20110809 health post

YOUR GUIDE TO LIVING WELL

TUESDAY, AUGUST 9, 2011

HEALTH POST Are the latest anti-ageing treatments all they’re cracked up to be? >PAGE 4

Illustration: Stephen Case

Stop the rot

UNBLURRING THE EDGES >PAGE 3

A BALANCED DIET: COOKING WITH TCM

>PAGE 9

2 NEWS HEALTH BITES ......................................................

Jeanette Wang jeanette.wang@scmp.com

Run for a cause HIV-positive mothers-to-be who know about their condition at an early stage can get medication and care to prevent the transmission of the virus to their babies.

To buy HIV test kits for pregnant women, the Hong Kong Committee for Unicef hopes to raise HK$8.5 million through the Unicef Charity Run 2011 on Sunday, November 27. The race includes a half-marathon, a 10-kilometre run and a three-kilometre fun run, and will start and finish at the Hong Kong Disneyland Resort. Some 13,000 runners are expected to participate.

Sign up at run.unicef.org.hk, or call 2833 6139 for details.

The good oil on eggs They’re known to be high in cholesterol, but not all eggs are created equal, according to new study by a Tel Aviv University researcher. Dr Niva Shapira’s findings, published in the Journal of Agricultural and Food Chemistry, show that hens fed a diet low in omega-6 fatty acids from a young age produce eggs that may lessen oxidation of bad cholesterol, avoiding the formation of dangerous plaque in the arteries. Healthier feed – high in wheat, barley and milo, and lower in soya beans, maize and sunflower, safflower and maize oils – is more expensive. Hence, “healthier” eggs are likely to cost more. But Shapira says with such eggs, we might be able to eat more than twice today’s recommended egg intake and still maintain a healthy cholesterol level.

Haven’t we met before?

It’s an overused chat-up line but scientists at the University of Bristol now know that it’s the result of a disconnection between regions in the brain. Published in the Journal of Neuroscience, the study shows that the three regions that process memories must work together. The perirhinal cortex recognises whether something is familiar; the hippocampus recognises places and navigates; while the medial prefrontal cortex is linked with higher brain functions. If communication between the hippocampus and either the perirhinal cortex, or the medial prefrontal cortex, was broken, we’d be unable to recall, for example, where we put our keys and when we last had them. This finding has vital implications for helping treat people with memory disorders such as Alzheimer’s disease.

Treats for little tykes Paul Lindley believes that with the rising trend of obesity in kids, children should have the opportunity to eat better food and discover that healthy food can be fun, tasty and cool. He set up Ella’s Kitchen, an organic children’s food range named after his 11-year-old daughter. The British brand, with more than 50 other new imported products – including skincare and accessories – from around the world, will be on sale at a Baby Fair at ThreeSixty’s Central and Kowloon outlets until September 1.

Crack the big time It’s no coincidence that the pili, a native nut of the Philippines, means “chosen one” in Tagalog. The fruit of a tropical tree grown in volcanic soil, pili nuts are high in calcium, phosphorus and potassium, and rich in fat and protein. They contain all eight essential amino acids and are full of heart-healthy omega oils. Crunchy and subtly sweet, they go well with salads, baked goods or even with Beluga caviar as an hors d’oeuvre. Hong Kong-based Stephen James Luxury Organics has just launched a sprouted version, which is said to boost the nutrient level and digestibility of the nuts. Available at Great at Pacific Place, from HK$38 for 34 grams.

APP OF THE WEEK

Tracker stays one step ahead of you even during your ups and downs ......................................................

Katie McGregor healthpost@scmp.com Runmeter US$4.99 Rating 10/10 This was to be a review of the Nike+ GPS app, which I have been happily using to track my running and hiking for some months, but then I came across the Runmeter.

The instant attraction was that Runmeter not only tracks calories burned according to distance, but also elevation change. In hilly Hong Kong, I have always felt cheated after staggering up and around The Peak for five kilometres only to be told that I had burned a mere 360 calories.

Like Nike+ GPS, Runmeter provides voice announcements, with

the advantage of a good degree of customisation. Select when you want your announcements: every certain number of kilometers, by time intervals or at an event. Choose the information you want to hear, which includes speed/pace, best/median/ worst time, and also a competitor’s time. You can also choose your “voice”. I was tempted by “Bruno Voice, French Male” to brush up on my French, but settled for “Graham Voice, British Male”.

To keep track of your performance, set named routes.

My first route is exotically named “Thailand Down Road”, an eventful run that involves waiting as a water buffalo crosses the road. At this point, another Runmeter feature comes into play. The GPS tracker senses that you have stopped for a period, and the app deducts this time from your overall time.

After my first run, I received a Runmeter e-mail that detailed my run statistics and provided a link to a .kml map file of my route. I then understood the “competitor” function that had been outlined in the set-up instructions. Share this file with a friend and the competition is on.

For the serious runner, the app can automatically send Tweets, emails or Facebook updates on your progress, to interest your fans. But for my humble five-kilometre runs, my “fans” barely notice I’m gone – a feature for another year, perhaps. > CONTACT US Culture Editor: Janelle Carrigan janelle.carrigan@scmp.com Health Post Editor: Jeanette Wang jeanette.wang@scmp.com Advertising: tel: 2565 2435; advertising@scmp.com

MEDICAL 3 CASE HISTORY

Blindsided by inaction Eileen Aung-Thwin healthpost@scmp.com Alan French always ensured that he had his eyesight checked regularly by his optician. When he was in his early 50s, he noticed that something was amiss with his right eye, although he could not pinpoint the problem.

“The best way to describe it was that the outer edges of my vision seemed blurred,” says French. As there was no pain and no other symptoms, he decided to ignore the problem. The inaction cost him.

About18 months after he started noticing the peripheral blurring, French decided on impulse to see his general practitioner about his eyesight. She conducted an air-puff tonometry test in which special equipment produces a puff of air to flatten the cornea and measure his eye’s internal or intraocular pressure (IOP). Although it is not the most accurate way to measure IOP, it was enough to show that French’s was extremely high.

His doctor immediately made French an appointment with an eye specialist, who ran more accurate tonometry tests and found that his IOP was more than 30 millimeters of mercury (mm Hg). Normal IOP is between 10mm and 21mm Hg. IOP in French’s eyes had built up because the aqueous humour – the clear liquid that fills the eye – was not draining properly from the channels in the front of his eyes in an area called the anterior chamber angle, or simply the angle. The excessive pressure was progressively damaging French’s optic nerves and shrinking his field of vision from the edges in, creating “tunnel vision”.

French had open angle glaucoma – an irreversible and incurable condition that is the leading cause of blindness in Hong Kong. French had already lost 90 per cent of the sight in his right eye, and sight in his left eye was beginning to deteriorate. The priority now was to control the IOP and prevent any further loss of sight.

He was given an injection to bring down the IOP and sent home with eye drops to help slow the production of the aqueous humour and to speed its drainage from the eye.

After six months on the eye drops, French’s IOP was still too high, and more drastic measures were needed to control the condition. Doctors wanted French to consider a surgical

procedure commonly used to treat glaucoma called trabeculectomy, in which the clogged trabecular meshwork – channels that normally help drain the aqueous humour – is removed and a new drainage valve is created.

The idea of cutting into a body part as sensitive as the eye made French very nervous. But his wife’s friend had also recently completed a trabeculectomy and highly recommended her doctor, which made him feel slightly more assured. So he took the plunge.

During the procedure, which lasted less than an hour, French was under local anaesthesia and awake while the surgeon cut into his right eye. After the surgery, antibiotics were applied to the eye, which was taped shut and protected with an eye patch.

French then had daily injections into his eye for almost a week to prevent the incision from closing.

Despite the successful trabeculectomy, French still has to have two types of eye drops daily for life. He also has to visit the eye specialist for regular tests, including a visual field test to monitor any further loss of his peripheral vision.

While the glaucoma was stopped in time for French not to have to suffer any major upheavals to his lifestyle, he still wishes that there was greater accessibility to the simple airpuff tonometry test that could help detect glaucoma early.

“If this simple test was included during regular eye checks in Hong Kong, [glaucoma] would be picked up much earlier, and many people could avoid the life-long process of dealing with glaucoma and its ongoing medical costs,” says French, who pays more than HK$550 for his medication every month.

With early detection and good care, open angle glaucoma patients like French can prevent further loss of vision.

The condition often runs in families. French eventually discovered that an aunt also suffered from glaucoma. Experts advise that people over 40 years old should have an eye examinations once every five years. Those with high-risk factors such as family history; systemic diseases such as diabetes, hypertension or migraine; severe near-sightedness and steroid use should consider getting even more regular eye examinations.

Illustration: Angela Ho

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ASK THE DOCTORS DR CHAN KWOK-KI Q: I’m a fanatical road cyclist. On the past few long rides, when I took a pee break after about 80 kilometres, I experienced a painful burning sensation. This recurred the first time I urinated having got home, but the next time, the pain disappeared. Is this normal?

A: For long-distance cycling, if the seat is too hard or is not well adjusted, it is possible that the perineal area may experience high

pressure. The urethra passes through the perineal area and may undergo compression, with consequent minor trauma, after a long ride. This may be the cause of painful urination. Of course this trauma is minimal and can resolve quickly. Therefore, the symptoms go away very quickly.

To prevent this, it is important to choose a bicycle seat that is comfortable enough and is well adjusted, so that it will not cause

compression to the perineal area during prolonged sitting. It is also important to wear specially designed bicycle trousers with thick padding. You may also try to alternate between the sitting and standing position when cycling, so as to prevent prolonged pressure on the perineal area.

Dr Chan Kwok-ki, a specialist in sports science, is on the Health Post advisory panel.

4 COVER STORY

Wonders never crease Anti-ageing solutions are big business in our appearance obsessed times. But what are the latest treatments that claim to turn back the clock – and do they work, asks Richard Lord

T

he one thing that’s true about getting old is that no one wants to.

So, many people are desperate to believe in technologies, treatments and supplements that claim to halt, delay, reverse or otherwise combat the effects of ageing.

That’s why there are countless antiageing solutions out there – and why the market for them is projected to reach US$291.9 billion by 2015, according to a 2009 report by Global Industry Analysts. In Hong Kong, figures from Datamonitor show that the market value for cosmetics and skincare in 2009 was US$408 million, with anti-ageing products among the largest product categories.

But it’s difficult to know whether any of these products actually work; there are so many claims and counter-claims, and little conclusive scientific proof.

An important distinction must be made between arresting the appearance of ageing and actually stopping the ageing process. Most of us are more focused on appearances because the evidence is out there to see. There’s also a big difference between reversing the effects of ageing and simply extending lifespan.

Western medicine has become particularly good at the latter over the past century or so but has never properly tackled the former.

The scientific name for the process of ageing is senescence: cellular senescence is when a cell loses its ability to divide, and organismal senescence is when an organism starts to respond less well to antagonists in its environment, for example becoming more prone to disease.

In humans, the latter usually starts at about the age of 35. This happens in almost all living things, although there are exceptions – turtles, for example –

291.9 • projected value of anti-ageing products market in 2015 in billions of US dollars

leading to the idea that it might be preventable.

There are many theories about why ageing happens – evolutionary explanations, others based on viruses, accumulation of wear and tear at a cellular level, and even the body’s immune system ganging up on it.

What we do know is that certain things hasten the process: smoking; radiation, mainly in the form of the sun’s ultraviolet rays; fatty, sugary and processed food; and lack of exercise. Take care of those and half the battle is won – but that’s not enough for many people, particularly youthobsessed Hongkongers.

And so, new clinics offering preventative medicine and aesthetics services – anti-ageing one-stop shops, if you like – have sprung up to cater for our desire for youthful looks.

Once such clinic, launched in May, is Life Clinic in Central, an integrated health and vitality centre that takes a threepronged approach to regaining youth: internal anti-ageing medicine, aesthetics and regenerative medicine. It was founded

by Dr Stephen Chan, from University College London Medical School. His clinic’s treatment packages include consultations with a physician, nutritionist and personal trainer or psychologist; testing of hormone levels, free radical damage, anti-oxidants, minerals and essential fatty acids; and three-month courses of personalised supplements and bio-identical hormones.

Medica Esthetica, in Wan Chai’s Sun Hung Kai Centre, takes a similar approach to preventing ageing. Soft-launched last year, it caters to a select clientele that founder Tony Agra describes as very highend. This is the new face of anti-ageing, with an interior that’s more spa than clinic and a healthy dose of new-age spin: a recurring spiral pattern motif and a tree of Egyptian crystals in the reception area, among them.

Agra, 52, whose background is in logistics, became interested in clinical research and ended up running similar clinics in Las Vegas and Texas. He was attracted to Hong Kong because people here “tend to say: ‘I don’t have to age – I’m not going to take this lying down.’”

He stresses that, whatever treatments a patient may undertake, ultimately most of the fight against ageing is in their hands.

Each client gets an individual programme

COVER STORY 5

focused on lifestyle as well as medical treatments. “It’s a two-way process,” he says. “We can do our bit, but they need to take ownership.”

He does, however, offer a big helping hand. Vitamin shots, for example, are administered in an area known as the Infusion Cafe. Agra says injecting vitamins means they have a direct impact at a cellular level, rather than having to go through the digestive system first.

Their benefits are disputed, however: Dr John Yu, a specialist in dermatology at Matilda Medical Centre, says our bodies only need so many vitamins – “the body will just secrete the rest”.

There’s also chelation therapy, a practice used in cases of heavy metal poisoning to remove the offending metals from the body. Not only does Agra claim it’s effective in combating the effects of ageing; he also says it takes just 20 minutes with the clinic’s special machines, rather than the usual few hours.

“The moment you step out there [on the street], you breathe in methylmercury, arsenic and lead,” he says. But Yu says chelation therapy can remove too much calcium from the body, and also affect the heart because the body’s electrolyte balance can be disturbed.

Medica Esthetica’s key offering is bioidentical hormone optimisation, in line with the belief that we age because our hormones decline, rather than vice versa.

Bio-identical hormones are identical in molecular structure to the hormones made by the body, but are synthesised from plant chemical extracts. “It’s never too early,” says Agra, who recommends women start the therapy at about age 28 and men at 35.

Some experts, however, say that such hormones offer little or no benefit, and the risks are high. In an editorial last year in the journal Aging Health, Dr Thomas Perls, an associate professor of medicine at Boston University School of Medicine, remarked: “The terms bioidentical or all-natural, particularly in the case of the drugs prescribed by endocrinologists, misleadingly convey a sense of safety to the gullible customer.

Arsenic is all-natural too, and it even has some medical uses, but it is anything but safe.”

Yu is likewise sceptical about other miracle cures. Sirolimus, or rapamycin, which is usually used to suppress organ rejection after transplants, was found in 2009 to extend the life expectancy of mice by up to 38 per cent – but because it’s a powerful immunosuppressant, “it will kill the patient before increasing their lifespan”, he says.

The enzyme telomerase shows promise as a supplement – telomeres, which it affects, are regions of DNA sequences at the ends of chromosomes whose length may help measure biological age – but, Yu says, “the only studies have been on mice.

There’s no study to suggest it’ll work on

We have a 50/50 chance of bringing ageing under a decisive level of medical control within the next 25 years or so AUBREY DE GREY, GERONTOLOGIST, SENS FOUNDATION

humans.” Originally developed for the US space programme, anti-ageing light therapy uses amber, red and infrared LEDs to stimulate production of collagen and elastin. Yu says that this is just about the only anti-ageing treatment with a proven scientific basis, albeit the effect is obviously a purely cosmetic one.

Aubrey de Grey, a biomedical gerontologist and chief scientific officer at the non-profit California-based Sens (Strategies for Engineered Negligible Senescence) Foundation, predicts that in the future, people will go to their doctors for regular “maintenance”. By then, this will include gene therapies, stem cell therapies, immune stimulation, and other advanced medical techniques.

“I’d say we have a 50/50 chance of bringing ageing under what I’d call a decisive level of medical control within the next 25 years or so,” de Grey said in an interview with Reuters recently.

But, even if all of it works, there’s no substitute for a healthy lifestyle.

Take, for example, 67-year-old grandmother Eddie Brocklesby. A social worker who runs her own charity, the Englishwoman is also a marathoner and triathlete who has competed in numerous events and won her age group several times – and who didn’t even take up regular exercise until 14 years ago, following the sudden death of her husband.

She doesn’t use any anti-ageing treatments, and takes no supplements except glucosamine for joint strength.

Instead, she goes through a punishing daily exercise routine, and eats a healthy diet including lots of vegetables, fruit and ground-up seeds.

“If a pill had all the benefits of twoand-a-half hours’ exercise per week, a normal healthy diet with fruit and vegetables, and no smoking, it would make a bomb,” she says. Yu puts it more succinctly: “There is no systemic medication that can arrest ageing,” he says.

Even Agra agrees that “the final step to self-realisation is something that has to be taken alone”. With anti-ageing, as with everything else, there are no shortcuts, no magic bullets, and no substitute for living a healthy life. healthpost@scmp.com

FEED YOUR YOUTH Eating right is one of the most important ways to prevent your body from ageing.

“The ageing process is caused by the oxidation of our cells,” says Karen Chang, dietitian in charge at Matilda International Hospital. “Cells don’t work as well as when you’re young, and degenerative diseases come with age, such as cancer, diabetes and high blood pressure. So to postpone the ageing process, your diet should try to stop oxidation.”

Oxidation is prevented by antioxidants, and unsurprisingly fruits and vegetables are stuffed full of them – they include vitamins C and E, certain minerals, and also compounds such as resveratrol and flavonoids (also present in tea, chocolate and red wine), and carotenoids (like beta-carotene, the stuff that makes carrots orange).

Fat, sugar and processed food all accelerate the ageing process, says Chong. The good stuff’s most effective when consumed in its natural form. “It’s very easy – instead of all those supplements, just go for vegetables and fruit.”

And even among healthy foods, rather than focusing on consuming large quantities of socalled superfoods, Chong says that the main thing is to keep the diet as varied as possible; she recommends that people try to eat foods covering the entire colour spectrum. “We’re talking about a variety of food,” she says. “There is no magic food. If there were, everyone would eat it and no one would get old.” Richard Lord

6 HEALTH FROM THE EXPERTS

Healing benefits of spirituality ......................................................

Dr Anthony Tong healthpost@scmp.com Spirituality and religiosity have all along been neglected and undermined in psychological studies in general and in psychotherapy in particular.

One reason is because spirituality and religiosity are regarded as being too controversial and difficult to be studied scientifically. Secondly, some traditional psychological theories are quite suspicious of religiosity or religious faith and its role in mental health.

As a result, psychology and psychotherapy have been criticised for focusing too much on the causes and processes of mental disorders, and not enough on well-being and psychological strengths, such as spirituality.

Early research studies seemed to suggest that religion impaired mental health, though these were found to have methodological flaws and biases. Within the past two decades, there have been more systematic studies with better methodologies, and they found that religious involvement is generally associated with greater psychological and physical wellbeing. One review found that among 100 studies, 79 per cent found religious beliefs and practices were related to greater life satisfaction, happiness and higher morale.

Recent studies confirm this. A study showed that 42 per cent of medical patients surveyed indicated that it was their religious faith that helped them the most in coping with illness. Another study showed that in a sample of seriously mentally ill people, 65 per cent used religious belief and practice to cope with symptoms and daily problems, and their religious coping lowered their depression and hostility, and was related to fewer hospital stays.

After the September 11 terrorist attack in the US, a study suggested that turning to religion (for example, prayer) was the most common way of coping (90 per cent) among Americans, after talking with others (98 per cent). Among cancer patients, research strongly suggests that spirituality can have a significant impact on symptom

control, psychological well-being and quality of life.

People are actually quite resilient to trauma. It is known that among trauma survivors, about 90 per cent of them do not develop posttraumatic stress disorder. The traumatised often turn to spirituality for a new sense of meaning and purpose in their life.

Moreover, spiritual growth or transformation is often a hallmark of post-traumatic growth among many survivors.

Why does spirituality and religiosity help? One possible explanation is that they promote an optimistic, positive world-view and give meaning, which in turn enhances hope and motivation.

Another explanation lies in attachment theory, which maintains that a secure connection with “God” produces greater strength and confidence in stressful

Why does spirituality and religiosity help?

One explanation is that they promote an optimistic, positive world-view and give meaning situations. A third possible explanation is that religion prescribes support and care, promoting forgiveness, compassion and social support.

On the other hand, spiritual conflicts and negative religious coping can be detrimental to mental health. In a sample of older adults in

hospitals, negative religious coping (such as feeling punished by God) was related to a higher number of medical diagnoses, higher depression and reduced quality of life. Negative religious coping was also associated with increased mortality in a two-year longitudinal study of medically ill elderly inpatients.

It is obvious that the dimension of spirituality should be included and examined in psychotherapy practice. The practical question is no longer whether to address spirituality issues in psychotherapy, especially with religious and spiritual clients, but rather, when and how to address these issues.

In fact, there is an increasing interest in spiritually or religiously oriented approaches to counselling and psychotherapy, and initial results seem to be promising as shown in some studies. Most

researched therapeutic techniques include exploring and applying religious/spiritual concepts, prayer and reading of sacred texts.

Psychotherapists should consider these general principles: • Assess the needs and opinions of the client regarding spiritual or religious interventions, and always seek informed consent.

• Be candid about whether they feel comfortable meeting the client’s spiritual needs. Make referrals to clergy or religiously focused therapists if needed.

• Apply basic psychological practices (and concepts) in a way consistent with the client’s religious/spiritual perspective. This can increase therapeutic alliance and treatment effectiveness.

Dr Anthony Tong is a clinical psychologist and chairman of the United Centre of Emotional Health and Positive Living

HIS SAY ANTI-AGEING SKINCARE

Youthful looks in a bottle? A wrinkle picker puts it on the lines .....................................................

Guy Haydon guy.haydon@scmp.com I was not looking my best the first time I tried Nu Skin products. I was bleary-eyed and tired after finishing a gruelling shift at 1.50am the night before. No matter; if the claims of the American skincare company – a billion-US dollar business listed on the New York Stock Exchange – about the effectiveness of its anti-ageing

creams and gels were to be believed then it would be a good test of their effectiveness.

I chose to pay my way, so I was free to comment. Like many skincare products on the market, the treatment is not cheap.

The Galvanic Spa pack of ageLOC gels (lasting a month) and applicator costs HK$5,000. But I was not disappointed with the results.

After the first treatment on only the right hand-side of my face, for

no more than 10 minutes – first gently washing the skin and then applying two different gels (one with the company’s ageLOC antiageing formula) – a look in a mirror showed a clear change.

The bags under my eyes and skin, from my forehead to my chin, had lifted; the whole half of my face felt tight and toned, as if it had just had a mini workout using tiny weights. I repeated the treatment on the left hand side of my face and the two sides matched.

The gels are applied with a lightweight battery-powered tool – the size of a mobile phone – called a Galvanic Spa. You feel nothing, save for gentle upward massaging and pressing as you move it over your face and around the eye and forehead.

Nu Skin says the ageLOC gel stimulates the skin’s natural antiageing properties, which, as we get older, fade over time and become less effective. And over four weeks – applying the gels three times a

week – they did seem to work. My face felt and looked tauter and more toned. And the lines around my eyes had begun to fade, too Coming back from Shenzhen, midway through the treatment, the border guard held me back and called over his colleague as they looked at my passport photo and then at me. “The picture doesn’t look like you,” he said.

“It’s me. But I’m older now,” I said. “No,” he said. “You are younger.”

8 HEALTH A woman receives a treatment at Corporacion Dermoestetica, Spain, which leads the way in European plastic surgery. Photo: AFP

BEAUTY MINIMALLY INVASIVE MAKEOVERS

Technology’s non-cutting edge ......................................................

Susan Carpenter

Dr W. Grant Stevens calls it his fire and ice room. Stocked with lasers, skin-tightening devices, fat-zapping machines and, on a recent Wednesday, a 65-year-old woman named Helen, the brightly lit corner of Marina Plastic Surgery Associates in Marina del Rey, California, is a smorgasbord of the latest nonsurgical cosmetic procedures.

In one corner, there’s an Exilis electronic wand not much bigger than a pen, plugged in and ready to roll over Helen’s face, tightening her skin. Two boxy Zeltiq machines, which are used as a nonsurgical alternative to liposuction, sit in another corner. The room also holds the newest version of the radiofrequency skin tightener Thermage, a Xeo hair removal device, and the Zerona laser, which is supposed to get rid of fat. An Exilis device uses radio frequency waves in an attempt to stimulate and strengthen collagen (and reduce fat).

And then there’s the Fraxel – a so-called fractionated laser used to resurface and smooth the skin. Its manufacturer, US-based Solta Medical, last week launched a less aggressive version called Clear + Brilliant in Hong Kong, following feedback from Asian doctors of increased inquiries for safe and gentle anti-ageing solutions.

“We try to be very comprehensive,” says Stevens, a board-certified cosmetic plastic surgeon who also runs the aesthetic plastic surgery fellowship at University of Southern California.

“When I was younger, my

husband called me yafah. He said I was beautiful,” says Helen, an Israeli socialite who flew to Los Angeles from Miami the day before, to embellish a surgical body lift she had received from Stevens three months earlier. “For many, many years, he forgot to call me yafah … Now he asks: ‘Do you have a boyfriend? You look so good it doesn’t make sense any more.’”

Helen, who asked that her last name not be used for privacy reasons, is having this conversation while the Zeltiq machines are attached to her legs and her cheeks were coated with numbing gel in anticipation of Exilis and Fraxel treatments. A book is propped open in her lap. Her iPhone is at the ready. Smiling as much as one can when one’s face is losing all sensation, Helen is evidence of a major trend: the growth of nonsurgical cosmetic devices and treatments.

In the US, 83 per cent of all cosmetic procedures performed in the offices of cosmetic plastic surgeons last year were nonsurgical, according to the American Society for Aesthetic Plastic Surgery. The American Society of Cosmetic Dermatology and Aesthetic Surgery reports a similar trend. Almost eight million nonsurgical cosmetic procedures were performed last year at a cost of US$4.1 billion.

“There’s a huge demand for nonsurgical procedures,” says Dr Jeffrey Kenkel, a cosmetic plastic surgeon in Dallas.

The reasons are simple, says Kenkel, who is president of the American Society for Aesthetic Plastic Surgery. “Some patients only want a little bit of change,” he says.

Today’s cosmetic surgeon or medical provider needs to be able to offer a fullservice shop DR SANJAY GROVER, COSMETIC SURGEON

Others “just aren’t interested in a surgical option”. They’re seeking procedures that are less expensive, less painful and less disruptive than, say, a face-lift, which costs an average of US$6,600 and requires weeks of recovery time.

In the last year, the US Food and Drug Administration has approved two new devices – Zerona and Zeltiq – used for the nonsurgical removal of fat. The latter is quickly gaining favour as a surgery-free alternative to liposuction.

Zeltiq is a device that vacuumattaches to the body and delivers controlled cooling through the skin to target subcutaneous fat deposits.

The one-hour treatment is designed to freeze and kill fat cells without damage to the skin or internal organs. If the treatment is successful, over the course of several weeks, the fat cells are broken down and processed by the liver, and ultimately expelled as excrement.

“The typical candidate needs one to two exposures on an average love handle,” says Dr Dieter Manstein, co-inventor of Zeltiq with Dr Rox Anderson. Both work with the Wellman Centre for Photomedicine at Massachusetts General Hospital

in Boston, a teaching affiliate of the Harvard Medical School.

“The ideal candidate is somebody who’s in reasonably good shape, somebody who has some love handles or a post-pregnancy pouch or back fat that doesn’t want to disappear,” says Manstein, who also co-developed, with Anderson, a fractional laser skin resurfacing technique popularised by the Fraxel.

FDA spokeswoman Erica Jefferson says the agency does not track the rate of applications for medical devices. But she adds that the agency has cleared countless of devices for skin tightening, body contouring and wrinkle reduction in the past decade. The number of FDA-approved skin-tightening devices has risen dramatically in recent years, including products such as Exilis and Pearl.

Dr Sanjay Grover, a cosmetic surgeon with practices in Newport Beach and Beverly Hills, says patients want options.

“The interesting thing these days is if you watch TV or look in magazines, the drug companies are bypassing doctors and going straight to the consumer,” Grover says.

“They’re creating a lot of awareness of their products among consumers.

“I offer a number of different products and services in my practice. Today’s cosmetic surgeon or medical provider needs to be able to offer a full-service shop to the patient … you want to tell them what to expect with any of these modalities because for some patients it won’t be worth paying the money for some things until they go through certain [other] procedures.”

Kenkel says some of the devices can be unpredictable. “That’s the

frustration many clinicians like myself have. It’s great to have a device that tightens skin, but can it do so [again and again]? Can it tighten skin or remove fat consistently and reliably? If a device tightens skin only 20 per cent but does so 90 per cent of the time, a patient can relate to it. A patient can’t relate to a device that in some people gives good results and in others doesn’t because you don’t know which group you’ll fall into.”

Many cosmetic plastic surgeons test devices on themselves or offer new procedures to their patients free or at a reduced cost.

Kathy Weatherwax, a 48-year-old mother of four, wanted her skin “to look brighter and younger and fresher”, without surgery. “I wanted maximum results with minimum down time because I have two little ones,” she says. “I want to save surgery for when I need it, when I’m 70 or something,” says Weatherwax, who paid US$1,500 for an ultrasound face-tightening treatment and was given free laser therapy by her doctor.

Weatherwax was hoping to reduce the ever-deepening groove in her forehead and the sun damage on her lower face from when she worked as a lifeguard as a teenager and used her breaks to lie in the sun and deepen her tan. Presented with a menu of options including microdermabrasion, fillers and a brow lift, Weatherwax chose ultrasound therapy to lift and smooth her brow, and a fractionated laser to deal with the sun damage.

Weatherwax says she got the results she wanted. “I think I could pass for 40,” she says.

McClatchy-Tribune

DIET 9 RECIPE FOR HEALTH SQUID

Cassia seed congee will help combat the affects of summer heat and hypertension.

Photo: Rose Tse

Healthy dish from the deep ......................................................

Jeanette Wang jeanette.wang@scmp.com

Burnt black pepper squid

Squid also contains all eight essential amino acids, and is a good source of copper

Chef Vicky Cheng If you’re looking for a protein alternative, why not consider squid?

Research has found that the protein in squid meat is nutritionally similar to that found in fish.

Squid also contains all eight essential amino acids, and is a good source of copper, which is necessary for the growth, development, and maintenance of bone, connective tissue, the brain, heart and many other organs. Experts recommend a daily copper intake of 0.9mg to 1.3mg, and squid has 1.9mg of copper per 100 grams, according to the US Department of Agriculture National Nutrient Database.

Further, 100 grams of raw squid has only 92 calories and 1.4 grams of fat (of which just 0.4 is saturated fat), 3.1 grams of carbohydrate, and a whopping 15.6 grams of protein.

Though it is relatively high in cholesterol – 233mg per 100 grams, close to the recommended daily limit of 300mg – taking squid in moderation can be healthy as it contains heart-healthy omega-3s.

Executive chef Vicky Cheng shares a popular recipe from his restaurant, Liberty Exchange Kitchen & Bar in Central. Grilling is a healthier way to have your squid and eat it. Deep-frying piles on calories.

For the burnt black pepper ½ cup black peppercorns Preheat oven at 230 degrees Celsius. Place peppercorns on an ovenproof tray. Roast in oven for about 30 minutes, or until you’re able to crush them with your fingers. Allow to cool completely, then coarse grind in a spice grinder.

For the sweet tomato fondue ½ onion, finely diced 2 cloves garlic, smashed ½ bunch basil leaves, stems reserved ½ cup olive oil 2 tbsp brown sugar 5 fresh ripe large tomatoes 1 small can whole tomatoes Let onion, garlic and basil leaves sweat in plenty of olive oil in a pan. Add sugar, tomatoes and basil stems. Lower heat and let mixture reduce until sweet and chutney-like (two to three hours).

For the squid 1 fresh squid 2 pinches burnt black pepper 3 tbsp tomato fondue Clean squid, remove clear cartilage, ink sack and skin. Cut into about 7.5cm long strips for grilling. Season with salt, burnt black pepper and olive oil. Place on grill (preferably open-flame barbecue). Grill on high heat until charred and just cooked.

Place on top of a generous dollop of warm tomato fondue.

Make it a meal by serving the squid on a bed of orzo pasta.

Photos: Nora Tam

TRADITIONAL CHINESE MEDICINE

Therapists know that you are what you eat ......................................................

Rose Tse healthpost@scmp.com Food is typically evaluated nutritionally according to calories, fat, carbohydrate, protein, vitamins and other nutrients. From a TCM perspective, however, the energetic properties of food – like energy, flavour and movement – are also considered. Other less important aspects include specific organs or meridians on which food can act.

Foods are categorised into cool, warm and neutral, which refer not to the state of a food but its effect on our bodies. Foods are also divided into five flavours: pungent (acrid), sweet, sour, bitter and salty. Each flavour affects the body in a unique and important way. The energies and flavours of food are essential for balance within the body, ensure that qi and blood flow smoothly, and that the organ systems work effectively.

Asian celery, for example, has sweet and bitter flavours, and a cool energy. Kelp and laver (an edible algae) are salty and have a cool energy. These help induce urination, soften tissues and cool the body, all beneficial for hypertension.

Food can also be consumed for therapeutic purposes. TCM physicians may suggest patients eat certain foods or prescribe a specific diet for them. Dr Billy Chan of the International Association of Medicinal Food Therapy says food is an ideal therapy choice for relieving ailments and providing health benefits, such as slowing ageing, since it is consumed on a daily basis.

The key lies in selecting and preparing the right foods to achieve the desired outcome. Knowing which foods to pick can be tricky.

For example, chronic problems such as hypertension develop gradually and are linked to a host of other health problems such as stroke or heart attack. Even if hypertensive

drugs are used to get blood pressure under control, individuals are counselled to eat foods that are low in salt and fat, and to include more fruit and vegetables in their diet.

Other foods Chan suggests for hypertension include kelp, laver, hawthorn, black fungus, mushrooms, garlic, onion, Chinese tea, lotus leaf, celery, water chestnut, preserved jellyfish and honey. These foods help lower blood pressure, bad blood lipids, and soften the blood vessels to help prevent clot formation. Deep-fried, grilled or very spicy foods should be avoided, as these preparation methods change the energy properties of the foods, making them similar to alcohol, coffee, or tea, which are stimulants and cause blood pressure to fluctuate.

Reducing restaurant visits and cooking on your own is the best way to ensure that you have complete control over what ingredients to include or omit in your diet.

To combat summer heat and hypertension, Chan recommends cassia seed congee. You’ll need 10 grams of cassia seed and 60 grams of uncooked white rice (coarse rice may be used for diabetics). First dry fry the cassia seeds until brown, then place them into three bowls of water and boil for 30 to 40 minutes. Drain the seeds, discard them and keep the water. Put the rice in the water, lower the heat and simmer until it becomes thick. Add rock sugar to taste, if you like, and serve warm.

Chan also recommends laver and spring onion chicken broth; kelp and bean curd miso soup; and tomato, Asian celery, onion and garlic soup.

For more on TCM cooking techniques, call 2576 1535.

Rose Tse is editor of shen-nong.com, a subsidiary of Integrated Chinese Medicine Holdings.

10 FITNESS

Hong Kong has a wide range of facilities for sports lovers.

Photos: Edward Wong, Felix Wong, Jonathan Wong

SWEAT SPORTS

Action stations for sporty types ......................................................

Joanna Hughes healthpost@scmp.com Looking for some summer sporting action? Here are eight of the best places to do the sports you love – or have always wanted to try.

Table tennis: Kowloon Tong Cornwall Street Squash and Table Tennis Centre, 17 Cornwall Street, Kowloon Tong, tel: 2337 4392 Cornwall Street Squash and Table Tennis Centre has 26 tables available for use by groups or individuals, and hours that run from 7am to 11pm daily (except for maintenance days).

Instruction and coaching are also available, with training programmes offered on a regular basis. There is also a pro shop and a restaurant.

For information on table tennis leagues and teams, contact the Hong Kong Table Tennis Association, tel: 2575 5330.

Outdoor climbing wall: Sham Shui Po Shek Kip Mei Park Sports Centre, 290 Nam Cheong Street, Sham Shui Po (near Pak Tin Estate), tel: 2784 7424 There’s no better way to get in shape for some of Hong Kong’s more strenuous hiking trails than

practising on an outdoor climbing wall. The Shek Kip Mei Park Sports Centre has a very well-maintained wall that will help you learn the ups and downs of climbing. Hours are 7am to 11pm daily, except for maintenance days. There’s a pro shop and a restaurant on the premises.

Horse Riding: Pok Fu Lam Pokfulam Public Riding School, 75 Pokfulam Reservoir Road, tel: 2550 1359, www.hkjcridingschools.com The public riding school at Pok Fu Lam is highly regarded in the riding community, both for the high level of its instructors and the quality of the horses. However, there is a long waiting list for beginner riding lessons, so the best thing to do is sign up for introductory courses, especially if you’ve never been around horses before. The mandatory hard hat is available for hire there, so if you are not sure about your commitment to riding, you won’t have to spend a bomb on safety equipment. If you already ride, you will be evaluated and placed in group lessons with others at the same level. Lessons are available in English and Cantonese.

Mountain biking: Sai Kung East Country Park Location and travel directions at the Agriculture, Fisheries and Conservation Department website, www.afcd.gov.hk Sai Kung East Country Park has been called the “wild east of Hong Kong”: no developments, no power plants, just nature, small fishing villages and more nature. There is really only one trail, but according to the Hong Kong Mountain Bike Association (HKMBA), it’s a mix of extremely technical and beginner trails. There is only one access road, Pak Tam Chung, and no ferries, so plan on an hour’s trip by road to get there. The HKMBA has a detailed trail map that you can download from its website, www.hkmba.org.

Alternatively, if you want to combine cycling with a guided tour of Hong Kong’s most interesting areas, sign up with Michael Hansen of Hansen’s Hikes (tel: 9552 0987). It’s great fun for a small group of friends, especially if you are keen on combining cycling with photography.

Sailing: Wong Chuk Hang Aberdeen Boat Club, 20 Shum Wan Road, Wong Chuk Hang, Aberdeen, tel: 2552 8182, www.abclubhk.com

The Aberdeen Boat Club offers sailing classes at all levels for both club members and the public. You’ll learn under two experienced skippers, beginning with dinghy (small boat) sailing.

Lessons for adults are offered on weekends and you will progress through various levels. Group lessons are more fun (and cheaper), but if you have limited time, private tuition is available.

Fencing: North Point Jubilee Fencing Centre, Unit B, 3/F, Tung Kin Factory Building, 192-202 Tsat Tsz Mui Road, North Point, tel: 2548 6669, www.jfc-fencing.com There’s more to fencing than waving a sword around; it’s a sport that combines grace, stamina and agility.

The Jubilee Fencing Centre is an accredited school and has an impressive staff of instructors who can take you from beginner to a highly competitive level. They offer classes for adults and children (they will even come to your child’s school to demonstrate swordsmanship). Group and private instruction are available, and there’s a pro shop on the premises to get you outfitted with the correct safety gear.

Ice skating: Island East Cityplaza Ice Palace, 18 Taikoo Shing Road, Taikoo Shing, Island East, tel: 2844 8688 Cityplaza Ice Palace is one of the world’s largest skating schools, with more than 2,000 students and 29 instructors. You can select from group, semi-private and private lessons at all levels, with a choice of regular coaches or “high test” ones. A course of five lessons starts at HK$575, with skate rental included. There’s also a pro shop where you can get ready for your Dancing on Ice debut.

Hockey: Kowloon Hong Kong Hockey Association, Administration Block, 1/F, King’s Park Hockey Ground, 6 Wylie Road, Kowloon, tel: 2782 4932 The Hong Kong Hockey Association is the mother ship of hockey for men, women and youngsters.

In addition to extensive league and team play, the association also offers instructional courses for adults. The association regularly brings in top professional players to offer clinics for its players, which is a real advantage for anyone seeking to improve their level of play.

WELL-BEING 11 PERSONAL BEST

The positive power of passion Zhang Tingjun healthpost@scmp.com A few days ago, I received a phone call inviting me to be the guest speaker at an event for a well-known company. I was talked through the details, before being told: “Oh, and by the way, the theme of the event is ‘In It To Win It’.”

By the time I put down the phone, an all-consuming energy had washed over me. I felt it swell through my heart and pulse through my veins. If it were visible, I know I would have seen it rippling beneath the surface of my skin.

I know the feeling well. As a child, this sense of energy often reared its ugly head in the form of temper tantrums. For years, I would cry, kicking and screaming, till my throat was sore and my voice hoarse. I threw books down the rubbish chute and jumped out of school bus windows. It was my way of releasing the frustration I felt at being unable to make right the cruel injustices I was subject to at that tender age. For example, having to eat my vegetables, or being blamed for something my sister had done.

Needless to say, I was, without a doubt, the most passionate tantrum thrower in the neighbourhood.

I count myself lucky (and I’m sure the neighbours do too) that it only took a decade before I finally made a startling and life-changing discovery. I was 10 years old when I picked up my first netball. I held it, bounced it, passed it … and felt coursing through my body the all too familiar “tantrum-throwing energy”. Usually a signal of bad things to come, for the first time, it felt right.

For the next 16 years, I channelled this energy into becoming the best netballer that I could be. I trained and pushed myself as hard as, if not harder than,

I had ever kicked and cried as a child. For every schoolbook I flung down the rubbish chute, I passed a netball just as hard. If we had to find a hill to train on, I would find the steepest. My “tantrum-throwing energy” eventually earned a new, more respectable title. It was called “passion” and I had found mine.

Eventually, I represented Singapore at the Asian Athletics Championships, the Commonwealth Games and the World Championships. It was my anchor through my formative years, building my confidence yet teaching me humility. It has shaped who I am today. But the most important lesson I would learn about the power of passion was yet to come.

I was a producer at Channel NewsAsia (CNA) when I first heard about the Tour de Timor, a five-day, 450-kilometre mountain-bike race through the rugged terrain of East Timor. Excited at the prospect of an adventure, I promptly signed up with a team of three other women and met them for coffee and a chat.

It was while we were sitting there, talking about East Timor’s turbulent past and current challenges, that I felt growing within me this energy that, had I been a child, would have erupted into a full-blown tantrum.

This time, the frustration I felt was for the cruel injustices that the people of East Timor were suffering.

I decided to channel my energy into making a difference to the lives of those who needed my help.

Together with my teammates, I co-founded The Chain Reaction Project (TCRP), an initiative that uses adventure as a platform to raise funds and awareness for causes around the world. Like my teammates, I was not familiar with charities, the non-profit sector, or the world of fund-raising. However, I was so consumed by the desire to make a difference that I found

myself deploying all my different skills and learning new ones in order to succeed. After all, I was no longer competing for myself. For those who depended on my team, our success was literally a matter of life and death.

Over the past two years, TCRP has fostered a network of more than 1,000 people and raised more than US$100,000 for our adopted charities. TCRP representatives, whom we call “catalysts”, have reached the summit of Mount Kilimanjaro in Tanzania, and raced through the villages of East Timor on bicycles and on foot, in the 2010 “Dili – City of Peace” marathon.

While TCRP has been a lifechanging experience for some of the individuals at our adopted charities, it has also been a life-changing experience for me.

There was a time when I was content with reaching ordinary levels of success, but I am no longer satisfied with that because I know I can do better. My journey as a netballer and co-founder of TCRP are proof that, fuelled by passion, anyone is capable of achieving the extraordinary.

I have left my job at CNA where I had ordinary levels of success, and instead, have structured my life around things I am passionate about, things that spark my “tantrum-throwing energy”. Things like talking about being “In It To Win It”.

Illustration: Bay Leung

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Zhang Tingjun is a former TV producer and an exnational netball player for Singapore. She now divides her time between freelance emceeing, motivational speaking and The Chain Reaction Project. www.zhangtingjun.com

THE TASTE TEST RAW BARS ......................................................

Jeanette Wang jeanette.wang@scmp.com

Raw Revolution Organic Live Food Bar HK$22 for 62g, Nature’s Village (Lyndhurst Terrace) I shut my eyes as I bit into this sticky and chewy bar, which looks like moss but tastes pretty good. The ingredients – dates, cashews, sunflower seeds, agave nectar, almonds, spirulina and sprouted flax seeds – have been ground down so finely, you don’t see them whole, though they show up as 270 calories and 16g fat per bar.

Verdict: Pleasantly sweet with a slight spirulina taste, but the texture and colour leaves much to be desired.

Prana Bar – Apricot Goji HK$24 for 48g, Nature’s Village (Lyndhurst Terrace) The idea behind raw bars is to preserve the natural enzymes in ingredients that help the body absorb nutrients and eliminate waste efficiently. Processing and cooking destroys these enzymes. This apricot and goji bar is 75 per cent raw, except for the nuts and seeds, which needed “slow cooking to denature the enzyme inhibitors they contain” to avoid stressing the digestive system.

Verdict: Palatable. Soft, sticky and sweet, it tastes of dates and nuts.

Stephen James Luxury Organics Smart Bar HK$39-HK$45 for 38.5g, ThreeSixty This bar was named best snack at Natural Products Expo West in California earlier this year, so I had high hopes for it. It has more bite than the other two and is chock-full of flax, pumpkin, sunflower seeds and walnuts in coconut flower nectar. A dash of natural, saffron-pink Himalayan salt brings out the nutty flavour.

Verdict: I would eat more of this if not for the nutritional content – 206 calories and 15g fat for each small, flat bar.