YOUR GUIDE TO LIVING WELL
TUESDAY, DECEMBER 11, 2012
HEALTH POST NEW KNEE FOR MAN OF ACTION
LESSONS IN PASTA AND POSTURE
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Points of contention More parents are refusing to have their children vaccinated
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2 NEWS ASK THE DOCTORS DR LUISA DILLNER
HEALTH BITES ......................................................
Q: Should I avoid taking antibiotics? A: If you caught pneumonia in the pre-antibiotic era, you had only a 50 per cent chance of surviving. So it is no wonder that England’s chief medical officer, Professor Sally Davies, is anxious that antibiotics don’t lose their effectiveness. Last month, she warned that bacteria are becoming increasingly resistant to antibiotics. If this carries on, we will no longer have cures for common infections. Each year, about 25,000 people in Europe die from antibiotic-resistant infections. But this isn’t new. Since 1961, Staphylococcus aureus has been resistant to penicillin and has caused serious illness (pneumonia and skin sepsis). Methicillinresistant Staphylococcus aureus is a real problem in hospitals, and there have been community outbreaks. Different antibiotics kill bacteria in various ways. They may destroy cell walls, stop protein production, or prevent them from copying their DNA so they can’t reproduce. Bacteria can evade destruction through random changes (and there is evidence that even before penicillin was discovered, some bacteria, through spontaneous mutations, were already resistant to it), or by picking up new genetic material from other bacteria. These resistant bacteria learn to deactivate
antibiotics or to continue to grow despite them. Resistance is fuelled by many things. Overprescribing is a major factor – by being constantly exposed to antibiotics, some bacteria learn how to avoid being killed – only take these drugs if you really need them. One-third of the public wrongly believe antibiotics can cure colds, but colds are caused by viruses, not bacteria. Most antibiotics are given by doctors for upper respiratory tract infections “just in case”. The patient is unlikely to need them, but the
doctor wants to play safe in case the infection turns out to be bacterial rather than viral (tests to prove what bug causes common infections take a while and are usually not worth doing). Nor do we need antibiotics for most sore throats, coughs or earaches, and definitely not for flu. There is evidence that not completing a course of antibiotics or reusing leftover prescriptions encourages resistance, as the drug concentrations in the bloodstream don’t reach the optimal levels needed to kill the bacteria. So, only the sensitive ones get wiped out, and the tougher bacteria become resistant. Fewer than half of us finish an antibiotic course. Ask your doctor for how long you need to take any antibiotics. Some of them work with shorter courses, but other infections need longer courses. You should never reuse antibiotics: you won’t have a sufficient dose for them to work and they may not work for your infection the second time. You don’t have to avoid antibiotics to do your bit to stem resistance. Just take them as directed when you really need them and be thankful that, for now, they still work. Luisa Dillner, who trained for her medical degree in Bristol, Britain, is the medical columnist for The Guardian
NUTRITION GIFT IDEAS
Tasty titles for your favourite foodie friends ......................................................
Fletcher, this book encourages those with diabetes or pre-diabetes to think, care, nourish, and live to develop a sense of balance with food.
Barbara Quinn Here are a few suggestions for the food and nutrition buffs on your Christmas shopping list. Recipes to CHOMP On (Morris Press CookBooks) Lovingly compiled by auxiliary volunteers from Community Hospital of the Monterey Peninsula (CHOMP) in California. A collection of favourites from volunteers and staff including CHOMP’s salmon filets in dill sauce by chef Lance Chambers.
Mayo Clinic Healthy Heart for Life! 2012 (Time Home Entertainment) Edited by Dr Martha Grogan, this well-illustrated book covers risk factors for heart disease, healthy eating, medication use, and goal-setting.
hearty meals, sweet treats and snacks for the everyday cook”.
Pregnancy Cooking & Nutrition for Dummies (John Wiley & Sons) Dietitian Tara Gidus provides research-based nutrition and weight-gain guidance along with 100 recipes for a healthy pregnancy.
Healthy Eating, Healthy Weight for Kids and Teens (Eat Right Press) Registered dietitians Jodie Shield and Mary Catherine Mullen offer research-based strategies to help parents address the nutritional health of their children. Includes three weeks of menus and more than 40 “kid-tested and approved” healthy recipes.
Nutrition: What Every Parent Needs to Know (American Academy of Pediatrics) Edited by Drs William Dietz and Lorraine Stern, this book addresses child feeding issues from picky eating to obesity. Allergies, eating disorders and even indulgent grandparents are addressed.
The Ultimate Volumetrics Diet (HarperCollins) Barbara Rolls and Mindy Hermann, a registered dietitian, teach us how to eat “fewer calories per bite” and still feel satisfied – a proven method for weight control. Includes four weeks of sample menus and recipes.
Whole Grains for a New Generation (Stewart, Tabori & Chang) Beautifully organised and illustrated, author Liana Krissoff provides simple, accurate information about whole grains and “light dishes,
Eat What You Love, Love What You Eat With Diabetes (New Harbinger Publications) Co-authored by Dr Michelle May and registered dietitian and certified diabetes educator Megrette
Sports Nutrition for Endurance Athletes (Velo) Registered dietitian Monique Ryan provides updated sports nutrition guidance for long-distance runners. McClatchy-Tribune
Jeanette Wang jeanette.wang@scmp.com Less food for thought A new study published in Neurology suggests people who sometimes went hungry as children have slower cognitive decline in their elderly years compared with those who’ve always had enough food to eat. The study involved more than 6,000 Chicago residents with an average age of 75 tracked for up to 16 years. The link, however, was found only in African Americans; no similar relationship was found in white people. Study author Lisa Barnes, a neuropsychologist at Rush University Medical Centre in Chicago, theorises that calorie restriction can delay the onset of age-related changes in the body and increase the lifespan. Fins aren’t what they used to be Darwinists, rejoice: Spanish researchers have found a scientific explanation of how fins may have evolved into legs. According to the study in the journal Developmental Cell, the development of hands and feet occurred through the gain of new DNA elements that activate particular genes. The scientists introduced extra Hoxd13, a gene known to play a role in distinguishing body parts, at the tip of a zebrafish embryo’s fin. This led to the generation of new cartilage tissue that resembles key aspects of landanimal limb development. Also, a DNA control element that activates Hoxd13 in mouse embryonic limbs could cause the gene in the fin to produce something, too. Fatten down Scientists at the Joslin Diabetes Centre in Boston have shown that brown fat transplants could help combat obesity. This type of fat is different from the white fat that’s associated with increased body mass. Brown fat, a specialised tissue in mammals that’s used to generate heat, is linked with a lower body mass index and consumes large amounts of energy. The researchers performed brown fat transplants in mice fed either a normal or high-fat diet, and found this significantly decreased body weight and improved insulin sensitivity and glucose metabolism. The transplanted fat also secreted hormones which affected the metabolism in the body. Pest in peace Commercial ultrasonic frequency devices that claim to repel pests such as bed bugs through sound have shown to be ineffective. A new study in the Journal of Economic Entomology tested four such devices, all purchased online and used according to manufacturers’ instructions. For each device, the authors created a sound arena and a control arena (with no sound). They found no significant differences in the number of bed bugs observed in the two arenas, and that bed bugs were neither deterred nor attracted to the arena with the sound device. The authors concluded the devices may not have produced the right frequencies.
NEWS 3 TECHNOLOGY
APP OF THE WEEK
Let them talk you through your workout ...................................................... Katie McGregor healthpost@scmp.com Fitness Coach HK$15 Rating 10/10
The geometry of porcupine quills enable them to penetrate the skin with ease, and once in the tissue, they are difficult to dislodge. Photo: K.Y. Cheng
Where there’s a quill, there’s a way ...................................................... Jeanette Wang jeanette.wang@scmp.com Inspired by North American porcupine quills, scientists from Brigham and Women’s Hospital in Boston hope to improve the design of medical needles. The researchers have uncovered how these quills easily penetrate tissues and why, once lodged in flesh, are often difficult to remove. In their study report published yesterday in Proceedings of the National Academy of Sciences, they say this discovery could prompt the design of medical needles that easily penetrate surfaces and resist buckling. The North American porcupine has about 30,000 defensive quills on its back, which are released upon contact with predators. Contrary to popular belief, porcupines do not shoot their quills over great distances, says lead researcher Dr Jeffrey Karp of Harvard University. The quills instead must penetrate tissue very easily and thus have evolved a specialised mechanism to achieve this. Each quill contains a conical black tip studded with a layer of microscopic, backward-facing barbs and a cylindrical base with smooth, scalelike structures. The quill’s geometry enables it to penetrate tissue with ease, and once in the tissue, it consistently stays in. The scientists used natural quills and replica moulded synthetic polyurethane quills to understand the physical forces at play when the quills penetrate and are removed from a variety of tissues,
including muscle and skin. The quills can “strongly grip tissue with minimal depth of penetration – less than half a centimetre is enough – and they don’t need to bend like staples to achieve secure fixation”, says study co-author James Ankrum. The researchers expect this approach to have many implications across multiple disciplines, including medicine. “Towards medical applications, we developed plastic replicas that remarkably mimicked the reduced penetration force and increased pullout. This should be useful to develop the next generation of medical adhesives and potentially design needles with reduced pain,” says Karp.
This should be useful to develop [new] medical adhesives and design needles with reduced pain DR JEFFREY KARP, LEAD AUTHOR
The authors compared the potential of this finding to other things in nature that have inspired bioengineered devices, such as the development of Velcro hook-andloop fasteners and the development of tape-based adhesives inspired by geckos. The next step will be to test the synthetic quill in a variety of medical applications.
> 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.
Despite the change in the weather that favours outdoor exercise, my workload has meant a three-week stint of little or no exercise and weight gain. In need of a serious programme to pick up my exercise habit again, I tried out a few get-ripped-fast apps and settled for Fitness Coach. The initial attraction was that unlike a few other apps I tried, this contains guided routines with audio, as opposed to lists of exercises that you work through on your own. It seems that some app developers forget you’re actually exercising while using the app, so you’re not really in a position to do much reading. I discovered many more useful features including a huge library of exercises and routines indexed according to body parts, fitness
goals or tools. The app also has the option to create your own routine, which is useful for home workouts that make use of equipment at hand. The first workout tested was “Focused on Woman Fitness” and this has three different routines for different days. Day one was all about the chest and back. You can adjust the number of sets and reps and the exercise time, but I chose to leave the default settings. As you move into the workout, a voice-over gives you advice on how to best perform each exercise, and a video demonstrates the move from different angles, so there is no excuse for bad form. The screen shows how many reps need to be done – you can go at your own pace. Check each set of reps off once done and the app moves into a rest period before moving to the next exercise. For the second workout, I made more of a commitment, choosing the “Weight Loss Programme” from the library of preset 12-week programmes. It’s well devised, mixing up circuit training, weight training and rest days. I hope it’s enough to bring things back in line.
You can also select from a list of audio tracks, which include dance music and nature sounds. There is something bizarre about exercising to tweeting birds, and the dance music is a repetition of about three bars of music. I’d recommend using your own tunes.
4 MEDICAL
Illustration: Angela Ho
CASE HISTORY
Rebuilt for speed ...................................................... Eileen Aung-Thwin healthpost@scmp.com William, 33, lived a high-octane life working in the advertising industry. In his leisure time, he got his thrills from sports such as wakeboarding, adventure racing, hockey and scuba diving. In 2006, William (whose full name has been withheld for reasons of patient confidentiality) twisted his knee while wakeboarding, which caused a large tear in the meniscus of his left knee. A human knee has two menisci, which are crescent-shaped pads made of fibro-gelatinous materials located between the thigh bone (femur) and shin bone (tibia). They are the shock absorbers of the knee joint and help keep it stable. Meniscal tears are commonly known as torn cartilage in the knee. Moderate to severe tears might result in a “pop” sound when the injury occurs. Meniscal tears might cause pain, swelling and stiffness in the knee, which can also suffer limited range of motion or might even give way. The tear on the inside of his left knee was severe enough that doctors had to trim the damaged portion, leaving him with only about half of the meniscus. Each meniscus is divided into a “red” zone and a “white” zone. The red zone is the portion closest to the outside of the knee and enjoys an abundant blood supply. Minor injuries to this part of the meniscus may not need treatment and will heal on their own with rest. Larger tears can be surgically sutured and repaired. The white zone is the part of the meniscus closest to the centre of the
knee joint and has no direct blood supply. Without a blood supply, the meniscus is unable to heal. Severe injuries to this part of the disc, such as the type of tear in William’s case, typically require surgery – a partial menisectomy – to remove the damaged portions. After the surgery, William was able to return to his high-impact sports. But six years later, he started feeling intermittent pain in the same knee. He consulted Dr Terence Chan Wai-kit, a specialist in orthopaedics and traumatology, about his discomfort. Magnetic Resonance Imaging (MRI) scans showed that the cartilage covering the ends of William’s femur and tibia inside the knee joint were starting to degenerate. The removal of half of one meniscus meant that the knee was less able to redistribute shock and impact, thereby transferring the stress to the cartilage and wearing it out prematurely. In time, William will face increasing knee pain. There will also be an increased risk of early onset osteoarthritis, which is joint inflammation arising from cartilage wear. To extend the lifespan of the knee, Chan told William he’d have to give up high-impact sports and settle for activities such as walking, cycling and swimming. To a thrillseeking athlete, this was devastating. Chan says other treatment options when knee degeneration and pain become severe include corrective high-tibial osteotomy, an operation in which the top of the tibia is broken to realign the bone into a position that helps relieve pressure in the knee joint. Another option is to replace the weightbearing surfaces of the knee joint.
William was told he’d have to give up high-impact sports and settle for activities such as walking. To a thrill-seeking athlete, this was devastating
In the US, transplants using menisci from cadavers are performed on patients. But this is not an option in Hong Kong, where law forbids the trading of organs. In the past three to four years, European doctors have started using a new treatment where a synthetic scaffold is used to replace the damaged part of the meniscus. The scaffold is made of a special material that stimulates the regeneration of meniscal tissue into the scaffold. The synthetic material slowly biodegrades over five to six years as more meniscal tissue grows and replaces the material. In William’s case, it held the promise that he would be able to enjoy his lifestyle for many more years to come. Chan roped in his fellow specialist in orthopaedics and traumatology, Dr Kong Chi-chung, to investigate the possibility of employing this method for William. Kong says this surgery is not for everyone. Candidates must be between 18 and 50 years old to ensure that the bones and joint are fully mature, and that the body still has optimal regenerative powers. The post-surgical rehabilitation process is long and requires a firm commitment from the patient to endure the process. Patients will not be able to participate in sports for at least a year while the meniscal tissue regrows. Finally, the patient’s knee must also be in a stable condition, and the shape and alignment of the bones and joint must be normal. Any cartilage degeneration must not be too advanced. William met all the criteria. Even so, he took six months to consider all
the factors before he agreed to the surgery, which had never been performed in the Asia-Pacific region. The inventor of the surgery, Professor Rene Verdonk, flew in from Belgium to assist with the 90-minute keyhole surgery. Small channels were made in William’s remaining meniscus so that more nutrient-rich blood could reach the implant and promote tissue regeneration. Then, a piece of the scaffold was trimmed and shaped to replace the missing portion of his meniscus, and sutured to his own meniscus to hold it in place. William now faces a year of physiotherapy. In the initial two weeks, he wore a special knee brace that only enables a 30-degree range of motion. This progressively increases to 90 degrees over six weeks. He also has to use crutches for the first three weeks after surgery. Over the next five weeks, he will slowly increase the weight loading on his knee, before trying to walk normally at eight weeks after surgery. For the first three months, he has to see a physiotherapist once or twice a week. Depending on his progress, he will eventually see her once every two weeks. After about six months, William will be able to start light exercises such as swimming and other aquatic exercises, and using a stationary bicycle or cross-trainer in the gym. At nine months, he will probably be able to start gentle jogging, and make a gradual return to his sports after a year. Despite the long road to recovery, the success of this treatment will enable William to regain his active lifestyle and longevity of his knee joint.
HEALTH 5 FROM THE EXPERTS
Disabled have right to intimacy ...................................................... Dr Justin Grayer healthpost@scmp.com In 2006, the UN Convention on the Rights of People with Disabilities was unveiled, with the aim of achieving the same human rights for the disabled as people without disabilities. But what about sexual rights? Almost 20 years earlier, the late Dr Ann Craft, a British social worker, was advocating freedom of sexual expression for people with learning disabilities. She argued that such people have the right: • To grow up – to be treated with the respect and dignity accorded to adults without learning disabilities; • To know – to have access to and assimilate information about themselves, their emotions, their bodies and those of other people, and appropriate social behaviour; • To be sexual and to make and break relationships; • Not to be at the mercy of the individual sexual attitudes of different care givers;
• Not to be sexually abused; and • To live in humane and dignified environments. The right not to be abused seems like a no-brainer to most people. But the other points may result in anxiety for some people. What if they get themselves or someone else pregnant? Won’t this put them at risk of abuse or abusing others? What if they don’t have the emotional capacity to be in a relationship? Actually, these are the same questions that are asked about normal people with respect to sex and relationship education. People with learning disabilities also go through puberty. This developmental leap occurs in, and exacerbates, a personal context in which they often already feel “different” and struggle to understand the world around them. But they’re often thought of as being asexual and therefore not wanting or needing relationships. Alternatively, they may be seen as promiscuous or deviant because of sexually inappropriate behaviour.
Both of these views can lead to these people being denied any information related to sex and relationships, which reduces the opportunities for them to gain helpful knowledge and to express themselves in appropriate ways. The lack of information, coupled with low self-esteem that arises from a denial of individual rights, makes these people vulnerable to abuse. “We believe that it’s important for our students to be given a space to ask questions and learn about sex and relationships in a supportive environment,” says Emma Rhoda, programme director at the Nesbitt Centre in Sai Ying Pun. “We run an Understand Relationships Group for students of a similar developmental age, which provides a safe forum for them to explore their social and sexual identities. Our students can learn about issues such as the difference between public and private behaviour and of appropriate and inappropriate touch. Not having this knowledge leaves our adults open to potential abuse or exploitation.”
A couple share a kiss at a nightclub in Barcelona that opens on Sunday afternoons for people with learning disabilities. Photo: Corbis In 2009, an Australian study that interviewed adults with mild learning disabilities demonstrated that they have the same sexual and intimacy needs as people without learning disabilities. Research has also shown that as people with learning disabilities engage in sexual activity in close relationships, there is a reduction in aggression. This fits with the knowledge base that healthy relationships are beneficial for people and are associated with longer, physically and psychologically healthier lives. “To be a human being is to be a sexual being,” says Craft. “Although
there may be a range of intensity, varying over time, we all have sexual needs, feelings and drives, from the most profoundly handicapped to the most able among us. Although we can shape [and mis-shape] sexual expression, sexuality is not an optional extra which we in our wisdom can choose to bestow or withhold according to whether or not some kind of intelligence test is passed.” Wise words. Dr Justin Grayer is a clinical psychologist and sex therapist at thinktalkpsychology.com
6 COVER STORY
More parents are refusing to have their children immunised against diseases, but doctors insist vaccinations
Who’s calling t W
hen a baby first comes to the world, painful vaccine shots are among the first things that befall the crying infant. Right after he is born in the hospital, he will get Bacillus Calmette-Guérin (BCG) vaccine against tuberculosis and another one against hepatitis B. Many more vaccine shots will follow right until the child completes primary school to give him comprehensive protection against a host of diseases. But a growing number of parents have spurned the government immunisation programme, citing health concerns, setting off alarm bells among paediatricians and infectious disease experts. Although the government says they have not observed any decrease in the immunisation coverage rate among children over the years, paediatricians say there are more parents, especially those returning from overseas, who refuse to get their children immunised. In 2009, parents set up the Hong Kong Vaccine Awareness League, which now boasts 200 members dedicated to the education of parents and concerned citizens regarding vaccination. The childhood immunisation programme, launched in the 1960s by the Health Department, targets children from newborns to primary six students. The current schedule covers 10 diseases: diphtheria, hepatitis B, measles, mumps, pertussis, pneumococcal disease, poliomyelitis, rubella, tetanus and tuberculosis. Disease cases decreased as related vaccines were added to the programme. For example, the hepatitis B vaccine was introduced in 1988; cases decreased from 100 in 1997 to 70 in 2011. Rubella cases dropped from 4,958 in 1997 to 85 in 2011, and measles cases fell from 316 to 12 in the same period. No cases
Dr Lau Hon-chung injects Gary Man with a flu vaccine. Despite scares, doctors recommend flu shots. Photo: Sam Tsang of diphtheria and polio have been reported since 1982 and 1995 respectively. But the drop has not been sustained for some diseases. From 2008 to 2011, mumps cases rose from 136 to 153, and rubella from 38 to 85. Immunisation rates plummeted after a paper – which has since been discredited – was published in the medical journal The Lancet in 2008 – linking the MMR (measles, mumps and rubella) vaccine to autism. Following the MMR vaccine scare, measles or mumps outbreaks have been reported in Chicago and San Diego in the US, and in Italy. Paediatrician Dr Maurice Leung Ping says parents from Britain often
prefer their children not to have the MMR vaccine. “Some parents have the misconception that vaccines contain mercury. Although the licensed vaccines are safe nowadays, some parents still do not accept the explanation from the local doctors.” Pertussis, a highly contagious bacterial disease that causes uncontrollable, violent coughing, rarely occurs in Hong Kong, says Leung. But he has diagnosed a few cases, the main source of which being the mainland. “The increased contact between mainlanders and Hong Kong people means we should be on alert,” he says. But vaccines are not without risks and not foolproof. From 5 per cent
to 15 per cent of people who get the MMR vaccine will develop a fever. In the US, 1,000 cases of the inflammatory disorder GuillainBarre syndrome (GBS) were reported after vaccination between 1990 and 2005, according to a study by the University of Medicine and Dentistry of New Jersey that was published in the Journal of Clinical Neuromuscular Disease in 2009. GBS causes the body’s immune system to attack the peripheral nervous system. Symptoms include weakness or tingling sensations starting in the legs and spreading to the torso and arms in many cases. In severe cases, it can cause total paralysis.
The researchers, using data from the US Vaccine Adverse Event Reporting System, found that most cases (63.2 per cent) occurred in subjects who received the influenza vaccine, followed by the hepatitis B vaccine (9.4 per cent). The remainder were associated with other vaccines or combinations of vaccines. The average age of patients was 47 years. In Hong Kong in 2010, there were some suspected cases of fetal death after pregnant women were given swine influenza vaccination. But paediatrician Dr Cheng Manyung says it’s better to have the inoculation than risk the disease, especially as the side effects are usually mild. “The high population density in Hong Kong and frequent international travel means outbreaks of diseases can make people vulnerable,” he says. “The phenomenon of parents refusing immunisation came after unfounded vaccine scares in the West. The growing community of parents who are ardent nature advocates and practise organic and chemical-free living are also to blame.” Leung says misconceptions about vaccines are still widespread among parents: “For example, some parents discredit the influenza vaccine when they see their children develop cold symptoms after the vaccination. But most of the time, people are confusing symptoms of influenza with the common cold.” Vaccination has been successful at eliminating diseases. Smallpox, which has caused widespread epidemics throughout history, was declared eradicated by the World Health Organisation in 1980. Polio, which struck 1,000 children per day in the mid-1980s, has been reduced by 99 per cent worldwide and is now found only in a few areas in Nigeria, Pakistan and Afghanistan.
COVER STORY 7
are essential, writes Elaine Yau
the shots Financial planner Kay Fung Yinha always prepares two letters before her six-year-old son Markus Tsui starts the academic term each year. One is addressed to the Health Department asking for exemption from immunisation. The other is addressed to the school, spelling out her reason for doing so. “My son has not had even one shot of vaccine since his birth,” she
The phenomenon of parents refusing immunisation came after some unfounded vaccine scares in the West DR CHENG MAN-YUNG
says. “When health officials visit the school to immunise children, the teacher shows the letter to them so that my son can be spared.” Fung feels there’s no need to subject her child to vaccine for diseases that are no longer found in Hong Kong. She says parents lack information about the content of vaccines to make an informed choice. “Pharmaceutical companies have axes to grind in their vehement push for vaccination,” she says. “Diseases are natural and stir up a child’s immunity system. Markus developed rashes before, but he quickly recovered from them.” Beautician Shirley Fu Pui-lam, chairman of the Hong Kong Vaccine Awareness League, says it’s irresponsible and immoral to dismiss as alarmist the diseases caused by immunisation. “Even if just one person fell ill, it still constitutes a risk which merits more research to further prove the safety of vaccines.
95% • Percentage of the population that needs to be vaccinated to create a herd effect, according to the WHO
Kay Fung, here with her son Markus Tsui, is concerned about the content of vaccines. But doctors say benefits outweigh risks. Photo: Warton Li
Tracking studies of over 10 years should be conducted to see whether those who are immunised develop any problems before mass immunisation programmes are promoted.” While the childhood immunisation programme is voluntary in Hong Kong, in parts of the US, Australia, Spain, Greece and Germany parents must provide vaccination certificates before children are allowed to start school. WHO recommends that at least 95 per cent of the population needs to be vaccinated in order to create a herd immunity effect. A government spokesman says Health Department surveys on Hong Kong children show that coverage rates of vaccines included in the childhood immunisation programme has consistently been higher than 95 per cent. Surveys are done regularly: four have been done between 2001 and 2009, covering those born between 1995 and 2006. The Children Health Concern Society – which runs the Child Vaccination Concern Group – surveyed 624 families with children under 12 years in 2008. They found that less than half the families had children who received the influenza vaccine. Society convenor Bill Lay says the government should update the childhood immunisation programme to include diseases such as influenza and meningitis. At present, the government provides free influenza vaccination only for chronic patients in paediatric outpatient clinics, and children aged between six months and six years from families on social security. A government spokesman says the Scientific Committee on Vaccine Preventable Diseases under the Health Department provides science-based advice on vaccine use at the population level. The pneumococcal conjugate vaccine was included in
the childhood immunisation programme in September 2009 following the committee’s recommendation. “The committee closely monitors and reviews the latest position of the World Health Organisation on immunisation and vaccination, scientific developments and application of new vaccines, vaccine formulations and cost-effectiveness, changes in the epidemiology of vaccine preventable diseases and the experiences of other health authorities,” says the spokesman. Compulsory immunisation is a contentious issue. Those against immunisation argue they should be given a choice; health advocates say failure to immunise will put the child and the population at risk. Following the MMR scare, and a resurgence of measles in England and Wales, there have been calls from the health community for the MMR jab to be made compulsory. In an article published in The Lancet in last year, Adam Finn, professor of paediatrics at the University of Bristol Medical School and Julian Savulescu, bioethicist and professor with the University of Oxford, equate the failure to vaccinate with child abuse. They wrote: “Some parallels can be drawn between immunisation and child protection. Child abuse and many vaccine-preventable infections are prevalent but are largely invisible or at least not widely known about … There are many challenges [for successful development and implementation of vaccines in the coming decades.] “For all the recent advances in biomedical sciences, particularly molecular microbiology, immunology and genetics, the biggest hurdle … could relate to failure of parental acceptance of safe and effective vaccination.” elaine.yau@scmp.com
8 FITNESS MARATHON MANIA WEEK 2
Into her stride ...................................................... Rachel Jacqueline healthpost@scmp.com Though I’m a marathon rookie, I know that come race day, the kilometres of training will have been more important than the 42.195 kilometres ahead. But training doesn’t have to be a slog: there’s a smarter approach, says running coach Clinton Mackevicius, who’s been tasked to get me race ready. Running my best requires variation, including training above and below my comfort zones. Most importantly, there need to be sessions that incorporate speed. “Many endurance runners believe more of the same long slow distance will make them better runners,” says Michael Tse, exercise physiologist and director of the Active Health Clinic at Hong Kong University’s Institute of Human Performance. “While there is a benefit in doing lower intensity endurance to develop an endurance base, speed work is vital.” Fast running produces stronger muscles and a cardiovascular system that’s able to push through peaks and troughs. But speed work doesn’t mean running your guts out. “Intervals should be run at a pace that is about 15 to 20 per cent faster than your intended race pace,” says Tse. Interval distance also matters and should be tailored to your training objective, whether it’s to build speed, improve speed endurance, or increase your aerobic threshold, says Mackevicius. Sufficient recovery time between intervals is essential. This allows your heart rate to drop, thereby enabling you to produce maximum speed and effort in each repetition. Each person’s pace is different, says Mackevicius, 34, who was once Australia’s 1,500 metres national champion. Knowing your own pace is the key to getting faster. “Efficient training needs you to benchmark your fitness and understand your different paces,” he says. I’m challenged to run one kilometre as fast as I can around a track. I push myself to puking pace and clock three minutes, 55 seconds. There’s no way I can keep that up for the whole marathon. But that’s not the point. Now that we have my upper limits, we work back to estimate my fast pace (about eight on a 10-point scale), medium pace (six to seven), slow pace (five) and race pace (five to six), setting the context for my marathon training. Tempo runs also boost speed. They push you close to – but not past – your lactate threshold. That’s the point where your body switches from aerobic to anaerobic exercise.
(Anaerobic means “without oxygen”, and so exercise can only be sustained for short bursts.) Performing tempo runs at the right pace is vital. Tse warns me not to run them too hard or too often. Mackevicius includes only one tempo run a week in my training, to be performed at medium pace for only 10 to 20 minutes at a stretch. While these sessions will make me stronger and faster, they are nothing without good running form. Mackevicius prescribes weekly running drills – high knees, bum kicks, knee drives and strides. “These fundamentals stimulate correct muscle activation, teaching you how to run efficiently, which, in turn, improves your timing,” he says. “Think more speed, less effort.” The final, necessary aspect of marathon training is building mileage. With a number of long distance trail races of up to 100 kilometres under my belt, I start my marathon journey with a strong endurance base to work from. For runners who’ve clocked less mileage, you should progressively increase your distance leading up to a marathon, peaking at 32 kilometres three weeks before race day, says Mackevicius. Starting slowly will also help you to avoid injury early. Central to my training plan involves splitting the programme into defined periods into blocks of three to four weeks, with each period having its own goal: Weeks 1-3: base endurance Conditions my legs for long kilometres and interval training. Performing drills will ensure efficient technique. Weeks 4-6: strength endurance Mileage and intensity increases to build up the muscles needed for the long haul.
RACHEL’S DIARY Despite being on three planes in 10 days, I stuck rigidly to my training plan last week. After a few runs, it seems my fast pace is around four minutes, 15 seconds per kilometre. Medium pace is 4.45, and easy pace is 5.15 to 5.30. While I’m enjoying the speed training, if I run fast on my own, my pace drops off. I’ve decided to get a training buddy next week to keep me on track (and keep me honest). Mackevicius predicts my race pace is 5.20, or a three-hour, 45-minute marathon. It seems ambitious at the moment!
Rachel Jacqueline (right), the writer, is coached by former Australian national runner Clinton Mackevicius. Photo: Felix Wong
The 12-week marathon training plan by running coach Clinton Mackevicius
Weeks 7-9: speed endurance Capitalises on the strength and speed that’s been developed. A minor increase in speed held over a longer duration of time, and longer runs while partially fatigued. This block is vital to ensuring I hit a good time.
Mackevicius has broken up the plan into smaller blocks. Here is the schedule for the first three weeks. The plan capitalises on the writer’s endurance running base, Mackevicius says. Runners with less experience will typically start with two-minute repetitions during speed endurance sessions and have a long slow run of only 50 minutes.
MON
TUE
WED
Weeks 10-12: taper Rounds off weeks of training and scales back on mileage in preparation for race day.
Focus
Active recovery
Speed endurance
Rest
Duration
45 to 60 minutes 30 to 40 minutes
With the building blocks for top running, and a method which Mackevicius assures will have me training like a top athlete, I’m feeling well on my way to my first marathon. Marathon Mania is a 12-week series leading up to the Hong Kong Marathon on February 24. For more preparation tips, go to facebook.com/hkmarathon
Drills consist of two sets of 60 high knees / 60 bum kicks / 20-metre knee drives / two 10-metre strides PE = perceived exertion, on a scale of 1 to 10, with 10 being the hardest
Description Drills, then fun run at PE 5
Drills, then six to eight threeminute fast runs at PE 8 with 60 to 90 seconds of recovery between each
THU
FRI
Medium-pace Tempo run run
SAT
SUN
Rest Long slow run
45 minutes
50 minutes
70 minutes
Run at PE 6
Warm up for 20 minutes at PE 5, then go straight into 10 minutes at PE 7, then 10 minutes PE 5, then 10 minutes at PE 7. Cool down for 10 minutes at PE 4
Steady-pace run at PE 5 or 6, incorporating 15-second surges at 10 per cent faster pace every 10 minutes. Surges break up the run and raise your pace after the surge SCMP
HEALTH 9 POLLUTION
Back in circulation ...................................................... Hans Schlaikier healthpost@scmp.com Consistently high air pollution index figures and frequent government-issued health warnings indicate that Hong Kong has a less than exemplary record when it comes to outdoor air quality. Air pollutant levels from January to June this year exceeded the World Health Organisation’s annual guidelines at all monitoring stations in Hong Kong with only two exceptions. Air pollution has been blamed for the deaths of 1,459 people during that period. Despite these damning figures, there is a silver lining: in general, there is a decreasing trend in the amount of overall air pollution in Hong Kong as described in the Clean Air Network’s air quality review for the first half of the year. As promising as this may sound, it is important to note that this data is focused on outdoor air quality only. Studies have shown that indoor air is often considerably more polluted than outdoor air in the largest and most modern cities. Given that, on average, we spend about 90 per cent of our time indoors, it’s clear that interior air quality has a huge impact on our health. Breathing polluted air can have a range of ill effects on the body, most notably on the pulmonary system, but also on the cardiovascular and neurological systems. Acute illnesses such as asthma and nausea and chronic diseases including cancer and neurological, reproductive, developmental and respiratory disorders are all linked to exposure to polluted air in confined spaces. Harmful indoor pollutants represent a serious health problem that caused more than 1.6 million deaths each year, according to a 2002 World Health Organisation report. It’s likely that figure is much higher one decade on. Sources of these pollutants range from the more obvious, such as cigarette smoke and dust, to less noticeable or visible pollutants such as emissions from new furnishings or appliances. Building materials, paints and lacquers, glues and adhesives and even the building materials and hills surrounding your property can all contribute to lowering indoor air quality. On a positive note, results of research done by the Clean Air Network suggest that indoor air quality in offices and other commercial buildings in Hong Kong is generally considerably cleaner than roadside air, due in large part to the elaborate and effective air
filtering systems in many buildings here, especially newer ones. As encouraging as this is for our working lives, the prognosis is less positive when it comes to residential spaces, where we spend most of our time. According to Dr Kenneth Tsang Wah-tak, a specialist in respiratory medicine, indoor air can be very different from outdoor air, especially in Hong Kong where we enjoy air conditioning for much of the year, often forgoing proper ventilation for the sake of keeping cool. “With the new ‘split-type’ air conditioners, it can be particularly risky, as it may seem like you are enjoying fresh cool air when in fact there is no new air coming in. The existing air is simply being cooled and circulated,” says Tsang. This allows for the accumulation of tobacco smoke, a host of volatile organic compounds (VOCs) or simply the build-up of dust particles and exhaled carbon dioxide. So what can you do to clean the air at home, remove these harmful pollutants and safeguard your loved ones? The simple answer is to lower the prospect of allowing pollutants to enter our homes. “Avoid smoking and any new furniture made with formaldehyde related resins and adhesives,” suggests Tsang. “VOCs can be released gradually in newly renovated apartments or from new furniture over many months.” Clean Air Network CEO Helen Choy urges people to adequately air any new furnishings or appliances before bringing them into their homes. She cites the recent delays in the opening of the University of Hong Kong’s newest student dormitory in Kennedy Town, which were due to high levels of formaldehyde in new furniture. Nature can also lend a helping hand: surrounding yourself with plants can also lower the concentration of VOCs in the air. These include bamboo palm, Chinese evergreen, English ivy, gerebra daisy, pot mum and the peace lily. Air purifiers or cleaners that can help to absorb or filter out particles and gaseous pollutants are often a good solution. “Investing in a good air cleaning system is one of the things you can do to improve air quality at home, especially when it comes to particulate matter in the air and the use of Hepa [high-efficiency particulate air] filters” says Choy. A recent study conducted in Canada and published in the American Journal of Respiratory and Critical Care Medicine confirmed that Hepa filters reduced the average concentration of fine particulates inside homes by 60 per cent.
HKU residential college students had to live off campus in September while the university addressed air quality issues. Photo: David Wong
These numbers sound convincing, but in terms of concrete medical proof, Tsang is more sceptical. “There is a wide variety of affordable and mechanically very powerful air cleaners which are effectively filters that absorb, particles and some gases … Although they sound fantastic, there is no definitive study that has unequivocally proven that by removing particles in the air you are less likely to contract infection or suffer from acute illness.” Plants and filters are partial solutions to improving indoor air quality. But Tsang says the answer is as easy and as economical as opening a window. “Opening the window is more effective simply on account of the dilution factor,” he says. “As soon as you open the window, air comes in, and there is an immediate dilution effect, whereas a filter has to work hard to clean all the air in the room.”
10 DIET HEALTHY GOURMET
Straighten up and fry right
...................................................... Andrea Oschetti healthpost@scmp.com I can run six marathons in six days in the Arabian Desert, and cycle thousands of kilometres along the ancient Silk Road. But after one evening of cooking for my guests at home, my back is incredibly sore. Good posture is a critical aspect of well-being. Back and neck pains can be reduced if we learn how to stand tall, sit properly in front of the computer, and go about our everyday movements with the proper posture. Alas, bad habits coupled with weak core muscles make us arch our back subconsciously, tilt our pelvis, roll our shoulders, and hold our head too far forward. Inevitably, we start to feel pain and get chronic muscle strain. Sadly, in the long run, the wear and tear on our joints leads to arthritis. Thanks to running, my posture while standing is good. But it is poor when I cook. To correct it, I invited Anna Serafinas, a former professional ballerina, to instruct me in my kitchen. Serafinas is co-director of Flex Studio, a Pilates, yoga and fitness centre in Wong Chuk Hang. She guides her clients towards
The more that you keep good posture, the more consciously aware of it you become ANNA SERAFINAS, FLEX STUDIO
“optimum mobility and strength”. It is something she calls “intelligent movement”, the ability to be in control of your body, whether you are doing strengthening exercises, playing with a newborn, or cooking. As she watches me kneading the ravioli dough, Serafinas points out that I am leaning over it. “Gravity is pulling your belly out, stressing your back,” she says. “Try to resist gravity by drawing your abdominal muscles in.” She also notices that my worktop is too low, as it is in many kitchens in Hong Kong: “If you keep your knees straight, you will arch your back, so bend your knees to avoid it.” It takes a lot of concentration to follow Serafinas’ tips on posture. “Andrea, keep your spine
natural,” she repeats. The upside of putting in all this effort is that good habits do become natural. “The more you keep good posture, the more consciously aware of it you become,” Serafinas says. “Eventually, you will not think about it, and you will assume a healthy posture naturally. This is called the development of subconscious competence, and it lies at the centre of Pilates’ mind-body philosophy.” Serafinas notices that my shoulders look strained when I cut the tomatoes. “When you chop and stir, be mindful of keeping the upper back straight. Do not bend over, and bring the shoulder blades down by dropping the shoulder away from you ears,” she instructs. She also notes that my back arches as I put the roast in the oven. “Bend the knees,” she says. “Squat in front of the oven, keep the back straight, and engage your core.” It’s recommended that we work out at least three times a week. If you have no time to go to the gym, incorporate your fitness routine into your daily activities, such as cooking. Serafinas shows me a conditioning routine I can easily follow when cooking my favourite pasta dish, a simple spaghetti with tomato sauce.
DIET 11 NUTRITION HARLAN GOLDSTEIN
Winning a losing battle ...................................................... Ben Sin healthpost@scmp.com
Left and above: Anna Serafinas shows Andrea Oschetti how to stay fit in the kitchen. Below: he would probably rather drink it, but Oschetti finds a couple of bottles of Barolo wine a fine substitute for dumb-bells. Photo: Nora Tam
Spaghetti al pomodoro Serves 4 300 grams spaghetti 400 grams cherry tomatoes One garlic clove A bunch of basil leaves Olive oil Parmesan cheese 1. Boiling hot push-ups Put a large pot full of water on the stove. While waiting for the water to boil, do push-ups against the worktop. Step away from the stove, place your hands on the worktop, and lean forward, getting into a plank position. Do at least 10 push-ups, or, if you are strong enough, keep going until the water reaches a rolling boil. Throw in a handful of salt, and one minute later, add the spaghetti. 2. Carved calves While slicing the tomatoes and garlic, rise up on your toes then lower your heels. Do it 20 times. This will work your calves. You can also stretch the calves: step back and push your heel down to the floor. 3. Stirring squats Put the garlic and tomatoes in a
casserole dish over a low heat, with minimal oil. While stirring the sauce, work your thighs. Place your feet in line with your hips, turn your feet out, and then bend your knees, keeping your back straight. Rise up, and repeat 15 times. 4. Saucy glutes While the sauce is simmering away, work your gluteals and hamstrings by lifting one leg at a time behind the body. Bend the knee, keep your foot flexed, and push your sole to the ceiling in little pulsing movements. Repeat this exercise at least 20 times, making sure that your core is centred and that the sauce is not burning. Strain the spaghetti and serve with the sauce. Add basil, and finish by sprinkling some grated parmesan generously on top.
When celebrity chef Harlan Goldstein visited his family in New York earlier this year, he was hit with a sobering realisation. “You’re a walking heart attack,” his sister said. Goldstein weighed 134kg at the time. Although he was a member of a gym, he hadn’t been training especially hard, and because of his status as a culinary celebrity in Hong Kong, he was always surrounded by the finest, most scrumptious, food. “The lifestyle of a chef – always tasting food – can lead to easy weight gain, obviously,” he says. The words of his sister – who practically raised him – struck a chord. So on his return to Hong Kong, he told his two trainers about his desire to lose weight. The trainers, Parfait N’donda Gnorol and Alvin Cooney, two veteran fighters at Impakt gym in Central, told him they had just the challenge. “They said they had another client, this big-shot banker, who was also looking to lose weight,” Goldstein recalls. “And they suggested that we did a Biggest Loser-style challenge to see who could lose more weight.” Goldstein met with the banker and they decided to take on the challenge – on the condition that money was put on the line. After all, what’s a bet without cash? The banker – who started the challenge at 135kg – initially suggested HK$5,000. Goldstein scoffed at the chump change, calling it a waste of time. He then suggested a significantly larger sum, one that took the banker a few minutes of consideration before accepting. “I won’t say exactly how much, but let’s just say it started with an eight and is a very lucky number,” Goldstein says. The challenge started on July 27, and went for six weeks. Despite working out – doing cardio, weight training, circuit training – five days a week and losing 13.5kg, Goldstein lost the competition. The banker lost 15kg. Happy he shed the weight
There are days when it’s very tough, when I just see a chocolate cake and I want it really bad HARLAN GOLDSTEIN, CHEF
Harlan Goldstein is betting on a healthy diet to lose weight. Photo: May Tse but not happy he lost the cash, Goldstein asked for a rematch, with yesterday as the deadline. The banker agreed. Goldstein made no mistake this time around, losing another 11.5kg to finish the challenge at 109kg. The banker actually ended up gaining 2kg to finish at 122kg. Goldstein’s 25kg total weight loss gave him a resounding victory. “This had nothing to do with the money; it’s everything to do with health and fitness – and that’s worth a million bucks for me,” says Goldstein, who is considering donating his winnings to charity. So what changed this time around? Goldstein says he still trained the same way as in the first competition, but ate a lot healthier. “I did a lot of research on healthy
5. Barolo biceps and triceps curls Hold two bottles of Barolo wine in your hands. Bring your right foot forward, lift the arms up in front to shoulder height, and do 15 curls. Put your other leg forward and repeat. Healthy gourmet is a weekly column by private chef Andrea Oschetti. cuoreprivatechef.com
Goldstein’s slow-cooked turkey with quinoa and cranberry. Photo: May Tse
foods, and foods that burn fat,” he says. “I came up with several dishes that I eat three to four times a week.” He was so satisfied with the result of his low-calorie, healthy meals – Goldstein claims the key to weight loss is 80 per cent diet and only 20 per cent workout – he will bring his “weight management menu” to his restaurant, Gold. These dishes, set to debut at Gold in December, include a “fatbuster mocktail” that features a blend of green apple, celery, cucumber, lemon juice, parsley, ginger, and a spoon each of chia seed and spirulina, a nutrient supplement known for promoting fat-burning. There’s also a soup filled with organic vegetables, and a tasty slow-cooked turkey with quinoa, a type of seed that has all sorts of health benefits. Goldstein says he worked really hard to find the right balance between “tasting yummy while being low calorie and healthy” for his dishes, which he hopes will help Hongkongers lose weight if they choose to do so. These past few months have been life-changing, Goldstein adds. He now eats healthy food all the time – he’s cut out alcohol and sweets completely over the past few months – and is confident he will get down to his target 103kg by January. “There are days when it’s very tough, when I just see a chocolate cake and I want it really bad,” he says. “But then I just think about my health and my goal and I’ll end up eating an apple instead.”
12 WELL-BEING FIT & FAB
THE TASTE TEST QUINOA ...................................................... Jeanette Wang jeanette.wang@scmp.com
Faith, hoops & charity
Alter Eco Organic Royal Rainbow Quinoa HK$89 for 397 grams, Just Green Known as the super grain of the Andes, quinoa is said to be a nearly perfect nutrition source: low in fat, high in protein and packed with slow-digesting carbobydrate. This product is a mix of black (hulled), red and pearl quinoa from the nearly 4,000-metre-high Salar De Uyuni salt flat of Bolivia. Cooked like rice. Verdict: light, fluffy, and with a slight crunch from the black quinoa.
Minsley Cooked Quinoa HK$26 for 120 grams, Just Green It doesn’t get easier than this: remove the top and serve cold, or pop it in the microwave for 90 seconds (no added water needed) for a hot side dish. This US-made product is organic and contains no cholesterol, gluten or preservatives. Verdict: delicious paired with hot curry chicken. The al dente grains soak up flavours and gravy well.
Samuel Song, founder of Solomon’s Porch Church, preaches the importance of leading an active life. Photo: Edmond So
...................................................... Rachel Jacqueline healthpost@scmp.com Samuel Song, founder of local Christian church Solomon’s Porch, is not your regular pastor. Song, 45, is youthful and fit, and an inspirational and formidable force both in the pulpit and on the basketball court. When he’s not shooting hoops, he hits the gym or leads his staff through circuit training at a park. “Sport is huge in my life,” he says. It was, in fact, basketball that first brought Song to Hong Kong in 1992 – as part of an outreach through sports programme. Despite being a Korean-American “suburban man” who spent much of his earlier life at the beach in southern California, he says he has always felt a calling to Hong Kong. “I love this city. I really enjoy the people and the place; things are always happening.” After that first trip to the city, he vowed to return, but a torn ligament in his knee temporarily diverted him from sport and along the path of accountancy. Ten years later, he made it back with his wife and established Solomon’s Porch. The congregation has grown from six members to 400. His mission is to give modern sermons that people can relate to. “I like to reframe people’s thinking about the ministry
Being inside a gym, when it’s just you and the ball, can be quite a religious experience and religious service,” he says. “Hong Kong has many different vices. We hope to answer people’s questions in a way that’s meaningful and contemporary, without taking away from the message, which we believe is central to our faith.” His church’s work extends to the rest of Asia, and to developing countries in particular. Says Song: “We are not just blessed, we must also be a blessing to others. I always say, ‘God has blessed my life with opportunities so that I can be a blessing in someone else’s life.’” It’s not only the Bible he preaches, but also the importance of being active. For years, the church has been organising an informal basketball game almost every Saturday morning. “We just come to play and have fun,” Song says. “It is a really relaxed atmosphere, and it offers a way for the new guys to get to know the church.” Song’s team dominated the South China Basketball League from
2005 to 2008, much to the dismay of hot-headed bankers in rival teams. “They didn’t like losing to a ‘bunch of Christians’,” he says. The team’s secret? “We weren’t playing for ourselves; we were playing for the Lord. It was our commonness and teamwork that pulled us through.”
I’m up quite early in the morning and walk to work every day. I still play basketball and softball when I can, and I often go to the gym at lunchtime. I’ve realised as I’ve gotten older that I’ve got to be very intentional; otherwise, it’s never going to happen. My health is more important to me nowdays.
Where do you think your love for sport comes from? I grew up very insecure and didn’t know who I was. I was an Asian kid in an all-white neighbourhood. I encountered a lot of racism. I took taekwondo, which was good, but also bad because I got into a lot of fights. I had a chip on my shoulder, and my natural mode was to fight. I was always looking for ways to prove myself. But now it’s all about getting in shape and staying healthy so I can keep up with my three daughters.
How do you encourage people to have a healthy balance in their lives? A requirement of the discipleship classes I am teaching is that students must exercise. In Christianity, we are talking about wholeness. Our lives are not just mental and emotional experiences. Fitness and eating right are part of what makes us a whole person. If you’re sick, it affects you mentally. In a recent retreat, we offered a morning exercise class. I’m always trying to encourage people to be healthy whenever I can.
How does your faith help you when you’re on the court? There are no ups and downs. My trust in God and what he is doing in my life is constant, so it doesn’t matter whether I win or lose. From that courage, everything grows. It helps me to be humble; I have nothing to prove, anyway. How do you fit it all in? I have a pretty regimented schedule.
Why basketball? When I’ve had some of the most difficult times of my life, other than prayer, I’ve found that being inside a gym when it’s just you and the ball, shooting on your own, can be quite a religious experience. It helps me to think and to process. And then when you get a bunch of guys together, it just adds a whole other element. My outlet is sports, it always has been, and it always will be.
Seeds of Change Quinoa & Brown Rice HK$49 for 240 grams, Just Green This is a “cup of noodles” version of quinoa: add some water and microwave the contents on high for 90 seconds (or heat up the grains in a skillet). Whole grain Boliviangrown quinoa is used, though the bulk of this product is brown rice. Verdict: convenient and tasty. Hints of garlic and salt make it delicious even when eaten on its own.