YOUR GUIDE TO LIVING WELL
HEALTH POST
TUESDAY, OCTOBER 25, 2011
JOBS’ DEATH PUTS SPOTLIGHT ON RARE DISEASE >PAGE 7
PUMPKINS: STARCH AS YOU MEAN TO GO ON >PAGE 9
A woman’s quest to climb the world’s highest mountain
>PAGE 4
Turning point
2 NEWS HEALTH BITES ...................................................... Jeanette Wang jeanette.wang@scmp.com
It’s not you, it’s us Replacing “I” with “we” in self-talk could be the secret to success, according to Michigan State University researchers. “By focusing on the team, you include yourself without putting the focus or extra pressure on yourself,” says Deborah Feltz, co-author of the study published in the Journal of Sports Sciences. Eighty subjects were randomly assigned to three groups before completing a team-based dart-throwing activity: one used neutral self-talk; another used selftalk focused on one’s personal abilities; and the third used self-talk focused on the group’s abilities. Overall, the last group had the greatest performance indicators and team confidence. “Reinforcing the sense of team and focusing on a team goal can help someone change health behaviour or reach sales goals,” says Feltz.
Sweetness and light It seems that constant chocolate craving not only means you have a sweet tooth, but it’s also likely you’re a sweet person. That’s the finding of researchers from North Dakota State University, Gettysburg College in Pennsylvania and Saint Xavier University in Chicago, after five studies. In one study, participants who ate a sweet food (chocolate) were more likely to volunteer to help a person in need than one who ate a non-sweet food or nothing. In another study, people believed a person who liked sweet foods most among the four taste types was more agreeable or helpful, and not more extroverted or neurotic.
A lesson in labels Having trouble understanding food labels? Learn how at a series of workshops next month organised by the United Christian Nethersole Community Health Service. Conducted in Cantonese by an Australianaccredited practising dietitian, the classes will cover the definitions of terms, nutrition labelling tricks, selection of healthier snacks, and more. Classes cost HK$320 and are on November 15, 22, 29 and December 6, from 3.30pm to 5pm, at the Jockey Club Wo Lok Community Health Centre in Kwun Tong. To sign up, call 2172 0727.
Bright, but not so early Students who do poorly may improve significantly after a few years. Researchers have found that one’s IQ, the standard measure of intelligence, is not constant. The study, published in the journal Nature, tested 33 healthy teens in 2004 between the ages of 12 and 16, and again four years later. Results showed that IQ can rise or fall markedly during one’s teens, with associated changes in brain structure detected by magnetic resonance imaging, according to the experts at the Wellcome Trust Centre for Neuroimaging at University College London and the Centre for Educational Neuroscience. “We have a tendency to assess children and determine their course of education relatively early in life, but here we have shown that their intelligence is likely to be still developing,” says lead researcher Professor Cathy Price.
Green pickings Here’s a tasty way to load up on your five a day: fancy salad concoctions by celebrity chefs. Think chipotle chicken, created by TBLS’ Que Dang; yuzu tofu cha soba by Sushi Kuu’s Satoru Mukogawa; and seared tuna with grilled pineapple and fennel (right), by Liberty Exchange’s Vicky Cheng. The three salads will be on one-week rotations starting November 1 at Dressed. From HK$78.
APP OF THE WEEK
Getting into the swing of a kettlebell workout has never been easier ...................................................... Katie McGregor healthpost@scmp.com Kettlebell Fat Loss Workout 99 US cents Rating 8/10 I first came across kettlebells – spherical weights with a handle, popular in Eastern Europe – about five years ago when I sat in on a class of trainers being trained in this functional fitness technique. I was totally entranced by the exercise, which involves swinging and lifting the kettlebell while standing in one spot – perfect for small Hong Kong flats and for building physical and aerobic strength fast. The drills are intense, taking less than 20 minutes, and
that, too, is perfect for busy Hongkongers. However, at the time, kettlebells were too pricey for me. But when I was recently gifted a bright red kettlebell, the next thing I did was look for an app to guide me on routines and found Samuel Pont Training’s Kettlebell Fat Loss Workout – perfect for my needs. On using the app, the first thing that comes up after the arty photo of Pont’s incredibly muscled back is a warning: kettlebell training is a potentially dangerous activity. Believe it. Proceed with caution. Aside from overreaching my body, I had worries about losing my grip and either dropping the kettlebell on my own head, or allowing it to fly off and squash the neighbour’s cat. The app comprises nine short videos in which, on a roof in
can take your bell outdoors to do your drills without worrying about connectivity. Mastering the form alone was enough to give me stiff legs for days. It takes just 10 swings to get my heart rate up, but it is easy to carry on because of the momentum. It’s early yet, but I do like this as an option on days when I am too busy to run – and with stronger glutes and core, I will no doubt run better. Brighton, Britain, accompanied by the sound of seagulls, Pont demonstrates the various techniques, and then a mobility drill to use before doing one of the four Fat Loss Drills. The instructions are clear: you need perfect form with the separate techniques before trying to do a drill. The videos can all be downloaded to your phone so you
> CONTACT US Deputy Culture Editor: Choong Tet Sieu tetsieu.choong@scmp.com Health Post Editor: Jeanette Wang jeanette.wang@scmp.com General inquiries: healthpost@scmp.com Advertising: tel: 2565 2435; e-mail advertising@scmp.com
MEDICAL 3 CASE HISTORY
Late diagnosis means life of pain ......................................................
When 12-year-old Jerry Lam started complaining of stiffness and pain in his lower back and hips, his parents scoffed at the idea that a child would suffer from an old man’s malady. But when the pain overwhelmed Lam to the point where he could no longer stand, his parents’ disbelief turned to worry and bewilderment as they took him to the hospital. Thus began Lam’s lifelong struggle with a debilitating and chronic ailment that would take some 10 years to be diagnosed. The young Lam was actually suffering from an autoimmune disease in which his body attacked his soft connective tissue. Called ankylosing spondylitis (AS), this chronic rheumatic condition causes inflammation of tendons, ligaments and joints between the vertebrae and between the spine and pelvis. It also affects other joints in the hands, ankles and knees, and can even affect the eyes. AS can cause the spine to fuse in a condition known as “bamboo spine”, causing stooped posture and limited mobility, says Dr Kwok Man-leung, a consultant rheumatologist at a private medical centre. Despite advances in medicine, doctors do not know what causes this condition and there is no cure. According to Kwok, there appears to be a genetic component to AS – 95 per cent of sufferers have a gene called HLA-B27 – but the presence of the gene does not necessarily doom one to suffer AS. This painful condition was virtually unknown in 1960s Hong Kong when it struck Lam. Doctors at the hospital were baffled by his condition. They gave him an initial diagnosis of rheumatism and treated it as such. Three months later, the young boy was back in the hospital in excruciating pain. Lam spent the next decade in and out of hospital as doctors struggled to control the episodes of intense pain. The frequent hospitalisations and debilitating pain stopped Lam’s studies, as he was unable to walk during flare-ups. He could only watch as a normal teenager’s life of school, sports and social activities passed him by. When medical science failed to give him relief, Lam and his parents turned to alternative treatments, including acupuncture and
Illustration: Angela Ho
Eileen Aung-Thwin healthpost@scmp.com
traditional Chinese medicine. Lam, 56, today rues those unconventional attempts. They failed to keep the pain in check, and so he would spend months lying in bed, aggravating the condition. “But the less you moved, the stiffer the joints became,” he says. In one of the worst episodes, Lam was bedridden for three months. He was in such extreme pain that he could not even turn himself over in bed. “With tissue inflammation, fluid collects in the affected areas,” explains Kwok. “When you move,
your muscles pump away the excess fluid, relieving pain.” But again, without that knowledge, the teenage Lam could only huddle in pain, speeding up the disease’s progress. Lacking proper diagnosis and treatment, AS ravaged Lam’s hips and knees. By the time he was correctly diagnosed in his early 20s, he needed hip and knee replacements. He also had the “bamboo spine” syndrome. Doctors could only advise him to sleep with a low or no pillow in an attempt to keep his spine as straight as possible.
As Lam was likely to suffer from AS for the rest of his life, his doctor told him to learn to cope. He accepted his condition and resolved to live as best he could. Lam started to exercise – he swam and underwent physiotherapy. Despite the damage to his legs, Lam learned to walk with a walking stick, and could eventually manage hourlong jaunts. When necessary, nonsteroidal anti-inflammatory drugs (NSAIDs) would help with the pain. Things started to look up for Lam as a young adult. He worked, studied,
they have appeared, they tend to stay. Whitening skincare products work by blocking the formation of new pigment particles and/or speeding up the turnover of the pigmented skin. Ingredients commonly found in over-thecounter skincare products include kojic acid, arbutin, vitamin C, mulberry and liquorice extract. Doctors may prescribe hydroquinone, azelaic acid and retinols. Glycolic acid, salicylic acid and retinols can speed up
skin turnover but may cause skin irritation at stronger concentrations. Unfortunately, skincare products can only lighten freckles to a limited degree and cannot eliminate them, although they may play a role in preventing new ones. If removal of freckles is desired, this can be effectively done with laser or intense pulse light treatment. The freckles will become dark scabs after about a week and then slough off. It’s important to remember the best
dated, fell in love, got married, raised a son and enjoyed overseas holidays. The condition seemed to stabilise, and while the pain would still flare up, especially when he was run down from the flu or overtired, the episodes were more easily controlled. Hospitalisation for pain has been necessary only every eight to 10 years or so. When Lam turned 50, his health started deteriorating. After one bad flare-up, his doctor ordered a magnetic resonance imaging (MRI) scan, which showed deterioration in Lam’s joints. Lam took the doctor’s advice to retire, but the flare-ups increased. He could walk only 30 minutes at a time, then he had to give up walking; he now uses a wheelchair. Instead of taking NSAIDs twice a week as he did in his younger years, he needed to take them every day. Without them, Lam suffered pain all over his body. His arms ached so much, he could not even lift a glass of water. But the prolonged, intense use of NSAIDs created a new problem. Earlier this year, Lam discovered blood in his stool and spent the Lunar New Year in hospital with a peptic ulcer – a side effect of the drug use. Traditional NSAIDs inhibit two types of enzymes – COX-1, which aids the production of the stomach’s natural mucus lining, and COX-2, which indirectly creates pain and inflammation. Hence, long-term use of NSAIDs has potentially lethal gastrointestinal (GI) side effects. Because of the ulcer, Lam could not continue with traditional NSAIDs. Doctors gave him a COX-2 inhibitor called celecoxib. Kwok says a recent study by the Chinese University of Hong Kong found that COX-2 inhibitors reduced the risk of GI complications and bleeding by four to five times. Unfortunately, because it is a self-funded drug, celecoxib can be expensive for patients such as Lam who are not well off. While it is too late for Lam, sufferers of AS – diagnosed early – can slow its progress through drugs called disease modifying agents. Unfortunately, says Kwok, many AS cases are still mistaken for rheumatism and correctly diagnosed only after permanent destruction to the body has already taken place. However, patients can manage their condition by controlling their body weight, doing low-impact exercises such as tai chi, yoga, hydrotherapy and learning how to protect their joints, advises Kwok.
ASK THE DOCTORS DR TINNY HO Q: I do not like my freckles. There are so many “skin whitening” products in the market – do they work? A: Freckles are little brown spots on the skin caused by ultraviolet (UV) light. Some people, especially those who are fair-skinned, are genetically predisposed to them, and freckles can come up at a very early age. However, as the skin ages, freckles also become much more common after sun exposure. Once
way to fight against freckles remains the meticulous use of a good sunscreen. The protection level against UVA is crucial, so you should choose sunblocks with UVA protection factor over 10 or PA+++. Make sure you have a good layer on (at least 2mg per square centimetre, or about a half-teaspoon for the face). Dr Tinny Ho, a specialist in dermatology, is on the Health Post advisory panel.
4 COVER STORY
A ridge too far Turning back just short of reaching the summit of Mount Everest taught Esther Tan Cheng Yin some valuable lessons. Here, she tells her own story
T
he Northeast Ridge of Mount Everest is notorious for being highly exposed, with long tricky technical sections and extreme wind conditions, and is considered the tougher and more dangerous way up compared to the popular wellsheltered south route. Conquering the 8,850 metre peak this way requires spending more time in the “death zone”, above 8,000 metres, where the oxygen level is only a third of that at sea level. There’s a higher risk of altitude illness, and you can’t spend more than 48 hours there, no matter how well-trained or conditioned you are. It can also be a bureaucratic nightmare. Lying on the Tibetan side of Everest, it’s susceptible to last-minute changes, due to sudden political interventions and closures from the Chinese authorities. Still, I chose to climb Everest the hard way.
It’s not like climbing Everest wasn’t tough enough already. It took two years of planning, training and preparation, including conserving two years’ of leave, to make my dream a reality. As a diver with the Singapore navy, I found it tough juggling a fulltime job with training and massive preparations. My weeknights and weekends were spent running, cycling, and doing a lot of lonely stair climbs carrying a 20kg pack. I also did triathlons and adventure races to keep me motivated for highintensity workouts. And then there was the cost. My teammate, Kenneth Koh and I paid S$48,000 (HK$294,000) each to the Project Himalaya expedition company, which we felt had the right ingredients for a safe and successful expedition. The company is led by Jamie McGuinness, a veteran climber with more than 20 years’ experience in the Himalayas. He also has a strong support crew. There were more costs, like personal gear and extra training climbs needed in the build-up to Everest. Even with generous sponsorship of apparel and back packs from The North Face, I paid S$65,000 (HK$398,000) in total. It came down to choosing between a new car or scaling a mountain. Of course, I chose the latter. I wanted a personal experience with the highest point on the surface of the earth. Chomolungma, or “Goddess Mother of the Land” to the Tibetans, was my personal quest. But even with all the planning and preparation in the world, things don’t always go one’s way. To summit Everest is to be at the mercy of the mountain, its environment,
people and yourself. At such an extreme altitude, it’s a matter of staying alive. The six-week long journey that began in April gave me plenty of time for writing and reflection; I’d like to share three stories with you.
To summit Everest is to be at the mercy of the mountain, its environment, people and yourself. At such extreme altitude, it’s a matter of staying alive
Esther Tan Cheng Yin (above); with the summit of Everest (top); climbing the Chinese ladder. Photos: Sherpa Jamling
Conquering Despite being highly trained, my body took a long time to acclimatise to the altitude at Everest. Above 6,000 metres, the body starts to break down, wounds cannot heal properly, effective functioning of the body organs deteriorates, and eventually death can occur. At the North Col climb, my body’s muscular structure became so weak that I sustained a cracked rib from coughing violently. My lungs were agitated from breathing in the cold dry air; even talking would trigger a coughing fit. My inflamed ribs throbbed with every breath. Coughing also triggers vomiting. Many times, I swallowed my vomit to keep the tents clean. Our risks of altitude sickness were mitigated by ascending conservatively and constant monitoring of signs and symptoms. For our bodies to acclimatise better, we trekked from Base Camp to Advance Base Camp four times before our big summit push. With barely enough sleep and whirling from the brain-changing effects of oxygen deprivation, we left our warm, insulated sleeping bags to make our push at 11.30pm in minus 35 degrees Celsius so we could reach the summit in daylight. It was sheer joy, as I never felt so close to the shiny crescent moon guiding our paths into the howling > CONTINUED ON PAGE 6
COVER STORY 5 The way to the top British mountaineers George Mallory and Andrew Irvine used the trickier Northeast Ridge Route in their fatal 1924 attempt to scale Everest, but that didn’t stop Esther Tan from following in their footsteps.
Effects of altitude on humans Pulmonary capacity (lungs’ ability to take in oxygen)
Metres above sea level
The team for Tan’s expedition
Symptoms
Cerebral oedema
9,000
30%
Above this height classed as danger zone
Oedema (swelling due to fluid accumulation) Frostbite on extremities
50%
5,500 5,000
CHINA
Everest
Mount Everest 8,848m
Western
100km
thern route Sou
Lhotse 8,516m
Total summits*
3,341
idge ast R e h t Nor 4
108
Southern
Tingri
NEPAL
5
Northern
Xigaze
Lukla
15
2,210
Deaths by route** 75%
Ismail Askerov (Azerbaijan)
Brahmaputra River
Total summits*
Dehydration, blood pH alteration
Headache and sickness
Jim Morrow (New Zealand)
Luke Smithwick (US) Alaskan guide and ski mountaineer, was living in Himalayas
rthern route No
No human settlements above this altitude
4,000
3,000
Kenneth Koh (Singapore)
Sherpas
Jamie McGuinness (New Zealand) Has completed more than 20 expeditions to above 8,000m
7,000
6,000
Grant Rawlinson (New Zealand)
Guides
Quick heartbeat, even when resting
8,848
8,000
Esther Tan (Singapore)
Hallucinations
100 11
North face
2,000
3
100%
North Ridge
1,000
0
Ice cliffs
2
wm rn C ste We
Changtse 7,543m
A
Eas tR on gb
uk
Gl ac ier
1
Rongbuk Glacier
To Tingri
CHINA
NEPAL
B Base Camp To Lukla
* as at September 24, 2011 ** as at January 3, 2011 B Base camp (5,300m)
Located on a gravel plain by the Rongbuk Glacier, you either trek 60km to here from Old Tingri in southern Tibet, or drive via smooth well-laid roads.
A Advanced base
camp (6,400m) Getting to this rocky camp under the slopes of Changtse Mountain involves hiking some 22km of rugged terrain, fraught with rock and ice falls. Esther did this trek eight times to acclimatise.
Sources: Project Himalaya, everestnews.com, 8000ers.com
1 Camp 1 (7,000m)
It’s a steady climb of five hours to the North Col (“Col” is Welsh for “saddle”), with one steep icy face of 60 degrees where climbers will use fixed rope, crampons, and may traverse deep crevasses using ladders.
2 Camp 2 (7,500m)
This is the start of the high camps, and where Esther started her summit push. The three to five hour-climb to here is typically pure snow, but high winds can expose rock.
3 Camp 3 (7,900m)
At this height, supplemental oxygen is needed. Climbers sleep in tents on small rock ledges since there are limited level areas. Getting here takes about three to six hours.
4 Camp 4 (8,300m)
Not much time is spent resting here due to the altitude. After some food and perhaps a nap comes the push for the summit at night to reach the peak in daylight.
5 Summit (8,848m)
Illustration: Adolfo Arranz
Khumbu Glacier
To get here, climbers will have to scale three “steps” or rock climbs, often steep, exposed, windy, and extremely cold. Climbers will spend eight to 10 hours to summit, and another four to six to return to Camp 3. SCMP GRAPHIC
6 COVER STORY > CONTINUED FROM PAGE 4
wind. The mountain ranges appeared out of the stone cold darkness. At dawn, the warm light lit the tips of the ridges. Although I struggled, I was certain of not giving up. I realised there were things I could control like my own pain management and things I could not, like the deteriorating weather conditions. Everest cannot be a prize to be owned, won, or conquered. Instead, we can only conquer ourselves. Humility The trek took us an average six to eight hours each day. According to McGuinness, speed was essential for survival; taking more than 12 hours to reach the summit would result in an 80 per cent chance of dying from exposure to the altitude. Panting over the steep endless crests made me ponder the mountains of life and daily uphill struggles of work. To find motivation, I looked to the unsung heroes, the sherpas, who tirelessly carried our tremendous piles of food, oxygen and supplies. They energetically pitched our tents while we were feeling half-dead. They enabled us to eat, rest and climb Everest safely. Yet they lead very simple lifes. The simplicity of the Everest region brings peace to any troubled soul with a much needed transformation of the mind. You realise that life need not be so complicated. In its simplicity, life can be deeply meaningful. I learned that greatness is found in the one who stands with the people, not above them. Humility is a virtue that can help prepare for any possible changes of life. Chomolungma humbled me. Life and death For all the excitement of climbing Everest, there was always a pervasive sense of sadness about the place. I walked past three dead climbers along my summit path, and realised that I could end up dead, too. Understanding priorities becomes significantly clearer if we live each day facing death. I hammered through 25cm of deep snow at the first step where the two pioneer mountaineers, George Mallory and Andrew Irvine, perished. I hauled my heavy body up the tricky technical section of rocky second step where many climbers have fallen off the slippery gullies. After 10 hours of climbing, I finally reached the third and final step. At this point, with my sherpa, Karji, I realised that many team members were not with us. We radioed back to Jamie and he
A touch of frostbite from the mountain winds (above); advanced base camp; the jetstream at the top of Everest signifies bad weather so Tan turns and heads back to camp four (below). Photos: Sherpa Karji
explained that the strong winds were not going to improve; he had advised the team to turn around. Kenneth, however, had walked on, resolute, with his sherpa, Jamling. There was a jet stream of lenticular clouds hovering above us, which signified ripping summit winds. The cold, howling southwest winds gave me frostbite on my cheek. Even the water in the bottles inside my down suit froze. I believe that if I had stopped, I would have frozen to death, too.
I walked past three dead climbers along my summit path, and realised that I could be dead, too
Could I and risk the dangers of inclement weather to climb to my peak? At 8,750 metres high, 100 metres or 90 minutes shy of the destination, we turned our backs on the peak to descend quickly back to safety. I was chided for not turning back earlier than I did. Although I had this one chance to summit Everest, I had only one life to live. If you understand something greater than yourself, you will certainly acknowledge the gravity of
the situation. Kenneth eventually reached the summit with Jamling on May 27, but got snow blindness because his corneas froze. Thankfully, he recovered when he returned to the camp. But that was the hardest part of my journey – making the decision to turn back. This made me consider: Have I done right? Have I lived right? Am I ready for what’s next? This means I must keep striving even as I come back to the office to face papers, monitors and e-mails, reminding me that success cannot be achieved overnight. When my mother suddenly died of cancer in December 1996, I felt that life was tough on me, why not make it tougher? After 15 years of repeating this personal motto, Everest was indeed a turning point that restored my purpose of pushing harder for more challenges. I discovered the hard way that it is not climbing the highest mountain that gets you what you want. Instead, it’s about upholding true values and living life meaningfully. As the saying goes, “Judge not a person by how well he wins, judge him by how well he loses.” The fact that I did not summit makes it far more important for me to accept losses with humility than to seek glory in wins. healthpost@scmp.com
HEALTH 7 DISEASE PANCREATIC NEUROENDOCRINE TUMOUR
Rare disease remains hidden ...................................................... Elaine Yau elaine.yau@scmp.com The recent death of Apple cofounder Steve Jobs has turned the spotlight on pancreatic cancer, which claims about 400 lives every year in Hong Kong. The type of cancer that Jobs had – a pancreatic neuroendocrine tumour (PNET) – is actually a rare form of the cancer. Only eight to 10 new cases of PNET occur in Hong Kong every year, compared to 400 for pancreatic cancer, the sixth leading cause of cancer deaths locally. Dr Lo Chung-yau, a specialist in endocrine surgery, says PNET is a less lethal form of pancreatic cancer. “PNET grows relatively slowly,” he says. “If the cancerous cells have not spread to other parts of the body, 60 per cent of patients will still be alive five years after diagnosis; 20 to 30 per cent of patients can still live 10 years after diagnosis.” If the cancerous cells spread, however, the survival rate drops to 20 per cent five years after diagnosis, says Lo. However, this rate is still higher than that for the common form of pancreatic cancer – adenocarcinoma – which is close to zero. Jobs was diagnosed at the age of 48 and died at 56. Because of the slow growth of PNET, the window for treatment is broad, so it’s not difficult to cure, according to Dr Peter Teo Man-lung, a specialist in clinical oncology. The flip side, however, is that the lack of clear symptoms usually delays treatment, says Lo.
While getting a liver scan is easy, normal medical check-ups can’t reveal PNET DR LO CHUNG-YAU, SPECIALIST IN ENDOCRINE SURGERY
Because the pancreas lies deep inside the body, it’s often difficult to diagnose tumours early because they have yet to interfere with the function of nearby organs such as the stomach, liver or gall bladder. “While getting a liver scan is easy, normal medical check-ups can’t reveal PNET,” says Lo. If the tumour is located in the head of the pancreas, it will cause an obstruction in the bile duct. The patient’s face will turn yellow, and they will have an infection that doctors can pick up. But the chance of having obvious symptoms is lower if the tumour is located in the tail, farthest from the duodenum. When the tumour grows big and suppresses the large intestine, it will cause obstruction and bleeding, explains Lo. For those whose cardiorespiratory functions are affected, they can show asthma-like symptoms such as shortness of breath. Other symptoms include dizziness and shaky hands. Lo adds that PNET may cause the pancreas to overproduce certain hormones such as insulin, which
makes the patient suffer from low blood sugar levels. Some produce excessive levels of serotonin (known as the “happy hormone”) and suffer severe diarrhoea. “But some patients can have no symptoms at all,” says Lo. “The cancerous cells in two-thirds of patients have already spread at the time of diagnosis.” The pancreas makes juices which are enzymes that help digest food in the duodenum. It also produces important hormones, including insulin, which controls the amount of sugar in the blood. PNET develops in the islet cells, which are clusters of cells that produce hormones. But doctors don’t really know what causes it. The US Food and Drug Administration approved two new drugs – sunitinib and everolimus – last year for the treatment of advanced PNET. Surgical removal is the preferred form of treatment. Chemotherapy, radiofrequency therapy and molecularly targeted therapy in oncology are used for those whose tumours have spread to other parts of the body. Teo says a liver transplant can extend the life of patients afflicted with PNET, especially for those whose cancerous growth is under control in the pancreas and the cancerous cells have not spread to other organs. However, to prevent the body from rejecting the new liver, patients will have to take immunosuppressant drugs, which weaken the immunity of the body and can make cancerous cells in other parts of the body grow faster. “It’s a dilemma,” says Teo. Jobs underwent surgery for PNET in 2004 and had a liver transplant in 2009. In his case, however, the cancer had already spread and a cure was impossible. “[Jobs] had to get a transplant to prevent liver failure and instant death,” says Teo. Lo speculates that before Jobs got the liver transplant in the US, he went to Europe for an experimental hormone-delivered radiotherapy, as the therapy has not been approved by the FDA. The treatment involves injecting hormones with radioactive substances to kill cancerous cells. Lo says the side effects are much less severe than those associated with chemotherapy, but the treatment costs HK$80,000 to HK$100,000. Only one or two local patients have received the therapy, he says. PNET is distressing because it tends to afflict people in their 30s and 40s. Overall, pancreatic cancers are increasingly striking people at younger ages. “In the past, most people who had adenocarcinomas were over 70. But recently I have seen patients who are just over 50,” Teo says. The risk factors for PNET are largely unknown. Risk factors for pancreatic cancer include not only age, but also cigarette smoking, obesity, diabetes and race. (Blacks are more likely to develop the disease than whites.) “Although we don’t know what causes the disease,” says Lo. “The best way to prevent it is to stay healthy by exercising regularly and eating less fatty foods.”
A photo of Steve Jobs is shown under notes from supporters outside an Apple store in California. Photo: AP
8 DIET TRADITIONAL CHINESE MEDICINE
A little bird told me ...................................................... Margaret Wee healthpost@scmp.com
WEIGHT LOSS
A stiff whiff can cut your raving craving
W
hen it comes to eating, smell is important. Who can say they haven’t walked into a cinema and had a craving for some popcorn? Or that they haven’t found irresistible the aroma of baked goods while walking past a bakery? If glorious smells make us want to eat, is there a scent that could have the opposite effect and actually reduce our urge? Yes, there is, says psychologist Bryan Raudenbush, a professor at Wheeling Jesuit University in the US state of West Virginia. It’s peppermint. His study showed that volunteers who sniffed a peppermint scent every two hours were not as hungry as non-sniffers and – even better – they ate 2,800 fewer calories in a week. That’s enough to lose close to half a kilogram. The peppermint, he says, “is
Peppermint scent could be used to curb individuals’ false hunger cravings; that is, emotional eating
distracting you from hunger pangs, and you don’t feel inclined to eat as much”. Eating peppermint candy or chewing peppermint gum, however, doesn’t work as well. Raudenbush’s earlier studies showed that athletes performed better if they sniffed peppermint. “They were able to go longer at the gym, able to push themselves, were more motivated, less fatigued and felt they had more energy,” he says. The study also concluded “another implication would be that peppermint scent could be used to curb individuals’ false hunger cravings, that is, emotional eating.” Peppermint oil is available online and can be dabbed on a wristband, for example, for easy sniffing. Raudenbush’s study used packaged peppermint inhalers available in nutrition stores or for US$9.99 at sportsinhaler.com. McClatchy-Tribune
Manufacturers of chicken essence have claimed for years that their brews are good for improving brain performance, increasing energy levels and keeping stress at bay. According to Vivien Chou, founder of Integrated Chinese Medicine Holdings Ltd, in traditional Chinese medicine, chicken essence is categorised as a qi tonic that can promote good digestion, enhance vitality, and replenish marrow in the bones and brain. “Chicken meat is sweet and warm in properties, and mainly manifests its actions in the stomach and spleen,” says Chou. New research claims to reveal how chicken essence works. The Brand’s Brain Research Centre, a Singapore facility set up by the manufacturers of Brand’s Chicken Essence, says it has identified a new compound – a dipeptide, produced when proteins are digested – in chicken essence that improves mental performance. They call it ProBeptigen. According to Brand’s, ProBeptigen does not occur naturally in chicken meat. It is produced through the chicken essence manufacturing process, which involves hot water extraction from chicken meat under high pressure. The centre’s Dr Paramjeet Singh presented the findings at the Asian Congress of Nutrition in Singapore a few months ago. Singapore-based Cerebos, which produces Brand’s products, and Japan’s Suntory Group, its parent company, have filed patents for ProBeptigen. The report has been submitted to journals, but when asked for the publication titles, a Brand’s spokesman says the scientists are “concerned about sharing their research ahead of it being published”. However, with a lack of independent studies to back it up it is perhaps best to proceed with discernment. In TCM theory, Chou, who was not involved in the Brand’s study, says tonics such as chicken
essence are for those experiencing general weakness, with symptoms like prolonged diarrhoea, heavy menses, emaciation, hot flashes and night sweats. “They are not suitable for people during an acute or active stage of disease, such as cold and flu with fever, chills, runny nose and cough, as they may make the body react more fiercely, leading to a worse condition,” says Chou. The Brand’s dipeptide study, involving 60 people aged between 35 and 55 years old, claims the compound promotes optimal levels of serotonin, a neurotransmitter that regulates mood, appetite, sleep, memory and learning, among other things. Prolonged stress causes serotonin levels to drop, and could lead to concentration and attention problems, chronic fatigue, poor sleep and low self-esteem. Study participants took either a placebo or a daily dose of 45 micrograms (mcg) or 90mcg of ProBeptigen for up to six weeks. They then did a series of learning and memory tests. Those who took ProBeptigen demonstrated enhanced performance in all the tests, with the 90mcg group performing the best. “ProBeptigen helps restore the neurotransmitter equilibrium that has been disrupted, overcoming the negative effects of stress in the brain,” says Dr Keiichi Abe, vice-president of the regional research and development division of Cerebos Pacific Limited. A separate study by a different team of scientists also found that ProBeptigen increases blood flow to the brain, boosting function. Twelve healthy subjects with an average age of 62 years took either essence of chicken or a placebo for four weeks, followed by a two-week wash-out period. They then switched to either a placebo or chicken essence for another four weeks, depending on what they took in the first phase. The subjects’ brain activity was measured through near-infrared spectroscopy and cognitive tests.
EAT SMART DUCK POT-AU-FEU
French duck journeys from cauldron to stockpot in search of a new local twist ...................................................... Jeanette Wang jeanette.wang@scmp.com Pot-au-feu, or “pot on the fire” in English, is usually a beef stew that is ubiquitous on French dinner tables. It’s cooked in stockpots, but in the old days, huge cauldrons were used over the permanent winter fire, for an ever-changing broth enriched daily with whatever was available. For a local twist, duck instead of beef is used in this version by The English-Speaking Dining Society of the Chinese Cuisine Training Institute. The dish is labelled “3 Less” [sic] by the Health Department, meaning it has reduced fat or oil, salt and sugar.
1duck carcass 2 litres water 12 new potatoes 3 carrots 200 grams of celery Handful of parsley A few sprigs of fresh thyme 4 skinless duck breasts (400 grams) 1/2 tsp fine salt Ground white pepper to taste
• Skim and set aside. • Meanwhile, cut the carrots and celery into sticks and chop the parsley. • Cook the potatoes with the duck stock for 15 minutes. • Add the carrots, celery and thyme. • Place the duck breasts on the top and lower the heat. • Simmer until cooked. • Add the parsley and season with salt and pepper. • Slice the duck breast and serve with the potatoes and vegetables.
• Chop the duck carcass into pieces and slightly brown in a preheated oven. • Place browned duck carcass in a soup pot and add two litres of water. • Simmer until cooked down to one litre of duck stock.
This regular column features recipes provided by the Health Department as part of the department’s EatSmart@restaurant.hk campaign. For more information, visit restaurant.eatsmart.gov.hk
Duck pot-au-feu Serves 4
Duck gives pot-au-feu a local flavour. Photo: Health Department
DIET 9 NUTRITION PUMPKIN
Pump up the benefits ...................................................... Elle Kwan healthpost@scmp.com As the night darkens and spooks and spirits howl, it’s easy to view jack-o’-lantern as just a glowing orange face with a sinister smile. But the end of October brings a bumper crop of nutritious, healthy pumpkins, in all shapes and sizes, which do more than frighten ghouls away. The pumpkin is an oftoverlooked fruit, but holds untold health benefits. Like carrots, its bright orange flesh contains high levels of beta-carotene, which works as an antioxidant to eliminate toxins from the body, says Denise Fair, a registered dietitian with Central Health Medical Practice. What’s more, the body turns beta-carotene into vitamin A, which is essential for good bone growth, vision, and the cell replenishment that slows ageing. Pumpkins also contain vitamins C and E, which fight the free radicals that cause cancer and heart disease, and a good helping of potassium. This is an important mineral for the proper functioning of cells, tissues and organs. The recommended daily serving of the fruit is 1 to 11⁄2 cups, or about the size of a fist, Fair says. “Because of its antioxidant potential, pumpkin is one of those foods we should be eating more of. It’s low in carbohydrates, so it’s
OK or diabetics and suits a lowglycemic diet,” she says. However, while the high-fibre, low-fat food is classed as a fruit, it should be treated as starch, replacing potatoes, yams or sweet potatoes in a dish to avoid starch overload, she warns. Pumpkin can be enjoyed in a variety of ways, in a pie, bread, muffin, salad, soup or pasta. Fair, having recently enjoyed pumpkin gnocchi, suggests puréeing it and using it in lasagne or spaghetti sauce. Justin Smolev, who created the Atlanta-based Dressed salad chain, loved pumpkin so much he used it for his final exam project in culinary school, creating a fivecourse meal around the fruit. He likes to pair pumpkin with wintry vegetables to enhance its hearty flavour. Sweet potatoes, green beans or chickpeas are favourites. Soups, which Smolev says “should be velvety smooth”, are another soothing filler in cooler weather.
Pumpkin is a food we should be eating more of. It replaces sweet potatoes, yams, and potatoes DENISE FAIR, REGISTERED DIETITIAN
But don’t forget to spice it up a little. “The pumpkin has a wonderful earthy flavour, but certainly needs seasoning and/or sugar to enhance the flavour,” Smolev says. At Dressed, maple syrup and nutmeg are added to pumpkin soup for a touch of sweetness. Salads and stir-fries are given added oomph with a pumpkin byproduct: its seeds. Slowly roasted, they maintain their high levels of monounsaturated “good” fat, and bring added protein, zinc and iron to the plate, Fair says. You can add a handful of pumpkin seeds to salads or granola, or eat them on their own as a snack to keep hunger at bay. Pumpkins grow around the world and come in a variety of colours such as red, white (known as ghosts) and green. Shapes range from squat to round to bulging. Most supermarkets stock a range of imports in addition to seasonal local treasures. Hong Kong-grown pumpkins, known simply as Chinese pumpkins, are green and pearshaped, says Todd Darling of Homegrown Foods, which grows organic produce in the New Territories. When selecting a specimen, shape tells a lot. “The more pearshaped, the better,” Darling says. Chinese pumpkins are famed for their sweet taste, and they are available long past the witching hour all the way through to December.
The result, made by Josh Chu (below) of Posto Pubblico. Photo: Edward Wong
RECIPE FOR HEALTH PUMPKIN PIE
Organic fruit has natural taste that canned filling can’t match ...................................................... Elle Kwan healthpost@scmp.com Local pumpkins share a similar flavour and texture to some of their popular American cousins. The local version is great for making a classic pumpkin pie. Josh Chu, executive chef of Posto Pubblico, uses local farm-grown organic Chinese pumpkin in this healthier version of the treat, instead of canned pie filling. “There is really no comparison. The canned filling is so full of artificial flavour enhancers and added sugar that, when tasted side by side, it doesn’t even taste like real pumpkin,” he says. The base is made with whole wheat flour rather than the usual refined white. “It is rich in dietary fibre and manganese, which is great for people who are on diets and can prevent diabetes,” Chu says. He uses full fat cream to get the traditional texture of pumpkin pie, but it can be replaced with skimmed milk or even water. “This particular recipe is special because it’s healthy and diet-friendly, but it tastes just like what Mama used to make,” he says. Pumpkin pie For the crust 1 ¼ cup whole wheat flour 1 tbsp granulated sugar A pinch of kosher or sea salt ½ cup cold unsalted butter, cubed 2 tbsp whole milk, cold
One-year-old Dino Cancellare explores a pumpkin patch during a visit to Pumpkin Town in Oklahoma. Photo: AP
• Sift flour into a bowl and add sugar and salt. • Add butter and squeeze together flour and butter until mixture forms small lumps. • Add milk and shape mixture into a ball. • Roll dough out into a sheet.
• Mould dough into a greased glass pie bowl and poke holes into the dough with a fork to prevent bubbles. • Blind-bake the base by covering the dough with baking paper and filling with rice or pebbles. • Bake at 200 degrees Celsius for 15 minutes. • Cool inside the bowl on a rack. The base should be half-cooked. For the filling 450 grams of local organic pumpkin, seeded, baked and puréed 2 ⁄3 cup granulated sugar 1 tsp ground cinnamon ½ tsp ground nutmeg ½ tsp ginger powder 1 ⁄8 tsp allspice ½ tsp kosher or sea salt 3 eggs, free range 1 ⁄3 cup heavy cream 1 ⁄3 cup skimmed milk A squeeze of lemon juice • Whisk all ingredients together until semi-smooth, and pour into pie shell. • Bake at 180 degrees Celsius for 30-35 minutes. • Stick a toothpick in the centre of the pie; if it comes out clean, it’s done. • Cool on a rack for 1½ hours. Refrigerate or serve.
10 FITNESS SWEAT BURN IT OFF
Calorific bookkeeping: how it all adds up ...................................................... Alexia Elejalde-Ruiz The office lunch – which 62 per cent of Americans eat at their desks, according to the 2011 Desktop Dining survey from the American Dietetic Association and ConAgra Foods – can deal a calorific wallop if you’re not careful. Deceptively fattening salads and sodium-heavy soups can surprise people who think they’re making healthy choices, says Jenny Sucov, editor of EverydayHealth.com. Skipping lunch, or waiting too long to eat, slows the metabolism, encourages overeating and hurts concentration, says Amy Jamieson-Petonic, director of wellness coaching at the Cleveland Clinic and spokeswoman for the American Dietetic Association.
Calories aren’t the only concern. People should also watch sodium, saturated fat and added sugar JENNY SUCOV, EDITOR, EVERYDAYHEALTH.COM
And though the Desktop Dining survey shows that most office workers make the healthy choice of bringing lunch from home, giving them control over ingredients, for the 41 per cent of those who buy lunch out or eat takeaway at their desks, popular meals can pack a heavy punch. Take a look at the top lunch foods eaten at restaurants and those taken back to the office to eat, according to market research firm NPD Group. We gave examples of each from popular restaurants, then used the calculator at everydayhealth.com/caloriecounter.aspx to determine what you’d have to do to burn them off. Of course, calories aren’t the only concern. People should also watch sodium, saturated fat and added sugar, Sucov says. And it’s best to eat a nutritionally dense meal of complex carbohydrates and lean
protein, plus fruit and vegetables, to leave you feeling full and nourished, says Jamieson-Petonic. But when it comes to weight loss, as elementary as it sounds, the key is to burn more calories than you consume (erase 3,850 calories to lose 500 grams of weight). The calculations are based on a 68-kilogram person. People who weigh less would have to exercise longer to burn the same number of calories. Carbonated soft drinks Cola, 590ml (240 calories, 0 grams fat, 75mg sodium) Burn it off: 38 minutes of tennis or one hour of mopping Alternative: Water (0 calories, 0 grams fat, 0mg sodium) Burn it off: Nothing Rob Lilwall prepares for his 5,000-kilometre Walking Home expedition from Mongolia to Hong Kong this winter Burger McDonald’s Quarter Pounder with Cheese (510 calories, 26 grams fat, 1,190mg sodium) Burn it off: 71 minutes of walking (7.2 km/h) or 45 minutes of running (9.7 km/h) Alternative: McDonald’s Cheeseburger (300 calories, 12 grams fat, 750mg sodium) Burn it off: 42 minutes of walking (7.2km/h) (or 27 minutes of running (9.7 km/h) Poultry KFC two-piece Original Recipe chicken (drumstick and thigh) (370 calories, 24 grams fat, 1,040mg sodium) Burn it off: 41 minutes of jumping rope or 93 minutes of vacuuming Alternative: KFC two-piece grilled chicken (260 calories, 14 grams fat, 829mg sodium) Burn it off: 29 minutes of jumping rope or 66 minutes of vacuuming Pizza Two slices of Pizza Hut Supreme Pan pizza (580 calories, 28 grams fat, 1,300mg sodium) Burn it off: one hour of soccer or 114 minutes of golf (walking the course and carrying clubs) Alternative: two slices of Pizza Hut Veggie Lovers Thin ’n’ Crispy pizza (360 calories, 12 grams fat, 1,050mg sodium) Burn it off: soccer for 37 minutes or 71 minutes of golf (walking the course and carrying clubs) McClatchy-Tribune
Less exercise is needed to burn off chicken if it’s grilled, not fried. Photo: AP
WALKING HOME
Best foot forward ...................................................... Rob Lilwall healthpost@scmp.com In three weeks, I will be flying from Hong Kong to Mongolia with a friend, and when we land, we will set off to walk back to Hong Kong – 5,000 kilometres through a rather wintry China. Of course I’m daunted by the adventures (and blisters) which we will no doubt encounter, but I’m also really excited to get back into living in the wild. Furthermore, the past four months have been mentally exhausting. There’s actually quite a lot of preparation involved – the logistics, acquiring of gear, learning of languages, negotiating with sponsors. But the most important, basic, and obvious task, has been to prepare my body for the challenges it will face. We were given the advice early on in our training that “mountain goats don’t play tennis”, meaning the best way to prepare for many months of hiking with a heavy pack is not to go running or swimming or to the gym, but rather just to go hiking a lot with a heavy pack. It seems obvious, but I had not thought of it like that beforehand. And so, since then, several times a week I have been heading out into the Lantau hills and getting some serious kilometres under my belt to develop my fitness and wear in my boots (to avoid blisters during the actual journey). Our concern is not only gaining fitness, but also not injuring ourselves. About a year and a half ago, a friend and I went on a big hike in Britain – walking a lap of the M25 motorway in the snow. We walked about 250 kilometres in seven days, and along the way, we slept in forests, tramped through fields, climbed over hedges, and
were even invited to stay with “the locals” (an Irish salesman let us stay in his spare room; a London banker would not allow us into his house, but did invite us to camp in his garden). Although this walk was a beautiful experience, it was also a very painful one. My feet, back and especially knees were all in agony – and that was after just a week. To try to avoid such agony occurring (or even worsening) on my much longer expedition this year, there are two main strategies for prevention.
We will be crossing a huge country in the depths of winter – a journey which even in a car would be tough and interesting The first is to force ourselves not to walk too hard for the first half of the expedition. Although we might feel fit and raring to go for our first few days, we will deliberately not walk more than 32 kilometres a day for the first month, and we will take at least one day off a week, so that our bodies can get used to this new way of life. Also, for the first month, we will be crossing the relatively flat plains of the Gobi desert, and actually pulling our gear in a specially designed human-wagon, so this will relieve the strain on our backs, too. After these relatively slow early weeks, all being well, we will build up to longer distances each day. The second strategy is that I have been going to a physio centre
in Central, which has been giving me excellent advice on injury prevention. Aaron, the physiotherapist from Sports Performance, has taught me stretches and strength exercises to ensure that my body has the right mixture of flexibility, balance and strength to not get aggravated by long days of tramping. Doug, the podiatrist, has taught me about foot care (blister prevention, ingrown toenail elimination, and so on), and also analysed my walk on a treadmill, and seen that my knees bend slightly inward. Apparently, most of us walk slightly out of line, although it does not cause huge problems when we are young, unless we go on massive 5,000 kilometre walks. To fix my slight non-alignment, he has given me special insoles, which correct my gait and so should dramatically reduce knee or back problems. So with these strategies, hopefully the walking part of the expedition will take care of itself. But of course, there are other challenges: we will be crossing a huge country in the depths of winter – a journey which even in a car would be tough and interesting. But we will be on our own, on foot, sleeping rough. I can’t wait. Next week, I will share with you the other pre-departure preparations that I have been going through. Rob Lilwall lives in Hong Kong with his wife. His previous expedition, Cycling Home From Siberia, became the subject of a television series, a book and many motivational talks. Every week in Health Post, he will report the progress of his new expedition, Walking Home From Mongolia, which will support the children’s charity Viva. For more updates, see www.walkinghomefrommongolia.com.
WELLBEING 11 FIT & FAB
The way to flying fitness ...................................................... Jeanette Wang jeanette.wang@scmp.com George Clooney, eat your heart out and say hello to Sergio Mello, the Italian entrepreneur who’d give your Up in the Air character a run for his money – or should we say, a run for his mileage. Mello, a native of Turin, has been based in Hong Kong since 2008, when he founded Satisfly. The company sells airlines software that finds ideal seating partners for passengers. He travels extensively to meet airlines and speak at conferences across the globe. “In terms of flown mileage, we may compete,” says Mello, referring to Clooney’s film character Ryan Bingham, “but I definitely care more about friends and family.” He rarely flies without meeting up with friends wherever he goes – even if it’s just 24-hour turnaround trip to Sydney. Travel, he says, keeps his attention deficit disorder under control. “Ironically, a stable and repetitive daily life stresses me more than a constant run to catch flights,” he says. The downside, however, is frequent neck pains and having limited time to train for triathlons. Mello took up that sport recently. He was inspired by a pair of bad knees that didn’t agree with all the skiing or running he had been doing. Having had knee surgery as a teenager, he picked up swimming and cycling for active recovery and therapy. His triathlete friends encouraged him to “connect the dots”, and in August he did his first sprint triathlon. Next weekend, he will be doing his first half-Ironman triathlon (swimming for 1.9 kilometres, cycling for 90.1 and running for 21.1) in Taiwan. How do you keep fit on the road? Eat well. It may be difficult when wining and dining customers or reuniting with old friends, but it’s the most important thing. Long flights mess up digestion, so it’s always imperative to stay light. On the training side, it’s hard to find decently long hotel pools. So I usually run in the morning. I hit the treadmill if the circumstances make an outdoor jog impossible. I’ve got a bicycle in Italy, so I can train on Turin’s hills, as well.
Sergio Mello, CEO of Satisfly, a company that finds ideal seating partners for people on planes, is an avid surfer and triathlete. Photo: Herbert Tsang I happen to be there quite frequently, whenever business brings me to Europe. Which is your favourite city to run? Sydney – the coastal trail from Bondi to Coogee Beach is a symphony of climbs over the cliffs and stunning ocean views – breathtaking, literally. However, I also have a passion for bringing my longboard skateboard with me to Taipei and Singapore. I love cruising the empty streets at night. It frees my mind. Business travel can take its toll on health, and frequent travellers are
more likely to be obese, studies show. How do you stay healthy? Flying time is detrimental to health if countermeasures are not taken. I strictly avoid sleeping pills and other similar drugs. Instead, I focus on eliminating carbs and alcohol before and during flights. I usually eat a light meal before and try to survive on fruit platters in-flight. Not all airlines provide this choice, unfortunately, and it’s often a psychological wrestle with my sweet tooth.I also stretch at any occasion before, during and after the flight, at the cost of looking goofy in front of hundreds of people lining up at an immigration queue.
If you had a choice, whom would you sit next to on a flight? On the left, I’d like to have a like-minded person, someone I can share hobbies or work experience with. On the right, it would be great to have a complementary profile. There’s always something new to learn about the world. Have you sat next to anyone interesting lately on a plane? During a flight from London to Milan, I once met a business lawyer. His colleague fell asleep, so we had a pleasant conversation. We were interested in each other’s
businesses and clicked right away. He eventually introduced me to a few venture capitalists. What don’t we know about flying? The atmosphere at cruise altitude contains almost no water particles, so the air flowing in the cabin is very dry, about 30 per cent humidity. And guess where that little humidity comes from. Human breath – yuck. That’s why it’s imperative to drink lots of water and avoid coffee, tea and alcohol while flying. Dehydration symptoms, like headaches, really don’t mesh with jet lag.
THE TASTE TEST YOGURT ...................................................... Jeanette Wang jeanette.wang@scmp.com FiorDiMaso Coffee Yoghurt Two 125g cups for HK$26, Il Bel Paese I’ve never had this flavour of yogurt before, and I can’t say I would again. It’s like having a slightly tart weak coffee – but too viscous as a yogurt and too thick as a drink. Verdict: not for me; I’ll stick to fruity yogurts.
Fruche Strawberry Fields Two 150g cups for HK$29.90, Wellcome Made according to a traditional European-style recipe, this has a texture like spoon-hugging pudding rather than the more fluid yogurt I’m familiar with. It’s still yummy, though. Verdict: right sweetness, but could be better with the addition of strawberry pieces.
Yeo Valley Organic Apricot Probiotic Yogurt 450g for HK$36, Market Place by Jasons This has a silky smooth texture, is light on the palate and doesn’t have the strong dairy taste that puts some people off yogurt. Could do with more apricot pieces – they’re few and tiny. Verdict: pair with crunchy muesli, as it can be a bit bland alone.