How Young Do You Eat?

We are pleased to introduce a series of articles How Young Do You Eat? from our panel of health and wellness consultants for your reading pleasure.

Food Consumption

Eating is one of the greatest pleasures in life, at least for some of us. And it forms the cornerstone for health. When it comes to healthy eating, many people feel that “If it’s good for you, then it will taste bad!” This is simply not true. You can eat your way to youth and health and do so deliciously.

1. Eating well is important

2. Or do you have the attitude, that since we will all go one day, we should just gorge and indulge.

3. Allow me to relate to you a little tale. For the longest time, I would talk to the significant other about nutrition, blood pressure and checkups etc. However, it soon becomes obvious that my beloved probably takes better care of his car than himself. So what the wife does is to change the language. Eg Honey, you really ought to ensure that the Octane rating on that fuel is the best for your gleaming new car like eating the right type of food.

4. Or how about this one, Darling, it’s time for your 100,000 km service. The man protests - but I feel fine. I don’t need to see the doctor every year. I am not that old. Response-it’s not the years, it’s the mileage. I don’t like going. It won’t be bad, she’ll listen to your engine and check your fluids. She’ll want to check my prostate. A moment of hesitation and then the vehicular equivalent-that’s like getting your oil checked. No’ it’s not. Well, it’s like getting your radiator flushed. No, says the significant other. Well, maybe it’s not like anything else but you still have to go to the doctor. I don’t want to. Listen, sweetie, you won’t be parking your car in my garage until you go for your checkup!

Remember that even though that is true, we would want to ensure that our bodies remain young and functional for as long as possible. Even though we may age , we want to have young and healthy cells and keep all the chronic degenerative diseases at bay.

It is really simple, if you do not maintain a machine properly, and supply it with optimal fuel, it will not operate as well. I know how appalled the guys will be if I fill up their new Beemers with the lowest quality petrol.

If you take this to the cellular level, remember that the human body is no different. The human body is made up of over 60 trillion cells and the body as a whole can only perform as well as the individual cells are performing.

The cells are constantly dying and regenerating. They need apart from the basic fuels of carbohydrates, proteins and fats, they also need over 50 different vitamins and minerals in the correct ratios for optimal performance. Someone did say that the human body is a machine but it takes 50 years for the import of all the fuel we feed it to soak in. By that time, you will know whether your machinery has been maintained well or otherwise.

Before it is too late, we may want to consider some steps to steer us out of a tight spot.

Contributed by Dr Sophia Chew

Next serving: How much should I eat?

Keywords: nutrition, chronic degenerative diseases , vitamins, minerals

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Value Based Management

From time to time, we will like to take stock of where we are heading. This chapter serves to highlight issues that are important but somehow not in our priority list. We get lost in the worklife jungle without the benefit of guidance from a wise hand.

By including this chapter along with others, we believe the juxtaposition will work its magic.

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High Blood Pressure and Kidney Disease

In this posting, Dr Stephen Chew Tec Huan, a Consultant Nephrologist and Physician will take a look at high blood pressure in relation to kidney disease.

High blood pressure in the setting of kidney disease is usually more difficult to control. Patients may need on the average 3 to 4 medications to reach blood pressure targets. There are several reasons why BP control may be difficult.

1: Patients omit their medication - If omitted they will have blood pressure problems uncorrected. Some patients take their medication only after they realize that a doctors visit is coming up. However, even if their pressures become normal, they would eventually suffer from problems of period of unsustained and only intermittent blood pressure control.

2. Patients continue with a high salt diet - Restricting salt is an important measure in controlling bp. Even without adding extra salt or sauce to our meals, the asian diet tends to be high in salt. Canned foods are another potential source of salt that the patient may be taking without realizing it.

3. Other medications like erythropoeitin may aggravate hypertension - You will need to discuss with your doctor on the relative importance of the issues at hand; ie is taking the injection critical versus the need or ability to control the blood pressure. Sometimes simple medication like flu medication can aggravate hypertension.

4. Certain antihypertensive medication can paradoxically cause periodic increases in hypertension. Your doctor is the best person to discuss this with.

Keywords: blood pressure, hypertension, kidney failure, diabetes, salt

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Hypertension - Blood Pressure Control

We continue with Dr Stephen Chew Tec Huan, a Consultant Nephrologist and Physician, for his insight into hypertension. In this post he will share with us some pointers on keeping blood pressure under control in the pre-dialysis patients.

Hypertension is usually silent. There maybe no symptoms even in the presence of severe hypertension unless complications set in. Hypertension can occur in the absence of any other medical problems and can be an isolated problem. According to Dr Chew, it is more frequent in obese individuals, patients with diabetes, patients with kidney disease, and can occur in association with high blood cholesterol levels. Some of these occur in the individual patients at different times of their lives, and it is important that the patient knows that he has to check regularly for these problems even if they were not first detected at the time he was diagnosed with hypertension. High blood pressure is like a time bomb, it exerts its effects slowly and progressively damaging kidneys, heart, brain and blood vessels to the legs and hands, and can explode (so to speak) by showing itself when the patients develop a catastrophic complication like a stroke or heart attack.

The first step is to know your blood pressure

There are many measures of the blood pressure and it may vary taken at different postures (eg standing versus sitting), it may vary according to the time a person has taken his medication for hypertension, and even may vary depending when it is taken (clinic blood pressures may be higher than home blood pressures). Special ambulatory machines can measure the blood pressure over 24 hours, and normal non-hypertensive individuals usually have a normal dip in their blood pressure in the night. In patients with hypertension due to kidney disease, this dip is usually absent, and ironically, the blood pressure actually surges in the early hours of the morning. Several measures of the blood pressure are more important a guage of effective control than single isolated readings.

Who should measure your blood pressure?

Ideally Yourself. And At Home, In the Morning, Before Medication. There may be exceptions to this, and your doctor can best advise you. Clinic blood pressure may be misleadingly high, leading to potential overtreatment; likewise, it may be deceptively normal if measured after medication. 24 hours BP measures are inconvenient to do all the time although they are possibly the best measures of how well the blood pressure is controlled through the day.

Some useful tips to consider.
1. Buy a blood pressure machine for home use especially if you can't measure your blood pressure with your doctor over at least over several periods.

2. Try to buy machines that use an arm wrap instead of a wrist wrap; they're better indicators of your true blood pressure.

3. Bring your home machine to your doctor when you see him. He can verify the accuracy or degree of reliability of your machine.

4. Take the BP at home, rested after 5 minutes, in the morning, same arm, before medication. Record the time you took it as well. Do it for at least one week for every month. If you do it daily, all the better.

5. The ideal target blood pressure is best discussed with your doctor. In general anything above 140/90 is considered hypertension, although what your target BP ought to be should be individualised after discussing with your physician.

That's all for the moment. Do stay in-tune for more insights.

Keywords: blood pressure, hypertension, kidney failure, diabetes

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Checking Hypertension With The Doctor

To kick-off this chapter, we thought it to be appropriate to deal with a topic close to our heart.
We are subject to stress on a daily basis, be it our work, personal life or both. And we know how stress can have an adverse impact on our immune system. Before we let our stress levels get out of control and develop into an extreme form of auto-immune sickness, we need to understand our body and how it reacts when we unconsciously abuse it. We checked with Dr Stephen Chew Tec Huan, a Consultant Nephrologist and Physician, for his insight into hypertension and how we can cope with it.

If you think of it, the word hypertension means high blood pressure of the blood vessels. It reflects the blood pressure that is over and above a norm.

In earlier days, when blood pressure was just beginning to be measured in clinical medicine, the inclination was that hypertension need not be treated. Earlier thoughts on hypertension were "the best thing for the clinician to deal with this entity of high blood pressure was to forget about it".

How things have changed. Not only is there conclusive evidence that hypertension is associated with the development of many diseases of the blood vessels, but more importantly its treatment is associated with the reduction of these risks. And the complications are many. Heart attacks and strokes were well known complications of untreated hypertension, but the list grows and includes kidney failure and blood vessel diseases of the legs causing gangrene just to name a few.
Furthermore the emergence of new data suggests that the blood pressure targets achieved previously were inadequate to reduce these complications, and now both patients and physicians must grapple with the challenges of achieving even more stringent blood pressure targets to reduce complications effectively.

Hypertension reflects a parameter in the body and is not the actual disease itself. Although the name sounds the same (ie hypertension), the reality is that different patients with the same label of hypertension will all come out of the clinic with different medication. There are furthermore distinctly different types of hypertension. It is important to exclude coexisting kidney disease, as well as certain metabolic disease such as glandular tumors that can cause hypertension. The diagnosis and therapy of a patient with hypertension must therefore be tailored to the individual’s needs for maximum effectiveness and minimal complications from drug therapy.

Most importantly, while reducing the blood pressure to a normal level is important, there are certain abnormalities that should be looked for and treated that tend to occur commonly in association with hypertension. These are factors which by themselves can exist in isolation, but tend to cluster with hypertension, and together with it, amplify the risk of complications. These factors are diabetes, gout and high cholesterol.

Care for the hypertensive patient should include management of all these risks. Like treatment of any chronic disease, treatment is a journey and not a distinct single episode, and requires both the hands of a physician and a cooperative patient to achieve the best outcomes possible.
We hope that in future postings to cover dangers of uncontrolled high blood pressures, how to keep your blood pressure in check and dietary approaches to stop hypertension.

You should consult your doctor if you require further clarification on this topic.

Feel free to provide your feedback and we will be pleased to follow up on your comments on the next episode.

Keywords: blood pressure, hypertension, kidney failure, diabetes

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Launch of Health and Wellness Program

We are pleased to launch eFrenzconnect Health and Wellness program. We hope to uniquely position this program that will serve to introduce health & wellness into the realm of value based management. Measuring and managing human resources within an organisation have taken on a greater degree of urgency as the value drivers of corporates in a knowledge-based economy, have shifted towards leveraging off intellectual capital to generate shareholder value.
We will introduce the concept of wellness that will serve to optimise the psychological, social and physical well-being of individuals. In a brief poll conducted with corporate executives, an overwhelming percentage felt that it is extremely critical for an organisation to implement a holistic Health & Wellness program and that such a system should be an integral part of a performance measurement system.

To sustain interest and making it fun to visit this site, we will develop a series of e-initiatives in order for our pool of medical consultants-cum-specialists to interact seamlessly with you.

We hope to build a firm foundation from which we all can be empowered to maintain a sustainable healthy lifestyle. Thank you.

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