2011 05 24 Health Post #1

YOUR GUIDE TO LIVING WELL

HEALTH POST SUPER SEEDS FROM THE ANCIENT ANDES >PAGE 8

WALK YOUR WAY TO FITNESS: A SIX-WEEK PLAN >PAGE 10

Secrets of long life Why Hong Kong leads in longevity >PAGE 4

TUESDAY, MAY 24, 2011

2 NEWS APP OF THE WEEK

THIS WEEK IN HEALTH

This one’s guaranteed to get you up off the couch Katie McGregor healthpost@scmp.com C25k – US$2.99 Rating 8/10

Greg Lee healthpost@scmp.com Dude, where’s your Java? Looks like that coffee addiction isn’t so bad after all – if you’re male. Regular cups, even decaf, may dramatically lower your risk of dying from serious prostate cancer, say researchers from Harvard School of Public Health in Boston. Data from a survey tracking the coffee intake of 47,911 men from 1986 to 2008 showed that those who drank the most coffee (six or more cups a day) reduced their risk of developing any form of prostate cancer by 20 per cent, and a lethal form by 60 per cent. Coffee is full of beneficial compounds, including antioxidants.

You booze, you lose. Binge drinking could affect your ability to absorb new information. A study of 122 Spanish university students has shown that males and females who regularly engaged in bouts of excessive drinking had a reduced ability to learn new verbal information in various structured

Working on your handicap? Pulley for you Up your golf game by working on strength and flexibility through Gyrotonic for Golfers (below). Created by Romanian ballerina Juliu Horvath, Gyrotonic is an exercise system that involves flowing, circular movements aided by wooden machines with rotational discs and weighted pulleys. Dave Rasmussen, a leading PGA Tour instructor, has adapted it for golfers, to suit the sport’s rotational movements. Only available at Iso Fit in Central. www.isofit.com.hk

Thigh’s the limit Knee-high socks aren’t too stylish unless you’re a soccer player. But what if they promise to help you perform better? Worn during exercise, CompresSport R2 Calf (HK$490, left) is said to increase blood circulation, reduce toxin build-up and deliver more oxygen to muscles. It decreases muscle vibrations, reducing muscle fatigue and injury. The socks can be bought from Escapade Sports. www.escapade.com.hk

The C25k app promises to keep you on your feet. Photo: Katie McGregor app purchase of US$0.90 will enable GPS support to track your route, distance and calculate calorie burn.

If you plan to use the app on a treadmill, you can manually add your workout data. And if you feel like boasting, the app allows you to share your achievements on Twitter or Facebook with a simple tap.

There’s plenty more support available from thousands of C25k websites, podcasts, and blogs.

Why not 10/10? C25k does not have the metric unit option, and other apps provide more functionality and support. But it scores well for achieving its objective – if you start today, you’ll be running five kilometres by July 26. Just in time for the autumn AVOHK 5km race series (see www.avohk.org).

HEALTH BITES ......................................................

J`eanette Wang jeanette.wang@scmp.com

The best cling ever The trouble with most sunscreens is that after an hour or so in Hong Kong’s summer heat and humidity it feels like you’ve sweated it all away. Ultrasun Very High 50+ SPF (HK$249, right) claims it will stay put for a day, standing up to water, sweat and even friction (like towelling dry). Its non-greasy, hypo-allergenic and fragrance-free formula protects against sunburn, premature ageing and long-term damage. www.youshine.net

......................................................

Running is one of the most efficient yet detested ways of getting your body “beach ready” for summer, and this app promises to have you running five kilometres – without stopping – in nine weeks, based on a thrice-weekly running schedule.

One of the more established programmes, it has a reputation for success. Sounds promising – I like it.

There’s nothing new behind the science of the C25k – or Couch to 5k – programme. Self-help books will tell you to start slowly, alternating short intervals of running with walking, and build from there. But in reality, it’s too easy to listen to your body and at the first whimper, switch straight back to walking. It’s no wonder so many people either return to the couch, or get stuck at one-kilometre run/walks.

The beauty of the C25k app is that “Alison” or “Michael”’ will tell you when to run, walk, stop, and when you are halfway there.

The programme starts gently enough on day one with a 30minute workout: a brisk five-minute warm-up walk, followed by eight reps of 60 seconds of jogging and 90 seconds of walking (20 minutes total), and finally a five-minute cooldown walk. If this is too easy for you, you can skip to a level that you find comfortably challenging.

You can train while listening to your own iPod tunes. If you are running outside, an additional in-

......................................................

tests. Researchers suggest that heavy drinking may have a toxic effect on the hippocampus, the part of the brain used for learning and memory.

Old heart, new findings. Experts say they have diagnosed the oldest recorded case of heart disease, showing the condition pre-dates our modern lifestyles. Computerised images of the 3,500-year-old mummified remains of Egyptian Princess Ahmose-Meryet-Amon, who died in her 40s, revealed that she had coronary artery disease and would have needed bypass surgery.

It’s believed she lived on an organic diet rich in vegetables, fruit, limited meat and plenty of fish from the Nile. “There was no gas or electricity at that time, so presumably she had an active lifestyle. Her diet was significantly healthier than ours,” says lead investigator Dr Gregory S Thomas from the University of California, Irvine. “Yet, she had these blockages. This suggests to us that there’s a missing risk factor for heart disease... that we don’t yet know enough about.”

CONTACT US Culture Editor: Janelle Carrigan janelle.carrigan@scmp.com Health Post Editor: Jeanette Wang jeanette.wang@scmp.com General inquiries: healthpost@scmp.com Advertising: tel: 2565 2435; advertising@scmp.com

Bobble or nothing Hong Kong’s tap water is safe to drink (if your pipes are clean). But for the extra cautious, the bobble (HK$99, below) reusable bottle will make sure water is free of organic contaminants and meets international standards for chlorine, taste and odour reduction.

The bobble’s carbon-based filter does the job for 150 litres, before you pop a new one (HK$73) on. www.waterbobble.com

Breathe easy Indoor air pollution can cause tiredness, general malaise and rhinitis. The Oxyvital Split Unit (HK$21,000 including installation, left) is certified

by Hong Kong University of Science and Technology, and has been scientifically proven to improve indoor air quality up to World Health Organisation and Hong Kong government standards. Good enough to purify a 1,000 sq ft home. www.oxyvital.com

EDITOR’S NOTE The character on our cover, shou, is the Chinese symbol for longevity.

More than just long life, shou is also about good health, prosperity and happiness. It’s a popular motif in Chinese homes, paintings, and at weddings and birthdays.

Shou is what Siu Man-cheuk, 100, has, and it can be yours, too, if you follow the secrets he and longevity experts have revealed.

But beyond this week’s cover story, shou is what Health Post hopes to help you attain, by sharing the latest and most interesting findings, trends and tips in health, medicine, fitness, nutrition and well-being with you every Tuesday.

It’s not difficult to see why

shou is the most revered among the five good fortune symbols in Chinese culture.

As American writer and philosopher Elbert Hubbard once said: “If you have health, you probably will be happy, and if you have health and happiness, you have all the wealth you need, even if it is not all you want.”

MEDICAL 3 CASE HISTORY: SEVERE ABDOMINAL DISTRESS

Burning pain hard to stomach Jacqueline Yang healthpost@scmp.com When 35-year-old Stephen Lee (not his real name) walked into Dr Wayne Hu’s office complaining of burning pains in his stomach, he was at his wit’s end.

A year earlier, Lee had had his gall bladder removed; he began experiencing abdominal pain several months later. The pain was much worse after meals, so it was hard to tell whether it was a general stomach ache or something more serious.

With a history of gastric problems, Lee underwent a gastrointestinal endoscopy, which found a small erosion in his stomach. His doctor at the time diagnosed him with a superficial ulcer, prescribed him medicine and sent him on his way. But the pain returned soon after the course of medicine ended, so Lee made an appointment with Hu, a specialist in gastroenterology and hepatology.

Familiar with symptoms such as these, the doctor performed a repeat endoscopy, this time testing for bile reflux. His suspicions proved correct, as the procedure found bile had risen from the small intestine to the stomach.

Causes Bile reflux is more common than one might think, and many sufferers are unaware they even have it.

Anyone can be affected by it, but those who have had gastric surgery, such as the removal of their gall bladder or stomach, are 30 per cent more susceptible to the condition, Hu says.

“Bile is produced in the liver to aid in the process of digesting fat and is stored in the gall bladder,” he says. “It is released via the second part of the duodenum, which is connected to the small

intestine by the pyloric valve.

Its release normally occurs when you eat, through the contraction of the gall bladder, so when the pyloric valve is damaged, it alters this timed synchronisation. What happens is the bile is then released at random and also flows upwards to the stomach, causing inflammation of the stomach lining and extreme gastric pain.”

Symptoms and complications Long-term misdiagnoses of bile reflux can lead to serious consequences. Gastritis (the most common form of stomach irritation), if left untreated, can lead to bleeding and stomach ulcers. In some instances, bile can travel as far as the oesophagus (food pipe) and combine with acid.

If left untreated, the combination can inflame the lower oesophageal lining and cause Barrett’s oesophagus, whereby the cells in the food pipe start to build new cell structures to protect it from the acid and bile. Eventually, this can lead to oesophageal cancer.

Hu says that misdiagnoses are often due to the symptoms of the condition – a burning pain in the stomach area and nausea, which are also traits of gastroenteritis.

“In some cases, people may also experience heartburn and mistake it for acid reflux. More often than not, sufferers will simply ignore the pain, excusing it as one of the aforementioned, or doctors will simply prescribe medicine to manage the stomach pain.

“Secondly, a gastric endoscopy does not necessarily find signs of bile. As in the case of Lee, the small erosion and inflammation in his stomach was misdiagnosed as an ulcer. If there is bile, this can also be attributed to retching. The only sure-fire way of diagnosing bile reflux is to measure bile exposure.”

ASK THE DOCTORS DR KENNETH TSANG WAH-TAK Q: Lately I’ve been having trouble breathing. I looked it up on the internet and found it could be anything from asthma to heart failure. I used to be able to jog for 30 minutes, but now I cannot jog for even one minute without choking up.

A: Without knowing your age, smoking habits, specific symptoms and medical history, it is not possible to determine the exact cause. Nonetheless, it is useful to consider the following causes: 1. Asthma is a very common condition affecting about 10 per cent of the adult population and 23 per cent of children.

This often presents as intermittent shortness of breath with or without wheezing (noisy breathing sometimes with high-pitched musical sounds), coughing and mucus production.

2. Chronic obstructive pulmonary disease has similar symptoms to asthma but generally affects only chronic smokers. It often manifests itself in a combination of chronic bronchitis (long-

term cough with mucus) and emphysema (destruction of lungs over time).

3. Other lung conditions such as tuberculosis, pneumonia (particularly if shortness of breath began recently), lung fibrosis and bronchiectasis can all cause difficulty in breathing.

4. Non-lung causes of shortness of breath include heart failure (could be associated with previous known heart trouble, leg or ankle swelling, or shortness of breath when lying down), inhaling of food into the lungs (particularly the elderly, who tend to choke while eating or drinking) and accumulation of fluid outside the lungs (pleural effusion).

It is important to note that shortness of breath is a very important and serious symptom, which should be evaluated properly by a physician.

Dr Kenneth Tsang Wah-tak is a specialist in respiratory medicine and a member of the SCMP Health Post advisory panel

Illustration: Angela Ho

......................................................

Treatment Although there is no outright cure for the condition, medicine can alleviate it. Ursodeoxycholic acid, for example, promotes the flow of bile and reduces pain symptoms, while medicines such as proton pump inhibitors can stop acid production in the stomach.

Leading a healthier lifestyle with a reduced intake of alcohol, fatty foods, carbonated and acidic drinks and weight loss can also help ease acid reflux.

If the condition cannot be managed, then surgery may be required. An operation called a Roux-en-Y bypass creates a new connection in the small intestine that the bile drains into, thereby directing it away from the stomach.

Those who have been experiencing persistent stomach problems for a few months should seek urgent medical advice, Hu says.

Those who are also experiencing reflux-like symptoms and are not responding to prescribed medicine should seek a second opinion or insist upon further tests.

Lee is now taking a three-to sixmonth course of medicine to help manage the pain and reduce bile reflux symptoms.

4 COVER STORY

They’re still in Hongkongers are living longer and better thanks to improved care for the elderly, more health education and greater affluence. Naps, a sense of community and having a passion and purpose in life all play their part, too, writes Elizabeth Snouffer

Healthy habits throughout a lifetime not only increase lifespan but decrease chronic conditions such as obesity DAN BUETTNER, AUTHOR AND EXPLORER

S

iu Man-cheuk, a national table tennis champion for more than five decades, drives a firm forearm shot across the table. Smack, pop, ping!

Within seconds, Charles Yuen tosses another ball gingerly towards the seasoned player and he smacks it again.

“Take a rest, old friend,” says Yuen, who has coached Siu for the past 45 years. Siu says little as he sets his paddle down and shuffles to his seat for a break, but action speaks louder than words when you are a century old.

Table tennis is a game that demands excellent eye-hand co-ordination and exact timing, so it is hard to believe coach Yuen is 84 years old and even more surprising to learn that Siu was born in 1911, with an identity card to prove he celebrated his 100th birthday in March. They meet at the Hong Kong Table Tennis Association in Wan Chai on Monday and Friday afternoons and the only concession made for Siu’s age is the drink break every 10 minutes. “Doctor’s orders,” Siu says, as he sips iced tea in the practice hall and glances at the clock.

He may not be in his heyday – he swept the national championships from 1929 to 1940, and the senior title from 1970 to 1997 – but Siu, Hong Kong’s first diamond importer, attributes his longevity largely to the sport. “It’s important to have a passion for an activity – mine was always table tennis.”

More Hongkongers realise this, and experts say it could be one of the reasons why life expectancy here has risen substantially in the past 30 years. In 2009, life

Siu Man-cheuk is a 100year-old former Hong Kong table tennis champion who still likes to mix it up.

Photo: Edward Wong

Is a longer life a better life? ..............................................

Elizabeth Snouffer healthpost@scmp.com A long life may not necessarily be a better life for some elderly folk, local experts say. Isolation is a problem, with about 20 per cent of senior citizens in Hong Kong living alone, says Professor Paul Yip Siufai of the department of social work and social administration at University of Hong Kong.

Dr Edward Leung, president of the

Hong Kong Association of Gerontology and a consultant geriatrician at United Christian Hospital, adds: “There are 800,000 elderly in Hong Kong and 97 per cent are no longer working. Their families cannot support them and there are not enough day care facilities.” Many suffer degenerative health problems, and have little resources or support.

“The government needs to increase elderly care services and provide retirement protection services,” he says.

Hong Kong has a rapidly ageing population. The number of people aged 80 and above will increase from 262,000 (3.7 per cent of the population) in 2010 to about 1.2 million (13.7 per cent) in 2050, says Dr Karen Cheung, who works with Yip. “The average annual growth rate of persons aged 80 years or over in Hong Kong is even faster than the global trend,” she says. “Such rapid growth will require far-reaching economic and social adjustments.”

expectancy was 79.7 years for men and 85.9 for women, according to the latest data from the Census and Statistics Department. Both are up 7.4 years from 1981, and have equalled other long-livers such as the Japanese (79.6 years for men, 86.4 for women) and Swedes (79.4 years for men, 83.4 for women).

The number of centenarians in the city has also quintupled, from 289 in 1981 to 1,510 in 2006, says Dr Karen Cheung, from the department of social work and social administration at the University of Hong Kong.

Dr Raymond Lo, president of the Federation of Medical Societies of Hong Kong and a specialist in geriatric and palliative medicine, believes three factors contribute to this. Firstly, people are better educated about how to look after themselves and many make healthy choices. “Temptations to smoke, overeat and drink are around, but Hong Kong’s health services make an impact with targeted public campaigns,” he says.

Secondly, care for the elderly has improved.

“The key is healthy independence,” Lo says. “The elderly are learning how to selfmanage chronic conditions on their own.”

Take, for example, Chan Tse Wa-ying, 90, and Sham Luk-yin, 88, who work out twice a week at the University of Hong Kong’s Stanley Ho Sports Centre in Sandy Bay. The two participate in the Golden

Years Fitness initiative by the university’s Institute of Human Performance, spearheaded by trainer Kenneth Liang. Golden Years Fitness is designed for senior citizens at risk from, or diagnosed with, chronic conditions. Its aim is to enhance their ability to live independently through a programme of cardiovascular exercise, strength training and flexibility work. Chan Tse, a lung cancer survivor who lives alone, says exercise is better than medication and the social aspect of the class keeps her happy.

Finally, Hong Kong’s growing affluence has helped boost longevity. Lo says: “Our high living standard has decreased our overall vulnerability. While wealth does not equal health, there is no doubt that as Hong Kong’s standard of living has increased, so has longevity.”

COVER STORY 5

the game Siu, who lives with his 87-yearold wife, sleeps eight to 10 hours a night and wakes at 8.30am. He eats a hearty breakfast of bird’s nest, oatmeal and eggs. For lunch and dinner, he prefers vegetables over meat. During the day, he might walk for an hour and ride an indoor bicycle for 15 minutes.

His lifestyle corresponds with what author Dan Buettner has found over 20 years of research into health and longevity best practice. Working with academics and doctors, the National Geographic explorer focused on regions in the world where people live remarkably long, full lives and, in 2008, published his findings in The Blue Zones: Lessons for Living Longer From the People Who’ve Lived the Longest.

Buettner and his team created a cross-cultural blueprint for longevity, based on nine shared common denominators among long-livers. These are called the “Power 9 Principles” and include moving actively every day, eating a variation of the Mediterranean diet (which Buettner says adds six years to a life), feeling an overall sense of satisfaction and serenity with life aided by regular naps, and having a strong sense of belonging in a community and with family.

Another key characteristic is ikigai, the Japanese equivalent of the French raison d’être, or, in English, loosely translated as finding one’s meaning or purpose in life. It results in psychological well-being and a broad sense of serenity, something Siu knows well. “I’m not ambitious for money any more,” he says. “I’m happy.

Money means nothing to me.”

Siu has three sons and a daughter, eight grandchildren and four great-grandchildren. “My family is my ikigai.”

However, Buettner says that making smart lifestyle choices before disease surfaces, and not after, is what counts. “Healthy habits throughout a lifetime not only increase lifespan but decrease chronic conditions such as obesity, heart disease, diabetes, cancer and dementia,” he says. “I expect we will see a drop in life expectancy in many countries if the obesity epidemic continues at its current rate.”

Of course, genetics affects longevity – but it is not nearly as big a factor as lifestyle.

In 1996, a study of 2,872 Danish twins born between 1870 and 1900 found that genetics plays only a 26 per cent role in living

Tips of the century: secrets of how to span the ages ......................................................

Jeanette Wang jeanette.wang@scmp.com How do you live past 100? The late doctor Li Shu-pui might well have advised you to stay faithful to your spouse.

The secret to his healthy 102-year life, the former Hong Kong Sanatorium and Hospital superintendent once joked to his son, Walton, was that he did not have the stress of juggling a mistress with his wife.

Shu-pui died in 2005, three months after his wife, Dr Ellen Li, who was 98.

Walton, HKSH’s current superintendent, says: “I never saw [my parents] arguing.”

Shu-pui and Ellen were eventempered. He, a private sector pioneer of Western medicine in Hong Kong, never raised his voice; she, an advocate of gender equality and social justice, was never one to hold a grudge.

Even as Shu-pui approached his 100th birthday, he still put in a full day’s work. longer for males and a 23 per cent role in females.

More recently, in a groundbreaking 20-year study published in March by the University of California, Riverside, researchers found that personality characteristics and social relations from childhood can predict one’s risk of dying decades later. Called The Longevity Project, researchers tracked 1,500 people – first studied at the age of about 10 years old in 1921 by the late Stanford University psychologist Lewis Terman – through their lives, collecting information such as family histories and relationships, teacher and parent ratings of personality, hobbies, pet ownership, job success, education levels, military service and other details.

Many of their findings went against conventional wisdom.

For example, participants who were the most cheerful and had the best sense of humour as children lived shorter lives on average, because they tended to take more risks with their health compared to more prudent and persistent individuals. Continually productive people lived much longer than their more laid-back counterparts. And starting formal schooling too early – being in first grade before age six – is a risk factor for earlier mortality.

It’s never too late to choose a healthier path, the researchers say.

The first step: do away with lists, and stop worrying about worrying.

“Thinking of making changes as ‘taking steps’ is a great strategy,” advises Leslie Martin, a psychology professor. “You can’t change major things about yourself overnight. But making small changes, and repeating those steps, can eventually create that path to longer life.” Picking up that ping pong paddle could be the change you need. healthpost@scmp.com

Medical doctor Li Shu-pui and wife Ellen lived to a combined age of 200.

He chaired daily hospital meetings, took 15-20 minute post-lunch naps, and saw patients in the afternoon. At home, he studied medical journals and the latest medical technology.

Ellen was the first woman Justice of

the Peace (1948) and legislative councillor (1966), defeated cancer in her 50s, dedicated the next 20 years to public and community service through the Ellen Li Charitable Foundation, and spent her retirement playing mahjong.

“Longevity is in the genes,” Walton says. “We try to prevent external factors from affecting that potential.”

Longevity is also about early detection and treatment of disease, reducing exposure to toxins and carcinogens, enhancing mobility and preventing falls, he says.

The couple were certainly blessed with good genes: Shu-pui’s mother lived beyond 100, while his wife’s parents survived into their 80s and 90s.

Shu-pui and Ellen did not stick to any particular diet: he ate “everything in moderation” and she ate “whatever she liked”.

Shu-pui’s main exercise was making his rounds in the hospital.

On Sundays, however, he took his sons hunting in the New Territories, and, after hunting was banned, to a shooting club in Shek Kong, near Yuen Long. In his youth, Li played tennis and soccer for the University of Hong Kong.

Li suffered from high blood pressure, heart valve problems and diabetes from his 70s, and bladder cancer in his late 80s. Controlled and treated, these factors did not cause his death. Ellen had diabetes and gall bladder stones in her 70s and heart disease in her 80s. These did contribute to her death, Walton says.

The message is: what you do at 40 may dictate what happens to you at 60, and what you do at 60 may dictate what happens to you at 80. And as you get older, it takes more effort to prevent decline. But if you manage your health well and early, a better quality of life will likely follow.

“The ‘secret’ to long life,” Walton says, “is actually not so secret.”

6 HEALTH TRADITIONAL CHINESE MEDICINE

Wisdom of ages for the 21st century ......................................................

Eileen Aung-Thwin healthpost@scmp.com To some people, the term traditional Chinese medicine (TCM) might conjure images of musty medical halls and geriatric practitioners who hover between mystical genius and opportunistic quackery. But Chinese medicine has evolved into something more innovative, and its modern clinics attract a younger set of both practitioners and clients.

TCM has been the main form of health care for Chinese for centuries, but in Hong Kong it languished under British rule as the medicine of choice for largely the old and the poor. Attitudes started changing in the 21st century – a 2002 survey showed more well-to-do people were using TCM. Internationally, the World Health Organisation has urged its member states to consider, where suitable, inclusion of traditional medicine in their national health systems. Last year, it published a 43-page report, Benchmarks for Training in Traditional Chinese Medicine.

TCM also seems to be attracting a younger crowd. Richard Eu Yeeming, group chief executive of health care firm Eu Yan Sang International, says most of its TCM clients are between the ages of 25 and 40. Today, about 22 per cent of medical consultations in Hong Kong are provided by Chinese medicine practitioners, the Chinese Medicine Council says. But TCM is still poorly understood, especially by

Westerners, in part because its philosophical approach is so different from that of Western allopathic medicine.

TCM is a comprehensive medical system with a 2,500-year history. It deals with promoting health, preventing disease and providing non-invasive, natural means of helping the body to heal itself.

Where allopathic medicine uses a scientific, biochemical approach, Chinese medicine adopts a holistic, systemic and individualistic one.

Chinese medicine treats a person’s body, mind and spirit as a whole and aims to maintain balance and harmony Sceptics may think Chinese medicine is rooted in superstition because it speaks of unseen forces such as qi. Kelly Chain, a registered Chinese medicine practitioner, describes qi as the life force present in all living things that travels along 12 major meridians – energy and communication pathways – in the body. When qi flows smoothly, you’re healthy. But if qi is blocked, stagnated or deficient, illness comes knocking.

It’s an unseen energy, the way emotions are invisible energy, says Chew Say Yeow, president of the Singapore Acupuncture Association.

Yet these forces can contribute to health or disease – a mind-body connection also acknowledged in Western medicine, if in different terms. TCM treats a person’s body, mind and spirit as a whole and aims to maintain balance and harmony within the person and with his or her environment. Balance is expressed in the yin-yang concept of two opposing, yet complementary and interdependent energies.

Physical symptoms are considered expressions of internal organ health, and the root causes of these symptoms must be addressed.

If you feel dizzy, for example, a weak stomach could be the culprit. So, to relieve the dizziness, the treatment must also enhance the stomach function, Chew says.

Symptoms and signs of illness – known as “patterns of imbalances” – aren’t always clear-cut. Multiple diseases can share the same pattern and need the same remedy, but one disease might display multiple patterns and require different remedies, says Mary Cheng, senior manager of Eu Yan Sang Integrative Medical Centre.

With TCM, treatment plans are customised for each person, says Chew, as people are unique and affected by diseases differently.

Acupuncture and herbal therapy are popular remedy options.

Chain, who uses acupuncture to aid weight loss and treat fertility

issues and skin conditions, says the treatment stimulates the nervous system, increases immune system activity and raises the production of substances such as adrenaline, endorphin and opioids. This boosts resistance and relieves pain.

Acupuncture is also used for nicotine withdrawal, to rehabilitate stroke victims and relieve asthma.

Herbal therapy, meanwhile, has modernised. The remedies are no longer the black, evil-smelling

concoctions of yore but convenient capsules, pills and powders.

“TCM needs to be incorporated into the lifestyle of a patient to enjoy the maximum benefits,” Chain says.

In Hong Kong, TCM is regulated by the Chinese Medicine Council, and legislation has given it greater health care recognition.

Perhaps a deeper, more widespread integration of East and West – in regulation and in practice – will eventually be realised.

FROM THE EXPERTS

Looking for a family doctor? There’s a lot of it going around ......................................................

Dr Joseph Chan healthpost@scmp.com As a distinctive medical speciality, family medicine offers primary care, continuing and whole-person care to an individual or a family.

It is the crucial building block of primary care worldwide, being the first point of contact for individuals and families in a continuing health care process. The discipline is popular and well-defined in most developed countries, such as Britain.

In Hong Kong, the term “general practice” is considered synonymous with “family medicine”, as are “general practitioner” and “family physician/doctor”.

Family doctors serve as a point of entry for patients into the health care system. They don’t just cure; they are family friends who should have a thorough understanding of your physical and psychological conditions, thereby giving appropriate health advice, initial management and proper referrals to specialists and other health professionals.

In fact, everyone should have a family doctor who can free them

from unnecessary procedures and expenses with accurate diagnosis and personalised management. It is possible to miss a diagnosis or overlap a treatment if patients – especially the elderly, who usually have multiple problems – see several doctors or specialists.

Holistic, or whole-person, health is an important concept of family medicine, which means seeing beyond the physical manifestations

of a specific illness. A family doctor views diseases not only as affecting a single organ or a particular system but also considers your social environment and emotional or psychological responses to the physical illness.

One of the major duties of family doctors is primary care, which includes early diagnosis, be it prognostic, pathological or psychological, and gate-keeping of

specialist services and clinical investigations.

Other areas include health promotion, prevention and support – the latter two aspects are especially important as chronic but incurable diseases become more prevalent in ageing people. For patients with chronic diseases, a family doctor plays a crucial role by providing continual screening and regular assessment.

So, how should you choose a family doctor?

First, find one whose clinic is close to your home or office. Second, he or she must keep abreast with rapid medical developments through continuing education.

(This, obviously, is hard to determine. Try quizzing your doctor, perhaps?)

Ideally, your doctor should also have a strong support network of allied health professionals, such as dietitians, physiotherapists and occupational therapists.

Patient-doctor rapport is key – your family doctor should have the right skills for communication, problem-solving and management, as well as a caring, attentive and empathetic attitude.

At a time when medical services have become increasingly depersonalised and medical resources are limited, provision of competent, general care by family doctors is of utmost importance. If the primary care system is functioning well, total health costs for individuals and the government can be reduced by early detection.

In recent years, the call for strengthening primary care has been high on the agenda of health care reform and even received special attention in the chief executive’s policy address.

With the new online Primary Care Directory, https:// www.pcdirectory.gov.hk/Public/ indexp.aspx?l=en, you can now access an electronic database containing practice-based information about primary care professionals in the community.

One should think carefully when choosing a good family doctor.

Dr Joseph Chan is the deputy medical superintendent at the Hong Kong Sanatorium and Hospital. He is also an honorary associate clinical professor with the Li Ka Shing Faculty of Medicine, University of Hong Kong

HEALTH / DIET 7 LIVING WELL VOCS

Dishing the dirt on cleaning products Margaret Wee healthpost@scmp.com When Hong Kong mother of two Tracey Kwong goes to the supermarket, she takes time to read the labels on household products.

She avoids any product containing volatile organic compounds (VOCs) – gases or vapours that may have adverse short- and long-term health effects on humans and animals – such as isopropyl alcohol, naphthalene and methylene.

“Given my son Matthew’s eczema, I look for VOCs in products such as laundry powder and body soaps,” says Kwong, 40.

Detergents, glass cleaners and floor washes help to keep the home spick and span, but the fumes they give out may also cause respiratory infections and even cancer.

A recent analysis of 25 top-selling US household products – from air fresheners to detergents, shampoos to dryer sheets – by Seattle’s University of Washington found that they emitted an average of 17 VOCs each. It’s a troubling figure, especially when there is no “safe” level of VOCs. A necessary evil?

VOCs are common in most organic solvents and appear in many consumer products because of their physical and chemical properties.

Formaldehyde, for example, a colourless gas with a strong odour, is widely used in manufacturing – car components, crease-resistant fabrics and furniture – because it is a building block for chemical compounds such as polymers. It is used in topical creams, cosmetics and personal hygiene products for its disinfectant properties.

Along with other VOCs such as tetrachloroethylene, hexane and toluene, its use in everything from hair spray to foam cushions has resulted in the concentration of VOCs being as much as 10 times higher indoors than outdoors, Toxins in personal and household products could be harming your health

according to studies by the United States Environmental Protection Agency and other air quality researchers.

In Hong Kong, coupled with the air pollution, this can lead to a multitude of health problems.

“Outdoor air pollutants such as nitrogen dioxide and ozone can affect the quantity of VOCs in the atmosphere. Humidity also affects the volatility of VOCs. For instance, formaldehyde emission from materials is faster on humid days than on dry days,” says Dr Lai Hakkan of University of Hong Kong’s School of Public Health.

Reducing the risks The effects of exposure to VOCs depend on several factors, including the toxicity of the chemical, its concentration in the air and the duration of exposure, says Professor Wong Tze-wai from Chinese University’s School of Public Health and Primary Care.

While each VOC affects health differently, known physical reactions include eye irritation, allergic skin conditions, headaches, nausea and dizziness. Long-term effects include liver, kidney and nerve damage and cancer.

Kwong’s daughter, Claudia, was particularly affected by the dual impact of poor air quality and VOCs. “The air pollution in Hong Kong was bad enough. Then I noticed that when we used sprays or perfumes, Claudia would cough badly,” says Kwong. “So I banned anything with sprays at home, even insecticides.”

Air circulation indoors helps.

“Good ventilation is the best way to reduce exposure to VOCs,” Lai says. Opening doors and windows and using exhaust fans can also help reduce VOC levels faster. In buildings that have been newly renovated or carpeted, airing is advised to allow VOCs to dissipate before moving in.

Those with green thumbs can cultivate indoor plants that are thought to help reduce VOC levels.

Researchers at the University of

Technology, Sydney, have found that keeping a mixture of plant species, including Howea forsteriana (Kentia palm) and Epipremnum aureum (devil’s ivy), in a closed chamber with no ventilation can result in a complete removal of VOCs in 24 hours. However, more research is needed to determine the most effective combination of plants.

Greenwashing VOCs The proliferation of “green” consumer goods may lead people to think that they are safer.

However, in the University of Washington study, 19 of the 25 products tested carried claims such as “green”, “organic”, “non-toxic” and “natural” but were just as toxic as their “non-green” counterparts.

This marketing practice, called “greenwashing”, has resulted in regulations in the US, Canada, Australia and Norway that prevent manufacturers making unsubstantiated eco-friendly claims.

While there is currently no worldwide standard for ecolabelling products, the Hong Kong Green Council is trying to establish local standards through the independent and voluntary Green Label scheme. So far, more than 100 consumer and industrial products have been tested and certified green (see www.greencouncil.org).

The Environmental Protection Department has also instituted regulations to limit the import and manufacture of consumer products with high VOC content.

The best way to mitigate the risks of exposure to VOCs, however, is to avoid or minimise the use of products that contain them.

“No product can be truly nontoxic,” Lai says. “That’s why we need to reduce VOCs as much as possible.”

For Kwong, avoiding VOCs has paid off. “It has done wonders for Matthew,” she says. “His skin has improved tremendously. He is less irritable and a more socially confident boy now.”

THE TASTE TEST

New-style snacks offer an easy way to get your fruit and veg ......................................................

Jeanette Wang jeanette.wang@scmp.com Greenday Broccoli Chips ● HK$23, 30 gram box, from VOle’.

In its raw form, broccoli is high in vitamin C, has about 35 calories and just a trace of fat per 100 grams, and is about 90 per cent water.

Greenday’s special “vacuum frying” process does wonders in retaining the colour, flavour and shape of the vegetable. But the chips left my fingers greasy, they were dry and the nutritional content – 180 calories, 15 grams fat and zero vitamin C per box – is hardly impressive.

Verdict: A convenient way to get fibre (5 grams per box, or a fifth of your daily needs), but I’d prefer a spear of fresh broccoli any day.

Farmer’s Choice Veggie’s Snack ● HK$18.90, 50 gram bag, VOle’.

The natural sweetness and earthy flavours of carrot, beetroot and parsnip come through beautifully in this moreish all-natural snack.

Frying in sunflower oil gives the vegetables a wonderful crunch, though upping their caloric and fat content. Still, they are healthier than regular potato chips gram for gram – at 106 calories, 6.9 grams fat and 5.6g fibre per 28g versus about 160 calories, 10g fat and 1g fibre.

Verdict: Yummy, but don’t forget to chase with a tall glass of water – the chips can get a tad dry and salty.

Delicious Orchard Freeze-dried Fruit Crisps, Pear Slices ● HK$11.50, 20 gram bag, VOle’.

Unlike the previous two varieties of chips, this one contains no oil or salt.

In fact, it has just one ingredient – pear. Freeze-dried and hence juiceless, nearly crunchless pears, to be precise. And that takes away the messy joy of having sweet, sticky liquid flow down your fingers as you sink your teeth into succulent flesh.

Verdict: Pears are not always in season, so at 70 calories and 0.2 grams fat per bag, these crisps offer a sweet, tasty alternative.

Photos: May Tse

......................................................

8 DIET RECIPE FOR HEALTH TABBOULEH

A light and quick take on a Middle Eastern salad ......................................................

Dr Wendy Yang healthpost@scmp.com

Quinoa is a great source of protein and minerals for diabetics, vegetarians and the gluten-intolerant

NUTRITION QUINOA

Super seeds from the ancient Andes ......................................................

Eileen Aung-Thwin healthpost@scmp.com In this age of globalisation and looking for the “next big thing”, exotic produce from around the world is regularly touted as the superfood of the future.

From the acai berry of the Americas to the goji berry of Asia, there are plenty of fascinating new foods that claim to boost well-being.

But few boast as strange a name – or form – as the quinoa of the Incas.

Warriors in the ancient South American empire used quinoa as a nutritional powerhouse on long marches. They so prized the crop that they called it chisaya mama, or “mother grain”, and the first seeds of each season would be sown by the Inca king using tools of gold.

Quinoa has nutrition experts excited about its exceptionally high protein content of 12 per cent to 18 per cent (compared with 7 per cent in rice), including the eight essential amino acids needed for tissue development. It’s a perfect food for vegans. It’s also a good source of fibre, iron, calcium, magnesium, phosphorus and vitamin B complex.

Because of its superior nutrition and the plant’s ability to thrive in harsh and semi-arid conditions, the UN’s Food and Agriculture Organisation (FAO) considers quinoa to be a “super crop” that could promote food security, while Nasa has plans to use it to feed astronauts on long space missions.

Although easy to digest, quinoa has a low glycaemic index – meaning your body will digest it slowly and keep you feeling full for longer – which makes it an option for diabetics. And it is gluten-free, making it suitable for those allergic, intolerant or sensitive to wheat.

For Fran Collard, 43, who is gluten-intolerant and vegetarian, quinoa fits her dietary requirements perfectly. It is her family’s staple, used for pancakes and baked goods, sauces and tabbouleh.

“It’s delicious,” Collard says, adding that she has not been sick since turning vegetarian last year.

In Hong Kong, quinoa costs about HK$35 for a 340 gram box.

Gourmet raw food chef and instructor Dr Wendy Yang says it is easy to find on the shelves of supermarkets, which shows there is steady demand for the low-key superfood even though most residents might not have heard of it.

What makes quinoa a real winner is its ease of preparation, whether raw and sprouted or cooked. Its mild, slightly nutty taste and pleasant crunch are easy on the palate, and it readily absorbs whatever seasoning you choose.

Julie Teo, 38, who has been

12 to 18 per cent of quinoa is protein, compared with 7 per cent of rice • It’s also a good source of fibre, iron, calcium and other nutrients

eating quinoa for the past four years, says she enjoys its distinctive nutty flavour. The mother of four first introduced the food into her family’s diet as a way to boost the nutritional quotient of the meals she prepared for her vegan husband; now quinoa patties are a firm family favourite.

Yang says her clients find that tabbouleh made with quinoa (see recipe) is tastier than the kind made with bulgur wheat, and its texture is more interesting.

An informal tasting for a group of first-timers drew comments that the grain tasted similar to rice, only less starchy. A five-year-old boy at the table insisted on replacing his white rice with quinoa, which had been cooked in chicken broth and garlic.

Although quinoa is easily used as a grain replacement, it is technically not a grain but a seed.

The plant, Chenopodium quinoa, is classified as a herb and is related to beet and spinach. The plant’s leaves, stem and seeds have medicinal uses in treating inflammation, pain and urinary tract infections. It is even used as an insect repellent, according to an FAO book on neglected plants.

The whole plant is used as animal fodder to feed cattle, pigs, sheep and horses.

Its decline as a major food staple in the Andes started with the fall of the Inca empire in the 1500s; the Spanish invaders despised quinoa for its role in what they saw as Pagan rituals and forced the Incas to grow wheat and other crops instead.

Quinoa’s revival appears to have begun in the late 1980s – ironically, thanks to the Spanish. Brigido Martinez, president of the National Association of Quinoa Producers in Bolivia, said earlier this year that the crop’s modern-day popularity can be traced to a visit by Spanish royalty to Bolivia in 1987, where the king and queen’s sampling of quinoa was noted by the media and the world.

As awareness of the food’s nutritional powers grew, so did its popularity. In 1999, quinoa exports from Bolivia – the world’s largest producer of the seed – were estimated at US$1 million per year; by 2009, it was US$25 million. Its wholesale price has reportedly soared sevenfold since 2000.

But quinoa’s popularity has had some adverse effects. It was recently reported that the poor in Bolivia can no longer afford quinoa and are turning to cheaper, less nutritious starches such as wheat.

Chronic malnutrition among children in Bolivia’s quinoa-growing areas is rising.

Regardless of the politics of quinoa, its nutritional standing remains undisputed. An ancient people’s sacred food could well become the food of the future.

Quinoa is easy to cook and takes much less time to prepare than rice or other grains.

The key to cooking it well lies in the soaking and rinsing of the seeds first.

This removes the outer coating of saponin, which is the crop’s protective layer against birds and can give a bitter taste.

When the quinoa is cooked, the seeds will look translucent and have a small white tail coming out of each seed – like a mini tadpole.

Quinoa is very versatile. It can replace rice, bulgur wheat, couscous or other grains in recipes; or you can make a quinoa burger patty, loaf, pancakes or even porridge.

You can find quinoa flour and quinoa pasta on the shelves of international supermarkets in Hong Kong.

When selecting quinoa, you should always check the use-by date and store it in a cool, dry place.

Generally, quinoa can be stored uncooked for 12 months.

Once cooked, it will keep in a sealed container in the fridge for a few days, or up to a month in the freezer.

If you are looking for a glutenfree and low-carbohydrate alternative to regular grains, a quinoa salad is a good place to start.

This recipe for quinoa tabbouleh is a lighter, gluten-free take on the popular Middle Eastern salad, which is traditionally made with bulgur wheat, various vegetables and spices.

Quinoa tabbouleh Serves six to eight people. Ready in 30 minutes.

The quinoa 1 cup quinoa, soaked for 15 minutes 1½ cup purified water ½ tsp salt (optional) •Rinse the quinoa. Stir and carefully pour away the water using a fine mesh strainer. Drain well.

•Transfer to cooking pot. Add water and salt (optional).

•Bring to a boil then turn the heat down to a simmer. Cover with a tight-fitting lid and cook for 15 minutes. In the meantime, prepare seasoning (recipe below).

•Remove pot from heat and let sit five minutes with the lid on.

•Fluff quinoa gently with a fork.

The seasoning 1 cup parsley, minced 1½ cup tomatoes, seeds removed and diced 1½ cup cucumber, seeds removed and finely diced ¼ cup olive oil ¼ cup spring onion, thinly sliced 3 tbs mint, minced 1½ tbs lemon juice 3 cloves garlic, finely minced 1 tsp sea salt •Place all the ingredients together with quinoa in a large bowl and toss well to combine. Serve, or keep in a sealed container in the fridge for up to two days.

Dr Wendy Yang is a holistic chiropractor and certified gourmet raw food chef and instructor (www.holistic-central.com)

When quinoa is cooked, the seeds will look translucent. Photo: Dickson Lee

FITNESS 9

Trainer Andrew Cox gives Ben Sin a workout on the Power Plate.

Photos: Edward Wong, May Tse

A twitch in time...

Vibration training is taking shape in Hong Kong. Ben Sin gets a whole lot of shakin’ goin’ on

T

he premise in vibration training is simple. The fitness machines are equipped with a vibrating plate that users exercise on to stimulate muscle contractions at a rate so fast (between 20 and 60 times per second) that the body experiences the effects of a full-on, strenuous workout in a fraction of the time.

Vibration training dates back to the 1960s, when Russian scientists developed the machines to help cosmonauts combat the effects of a decrease in muscle mass and bone density from the lack of gravity in space. Its benefits were next used in Russian ballet and, later, by big names such as former cyclist Lance Armstrong and the NBA. Vibration training made its Hong Kong debut in 2007 when Andrew Cox, master trainer for the US-based National Academy of Sports Medicine, introduced the Power Plate brand of machines to Innate Fitness, a company he founded.

Two other brands, TurboSonic and iShape, became available last year.

It works, says Dr Billy Law Kinyip, of the faculty of medicine at the Hong Kong Jockey Club Sports Medicine and Health Sciences Centre. He adds: “Vibration training benefits those who haven’t exercised regularly more than those who are normally active.”

Because of its low-impact nature, it is an ideal form of exercise for the elderly, Law says. “In fact, several hospitals … have these machines.”

With each brand of machines claiming superiority, we decided to give them a go.

Power Plate I have just finished a 30-second squatting exercise on the Power Plate, when Cox says: “What you just

did is equivalent to carrying me on your back for 10 minutes.”

Judging from my wobbly legs after just a few minutes of drills on the machine, I believe him. Power Plate terms this – and trademarked the term – “acceleration training”.

“Due to the mechanical vibration produced by the plate, your body is reacting involuntarily to the loss of balance – your muscles are working to maintain balance, even if you’re just standing there,” Cox explains.

The vibrations basically increase the gravitational forces – or acceleration – on your body, making you work as you move against them.

It is similar to traditional exercise: working your muscles by increasing mass, usually by lifting weights. But with the Power Plate, the highimpact and high stress factors of weightlifting are reduced.

Cox, who prefers variations of light exercises, such as squats, pushups and minor weightlifting, says this workout can’t be replicated with conventional exercise. “When you combine the machine with minor weightlifting, it smashes the beejesus out of fat.”

My wobbly legs believe him.

TurboSonic Developed in 2000, a year after the Power Plate’s debut, the TurboSonic differs in that it uses soundwaves to create vibrations.

Strength and conditioning coach Anfernee Leung, spokesman for TurboSonic in Hong Kong, says its vibrations – created using amplifiers and speaker systems – has advantages over motor-created rumbles.

“The vibrations are more natural and smooth, not restricted to just up-and-down and left-to-right,” he says. “This allows for more variation in the vibrations, which we can use

to target specific body parts.”

I stand still on the machine as he changes the settings. “You feel that?” he asks. “By changing the vibration, I’ve now targeted your stomach.”

From the easy light drills he puts me through (including stretches and crunches on the circular, rubberpadded plate), my impression is that the TurboSonic is aimed at an older demographic.

“Yes, our main client base consists of elderly women and stroke victims,” says Leung, who opened Core Functional Fitness with a partner last year. Training on the TurboSonic can improve circulation and muscle tone, and is great for rehabilitation from strokes and Parkinson’s disease because it improves balance.

Will it make me more buff? I ask.

“No,” Leung says, “but I’m sceptical that the other machines will, either.” iShape The iShape is the latest addition to the vibration training market from Taiwanese company Magtonic.

Released last year, it works in virtually the same way as the PowerPlate, except it has a spiderweb-like stretching cage, in which users can do various poses not possible on the other machines.

Pure Fitness Two IFC is the only place in Hong Kong with this machine, and personal trainer George Cheng Kwok-choi says it’s been very popular with women.

“The iShape has three functions: it helps stretching by increasing your range of motion, it strengthens muscles and it massages,” he says.

Lying on the floor with my legs on the vibrating plate, Cheng applies pressure on my legs, and the sensation does feel like a massage.

Next comes a series of simple stretching exercises, in which I have

to hold on to the spider-cage while contorting my body in various ways.

Supposedly, 30 seconds of this increase my body’s range of motion up to five centimetres. A toe-touch test after the drill confirms this.

“The biggest benefit of vibration training, to me, is it allows one to work their muscle fibres without the risk of high-impact exercises,” Cheng explains.

The verdict After three straight days of vibration training, I can confirm that it lives up to the claims for the most part – I feel tired and sore quicker doing exercises on the machine than I would have normally.

While all three machines offer similar workouts, the motor-based PowerPlate and iShape seem to cater to more active exercisers looking to break a sweat, while the soundwave vibrations of the

TurboSonic are more suitable for a lighter workout.

Cheng suggests using vibration training to warm up. “One way is to use it to get your circulation and flexibility going before, say, jogging on the treadmill,” he says. “Vibration training won’t replace cardio, but it can strengthen your body to sustain longer periods of cardio.”

I find the machine is best for lower-body training – the throbbing, burning sense of muscle fatigue I get from simply squatting on the vibration plate for 30 seconds rivals some of the toughest basketball squatting drills of my high school years. Upper-body drills didn’t have nearly the same result.

“It’s not a miracle machine; you still have to work, but you can do it faster and more efficiently,” says Siqi Yu, a regular PowerPlate user at Pure Fitness. ben.sin@scmp.com

SHAKE A LEG

George Cheng demonstrates the use of the motor-based iShape machine

Power Plate Innate Fitness at Optimum Performance Studio.

2/F, 50 Stanley Street, Central; 9263 3991 Private one-on-one 30-minute session: HK$480 Power Plate class (in groups of four) HK$400 each; HK$1,800 for package of five classes TurboSonic Core Functional Fitness.

20/F, Quality Education Tower, 476 Nathan Road, Yau Ma Tei; 2770 8783 Private one-on-one 60-minute session: HK$600 iShape Pure Fitness. Level 3, Two IFC, 8 Finance Street, Central; 8129 2200

10 FITNESS Walking is a workout that packs a big punch.

Photo: Shutterstock

STEP RIGHT UP: WEEK 1

Put your best foot forward Walking will lengthen your life, enhance its quality and improve your health, writes Jeanette Wang

S

itting down and standing up are things many take for granted, but for Gregory Lo, they were once a challenge.

The accountant had been plagued with chronic back pain and undesirable cholesterol levels, the results of a sedentary life and long office hours.

In October 2009, with the late forties looming, the father of two decided to make a change. He signed up for a 10-week healthy walking programme organised by the Hong Kong Institute of Certified Public Accountants.

Walking led to jogging, then running. Within four months, he ran his first ever 10-kilometre race at the 2010 Standard Chartered Hong Kong Marathon. This year, he finished the half marathon. Now, he has his sights on the marathon.

“A year-and-a-half ago, I would never have imagined that I could do all this,” Lo says. “Walking was a good idea because everything starts from walking.”

Indeed, it may not seem like much – especially if your idea of exercise involves panting and perspiration – but walking is a workout that actually packs a punch.

In fact, done at a moderate intensity for 30 minutes a day, five days a week, walking can reduce your risk of early death by 19 per cent, according to a study published last year in the International Journal of Epidemiology. Raise that to seven hours weekly, and your risk of death falls by 24 per cent.

Hongkongers are certainly not walking enough – of 2,013 people surveyed by the Centre for Health Protection in April last year, only 67.4 per cent walked for at least 10 minutes at a time (regardless of pace) every day.

The American Podiatric Medical Association says that walking improves the strength of your heart, lungs, leg and abdominal muscles, and boosts your cholesterol numbers and circulation. Along with this comes a lower risk of high blood pressure, obesity, stroke and heart attack, and reduced tension and stress.

More recent research shows that walking at least 9.7 kilometres a week can maintain brain volume in healthy adults and significantly reduce the risk for cognitive decline, and that sedentary folks who walk 10,000 steps a day can significantly

lower their risk of diabetes. With no expensive gym memberships, special skills or equipment involved, there is hardly an excuse not to walk.

Besides, with 70 per cent of Hong Kong being green, there are plenty of paths and trails – many of which are easy, flat and accessible – to explore on foot.

So, Health Post has teamed up with Freeman Lee Ping-chiu – a certified International Association of Athletics Federations track and field coach, who has a masters degree in sports medicine and health science from Chinese University – to create a walking plan that will get you fit in six weeks.

Stick to the programme and Lee says you can expect improvements in endurance, flexibility, mood, energy, confidence and quality of sleep. Coupled with a balanced diet, you may see a reduction in body fat and/or weight.

Lo says he has lost about 5kg in the past 18 months. More importantly, he eats healthier, feels more confident, falls ill less often and leads a more disciplined life. His back pain has gone, too.

“Walking will have a ‘butterfly effect’ on your life,” says Lee, who

has been organising healthy walking programmes for various corporate groups since 2005. And, as Lo has shown, it is a stepping stone to achieving that 10-kilometre half marathon or marathon you have always dreamed about.

The plan will be rolled out weekly so that at the end of six weeks you will be able to walk for 45 minutes continuously at a moderate pace. That means holding a heart rate of about 65 per cent of your maximum (generally calculated as 220 minus your age), or at a pace at which you can talk but not sing.

Each week we will offer tips to enhance your walking experience including essential stretches, a basic core conditioning circuit, information about common walking injuries and advice on selecting walking shoes.

Next week, Lee will demonstrate the correct walking posture and gait. jeanette.wang@scmp.com Join Freeman Lee on Thursday, June 2, 7pm at Causeway Bay Sports Ground for a free walking clinic.

To sign up, e-mail freeleeman@yahoo.com.

Make sure you’re ready for it

67.4 per cent of Hongkongers walk for about 10 minutes a day. Walking for 30 minutes a day will reduce risk of early death by 19 per cent

Before you begin this six-week programme, consider these points:

continuous walking, not to set any records getting there.

1. If you are over 40, not accustomed to any exercise, or more than 9kg overweight, consult your physician 2. Schedule your workouts. You won’t find time for them unless you make time.

Jot the details down in your diary.

3. Expect bad days. Everyone has them, but they pass quickly, and the next workout is often better than the previous one. So stick with the programme as much as possible.

4. Do not rush. In the fitness world, rushing leads to injuries and discouragement. Be patient and go slow.

The goal is to reach 40 minutes of

Week 1 Monday Walk an easy 20 mins Tuesday Core training Wednesday Walk an easy 20 mins Thursday Core training Friday Walk an easy 20 mins Saturday Rest Sunday Walk an easy 20 mins Training tip Two hours before your workout, eat a piece of fruit or energy bar. An hour later, drink a cup of sports drink, to ensure you’re hydrated and have enough electrolytes for your workout.

Freeman Lee will demonstrate posture, stretching and conditioning exercises.

Photo: May Tse

WELL-BEING 11 PERSONAL BEST

Credit: Byline:

How facing the ugly truth can set you free ......................................................

Yeo Swee Lan The rules for pictures run contrary to each other when it comes to social networking versus weight loss. For Facebook, upload only the most flattering pictures of yourself, preferably smiling. But when dieting, pretty pictures are counterproductive.

Timothy Ferriss says in his new book, The 4-Hour Body, that to help yourself stick to a weight-loss regimen, get a “before” picture of yourself in your skivvies and pin it up as your starting point. I went one better. My picture was a dark yellow mass fed by fine red veins, so large it eclipsed an entire half of my postsurgery photograph.

My doctor confirmed my worst fears. “That’s fat,” he said, none too subtly.

I’d done a good job of ignoring it for years. At 172cm, I told myself my big-boned frame needed all of its 79.5kg and soft curves. But this I could not escape – visceral fat, glaring at me defiantly.

Never mind that in my 38 years, I’d always been fit – I had the bloodpressure reading of a 17-year-old and an enviable cholesterol count. I had thrice-weekly cardio workouts and had even run three halfmarathons in as many years. But I was undeniably fat, and cleverly tucked extra flesh into a US size 10, then 14, then 16.

Staring at the scary picture, I knew it was time to face the fat. But with a three-month break from strenuous exercise after a major operation, a diet seemed the only solution. Having never been on one, I’d taken the advice of one of my best friends, who recommended the Dukan Diet. She called it “gruelling”, with its emphasis on a high-protein intake while avoiding fat, sugar and carbohydrates, including fruit.

I was sceptical. I’d always thought diets were faddish. Like Fendi baguettes and parachute pants, the Atkins, then the South Beach diet, had all held the bestselling hot spot that the Dukan now enjoys.

Confusingly, nutritionists cannot agree on what is worse – the risks of heart disease and cancer from these diets, or the ill effects of obesity without a diet.

So as I read Dr Pierre Dukan’s book from cover to cover, I also looked at dieters’ blogs and, most importantly, sought my doctor’s advice. He evaluated my weight and target – 12kg loss in six months – and put me on the right track. It wasn’t just water I wanted to lose, but fat.

And I wanted to keep it off without affecting my health.

The first step, which lasted about five days (it can be up to 10), involved no fat, sugar or carbs, including vegetables and fruit (yes, they’re carbs).

The next stage – three months – involved alternating protein-only days with protein-and-vegetable

ones, until I hit my target weight.

Though awful, I surprisingly managed these two parts easily enough.

Keeping the weight off would be the challenge. On the diet’s third step, which allows fruit and some carbs, I was craving desserts despite never having much of a sweet tooth.

I struggled with a lust for caramel chocolate cake and peanut butter cookies, and sometimes I lost, especially during Christmas and the Lunar New Year. The challenge was not just physical.

Firstly, I had to avoid diet saboteurs, especially those closest to me – colleagues, friends and wellmeaning loved ones – who typically resisted my efforts by telling me: a) I was fine the way I was (I knew I was not); b) Just one piece of dessert “won’t hurt you”; c) What you’re doing is too difficult, so why bother?

Secondly, I never went hungry while dieting. I ate healthily but well.

To dispel ideas that I had an eating disorder, I told people about my

I told myself my big frame needed its 79.5kg and curves.

But this I could not escape – visceral fat, glaring defiantly revised eating habits. I figured it was bad enough to give up Coke; but bottling it up only made my secret dirtier. I started saying things like, “No thanks, I’m watching what I eat” or “I’m on a diet, and I can’t have sugar, my doctor said so.”

But let’s face it. No one is immune to the call of eclairs and, in weak moments, I succumbed. I learned to forgive myself. Even three steps forward and two back was still one step in the right direction. I would feel so guilty after sneaking treats that crawling back onto the wagon was easy. I soon put out of reach all foods that I couldn’t eat.

It wasn’t until I finally embraced a US dress size of 8 that I learned to own my new weight, and enjoy the happiest problem I’d ever had: having to buy new clothes.

After embarking on the first physician-approved diet I’d ever attempted in August, I hit my target of 67kg (a healthy 22.6 BMI) by January, and felt better than ever.

Now in the final part of the diet – maintenance for life – I enjoy a balanced diet with whole grains and fruit, judiciously read all food labels and prepare most of my meals. I keep a journal, audit what I eat and swap healthy recipes with others.

All it took was a picture of the truth. healthpost@scmp.com