Monday, June 3, 2013 C7
THIRST
Illustration: Corbis
HEALTH
THINGS FIRST It’s important to drink about two litres of water every day, but what’s the best source – filtered from the tap or bottled? Nadine Bateman asks the experts
H
umans can survive for quite a long time without food but it doesn’t take long to suffer from dehydration. We lose water through sweat, urine, faeces and even just breathing. In severe heat a human can lose up to 1.5 litres of water an hour. Our bodies are mostly comprised of water – it’s in every cell, tissue and organ, it keeps our body temperature normal, lubricates and cushions our joints, protects our spinal cord and other sensitive tissues, and eliminates waste through urination, perspiration and bowel movements. Dr Sue Jamieson, a GP in Central, says: “Depending on your age, 60 per cent to 80 per cent of your body is water. Your brain is about 10 per cent more water than your body,” she says. “On a basic level, water is the ‘soup’ in which everything survives, and it also conducts really well. We’ve got to transmit [our body’s] signals through bioelectric means, and water’s a good medium for that. So I believe it is important to drink good quality water.” The definition of good quality drinking water is highly debatable, and there are myriad options. Filtered or bottled? There are so many varieties of both. On a recent trip to the supermarket, I counted nine brands of bottled water. Then there were the various types: spring, mineral, mineralised, distilled, for example. When it comes to filters, you can buy equipment that ranges from a simple tap fitting to elaborate and expensive units that take up a lot of kitchen space. In the US, where the Food and Drug Administration regulates bottled water as a food, spring water is defined as that which is derived from an underground formation from which water flows naturally to the surface of the earth. Mineralised water must contain not less than 250 parts per million total dissolved solids that originate from a geologically and physically protected underground water source, while purified water is produced by distillation, deionisation, reverse osmosis or other “suitable” processes and may also be known as demineralised, de-ionised or distilled water.
balanced diet from the and drink tap bone tissue water. Don’t to buffer buy bottled against the water, save acidity in the The approximate amount of your money tissues. the human body that is instead.” This could composed of water But Hong lead to Kong tap water osteopenia or also has added osteoporosis. fluoride, which is cause “Magnesium for concern among some deficiency is rampant today, medical professionals such as so we need to make sure we Central-based family doctor optimise our calcium and Lauren Bramley. She believes magnesium ‘storage’,” he fluoride is not good for us adds. The problem with relying on because it affects thyroid function. bottled water to provide a Studies from China, India, balance of minerals is a lack of and Russia that have found consistency between brands, alterations in thyroid hormones says US-trained dietitian Tracey in people exposed to elevated Pui, who works for the Tetra levels of fluoride in water. Nutritional Consultation Centre Bramley advises using “a very in Central. good quality” filtration system, Some brands have a high and wouldn’t advocate drinking calcium content, others have bottled water either, but for nothing; some have sodium different reasons: she is while others do not, and concerned about the plastic manufacturers in many leaching chemicals and other countries, including those in compounds into the water. Hong Kong, are not legally Bramley cites many studies required to label the amount, such as recent research from the she says. “We have to label sodium but Johann Wolfgang Goethe University in Frankfurt, not calcium, potassium or Germany, which uncovered magnesium,” she notes. The what they describe as implications of this are very “widespread contamination” of important when you take into mineral waters with endocrine account people who may have disrupting chemicals that renal disease and who need to appear to have leached from be careful about their intake of packaging material. those minerals, she says. “At my home, and in my Pui advocates drinking clinic, I use a reverse osmosis municipal (tap) water. “I believe [filtration] system by Life Hong Kong tap water is safe to Solutions which I believe is the drink. If there are any pathogens best one available in Hong in it, then they come from the Kong,” says Bramley. plumbing system, or the water Jamieson also has concerns tank in the building, so it’s about chemical compounds, important for those to be kept saying: “They are definitely clean and maintained.” something to consider, and may Filters are an option, “But be another reason not to take some only filter chlorine rather 100 per cent of your water from than bacteria, and the carbon plastic bottles. I drink a filters don’t work if they are not combination [of bottled and renewed on time. The reverse filtered water].” osmosis system can filter Trying to work out what pathogens as well as other toxic water is healthiest is a minefield, contaminants such as mercury Jamieson concedes. “It’s like all and cyanide,” Pui says. “The kind of filter you choose these faddy diets ... why not just have a mixture of things, and is important, as is how regularly everything in moderation?” you change it. Otherwise the The most important thing is filter becomes a good home for to encourage people to drink bacteria.” more water, she says. “Drinking Pui also raises a concern enough is so important: you about the cost of bottled water. need around 1½ to two litres a “When [people] buy bottled day, and it’s better to drink water they’re paying for the bottle rather than the water. “For constantly throughout the day, not in half-litre gulps when you every Hong Kong dollar you pay suddenly remember. I think for bottled water, around 99 many of us have been guilty of cents is for the bottle [and the that.” manufacturing process] rather life@scmp.com than the water. I’d say, eat a
60%
Hong Kong tap water is safe. Any pathogens come from the plumbing system TRACEY PUI, TETRA
While these processes mean that harmful bacteria and impurities have been eliminated, it also means that the minerals have been eliminated, too. That’s not healthy, according to experts. Hong Kong-based nutritionist Miles Price says we need mineral-rich drinking water because minerals are the most bio-available when they’re in water – our bodies absorb them more easily. “We need minerals because, even in daily routines such as working on computers, we lose a bit of sodium, magnesium and potassium. That always needs to be replenished through mineralrich water or food,” Price says. “But some food, such as nuts
if they’re not prepared well, can block the absorption of minerals. “The best source of water comes from a mountain stream which has been fed from a cloud in the Swiss Alps and has absorbed the minerals from the rocks.” He says that companies, such as Evian, bottle those waters and deliver them around the world so that “we can have very good quality mineral water which is pure, and not contaminated by heavy metals or environmental materials that are added during the bottling process”. Brands such as Bonaqua and Watson’s which come from local water and not from a spring, have minerals added. “It’s okay, you’re still getting the minerals, but the water’s Ph [a measurement of how acidic or alkaline a solution is] is more acidic, and that affects the metabolism,” says Price. “So the body’s ability to make energy from a cellular point of view becomes less efficient, and you become more fatigued. That means the body will start drawing various minerals, such as calcium and magnesium,
HITS AND MYTHS
Thanks to chillies, dieting is hotting up ................................................ Sasha Gonzales life@scmp.com The claim: eating chillies can help you lose weight. The straight answer: yes The facts: if you’re trying to slim down, you might want to start adding a little spice to your meals. In addition to their high vitamin C and beta-carotene content, red chillies also contain a group of chemicals called capsaicinoids, and their sister compounds capsinoids, which are believed
to play a beneficial role in weight management. These chemicals are found in the white membrane in the chilli and are what give the pungent pod its “heat”. They bind to a receptor called TRPV1, a pain nerve cell located underneath the top layer of the tongue, causing that familiar burning sensation. The TRPV1 receptor also detects and regulates body temperature, according to registered dietitian Charmain Tan from Seventeen Nutrition Consultants. According to a 2012 study
They push the body to burn stored fat as fuel and aid weight loss by raising body temperature
carried out by researchers Stephen Whiting, Emma Derbyshire and B. K. Tiwari, capsaicinoids fight flab in three ways: by boosting the body’s fat-burning abilities, speeding up the metabolism and reducing energy intake by suppressing hunger pangs. Regular consumption of chillies was specifically observed to reduce abdominal fat, which is known to increase one’s risk of heart disease. A University of California at Los Angeles study conducted in 2010 also found that, when included as part of a low-calorie diet, chillies push the body to burn stored fat as fuel and aid weight loss by raising body temperature, a process called thermo-genesis. And in yet another 2010 study performed by researchers in Korea, capsaicinoids were shown to have a significant inhibitory effect against the build-up of body fat. How these compounds work is not understood, but it is thought that they act on the TRPV1 receptor to decrease hunger, increase satiety, reduce insulin, and increase energy expenditure. Is your stomach sensitive to large amounts of chilli? You don’t have to overdose on the stuff to enjoy its effects. Brian
Leung, a naturopathic doctor from the Integrated Medicine Institute says that consuming one-fiftieth of an average-sized red chilli per day can burn 60 to 120 calories. For something less spicy, go for green chillies, which also boast some fat-fighting properties. Capsaicinoid supplements may produce negative side effects such as stomach discomfort, heartburn and ulcers, so do not take these without consulting your doctor. Despite their impressive fat-burning and appetitereducing powers, chillies are not the magic bullet for weight loss, says Daphne Wu, a British state-registered dietitian and Hong Kong PhD researcher. Weight loss occurs when you expend more calories than you take in. The Whiting study found that regular consumption of chillies burned about 50 calories a day, resulting in a significant weight loss after one to two years. But Wu says that you can shed the same number of calories by drinking one-third less of a can of cola or walking one kilometre a day. But there is no denying that, as part of a healthy and balanced diet, this small, fiery fruit can play an active and important role in weight management.
Lessons for couples facing fight together ................................................ The New York Times Three days after her double mastectomy for recurrent breast cancer, Elissa Bantug, then 25, needed to feel whole again. But when she expressed a desire for intimacy, her fiancé (now husband) walked away, leaving her feeling hurt, angry and worried about their future. Weeks later she learned that his rejection was based not on any lost attraction, but on the fear that he might hurt her physically. “It would have been really helpful to hear his thoughts, fears and concerns,” Bantug says. But she admits she did no better at expressing her own. “It was really hard, but we got through it because we love each other,” she says. “He finally told me: ‘I want you alive. I don’t care what your breasts look like.’” Bantug, now 31, went on to run a cancer survivors’ clinic at the Johns Hopkins Breast Centre, helping other couples through the cancer experience. She discussed her ordeal with Dan Shapiro, a psychology professor at Pennsylvania State University, and author of a new book, And in Health: A Guide for Couples Facing Cancer Together. Shapiro and his wife, Terry, have also survived serious bouts of cancer. He struggled with Hodgkin lymphoma for years and admitted that when his wife was found to have breast cancer, he became “terrified that she might die”. But instead of telling
It was really hard, but we got through it because we love each other ELISSA BANTUG, CANCER SURVIVOR
his wife, he tried to protect her from his fears. He has since learned that withholding his feelings was a big mistake. Here are lessons derived from his and 40 other cancer couples’ experiences: Teamwork is essential. When couples see doctors as a team, with one assigned to take notes and both open to asking questions, misunderstandings about diagnoses and treatment options are less likely. When both members of a couple are educated about side effects, they are less likely to panic when a symptom develops. Talk and touch. Whenever and however you can, express and show your love and concern in words, actions and touch. “A soft, non-sexual touch on the arm or shoulder can be a soothing balm when we feel vulnerable,” Shapiro wrote. Allow for mistakes. Shapiro warns against acting on “negative feelings” that inevitably arise, for example, when couples are waiting for the results of treatment. Rather than take out their anxiety on spouses, themselves or anyone else, he suggests, “Do exercise, go for walks, see a movie, talk to friends and distract yourself.” Nobody can read minds. Like Bantug, patients often expect their partners to know how they are feeling and what they may want, then resent it when unexpressed needs are not met. It’s better to ask than to assume. “Talk about what needs to be done today and who’s going to do it,” Shapiro says. Prepare for the unknown. When Penny Carruth’s husband’s body “shut down” while he was being treated for lymphoma, she didn’t know if he would want to be artificially ventilated. In Shapiro’s book, she urges couples to have a conversation about end-of-life care, making clear their wishes in case a spouse later faces decisions about life support.