20111108 health post

YOUR GUIDE TO LIVING WELL

HEALTH POST Naturally better Our experts put organic food to the taste test >PAGE 4

HONG KONG: ARE WE A HEALTHY SOCIETY? >PAGE 6

STROKE: SEIZE THE THREE GOLDEN HOURS >PAGE 7

TUESDAY, NOVEMBER 8, 2011

2 NEWS HEALTH BITES

ASK THE DOCTORS DR OR YU-WAH

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

Jeanette Wang jeanette.wang@scmp.com

Q: I have been running every day for almost 10 years without any pain or injury, but lately I started feeling a sharp pain at a point below my knee cap every few strides. It hurts when I start my runs, but it usually disappears once I get warmed up. What is causing this pain, and how can I get rid of it?

Rare, medium or carcinogenic, sir?

It’s known that cooking meat under high heat forms cancer-causing substances, but now a study shows the effects of eating well-done meat might be worse than imagined.

Researchers at the Norwegian Institute of Public Health have found that mice, often used to test the safety of food for humans, metabolise carcinogenic substances in different ways. This is because humans have enzymes called sulfotransferases in many organs of the body, while normal mice only have them in the liver.

These enzymes may transform harmless substances into carcinogenic substances. The study found the health risk posed by harmful foods is underestimated: the incidence of intestinal tumours increased from 31 per cent to 80 per cent in “human-like” mice after consuming substances from well-done meat.

The campaign on everyone’s lips this month It’s that time of year again – when men get hairy and women get … hairy kisses. Since 2003, November has been Movember in many countries worldwide, a month where men voluntarily grow a moustache to raise awareness and funds for a taboo subject – their health, focusing primarily on prostrate cancer. While “Mo Bros” grow their ’tache, women, or “Mo Sistas”, play an important role by recruiting more Bros and garnering donations. In Hong Kong, a series of events has been planned, including a Gala Party on November 30 at Irish pub Kila in SoHo. Mo Bros will also get complimentary moustache trimming and grooming trips from The Mandarin Barber all through this month. For more info and to sign up, see www.movember.com.

A: Although running is good for your health, sometimes it causes problems.

You are very observant and notice the characteristics of the pain and its relationship with specific activities.

There are many possibilities, but it sounds like you have an overuse injury, namely patellar tendinitis, which usually gets worse with knee extension and improves if you fully warm up before starting to run. Others possibilities include a stress fracture, but the patella (knee cap) is not the typical site.

If you don’t want to consult a doctor at the moment, you can try a course of non-steroidal anti-inflammatory drugs, physiotherapy, patellar strapping, or reducing your volume of exercise.

If the condition doesn’t improve or

gets worse after one to two weeks, talk to your doctor. He would have to gather a thorough history of your activities and injuries, followed by a detailed physical examination. Additional investigation may be necessary to establish a full diagnosis.

Dr Or Yu-wah is a specialist in orthopaedics and traumatology

APP OF THE WEEK

Chocolate bar casts a stronger spell than weight loss app ......................................................

Katie McGregor healthpost@scmp.com

New clinic may reduce the wait The frustrating wait for an outpatient appointment will hopefully be reduced with the addition of a new facility last week.

Matilda Medical Centre, the fourth clinic run by Matilda International Hospital, has opened at Ocean Centre, Tsim Sha Tsui, offering primary and preventative healthcare services, including a dedicated corporate health assessment section and a full range of advanced diagnostic facilities.

For more information, visit www.matilda.org or call 3922 7500.

Believe in Weight Loss with Hypnosis with Benjamin P. Bonetti US$3.99 Rating 5/10

Play blocks build foundations for life Parents, you might want to swap that gaming console in your child’s hands for building blocks. Playing with the old toy classic has some real benefits, according to a recent study by Temple University’s Infant Lab published in Mind, Brain and Education. The researchers found that when playing with blocks under interactive conditions, children hear the kind of language that helps them think about space – such as “over”, “around” and “through” – which is critical for developing spatial ability and awareness. Spatial skills are not only important in science, technology, engineering and mathematics, but also many everyday tasks – like packing the boot of a car, assembling Ikea furniture or finding your way around town.

Fun, fashion and fund-raising Here’s a party with a difference that will make a difference: fashion designer Marisa Zeman of Nude is Rude has teamed up with Flex Studio and Hong Kong Cancer Fund for a special evening this Thursday. Enjoy canapés, wine and champagne, along with a fashion show and silent charity auction.

The party starts at 6.30pm at Flex Studio, 1/F Regency Centre (Phase II), 43 Wong Chuk Hang Road, Aberdeen. Tickets are HK$250 at the door. All proceeds go to charity.

The first app I downloaded for weight loss through hypnosis was the free Ultimate Weight Loss Lite.

The approach was to talk to my subconscious, telling me to picture piles of disgusting fatty foods and imagine myself throwing up after eating them. You’d think this would put me off my mid-afternoon chocolate bar, but no. It seems my subconscious is OK with picturing a disgusting pile of fat, and eating it.

As I have been successfully treated by a real hypnotist for a fear of heights, I put this failure down to the quality of the app and decided to try what I hoped would be a more effective treatment.

I chose Benjamin P. Bonetti, who has a voice you’d expect of a hypnotist – mellow and … chocolatey. After the induction, where the hypnotherapist gets you to relax “deeper and deeper”, Bonetti tells your subconscious: “You’ll stop eating as soon as you feel satisfied, and before you are full.” It continues with imagery of yourself in a garden, then on a swing: “Imagine yourself on a swing at the perfect weight and size and that as you swing higher … I want your metabolism to adjust to the perfect level.”

On the first two days using the

Bonetti app, I could manage without my chocolate bar. On day three I took the session before going to bed as recommended, but I fell asleep and things unravelled from there. The chocolate bar was back on the menu, and because the session takes half an hour, I found it hard to fit another session in.

Unlike a real hypnotherapy session, in which you may only need two treatments, Bonetti recommends you use the app every day for three weeks!

My daughter observed that if I were to spend that half hour doing just a bit of exercise every day, I’d be sure to lose some weight over three weeks. I had to agree.

> 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

Defusing a DNA time bomb Eileen Aung-Thwin healthpost@scmp.com Sandy Ho, 31, was in the prime of her life. With a career in banking, a loving husband and a young child, her future looked rosy.

However, Ho, whose real name is withheld for reasons of patient confidentiality, was in for a shock.

A regular health check revealed that she had leukocytosis, which is a high white blood cell count, and thrombocytosis, or a high blood platelet count. Leukocytosis can be caused by infections, drugs, a bone marrow disease or immune disorder.

As Ho felt healthy with no signs of infection, had a good health history and was not taking any drugs that would elevate her white blood cell count, she was referred to Dr Raymond Liang, director of the Comprehensive Oncology Centre at the Hong Kong Sanatorium and Hospital, for further investigation.

Liang found that Ho’s blood had a profusion of different types of myeloid white blood cells, or cells that originate in the bone marrow. These myelocytes and metamyelocytes were in varying degrees of maturity, unlike the immature cells called myeloblasts, which multiply uncontrollably in acute leukaemia.

The doctor knew that he was looking at chronic myeloid leukaemia (CML), a blood cancer that tends to strike patients at a median age of 30 to 40 years.

To confirm his diagnosis, a genetic test was conducted on Ho’s bone marrow. Liang was looking for a unique genetic abnormality called the Philadelphia chromosome, in which two chromosomes – nine and 22 – exchange material and produce an abnormal protein, tyrosine kinase, which causes white blood cells to proliferate rapidly and crowd out normal cells.

Ho tested positive for the Philadelphia chromosome and, hence, CML. Despite feeling well and being symptom-free, the young mother was handed a cancer diagnosis from out of the blue. But it was not necessarily a death sentence.

CML is one of the very few cancers triggered by a single genetic abnormality in what is termed the chronic phase. Most cancers appear with several genetic abnormalities.

During this deceptively benign chronic phase, patients will be asymptomatic. Most would know they have leukaemia only if they, like Ho, undergo regular health checks.

Others might seek medical attention because their enlarged spleens might cause them discomfort in the left side of their abdomens. Yet others will have no idea they are living with a time bomb.

The disease usually accelerates after three to four years. Within 10 years, almost all untreated CML patients will undergo further genetic changes that will trigger acute leukaemia, at which point treatment is difficult and patients may not survive beyond one year.

Liang says that in the past, CML patients would be treated with an oral chemotherapy drug called hydroxyurea, which could control the

white blood cell proliferation and shrink the spleen. It was effective in improving the blood count and helping the patient feel better.

However, it did nothing to slow the progression of the disease into acute – and fatal – leukaemia.

Patients could opt for a cure with a bone marrow transplant, which carried a 10 per cent to 20 per cent rejection rate. But it was not easy, says Liang, to convince young, asymptomatic patients that they needed a risky operation or they could die in a few years.

Medical science then discovered that a special type of protein called interferon could help stall the transition to acute leukaemia in a very small percentage of CML patients. Unfortunately, the treatment’s high toxicity, frequency of injections required and low

success rate made this option less than ideal.

But more than 10 years ago, scientists had a breakthrough and created a chemical called Imatinib that could stop tyrosine kinase in its tracks, and prevent the white blood cells from proliferating.

Because CML was caused by this one deviant protein, Imatinib was a powerful tool for controlling the disease, so much so that bone marrow transplants are now rarely needed to treat patients. Also, Imatinib is easy to administer in the form of a daily pill and has easily manageable side effects.

Recent research shows that patients who respond well to Imatinib have an overall survival rate of 95 per cent after eight years.

Because some patients developed a resistance to Imatinib after some

Despite feeling well and being symptomfree, the young mother was handed a cancer diagnosis from out of the blue time, second-generation drugs such as Dasatinib and Nilotinib were developed. Much more potent than Imatinib, these new drugs cause the number of leukaemia cells to plummet very quickly.

Some doctors, including Liang, are no longer waiting for patients to develop resistance to Imatinib but are

starting their patients on Dasatinib and Nilotinib. Hence, Ho was given Nilotinib, and six months after treatment first started her condition is under control. However, Ho will need long-term treatment with Nilotinib as research has shown that CML will continue to progress without continued therapy.

These new drugs are expensive, but fortunately for Ho the HK$20,000 to HK$30,000 monthly cost of Nilotinib is covered by her insurer.

Patients without insurance coverage must pay on their own or seek government subsidies.

Although she has to return every quarter for a blood test, Ho’s life has returned to normal. She is back at work and revelling in the joys of family and motherhood. Thanks to medical science, Ho’s time bomb has been all but defused.

Illustration: Angela Ho

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

4 COVER STORY

Chewing what Is all organic food more flavoursome than non-organic?

Jacinta Read asks four experts if they can taste the difference Top: Harlan Goldstein, Joe Chow, Leslie Chan and Lakshmi Harilela at the tasting at Gold restaurant in Central. Byline: May Tse

A

few years ago, you had to make a special trip to a grocery store to buy organic food. These days, you can find it everywhere, even at the Wellcome or ParknShop, although, typically, still at two or three times the price of regular products.

But is organic food really superior or is it overrated?

There is something of a health “halo” that surrounds organic food – it’s generally perceived as more nutritious than conventionally grown produce.

In a study presented at the Experimental Biology 2011 meeting in Washington in April, Cornell University graduate student Jenny Lee Wan-chen put 144 subjects at a mall through a taste test of organic cookies, yogurt and potato crisps, labelled as either “regular” or “organic”.

Most subjects perceived the organically-labelled foods to be tastier, lower in calories and fat, and higher in fibre, even though they were identical to their conventionally-labelled counterparts.

However, an independent review in 2009 commissioned by Britain’s Food Standards Agency showed that there were no important differences in the nutritional content of organic crops and livestock products, or

any additional health benefits compared with conventionally produced food. Two other independent reviews conducted

by French and Swedish food safety authorities also shared similar conclusions.

While you shouldn’t judge a cookie by its wrapper, as Hong Kong’s Centre for Food Safety states, it is likely that organic produce will have lower concentrations of synthetic chemical residues. There may be other benefits, such as it being more environmentally friendly and, in some cases, fresher.

What about tastier? To find out, Health Post put four food experts to a taste test.

We gathered top American chef Harlan Goldstein, registered dietitian Leslie Chan, food consultant Lakshmi Harilela and self-professed food enthusiast Joe Chow, and had them blind taste both the organic and conventional variations of nine different items, before revealing which products were organic or regular. The question here, of course, is whether experienced palates can taste any difference between foods that contain “nasties” – chemical pesticides, fertilisers, hormones, additives and so on – and those that don’t.

As far as whole foods (unprocessed and unrefined) are

Finding flavour

30% • the increase in consumption of organic food in Hong Kong between 2005 and 2008

concerned, organic strawberries and tomatoes win hands down.

“These are very yummy,” says Harilela, as she tastes the strawberries.

“I think tomatoes are supposed to taste like this,” says Chow.

The panelists all prefer the organic gourmet ham slices, priced only slightly higher than the non-organic version, which Chan says tastes “like normal, processed sandwich ham.” The organic version of the bread is also voted superior, with Goldstein saying it “looks, feels and tastes homemade”.

These results suggest that perhaps the best way to make fruit, vegetables, meat and bread taste the way we like them to taste is to leave them alone as much as possible. It’s not rocket science, nor is it a blanket truth.

It is the non-organic processed foods that beat their organic equivalents. Our tasters prefer the regular wafer crackers, cheese and juice. “This has almost a rancid taste to it,” says Goldstein after tasting the organic wafer. Chan agrees: “It tastes bland and sticky.”

A possible reason for this could be that the higher costs of organic component ingredients result in less money to spend on production and/or quality control.

Perhaps it is also because the producers of non-organic

COVER STORY 5 Results of Health Post’s organic taste test = Preferred organic

= Preferred non-organic

WHAT EXACTLY IS ORGANIC?

/ = Ambivalent

Lakshmi Harlan Harilela, Leslie Chan, Joe Chow, Goldstein, health food chef consultant dietitian foodie

It can be confusing trying to define “organic”, especially when standards vary worldwide.

In some jurisdictions, such as the United States, the EU and Japan, the government has drawn up and oversees comprehensive legislation on organic foods. In other countries, laws may not exist, the government may or may not issue guidelines and certification is handled by non-profit organisations and/or private companies.

According to the International Federation of Organic Agriculture Movements (Ifoam), there are currently hundreds of private organic standards worldwide; in addition, organic standards have been codified in the technical regulations of more than 60 governments.

While there are international certification bodies, including members of Ifoam, the Organic Crop Improvement Association and Ecocert, there is no international harmonisation of certification yet.

In Asia, the Asia Regional Organic Standard is being developed – presently in its second draft. The scope of this standard is, for now, crops, wild production processing and labelling.

In Hong Kong, according to the Centre for Food Safety, organic standards include: • For planting: avoiding the use of chemical pesticides and fertilisers, but emphasising crop rotation, animal and plant manures, hand-weeding and biological pest control.

• For raising animals: avoiding the use of antibiotics, growth hormones and other animal feed additives.

• No application of genetic modification and ionising radiation.

The city, however, does not have any specific regulation for organic products. But there is a non-profit organic certification organisation, the Hong Kong Organic Resource Centre (HKORC), which was set up with a grant from the Agricultural Development Fund of the Vegetable Marketing Organisation in December 2002.

False organic labelling is dealt with by the Customs and Excise Department.

According to the Agriculture, Fisheries and Conservation Department, as at last month, there were 400 organic farms in Hong Kong, with 86 crops production farms and four additional processing farms certified organic by the HKORC. Jeanette Wang

Item Strawberries Driscoll’s Strawberries (HK$64.80) Driscoll’s Organic Strawberries (HK$89.80) Bread Great Bakery Butter Toast (HK$18) Great Bakery Organic Round Loaf (HK$24) Cheese Mainland Vintage Tasty Cheddar (HK$51.50) Duchy Originals Organic West Country Farmhouse Cheddar (HK$99) Milk Pura Hi-Lo Milk (HK$32.90) Clover Organic Farms Low Fat Milk (HK$49)

Peanut butter Fifty 50 Creamy Peanut Butter (HK$39.90) Waitrose Organic Smooth Peanut Butter (HK$32.90) Ham Gourmet du Chef Honey Baked Ham (HK$65.90) Dorset Farms Organic Honey Ham (HK$70.50) Juice Bolthouse Farms Strawberry Banana Fruit Smoothie (HK$40.90) Happy Planet Organic Strawberry Banana Smile (HK$50.90) Wafers Waterthins Natural (HK$30) Waterthins Organic (HK$24) Cherry tomatoes Calfruit Mina-Roma Tomatoes (HK$49.80) Del Cabo Certified Organic Heirloom Medley Cherry Tomatoes (HK$56.80)

/

comes naturally products have been in the game longer, and know how to manipulate certain food and drink products to make them taste “right” to their customers.

Goldstein thinks the regular wafer is “much better than the other one. It has a vanilla sweetness to it.”

Interestingly, the organic and non-organic dairy products do not differ widely from each other. The taste test panelists were unanimously underwhelmed by both varieties of milk and cheese.

“They taste very similar,” says Goldstein. Harilela found both equally “bland”. A probable explanation for this is the fact that all the dairy products were imported. The act of transporting certain foods has a negative effect on their taste.

Hong Kong ranks high on the Nomura Food Vulnerability Index – a list of countries’ dependency on imported goods. Very little is produced locally and that means everything else has to be shipped, flown and/or trucked in to us.

This, on top of the already higher costs that organic farmers are dealing with, makes the prices we pay higher than most of us are happy about.

Statistics from the Hong Kong Organic Resource Centre show a rising demand for organic food, with a survey showing a 30 per

My diners say that non-organic meat can be tasty, but it tends to bloat the tummy.

I prefer to use allnatural products even though it costs more.

I don’t want meat full of hormones HARLAN GOLDSTEIN (BELOW), CHEF AND RESTAURATEUR

cent increase in organic consumption between 2005 and 2008. But this increase only translated to less than 20 per cent of supermarket sales.

Research by Baptist University in 2009 found that although most of their 330 study participants held positive attitudes towards organic food, more than half said they seldom consumed it. The study concluded that age, education and income do not have a major influence on the consumption of organic food. Attitude, health consciousness, environmental concerns and knowledge were stronger factors.

“If price was not a factor I would definitely eat more organic food,” says Chow, a young professional whose budget largely dictates his diet. “But I suppose you could think of things in the long run – medical bills over a lifetime would probably be lower if we all ate very healthily. But not everyone is in a position to do that.”

At the end of the taste test, each expert was asked about their stance on organic food. Goldstein says he prefers to serve organic meat. “My diners say that nonorganic meat can be very tasty, but it tends to bloat the tummy. I prefer to use all-natural products even though it costs more. I don’t want meat full of hormones.

“I have four dogs at home and they eat 100 per cent organic meat and veg. It is very expensive but I can see the difference in their coats and skin, and energy levels.”

But not all the panellists hold the same opinion. “I try to cook organic food for myself and family when I can, but if it’s a big group of friends I will choose cheaper, regular ingredients,” Chan says. “I think people can be too obsessed with organic food and sometimes they can have false beliefs.”

Asked to choose between imported organic foods and nonorganic local produce, Harilela says that although she tries to buy organic food, she chooses local and seasonal every time. Her overall philosophy is that “food should taste good, look good, and make you feel good when you are eating it. It should nourish all of the senses.”

The general consensus among our experts is that you don’t have to go organic for all foods. As obvious as it may sound, the foods that taste best organic are produce. The non-organic foods that taste better are the man-made ones that don’t grow on a tree or in the ground. Some foods taste better as nature intended. healthpost@scmp.com

CHEMICAL REACTIONS Prioritise your organic purchases with this guide from the US-based Environmental Working Group.

12 most contaminated * Peaches * Apples * Sweet bell peppers * Celery * Nectarines * Strawberries * Cherries * Pears * Grapes (imported) * Spinach * Lettuce * Potatoes 12 least contaminated * Onions * Avocado * Sweetcorn (frozen) * Pineapples * Mango * Asparagus * Sweet peas (frozen) * Kiwi fruit * Bananas * Cabbage * Broccoli * Papaya

6 HEALTH

Pedestrians cross a busy street in Mong Kok. The district has the highest population density in the world, with 130,000 people living in one square kilometre. Photo: Reuters

FROM THE EXPERTS

Isolated in a connected city ......................................................

Paul S. F. Yip healthpost@scmp.com The moment you set foot in Hong Kong International Airport, you are greeted by sleek and modern design and a streamlined customs experience that’s expected of a facility that’s been named “world’s best” eight times since 2000.

A world-class transport system will take you to the heart of the city in as little as 20 minutes. Hong Kong is extremely well connected, with most places accessible within an hour. The Mass Transit Railway (MTR) carries an average of four million passengers every workday and is the primary mode of transport for many of the city’s inhabitants.

Only half an hour’s drive from the airport is Tsim Sha Tsui, where the only thing longer than the list of shops is the line of tourists waiting to enter each one. Just across the harbour is Central, where money is made as quickly as it is spent.

This high connectivity and wealth is a stark contrast, however, to the districts that stand between the tourists and their top shopping destinations.

Despite 40 per cent growth in GDP per capita in the past decade, to about US$32,000 per year, about 30 per cent of people on the lowest incomes actually make less money than they did a decade ago, while 10 per cent of the working population still earn less than US$10,000 a year.

In the north and northwestern

districts of Hong Kong, there are communities that are isolated, vulnerable and characterised by poor financial conditions. They are often made up of “broken” families and experience higher suicide rates than communities in other districts in the city.

Furthermore, about 150 migrants a day enter Hong Kong from the mainland, resulting in an increase in population of 54,000 every year.

Many are the spouses and/or children of the city’s male population.

Unlike mainland tourists, these individuals often are not well off.

They face challenges and difficulties in integrating into the local community and in finding work – a result of differences in language and of having qualifications that are not recognised in Hong Kong.

Since newcomers face restrictions in receiving welfare, they have to work to meet their needs, usually taking on low-paid jobs for as little as US$500 a month, and often finding themselves stuck at home during bouts of unemployment.

In August this year, a minimum wage law – of HK$28 per hour – was passed, but the rate is still very low in view of rising inflation (now at 7 per cent) and high living costs in Hong Kong.

Though the city has the most expensive housing in the region, there’s also a very high income disparity. Hong Kong’s Gini coefficient (a statistical measure of income disparity) is ranked as one of the highest in world – at 0.535 last year – while social mobility, especially

Though the city has the most expensive housing in the region, there’s also a very high income disparity among the younger generation, is reaching stagnation.

Those between the ages of 15 and 29 are more likely to face unemployment than any other group, with those in their 20s experiencing rising unemployment (since 1991), irrespective of educational background. With no space, expensive housing, less promising job prospects and the population squeeze, young people feel trapped, with opportunities less plentiful than before.

Hong Kong is notorious for its small living spaces, an infamous example being the Kowloon Walled City, a densely populated area that was demolished in 1994. People still live in “cage” homes, or cubicle flats, in such areas as Sham Shui Po, Mong Kok and Kwun Tong, where indoor temperatures can reach upwards of 35 degrees Celsius in the summer.

To accommodate the rising population, satellite towns were developed in the 1970s, many of which were separated from the city centre by the mountains. The

distance of these towns from the city, and consequently the greater travel costs, means that low-income groups living in these areas (such as Tung Chung and Tuen Mun) are more isolated.

These communities have been plagued with problems of inadequate job opportunities and public facilities, resulting in “bedroom” communities within high-density public housing estates.

The relatively younger residents in these areas are generally less educated and come from lower socioeconomic backgrounds than the general population. They face a host of problems, such as low wages, insecure or unstable jobs, domestic violence and suicide (the rates of which are 16 to 25 per cent higher than the population average).

Even access to services provided

by NGOs and other such organisations is characterised by a certain disconnection, possibly due to the branch’s lack of communication with headquarters.

Especially at risk seem to be teenagers, many of whom have low self-esteem, lack problem-solving skills and consequently have poor mental health. They are also less likely to seek the support they need in order to address these problems.

For the elderly, their limited mobility causes a lack of a firm social and family support network. As a result, they become isolated and cut off from the community. Some had been relocated from the older districts in Kowloon and Hong Kong Island, breaking social networks.

These older people feel disconnected from a new system yet to be established.

With Hong Kong’s increasingly greying population, and a dependency ratio of 334 per 1,000 of the working population (aged 15 to 64) that’s expected to increase rapidly in the next decade, the number of suicides among the elderly is a growing problem.

Social deprivation and fragmentation unquestionably play a role in the general mental health of the inhabitants of any given area.

Steps need to be taken to ensure that these isolated and vulnerable districts are integrated into the rest of Hong Kong and that they receive the resources and attention they need to truly become communities.

The success of a city cannot be measured only by its financial prowess, but also the mental health and the well-being of its residents.

If this imbalance continues to grow and the income gap continues to widen, as expected, is the whole development sustainable? Will it not cause social disharmony and unrest?

Is Hong Kong moving in a direction where the overall well-being of the city’s inhabitants is at stake?

Even with outstanding economical achievements and world-class infrastructure, a city is only as strong as its weakest link.

Dr Paul Yip is the founding director of the Hong Kong Jockey Club Centre for Suicide Research and Prevention and a professor of social work and social administration at the University of Hong Kong

HEALTH 7 TREATMENT STROKE

Three golden hours could save your life ......................................................

Elaine Yau elaine.yau@scmp.com Two years ago, Mr Mak had a stroke while dining at a Chinese restaurant. The 70-year-old’s right arm and leg suddenly went numb, and he found it difficult to speak.

His family rushed him to hospital.

Two hours and 50 minutes after the attack, he was injected with a blood clot dissolving agent that helped remove the blockage in one of the arteries on the left side of his brain. He recovered the next day and did not suffer any serious complications.

Mak is one of the few lucky stroke victims for whom prompt treatment averted devastating complications such as damaged brain cells, disability and even death.

Doctors say only 10 per cent of stroke victims receive treatment within three hours of an attack.

Prompt treatment can reduce the risk of disability and death by 50 per cent. The failure of the majority to do so results from a lack of knowledge of stroke symptoms, says Dr Yannie Soo Oi-yan, a specialist in neurology at Prince of Wales Hospital.

To raise awareness of strokes and the importance of prompt treatment, a group of doctors and academics set up the Hong Kong Stroke Fund just over a week ago.

“Less than 3 per cent of the stroke patients in our hospital get treatment within the three golden hours,” Soo says.

“Showing only slight symptoms, patients are not sure whether they should go to the hospital, where they may have to wait for hours.

“Chinese are also conservative and reluctant to seek medical treatment. Some elderly people want to wait for their children to see them before they make a decision.”

Such dithering over seeking treatment can be deadly, says Dr Dawson Fong To-sang, a neurosurgeon and fund president.

He cites worrying statistics: stroke is the fourth leading cause of death in Hong Kong. Every year, 18,000 people suffer strokes, resulting in 3,500 deaths.

An estimated one in six Hongkongers – nearly 1.2 million – will suffer from a stroke at least once.

“The figure is staggering,” Fong says.

1.2 • Estimated number (millions) of Hongkongers who will suffer a stroke at least once in their lives

Less than 3 per cent of the stroke patients in our hospital get treatment within the three golden hours DR YANNIE SOO, NEUROLOGIST

Equally worrying are the statistics that show Hongkongers’ poor knowledge of the disease.

In a recent survey done by the Stroke Fund in collaboration with Polytechnic University, 91 per cent of 525 respondents aged above 18 could not identify all the symptoms of stroke.

These include severe headache, numbness and lack of strength in limbs, lopsided facial expressions and difficulty in speaking.

More than 70 per cent did not know all the risk factors for stroke, which are high blood pressure, high cholesterol, drinking, smoking and diabetes.

Stroke is an acute cerebrovascular disease that affects blood supply to the brain owing to the blockage or rupture of the brain’s blood vessels.

But only 73 per cent of respondents knew this, with 19 per cent mistaking it for heart disease, and others thinking it was a disease of the limbs or even a psychiatric illness.

Eighty per cent of the victims suffer an ischaemic or acute stroke, caused by a clot in one of the brain’s blood vessels, Fong says.

The remainder suffer a haemorrhagic stroke, which is caused by the rupture of a vessel.

Acute stroke victims need treatment within the “three golden hours” – the intravenous injection of a blood clot dissolving agent like the one Mak received.

Failure to obtain such treatment can result in severe damage to the brain cells, as the blocked vessel is unable to transport blood and nutrients to the brain.

“In such cases, acute stroke can become haemorrhagic, which needs surgery and [has a death rate of 30 to 50 per cent],” Fong says.

He says severe complications of stroke include paralysis and impairment of memory and cognition. Some 30 to 40 per cent of victims lose the ability to take care of themselves, while 20 to 25 per cent of stroke patients die within a year after the attack.

Knowing the symptoms of stroke and reacting quickly can help avoid these complications.

Neurologist Dr Huang Chenya, vice-president of the Stroke Fund, says people should be aware of even minor symptoms, such as severe headaches.

“While some patients will have severe symptoms, like being unable to move the legs or loss of

consciousness, some show only minor symptoms, such as slightly slurred speech, at the outset,” he says. “Those with minor symptoms may fail to respond quickly and suffer dire consequences.”

Fong says given Hong Kong’s small size, patients should be able to get hospital treatment promptly.

“Hong Kong is not like Australia, where you have to drive for two hours [to get to a hospital],” he says.

He relates the example of a doctor who had a headache during a banquet. Instead of taking immediate action, the doctor decided to finish dancing.

The doctor later collapsed while driving and lapsed into a coma. He was eventually diagnosed as having had a stroke.

“It’s like a scenario where the water pipes burst in your house,” Fong says. “Delayed action means all the carpets and furniture are destroyed.”

Narrowing of an artery could lead to a stroke.

Photo: Science Photo Library

8 DIET If possible, try before you buy when choosing oil

NUTRITION OILS

Let’s get the fats straight ......................................................

Elle Kwan healthpost@scmp.com If you’re shunning all kinds of oils for fear of getting fat, here’s something you should know: the amount of oil and fat you eat isn’t linked with disease. What matters is the type you eat.

No doubt, consuming too much bad fat – saturated and man-made trans fats – can lead to obesity, high cholesterol and other diseases. But fat is a vital part of the diet. It’s a source of energy, protects the bones and vital organs, aids blood vessel function and keeps us warm.

Without it, we simply can’t function.

According to Christine Jonkers, a nutritionist at Super Natural, about 30 per cent of the regular diet should be derived from fat; this translates to about 60 grams to 70 grams a day for women (about four tablespoons of olive oil) and 70 grams to 80 grams for men.

When it comes to cooking, plantderived oils rich in good fat can have a positive impact on the body.

Jonkers says two to three tablespoons, or 30 grams of the daily fat intake, should come from good oil. But what exactly is “good” and “bad” fat and oil?

For a start, cooking with butter, coconut oil, palm oil and palm kernel oil is bad. They’re high in saturated fat, which raises one’s levels of bad cholesterol – lowdensity lipoprotein (LDL) – in the body that can cause plaque build-up in arteries, potentially leading to a heart attack or stroke. Solid at room temperature, saturated fat is found mainly in animal products – meat, seafood, poultry with skin – and whole-milk dairy products such as cheese and ice cream.

Though saturated fat, like all dietary fat, also raises the body’s levels of good cholesterol – highdensity lipoprotein (HDL) – it’s still better to eat as little of it as possible.

Our bodies make all the saturated fat we need. Trans fat is even worse for

you because it raises the body’s levels of bad LDL and lowers the level of good HDL. It’s made by heating liquid vegetable oils in the presence of hydrogen gas, a process called hydrogenation that turns the oils into a solid. Commercially prepared baked goods, processed food and fried fast food are the main sources of trans fat.

Good fats are unsaturated, such as polyunsaturated and monounsaturated fats. Liquid at room temperature, they raise levels of good cholesterol and lower bad cholesterol, ease inflammation and stabilise heart rhythms.

Polyunsaturated fat is found in sunflower, corn, soya bean and flaxseed oils, as well as walnuts, flax

Extra virgin olive oil from Liguria is light and good for salads.

For steak, use oil from south Italy ANDREA FRAIRE OF GRISSINI RESTAURANT

seeds and omega-3-rich oily fish such as salmon and mackerel.

Monounsaturated fat is found in nuts, seeds and canola, peanut and olive oils.

So, it’s sensible to replace saturated fat in the diet with good fats whenever possible. Swap butter in cooked dishes, for example, with olive or canola oil. How you use the oil matters, too. Stir-frying is one of the healthiest ways, with one or two spoonfuls enough for large plates of food. Dressing salads with oil-based vinaigrettes is also good.

Deep-frying in plant-derived oils, however, is a no-no. By dipping products in flour or egg-based batters, a coating is created on the food’s surface that absorbs oil “like a sponge”, says Jonkers. It can push

one’s fat intake way over the daily limit. Avoid deep-frying with extra virgin olive oil as it is claimed that it can become toxic and pose a health risk at the higher temperatures reached in this cooking method.

Many restaurants use hydrogenated instead of plant oils to deep-fry. At home, if you aren’t doing the cooking, let helpers know your preferences. Many might not be aware of the health guidelines.

In Italy, using oil is simply a way of life, says Andrea Fraire, chef de cuisine at the Grand Hyatt’s Grissini restaurant. He recommends oils that have been cold-press extracted, which preserves the flavour. “The first part of the oil [in extraction] is the extra virgin olive oil, after that you have regular olive oil,” he says.

Fraire uses olive oils for sautéing, but chooses richer-tasting extra virgin olive oils for finishing dishes, from meats and fish to salads.

Not all extra virgin oils are created equal. The type of olive, where they are grown and when they are picked all affect flavour. “If you use extra virgin olive oil from Liguria it’s lighter and good for green or mixed salads. If you add to steak, use oil from south Italy because it’s stronger,” says Fraire.

Choosing oil is like choosing wine, he says. Look for a good colour: clear vivid green or yellow, and try (if you can) before you buy.

That may not be possible to do at the supermarket; an option is Premiere Pression Provence on Central’s Graham Street. It stocks oils from 17 producers in the French region of Provence. They are split into three categories: those made with green, ripe and black olives.

You can customise your own blend.

The shop has an upscale readymade dressing that fuses balsamic vinegar with oil, but you can make your own with this foolproof formula from the shop’s business development manager, Olivia Daltroff: “Blend one-third vinegar with two-thirds oil. A pinch of sea salt and pepper is a must.”

Black olives and red onions are redolent of Italy. Photo: Safran Lecuivre

RECIPE FOR HEALTH PAN-FRIED SEA BASS

Olive oils bring flavours of the Mediterranean to the surface ......................................................

Elle Kwan healthpost@scmp.com Andrea Fraire, chef de cuisine at Grissini at the Grand Hyatt hotel, brings a delightful Mediterranean flavour to this dish, which is finished in oil.

He uses taggiasca black olives from Liguria and Italian tropea red onions to create a true taste of home, but other red onions and black olives will do the trick, too.

He has also chosen extra virgin olive oil from Puglia for its deep, layered flavour. Look for something with as much impact to enhance the flavour of the fish.

Pan-fried sea bass Mediterranean style Serves 4 120g tropea red onions Puglia extra virgin olive oil 10g chopped garlic 350g cherry tomatoes 50g taggiasca black olives 40g capers Four 200g fillets of sea bass Handful of fresh basil Salt to taste • Bake onions in their skins for 40 minutes at 140 degrees Celsius.

• Peel and julienne them.

• Put oil into pan.

• Cook garlic and cherry tomatoes slowly until the tomatoes soften.

• Add olives, capers and onion to the pan.

• In a separate pan, fry sea bass until the skin is crispy.

• Add sauce, and continue until the fillet is cooked through.

• Add fresh basil, salt and extra virgin olive oil.

DIET/ FITNESS 9 STAR ATHLETE THE TRAILBLAZER

Status grows by leaps and bounds ......................................................

Jeanette Wang jeanette.wang@scmp.com You wouldn’t normally call a 24-yearold a legend, but Kilian Jornet has taken just a few years to earn that status among the fast-growing global trail running community.

For a glimpse of his athletic prowess – especially his downhill skills – check out season three, episode seven of his monthly web series, Kilian’s Quest, on YouTube. As the Spaniard carves his way swiftly down a near-vertical mountainside on foot, the camera cuts to a mountain goat doing the same. It’s a perfect comparison.

Running with Jornet, along with 19 others, in Sai Kung two weeks ago on his birthday, I saw the ease at which he scales and skips down summits. I was on all fours going up Sharp Peak, as he gently bounded up the rocky and steep terrain as if it were a Sunday stroll on Bowen Road.

“When I’m in the mountains, I feel it’s my home,” says Jornet, who was in Hong Kong as part of an Asian tour organised by his sponsor, Salomon.

There is a specific mountain range he calls home: the Catalonian Pyrenees, near Spain’s border with France. He was born and raised on a refuge there at an altitude of 2,000 metres. At 18 months, he could walk for four to five hours at a go. At age five, he scaled the 3,404-metre-high Aneto, the highest peak in the Pyrenees. At age 10, he spent 40 days hiking with his sister and mother across the entire mountain range, a 740-kilometre trek from the Mediterranean to the Atlantic, with an elevation gain of more than 40,000 metres.

“When he was young, we soon realised that he was a child we had to tire out,” says his mother, Nuria Burgada, in an episode of Kilian’s Quest that documents her son’s run across the Pyrenees in nine days in May this year.

However, exhausting Jornet is not that easy. He’s blessed with a powerful engine: a resting heart rate of 34 beats per minute, and a VO2 Max – or maximum oxygen uptake, a measure of aerobic capacity – of 92ml/kg/min. Most world-class athletes fall between 75 and 85 ml/ kg/min. He’s also lean and light, at 1.71metres tall and 56 kilograms.

By age 16, Jornet was on the Spanish national ski mountaineering team; by 17, he was one of the world’s best. His slingshot to superstardom, however, came at 20, when he won and set the course record for the 166-kilometre UltraTrail du Mont-Blanc (UTMB), which is notorious for its fickle weather (runners experience all four seasons throughout the entire race) and a leg-crunching elevation gain of 9,400 metres.

Since then, he’s won the UTMB two more times, along with a clutch of other top races. He also holds the world record for the fastest ascent of various epic peaks, including the 5,895-metre-high Kilimanjaro in five hours, 22 minutes.

Humble, softly spoken and always smiling (even when bounding down the sides of mountains), Jornet looks like an unlikely legend – and he’s certainly nonchalant about the label.

“I don’t like to think about this,” he says, when asked how he feels about being called a legend, “because for me the main goal is not to win races. It’s just to enjoy the races and spend time in the mountains.”

If there were no medals or money, Jornet would still be running, simply for the love of it. In the days leading up to this year’s UTMB, for example, while most people put their legs up, he did the six-hour climb up Mont Blanc twice in the span of three days, then ran for six hours the following day – instead of the planned two hours – because the scenery was so breathtaking.

Earlier in June, while attempting to set a record on Mount Olympus in

Greece, he took the wrong route and went up Mount Stephanie instead.

Still, he went on to climb up and down Olympus in a record five hours, 19 minutes, 45 seconds. “[The mistake] took me about 20 minutes, but, as I say, more kilometres means more fun. It gave me the chance to enjoy new views.”

He has an almost Zen-like approach to trail running that is unlike the hi-tech flashiness of many athletes. He speaks of the “spirit of discovery” – of countries, landscapes and of the soul of every mountain – with a sparkle in his eye. He also believes in the bare minimum for a short run (less than 10 hours), sustaining himself with only blueberries, roots and plants, and water from streams or snow.

“Kilian was born in the mountains, and I think he’s someone who knows them better than anyone else. And you have the impression that he takes care of them,” says Greg Vollet, Salomon’s outdoor sports and community marketing manager, who often runs and competes with Jornet.

“He takes care of the mountains, and maybe it’s reciprocal.”

The trip to Hong Kong marked the end of Jornet’s running season, which began in April with the goal of running five races in five continents “to see different parts of the world, cultures and the spirit of trail running”. It was a perfect streak, winning The North Face 100 (100 kilometres) in Australia, the Western States 100 (100 miles) in the US, UTMB in France, the Table Mountain Challenge in South Africa and the Mount Kinabalu International Climbathon in Malaysia.

After a few weeks’ break, he’ll begin his six-month ski mountaineering season, which keeps his knees and mind fresh until the next running season starts. It’s a cycle he plans to keep up until the day he doesn’t enjoy racing any more.

“I’ll stop, but I’ll stay on in the mountains,” he says.

Kilian Jornet scales and skips down summits with ease. Photo: AFP

EAT SMART BRAISED SEA CUCUMBER

Peel it off but don’t throw it out – that skin is packed full of nutrients ......................................................

Braised sea cucumber with dried prawns and pomelo peel Serves 4

Jeanette Wang jeanette.wang@scmp.com The next time you have a piece of fruit or veg, think twice before tossing out the skin.

Apple peel, for example, is rich in quercetin, an antioxidant that could help ward off certain cancers. Potato skin contains about half of the spud’s fibre.

The citrus giant, pomelo, is no different. Citrus peel is high in vitamin C, and studies show that it could prevent diabetes, lower cholesterol, and help protect from cancer through its high level of antioxidants.

In this recipe provided by the English-Speaking Dining Society of the Chinese Cuisine Training Institute, pomelo peel adds a fragrant touch and enhances the flavour of the sea cucumber.

For the stock 3 cloves garlic 2 sticks spring onion 1 ⁄3 stick of leek 30g peeled ginger 1 tbsp canola oil 1 tbsp shaoshing wine 400ml chicken stock • Slice garlic, spring onion, leek and ginger.

• Heat oil and saute them until golden brown.

• Add shaoshing wine and chicken stock, bring to a boil and strain.

• Set aside.

Fragrant pomelo peel brings out the flavour of the sea cucumber in this dish.

For the dish 100g dried medium prawns 300g soaked pomelo peel 400g soaked sea cucumber

30g sliced ginger 300g green vegetables 1 tbsp starch 3 tbsp water 1 tsp dark soy sauce • Wash dried prawns and pomelo.

• Peel, drain and set aside.

• Wash sea cucumber and cut into pieces.

• Blanch in water with sliced ginger, drain and set aside.

• Poach green vegetables in boiling water.

• Drain and place on a plate.

• Use simmering stock to braise the dried prawns.

• Thicken with starch and water mixture (add dark soy sauce for colouring), and pour over sea cucumber, pomelo peel and vegetables. Serve.

This 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

10 FITNESS WALKING HOME

The tough times make me feel alive ..............................................

Rob Lilwall healthpost@scmp.com In a few days I will fly to Mongolia, to walk 5,000 kilometres back to Hong Kong, through a very cold and wintery China. One of the most frequent questions I am asked about this expedition is why.

Why leave behind a comfortable life in Hong Kong? Why set out on an expedition which, to quote Shackleton’s apocryphal newspaper advert recruiting people for a 1914 Antarctic expedition, will consist of “low wages, bitter cold, long hours of complete darkness. Safe return doubtful.” (He allegedly received more than 5,000 applications.)

My frequent expedition partner, Al Humphreys, points out that different adventurers have given very different answers to this question. George Mallory, perhaps the first man to climb Everest (although we don’t know if he made it to the top before he died) said he was trying to climb the world’s tallest mountain “because it’s there”; Ranulph Fiennes, Guinness World Records’ “greatest living explorer”, says he keeps going on adventures to pay the bills; Robert Swan, the first man to reach both poles on foot, apparently said it was

“to impress girls at parties”.

While many women enjoy adventure, it seems to hold a particularly powerful appeal for men. Indeed, upon hearing about the new expedition, the first thing that women usually say is “Gosh, how does your wife feel”, whereas a guy’s reaction is usually “Man, I wish I could do that!”

For me, an initial reason for seeking adventure is that it makes me feel alive to get out into the wild and take on a huge challenge. I love cycling or hiking all day through valleys or deserts or plains and seeing what they are really like (rather than surveying them on Google Earth, as intriguing as that may be), and then camping on the sides of mountains in the snow under the stars.

I relish the unpredictability of adventures – I don’t know what will happen, who I will encounter, or how I will respond to situations, although I usually find that I meet many interesting and kind people.

On this Walking Home From Mongolia adventure, I am incredibly excited to get a chance to view rural, rarely seen China at ground level, at walking pace. We hear so much

There will undoubtedly be more snow to come during Rob Lilwall’s Walking Home adventure. Photo: Rob Lilwall about China. We all know it is developing faster than almost any other country in history, and yet we mainly tend to see and hear about the booming cities and popular tourist sites, rather than the regular lives of millions of people.

Two other more practical reasons for the journey are that I will be using the expedition to raise money for my favourite charity (Viva, which works with vulnerable children. See www.viva.org), and also that I have stumbled into a career whereby doing such crazy things has become the way that I pay the bills – through writing, television and motivational speaking.

At the same time, I am under no illusion that this is going to be easy or painless. It is easy to romanticise

going on an adventurous journey, but the reality is that this expedition will actually involve endless hours (or days or weeks) of walking through quite monotonous landscapes, lost in my own thoughts, sometimes growing very bored of my own company.

I will be doing this expedition with my friend Leon – great for companionship – but no doubt we will sometimes drive each other mad. Carrying more than 20kg for more than seven hours a day, for more than 150 days, the journey will also involve plenty of pain – blisters, sore knees and backache. There will be moments of fear (perhaps the occasional aggressive person or when the temperature drops below minus 20), as well as emotional sadness

because I will be missing my wife, Christine, every day.

All these tough aspects drive me to look forward to finishing the expedition and getting home again.

At the same time, I am determined to live and enjoy every moment. And the challenging, tough times will make me stop taking for granted the many things that make “home” such a good place to be, when I eventually make it back there.

Rob Lilwall’s previous expedition, Cycling Home From Siberia, became the subject of a television series, a book and an acclaimed motivational talk. Every week in Health Post, he will write about the progress of his new expedition, Walking Home From Mongolia, which supports the children’s charity Viva. www.walkinghomefrommongolia.com

WORKING OUT MENTAL FITNESS

To beat stress, try seven on-the-spot relaxation techniques ......................................................

McClatchy-Tribune For whatever reason – a confrontation with the boss, a fender-bender in the supermarket parking lot, a backed-up toilet just in time for your dinner guests – your emotions sometimes bubble up to the point where they become almost impossible to control.

But you can’t let those moments get the better of you. The secret to riding the stress wave and coming out relaxed on the other side is a little mind over matter.

The next time you find yourself in an unpredicted pickle, practise one of these expert-endorsed stress-busting techniques. This isn’t so much a workout for the body, but really for the mind. In a matter of seconds, you’ll feel calm and in control.

1. Focus on past experience A sunny day at the beach. A cool autumn day in New York. Your wedding day. Whatever memory makes you happy and puts you at ease, go back there for just a moment. Imagine yourself soaking up that sense of relaxation, and

apply that empowerment to the present situation.

2. Make a fist No, not to take a swing at someone.

In this technique, you let the emotion wash over you before capturing it in your hand, figuratively speaking.

Make a fist with your right hand, tighten it, then release, inhaling and exhaling deeply. Then shake those feelings right out of your system.

3. Just breathe Deep breathing is the key to true relaxation. Here’s how it’s done: put your right hand on your abdomen and your left hand on your chest, then breathe deeply so that your abdomen rises slightly under your right hand. Take up to five deep breaths this way to calm yourself.

4. Tickle your funny bone Stress usually isn’t funny, but sometimes being able to laugh can defuse a situation. Select three to five memories that make you laugh, and store them away. Then, when something upsets you, go to your “funny bank” and chuckle to yourself.

5. Make like a monk Chanting may seem like a strange way to relax, but experts swear by it.

The chant can be a religious phrase or just a few words, such as “I am a good person” or “All will be well”.

6. Walk away The easiest way to calm down and gather yourself in the face of stress is just to take a break from it. Get up from whatever you’re doing and walk away. Take deep breaths, shake out your shoulders, stretch your arms and legs, and perhaps go and get a cup of tea or coffee, preferably decaf.

7. Grin to bear it Have you ever seen a sports coach crack a smile at one of the most tense moments of a game? Maybe he or she has heard this advice about how to handle a pressure-packed situation. Close your eyes and allow yourself to smile gently. Your brain will respond by recognising that you usually smile when you’re feeling relaxed and happy. Even if there’s nothing to smile about at a given moment, taking a few seconds to smile consciously will send positive signals to your brain.

WELL-BEING 11 THE TASTE TEST SALAD DRESSING

Give your plain greens a fresh kick from a bottle ......................................................

Jeanette Wang jeanette.wang@scmp.com

McCormick Yuzu & Green Pepper dressing 150ml for HK$30.80, Wellcome It’s a relatively pricey little bottle, but you need just a little to spice up plain greens. The heat from the green pepper gives an unusual kick to a salad.

Verdict: an oil-free dressing that I enjoyed with zero guilt.

A self-portrait of Olaf Mueller that shows off the newly athletic physique he has developed through triathlon training

FIT & FAB

Zoom for improvement ......................................................

Good Housekeeping Asian Sesame Dressing 350ml for HK$38, City’super Gather some cabbage, julienned carrots, chopped peanuts, shredded chicken and noodles, and marry them with this for a delicious savoury salad.

Verdict: all-natural and nutty, a versatile dressing that works as a marinade, too.

Newman’s Own Light Caesar 473ml for HK$54.50, Market Place by Jasons Typical Caesar dressing is a dietwrecker, but this version is oil and vinegar based (instead of egg and/or mayo), and so has 53 per cent less fat and 46 per cent fewer calories (6 grams fat, 70 calories per two tablespoonfuls).

Verdict: Hail, Caesar!

P. Ramakrishnan rama.p@scmp.com Photographer Olaf Mueller has never really struggled with weight. At university, he was a sporty student, working out and playing team sports regularly. After marriage and two children, he continued to be active, eat a low-carb, high-protein diet and exercise religiously.

But even those who’ve known him for years have been amazed by his recent transformation to a lean, mean silhouette. Apart from weight, he has shaved years off his looks. But he’s swallowed no secret Benjamin Button pill. Since taking up triathlons, Mueller has transmogrified from artist to athlete in the space of months.

“I wanted to break out of the routine of my daily life. I love challenges and one day in March I decided, for myself, I must do something new,” says Mueller, 31, who did his first triathlon in June.

He’s signed up for the Ironman 70.3 Asia-Pacific Championship in Phuket, Thailand, on December 4 – a triathlon that involves a 1.9 kilometre swim, 90.1 kilometre cycle and 21.1 kilometre run.

The challenge of the sport, he says, is not race day itself, but the long preparation before it. “I started [training] seven months before and it’s a daily commitment.”

His wife, Jessica, is amazed that his recent self-shot pictures aren’t the product of Photoshop. “I’ve never been this fit in my entire life.

My entire physical structure has changed,” he says.

Mueller admits he was tempted to quit in the beginning. A natural runner, he was so bad at cycling that he found it “depressing”, and swimming was even worse. But he never let go. “I’m an extreme character; once committed, I’m in for the long run. I was tired for the first two to three months, then I hit a wall and something clicked and it stopped hurting. Now I have so much energy; if I don’t train, I feel something’s wrong.”

Was it hitting 30 that made you rethink your life and health?

Age had nothing to do with it. I wanted to do something new.

Especially in Hong Kong, you can get so sedentary and stuck in a routine. I’m always at events and exhibitions, and the drinking culture of the city is hard to escape. I’ve always loved my beer, but something strange has happened recently. My body automatically rejects alcohol after a certain point. I get my fix through sport.

Do you train with others?

I train on my own – I have a busy life full of people so this is my quiet time. I get up at five in the morning

school. I work long hours, so in the past I rarely saw the kids in the morning as I was asleep.

For me, [this has] been the best thing.

Triathletes are the fittest people in the world to start my training routine – it used to be hard to get up early, but not any more. I live in Clear Water Bay, where there are others in group training, but I wanted to do this at my own pace.

I have an online coach – it costs about US$250 a month – who puts me on a training schedule. He plans my workouts, he understands how fast I can recover, he tells me what to do and what not to do, what sort of equipment to get, and so on. What most people do wrong is that they dive right into the routine and crash and burn. You need to build your stamina, heal your muscles and get your bones ready for the impact.

The trainer helps pace me properly.

How long do you train for?

I train between 14 and 16 hours per week. People think they don’t have that kind of luxury of time, but it’s really a matter of discipline. It’s not that difficult. Because I’m up so early, I get to see my kids go to

What’s the best part of your routine?

It may seem wrong but I eat more than ever – guilt-free. Most people eat less because they want to get slimmer, but my primary objective was never to get thinner – that happened automatically. I wanted to be fit, to meet the challenges.

Because I burn so many calories so quickly, I get to eat whatever I like. I eat more carbohydrates, more healthy fats, and less protein, as digesting red meat makes me tired. I still enjoy wine and beer, but I drink plenty of water as alcohol is dehydrating. I don’t deprive myself of anything – and still this is the best shape my body has ever been in.

Have you changed your wardrobe?

I was always a large or extra large and I have all these amazing clothes that now float on me. I still haven’t had a chance to shop – my waistline has gone from 35 to 30.

But surely this isn’t for everyone?

I think for me, that was part of the appeal. Only a very small part of the population has the stamina to do this, to commit to it, to not give up. I do have to say, it’s an expensive sport to get into. But for me, it’s been the best thing. Triathletes are the fittest people in the world.