StarSpecialTHE STAR Monday 29 September 2014

Serving the public with excellence > 6 Nutrients for living well > 13

HEALTHY HEART

What will you do for your

heart today?

2 HEALTHY HEART StarSpecial, Monday 29 September 2014

MANY Malaysians have high cholesterol levels because of the unhealthy lifestyles

that they lead.High cholesterol is not like a cut

or infection. It cannot be treated with a plaster and left forgotten. You need to be constantly mindful of your cholesterol levels so that healthy levels are maintained throughout your life. The ideal cholesterol level for a healthy adult is less than 5.2mmol/L.

How you can maintainyour cholesterol levels

You will need to make a major change in your lifestyle. This includes changing your diet and engaging in more physical activities. These changes will effectively help lower your cholesterol levels and the risk of heart disease.

Even if your doctor has prescribed a cholesterol-lowering drug, you will still need to change your dietary patterns and live an active lifestyle as this will improve your overall cardiovascular health.

Here are some simple steps that can help keep your cholesterol levels in check:

l Watch what you eatReduce your consumption of

foods that are high in cholesterol such as innards, deep-fried foods, eggs and shellfish. Next, increase your intake of foods that are high in fibre such as fruits, vegetables and wholegrains.

Also eat more foods that are high in unsaturated fats such as nuts and olive oil, which are considered the “healthy” fats and are encouraged as part of a healthy diet.

Increasing your consumption of these foods will greatly reduce your risk of contracting heart disease.

What is Acticol?

Acticol is made up of plant sterols. Plant sterols are found naturally in fruits, vegetables, nuts, seeds, cereals and legumes. Plant sterols also have similar molecular structures as cholesterol.

Plant sterols help block the absorption of cholesterol from the digestive tract.

Without plant sterol, cholesterol can be easily absorbed

Why you should drinkNestlé Omega Plus milk DRINKING two glasses of Nestlé Omega Plus milk will help you manage your cholesterol levels as it is the only milk that contains Acticol.

Acticol helps reduce cholesterol absorption into your bloodstream.

Nestlé Omega Plus milk is easy to integrate into your lifestyle. You can drink one glass with breakfast and another glass before going to sleep.

You can also add more excitement to your glass of Nestlé Omega Plus milk by blending it with fruits such as bananas and strawberries.

One glass of Nestlé Omega Plus milk has only 122 calories and complements your daily meals.

It is lower in fat compared

to full cream milk, high in calcium and helps manage your cholesterol levels while keeping you feeling full.

Drinking Nestlé Omega Plus PLUS milk daily also provides you with the daily dose of calcium you need to strengthen your bones.

In addition, drinking two glasses of Nestlé Omega Plus milk every day, which has Acticol that proactively helps reduce cholesterol absorption into your bloodstream, is like two doses of extra care for your heart.

Nestlé Omega Plus milk is available at all supermarkets, grocery stores and convenience stores.

The next time you go grocery shopping, be sure to include Nestlé Omega Plus milk in your shopping list.

Keeping cholesterol levels in check

The Malaysian Food Pyramid is a great guide for designing a healthy diet.

into the blood stream and excessive cholesterol can lead to heart diseases.

l Be physically activeThirty minutes of physical

activities performed five days a week can help lower LDL cholesterol levels and raise HDL cholesterol levels.

If 30 minutes of non-stop exercise puts too much stress on your body, you can opt to break your exercise up into 10-minute increments.

Regular exercise also helps maintain your ideal body weight and greatly reduces your chance of developing clogged arteries.

Aerobic and cardiovascular exercises such as walking can lower the risk of stroke and heart diseases.

These activities can also help you to manage your weight and

• The body produces 75% of cholesterol through the liver.

• Cholesterol is useful in the body as it helps the formation of cell membranes. High-density lipoprotein (HDL) is often referred to as “good” cholesterol and helps keep cholesterol away from arteries. It also removes excess arterial plaque, which can help prevent heart disease.

• Low-density lipoprotein (LDL) is often referred to as “bad” cholesterol. It circulates in the bloodstream and may build up in arteries. The build-up forms plaque, which narrows the opening of arteries and makes them less flexible. This condition is known as atherosclerosis. If a clot forms in one of the narrowed arteries that leads to the heart or brain, it can result in a heart attack or stroke.

Interesting facts on cholesterol

You will need to make a major change in your lifestyle. This includes changing your diet and engaging in more physical activities. These changes will effectively help lower your cholesterol levels and the risk of heart disease.

keep your bones strong. Start with a 10-minute walk and you can increase your workout intensity from there.

l Be responsible for your health

If you have high cholesterol levels, there are a number of steps that you can take to help lower your cholesterol levels.

These include improving your diet, losing weight and exercising regularly.

Your doctor will advise if you are required to take any cholesterol-lowering medication.

Working out a daily diet plan and exercise plan can help you stay on track.

You can also nominate a friend or a family member to be your motivator to help you get through it.

You should remember that even though your cholesterol levels can be lowered, it can

increase just as easily if you continue your old habits of not

watching your diet and not exercising.

The key to a healthy heart starts with you managing your cholesterol

levels every day.

StarSpecial 3Monday 29 September 2014

4 HEALTHY HEART StarSpecial, Monday 29 September 2014

Your life in your hands

By ANUSHIA KANDASIVAM

MEDICAL science is constantly evolving and improving through

research and study by medical professionals and other scientists.

Heart disease being the No.1 killer of men and women around the world, there are numerous studies on its causes and risk factors, preventative measures and cures, and processes of rehabilitation and recovery.

Here are just a few of the numerous studies that have led to breakthroughs that will improve the lives of people living with heart disease and help prevent more people from developing it.

Drug that reducesrisk of heart failure

A study recently published online by the New England Journal of Medicine reports that a new drug could possibly be one of the biggest advances in combating heart failure in more than a decade.

The study involved about 8,500 people in 47 countries, the largest experiment that has ever been conducted on heart failure. It was designed and paid for by a Swiss pharmaceutical company.

The drug, which is as yet unnamed, was compared to the current standard drug. The study was stopped by independent monitors seven months early – after a 27-month study – according to pre-specified rules, when the boundary for an overwhelming benefit for the new drug had been crossed.

The people in the study were already taking three to five different drugs to control

their risk of heart failure. One of these drugs, an ACE inhibitor (a pharmaceutical drug used to treat hypertension and congestive heart failure), was tested against the new drug in this study.

The new drug is a combination of two medicines used to block the effects of substances that harm the heart while preserving the ones that help protect it.

It is taken twice a day in pill form.

The study found that the new drug reduced the chances of dying of heart-related causes by 20% and for any other reason by 16% compared to the older drug, and reduced the chances of being hospitalised for heart failure by 21%.

According to the study, the new drug also seems relatively safe. There were more cases of too-low blood pressure and non-serious swelling beneath the skin with the new drug, but more cases of kidney problems, excess potassium in the blood and cough with the older drug.

The pharmaceutical company will seek approval for the drug by the end of this year in the United States and early next year in Europe.

Dairy goodfor the heart

New research by international scientists suggests that there is a correlation between the consumption of dairy and heart disease.

At the recent 12th Euro Fed Lipid Congress in Montpellier, France, researchers from Wageningen University in the Netherlands explained that as total dairy, low-fat dairy and milk

(a little more than two cups a day) consumption increased, the risk for high blood pressure decreased, which relates to a reduced risk of cardiovascular disease.

The study also reveals that the association between coronary heart disease, stroke or total mortality and the intake of milk was not statistically significant.

The research results are based on nine studies with 57,256 individuals and 15,367 cases of hypertension.

A clinical trial published in the American Journal of Clinical Nutrition in May this year reveals supporting results.

It shows that the addition of four servings of non-fat dairy per day to a person’s usual diet lowered blood pressure in middle-aged and older adults.

A similar study published online in July this year by the Journal of the American College of Nutrition states that a small serving of dairy food daily may reduce the risk of heart disease or stroke even in communities where such food are not traditionally part of the diet.

This study involved about 4,000 Taiwanese people who, living in a dominantly Chinese food culture, were unaccustomed to dairy foods. It was found that even in these communities, consuming dairy foods up to seven times a week does not increase mortality.

The optimal rate of consumption is about five servings per week, with one serving being equivalent to 8g of protein – one cup of milk or 45g of cheese.

The study also found that such quantities rarely cause trouble even for people considered to be lactose intolerant.

Good background checks could save more lives

In a joint statement released earlier this month, the American Heart Association and the American College of Cardiology recommended that health care professionals include 14 key elements that can be used as a checklist for screening young people aged 12 to 25 for congenital and genetic heart disease. If any of the elements are positive, further testing may be needed.

Screenings using electrocardiograms (ECG) to detect underlying genetic and congenital heart disease in this age group prior to employing this checklist has not been shown to save lives.

ECGs record the heart’s electrical activity and may detect some cases of congenital heart disease that can lead to sudden cardiac death. The 14-element questionnaire should be part of history taking and used together with an ECG or other tests and physical examination.

The questionnaire is actually an expansion of a 12-item checklist that was recommended in 2007. Since then, two questions were added.

Included in the 14-element checklist are questions relating to:l unexplained faintingl chest pain upon exertionl excessive shortness of breath or fatigue during exercisel family history of premature death or disability due to heart disease or known cardiac conditions involving the heart muscle or heart rhythm before age 50l if the individual has been

restricted from participation in sports in the pastl if the individual has had prior testing for the heart, ordered by a health care provider

Although media coverage has brought sudden cardiac arrest and death in young people, especially athletes, to the attention of the wider public, the authors of the statement point out that there is no evidence that sudden cardiac arrest is more common in athletes than in the general population of young people.

The statement also notes that broader availability of automatic external defibrillators (AEDs) in public gathering places such as schools and sports arenas can be highly effective in saving young lives on the sports field and elsewhere when cardiac arrest occurs.

THE World Heart Federation has declared today World Heart Day 2014, when everyone is encouraged to reduce their cardiovascular risk and help create a heart-healthy planet.

According to the World Heart Federation, at least 80% of premature deaths from cardiovascular disease can be avoided if the four main risk factors – tobacco use, unhealthy diet, physical inactivity and harmful use of alcohol – are controlled.

For more information on heart health and what you can do this World Heart Day, visitwww.malaysianheart.org,www.yjm.org.my orwww.world-heart-federation.org

World Heart Day

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StarSpecial, Monday 29 September 2014 HEALTHY HEART 5

Heart disease and the athlete

Underlying causes

A YEAR ago, 25-year-old national basketball player Jacky Ng Kiat Kee collapsed

while on the bench during a game in China and later died of suspected heart failure.

Two years ago, 23-year-old Fabrice Muamba, a professional footballer in Britain, suffered a massive cardiac arrest while on the field; he survived.

Over the years, there have been numerous cardiac-related medical emergencies and deaths of athletes.

These emergencies are caused by sudden cardiac arrest, when the heart abruptly ceases functioning. If immediate life-saving action is not taken – such as performing CPR – death will occur.

According to Dr Aizai Azan Abdul Rahim, senior consultant cardiologist at the National Heart Institute (known by its Bahasa Malaysia acronym IJN), the causes of sudden cardiac arrest in athletes are variable, and most of them depend on the age of the person in question.

“In younger athletes, it is usually due to an underlying congenital heart condition that the intense physical activity has aggravated. In older athletes, it is usually a coronary event such as a blockage of the coronary arteries leading to a heart attack,” he explains.

Anyone, anytime

The reason heart attacks in athletes is so shocking is because people think that an active and healthy person would be immune to such things.

When it comes to congenital heart diseases, the person is born with the condition and so it is to a certain extent out of their control.

However, in cases of athletes without a congenital condition suffering a heart attack, it is more often than not caused by an unhealthy lifestyle.

Being active does not necessarily mean being healthy. A person who plays badminton every week but who is also a heavy smoker or has diabetes caused by an unhealthy diet is still at high risk of getting a heart attack.

While playing sports, there are two types of triggers for a heart attack.

One is an emotional trigger that causes the heart rate and blood pressure to rise, putting strain on the heart.

The other is physical – the heart cannot cope with the increased demand of having to pump harder to deliver more oxygen during the physical activity and suddenly stops.

In your hands

At the current level of knowledge, about 80% of the time, heart disease is controllable or preventable as it is caused by unhealthy habits or non-communicable diseases, while about 20% of the time it is caused by unalterable factors such as genes and gender, says Dr Aizai.

“In crafting a healthy lifestyle for yourself, you should concentrate your efforts on that 80% that is controllable.

“If you are inactive you can become more active, if you smoke you can make yourself stop smoking, you can change your diet,” he says.

“Heart disease does not differentiate between ordinary

HERE are some congenital heart conditions that may cause young athletes to suffer from a sudden cardiac death.

When these conditions are aggravated by intense physical activity, they may cause ventricular fibrillation (VF), where there is uncoordinated contraction of the cardiac muscles, making them seem to quiver instead of contract.

This leads to sudden death if not treated immediately.

Long QT syndrome

This is basically when there is a disorder in the cardiac rhythm that can cause very quick or chaotic heartbeats. This is quite a rare inherited condition.

Steve Konowalchuk, an American professional ice hockey player, retired in 2011 after a regular heart screening detected Long QT syndrome.

Arrhythmogenicright ventricular dysplasia

ARVD is caused by genetic defects of parts of the heart muscles.

Several professional footballers have died from the condition – English player Matt Gadsby (age 27) collapsed on

the pitch in 2006 and later died, American midfielder Kirk Urso (age 22) collapsed and died when out with friends in 2012, and Spanish international player Antonio Puerta died (aged 22) three days after suffering several cardiac arrests in 2007.

Hypertrophic cardiomyopathy

This is basically where the muscles in the heart are thickened and the heart is bigger than normal.

It causes disruptions in the electrical functions of the heart. It is a leading cause of sudden cardiac death in young athletes.

Numerous professional athletes have died of this condition, the most famous of whom is perhaps Cameroon international footballer Marc-Vivien Foe who collapsed on the pitch in 2003 (aged 28) and died shortly afterwards.

Several professional athletes have retired after regular heart screenings diagnosed them with the condition: American former basketball player Robert O’Kelley, English footballer Mitchell Cole (who later died from the condition in 2012, aged 27) and most recently former Arsenal and Watford goalkeeper Manuel Almunia, who retired in August this year.

people who do not take part in much physical activity and active people or even professional athletes, so it’s up to you to be responsible for your health and go for a check-up.

“It is always a good idea to go for a medical check-up and a heart screening before starting on a sports regime, especially if there is a history of heart disease, hypertension or stroke in your family,” he continues.

Regular yearly heart screenings are recommended for men above the age of 45 and women above the age of 55.

A heart screening will involve detailed history taking, physical examination, blood tests and an exercise stress test, where the person will go through a graded physical activity, usually involving walking or running on a treadmill, and the condition of their heart during this “stress” will be recorded and examined.

Athletes should also take precautions when they are playing sports.

There are several things to avoid to ensure that your heart continues to function at optimal levels during intense physical activity:l Dehydration – too much water loss causes a drop in blood pressure. It is easy to lose too much water through sweat in the hot and humid Malaysian weather. Drink lots of water to stay hydrated.l Alcohol – drinking alcohol just before a game is not a good idea – it not only impairs your responses,

it is also a diuretic and thus can cause dehydration.l Exercising immediately after a meal – the heart needs to pump blood to the digestive system and the muscles being used for the physical activity. This may cause

Dr Aizai Azan Abdul Rahim, senior consultant cardiologist at the National Heart Institute.

angioplasty, you can resume exercise two to four weeks afterwards.

It is a good idea to take part in a cardiac rehabilitation programme or consider going for a stress test before returning to competitive sports.

“Because you have been unwell and have not been active for a while, you have to start slowly and gradually build up the strength of your heart and stamina of your body. Just use your common sense and listen to your body. Once you feel better, you can go further,” says Dr Aizai.

If you are on medication, take your normal dose before playing sports and be aware of your physical limits during the activity.

If you have any discomfort in your chest, difficulty breathing, or feel nauseous and dizzy during exercise, stop the activity immediately and see your doctor before resuming it.

“There is always some risk involved in vigorous physical activity, even in sports, but as long as you keep within reasonable limits, you will be fine,” says Dr Aizai.

“Overall, the risk of a cardiac complication happening during physical activity is extremely low – less than 0.001%, so don’t let that stop you from exercising.

“Hippocrates, the father of modern medicine, said ‘If we could give every individual the right amount of nourishment and exercise, not too little and not too much, we would have found the safest way to health’.”

too much strain. Wait at least an hour after the meal to exercise.l Extremes of temperature – being too hot or too cold will put strain on the heart to pump sufficient blood to the bodily functions that require it. In Malaysia, this could be compounded by dehydration caused by excessive sweating, making the situation worse.l Avoid exercise if you are unwell with fever, flu or cold. Resume once you feel better.l Always warm up before beginning exercise and cool down afterwards.l Wear comfortable clothes and good footwear.

Back on form

Staying active and leading a healthy lifestyle are important for everyone to prevent heart disease. But what if you have already had a heart attack – can you go back to physical activity?

“After treatment and recuperation, the healthier your lifestyle is, the faster you will heal,” says Dr Aizai.

Each individual heals at different rates, so always consult your doctor before resuming physical activity.

After cardiac surgery, it normally takes about two months before you will feel well enough to engage in some form of exercise involving your upper limbs such as lifting weights, golf and tennis but leisurely daily walks are a good form of exercise at this point.

If you have had an uncomplicated heart attack or have undergone a successful

Over the years, there have been numerous cardiac-related medical emergencies and deaths in athletes. These emergencies are caused by sudden cardiac arrest, when the heart abruptly ceases functioning.

It is a good idea to go for a full medical check-up, including a heart screening, before you start an intensive sports regime.

6 HEALTHY HEART StarSpecial, Monday 29 September 2014

Serving the public with excellenceARA Damansara Medical

Centre is a 220-bed hospital with facilities and

services able to provide 24-hour emergency and primary care.

One of the main services is the hospital’s Centre of Excellence dedicated to cardiovascular care.

Though a relatively new hospital – it was officially opened in March 2012 – it is steadily building a reputation for itself.

“Setting up a Centre of Excellence for heart in this hospital was part of a bigger plan to provide quality services and facilities to the public, as heart disease is now the leading cause of death among Malaysians,” says Sue Lee, the hospital’s CEO.

“We want to be the hospital that is at the top of people’s mind when they think about cardiac treatment. Our clinical team has expertise of various complex diagnostic and therapeutic cardiac services.

“This hospital provides a full spectrum of diagnoses and treatment services for cardiovascular diseases for adults and children.”

In the course of it being a stand-alone private hospital catering to cardiac care, the hospital also attracts patients from overseas – Indonesia, Myanmar, Bangladesh, Maldives, Cambodia, among others.

When it comes to medical tourism, apart from the

Top technology for the heartWHEN it comes to heart care, cardiac specialists use all kinds of equipment to determine heart function and condition.

Here are some of the latest equipment available in Malaysia.

l Cathertisationlaboratory

The Cath Lab is equipped to carry out intracardiac electrophysiology study, coronary angiography and angioplasty, and vascular and interventional radiology procedures.

This includes radiofrequency ablation, permanent pacemaker insertion, cardiothoracic surgeries and cardiac rehabilitation.

l Electrophysiology labAn EP study is done to

diagnose the source of your problem before a catheter ablation is performed.

Catheter ablation is used primarily to treat people who have problems with heart racing or rapid beating of their heart.

Radiofrequency energy is used to “burn

„ the heart tissue

that is causing the abnormal heart beat.

l Telemetry monitoringCardiac telemetry is

continuous monitoring of a patient’s heart rate and rhythm that takes place at a remote location, usually a nursing station in a special ward. This service is offered to patients recovering from heart events, those who may be at risk of heart events and individuals experiencing ongoing heart problems.

l Tilt tableA tilt table test, occasionally

called upright tilt testing, is a medical procedure often used to diagnose dysautonomia or syncope.

Patients with symptoms of dizziness or light headedness, with or without a loss of consciousness (fainting), suspected to be associated with a drop in blood pressure or positional tachycardia are good candidates for this test.

This test allows the doctors to evaluate the body’s cardiovascular response to the change in position.

l Cardiac MRIThe 3-Tesla MRI machine is

designed for patient comfort

and enhanced levels of clinical performance. With up to 40% faster protocols, this MRI is able to execute its operations faster and more precise than any other. This allows the cardiologist or radiologist to clearly see any indication of abnormality in the muscles.

With its enhanced image quality and consistency, it provides a new benchmark for cardiac imaging which is likely to become a mainstream application in high-field MRI.

l Computerise tomography scan

The Dual Source Flash CT is able to deliver excellent image quality for better diagnosis. At present, it is the fastest scanner and has the best temporal resolution and the shortest rotation time, which is essential for cardiac applications.

In addition, it is a low dose cardiac scan with only 10% to 20% of the radiation dose in comparison with other types of similar machines.

It is used to scan patients with any cardiac conditions, including low or high heart rate, irregular heartbeat, and to detect breathing difficulties.

Sue Lee, CEO of Ara Damansara Medical Centre.

After a cardiac event, a patient goes through a cardiac rehabilitation

programme to improve heart function.

government’s efforts in promoting the hospital, most patients find Ara Damansara Medical Centre online through word-of-mouth.

Its location, five minutes away from the Skypark Subang Terminal, also makes it convenient for overseas patients as well as emergency air ambulance cases from other parts of the country.

“We are proud to say that this hospital has been recognised by Pemandu as part of the government’s Economic Transformation Programme for medical tourism.

“Of course we are still growing and we aspire to be the leading private referral centre for cardiovascular care,” says Lee.

Recovery programmeAFTER a person has had a cardiac event – a heart attack, for example – the next steps after treatment are rehabilitation and recovery.

Cardiac rehabilitation is a process where a patient who is recuperating after a cardiac event goes through a prescribed exercise programme in order to improve heart function and prevent another cardiac event from happening.

“We draw up an individualised exercise programme to help patients improve their heart function.

“The programme can be a simple one or it can be complex, depending on the patient’s condition,” says Dr Lydia Latif, a visiting rehabilitation physician at Ara Damansara Medical Centre.

The programme incorporates two main components – physical exercise and education.

Dr Lydia explains that when the patient comes to the hospital experiencing a cardiac event, they are usually concentrating just on that event and the treatment they are receiving.

During the rehab process, the rehabilitation physician takes things slower to create a calm and reassuring atmosphere.

“We provide education on the risk factors that caused the cardiac event in the first place and advise the patient on secondary prevention measures, which usually involve lifestyle changes,” she says.

The patient will be given advice about dietary modification, quitting smoking and stress management, among other recovery and rehabilitation measures.

In devising a programme for a patient, the doctors will put the patient through an exercise stress test to determine current heart function as well as assess the risk of another cardiac event occurring.

The patient will then be prescribed an appropriate set of exercises.

He will be advised as to the intensity and frequency of the physical activity he can carry out.

There are two types of exercises:l Endurance – after a cardiac event, the heart’s endurance will be poor. In other words, the patient will have very little stamina and is easily fatigued. Endurance exercises are aerobic exercises such as swimming or cycling that challenge the heart to pump harder. As with any other muscle, the heart needs to be exercised in order to reach optimal function.l Resistance – exercises such as lifting weights not just exercises arm and leg muscles, they also help the heart pump better.

At the start of the rehabilitation process, the patient will come to the rehab centre for about six to eight weeks where he will go through the physical exercises in a controlled environment under supervision.

Eventually, the patient will have to incorporate these exercises into his daily life.

“Cardiac rehab is part of long-term cardiac management and care. It’s not sufficient to just prescribe medication; we need to take management to the next level.

“Medicines restore primary heart function, but the rehab process and lifestyle changes the patient makes are to prevent another cardiac event,” explains Dr Lydia.

When it comes to heart health, each patient’s level of knowledge of what caused the event and how to prevent another one is different.

“The physician assesses the patient’s level of knowledge, his or her daily practices and attitude towards heart health and making changes. From there, we will be able to streamline the rehab needs to the patient,” says Dr Lydia.

It can take as few as two or three sessions for the patient to receive all the knowledge he needs, and change his attitude and lifestyle, so the rehabilitation process is not one that has to go on for the rest of the person’s life.

However, the lifestyle changes and taking care of one’s health have to go on forever.

The hospital has a Centre of Excellencededicated to cardiovascular care.

StarSpecial, Monday 29 September 2014 HEALTHY HEART 7

Dr Chua Seng Keong, consultant cardiologist at Ara Damansara Medical Centre.

Dr Abdullah Asad Siddiqui is an emergency physician and head of the Emergency Department at Ara Damansara Medical Centre.

Getting down to the coreWHEN people think about

magnetic resonance imaging scans, they

usually think of brain scans. But the cardiac MRI – an MRI scan for the heart – has been in clinical use in Malaysia for nearly 12 years now.

The use of this technology has gained popularity over the past few years, but there are still a limited number of centres that perform cardiac MRIs in the country, explains Dr Chua Seng Keong, a consultant cardiologist at Ara Damansara Medical Centre.

Cardiac MRIs are considered the gold standard of non-invasive tests used to assess right and left heart function and are commonly used to ascertain in detail the tissue health of heart muscles and provide information to the

• You will be asked if there is any metal device or implant in your body. Because the MRI uses strong electromagnetic waves, metal in the body can significantly distort the images, cause the device to heat up or to malfunction. Patients with pacemakers, orthopaedic implants or metal implants in the ear or eye usually cannot go through an MRI scan unless they have been tested and certified MRI-safe.

• Inform your doctor should you be uncomfortable in tight spaces. Your doctor can take measures to help you relax and undergo the MRI scan successfully.

• You will hear knocking and humming sounds during the scanning. The scan itself is painless. Padded headphones reduce the noise and music can be played if desired.

• Throughout the procedure, you will be required to hold your breath each time an image is taken.

• Expect mild discomfort from tube that is inserted into your vein for injecting the dye into your system. This dye provides the information on blood flow and heart muscle tissue. You will be required to go through a mandatory blood test to ensure normal kidney function before this is done.

• The whole procedure usually takes 1 to 1.5 hours; you will be able to take short breaks in between and the technicians will communicate and check on you throughout the procedure.

What going through an MRI is like

cardiologist or surgeon on whether or not an invasive procedure (angioplasty or bypass surgery) is required when dealing with coronary artery disease.

Nowadays, cardiac MRIs are used in a multitude of ways:

• Assess left and right heart structure and pump function

• Assess heart valve function, especially leaky valves

• Assess large blood vessels of the heart

• Determine the presence of heart muscle scarring, primary heart muscle diseases and extent of damage caused by heart attacks in patients with weakened hearts

• As a cardiac stress test to determine if there is significant coronary artery disease

• To detect excess iron deposition in the heart (especially useful in Thalassemia patients requiring regular blood transfusions)

Cardiologists turn to cardiac MRIs when one of the more basic tests or scans, such as an echocardiogram or a treadmill stress test (an ultrasound of the heart) is unsuitable or do not provide adequate answers.

“Cardiac MRIs become indispensible when monitoring adults with congenital heart diseases because tests on them

need to be repeated serially and the MRI does not carry any risk of radiation.” says Dr Chua.

Pros and cons

Compared to other tests, MRIs have a significant number of advantages:

• No radiation risk• Non invasive• Best non-invasive test

available to determine heart function

• The adenosine stress perfusion cardiac MRI used to detect significant coronary artery disease is superior to the equivalent nuclear perfusion study that involves radiation and has a lower resolution

There are, of course, a few disadvantages:

• Cost – it is the most expensive

non-invasive test• Confined space - the space

in which the patient lies in the MRI scanner is small, typically 60-70cm in diameter

• Long scan time – patients may have to lie in the scanner for an hour or more

• Limited availability – there are limited cardiac MRI-enabled equipment, software and trained personnel in Malaysia

“MRIs are not for everyone and are indeed a luxury, but now that this technology is available we have a robust alternative should other initial imaging modalities fail to provide answers.

“Hopefully, with more trained cardiologists and radiologists this service will become more affordable and easily available to the heart patients that need it,” says Dr Chua.

A matter of life and deathA HEART attack is a serious thing that requires immediate medical intervention. Not only is it important to know the signs of heart attack, everyone should also know where to go during such an emergency.

Hospital emergency rooms (ERs) are usually equipped to deal with all kinds of emergencies, including those related to the heart.

An ER physician in Malaysia will see trauma cases – where there has been injury to the heart, such as when a person is stabbed in the chest – and medical emergency cases such as heart attacks or acute pulmonary oedema (accumulation of fluid in the lungs) leading to a cardiac arrest.

“Most of the time, when patients come into the ER with chest pains, it does turn out to be a heart attack, or something like an unstable angina, which is one step away from becoming a full-blown heart attack,” says Dr Abdullah Asad Siddiqui, emergency physician and head of the Emergency Department at Ara Damansara Medical Centre.

When a patient comes into the ER with chest pains, it is taken very seriously, says Dr Asad. He explains that the doctors and nurses

immediately start to diagnose whether or not the patient is having a cardiac event or one is imminent using a few methods:l Electrocardiogram – this machine records the heart’s electrical activity and will pick up any unusual activity, allowing doctors to determine if the patient is experiencing a heart attackl Blood examination – this tests the enzymes in the blood and takes a few minutes

If it turns out that the patient is having a heart attack, medical management starts straight away.

If it is a severe heart attack, what doctors refer to as STEMI (ST segment elevation myocardial infarction), the patient will immediately be sent to the catheterisation lab for an angioplasty, a procedure where the blocked artery is opened with a balloon-like device.

“An angioplasty is the most preferred treatment in such an emergency. In STEMI cases, time is critical from when the patient comes into the ER to the life-saving procedure. Ideally, the door-to-balloon time should be no more than 90 minutes.

“Of course, not all patients who come in will need this procedure. Some just require medication, which can be administered through the bloodstream,” he continues.

There is a wide range of heart-related issues that an ER will see in a given week. For example, out of 10 cases Dr Asad sees in the ER on a given day, on average seven of

them will be heart-related.It is important for people to

know where they can go during a heart emergency, says Dr Asad.

During a cardiac medical

emergency, the person must go to the right hospital that is equipped with the right facilities and services so that vital time is not lost.

Cardiac MRIs are used to assess heart function and are considered the gold standard of non-invasive cardiac tests.

Cardiac conditions seen in the ERHERE are some common heart-related emergencies that an ER physician will deal with:l Unstable angina – a condition where there is not enough

blood flow or oxygen to the heart. Patients experience chest pains of increasing intensity and duration, but often when an ECG or blood test is administered, results are normal. This means a heart attack may occur at any time and the patient should go for an angiogram within the next 24 hours.l Arrhythmia – this is basically where the heart pumps at an

irregular rhythm or there is ventricular fibrillation (where the cardiac muscles of the ventricles contract in an uncoordinated manner). Blood that should be sent out of the heart becomes compromised.l Acute pulmonary oedema – this happens when the heart is

not strong enough to send out all the blood that the lungs send to it and there is a backflow of blood into the lungs, causing the lungs to flood. The patient will start feeling breathless, and eventually experience a cardiac arrest. The doctor will intubate the patient to improve oxygen flow and administer medication to draw the liquid out of the lungs.

8 HEALTHY HEART StarSpecial, Monday 29 September 2014

© World Heart Federation

Women, children and heart disease: ACT NOW to protect the hearts of those you love

Cardiovascular disease (CVD), including heart disease and stroke, takes lives prematurely. Contrary to common belief, women are affected equally to men, and children are vulnerable too. Most deaths caused by CVD are preventable. Individuals, families, communities and governments must work together to avoid the physical, emotional and financial burden caused by CVD. Immediate action is required to ensure a heart-healthy future for all: encourage healthy eating and physical activity, and ban tobacco use.

The burden of cardiovascular disease

It is a myth that CVD mostly affects affluent, male, older populations - it can affect all ages and population groups, including women and children

2019181716151413121110

9876543210

Cardiovascular disease

3.86 million deaths a year

Malaria, HIV/AIDS & tuberculosis

CVD can develop before birth

17.3 million deaths a year

Heart disease causes 1 in 3 female deaths each year

Number of babies born each year worldwide with a congenital heart defect

Playing an outdoor game with the children

Taking the stairs

Doing household chores

Cycling to work

Together we can prevent heart disease and stroke

Most heart disease and stroke can be prevented by making healthy changes: eating healthily, being active and stopping smoking

Physical activity is not just exercise but also includes:

Eating a heart-healthy diet:

If you take public

transport, get off a

stop early and walk the

rest

Worldwide, one in 10 schoolchildren are estimated to be overweight, a risk factor for heart disease and stroke

Try reducing the portion size of less healthy food and increasing the portion size of healthy food

Try swapping foods – if you have a sweet tooth, try mango instead of chocolate

Diets high in saturated and trans fat, sugar and salt increase the risk of heart disease and stroke

You don’t have to stop eating the foods you love completely!

A balanced diet rich in fruit and vegetables helps prevent heart disease and stroke About the World Heart Federation

The World Heart Federation leads the global fight against heart disease and stroke with a focus on low- and middle-income countries via a united community of more than 200 member organizations that brings together the strength of medical societies and heart foundations from more than 100 countries. Through our collective efforts we can help people all over the world to lead longer and better heart-healthy lives.

Follow us on Twitter: www.twitter.com/worldheartfed Join us on facebook: www.facebook.com/worldheartfed www.worldheart.org

After stopping smoking for 15 years, the risk of heart attack falls to the same level that it would be for someone who has never smoked

Efforts to encourage healthy changes in women’s and children’s lives are required from conception through to life end (a life-course approach)

All of society (policy-makers, healthcare professionals, parents and employers) have a role to play in encouraging and enabling heart-healthy living

On 29 September for World Heart Day, take action for you and your family to live better, longer, heart-healthy lives

www.worldheartday.org www.facebook.com/worldheartday #worldheartday

Your doctor, pharmacist, employer and friends may all be able to help you to stop smoking

Non-smokers, including children, are killed each year from exposure to second-hand tobacco smoke. Half of the world’s children regularly breathe air polluted by tobacco smoke. Smoking causes 10 per cent of CVD

Say ‘no’ to tobacco:

Children may suffer a double burden from CVD, seeing a loved one becoming ill, or experiencing congenital or acquired heart disease themselves

Disease does not discriminateHEART disease is the No.1 killer in Malaysia for both men and women. Though most people believe that it is a “man’s” disease, the reality is that with our modern lifestyles, everyone is vulnerable to cardiovascular disease (CVD), even children.

Today is World Heart Day, the day designated by the World Heart Federation to bring awareness and knowledge of heart disease to the people all around the world.

This year’s theme is Creating Heart-Healthy Environments. The idea behind this is that the places in which people live, work and play should not increase their risk of CVD.

However, individuals may not be able to make heart-healthy choices due to environmental factors such as the availability of healthy food or smoke-free zones.

Changing this starts with the individual. You can start by making changes in your home such as making healthy food choices and banning smoking.

You can encourage change in your community by working together to create a safe environment for people to exercise in, ensuring schools provide healthy and nutritious food.

To make an impact on a national level, you can lobby policymakers for more regulation on the amount and reach of fast-food advertising on TV and radio or ensuring timely detection of CVD and cost-effective treatment to modify the risk factors in high-risk individuals.

Here is some vital information about the risk of CVD to women and children, and what you can do to reduce this risk.

StarSpecial 9Monday 29 September 2014

10 HEALTHY HEART StarSpecial, Monday 29 September 2014

Managing your cholesterol levelBETA-glucan obtained from

oats is known for its ability to reduce LDL (bad) cholesterol.

The Malaysian Ministry of Health recommends 3g of oat beta-glucan to be consumed daily to produce cholesterol-lowering effects.

Taking less than the recommended amount will incur minimal or have no effect on LDL cholesterol levels.

A study by the University of Toronto, Canada, revealed that the ability of oat beta-glucan to lower LDL cholesterol (efficacy) is related to its molecular weight

and viscosity while in the gut. Consumers need to ensure that

they are taking the recommended amount of 3g oat beta-glucan daily to ensure that the ingested oat beta-glucans produce an effect enough to reduce cholesterol in the human body.

Consuming oat bran cereal containing 3g of high-molecular weight oat beta-glucan daily has been proven to lower LDL cholesterol by 5%.

Higher molecular weight oat beta-glucan (more than 2,200kDa) is shown to produce a higher

viscosity effect in the upper gut or small intestine, thus having a greater effect on reducing LDL cholesterol levels.

Low molecular weight (less than 210 kDa) oat beta-glucan, on the other hand, had minimal or no effect on LDL cholesterol levels.

To ensure that a product’s performance lives up to its claim, the molecular weight and viscosity effect of oat beta-glucans in the human body should be taken into consideration when choosing a brand to use.

There are five reasons why

Biogrow Oat BG22 Oat Bran Powder and Biogrow Oat BG22 Crispy Cereal are effective for cholesterol problems.l Both are made purely of natural ingredient(s) – Swedish oat bran. They are free of artificial ingredients, thickeners and fillers.l Two scoops or sachets (about 18g) of oat bran powder or one packet (30g) of crispy cereal provide 3g and above of high molecular weight oat beta-glucan. l They are high in fibre. Both choices offer a balanced combination of soluble (for

cholesterol health) and insoluble fibre (for gut health). l They have good solubility and viscosity effect. The powder dissolves well in cold or lukewarm water. Both the powder and crispy cereal are scientifically shown to produce good viscosity or gelling effect in the gut to produce optimal cholesterol-lowering effect. l There has been proven cholesterol-lowering effects from more than 30 clinical studies (European Food Safety Authority Journal 2010).

How to consume

Biogrow Oat BG22 Oat Bran Powder: Mix one scoop or one sachet with 200ml of cold or lukewarm water and drink immediately before meals.

Take at least twice a day for optimal cholesterol-lowering effect. You can also mix in honey, soy milk, a chocolate drink or fruit juice.

Biogrow Oat BG22 Crispy Cereal: Can be eaten straight from the packet as a high fibre snack or enjoyed with low fat milk, soy milk or yogurt.

n For more information,call 03-7956 2220 or e-mailinfo@biogrow.com.my

Children are also at risk HEART disease is not only a concern in adults, but in children as well. Here are descriptions of some conditions known to be found in young children.

Congenital heart disease Congenital heart disease

(CHD) describes a number of different problems that affect the heart.

It is a type of birth defect that can be described more accurately as a defect or abnormality of the heart or blood vessels near the heart.

According to the world heart federation, the majority of children born today with CHD will survive and lead a normal or near-normal life with proper treament. CHD may be diagnosed during infancy (mild CHD) or soon after birth (severe CHD). Some are diagnosed during prenatal screening.

Acquired heart diseaseThere are heart diseases

that are not present at birth but acquired.

The two major types are rheumatic heart disease and Kawasaki disease. • Rheumatic heart disease

Rheumatic heart disease (RHD) is the most commonly acquired heart disease in many countries, especially in developing countries.

It is a condition where the heart muscle and heart valves are damaged due to rheumatic fever, which is caused by streptococcal bacteria.

Rheumatic fever is an inflammatory reaction and begins as a consequence of the streptococcal infection of the throat (strep throat).

Most strep throat infections do not lead to rheumatic fever but when the infection is undiagnosed, untreated or undertreated, rheumatic fever can occur.

According to the World Heart Federation, rheumatic fever and RHD are responsible for about 233,000 deaths annually and affects mostly children and young adults. • Kawasaki disease

Kawasaki disease is characterised by fever, rash, swollen hands and feet, bloodshot eyes, swollen lymph nodes, a strawberry apprearance to the tongue and an acute inflammation of the blood vessels, especially the coronary arteries.

The cause of the disease is unknown but may be caused by some kind of infectious agent.

The disease occurs in young children. According to the World Heart Federation, 80% or more that are affected are less than five years old and it occurs more in boys than in girls.

Children who are undiagnosed or untreated may suffer serious heart damage.

Obesity Obesity is one of the factors

that causes cardiovascular disease and is determined by the dietary habits of individuals. It is a major public health concern and is steadily affecting many low- and middle-income countries, particularly those living in urban settings.

There are several environmental factors associated with childhood obesity.

In many economic-driven nations, increased consumption of energy-dense, high-calorie foods and drinks and decreased physical activity contribute to uncontrolled weight gain in children.

The information above was

taken from the World Heart Federation website.

n For more information, visit www.world-heart-federation.org

StarSpecial, Monday 29 September 2014 HEALTHY HEART 11

Get a goodcardio workout CARDIOVASCULAR disease (CVD) is the

world’s No.1 killer, causing 17.3 million deaths per year and this number is

expected to increase to 23 million by 2030, according to the World Heart Federation.

You can lower the risk of CVD when you quit smoking, eat healthily and do regular physical activities.

In conjunction with this year’s World Heart Day theme of creating heart-healthy environments in places we live, work and play, Fitness Concept has introduced the latest in home exercise equipment, the ProForm Hybrid Trainer.

You and your loved ones can start exercising your way to a healthier heart at the convenience and comfort of home with this hybrid trainer from ProForm, which is the world’s No.1 in home fitness.

It can work as a recumbent bike for lower body toning or as a crosstrainer for total body endurance by simply adjusting the pedals of the hybrid trainer. It also saves space and money, making it the preferred choice at home.

The hybrid trainer is equipped with 14 digital resistance levels that will allow you to progress from beginner to advanced levels as you get stronger.

You can also maximise your workout by keeping track of your heart rate with the EKG heart monitor.

Its front mounted wheels allow you to conveniently move this two-in-one machine out of the way when not in use.

The ProForm Hybrid Trainer also has these features:l Two machines in one: The hybrid trainer offers comfort, variety and a low-impact cardio workout. Pedals can be easily adjusted to make it a crosstrainer or bike. The console can also be adjusted, so whether you are sitting or standing, you can easily monitor your workout on the large LCD window.l Target pacer: You can customise your workout with the target pacer. An indicator light tells you when to speed up or slow down to maximise your workout and achieve your weight loss goals.l Upper-body grips: Improve muscle tone with the upper-body crosstrainer resistance arms that provide a great total-body workout and increased cardio benefits.l 14 smart workout apps: The 14 programmes are designed by a certified

14 Smart workout apps.

Oversized, adjustable pedals.

SMR silent magnetic resistance.

personal trainer and automatically adjust the resistance of the crosstrainer/recumbent bike to maximise your time for faster results.

The simple navigation of the apps makes it quick and easy to select your workout and get moving.

The ProForm Hybrid Trainer is available exclusively at all Fitness Concept outlets nationwide. Fitness Concept is Malaysia’s largest fitness specialist chain as certified by The Malaysia Book of Records with 45 outlets in leading shopping malls nationwide.

Fitness Concept is running Sit Less, Move More promotion with exciting deals on treadmills, crosstrainers, exercise bikes, gym stations and fitness accessories with in-store gifts, purchase-with-purchase offers and many more great offers.

Fitness Concept will be running roadshows at Aeon Rawang Shopping Centre and Aeon Cheras Selatan on Sept 30 where visitors can try out the ProForm Hybrid Trainer.

n For more information, call 03-8026 2222, e-mail enquiries@fitnessconcept.com.my or visit www.fitnessconcept.com.my

The ProForm Hybrid Trainer.

12 HEALTHY HEART StarSpecial, Monday 29 September 2014

• UBIQUINOL is the active antioxidant form of Coenzyme Q10 (CoQ10).• Our body naturally produce CoQ10 and convert it to UBIQUINOL - the nutrientessential for cellular energy 'function and antioxidant protection.

• However, our body's ability to produce UBIQUINOL significantly decreases as weage.Without proper levels of these vital substances, the body produces less energyand lacks a strong defence against oxidative stress.

• Because UBIQUINOL is pre-converted, it is ready for immediate use by the body,making it ideal for those unable to efficiently convert CoQ10 in the body.

• Thus, taking a supplement containingUBIQUINOL becomes increasingly importantto maintain good health.

K.K.L.I.U No : 0999/2013

***Available at all leading pharmacies.

Product Owner:VITAMODE HEALTHCARE (AUSTRALIA) PTY LTDDistributed By:MEDISPEC (M) SDN BHD (137156-U)Toll Free: 1300-800-228

Tel : 082-483450(J Bio Medic Marketing Sdn Bhd, Sarawak)Tel: 088-215312(UMH Pharmacy Sdn Bhd, Sabah)

Quality drinking waterWATER is the matrix of all life. The human body constitutes 70% of water. However, 75% of the modern population in the United States suffer from chronic dehydration.

This is because a mere drop of 2% in body water percentage can result in fatigue and a 10% drop can lead to serious health problems while greater loss can be fatal.

Chronic dehydration can lead to:l Allergies l Alzheimer’sl Arthritisl Attention deficit disorderl Autoimmune disorderl Cancerl Cravingsl Depressionl Fatiguel Headache and migrainel Heartburnl Impatiencel Insomnial Osteoporosisl Parkinsonl Diabetes

Ordinary tap water forms large clusters. These large clusters do not easily permeate into our cellular membrane and hence, does not adequately hydrate our tissues. Most of the time, we are drinking recycled water, which is water that has had its structure altered.

Naturalist and scientist Johanne Grander reveals that water is capable of storing information and vibrational frequencies. Hence, no matter what filtration or purification process is performed on water, disease markers will remain in the “memory” of the water.

For a long time now, disease markers from waste products of people and animals have been digitally recorded in the water.

Drinking VWA Cellular Functional Water will give you a different experience. The resulting living water is more hydrating and it provides an abundance of beneficial properties such as antioxidants.

VWA Cellular Functional Water is a registered medical device by the Korea Food and Drug Administration.

It is rated as the world’s No.1 water ioniser in the United States with advanced hybrid-ionisation technology.

It is able to convert tap water into a natural antioxidant and is a standout system in the water treatment industry that provides you with near-instant cellular absorption.

The proprietary dual-filter is made up of fermented total-microorganism Pi ceramic that emits a special resonance characteristic that destroys disease markers or frequencies.

This subsequently re-energises water molecules to form smaller clusters and crystalline structures for better absorption, hence achieving near-instant cellular hydration.

n For more information,call 1300 222 123 or visitwww.vwawater.com

The VWA Cellular Functional Water is a water ioniser equipped with advanced hybrid-ionisation technology.

Milking benefits for your healthWORLD Heart Day began in

1999 and was created to raise awareness around

the world of heart diseases and stroke, which are the world’s leading causes of death.

About 17.5 million people

died from cardiovascular disease in 2005, representing 30% of all global deaths.

Risk factors for heart disease and stroke include raised blood pressure, cholesterol and glucose levels, smoking, inadequate intake of fruits and vegetables, being overweight and physical inactivity.

Heart disease in Malaysia

Similarly, heart disease is also the leading cause of death in

Malaysia, according to The Heart Foundation of Malaysia (Yayasan Jantung Malaysia).

While many people think of heart disease as generally being a man’s problem, women are also at risk.

Based on data collected by the Health Ministry of Malaysia, cardiovascular disease accounts for about 25% of deaths among women and causes almost two and a half times more deaths than cancer.

As a woman gets older, it is more likely that she will develop heart disease, especially during menopause.

Today, there are 10 million Malaysians with unhealthy cholesterol levels.

One in five Malaysians are diabetic and about 40% are overweight or obese.

Cultivate a healthy lifestyle

According to WHO and the World Heart Federation, at least 80% of premature deaths are due to heart disease and stroke.

These can be avoided if the main risk factors such as smoking, having an unhealthy diet and physical inactivity are taken care of.

This year’s World Heart Day

is focused on cultivating a healthy-heart environment where we can take steps towards healthier living through performing activities such as eating healthy and nutritious food and exercise.

This includes reducing intake of saturated and trans fat, sugar and salt, and eating a balanced diet rich in fruits and vegetables.

Start eating plenty of fruits and vegetables as they contain fibre, vitamins, minerals and antioxidants, which are beneficial to the body.

An easier way will be to incorporate two glasses of Marigold HL Low Fat Milk with Plant Sterols into your daily diet.

A good milk option

Marigold HL Low Fat Milk with Plant Sterols has been shown to lower blood cholesterol. Plant sterols occur naturally in foods such as nuts, seeds, legumes, fruits and vegetables.

It works by blocking the body’s cholesterol absorption. It is also low in fat, containing only 1% fat compared to regular milk (4% fat), which helps keep you healthy and slim.

In addition, the high calcium content helps keep bones strong to prevent osteoporosis and its high protein content builds and repairs

muscles. It is also low in lactose to suit

people with lactose intolerance and fortified with nine essential vitamins, including vitamin A, B1, B3, B6, B12, C, D, E and folic acid.

These meet most of the recommended daily allowance (RDA) of vitamins, providing more nutritional benefits than what other regular milk can offer.

Including Marigold HL Low Fat Milk with Plant Sterols in your daily diet, coupled with exercise, can help maintain your cholesterol levels at a healthy range.

Two glasses of Marigold HL Low Fat Milk with Plant Sterols every day will provide you with 1.6g of plant sterol esters.

This will ensure that getting your daily dosage of plant sterols is made easy.

Marigold HL Low Fat Milk is available in four variants – plant sterols, plain, chocolate and strawberry.

Being the first to introduce high-low milk in Malaysia 26 years ago, Marigold HL low-fat milk continues to reign as consumer’s No.1 choice for pasteurised low-fat milk in the market.

StarSpecial, Monday 29 September 2014 HEALTHY HEART 13

Kordel’s has a range of dietary supplements for people with various requirements.

Nutrientsfor living wellIMAGINE continuously moving without

a single moment of rest for your entire life. That pretty much sums up how your

heart works. The heart is the organ that is responsible for nutrient and oxygen delivery to your entire body.

The coordinated contractions of this organ produce the continuous beat that ensures efficient delivery of nutrients and removal of toxins.

To have a healthy body, it is important to adopt a balanced diet and lead an active lifestyle.

Scientific research has helped identify nutrients that are essential for a healthy body, such as omega-3, co-enzyme Q10 and beta-glucan.

Omega-3 Fatty Acids

Kordel’s Hi-Omega Fish Oil contains 50% eicosapentaenoic acid (EPA) (300mg) and docosahexaenoic acid (DHA) (200mg), two of the most studied omega-3s for the maintenance of overall health.

Kordel’s Hi-Omega Fish Oil is molecularly distilled, a process that eliminates heavy metals and the fishy odour.

Getting yourdaily requirement

Kordel’s Omega 3 Fish Oil contains 180mg EPA and 120mg DHA in each Vegicaps soft capsule. It provides all the benefits of omega-3 for the maintenance of good health.

The oil is obtained from deep-sea cold water fish such as anchovies and sardines. This product is molecularly distilled to remove toxins such as dioxins, PCBs (polychlorinated biphenyl), mercury and other heavy metals.

Kordel’s Omega 3 Fish Oil is a convenient way to help you achieve your daily requirement of omega-3 fatty acids.

More than regularomega-3

Kordel’s Krill-Xanthin 500mg is extracted from krill, a shrimp-like creature from the Antarctic Ocean. Omega-3 in krill oil is in phospholipid form, which makes its entry into the body’s cells much easier.

The absorption of the phospholipid form of omega-3 is two times better, as displayed by the omega-3 index. Phospholipid-bound omega-3 also blends well with gastric juices and does not produce a fishy aftertaste.

As a bonus, krill oil is rich in naturally occurring astaxanthin, a potent antioxidant that is responsible for limiting free radical damage.

Wild and naturalsalmon oil

Kordel’s Wild Alaskan Salmon Oil 1,000mg is 100% wild salmon oil. It contains a wide spectrum of omega fatty acids as well as the antioxidant astaxanthin in the ratio that you would find in wild salmon.

The orange-pinkish hue of the salmon oil indicates that this is an unrefined form of salmon oil. Unlike farm-raised salmon, wild salmon swim freely in the sea and do not require the use of artificial colouring, antibiotics or hormones to ensure yield and sustainability.

This product supports the sustainable use of wild salmon through contributions to the Pacific Salmon Foundation, making it an environmentally friendly product.

Power up the beatwith co-enzyme Q10

Co-enzyme Q10 is also known as ubiquinone. CoQ10 is highly concentrated in most of the vital organs, such as the heart, liver and kidneys. These organs are very active and require high amounts of energy.

Eat the ‘rainbow’EVERYONE knows that vegetables and fruits are great sources of vitamins, minerals and fibre besides being relatively low in calories.

To get the full benefit of the goodness of fruits and vegetables, make sure that you consume them in a variety of different colours. Each colour indicates the different nutrients they contain and many of them are also beneficial for heart health.

Red fruits and vegetables are naturally coloured by lycopene that reduces risks of several types of cancer, including prostate cancer, or anthocyanins that are powerful antioxidants that protect cells from damage. Antioxidants are linked to keeping our hearts healthy, too.l Tomatoes, watermelon and pink grapefruit are pigmented by lycopenel Strawberries, raspberries and red grapes are pigmented by anthocyaninsl Other red roughages are red cabbage, cherries, red peppers and red apples

Orange and yellow fruits and vegetables are pigmented by carotenoids. Foods that are rich in carotenoid can help reduce risks of cancer, heart disease and improve immune system functions.

One study found that men with high cholesterol who ate plenty of carotenoid-rich food had a 36% lower chance of a heart attack and death than their counterparts who shunned them.l Vegetables: Cantaloupe, carrots, yellow peppers, pumpkin, sweet corn and sweet potatoes.

l Fruits: Grapefruit, mangoes, oranges, papayas, pears and pineapple.

Green is the most abundantly available type of fruits and vegetables. They are naturally coloured by the chlorophyll pigment.

The darker the green colour is, the higher the chlorophyll content. Some dark leafy greens contain lutein. In general, this chemical works with another chemical, zeaxanthin found in orange and yellow roughage, to reduce risks of muscular degeneration.l Vegetables: Asparagus, green beans, broccoli, celery, cucumber, green peppers, lettuce, peas, spinach and green onions.l Fruits: Green apples, avocados, honeydew melon and kiwi.

Blue and purple fruits and vegetables are the rarest coloured roughage. They are coloured by the natural plant pigment called anthocyanins, which are antioxidants that work against chances of cancer, stroke and heart diseases. l Vegetables: Brinjal and purple cabbage. l Fruits: Blueberries, plums, prunes and purple grapes.

According to the Mayo Clinic, it is best to choose fruits and vegetables that are fresh.

Alternatively, if you are choosing varieties that are seasonal, frozen ones are a good option.

Avoid fruits and vegetables that are canned in high sodium brine or syrup with high sugar content.

CoQ10 is packed in the cell of the body and is required to convert food into energy to power up the body’s activities. The generation of this chemical energy supplies the vital force for even the simplest actions such as breathing and maintaining a heartbeat.

Being a fat-soluble antioxidant, CoQ10 is better absorbed in oil form. Kordel’s CoQ10 75mg + Omega 3-6 ensures the bioavailability of CoQ10 by using the two essential fatty acids – omega-3 and omega-6 as carriers.

Kordel’s supports World Heart Day. Make healthy choices wherever you live, work and play, to help reduce health risks, for both you and those around you.

This information is brought to you by an in-house pharmacist at Cambert (M) Sdn Bhd.

n For more information, call 1300 881 712, e-mail ask-kordels@cambert.com.my or visit www.kordels.com.my(KKLIU 1648/2014)

14 HEALTHY HEART StarSpecial, Monday 29 September 2014

Keeping things in checkHEART disease is the No.1 killer among Malaysians. One of the major risk factors for coronary heart disease is high blood cholesterol levels.

Cholesterol is a fatty substance that circulates in the bloodstream. It is produced naturally in the body and may also come from the food that we eat such as eggs, meat and dairy foods. There are two types of cholesterol – LDL cholesterol (bad) and HDL cholesterol (good).

Elevated levels of LDL-cholesterol in the blood can cause the formation of plaque and clogging of arteries, making them less flexible.

This condition is known as atherosclerosis, which may put you at risk of coronary heart diseases and stroke. On the other hand, HDL cholesterol helps prevent atherosclerosis by flushing out excessive LDL cholesterol to the liver for disposal.

Weight, genes and age are important factors that determine cholesterol levels. Other factors such as living a sedentary lifestyle, stress, smoking and regular alcohol consumption can also elevate cholesterol levels.

Maintaining a healthy cholesterol level is essential in reducing the risk of cardiovascular diseases. The American Heart Association (AHA) recommends that the average intake of fat should not be more than 30% of the total daily calories.

Fat intake should consist of balanced fat, which provides nutrients that are essential to sustaining a healthy life. A balanced fat intake should contain approximately 30% saturated fat, 33% polyunsaturated fat (containing essential fatty acids) and 37% monounsaturated fat.

Among all fats, rice bran oil (RBO) has the most balanced fatty-acid profile that is closest to meeting AHA recommendations.

The health benefits of RBO are largely attributed to the presence of gamma oryzanol, the most notable feature of RBO that is not found in any other edible vegetable oils.

Gamma oryzanol is a potent antioxidant that has been shown to selectively reduce bad LDL cholesterol while improving good HDL cholesterol in the blood.

It is known as the world’s healthiest edible oil due to the high proportion of monounsaturated fatty acids (40%-50%) and polyunsaturated fatty acids (29%-42%), which are potentially useful in the maintenance of healthy cholesterol profiles.

RBO is naturally rich in vitamin E – a mix spectrum of tocopherol and tocotrienol. Both types are potent antioxidants that can protect the body from the harmful effects of free radicals.

Tocotrienols have been shown to reduce triglycerides, strengthen the arterial wall and support blood flow through the arteries.

n For more information,call 03-7729 3873.

Rice bran oil (RBO) contains a balanced fatty-acid profile that provides nutrients essential to sustaining a healthy life.

Power up your cellsEVERYDAY, the 100 trillion or so cells in your body work hard to multiply, digest

nutrients, remove waste and ensure that you can perform your daily activites.

To perform these tasks, your cells require an adequate supply of energy in the form of a adenosine triphosphate (ATP). This requires a sophisticated production system that relies on Coenzyme Q10 (CoQ10).

Without sufficient amounts of CoQ10 in your body, your cells cannot produce ATP efficiently, resulting in serious disease or even death. To understand how CoQ10 helps to produce energy, you need to know a little about mitochondria.

Imagine that within each of your cells are tiny power companies called mitochondria that produce 95% of the total energy found in your body.

Mitochondria transform the carbohydrates in your food into ATP, the fuel on which your body runs. This is where CoQ10 comes into play. CoQ10 is the catalyst that makes it possible for the mitochondria to produce ATP, which is the molecule that all cellular functions in the body depend on.

The difference between a child

and an elderly person is the varied levels of CoQ10 in their bodies – ageing depletes natural CoQ10 levels and produces more free radicals.

Ageing is not the only factor that causes the body to be short of CoQ10. Stress and exercise as well as drug interactions also deplete this energy nutrient.

Do you know that commonly prescribed medications deplete CoQ10? Blood-pressure lowering drugs (beta-blockers) and cholesterol-lowering drugs (statins) block the production of CoQ10.

In fact, statins can reduce blood levels of CoQ10 by up to 40%.

Other drugs that reduce CoQ10 levels in the body include hormone replacement therapy (HRT) and oral contraceptives. Patients on these types of drugs may find themselves tired, irritable, unable to handle stress well and aggressive.

Since it is difficult to obtain adequate CoQ10 levels from the diet, supplementation can

be useful. With so many CoQ10 formulations out there, it is not unusual for consumers to be confused over which to choose.

CoQ10 comes in two forms – ubiquinone and ubiquinol. Ubiquinone is more common and widely known because it is the form most commonly sold commercially.

Ubiquinol has only been commercially available for about seven years, but there are already more than a hundred studies demonstrating its health benefits.

People have been taking CoQ10 supplements to improve their heart health for decades, but most probably do not realise that Ubiquinol is a better form of CoQ10.

Ubiquinol is the active, antioxidant form of CoQ10 that is ready for immediate use by the body. Conventional CoQ10 supplements, however, use the inactive form of Coenzyme Q10 called ubiquinone.

Both ubiquinol and CoQ10 are essential nutrients found in

every cell of your body. Ubiquinol is the fully reduced state or the un-oxidised form of coenzyme Q10, which the human body can easily use for energy.

Ubiquinol in its readily available state also provides greater antioxidant levels protecting cells from free radical damage. Your body must first convert CoQ10 into ubiquinol to use its full antioxidant properties, which, as we age, becomes more difficult for our bodies to do.

When compared to conventional CoQ10, ubiquinol is easier to absorb into our systems, fully utilising its antioxidant protection. In a healthy adult, 95% or more of the total CoQ10 in the body is in the ubiquinol form.

How does ubiquinol works?

There are molecules in your system with unpaired electrons called free radicals. These free radicals are unstable and search out cells in your body to steal an electron.

This causes damage to the

cell and is called oxidation. Antioxidants have extra electrons that they donate to free radicals to neutralise them. Ubiquinol is an antioxidant that helps protect against oxidative stress and free radical damage.

After ubiquinol donates an electron, it turns into CoQ10. Your body has a process to recycle CoQ10 back into ubiquinol, making it ready to go back out and donate an electron to another free radical.

This process happens in our body 24 hours a day, seven days a week. However, preliminary studies have shown that ubiquinol levels are significantly diminished with ageing.

Your body has CoQ10 in your system but it is not in a form that can go out and donate electrons. Taking ubiquinol supplements help to maintain healthy levels of ubiquinol in your body.

n This article is courtesy of Vitamode Sdn Bhd.

StarSpecial, Monday 29 September 2014 HEALTHY HEART 15

Heart-y good rice

RICE, despite its popularity among many consumers, has high sugar content that can affect heart health.

Excess sugar increases blood pressure, “bad” cholesterol and triglyceride (a type of fat found in blood) levels. One bowl of rice is equivalent to 10 teaspoons of sugar and a teaspoon of sugar contains approximately 16 calories.

The consumption of added sugar can lead to the formation of cavities in teeth, cause weight gain and does little for one’s health as it lacks nutrients such as fibre, vitamins and minerals.

This realisation about the effect of rice should compel people to monitor their rice intake.

Making rice healthier

The key lies in the way rice

is cooked to remove its sugar content. To achieve this, the researchers at Grayns Labs USA Inc and Ascenteus Research have developed the Grayns Rice Cooker, which uses an innovative technology to remove sugar from rice with its four-stage cooking process known as RevoCook.

Rice is a carbohydrate and it contains two starches – amylose and amylopectin. However, rice is high in amylopectin and low in amylase and this causes the rapid rise of blood sugar levels.

People traditionally cooked rice with lots of water, which they threw away to discard the unhealthy starch that dissolves in the water during the cooking process.

This differs from the typical rice cooker found in most homes, which cooks rice without dissolving and discarding the unhealthy starch, leaving the sugar to be consumed with your bowl of rice.

This explains the intense sleepiness one experiences post-lunch as

The Grayns Rice Cooker removes sugar from rice during the cooking process, making it healthier to consume.

Better diabetes controlTHE primary objective of managing diabetes is to constantly maintain near-

normal blood sugar levels to prevent diabetes complications such as heart disease and kidney disease.

Self-monitoring of blood glucose (SMBG) is an important part of managing diabetes.

It provides a timely reading of blood glucose levels and enables diabetes patients to safely manage their condition, detect hyperglycemia and hypoglycemia and generate information for adjusting medications, dietary content and physical activities.

While it is already acknowledged that proper use of SMBG is associated with a reduction of glycated hemoglobin (HbA1c) as compared with those not using SMBG, structured testing could reduce HbA1c more significantly than random performance of SMBG.

Structured testing is testing during the right time, in the right situation, and at the right frequency enough to generate Self-monitoring of blood glucose is an important part of managing diabetes.

useful information to support better decisions. After-meal testing is one of the examples of structured testing.

Blood sugar peaks occur mainly after meals. The higher the level of after-meal blood glucose, the greater the risk of developing serious heart diseases.

The recommended target value for blood sugar level after meals is less than 8mmol/L.

Testing blood sugar levels after meals can not only help identify episodes of after-meal hyperglycemia, it also gives feedback on how a particular meal or food affects the blood sugar level.

It helps to understand which food may be the best for blood sugar control.

Accu-Chek Performa Blood Glucose Monitoring System features easy-to-use tools that help to simplify the management of after-meal hyperglycemia. Users can also set a reminder to do post-meal testings.

Before- and after-meal marker functions make it easier to identify and compare values taken before and after meals.

n For more information, visit www.accu-chek.com.my

Timely reading of blood glucose levels enables diabetes patients to safely manage their condition.

sugar peaks prompt a flood of insulin into the body, shocking the body from a state of hyperglycemia to hypoglycemia.

Here is where Grayns Rice Cooker positions itself as a frontier in healthy rice cooking.

Similar to how our forefathers traditionally cooked rice, Grayns dissolves the amylopectin in rice so that consumers can enjoy their favourite carbohydrate without the sugar.

As a result, rice will have a lower glycemic index (GI) and this means you will not only be full and energetic for longer but rice will be made healthier for consumption.

With Grayns, you will no longer need to worry about keeping rice as a staple part of your diet at the expense of your heart.

By removing sugar from rice, Grayns Rice Cooker allows you to enjoy rice the way our forefathers have, keeping it wholesome, hearty and delicious, and good for your heart.

n For more information,call 1300 887 474 or visitwww.grayns.com

16 HEALTHY HEART StarSpecial, Monday 29 September 2014

Wholegrains for wellnessDIET plays a key role in

reducing your risk of developing heart disease.

Wholegrains such as oat bran and brown rice can be helpful as consuming wholegrains may reduce your cholesterol levels, while the fibre content may help with weight loss.

Oat bran and brown rice both retain the outer layers of the grain, which improves their cholesterol-lowering effects and nutritional value.

In fact, the consumption of wholegrain products and dietary fibre has been shown to reduce the risk of high blood pressure and heart attacks.

Start your daywith wholegrains

Having a bowl of oatmeal or other wholegrain cereals for breakfast can provide you with all-day benefits.

Wholegrains such as oats and brown rice contain high levels of fibre and complex carbohydrates, which will help you feel fuller for longer, making you less likely to overeat at lunch.

It also helps lower your LDL (bad) cholesterol levels and can help you lose weight.

Oatmeal and brown rice also contain plenty of soluble fibre, which have been proven to lower LDL cholesterol levels by reducing the absorption of cholesterol into the bloodstream.

A versatile ingredient

Despite knowing its heart health benefits, it is a challenge for many Malaysians to have oatmeal as a staple breakfast.

The good news is that Kordel’s Active Oat 35 is neutral in taste and the powder is white or off-white in colour with a smooth and fine texture, which makes it easy to add to food and drinks.

The versatility of Kordel’s Active Oat 35 allows it to be easily incorporated into everyday meals.

glucan dissolves in water and forms a thick gel in the digestive tract.

This gel is able to bind to excess cholesterol and cholesterol-like substances in the gut and helps prevent it from being absorbed by the body. The gel and cholesterol are then excreted as part of the body’s waste.

Oat beta-glucanand blood glucose levels

Oat beta-glucan has been well documented to help control blood glucose levels.

The carbohydrate found in oat bran is highly recommended as an energy source because it is converted into glucose gradually.

This provides sustained energy and greater control of blood glucose levels. It is really good for pre-diabetics who are trying to lower their blood glucose levels. Studies have also shown that oat beta-glucan has beneficial effects on diabetes.

Patients with Type 2 diabetes who were given oat beta-glucan experienced smaller rises in blood sugar levels compared to those who were given other grains.

This information is brought to you by an in-house pharmacist at Cambert (M) Sdn. Bhd.

n For more information, call1300 881 712, e-mail ask-kordels@cambert.com.my or visitwww.kordels.com.my/activeoat35

cholesterol levels and reduce LDL cholesterol levels.

Try consuming Kordel’s Active Oat 35 before or after exercising to provide you more energy for the day.

Oat beta-glucanand LDL cholesterol

Oats contain a form of soluble fibre called oat beta-glucan, which is concentrated mostly in the outer layers of the grain (oat bran). Most of the research into the cholesterol-lowering effects of soluble fibre has centred on oat beta-glucan.

As a soluble fibre, oat beta-

When losingmeans winning

If you are overweight, getting rid of the extra kilos is one of the best things you can do to help prevent heart disease and reduce the chances of getting high cholesterol, high blood pressure and Type 2 diabetes.

All these conditions affect the lining of your arteries, making them more likely to collect plaque from cholesterol.

A good combination of healthy meals and exercise can help you lose weight, raise HDL (good)

Kordel’s Active Oat 35 is versatile enough to be incorporated into everyday meals.

Having a bowl of oatmeal or other whole-grain cereals for breakfast can provide you with all-day benefits.Wholegrains such as oats and brown rice contain high levels of fibre and complex carbohydrates.