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World Diabetes DayFREE SEMINARS

PRODUCT DISCOUNTS GAMES & QUIZZES

GOODIES BAGSMORE DETAILS ON BACK PAGE

11 November 2012

JOIN US ON

DiabetesSingapore

Issue 43 OCT-DEC 2012

Publication of Diabetic Society of

MIC

A (P) 148/09/2012

SPECIAL REPORT: The Diabetes Pandemic SPECIAL FEATURE: Healthier Hawker Guide

DSS m

anagement com

mittee

2012/2014

PATRONProf Arthur Lim

ADVISORDr Warren Lee

PRESIDENTMr Yong Chiang Boon

VICE-PRESIDENTSDr Kevin Tan Eng KiatHj P.M. Mohd Moideen

HON SECRETARYMs Esther Ng

ASST HON SECRETARYMs Rohanah Bte Pagi

HON TREASURERMr Stanley Lim

COMMITTEE MEMBERSDr Yeo Kim TeckMs Kalpana BhaskaranMr Greig PriceMs Juliana Lim

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World Diabetes Day is upon us again. 14 November marks the occasion when the whole world unites against diabetes the condition, to heighten awareness about what diabetes is all about, how it can be prevented and how it should be controlled; so as to reduce the suffering that diabetes complications can

bring.

The International Diabetes Federation has a theme each year. The focus is on Diabetes Prevention and Education. This year, the aim is to Educate, Engage and Empower youth and young persons, as well as the general public on diabetes. One of the key messages is relevant to us in Singapore, that “the way we live is putting our health at risk” for diabetes.

The slogan for the campaign – “Diabetes: Protect Our Future” – hopes to disseminate education and prevention messages to communities and make children and young people aware of the warning signs and risk factors for diabetes. In many cases, type 2 diabetes can be prevented through healthy eating, physical activity and the prevention of obesity. The plan is to galvanise action for the protection of the health of our future generations.

Our World Diabetes Day commemorative event in Singapore will be held on Sunday, 11 November, at the NUSS-The Graduate Club at Kent Ridge Drive from 9am to 3pm. The Minister for Health, Mr Gan Kim Yong, will be our Guest-of-Honour. Our partners in this cause are NUSS, who will also be raising funds for Diabetic Society of Singapore, and Singapore National Eye Centre for its combined National Eye Care Day!

We need your help to make this year’s World Diabetes Day a success, especially since the venue is not in a high-visibility location. Please come, bring your friends, spread the word around from now till November 11. Persons with or without diabetes can come to learn more, as well as have their regular checks and to buy diabetes-related products and enjoy the special offers on that day.

Let’s protect our future.Together.

See all of you at World Diabetes Day!

Dr Kevin TanVice-PresidentDiabetic Society of Singapore

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edito

rial

teamA WORD FROM THE VICE-PRESIDENT

Chief EditorDr Yeo Kim Teck

Managing EditorCharlotte Lim

Editor (Dietetics)Janie Chua

Editorial ConsultantsDSS Mgmt Committee

WritersHenry Lew (psychologist)

Kohila Govindaraju (nutritionist)Cindy Ng (physiotherapist)

Chionh Lay Keng (diabetes nurse educator)Rodiah Hashim

ContributorsDr Ang Chee Wan; Dennis Oh;

Eric Teo; Milind Sovani; Yen Koh;Pravin Rajwani; Delcie Lam;

Hj P M Moideen.

DesignCharlotte’s Web Communications

PhotographyDreamstime.com & sxu.hu

Printing Stamford Press Pte Ltd

AdvertisingGeorge Neo

Esther Ng

Advertisement BookingsT: 6842 3382 or E: editor@diabetes.org.sg

Feedback editor@diabetes.org.sg

Back Issues www.diabetes.org.sg

Diabetic Society of Singapore HQBlk 141 Bedok Reservoir Road #01-1529 Singapore 470141 T: (65) 6842 6019 /3382

DisclaimerThe views, opinions and recommendations given by

the contributors of Diabetes Singapore or are merely for general reference. All materials in this newsletter are

for informational purposes only. The individual reader should consult his own doctor or specialist for his personal

treatment or other medical advice. DSS and Diabetes Singapore Editorial Board disclaim all responsibilities and

liabilities for content expressed in this newsletter including advertisements herein. All contents of the newsletter are the

copyright of the contributors and newsletter. Reproduction in any form is strictly prohibited unless with written permission.

Protect Our Future

Diabetic Society of Singapore is a non-profit organisation affiliated to the International Diabetes Federation and the National Council of Social Service. DSS gratefully accepts donations of any amount to help fight diabetes. All donations are tax exempt. Cash donations must be made in person at our HQ. Cheque donations should be made payable to Diabetic Society of Singapore. You may also make online donations via www.sggives.org/diabetes.

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Manage Your Diabetes, Successfully!A Retreat for Adults with Type 2 Diabetes

6

by Rodiah Hashim

by Rodiah Hashim

Cooking Demonstration

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by Kohila Govindaraju

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by Rodiah Hashim

Bulan Ramadan, telah datang dan pergi dengan perayaan Hari Raya Aidilfitri pada 19 August. Bagi 35 orang pesakit kencing manis dan

perawat mereka, persiapan untuk bulan Ramadan dimulai pada 7 Julai ketika mereka menghadiri sebuah forum bertajuk ‘Fakta-fakta mengenai berpuasa di bulan Ramadan’ yang di adakan di bilik activiti di Pusat Pendidikan Kencing Manis Bedok.

Di anjurkan oleh Persatuan Kencing Manis Singapura (Diabetic Society of Singapore – DSS) dengan penaja utama MSD, forum itu di harap dapat membantu pesakit kencing manis mengurus dan memahami risiko yang berkaitan dengan berpuasa. Hal ini tegas di ulangi oleh pembicara utama Puan Rohanah Bte Pagi, Jururawat Kanan dari SingHealth Poliklinik dalam tajuk ceramahnya ‘Kencing Manis dan Ramadan’. Beliau begitu prihatin sekali

mengemukakan langkah – langkah dan nasihat yang dapat di praktikan oleh pesakit kencing manis.

Selain penjagaan tahap darah glukosa (gula dalam darah), pemakanan dan diet juga penting. Demikian di tegaskan pembicara seterusnya Saudari Siti Hussain, pensyarah dan Pakar Pemakanan dari School of Applied Science Temasek Polytechnic dalam tajuk ceramahnya “Pengawalan Kencing Manis dan berat badan melalui pemakanan’. Menurutnya, makanan yang seimbang, terutama sekali pemilihan makanan karbohidrat yang bijak, dapat mengimbangi kandungan darah glukosa. Semasa berpuasa, kita di galakkan memakan makanan yang mengandungi zat serat yang tinggi dan rendah glisemik. Makanan yang sedemikian baik untuk pesakit kencing manis dan juga ahli keluarga mereka.

Kami berharap bahwa dengan pengetahuan yang diperoleh semasa forum dan dengan buku pegangan berguna yang didistribusikan oleh MSD, semua peserta kami berhasil menguruskan kencing manis mereka di bulan Ramadan. DSS ingin mengucapkan terima kasih kepada MSD dan pembicara terkemuka kami yang sama-sama telah menjayakan forum ini.

FOR THE LATEST ON DSS EVENTS, LOG ONTO WWW.DIABETES.ORG.SG

carecorner

How to manage your diabetes successfully

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Translated by Hj P M

Moideen, D

SS VP

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DSS HQ @ BedokBlk 141 Bedok Reservoir Road #01-1529 Singapore 470141Tel: (65) 6842 6019 /3382 Fax: (65) 6842 3118Opening Hours: Monday-Friday 8.30am - 5.00pmSaturday 8.30am - 12.30pm

Hong Kah Diabetes Education & Care CentreBlk 528 Jurong West St 52 #01-353 Singapore 640528 Tel : (65) 6564 9818, (65) 6564 9819 Fax: (65) 6564 9861 Opening Hours: Monday-Friday 8.30am - 5.00pmSaturday 8.30am - 12.30pm

Central Singapore Diabetes Education & Care CentreBlk 22 Boon Keng Road #01-15 Singapore 330022 Tel : (65) 6398 0282 Fax : (65) 6398 0275Opening Hours: Monday-Friday 8.30am - 5.00pmSaturday 8.30am - 12.30pm

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10carecorner

如何应付低血糖 Prevention and Treatment of Hypoglycaemia by Chionh Lay Keng, diabetic nurse educator, Diabetic Society of Singapore

低血糖是: <4 mmol/L or < 72 mg/dL

低 血 糖 可 能 会 发 生 在 下 列 情 况:当 血 液 里 有 过 多 的 胰 岛 素 时，所 有 的 血 糖 就 快地 进 入 体 内 的 细 胞，血 液 中 的 血 糖 量 就 会 变 低。这 种 情 况 就 是 低 血 糖 症 。

过 量 的 药 剂 (注 射 过 量 胰 岛 素)误 餐 (进 食 过 少 或 不 定 时)过 渡 运 动 或 工 作注 射 胰 岛 素 后 太 久 才 进 餐 一 直 在 呕 吐 或 腹 泻

血糖過低現象:

1. 心跳加快(心慌) 2. 飢餓3. 頭暈出汗4. 顫抖5. 軟弱無力6. 面色蒼白7. 舌或唇麻木8. 遲鈍,注意力不集中心 9. 脾氣改變後果做成精神錯亂動作和言語不清及昏迷等。

测试血糖患者必須立刻服食一些容易吸收的糖類食物:

3 粒方糖3 茶匙蜜糖、砂糖或葡萄糖1/３罐汽水或果汁15分钟后再测试血糖

避 免 低 血 糖:

1. 运 动 前应量 血 糖进 食2. 准 时 定 量 进 餐3. 服 用 正 确 的 药 物 及 剂 量4. 定 期 量 血 糖5. 避 免 空 腹 喝 酒

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13carecorner

Medical conditions that may cause oral health problems

Menopause

As a woman goes through menopause, her oestrogen levels decline. Since oestrogen is important for absorption of calcium and bone formation, a decrease in oestrogen

levels in menopausal women can lead to osteoporosis. This effect of poor calcium absorption and bone formation can sometimes be seen on jawbones. Osteoporotic patients have more severe gum disease that often leads to teeth loss. Other effects of declining oestrogen levels include more severe gum bleeding and dry mouth.

There are ways to prevent or limit the effect of menopause on oral health. Hormone replacement therapy (HRT) might be able to slow down the effect of menopause on the oral cavity. Regular dental visits and cleaning can also keep gum disease in check. The dentist or gum specialist will formulate a comprehensive plan to keep the gums healthy and hence prevent the negative effects of menopause on the oral cavity.

Osteoporosis

Osteoporosis is commonly seen in post-menopausal women and osteoporosis may be linked to more severe gum disease and tooth loss. The loss of bone mass can sometimes

be seen in the jawbone and this can lead to loosening of teeth and ultimately tooth loss.

Diabetes

Diabetes is another common medical condition that can lead to more severe gum disease. Usually patients with diabetes have more gum bleeding, receding gums, shaky teeth and

tooth loss. Interestingly, when a patient has her diabetes treated well, her gum condition can also improve.

Lupus Erythematosus

Another medical condition commonly affecting women is Lupus Erythematosus, commonly called lupus. Lupus is an autoimmune condition with unknown

causes but it can appear as ulcers or swellings in the gum.

Many medical conditions or even physiological ones can show up in the oral cavity. Hence, your dentist can help in picking up signs of possible underlying medical conditions.

Due to the possible link between gum disease and women’s health status, it is advisable for women to see a gum specialist on a regular basis.

Menstruation gingivitis & pregnancy gingivitis

There are no accurate data on the prevalence of menstruation gingivitis and most females do not notice any changes in their gum condition. This is because when menstruation gingivitis occurs,

it is usually mild in 75% of females.

However, some female patients have complained of more severe gum bleeding during menstruation or pregnancy. In fact, some patients can even experience gum swellings that bleed easily to brushing or eating.

Female patients with more “dramatic” gum reactions during menstruation and pregnancy tend to have pre-existing gum disease to start with. Hence, most of these patients can resolve menstruation gingivitis and pregnancy gingivitis with effective gum treatment by a gum specialist.

Physiological conditions that can lead to oral health problems

RAL DISEASE & O WOMEN’S HEALTHby Dr Ang Chee Wan, dental specialist in periodontics,clinical director, T32 Specialist Division

Please ring 9711 0132 for an appointment.

Our trained and experienced diabetes nurse educators will be available to provide the following services:• Diabetes Retinal Photography• Diabetes Foot Screening & Foot Care Advice• Individual & Group Diabetes Education (including self blood glucose monitoring & insulin injection technique)• HbA1 c (glycosylated haemoglobin)

DIABETES

CARE

ON WHEELS

For more information, visit www.bddiabetes.com BD, BD Logo and all other trademarks are property of Becton, Dickinson and Company. © 2011 BD, SEAPM112011-182.*Photographs from Dieter Look and Kenneth Strauss: "Nadeln mehrfach verwenden?" Diabetes Journal 1998, 10: S. 31-34

BD Medical30 Tuas Avenue 2Singapore 639461

There are so many things in your daily life that you would never use twice.

Think about products like tissues or plasters. Syringes and Pen Needles are sterile, single use products and are intended to be used only once.

Think twice, use once.

Photographs showing the type of damage that can occur with needle reuse*

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Have you ever wondered why it is so hard to change and maintain your diet? Why you just cannot bring yourself to exercise regularly even though you know that it is good for you? Well, perhaps because even though you “know what to do”, something else could be getting in the way. It is called environmental influences.

CHANGE YOUR ENVIRONMENT by Henry Lew, psychologist

Myth #2I control how much I eat.

Environmental cues that suggest what kind of meal we are having may instead determine how much we eat!

Two groups of people were provided with the same food but different environmental cues. One group had disposable utensils (paper/plastic) normally associated with snack time or tea, etc. Another group was given ceramic utensils normally associated with a proper meal. These individuals actually ate more than those using disposable utensils, highlighting how subtle environmental cues can prompt us to eat more and circumvent our best efforts to eat less.

What you can do:

• Plan and decide what you want to eat before you go out to eat or prepare your own meals to avoid temptation.

•• The size of your plate or bowl should be based

on the amount of food you want to eat till you are comfortably full, and not beyond the point of fullness.

• If you need to have a snack, limit the size to a snack’s portion and keep the rest away. Out of sight, out of mind and out of your autopilot hands that feed your mouth when you are multi-tasking.

1. I know how much I eat. 2. I control how much I eat 3. I just need discipline to exercise.

As much as the statements appear to be facts, they are actually myths. These myths minimise, discount and disregard environmental influences on our behaviours pertaining to exercise and diet.

Myth #1I know how much I eat.

Our environment may actually determine how much we eat instead!

In a landmark study by Dr Brian Wansink, individuals were given either medium or large size popcorn. Those with the large size portion ate 50% more than those who ate from the medium portion. In another instance, individuals drank soup from a bowl that was either bottomless (i.e. it kept replenishing itself ) or a normal bowl (soup supply was limited). Those who drank from the ‘bottomless’ bowl drank more.! In both studies, all were unaware of the portion size and simply ate what was given. The arrangement of food seems to influence our eating habits as well. Individuals tend to eat more when food is arranged neatly, and also when the dish looks like it has some variety of ingredients, compared to the same dish that is all mixed up!

What you can do:

• Limit your patronage of ‘high-risk ‘ places that offer bigger or upsized portions, top-ups, free flow of soft drinks, etc.

• When preparing healthy meals, arrange the dishes/ingredients neatly so that the food appears more appetising.

Consider the following three statements. Are they myth or fact?

HEARTWARE14

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01 It's not right to say "no” when someone is just trying to be nice to me.

02 It’s often hard for me to speak up for what I need or want.

03 I’d rather put my own needs second than hurt someone else’s feelings.

04 It isn’t fair to want others to help me in my weight-management efforts.

05 I shouldn’t not involve others in my problems.

06 I need to drink or eat a lot at a restaurant in order to make others feel comfortable.

07 When someone else is paying for it, I feel I may as well take advantage of it.

08 Guests who are invited to dinner expect to be treated to fancy (i.e., high calorie) meals.

09 A good host prepares special meals for invited guests, and this involves a heavy meal and a sweet dessert.

10 When invited to dinner, I should show my appreciation by eating well.

11 Calling ahead to inquire about the menu or making special requests of a host is making a nuisance of myself.

12 Other people depend on me, and their needs must come first.

13 When someone tries to pressure me, I resist, even if what they want me to do is a good idea.

14 When someone I care about does not want me to change, I feel I should do as they ask.

15 I like the attention and sympathy I get from having a weight problem.

16 I can't resist food at parties or celebrations.

17 When I see others eating, I just cannot resist getting something to eat too.

18 It isn't polite to refuse food when someone has prepared it especially for me.

TOTAL

Here is a quiz to help you determine how well you cope with social influences on your eating habits. Rate yourself on each of the statements then refer to the scoring for some guidelines on how to manage these environmental social cues. 1= Never 2 = Sometimes 3 = Usually 4 = Almost Always 5= Always

My Score

Social Environmental Pressure to Eat

18-36: Low Pressure QuotientYour beliefs are strong enough to help you resist social influences.

37-53: Moderate Pressure QuotientSome of your beliefs make it difficult for you to cope with social pressures. Identify which beliefs are a hindrance and try to change them.

54-90: High Pressure QuotientMuch of your belief system makes it harder for you to cope with social influences. You need to challenge your beliefs and change the way you think about them.

Myth #3I just need the discipline to exercise.

You may think that exercise is just about getting down to it. It appears that reminders make quite a difference. Individuals who saw cues about exercise along their way home from work were more likely to hit the gym compared to those who did not encounter such cues. Individuals who received SMS reminders to exercise were also more likely to initiate regular exercise.

Habits could well be a result of “automacity” rather than “frequency”. In other words, habits like regular exercise are usually formed because there are cues in the environment that regularly prompt and support one to exercise, e.g. Mdm Sulaiman walks regularly after dinner, mainly because her grandchildren will remind and encourage her to join them for walks.

What you can do:

Build cues into your physical or social environment to help you to exercise regularly since good habits are better formed if we engineer our environment. This may include:

• Physical reminders to exercise, e.g. timetable to exercise, mobile alerts that are programmed into your phone to go to the gym or take a brisk walk, etc.

• Social reminders, e.g. a workout buddy, exercising with your family and friends, etc.

In our journey to achieve a healthier lifestyle, we may meet with obstacles and difficulties. In some situations we cannot change much, but there are bound to be areas in our environment we can modify, even if it is the tiniest thing. Remember small drops of water make up an ocean.

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HOW DID YOU FARE?

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DAL PANCHANGRA

•25gwholegreenmoongdal

•25gsplitchannadal

•25gturdal(arhandal)

•1tspturmeric

•21/4cupswater

•80gdrumsticks,medium-sized

•2greenchillies

TEMPERING

•1tbspFairPricericebran

oil

•1tspcuminseeds

•4garlic,chopped

•50gredonions,choppe

d

•10gginger,chopped

•50gtomatoes,chopped

•1tspredchillipowder

•1tbspasafoetida(hing

)

•1tbspgreencoriander,

chopped

•1/4tspsalt

HO

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by Chef Milind Sovani

ingredients

1. Wash and soak all the dal (lentils) in water for 2 hours.

2. Drain the lentils and boil them in a thick bottom pan in 600ml water.

3. Add in the turmeric and slit green chillies when water starts to boil. Cook for 15 minutes.

4. Cut the drumsticks into 2-inch pieces, and add to the lentil mixture. Cook the entire mixture till done (approx.

30 minutes). Set aside.

5. In a separate frying pan, heat oil and add in the cumin seeds until they crackle.

6. Add in the garlic and saute for few seconds. Add the onions and saute till translucent. Add the ginger and

saute for another 15 seconds.

7. Add in the hing (asafoetida) and then the tomatoes. Saute till they are well cooked and mashed.

8. Add in the red chilli powder and saute. Add the boiled dal and chicken mixture into frying pan. Stir to mix

well for 2 to 3 minutes.

9. Add in the salt, bring the mixture to a boil, add in the green coriander. Mix well and remove from heat.

10. Serve hot.

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Heat oil till hot before stir-frying, as this will shorten cooking time and reduce the amount of oil absorbed

by the ingredients.

Use unsaturated oils (e.g. sunflower oil, canola oil, olive oil) instead of saturated oils (e.g. ghee, butter,

blended vegetable oil) to reduce your risk of heart disease.

Beancurd, pulses, lentils, peas and beans are good sources of protein and low in saturated fat. They can

be used to replace meat in some dishes.

To shorten cooking period, use a pressure

cooker for step 4.Chef Milind Sovani

NUTRITION INFORMATION per serving: Energy (1 kcal = 4.2kJ) 125kcalProtein 6gTotal fat (g and % of total calories) 4.3g (30.4%)Saturated fat 0.7gCholesterol 0mgCarbohydrate 16.4gDietary Fibre 4.5gSodium 153mg Recipes courtesy of Health Promotion Board Singapore

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ingredients

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1. Heat up 1 tablespoon of oil in wok. Stir-fry sliced ginger untiI fragrant.

2. Pour in 6 cups of hot water. Add in concentrated chicken stock to boil for 2 minutes.

3. Add brown rice spaghetti, Toman fillet slices, tomato wedges, spring

onion, sesame oil and low fat evaporated milk. Cook for 2 minutes.

4. Add salt and pepper to taste.

5. Ready to serve.

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grandma's famous sliced fish

with beehoon soupby Chef Eric Teo

serves 4

200g Toman fillet, sliced and blanched

200g brown rice spaghetti, soaked and drained

2 tomatoes, cut into wedges

2 spring onion, cut into 2-inch lengths

5g ginger, sliced and blanched

1 tsp sesame oil

6 tbsp low-fat evaporated milk

6 cups hot water

25ml concentrated chicken stock

1 tbsp corn oil

Salt & pepper to taste

For soup-based dishes, skim away visible fat or oil after cooking to maximise

the healthfulness of the dish.

Use more water when cooking whole grains, as whole grains absorb more

water than refined grains.

Select low-salt soup stocks or prepare at home.

NUTRITION INFORMATION per serving: Energy (1 kcal = 4.2kJ) 303kcalProtein 14.3gTotal fat (g and % of total calories) 5.8g (18.5%)Saturated fat 0.9gCholesterol 25mgCarbohydrate 43gDietary Fibre 3.2gSodium 617mg

cookout!

Try substituting beehoon with brown rice spaghetti for a

healthier alternative.Chef Eric Teo

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ingredients

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1. Wash the rice and drain.

2. Heat the oil in a non-stick wok. Stir-fry rice, turmeric, coriander, garlic, lemon grass and lime leaves.

3. Transfer to rice cooker. Add peppercorns, pandan leaf, salt, low-fat evaporated milk and water. Then bring to

boil with the lid uncovered.

4. Stir to mix. Cover rice cooker and let it simmer till cooked.

5. Fold in the tuna, diced tomatoes and green peas while the rice is hot.

6. Garnish with raisins, almond flakes, lime leaves and lemon grass.

7. Serve hot.

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NASI KUNINGby Chef Yen Koh

serves 4

180g FairPrice White Rice

70g FairPrice Brown Rice

1 tbsp canola oil

1 tbsp turmeric powder

2 tbsp coriander powder

1 tbsp garlic

1 tbsp peppercom

1 pandan leaf

3/4 cup low-fat evaporated milk

salt to taste

2 cups water

200g canned tuna flakes, unsalted

50g tomatoes, diced

50g green peas

1 tbsp raisin/sultanas

1 tbsp almond flakes

3 lime leaves, finely chopped

2 tbsp lemon grass, chopped

Use more water when cooking wholegrains, as wholegrains absorb more water than refined

grains.

Use fresh ingredients, herbs and spices or low sodium seasonings as flavour enhancers.

Vegetables such as tomatoes, corn, peas and mushrooms are good sources of glutamate and act

as natural flavour enhancers.

cookout!

A simple way of creating this recipe

is to cook the rice first and mix the

other solid ingredients while the rice is still warm.

Chef Yen Koh

NUTRITION INFORMATION per serving: Energy (1 kcal = 4.2kJ) 412kcalProtein 20.1gTotal fat (g and % of total calories) 6.2g (14.6%)Saturated fat 1.1gCholesterol 17mgCarbohydrate 62gDietary Fibre 3.0gSodium 485mg

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21

things you should not store in your fridge

Tomatoes: Technically a fruit, but taste-wise, it is closer to a vegetable. If you have ever grown tomatoes, then you know that they love the heat and hate the cold. It turns out even after they are plucked from the vine, they still dislike cold. The refrigerator is not the ideal place to store tomatoes. Store them there and your perfect tomatoes turn into a great disappointment. They will still be good for cooking, but not the best for eating fresh. Store them on your counter instead (but not in direct sunlight) and enjoy them when they are ripe.

Basil: Tomatoes and basil go well together on your plate and they have similar needs in the storage department too. Like tomatoes, basil loves the heat, so extended periods of time in a cold environment like a refrigerator causes it to wilt prematurely. Basil will do best if it is stored on your counter and treated as you would fresh cut-flowers. A fresh bunch of basil can be stored for in a cup of water (change it every day or two) away from direct sunlight. Covering it loosely with a plastic bag will help keep it moist (but make sure the bag has an opening to allow for some fresh air in).

Potatoes: Potatoes like cool, not cold temperatures. They do best at around 7 degrees celsius, which is about 10 degrees warmer than the average refrigerator. Most of us do not have a cool, dark place to store root vegetables like potatoes, so keeping them in a paper bag in a coolish spot is best. Why paper? It is more breathable then plastic so potatoes will not succumb to rot as easily. And why not the refrigerator? Storing potatoes at cold temperatures converts their starch to sugar more quickly, which can affect the flavour, texture and the way they cook.

Onions: Onions do not come out of the ground with that protective papery skin. To develop and keep that dry outer layer, they need to be “cured” and kept in a dry environment like a pantry, which is not as damp as the refrigerator. Also, a lack of air circulation will cause onions to spoil, as will storing them near potatoes, which give off moisture and gas that can cause onions to spoil quickly. Store onions in a cool, dry, dark, well-ventilated place as light can cause the onions to become bitter. Scallions and chives, however, have a higher water content, bruise more easily and have a shorter shelf life, so store them in the refrigerator.

Avocados: Avocados do not start to ripen until after they are picked from the tree. If you are buying a rock-hard avocado, do not store it in your refrigerator, as it slows the ripening process. On the other hand, if you have a perfectly ripe avocado that you are not ready to use, storing it in the refrigerator may work to your advantage by prolonging your window of opportunity to use it before it becomes overripe. So the bottom line on storing avocados is store hard, unripe avocados on your counter and store ripe avocados in your refrigerator if you are not going to eat them right away.

{ the LIGHTER side }

By Hilary Meyer, EatingWell.com

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REC

OMMENDED PLAT E SIZE IS 10 INCH

ES

Grains/Starchy VegetablesFill ¼ of your plate with whole grains or

starchy vegetables.

Whole grains include brown rice, whole wheat pasta, whole-grain breads and cereals.

Starchy vegetables include potatoes, corn, peas and legumes.

Make at least half of your choices per day whole grain and/or

unprocessed grains.

Veget ables Fill ½ of your plate with non-starchy vegetables.

An Alternative Way to Portion Control for Diabetes? by Derrick Ong, Eat Right Nutrition Consultancy

The Plate

Non-starchy vegetables include carrots, broccoli,

cauliflower, green beans, peppers

and asparagus.

Pack pre-cut vegetables for a quick snack.

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REC

OMMENDED PLAT E SIZE IS 10 INCH

ES

Veget ables Fill ½ of your plate with non-starchy vegetables.

Meat/ProteinFill ¼ of your plate with

lean protein sources.

Choose protein sources such as non-fried chicken, fish or lean cuts of beef and pork.

No more than three eggs per week.

Meatless protein choices include soy (tempeh, tofu) and legumes.

Source: michigantoday.umich.edu/2008/03/images/great-plate.pdf

Aim for a variety of colours.

Veggies are low in calories and full of

fibre, vitamins, minerals and antioxidants.

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Your stomach is growling, but lunch is hours away. You might just grit your teeth, thinking that waiting

for lunch is the best. But why? You could always indulge in a snack!.

Isn’t snacking the same as eating junk food?

We are talking about healthy snacking, of course! Healthy snacks reduce the risk of developing type 2 diabetes, obesity, and heart disease. Snacking helps people with diabetes better control their blood sugar and decrease the risk for hypoglycaemia as well.

My friend packs snacks such as mixed nuts, banana, wholemeal crackers, an apple and baby carrots for her daughter every day.

They are so easy to pack, lightweight, low in calories, and high in vitamins and minerals to boost her child’s energy in school.

It is the variety that makes the snack more appealing. The wider the range of foods we eat, the more nutrients we get.

But aren’t snacks fattening?

Well, not really. Snacks help manage hunger and reduce binge eating. Moderation and balance is the key while incorporating the snacks in our daily diet. Remember to opt for snacks of 100 calories or less to stay within our daily calorie goal.

The nutrient-poor, sugar-laden snacks like candy bars give us a quick jolt of energy that is followed by a crash that can leave us hungry, cranky, sleepy, and unable to concentrate.

Healthy snacks are like slow-burners that help us keep going all day. Eggs, tofu snacks help to regulate concentration and alertness for they increase the production of neurotransmitters or chemical messengers that can affect mood, appetite, anxiety, sleep, heart rate, temperature, aggression, fear and many other psychological and physical occurrences.

A piece of a fruit or some raw veggies as a snack can tame our hunger without ruining our appetite for the next meal. In the afternoon, a snack would stave off the overwhelming fatigue and sleepiness. Having two to three snacks a day may just banish the postmeal sleepiness that usually results with engulfing too many calories at one sitting.

To get all the essential nutrients our body needs in a day, snacking can be very beneficial!

FUEL UP‘TWEEN MEALS

References:The Complete Diabetes Prevention Plan: A Guide to Understanding the Emerging By Sandra Woodruff, Christopher D. Saudek Knack Healthy Snacks for Kids: Recipes for Nutritious Bites at Home Or On the Go By Amy Wilensky, Peter Ardito, Susan ByrneDiabetes Snacks, Treats and Easy Eats ,for Kids By Barbara Grunes, Linda R. Yoakam R D, M S

by Kohila Govindaraju, freelance nutritionist

TRY THESE!

Fruits & VegetablesSmall number of calories, good amount of vitamins, minerals and fibre. Try celery sticks, cherry tomatoes, grapes and cucumber.

Nuts & SeedsHigh in calories, high in fat, thankfully the good fat, but still, a handful is just about enough.

Whole-grainsHigh in complex carbohydrates that give energy with staying power.

Low-Fat Dairy Products Cheese and yoghurt are good sources of calcium and protein.

Healthy snacks are like slow-burners

that help us keep going all day.

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SPE

CIA

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E26

Photos courtesy of Health Prom

otion Board

Healthier Chicken Rice and Shredded Chicken Noodle/Hor Fun at Yuhua Hawker Centre

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Preliminary results from the Health Promotion Board”’'’s 2010 National Nutrition Survey (NNS) showed that seven in 10 exceed their recommended calorie requirements. Among them, about 15% consume at least twice the recommended allowance.

Source: Health Promotion Board Singapore

The 2010 National Nutrition Survey showed that the Malay community consumes more calories, total and saturated fat, and less whole-grains than other Singapore residents.

The Malay community consumes about a third more salt than the recommended amount.

The incidences for stroke and heart

attack in the Malay community are about

240 and 404 respectively per 100,000,

compared to about 155 and 207 per

100,000 across all races.

The 2010 National Health Survey (NHS) found that 24% of the Malay community are obese, a figure which is double the national average.

SPECIAL FEATURE

Malay Community Health Figures

Deep-fried snacks and fast foods, fried rice and stir-fried vegetables, coconut dishes and flavoured dishes such as nasi briyani, nasi lemak and chicken rice, contribute up to 50% of saturated fat intake by the Malay community.

28% of the Malay community have high blood pressure and 23% have high blood cholesterol, which are also the highest percentages across all races.

Healthy

Hawker Fare

at Geylang

Serai

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Have your kueh and eat it!

Selected hawker centres at Geylang Serai now offer healthier versions of their famously delectable local delights - without compromising on price, taste or enjoyment.

Participating stalls use whole-grain noodles, brown rice bee hoon, healthier oil and salt, and sell drinks with lower sugar content.

These stalls serving traditional Malay dishes such as mee siam, mee rebus, nasi lemak and nasi padang are located at:

• Eunos Crescent Block 4A Market and Food Centre

• Haig Road Market and Cooked Food Centre

• Geylang Serai Market and Food Centre

Source: Health Promotion Board Singapore

30

Dire warnings for a dire global situation. The world’s population has surpassed seven billion, and people are moving from rural settings into cities around the globe at a speed that is creating alarming

challenges for diabetes and diabetic care.

THE NUMBERS DON’T LIE

Current statistics from the World Diabetes Foundation (WDF) reveal that in 2011, China and India led the pack in diabetes – a staggering 90 million and 61.3 million diabetic patients respectively; and numbers are rising. The next largest nation, the United States, stands at 23.7 million. Leaders in health care have no qualms calling this trend a diabetes pandemic. Look at the statistics and you will understand why. Estimates show that 366 million people currently live with diabetes and additionally 280 million are at identifiably high risk of developing diabetes. During 2011, diabetes killed more than 12,600 people a day. Of these deaths, nearly half (48%) occurred in people under the age of 60.

WHAT THE FUTURE HOLDS

The WDF projects that 9.9% of the world’s population will have diabetes by 2030. Statistics from the International Diabetes Federation (IDF) reveal that 552 million people are expected to live with the disease and 398 million are at high risk of developing diabetes.

Perhaps one of the scariest things about diabetes is that more than 50% of people with diabetes are unaware of their condition, which is costing society millions of dollars in treating the many serious complications that arise from undiagnosed or poorly treated diabetes (blindness, kidney failure, nerve diseases, limb amputations and cardiovascular diseases). In some countries, this figure may reach 80%.

Because of its nature and the multiple risk factors and co-morbid conditions connected

with this chronic illness, diabetes tops the World Health Organization’s priority list for the prevention and care of non-communicable chronic diseases (NCDs). In other words, controlling diabetes minimises the risk and complications of other long-term illnesses.

A SEA OF URBAN WOES

According to Jesper Høiland, Senior Vice President of Novo Nordisk and head of international relations, “another place where diabetes is exploding is Southeast Asia.” IDF predicts that the number of people with diabetes in the region will increase to 120.9 million by 2030; that is 10.2% of the adult population. A further 23.8 million people have impaired glucose tolerance (IGT) in 2011, and this will increase to 38.6 million by 2030.

Approximately 95% of people with diabetes struggle with obesity, and as waves of people in Southeast Asia flow into cities and enjoy the finer things in life with less physical effort, blood sugar levels go up and so does the average weight. This spells nothing but trouble for Asians who, because of their generally weaker pancreatic beta cells, already have a higher prevalence of insulin resistance than Caucasians.

WEIGHT ON SINGAPORE’S SHOULDERS

Singapore functions as a major rallying point for many nations of various socio-economic levels and serves as a prime example of urbanisation that has led to an improved quality of life. Recent national health survey results done

in 2010 reveal that the rate of diabetes in Singapore has risen to a 12-year high. 11.3% of adults

aged between 18 and 69 years are diabetic, compared to 8.2% in 2004 and 9% in 1998.

The obesity rate has ballooned to 11%, up from 6.9% in 2004.

With those figures growing on our own shores, we cannot ignore the fact

that the world diabetes burden is Singapore’s burden as well. We are

in this fight together with the rest of the world.

Without urgent action, the World Health Organization has warned that the death toll will increase by 17% over the next 10 years … across the world diabetes now kills 4.6 million people annually, higher than the combined death toll from HIV/AIDS, tuberculosis and malaria, the three most deadly infectious diseases.Kofi Annan, former Secretary-General, United Nations, at the European Diabetes Leadership Forum 2012

The Diabetes Pandemic by Dennis Oh

Source: Novo N

ordisk Headquarters, Copenhagen, D

enmark

WORLD DIABETES DAY SPECIAL REPORT

31

Novo Nordisk, a global leader in diabetes care, insulin production, and insulin delivery devices, is putting a new face to diabetes care, which one might call an

“integrated approach.” At their Steno Health Promotion Centre, two initiatives are underway to take diabetes care to the next level.

DIABETES AT THE COMMUNITY LEVEL:LESSONS FROM DENMARK by Dennis Oh

A second notable initiative involves community-level diabetes prevention. At a Danish town called Bornholm, Steno researchers are bringing diabetes prevention into schools, day care institutions, the media, and even into supermarkets.

Spheres of influence, ranging from teachers, advertisements, and the re-organisation of food products in a grocery store are working in tandem to send the urgent message of diabetes prevention to the consumer.

This project involves some 220 families and the cooperation of municipal leaders and businesses with the main aim being local ownership by the community.

First is in the area of patient education.

It appears that physicians in general do not view diabetes seriously enough to improve their usual patient education procedure. Given the facts about diabetes and its connection to many other factors, researchers at Steno are challenging the paradigm of the top-down monologue that merely centres on the problem and the solution and are proposing a more “democratic” approach of patient-centered, participatory education.

As coaches working with participants, physicians should come alongside patients and help them balance their complex condition and its effects on their lives socially and psychologically.

1 2

Diabetes in a Connected AgeDiabetes is a highly “connected” condition. On the

physiological level, it is a problem involving many chemicals, organs, and systems. Psychologically,

it affects emotions and feelings of self-worth, pride, and hope. Socially, it alters our relationships and aspirations. Globally, it is one of the greatest health and economic threats in society.

As our generation also becomes increasingly connected with each other and our

environments, new challenges and opportunities face us in how we deal with diabetes.

At the end of the day, it is the individual struggling with

diabetes, or the at-risk, pre-diabetic with high blood glucose that will face the challenge of

controlling his or her incurable condition in this ever-changing world.

Even so, connectivity with one’s environment and social network will have a profound effect on how diabetes is managed.

The main path to increased connectivity is communication. Does everyone around you know about your condition? Tell them! There’s nothing to be ashamed about, and their understanding of your daily needs and routine may become very helpful, or even save your life, one day.

Unveil the condition which has been hidden behind closed doors and let people understand, remind, and support you with your dietary restrictions, medications, and exercise routine. You are not alone in the fight against diabetes.

by Dennis Oh

WORLD DIABETES DAY SPECIAL REPORT 31

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It is quite common to hear complaints of pain in the knees with activities such as climbing stairs, jogging or even walking.

The causes of knee pain are plenty, ranging from overuse to an injury or a traumatic incident that happened years ago.

Having a sedentary lifestyle, being overweight or being involved in high impact sports or activities are all risk factors of knee pain.

Being sedentary can weaken your knee muscles and any additional weight may put pressure on the knee joints, thus increasing the rate of wear and tear.

Regular aerobic exercises such as walking and cycling are recommended as these can help to improve your fitness, plus reduce or maintain weight.

The knee joint is like a hinge, allowing one to bend (flex) and straighten (extend) it with very slight medial and lateral rotation. As it is one of the major joints supporting your weight, it is easily injured and prone to wear and tear with time.

The knee joint also consists of a group of muscles and ligaments as well cartilages to help support and protect it.

Regular exercises are important for health including healthy joints. A combination of flexibility, strengthening and aerobic exercises are essential to ensure that.

Exercises are usually prescribed to provide flexibility to the joint and ensure the muscles around the knee are strengthened.

Stretches of the quadriceps and hamstrings are essential to ensure the muscles around the knee are not tight such that it affects function. For example, someone with very tight quadriceps may not be able to squat down.

These stretches can be done every day – three repetitions with 10 seconds hold for each repetition. If you exercise regularly, you should carry out these stretches before, and especially, after you exercise.

It is also important to strengthen the muscles around the knees and hips as they help to provide stability and support. Leg exercises can be carried out at home at least twice a week with minimum equipment.

These include wall squats, leg raises and knee extension in sitting, as well as hip abduction, adduction and extension exercises.

However, it is recommended that exercises for knee pain should be individualised, taking into account age, overall mobility and function as well as other existing medical conditions.

References:Thomas KS, Muir KR, Doherty M, Jones AC, O’Reilly SC & Bassey EJ on behalf of the Community Osteoarthritis Research Group. Home based exercise program for knee pain and knee osteoarthritis: a randomised controlled trial. BMJ 2002; 325:752Roddy E, Zhang W, Doherty M, et al. Evidence-based recommendations for the role of exercise in the management of osteoarthritis of the hip or knee—the MOVE consensus. Rheumatology 2005; 44:67-73 Clegg DO, Reda DJ, Harris CL, Klein MA, O’Dell JR, Hooper MM, Bradley JD, et al. Glucosamine, chrondroitin sulfate, and the two in combination for painful knee osteoarthritis. The New England Journal of Medicine 2006; 354:795-808

SHAPE UP

WEAK IN THE KNEES

Having a sedentary

lifestyle, being overweight or being involved in high impact

sports or activities are all risk factors

of knee pain.

by Cindy Ng, principal physiotherapist, Singapore General Hospital

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© PhysioTools Ltd

NOTE: These are general exercises and if the pain persists or if you experience pain during these exercises, do consult a physiotherapist to assess your knees and individualise your exercise programme.

Wall Squats

Abduction

Extension

Adduction

SHAPE UP with

Quadriceps stretches

Hamstring stretches

Leg raises

Knee Extension

© PhysioTools Ltd

© PhysioTools Ltd

© PhysioTools Ltd

© PhysioTools Ltd

© PhysioTools Ltd

© PhysioTools Ltd

© PhysioTools Ltd

© PhysioTools Ltd

Leg strengthening stretches

Illustrations reproduced with perm

ission from PhysioTools Ltd.

There are advertisements promising a relief of pain with supplements such as glucosamine. Studies have produced inconsistent results from the effect of glucosamine sulfate on the treatment of osteoarthritis of the knee.

A recent study in The New England Journal of Medicine found that the combination of glucosamine hydrochloride and chondroitin sulfate may have some efficacy in people with moderate to severe knee pain, but not in those with mild pain. The same study did have a high placebo rate and most of the patients had only mild pain.

However, these supplements are safe to take with minimal side effects compared with steroids and pain killers.

DO SUPPLEMENTS WORK?

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I fall under category of a young working single adult, hitting the big 3-0 this year. The only difference - and a huge one - is that I have been living with type 1 diabetes since I was seven. Well, I guess you can’t really escape the condition when it runs so deep in the family

- mum has type 2 diabetes, so do all my grandparents and a host of other relatives.

The fateful day we discovered I was diabetic was quite traumatic for mum. She had just returned from a trip to India. I greeted her at the door with a ‘hi’ , and collapsed. I was rushed to the hospital where the specialist confirmed that I was diabetic.

Then came the oranges. That was how the nurse educator taught us the fundamentals of injections. I would like to say I was a tough kid, but I cursed like a sailor every time they injected me. My dad, a medic during his NS days, took it upon himself to inject me and used to joke that it was like playing darts. Well, this dart board was not laughing. After a couple of days, I told him not to quit his day job and tried to master the skill myself.

I missed the majority of classes when I was in Primary 1 because I was in hospital. On my first day back in school, the form teacher explained my condition to the class. Some were nice. Some plain mean and ate ice cream in front of me. In retrospect, the teachers, principal and most students were very supportive. It helps to tell people what you are instead of trying to hide. Acceptance is the only way forward. When I was in secondary school and junior college, I was exempted from doing the NAFTA tests but I did them anyway. I don’t like being told I can’t do something. I even earned the gold award a couple of times.

When I was five, I wanted to be a fighter pilot. You can’t even get a private pilot’s license (PPL) if you are medically unfit, let alone a commercial pilot’s license. But when life gives you lemons, you make lemonade. I decided to become an aerospace engineer instead. That is what I am today. My dream of flying is still very much alive though. Perhaps one day.

When I decided to start my cake business in September 2008, my mother who was a businesswoman herself objected. She said, “I put you through studies of your own interest (design and advertising), you had a great career as an

art director in a good company that paid you well, why do you want to give that all up?”.

I told her, “I want to be like you!”I remembered her look of disappointment. “Perhaps you should learn it the hard way”, was her last word of advice to me before she passed away six

months later.

In 2006, mum was diagnosed with stage three breast cancer and needed surgery. She suffered

chemotherapy and radiation over the next six months, to be declared cancer free in 2007. After that, she went on an organic and hi-fibre diet influencing me to do likewise. I did not follow her strictly organic diet and still had my hawker indulgences when I was not with her.

I immersed myself in my cakery, 12 hours a day tending the shop and running around meeting people. Three months into my business, mum complained of stomach bloating; she looked as if she was four months pregnant. We rushed her to the doctor and she was immediately diagnosed with stomach and intestinal cancer.

Everyone was devastated. We thought she might beat the cancer again, but her condition worsened. I watched her scream

in agony for more morphine shots every day. On 31 September 2009, mum passed away, quietly, while everyone was outside the hospital ward.

Mum had a heart of gold, doing charity work and always giving to people who needed money. What did she do to deserve such sickness? I grieved for a whole year, searching for the reasons. Then one day my fiancé opened my eyes.

Yes, it was mum’s food, lifestyle and stress that cumulatively caused her cancers! The organic diet after her breast cancer could not prevent another cancer because she had fallen back into the old unhealthy pattern of irregular meals and long working hours.

I had the answer right in front of me all along - vegetarianism.I then made a life choice for myself. No, I do not want to be like my mother. I want to live my life differently. Food can either be your medicine or your poison.

Because of this, I transformed my entire bakery’s menu in 2010 and pioneered the technique in baking organic, egg free, dairy free, gluten free and diabetic friendly cakes in Singapore and in 2011 my bakery became the proud recipient of the Healthier Bakery Award by Health Promotion Board.

I am sure mum is smiling right now. Everything that I am now, I owe it all to her. She is and will always be my inspiration.

34

Pravin with his younger sisters Nisha (left) and Neeta who was diagnosed with diabetes when she was three.

ORANGES & LEMONS

Diablogue

MUM’S THE WORD by Delcie Lam

by Pravin Rajwani

photos courtesy of ww

w.delciesdesserts.com