April 29, 2017

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Featured image by Flickr user Ray_LAC CC BY 2.0

by Abraham Lee

DIABETES isn’t a disease you “catch”, and that means that nobody can “give” it to you. But it’s not far-fetched to say that your job could put you at risk. Lifestyle factors form many of the risk factors for developing diabetes, and since we spend about a third of our day working (and for some of us another third of our day thinking about work), your job, work environment and the people around you become key factors in the war against diabetes.

Singaporeans work among the longest hours in the world. In 2015, we worked “an average of 2,371.2 paid hours” – longer hours than those in reputedly ‘workaholic’ nations like South Korea and Japan. Work habits and culture have a great deal of influence over our lives simply because we spend so much of our time at work.

While great habits at work can promote positivity, bad ones can debilitate other areas of our lives, especially our health. Singapore ranks second among developed nations for diabetics as a proportion of the population, with 11.3 per cent of Singapore residents suffering from diabetes in 2010. That number is projected to rise dramatically to 20 per cent by 2050.

None of us wants the lifetime burden that diabetes promises. The incurable disease is also the gateway to heart disease, stroke, blindness and other complications. The most common strain, Type 2 diabetes, is largely due to lifestyle factors and is usually seen “in people aged 40 and above who are overweight and physically inactive”.

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So what are the riskiest things about our job, diabetes-wise?

Working late can disrupt your mealtimes, sleep patterns, and heighten stress levels. Irregular meal times from skipped meals or late lunches or working late “are linked to a higher risk of metabolic syndrome”, a group of factors that increase the risk of heart disease and problems like diabetes.

Stress from work also messes up your hormone levels, including cortisol which increases appetite and can lead to overeating when its levels remain elevated due to continued stress.

Entertaining clients over drinks, or going out drinking with colleagues, if done too frequently, can also become a hazardous habit as alcohol intake is linked to Type 2 diabetes.

Your work posture can cause tension in your muscles which in turn changes our hormone levels. Sedentary, desk-bound work also lowers our activity levels, which puts us at risk of weight gain, which can lead to diabetes.

Fatigue from work often discourages us from spending time in the evening exercising – it’s much more tempting to veg out in front of the computer or TV, and then go to sleep.

While workers should take responsibility for their own choices, companies are also key stakeholders in promoting healthy lifestyles for employees through healthier work culture. Promoting work life balance, encouraging workers to exercise more and reminding them to practise self-care will result in healthier and more productive employees.

It’s not all that difficult to do either. The Health Promotion Board (HPB) has led the way with healthy eating campaigns and the National Steps Challenge which encourages walking 10,000 steps per day with in-kind rewards. In its second season, it introduced the Corporate Challenge pitting companies against each other with cash prizes at stake and setting up a platform for intra-company challenges.

Complementing HPB’s National Step Challenge is AIA Vitality, a comprehensive wellness programme, launched by AIA Singapore to help users make real change to their health. The programme offers weekly rewards to members when they meet their weekly physical activity targets, cashback, discounts on gym memberships, airfares and more to incentivise them in making healthy choices. This wellness programme is also made available to companies who wish to have it as part of a comprehensive health and wellness benefit for its employees.

It’s going to be a tough fight to live a healthy lifestyle at the workplace, but with the commitment from both the public and private sectors to create a healthier workforce, we can win the fight against diabetes. In the end everyone stands to gain – us, the G, employers and our children.

 

This story is part of a series with AIA Singapore.

AIA Singapore is invested in the health and wellness of Singaporeans and has launched AIA Vitality, a comprehensive wellness programme that rewards members for taking small, everyday steps to improve their health.

 

Featured image by Flickr user Ray_LAC. (CC BY 2.0)

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by Daniel Yap

SINGAPORE is engaging in a long-term war, with high stakes. It’s the war for our health and overall well-being, and for disease prevention which has long-run payoffs – better quality of life, reduced costs, lower risks. The details of NurtureSG, a Ministry of Health plan to instill healthy habits in our children, will be announced later this year, but any plan needs to consider potential obstacles.

The first thing standing in the way of healthier children is unhealthy adults. We need no reminding that children are most influenced not by what they are told by their parents and teachers to do, but by what they see their parents and teachers doing. Thus, any aim to change the health-wise behaviour of the next generation must take into account the behaviour of this generation.

It may be straightforward enough to try to drill healthy habits into our children, but how then can we incentivise adults, whose habits have already been formed and practiced for decades, to change? We would not want to train our children up a certain way only to have them slip back into an unhealthy adult lifestyle because they were following their parents’ footsteps.

Adults need to replace old habits by forming new ones, and new habits are formed by repetitive behaviour. Without long-term goals, such sustained change would be difficult.

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For starters, we need to address the psychology that defeats long-term goals: affective bias, risk discounting, and hyperbolic discounting.

Affective bias, that is, bias that is rooted in our emotions, causes us to hear only what we want to hear. For example, the strong emotion associated with comfort eating can cause us to put too much stock in a “reduced fat” label on an unhealthy snack…and there goes the diet.

Uncertainty about the goals we set is what leads to risk discounting, where we downplay the risky effects of our behaviour. If you didn’t know how much you needed to eat to lose weight, would you have chicken nasi briyani for dinner, and a large bag of potato chips at the movie afterwards? Probably. But if you knew you had to eat under 1700 calories a day to lose weight, then it would be immediately clear to you that the 900 calorie nasi bryani and the 1000 calorie bag of chips would completely wreck your goals, especially if you already had a typical 500 calorie breakfast and “diet” 400 calorie lunch.

Hyperbolic discounting is the cognitive bias that favours short-term gains – why someone would choose to get $50 now than $1,000 a year later. It is why diet plans fail, why savings plans fall through, why we won’t cut our carbon footprint even though we know we put the future in peril.

How can children and adults get past these roadblocks to a healthier life? First, the emotional appeal of a long-term healthy lifestyle needs to stay strong. We need constant reminders that this is good for our family, good for our children and good for our silver years. Strong campaigns and culture-building are key to achieving this.

Then, we need instant gratification for our efforts. This is the short-term counter to short-term temptations, and this has so far been the hardest to achieve on a national scale.

This is why people post their workouts and gym bods on social media – to soak up the likes and encouragement as fuel for the next workout. This is why wearables are effective, because they are a constant reminder on your wrist of whether you’ve covered your 20,000 steps today, or gotten enough sleep, or pushed your heart rate frequently enough this week.

Instant gratification is why we need incentive programmes like the national steps challenge, in-house corporate fitness or weight-loss competitions, or programmes for individuals like AIA Vitality to reward workouts with vouchers, send encouragement, form support groups, set reminders, and do anything necessary to keep our eyes on the short-term goal for as long as it takes to reach the long-term one.

We are all, in one way or another, attracted by short-term gain. And if healthy living isn’t attractive in the short-term, then unhealthy living will win out. And what happens in the short term determines who wins the long-term war for our well-being. If we lose the war for our own well-being, we’ll be putting unnecessary obstacles in the way of the G’s push to make our children healthier.

 

This story is part of a series with AIA Singapore.

AIA Singapore is invested in the health and wellness of Singaporeans and has launched AIA Vitality, a comprehensive wellness programme that rewards members for taking small, everyday steps to improve their health.

 

Featured image by Sean Chong.

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Bertha in coffee shop

by Bertha Henson

WHEN my mother was in her 60s, she had both her knees replaced. Last year, when she was 71, she had surgery to her spine. She made a swift recovery but age is telling on her. She laments that she isn’t able to walk as quickly or as far as she could. She laments that she is unable to carry the bags of groceries and has to ask the Sheng Siong staffers to lug it for her to her car boot. Yes, she still drives and I’m thinking of taking away her keys because she has a greater tendency now to confuse her routes.

How does one come to terms with getting old(er)?

Everywhere you see material that caters to the younger set, whether on looking good or dressing well. If there is material on the old, it’s about how some elders are ageing gracefully, like doing the triathlon or something. Or it is the rather more depressing stuff, like end-of-life issues and hospital or hospice care. Or it’s about maintaining enough funds for retirement.

The truth is, ageing is not graceful.

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I see increasing signs of an ageing population everywhere everyday. Like hawkers and stallholders in my neighbourhood who are now wheelchair bound. Like having to make my way through sidewalks crowded with personal mobility devices – and I don’t mean skateboards and wheels for the young. Like seeing an increasing number of foreign helpers who go out marketing with their older charges.

There is a couple I’ve known half my life who walk bent and at a snail’s pace around the neighbourhood. They used to be perky and sprightly. At least, I thought, they have each other and they still hold hands. I tell my mother to straighten her posture when she’s walking or she’ll end up looking like them.

How does one come to terms with growing old(er)? My mother fights age with every ounce of her decreasing energy. She colours the tuft of grey on her head with hair mascara. She dons track shoes for her increasingly shorter walks. She maintains herself well, never neglecting the face powder, lip-stick and earrings when she gets out of the house, even if she’s bound for the wet market. She makes sure her spectacles are youngish – she just bought a red-framed one which she worries would be too flashy for her age.

She knows, however, that she is losing her battle with age. She complains about being “useless’’ because she can’t bake as many cookies as before or cook the big family spreads she used to.

Nothing really prepares you for the slow and steady drip of energy and strength. It doesn’t help when friends you’ve known half your life suddenly succumb to illness. A friend of my mother’s who is one of the most out-going and social beings in her set, collapsed at a mall a few weeks ago and died in hospital a few days later. It’s depressing when people your age suddenly pass on, as it was for my mother.

It’s one aspect of ageing that is seldom talked about: the psychological acceptance that you are not as young as you used to be. We can mend our body parts and even replace them, or slow down the ageing process. We can ensure we have enough funds to live until death, but what is the point when you can’t live life to the fullest in the meantime? You hear it, don’t you? Older folk saying they want to holiday overseas before they become incapable of walking. That they want to enjoy their life with their CPF savings while they are still healthy and sprightly. Yet we tell them to see the big picture: that without funds, society would end up caring for them. It’s a message for the young, who can yet envisage being old.

I feel age creeping on too. Creaky knees, reading glasses and a bad wrist that appears to be the result of too much time on the keyboard. Like my mother, who considers herself young, I look at older folk and wonder about the day I become one of them.

Singapore has to get used to the presence of older folk. I can declare that I have never heard any driver honk at an old person who is taking his time to cross the road. And I have never seen anyone not responding to an older person who asks for help. But I also know that statistics show that the elderly are vulnerable on the roads and die in accidents, and that they are susceptible to scams, especially if the trick involves their children’s well-being.

I read on Friday about an old lady who has kept herself in her own home because she is afraid of falling down when she ventures outside. I smile because my mother is afraid of falling too, not just because of broken bones, but that she would look like a foolish sight in public, sprawled on the ground in an unsightly manner.

Maybe that’s why she always dresses well when she ventures out of the house. You really want to look your best when you are at your worst.

May age be kind to all of us.

 

Featured image by Sean Chong.

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Featured image by Flickr user Vaping360. (CC BY 2.0)

by Daniel Yap

SENIOR Minister of State for Health Amy Khor’s answer to WP Non-constituency Member of Parliament (NCMP) Leon Perera’s question about heated tobacco products exposed a weakness in the Ministry of Health’s policy on alternative tobacco products, and its approach to science. Smoking is a big risk for our healthcare system, and if alternative products can lower that risk, then perhaps we need to consider them more carefully.

Heat-not-burn tobacco may be strange to Singaporeans because it is banned here, but it accounts for more than five per cent of the tobacco market in Japan after being on the market for just two years, and is catching on in many major markets worldwide. Its popularity is due to rising fears of the effects of second-hand smoke and also smokers’ desire to quit or reduce harm to themselves and their families.

But since Singapore plays host to research and development facilities of tobacco companies, it’s odd to think that we know so little.

How Philip Morris International's iQOS system works
At least we know how Philip Morris International’s heat-not-burn iQOS system works

Plus, since we are at war with diabetes (of which smoking is a major risk factor), it behooves us to be interested in even preliminary studies of products that claim to reduce risks, including e-cigarettes and heat-not-burn products.

I have family and friends who smoke and I would like to know whether this product (or any other, like vaping) could reduce the harm they are doing to their bodies (and to mine). I would think every smoker’s family does.

It takes time, of course, but Dr Khor did not say that studies were underway. Are they? I know the budget is tight, but this is a budget for the future, isn’t it? Why not spend a few million now to potentially reduce future healthcare costs by billions of dollars?

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1. Don’t know means don’t know, not “no”

Dr Khor’s reply sounds like a defence of the G’s policy of banning heat-not-burn products, along with e-cigarettes and non-smoking tobacco. If a lack of information exists for an issue as important as smoking, then it is the duty of the G’s scientists to go and find out more.

If we don’t know, we should be open to trying. I’m not saying we should completely legalise alternative products to all and sundry. Even Mr Perera’s suggestion to start with giving these products to smokers trying to quit will be a start.
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2. Citing nicotine levels as a reason why heat-not-burn is bad

Mr Perera was asking about the overall risk of heat-not-burn products. Dr Khor answered with how nicotine levels were comparable to regular cigarettes. This answer is strangely off-track.

Smokers are addicted to nicotine but killed by tar and other chemicals. Shouldn’t the answer be about tar and carbon monoxide instead? Or at least one of the many other chemicals in cigarettes that could harm your body?

And if lower levels of other chemicals are detected in heat-not-burn products, then the same level of nicotine would be a good thing because it would be easier for addicts to switch products because they get the same high while causing less harm to themselves and others.

We practise “reduced harm” policies for other vices. If heat-not-burn products and e-cigarettes reduce harm, we should allow them, and the health authorities should commit to this and then go research it.
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3. Criticise the research, not (just) the researcher.

Dr Khor is a little too dismissive of the research done by tobacco companies when she says “while there have been claims that such tobacco products are less harmful…these claims are made by the tobacco industry”. It is one thing to know that a person or organisation is an interested party in a study or has lied in the past, but that isn’t what makes a study true or untrue.

Research done by tobacco companies on heat-not-burn stretches back to 2008. And it is extensive, with publicly available methodology. Philip Morris, for example, has submitted a two million-page dossier to the US Food and Drug Administration on the effects of heat-not-burn. If heat-not-burn is as harmful as cigarettes, as Dr Khor presumes, then we need to dive into the research, not ignore it.

Since there is currently no research to disprove the tobacco companies, why not peer review their studies? Why not attempt to replicate them? Why not conduct independent studies? That is how one refutes (or proves) another’s research, not by a mere claim that the other party is an interested party. That’s what we do with big pharma, so apply it across the board.

Good science was responsible for linking cancer, diabetes, heart disease and a host of other ailments with smoking. We need to drop the lazy rhetoric and do the hard work of science.
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4. “There is no safe level of tobacco use”

This was the answer Dr Khor gave to Mr Perera’s query about trialing reduced-risk products to help smokers who have registered for smoking cessation programmes quit.

Not only does it fail to answer Mr Perera’s question, the answer hides behind a truism. Of course there is no safe level of tobacco use. There is also no “safe level” of particulate pollution. There is no safe level of red meat consumption. But we know that a PSI below 50 is considered “healthy”. We know that one can eat a moderate amount of red meat and not be considered “at risk” by doctors or insurers.

We want to know whether heat-not-burn is safer than cigarettes, not whether tobacco is bad for you. Big tobacco is claiming that heat-not-burn is safer. There are no claims that it is safe.
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5. The “gateway effect” and other “evidence from other countries”

Dr Khor says that “evidence from other countries” shows that heat-not-burn products have emissions that are not too different from cigarettes. However, a November 2016 Ontario Tobacco Research Unit report on heat-not-burn products comes to this conclusion:

“To date, we have not found new independent science that has assessed the harm reduction potential or the acceptability of the current generation of heat-not-burn products… If independent science finds that the new heat-not-burn products do indeed considerably reduce harm and are widely acceptable to smokers, an opportunity would arise for eliminating the sale of the higher risk combustibles.”

So other “evidence from other countries” so far is a well-documented seven-year-long and counting study by UK health authorities disproving Dr Khor’s “gateway effect” fears, and showing the exact opposite.  Dr Khor mentioned the study but didn’t have the time to explain why she didn’t accept its findings.

Instead, her evidence backing up the “gateway effect” is only half a story – that adolescent e-cigarette use in the US is growing quickly (ten-fold since 2011). The other side of the story, which she left out, is that there was a sharp decline in conventional cigarette use over the same period. I’ll not be one to confuse cause and correlation, but telling only one side of the story robs us of the facts.

Add to that the fact that the UK government has concluded that e-cigarettes are definitely less harmful than regular cigarettes and you’ve got to ask: Could the Ministry of Health, in their over-zeal to protect Singaporeans from “potential harm”, also be holding us back from potential benefits? All I know is that we can’t justify our policy positions with bad, bad science.

 

Featured image by Flickr user Vaping360. (CC BY 2.0)

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ASIA is home to thousands of cultures, yet the one ingredient that unites us all is having rice as part of our daily meals. From India in the west to Japan in the far east, down to furthest southern reaches of the Indonesian islands, rice has been a staple for billions of people for thousands of years.

Yet the humble grain, or at least the processed white version of it, has been at the crosshairs of health authorities in recent years for its role in diabetes.

Harvard researchers studying over 350,000 participants way back in 2012 for instance, noted that an additional serving of white rice raises the risk of Type 2 diabetes by 10 per cent. This is explained in part by its high glycemic index (GI) score which causes spikes in blood sugar.

But these same researchers note that modern sedentary lifestyles have a large part to play as rice has been in the Asian diet for millennia and health issues are cropping up only now. One solution: reduce the amount you eat, but do it without starving.

This is easily done by adding seeds, nuts and grains. While the purity of a simple bowl of white rice is certainly hard to beat, these small modifications not only add interest in flavour and texture but ramps up the amount of nutrition you’d get in one sitting. Here’s 7 you can add for a healthier bowl of rice.

01 Barley
Barley incorporated into short grained rice yields a nutty taste with the chewy texture of al-dente pasta while providing more manganese, phosphorus and proteins. The grain cooks at the same rate as rice so it can be mixed and cooked at the same time. To get this right, combine 1 cup barley with 1 cup rice with 2 ½ cups of water and cook as per normal in your rice cooker.

02 Quinoa
For those looking to increase the amount of protein in your diet, quinoa is your go-to grain. The cereal which is native to South America takes just 15 minutes to cook so add it into your rice towards the end if you prefer it still crunchy. While white rice and quinoa is an easier combination, consider cooking with brown rice to include more fibre.

Amaranth, the ancient Aztec grain.
Amaranth, the ancient Aztec grain.

03 Sesame Seeds
There’s more to sesame seeds than just having it as an oil or to sprinkle on top of burger buns. They’re packed with nutrients like proteins, fat and fibre, and tastes best when roasted and crunchy. To get the best out of this flavour and texture, dry roast the sesame seeds on a hot saucepan until slightly browned, and mix it in with cooked rice.

04 Amaranth
This ancient grain was a staple of the Aztecs and is as protein packed as quinoa. Unlike quinoa though, amaranth turns mushy when cooked, so go by your preference when cooking it with rice. Generally, more amaranth leads to a soft pudding-like texture. But a good way to start and gauge your preference would be to use 1/4 cup of amaranth to 3/4 cups of other grains.

05 Soy Beans
Soybeans have long been cooked with glutinous rice in Asia as part of leaf-wrapped dumplings and often come seasoned with savoury additions. The beans are also so protein-packed that it’s recommended as a replacement for those on meat-free diets. To cook it, soak the soy beans overnight so they soften up, dehull them and then add your desired amount into the rice to cook simultaneously.

A bowl of garbanzo beans
A bowl of garbanzo beans

06 Mung Beans
Healthy ingredients can be difficult to find but thankfully, mung beans or green beans as they’re commonly known are found everywhere. They’re packed with nutrients like magnesium, manganese, potassium, copper, folate, zinc and vitamin B6. Like soy beans, soak the green beans overnight before cooking. Recipe-wise, the Iranians have a dish named Mash M’tubuq which calls for ½ cup of mung beans to 1 cup of rice. It also calls for other ingredients like yoghurt, onions, molasses and dill but there’s no reason why you can’t try it out plain.

07 Garbanzo Beans
Garbanzo beans are often seen more as the main ingredient in hummus than with rice but it’s a combo that’s also seen in Mediterranean and Indian dishes. Save yourself some time and go for the canned version rather than the dried version as getting the buttery texture it’s so loved for requires more than just soaking, but also simmering for 1 ½ hours. As canned versions are already cooked, simply add your desired amount towards the end of the rice cooking cycle and give it a good stir.

 

This article first appeared on Michelin Guide Singapore. Visit Michelin Guide Singapore on Facebook.

Featured image mixed rice by Flickr user theilr. (CC BY 2.0)

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Photo By Shawn Danker
Singapore Parliament.

by Wan Ting Koh

IS ZIKA here to stay, and is it even possible to eradicate it fully? What about fogging – is it useful in the long term?

These were questions asked in Parliament yesterday (Sept 13) after two ministerial statements concerning the mosquito-borne disease were read out.

The first statement was by Health Minister Gan Kim Yong, who spoke about the current local situation of Zika and outlined strategies concerning the disease moving forward. He was followed by Minister for Environment and Water Resources Masagos Zulkifli who spoke about efforts to control the disease in terms of eradicating mosquito breeding grounds.

Both ministers responded to questions from eight Members of Parliament (MP), including the MP for MacPherson SMC Tin Pei Ling. MacPherson SMC is currently one of the seven Zika clusters in Singapore.

And it was Ms Tin who asked if Zika could be considered endemic and if it was possible to rid Singapore of the disease. The answer? In short, don’t know.

Mr Gan replied that it was “too early to tell” if it was endemic. He said that to focus on the terminology at this point in time is “not productive” and that the focus should be on the “immediate task”, which is vector control. Basically, to eradicate the source of the mosquitoes to prevent the transmission of the disease.

(Endemic diseases regularly occur among a certain region or place. The term is different from “epidemic” which describes an infectious disease that spreads rapidly to many people. Think SARS.)Why delay in detection?

Speaking of endemic, non-constituency MP Daniel Goh brought the house back to when Zika first started and asked why the 36 foreign workers, whose Zika infections the Ministry of Health (MOH) announced on Aug 28, were not detected earlier. Mr Gan said the symptoms were mild and that the infection is difficult to identify; the workers had also tested negative for dengue and chikungunya.

On Aug 23, a general practitioner at Sims Drive Medical Clinic, informed the MOH of an unusual increase in cases with fever, rash and joint pains. The cases were classified as mild as the initial hypothesis was a cluster of mild viral illness transmitted from person to person. MOH then made arrangements for the clinic to refer new cases to the Communicable Diseases Centre (CDC) for further testing and to start tracing past cases for review and testing if appropriate.

The ministry also communicated with nearby clinics and construction sites to be more vigilant and report cases to the ministry. Patient A, a 47-year-old Malaysian woman whose case was reported on Saturday (Aug 27), is considered the first case of locally transmitted Zika infection here. Patient A visited the same clinic as the construction workers on Aug 25 as she had developed fever, rash, and conjunctivitis. She was referred to the CDC at Tan Tock Seng Hospital, where she was tested positive for Zika.

The infections of the 36 foreign workers were identified via back-tracing.

As for its current Zika control measures, the G is now extending Zika testing beyond the clusters and providing a subsidy to all Singaporeans with Zika-like symptoms at public healthcare institutions, Mr Gan said. In addition, it is keeping doctors, especially GPs, which Mr Gan describes as the “key gatekeeper”, up to date with Zika developments. Zika was made a notifiable disease under the Infectious Diseases Act from January 5 this year, which means that MOH would immediately be alerted if any doctor or laboratory in Singapore detected a case of Zika.

Fog more often?

As for the Ministry of Environment and Water Resources, Mr Masagos said that the ministry will continue to employ more “boots on the ground” in terms of inspectors who check both household and construction sites for mosquito breeding grounds.

What about fogging? He said that routine and indiscriminate fogging was “not wise”. It is not a sustainable measure or effective against the local mosquito population, he added.

Fogging is only effective if the chemical has direct contact with the Aedes aegypti mosquito and it will have to be applied frequently as there would always be new batches of mosquitoes from breeding grounds that are not removed, said Mr Masagos.

Said Mr Masagos: “Fogging should only be used when there are Zika or dengue clusters or when the adult population [of Aedes mosquitoes] is observed to be high.”

In fact, fogging may cause a “build up of resistance in mosquitoes” which may then become immune to the insecticide. A more effective solution would be the “detection and removal of mosquito larvae”, he said.

Featured image from TMG file. 

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ZIKA is here. We’d rather not say “finally”, since we’ve been warned about it so many times that it seemed like a bad mantra. That exotic word by the way, refers to a disease spread by that dratted Aedes mosquito, the type which also spreads dengue.

We’ve been warned that we’re vulnerable because we have so many people going through Singapore. In May, Singapore reported its first imported case, a 48-year-old who travelled to Sao Paulo. It had seemed like something so far away, in Brazil, where pregnant women could pass the infection to the foetus who would be born with birth defects.

But Singapore’s latest Zika patient, a 47-year-old female Malaysian who resides at Block 102 Aljunied Crescent and works in Singapore, hasn’t travelled to Zika-affected areas recently. This means she was probably infected in Singapore which makes her the first case of local transmission.

MOH is also screening others living and working in the area who have symptoms of fever and rash. At this point, two members in a family who live in the Aljunied Crescent area and an individual who works there, had preliminarily tested positive based on their urine samples.

Don’t start panicking.

According to MOH: “Zika is generally a mild disease. It may cause a viral fever similar to dengue or chikungunya, with fever, skin rashes, body aches, and headache. But many people infected with the Zika virus infection do not even develop symptoms.” But pregnant women who live or work in the vicinity and who have a fever or rash should see a doctor.

The Malaysian, who developed fever, rash and conjunctivitis on August 25, is recovering well.

As for precautions, we should just do what we’ve always known we should do – wipe out the mosquito population. That might just rid us of the dengue fever scourge as well. Dengue has claimed seven lives so far. By the way, the Malaysian isn’t living in an active dengue cluster but there are two other clusters nearby.

 

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PHEW.

It’s all clear for PM Lee and he called it a night at 1.30am today after nearly fainting onstage during the National Day Rally.

The good news was delivered via Facebook by Minister for Foreign Affairs Dr Vivian Balakrishnan at around 10am. Dr Balakrishnan said that PM Lee was “fully conscious” when he fell on stage due to a “vasovagal episode”, showing “classic symptoms and signs – sweatiness, low heart rate and low blood pressure”. After the rally ended, they went to Singapore General Hospital (SGH) where more tests were done on PM Lee. These tests showed that nothing was out of the ordinary and he was in the clear.

Within an hour of surfacing on Facebook, Dr Balakrishnan’s post garnered almost 400 likes and reactions, and many comments wishing for PM Lee’s good health.

 

Featured image from TMG file. 

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by Andrea Wang and Vir Chiniwala

AFTER the abrupt closure of California Fitness, some of us will now have to find a new gym. Others just want to get in on this whole exercise thing, but are unsure of where to start.

Consider boutique gyms. More of these smaller gyms, many of which specialise in a specific type of workout or machine, are popping up.

Here’s why (and where) you can get in on this trend:

 

They offer more unconventional methods of exercising 

No, your options are not limited to running, the elliptical and weight training. Find the workout that’s perfect for you, and in the process, you might also find a like-minded community of people.

 

Upside motion

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Image taken from lululemon athletica Singapore‘s Facebook page

If you’re looking to shake things up, Upside Motion is a good place to go. With a focus on three main programmes – Pilates, Xtend Barre, and Aerial – Upside Motion offers a unique range of workouts.

That coveted dancer’s body can become a reality with Xtend Barre, a fast paced exercise that taps into ballet and Pilates to sculpt a leaned and toned body. Aerial, on the other hand, is a low impact workout that uses a silk hammock to loosen your joints and strengthen your core.

Location: 36 Armenian Street, #02-03, 179934 / 321 Orchard Road, #04-05, 238866

 

SURFSET Singapore

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Image taken from SURFSET Singapore‘s Facebook page

Ever dreamt of living on the beach and surfing the waves every day? SURFSET gets you halfway there with a workout that is done on top of a surfboard. Designed to mimic what it’s really like on the waves, the surfboard is on an unstable base, which helps build core strength and balance.

SURFSET gets you moving with a fat-burning, muscle-toning cardio work out that will have you ready to hit the beach in no time.

Location: 454B Joo Chiat Road, 427667

 

Work out in a gym that doesn’t look like a gym

There’s no need to confine yourself to an overly bright room – or even a room at all. Switch it up with a change of environment, and you won’t even feel like you’re working out.

UFit

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Image taken from UFIT‘s Facebook page

You have a dilemma – you like the idea of getting out to exercise but you don’t like running, are terrible at conventional sports and want something a little more intense than just talking a walk.

Develop your fitness and strength with UFit by doing crossfit – outdoors. If crossfit isn’t your thing, it’s not the only outdoor activity that UFit offers. Yogafit, Hiitfit, and Boxfit are some of the many activities that you can get involved with while being in some of Singapore’s most scenic locations.

Location: Multiple locations

 

7Cycle

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Image take from 7Cycle‘s Facebook page

If the one thing you really hate about going to the gym is how boring it is, try out 7Cycle. It’s indoor cycling that will get your heart pumping. With their self-proclaimed “pulsating soundtrack and party-like atmosphere”, it’ll feel less like exercise and more like being at a dance club.

Whether you want to enhance your cycling, you’re looking for an intense conditioning class, or if you’re just doing it for fun, 7Cycle has a range of classes to fit your needs.

Location: 19 Anamalai Avenue, #01-01, 279987

 

You won’t be just another face in a sea of faces

For those who are worried about getting lost in a group, these gyms look after every member with a specialised personal touch.

The PIT

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Image taken from The PIT Singapore‘s Facebook page

For those who are serious gymming enthusiasts, look no further than The Pit. It has personal training classes ranging from metabolic conditioning to cardio boxing classes – this gym really isn’t for the faint of heart.

The Pit trainers or “Pitmasters” have a no-nonsense attitude and will put you through a gruelling schedule that might make National Service look like a piece of cake. Its methods are exclusively tailored for each individual, with exercises involving kettlebells and clubbells. Plus, if you remain devoted, you might even get a chance to flip tyres or push sleds as part of Pit’s strength workout.

Location: 123 Devonshire Road, 239883

 

Breathe Pilates

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Image taken from Breathe‘s Facebook page

Breathe Pilates (BP) might seem like a run-of-the-mill aerobics gym but it is refreshingly different. It provides rehabilitative physical training for a range of issues, from headaches to larger problems like muscle pulls. BP also offers special classes for mothers and expectant mothers in order to ensure their health and fitness levels remain high.

Moreover, its unique class “Zen.Ga” is the first of its kind that combines science, yoga, and relaxation – sounding more like a fascinating science experiment than a sort of workout.

Location: Four branches islandwide

 

Instead of shifting your schedule to accommodate them – they’ll accommodate you

For those who require a gym that can work around a hectic work schedule and can be completed quickly, look no further – these gyms will allow you to lead a healthy lifestyle without wrecking your daily calendar.

 

Ritual

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Image taken from Ritual‘s Facebook page

Ritual calls itself “the world’s most efficient gym” – it focuses on high intensity training (HIT) utilising kettlebells and bodyweight, so that you can get in and out of the gym in a guaranteed 30 minutes. To further ensure that you don’t put your timetable in a jam, Ritual holds a workout session every 20 minutes from 6.30am to 9pm daily.

Furthermore, it provides gym clothes and amenities such as towels along with protein shakes in case you feel the hunger pangs after the intense workout – how’s that for convenience? To quote the gym – “All you need to do is show up.”

Location: 11 North Canal Road, #03-01, 048824

 

Club Insignia (GYMM BOXX)

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Image taken from Club Insignia‘s Facebook page

Club Insignia was recently acquired by GYMM BOXX – a rapidly growing chain in the gym market, but Insignia’s style of working out will remain intact. What sets this gym apart from others is that no session is identical – in each workout, the exercises and routine are unique, making it ideal for those who get bored of doing the same repetitive exercises.

The gym is also accessible for the elderly, with its trainers holding specialist classes reserved for senior citizens. These “aqua fit” classes use cardiovascular exercises to ensure that even the aged are able to maintain a healthy lifestyle.

Location: The Oasis #03-02, 87 Science Park Drive, 118260

 

Featured image from UFit’s Facebook page.

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Quinoa, a popular alternative to rice

by Varsha Sivaram

THE buzz over a Health Promotion Board (HPB) study that linked white rice to diabetes might have died down, but the health conscious are still substituting rice with other alternatives. We’ve talked about the different types of rice besides white, but what about skipping out on the grain altogether?

Popular reasons for forsaking rice include low-carbohydrate diets, a desire for more fiber, and simply to make meals more diverse. Superfoods like quinoa – a grain crop with edible, starchy seeds that are rich in protein – and sorghum have garnered a solid reputation as substitutes. However, there’s another side to them besides nutrition: Like a lot of organic goods, they’re expensive.

We’ve rounded up a few alternatives that won’t break the bank, from grains to even vegetables.

 

1. Cauliflower

Cauliflower rice

Spiced Cauli ‘Couscous’ by Flickr user jules. CC BY 2.0.

An emerging favourite among foodies, the rice-like texture and look of the vegetable, as well as its lack of a strong flavour, makes it a popular substitute for rice. As for nutrition, the florets clock in at 25 calories per 100 grams, as opposed to about 140 calories in cooked white rice. Cauliflower is also rich in vitamins C and K, and a good source of dietary fibre.

Simply pulse it for a few seconds in a food processor – so that it does not end up puréed instead – or grate it finely to achieve the look of rice. Then, cook it as you might regular cauliflower: With some olive oil or butter on the stove, or on a tray in the oven.

Options include Australian Cauliflower, priced at $14.83/kg from Redmart, and regular cauliflower, priced at $3.21/kg from Fairprice.

Recipes

1. Healthy Cauliflower Rice – Food Network

Ingredients:

  1. 1 large head cauliflower, separated into 1-inch florets
  2. 3 tablespoons olive oil
  3. 1 medium onion, finely diced
  4. Kosher salt
  5. 2 tablespoons fresh parsley leaves, finely chopped
  6. Juice of 1/2 lemon

Directions:

  1. Trim the cauliflower florets, cutting away as much stem as possible. In 3 batches, break up the florets into a food processor and pulse until the mixture resembles couscous.
  2. Heat the oil in a large skillet over medium-high heat. At the first wisp of smoke from the oil, add the onions, and stir to coat. Continue cooking, stirring frequently, until the onions are golden brown at the edges and have softened, about 8 minutes.
  3. Add the cauliflower, and stir to combine. Add 1 teaspoon salt, and continue to cook, stirring frequently, until the cauliflower has softened, 3 to 5 minutes.
  4. Remove from the heat.
  5. Spoon the cauliflower into a large serving bowl, garnish with the parsley, sprinkle with the lemon juice and season to taste with salt. Serve warm.

 

2. Fried Cauliflower – Kitchn

Ingredients:

  1. 1 medium head cauliflower
  2. 1/2 pound (8 slices) thick-sliced bacon, optional
  3. 2 large eggs
  4. 1 tablespoon minced ginger
  5. 3 cloves garlic, minced
  6. 2 medium carrots, diced (about 1 cup)
  7. 1 cup corn, fresh or frozen
  8. 1/2 cup peas, fresh or frozen
  9. 4 green onions, thinly sliced
  10. 1/4 cup cashews, almonds, or other nut
  11. 2 to 3 tablespoons soy sauce (or if gluten-free, 1 to 2 tablespoons tamari)

Directions:

  1. Cut the cauliflower into florets, discarding the tough inner core. Working in batches, pulse the cauliflower in a food processor until it breaks down into rice-sized pieces. You should have 5 to 6 cups of cauliflower “rice.”
  2. Cook the bacon in a 12-inch skillet over medium heat until crispy. Transfer to a plate lined with a paper towel to drain. Once cooled, roughly chop into pieces. Drain off all but a teaspoon of bacon grease (or use 1 teaspoon vegetable oil), reserving the grease.
  3. Place the pan back over medium-high heat. Whisk the eggs and pour them into the skillet. Quickly scramble the eggs or make an omelet. Transfer the eggs to a cutting board and roughly chop into pieces.
  4. Wipe the skillet clean and warm 1 tablespoon of bacon grease or vegetable oil over medium-high heat. Add the ginger and garlic, and sauté until fragrant, about 30 seconds. Stir in the carrots and sauté until crisp-tender, 2 minutes. Stir the corn, peas, and cauliflower “rice” into the pan, mixing the ingredients thoroughly.
  5. Lower the heat to medium, cover the pan, and cook until the cauliflower is tender, 5 to 8 minutes. Uncover and stir in the bacon, eggs, green onions, cashews, and 2 tablespoons soy sauce. Taste and add more soy sauce to taste. Serve immediately.

 

2. Couscous

Couscous

Couscous by Flickr user Ralf Peter Reimann. CC BY-SA 2.0.

Known most commonly as a Moroccan staple, these balls of semolina are actually common across North Africa, and have made their way to our plates as well. Rich in protein, dietary fibre, and vitamins, it’s a whole grain substitute with no lack of nutrition.

Cooking couscous is straightforward: Bring water to a boil, toss the couscous in, let them cook until your desired texture and fluff it up before serving.

Options include San Remo Couscous, priced at $7/kg from Redmart, and Casino Couscous from Cold Storage, priced at $4.70/kg.

Recipes

1. Roasted veg & couscous salad – BBC Good Food

Ingredients:

  1. 1 red and 1 yellow pepper, halved and deseeded
  2. ½ butternut squash
  3. 2 courgette, thickly sliced
  4. 4 garlic cloves, leave skin on
  5. 3 tbsp extra-virgin olive oil
  6. 1 red onion, thickly sliced
  7. 1 tsp cumin seeds
  8. 1 tbsp harissa paste
  9. 50g whole blanched almonds
  10. 250g couscous
  11. 300ml hot vegetable stock
  12. zest and juice 1 lemon
  13. 20g pack mint, roughly chopped

Directions:

  1. Heat oven to 200C/180C fan/gas 6. Cut peppers and squash into bite-size pieces (leave skin on the squash). Tip all the veg into a baking tray, add garlic, 2 tbsp oil and seasoning, then mix and roast for 20 mins. Add onion, cumin, harissa and almonds. Roast for another 20 mins, then cool.
  2. Put couscous into a large bowl, pour over the stock, cover, then set aside for 10 mins. Fluff up with a fork.
  3. In a bowl, mix zest, juice and remaining oil. Squeeze garlic pulp from skins into the bowl, mash well and fold in the mint. Pour over the veg, then toss with the couscous.

 

2. Salmon and couscous – Jamie Oliver

Ingredients:

  1. 75 g couscous
  2. 120 g salmon fillet , skin on, scaled and pinboned
  3. extra virgin olive oil
  4. sea salt
  5. freshly ground black pepper
  6. 1 small courgette , sliced into batons
  7. 1 small handful asparagus tips
  8. 1 red chilli deseeded and finely chopped
  9. 2 ripe tomatoes , roughly chopped
  10. ½ lemon , juice of
  11. 1 small handful fresh coriander , roughly chopped
  12. 1 tablespoon fat-free natural yoghurt

Directions:

  1. Put your couscous in a bowl, then pour over just enough boiling water to cover it. Set aside for 3 minutes to allow the couscous to soak up the water.
  2. Slice the salmon widthways into finger-size strips, drizzle with olive oil, and season with pepper and a small pinch of salt. Heat a small non-stick frying pan and add the salmon strips on their side.
  3. Scatter over the courgette, asparagus tips and chilli and cook for 2 minutes, turning the salmon over halfway.
  4. Mix the tomatoes, lemon juice, 1 tablespoon of olive oil and the coriander into the couscous and season to taste.
  5. Remove the salmon strips to a plate and add the couscous to the veggies left in the pan. Mix together and then put the salmon strips back into the pan on top of the couscous, place a lid on and put back on a high heat for a minute.
  6. To serve, slide everything on to your plate and spoon over some yoghurt.

 

3. Lentils

Lentils

Puy lentils by Flickr user Jessica Spengler. CC BY 2.0.

If you’re looking to avoid carbohydrates, this alternative is not your best option. But if an enhancement of the nutrients in rice is what you’re after, lentils are a strong contender as substitutes. Lentils have higher protein levels per cup, as well as less fat, than rice.  The legumes also come in several varieties of their own: Brown, green, and red are some broader categories to get you started. If you’re on the lookout in an ordinary supermarket, brown lentils are the easiest of the three to find. While they have a slightly earthy flavour, the green varieties are more peppery, while the reds have more of a sweet and nutty taste.

The ratio is simple: Three cups of salted water – or any stock, if you want more flavour – to one cup of dry lentils. Bring them to a boil over the stove, and then let them simmer. You will know that they’re cooked when they are tender in texture, but take note that they can double or triple in size upon cooking. Lentils also take longer than rice to cook; red lentils in particular.

Options include Progresso Black Beans, priced at $4.94/kg from Redmart, and Raitip Red Kidney Beans, priced at $3.90/kg from Fairprice.

Recipes

1. One Pot Lentils and Rice – Food.com

Ingredients:

  1. 1 cup dry green lentils
  2. 6 1⁄2 cups water
  3. 4 -5 garlic cloves
  4. 1 -2 bay leaf
  5. 1⁄2 tablespoon cumin seed
  6. 1 pinch cinnamon
  7. 2 cups basmati rice
  8. 1⁄2-1 tablespoon kosher salt
  9. 1 tablespoon olive oil

Directions:

  1. Cover the lentils with the water.
  2. Peel and crush the garlic cloves lightly with the back of a knife. Leave the cloves whole, so that they flavor the dish but can be removed if desired. (I leave them out of the kids’ portions, and give them to my DH and myself).
  3. Add garlic to the pot, along with the bay leaves, cumin seeds and cinnamon. (DO NOT add salt at this point, as lentils will not cook properly).
  4. Bring to a boil. Cook at a boil until the lentils are just tender. This should take about 25 minutes, but may take longer dependig on the age of your lentils.
  5. Add the rice, salt and olive oil, and bring back to a boil.
  6. Stir, cover pot, reduce heat to low, and cook for 15 minutes.
  7. Check to make sure the rice is done, adjust seasonings, and serve. If there is still too much liquid in the pan, just let it sit uncovered for a few minutes.

 

2. Lebanese Lentils, Rice and Caramelized Onions (Mujadara) – Food Network

Ingredients:

  1. 1 cup brown or green lentils (not lentils du Puy), sorted for debris and rinsed
  2. 1/2 cup extra-virgin olive oil
  3. 1 teaspoon cumin seeds
  4. 1/2 teaspoon cracked black peppercorns
  5. 3 medium red onions, thinly sliced
  6. Kosher salt
  7. 3/4 cup basmati rice
  8. 1/2 teaspoon ground cumin
  9. 1/2 teaspoon cayenne pepper
  10. 1 (1-inch) cinnamon stick
  11. 2 tablespoons pine nuts, optional
  12. Squeeze of fresh lemon juice
  13. Greek yogurt, for serving, optional

Directions:

  1. Throw the lentils into a medium saucepan. Fill with enough cold water to cover the lentils by about an inch. Bring it to a boil over medium-high heat, then turn down to a simmer and cook until the lentils are tender but not mushy, about 20 minutes. Drain and set aside.
  2. Meanwhile, as the lentils cook, grab a large skillet. Pop it over medium-high heat and add the oil. Allow the oil to warm for a minute, then drop in the cumin seeds and cracked peppercorns and cook, shaking the pan once in a while until the cumin seeds darken a touch, about 1 minute.
  3. Add the onions, sprinkle with a dash of salt and cook until they turn dark caramel brown, stirring often. This will take about 15 minutes. Splash the onions with a little water if they stick to the bottom of the pan. You’ll know they’re done both by their deep chestnut color and by the slight crispiness developing on some of the onions.
  4. Using a slotted spoon or spatula, remove about half of the onions to a paper towel-lined plate; these are for garnish later. Sprinkle in the ground cumin, cayenne and then add the cinnamon stick; saute about 1 minute.
  5. Add the rice and cook, stirring often (but gently so you don’t break the rice!) until some rice grains start to brown. Quickly, add the cooked lentils, 3 cups of water and 1 1/2 teaspoons of salt; bring to a boil. Turn the heat down to low so that the pan is at a simmer, cover and cook 30 minutes. The water should be completely evaporated and rice should be tender. (If there’s still too much water in the bottom, put the lid back on and cook for another 5 minutes.)
  6. Turn off the heat, keep the lid on, and allow the rice to steam undisturbed for about 5 minutes.
    Meanwhile, toast the pine nuts, if using, in a small skillet over medium-low heat, shaking often, about 5 minutes.
  7. Taste the rice for seasoning. Serve with the reserved caramelized onions, toasted pine nuts, if using, and a little squeeze of lemon juice.

 

4. Barley

Barley

Cardamon and barley by Flickr user Migle. CC BY-SA 2.0.

Barley pearls aren’t just restricted to drinks. With their relatively low calorie count, high fibre content and low carbohydrate levels, the grains have the look, feel, and nutritional value to qualify as solid contenders for a rice substitute. Be wary, however, of their slightly higher sodium content.

You can even cook the pearls the same way that you would rice, but with just a little bit more water. Three parts of water to one part of barley will do the trick.

Options include Ayam Brand White Pearl Barley, priced at around $5.56/kg at Fairprice, and Pagoda Finest Pearl Barley, priced at $2.75/kg from Redmart.

Recipes

1. Mushroom Barley – Food Network

Ingredients and directions:

  1. Cook 2 sliced onions in 2 tablespoons olive oil until caramelized, 20 to 25 minutes.
  2. Saute 3/4 pound sliced cremini mushrooms in 2 tablespoons butter.
  3. Cook 1 1/2 cups quick-cooking barley in chicken broth as the label directs, then toss with the mushrooms, onions, some dill and salt.

 

2. White Bean, Spinach, and Barley Stew – allrecipes

Ingredients:

  1. 1 cup uncooked pearl barley
  2. 3 cups water
  3. 1 teaspoon olive oil
  4. 1 cup chopped yellow onion
  5. 2 cloves garlic
  6. minced 1/2 teaspoon dried rosemary
  7. 3/4 cup small fresh mushrooms
  8. 1 cup chopped yellow bell pepper
  9. 2 tablespoons white wine
  10. 1 (15.5 ounce) can white beans, drained and rinsed
  11. 1 (14.5 ounce) can Italian-style diced tomatoes, drained
  12. 2 cups fresh spinach
  13. 1 pinch red pepper flakes

Directions:

  1. Bring the barley and water to a boil in a pot. Cover, reduce heat to low, and simmer 30 minutes, or until tender.
  2. Heat the olive oil in a large pot over medium heat, and cook the onion and garlic until tender.
  3. Season with rosemary. Mix the mushrooms, yellow bell pepper, and wine into the pot, and cook 5 minutes.
  4. Stir in the cooked barley, beans, tomatoes, and spinach. Season with red pepper flakes.
  5. Continue cooking 10 minutes, or until spinach is wilted.

 

Featured image Quinoa by Flickr user Judit Klein. (CC BY-ND 2.0). 

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