ONEHealth Issue 2 by JurongHealth Campus

us?

YOU R Q UA RT ER LY H EA LT H &WEL L N ES S J OU R N A L

2013ISSUE

Have you

www.facebook.com/JurongHealthServices

health & happiness HealthBUZZ

Your ‘Gateway to Health’ event & new hospital innovations

HealthSense Respiratory Medicine explained & health questions answered

WeCARE

Advance Care Planning to prepare for a medical crisis

FOOD forLIFE!

‘Skinny’ cheesecake recipes

HealthMatters HealthBites Out with gout! Risk factors and prevention

Find a little inner bliss every day

“ Haanpdp i nt he se s pius r ptohsee mo fe a lni ifne g, t hoef whhuoml ea na i me x i as nt de n ceen.d” - Aristotle

Be the first face to welcome and to guide our visitors and patients around our new hospital when we open our doors in December 2014! We invite caring and outgoing individuals to volunteer with us as greeters and guiders.

This certainly has been a busy year for us! JurongHealth celebrated several milestones, including the completion of the Jurong Gateway Road that will run between Ng Teng Fong General Hospital and Jurong Community Hospital. Catch up on the excitement of the community event, ‘Build with us! Your Gateway to Health’, and learn more about the patient-centric features of the new hospitals in HealthBUZZ. The folks at JurongHealth are already counting down to the official opening and the excitement is mounting! As we approach the end of the year, it is inevitable that work responsibilities and the coming festivities will add to your ‘to-do’ list. But amid the bustle, don’t overlook your physical and mental health.

ROLES OF GREETERS & GUIDERS • Help with way-finding, guide visitors/patients to their destinations • Assist patients on/off vehicles and wheelchairs • Help with hospital tour requests

REQUIREMENTS • Minimum Age: 16 • Minimum Time: 4 hours, once per week or per 2 weeks for a minimum of 3 months • Time: Mon to Fri – 9am to 1pm or 12noon to 4pm • Best Suited for: Retirees, home-makers, shift workers and students

OTHER VOLUNTEER PROGRAMMES • Moving Art & Music • Ward Befrienders (coming soon)

NEED MORE INFORMATION? Contact our friendly volunteer coordinator at 6370 6827 / 6830 or email volunteers@juronghealth.com.sg

In this issue of ONEHealth, we want you to and find ways to keep your mind, body and spirit in the full bloom of health by focusing on the brighter side of life. The Gethappy! special (pages 16 to 33) explores the positive connection between health and happiness. It also sets out some of the activities and lifestyle changes that you can adopt for a happier, healthier and more positive you. Meanwhile, in our regular features, we talk to Respiratory Medicine specialists in HealthSense about the conditions they treat and how more patient empowerment, and an integrated healthcare approach can improve care for people with respiratory illnesses. Our health experts also field some of your health and medical questions. Do keep those letters coming in! To read more about Advance Care Planning, turn to WeCARE, where JurongHealth’s Medical Social Workers explain the benefits of thinking about – and setting down on paper – your care and treatment preferences in the event of a medical emergency. In HealthMatters, we explain the conditions of gout and safe eating tips for those at risk. FOODforLIFE! brings you ways to increase your fibre intake and two healthier-version ‘cheater’s cheesecake’ recipes. Lastly, do try out the tips in HealthBites for a little bliss every day. From all of us here at ONEHealth, happy holidays and cheers to your good health!

T h e ed i to r i a l tea m

O N E H E A LTH

C NTENTS

2013 • ISSUE 2

PUBLISHER JURONG HEALTH SERVICES PTE LTD EDITOR-IN-CHIEF CASEY CHANG DEPUTY EDITOR AARON LOH CONTRIBUTING EXPERTS DR CHOO CHUAN GEE DR CHUA AI PING DR JANE CLAYTON DR JIMMY CHIN DR LESLEY-ANN GOH DR NOEL TAY DR RAPHAEL CHAN DR ROBIN YONG DR SUMMER NATSUKO ISHIKAWA ELISA MAK GRACE LAI KRUTIKA MENON LYDIA HOALIM MARTHA NG OLIVIA TASKER TAN XING YU TOO SAN MUAN PUBLISHING CONSULTANT THINKFARM PTE LTD MANAGING DIRECTOR CHRISTOPHER TAY EDITORIAL & DESIGN SHERALYN TAY SHARON HO CHRISTALLE NEO DENISE LIM WRITING & PHOTOGRAPHY CARYN YEO CHUA HWEE LENG LINA LEWIS NARENDRA AGGARWAL SATISH CHENEY JUSTIN LOH LEO GOH RAY CHUA CLIENT RELATIONSHIP MANAGER JESSIE KEK –––––––––––––––––––––––––––––––––––– The information in this publication is not meant to take the place of healthcare or services you may need. Please see your doctor or primary healthcare provider about any personal health concerns. All information is correct at time of print. ONEHEALTH IS PUBLISHED QUARTERLY BY JURONG HEALTH SERVICES PTE LTD. COPYRIGHT IS HELD BY THE PUBLISHER. REPRODUCTION IN PART OR WHOLE WITHOUT PERMISSION IS PROHIBITED. ALL RIGHTS RESERVED. MICA (P) 112/06/2013 PRINTED BY KHL PRINTING CO PTE LTD. –––––––––––––––––––––––––––––––––––– For general enquiries, email

onehealth@juronghealth.com.sg

02 O N E H E A LT H

HealthBUZZ 04 JURONG ‘GATEWAY TO HEALTH’ EVENT

Health questions answered

The community comes together for free health screenings and a preview of JurongHealth’s upcoming innovations

A SMOOTHER PATIENT JOURNEY

WeCARE 14 MAKING PLANS

A ‘one queue, one bill, one patient experience’ approach saves time for patients

HealthSense 10 ASK THE EXPERTS BREATHE EASY

Respiratory Specialists explain the different facets of their field

SMILE & BE HEALTHY

REST IS BEST

IN ADVANCE

Medical Social Workers share the advantages of Advance Care Planning

Make bedtime restful to boost your mood and overall health

THE GREAT OUTDOORS

FOODforLIFE! 37 FIBRE UP YOUR LIFE

HealthBites 41 YOUR 3-MIN GUIDE

Gout risk factors and diet tips to keep attacks at bay

Smart ways to fill up with more fibre

HALF THE FAT: THE CHEATER’S CHEESECAKE Try these healthier cheesecake recipes

TO HAPPINESS

A small step goes a long way

Get out and get more active; spend quality time together

HAPPY FEET

AROUND THE WORLD IN HEALTHY WAYS

A&E IN ACTION!

Ng Teng Fong General Hospital’s Emergency Department improves trauma-care response

Why happiness is essential for mental and physical vitality

HealthMatters 34 CRYSTALS OF PAIN

A little TLC and better shoes can ease those foot-aches

Holidays are great for the soul – tips to help you stay well on your journeys

JurongHealth is a public healthcare cluster formed to integrate healthcare services and community care for the west.

Managing Alexandra Hospital since August 2010, JurongHealth is growing in capacity and skills in preparation for the big move to the Ng Teng Fong General Hospital in December 2014 and Jurong Community Hospital in June 2015.

O N E H E A LTH

HealthBUZZ

JurongHealth CEO, Mr Foo Hee Jug (far left) explaining the new features of the upcoming hospitals to Health Minister Gan Kim Yong and other VIPs

Innovations on display During the event, JurongHealth introduced some of the unique service innovations and patient care processes aimed at bringing about seamless and integrated care for greater convenience to patients and their families. The launch displayed life-sized mock-ups of a future ward with “a window for every patient”. Other mockups included the new ergonomically designed clinic consultation room and the trauma-ready Emergency Department (read more on page 8). There was also an on-site recruitment drive as JurongHealth prepares for the opening next year.

Injecting even more excitement to the event was a dramatic “live” trauma-case simulation showcasing the specially-designed modular resuscitation room units which can swiftly transform into a much larger trauma-ready emergency room. JurongHealth CEO, Mr Foo Hee Jug, introduced the hospital’s hassle-free “one queue, one bill, one patient experience” that will reduce waiting time (read more on page 6).

JURONG ‘GATEWAY TO HEALTH’ EVENT

With the building of the 700-bed Ng Teng Fong General Hospital (NTFGH) and 400-bed Jurong Community Hospital (JCH) well on track to open in December 2014 and June 2015 respectively, JurongHealth marked the milestone by welcoming the community to a preview of the planning and development of the hospitals in July.

JurongHealth welcomed the community to preview the upcoming Ng Teng Fong General Hospital and Jurong Community Hospital at its ‘Build with us! Your Gateway to Health’ event

The event also showcased a recent community engagement activity, ‘Paint a Picture of Health’. Guestof-honour, Health Minister Gan Kim Yong added the final touches to the colourful community-created murals that decorated the hoarding around the construction site. Joining him were Mdm Halimah Yacob, Speaker of Parliament and MP for Jurong GRC; Ms Grace Fu, Second Minister for Environment and Water Resources; Dr Amy Khor, Minister of State for Health and Manpower; and Dr Lam Ping Min, Chairman, Government Parliamentary Committee for Health.

04 O N E H E A LT H

The community gathered at Jurong Gateway Road, the six-lane road that runs through NTFGH and JCH, for free health screenings – part of JurongHealth’s ongoing outreach efforts to help the community stay healthy. 4

Expressing his enthusiasm for the upcoming hospitals, Mr Foo said: “Planning, designing and building two new hospitals at the same time has allowed us to build an integrated patient experience from the acute and community hospital setting while fully maximising opportunities to share substantial support services. At the same time, we are extensively leveraging technology to achieve a vision of better integrated care.”

1. A St Luke’s ElderCare resident putting the finishing touch on the community-created mural that decorates the hoarding around the building site 2. The A&E team presenting an exciting ‘live’ simulation to an avid audience 3. Health Minister Gan Kim Yong installing a finished mural with the help of a student 4. The new wards will have a window for every patient

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HealthBUZZ

A smoother patient journey A TYPICAL OUTPATIENT CLINIC VISIT

Ng Teng Fong General Hospital will adopt a whole new approach to outpatient clinic appointments, making a visit to the doctor more convenient for patients and caregivers

REGISTRATION AT PROCEDURE ROOM QUEUE NO.

REGISTRATION AT SPECIALIST OUTPATIENT CLINIC

One queue, one bill, one patient experience

The long wait A patient appointment at the specialist outpatient clinic can be a time-consuming affair. It involves waiting and queuing to register, see a doctor and pay for treatment, and then queuing, registering and paying again at each different service point. The waiting time becomes longer when patients require additional services, such as blood tests and x-rays, at the different touch points.

QUEUE NO.

Save time, save money QUEUE NO.

DOCTOR CONSULTATION

BLOOD TEST

REGISTRATION AT X-RAY ROOM

X-RAY

POSTPROCEDURE REVIEW

QUEUE NO.

50 PAYMENT MEDICINE COLLECTION

REGISTRATION AT PHARMACY

QUEUE NO.

A STREAMLINED OUTPATIENT JOURNEY AT NTFGH

06 O N E H E A LT H

A streamlined system at Ng Teng Fong General Hospital’s (NTFGH) specialist outpatient clinics will cut the waiting time. Patients register only once – at the start of the visit – and get a single queue number. At each clinic or service point, they only need to scan their queue slip. Payment for all these services will be consolidated at the end of the visit.

REGISTRATION

DOCTOR CONSULTATION

BLOOD TEST

X-RAY

MEDICINE COLLECTION

CONSOLIDATED PAYMENT

An integrated system also improves the accessibility of patient records and care plans, so it becomes possible to schedule multiple appointments on the same day. For patients who need to see different specialists and undergo different tests and procedures, the system reduces the number of hospital visits, saving time and travel costs.

A familiar & friendly face Patients going for their checkup or regular follow-up appointments at the new NTFGH will get a helping hand from JurongHealth’s new team of Patient Service Coordinators. The team will be a key point of contact for patients, answering general healthcare queries and offering personalised attention to patients and caregivers. They will help to coordinate appointments, remind patients about diagnostic tests and point them to relevant support services.

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HealthBUZZ

Flexible, scalable & integrated emergency care

Ready for Emergencies

Dedicated trauma lifts

Modular trauma-ready room The room combines two typical resucitation units to provide more space for life-saving care Operating Theatre (OT)

Emergency Department (ED)

Dedicated ambulance drop-off zones

Dedicated ambulance drop-off from Boon Lay Way allows swift access to the core of the emergency department for resuscitation of critically-ill patients. There is also a separate drop-off driveway for walk-in patient

A&E in action! Building an A&E that readily responds to all sorts of emergency cases takes a lot of planning. At Ng Teng Fong General Hospital’s Emergency Department, emergencies will be handled with a 360° perspective

08 O N E H E A LT H

A bigger space for better trauma care

Chemical spills or mass casualties can be treated at a dedicated decontamination site

Intensive Care Unit (ICU)

From the emergency department, critical cases can be transferred directly to the OT & ICU for swift care

Modular Trauma-ready Room

A major chemical leak has occurred in a factory. The 12 affected workers are rushed to the hospital and decontaminated in the dedicated decontamination zone. They are then quickly transferred to the core of the ED for care. The readiness to cater to industrial accidents is critical because of Ng Teng Fong General Hospital’s proximity to industrial areas and Jurong Island.

ElderlyFriendly Features

More comfortable emergency treatment for the elderly

A retiree is rushed to the hospital after a fall. A patient with mild dementia, he is not in extreme pain but is confused by the incident. The subtle lighting, wide walkways and private rooms help reduce his agitation. Geriatric-friendly features like large clocks and clear signages also reduce disorientation. A bedside commode, urinal and the special pressure-reducing mattresses ensure his comfort while seeking treatment.

Emergency Department (ED) is designed to have the flexibility to scale services for future increase in demand. All critical resources are centralised at the ED core so that manpower and services can be readily re-deployed to other areas when required. Services are also pandemic-prepared, mass-casualty and decontaminationready. Patients at the ED who need immediate medical intervention can also rapidly access trauma lifts to the Operating Theatre (OT), Intensive Care Unit (ICU), modular resuscitation areas, isolation wards and diagnostic imaging.

The ED gets a radio call from an incoming ambulance. A young woman has been seriously injured in a car accident. The team quickly prepares the modular traumaready room by combining two resuscitation rooms, doubling the space to 7m by 9m. This gives the trauma team more space to work effectively. The room is equipped with a range of trauma-ready equipment and these are used to diagnose the extent of her injuries.

Swift Access to Critical Care

Close to operating theatre, intensive care unit and diagnostic services The trauma team has stabilised the patient and readies her for an operation to stem the bleeding in her head. Designed to be close to a range of critical care services, the patient is transferred via one of two dedicated trauma lifts to the operating theatre. The essential services required by the ED – from OT and intensive care unit to isolation wards – are all located close to the ED for seamless and swift transfer of patients. O N E H E A LTH

HealthSense

of antibiotics and a friend told me to avoid pomelo, grapefruit and pineapple. Why? What are some other antibiotics and food interactions that I should be aware of?

I am turning 40 and going for my first mammogram soon. I am concerned about the radiation that will be used. Is it safe? Also, what do I need to do to prepare myself for the examination?

Good on you for being so proactive! It is recommended that women aged 40 to 49 go for mammography screening once a year and for women above 50 to go for screening once every two years. A mammogram is a very low-dose X-ray that can help detect breast cancer, especially in its early stages when the chance of recovery is very high. Hence, the benefits of screening far outweigh the risk of radiation exposure. Moreover, the compression applied to the breasts during the examination also lowers the amount of radiation you are exposed to. On the day of the procedure, do not use talcum powder, body lotion or deodorant on your chest and underarms as these interfere with the X-ray readings. It is best to wear a two-piece outfit as you will need to undress from the waist up for the examination. The examination will take 15 to 30 minutes on average.

Dr Lesley-Ann Goh, H E AD AN D S ENI OR CONSULTANT, RADIOLO GY

A Schedule your screening AGE

SELF BREAST EXAMINATION

MAMMOGRAM

20-39

Monthly

40-49

Monthly

Yearly

50 & above

Monthly

Every two years

Q&A

O N E H E A LT H

I started a course

Ask the expert!

Have a burning health question? Send your question, name and contact number to onehealth@juronghealth.com.sg

Food-drug interaction can take place if the food you eat affects the level of drug you are taking. Citrus fruits such as grapefruit, pomelo and lime contain furonocoumarin, which can block the activity of an important enzyme found in our small intestines. Blocking this enzyme can raise the level of drugs absorbed into the blood, resulting in an increased risk of overdose and adverse drug effects. Grapefruit juice can also block the transportation of antibiotics into cells. If you take clarithromycin, erythromycin or ciprofloxacin, avoid grapefruit, pomelo and lime. Do not drink milk when taking tetracycline or fluoroquinolone and abstain from alcohol if you are taking metronidazole as it can cause severe reactions such as intense flushing, irregular heart rate and vomiting. Always consult a pharmacist if you are unsure.

During a bad bout of flu a month ago, I felt a sharp pain in my right ear when I blew my nose very hard. After that, air felt like it was ‘escaping’ and my hearing became muffled. My GP said my eardrum was perforated but would heal on its own. But I still cannot hear well. What should I do?

Perforated eardrums are common. When a person blows his/her nose too hard, it causes a build-up of pressure that is transmitted through the eustachian tubes – which equalise ear pressures when we are at high altitudes – to the middle ear, causing the eardrum to balloon outwards. In a strong blowout, the eardrum will rupture like an over-inflated tire and cause temporary hearing loss. Your GP is right, your eardrum will heal on its own. While it does, it is important to keep the ears dry and not put any drops or let water into the ear. It is also a good idea to go to a specialist clinic to check that the perforation is healing without any problems.

Dr Raphael Chan, S E N I O R CO N S U LTA N T, E N T

Tan Xing Yu, P H A R MACI S T

The information in this publication is not meant to take the place of healthcare or services you may need. Please see your doctor or primary healthcare provider about any personal health concerns.

O N E H E A LTH

HealthSense

JurongHealth’s Respiratory Medicine specialists explain some sub-specialty disciplines under their umbrella – and how a more integrated, team-based and holistic approach has improved the way they offer treatment

Breathe Easy

O N E H E A LT H

Sleep is essential. It is not an option. The impact sleep has on one’s mental and physical health is tremendous. Although sleep medicine is a comparatively young medical specialty worldwide, it is a fast evolving one. Obstructive sleep apnea and chronic sleep deprivation are some examples of the highly prevalent conditions in this field, the importance and long-term health implications are only just gaining wide recognition internationally. As sleep specialists, one of our key roles is to raise public awareness and promote sleep health. And like any chronic care discipline, our strength lies in working closely with many other healthcare professionals to provide our patients with effective and holistic treatment using a multi-disciplinary team approach.

I am particularly interested in pulmonary rehabilitation for patients with chronic lung diseases such as chronic obstructive pulmonary disease because it is a holistic and integrated approach that goes beyond just medicine. Pulmonary rehabilitation for chronic lung diseases comprises medical treatment, patient education, supervised prescribed exercise, physical and occupational therapy as well as nutritional advice. Psychological support and psychiatric intervention are also important as depression and anxiety are common among these patients. The proper integration of all these elements – to make an otherwise complicated system more convenient – is crucial to motivate patients. All these will help in achieving our primary goal of improving the quality of life for patients with chronic lung diseases.

The prevalence and incidence of asthma is increasing worldwide, Singapore included. The development of asthma is associated with genetics, a more urbanised society, environmental factors and even food additives. It is important to manage asthma well in order to ensure patients’ quality of life and to prevent disease complications. Besides medication, the Respiratory Medicine service at JurongHealth places an important emphasis on patient education as an integral part of comprehensive asthma treatment. Patients who are better educated about their condition and asthma treatment plans, will comply better and improve long-term outcomes. Working together with doctors and specialised asthma nurses, our patients will be empowered to self-manage and feel in control over their asthma condition.

“As sleep specialists, our strength lies in working closely with many other healthcare professionals… for effective and holistic treatment. ”

“ Pulmonary rehabilitation of patients with chronic lung diseases… is a holistic and integrated approach that goes beyond just medicine. ”

Dr Chua Ai Ping

Dr Noel Tay

“ The respiratory medicine service at JurongHealth places an important emphasis on patient education as an integral part of our comprehensive asthma treatment. ”

S E NIOR CONS ULTA NT

S E N I O R CO N S U LTA N T

Dr Choo Chuan Gee CO N S U LTA N T

O N E H E A LTH

WeCARE

ACP allows you to make the best medical decision for yourself in an emergency.

Making plans in advance Thinking about – let alone planning for – a medical crisis is not something most people are likely to embrace readily, but Advance Care Planning ensures that you get the care you want should the worst happen By Narendra Aggarwal We make plans for almost everything in life, from scheduling errands to mapping out career progression. But one thing we tend to overlook is our medical plans for dire medical scenarios. At JurongHealth, a team of healthcare workers is trained to help patients and family members in such situations. “Advance Care Planning (ACP) is invaluable when patients cannot voice their decisions on medical treatment and the family has to step in”, explained Medical Social Worker, Ms Martha Ng, 34. She meets a lot of critically-ill patients in her work at the intensive care unit. “It is often difficult for the family members to decide on the course of action as they do not know the patient’s preference,” said Ms Ng, who always advises patients and their families to plan for medical emergencies. “ACP is not just for terminally-ill patients,” said fellow Medical Social Worker, Ms Krutika Menon, 23. She believes in planning for future medical care even when in good health, encouraging everyone to consider ACP regardless of age and health condition. Ms Menon has helped a single, middleaged patient record her wishes and look into financial planning for her old age as ACP extends beyond medical planning to cover asset distribution following a patient’s demise. The whole idea is to “achieve the best decision for yourself and get a greater peace of mind”, Ms Menon said.

O N E H E A LT H

A strong believer in patient empowerment is Senior Occupational Therapist, Mr Too San Muan, 35, who has been actively promoting ACP to his patients. “When I visit patients and their families at their homes for therapy, I will use the opportunity to educate them on the need for ACP and its benefits,” he said. “It allows them to match their own goals and values with the care that they will want to receive.”

The ACP Process

Discuss your ACP with your primary healthcare provider, who will then refer you to a trained ACP facilitator. Your preferences will be recorded and included in your medical records. You will be given a copy of the completed ACP, which is free for everyone.

What is ACP?

ACP is a non-legally binding voluntary process where you tell your healthcare provider what you want done should a medical crisis render you incapable of making your own healthcare decisions. When discussing your own ACP, think through your preferences for medical care. For example, if a catastrophic medical crisis occurs, would you prefer medical treatment to: a) Ensure comfort but not prolong your life; or b) Continue all necessary life-sustaining treatment till a predefined unacceptable situation?

(L to R) Ms Krutika Menon, Mr Too San Muan and Ms Martha Ng work with patients, families and interested parties on Advance Care Planning

O N E H E A LTH

inspiration surprises

‘me’ time good health

loving someone

mum’s cooking

embracing life

financial security

Laughter

family

freedom

a good massage

a kind gesture silly dancing friendship

O N E H E A LT H

Emotional wellness Rest Social health Discovery Personal Fulfilment Empowerment Taking charge of my health The benefits of laughing, smiling and feeling at ease with the world is more than an important part of emotional health; a positive outlook can also benefit your heart, protect you from illness and help you live longer! So take the steps to achieve a better mood and better health, whether it’s a good night’s sleep, quality time with family, an exhilarating workout or a relaxing getaway…

O N E H E A LTH

Smile, laugh and appreciate the little things in life. A positive mind does more than combat daily challenges – it strengthens your ability to overcome stress and boosts your health By Satish Cheney IN CONSULTATION WITH LYDIA HOALIM, HEAD OF PSYCHOLOGY

smile & be healthy What makes you happy? For a child, it could be the sweet chimes of the ice-cream cart or the start of the school holidays. For an adult, it could be a long-awaited pay rise or the bittersweet joy of seeing a child graduate. It could be new shoes, a relaxing massage or a good meal with friends. What happiness means to you and me changes with our stages in life and often what makes us happy becomes less straightforward as we get older. While there are certain things that will make most people happy – like winning the lottery – happiness comes in different forms for different people.

What is happiness?

So what is happiness? It is a complex question that philosophers, psychologists and spiritualists have debated for centuries. Taken on a much broader perspective, Ms Lydia Hoalim, Head of

happiness is something that is beyond having pleasure, wealth or status. Happiness Psychology, JurongHealth, says

can be defined as the combination of different dimensions (see page 20). “There are also others who define it as the fulfilment of one’s human potential,” she said. “To be happy, we should strive to become what we are meant to be. All of us have different potentials and talents, and happiness can be found in fulfilling our inherent potential and talents.”

O N E H E A LT H

For some, happiness is not seen as an end goal but the result of pursuing the things that give your life meaning.

Positive effects

There’s more to happiness than feeling good about life. Studies have shown that people who are more cheerful, relaxed, contented or optimistic tend to be healthier and cope better with illness. A 2013 study by John Hopkins University found that happier participants suffered a third fewer heart-related episodes than those who were not as happy. Another study in 2006 by Carnegie Mellon University revealed that people with positive emotions were less likely to catch a cold even after being exposed to the virus. For those who did catch the cold, the ones with a more positive outlook experienced fewer symptoms.In 2002, a Yale University study discovered that those who felt more positive

about getting older lived seven and a half years longer than those with a negative outlook. In the same vein, a 2001 study found that people who genuinely smiled were more likely to live past the age of 80 than those with sour faces.

O N E H E A LTH

Effects of stress

Our emotional wellbeing can be affected by stress. Some stress is good for us and is an important survival instinct. The stress reaction, also known as the fight-or-flight response, is the body’s “turbo drive”. When a sudden physical threat occurs or when pressure forms, the body releases chemicals that raise the blood pressure, increase the heart rate, redistribute blood from the gastrointestinal system to the muscles and the brain, flood the body with energy and sharpen the cognitive senses to help us cope and react. These hormone levels return to normal after the threat has passed. However, prolonged stress can have serious effects on your health. Overexposure to cortisol and other stress hormones can disrupt almost all the body’s processes. “This can result in increased risk of numerous health problems such as cardiovascular disorders like hypertension, myocardial infarction and stroke, diabetes, reduced immune function, and memory and concentration impairment,” said Ms Hoalim.

Look on the bright side

The secret to feeling happier is not to ignore troubles and challenges, but to tackle them differently, said Ms Hoalim. When stuck in peak-hour traffic, do you: 1. Start to panic and think of how your boss will be furious when you turn up for work late because of the jam, worrying if your performance appraisal will be affected by this tardiness? 2. Inform your boss of the holdup, think of ways to make up for the time lost by being stuck in the traffic jam and switch on the radio while negotiating the traffic calmly. If your choice is 1, you will most likely be less happy and more stressed than if you were to pick option 2, where you can take events in stride and can manage stress levels.

A happy life

To prime yourself for greater happiness, which leads to better health, there are steps you can take – such as exercise. Endorphins are released when people exercise, resembling opiates that provide relief from pain and give a sense of well-being. “This is why exercising has been found to reduce stress, ward off feelings of anxiety and depression, boost self-esteem and improve sleep,” explained Ms Hoalim. Getting enough quality rest and relaxation is another good way to keep those stress hormones low.

Want to learn more about the steps to a happier you? Continue reading this special Get Happy! series to learn how to be happier and healthier – from the benefits of a good night’s sleep (page 21) to the importance of quality family time and physical activity (page 24). The key to improving your wellbeing and emotional health could well be a safe and pleasant vacation (page 30) or a pampering sessions your feet (page 27). Happy reading!

20 O N E H E A LT H

Dimensions of Happiness Leading American psychologist Martin Seligman theorises that happiness has three dimensions that can be cultivated. All three dimensions need to come together for a person to experience greater happiness.

The Pleasant Life

Realised when we experience pleasure and gratification in areas such as social activities, family life or physical needs

The Good Life

Achieved through healthy exercise and developing our strengths and virtues

The Meaningful Life

Happiness due to fulfilment, such as using unique strengths for a greater good

rest is best! There’s nothing like restful sleep to lift the spirits and get you in the right frame of mind to tackle the day. Learn why sleep is essential and find out if you are getting enough – and how to make sure that you do By Sheralyn Tay IN CONSULTATION WITH DR CHUA AI PING, SENIOR CONSULTANT, RESPIRATORY MEDICINE

O N E H E A LTH

More than just snoring

You only need to wake up cranky and out-of-sorts after a night of tossing and turning to understand the importance of a good night’s rest. And it is no wonder that you feel lousy – sleep is essential for a healthy lifestyle. Apart from physical rest, sleep is critical to ensure all the functions of the body are in optimal condition. “Not getting the proper amount or quality of sleep leads to more than just feeling tired,” explained Dr Chua Ai Ping, Senior Consultant, Respiratory Medicine, who specialises in sleep disorders. She added, “(Lack of sleep) can lead to a lower quality of life and can impact personal health.” Sleep is essential in keeping every organ in good working condition. When you enter into a deep sleep, the body releases hormones that repair and regenerate organs, skin, muscles and other bodily tissues. The metabolic rate slows down, allowing organs to rest and recover. The brain forms memories and regenerates neurons.

Effect of sleep loss

Lack of sleep does more than affect your mood. It can interfere with cognitive function, said Dr Chua, and can lead to learning disabilities in children, memory impairment in people of all ages, personality and mood changes, and even depression. “People suffering from sleep deprivation experience difficulty in making decisions, irritability, problems with performance and slower reaction times, placing them at risk for traffic and work-related accidents that can endanger public safety,” she said. Sleep loss can also increase the risk of obesity, diabetes, hypertension, heart attack and stroke, as well as lower the immune system, making us more prone to falling ill.

What’s keeping you awake?

If you’re not getting enough sleep, it could be due to a sleep disorder or poor sleeping habits. Common sleep problems include sleep breathing disorders, insomnia, circadian rhythm sleep disorders, nightmares, sleep talking, sleep walking and teeth grinding or clenching (bruxism).

O N E H E A LT H

Sleep Disorder Checklist

Do you experience any of these symptoms? I feel sleepy during the day, even after a good night’s sleep

It usually takes me a long time to fall asleep

1 2

I often wake up very early and cannot fall back to sleep I usually feel achy and stiff when I wake up in the morning I often seem to wake up because of dreams I sometimes wake up gasping for breath My bed partner says my snoring keeps her/him from sleeping I have fallen asleep while driving If you experience more than two of these symptoms, consider seeking help from your healthcare professional.

simple tips for a good night’s sleep

Tired of being tired? Good sleeping habits – known as sleep hygiene – can help you get a better night’s rest.

I get very irritable when I cannot sleep I often wake up at night and have trouble falling back to sleep

Sleep apnea is a form of severe snoring in which the airway becomes blocked repeatedly. Sufferers tend to snore loudly, choke or cough during sleep. The condition is potentially life-threatening and increases the risk of heart attack and stroke.

Keep it regular

Go to bed and wake up at the same time every day, even on non-workdays to build a rhythm

Dedicate bedroom space

Use your bedroom mainly for sleep. Using the bed for other activities can make it hard for the mind to associate it with sleep

5 6

Avoid daytime naps

If you really must take a nap, do so only once a day at the same time for no more than 30 minutes and no later than 3pm

Establish a routine

A regular schedule keeps the inner clock running smoothly. A relaxing bedtime ritual (a warm bath, massage, light reading) also helps

20-minute rule

Ban TV in bed

Dark, cool and quiet

Curb the caffeine

If you can’t sleep in 20 minutes, do something else to help you relax and return to bed only when you are sleepy

Keep the bedroom dark, cool and free of disruptive noise – use ear plugs if necessary

Watching TV in bed disrupts good sleeping habits. Listen to soft, gentle music or indulge in a relaxing bedtime ritual instead

Are you getting enough Zzz’s?

For adults, enough sleep helps you wake up refreshed the next day and function at your best – typically, 7 to 9 hours. For children, sleep plays a crucial role in physical and mental development. Growth hormones, for example, are secreted at night when a child is asleep. Ideally, a child should clock these hours of sleep a day.

Toddlers (1 to 3 years): 12 to 14 hours

Preschoolers (3 to 5 years): 11 to 13 hours

School-aged children (5 to 12 years): 10 to 11 hours

Adolescents (13 to 18 years): 8.5 to 9.5 hours

Avoid caffeinated drinks (coffee, tea, sodas, cocoa or chocolate) 4 to 6 hours before bedtime O N E H E A LTH

the great outdoors Feeling low? Put on your walking shoes and get out there. Some fresh air will do you good and is a great mood booster By Chua Hwee Leng IN CONSULTATION WITH DR JIMMY CHIN, PRINCIPAL RESIDENT PHYSICIAN, SPORTS MEDICINE

Exercise was never a top priority for former journalists Bob Lee and Lim Hwee Hwee, their hectic work schedules leaving very little time for meals, let alone a good workout. But these days, running their own communications firm, the married couple allocate time for physical activities with their six-year-old son, including regular morning walks. Ms Lim is the household’s “activities supervisor”, ensuring that her son and husband keep pace when they go brisk walking thrice a week. Mr Lee said: “Given my size and knee problems, it is quite difficult for me to jog. Walking is a good and convenient alternative.” Although he has not seen much weight loss, Mr Lee has been feeling more rejuvenated since they started the routine last December. “To drag myself out of bed and put on my walking shoes in the morning is the biggest challenge I face. But I must say that I feel much more refreshed and alert after each walk,” he said.

The power of walking Walking is one of the simplest, most intuitive forms of moving, said Dr Jimmy Chin, Principal Resident Physician, Sports Medicine, JurongHealth. “For an infant, a natural progression from crawling is to start walking. As a form of exercise, it is simple, cost-effective and easy to start.” It is also often underestimated and under-valued as a good and effective exercise.

As a low-impact exercise, walking can also benefit older adults, pregnant women and people with joint pain. Older adults • Strengthens bones and muscles • Boosts balance • Slows the effects of aging

Pregnant women

Regular walking • • • • • • • • •

Trains major muscles in the hip, knee, ankle and foot joints Improves muscular endurance and dynamic balance Benefits the heart, lungs and circulation Lowers heart disease risk Reduces the waistline, aids and maintains weight loss Lowers the risk of diabetes and improves diabetes control Improves the control of high blood pressure and cholesterol Builds bone strength, joints and muscles Decreases the risk of cancer of the large intestine and breast SOURCE: AMERICAN COLLEGE OF SPORTS MEDICINE

Positive benefits Apart from physical benefits and its impact on reducing the risk of many chronic diseases, walking also has a positive impact on the mental health of people who are feeling down or suffering from depression. It’s also an enjoyable social activity. For Mr Lee and his family, their morning walk is something he looks forward to, since it means he gets to spend at least an hour of uninterrupted time with his wife and son. He said: “These days, with the smartphones and tablets, everyone is always preoccupied even when they are on the go. But when we are brisk walking, we have our attention trained on the activity and one another, and nothing else. Now, that is really precious quality time.”

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Low in impact, high on benefits

• Provides health and fitness benefits to both mother and child • Reduces the risk of gestational (pregnancy-induced) high blood pressure • Lowers the risk of gestational diabetes

Those with joint pain • Reduces joint pain and stiffness • Maintains muscle strength around the affected joints • Prevents the reduction of daily function • Improves mental health and quality of life Consider speaking with your doctor or a sports doctor before starting a new fitness regime, especially if you have any existing chronic conditions or if you belong to one of the three groups above.

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Step up, step out! Keen to take up brisk walking? Dr Chin shares some tips on how to take the right steps. Maintain good posture by keeping your back upright, chin slightly up and shoulders slightly backwards and relaxed

Take confident steps forward while keeping to a comfortable stride

Contact the heel lightly to the ground and keep feet pointed straight ahead

Start walking on even, flat surfaces to reduce the impact and strain on the legs

Aim for a total of 30 minutes a day (you can even break up your walks into three 10 minute sessions) for most days of the week. Target to reach a total of 150 minutes or more per week

For weight loss, target a total of 250 minutes or more per week of moderateintensity brisk walking

Gradually increase the duration or intensity by about 10 per cent per week as your fitness improves and as long as you do not have any increasing pain or new problems

Make sure you warm-up (5 to 10 minutes) with lightintensity activities before your main exercise. Don’t forget to cool down and stretch afterwards (5 to 10 minutes)

Can you talk to a friend while walking? If you can’t, you’re moving too fast. Slow down to a pace that allows you to hold a conversation while still breaking a sweat

Wear appropriate footwear and comfortable clothes. If you have very flat or high arches, consider consulting a sports doctor or podiatrist for advice on the correct shoes or for special insoles. Opt for light, breathable clothing that suit the climate

Feel the burn

15 = 114

grams fat 26 O N E H E A LT H

calories

That’s how much an average 60kg adult burns running seven laps around a track (at a pace of 5.5km/hr).

Bob Lee and Lim Hwee Hwee enjoying their morning walks with their six-year-old

Take a walk in the west side

Spend quality time with your family at these parks. Jurong Central Park Between Jalan Boon Lay Junction & Boon Lay Way How to get there: 5 minute walk from Boon Lay MRT station

Chinese Garden Chinese Garden Road How to get there: 5 minute walk from Chinese Garden MRT station

Pandan Reservoir Opposite Block 35, West Coast Road How to get there: Bus 78 or 143 from Jurong East Interchange; alight at Block 35, West Coast Road

Few things are as disabling as foot pain. In fact, it must have been during a bout of such discomfort that led Plato to say, “When our feet hurt, we hurt all over.” Learn how to keep your feet healthy and prevent aches By Sheralyn Tay IN CONSULTATION WITH OLIVIA TASKER, PODIATRIST

happy feet

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“Feet are generally dismissed and it is not until foot pain occurs that we remember how important they are,” said podiatrist Olivia Tasker, JurongHealth. She explains the causes of four of the most common problems and how to prevent them. In-grown toenails The nail grows outwards and sideways, cutting into the surrounding skin. This condition commonly affects the big toes. CAUSES: Improper nail cutting, curved nails, tight footwear, trauma PREVENTION: • Wear good-fitting shoes with a wide toe box (shoe front) so that the toenail is not squeezed against the skin. A deep toe box can help prevent pressure on top of the nail as well • Trim toenails straight across and not into the corners of the nail to prevent the nail from growing into the surrounding skin • Avoid picking toenails to prevent jagged or sharp nail edges

As hardy as they are, our feet can suffer from painful problems that can affect your daily activities and mood. A little more consideration for the health and comfort of our feet reduces the risk of pain – and ensures that you start every day on a good foot! 28 O N E H E A LT H

Heel pain (Plantar fasciitis) The tissues on the sole of the foot become painful and/or inflamed. CAUSES: Excessive exertion (running, standing, walking), poor footwear PREVENTION: • Ensure shoes provide the appropriate support for your activity, especially if you walk/stand for long periods or do sports • Warm up and stretch before exercising, especially the calf muscle and arch of the foot. If you suffer heel pain, stretch your feet in the morning and after a long period of sitting • Wear shoes with a very slight gradient so your heels are slightly elevated, reducing the strain on the heel

Swollen Achilles heel (Achilles tendonitis) A tender and swollen Achilles heel is caused by the inflammation of the tendon that extends from the back of your heel up towards your knee. CAUSES: Overuse, particularly through sports or exercise PREVENTION: • Ensure the shoes you wear are appropriate for the sports you do and that they do not put excessive pressure on the Achilles heel • Wear in your athletic shoes slowly • Avoid ‘overdoing it’ if you are starting a new or more intense exercise regime to prevent muscle and tendon strain

Bunions Bunions refer to a bony bump that forms at the base of the big toe; it causes the toe to push towards the second toe. This ‘bump’ is prone to rubbing, inflammation, trauma and increased pressure that can cause pain. CAUSES: Genetics, poor fitted footwear and foot posture PREVENTION: • Reduce discomfort and worsening of the condition by wearing shoes with a wider toe box • Avoid high heels as they cause a lot of pressure in the first toe joint and forefoot

Foot Care 1O1

Pamper your feet Soak your cares away

Good foot hygiene includes:

• Good nail care, cutting toe nails regularly and straight across • Keeping feet clean and dry • Wearing shoes that fit well

Revive tired feet quickly with a soak in warm water scented with aromatherapy oil. If your feet are swollen, alternate soaking your feet first in warm water for about 3 minutes and then in cold water for about 15 minutes.

‘Froot’ scrub, anyone?

Good foot care is particularly important for diabetics and people with conditions such as peripheral vascular disease and arthritis. It is also important to check for wounds and go for annual foot screenings.

The shoe did it! Foot pain? Fashionable and illfitting shoes are common culprits.

Kneadful comfort

In your lifetime, your feet would have taken you over a distance of some 185,074 kilometers, that’s four times around the globe! Isn’t it about

time you make sure your feet are properly “dressed” for your life journey? Choose footwear that has:

1 A long vamp that can support the foot

2 A firm but flexible shoe base

3 A firm heel counter with a heel height between 0.75 and 1.5-inches

4 A toe box that fits the widest part of your foot

Combine crushed pineapple, kiwis or strawberries with a generous handful of coarse salt or sugar with enough olive oil to achieve a spreadable consistency and apply to feet for a natural fruit scrub. Leave it on for a while and then rinse. The natural acids from the fruit will soften the skin – and leave feet smelling fantastic!

One of the best cures for sore feet and a restless mind is a good foot massage. Foot massages not only ease the knots and kinks out of the feet, they also increase blood circulation, which can help alleviate foot pain.

What about high heels? High heels increase the pressure on the forefoot, making your ankle more unstable. Some designs also squeeze the toes together. While not ideal for daily or extended wear, high heels are fine for the average healthy person to wear occasionally. O N E H E A LTH

around the world in healthy ways The anticipation of a holiday is enough to put a smile on your face and the last thing you want is to fall ill while abroad. Here’s how to ensure that your vacation stays illness-free By Sheralyn Tay IN CONSULTATION WITH DR SUMMER NATSUKO ISHIKAWA, SENIOR RESIDENT PHYSICIAN, DR ROBIN YONG, SENIOR RESIDENT PHYSICIAN, HEALTH & WELLNESS CLINIC

If a change is as good as a rest, imagine what an entire change of country, scenery and pace of life can do to lift your spirits. A trip of any kind is a therapeutic break from the daily routine – and a great way to dedicate time to friends, family or just yourself.

Medicine on the go

But the exhilaration of a vacation can come to a crashing halt if a bout of diarrhoea, heat exhaustion or a cold strikes. Avid traveller Dr Robin Yong, Senior Resident Physician, Health & Wellness Clinic, JurongHealth, shares amazing shots of his travels as well as travel tips to help you and your family stay healthy during your forays around the world.

should carry their doctor’s note for customs enquires

If you’re on medication,

pack some into your hand luggage just in case your check-in luggage is lost or delayed

Diabetics with syringes Clearly label all medicines

and carry a spare prescription

Vaccination before vacation

Check the vaccination requirements and recommendations for the countries you are going to.

Yellow Fever Required for some African and South American countries, even for entry purposes.

Pack useful medicines

such as paracetamol, antihistamines, charcoal pills and insect repellent

Hepatitis A Recommended for many parts of the world; check with your doctor if you are not already protected.

Malaria prophylaxis May be recommended for developing Asian countries, and Africa and South America, particularly rural areas.

Japanese Encephalitis May be recommended for travellers spending more than a month in rural areas of some developing Asian countries.

Rabies vaccination Only Australia, New Zealand, Japan, Singapore, Hawaii, Guam, Iceland, Denmark and the United Kingdom are free from rabies. If you’re working with animals while overseas, consider getting a rabies vaccine.

Have you been immunised? Wherever you roam, journey safe and stay healthy so you can indulge in the joy of exploring new horizons

30 O N E H E A LT H

Healthcare workers and teachers doing volunteer work overseas should check that they are up-to-date with vaccinations for chickenpox, mumps, measles and rubella.

Visit your Travel Clinic before you fly Go six to eight weeks before your trip for vaccinations and health advice O N E H E A LTH

Weather the elements

One of the pleasures of travel is to experience different climates and weather conditions. But these changes in temperature can take some getting used to – and may cause you to fall sick.

For car sickness, gaze towards the horizon in the direction of the travel to re-orientate your inner sense of balance. Eat sweets or snacks. For sea sickness, seek refuge in a cabin and close your eyes or nap.

Take cover from the heat

Jet lag

For sun protection, wear sunglasses to reduce glare, use sunscreen and consider using a wide-brimmed hat. Prevent sunburn, sunstroke and heat exhaustion by wearing light-coloured and loose clothing that covers the arms, neck and legs. If temperatures go beyond 32 oC, avoid sleeveless tops, shorts and slippers. Drink plenty of water and avoid sporting activities during the hottest parts of the day.

Essential cold protection

In winter climates, appropriate warm clothing is crucial to prevent frostbite and colds. Most winter clothes purchased locally are ineffective against the extreme winter cold in some countries. Tour operators in Finland and Greenland usually have effective winter wear for rent and these are highly recommended. Ensure hands, neck and ears are well-protected. Wear waterproof boots or shoes. 1. Yellow fever vaccination is a necessary entry requirement for many African nations 2. Prepare yourself for extreme weather conditions. For instance, summer in Egypt and some Middle Eastern countries can be scorching hot 3. If you’re going off the beaten track to more rural areas that lack proper sanitation, take extra precautions to prevent food-, water- and insect-borne diseases Photos: Dr Robin Yong 2

Safety on the move

Deep vein thrombosis (DVT)

The risk of DVT is higher for smokers, pregnant women and those who are obese. People who suffer from certain blood disorders, take oral contraceptives or have a history of DVT are also at higher risk. Prevent DVT • Drink lots of water on the flight • Do frequent leg exercises and leave your seat to walk around • Break up long-haul flights, especially those longer than 12 hours where possible • Consider resting a day or two at the transit destination

Motion sickness

Motion sickness can cause dizziness, fatigue, headache, nausea and vomiting. Speak with a doctor for medication to alleviate these symptoms.

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When travelling from one time zone to another, the disruption of the body’s circadian system and loss of sleep can cause jet lag. For flights going through six or more time zones, most travellers will take four to six days to re-establish a normal sleeping pattern. Speak with your doctor about taking melatonin to prevent and reduce jet lag.

Roughing it out

If your idea of a vacation entails shopping, eating and sightseeing in a developed metropolitan city and staying in a 5-star hotel – you won’t need to worry as much about infectious diseases. But for adventure holidays, treks, safaris or volunteering efforts at rural locations, be aware that there may be a lack of proper sanitation, clean food and water or the risk of insect and animal bites. Traveller’s diarrhoea remains the most common ailment worldwide. Avoid tummy trouble • Buy food that is freshly prepared and well-cooked • Wash and peel fruit before consumption • Avoid street food, dairy, ice, salads and spicy food, especially if you have a sensitive stomach • Drink only bottled and canned drinks • Brush your teeth with bottled water if the tap water is not potable

Know your limits

A vacation may be the only time to let loose, and it’s understandable if you want to try everything. But know your limits. “Know your own medical conditions and take the necessary precautions,” said Dr Yong. “If you can’t do certain activities with a tour group, it is important to let your tour operator or travelling companions know.” Bear in mind that the very young and the elderly are more prone to falling ill and may not be as ready to take on as many activities or adventures. It’s a holiday, so take your time.

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HealthMatters

Crystals of pain The festive season is a time for merrymaking and feasting, but if you have gout or are at risk, be vigilant about indulging too much lest an attack occurs! By Sheralyn Tay IN CONSULTATION WITH DR JANE CLAYTON, CONSULTANT, RHEUMATOLOGY & ELISA MAK, DIETICIAN

It attacks in the night, unleashing bolts of sharp pain to the joints. The pain caused by gout can be so severe that even the gentlest touch can cause agony. Dr Jane Clayton, Consultant, Rheumatology, JurongHealth, said gout is a form of inflammatory arthritis. “It arises as a result of too much uric acid in the bloodstream. When uric acid in the blood is high (hyperuricaemia), uric acid crystals may form in the joints and other body tissues.” The crystals can also form visible lumps (tophi) over the joints or skin. Contrary to popular opinion, gout is not a disease of the rich or privileged, she added. “The incidence of gout is rising worldwide. This rise parallels the increasing rates of lifestyle diseases such as obesity, hypertension, high cholesterol and diabetes mellitus.” Significantly, gout is a risk factor for developing Type 2 diabetes, renal failure and cardiovascular disease. Dr Clayton pointed out that people with gout have a higher rate of heart failure. “Although the evidence is not clear as yet, treating gout may help reduce the risk of these diseases.”

Gout hurts! When crystals form inside the joints, they periodically cause the affected areas to swell, turn red and become inflamed. A common first symptom of gout is a sudden pain and swelling in the big toe, said Dr Clayton, and over time, the attacks can become more frequent and involve larger joints such as the ankles and elbows.

Risk factors The main risk factor of gout is hyperuricaemia, a high level of uric acid in the blood.

Other factors include:

High uric acid levels

Genetics This is one possible cause of gout, where the body may not break down purines efficiently, leading to more uric acid in the blood.

Gender and age Men aged 40 and above have a significantly higher risk for gout. The disease is less common in young women, although the risk increases after menopause.

Excess uric acid collects as crystals and are deposited in the joints

Gout attacks Elbows • Wrists • Knees • Ankles • Feet •

Gout attack!

Obesity Being overweight can lead to a higher chance of developing gout. Purines are not only found in food, but also in our tissues. When tissues are broken down in normal bodily processes, the purines in the tissues convert to uric acid. More tissues in the body for breakdown results in a higher production of uric acid.

Excessive alcohol intake Alcohol breaks down to purines and uric acid, and increases the body’s production of uric acid while reducing its ability to remove it. Beer, in particular, increases the risk of gout.

34 O N E H E A LT H

How gout occurs

Diagnosis and treatment Gout is diagnosed with a simple test: some fluid is drawn from the affected joint and tested for uric acid crystals. In some cases, a diagnosis can be made after taking a detailed history and performing a clinical examination.

What to do if you’re at risk: • Discuss your concerns with your doctor • Cut down on high-purine food such as organ meat and seafood • Avoid excessive alcohol intake • Drink more plain water daily • Exercise regularly – even a 30-minute walk several times a week is a good start

O N E H E A LTH

FOODforLIFE!

HealthMatters

Gout diet guide If you have gout, cut down on high-purine foods. But because purines are present in almost all foods – and even in your own bodily tissues – total avoidance is unrealistic. So, eat smart! Elisa Mak, Dietician, JurongHealth, advises those at risk to eat more low-purine foods, include some moderate-purine foods for variety, and avoid foods highest in purines. Dr Clayton says vegetables, low-fat dairy products, vitamin C and coffee may also reduce the risk of gout attacks.

Simple carbohydrates

Keep your gut healthy with a fibre-rich diet. Fibre is a natural scrubbing brush for the body, sloughing away waste matters in your digestive system and absorbing water to slow down digestion, great for regulating appetite and even lowering cholesterol levels By Sheralyn Tay

White bread, pasta, noodles, rice

IN CONSULTATION WITH ELISA MAK, DIETICIAN

LOW PURINE

(eat in moderation)

Coffee and tea Coldwater fish Tuna, salmon, cod (limit to one serving a day)

Low-fat dairy & eggs Nuts Walnuts, almonds, flaxseed, cashews

Fruits Apples, bananas, berries, cherries, oranges, papaya

MEDIUM PURINE

(2-3 times a week)

Meat & poultry Beef, chicken, pork (limit to 60-90g/day)

Vegetables Cabbage, celery, eggplant, kailan, tomatoes

Seafood Crab, lobster, oysters, prawns

Complex carbohydrates Wholegrain bread, wholegrain pasta, oats

Anchovies, mackerel, sardines, scallops

Fibre is an essential part of a healthy and balanced diet, and plays an important role in keeping your digestive system and bowel movements in regular working condition. Dietician Elisa Mak said you should aim to get about 20g to 30g of dietary fibre a day. There are two forms of fibre:

Legumes

Insoluble fibre

HIGH PURINE

(avoid; gout-causing!)

Fish & seafood

Dried beans and peas Venison, quail, duck, bacon

Also known as ‘roughage’, this form of fibre cannot be digested, so it passes into our digestive tract without being broken down. This speeds up the passage of food and waste through your gut, preventing constipation.

Meat extracts

Soluble fibre

Meat, game & poultry

Gravy, stock

Organ meats Beef kidneys, brains, liver, sweetbreads

36 O N E H E A LT H

Fibre up your life Soluble fibre absorbs many times its own weight in water, forming a viscous (sticky) gel that lines the stomach, slowing down the rate in which food passes into the intestines. This promotes satiety – useful in helping you feel full. This effect also has a beneficial impact on regulating insulin and slowing the absorption of dietary cholesterol.

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FOODforLIFE!

FOODforLIFE! Unlike the refined grains we typically eat, such as white rice or bread, a whole grain still contains its vitamin and fibrepacked bran, endosperm and germ. Jazz up your staples like rice, bread and pasta with their wholegrain varieties and increase your fibre intake by up to three times! Swap this

Fibre

1 bowl white rice 2 slices white bread 1 cup cornflakes 1 cup spaghetti

For this

Fibre

1 bowl brown rice

1.5g

2 slices wholemeal bread

1 cup bran cereal

1 cup whole wheat spaghetti

2.5g

Choose whole grains

the cheater’s cheesecake

the great fibre swap

A healthy dessert doesn’t need to be boring or bland. This Christmas, serve these easy-to-make yoghurt or tofu cheesecakes that have all the rich delicious creaminess of the traditional ones at half the fat!

Looking for ideas to increase fibre? Swap some of your low-fibre choices for much healthier versions.

CONTRIBUTED BY GRACE LAI, DIETITIAN, JURONGHEALTH

What happens when a dietician with a passion for kitchen experimentation meets a recipe of a delicious and sinfully rich cheesecake? A great cheesecake makeover!

Opt for more nutritious snacks Swap this

Fibre

For this

half the fat

Fibre

Small pack potato chips

Small pack plain baked tortilla chips

1 chocolate covered wafer

A handful of almonds

1 cup bubble tea

1 cup papaya soya milk

1 small pack jelly sweets

5 prunes

3.5g

Earlier this year, Grace Lai, Dietitian, JurongHealth, helped a diabetic colleague put a regular full-fat cheesecake recipe through a “slimming process”. The result: two lower-fat, lowercalorie cheesecakes – both as delicious! If you’re watching your weight this festive season, but would still love a little sweet treat, why not attempt one – or both – of these light cheesecakes!

Skip fattening potato chips and fried snacks and get the same satisfaction from these high-fibre and vitamin-rich power snacks.

38 O N E H E A LT H

O N E H E A LTH

HealthBites HealthBites

FOODforLIFE!

try this place gelatin mixture in a hot water bath to melt it

These ‘skinny’ cheesecakes are just the thing for a light and healthy dessert. Glaze with jam or top with juicy berries for a real treat! Recipes by Grace Lai, Dietician, JurongHealth

tofu cheesecake

yoghurt cheesecake

equipment 6” springform pan base 60g low-salt wheat crackers, crushed to crumbs 50g ground almond 35g butter/margarine, melted filling 250g 80% fat-free cream cheese, softened 100ml thickened cream 100g silken tofu, mashed 1½ tsp sweetener ¼ tsp vanilla essence 1 tbsp freshly squeezed lemon juice ½ tsp finely grated lemon zest 2½ tsp gelatine dissolved in 3tbsp hot water method

equipment 6” springform pan base 60g low-salt wheat crackers, crushed to crumbs 50g ground almond 35g butter/margarine, melted filling 250g 80% fat-free cream cheese, softened 2 tubs (135g) low-fat plain yoghurt 2 tsp sweetener ¼ tsp vanilla essence 2 tsp freshly squeezed lemon juice ½ tsp finely grated lemon zest 4 tsp gelatine dissolved in 4tbsp hot water method

serves 6-8

Combine biscuit crumbs, ground almond and melted butter/ margarine. Mix well. 2 Press the crumb mixture firmly onto the bottom of a 6” springform pan and bake at 200°c for 10 minutes. 3 In a mixing bowl, add the cream and whip till stiff peaks form. 4 In a separate mixing bowl, combine the cream cheese and sweetener, and whip till creamy. 5 Add lemon juice, lemon zest, vanilla essence and mashed tofu to the cream cheese mixture and combine well. 6 Add the gelatin solution with the whipped cream and mix well. 7 Spoon the filling over the base and level with a spatula. 8 Cover the pan and refrigerate for 4 hours or until set.

nutrient value (100g) Energy (Kcal)

152

Total Fat (g)

10.2

Protein (g)

5.9

Total Carbohydrates (g)

14.4

Sodium (mg)

182

serves 6-8

3 4 5 6 7

Combine biscuit crumbs, ground almond and melted butter/margarine. Mix well. Press the crumb mixture firmly onto the bottom of a 6” springform pan and bake at 200°c for 10 minutes. In a mixing bowl, combine the cream cheese and sweetener, and whip till creamy. Add vanilla essence and yoghurt to the cream cheese mixture and combine well. Mix the lemon juice, lemon zest and gelatin solution. Spoon the filling over the base and level with a spatula. Cover the pan and refrigerate for 4 hours or until set.

nutrient value (100g) Energy (Kcal)

181

Total Fat (g)

Protein (g)

5.5

Total Carbohydrates (g) Sodium (mg)

13.7 171

original cheesecake nutrient value (100g) Energy (Kcal)

290

Total Fat (g)

Protein (g)

4.1

Total Carbohydrates (g) Sodium (mg)

40 O N E H E A LT H

breathe deeply

21 171

The trick is to Slow deep breathing brings a surge of oxygen into the lungs and can help clear the mind and raise energy levels.

Chocolate peel your cares away ec asy For a dose of feel-good nutrients,

peel and eat an orange or banana. The fresh citrus scent and vitamin C in the orange will revive your senses and combat stress, while the dopamine quinine in the banana will boost your mood.

say I love you

just call to Bring out the Stevie Wonder in you. Whether you call, SMS, email or say it face-to-face, expressing affection can release happy hormones and put you in a better state of mind.

This ought to make you happy:

a little dark chocolate a day is good for you and your mood. The antioxidants and other compounds can uplift your day.

do something nice for someone Pay a compliment, share a joke or do something nice for someone. It helps you feel just as good as doing something for yourself.

keep calm and smile embark on a Even faking a smile helps lower the body’s stress response and bring about feelings of wellbeing. So be generous with your smiles and let them come from within!

turn to music

Crank up a favourite upbeat song. Studies show that listening to music can stimulate the part of the brain that produces happiness and enforce positive emotions.

mental vacation Think back on that amazing holiday last year or the vacation-to-come. The anticipation of a break can boost happiness and raise endorphins.

three good things Write down three good things that happen to you each day. Focusing on the positive is transformative for good mental health.

doodle a li le Indulge your creative side and scribble or sketch. Tapping into your imagination can enhance your positive mental state.

your Take a moment to find your inner zen with these tips and tricks for instant bliss! 3-min guide

to happiness ONEHEA LTH ALTH