20120103 health post

YOUR GUIDE TO LIVING WELL

TUESDAY, JANUARY 3, 2012

HEALTH POST Flex, hugs and rock ’n’ roll The best yoga festivals around the world

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ACUPUNCTURE GETS CLEAN BILL OF HEALTH

MAKE 2012 YOUR FITTEST YEAR EVER

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2 NEWS HEALTH BITES

ASK THE DOCTORS DR REGINA LO

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Jeanette Wang jeanette.wang@scmp.com

Q: I felt a hard, immovable lump about the size of a marble, on the left side of my neck a few weeks ago. However, it has since shrunk and is almost unnoticeable.

What could it have been, and should I go for a further check?

Silent but deadly “Silent strokes”, which may not show any noticeable symptoms but result in small pockets of dead brain cells, are found in about one in four older adults. These strokes are a cause of memory loss, regardless of the size of the part of the brain responsible for memory (hippocampus), say scientists from Columbia University’s Taub Institute for Research on Alzheimer’s Disease and the Ageing Brain. Magnetic resonance imaging brain scans and tests were done on 658 men and women aged 65 and older, none of whom had a history of dementia. The researchers say this finding may lead to further insight into what causes symptoms of Alzheimer’s and the development of new ways of prevention.

Easy as B, C, D and E High levels of those vitamins, along with omega-3 fatty acids, have been linked to a sharper mind among older adults, according to a new study by Oregon Health & Science University in Portland. Conversely, a high level of trans fats was linked with reduced mental abilities and smaller brains. Published in the journal Neurology, the study measured levels of more than 30 nutrients in the blood of 104 generally healthy people aged 87 years on average. Those with high levels of the four vitamins performed better on tests of higher-level thinking (planning, attention, and problem solving), and had better visuospatial skills, global cognitive function and bigger brains. Omega-3s were associated with better higher-level thinking and fewer changes to the brain’s white matter. (Changes may indicate damage to the brain’s small blood vessels.)

A: The most common neck lump is a swollen lymph node. Lymph nodes are part of our immune system. They become swollen when confronting invaders, such as viruses and bacteria.

The location of the swollen lymph node often helps identify the underlying cause.

For example, swollen neck lymph nodes are also often associated with a common cold. But it is important to note that the lymph nodes can also be swollen in patients with immune disorders such as lupus or HIV, those infected with tuberculosis, or those who suffer from cancer that originates in the lymphatic system.

In general, swollen lymph nodes that are due to infection are tender, mobile, and resolve spontaneously after the infection subsides. So, one should seek medical attention upon noticing any

Hear today, gone tomorrow One in four Israeli teenagers is in severe danger of hearing loss as early as in their 30s and 40s because of their music-listening habits, say Tel Aviv University researchers. The warning is based on their study published in the International Journal of Audiology. First, 289 youths aged 13 to 17 were asked about their listening levels and duration on their personal music devices. Measurements of these listening levels were then performed on 74 of the teens in quiet and noisy environments. It was found that 80 per cent used their devices regularly, with 21 per cent listening from one to four hours daily, and 8 per cent listening more than four hours straight. Hearing loss caused by continuous exposure to loud noise is a slow, progressive process, and the harm may not be noticeable until accumulated damage begins to take hold, says one of the study authors, Professor Chava Muchnik.

Dr Regina Lo is a family physician

APP OF THE WEEK

Some pedometer apps can’t distinguish a walk from a ride ......................................................

Where the living is queasy A freer economy equals a fatter population, according to findings from University of Michigan’s school of public health. Associate Professor Roberto De Vogli, who analysed data from 26 Organisation for Economic Co-operation and Development (OECD) member countries, says: “It’s not by chance that countries with the highest obesity rates and fast-food restaurants are those in the forefront of market liberalisation, such as the United States, Britain, Australia, New Zealand and Canada, versus countries like Japan and Norway, with more regulated and restrictive trade policies.” For example, the US has 7.5 fast-food restaurants per 100,000 people and an obesity rate of 31 per cent for men and 33 per cent for women; Japan has 0.13 fast-food restaurants per 100,000 people, and an obesity rate of 2.9 per cent for men and 3.3 per cent for women. The study was published last month in the journal Critical Public Health.

hard, immobile lumps, especially ones that persist for more than two weeks, or those that are accompanied by night sweats or weight loss.

In your situation, as the lump has shrunk and become less noticeable now, all you need to do is to keep an eye on it.

Katie McGregor healthpost@scmp.com Pedometer Ultimate – iStepCounter 99 US cents Rating 9/10 It’s the first week of 2012, and you’re probably still sticking to your New Year’s resolution: mission new svelte body. Dietitians will tell you that small steps count in what could be a mission impossible, and the best way to track your steps is with a pedometer.

The idea is that you use a pedometer to become aware of how many steps you take each day, and make conscious choices that will result in a higher calorie burn through walking more – choices such as walking up one or two flights of stairs or getting off the bus early.

My first pedometer download was the All-in Pedometer (US$1.99), which allows trackers to record daily goals, heart rate, weight and waist and hip measurements. It also has a pacer and a GPS function that maps your movements. You can also load a playlist of your music.

I used this app around Taipei: I wanted to test the theory that while on holiday, you can eat as much as you want because you burn it all off as you traipse around sightseeing. If I believed the results displayed at the end of day one, I would have achieved my goal. But even I couldn’t fool myself that I had walked 17.3 kilometres.

Despite its gadgetry, the app is oversensitive, so it also tracked my trips on the MRT (Taipei’s mass transit railway). This I could see from its useful mapping function. It was also a heavy drain on my battery.

While not something to use through the day, because of its functionality this app would be useful for tracking an exercise session.

On day two, I took Pedometer Ultimate – iStepCounter out for a walk. The write-up promised that this app could tell the difference between walking and a trip on the subway. The app also features a smart sensing technology that helps save battery power. Despite its lower price, the app also tracks weight and gives a count of steps, estimated distance, speed and calorie burn.

In practice, this app works better for daily tracking, but I did find that I had to check after periods of inactivity counting steps, as it turns itself off occasionally. And no, in conclusion, I cannot eat as much as I want while on holiday.

> 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

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Wynnie Chan healthpost@scmp.com Chan On-ming, 29, started showing signs of separation anxiety and shyness in primary school. As Chan grew up, he was constantly anxious about his and his parents’ health, his grades at school, meeting new people and the dark.

These fears became more pronounced when he went abroad to university. He was persistently worried, so much so that he could not sleep and was irritable and tired. Chan (whose name has been changed for reasons of patient confidentiality) sought help from a university doctor who prescribed an anti-anxiety drug, which he took whenever needed, such as during exams.

He did not make many friends because, worried about social situations, he would turn down party invitations. His anxiety would often spiral into more negative thoughts and he would think about past experiences.

The few close friends he had said he was a “worrywart” and felt that his constant need for reassurance about everything was too much of a

Mindfulness meditation is about paying attention to the present moment without drifting into thoughts about the past or concerns about the future burden. Some found excuses not to socialise with him.

After graduation Chan found a job in a busy office. He suffered from depression and was prescribed an anti-depressant, which made him feel jittery and even more agitated.

Finally, a few years ago, the young professional was diagnosed as having general anxiety disorder.

Worried about his future job prospects and ability to form and sustain relationships, he sought help from a psychologist, who suggested mindfulness meditation as an adjunct to his current cognitive behavioural therapy.

Mindfulness meditation is about paying attention to the present moment without drifting into thoughts about the past or concerns about the future, and without analysing or making judgments about what’s going on around you.

Dr Helen Healy, clinical

psychologist at The Middle Path in Hong Kong, says: “Cognitive behavioural therapy has been found to be effective in the treatment of generalised anxiety disorder, but a significant number of people continue to struggle with residual symptoms.

“Recent research and theory supports the integration of mindfulness and acceptance-based treatments with existing cognitive behavioural treatments to improve the efficacy and clinical significance of such approaches.”

In mindfulness-based approaches, Healy says one learns how to observe and accept what is going on, rather than avoiding or fighting it. This can be more effective than solely focusing on negative thoughts, as in traditional cognitive behavioural therapy.

When Chan received invitations to social gatherings, his internal dialogue would usually be: “People will be staring at me, they must think I am so weird, I can’t do this, I must get out of here.” During counselling, he was encouraged to separate his feelings, internal dialogue and usual responses from the situation.

Through many sessions, the counsellor worked on getting him to change his irrational and negative thoughts into more rational ones, and to focus on his bodily sensations, thoughts and feelings whenever he started feeling anxious.

Chan used to feel his heart pounding, palms sweating and throat drying before an anxiety attack. He was encouraged to break the cycle of negative thoughts using breath counting as soon as he felt his heart pounding, rather than when the anxiety had already begun.

The counsellor taught him to breathe from the abdomen, inhaling through the nose and slowly counting to five, then to hold his breath to a count of five and exhale slowly and fully, through the nose or mouth, to another count of five. This was repeated for up to five minutes.

Breath counting has enabled Chan to pay attention to his feelings at the present moment, without trying to change, justify or repress them. Therapists say that by doing this, the brain has less opportunity to build scenarios and apply internalised interpretations to forecast social responses.

After practising this technique and meditating for 15 minutes daily, Chan has been able to acknowledge and accept his feelings so that when they arise, he is able to let go and change his inner dialogue into something more rational.

These days, Chan focuses more on the brighter side of life. He says: “When I talk to a group of people, I’m usually able to say to myself, ‘Hey, I’m feeling anxious, but I’m still able to hold a conversation and look people in the eye’.”

Illustration: Angela Ho

‘Worrywart’ learns to live in the moment

4 COVER STORY

Om vacation Yoga enthusiasts are increasingly flocking to outdoor festivals that offer a heady mix of meditation, music and dance against a backdrop of nature. Sue White looks at the world’s top five

Knees up at the Dutch Yoga Festival

I

t may sound like an unlikely healing recipe, but take lashings of yoga, mix in a generous serving of dance, a side order of music (anything from electronica to kirtan will do) and add a serious slice of nature. Bake for two to four days.

The result: a yoga festival that could attract up to 5,000 people to a mountain, village or desert for some intense yogic fun.

While more formal yoga conferences such as Evolution in Hong Kong or Yoga Journal conferences across the US continue to draw crowds, thousands of yoga fans now prefer to master the pigeon pose (Eka Pada Rajakapotasana) in less prescribed, outdoor environments. Enter the yoga festival – a trend that’s taken the yoga world by storm over the past five or so years.

There’s now enough diversity among yoga festivals that you can plan by location or your personal style. Are the Italian mountains your thing? Check out the yoga festival in the spa town of Merano (www.yogafestival.it). After something slightly more spiritual?

Spend a week celebrating on the River Ganges at the International Yoga Festival in Rishikesh, India (internationalyogafestival.com).

Regardless of where you go, you can be guaranteed one thing: the mix of yoga, music and the great outdoors is bound to leave you floating on happy healing vibes for weeks. Check out five of the best for this year.

The Phoenix Weekend www.thephoenixweekend.com Where: Satyananda Mangrove Ashram, Mangrove Mountain, about 11⁄2 hours north of Sydney, Australia When: February 3-5 Cost: A$360-A$515 (HK$2,800HK$4,000) per person Attractions: Yoga, music, meditation, and rave? If you like your yoga accompanied by a bit of electronica, the three-day Phoenix Weekend is the festival for you. The festival is now in its second year, and this year’s line-up has several events per time slot, with an emphasis on dance, yoga and meditation.

Days offer workshops and classes with teachers such as Mark Whitwell (US), Katy Appleton (Britain) and Simon Borg-Olivier (Australia), as well as speakers from the Satyananda Yoga tradition. Evenings are all about music: Friday is more traditional, with kirtan (yoga chanting to live musicians), while Saturday is anything but. Dress up and get set to rave with the Future Sound of Yoga duo, the popular pair behind the event.

While you’re there: Mangrove Mountain is tucked deep in the Australian bush. Plenty of bushwalks start at the back of the Ashram.

Otherwise, take a dip in the lake across the road, or simply enjoy the fresh mountain air surrounding this inspiring yoga ashram.

around the world. It’s easy to see why. The line-up boasts a dozen musicians, including Dave Stringer and Daphne Tse and more than 30 yoga teachers, including Simon Low (Britain) and Twee Merrigan (US), as well as dance and meditation teachers galore. Although the schedule is packed, the vibe is relaxed, and many venues are outdoors. The Bali Spirit Festival manages to merge East and West: teachers and musicians come from across the world, but there’s also a good local representation so you don’t forget where your downward dog is taking place.

While you’re there: for some postfestival relaxation, spend a few days in the nearby Gili Islands – three idyllic atolls. www.gili-paradise.com

Bali Spirit Festival www.balispiritfestival.com Where: Ubud, Bali, Indonesia When: March 28 to April 1 Cost: US$625 for a full festival pass (less for early birds and day passes) Attractions: Now entering its fifth year, the Bali Spirit Festival has loyal followers from Australia, Asia and

Wanderlust www.wanderlustfestival.com Where: Squaw Valley, California, US When: July 26-29 Cost: US$450 for four days of music and yoga Attractions: No one does a yoga festival quite like the United States, and Wanderlust California is the

COVER STORY 5

Clockwise from far left: never too young to yoga at the Bali Spirit Festival; dance along to drum beats at the Dutch Yoga Festival; it’s always a fun and friendly affair at Bali Spirit Festival; the Dutch Yoga Festival, Phoenix Weekend in the Australia, and Wanderlust in the US

Planet-friendly initiatives such as biodiesel powering the main performance stage and the banning of all styrofoam and non-recyclable plastics

best one in the country. It is set in the village of Squaw Valley in the Lake Tahoe region. Every summer, thousands converge on the town for a weekend of meditating in the mountains by day and getting down to chakra-spinning music events by night.

Expect plenty of big name teachers on the schedule – John Friend, Seane Corn and Shiva Rea were all there last year, and Michael Franti and Jai Uttal rocked the musical line-up. Although this festival experience screams “huge”, organisers try to keep their footprint small. Last year as a result of a renewed emphasis on the environment, planet-friendly initiatives were implemented such as biodiesel powering the main performance stage and the banning of all styrofoam and non-recyclable plastics on site, in keeping with the yogic practice of ahimsa (do no harm).

While you’re there: hike or horseback ride in the Sierra Nevada, or chill out at Uncorked, a popular wine bar at the Village in Squaw Valley. www.uncorkedsquaw.com

Dutch Yoga Festival www.yogafestival.info Where: Terschelling, the Netherlands When: June 29-July 1 Cost: ¤195 (HK$1,980) for a three-day pass, including meals, drinks, bike rental and a spot for your tent (rental tents and airbeds additional if required).

Attractions: There’s so much to love about this laid-back yoga festival.

For one thing, it’s on an island; second, tickets are all-inclusive; and third, your entry includes bicycle rental. The island of Terschelling is about 100 kilometres from Amsterdam, or a 45-minute ferry ride from the mainland. Festival tents are set up among the sand dunes, and wide beaches are at the ready whenever you need a break from the workshops on dance, voice, massage or meditation.

Although the destination is Europe, classes are conducted in English – but really, you don’t need too many words to bond over a Shakti dance session or therapeutic flying experience. Teachers from all yoga traditions come here, including

Switzerland, Sweden, the US and, mainly, the Netherlands, to help you stay balanced in that tree pose despite your sandy feet.

While you’re there: While hanging out in Amsterdam pre- or postfestival, grab a meal at the Golden Temple Vegetarian Restaurant on the popular shopping street Utrechtsestraat (number 126).

Owned by yoga teacher and musician Michael van Maasdijk, the restaurant offers a menu that is 60 per cent vegan but 100 per cent fabulous. www.restaurantgoldentemple.com Bhakti Fest www.bhaktifest.com Where: Joshua Tree Retreat Centre, California, US When: September 6-9 Cost: A four-day early bird pass costs US$200 plus administrative fees Attractions: While newcomers to yoga might feel more at home with the rave music found at the Phoenix weekend, those who experience the call and response chanting of mantras (kirtan) quickly get hooked.

When they do, they descend on Bhakti Fest – and they’re hardly

alone. Last year more than 5,000 yogis headed to this flagship event, where yoga meets rock’n’roll, Sanskrit style. Jai Uttal, Wah!, Krishna Das and Donna De Lory have all rocked Bhakti Fest in the past. Although there’ll be plenty of yoga classes on the bill, music is king here; expect plenty of big names in the yoga world to help fill the 80 hours (or more) of live music on the schedule. If you can’t wait until September, check out its new sister event, Shakti Fest, held in May. While you’re there: You’re on the fringe of two deserts (the Colorado and the Mojave, where Joshua Tree National Park is located), so make sure you get out and explore. The closest visitors’ centre to the festival, at 6554 Park Boulevard in Joshua Tree, runs ranger-guided walks and talks. www.joshuatree.org Sue White is a writer and long-time yoga practitioner based in Sydney, Australia.

Her e-book World Yoga Festivals Guide 2012 is now available on Amazon, and her app, Yoga Holidays Worldwide (US$2.99), will be available soon on iTunes. www.suewhite.com.au

6 HEALTH TRADITIONAL CHINESE MEDICINE

Child study a turning point for therapy ......................................................

Elizabeth Snouffer healthpost@scmp.com Acceptance of acupuncture as a has turned a corner, according to a report published last month in the American Academy of Pediatrics’ journal, Pediatrics, which concluded that the ancient Chinese needle therapy is safe for use on children, provided that it is performed by “appropriately trained practitioners”.

The study is the first large-scale systematic review reflecting the growing trend in paediatrics worldwide of using acupuncture on children and adolescents suffering from pain such as migraines. The researchers, from the University of Alberta in Canada, pooled data from more than 37 international studies, randomised trials and single case reports. They focused on the adverse effects associated with using the therapy in children and teenagers.

Out of the 1,422 children and

teens in the study, 168 experienced mild side effects (pain, bruising, bleeding), one had a moderate side effect (infection), and 25 were listed as severe (overnight hospitalisation, reversible coma and intestinal obstruction). The report indicated that the severe adverse effects were the result of substandard practice.

It was great news for someone like me, who has always been fearful of acupuncture. If the therapy is considered safe enough for children, then nothing should prevent me – a middle-aged adult – from giving it a try.

Acupuncture had been recommended on many occasions over the past two years as a therapeutic solution for my chronic and acute shoulder pain symptomatic of adhesive capsulitis, or frozen shoulder. The disorder is a chronic and inflammatory disease of the shoulder joint capsule and the surrounding soft tissue, manifesting as pain, soreness, dysfunction and loss of mobility.

NEEDLE AND NO DAMAGE DONE According to the Centre for Health Protection’s Guidelines on Infection Control Related to Acupuncture, published in June, acupunctureassociated infections are extremely rare when done under good management by a qualified practitioner. Here are a few things to keep in mind when seeking treatment: 1. The treatment room should be clean, dry, well ventilated and well lit.

2. There should be facilities for hand hygiene and the practitioner should perform hand hygiene before and after patient contact to prevent infections.

3. All work surfaces should be smooth and impervious so they can be disinfected thoroughly, and bed linen should be clean and changed after each patient.

4. The practitioner should review client information and pay attention to potential risk factors regarding medical history (skin infections,

chronic illness); drug history (steroid or anticoagulant, such as warfarin); allergy history (drugs or alcohol allergy); and lab results (microbiology and viriology reports).

5. The practitioner should use prepackaged, disposable sterile acupuncture needles and guide tubes.

Package should be opened just before use.

6. In preparation for treatment, skin should be swabbed with 70 per cent alcohol or povidone-iodine or chlorhexidine-in-alcohol to disinfect the penetration site. Once the practitioner has disinfected the penetration site, bare hands should not touch the area again.

7. Acupuncturist should hold the handle of the needle upon insertion and never the area near the needle shaft.

8. Needles, after removal, should be discarded immediately into a sharps box as clinical waste.

However, I had rejected acupuncture – and was also a bit of a sceptic – because of possible pain or bruising, hygienic safety and risk of infection. But the Canadian study gave me some assurance that as long as I sought treatment from a professional who met appropriate standards, my risks would be minimal.

Throughout its 8,000-year history, acupuncture has survived periods of robustness and suppression, but remains an important element in today’s traditional Chinese medicine as well as its modernisation as a primary component of Complementary and Alternative Medicine (CAM). Before the Iron Age, acupuncture was initially administered with stone instruments or bian stone, as recorded by ancient literature.

The Huangdi Neijing, compiled about 2,200 years ago and regarded as the earliest book written on Chinese medicine, contains the first description of acupuncture.

From the start of the Qing dynasty in 1644 to the opium wars around 1840, herbal medicine was perceived as superior to acupuncture in practice, but during the Long March (1934-35), acupuncture was used as the primary tool to help maintain the health of the army. Mao Zedong officially united traditional Chinese medicine with Western medicine in 1950, with acupuncture utilised as the primary application in Chinese hospitals.

Today, acupuncture is used to as a therapeutic tool to help restore health and minimise pain for people suffering from osteoarthritis, digestive disorders including diarrhoea and constipation, migraines, autism, infertility, depression, labour pains in childbirth, chemotherapy and musculoskeletal disorders or injuries, such as frozen shoulder.

Donna Sutton, a physiotherapist at Peak Performance in Central who was educated in New Zealand and Hong Kong, has administered physiotherapy and acupuncture to many, including Hong Kong rugby

If the therapy is considered safe enough for children, then nothing should prevent me ... from giving it a try

team members with sports injuries.

She has seen a variety of outcomes: some patients have noted relief after only one or two treatments; others have required four to six visits before any benefits are realised, and still others have felt no effect and stopped the therapy altogether.

Sutton says acupuncture is most effective for musculoskeletal problems such as plantar fasciitis, tendinopathies including tennis elbow, achilles tendinosis, rotator cuff tendinitis and frozen shoulder.

Two years ago, I tore my rotator cuff playing tennis and within two weeks was diagnosed with a mild case of frozen shoulder. My mobility

HEALTH 7 ORGAN DONATIONS

A gift that keeps on giving ......................................................

Jeanette Wang jeanette.wang@scmp.com

Writer Elizabeth Snouffer receives acupuncture treatment from physiotherapist Donna Sutton.

Photo: Nora Tam

range hovered around 45 per cent, but the pain and swelling in the shoulder and back area was acute. In the past 24 months I have had four steroid injections, more than 10 appointments with orthopaedic surgical specialists for shoulder, back and neck examinations, two magnetic resonance imaging, physical therapy, osteopathy and therapeutic massage.

The cost and time spent on managing the disorder have been overwhelming, with little success or sustainable relief, and in the past two years I haven’t experienced one pain-free night of sleep.

According to acupuncture etiology, I have wind and cold

invading my taiying and yangming meridians, causing pain in my shoulder, radiating to the neck and back; constant yin deficiency, which disrupts the exuberance of my yang; and qi stagnation and blood stasis, among a host of other ailments.

Sutton inserted seven sterile, prepackaged 50 millimetre acupuncture needles into my right shoulder, arm, hand, upper calf and lower calf, which correspond to points of the large intestine, small intestine, gall bladder and stomach meridians. All insertions were four millimetres deep and relatively painless, except the needle just below my thumb and the point near my ankle. I had aching sensations with referral pain on the corresponding left side of my body and mild throbbing in my head. The session lasted for about 20 minutes. When the needles were removed, my right arm felt heavy and I felt tired, with some mild discomfort in my abdomen, which subsided after two hours. There were no marks on my arm, no bleeding and no apparent bruising.

It had gone well.

Later in the day, it became apparent that something had significantly changed. As I got ready for bed in the evening, I was stunned by how comfortable and relaxed I felt. When I woke up the following morning, I felt rested and relieved.

For the first time in nearly two years, I had experienced a pain-free night’s sleep.

When I returned to the physiotherapy office for my second appointment, Sutton measured my range of mobility, which had improved by almost 20 per cent. I had not expected such improved conditions from a treatment I had rejected as suspicious. I was stunned. My improved mobility was evidence reflecting more than just a placebo effect.

When I asked Sutton how such a huge difference was possible after only one appointment, she smiled and said simply: “Don’t secondguess it. For some patients, acupuncture just works.”

At age 11, doctors told Lomond Chu Lok-man he had no more than two months to live if he didn’t get a liver transplant. Born with congenital bile duct obstruction that developed into liver cirrhosis, he had spent his childhood vomiting and passing blood, and making trips to the doctor and hospital.

With time running out, he was given a second chance at life through a liver donated by the family of someone who died. The precious gift turned Chu’s life around – he’s now a scholarship student at Baptist University and a track athlete who’s represented Hong Kong at the World Transplant Games.

Heartwarming stories like Chu’s are becoming more common in the city as organ donation is gradually being accepted.

At the end of last year, there were more than 90,000 registered donors in the Centralised Organ Donation Register, up from about 65,000 at the end of 2010.

However, this still represents just 1 per cent of the population, despite 70 per cent of respondents to a phone survey in 2007 by the Health

The Garden of Life celebrating organ donations in Kowloon Park Department saying they were willing to donate their organs.

To help boost donor numbers on the three-year-old register, the Health Department recently inaugurated the Garden of Life, a 300-square-metre area near the Hong Kong Heritage Discovery Centre in Kowloon Park. Not only will the garden be used as an educational site on organ donation and a tribute to donors, it also will be a venue for publicity activities aimed at getting people to sign up for the register.

The garden’s design is based on the theme “light up lives”. It is laid out in a circle to represent life’s continuation, a pond with a butterfly logo symbolises organ donation, and pillars mimic candles that

signify the kindling of hope and the continuation of good deeds.

Last year, Hong Kong saw organ donations from seven people (deceased) per million, up from four per million in 2005, according to statistics compiled every five years by the government. Despite the rise, there is obviously still a severe shortage, with more than 2,000 people on the waiting list, most of whom need a kidney.

Preliminary results of a phone survey conducted by the Health Department last year show that among 2,100 people aged 18 to 64 interviewed, 95 per cent indicated that they wouldn’t object to organ harvesting if their dead family member had expressed a willingness to donate organs.

“The finding underlines the importance of potential organ donors to register their wish early,” says Dr Kung Kin-hang, senior medical officer at the department’s Central Health Education Unit.

There is no restriction of gender, age or race for organ donation. The kidney, liver, heart, lung, cornea, bone and skin can be transplanted.

It takes only a minute to put your name on the register (www.organdonation.gov.hk), but it could mean a lifetime of happiness for someone else.

8 FITNESS SWEAT NEW YEAR REGIMEN

How to kick-start a fitness revival ......................................................

Greg Chertok healthpost@scmp.com New year, new you. Here are 10 steps to beginning an exercise programme – and to making 2012 your fittest year ever.

1. Get to know your body If you know nothing about the workings of the body, you may be putting yourself in a dangerous position. Every exerciser must have a basic understanding of the human body. This includes: • proper identification of the major muscle groups; • knowledge about the effects of activity versus inactivity; • distinction between stretching and strengthening a muscle; and • distinction between “good pain” (muscle burn and fatigue) and “bad pain” (joint pain, lower back pain/ impingement).

I once worked with an older man who, in response to experiencing soreness from exercise the day before, decided to do more of what got him sore in the first place. Rather than stretching or resting the muscle, he assumed that working more would do the trick. He was forced to take even more time off to relieve the resulting soreness.

This man, a senior vice-president for a financial firm, was obviously well educated but uninformed about his body and how to exercise correctly.

2. Understand why you are exercising Pose questions to yourself such as, “Why did I decide to start

exercising?” It is suggested that exercisers who are intrinsically motivated experience more positive effects and better adherence than those who are extrinsically motivated.

Intrinsically motivated exercisers do so for the satisfaction gained from engaging in the activity itself; in other words, they exercise for the challenge, to gain or learn skills, or to have fun.

Extrinsically motivated exercisers do so as a means to an end; they exercise simply to improve their appearance or because of pressure from someone else. The proper reason behind exercising can act as powerful and long-lasting fuel.

3. Know where you are In other words, know what your current fitness level is. You will need at least a general idea so you can accurately measure your progress. Assess your aerobic and muscular fitness, flexibility and body composition by recording: • your pulse rate before and after you walk one mile (1.6 kilometres); • how many push-ups you can do at one time; • your sit-and-reach (how far you can reach forward with your legs out in front of you); and • your waist circumference – the distance around your abdomen.

4. Know where you want to be To start, create a clear and vivid picture in your mind – what does this look and feel like? When you reach this ideal, what will you be able to do that you aren’t able to do now? The act of creating this picture alone can conjure positive

and pleasant emotions, and reminding yourself of this image can motivate you.

something more private, inquire at your local gym about personal training.

5. Know how you will get there Identify the exercise programme or activities that will take you to your ideal fitness level. As a rule, never choose an activity that doesn’t interest or excite you. Rather than fit into a generic exercise regimen, try to fit one to your needs.

If you are looking for a social atmosphere, think about joining a class – there’s Zumba, Pilates, yoga, spinning, swim and dance, among others. If you are looking for

6. Develop a comfortable routine The American College of Sports Medicine recommends that adults participate in at least 150 minutes per week of moderate intensity physical activity. With this understanding, find a challenging yet realistic starting point on which you can build over time. Don’t overwhelm your system by doing too much, but don’t underwhelm your system by doing too little.

While devising your schedule – that is, minutes per day and days per week of exercise – also recognise any obstacles that may impede your progress.

What excuses have you made in the past that have prevented you from exercising consistently? Start by altering your thinking. Mentally commit to the process so you’re in a good mindset to begin.

7. Write it all down Organise your daily goals, weekly goals, longer-term goals and exercise programme/routine on paper. Studies find that those who write down their goals can accomplish up to 16 per cent more than those who don’t.

8. Gather your accessories What special clothing, shoes, or gear does your fitness routine require? You might need to buy a new pair of athletic shoes or sports gear before starting your programme. Having the right clothing and equipment can make

the exercise easier and safer. You may find yourself more likely to continue with exercise when you know you have the right equipment. Some people like to exercise with music, so you might compile a soundtrack of your favourite songs. Studies have shown that listening to music during exercise can improve results as a motivator (people exercise longer and more vigorously to music) and as a distraction from fatigue.

9. Create incentives Develop a reward system ahead of time for the goals you accomplish along the way. Be proud of your accomplishments, and don’t be shy about celebrating your successes.

10. Get started and trust the process You’ve done all the behind-thescenes work; now it’s time to go out and reap the benefits of your preparation. A common deterrent to exercise adherence is impatience. Many first-time exercisers expect dramatic bodyaltering results after mere weeks, or even days, of increased movement.

But don’t give up if you aren’t immediately seeing the desired physical results. Real change may take up to several months. Trust the process, and enjoy the journey.

Greg Chertok, M.Ed, is a sport psychology counsellor and fitness trainer at the Physical Medicine and Rehabilitation Centre in New Jersey.

Reprinted with permission of the American College of Sports Medicine, ACSM Fit Society Page, Summer 2011, p6.

FITNESS/ DIET 9 WALKING HOME

Can friendship go the distance? ......................................................

Rob Lilwall healthpost@scmp.com Leon McCarron – my expedition partner and cameraman on this 5,000-kilometre trek home, which began in Mongolia about two months ago – is a softly spoken, tall, lanky, Northern Irishman in his mid-20s.

When we set off, Leon and I did not know each other very well. He films adventures for a living and we had met briefly in London and New York to discuss a cycling expedition he was planning.

Then about a year ago my wife and I invited him to stay with us when he arrived, on his bicycle, in Hong Kong.

It so happened that I was in the

Many an expedition has come undone owing to team members falling out, even when they are old friends early stages of planning this Walking Home From Mongolia adventure when my previous expedition partner pulled out for family reasons two days before Leon arrived. And so, a few days later, after getting to know Leon a bit better and gaining respect for both his camerawork and adventuring ability, I invited him to join me on the trek.

Any serious adventurer will now perhaps remark that asking someone I barely knew to come on a long, gruelling and risky journey was a rash thing to do. Indeed, many an expedition has come undone owing to team members falling out, even

when they are old friends. By the time Peter Hillary and Graeme Dingle finished walking the length of the Himalayas in 1981, they were almost unable to speak to each other. On his 860-day walk across the Amazon, Ed Stafford’s expedition partner left him after just three months. The list goes on.

British adventurer Ranulph Fiennes has said how rare it has been for him to find reliable teammates, and has a general rule of “never selecting Yorkshiremen for my teams, because they are dour and nurse grievances; small men, because they need to work hard to make themselves seen and heard; and spectacled men because, when their spectacles break, they may become pains in the neck”.

I guess big bust-ups should be expected in an environment that combines the big egos and ambitions of adventurers with severe conditions, regular dangers, complex logistical decisions and tricky deadlines.

It’s sometimes easier and better to travel alone. For the vast majority of my three-year Cycling Home From Siberia expedition, I was by myself, and I think this enabled me to learn more, grow up more, and also make friends with and receive hospitality from locals more easily.

However, there are also some very good reasons to pair up. It’s certainly safer (if one person is sick or injured); less scary (when facing a perceived danger); and better for documenting with film and photos.

So, how have Leon and I fared?

So far, pretty well. Much of the credit for this must go to Leon, who is an intelligent, patient, tough and easy-going guy, who does not harbour delusions of grandeur and has the guts to have difficult conversations early on and admit when he is wrong.

Warm and fuzzy: Rob and Leon pause for a shot as they cross the Gobi Desert. Photos: Rob Lilwall When we set off into the Gobi, Leon had no hesitation in getting the camera out and removing his gloves to set the controls, even when it was a blistering minus 20 degrees Celsius. He would then cheerfully take his turn dragging our trailer through the desert, singing loudly along to Red Hot Chilli Peppers on his iPod. He has been quick to try and find solutions to various problems we encounter, and is so optimistic at times that I now call him a “hopevist”.

At the same time, we’ve had a number of disagreements: on the route, estimated day of arrival and how much water to carry. Usually, we get through these by debating them as we hike, before coming to some kind of resolution.

More serious, however, are the petty irritations. For example, Leon gets annoyed that I’m not a morning person and so take longer to get

ready in the morning, which means we set off late and have to hike into the dark to reach our destination. I get annoyed that he gets ready so quickly.

To deal with such things, it has been essential for us to talk through

From left: Rob Lilwall and his wife, Christine; Clare Symons, girlfriend of Leon McCarron (right) at the Hanging Monastery in Shanxi

the problems early, before they grow into full-blown resentments (this principle is very helpful in marriage, too). We’ve also given each other space by taking two tents instead of one and spending our days off apart to do our own thing.

So, with 20 per cent of the journey done, we’re getting on well.

I hope it continues this way. It needs to if we are going to make it past the many challenges that still await us on our long walk home.

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

EAT SMART PRAWN AND HERB WILD RICE

Adding extra fibre to your rice dish is easy – just go wild ......................................................

Jeanette Wang jeanette.wang@scmp.com By simply substituting three quarters of your plate of white rice with the wild variety, you can increase your intake of dietary fibre by four times, as this recipe

by Shing Hin Catering Group shows.

The mixture of wild and white rice provides four grams of dietary fibre, or 16 per cent of the daily requirement for adults.

Previously limited to Western cuisine, whole grains such as wild rice and quinoa have become a common ingredient in the city.

As Hongkongers become more health conscious, dishes such as

brown rice with pumpkin and steamed oat groats are starting to appear on some restaurant menus.

Compared with refined grains such as white rice and pasta, whole grains are not only higher in dietary fibre, but also richer in vitamins (such as vitamin B1, B3 and folate) and minerals (iron, potassium and magnesium).

This dish contains about 534 calories, 11 grams of fat, 86 grams of carb, and 25 grams of protein per serving.

Italian style prawn and herb wild rice Serves 1 60 grams wild rice 20 grams white rice 2 tsp olive oil Some minced garlic

4 tbsp stock 30 grams prawns 125 grams canned green peas, drained Basil, finely chopped, to taste ¼ tsp salt • Wash and strain wild and white rice.

Add 1 tsp of olive oil, minced garlic and stock. Parboil to almost done; set aside.

• Peel and wash the prawns. Drain and set aside.

• Heat remaining olive oil. Add prawns, garlic, salt and parboiled rice. Cook until done.

• Add green peas until heated through.

• Sprinkle with basil and serve.

This column features recipes provided by the Health Department as part of its EatSmart@restaurant.hk campaign. For more information, visit restaurant.eatsmart.gov.hk

10 DIET NUTRITION

Beet a path to better health ......................................................

Elle Kwan healthpost@scmp.com

Shima Shimizu’s raw chocolate and beetroot cake. Photo: Dickson Lee

RECIPE FOR HEALTH

This will definitely put you in the pink ......................................................

Elle Kwan healthpost@scmp.com We usually think of beetroot as a savoury food. But Shima Shimizu, raw food chef and founder of Sesame Kitchen, dispels this notion by using beetroot as a key ingredient in a cake.

Shimizu’s brownie-like cake needs no baking. Raw beetroot is blitzed in a food processor with walnuts, dates, cocoa powder and spices, then refrigerated. The vegetable imparts depth to the chocolate and spices, and a vivid pink colour to the topping. Eating the ingredients raw preserves their goodness, while coconut sugar, rather than refined white sugar, lowers the glycaemic index.

Raw chocolate and beetroot cake For the cake 290 grams walnuts, soaked and dehydrated 300 grams dates, pitted 70 grams raw cocoa powder Half a beetroot, shredded 1 tsp cinnamon ¼ tsp nutmeg Pinch of salt • Place ingredients in a food processor fitted with an S-blade and process until the mixture binds. Over-processing will result in oil leaking from the nuts.

• Pat the mixture into a seven-inch (18cm) round, spring-form cake pan.

Press down evenly for about three minutes to shape the cake, packing it well to avoid crumbling later. Place cake in freezer or refrigerator to harden.

For the cashew icing 150 grams cashews 100 grams coconut sugar (available in

Thai and Indian supply stores) 80ml coconut oil Half a beetroot About 150ml water 30ml lemon juice • Place chopped beetroot in a blender and blend slowly with the water in small quantities until it forms a smoothie-like consistency. (You may not need all the water.) Squeeze the juice through a nut milk bag or cheese cloth to remove pulp.

Set aside and clean the blender.

• Place cashews, coconut sugar, coconut oil, lemon juice and a pinch of salt into the blender. Add enough beetroot juice until the liquids cover the dry ingredients.

Blend until creamy, adding more beetroot juice if needed.

• Remove cake from pan. If it crumbles, pack it back into the pan, press gently and turn it out again. Pour the icing on top of the cake. Set in the refrigerator for at least an hour.

For the decoration 20 grams raw cocoa powder 1 tbsp coconut oil 10 grams coconut sugar • Mix raw cocoa powder, coconut oil and coconut sugar by hand. Drop the chocolate mixture in dots on top of the icing and swirl with a toothpick.

• The cake can be refrigerated for up to five days.

First came tomatoes, then strawberries, pomegranate and acai berries. If shelves in Hong Kong are anything to go by, the next superfood is also red: beetroot.

The vegetable is sold in street markets. You’ll find it on menus at Western restaurants across town.

Marks and Spencer offers a beetroot, apple and blackcurrant juice, a portion of which can serve as one of the “five-a-day” helpings of fruit and veg recommended for good health. At ThreeSixty supermarket, customers can buy fresh beetroot imported from Australia mixed with ginger at the juice concession, or in a Mediterranean salad.

Red vegetables are a great addition to any dish, Nicole Wong, a nutritionist with NutraCare Consultancy, says.

Beetroot’s distinctive colour comes from the presence of betacyanin, an antioxidant. “Betacyanin can help reduce oxidation of LDL [bad] cholesterol and lower the risk of cardiovascular diseases and heart attacks,” Wong says.

Beetroot is also high in potassium, which is vital for brain function, muscle growth and the nervous system. A cup of raw beetroot contains the same amount of potassium as a medium-sized banana. That same cup will also provide as much fibre as a cup of brown rice, as well as almost a third of the recommended folate intake for pregnant women. Wong suggests eating three portions of beetroot a week as part of a vegetable-rich diet to receive optimum levels of folate, fibre, potassium and betacyanin.

Some studies have found that the nitrates in beetroot boost athletic performance and, in two separate studies, researchers at Queen Mary, University of London and The London School of Medicine found that drinking beetroot juice lowered blood pressure. Wong says the trials have been on a small scale, and she would need more evidence before recommending them to athletes in training. However, she says beetroot’s high potassium content does balance pH levels in the body, which can aid blood

Beet leaves are richer in calcium, iron and certain vitamins than the actual beetroots ANITA CHEUNG, I-DETOX INTERNATIONAL

pressure regulation and can also be good for treating cases of hypertension.

Beetroot can also work to flush the body of toxins. Anita S.K. Cheung, a certified holistic health coach at i-Detox International, uses beetroot to help cleanse the liver, gall bladder and kidneys.

Nutrients are best gained from eating raw beetroot, although gentle steaming doesn’t diminish its generous amount of antioxidants and enzymes, Cheung says. Heat used in the canning process can eradicate some of the healthy properties, while water surrounding beetroot can leech it of potassium and folate, so it is worth buying fresh.

Beetroots are now in season.

Cheung recommends selecting deeply coloured specimens with a good round shape. If they haven’t been grown organically, it’s a good idea to soak them in water with a chemical-free detergent, she says. And don’t ignore the leaves. “Beet leaves are richer in calcium, iron and certain vitamins than the beetroots themselves,” Cheung says.

Many markets and supermarkets sell beetroot with the stalks lopped off, but some local produce companies, such as Homegrown Foods, deliver with leaves on.

(Leaves are a good indicator of freshness, because they tend to wilt within a few days of the vegetable being picked.)

They work well as an addition to salads and are great in a stir-fry.

Beetroot flesh adds texture and depth to a salad.

Try pairing its earthy flavour with rocket or spinach, adding nuts for extra crunch.

Cheung recommends a do-it-yourself juice, but suggests starting with small quantities and building up tolerance since raw beetroot can be hard for the stomach to digest at first. “When using raw beet juice, start with a small amount like half to one ounce (15 to 30 millilitres) daily, mixed with other juices like carrot, apple and ginger,” she says.

It seems there are as many ways to serve beetroot as the many nutrients it contains, so this winter don’t just see red, eat it.

WELL-BEING 11

Strike a pose: Pure Yoga instructor Claudia Whitney. Photo: May Tse

FIT & FAB

How yoga straightened me out ......................................................

P. Ramakrishnan rama.p@scmp.com German-born, American-bred Claudia Whitney, 36, wasn’t always keen on the idea of doing yoga pretzel poses. She once saw yoga as a foreign form of exercise that wasn’t meant for her.

“I had the same excuses as a lot of people I meet today: ‘I’m not flexible’, ‘There is not enough time’, or ‘This isn’t for me’,” she says. “But I finally got into it 11 years ago in New York. I was hooked from my first class. I struggled the whole way through, but the experience shifted me on so many levels that there was no looking back.”

An ancient practice originating in southern India, it seemed like a fad at first, when celebrities (and then everyone else) took to it. But why did the fad not fade?

“Yoga is more than a workout; I think that it becomes a way of life for most people,” says Whitney, now an instructor at Pure Yoga. “You start to shift destructive patterns on the mat,

THE TASTE TEST FROZEN WAFFLES ......................................................

Jeanette Wang jeanette.wang@scmp.com

De Wafelbakkers Blueberry waffles Nine waffles for HK$40, City’super These whole grain waffles were crisp on the outside, and thick and fluffy inside. With the sweetness of blueberries and nuttiness of spelt flour, they were fantastic on their own.

Verdict: I had them for breakfast, dinner (with soup), and dessert ... and still can’t get enough of them.

and then you’re capable of changing things in your everyday life. Without this outlook, the poses we do in class mean nothing, and I think that is what keeps people coming back.”

Whitney thinks yoga would benefit youngsters, too, to help calm teenage anxiety and hormonal turmoil.

“I was a wild child – well, I’m still a wild girl – but growing up, I had to face some tough times,” she says.

“Yoga has helped me find balance and calmed me down. I wish I had started earlier, as it really centres you. I’ve learned to let go of a lot of the nonsense and focus on positive things ... I’ve honestly never been happier in my life.”

Were you a sporty person as a child?

I was not a sporty child, and my diet was terrible. I ended up being overweight in my late teens and early 20s, so I started educating myself about nutrition and fitness, and that is when I first committed to working out. Changing my diet and working with a personal trainer helped me to shed the extra weight

and improve my confidence.

Eventually, I found yoga and, while it keeps me fit, it has become more than a physical practice. I can’t imagine my life without it.

I guess you had the diet of most teenagers?

Yes, I grew up eating fried food, junk food and fast food. When I made the choice to lose weight and get healthy, I stopped eating all of these things and started experimenting with my diet. At one point I ate only raw vegan food for three years, and I felt amazing. When I moved to Asia, I was so excited about the variety of

Yoga is more than a workout; I think it becomes a way of life for most people CLAUDIA WHITNEY, INSTRUCTOR, PURE YOGA

food and flavours that I reintroduced cooked food, and now I’m about 70 per cent to 75 per cent raw vegan, and I’ve never felt better.

Have you made a spiritual journey to India?

I spent three months in India six years ago. I travelled to Mysore first to study ashtanga yoga with Pattabhi Jois and Sharath Rangaswamy.

Practise started at 5am, so I had the rest of the day to study anything I was interested in. I learned a southern Indian style of painting called Kannada, and I studied meditation and drawing with another teacher. We would sit outside his house on the ground and meditate before each lesson, which started out with scribbling with crayons to get me to loosen up. I also took vegetarian Indian cooking classes and studied Carnatic music [the classical music of southern India].

As a yoga teacher, what’s your sales pitch?

If someone is really interested then I

usually invite him or her to try a complimentary class at Pure Yoga.

Most people are usually only interested in the physical benefits because practising yoga creates a toned, flexible and strong body, but there are benefits beyond that, like feeling more energetic and maintaining a balanced metabolism. You’re promoting cardio and circulatory health, and it helps stress levels. When you practise steadily, you are also building awareness of your body, feelings, relationships and the world around you. It’s a complete package.

Are men more averse to yoga than women?

Men who go to the gym usually have a misconception that yoga is only stretching and meditation, and they don’t realise that it is also extremely physically challenging. I have noticed an increase in male attendance in the past couple of years. They find it’s a great complement to their gym workout or any sport. Anyone can do it, and it’s not going to tear up your body.

Van’s 8 Whole Grains Multigrain waffles Six waffles for HK$46, City’super The smell of these baking was promising, but they were a tad bland and dry, so reach for some butter and honey. They’re healthy, though, with 18 grams of whole grains and six grams of fibre.

Verdict: a good alternative to whole grain toast for breakfast.

Earth’s Best Organic Mini Waffles 32 mini waffles for HK$43, City’super These bite-sized waffles, about the size of a watch face, are fun to eat. Each serving of four waffles has 12 grams of whole grains and is an excellent source of iron, zinc and six B vitamins, the box says.

Verdict: serve with fruit for a healthy breakfast for children.