December 2018 - February 2019

MCI (P) 012/11/2018 fb.com/heartfoundationmyheart.org.sg twitter.com/heartSG

Official Publication of the Singapore Heart Foundation

@singaporeheartfoundation

03

心脏复苏新指南

04

16

Egg White OmeletteOr Sunny Side Up?

About Eggs & Cholesterol

New ResuscitationGuidelines

PATRONESM Goh Chok Tong

CHAIRMAN EMERITUSDr Low Lip Ping

SHF 48TH

BOARD OF DIRECTORS

CHAIRMANProf Terrance Chua

VICE-CHAIRMENDr Tan Yong SengMs Tan Lee Chew

HONORARY SECRETARYProf Tan Huay Cheem

ASSISTANT HONORARYSECRETARYMr Goh Chiew Seng

HONORARY TREASURERMrs Elsie Foh

MEMBERSDr Chee Tek SiongMr Chong Chou YuenDr Goh Ping PingMdm Koh Teck SiewDr Bernard KwokMrs Regina LeeProf May LwinDr Mak Koon HouMr Peter SimDr C SivathasanAdj Asst Prof Jack Tan

HONORARY ADVISORSProf Koh Tian HaiMr Liak Teng LitMr Lim Soon HockA/Prof Lim Yean TengDr Lily NeoMr Tan Kin LianMr Wong Yew Meng

EDITORIAL COMMITTEE

EDITORMr Patrick Deroose

MEMBERSProf Terrance ChuaDr Chee Tek SiongDr C Sivathasan

SECRETARIATMr Vernon KangMs Stephanie HoMs Samantha Chan

2 Editor’s Note

heartline is a quarterly publication of the Singapore Heart Foundation.9 Bishan Place, #07-01 Junction 8 (Office Tower), Singapore 579837Tel: 6354 9340 • Fax: 6258 5240 • Email: info@heart.org.sg

The information provided in heartline is for educational purposes only. It should not be used for diagnosingor treating a heart problem or a disease, and should not be substituted for professional health care. Opinions expressed by contributors and advertisers do not necessarily reflect those of the SHF.The SHF does not endorse any products or services in heartline advertisements.

All rights reserved. Copyright is held by SHF.No portion of this publication can be reproduced without the permission of SHF.To advertise in heartline, please email info@heart.org.sg or call 6354 9340.Terms and conditions apply.

Want a copy of heartline delivered to your doorstep?Call 6354 9340 for a copy of the subscription form.Designed by: Vacain Design Pte Ltd • Printed by: A&D Printhub Pte. Ltd.

DEAR READERS,

The term “fake news” has been around since the 1890s, but it has been made popular by President Donald Trump in the 2016 US elections. According to the Cambridge dictionary, fake news is false stories that appear to be news, spread on the Internet or using other media, usually created to influence political views or as a joke. The Internet search engines direct you to the websites which you want to see, based on algorithms determined by your Internet use.

In the healthcare industry, there is indeed a lot of fake news - myths about certain drugs, superfruits, questionable treatments… How do you then differentiate between fake news and the truth? The Singapore Heart Foundation has always taken the position that we will bring to all Singaporeans solid, time-tested information supported by scientific evidence, and not fall into the trap of releasing unfiltered Internet information. Good science is peer-reviewed, published in reputable magazines and journals, and supported by a wide base of evidence such as outcome studies, etc.

That is why I was very interested in the study published in The Lancet September 2018 on “Worldwide trends in insufficient physical activity from 2001 to 2016” by Regina Guthold of World Health Organization in Geneva. This mega study covering 1.9 million participants indicates that there is a wide variation in country prevalence of insufficient activities, even within regions, suggesting that factors that influence inactivity lie mostly at the national, subnational or community level, which is where policies are needed to increase physical activity. This is a reality, and not fake news. Since its inception, the Singapore Heart Foundation has been a voice in the Singaporean community, advocating for increasing physical activity as part of creating a heart healthy society.

In this issue's article “Egg White Omelette or Sunny Side Up?", Dr Low Lip Ping demystifies the notion that eggs are bad for your health. Based on an understanding of cardiovascular disease, its risk factors and understanding of cardiovascular disease at a molecular level, he provides you, our members, solid advice on eggs and cholesterol. This is not fake news, this is the real thing.

As responsible citizens, we have the obligation to look after ourselves and the next generations. If you want to develop a heart healthy society, we must be guided by the real stuff and not by fake news that seeps in our minds unfiltered and uncorrected. This however, requires an effort to

investigate, question and have a high index of suspicion on the value of stories that seem too good to be true. The Singapore Heart Foundation through its initiatives, can help you to make those decisions.

This issue of heartline in front of you is the last for 2018. On behalf of the editorial committee, I wish each one of you happy holidays and a great new year ahead!

Patrick Deroose

New Practice

Check for Danger Ensure that the scene is safe before approaching.

Danger

Response

Shout for Help

AED

Breathing

Compression

Check for Response Tap firmly on the casualty’s shoulders and shout “Hello, hello! Are you OK?”

Shout for Help Call 995 for an ambulance and stayon the line.Note: Follow dispatcher’s instructions, if unsure.

Ask someone to get an Automated External Defibrillator (AED) When alone, only get the AED if it is visible and nearby.

Check for normal Breathing Look for rise and fall of the chest (not more than 10 sec). If casualty is not breathing normally or if you are unsure, start CPR. Note: Agonal breathing or gasping is not normal breathing.

Perform continuous CPRPush hard at a rate of 100 – 120 compressions per min at a depth of4 - 6 cm at the lower half of breastbone.

New Practice

Automated External Defibrillator

If you are a single rescuer and feeling tired, you may take a rest of not more than 10 seconds (preferably after 100 compressions).

Arrival of AEDCheck for safety – no metal surface, water or combustible gas.Switch on the AED.

Follow voice prompts and apply pads.

Press shock button if instructed, after checking for safety.

If no shock is advised, continue CPR.Stop CPR when:- AED analyses heart rhythm, is charging or is

executing a shock- Casualty wakes up or regains normal breathing- Paramedics arrive

The information provided in this article is based on guidelines by the Singapore Resuscitation and First Aid Council.

New Practice

New Practice

How to React When a Cardiac Arrest OccursWhen a cardiac arrest occurs, the heart stops beating and blood flow to the vital organs stops. Without immediate intervention, the chances of survival decreases by 7 – 10% per minute.

The essential steps for helping a cardiac arrest victim are illustrated in a system called the “Chain of Survival” as well as essential protocol known as “DRS-ABCD”. Over the years, improvements have been made with the introduction of new practices.

Article contributed by Mr Eric Lee, Singapore Heart Foundation’s Volunteer Principal Chief Instructor andBasic Cardiac Life Support, Cardiopulmonary Resuscitation and Automated External Defibrillator Training Consultant

Completed by First Responders, also known as Bystanders

Early Recognition and Access

Early CPR Early Defibrillation

Emergency Medical Services

Advanced Cardiac Life Support

Resuscitation New Guidelines3Feature

4 Feature

Egg White Omeletteor Sunny Side Up?

About EGGS and CHOLESTEROL

Are eggs bad for the heart? This is a question patients frequently ask their doctors.

Until recently and for many years, the answer was yes because egg yolk contains a lot of cholesterol. However, recent research findings have changed this view.

Let us first understand some basic facts about cardiovascular disease and its risk factors.

Cardiovascular Disease (CVD)Cardiovascular disease is a disease affecting the arteries, which are blood vessels that carry oxygen-rich blood to the heart and other parts of the body.

The commonest and most important CVD is atherosclerosis, in which plaques containing cholesterol, fibrous tissue and other cells build up in the walls of arteries. Atherosclerosis causes heart attacks (when it affects the arteries of the heart) and strokes (when the brain arteries are affected).

CVD Risk Factors Cardiovascular disease risk factors are characteristics or conditions that increase the risk of developing CVD, due to atherosclerosis. It may be non-modifiable or modifiable.

Non-modifiable risk factors include age, family history and male gender.

The risk of atherosclerosis increases with age, in those with a history of heart attack or stroke in close relatives and is higher in men than women before menopause. Menopausal women have similar CVD risk to men.

Modifiable risk factors include cholesterol, hypertension, diabetes, smoking, overweight, sedentary lifestyle and psychosocial stress.

Cholesterol Cholesterol is a lipid (fatty substance) present in the bloodstream and in all of the body’s cells. It is important to the healthy functioning of our bodies. Most of the cholesterol in the body is made by the liver and does not come from cholesterol that we eat. It is needed to form cell membranes and hormones. It is also derived from certain foods like animal meat, milk and milk products such as butter and cheese, cakes, cookies, as well as in egg yolk.

Cholesterol is carried through our blood by particles called lipoproteins, consisting of low-density lipoprotein (LDL) and high-density lipoprotein (HDL). Not all LDL particles are the same. Some LDL particles are less dense and less harmful than more dense LDL. High blood levels of LDL lead to deposition of cholesterol in the walls of arteries, causing atherosclerosis leading to heart attack and ischemic stroke.

By Dr Low Lip Ping, Chairman Emeritus of Singapore Heart Foundation

HDL cholesterol, on the other hand, reduces the risk of CVD as it carries cholesterol away from the blood stream and from the walls of blood vessels.

A high blood LDL level can be inherited. The condition is known as familial hypercholesterolemia, in which a build-up of LDL cholesterol in the blood is present from birth. This can lead to coronary heart disease at an early age.

For many years, it was believed that cholesterol in the diet would significantly increase blood levels of cholesterol. Since egg yolk contains a significant amount of cholesterol (about 200mg), it was assumed that it would contribute to increased blood cholesterol levels. Many dietary guidelines hence recommended that eggs be eaten sparingly or not at all.

We now know from recent studies that dietary cholesterol increases blood cholesterol only slightly. In comparison, saturated fats and trans fats (made through the chemical process of hydrogenation of oils for example, in the manufacture of margarine) increase blood cholesterol more than dietary cholesterol.

Recent research has also established that dietary cholesterol increases the concentrations of both circulating LDL (“bad”) and HDL (“good”) cholesterol in individuals who absorb more dietary cholesterol. Hence, the ratio of bad to good cholesterol remains the same. In the majority of people who absorb less cholesterol from their diets, there is only a mild or no increase in blood cholesterol levels.

In addition, dietary cholesterol from egg intake has been shown to promote the formation of large LDL particles which are less harmful, and HDL particles which oppose the harmful small and dense LDL particles.

Large epidemiological and clinical studies indicate that for the general population, dietary cholesterol from eggs does not increase the risk of atherosclerotic cardiovascular disease.

Beneficial Constituents of Eggs One average egg contains around 4.6g of fat, but only one quarter of this fat is saturated fat.

Egg yolk and the albumin in egg white contain many beneficial nutrients including lutein and zeaxanthin, which are good for the eyes; choline, which is good for the brain and nerves; various vitamins A, B (riboflavin, B12), folic acid and vitamin D. A single large egg contains roughly 6 g of protein and 72 calories.

Eggs are easy to prepare and serve and goes well with many other foods. So for most people that eat one or two eggs a day, this will not increase your blood cholesterol significantly and will provide many good nutrients. For a small percentage of people, including those who have diabetes and very high blood cholesterol levels due to genetic factors, they are more sensitive to eating dietary cholesterol than others. This means that when they eat food containing cholesterol, their LDL (“bad”) cholesterol levels will rise more than other people. For these people, it is important to discuss this issue with their doctors.

Of course, what you eat with your eggs matters greatly. The saturated fat in butter, cheese, bacon and sausage, for example, raises your blood cholesterol much more than the cholesterol in your egg.

5Feature

7Health Bites

Do you wish to receive heart health related news on a regular basis? Subscribe to our newsletter heartline by emailing samantha@heart.org.sg with your name, mailing address and contact number.

HealtH BitesMoveMent is MedicineAlthough a healthy lifestyle has been often encouraged by “10,000 daily steps”, based on the latest National Physical Activity Guidelines, the new health gauge of “150 minutes per week” is recommended instead. For a regular adult, this can be clocked via moderate to vigorous physical activities such as jogging and swimming.

So why 150 minutes? According to a physiotherapist at Khoo Teck Puat Hospital, 150 minutes of moderate-intensity exercise is about 50 to 70% of maximum heart rate exercise per week based on numerous international exercise guidelines. This translates to 30 minutes of moderate-intensity exercise for five days a week.

Findings from SHF’s Heart Health Survey 2018, show that close to half of those surveyed (48%) may have insufficient exercise. It is important to put aside time for physical activity as a long-term investment towards good health. By doing so, you will reduce risk factors such as high cholesterol and high blood pressure, which result in heart problems.

Holiday for your HeartLife in the little red dot can get stressful and if you are craving for a holiday, you now have another good excuse, as it has been proven that getaways do have benefits for the mind and body.

Your short getaway can help you to clear your mind and reduce stress, which in the long run will reduce your risk of heart diseases. This is because stress causes hormones like adrenaline and cortisol to be released. Adrenaline is known to increase heart rate and blood pressure, while Cortisol creates a craving for sugary and fatty foods. Over time, these accumulated fats can lead to cardiovascular health problems.

Travelling also allows you to stay active and get out of your sedentary lifestyle. Simple activities like sightseeing, or strenuous ones such as hiking, means that you are unknowingly clocking in many hours of exercise. So pack your bags and

take that trip you have been daydreaming about for a healthier heart!

HealtH tips against festive indulgenceDecember usually marks the start of feasting, which will only end after the Lunar New Year. Instead of overindulgence, let us adopt a more mindful approach this festive season and remember that moderation is key.

It is noteworthy that overeating can trigger symptoms or start the process of a heart attack, as the body is flooded with insulin after a large and fatty meal. Eating and digesting a large amount of food causes the release of the stress hormone norepinephrine, which increases heart rate and blood pressure.

In fact, according to an American Heart Association study, heart attack risk jumps 4 times in the two hours after a heavy meal – especially for people who are already suffering from heart disease.

Here are some health tips towards a more mindful approach: 1. Control Portions – try to eat smaller portions and less often 2. Eat when you are hungry – do not eat just because there is food available 3. Plan – prepare healthy snacks throughout the day4. Slow Down – enjoy each bite and put your fork down while chewing 5. Pay Attention – do not be distracted by other activities e.g. watching TV or being on

your phone

8

Amino acids are often found in meat and eggs, but did you know that amino acids can also be found in

plant items such as soybean? Amino acids are essential because they are the building blocks of protein, which is needed in many important bodily functions. Foods that contain all 9 essential amino acids are known as complete protein, such as fish, meat, poultry, eggs and soybean. It is recommended to have a good combination of animal and plant-based protein, for a wider variety of nutrients.

Soybean is one of the few plant items with all 9 essential acids, and is lower in saturated fat as compared to animal protein. Isoflavones is also present in soybean, which may help to lower LDL-cholesterol and thereby, reducing the risk of cardiovascular disease.

With recent innovation, other food ingredients such as walnuts are added into soybean milk, increasing its nutrient content. Walnut, being high in unsaturated fatty acids, is identified to have a positive effect on LDL-cholesterol with a daily intake of 30g (which translates to 7 whole or 14 halves), when it is consumed with a healthy and balanced meal.

Furthermore, soybean milk is enriched with calcium which contributes to bone health, so drink up the cup of wholesomeness, to enjoy its benefits and always remember to choose the less sugar or no added sugar options!

Editorial

9Legacy Giving

Trust your HeartThe article is contributed by Mr Kelvin Koh (Associate Estate Planning Practitioner)

Trusting our hearts is difficult. Our minds come up with numerous reasons why we should not do

something, even when our hearts tell us otherwise. It is too time-consuming, too costly, too complicated, too troublesome. It is not urgent.

When it comes to estate planning, many behave in the same manner. Their hearts tell them that it is important to make adequate afterlife plans to safeguard the interests of their loved ones. They then rationalise and eventually no action is taken.

Having a clear understanding of estate planning is an effective way to convince your mind to trust your heart

Estate planning consists of three important steps - estate creation, estate preservation and estate distribution. In the event of your demise, your assets will become your estate. Estate creation is an important first step to ensure that your funnel will be ‘full’ when you pass on. This ensures that your loved ones will be well provided for.

Before your beneficiaries can receive your estate, there may be ‘leakages’ that reduce the value of your estate and these take priority over your beneficiaries. It is essential to minimise them and ensure estate preservation.

Next, plan for your estate distribution by using tools like a Will, Trust, Lasting Power of Attorney and CPF Nomination.A will is a legal document that expresses your intentions after your passing. It allows you to appoint a trusted executor to carry out your final wishes, name guardians for your minor children, distribute your assets according to your intentions, avoid potential family disputes and bequeath a deserving charitable organisation.

Even with these benefits, many simply have not written their wills. Parents with young children are potentially leaving their

children without any suitable guardian – not just a next-of-kin but more importantly, one who is able to raise the children with the right values.

Many people misunderstand that estate planning is simply about writing a willA will only makes immediate distribution of your estate upon your demise. However, if you have vulnerable beneficiaries, it might be wise to consider a delayed distribution under a trust. Vulnerable beneficiaries may include seniors, immature youths, financially un-savvy spouses or people with addictive habits like gambling, drug or alcohol abuse. A trust helps safeguard the interests of your beneficiaries who might not be equipped to handle large sums of inheritance monies. Your appointed trustee will be able to hold and manage your estate professionally and ensure that the welfare of your beneficiaries is taken care of.

Listen and trust your heart Start your estate planning journey to protect your loved ones. For a more comprehensive estate plan, it is wise to consider putting in trust, the love that you have for your beneficiaries.

ConclusionWhether you bequeath to loved ones or contribute to charities such as the Singapore Heart Foundation’s Legacy Giving Programme, take a moment to decide how you will share those plans. Some simple steps will go a long way to ensure that your wishes are carried out.

SHF Legacy Giving ProgrammeA gift of any size, after you have provided for your loved ones, will enable us to continue our important life-saving work to reduce premature death and suffering from heart diseases and stroke.

Types of Legacy Gifts• CPF (Central Provident Fund) Savings• Making a bequest through a Will• Life Insurance• Memorial Giving

If you would like to find out more about the SHF Legacy Giving Programme, please call us at 6354 9340 or email legacy@heart.org.sg.

Asset Estate

Beneficiaries

1. Estate Creation

2. EstatePreservation

3. Estate DistributionWill, Trust, LPA, Nomination

Creditors

Legal Cost

Medical Expenses

Retirement Needs

BizInvestProp

Cash CPF Home StockShares

CarUnitTrusts Insurance

Scan this QR code for more information

Estate planning in 3 steps:1. Estate Creation2. Estate Preservation3. Estate Distribution

Event Reviews10

In recognition of the increased incidence of atrial fibrillation (AF), the Asia Pacific Heart Rhythm Society (APHRS) Public Education Forum 2018, organised by the

Singapore Heart Foundation and initiated by the Asia Pacific Heart Rhythm Society and Singapore Cardiac Society, took place at Toa Payoh HDB Hub Convention Centre (Auditorium) on 8th September 2018 to raise awareness on AF.

AF is one of the most common types of rapid and irregular heart rhythm that affects 1 to 2% of Singaporeans and it is expected to increase with the aging population. In general, AF patients have a stroke risk five times higher than those who do not have AF, and mortality rate of strokes related to AF is twice as high as that of strokes unrelated to AF. The risk of developing AF increases with age – the condition affects as many as 1 in 20 people over the age of 65. In Singapore, the number of seniors aged 65 years and above is estimated to reach 1.8 million people by the year 2030.

Guest of Honour Mr Edwin Tong, Senior Minister of State, Ministry of Law & Ministry of Health, MP for Marine Parade GRC, graced the event with more than 900 participants in attendance. Conducted in both English and Mandarin, experts weighed in on the conditions and also highlighted the precautionary measures that can prevent the onset of AF. The event concluded with the ‘Ask the Expert’ session, where the panel of guest speakers addressed questions from the floor.

Asia Pacific Heart Rhythm Society (APHRS)Public Education Forum 2018

Special thanks and appreciation to all our esteemed sponsors:

* Gardenia Foods (S) Pte Ltd * IMI Lifestyle Products Pte Ltd * Nestlé Singapore (Pte) Ltd * Brilliant Marketing Pte Ltd* F&N Foods Pte Ltd * Colgate Singapore * GSK Singapore * Philips Electronics Singapore Pte Ltd

Back for its 7th edition, the annual Project Heart initiative by the Singapore Heart Foundation saw over 600

participants coming together on 3rd November 2018 at Singapore EXPO, to be empowered with the essential life-saving skill of cardiopulmonary resuscitation (CPR) and learn how to operate the automated external defibrillator (AED) safely. Guest of Honour was Ms Sun Xueling, Senior Parliamentary Secretary, Ministry of Home Affairs & Ministry of National Development, MP for Pasir Ris – Punggol GRC, who launched the Restart A Heart (RAH) programme.

With the theme, “Power to Save A Life”, this year’s event offered two different types of learning approaches for CPR and AED training. Participants could either learn simple steps on how to respond during a cardiac emergency through the RAH programme or undergo the 3-hour CPR & AED certification course. To enhance the learning experience, training was conducted using an illuminating manikin, which provides real time feedback on how to achieve good quality CPR.

Dr Chee Tek Siong, Organising Chairman of Project Heart 2018 shared, “With statistics indicating that approximately 7 out of 10 cardiac arrest cases occurring in residential areas, we need to actively galvanise Singaporeans to pick up these life-saving skills so that we can potentially increase the chances of survival for victims who suffer from out-of-hospital cardiac arrest. Through the annual Project Heart event, we hope to give Singaporeans the confidence to respond to cardiac emergencies which can happen anytime, anywhere. Together, we can build a responsive community, supporting each other at every step of the way.”

Project Heart 2018Restart A Heart

11Event Review

On 20th October 2018, Singapore Heart Foundation (SHF) officially opened its third Heart Wellness Centre

(HWC) in Bukit Gombak. Located at the Bukit Gombak Sports Hall, level 2, the 1,840 sqft new centre provides heart patients and at-risk individuals in the west with easy access to cardiac prevention and rehabilitation programmes.

More than 100 guests, comprising of heart wellness clients, Bukit Gombak constituency members and staff celebrated the official opening. Ms Low Yen Ling, Senior Parliamentary Secretary, Ministry of Education & Ministry of Manpower, Mayor of South West CDC and MP for Chua Chu Kang GRC, graced the event as Guest of Honour.

The official opening was kicked off with an opening performance by a string sextet conducted by our own HWC client, Mr Lee Tsu Hock. With the accompaniment of the orchestra, our SHF physiotherapist, Fendi enchanted the crowd with a song rendition of Kit Chan’s song “Home/家”.

After the opening performance, Chairman of the Heart Wellness Committee, Prof Tan Huay Cheem gave a warm welcome address to the crowd before Mayor Low Yen Ling delivered her speech highlighting Singapore’s strategy to keep healthcare good and affordable with the “3 Beyonds”.

Two cheques were presented to Prof Tan by supportive donors like Mr Yong Soon Kiat, our client and Bukit Gombak Citizens' Consultative Committee, who contributed generously to the new centre. This was followed by Mayor Low Yen Ling, unveiling the commemorative plaque.

For more information on our Heart Wellness Programme, please call 6354 9370/48 or visit www.myheart.org.sg.

SHF OPENS

Third HeartWellness Centre Thank you Mr

Yong Soon Kiat (HWC client) for your generous support towards the new Heart Wellness Centre

Generous donation from Bukit Gombak Citizens’ Consultative Committee to SHF

Unveiling of commemorative plaque by Guest of Honour

Cardiac Rehabilitation Cardiac rehabilitation is an integral part in the recovery of heart patients. It involves structured exercise, education about the heart and adoption of a heart-healthy lifestyle.

Singapore Heart Foundation offers the only community-based cardiac rehabilitation programme (also known as the Heart Wellness Programme) in Singapore through its three HWCs*. The HWCs focus on both rehabilitative and preventive care for recovering heart patients and at-risk individuals who have medical conditions such as hypertension, diabetes mellitus, high cholesterol and obesity.

*Heart Wellness Centre @ Bishan, Heart Wellness Centre @ Fortune Centre, Heart Wellness Centre @ Gombak

Launch of Asia’s first ever CPR self-learning kiosk in Singapore

During the event, SHF together with the Singapore Resuscitation and First Aid Council, launched the first ever CPR self-learning kiosk in Asia, which brings hands-only CPR training opportunities to members of the public. This was also in line with the celebration of World Restart A Heart Day on 16th October 2018 – a global initiative to increase cardiac arrest awareness and bystander CPR rates nationwide.

With the belief that everyone has the ability to save a life, the CPR kiosk aims to raise awareness of this important life-saving skill and encourage more people to sign up for certication courses in CPR and AED skills. One will be able to find the kiosk at various public locations around Singapore, such as shopping malls, cinemas, hospitals and schools.

National Heart Week/World Heart Day 201812

National Heart Week/World Heart Day 2018

My Heart, Your HeartIn commemoration of National Heart Week/

World Heart Day (NHW/WHD) 2018, Singapore Heart Foundation (SHF) organised a full-day event at Toa Payoh HDB Hub Atrium on 29th September 2018. The event aimed to create a heart healthy platform for Singaporeans to get together and engage in fun-filled and interactive activities that are good for the heart. Through this, SHF hopes to continue to raise awareness on the risks of cardiovascular disease and the simple lifestyle changes that Singaporeans can adopt for better heart health. Mr Amrin Amin, Senior Parliamentary Secretary, Ministry of Home Affairs & Ministry of Health, MP for Sembawang GRC, graced the event as Guest of Honour.

Scan this QR code for more information

SHF Heart Health Survey 2018

❤ 6 out of 10 Singaporeans face the risk of being overweight

/ obese, i.e. their BMI is in the unhealthy range, putting

them at higher risk of heart diseases and other health

problems. Those aged 45-64 years old had the highest

BMI, as compared to the other age brackets.

❤ Despite diabetes being one of the key factors that leads

to heart problems, the survey showed that only 37% of

Singaporeans could identify it as a risk factor of heart

disease.

With these survey results, SHF will continue to work

hard at translating this knowledge into programmes that

can result in positive behavioural changes for our targeted

outreach groups.

SHF surveyed 1,000 Singaporeans between the ages of

21 to 75 years to gain a deeper understanding on their

knowledge and awareness levels of cardiovascular disease

and heart health. Some key findings from the survey were

unveiled at the launch. These included:

❤ 8 out of 10 Singaporeans have a good knowledge

of heart disease, yet close to half (48%) do not have

enough exercise, mainly because they are unwilling to

change their current lifestyle or believe that they are

not at risk of heart disease.

❤ 1 out of 3 Singaporeans do not participate in any physical

activity or exercise outside of their regular job.

13National Heart Week/World Heart Day 2018

Red Light Up for NHW/WHD 2018

From 28th till 30th September, Singapore supported the global movement of illuminating iconic buildings and landmarks in red. Red symbolises the colour of health, life and vibrancy – but it can also serve as a warning and a red alert, to beware of the red flags, i.e. the warning signs and symptoms of cardiovascular disease.

This year, there were 9 locations that lit up which included the Singapore Flyer, Maybank Tower, Millenia Tower, Suntec Singapore Convention & Exhibition Centre and Suntec City, Marina Square, OCBC Centre, Helix Bridge, Cavenagh Bridge and Ocean Financial Centre. We would like to sincerely thank all our partners that joined us in raising awareness of Singapore’s #1 killer.

Other Activities

At the event, 3,000 participants were treated to a wide lineup of informative and engaging activities. Pre-registered participants underwent a CPR and AED certification course to learn the important life-saving skills that will come into use during cases of cardiac arrests. To reinforce the importance of regular exercise, Chair and Pound workout sessions were also conducted on-site.

Other highlights at the event included health checks (HbA1c, BMI and BP checks), heart healthy themed educational games, the Save-A-Life roadshow, exhibition booths, quizzes and interactive stage programmes. There was also a live cooking demonstration by Celebrity Chef Martin Yeo, where he whipped up a healthier version of Curry Chicken with Basmati Brown Rice for the audience.

A big thank you to all our National Heart Week/World Heart Day 2018 sponsors, partners, volunteers and the 3,000 of you who turned up for the event. See you again next year!

Partner: Supporting Organisations: Health Check Partner:

Main Sponsors: Sponsors:

‘For Your Sweetheart Singapore’ campaign

To raise awareness about the critical link between diabetes and heart disease, NHW/WHD 2018 marked the launch of the ‘For Your Sweetheart Singapore’ campaign. A joint initiative by SHF, Diabetes Singapore and Boehringer Ingelheim, the campaign aims to encourage people with diabetes to know their risks and speak to their doctors about it. In fact, about 1 in 2 heart attack victims in Singapore have diabetes. Ambassadors of the campaign, Left Profile artiste Michelle Chong and her father Papa Chong, made a special appearance during the event to share more about the campaign as well as their personal story.

The DIRECT DONOR DEBIT PROGRAMME (DDDP) is designed toencourage individuals to give small donations to SHF on a regular basis, for ourlife-saving programmes. SHF would like to thank the following DDDP Event Site

Sponsors, who have generously provided their venues for our various roadshows.

TOGETHER, WE CAN WORK TOWARDS A HEART HEALTHIER NATION!

On National Heart Week/World Heart Day this year, which was celebrated on 29th

September, the Singapore Heart Foundation together with the Singapore Resuscitation and First Aid Council, launched Asia’s first ever CPR self-learning kiosk. The CPR self-learning kiosk aims to raise awareness of this important life-saving skill and to encourage more people to sign up for CPR+AED certification courses. To make hands-only CPR training more accessible to members of the public, the kiosks are placed at various public locations around Singapore, such as shopping malls, cinemas, hospitals and schools. Sudden cardiac arrest can happen to anyone at any time, regardless of age or fitness level. Hence, we all need to be better prepared and come forward to save a life, who may also be a loved one.

Mr Dhiyab Alsharki, 31, director of a company that sells yogurt, was among those who tried learning CPR at a kiosk. “Within two minutes, I can have an understanding of CPR. Everyone should have this knowledge," he said.

Asia’s First EverCPR Self-Learning Kiosk

15New Initiative

自动体外除颤器(AED)

获取 AED检查其是否安全-金属潮湿或易燃气体。启动AED。

遵循语音提示并贴上电击贴片。

按照指令与决定安全下，方可按钮。

若AED未提示实施电击，请继续实施CPR。可在出现以下情况时暂停CPR：- AED在分析心律，正在充电或正在执行电击

- 患者苏醒或呼吸恢复正常- 医护人员抵达

本文中的信息基于新加坡心肺复苏与急救理事会提供的指南。

新步骤

如果您只身一人且在救助过程中感到疲倦，可休息不超过10秒(最好在按压100次胸部后休息)。

新步骤

危险

回应

大声呼救

自动体外除颤器

呼吸

按压

检查是否有自身与他人存在危险 靠近患者前，请确保周遭环境是安全的。Danger

Response

Shout for Help

AED

Breathing

Compression

检查患者能否作出回应 稳定拍打患者的肩部，并喊道：“喂！喂！你还好吗？”

大声呼救拨打995呼叫救护车并保持通话状态。注意：如果不确定，请遵循调度员的指示。

请他人帮忙获取1台自动体外除颤器(AED)当只身一人时，仅在附近可见AED的情况下去获取AED。

检查患者是否仍有正常呼吸 查看胸部是否存在起伏(不超过10秒)。如果患者未正常呼吸或者您对此不确定，请实施CPR。 注意：濒死时的断续抽气不属于正常呼吸。

连续实施CPR以每分钟100-120次的速度在胸骨下半部用力按压的4-6厘米深度。

新步骤

新步骤

发生心脏骤停时的应对方式

发生心脏骤停时，心脏会停止跳动，流向重要器官的血液也会停止流动。若未采取紧急救助措施，则每过一分钟，患者的存活几率就会降低7-10%。

“生存链”系统与“DRS-ABCD”基本协议都对救助心脏骤停患者的基本步骤进行适当说明。多年来，这些基本步骤通过引入新实践步骤得到完善。

本文由担任新加坡心脏基金的基础心脏生命支持、心肺复苏和自动体外除颤器培训顾问的志愿首席指导李福泉先生撰写。

由第一反应者完成，即路人

新指南心脏复苏

及早发现并获取帮助

及时实施CPR

及时除颤 紧急医疗服务

先进的心脏生命支持

16 特写

生存链

蛋白鸡蛋饼还是荷包蛋？

关于鸡蛋和胆固醇

患者常有的疑问是鸡蛋是否对心脏有害。

多年来，问题的答案一直为“是”，因为蛋黄中富含大量胆固醇，但最近的研究结果改变了这一观点。

不过，我们首先需要了解关于心血管疾病及其风险因素的一些基本知识。

心血管疾病（CVD）心血管疾病是一种会影响动脉的疾病，血管将富含氧气的血液输送至心脏和体内其它部位。

最常见且最重要的CVD是动脉粥样硬化，这指的是含有胆固醇、纤维组织和其它细胞的斑块会积聚在动脉壁中。若动脉粥样硬化影响了心脏动脉，则会引发心脏病；若影响了脑动脉，则会引发中风。

引发心血管的风险因素 心血管的风险因素是指会增加引发动脉粥样硬化等CVD的特征或条件。它们可分为不可改变与可改变因素。

不可改变的风险因素包括年龄、家族史和男性别。

动脉粥样硬化的风险随着年龄的增长而增加，该风险在拥有近亲发作过心脏病或中风家族史的人群中也会有所增加，且男性的风险要高于停经前的女性。停经后女性患CVD的风险与男性相似。

可改变的风险因素包括胆固醇、高血压、糖尿病、吸烟、超重、久坐不动的生活方式以及社会心理压力。

胆固醇 胆固醇是存在于血流与所有体内细胞中的一种脂质(脂肪物质)。它对人体维持健康运作十分重要。体内大部分胆固醇都是由肝脏制成的，并非来自我们吃的胆固醇，而胆固醇是形成细胞膜和激素所必需的。动物肉、牛奶和奶制品，如黄油和奶酪，蛋糕，饼干以及蛋黄都可转换为胆固醇。

胆固醇由名为脂蛋白的颗粒通过血液进行传递，其中的脂蛋白由低密度脂蛋白(LDL)和高密度脂蛋白(HDL)组成。但是，并非所有的LDL颗粒都相同。相比之下，密度较小的LDL比高密集LDL的危害小。

由刘立彬医生编辑，新加坡心脏基金的名誉主席

17特写

18 特写

这取决于您自己，祝您吃得开心！

荷包蛋 蛋白鸡蛋饼

血液中高水平的LDL会导致胆固醇沉积于动脉壁中，从而引发动脉粥样硬化，造成心脏病发作和缺血性中风。另一方面，HDL胆固醇则会降低引发CVD的风险，因为它携带胆固醇远离血流和血管壁。

血液中高水平的LDL具有遗传性，这便是所谓的家族性高胆固醇血症，指的是LDL胆固醇从出生起就积聚在血液中。这会导致幼年冠心病。

多年来，人们都认为膳食胆固醇会显著增加血液中的胆固醇水平。鉴于蛋黄中富含大量胆固醇(约200mg)，人们认为它会造成血液中的胆固醇水平升高。因此，许多饮食指南都建议少吃或完全不吃鸡蛋。

通过最近的研究，我们现在了解到膳食胆固醇只会略微提高血液中的胆固醇水平。相比之下，饱和脂肪和反式脂肪(通过油脂氢化这一化学过程制造而成，如制造人造黄油的过程)比膳食胆固醇会使血液中的胆固醇升高到更高水平。

最近的研究也证实膳食胆固醇会提高吸收更多膳食胆固醇的个体体内的LDL(“坏”)和HDL(“好”)胆固醇的循环浓度，因此好坏胆固醇的比例会保持不变。对于大部分吸收更少膳食胆固醇的个体来说，血液中的胆固醇水平只会轻度升高，或是根本不会升高。

此外，从鸡蛋中摄入的膳食胆固醇经证实能促进形成大的LDL颗粒，这些颗粒的危害较小，而，这些HDL颗粒与有害且致密的LDL小颗粒相对。

大型的流行病学和临床研究表明，对于一般人群来说，鸡蛋中的膳食胆固醇并不会增加引发动脉粥样硬化性心血管疾病的风险。

鸡蛋的有益成分 1颗普通鸡蛋约含4.6克脂肪，但其中只有四分之一的脂肪属于饱和脂肪。

蛋黄和蛋白中的白蛋白富含许多有益的营养成分，包括对眼睛有益的叶黄素和玉米黄素、对大脑和神经有益的胆碱以及各类维生素A、B(核黄素、B12)、叶酸、维生素D 、6克蛋白质和72克卡路里。

鸡蛋易于准备和烹饪，而且与许多其它食物都能进行很好的搭配。

因此，对于大部分人来说，每天食用一两颗鸡蛋不会显著提高血液中的胆固醇水平，而且还营养丰富。与其他人相比，一小部分人，包括那些患有糖尿病和因遗传因素而具有很高血液胆固醇水平的人群对摄入膳食胆固醇更为敏感。这意味着当食用含胆固醇食物时，他们的LDL(“坏”)胆固醇水平会比其他人升高更多。对这类人群来说，与其医生讨论食用鸡蛋的问题十分重要。

当然，与鸡蛋共同摄入的食物也会起到非常大的作用。例如，与鸡蛋中的胆固醇相比，黄油、奶酪、培根和香肠中的饱和脂肪会导致血液中的胆固醇水平更高。

Congratulations to all winners* and thank you for your participation!

*Winners have been notified via phone or email.

20 Nutrition

1. _____________ is only present in animal products.

2. Foods produced by the __________ farming method, may not necessarily mean a better nutrient profile than foods which are not.

3. Items in the ingredient list are being arranged in ______________ order of weight.

4. For a food product to be considered as a whole grain, it needs to contain a minimum of _____ of whole grain.

5. ___________ yoghurt generally has a higher sugar content than plain yoghurt due to added sugars.

6. 1 tablespoon of butter has the _______ amount of calories as 1 tablespoon of margarine.

7. To truly choose a healthier option between two similar products, look at per _______ in the nutrition information panel.

8. Be wary of _______ fat sources such as vegetable shortening and partially hydrogenated oil.

Food Labels!Food Labels!Taking a Peek at

Cholesterol

organic

descending

51%Flavoured

same

100g

trans

ANSWERS (Sep – Nov 2018)

Simply email/fax this page to heartline@heart.org.sg / 6258 5240 by 28 February 2019.

Name: ______________________________________________ NRIC: ______________________________________________

Email: ______________________________________________ Mobile: ______________________________________________

All winners will be notified via phone or email. Good luck!Look out for the answers in the next issue of heartline or visit www.myheart.org.sg after 1 March 2019.

Fill in the blanks with the following options:

Submit your correct answers and 5 lucky winners will receive an interesting book on Health Myths and Facts in our lucky draw!

21Nutrition

1. Alcohol contains ________ ; the daily limit for men is no more than 2 standard* drinks and no more than 1 standard drink for women.

*1 standard drink: • 1 can (330 ml) of beer — 158kcal • Half glass (100ml) of wine (height of glass = 15cm) — 140kcal • 1 nip (30ml) of hard liquor — 89kcal

2. Try some fruit-infused water in replacement of sweetened beverages, to cut down the ________ intake.

3. ________ sizing does matter. Instead of having the whole dessert, share it.

4. For a ________ dressing, replace your mayonnaise/cheese dip with tzatziki.

5. Cut down on ________ meat and opt for fresh meat.

6. Use herbs and spices as a ________ enhancer, rather than butter.

7. Opt for ________ meat instead of red meat to reduce saturated fat intake.

8. Have fruits as a ________, rather than juiced for the extra dietary fibre and satiety.

9. Select healthier cooking methods like steaming, baking, boiling and grilling rather than ________.

10. Reduce the risk of ________ by taking out a portion on your plate and avoid having a second serving.

Processed

Overeating

Portion

Healthier

White

Whole

Deep-Frying

Sugar

Flavour

Calories

For Festive Seasons!Plan Out Your Diet

Tri-Colour Quinoa Salad

Method 做法: 1. In a rice cooker, combine both quinoa and water, and set to cook. 将藜麦和水混合倒入电饭煲内，煮熟。2. Set aside to cool, once it is cooked. 煮熟后放置一旁冷却。3. Rinse the chickpeas around 2 to 3 times. 将鹰嘴豆冲洗2至3次。4. Combine chickpeas, cucumber, capsicums, red onion and parsley in a large bowl. 将鹰嘴豆、黄瓜、灯笼椒、红洋葱和香菜倒入大碗中，然后混合。5. In another bowl, mix together olive oil, lime juice, garlic and salt. 将橄榄油、酸柑汁、大蒜和盐倒入另一碗中混合至均匀。6. Scoop the quinoa into the large bowl and pour in the dressing. Toss till well-mixed. 将藜麦舀入大碗，并倒入调料搅拌均匀。7. Season with some black pepper to taste and it is ready to serve! 用一些黑胡椒调味，即可食用！

Ingredients 材料:• Quinoa,uncooked,1cup 生藜麦,1杯• Water,2cups 水,2杯• Chickpeas,drained(460g),2cans 鹰嘴豆,滤水(460g),2罐• Cucumber,diced,1whole 黄瓜,切丁,1条• RedCapsicum,diced,1/2 whole 红色灯笼椒,切丁,½粒• YellowCapsicum,diced,1/2 whole 黄色灯笼椒,切丁,½粒• RedOnion,chopped,1small 红洋葱,切碎,1小粒• Parsley,chopped,1/2 cup 香菜,切碎,½杯• OliveOil,21/2 tbsp 橄榄油,2½汤匙• Lime,juiced,4tbsp 酸柑汁,4汤匙• Garlic,chopped,2cloves 大蒜,切碎,2瓣• Salt,1/2 tsp 盐,½茶匙• BlackPepper,Totaste 黑胡椒,调味

Nutrients per Serving 每份营养

Energy 能量: 406.2 kcal 千卡

Protein 蛋白质: 17.5 g 克

Fat (Saturated fat) 脂肪(饱和脂肪): 8.9 g 克 (1.1 g 克)

Carbohydrate 碳水化合物: 65.3 g 克

Sodium 钠: 198.7 mg 毫克

Cholesterol 胆固醇: 0 mg 毫克

Dietary fibre 膳食纤维: 13.1 g 克

22 Recipes

RecipecontributedbyMsTohYunXuan,SeniorNutritionistatSingaporeHeartFoundation.本食谱由新加坡心脏基金的高级营养师卓芸瑄女士提供。

TIP! 提示!

You can replace chickpeas with

shredded chicken too.您也可用鸡丝

代替鹰嘴豆。

三色藜麦沙拉

Preparation Time 准备时间: 20 minutes 分钟

Cooking Time 烹饪时间: 20 minutes 分钟

Serves 份量: 4 人份

23食谱

希腊黄瓜酸奶酱RecipecontributedbyMsTohYunXuan,SeniorNutritionistatSingaporeHeartFoundation.本食谱由新加坡心脏基金的高级营养师卓芸瑄女士提供。

Method 做法: 1. Gratethecucumber,placeitonthecheeseclothandsqueezeouttheexcessmoisturefromthe

cucumber, set aside. 把黄瓜磨碎铺在奶酪布上，并将黄瓜中的多余水分挤出，置于一旁待用。2. Addthelimejuicetotheyoghurtandsetasidefor5mintoallowittocurdforathickerconsistency. 将酸柑汁倒入酸奶中，静置5分钟使其凝固，以使稠度更浓。3. Add in olive oil, mint, garlic and salt, stir well. 加入橄榄油、薄荷叶、大蒜和盐，并搅拌均匀。4. Setasidefor5–10minutesfortheflavourstomeld. 静置5-10分钟，使味道融合在一起。5. Stir in the olive oil mixture and cucumber to the yoghurt and mix. 将橄榄油混合物和黄瓜倒入酸奶中进行搅拌。6. Chillfor3hoursanditisreadytoserve! 冷却3小时即可食用！

Preparation Time 准备时间: 3 hours 小时

Serves 份量: 4 人份

Tzatziki

TIP! 提示!

Tzatziki is a healthier replacement for mayonnaise and it provides a

good source of calcium!This is a refreshing dip for tortilla

chips and vegetable sticks.希腊黄瓜酸奶酱是较健康的美乃滋

酱替代品，可提供良好的钙质来

源！此外，也是蘸玉米片和蔬菜

条的一款爽口蘸酱。

Ingredients 材料:• Cucumber,1cup 黄瓜,1杯• Non-FatPlainYoghurt,1/2 cup 非脂肪酸奶,½杯• Lime,juiced,11/2 tsp 酸柑汁,1½茶匙• OliveOil,2tsp 橄榄油,2茶匙• FreshMint,chopped,2tsp 新鲜薄荷叶,切碎,2茶匙• Garlic,minced,1clove 大蒜,切碎,1瓣• Salt,1/4 tsp 盐,¼茶匙

Nutrients per Serving 每份营养

Energy 能量: 43.5 kcal 千卡

Protein 蛋白质: 1.1 g 克

Fat (Saturated fat) 脂肪(饱和脂肪): 2.7 g 克 (0.5 g 克)

Carbohydrate 碳水化合物: 3.6 g 克

Sodium 钠: 133.7 mg 毫克

Cholesterol 胆固醇: 0.9 mg 毫克

Dietary fibre 膳食纤维: 0.3 g 克

Contact us atcassandra@heart.org.sg orcarine@heart.org.sg.

Our heartfelt appreciation to our location partners:

AsiA's First EvEr

LOOK OUT FOR OUR KIOSKS ISLANDWIDE AND TRY OUT HANDS-ONLY CPR FOR YOURSELF!

Interested to have the CPR self-learning kiosk* within your premises (e.g. office, malls, schools)?

*All requests will be granted at the Foundation's sole discretion.

Instructional Video

Step by Step Instructions

Training Manikin

CPR Self-Learning Kiosk