They are not peer reviewed as such, but are assessed in-house to make sure they are factual and non-inflammatory, etc. Submit all comments, letters and/or subscription requests to: U The Caribbean Health Digest, Gaston Court, Gaston Street, Lange Park, Chaguanas, Trinidad & Tobago or email us at info@uhealthdigest.com www.uhealthdigest.com Advertising. P: 868-665-6712 + 5994 + 4428 F: 868-672-9228

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