20120619 health post

YOUR GUIDE TO LIVING WELL

TUESDAY, JUNE 19, 2012

HEALTH POST At home on the range Why archery is the perfect pursuit for not-so-sporty types >PAGE 6

STRAIGHTEN UP AND SMILE RIGHT >PAGE 5

FIVE GREAT GLOBAL ENDURANCE RUNS >PAGE 11

2 NEWS APP OF THE WEEK

HEALTH BITES

DIY acupressure offers a few pointers for a firmer face

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Katie McGregor healthpost@scmp.com Self Acupressure Facelift US$3.99 Rating 8/10 The before and after photos on this app brought snorts of derision from colleagues in my office. “Is it even the same man?” someone asked. It seems too good to be true that such a transformation could take place in five short months through simple acupressure, but I’m giving it a go.

I’m doing it because in the past I interviewed the fresh-faced Dr Helen He, a traditional Chinese medicine practitioner who is known for her acupuncture facelifts. She explained that while it wasn’t a miracle facelift, over time she sees a marked improvement in her clients’ muscle tone, skin colour, fine lines and age spots, and she put this change down to better circulation of chi and blood brought about by acupuncture.

Because of He’s more modest claims of a visible change after 10 sessions using acupuncture, I am approaching this app, which uses acupressure, with modest expectations; but at US$3.99, it’s a lot cheaper than visiting a pro.

The first step is to take a photo of your face with your iPhone. You then select one of nine face grid templates, each showing different acupressure points, to work on for different solutions – from a full facial treatment to a specific issue such as “upper lip”. You then position a template grid over your face, and try to align it as best you can.

Once in place, you “lock” and start therapy. Each point flashes in turn with a 15 second countdown while you gently massage, and then you move onto the next point. For the full therapy there are 27 points, so the therapy from start to finish will take just short of seven minutes.

Dr Russell Erhardt, acupuncturist and designer of the programme, explains in the notes that the stimulation of the points can be done with your fingertip or the ball pad of your finger and you should massage in a circular or back-and-forth motion, but “do not massage too hard to the point of pain; remember you are stimulating, not digging for gold”.

If I notice the same transformation in the before and after photos, I think I might have struck gold. I can only wait and see.

ASK THE DOCTORS DR ANTHONY LUKE Q: I’m worried about gaining weight once menopause occurs. I heard weight gain happens, and I’m starting to experience hot flushes.

What can I do?

A: Unfortunately, it’s estimated that about 90 per cent of women gradually gain about 4.5kg to 7kg after menopause. Weight changes may be greater and faster when women undergo menopause early.

There are several reasons for this.

Changing hormone levels associated with menopause are not necessarily the only cause of weight gain. It’s natural that as you age, your metabolism slows down and you burn fewer calories. Ageing also leads to the body having more fat than muscle – and fat burns fewer calories. Many people also eat more and exercise less over time. Doing the same exercise routine and eating the same diet may not be able to

keep the weight off, requiring further lifestyle changes. Of course, eating a healthy, balanced diet is always recommended. Avoid refined sugars, caffeine, nicotine and alcohol. Maintaining or increasing aerobic activities can be useful, especially moderate or vigorous activity levels that can burn calories and fat at a higher rate. Reducing stress can be helpful also to avoid excessive stress hormone levels that trigger the body to store more fat. It’s important to remember that this is a normal part of life, and accepting the transition and living a healthy lifestyle are the best ways to prepare for life’s changes.

Dr Anthony Luke is an associate professor of clinical orthopaedic surgery at the University of California, San Francisco.

Reprinted with permission of the American College of Sports Medicine’s ACSM Fit Society Page

> 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 Printed and published by South China Morning Post Publishers Ltd, Morning Post Centre, 22 Dai Fat Street, Tai Po Industrial Estate, Tai Po, Hong Kong. Tel: 2680 8888

Jeanette Wang jeanette.wang@scmp.com

I’m not just a plastic bag Buy this, support mental rehab. This large shoulder bag is one of a range of products designed by renowned local artist Stanley Wong Ping-pui and available at the new “rwb330” concept store at the Flower Market on Prince Edward Road West. Rwb is short for red-white-blue, the colours of the signature Hong Kong plastic fabric used by Wong, who goes by the name “anothermountainman” in his artwork. A social enterprise operated by New Life Psychiatric Rehabilitation Association, the shop aims to provide work and training opportunities for people in recovery of mental illness, and promote the spirit of “Positive Hong Kong” to the public. Five of the six job vacancies at the shop are for people in recovery.

Relief for liver cancer patients The Hong Kong Liver Cancer Foundation has launched a new drug subsidy programme. Through support from pharmaceutical companies and community service organisations, the first phase will offer four drugs, including targeted therapy, selective internal radiation therapy and anti-hepatitis-B drugs. “Apart from targeted therapies, expensive diagnostic tests such as Positron Emission Tomography (PET) scanning and other costly treatments such as selective internal radiation therapy are currently self-financed by the patient,” says clinical oncologist Dr Cheung Foon-yiu, a Hong Kong Liver Cancer Foundation council member.

“As a result, patients cannot benefit from the most optimal treatments because of their limited affordability.” For more information on the programme or to support it, go to hklcf.org or call 3689 7596.

Peel appeal Some 15.6 million tonnes of orange and other citrus peel are discarded worldwide every year. Rather than let it go to waste, scientists in Britain have developed a sustainable way to extract and use every bit of peel.

Among the uses include biosolvents, fragrances and water purification. The process involves exposing orange peels to high-intensity microwaves at low temperatures that transform many of its components into liquid that can be later collected and used to extract useful products.

What remains is cellulose, which can be used as a food additive or thickening agent, or converted into a solid biofuel. The project, dubbed Orange Peel Exploitation Company, is a partnership between researchers from the universities of York in Britain, Sao Paulo in Brazil and Cordoba in Argentina. The team hope to have a prototype biorefinery up and running soon.

A lasting impression The effects of exposure to low doses of Bisphenol A (BPA) during gestation may be immediate and last for generations, according to a recent study accepted for publication in the journal Endocrinology. BPA is a man-made chemical present in various products such as food containers and receipt paper, and studies in mice show prenatal exposure to BPA is associated with increased anxiety, aggression and cognitive impairment. In this study, female mice were given food with or without BPA before mating and throughout gestation.

Juveniles in the first generation exposed to BPA in utero displayed fewer social interactions as compared with control mice.

Some gene changes persisted into the fourth generation, though with weaker effect.

NEWS 3 HYGIENE

QUIZ

Dirty secrets: what else is living in your hotel room?

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Jeanette Wang jeanette.wang@scmp.com A hotel room is usually spick and span, but beyond the crisp white sheets lurks bacteria in places you’d least expect. The television remote control and the bedside lamp switch have been found to be among the most heavily contaminated, apart from the toilet and bathroom sink, according to University of Houston researchers.

Worryingly, some of the highest contamination levels were found in the housekeepers’ carts: sponges and mops, which carry the potential to cross-contaminate rooms.

“Currently, housekeeping practices vary across brands and properties without standardisation.

The current validation method for cleanliness is a visual assessment, which has been shown to be ineffective,” says the university’s Katie Kirsch, who presented the study on Sunday at an annual American Society for Microbiology meeting.

The researchers sampled 19 surfaces in each room. Nine rooms in Texas, South Carolina and Indiana were tested for levels of total aerobic bacteria and coliform (faecal) bacteria on each surface.

The least contamination was

found on the headboard of the bed, curtain rods and the bathroom door handle. The researchers cannot say whether or not the bacteria detected can cause disease, however, the contamination levels are a reliable indicator of overall cleanliness.

“Identifying high-risk items in a hotel room allows housekeeping to design cleaning practices and allocate time to reduce the potential health risks posed by microbial contamination,” says Kirsch.

The study was designed as the first step in applying the Hazard Analysis and Critical Control Points (HACCP) system to hotel room cleanliness. Originally developed by US space agency Nasa, HACCP is a preventive approach that identifies potential physical, chemical and biological hazards, and designs measurements to reduce these risks to safe levels.

However, Kirsch notes that this study is preliminary and limited by sample size. More research could help offer a scientific basis to hotel housekeeping.

“The information derived from this study could aid hotels in adopting a proactive approach for reducing potential hazards from contact with surfaces within hotel rooms, and provide a basis for the development of more effective and efficient housekeeping practices.”

Jeanette Wang jeanette.wang@scmp.com On Thursday cities worldwide will observe World Music Day by organising free public concerts and encouraging amateur and professional musicians to perform in the streets.

The annual event, which originated in France in 1982, is a celebration of one of the greatest gifts of life: an art, a universal language, a medicine of the mind and an outburst of the soul.

Music has many effects on well-being. A recent study by McMaster University in Canada found that year-old babies who participate in interactive music classes with their parents smile more, communicate better and show earlier and more sophisticated brain responses to music.

Another study, published in the Journal of Cardiothoracic Surgery in March, showed that music can reduce rejection of heart transplants in mice by influencing the immune system.

While the link between the immune system and brain function is not clear, music is used clinically to reduce anxiety after a heart attack, and to reduce pain and nausea during a bone marrow transplant.

There is some evidence that music may act through the parasympathetic nervous system, which regulates the bodily functions that we have no conscious control over, including digestion.

Music can evoke positive emotions, which in turn lower the listener’s stress levels, according to a doctoral thesis in psychology from the University of Gothenburg in Sweden. The thesis is based partly on an experiment involving 42 people, of whom half listened to self-chosen music for 30 minutes per day for two weeks, and the other half relaxed without music.

It was found that the music group experienced positive emotions more often and more intensively, and also perceived less stress and had lower levels of the stress hormone cortisol. The more the participants liked the music, the less stress they experienced.

But just how loud should you be listening to music?

Test yourself here.

1. Which of the following can cause noise-induced hearing loss? a. A sudden “impulse” sound, such as an explosion

b. Long or repeated exposure to heavy city traffic noise c. The humming of a refrigerator 2. How loud does a sound have to be before it can damage your hearing? a. Above 85 decibels b. Above 100 decibels c. Above 115 decibels 3. At most rock music concerts, the sound typically registers continuously over a. 85 decibels b. 100 decibels c. 115 decibels 4. According to a study by researchers at Ghent University in Belgium, you can listen to your iPod all day without risk for hearing loss at a maximum volume of a. 80 per cent b. 60 per cent c. 40 per cent Answers: 1. a and b; 2. a; 3. b; 4. b

4 MEDICAL

Illus trat ion: Ang ela Ho

CASE HISTORY

Hope in sight ......................................................

Eileen Aung-Thwin healthpost@scmp.com May Yan has battled eye problems for many years. When Yan (whose name has been changed for patient confidentiality reasons) was 60 years old, she developed glaucoma, where unusually high pressure inside her eye threatened to destroy her optic nerve. An imbalance between the production and drainage of the fluid in her eye caused the pressure.

Unfortunately, the glaucoma in her right eye was so advanced that her sight in that eye could not be saved. All efforts were then focused on saving her left eye, but it failed to respond to medication aimed at controlling the pressure. Two rounds of surgery were needed to remove the fluid inside her eye and control the pressure.

Some years later, Yan’s vision was threatened again when she developed a cataract in her left eye, in which the proteins in her lens started breaking down and clouding the lens. Surgery was needed to remove the occluded lens and replace it with an artificial intraocular lens (IOL). To do so, her surgeon had to cut into her remaining good eye again.

A few years after the cataract surgery, Yan noticed that her vision was deteriorating again, although the eye pressure was well controlled. This time, her vision was blurred, and she sometimes experienced pain in her left eye.

Her glaucoma specialist found that the source of her problems lay in her cornea, and referred her to Dr Arthur Cheng Chak-kwan, a specialist in ophthalmology at the Hong Kong Sanatorium and Hospital, who specialises in corneal disorders.

The cornea is the clear, dome-shaped outermost surface

of the eye. It is composed of five distinct layers with different properties and functions.

The top layer is the epithelium, which protects the eyes from foreign material, and absorbs and redistributes the nutrients that the eyes need from tears. It is also filled with thousands of nerve endings, which makes the epithelium very sensitive to pain and irritation.

Below the epithelium is a layer composed of collagen, called the Bowman’s layer. This sheet can scar easily if it is damaged. If the scar is big enough, it can obscure one’s vision.

Under the Bowman’s layer is the thickest component of the cornea, called the stroma. Making up 90 per cent of the cornea’s thickness, this layer is largely responsible for the cornea’s light-conducting transparency.

Descemet’s membrane lies

The high pressure ... had caused some damage to the endothelium. The repeated eye surgeries also inflicted trauma on this sensitive layer

under the stroma, and its main job is to protect the eye against infection and injury.

Finally, the innermost layer of the cornea is called the endothelium.

Although extremely thin, this layer is responsible for maintaining the delicate fluid balance of the stroma.

Fluid from the inside of the eye continually leaks into the stroma, and the endothelium cells pump out the excess fluid to keep the cornea clear. Excess fluid will swell the stroma, making it hazy and eventually, opaque.

Unfortunately, endothelial cells do not regenerate, so any loss to this layer is permanent. In Yan’s case, Cheng found that the high pressure from the glaucoma had caused some damage to the endothelium.

The repeated eye surgeries also inflicted trauma on this sensitive layer, and eventually there were too few endothelial cells remaining to

maintain the critical fluid balance in her cornea.

The swelling in the cornea also caused the surface to break down, exposing the nerve endings and causing her pain.

Yan’s only hope lay in a corneal transplant. Cheng assured her that medical advancements meant she needed to replace only the damaged endothelium, unlike in the past, when the entire cornea had to be transplanted.

Yan was put on the waiting list for a cornea. After a nine-month wait, a donated cornea become available.

Her operation was scheduled two days later.

During the surgery, Cheng made a 4mm cut in the eye at the junction between the white and the dark part, called the limbus. He used miniature forceps to remove an area of about 8mm in diameter from the damaged endothelium and replaced it with one of the exact same size from the donated endothelium. The natural pumping action of the endothelial cells help the graft to adhere to Yan’s cornea.

To further aid adherence, Cheng pumped some air into Yan’s eye to maintain pressure within the space. The eye continued to produce aqueous humour to fill the space behind the cornea, and so the air bubble shrank over several weeks.

Finally, Cheng sutured the 4mm incision. Yan had to lie completely flat on her back, looking straight up for 24 hours to ensure that the graft had time to integrate with her own tissues.

Two days later, she was discharged, and two years on, she continues to enjoy healthy sight.

Cheng says the sutureless method in a corneal transplant reduces inflammation and the risk of rejection from 20 per cent to 10 per cent over five years.

HEALTH 5 ORTHODONTICS

Never too late to go straight ......................................................

Ly-ann Tan healthpost@scmp.com Gabriel Chung, 22, has been hiding behind a goofy smile ever since he put on metal braces last year to align his crooked teeth.

The braces have affected his social life because he feels embarrassed when meeting people.

He spends an hour each day cleaning his teeth as braces make it inconvenient to brush and floss.

But a lesser-known tooth straightening device has given him hope. Invisalign, a nearly invisible plastic orthodontic product, costs roughly the same as braces. But it can be removed, so you can eat all foods and brush and floss normally.

Since its launch in 1999, more than 1.7 million dental patients worldwide are said to have used it as an alternative to fixed braces.

But most people still think of metal braces when considering orthodontic treatment. A survey last year found that nearly 40 per cent of respondents were unable to recall any other type of treatment other than fixed braces.

Malocclusion, or crooked teeth, is a big problem. A University of Hong Kong survey last year, commissioned by the Hong Kong Society of Orthodontists, showed that more than three quarters of 1,000 respondents aged between 18 and 40 required some form of orthodontic treatment, yet only 13 per cent received any.

More alarming is that almost none of the respondents realised that crooked teeth could lead to cavities and gum disease.

Most people believed that orthodontic treatment was only for aesthetic purposes.

According to the orthodontists’ society, teeth irregularities can also impede pronunciation and, thus, daily communication.

Dentists attribute crooked teeth to hereditary defects, diseases and deficiencies in nutrition. But diet has also been shown to play a part.

A study published in November in the Proceedings of the National Academy of Sciences found that

1.7 Number of patients, in millions, who have worn Invisalign products since they were launched in 1999

people living in subsistence farming communities around the world have shorter, wider jaws than those in hunter-gatherer societies. This leaves less room for teeth, which have changed little in size or abundance over human history. It may help explain why crooked teeth are so common, according to study author Dr Noreen von CramonTaubadel, an anthropologist at the University of Kent in Britain.

She suggests that the transition to farming and an increase in food processing led to consumption of softer foods such as wheat, corn and rice. This resulted in a shorter and weaker human jaw, and that led to greater crowding of the teeth.

Teeth move forward with age, says Dr Louise Wong Shu-hing, an orthodontist with 16 years of experience. “It’s a natural part of ageing,” she says. So the myth that adult jaws are immovable is false.

Studies have shown that even 90-year-olds have had successful orthodontic treatment.

Most people think fixed braces are used to improve how the wearer looks, so it’s ironic that many adults avoid wearing braces because of what they look like. The invisible aligners are designed to have minimal impact on facial appearance.

It is virtually impossible to notice them at first glance.

The invisible aligners are made of medical-grade polyurethane and produced to a pattern based on a practitioner’s diagnosis. A threedimensional model of the patient’s teeth is made through software that designs and models the aligners.

The practitioner then oversees the correct prescription of the aligners by way of an internet-based treatment-planning tool that relies on 3-D graphic and manipulation technology before the factory produces each aligner individually.

Victor Yiu, 15, a student in a boarding school in Britain, has worn invisible aligners for two years. He wears his aligners for three weeks each time before replacing them with the next set in the series.

This gives his teeth enough time to move and set in position.

According to Wong, patients wearing fixed braces usually have to come for a visit once a month to have the wires and brackets readjusted. But that’s not the case with invisible aligners.

Yiu has to visit only once every few months and take care not to misplace them when he takes them out for meals and drinks.

There are some advantages to using traditional fixed braces.

Dr Tsun Ma, a specialist in orthodontics, finds that he has more control with fixed

Orthodontist Louise Wong says it is natural for teeth to move forward with age. Photo: Edmond So braces. Sometimes the teeth do not move with the aligners.

“That’s because what’s going on in the mouth doesn’t fit with the computer simulation, since there are limits to how much a tooth can move,” he says.

In these cases, a fixed pressure point is needed through the wires and brackets of fixed braces.

Dentists call this the “human factor”, an influence that they say computers cannot possibly foresee.

Only orthodontists looking at the

An increase in food processing led to a weaker human jaw.

This led to greater crowding of the teeth

teeth can identify it. Such cases require a mid-course correction.

The final type of braces prescribed is contingent on the jawbone condition and severity of the malocclusion. So Wong always assures her patients that if the invisible aligners do not deliver, fixed braces are always an option.

The best way to ensure a winning smile is for children from the age of six years to visit an orthodontist if there is a possibility of overcrowding or crooked teeth.

6 COVER STORY

Arrow escape

COVER STORY 7

Archery offers an exciting way to exercise. Charley Lanyon gives the noble pursuit his best shot

T

he ancient sport of archery – unflashy, static and hardly sexy – is reportedly the new black. Children around the world are rushing to pick up bow and arrow, inspired by the recent box office hit The Hunger Games, according to Jay McAninch, CEO and president of the US-based Archery Trade Association.

The film, based on Suzanne Collins’ best-seller about a teenage girl who uses her archery skills to survive a post-apocalyptic game of life and death, has raked in US$648 million worldwide, including US$2.6 million in Hong Kong.

The sport has been growing here in the past couple of years. Archery coach Derek Chan, who has been representing Hong Kong in international competitions since 1987, says this year’s main local archery tournament had to expand from one day to six to accommodate the unprecedented 600 contestants.

Archery has been around for about 10,000 years, when bows and arrows were first used for hunting and warfare. It developed as a competitive activity in medieval England. The English won the Battle of Agincourt in 1415 against a numerically superior France thanks to the longbow; in Japan, archery is an art called kyujutsu, practised by samurais since 1185; and the Mongols practically took over the world because of their ability to shoot arrows while riding a horse.

Since 1972, archery has been a permanent fixture at the Olympics. Athletes shoot a number of arrows within a set time limit at a target – 1.22 metres in diameter with a bullseye of just 12.2cm – from a distance of 70 metres.

In other competitions, which may be held indoors or outdoors, distances range from between 30 and 90 metres.

The sport works your upper body strength, balance and co-ordination, which are beneficial to general health, according to Britain’s National Health Service (NHS).

“Archery is a wonderful adjunct to other forms of physical activity,” says Dr Jane Sandler, a family physician with Baylor Medical Centre in Texas who has tried the sport. “The muscles used to draw a bow involve primarily the large muscles groups in your upper back.

Over time, you can gain strength in these muscles from repeated archery exercise.

“The pull on an adult beginner bow may be [18kg to 20kg]. Many people have the upper body strength to use the instrument once, but pulling the bow three to four times can be exhausting for the average person. Over time, upper body strength needs to increase.

Only then can you advance to the [32kg to 41kg] bow.

“It is necessary to build core body strength in order to maintain a strong stance and stabilise the upper body. A stable upper body can improve aim and pull strength and control of the bow.”

At the recreational level, the sport is not demanding in terms of fitness, says Calvin Lee Kar-wai, 29, an archery enthusiast who coaches disabled archers and secondary school students. But extra effort is needed if you want to do well.

“When [preparing] for higher level competitions, I go to the gym for cardio and do some training on the side,” says Lee. Neglecting fitness and strength training can lead to injuries around the shoulder and collar joints. The wrong technique can also cause wrist and finger joints and ligaments to become inflamed and sore.

Sandler recommends using a rowing machine to develop muscle balance in the back.

“You need to build symmetry of muscles as weakness of one side or over-strength of the other side of the back muscles could cause an increased risk of back sprain or strain over time.”

Archery is not all brawn, however; mental strength is just as important, says Chan. Focus and concentration are key. In

Archery bows Recurve bow Ancient design updated with modern materials – relies more heavily on the archer’s technique to ensure a clean shot Nock Recurve

Compound bow Modern bow that uses a levering system to bend the limbs – tends to favour beginners

Upper limb

Sight window Arrow rest Grip

Handle/riser

Handle/riser

Upper limb

Wheel

Bow sight Cable guard

Lower limb

Lower limb

Cable

String groove

SCMP

Coach Derek Chan gives Charley Lanyon a few pointers at the Ngau Chi Wan Park archery range. Photos: Dickson Lee

INNER CIRCLE Hong Kong Archery Centre 902, 20 Hillwood Road Tsim Sha Tsui Tel: 2739 8969 hk-archerycentre.com Hong Kong Island Archery Club Kei Lung Wan Service Reservoir Pok Fu Lam Tel: 9801 0830 archery.com.hk Hong Kong Archery Workshop Tel: 2782 3528 archery.cc Hong Kong Archery Association archery.org.hk

competition, the person who best handles the pressure wins.

“It is not like ball games or track and field, where you might have an obvious advantage by having a better body shape and fitness,” says Lee. And that’s one of the sport’s big attractions, according to Barry Eley, performance manager with Britain’s Archery GB. People of all ages and abilities can participate together. Eley himself took up archery when he could no longer keep up with the youngsters on the football pitch.

Archery certainly appeals to a relatively sedentary person like me. I decided to take a lesson from Chan at the archery range at Ngau Chi Wan Park in Wong Tai Sin, Kowloon.

He let me use a typical beginner’s bow that costs between HK$1,000 and HK$2,000.

Chan’s bow was more than twice as powerful as mine (meaning twice as difficult to pull back), but I didn’t dare try it after I found out that a competition bow can cost as much as HK$20,000.

I confidently stepped up to the line. I didn’t tell Chan, but I have a bit of archery experience. As a child, and in the throes of a Robin Hood obsession, my parents bought me a basic bow and target, and we would take turns letting fly in the backyard.

I vaguely remember myself as a bit of a child prodigy, scoring bullseye after bullseye.

Many people have the upper body strength to use the instrument once, but pulling the bow three to four times can be exhausting for the average person JANE SANDLER, FAMILY DOCTOR

Unfortunately, the fun came to a premature end when my father, acting out something he had seen in the movie Braveheart, accidentally sent an arrow flying over the next door neighbour’s fence and nearly skewered a cat.

But in this instance, my first volley of arrows barely even hit the target just five metres away.

Chan proceeded to teach me the competitive shooting technique.

Stand perfectly straight, feet wider than shoulder width apart, side turned to the target. He showed me how to hold the bow, and the right way to lock the arrow to the string.

He also fitted me with one of the most important pieces of equipment for an archer: an arm guard. Even when you have good form, the bow string has a nasty habit of digging into your arm when you release it.

I saw a fellow novice archer with a very serious scar.

He told me to raise the bow and draw the arrow all the way back so that the string touched my nose and chin, and to sight down the arrow towards the target.

Drawing the bow fully made my arm shiver and shoulder quake. But when I released the arrow it flew straight and hit the target with a gratifying thwack. No bullseye, but at least this time I managed to hit the target.

Chan says archery gave him the chance to be a “true athlete”.

“When I was a schoolboy I had no chance to join in any sports, so this is a rare chance for me,” he says. “The competition is very fair and the entry requirement is a little bit lower than other sports.”

The standard of archery in Hong Kong is low compared to the rest of the world. There are no professional archers in the city. “So, if you have the heart to be an archer, after 18 months from your first start you could feasibly represent Hong Kong in an international sport.”

As I stood there under the floodlights in the warm night, the peace of the evening punctuated by the soothing sound of flying arrows, it struck me how archery is a contradiction: somehow primal and meditative, inherently violent but also profoundly peaceful, both a social activity and intensely solitary and cerebral. Ultimately, archery is a game one plays against oneself. charley.lanyon@scmp.com

8 HEALTH TRADITIONAL CHINESE MEDICINE

Developers eye a world of promise ......................................................

Elizabeth Snouffer healthpost@scmp.com Ivan Lau Kwong-lung, a 26-year-old computer science graduate of Polytechnic University, and a self-taught app developer and director of ISPlatform, has had about 100,000 downloads of his Chinese medicine app for Android and iOS hand-held devices, but that wasn’t what he was originally after.

His app, iAsianDr, is a Chinese medicine reference guide he developed after studying iPharmacy, an English languagebased guide listing more than 20,000 prescription drugs. “I studied iPharmacy’s concept, and considered the broad use of Chinese medicine in Asia believing I could easily replicate the idea for the Hong Kong market.”

Lau also decided to add a procurement system so doctors could order Chinese medicine, which would bring him additional income and new business opportunities. Unfortunately, Lau couldn’t find a supplier and believes Hong Kong’s Chinese medicine regulatory environment is the main problem. While this initial barrier posed a huge threat to iAsianDr, it wasn’t the most significant.

“Because I lacked medical qualifications, doctors weren’t interested, either,” says Lau. According to Tim Miller of Apple’s public relations department, there are more than 600,000 apps today and more than 200,000 native to iPad. Matthew Firestone, AsiaPacific communications manager at Google, confirms that there are more than 500,000 apps (free and priced) available on Google Play for Android devices.

The number of Chinese medicine apps – about 1,000 or 0.1 per cent of the total number of apps worldwide – is tiny by comparison, but even this figure is hard to confirm. While neither Google nor Apple releases totals for apps in categories, MobiHealthNews, a publication focused on digital health, estimates there will be 13,000 medical apps for patients and 6,000 for professionals by September.

1,000 Estimated number of downloadable apps available in the category of traditional Chinese medicine

In the apps business, paid consumer downloads are key markers of success for developers.

Total mobile app revenue is expected to reach US$10 billion this year, with games dominating the field.

According to Lau, iAsianDr has not given him any direct income, but it has expanded his business in game applications. While many of his customers for IAsianDr choose to download it for free, they often end up browsing other apps he has developed and pay to download games. “IAsianDr hasn’t done what I want it to do, but I am not giving up on it just yet.”

What are the reasons for the slow development and uptake for apps related to Chinese medicine? The greatest issue is the credibility of the developers, who take weeks, months and even years to collect all the data on the web and then construct a platform for the app.

Are Chinese medicine practitioners ready for a digital tool?

Dr Leung Ping-chung, professor at the Institute of Chinese Medicine at Chinese University, believes apps for TCM are not credible sources.

“Academics are not interested in TCM apps currently under promotion,” says Leung.

Although he believes medicine and technology can be powerful, Leung mistrusts the information collected by developers, saying: “Technology is powerful, but it can lead to misinformation.”

Sunny Ng Ka-lok, a local software engineer who develops software for SOHO (small office/ home office) professionals and has a personal interest in TCM, wanted to be able to develop an app that would benefit patients like himself.

“I had gastro-oesophageal reflux disease in 2009, and instead of turning to surgery I tried Chinese medicine.”

Ng developed the idea for his TCM app while he was taking Chinese medicine. “I had to filter out a lot of information on the web when I was doing my research, which I thought would be helpful for individuals and students.”

It took Ng two years to consolidate the data and develop the app. Today he has customers all over the world – the mainland, Hong Kong, Singapore, Taiwan, South Korea, Japan, Germany, France and Britain.

“It’s not a huge selling item compared with popular games.

I think it is more of a contribution rather than a profit-making business,” he says.

Alan Mo Zhen-lun, who graduated from Guangzhou University and majored in computer science, developed a TCM app called Chinese Medicine

Ivan Lau, director of ISPlatform, shows off his iAsianDr app for the iPad. Photo: May Tse

Inquiry. Mo worked as a systems engineer in telecommunications for 13 years before moving to Vancouver in 2007.

“I left China because I saw people living unhealthy lives all around me, and I believed it was because of the environment.

This is when I began my journey into Chinese medicine. I began to think that health was related to what people eat and how they live personally. Modern medicine doesn’t work well for this problem.”

Mo’s app lists thousands of herbs that make up all the prescriptions that Chinese medicine doctors prescribe to patients. “Patients can plug in the name of the prescription and my app will reveal all the

Academics are not interested in TCM apps currently under promotion.

Technology ... can lead to misinformation DR LEUNG PING-CHUNG, CHINESE UNIVERSITY

ingredient names with information about the listing and a photo.”

Mo designed the app for himself as a tool for studying Chinese medicine. Later, he made it available for the Android and iOS market, with the help of a friend who had experience developing apps. It took 100 hours to get the app running and about two weeks to collect all the data for the reference guide.

“It was launched end of March, and 30,000 people have downloaded the app,” Mo says. “It’s free, although people can also buy it for 99 [US] cents if they want to donate funds to me.” Most of Mo’s customers are from Taiwan and Hong Kong, but his mainland fanbase is growing, too.

DIET 9 NUTRITION ANTIOXIDANTS

Dark art to fighting cancer ...................................................

Maxine Barish-Wreden and Kay Judge Inflammation, and the use of antioxidants to put out inflammatory fires, is a hot topic these days.

Inflammation is the body’s natural and necessary response when accosted by harmful germs or injury. When this occurs, our immune system steps in to fight foreign invaders and to bring our body back into balance so that we can heal.

Inflammatory chemicals are produced during this process and these can be harmful to our tissues, but antioxidants in our foods, such as vitamins C and E, help to quell this response and restore order.

Inflammation can run amok, however, and cause persistent damage to healthy tissue, especially if we smoke or if we are overweight.

Chemotherapy drugs also produce severe inflammation in the body, and this particular inflammatory response helps to kill off cancer cells. But it also harms healthy tissue in the process.

Many oncologists have been fearful of having their patients take any antioxidants during chemotherapy for fear that they might reduce the effectiveness of the treatment.

In a recent article in the journal Alternative and Complementary Therapies, Dr Keith Block, a renowned integrative cancer specialist affiliated with the University of Illinois, discussed his review of more than 2,300

studies on the use of antioxidants during chemotherapy, and his report is very reassuring.

In summary, antioxidants often help to reduce side effects from chemotherapy, and this may allow patients to complete their full course of medication without interruption, which itself leads to better results. Certain antioxidants also enhance the effectiveness of chemotherapy, reduce long-term toxicity and improve survival.

Inflammatory chemicals can be harmful to our tissues, but antioxidants help restore order

Not a single study reviewed by Block showed any evidence of antioxidants interfering with the effectiveness of chemotherapy.

In fact, a recent article looking at the impact of antioxidants in Chinese women undergoing treatment for invasive breast cancer found that use of antioxidant vitamin supplements in the first six months after diagnosis resulted in a reduced risk of both mortality and cancer recurrence.

Other studies have suggested survival benefit in certain cancers when patients take melatonin, as well as reduced toxicity from chemotherapy with the use of glutathione and coenzyme Q10 among others.

So if you are affected by cancer, what should you be thinking about to protect yourself during and after chemotherapy?

First and foremost, begin by eating a super-healthy, plant-based diet that is loaded with dark-coloured fruits and vegetables so that you maximise your intake of antioxidants from your food, which is the most powerful way to get them.

You can also consider supplementing your diet with some of the more powerful antioxidants, such as fish oil, coenzyme Q10, vitamin C, vitamin E and selenium, though we recommend that you consult an integrative cancer specialist first to determine which supplements are ideal for you, given your particular tumour and treatment regimen.

For more information on an integrative approach to cancer treatment, look at Block’s 2009 book Life Over Cancer: the Block Centre Program for Integrative Cancer Treatment or Lise Alschuler’s and Karolyn Gazella’s, The Definitive Guide to Cancer: An Integrative Approach to Prevention, Treatment, and Healing.

Maxine Barish-Wreden and Kay Judge are medical directors of Sutter Downtown Integrative Medicine programme

EAT SMART

Marvellous mangoes pack a potent punch ......................................................

Jeanette Wang jeanette.wang@scmp.com It’s not exactly what comes to mind when you think “superfood”, but mangoes have enough antioxidants to prevent or stop certain colon and breast cancer cells, according to lab experiments commissioned by the US National Mango Board and carried out by Texas AgriLife Research food scientists.

Mangoes are also an excellent source of vitamin C (promoting

healthy immune function and collagen formation) and vitamin A (important for vision and bone growth). It is also a good source of dietary fibre.

In this recipe, from New Life Restaurant at Shek Kip Mei Park Sports Centre, mango provides a good flavour and texture contrast to the beef. Use ripe but firm mangoes for the best results.

Braised beef cubes with pumpkin, mango and green bell pepper Serves 2

80 grams beef, diced ½ tsp salt 1 tsp starch 100 grams pumpkin, diced 30 grams green bell pepper, diced 25 grams red bell pepper, diced 25 grams mango, diced 25 grams straw mushrooms, diced 1 clove garlic, minced 1 tbsp canola oil 5 tbsp pork broth

1/4 tsp sugar Starch water (3 tsp starch and 2 tbsp water) • Marinate beef with ¼ tsp of salt and 1 tsp starch. Blanch in boiling water and set aside.

• Blanch pumpkin, bell pepper, mango and straw mushrooms in boiling water. Set aside.

• Heat oil in a wok. Stir-fry garlic.

• Add beef, pumpkin, peppers, mango and mushrooms, along with pork broth and ¼ tsp each of salt and sugar. Stir-fry until done.

• Thicken with starch water. Serve.

Recipe provided by the Health Department as part of its EatSmart@restaurant.hk campaign.

For more information, go to restaurant.eatsmart.gov.hk

10 FITNESS SADDLE UP WEEK 2

Different spokes ......................................................

Guy Haydon guy.haydon@scmp.com Buying a bicycle is like buying clothing; that is, style and price matter. But with so many types of bicycles on the market, which is the right one for you?

There are four main types: racing models, with lightweight frames, large, thin wheels and drop handlebars; mountain types, with sturdy frames, thick wheels and easy-to-use gearing; hybrids, combining an upright riding position, larger wheels and sturdier frames; and comfort or commuter bikes, such as fold-up models.

Your particular cycling needs will determine what you buy. These could be commuting over short distances, taking a bike by car to use on cycleways in the New Territories, tackling bumpy off-road tracks, racing over long distances or a combination of these.

“For beginners, I’d recommend starting with a bike costing no more

It’s not wise buying something too expensive if you don’t know you’ll actually keep cycling PAUL YEUNG, SUN PING BICYCLE COMPANY

than HK$1,000 to HK2,000, to see if you like to cycle,” says Paul Yeung Wai-tong, 46, who runs Sai Kung’s Sun Ping Bicycle Company.

“It’s not wise to buy something too expensive if you don’t know you’ll actually keep cycling. Hong Kong people like the fancy look of expensive bikes, but you can buy, or upgrade, to something between HK$4,000 and HK$6,000 later.”

Yeung’s bikes range from HK$600 to $6,000. “The cheapest ones are fine for short-distance cycling such as going to the shops, but I don’t recommend them for sports because the basic gears aren’t reliable or easy to control,” he says.

Shops often allow people buying bikes to test similar-sized rental models. Sometimes the actual bike is set up on a training frame. “It’s most important to get the right-sized frame for your body size, to ensure maximum cycling comfort,” he says.

For people living in Sai Kung and the New Territories, mountain bikes are the most popular choice. These bikes make up 70 per cent of Yeung’s sales, with the three other types claiming 10 per cent each.

In the city, fold-up commuter bikes are the most popular choice.

They form 50 per cent of all sales at Wan Chai retailer The Bicycle World, which opened in 1994. It is partowned by Wan Wai-wan, a former Hong Kong international cyclist.

“Fold-up bikes are most popular on Hong Kong Island because they are easy to take on public transport, or in a car to ride in the New Territories. They are easy to store in a Hong Kong home,” says Wan, 40.

But he recommends beginners buy mountain bikes. “They allow you to sit comfortably and straight,” he says. “Such bikes also have thicker tyres and are easier to control. The thick tyres can run easily over drainage covers on roads, so people don’t need to worry about too many things.” Mountain bikes form 20 per cent of his sales, he says.

In the past five years, cycling has become much more popular in Hong Kong. People have become more health conscious, and the price of bikes has come down.

Most bikes are made in Taiwan, including Giant, Hong Kong’s most popular brand, according to Yeung. “[Taiwan is] the biggest bike manufacturer in the world. It has a good reputation for value and quality – much better than mainland brands – and has production lines in most countries.”

On average, an adult will spend about HK$5,000 on a new bike, Wan says. Some people come looking for particular models they have researched on the internet.

The most expensive bike in his shop – a racing bike – costs HK$140,000. But he says, for beginners, it’s not important to have a costly bike; a HK$2,000 bike is good enough. “When people come to my shop, they usually consider the price first, then the colour. I recommend the right size for their height,” Wan says.

“I won’t recommend a bike based on price. I’ll tell people what the difference in value is between different bikes so that they can decide.”

Both Leung and Wan agree that wearing a helmet is an essential safety measure. “It’s a necessity, not an option,” Wan says. About HK$300 will get you a good helmet, such as one from US brand Bell, says Yeung. More expensive ones, which cost more than HK$1,000, are priced for lighter weight and looks.

Cycling gloves, for added grip and protection, padded shorts for extra comfort on long trips, and sunglasses are recommended. So are clear frames, which protect against dirt, insects and rain.

If you plan to cycle after dark, you must have a bell and lights, or you could be fined at least HK$320, warns Wan.

Former Hong Kong cycling team member Wan Wai-wan, pictured at The Bicycle World in Wan Chai, says the most important thing is to get the right size bike for your height and weight. Photo: Jonathan Wong

HOW TO FIND THE RIGHT MODEL FOR YOU Four steps to follow • Decide what type of riding you enjoy: paved roads, bike paths or rocky trails • Consider what you can afford: the price of a bike is relative to its weight, components and technology • Visit a good bike shop: professional staff will help you find the right bike, the correct size and offer good after-sales service • Size it up: the most important thing when buying a bike is a correct fit

Road bikes The fastest bikes for paved roads. A sleek, aerodynamic frame and narrow, high-pressure tyres allow for efficiency and speed Best for: longer rides, road racing Cons: less comfortable riding position, not good for off-road Mountain bikes Wide, grooved tires and shockabsorbing suspension make these suited for rocky, bumpy terrain Best for: off-road trails Cons: heavy, poor twist-shift handlebar gears on basic models

Hybrid bikes A cross between a mountain and a road bike. Good value, upright and easy to ride Best for: commuting and fitness Cons: not for rough off-road trails and not for fast road rides Fold-up/ commuter bikes These have an upright riding position and may come with comfort enhancers such as suspension in the seat Best for: short commutes and bicycle paths Cons: basic models, heavy, slow

WELL-BEING 11

Illustration: Martin Megino

THE TASTE TEST PROCESSED FRUIT ......................................................

Jeanette Wang healthpost@scmp.com

Jalancina Pear Halves in Syrup 700 grams for HK$69, City’super Hand-peeled whole Spanish pears are sold in a syrup of water, sugar and citric acid, and packaged in a tall glass jar. A top-quality product that isn’t sickeningly sweet.

Verdict: has an almost jelly-like texture that might not please those who prefer a little crunch.

PERSONAL BEST

Pushed to the wall ......................................................

Sasha Gonzales healthpost@scmp.com Running a marathon used to be a revered feat reserved for only a fit few, but these days it’s becoming more and more common to meet people – of all shapes and sizes – who have completed the 42.195 kilometres.

If you’ve ticked the typical road marathon off your to-do list and are looking for a new challenge, here are five races that will surely push you to new limits.

A tough climb What: Western States 100 mile endurance run When: June 23-24 Where: starts in Squaw Valley, California and ends in Auburn, California This race covers 161 kilometres through the Sierra Nevada. It is arguably the most prestigious of the “professional circuit” ultramarathons around the world.

Entries are strictly limited, and the race is very competitive: there are qualification criteria, and meeting them doesn’t guarantee you a spot, as everyone goes into a lottery.

Two top Hong Kong runners, Claire Price and Ida Lee Bik-sai, will participate this year.

Why do it? The challenge lies not just in the distance. The course involves nearly 5,500 metres of elevation gain and 7,000 metres of thigh-trashing descent. Heat is also a factor: temperatures regularly

soar over 38 degrees Celsius in the deep, exposed canyons, so runners will have to race smartly to fend off heatstroke and dehydration. ws100.com Run under the stars What: Barclays MoonTrekker When: October 19 Where: starts at Mui Wo and finishes at Cheung Sha beach on Lantau Island This night race, in its fourth year, features two distances: the Sunrise 40 kilometre run and the Moonlit 26 kilometre run. It’s true that both are short of marathon distance, but if you’ve ever hiked Lantau’s trails – especially in the dark – you’ll know it’s way tougher than any marathon on a flat road.

The 40-kilometre starts at 9pm and the 26-kilometre at 11.20pm. These are strategic start times set to allow the average hiker to finish in time for sunrise.

Why do it? It’s for a good cause.

Each participant is expected to raise at least HK$500, which goes to Room to Read, a charity that works in collaboration with communities and local governments across Asia and Africa to promote literacy and gender equality in education.

In the past three years, participants have raised more than HK$2 million. This has helped fund 26 projects, including primary schools and libraries, around Southeast Asia and Sri Lanka. barclaysmoontrekker.com

Run on ice What: Antarctic Ice Marathon When: November 20 Where: starts and finishes at 80 degrees south at the foot of the Ellsworth Mountains, Antarctica It’s the southernmost race in the world, and likely the most extreme in terms of climate, with minus-20 degree temperatures and strong winds. Also, the organisers also offer a 100-kilometre race, a half-marathon (21.1 kilometres), and a 1.6-kilometre race for beginners or speedsters. A five-day itinerary costs HK$97,000 and includes return flights from Punta Arenas, Chile, to Antarctica, accommodation and meals and entry to the marathon itself.

Why do it? It has a spectacular and surreal environment like no other. icemarathon.com A run back in time What: The Great Wall Marathon When: May 18, 2013 Where: Huangyaguan, Tianjin municipality section of the Great Wall, east of Beijing The course takes runners through one of Asia’s most iconic man-made structures, as well as quaint villages and rice fields. The run is extremely steep at certain points, and it includes an ascent of 5,164 steps.

The website advises that “well-prepared runners” will take five to six hours to complete the course – or about 50 per cent longer than an average marathon due to

extreme ascents and descents. The time limit that organisers set to complete it is eight hours.

If the marathon sounds too gruelling, there are also half-marathon, 10 kilometre and five kilometre distances.

Why do it? It’s an opportunity to experience one of the seven ancient wonders of the world in a new way. great-wall-marathon.com Race for the fallen What: Comrades Marathon When: June 2, 2013 Where: between Durban and Pietermaritzburg, South Africa This ultra-marathon is an out-and-back 89 hilly kilometres that changes direction every year (next year it starts in Durban).

It was founded by first world war veteran Vic Clapham, who started the marathon as a way to remember and honour all those who fought in the war. The first race took place on May 24, 1921, with 34 runners. It has been an annual event ever since, although it was stopped during the second world war years of 1941-45.

Why do it? It has the most extraordinary traditions. For example, international runners get blue race numbers, while runners in their 10th Comrades race wear yellow. Complete 10 races and you get the same number – a green one – that will be yours forever. No other runner will ever have that number. comrades.com

Native Forest Mangosteen in Organic Light Syrup 411 grams for HK$42, City’super This product uses fruit grown in certified organic orchards in southern Thailand and tinned in a syrup of water, organic evaporated cane juice and citric acid. There are about seven whole mangosteens per can.

Verdict: overpriced and way too sweet; any natural mangosteen taste and texture are completely lost.

Le Conserve Della Nonna Peaches in Syrup 690 grams for HK$36, City’super Made in Modena, Italy, these peaches, ripened by the Mediterranean sun, are said to be picked at their peak and processed within 24 hours. Ingredients include sugar, glucose-fructose syrup, citric acid and ascorbic acid.

Verdict: succulent but bordering on too sweet.