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The Internet is so convenient, so easy but yet it is so dangerous.

It came to light in Singapore that a man and a woman in their early 20s had suffered symptoms of psychosis such as hearing of voices, hallucinations, confusion and thyrotoxic symptoms such as anxiety and increased heart rate after using a product named Relacore, a product they bought over the Internet.

So what is wrong with this anti-‘belly fat and stress control’ dietary supplement?

This product was not declared to have included a Western drug, a potent substance known as Sibutramine. Sibutramine is a prescription drug marketed under trade names such as Meridia in the USA, Leptos in India, Reductil (read Want to slim down? Don’t count on weigh-loss drugs) in Europe and other countries. It is used as an appetite suppressant in the management of obesity. That means that it works by making you feel more ‘full’ with less food (it reduces appetite and enhances satiety).

On Wikipedia, it is documented that frequent encountered side effects from sibutramine are: dry mouth, paradoxically increased appetite, nausea, strange taste in the mouth, anorgasmia and delayed ejaculation, upset stomach, constipation, trouble sleeping, dizziness, drowsiness, menstrual cramps/pain, headache, flushing, or joint/muscle pain.

It can substantially increase blood pressure and pulse in some patients. Therefore all patients treated with sibutramine should have regular monitoring of blood pressure and pulse.

Infrequent but serious ones that require immediate medical attention: cardiac arrhythmias, paresthesia, mental/mood changes (e.g., excitement, restlessness, confusion, depression, rare thoughts of suicide).

Symptoms that require urgent medical attention are seizures, problems urinating, abnormal bruising or bleeding, melena, hematemesis, jaundice, fever and rigors, chest pain, hemiplegia, abnormal vision, dyspnea and edema.

Could what they have consumed a counterfeit version? Health Science Authority (HSA) is investigating now. In HSA’s press release today, it has said that Given the borderless nature of the Internet and the ease with which this product could be bought and sold in different countries around the world, HSA has alerted its international network of enforcement counterparts to be on a lookout for the adulterated product and where appropriate, to act against websites selling this product within their respective jurisdictions.”

This is the second case in the last 6 years concerning slimming product that created adverse reaction. Slim 10 pills in 2002 hit headlines in Singapore after it killed a woman and caused severe liver damage to local actress Andrea De Cruz which would have killed her if not for an emergency liver transplant done with the liver donation from her then-fiance actor Pierre Png (now husband). The China-made diet pills contained fenfluramine, an appetite suppressant that has been banned in the U.S. since 1997 for damaging heart valves and which doctors later confirmed also caused liver failure.

Can 4 Red Bull really kill a man ?

2 years ago, a Bolivian man working in Oxfordshire, UK died of heart attack after consuming 4 cans of the ‘It gives you wings’ energy drink, Red Bull

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Last week, Oxfordshire coroner recorded a verdict of “death by unascertained natural causes” which he compared the death to sudden adult death syndrome which is linked to cardiac illness.

What killed Alfredo Duran since the coroner stated that he was healthy and Red Bull has such a long sale record as far back as 1982 and had since sold 3.5 billion drinks in 140 countries in 2007?

Overdose of caffeine and an enlarged heart are probably the resultant cause.

As he had to work up to five night shifts a week, 40-year-old Alfredo, a father-of-two was known to consume at least 4 cans of the Red Bull each night. The amount of caffeine found in him although not fatal by itself, could have triggered a card­iac arrest for someone who has already an enlarged heart. According to the pathologist, this will not have any effect in people with a normal heart.

Looking at a chart from the American Beverages Association, taking a can of Red Bull is pretty close to a cup of instant coffee (hmm, Sprite & 7-Up no caffeine).

Although caffeine is not addictive, a consumer may go for additional can of energy drink to stay awake once he starts to lose that peppy feeling.

However, it is also known that when people take too much caffeine, side effects like nervousness, insomnia and elevated blood pressure will be experienced. That being the case, one can imagine how it will be like downing 4 cans of the Red Bull. In fact, some countries banned it because of fears of causing high blood pressure.

Still, Red Bull said that “clin­ical tests and toxicological evaluations by independent experts had concluded it was safe to drink for adults” . Just don’t drink more than 2 cans, they said. Understandably, they are in a market which according to market research firm ACNielsen clocked $4.7 billion in 2007 up from $3.5 billion in 2006 and expecting to grow to $10 billion by 2010.

Yes, many consumers will swear by it as several studies have indicated that energy drinks may help boost cognitive performance, verbal reasoning and attention levels. However, other experts are saying that there is nothing unique in them that sustain the alertness. Rather, it is the work of the high sugar and caffeine in them which one can easily get from other sources like coffee and candy bars.

For me, no coffee during my “night-shift” writing this blog. I will just head for the aromatic kopitiam’s coffee-O in the morning.

First it was about Taoist’s enlightenment, meditation and self-defense in the 13th century, then it was seen as an exercise for the old and those who got nothing else to do. Now, it might be the easy exercise that one can practice to effectively curb diabetes and thus saving and prolonging one’s life.

Tai Chi, better known as Tai Ji Quan (太极拳) was founded by Master Zhang San Feng (张三丰), one of my most admired heros in Chinese history. Since then,  it has more than 100 possible movements and positions and is now enjoyed by people all over the world.  Many Community Clubs (CC) in Singapore have regular Taiji or Qigong classes and there are also many free video online. Unlike many exercises, this dance-like exercise can be done by people of all ages as it is slow (some movements are fast paced), gentle, graceful self-paced kind of exercise and does not required any equipment. It can be done at any permissible open space with clean air.

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It is easy yet not that easy as it combines movements with meditation to align the body and the mind. Those who had been practicing it can attest to its benefits of reducing stress; increase agility, flexibility, energy, stamina as well as improve muscular strength. Overall, it is a great feeling and makes one sleeps well.

 The British Journal of Sports Medicine has just reported that studies by researchers in Taiwan and Australia indicated that Tai Chi exercises can help people control type-2 diabetes, the disease suffered by some 250millions people worldwide and which can lead to blindness, kidney failure, high blood pressure and heart disease.

 Of the group of 30 diabetics involved in the Taiwanese study, at the end of the 12 weeks (3hours per week) program in which they learned 37 Tai Chi movements, their blood sugar level had dropped. The levels of glycated haemoglobin  (excess sugar carried by red blood cells) fell significantly. Thus, the researchers suggested that Tai Chi may prompt a fall in blood glucose levels, or improve blood glucose metabolism, which in turn sparks a drop in the inflammatory response

 In Australia, 11 diabetic patients were put to a 12 week sessions of Tai Chi and Qigong 气功(Chinese Yoga) for 60 to 90 minutes three times a week. The result was they have less craving for food, slept better, experienced less pain but more energy, lost weight averaging 3kg, waist line reduced by almost 3cm but most importantly, their insulin resistance improved, blood sugar level dropped and blood pressure dropped significantly.

 It was explained that “the relaxation element of Tai Chi may help to reduce stress levels, preventing the release of adrenalin which can lead to insulin resistance and high blood glucose levels”.

 Long live the tradition of Tai Chi which promotes maintaining optimum functioning of the body’s self-regulating systems to restore the body to its natural state of health through the cultivation of inner strength and calming the mind.

Desire : Reduce weight, prevent high blood, reduce cholesterol, relieve pain

Remedy : Kissing 3 times a day, 20 seconds each

A Russian newspaper quoted a scientific research saying that kissing can stablize heart artery behavior, prevent high blood pressure, reduce cholesterol, and in the long run can result in weight loss. No details given.

The research also reported that during kissing, the massive saliva released in the mouth which is high in calcium and phosphorus can protect against tooth decay as well as reduce the probability of gum inflammation. I wonder who is cleaning who ?

On the other hand, kissing is good for facial beauty as passionate kissing exercises 30 muscles on the face, promotes blood circulation, thus resulting in smoother skin. Is that how those skin beauty equipments were simulating ?

Kissing relieve pain as the saliva contains pain relieving properties and the more passionate the kissing, the more saliva will be released. The researcher joked that if ever pain is unbearable, try kissing instead of pain killer medicine. Are the manufacturers of Panadol, Tylenol, Aspirin, etc. laughing away ?

For those who buy in this research, please share the result. For those who are not taking the chance on kissing or weight loss pills, try tea.

Every day, over 5 Singaporeans suffered heart attack (2,000 per year). 50% of them died when proper medical help cannot arrive on time. Shocking ?

This is case of MC King, although the actual cause of his death resulting in “breathing difficulties” is awaiting the coroner’s report. Few days ago, a Chinese evening daily reported that a healthy fat Indian working in Singapore suffered breathing difficulties as he was riding on his motorcycle back to Johor Baru (Malaysian city across from Singapore) and died soon of heart failure. Heath Ledger, the Academy Award-nominated Australian actor is now suspected of dying from heart attack instead of drug overdose.

No one will die from cancer instantly, but when the heart stops pumping, that can the end of it! So what is the point of just having the best brain?

Heart disease is now the NUMBER 2 killer in Singapore, closing in cancer. In the USA & Europe, heart disease has already dethroned cancer as the #1 killer.

According to the “State of Health 2001” report, it showed that heart disease accounts for 26.3% death; that is 1in 4 persons. In the USA, it is only 1 in 5. Scary huh ?

If anyone has one or more of these major risk factors (identified by the World Heart Federation) which is associated with coronary heart disease and stroke such as smoking, alcohol consumption, high blood pressure (hypertension), high cholesterol, obesity, physical inactivity, unhealthy diets, he/she is likely to add to this statistics.

According to the same report, 27.3% of Singaporeans are hypertensive; 58% are physically inactive during their leisure; and 24% are overweight, of whom about 6% are obese.

That is 7 years ago, based on the modern increasingly “unhealthy” living and the deteriorating mother earth, what will be the statistics now ?

How to add 14 more years to your life ?

While many in Singapore might be disillusioned about healthy living after seeing the sudden death last week (4th January) of Jimmy Nah, the healthy-looking 40-year-old comedian/actor who does not smoke or drink alcohol and have a clean bill of health, BBC this morning reported that a study shown “Taking exercise, drinking moderately, eating sufficient fruit and vegetables and not smoking can add as much as 14 years to your life”.

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The study between 1993 and 2006 by the UK’s Public Library of Science Medicine which involved 20,000 people aged between 45 and 79, suggested that regardless of how overweight or poor they were, they found those who failed on all criteria were four times more likely to have died than those who succeeded.

Participants were known during this period to be free from cancer or any heart problems.

The participants were awarded a point for :

1. not currently smoking
2. consuming between one and 14 units of alcohol per week (the equivalent of between half a glass and seven glasses of wine)
3. eating five servings of fruit and vegetables each day and not being inactive.

They found that the risk of

A 60-year-old person + score ZERO = a 74-year-old + FULL FOUR points

The conclusion was that many people through some simple changes can increase their lifespan as well as reduce their risk of dying from heart and circulatory disease as shown from the research participants.

Yesterday (9th September 2007), I read about the Singapore Health Promotion Board big ad in Sunday Times entitled “Bad fats come in many disguises”. It showed 4 of Singaporean’s favourite cravings that are unfortunately high in saturated and trans fat – poultry with skin (chicken drumstick), food with coconut milk (nasi lemak), pastries (looks like apple pie) and deep fried food (French fries).

It stated that “A diet high in saturated and trans fats increases the risk of heart disease and stroke …. So, the next time you eat, choose a meal with less of these fats. Your body will thank you for it.”

It also displayed a simple chart showing the main sources of the 2 fats and their adverse effects.

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It even came out with a “Spot the Fat and Win!” promotion where every week, a winner who SMS the code “6GR824” to 76868 will walk away with S$100 shopping voucher.

Surprisingly, contrary to what was advertised, although the promotion was started on 26th August and ending 26th September, I cannot find this information or the “other terms and conditions” on their otherwise very informative http://www.hpb.gov.sg. The latest on their homepage was

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Coming to the bad fats, other than eating fishes and vegetables, it looks like one got to do alot of detox to purge the bad fats and toxins from the body if one wants to indulge in those mouth-watering delicacies.

Are you killing your pets with your smoke ?

Pets are getting all kinds of cancers, no thanks to the smokers who passed the secondhand smoke to the hapless animals. 

Just a sidetrack – I am glad that there is no smoking in confined public places in Singapore. The most recently are the pubs. Secondhand smoke is attributed in the west with killing thousands of adult nonsmokers annually. No matter what is the figure in Singapore, kudos to our government for taking tough but well-appreciated progressive ban in public places. Since July this year, I can walk into any pub to have a nice cold beer and songs with business associates and friends and go home without smelling like a walking piece of shit.

But what about the private confined areas like the individual homes? While many smoking adults might not expose the secondhand smoke to their spouse or children, what about those irresponsible habitual smokers living with pets? 

Secondhand smoke kills cats fast

“Secondhand smoke has been associated with oral cancer and lymphoma in cats, lung and nasal cancer in dogs, as well as lung cancer in birds,” said Dr. Carolynn MacAllister, Oklahoma State University Cooperative Extension Service veterinarian. 

Cats that lived with smokers for five or more years had an even higher incidence of squamous cell carcinoma, simply known as mouth cancer.

Cats are twice as likely to have malignant lymphoma cancer compared to cats living in a non-smoking home. It is a type of cancer that occurs in the lymph nodes and is fatal to three out of four cats within 12 months of developing the cancer. 

MacAllister disclosed that one reason cats are so susceptible to secondhand smoke is because cats constantly lick themselves while grooming. By licking their fur, they expose the mucous membrane of their mouth to the cancer-causing carcinogens that accumulate on their fur.

What about dogs? 

MacAllister also pointed out that “a recent study conducted at Colorado State University shows that there is a higher incidence of nasal tumors in dogs living in a home with secondhand smoke compared to dogs living in a smoke free environment,”

She said. “The increased incidence was specifically found among the long nosed breed of dogs. Shorter or medium nosed dogs showed higher rates for lung cancer.” 

MacAllister said the longer nosed breeds of dogs have a great surface area in their noses that is exposed to the carcinogens. This also provides more area in which the carcinogens can accumulate. The carcinogens tend to build up on the mucous membranes of long nosed dogs so not as much reaches the lungs.

Unfortunately, dogs affected with nasal cancer normally do not survive more than one year

The reason short and medium nose dogs have a higher occurrence of lung cancer is because their shorter nasal passages aren’t as effective at accumulating the inhaled secondhand smoke carcinogens,” she said. “This results in more carcinogens reaching the lungs.”

What about birds? 

Pet birds also are victims of secondhand smoke. A bird’s respiratory system is hypersensitive to any type of pollutant in the air.

MacAllister said the most serious consequences of secondhand smoke exposure in birds are pneumonia or lung cancer. Other health risks include eye, skin, heart and fertility problems. 

Killing them at home without smoking  

Secondhand smoke is not the only danger faced by pets that live in smoke filled environments. Poisoning is another risk they face.

 “Curious pets can eat cigarettes and other tobacco products if the products aren’t stored properly,” MacAllister said. “When ingested, this can cause nicotine poisoning, which can be fatal.” 

It is important both for the health of pets and others living in the household, that the smoker has a designated area in which to smoke that is physically separated from the home. In addition, always keep cigarettes, cigarette butts and other tobacco products put away.

A better choice that could enhance your chances of enjoying a healthier lifestyle with your family and pets would be to stop smoking altogether,” MacAllister said. 

Obesity Epidemic – Can America learn from Singapore TAF programme?

It is sad to read headline news recently like this one in the Philadelphia Inquirer Americans getting ever fatter. In most states, a new report says, 1 in 5 is obese. But little is being done about it“.

This came right after Trust for America’s Health (TFAH) released the report “F as in Fat: How Obesity Policies are Failing in America, 2007”.

Notwithstanding some experts think the estimates in the report are conservative because people are underreporting their weight in surveys, 85% of the Americans surveyed believed obesity has become a public health epidemic. Yet it seems that most Americans aren’t doing much about it and they are not only getting fatter, but they are actually getting fatter faster.

The unfortunate young generation

Washington Post reported that “A new report gives District (Washington DC) children a dubious distinction: Nearly one in four of those ages 10 to 17 is overweight, making them the heaviest kids in the country.

In the Los Angeles Times, Jim Marks, a senior vice president of a healthcare philanthropy group was reported that he was so discouraged that “These children could be the first generation to live sicker and die younger than their parents“.

Obesity costs America US$117 billion a year in preventable healthcare expenditures and Mark said that it “is pushing the healthcare system to the breaking point“.

How can it so high and still growing when corrective measures at the local and state levels have been implemented? Example, nine of the states with the highest percentages of overweight kids track the MBI (body mass index) of students, improve the nutrition of school lunches or limit the sale of high-calorie foods in school vending machines or snack bars.

However, it seems that the desired effect is doubtful. Weeks ago, I watched a documentary on Singapore TV station, Channelnews Asia in which one of the experts commented that although American schools provide healthy meals, kids are flocking to the vendor machines filled with irresistible unhealthy snacks and beverages. It also showed that young teenagers are getting diabetes and are experiencing heart diseases.

Should America learn from Singapore ?

Although being criticized from time to time even by foreign media, Singapore’s TAF (Trim and Fit) programme which was launched in 1992 by the Ministry of Education (MoE) and refined through the years have reduced the percentage of overweight students (primary schools to pre-university levels) from 14% to 9.8% in 2002.

No system is perfect but the result has been impressive. Many children have emerged from the TAF Programme fitter and more aware of the importance of keeping a healthy lifestyle; and the number of students passing the Singapore government’s National Award for Physical Fitness (NAPFA) test went up from 58% in 1992 to 82% in 2002.

MoE works with the Health Promotion Board (School Tuckshop Programme), school canteen operators and parents closely to make the “TAF programme a more meaningful part of school life, with due emphasis on the physical, nutritional and psychological aspects. It will work with schools to introduce activities and programmes that are inclusive, fun-filled and interesting for all students, so that they take pride and ownership in their own health and physical well-being.”

5 + 4 about Good Cholesterol.

Cholesterol, the fat-like substance is the word that most people especially the middle-age group and above hate to hear.

It is a constant advice that we should all cut down or avoid red meats, seafood and products from animal fats because they are high in cholesterol or are high saturated fatty acids which will raise the triglycerides (a form of fat made in the body) and cholesterol levels in the body. However, for most people, without the wonderful delicious pork, beef, mutton, liver, skin of poultry, ham, bacon; drunken prawns, chilly/pepper “Sri Lanka” crabs, “hum/tua tao/lala” (clam), “sotong” (squid, cuttlefish), lobsters; butter, lard, egg yolk, etc., life will be meaningless.

That is just negative which we remembers. The flipped side is that our body needs cholesterol for functions such as making hormones. Besides being found in those products above, it is also produced in our body.

There are good and bad cholesterols. They can’t dissolve in the blood and have to be transported through the bloodstream in different carriers called lipoproteins. Low-density lipoproteins (LDL or “bad” cholesterol) deliver cholesterol to the body, while high-density lipoproteins (HDL or “good” cholesterol) take cholesterol out of the bloodstream to the liver which will then passes them out of the body.

We are told the higher your HDL cholesterol, the better it is. Now, I learned that biological reality is more complex as genes direct the body’s production of HDL and that many of us might not be lucky enough to inherit genes that result in a lot of HDL. Luckily, genes are only part of the story because lifestyle factors and, to a smaller extent, medications can strongly influence HDL levels.

The National Cholesterol Education Program (NCEP) and the American Diabetes Association advise people to aim for HDL levels of at least 40 mg/dL. An even more protective goal, according to the NCEP, is 60 mg/dL or higher.

Why is having high HDL cholesterol is important?

At first, scientists believed that HDL was simply a garbage collector that picked up cholesterol from an artery’s walls and delivered it to the liver for disposal. That’s still considered the main role of HDL, but research is starting to suggest that HDL can help protect the heart in many ways:

  • Reverse cholesterol transport. HDL latches onto LDL embedded in an artery wall, lugs it back into the bloodstream, and carries it to the liver. The liver collects cholesterol from the HDL particles, packages it into bile salts and bile acids, and dumps it into the intestines for excretion.
  • Antioxidant activity. LDL cholesterol in the artery wall is bombarded by oxygen free radicals, which turns it into oxidized LDL cholesterol. Oxidized cholesterol is the stuff that’s actually responsible for arterial damage — and research shows that HDL can help protect LDL cholesterol from free radicals.
  • Anti-inflammatory action. HDL helps to quiet the inflammation of an atherosclerotic plaque. Elevated levels of C-reactive protein (CRP) reflect the inflammation of such a plaque and HDL may neutralize CRP’s tendency to perpetuate the inflammatory cycle.
  • Antithrombotic activity. Plaque rupture triggers the formation of an artery-blocking blood clot. By halting the flow of oxygen-rich blood, the clot kills heart muscle cells (heart attack) or brain cells (stroke). HDL reduces clot formation and accelerates the healing process that dissolves clots.
  • Endothelial function. Blood vessels plagued with atherosclerosis sustain other damage. In particular, the endothelial cells lining the arteries fail to produce normal amounts of nitric oxide, the chemical that allows arteries to dilate (widen) when tissues need more oxygen. HDL helps preserve nitric oxide production and protect endothelial function.

How much does HDL help?

The Framingham Heart Study was responsible for many landmark discoveries about HDL cholesterol, and the Physicians’ Health Study helped confirm that HDL was protective, reporting that various HDL subtypes are all helpful. Data continue to show that the good cholesterol is very good indeed.

  • Heart disease. Low HDL levels are associated with an increased risk of heart attacks, while high levels are protective. According to the Framingham Heart Study, cardiac risk rises sharply as HDL cholesterol levels fall below 40 milligrams per deciliter (mg/dL). In general, each 1 mg/dL rise in an HDL cholesterol level can be expected to cut cardiac risk by 2% to 3%.
  • Stroke. Strokes come in many forms, but the most common type, ischemic stroke, shares many risk factors with heart attack. High HDL cholesterol levels reduce the risk of stroke; in several studies, HDL cholesterol is a much better predictor of risk than LDL cholesterol, particularly in people older than 75.
  • Erectile dysfunction. Normal erections depend on many things, including healthy arteries that produce good amounts of nitric oxide. It’s no surprise, then, that the Massachusetts Male Aging Study found that 16% of men with low levels of HDL cholesterol had erectile dysfunction, but none of the men with the highest levels did.
  • Longevity. Several investigations suggest that high HDL levels are linked to longevity, particularly exceptional longevity. Other research links high levels of HDL cholesterol to preserved cognitive function in old age. More research is needed to learn if HDL deserves the credit or if other genetic factors are responsible.

Ways to raise your HDL

  • Exercise. Exercise is an important way to boost HDL levels. On average, sedentary people who start to exercise regularly can expect their HDL levels to rise by 3% to 20%. The benefit can occur with as little as one mile of walking or jogging a day, but the more you do, the better your result. Brisk walking for 40 minutes a day is a good target, but if you need more help, aim higher.
  • Watch your dietary fats. Saturated fat won’t affect your HDL cholesterol, but it will raise your LDL cholesterol. The latest American Heart Association (AHA) guidelines call for limiting saturated fat to less than 7% of your total daily calories. Reduce your intake of trans fats to less than 1% of your total daily calories. Trans fat lowers HDL cholesterol and raises LDL cholesterol, a double whammy to health. But unsaturated fats like virgin olive oil may boost HDL levels, and the omega 3 fats in fish, nuts, and canola oil may promote cardiac health even if they don’t affect your HDL reading.
  • Watch your carbs! Or at least the types of carbs you’re eating. Diets that provide large amounts of rapidly absorbed carbohydrates are clearly linked to low levels of HDL cholesterol. Avoid highly refined carbohydrates in favor of coarsely ground, whole grain, unrefined carbs like whole grain bread, oatmeal, and beans.
  • Alcohol. Moderate drinking will raise HDL levels by about 4 mg/dL, which should cut cardiac risk by about 10%. This translates to one to two drinks a day for men, and one drink a day for women. For this “prescription,” count 5 ounces of wine, 1½ ounces of liquor, or 12 ounces of beer as one drink.
  • Weight control. Obesity is linked to low HDL levels, but weight loss can help. Exercise and diet are the dynamic duo for weight loss, but shedding excess pounds will boost HDL levels over and above the independent effects of regular exercise and a healthful diet.

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