20110830 health post

YOUR GUIDE TO LIVING WELL

TUESDAY, AUGUST 30, 2011

HEALTH POST Survivors of laryngeal cancer draw strength from support group >PAGE 4

Illustration: Emilio Rivera III

Finding a voice TEN PANTRY ESSENTIALS >PAGE 10

IS A SIX-PACK WORTH THE EFFORT? >PAGE 11

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

Jeanette Wang jeanette.wang@scmp.com Dirty secrets about clean laundry They may make linens smell great, but scented liquid laundry detergent and drier sheets might be bad for you.

New research from the University of Washington in the US shows that the air vented from machines using top-selling laundry products contains hazardous chemicals, including two carcinogens – acetaldehyde and benzene. “These products can affect not only personal health, but also public and environmental health. The chemicals can go into the air, down the drain and into water bodies,” says lead author Anne Steinemann, a professor of civil and environmental engineering and of public affairs. She recommends using unscented laundry products.

Lather up with a latte It sounds like a wacky idea, but caffeine applied directly to the skin might act as a sunscreen and help prevent damaging ultraviolet light from causing skin cancer, according to Rutgers University researchers.

It’s known that caffeine guards against certain skin cancers at the molecular level by inhibiting ATR, a protein enzyme in the skin. In the new study, a group of mice were genetically modified to have diminished ATR, and this resulted in 69 per cent fewer tumours than in regular mice. They also developed tumours more slowly and had four times fewer invasive tumours compared with unmodified mice. To find out more beneficial properties of caffeine, and hazards, turn to page 9.

ASK THE DOCTORS DR WAYNE HU Q: What are the first signs of alcohol damage to the liver and general health in women? I love wine but am concerned about its long-term effects.

Eat these for lower cholesterol Adding three types of foods – margarine enhanced with plant sterols; viscous fibre-rich oats and barley; and soya bean protein and nuts – to your diet can lower cholesterol more than a low-fat diet alone, according to new research published in the Journal of the American Medical Association. In the study, foods with plant sterols, in particular, when combined with a low-fat diet, lowered LDL (bad) cholesterol by more than 13 per cent. A low-fat diet alone produced only a 3 per cent LDL reduction. However, lead author, Dr David Jenkins of St Michael’s Hospital and the University of Toronto, warned that eating cholesterollowering foods doesn’t mean you can eat high-fat foods without consequence. Moderation is still the key.

Think pink for charity Here’s a race in which style, rather than speed, makes a winner. The Pink Walk Against Breast Cancer on Sunday, October 9, offers fabulous prizes (think hotel stays and movie vouchers) for the best dressed participants and top fund-raisers. Held on The Peak, the event will have a 3.5-kilometre and a seven-kilometre route. A HK$350 “minimum donation” per walker will be required. The funds will support the Hong Kong Breast Cancer Foundation’s work on breast health education, patient support services, local research and advocacy. Don’t forget to dress in pink! Sign up at www.hkbcf.org/pinkwalk

by September 30.

A: Although wine in moderation is pleasurable and may be beneficial to health, excessive alcoholic intake can damage all parts of the body. Women in general have less toleration of alcohol than men.

The first organ that may be damaged is the liver. In the initial stages, fatty liver may develop. Gradually, fibrous tissue forms, and the liver hardens until cirrhosis develops. The liver becomes nodular and loses its functions.

Fatty liver and the early stages of cirrhosis are generally asymptomatic. In advanced stages, the patient may become jaundiced (turn yellowish) and the abdomen may be filled with liquid. One may also experience heavy bleeding from enlarged veins in the oesophagus and stomach, which can be fatal.

A sudden intake of a large dose of alcohol can also cause acute hepatitis and even liver failure.

Another condition frequently caused by alcoholism is chronic pancreatitis.

Apart from upper abdominal pain, the patient suffers from impaired digestion, diarrhoea and malnutrition. Alcohol also has direct toxic effects on the gut, causing stomach ulceration and diarrhoea.

Apart from the digestive system and liver, chronic alcohol intake can damage the nerves and brain, especially if there is accompanying malnutrition and vitamin deficiency. There may be numbness and tingling in the periphery, and impaired brain function.

Alcoholics also run the risk of developing heart disease, stroke and high blood pressure. In addition, cancers of the mouth, throat, breast, oesophagus and colon may be related to alcoholism.

As many of the diseases caused by alcohol may be silent, moderation in intake is essential. The recommended maximal intake of wine is two to three units a day for women and three to four units a day for men. A 125ml glass of wine contains 1.5 units of alcohol.

Dr Wayne Hu, a specialist in gastroenterology and hepatology, is on the Health Post advisory panel

APP OF THE WEEK

Got your finger on the pulse? Now there’s a more hi-tech way to check ......................................................

Katie McGregor healthpost@scmp.com Instant Heart Rate by Azumio HK$0.99 Rating 9/10 Measuring your heart rate is simply a matter of placing your fingers on a pulse point and measuring what you feel – but doing it with your iPhone is a lot more fun. So much so that everyone in the family has had a go.

Interestingly, teenagers generally have a higher resting heart rate than adults, which does seem the wrong way round given the laid-back lifestyle of the average youngster.

The Instant Heart Rate app uses the iPhone 4 or 3GS camera lens to

measure heart rate by tracking the fluctuations in skin colour caused by blood as it is pumped through the body at each heartbeat. Place your fingertip on the lens and the app measures your heart rate over 10 seconds. You can choose to store the reading for future reference, with the option of adding a note so you can explain an unusual measurement,

for example: “argument with teen over cleaning bedroom” or “second coffee”.

When measuring your resting heart rate – that is, first thing when you wake in the morning – a table indicates whether it’s normal, excellent or poor. A lower resting heart rate generally indicates better cardiovascular fitness as a healthy, strong heart pumps blood more efficiently. While the normal rate is 60 to 90 beats per minute (bpm), conditioned athletes may have a heart rate closer to 40. Champion cyclist Lance Armstrong is said to have a heart rate of 32 bpm.

You should see your doctor, however, if your heart rate is abnormally low and you are not a conditioned athlete, or abnormally

high and you are not in the middle of an exercise routine.

The app also has a page listing heart rate zones so you can keep an eye on the efficiency of your exercise routines.

By turning the iPhone on its side, you get to see a chart for both your heart rate and recovery rate measurements over time. Let’s hope mine improve. > 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; e-mail advertising@scmp.com

MEDICAL 3 CASE HISTORY

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

Wynnie Chan healthpost@scmp.com Terry Chan knew he was carrying extra weight around his middle and had high blood pressure. But when Chan (name changed of patient confidentiality reasons) came out of his doctor’s office with a medical report showing high blood sugar and high cholesterol, and a diagnosis of syndrome X, it was more than he’d bargained for.

Syndrome X is also known as metabolic syndrome, where one displays a combination of risk factors that is linked to a greater chance of type-2 diabetes and a doubled risk of developing cardiovascular disease.

The condition has become increasingly common across the world, with an estimated 47 million adults affected in the United States.

According to Dr Annette W. K. Tso, a specialist in endocrinology, diabetes and metabolism, and a former clinical assistant professor at University of Hong Kong’s medicine department: “Globally, obesity is rising in epidemic proportions, and,

Research may enable a more personalised approach to the prevention of metabolic syndrome PROFESSOR SHAM PAK-CHUNG, UNIVERSITY OF HONG KONG

together with a sedentary lifestyle, contributes to a rising prevalence of metabolic syndrome.”

A major risk factor for metabolic syndrome is abdominal obesity – a waist circumference of more than 90cm or 80cm for Asian men and women respectively, or, for Caucasians, 102cm for men and 88cm for women.

Insulin resistance, in which the body cannot use insulin effectively, is another factor. The hormone insulin helps control the amount of sugar in the body. A diminished ability to respond to insulin causes the body to produce even more of the hormone, raising blood sugar levels, in turn affecting kidney function and increasing the level of blood fats. There is increasing evidence that the type of fat consumed plays an important role in insulin sensitivity, with saturated fats being bad and unsaturated fats beneficial. Severe insulin resistance can lead to type-2 diabetes.

Even for those without diabetes, Tso says the presence of a family history of diabetes increases the likelihood of metabolic syndrome.

Other contributing factors may include a proinflammatory state, identified clinically by elevated levels of proteins called cytokines, which are released by excess fat tissue. This increases the risk of cardiovascular disease.

Research is indicating a major role for a genetic susceptibility to metabolic syndrome. Professor

Sham Pak-chung, from University of Hong Kong’s faculty of medicine, says: “Studies on identical and nonidentical twins have shown genetic factors account for much of the individual variation in the components of metabolic syndrome.”

A 2009 study on the progression of metabolic syndrome, from the US National Health Statistics Reports, shows that out of about 3,000 people in the US, those who simultaneously have excess fat around the waistline, high blood pressure and high blood sugar are twice as likely to have a heart attack and three times more likely to die early than the general population – sobering news for people like Chan.

But simple lifestyle changes – such as weight loss, quitting smoking, reducing dietary fat intake and physical activity – can help greatly. In fact, such changes are twice as effective as diabetes medicine for those at risk of metabolic syndrome, according to a 2006 study published in the Annals of Internal Medicine.

There is an increasing body of evidence suggesting that a low-fat, Mediterranean-style diet supplemented with nuts can be useful. A low glycaemic index (GI) diet can be beneficial, too, says Sylvia Lam, chairwoman of the Hong Kong Dietitians Association and a senior registered dietitian at Qualigenics Diabetes Centre. Low GI foods, which release blood sugar gradually into the bloodstream, include most fruits and vegetables, and whole grains such as brown rice and wholewheat bread.

But it’s not only the type of food, but the frequency of meals, that matters. Scientists at Karolinska Institutet in Sweden have found that those who eat irregular meals have a larger waist size, more blood fat disorders and exhibit more signs of insulin resistance than those who eat more regularly.

Exercising regularly and eating a low-fat diet is exactly what Chan is now doing. “It was so hard to get motivated at the beginning,” he says. “I was out of breath just after five minutes on the treadmill, but I was so scared of having a heart attack that I persevered. I have two young kids and I don’t want them to be left without a dad. I’m working hard on eating less at each meal and eating more fibre, too.”

But for some, lifestyle changes – particularly dietary fat modification – aren’t enough to reduce disease risk. It’s thought that the thrifty gene that once allowed people to store fat to protect from starvation could now be working against some people by contributing to their retention of unhealthy amounts of fat.

“The genomes of modern humans may be adapted to survive scarcity and be unable to adapt quickly enough to the modern sedentary lifestyle and rich diets,” Sham says. “Research on how genetic make-up influences one’s response to different diets and other risk factors may eventually enable dietitians and other health-care professionals to adopt a more personalised approach to the prevention of metabolic syndrome and health improvement.”

Illustration: Angela Ho

How metabolic woes multiply

4 COVER STORY

Stares and Local laryngeal cancer survivors have formed a support group to help each other adjust after the trauma of surgery, writes Wynnie Chan

W

Deadly habit

90% of patients with laryngeal cancer in Hong Kong were smokers • For heavy smokers and drinkers, the risk rises by up to 40 times

ith an 18-year difference between the youngest and oldest of the group, Lo Hok-lin, Lau Fung-king, Lo Tam-wing and Tang Yu-chung seem unlikely buddies. But they meet regularly at the New Voice Club at Shek Kip Mei Estate, chatting the hours away happily.

Their friendship was forged by a common experience: they’ve all had their voice boxes removed due to laryngeal cancer, and each has found a new voice with the help of medical technology.

Every year in Hong Kong, there are about 190 new cases and 70 deaths from the disease, also known as voice box cancer, according to Dr Alexander Vlantis, a consultant at the department of otorhinolaryngology, head and neck surgery, at Chinese University.

Most patients are aged 40 or above, with male patients outnumbering female patients by 16 to one. The primary risk factors are smoking and use of alcohol, particularly spirits.

A recent study by University of Hong Kong’s School of Public Health showed that about 90 per cent of patients with voice box cancer were smokers. If a person is a heavy smoker and a heavy drinker, the risk rises by up to 40 times.

In the US, the University of Maryland’s cancer centre estimates that a heavy drinker has two to five times greater risk of developing the cancer than a non-drinker, and a smoker has three to 35 times greater risk than a non-smoker. It’s been estimated that 70 per cent of voice box cancer cases can be attributed to smoking, and 25 per cent to alcohol. Other risks factors include exposure to wood dust, paint fumes and asbestos; chronic irritation from laryngitis; chronic gastric reflux; human papillomavirus infection; a

At first I was scared and didn’t want to face friends or relatives or to go out ... I didn’t want people to stare at me. Not many people understand why I can’t speak normally LAU FUNG-KING, CANCER SURVIVOR

weak immune system; and poor eating habits associated with heavy drinking.

“In Hong Kong, about 50 per cent of voice box cancers occur on or near the vocal cords,” Vlantis says.

“Patients with this tend to present early because even a very small cancer can stop the vocal cords from vibrating properly and cause the voice to change or become hoarse.”

Other symptoms may include difficulty or pain when swallowing, a sore throat or feeling that something is stuck in the throat, a cough that doesn’t go away, bad breath, an ear ache and difficulty breathing or noisy breathing.

Vlantis adds: “The other 50 per cent of voice box cancers occur in the area above the vocal cords where there are no early warning signs, and so symptoms don’t appear until the cancer is well advanced.”

According to the American Cancer Society, this type of voice box cancer spreads more quickly because the affected area contains more lymph vessels through which cancer cells spread.

Patients who present symptoms will have their throat inspected using a flexible nasoendoscope,

Vlantis says. The tube is passed through the nose and into the throat, led by the tip, which has a light and camera. On the other end is an eyepiece, which the doctor uses to visually examine the voice box. If an abnormality is detected, a laryngoscopy is performed under general anaesthesia and a biopsy is taken for further examination.

The main treatment, Vlantis says, is radiation therapy, which preserves the voice box and hence also the ability to speak. But if the cancer is advanced or the radiation treatment fails, the voice box will have to be removed through a laryngectomy, and the patient will lose the ability to speak normally. During this operation, a new route for breathing is surgically created by connecting the end of the trachea (windpipe) to a hole made in the front of the neck.

Rather than use the mouth or the nose, the patient now has to breathe through this hole.

When we speak, our voice box vibrates air to create a sound, which is shaped into words by movement of the palate, tongue and lips. For patients, voice rehabilitation is essential, to teach them to speak using other methods that do the job of the larynx.

Post-operative patients also have a greatly reduced sense of smell and taste because they are unable to breathe through their mouth and nose. Swimming and showering isn’t possible without special equipment to prevent water entering the hole in their necks and into their windpipes.

But there are other inconveniences for patients.

“A laryngectomy imposes very significant changes in the life of the patient, who has to cope with major physical, social and psychological disturbances, which can test the toughest of individuals,” says Dr Eddie Wong, a colleague of Vlantis.

“It’s difficult to come to terms with these changes, and often patients face social isolation, psychological stress and depression.”

Lau, 72, neither smoked nor drank, but was diagnosed with advanced laryngeal cancer 17 years ago. “At first I was scared and didn’t want to face friends or relatives or to go out,” she says. “Getting into a taxi or a minibus meant I had to speak. I didn’t want people to stare at me.

Not many people are aware or can understand why I can’t speak normally.”

So the New Voice Club plays an important role, Wong says. “It provides an environment where similar patients can interact with each other, make new friends, receive help in social readjustment, and gain the confidence to speak again, if necessary, to reintegrate back into society.”

The club, founded in 1984, began with about 20 members and now has more than 2,500. It was through its voluntary visitation service that Lau got to know Tang. He had visited her before and after her operation, and provided her with the support she needed to ease her anxiety and accept her illness.

“I now accept the reality of my situation, my social circle has expanded and I have confidence to face the world again,” Lau says.

Laryngeal cancer is preventable, Vlantis says, and quitting smoking can help greatly. “Smoking is the single biggest cause of preventable ill health and death. The average life expectancy of a smoker is 13 years shorter than that of a non-smoker. If you are a smoker, it’s never too late to give up and you will begin to benefit from the moment you do.”

If you experience a hoarse voice for more than six weeks, Vlantis suggests you see a doctor, especially if you are a smoker or have been in the past. healthpost@scmp.com

COVER STORY 5 The voice box

Nasal cavity

whispers

Epiglottis Elastic cartilage preventing food going into windpipe

Mouth

Cartilage Glottis Opening between vocal cords

Vocal cords (Behind cartilage) Thin skin stretched horizontally across larynx that produces mucus. It vibrates, modulating air flowing from lungs to make speech

Oesophagus Food pipe Trachea Windpipe

Lau Fung-king, 72

Lo Hok-lin, 54

Lo Tam-wing, 67

Tang Yu-chung, 56

Lau neither smoked or drank but was diagnosed with advanced voice box cancer 17 years ago. Following a successful initial operation, the cancer returned and her voice box was removed in 2001. She now uses a pneumatic artificial larynx.

This is one of four technologies used for speech by people who have lost their voice box. With each of the four methods, the speaker shapes sound that has been passed to the mouth into words by movements of the lips, cheeks and tongue.

Lo used to smoke a pack of cigarettes a day. He initially thought his hoarse voice was the result of a cold, and a year passed before he sought medical advice. His voice box was removed in 2004, and a connection called a tracheoesophageal puncture was made between his windpipe and his oesophagus, and a voice prosthesis placed between them. The voice produced using the prosthesis tends to be a bit “gruff” but is otherwise natural sounding. The prosthesis gets worn out and needs replacing every few months.

Lo used to smoke two packs a day and was a regular beer drinker. He was diagnosed with voice box cancer when his children were still young and says he found the experience traumatic. His voice box was removed in 2005 after an unsuccessful course of radiation therapy, and he now speaks using oesophageal speech. Lo initially found the technique difficult and could only talk in short phrases and quietly, but now speaks well without having to use his finger or hold any device.

Tang, who used to smoke a pack of cigarettes daily and regularly enjoy beer and red wine, had a laryngectomy in 1999.

He remembers his voice being hoarse, but with a busy work life didn’t seek help until he wasn’t able to swallow and was coughing. Tang now uses an electrolarynx to talk – a battery-operated electronic device that he holds against his neck. His electrolaryngeal voice sounds more mechanical and artificial than a natural voice, but Tang says he was able to speak almost immediately after his laryngectomy.

Pneumatic speech Bell-shaped cup connected to a tube placed over hole in neck

Tracheoesophageal speech One-way valve prevents foods and liquids passing into windpipe

Oesophageal speech Air swallowed into throat and oesophagus, then forced out again, like a burp or belch

Electrolaryngeal speech Device creates vibrations which are transmitted through neck to air in throat

Vibrating air passes through tube into mouth

Oesophagus Rubber diaphragm in cup vibrates when exhaling

Trachea

Hole in neck covered with finger when breathing out

Air passes through prosthesis into oesophagus, vibrating its walls to produce a sound

Air movement makes lining of oesophagus and throat vibrate and make a sound

Vibrations are shaped into words using the mouth

6 HEALTH TECHNOLOGY

How advances in medical scie ......................................................

Ed Yong “Electronic skin” has been developed that records heartbeats, brain activity and muscle contractions as accurately as bulky conventional electrodes, yet is no thicker than a human hair.

The patch – created by Dr John Rogers, a materials scientist at the University of Illinois in the United States, and his colleagues – consists of a flexible and stretchy lattice of sensor-laden circuits. It can be applied and removed like a temporary tattoo, and sticks to skin without adhesives.

So far, it can be used for only a few days at a time, but researchers hope that the technology can one day allow doctors to monitor patients’ health without wires or clunky equipment.

The electronic skin can also do things that conventional medical sensors cannot. When placed on the throat, for example, it senses spoken words well enough to control a simple computer game.

“We focused on the throat because it really highlights the mechanical invisibility of these epidermal electronics, even on a sensitive part of the body,” Rogers says. The study is published in the journal Science.

The sensor patch is stretchy, flexible and the width of a human hair, but it falls off after a few days. “Electronic skin” could some day replace electrodes. Photos: NYT

FROM THE EXPERTS THE PSYCHOLOGY OF LOVE

Here’s one love triangle that has a future ......................................................

Dr Richard Lau and his team healthpost@scmp.com

Scientifically, it’s all about when our adrenaline and cortisol levels dramatically pump up. Photo: Martin Chan

What is it that makes your heart skip a beat when you see your crush, and what drives people to glorify love with poems and music?

For many years, scientists have attempted to decipher how our brain entices us to fall in love, as well as the means to sustain a relationship. Among them was Dr Robert Sternberg and his triangular theory of love, which posits that the durability of a relationship is based on three components – passion, intimacy and commitment.

Passion refers to feelings of bonding and attachment; intimacy encompasses drives connected to both limerence (being in love with someone, not just loving someone) and sexual attraction; and commitment is the willingness of the couple to remain with each other and plan their future together.

Every relationship encompasses at least one of these components, and while romantic (passion plus intimacy) and fatuous love (passion plus commitment) – the infatuation stage of a reciprocated relationship – are highly celebrated in Jane Austen’s novels and Hollywood movies, Sternberg believes that ideal relationships exist only when all three components are present. This is known as consummate love.

A person’s likeability to another increases when they mirror each other’s body language Before you begin analysing into which category your current relationship fits, however, how did it all happen in the first place? After all, it is the passion and intimacy in love that make us become attracted to one another, before we decide to offer and accept the rings. Although we don’t have the formula for a love potion, there are some elements that psychologists have found to attract a potential partner.

Smell Animals tend to turn up their nostrils when excited by love. This is evident where mammals like to sniff their partner’s scent during courtship. (Think about your dogs and cats.) Some also suggest that the Eskimo kiss of rubbing noses and a greeting peck on the cheek are actually gestures of human sniffing.

Researchers have found that bodily scent is actually chemical compounds of one’s major

histocompatibility complex gene expression, relating to mate choices and immunity. Women tend to prefer scents or gene pools that are different from their own, as it enhances the gene diversity of their offspring and gives them the best immunological head start possible.

Interesting examples can be found in some studies where ladies were asked to rate their likeness of the scent of smelly T-shirts worn by different men, and those that have larger variations of their own (tested earlier) received higher ratings.

Adrenaline We all sweat, our heart races and our mouth goes dry when we bump into our new love. These are all signs of activated stress response, where our adrenaline and cortisol level dramatically pumps up.

As much as passionate love induces physiological arousal, it can also work the other way around.

This is not to say that love can be provoked in the laboratory, but a person who is physiologically aroused is more likely to be more intensely drawn to a partner than they would be in normal circumstances.

One study illustrating this phenomenon involved researchers leading one of three groups of men to believe they would soon receive three stiff electrical shocks to

HEALTH 7

ence are wearing a bit thin The device might be used to help people with laryngeal diseases communicate, to monitor premature babies, or to enhance the control of prosthetics. Rogers is also collaborating with physical therapists to use the skin to induce muscle contractions in regions of the body that have degenerated.

Stephanie Lacour, an engineer at the University of Cambridge, says it’s exciting work. “This is a key demonstration that highperformance electronics can be designed to mechanically mimic biological tissues and yet function reliably. It will be likely to help in designing unnoticeable yet hi-tech wearable systems.”

Rogers’ team has worked on flexible electronic circuits for about 15 years, and recently turned to creating machines that mimic human skin. “It was a natural evolution of what we’ve been doing,” Rogers says.

The electronic skin consists of sensors, antennae, light-emitting diodes and other components, sandwiched between two protective layers. It is powered by embedded solar cells or by inductive coils that can generate current wirelessly.

The sandwich sits on a stretchy sheet of polyester designed to match the physical properties of skin. “To my knowledge, this is the softest

frighten them and enhance physiological arousal. The men were then introduced to a girl and later asked how much they liked her.

Those who were expecting an electrical shock reported more liking for the girl than did the control group who was not told of the possibility of shocks.

Body language Actions speak louder than words.

Research has shown that what you say often makes up to only 7 per cent of your expression, while body language conjures 55 per cent and 38 per cent through tone and speed of voice. A person’s likeability to another increases when they mirror each other’s body language, such as crossing legs and smiling at the same time, as it signifies that the two are “on the same wavelength”, and indicates that one is open and willing to accept the other’s ideas.

So if you’re about to see your crush, you may want to consider wearing some nice perfume, suggesting a roller-coaster ride together, and mirror what he or she does. Or if the person is doing this to you, you know what they’re up to.

Dr Richard Lau is the director of psychological services with the Whole Person Development Institute and a former assistant professor in the faculty of medicine at Chinese University

substrate ever to carry complex, functional electronic circuitry,” Lacour says.

The device is less than 40 micrometres thick, making it far more flexible than the millimetrethick silicon chips found in most electronics. “At this scale, something that would otherwise be brittle is completely floppy,” Rogers says.

“You can trick the system into behaving like tissue even if it uses these tiny, rigid pieces of silicon.”

It will be likely to help in designing unnoticeable yet hi-tech wearable systems STEPHANIE LACOUR, ENGINEER

The device is thin enough to stick to skin using only the short-range van der Waals forces that hold molecules together. The circuits are fashioned as narrow S-shaped filaments, so they can stretch and contract without breaking.

The team are now working on adding new components such as wireless communicators for uploading data or commands.

One major downside is that the continual shedding of skin cells

means that the patch falls off after a few days. The researchers are looking for ways in which it can be worn for months at a time.

It’s also expensive to make, but Rogers hopes that the patches could eventually be mass-produced.

“We’re building on existing technology rather than reinventing it, so I think the technical hurdles to commercial manufacture are lower than normal.”

The New York Times

8 HEALTH

SAFETY WITH STYLE Keeping your peepers safe from the sun’s dangerous rays need not be an unfashionable affair. Moh Lee, an optician and fashion eyewear consultant at Eyes@Work in Singapore, recommends five shades that will have you soaking up the sun in style. From the top: • Alain Mikli AL1070 • Theo “Beech” • Jeremy Tarian “Sky Bar” (polarised) • Barton Perreira “Noble” • Starck Biosun PL0804 (polarised)

WELLNESS EYE CARE

Glaring omission can cost vision ......................................................

Margaret Wee healthpost@scmp.com Most people associate overexposure to the sun with skin cancer but are less aware of its effect on the eyes and just how important it is to wear a pair of good sunglasses.

The sun emits light of different wavelengths, including ultraviolet radiation in the UVA, UVB and UVC bands.

UVA rays are closest to visible light rays and have the lowest energy among the three bands. They pass through the cornea and reach the lens and retina.

Overexposure to UVA rays has been linked to the development of certain types of cataracts.

UVB rays, with a slightly shorter wavelength than UVA rays, are partially filtered by the ozone layer but still reach the earth’s surface.

Moderate doses of UVB radiation stimulate the production of melanin – which results in the golden tan that beach-goers long for. In higher doses, however, they cause sunburn, increasing the risk of developing skin cancer as well as premature signs of skin ageing, such as wrinkles.

UVC rays have the highest energy and are the most harmful to the eyes and skin. Although the ozone layer blocks almost all UVC rays from reaching the earth, its gradual depletion could mean increased exposure and more health-related complications in future.

When UV rays enter the eye, they are absorbed by chromophores,

substances in the eye cells and tissues that absorb light energy, triggering a series of molecular changes that enable light signals to be transmitted to the brain, producing sight.

Unlike the skin, which adapts to UV radiation by producing melanin, the eye has no protection from exposure to strong sunlight. If too much UV light is absorbed, the cornea, lens and retina can be damaged.

The bad news is that the average Hongkonger is likely to develop eye damage related to sun exposure in his or her lifetime. Every person will develop cataracts – if he or she lives long enough – says Dr Chng Nai Wee, an ophthalmologist at the Singaporebased Eagle Eye Centre.

According to the World Health Organisation, cataract is the world’s leading cause of blindness. It is responsible for 30 per cent of blindness and low vision in Hong Kong patients. In 2008 alone, nearly 20,000 people in Hong Kong were diagnosed with cataract, which forms when the lens of the eye becomes clouded because of wear and tear on its protein fibres.

Cataracts can form at the back, on the periphery or deep in the central zone of the lens. They develop gradually and may go undetected for months or years.

Eventually, eyesight begins to be affected; blurred vision, haloes around lights and glare from the headlights of oncoming cars at night are common. If left untreated, the lens will liquefy and become totally opaque, leading to blindness.

With advances in surgery, cataracts can be taken care of quickly in a day surgery under local anaesthesia. The clouded lens is removed and replaced with an intraocular lens implant that will offer regular vision or correct presbyopia (long-sightedness), depending on the patient’s lifestyle needs and budget.

Another complication that can develop when the eye is exposed to

For the layman, a pair of 100 per cent UV-blocking wrap glasses will do fine CHNG NAI WEE, OPHTHALMOLOGIST

too much sun is solar maculopathy.

The lens of the eye acts very much like a magnifying glass. When too much light enters the eye, it burns the centre of the retina at the back of the eyeball, an area called the macula.

Only 20 seconds of sun gazing will result in a burn.

“Solar maculopathy is due to damage to the photoreceptor cells at the macular area. UV light causes photochemical injury to the cells in the retina, causing permanent damage to the macula,” Dr Alan Ng, an ophthalmologist with a private practice in Mong Kok, says.

The extent of the damage

depends on the duration of exposure, the position of the sun in the sky at the time and the individual’s eye health. Symptoms include blurred vision, headache, blind spots in vision and distorted vision. Solar maculopathy is not treatable.

The sun can also cause problems with the conjunctiva – the transparent mucous membrane that lines the white (sclera) of the eye and the insides of the eyelids. Pterygia (pronounced tuh-rij-ee-ya) and pinguecula (ping-gwek-you-la), which are common, non-cancerous growths on the cornea and conjunctiva, may develop as a result of prolonged sun exposure.

A pinguecula is caused by the degeneration of the conjunctiva’s collagen fibres. The original transparent fibres are gradually replaced by thicker yellow fibres, or calcified deposits. A pterygium, which often develops from pinguecula, is a triangular-shaped growth that may eventually extend over the cornea, causing vision problems.

Both conditions usually do not require treatment unless symptoms are severe or vision is affected.

Lubricating or mild steroid eye drops are usually prescribed to relieve the symptoms. In serious cases, an ophthalmologist may surgically remove the growth.

“Pinguecula and pterygia may require surgery when the growth is very thick, causing irritation while blinking,” Ng says. “A pterygium can grow into the cornea, causing astigmatism. It may also grow towards the centre of the eye,

obstructing the visual axis. In these circumstances, surgery is indicated.”

Younger patients may also opt for surgery because of cosmetic concerns.

Protecting your eyes from sun damage is as simple as buying a pair of good sunglasses. Look for a pair that guarantees at least 99 per cent protection from UVA and UVB rays.

They should fit as close to the face as possible. Wrap-around styles are best, as they provide better coverage of the eye area. For extra protection, wear a large-brimmed hat.

If you plan to engage in water sports or fishing, you may want to consider sunglasses with polarised lenses. These lenses reduce glare from reflective surfaces, such as the surface of the sea, by allowing only vertically polarised light to enter the eyes. Chng says that their advantage will mainly be appreciated by sportsmen. “For the layman, a pair of 100 per cent UV-blocking wrap glasses will do fine,” he says.

The time of day you choose to get your dose of sunshine also matters.

“Avoid exposure to the midday sun,” Ng advises.

The sun is at its highest overhead and is therefore strongest between 11am and 3pm. While this is the time that many sunbathers will choose to work on their tan, it is also when the highest levels of UV damage occur.

Even if the day seems cloudy or overcast, UV rays can still penetrate cloud cover and reflect off water and concrete. If you must be outdoors, sunglasses and a hat will keep you looking and feeling cool.

DIET 9 NUTRITION COFFEE

It’s brew love for our cafe society ......................................................

Margaret Wee healthpost@scmp.com “Venti double mint mocha. Whip.

For here.” If you can fire off that coffee order perfectly, you are probably one of the thousands who frequent Hong Kong’s coffee shops day and night.

Coffee is fast becoming the beverage of choice in the city, displacing its traditional rival, tea.

Nestle, which produces instant coffee as well as the popular Nespresso capsule coffee machines, puts the per capita consumption of coffee in the territory at 60 cups a year. While two-in-one and threein-one “cuppas” are a staple at home, more are flocking to coffee house chains such as Starbucks and Pacific Coffee for fancier picks.

The dark, bitter brew that is coffee is made from the roasted seeds of the coffee plant, and has a history dating to the 15th century.

Coffee is grown commercially in more than 70 countries worldwide, with the main species cultivated being C. arabica. From this, arabica, the crème de la crème of coffee beans, is obtained.

What gives coffee its kick is caffeine, a pesticide found naturally in the seeds, leaves and fruits of

plants such as kola nut, yerba mate, guarana berries and the yaupon holly.

The amount of caffeine in a cup of coffee depends on the strength of the brew, the brewing method and the type of coffee blend used.

According to the United States Food and Drug Administration, coffee made using the drip method contains an average of 115 milligrams of caffeine per 150ml cup, while percolator coffee has 80mg. A cup of instant coffee usually contains about 65mg of caffeine.

Contrary to popular belief, decaffeinated coffee still contains a small amount of caffeine.

Researchers at the University of Florida have found that some dripbrewed decaf brands can contain up to 13.9mg of caffeine per 473ml.

You can ask for skim or low-fat milk, and avoid putting whipped cream in your coffee KATHLEEN YAU KA-YAN, NUTRITIONIST

Tim Hortons, a Canadian-based coffee firm, tests samples. Photo: Bloomberg

While most people drink coffee for its stimulant effects – it increases alertness and boosts energy levels – it has also been shown to reduce the risk of developing dementia and Alzheimer’s disease, protect against certain types of cancer and even keep you from contracting methicillin-resistant Staphylococcus aureus (MRSA), a bacterial infection that is resistant to traditional antibiotics.

But research into caffeine’s negative effects is equally extensive.

Caffeine consumption may make it harder for a woman to get pregnant by interfering with muscle contractions that push eggs from the ovaries through the fallopian tubes into the womb. It may also increase the risk of gout, a painful form of arthritis that occurs when uric acid crystals build up and inflame the cartilage of joints, tendons and other surrounding tissue, especially in the feet. Those who love unfiltered coffee such as espresso appear to have an increased risk of high cholesterol levels.

So how much coffee is safe to drink? According to Kathleen Yau Ka-yan, a registered dietitian with the Hong Kong Nutrition Association, drinking four to five cups, or less than 650mg of caffeine, daily is acceptable. “Overconsumption of caffeinated drinks may lead to dehydration, as caffeine is a diuretic,” she says.

Pregnant women who are moderate drinkers can continue to enjoy their coffee at a reduced intake, as caffeine is metabolised more slowly during pregnancy. The safe limit is under 200mg, or two cups of instant coffee, a day, according to the Britain-based Food Standards Agency.

Unless you have a 36-espressosa-day habit like pop singer Robbie Williams, your biggest concern about drinking coffee should be what you order at the counter.

“Some coffee drinks like Frappuccino or Caramel Macchiato [both sold by Starbucks] are high in

WHAT’S IN YOUR COFFEE? Yuan yang (tea-coffee), sweetened Serving size: 100 grams 52 calories, 2.3g fat, 4.8g sugar

Hong Kong-style coffee, sweetened Serving size: 100 grams 51 calories, 2.3g fat, 2g sugar

Pacific Coffee Company Caramel Swirl Chillino with whipped cream Serving size: Tall (12oz) 360 calories, 14g fat, 48g sugar

Starbucks Cappuccino, whole milk Serving size: Tall (12oz) 110 calories, 6g fat, sugar self-added

Nescafe Home Cafe 3-in-1 instant coffee Serving size: 1 sachet 186 calories, 6.7g fat, 15g sugar

fat and sugar because they contain milk and whipped cream. The caloric content of such drinks is not ideal, especially for overweight and obese people,” Yau says.

According to Starbucks’ website, a grande (16 US fluid ounces, or 473ml) Caramel Frappuccino with whipped cream has 370 calories and 12g of fat. By contrast, a Caffe Americano, which is espresso with hot water, contains only 15 calories and no fat at all.

What can inveterate coffee

addicts do to keep both their habits and their waistlines? “You can ask for skim or low-fat milk, and avoid putting whipped cream in your coffee,” Yau advises. Since both Chinese and Western coffee houses usually use full cream, evaporated or condensed milk to make their brews, consider taking home-made brew to work instead of stopping by your local coffee joint. Yau says: “It is easier for you to make healthier choices like using less sugar ... if you make your coffee at home.”

10 DIET NUTRITION PANTRY ESSENTIALS

Boost your shelf esteem ......................................................

Mary Agnew mary.agnew@scmp.com This is what every Hong Kong kitchen cupboard needs.

1. Goji berry The importance of incorporating antioxidants into the diet is well known. The native Chinese goji berry, or wolfberry (Lycium barbarum), is packed full of immunity-boosting antioxidants that have shown to help maintain and improve eyesight and prevent liver and kidney disease. The small red berries can be easily consumed by the handful as a light snack, or added to Chinese soups or breakfast cereals for a healthy start to the day.

and aroma vary greatly, however, depending on the origin of its ingredients.

4. Mandarin peel Mandarin peel can be used fresh or dried. A rich source of vitamin C, it is also one of the most versatile and flavourful ingredients, featuring in hearty soup and stew recipes, in sauces for duck or chicken, or as a zesty addition to batter for cookies, cakes or breads. In Hong Kong, mandarin peel is most commonly added to the soup base for ngau lam (beef brisket) noodle soup.

5. Low-sodium soy sauce No Asian pantry worth its salt would be complete without soy sauce. But as a high salt intake increases one’s risk of hypertension and its complications, consider stocking up on a low-sodium version instead.

Soy sauce is made from fermented soya beans mixed with some type of roasted grain (such as wheat, barley or rice), injected with a special yeast mould, liberally flavoured with salt and left to age for several months.

6. Stock Every good home-made stock begins with the holy trinity of carrot, onions and celery sweating slowly in a pot – then pretty much anything goes. Once water has been added, season with some salt and pepper, and boil off those pesky leftovers – chicken, beef, veal or fish remnants will do – for a fresh and flavourful stock that’s a perfect base for soups, stews, sauces and casseroles. Fresh stock will keep happily in the freezer, but dried stock or bouillon cubes work just fine and are handy for the time-pressed cook.

2. Olive oil Not all oils are bad. High-quality olive oil can be the crowning jewel of a delicious meal of fresh fish; the finishing touch to a salad; or a complementary ingredient for sauces. It’s the top pantry essential for executive chef Uwe Opocensky of The Krug Room at the Mandarin Oriental. “I am not a big fan of butter, so olive oil is very important to me,” the German says.

“I have a large selection of olive oils at home and my favourite is Manni Olive Oil. I use it in pretty much everything from home-made mayonnaise to delicious salad dressings.”

7. Red and white wine vinegar A favourite of the French, these are tangy and great in a multitude of salad dressings, sauces, marinades and dips. They balance out oily ingredients and have been linked to lowering high cholesterol levels.

8. Quinoa Originally from South America, this cereal is so nutritious that the Incas used to worship it. It can be quickly boiled to make a wholesome salad similar to tabbouleh, eaten with a bit of milk as porridge, or added to breads, cakes and soups to make them more hearty. Food blogger Paola Sinisterra (thekitchennomads.com) says: “I add two tablespoons to my standard bread recipe and it makes the crumb not only super tasty but has enough protein, calcium and iron to keep a small army going.”

9. Canned fish A couple of tins of canned tuna or mackerel in brine can add a delicious source of protein and omega-3 fats to salads, omelettes, sandwiches or wraps.

While the canning process leaves the protein nutritive values largely unchanged, it does strip tuna of its oils and hence reduces the level of heart-healthy omega-3s.

But for convenience’s sake, tinned fish is ideal.

10. A mixture of salts Differing sodium and flavour levels in Maldon sea salt compared to fine table salt can completely alter the texture and taste of a dish.

Vinny Lauria, executive chef of Italian restaurant Linguini Fini in Central, says having a mixture of salts is key to any conscientious cupboard. “I like to use different salts due to the difference in the mineral content for different flavours,” he says. “Salts are also great for preservation techniques.”

3. Miso High in protein and rich in vitamins, miso is a versatile and nourishing addition to any pantry.

Available as a thick paste, it is traditionally used in Japanese cooking for sauces and spreads. It’s typically mixed with dashi, a simple broth made from sea kelp and bonito flakes, for low-calorie miso soup. Traditional miso paste is made with fermented rice, soya beans, salt and a fungus called koji-kin. Its taste

NUTRITION ORGANICS

Natural choice not always better for you Step into any health food store and you may feel as though you’ve stepped into a parallel universe: you’re likely to find an organic version of just about everything, including cotton candy and chewing gum. While it’s true that organic “junk foods” are better for the planet (possibly owing to less packaging or more environmentally sound manufacturing processes), they generally aren’t better for you.

Similarly, certain fruits and vegetables that are available in organic varieties may be just fine in their conventional form. A shopping guide created by the

US-based non-profit Environmental Working Group (EWG) includes a list of the “clean 15” – the conventional produce selections that are lowest in pesticides and, therefore, acceptable to buy.

The bottom line is you needn’t go completely organic. Here are some items that you can confidently buy in conventional form:

355ml of Coca-Cola Classic) and no nutrients.

Soft drinks A six-pack of organic soft drink can cost a lot more than a conventional brand. Yes, it’s made without highfructose corn syrup, but each can contains 160 calories (20 more than

Seafood Whether caught in the wild or farmed, fish can legally be labelled organic, even though it may contain contaminants such as mercury and polychlorinated biphenyls,

Low-calorie or sugar-free items If organic sugar-free cookies sound too good to be true, they probably are. Check the label for artificial sweeteners such as aspartame. If you’re trying to stay natural, you’re better off choosing a non-organic baked treat that’s free of fake sugars.

according to the Consumer Union.

That’s because the US Department of Agriculture has not yet developed organic certification standards for seafood.

Onions These underground wonders rank lowest on the EWG’s pesticide-load list. Stock up with conventional onions at the supermarket, and store them in a cool, dry place such as a pantry closet or low-humidity refrigerator door.

Frozen sweetcorn Much easier to prepare and enjoy than shucking niblets from the cob,

conventional frozen corn is considered extremely low in pesticides. Use it in soups or cornbread mix.

Tomatoes More than half of the tomatoes screened by the EWG contained no detectable pesticides, although they were most likely to have evidence of more than one kind of pesticide.

Watermelon Just over one-quarter of the EWG’s samples showed evidence of pesticides. Ripe watermelons are usually a uniform colour inside and shiny outside. McClatchy-Tribune

FITNESS 11

SWEAT ROCK-HARD ABS

When it comes to the crunch ......................................................

Gretchen Reynolds For a study published this year, researchers at Indiana State University had a group of healthy, young adults squat, lunge, twist, crunch and hold a rigid plank position to measure the hardiness of their back, abdominal and side muscles, the area generally known as the core.

The same volunteers then completed a battery of physical performance tests, including leaping off the ground while tossing a medicine ball backward over the head and sprinting through a short obstacle course.

The researchers had expected that the volunteers with the sturdiest cores would outshine the others on the tests of physical performance.

But they did not. There was little correlation in this study between robust core muscles and athleticism.

Despite the emphasis that many coaches, trainers and athletes themselves place on “core training

Personally, I do not believe that it is necessary to specifically train the core THOMAS NESSER, STUDY AUTHOR

for increased performance”, the authors write, “our results suggest otherwise” – and in the process raise some intriguing questions about just how core strength affects fitness and whether a rippling abdomen, while attractive, is worth the effort.

The role of the core in physical performance has been a topic of considerable interest and controversy among sports scientists, as well as coaches and trainers, for years. Most of us think that a taut midsection, achieved usually by multiple crunches, will make us not just less self-conscious in our swimsuits but also better athletes.

Findings about the effect of standard core exercises on athleticism, though, have been mixed. A representative study of

collegiate rowers, for instance, found that after eight weeks of an arduous core-exercise regimen – added to their normal workout routines – the rowers had greatlooking abs but weren’t better rowers; their performance was unchanged in a rowing-machine time trial.

But in another study, this time of novice adult runners who displayed weak core strength in preliminary testing, those who completed six weeks of core training drills lowered their five-kilometre run times significantly more than a control group of beginning runners who did not focus on their midsections.

How much core strength most of us need, how to achieve it, how to measure it and how to define core stability and core strength are questions that remain largely unanswered by available science, says Stuart McGill, a professor of spine biomechanics at the University of Waterloo in Ontario and author of the book Ultimate Back Fitness and Performance, as well as of many, much-cited studies of core performance. “Core performance is quite an involved concept,” he says.

Even the importance or desirability of performing crunches, the most common of core exercises, is uncertain. Research by McGill and others has shown that repeated bending of the spine, such as occurs when most of us do crunches, can over time contribute to damage of the spinal discs. When cadaver pig spines were placed in machines as part of a series of recent experiments and bent and flexed hundreds of times, the pigs’ spinal discs almost always ruptured, eventually.

No one needs to perform hundreds or even dozens of crunches, says Brad Schoenfeld, a professor of exercise science at Lehman College in the Bronx and an author of a newly published review article about core exercises titled “To crunch or not to crunch”. And while everyone needs some basic minimum of core strength – getting up out of a chair requires a certain amount of core strength; serving a tennis ball requires more – “six or eight crunches would be plenty,” he says, “and only a few times a week.”

It’s also important you perform them correctly, McGill says. “Don’t flatten your back into the ground,”

he says. Instead, place your hands, palm down, beneath your lower back to lessen pressure on the spine.

Bend your knees, and “pretend that your head and shoulders are resting on a bathroom scale,” he says. Lift them only enough to send the imaginary scale’s reading to zero.

“You don’t need to crunch up very

much” to achieve the desired workload on the abs, he says.

Or forgo the crunches altogether.

“Personally, I do not believe that it is necessary to specifically train the core,” says Thomas Nesser, an associate professor of exercise science at Indiana State and senior author of the study about core

stability and performance. In most instances, if you “train for your sport, core strength will develop”, he says, and it will be the right amount and type of core strength for that sport.

But what about those taut abs sported by celebrities? It’s all about low body fat, McGill says, and not the crunches. The New York Times

12 WELLBEING FIT & FAB Heinz Fischer puts in long hours in the kitchen and on the running track.

Photo: Dickson Lee

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

Jeanette Wang jeanette.wang@scmp.com Heinz Fischer is not the president of Austria – at least not this Heinz Fischer, an award-winning chef who is experienced at running both kitchens and ultramarathons.

“I think I’m more famous than him around here,” says the Swiss national, who moved to Hong Kong in the late 1980s to work as an executive pastry chef at the Hilton. He then worked at other top kitchens before starting his own pastry and bakery consultancy business in 1998.

Sport, like cooking, has always been in Fischer’s blood. Growing up in a small village of about 800 people near Zurich, he ran, did gymnastics, and played football and handball.

These days, he focuses on running, such as the 100-kilometre Oxfam Trailwalker in Hong Kong (his best time is 18 hours, 45 minutes) and the

One chef who never runs out of steam 79-kilometre Swissalpine Marathon in Davos (10 hours, two minutes).

“Ultramarathon training makes it easier for me to work for long hours,” says Fischer, who worked 26 hours without a break during a culinary competition in Singapore. “In return, those hours of standing help in ultramarathons.”

Only once has his identity been mistaken: while conducting a cooking seminar in China. To prepare for his arrival, a translator had searched the internet and printed out photos and details of the Austrian president. “When the translator finally met me, he put them away.”

last six to eight months, I’ve had a lot of whole-day classes, so I started work at 9am and it could be non-stop ‘til 11pm. At the moment I don’t have a lot of classes, so I do a lot of paperwork and preparation.

Sometimes I work weekends, although I try not to work on Sunday because that’s my training day.

You don’t want to reveal your age, but how old do you feel?

I feel like I’m in my 30s, because physically I can beat a lot of people in their 20s and 30s. I think I’m quite fit.

Do you try to run every day?

No. My standard training week is to have a long run at the weekend of 20 to 25 kilometres, or, if I’m training for a long race, more than 30 kilometres.

I run twice during the week, so my total weekly mileage is 40 to 50 kilometres. But I also do what most people in the office don’t: when I work I usually stand and walk for the whole day, which is low-level endurance training. So, every day I do some training.

What’s a typical day for you like?

There are lots of typical days. For the

You ran the Old Mutual Two Oceans Marathon in Cape Town and visited

wineries in Stellenbosch afterwards.

Do you enjoy mixing both passions on a trip?

Well, I normally mix several things at once. Basically, I’m never off work.

Wherever I go, I’m always looking around to find an interesting hotel or shop or market or ingredient to get some ideas. I try to do some running, and also to see if there’s any social life.

I always try to include different spectrums. Otherwise, if you go to some place, run, stay in a hotel and leave, you don’t get a very good feeling of the place as a whole.

Which is your favourite city and why?

To some extent, it’s Hong Kong. It’s good for business, for its location within Asia, and its social life is very active. Obviously, what’s missing is some space and some clean air, but you can get that at the country parks.

Within Asia, Hong Kong is probably No 1by far. There are no other cities that have this kind of variety. As a

contrast, I also like Switzerland; I like my village, which is very open and green. The trails there are almost unlimited; it depends on how long you want to go.

Which is tougher: a long day in the kitchen or doing an ultramarathon?

Physically, of course, it’s the ultramarathon. But the kitchen can be really tough mentally, especially if you are doing a banquet or a seminar.

With an ultramarathon, if it really doesn’t work, you can stop and there are no big consequences. Maybe your friends will say: “Oh you gave up so early.” But in the kitchen you cannot say: “Sorry guys, something has gone wrong, you can go home and come back tomorrow.” On the other hand, I’ve worked in the kitchen for so many years and am very experienced, so that makes things a lot easier. If I were to do the same intensity of running as I do in the kitchen, maybe running would get a bit easier.

THE TASTE TEST GLUTEN-FREE PASTA

Is it still good to eat without the wheat? ...............................................

Jeanette Wang jeanette.wang@scmp.com Mrs Leeper’s Corn Rotelli HK$38 for 340 grams, Nature’s Village (Lyndhurst Terrace)

Ancient Harvest Quinoa Pasta Shells HK$29 for 227 grams, Nature’s Village (Lyndhurst Terrace)

Tinkyada Organic Brown Rice Pasta Spirals HK$46 for 340 grams, City’super

These complemented the corn, beans and tuna in my cold pasta salad well, although they were pretty tasteless on their own. Tricky to cook, however, as it turns from hard to mushy very quickly. But get the timing right and its texture is firm and doesn’t get all gluey.

Verdict: Good, but I wouldn’t give regular pasta up for this.

This is made with a blend of corn and quinoa, the ancient grain of the Incan empire recognised by the UN as a nutritional powerhouse.

Cooked as directed on the package, the pasta comes out a bit hard and chewy. It also doesn’t keep well, so try not to leave any leftovers.

Verdict: Bland on its own, but soaks up flavours well.

Gluten-free pasta can be mushy, slimy and mealy.

But as the package promised, this was a “delightful eating experience”. Cooked for 10 minutes – rather than the recommended 16 – it is al dente and tastes great.

Verdict: You won’t be able to tell it’s not your regular wheat pasta.