November 2007


The recent media report revealing the statistics from the nationwide Student’s Health Survey done between April and August 2006 by the Singapore Health Promotion Board (HPB) reminded me of a couple of sayings on statistics.

Like Aaron Levenstein and Storm P said Statistics are like bikinis.  What they reveal is suggestive, but what they conceal is vital” and “Statistics are like lampposts: they are good to lean on, but they don’t shed much light“, indeed, the statistics reported on the media is so little and there is nowhere on the HPB website to see the details.

Another saying by Evan Esar that statistics is the only science that enables different experts using the same figures to draw different conclusions.

Yes, experts like youth counselor, Ms Carol Balhetchet whom I guessed had her hands on the statistics, commented that as compared with other surveys, the following statistics seemed low – that “4 per cent of all Secondary 3 and 4 respondents have had sex and half of this group had sex before they were 15, and one-quarter of them had sex more than five times in the past 12 months”.

Was that because the 3,844 Secondary 1 to 4 students from 51 schools had to fill out the anonymous questionnaires in class where a teacher was present? Thus they did not answer what they should to avoid embarrassment. 

The regular teen smokers remain at 2 per cent. Lesser teens are likely to try smoking, down 19 per cent from 26 per cent in year 2000 yet half of teen smokers picked it up before the age of 12 and 19 per cent of them do not think it is harmful.

Come to healthy eating of two serving of fruits and vegetables every day, more than 70 per cent of the respondents knew. Given the ubiquitous availability of delicious sugary and deep-fried foods throughout the island, it is no surprise to me that they said that they are fond of. Exercise was not a top priority – not surprising again. Boys were more than twice as likely to exercise than girls – most boys like outdoor sports like soccer? 

Can I conclude that these questions are easier to answer than the sensitive sex and smoking ones?

Anyway, healthy teens are the future and health of our country. That is why the HPB wants to focus on their practices and attitudes towards smoking, sex, diet, exercise and mental health (report is under evaluation) because many habits which persist in adulthood are formed in one’s teens”.  It hoped that this survey will provide the baseline data for future youth health initiatives in shaping these habits.

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On 16th November 2007, the Prime Section’s headline of the Straits Times, “Want to slim down? Don’t count on weigh-loss drugs” would have a lot of Singaporeans and those reading in the air (e.g. Singapore Airlines) fitting their eyes on this piece of news.

What a great catchy headline as many Singaporean particularly the female population considered themselves overweight, judging by the continuous flood of slimming advertisements in all appropriate local media. Is this to wake Singaporean up as their online version was not punchy – Weight loss drugs may slim users down – but at high costs” ?

It has been reported obesity and overweight affect over 1.1 billion individuals worldwide and are highly and increasingly prevalent chronic conditions associated with premature mortality, chronic morbidity, and increased healthcare use.

Apart from traditional non-medicinal herbal options, the commonly used treatments are through the use of anti-obesity drugs such as orlistat, sibutramine and rimonabant. They are approved for long term treatment of obesity and choked up an estimated US$1.2 billion in global sales in 2005. The 3 drugs are prescribed for severe cases of obesity as obese people can reduce their risk of getting diabetes by 30 to 40 percent if they were to lose 4 kg.

Orlistat also known as tetrahydrolipstatin is marketed under the trade name Xenical. Its primary function is preventing the absorption of fats from the human diet, thereby reducing caloric intake.

Sibutramine is marketed under the trade name Meridia in the USA and Reductil in Europe and other countries. It acts by increasing serotonin and norepinephrine levels in the brain. The S$4 pill makes the patients feel full with less food and is needed to be taken for between 6-12months.

Rimonabant which is also known as Accomplia, Riobant, Slimona, Rimoslim, Zimulti and SR141716, is an anorectic anti-obesity drug. Its main avenue of effect is the reduction in appetite. On 15 June 2007 the BBC News reported that a committee advising the US FDA has voted not to recommend the drug’s approval because of concerns over suicidality, depression and other related side effects associated with use of the drug.

The Straits Times report was following up on the British Medical Journal’s article published a day ago on their meta-analysis that :-

  • 30 per cent of patients on Xenical lost an average of 3 kgs and had unpleasant digestive and intestinal side effects, such as incontinence.
  • Patients on Reductil lost 4 kgs and had improved cholesterol levels. But up to 20 percent suffered from raised blood pressure and pulse rates, insomnia and nausea.
  • Patients on Accomplia lost the most weight – 5 kgs on average. Their blood pressure and cholesterol levels also improved but their risk of mood disorders rose 6 percent.

Straits Times reported that another study released on Friday by a different medical journal, The Lancet, found that patients on Accomplia were far more likely to suffer from depression, anxiety and, in severe cases, suicidal tendencies.

Thus the conclusion from the BMJ article is that “Orlistat, sibutramine, and rimonabant modestly reduce weight, have differing effects on cardiovascular risk profiles, and have specific adverse effects.”

On my morning transit flight onboard the Air China from Beijing to Dailan on the 11th of November, flipping through the only available reading materials, Beijing Evening News, I stopped at the headline “千个北京娃 五个糖尿病”. Only interesting headline like this can stop me in this world of media clutter.

The disease control center of Beijing states that in every thousand of the female children population, five of them have diabetes. Majority of the “甜娃娃” or diabetic dolls (little girls are referred to as dolls in China) are also “胖娃娃” or obese dolls. The information released is to part of the global observation of the disease.  

Used to be observed as World Diabetes Day on 14 November yearly at a global level since 1991 by the International Diabetes Federation with co-sponsorship of the World Health Organization, the United Nations has since passed a resolution to observe it as United Nations Diabetes Day yearly starting from 14 November 2007.

Once only thought of as the disease of the aging population, diabetes is catching up with the younger population and in particular, the young children and teenagers. This is evident as the number of young people seeking treatment is increasing as according to the eye clinic of the University of Beijing. One doctor there reported that a 23 year old patient has become blind.

In Beijing, the number of diabetic children between the ages of 6 to 18 is 5.4% of the diabetic population. This rate is increasing at a staggering 10% yearly. The report stated that currently, for those 6 to 10 years old, 4.7% is diabetic, 10 to 15 years old 5.3% and 15 to 18 years old 6.1%.

The trend is so worrying that the local medical authority is publicing the UN anti-diabetes messages and has sent out a “远离糖尿病 健康新生活” (Keep distance from diabetes, have a healthy new living) proposal to all parents of students in all primary and secondary schools.

“For the first time, the research has begun to reveal the biochemical and biophysical mechanisms that appear to underlie a number of beneficial health effects that have long been ascribed to cranberries and cranberry juice–in particular, the ability of cranberry juice to prevent urinary tract infections (UTIs).

The mechanism by which cranberry juice prevents such infections has not been clear, though scientists have suspected that compounds in the juice somehow prevent bacteria from adhering to the lining of the urinary tract.”

See the Science Daily report for the report.