20120918 health post

YOUR GUIDE TO LIVING WELL

TUESDAY, SEPTEMBER 18, 2012

HEALTH POST

CULTURED TASTE: THE QUEST FOR IN VITRO MEAT >PAGE 5

FRESH START: WINDSURFING OSTEOPATH >PAGE 11

Frozen assets Parents tempted by the promise of umbilical blood storage >PAGE 6

2 NEWS APP OF THE WEEK

HEALTH BITES ......................................................

A guide for all walks of life

Science makes light work of drugs Could it be magic? Scientists at the US Department of Energy’s Argonne National Laboratory near Chicago are using levitation to improve the drug development process. “One of the biggest challenges when it comes to drug development is in reducing the amount of the drug needed to attain the therapeutic benefit, whatever it is,” says Argonne X-ray physicist Dr Chris Benmore, who led the study. The scientists have found a way to manipulate sound waves to create an acoustic pressure that cancels gravity, thereby allowing light objects – in this case, droplets of drug solutions – to be levitated. The result: the ability to create amorphous (liquid) drugs, which are both more highly soluble and have a higher bioavailability than solid drugs. This means a lower dose can produce the desired effect, thus reducing the side effects. The researchers are now working on identifying on which drugs the levitation will have the best results.

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Katie McGregor healthpost@scmp.com Enjoy Hiking Free Rating 9/10 Just like the app, hiking in Hong Kong is free and there are few better things for your body and mind.

Besides the benefits of a slow, steady calorie burn and a steady pace of exercise in your own rhythm, hiking awakens a sense of adventure.

I like hiking and Enjoy Hiking is full of new possibilities. This bilingual app is produced by the Agriculture, Fisheries and Conservation Department.

The trails can be searched by type – family walks, nature trails, country trails, long trails and others – or by region. The “others” category includes a War Relics Trail and the Lung Fu Shan Fitness Trail, which runs up The Peak near Pinewood Battery. Because the trails are crossreferenced I’m uncertain how many are mentioned, but there are enough to keep you busy.

Pick a trail and you get a simple map showing the route and landmarks along the way together with the option to see a hybrid satellite/map view. Tap for trail information, which includes the basics such as starting and finishing points, distance and estimated time to complete the trail, plus a full description. Possible bus numbers to take you to and from the hike are also provided, but this information

is only useful if you know where you are going; it doesn’t tell you where to get off.

The notes give a detailed description of the trail, including historic points of interest, and observations about the views you might expect. The style in which these sections are written suggests that it was done by someone who also enjoys hiking.

As this is a governmentsponsored app, you can be assured that there is a useful information section covering everything from how to walk, to what to pack in your bag: sewing kit, map packed in a plastic bag, a whistle, compass, emergency food, notebook and much more.

One thing I can now dispense with is my old faithful hiking book.

ASK THE DOCTORS DR MICHAEL SOON Q: I have a terrible posture and slump at my computer all day. Other than trying to sit straighter, what can I do to improve the resulting back pain?

A: Sitting on a chair is an activity that only humans do – no other animals do that. Research has shown that the pressure on the spine (specifically on the discs) is the highest when seated, compared with lying down and standing.

This can lead to low back pain. With the stooped posture associated with computer or, worse, laptop use, the neck is also brought into a poor position and the shoulders hunched, leading to neck and upper shoulder aches and pains.

With increased stresses on the spine, the core muscles maintaining the posture and alignment of the spine become important. Unfortunately in city living, there are a significant number of people who do not exercise sufficiently to maintain good muscle tone. As much as we do not want to admit it, muscle atrophy is a factor that predisposes us to back pain.

Doing sufficient exercise, especially for core strength is important. This can be either through gym work, Pilates or

Jeanette Wang jeanette.wang@scmp.com

similar. If this is not sufficient, seeing a physiotherapist can be very helpful in reeducating the body to maintain good control of the posture and gait.

Sitting straighter is an option, but what is more important is examining your work ergonomics. You should see if your chair is too low or too high for your desk and adjust it to a comfortable height.

Using a lumbar support or rest with your chair can be useful in reminding you to maintain good posture.

I tell my patients with such issues to exercise for two minutes every hour. This means you stop your work on the hour, get up and stretch your neck, shoulders and back. If you are embarrassed, view it like a toilet break. Prevention is better than cure.

Having stronger muscles and awareness of a good posture, will lead to a good posture. Half the battle is won at this stage.

Continue with these regular strengthening exercises and you will not need to see a doctor for such conditions.

Dr Michael Soon is a consultant orthopaedic surgeon at the Centre for Orthopaedics in Singapore

When in doubt, run away Sometimes it’s good to listen to that inner voice. Brides-to-be who get cold feet are likelier to have an unhappy marriage and divorce, according to a new study by University of California, Los Angeles psychologists published in the Journal of Family Psychology. Among 232 couples in Los Angeles tracked regularly over four years, women who had doubts about getting married before their weddings were 21⁄2 times likelier to divorce within four years than wives without these doubts.

Among couples still married after four years, couples with doubts were significantly less satisfied with their marriages than those without doubts. At the time of marriages, the average age of the husbands was 27 and the wives 25.

The researchers say premarital doubts are “common but not benign”. However, they are not advising women with doubts to necessarily end their relationships. “Talk about it and try to work through it,” says Professor Thomas Bradbury, the study’s co-author. “You hope that the big issues have been addressed before the wedding.”

Coconut water hits the trails Coconut water mania is truly sweeping through Hong Kong. Not only has it invaded supermarket shelves all over town, but it has also made its way to the trails. The Jax Challenge, a new running race to be held on October 7 at Tai Tam Country Park, will feature coconut water at aid stations along the route in place of traditional sports drinks. Participants can choose between the 12-kilometre “family friendly” race or the hillier 14-kilometre loop. Both start and finish at Hong Kong International School on Tai Tam Reservoir Road. Besides the entry fee, participants are required to raise funds for the race’s chosen charities, Kids4kids and the Animals Asia Foundation. For more details, go to jaxcoco.com/jaxchallenge.

A well-rounded workshop A new workshop aims to empower expectant mothers to manage, enjoy and thrive through the challenging pregnancy process. Jointly organised by maternity services company A Mother’s Touch and health coaching provider Inspire Health, Bump 4 Joy is a 21⁄2-hour workshop that offers tips, tools and ideas related to mental, physical, emotional and spiritual wellness. The first workshop will be on Saturday and costs HK$800. For more information, contact Liz Purnell-Webb on 9769 2701 or Martike de Grip on 6341 3858, e-mail program@bump4joy.com, or visit bump4joy.com

NEWS 3 MENTAL HEALTH WORLD ALZHEIMER’S DAY, SEPTEMBER 21

Act on the early signs before the damage is done ......................................................

Sasha Gonzales healthpost@scmp.com Nancy Kwok had always prided herself on her razor-sharp memory, so when little things began to slip her mind – like what she’d eaten the day before – the 70-year-old thought it was just due to old age.

It wasn’t until Kwok (whose name has been changed for patient confidentiality reasons) started forgetting whether she’d paid bills and had trouble expressing herself that her son, Richard, knew something was wrong. She was diagnosed with Alzheimer’s disease.

“My mum used to be so full of life, but as these problems got worse, she became increasingly frustrated and withdrawn,” says Richard. “She seems to have stabilised a little, thanks to medication, but she’s not the same person and her quality of life has deteriorated.”

According to a recent paper in the Hong Kong Medical Journal, about 6.1 per cent of elderly Hongkongers have Alzheimer’s disease. That figure is rising because

the population is ageing and age is the biggest risk factor, says Dr Gary Small, director of the UCLA Longevity Centre. Women are at a greater risk, partly because they tend to outlive men.

Alzheimer’s is the most common form of dementia. Small says it’s an “accumulation of abnormal protein deposits – plaques and tangles – in brain regions that control memory and other cognitive abilities”.

There are many factors that cause Alzheimer’s. Genetics is believed to play a role – about 30 to 40 per cent – and the rest is due to lifestyle and other non-genetic factors. Dr Chong Mei-sian, senior consultant at the department of geriatric medicine at Tan Tock Seng Hospital in Singapore, says diabetes, heart disease and hypertension are strong risk factors.

Alzheimer’s symptoms typically begin after the age of 65 with short-term memory loss. Small says certain symptoms of mild Alzheimer’s may be similar to other conditions or the side effects of some medications, so a proper medical evaluation is required.

Image: Corbis As the condition worsens, sufferers may have trouble with simple tasks such as getting dressed and eating. They often become withdrawn, agitated and aggressive as they struggle with basic functions.

This affects caregivers and family members; caregivers have a 50 per cent risk of developing depression, says Small.

There are treatments – both drug and non-drug – to slow the progression of Alzheimer’s and temporarily ease symptoms. But Dr Kay Li-chi, a specialist in neurology at Hong Kong Adventist Hospital, says not much can be done to reverse or prevent Alzheimer’s.

However, staying active, keeping up with one’s hobbies and becoming more social can greatly improve the sufferer’s quality of life.

It’s important to keep chronic medical conditions such as hypertension and diabetes under control, and to live healthily and maintain a positive mental attitude.

Small’s book, The Alzheimer’s Prevention Program: Keep Your Brain Healthy for the Rest of Your Life, details the physical exercises, cognitive training and nutritional factors that can help delay the onset of the disease.

New research shows there might be a way to detect if a person is at an increased risk of developing Alzheimer’s. Erin Johns, a doctoral student at Concordia University’s Department of Psychology, says small impairments in memory and

“executive functioning problems” may be a sign of early-stage Alzheimer’s. These include problems with attention, planning activities and making decisions.

Johns wants to make it easier to be able to identify such people “so they can be targeted for preventive strategies that would stop brain damage progressing”. It’s a chance to help them know what to expect and how to cope, she says.

This month, researchers in the United States reported that an experimental drug called bapineuzumab showed positive effects in patients with mild to moderate Alzheimer’s. It is made to work on the biology of the disease, removing the plaque that damages nerve cells in the brain. Researchers will now test the drug on people with mild mental impairment.

As for a cure, Small says drugs and vaccines are being tested all over the world. “The strategy is to develop a treatment that forestalls the onset of symptoms,” he says. “[But] while we are waiting for science to catch up, lifestyle strategies offer a chance to nip symptoms in the bud.”

4 MEDICAL CASE HISTORY

Beyond a choke ......................................................

Eileen Aung-Thwin healthpost@scmp.com Little Danny Lai was having a rough two weeks. The 23-month-old toddler had diarrhoea, low-grade fever and a persistent cough that would not go away.

The gastric flu he seemed to be suffering was exacerbating his asthma, diagnosed just a few months earlier. His breathing sounded like a little whistle was lodged in his windpipe. Danny (whose name has been changed for patient confidentiality reasons) had difficulty breathing, which was consistent with asthma.

When the symptoms surfaced, his mother took him to the family doctor, who prescribed cough suppressants and bronchodilators.

But the symptoms persisted. After two weeks, Danny’s mother took him to see a paediatrician at Queen Mary’s Hospital. She was concerned

The catheter was slid past the obstruction before the balloon at its tip was inflated to fill the width of Danny’s airway about the prolonged diarrhoea and fever, and feared her son might suffer a bad asthma attack.

When the paediatrician examined Danny, he expected to hear the wheezing reverberate through the entire chest area.

But the doctor was surprised to hear the wheezing only in a localised area.

Danny’s symptoms did not seem to add up. No one condition would explain his symptoms, so the

paediatrician had to consider other less common possibilities. Having recently encountered another presentation of localised wheezing in a young child, the paediatrician suspected that this was no asthma attack. He investigated the boy’s recent history and asked Mrs Lai if her son might have choked on anything recently.

At first, nothing came to mind.

Then she remembered that Danny had a seemingly very minor choking incident two weeks ago during a meal. He was eating a peanut when he sputtered and coughed for a bit but seemed fine after that.

The doctor called on Dr Patrick Chung Ho-yu, associate consultant with the University of Hong Kong’s Division of Paediatric Surgery.

Given the history of a choking incident, there was a good chance that Danny’s symptoms were caused by an obstruction in his airways. It would explain the localised wheezing. If so,

Illustration: Angela Ho he would need immediate surgical intervention.

Meanwhile, the paediatrician had the boy undergo an X-ray, which showed that his left lung was hyperinflated, or larger than normal.

If a foreign object was obstructing his airways, it could act like a ball valve, allowing air to enter the lung but not fully leave it, thereby inflating the lung like a balloon.

Moreover, the enlarged lung had displaced his windpipe a little. In the worst-case scenario, an increasingly enlarged lung could compress his heart and blood vessels, giving rise to circulation problems.

Given that Danny also had diarrhoea, which was not typically related to respiratory conditions, the paediatrician also did a computed tomography (CT) scan, which confirmed that an object was lodged in the boy’s left main lung airway.

The team put the boy under general anaesthesia before performing a bronchoscopy on him. Given his size, a special endoscope was used to look down his narrow airways. Chung found a 5cm wad of pasty material wedged in the left airway.

The fragment – likely of a peanut based on Mrs Lai’s account of the choking incident – had deteriorated over the two weeks. It was extremely fragile and broke apart under the forceps Chung used to extract it. The surgeon used a special suction tool to suck up the fragments.

Chung also had to use a Fogarty balloon, which is a catheter with a deployable balloon on one end, to help remove the crumbling material.

The catheter was slid past the obstruction before the balloon at its tip was inflated to fill the width of Danny’s airway. This would then prevent the fragments from falling deeper into his airway as Chung extracted the rest of the material.

Although this technique is typically used to remove obstructions from the bloodstream,

Chung successfully applied the same technique to clear Danny’s airways. Most of the material was removed after one painstaking hour.

Danny remained in hospital for another three days for chest physiotherapy to help him cough up any remnants of the material, and for clinical observation.

He was also given antibiotics as the presence of a foreign object in his airways could have provided a breeding ground for bacteria, which could potentially lead to pneumonia or lung infection.

A few weeks after his discharge, Danny’s check-up showed that his lungs were healthy and clear.

Chung says that the presence of foreign matter in the airways, a condition called aspiration, is relatively uncommon. The hospital sees only about one case a year.

Most healthy adults have a natural cough reflex that will attempt to expel any material that touches the airways. However, the cough reflex might be impaired in the elderly and in children with certain medical conditions such as cerebral palsy.

Young children under three are also at risk because they have a tendency to put objects in their mouth, and they are unable to articulate when something is wrong or when they feel unwell.

Chung says it is important for parents to be vigilant about choking hazards, and for doctors, especially general practitioners who are more likely to be the first line of consultation when symptoms arise, to recognise the risks and potential for foreign object aspiration.

Suspected cases should be referred as a matter of urgency to a specialist who has the necessary equipment to manage the problem.

The longer the foreign matter remains in the airways, the greater the potential for harm and complications, and the greater the difficulty of removal.

HEALTH 5 NUTRITION

How to make a veal of it Faking bacon: in vitro meat grown in a laboratory at Maastricht University. Photo: Reuters

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Sunory Dutt healthpost@scmp.com In 2008, the American animal rights organisation People for the Ethical Treatment of Animals (Peta) announced a US$1 million reward to anyone who could use chicken cells to develop a marketable lab-grown meat by June this year.

The contest deadline has been extended to January 1 next year because no one has succeeded as yet. But scientists are getting closer to producing the first test tube chicken nugget. According to Peta, “some promising steps have been made towards this technology, but we’re still several years away from having in vitro meat being available to the general public”.

Over the years there have been many attempts to create meat substitutes to please both vegans and animal rights activists. Many involve soy protein (such as Tofurky roasts and Soyrizo breakfast burritos) or wheat-gluten (such as Seitan gyros), or a combination of both.

But Peta’s latest project is no meat substitute. We’re talking real meat and flesh, but produced in a lab, using animal stem cells

Illustration: Joe Lo

placed in a medium to grow and reproduce. No killing involved.

The Netherlands has been leading the way in research. Stem cell scientist Dr Mark Post, from Maastricht University, expects to unveil the first-ever taste test of an in vitro hamburger next month – albeit at an expected initial price of ¤250,000 (HK$2.5 million).

Some biologists warn that cell culture is expensive and technically difficult. But others believe costs will fall to mass-market prices once the technology becomes more common.

Benjamin Wang, managing director of the Hong Kong Stem Cell Centre, says: “In vitro meat could replace traditional meats in the future if it proves to be energy efficient. Specifically on a large scale, if we are committed to this research, I think it is very likely to be able to provide a new source of food.”

Consuming lab-grown meat won’t have any more adverse effects on human health than real meat, according to Jason Matheny, founder of New Harvest, an organisation which is devoted to advancing technologies for new meat substitutes.

“Cultured meat is made of the same stuff that real meat is made of.

Our goal is to develop a vegetable surrogate for meat that is both juicy and fibrous FLORIAN WILD, RESEARCHER, EU LIKEMEAT PROJECT

But in principle one could make it much healthier by controlling the amount and type of fat,” he says.

In vitro meat is also more eco-friendly and less costly to produce than traditional meat.

Fatted animals have to consume five to eight kilograms of grain just to generate one kilogram of meat.

Globally, more than 60 billion animals are killed for consumption each year.

The UN Food and Agriculture Organisation expects world consumption of meat to double between 2000 and 2050. The challenge of increasing food supplies with less land and water available will be enormous.

In new research published in the

online-only journal BMJ Open last week, scientists in Britain suggest that reducing red and processed meat consumption by about 40 per cent to 45 per cent would shrink Britain’s carbon footprint by 28 million tonnes a year from the current 456 million tonnes.

According to the research, food and drink account for a third of all greenhouse gas emissions attributable to British consumers, with livestock farming accounting for around half of this proportion.

Food scientists are not only working to replicate meat, but also eggs, with test tube technologies.

Plant-based alternatives that mimic the nutrition, texture, taste and functionalities of meat are being developed. The “emerging, next generation plant-based meat [alternatives] promise to deliver the sensory experience of conventional animal proteins for specific culinary applications”, says Nicholas Genovese, visiting scholar and consultant at the University of Missouri-Columbia, who made a presentation at the Institute of Food Technologists Annual Meeting and Food Expo in Las Vegas.

There are many plants that are suitable for the production of meat substitute products – such as wheat,

peas, lupins and soya beans – according to researchers for the EU project, LikeMeat. They are investigating how these can be incorporated into a product that tastes like meat. “Our goal is to develop a vegetable surrogate for meat that is both juicy and fibrous, and that also has a pleasant flavour,” says Florian Wild, researcher at the Fraunhofer Institute for Process Engineering and Packaging IVV in Freising, in Bavaria.

Scientists last year showed that the process of creating in vitro meat will use 1 per cent of the land and 4 per cent of the water, compared to conventional meat production.

Once scalable cultivation methods for test tube meat have been optimised in a lab, production will be transferred to a dedicated facility, says Genovese. He likens this facility to a bakery, brewery or dairy, and suggests it be called a “carnery” – from the Latin “carnis”, for meat.

In contrast to pastures and factory farming, carneries can be located in or near urban areas and accommodate decentralised production close to population centres, he says. “As consumers understand that cultured meat will never be produced in the lab, the lab-grown meat stigma will fade.”

6 COVER STORY

Cold comfort Is storing the umbilical cord blood of your child worth the high cost? Elaine Yau investigates

T

he sales pitch of the blood bank is something firsttime mother Mrs Leung couldn’t ignore. When she gave birth to her son at Union Hospital last year, she was told her child’s umbilical cord was rich with stem cells that may have the potential to treat Alzheimer’s disease and traumatic brain injury in the future.

Tempted by the promise, she shelled out HK$100,000 for the collection and storage of her umbilical cord and its blood, with private blood bank CordLife.

“Of course, I don’t want to use the cord or cord blood in future,” says Leung, a marketing manager.

“But they might come in handy if, unfortunately, diseases related to blood or the immune system strike in future. There are cases of successful treatment of those diseases using them.”

Increasingly, parents like Leung are using blood banks for collection and storage of cord blood. But doctors say the cases of using one’s own cord blood for successful treatment are rare, and the lack of government regulation over the private blood bank industry leads to security concerns.

A government spokesman says

they do not have information on the number of companies that help people store umbilical cord blood.

However, a Consumer Council study in 2010 listed six cord blood storage providers, whose cost of service ranged from about HK$6,000 to more than HK$30,000, CordLife, a Singapore-listed blood bank which entered the local market in 2005, is among the major operators. Arthur Lau Yi-king, its senior project and quality assurance manager, says its services are popular with local and mainland parents. Another provider, HealthBaby, says it has more than 20,000 customers.

Cord blood is rich in haematopoietic (blood-forming) stem cells – called HSCs, which are primarily responsible for replenishing blood and regenerating the immune system. Typically, the umbilical cord blood is discarded after birth. For mothers who want the storage service, cord blood is retrieved from the umbilical cord and placenta after the baby is born and the umbilical cord is cut.

The blood is stored at minus 135 degrees Celsius for future use.

The first-ever successful transplant of stem cells from cord blood was in 1988. A six-year-old boy

You don’t know when you will be struck by lymphoma. Will the cells last that long?

Parents are buying hope, not insurance TSE HUNG-HING, PAEDIATRICIAN

in Paris was afflicted with Fanconi anaemia, a blood disorder. Stem cells were used to regenerate blood and immune cells in the boy. Since then, stem cells in cord blood have been used to cure a series of diseases including blood cancers, solid tumours, and immunodeficiency and metabolic disorders. Recently, scientists at the Salk Institute for Biological Studies in California found a new way to convert cord blood cells into neuron-like cells that may prove valuable for the treatment of a wide range of neurological conditions, including stroke, traumatic brain injury and spinal cord injury.

One of the Salk study’s researchers, Alessandra Giorgetti of the Centre for Regenerative Medicine in Barcelona, says cord blood cells have advantages over other types of stem cells: they are not embryonic and thus they are not controversial. They are more plastic, or flexible, than adult stem cells from sources like bone marrow, which may make them easier to convert into specific cell lineages.

Furthermore, the collection of cord blood cells is safe and painless and poses no risk to the donor, and they can be stored in blood banks for later use. Says Lau: “The HSCs

can be applied in treatment of over 200 diseases like type-one diabetes and systemic lupus erythematosus [a connective tissue disorder involving the immune system].”

HSCs are also found in bone marrow or peripheral blood that circulates through the body, and can be used to restore stem cells destroyed by chemotherapy or radiation therapy during cancer treatment. But Lau says cord blood stem cell extraction has advantages over bone marrow or peripheral blood extraction. “Patients receiving bone marrow transplants have to take immunosuppressants, whereas the incidence of developing graft-versus-host disease using cord blood is much lower as the patient is using his own stem cells. Using bone marrow or peripheral blood requires extensive donor search and a perfect match between donor and recipient.

But [cord blood] is readily available when needed.”

Cord blood stem cells come in handy in cases where a suitable bone marrow donor cannot be found. Medical surveys show about half of the patients requiring a bone marrow transplant will not find a suitable donor within a critical period.

COVER STORY 7

Umbilical cord blood is stored at minus 135 degrees Celsius at the CordLife facility (left). The stem cells can be used for medical emergencies later in life.

Photo: K.Y. Cheng. Illustration: Corbis

It costs HK$100,000 to store cord blood and cord for 18 years at CordLife, or HK$36,000 for cord blood only. Since setting up in Hong Kong, Lau says, it has had one successful case of using cord blood. “Last year, the Queen Mary Hospital did a transplant on a two-year-old boy afflicted with neuroblastoma, a form of childhood cancer. The stem cells from the boy’s cord blood stored at birth with us were infused back

into his body after chemotherapy.”

The medical benefits of cord blood are established. In the first large-scale study on treatment for childhood leukaemia, researchers at the Medical College of Wisconsin found that umbilical cord blood is more successful at treating cancer than a bone marrow transplant.

The study, published in the medical journal Lancet in 2007, studied the survival rate of 785 leukaemia-afflicted children who

were treated with either cord blood or bone marrow. The use of cord blood stem cells was associated with a lower risk of rejection and patients given higher cell doses of cord blood had better survival rates.

However, local cord blood bank development is 20 years behind that in the West in terms of regulation and popularity, says a HealthBaby spokesman. “Cord blood bank storage is available in private hospitals only. We hope that it will soon change so that children with terminal illnesses like leukaemia will have different treatments at their disposal.”

The only public cord blood bank in the city has been run by the Hong Kong Red Cross’ Blood Transfusion Service since 1998. It stores about

3,600 cord blood samples and successful transplants have been done on some 40 patients, according to a spokesman.

Although cord blood is regarded as an “organ” under the Human Organ Transplant Ordinance, the collection and storage of it is not regulated in Hong Kong. Lau from CordLife says it does not need to register with the Pharmacy and Poisons Board.

“Only treatments using [stem cell] products are covered by the ordinances. They concern hospitals that carry out transplants using the products. But we, as the storage provider, are not covered,” he says.

Former Public Doctors Association president and paediatrician Tse Hung-hing says the government should strengthen regulation of the sector. “If the blood products are not handled well and get contaminated, there could be severe consequences.”

Tse says the medical claims made by private blood banks are overblown. “Stem cells are not a panacea. They are used mostly for treating genetic diseases related to blood or the immune system. If the patient suffers from congenital

diseases, the stem cells of the patient will contain the same genetic abnormality and can’t be used.

“Cord blood for self-use is only possible for those who acquire blood or immunity related diseases after birth, such as leukaemia. There are few cases of transplant treatment using the patient’s own cord blood.”

In 2007, the American Academy of Paediatrics discouraged storing cord blood privately as “biological insurance” for a child without a known disease risk. It said that the chance of the child needing a transplant from cord blood stem cells was only one in 20,000.

The amount of stem cells stored at birth might not be enough for adult treatment, Tse adds. The clinical application of stem cells extracted from a standard collection of cord blood at birth is limited to patients weighing less than 40kg.

And the technology could change so much that cells stored now may not be needed if disease strikes later.

Tse adds: “You don’t know when you will be struck by lymphoma.

Can the cells be stored for so long?

Parents are buying hope instead of insurance.”

But for Mrs Leung, the money is well spent. “Life is priceless,” she says. elaine.yau@scmp.com

8 DIET THE TASTE TEST WAFERS ......................................................

Jeanette Wang jeanette.wang@scmp.com Rutherford & Meyer Waferbites HK$41 for 120 grams, ThreeSixty This all-natural, dollar-coin-sized snack is baked not fried, and so has 72 per cent less fat than standard chips. Each serving of 15 pieces has 40 calories and 0.8 grams of fat. Too small for toppings, but delicious on its own. Made in New Zealand.

Verdict: cute, crisp and a great low-calorie snack, but you should definitely brush afterwards.

HEALTHY GOURMET

Airline fare heads into the stratosphere ......................................................

Andrea Oschetti healthpost@scmp.com Waterthins Pepper & Chives HK$36 for 150 grams, City’super The packaging suggests you try these Australian wafers with cheese, dips, pâté or antipasto, but they are subtly flavoured so you could have them straight out of the box. The pepper gives a good spicy kick.

Verdict: thin, light and so addictive.

Good Food NZ Natural Wafers HK$51.50 for 120 grams, ThreeSixty After having the two flavoured varieties above, this one tasted a tad bland on its own. But, with no artificial flavours or colours, that’s perhaps a good thing. It’s the perfect foundation for creamy cheese or scooping up your favourite dip.

Verdict: crisp but a little tough – lacks the melt-in-your-mouth texture of the other two brands.

Eating on an aircraft is a dreadful prospect. Especially in economy class, airlines provide a poorer version than what is on display at frozen aisles at a supermarket.

We, the passengers, are guilty too: our behaviour towards food changes on planes. We lower the standard of what we allow ourselves to eat because it is difficult to say no to free food.

However, we can eat better when we fly and we can have hope for the future, as airlines are recognising that better food might help them win more passengers.

Airlines give several excuses why the food experience they provide is not fun (although one wonders why food in airport lounges is often equally bad). Food cannot be cooked on aircraft as open flames are banned on board. It can only be reheated in dry ovens, although newer planes are introducing steam ovens.

At altitude, you lose about 20 to 30 per cent of your sense of taste, as the decreased humidity in the cabin dries out your nose and the increased cabin pressure numbs taste buds. This prompts airlines to salt food heavily. But through the smarter use of natural flavouring, they can make food taste better.

Despite clear technical limitations, economics doesn’t help airlines make good food decisions either. The slightest variation in your food tray means significant price differences. According to a report in The New York Times, a few years ago Delta Airlines saved US$250,000 a year by cutting 30 grams from its steaks. The airline has also calculated that it might save a further US$210,000 by removing a single strawberry from salads served in first class on domestic routes.

Food freshness has nothing to do with limited space on a cabin’s galley but it does not feature often in

aircraft food experiences. Terminal U, a travel news website, visited one of the world’s largest independent airline caterers and found that all economy meals are outsourced to a frozen ready meal supplier.

In business class, the attention to freshness is higher.

The future looks brighter as airlines are starting to focus on food experiences, although the efforts are mostly confined to business class. As a chef, I learned of Turkish Airlines’ Flying Chef programme with a mix of enthusiasm and scepticism. The programme involves onboard chefs who explain the menu and prepare the food for business class passengers. I wanted to look into it to find out if it was just a marketing gimmick, with cabin attendants dressed as chefs, or a real food revolution in the air.

Last August I went to Istanbul and visited the food operations at Turkish Do & Co, the catering company which provides Turkish Airlines’ food. What I found was good news. The operations, which produce 130,000 meals a day, resemble a large restaurant kitchen rather than an industrial plant. An army of 600 cuts all the vegetables by hand. Restaurant-sized ovens and grills are used; I saw the cooks preparing 10,000 omelettes per day using frying pans, and the cauldrons where the stocks are made from fresh ingredients.

The guiding principles are revolutionary for an airline: no industrial food, everything is handmade for all classes. Raw materials such as vegetables, fish and meat are the same in business and economy class; the only difference is a wider selection for the former. The food is produced within six hours of the flight.

On my flight to Hong Kong I met flying chef Mustafa Aydogdu. He graduated from the Istanbul Culinary Institute and worked in a restaurant in Florence. As I watched him preparing the dinner service, he told me: “How can you reheat food

example, I reheat meat and vegetables separately.”

Mustafa enjoys the opportunity to interact with the passengers.

Food is seen as an opportunity to entertain people, not simply feeding them.

While we wait for a change in the quality of in-flight food, the prospect of eating well on an aircraft depends very much on us. This week, instead of the usual recipe, I will share with you some simple tips on how to eat healthily on your next flight.

The height of catering: Turkish Airlines’ flying chef Mustafa Aydogdu. Photo: Andrea Oschetti

Keeping the moisture in the food is my key challenge. Different food requires different heat MUSTAFA AYDOGDU

properly if you don’t understand ingredients, don’t know how the oven works, and you are constantly faced with issues such as the need to stop the cooking process because of turbulence?”

He explains: “Reheating food cannot be standardised: conditions change all the time and you need a trained eye to end up with food which is not overcooked or dry.

“Keeping the moisture in the food is my key challenge. Different food requires different heat; for

Behave as you normally do You don’t eat chicken with rice at 1am at home, so why should you do it on the intercontinental flight which departs late in the evening? Have your breakfast, lunch and dinner as you normally would. Also, you really do not need to eat on a two- to three-hour flight. On my flight to Hong Kong from Istanbul, 30 per cent of business passengers compared to 90 per cent in economy ate the dinner served at 1.35am. The reason is that in the cramped space of economy class, eating helps to pass the time. The food is not nutritious, nor satisfactory, nor do you need the extra calories: resist.

Choose wisely Stews, vegetables and fatty fish stand up well to reheating and keep their moisture and texture.

On the other hand, al-dente pasta in the air is almost always a dream.

Bring your own On long-haul flights I always pack my own food: granola bars, fruits and peppermint tea bags.

This will suffice for me, especially because I eat a few hours before and after the flight. If you need more, try nuts, muffins, and veggies.

Move Walk around the cabin and stretch your muscles during those long-haul flights.

Healthy Gourmet is a weekly column by private chef Andrea Oschetti. He can be reached at andrea@fioreblu.com

SOUTH CHINA MORNING POST SEPTEMBER 18, 2012

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10 FITNESS GREAT STRIDES PHUKET

A run with a view ......................................................

Troy de Haas healthpost@scmp.com The name “Phuket” comes from the Malay word for “hill” (bukit), and true to that moniker, much of the island’s interior is dominated by lush, green hills. Thais call Phuket “the Pearl of the South”, and its 40 kilometres of white-sand beaches have been attracting holidaymakers for many years.

In more recent times, runners and triathletes have begun to discover its allure.

The combination of a holiday destination and an internationalstandard running event, together with the Thai hospitality, makes this seem like paradise.

“What better way to unwind after a tough marathon than to head to Surin beach for a few hard-earned Singha beers? You can enjoy quality Thai cuisine at a great price,” says two-time Phuket International Marathon winner, Australian Stephen Paine.

Whether you come to Phuket for the marathon or triathlon, or just a holiday, here is a list to get the most out of your running around

the island. To get to the respective places, it’s best to hire a taxi or tuk-tuk – and expect to bargain for your fare in advance.

Best running spots • Bang Tao bay (Laguna) Home of the Phuket International Marathon and the grand estates that surround many of the island’s premier five-star resorts.

Away from the hustle and bustle of Phuket’s residential areas, Bang Tao bay offers kilometres of lush tropical gardens, golf courses and wide boulevards that are popular with runners throughout the day.

It’s a good idea to take a map to find your way around the area’s maze of winding lagoons, bridges and resorts.

It’s completely flat, and has a solid path for those interval sessions.

We simply want everyone who takes part to run for fun and fitness, and enjoy a run in paradise ROMAN FLOESSER, GO ADVENTURE ASIA

• Nai Harn beach The island’s southernmost beach.

The area is much less developed and has a bucolic charm. There are some quiet back roads that wind through rolling green hills.

My favourite spot here is the 1.6-kilometre lap of Nai Harn reservoir, just a few hundred metres from the beach.

• Kamala beach The beach at Kamala is pleasant to run along. Just to the south is Nakalay Road. This follows the water for a few hundred metres until the beach runs out. Then it clings to the side of the hill, and weaves up and along the rugged coastline. On the 10.5-kilometre return route, you can enjoy a stunning sunset over the Andaman Sea. • Yot Sane 1 (Giant Buddha) From here, you can see the Giant Buddha on the south of the island.

Perched atop the Nakkerd Hills between Chalong and Karon beach, red signs with “Mingmongkol Buddha 45 metres high” indicate the turning from Chalong, and the start of the only access road, Yot Sane 1. It’s a no-through road, so it has minimal traffic. It’s quiet, apart from the occasional tourist or trekking elephant.

It’s a steep five kilometres to the Giant Buddha. You run over a well-made concrete surface, with sharp turns and panoramic drop-offs.

The main event • Run Paradise! Laguna Phuket International Marathon The Laguna Phuket International Marathon, which is held each year in mid-June, is the fastest growing destination marathon in Southeast Asia. The event, which will be eight next year, is being promoted as one of the Top Three Destination Marathons in the World.

The marathon course runs along the coast, and takes in a typical Thai village market, rubber plantations, and buffalo-ploughed rice paddies before finishing in the resort of Laguna Phuket. Each step of the 42.195-kilometre marathon course has been officially measured, and it is sanctioned by the Association of International Marathons.

Marathon and half-marathon runners follow the course out of Laguna and rubber plantations. The 10.5-kilometre, five-kilometre and two-kilometre races all take place within the Laguna Phuket resort complex.

Race director Roman Floesser, of organiser Go Adventure Asia, says of the event: “It reflects Phuket’s family-friendly atmosphere. It’s a fun event with a range of courses to suit all abilities from families wanting to participate in a five-kilometre walk to those who want the challenge of a full marathon.”

Although the organisers encourage runners to strive for a personal best time, there is no prize money for elite runners. “We simply want everyone who takes part to run for fun and fitness, and enjoy a run in paradise,” Floesser says.

Après run Whether you enjoy nature or nightlife, there’s plenty to do.

• Visit the setting for the film The Beach with a speedboat day tour to Phi Phi island where you can snorkel in crystal-clear waters.

• Travel by jeep to Siam Safari camp in the Chalong highlands where you can put your feet up and let an elephant carry you through the lush tropical forest.

• Phuket’s night-time entertainment includes live music, pumping Bangla Road bars, night markets and several shows, including the family-orientated Phuket FantaSea embracing Thailand’s ancient culture in dance and magic.

• Finally, when you need to escape, a day spent at a spa, or a two-hour Thai massage is a brilliant way to unwind.

Phuket’s 40 kilometres of beaches are a great place to run and to unwind. Photo: Troy de Haas

Great Strides is a part of a series of city running guides by Troy de Haas, a sports travel manager with Flight Centre who represented Australia in orienteering, mountain running and tower running

WELL-BEING 11 FIT & FAB

Benjamin Lai on Stanley Main Beach.

Photo: Thomas Yau

And the living is breezy ......................................................

Rachel Jacqueline healthpost@scmp.com In the five years since Benjamin Lai moved to Hong Kong, he’s had one night stands with aikido, wing chun and Brazilian jiu-jitsu, as well as wakeboarding, hot yoga and TRX suspension training. Lately, he has been flirting with windsurfing and the 33-year-old Hong Kong-born Australian finally thinks he is on to a good thing.

“I love windsurfing because you are at one with nature, and you are at its mercy – you have to work with the sail, the wind and your body,” he explains. “If your balance is not right, you don’t move. You also need to read the wind. That’s what keeps it interesting – the wind is changing all the time.”

Lai, an osteopath, first tried the sport with friends two years ago, but only recommitted to learning it this summer. After taking lessons, he now windsurfs every week at Stanley Main Beach.

For Lai, trying new sports is not just a hobby, but also a way to better understand his patients. “I like to

give new sports a go, so I can study what movements are involved in the activities,” he says.

“It allows me to keep up with the lingo that patients use, and helps me to understand any injuries from those activities.”

Lai’s endless curiosity filters through everything he does in life.

During the five years he studied osteopathy, he also got certified as a personal trainer, and worked with clients part time. Now working at Central Osteopathy in Central, he has also found the time to study two of his life-long interests: acupuncture and traditional Chinese medicine (TCM).

“I am intrigued by Eastern medicine’s philosophy on preventative health and well-being.

Especially the intimate relationship between external lifestyle and environmental factors, such as climate, seasons, and food and internal ecology – our mind and body,” he says.

He is also a firm believer that keeping active is central to one’s health. He works out for at least 30 minutes daily, preferably outdoors.

“We are part of nature,” he says.

Being healthy is simple. Be active, eat well, rest, and have a positive outlook on life

sitting in front of a desk in a bad posture. Usually, headaches and neck pain follow. We sometimes see people who’ve been inactive for a long while and then try to get back into it, pushing themselves too hard and too quickly.

Have you always been healthy?

Being Chinese, well-being has always been important to me. My mother was always interested in TCM. But as a kid, I was quite chubby – I had to tailor my school trousers as a nine-year-old because I loved McDonald’s thick shakes.

What’s the most frustrating thing about being an osteopath?

Being healthy is simple: be active, eat well, rest – mentally and physically – and have a positive outlook on life. It can be very easy, but it’s very difficult to make the changes that you need to do that.

People in Hong Kong wake up at 6am, go to the gym, then work a tremendously long day, maybe grab dinner, and go back to work.

They may not get to bed until past midnight. They come to me with sore necks and shoulders, feeling exhausted. It is frustrating for me to see a problem and a solution, but no connection between the two.

What’s the most common injury you treat in Hong Kong?

Unsurprisingly, it’s lower back pain from people spending too long

Are you always perfectly healthy?

I’m like anybody else. I’m just a regular guy. Sometimes, my nutrition isn’t very good. I tried a

BENJAMIN LAI, OSTEOPATH

“There’s nothing more calming than feeling the sun on your face and salt water on your skin.”

vegetarian diet earlier this year and it didn’t work, as I wasn’t getting enough variety.

Sometimes I get lazy, fall behind in my exercise, and go for that packet of chips. But I believe our lives are about balance and moderation. It’s also important to enjoy life. I don’t think it’s good to be too regimented.

What’s your worst habit?

Like many people in Hong Kong, I have a tendency to overwork myself and pack too much into my day.

When I get tired, I make bad decisions, lose my drive for exercise and then get more tired. It’s a vicious cycle.

But if you’re not getting the proper nutrition, you’re not going to have the energy to break it. So I try and focus on eating well as much as possible, and looking after myself to counter that.

Where do you think best?

On the beach. I can’t say it happens while I am windsurfing, as I’m thinking too much [about what I’m doing]. But it’s great just to relax on the beach and have a good think.

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SEPTEMBER 18, 2012 SOUTH CHINA MORNING POST