Sunny Health

It’s almost impossible to miss the video about “Ah Keng” taking care of his demented grandfather. In the past weeks, this bittersweet mini film made by local director Royston Tan a couple of years ago for the Health Promotion Board has been making its rounds again on television and the social media, promoting public awareness about dementia. In the film, the grandfather's mind is so disoriented that he is hallucinating about feeding his chickens, despite living in a HDB flat and possibly not been in a poultry farm for decades. While it is heart-warming to see "Ah Keng" doing the right thing to keep his grandfather happy and occupied by following his antics, in reality, many adult Singaporeans are so busy working to support our families that we find it hard to spare time for our healthy parents, let alone provide adequate special care for those who need it. In this case, prevention is better than a cure that doesn't look likely to exist in the near future. After all, leading a blissful and fulfilled life till the end of one's days is a common desire of most people.


In an aging population like Singapore, it is important to understand dementia and its implications. Contrary to popular belief, it is not normal for elderly people to exhibit signs of obvious deterioration in memory and intellectual functions, as well as become cranky when one isn’t originally like these. These are notable symptoms of dementia, and are not part of the normal ageing process. However, age is a high risk factor for dementia, hence people often speak of age and dementia in the same vein. In Singapore, the prevalence rate of people with dementia aged 65 years and above is about 6.2%.

Why is dementia such an intimidating illness?

Growing old shouldn’t be scary as it is a natural process that everyone goes through. What frightens people about ageing is the possibility of losing dignity – losing capability to do regular tasks, and having to depend on others. This is precisely what happens with dementia. When dementia patients lose memory and brain functions, they have to depend others on many necessary daily activities, including bathing and eating. They even pose a danger to their lives, not knowing how to identify and avoid hazards. They lose their ability to make decisions and even to enjoy their old age.

Can dementia be prevented?

Sadly, no concrete cause of dementia has been discovered, though the following are known to be risk factors:

• Diseases that cause degeneration or loss of nerve cells in the brain such as Alzheimer's, Parkinson's and Huntington's.
• Diseases that affect blood vessels, such as stroke
• Toxic reactions, like excessive alcohol or drug use.
• Nutritional deficiencies, like vitamin B12 and folate deficiency.
• Infections that affect the brain and spinal cord, such as AIDS, dementia complex and Creutzfeldt-Jakob disease.
• Certain types of hydrocephalus, an accumulation of fluid in the brain that can result from developmental abnormalities, infections, injury, or brain tumors.
• Head injuries
• Infectious disease
• Brain tumours
• Depression
• Thyroid problems
• Cardiovascular factors e.g. hypertension, heart disease, high cholesterol
• Genetic factors (rare)
• Illnesses other than in the brain, such as kidney, liver, and lung diseases, and diabetes can all lead to dementia.
• Down syndrome (patients with Down syndrome will develop the brain changes of Alzheimer's disease by 40 years of age.)
• Age

Yes as you can see, most of the factors leading to dementia are basically deterioration of health (which explains why dementia is more prevalent in old age), which can be prevented if you adopt a healthy lifestyle.

But even if it is too late, don’t despair, as the impact of dementia can be reduced with the right treatments and care, even if it cannot be eliminated completely. In my next blog entry, I’ll discuss about the symptoms of dementia and how to seek treatment.

Some private estates have ponds for decorative purposes. While these ponds are beautiful to look at and create a scenic environment, they are excellent procreation grounds for mosquitoes when left untouched. Maintaining a pond can be troublesome, and many people lack the know-how to do it properly, or fail to realize that regular cleaning and maintenance of a pond is necessary. Some households leave the cleaning of the pond to their maids, not realizing that this task requires some level of expertise that the regular person wouldn’t have.

Understandably, many people do not have time and effort to maintain their ponds on a frequent basis. Here are some tips to keep the mosquitoes out of your pond so that it can be sustained for a long time with little maintenance.

First of all, understand why water stagnates:
- little or no movement in flow of water
- Low oxygen levels
- Waste and carbon dioxide from fish and rotting vegetation.

It is common misconception that keeping fish in the pond prevents water from stagnating. While fish do keep the water moving, they also pollute the water and reduce oxygen levels in the pond. On the other hand, some fish like goldfish, koi and mosquitofish will eat mosquito eggs, larvae and pupae when hungry. In fact, if you notice lavae in your pond, don’t feed your fish for a few days and the lavae will most likely end up in their stomachs.

If you have fish, do introduce a pond filter, which will remove the toxins in the water released by fish and water plants, and increase oxygen levels.  

Populate your pond with oxygenating plants to keep oxygen levels high. Ask your plant supplier to point out the oxygenating plants for you. However, bear in mind that plants will populate if healthy, and you should not plant too much in your pond, or the plants could overcrowd and die from lack of light and nutrients, releasing carbon dioxide and toxins instead.

Add a water feature such as a fountain or artificial stream to get the water constantly on the move, thus preventing stagnation.

Keep your pond in a bright and sunny environment. Avoid obscuring it with overhanging trees and other ornaments.

Avoid planting landscape plants near the pond edge as the plants could serve as shelter for mosquito larva. For similar reason, choose plants that are submerged, instead of floating. Water lilies are lovely and all, but they could become protective shelter for mosquito larvae.

Don’t forget to call in the experts to give your pond a good clean-up when the pond does get murky or algae have accumulated!

A decorative pond should charm you, not harm you. Take good care of it so that it doesn't turn into a mosquito hatchery!

Last Friday, the Straits Times revealed a worrying report about diabetes in Singapore, that one in three Singaporeans will develop it by the time they are 69.
Quoting Professor Chia Kee Seng, the dean of the Saw Swee Hock School of Public Health.

'It is no longer a question of 'if I will get diabetes', but 'when I will get diabetes.'

Diabetes is serious business. A diabetic patient has to be placed under medication for the rest of his lifetime as there is no cure. If diabetes is not adequately controlled, it can lead to a significantly higher risk of developing further health complications, leading to blindness, kidney failure, nerve damages, gangrene on feet leading to amputation, impotence, heart diseases and more.


There are 2 types of Diabetes, Type 1 and Type 2. Type 2 is the more common form of diabetes. It generally appears later on in life and is preventable, unlike Type 1 which is caused by genetics.
Type 2 Diabetes is characterised by the body not producing sufficient insulin, or the insulin is not working properly. Insulin breaks down glucose to be used for energy. If you have insufficient working insulin, your body will have problems breaking down glucose, which leads to high sugar levels and in turn, health problems.


What increases the risk of getting Type 2 diabetes?

Age and ethnicity: The older you are, the higher your risk is. In the UK, it has been found that the risk of South Asians developing Type 2 diabetes is five times higher than Caucasians.
Genetics: If immediate family members have diabetes, the risk is increased.
Obesity: Overweight people who lead sedentary lifestyles have a high risk in contracting diabetes.
Specific conditions:
Those who have been diagnosed with Cardiovascular problems and stroke,  Impaired fasting glycaemia (IFG) and Impaired glucose tolerance (IGT) and severe mental health problems develop higher probability of contracting Type 2 diabetes.

A woman may become temporarily diabetic during pregnancy, a condition known as gestational diabetes. This may contribute to a higher risk of developing Type 2 later on. Giving birth to a large baby is a risk factor too.

Fortunately, with the right diet and exercise, Type 2 diabetes isn’t hard to prevent, nor is it difficult to keep under control.

A Balanced Diet

To prevent your blood sugar level from fluctuating, you need to eat healthily, and consume about the same amount of food per day and at the same time. Do not over-eat or attempt to diet. Never skip meals, as this will lead to aggressive fluctuation of your blood glucose levels.

If you adhere to the same portion sizes and eating times per meal, you should be eating the same mix of carbohydrates, proteins and fats each day.

Fiber helps to control blood glucose. Therefore, it is good to include in your diet a variety of grains, fruits and vegetables. Brown rice has more fiber than white rice.


To know what kind of food you should eat and how much, a good way is to reference the food pyramid. There are four tiers – at the base are foods rich in carbohydrates (e.g. rice, bread, grains). The next tier is fruit and vegetables. This is followed by protein-rich foods like meat, fish and cheese. At the top are fatty foods. Follow the pyramid and eat more of the foods below and less of those on top and you will have a well-balanced diet.

Contrary to some misconceptions about diabetes, you do not have to avoid sugar or unhealthy foods like plague, as long as within healthy levels. Neither do you need a special diet. You should eat like how any health-conscious person would.

If in doubt, consult your doctor or a dietician to help you tailor a meal plan.

Exercise
Regular physical activity is important for a person with diabetes. The benefits of exercise include:

• controling your blood glucose
• keeping your weight down
• keeping your blood pressure down
• raise your HDL (High-density lipoprotein), good cholesterol levels
• lower your LDL (Low-density lipoprotein), bad cholesterol levels

Avoid vices

Reducing or stopping alcohol and tobacco consumption are a given for anyone who wishes to regain health.
Seek Medical Treatment

As mentioned earlier, a diabetic patient has to be placed under medication for the rest of his life to keep the diabetes under control. Your health care provider will guide you to monitor your blood glucose levels, and provide oral medication or insulin to help you to control your blood glucose levels.

As the risk of heart problems is higher in a diabetic patient, monitoring of blood pressure and cholesterol levels is important in diabetes management. Your doctor may also prescribe medication to keep your blood pressure and cholesterol at healthier rates. Nevertheless, it is never good to get dependent on medication, so it is essential to complement medication with a healthy diet and regular exercise.

While diabetes is not good news, it is not the end of the world either. One can still lead a normal and fulfilled life while under medication. Check out this list of famous people with diabetes!

Life goes on, with or without diabetes. Get as much happiness as you can out of it by keeping your condition under control!