D iabetes Issue 50 JUL - SEP 2014

Transcription

1 D iabetes Issue 50 JUL - SEP 2014 Singapore MCI (P) 054/09/2013 Publication of Diabetic Society of ACCEPTANCE: Gateway To A New Life? Pre- & Post- Workout Meals Helplines to be smoke-free 50TH ISSUE SPECIAL: GUIDE TO EATING HAWKER DELIGHTS MINUS THE GUILT & GLUT

2 3 2014/2016 DSS management committee PATRON Prof Arthur Lim ADVISOR Dr Warren Lee PRESIDENT Mr Yong Chiang Boon CONTENTS 04 A WORD FROM THE PRESIDENT 06 DSS BUZZ DIABETES SELF-CARE MANAGEMENT SHARING PROGRAM FOR COMMUNITY HOSPITALS & NURSING HOMES PAST OUTREACH PROGRAMMES HEALTH SCREENING HEALTH TALKS DSS AGM 2014 DSG DIARY DSS FLAG DAY 09 CARE CORNER BE SMOKE-FREE 10 HEARTWARE ACCEPTANCE: GATEWAY TO A NEW LIFE? VICE-PRESIDENTS Dr Kevin Tan Eng Kiat Dr Ben Ng HON SECRETARY Ms Esther Ng 12 FEATURE A DIABETIC S HAWKER FOOD SURVIVOR GUIDE GR8 DELIGHTS THE GOOD, THE BAD AND THE UGLY ASST HON SECRETARY Mr Stanley Lim HON TREASURER Mr Seah Peck Hwee ASST TREASURER Ms Caroline Lim COMMITTEE MEMBERS Dr Yeo Kim Teck Mdm Rohanah Pagi Ms Kalpana Bhaskaran Ms Juliana Lim 18 COOKOUT 20 SHAPE UP SALAD ROLL STIR-FRIED TUNG HOON PRE- & POST-WORKOUT MEALS

3 4 A WORD FROM THE PRESIDENT NEW BLOOD, FRESH IDEAS... During our AGM in April, I was re-elected President for another two years till April It is an honour indeed to be able to continue serving the community in this capacity and I am grateful to committee members and DSS members for their endorsement. I would like to thank outgoing committee members and welcome new committee members for stepping up and in to help us fight diabetes. With new blood in the team, I hope they will inject new energy into DSS and initiate interesting ways to serve members better. We face many challenges ahead for us and the road has been a long and hard one but I am confident that together we can tackle the future. I am pleased to share the good news that DSS has raised about $150,000 for our Flag Day through street-to-street collection and individual and corporate donations. Special thanks to all school students, teachers, members, diabetes education centre staff, volunteers and corporations. The fund will enable DSS to carry out more diabetes awareness activities for the public and run educational workshops for our members to manage their diabetes. editorial team Editor-in-chief Dr Yeo Kim Teck Managing Editor Charlotte Lim Editor (Dietetics) Janie Chua Editorial Consultants DSS Mgmt Committee Writers Henry Lew (psychologist) Kohila Govindaraju (nutritionist) Ray Loh (physiologist) Rodiah Hashim (DSS) Contributors Helena Wee, Ong Fangyi, Janie Chua, Derrick Ong Design Charlotte s Web Communications We are also counting down the months to the next World Diabetes Day 2014 on 9 November 2014 at Suntec Convention and Exhibition Centre. We hope for your participation again in this annual event. Bring along friends with diabetes to sign up as members and, at the same time, take home attractive welcome gifts. Invite family members to learn more about diabetes and the role they can play in supporting and caring for the person with diabetes. This event is not to be missed by those who want what is best for themselves and their loved ones. In the same month, from 21 to 24 November 2014, DSS will be welcoming delegates from International Diabetes Federation-Western Pacific Region to attend the congress which will also be held at Suntec Convention and Exhibition Centre. We are expecting more than 2,000 medical professionals, researchers and caretakers here to share their expertise and new findings. This congress will certainly give Singapore the opportunity to pick up new knowledge and develop better methods of treating and managing diabetes. Look out for more information on these two events in the next issue of this magazine. In this issue, which is our 50th, we bring you a very special compilation of something that is so much a part of our local food culture and lifestyle hawker food. We hope you will be enlightened! Yong Chiang Boon, PBM President, Diabetic Society of Singapore WHAT IT SHOULD HAVE BEEN In issue 49 Apr-Jun 2014, in the article titled Pump Up on Antioxidants by dietitian Lock Poh Leng, it was reported that 1 serving of vegetable equals 1 round plate (10 inches) of cooked vegetables. It should have been 1/4 round plate (10 inches plate) of cooked vegetables. We apologise for the typographical error. Photography Dreamstime.com, Shutterstock & sxu.hu Printing Stamford Press Pte Ltd Advertising George Neo Esther Ng Advertisement Bookings T: or E: editor@diabetes.org.sg Feedback editor@diabetes.org.sg Back Issues Diabetic Society of Singapore HQ Blk 141 Bedok Reservoir Road # Singapore T: (65) /3382 Disclaimer The views, opinions and recommendations given by the contributors of Diabetes Singapore or are merely for general reference. All materials in this newsletter are for informational purposes only. The individual reader should consult his own doctor or specialist for his personal treatment or other medical advice. DSS and Diabetes Singapore Editorial Board disclaim all responsibilities and liabilities for content expressed in this newsletter including advertisements herein. All contents of the newsletter are the copyright of the contributors and newsletter. Reproduction in any form is strictly prohibited unless with written permission.

4 6 DSS BUZZ Diabetes Self-Care Management Sharing Program for Community Hospitals & Nursing Homes SESSIONS START IN JULY! Jul to Dec 2014 Tuesday 8 & 15 Jul Tuesday 14 & 21 Oct Time: 9.00am to 5.00pm Please contact DNE Crystal Tan at or dss@diabetes.org.sg for enquiries. Past Outreach Programs HEALTH SCREENING PROGRAMS Tuesday 12 & 19 Aug Tuesday 9 & 16 Sep Tuesday 11 & 18 Nov Tuesday 9 & 16 Dec 22 Mar 2014 Health Screening at Bishan CC 18 May 2014 Health Screening at Thomson/Shunfu RC 1 Jun 2014 Health Screening at Abdul Gafoor Mosque HEALTH TALKS 29 Mar 2014 Diabetes Prevention and Healthy Aging KDF World Kidney Day Jun 2014 Diabetes & Ramadan Diabetic Society of Singapore FOR THE LATEST ON DSS EVENTS, LOG ONTO For enquiries, please contact

5 DSS AGM The 43rd Annual General Meeting for the society was held at NUSS Suntec City Guild House on Saturday, 26 April The meeting kicked off at 3.00pm with a welcome speech by the President, Mr Yong Chiang Boon. Minutes of the previous meeting were confirmed by all members and the financial reports accepted. Issues on membership and programs as well as suggestions by members were addressed by the committee members. We welcome our new management committee 2014/2016! President Mr Yong Chiang Boon Vice President Dr Kevin Tan Vice President Dr Ben Ng Hon Sec Ms Esther Ng Asst Hon Sec Mr Stanley Lim Treasurer Mr Seah Peck Hwee Asst Treasurer Ms Caroline Lim Committee Members Dr Yeo Kim Teck, Mdm Rohanah Pagi, Ms Kalpana Bhaskaran & Ms Juliana Lim DSG EVENTS July - October 2014 ACTIVITY DATE MEETING POINT TIME WALK - ADMIRALTY PARK Saturday, 19 July Woodlands MRT 5pm WALK - LABRADOR NATURE RESERVE & WALKING TRAIL Saturday, 23 August Labrador Park MRT 9am WALK - CHANGI POINT COASTAL WALK Saturday, 20 September Bedok MRT 5pm WALK - BUKIT BATOK NATURE PARK Saturday, 18 October Bukit Batok MRT 9am Care to join us for our next DSG outing/ meeting? Ring Juliana at for information.

6 8 THANK YOU FOR MAKING OUR FLAG DAY A RESOUNDING SUCCESS! Rodiah Hashim On 26 September last year, DSS successful balloted to have our Flag Day for this year on Saturday, 5 April Months of coordination work followed, fast and furious, and even after everything on my checklist had been ticked, I still had butterflies in my tummy when the day finally dawned. Five centres at Woodlands, Ang Mo Kio, Jurong, Bugis and Tampines were set up to distribute and collect the donation bags and stickers from 1,131 secondary school students and volunteers from all ages as early as 7.30am. Rain in certain areas during the day did not dampen the spirit of volunteerism in the participants till closing time at 4.00pm. DSS is pleased to announce that a total amount of $150,000 was collected for this year s Flag Day*. The funds raised will help us to continue in our care for people with diabetes and to promote and educate the community in understanding and managing the complications of diabetes. DSS thanks all corporate and individual donors, volunteers and the building managements of Woodlands Civic Centre, Ang Mo Kio Hub, Jurong Point, Bugis Plus and Tampines Mall for their support and contribution to the success of our fundraising event. A very big Thank You also to the teachers and students from the following participating schools: Regent Secondary School Hai Sing Catholic School Si Ling Secondary School CHIJ Katong Convent Fuhua Secondary School Jurong West Secondary School Boon Lay Secondary School Geylang Methodist School (Secondary) St Andrew s Secondary School Whitley Secondary School Peirce Secondary School Xinmin Secondary School Canberra Secondary School DSS would like to thank the following corporate and individual donors for their generous donations of $10,000 and above: Diamond Award Lee Foundation States of Malaya Gold Award Mr Ng Chee Hwa Bronze Award Eng Seng Lee Construction Overseas Academic Link *amount correct at time of printing

7 CARE CORNER 9 BE SMOKE-FREE Helena Wee, diabetes nurse educator, Diabetic Society of Singapore It s a well known fact that people who have diabetes and smoke have higher blood sugar levels, making it more challenging to control their condition. It also puts them at a higher risk of developing the following complications. Decreased blood flow to legs & feet Numbness or tingling of hands and feet Damaged blood vessels and nerves Poor vision Poor diet control in both men and women who have diabetes can lead to unstable blood sugar levels and, hence, contribute to sexual dysfunction, sexual impotence and infertility. IT S THE NICOTINE Studies have shown that it s likely to be the nicotine in cigarettes that wreaks havoc on blood sugar levels. When nicotine is added to human blood samples, it can raise levels of haemoglobin A1c (HbA1c) by as much as 34%. Haemoglobin A1c which is a combination of haemoglobin (which carries oxygen) and glucose is a standard indicator of blood sugar content in the body. HOW TO QUIT SMOKING Keep cigarettes and lighters out of reach and out of sight. Drink lots and lots of fluids. Water, decaffeinated teas, fruit juices, and certain decaffeinated soft drinks are good choices. Avoid coffee, soft drinks containing caffeine, and alcohol, as they can increase the urge to smoke. Continue SMBG (Self-monitoring of blood glucose). Keep a distance from smokers (do not be a passive smoker). Tell everyone that you are trying to quit smoking and rope family, friends and colleagues in to keep you from backsliding by asking those who smoke not to do so around you. Eat healthily (consume more fibre and have a balanced diet). Exercise regularly to keep a healthy BMI (e.g. jogging, brisk walking, cycling, swimming). Try the Health Promotion Board s I Quit programmes or refer to a smoking cessation clinic which offers counselling & medication to help you quit. Keep to your doctor s appointment and maintain visits regularly. Follow the instructions & remember to take any medication as prescribed. HELPLINES TO QUIT Let s Quit: The 28-Day Countdown The 28-Day Countdown is based on findings that smokers who stay smoke-free for 28 days are five times more likely to succeed for good. To sign up for the countdown, smokers can register online at or at partnering pharmacies or I Quit roadshows. QuitLine The QuitLine is a helpline for smokers and people who are interested to find out more about how to stop smoking, with trained staff to provide customised professional advice and tips. For more information on methods to quit smoking, please call the QuitLine at (toll-free). QuitLine SMS Talking may be uncomfortable to some; thus, the SMS platform is available for smokers and non-smokers to send questions or doubts about smoking-related issues. Text questions or doubts to or I Quit Club I Quit Club is a Facebook community created to gather all exsmokers who have successfully quit smoking or have taken the pledge to quit smoking. For more information, please visit iquitclub.sg. I Quit Mobile Application The application helps individuals to determine their smoker profile type to provide the most effective method to quit smoking, and offers tips and strategies to cope with the withdrawal symptoms from quitting smoking. Currently available for free downloading on itunes and Google Play. Source: Health Promotion Board Singapore

8 10 HEARTWARE ACCEPTANCE: GATEWAY TO A NEW LIFE? Henry Lew, psychologist Acceptance is to recognise the need to adapt to chronic illness. to develop the ability to tolerate the unpredictable, uncontrollable nature of the disease and manage its negative consequences. to live a valuable and meaningful life as realistically as possible. Acceptance is not that we deserve the illness nor we deserve to suffer. that we give up and do nothing. that we lie to ourselves and ignore the negative.

9 11 C hronic illnesses can wreck our lives. We experience the discomfort, or even pain, from the associated symptoms. We become limited in our ability to perform certain tasks. Chronic illnesses affect us emotionally as well, making us more restless, and irritable at times. And we are not spared the constant anxiety and worry about our health. The reality is that despite our best efforts, there are some things we cannot avoid about chronic illness. Acceptance could be one way to manage the impact that chronic illness has on our life. But what good would it do us to accept chronic illness, you say? It may seem ironic or even cruel to try to accept something we are struggling hard to get rid of. When we hear the word acceptance, we often think of giving up or throwing in the towel. But giving up is not acceptance or vice versa it simply means the recognition that the moment is as it is. Acceptance is seeing reality as it is. It does not mean we are stuck in the moment either. If we accept something is true in this moment, we can still work towards changing it in the future. Let s look at some appropriate ways to cultivate acceptance. PERSPECTIVE Remind yourself of the perspective that the sooner you accept the chronic illnesses and struggle less with it, the sooner you will be able to focus your attention on what you could do to manage your life better. FOCUS Constantly focus on the fact that although your cannot reverse your situation and return to what you were like before the diagnosis, your life can still be close to what it used to be. TRANSFORMATION Focus on internal resources for transformation. You are a survivor. And you may have even gone through much worse times in your life and triumphed over them. Like in your previous experience, although you have no control over what happened, you have control over your response. Use those experiences where you successfully managed the impact of the adverse situations of your life to help you manage the impact of the current situation. REFRAME Reframe the situation into a roller coaster ride. Chronic illness is unpredictable. There will be good days, there will be bad days. Recognise that the bad days will not last forever and learn to treasure the good days. As in a roller coaster ride, there are teeth clenching moments and there are exciting moments. STANDARDS Use the same universal standards. In your attempts to manage your chronic illness, ask yourself sometimes if you are overdoing it, or being too hard on yourself. If you find that what you are doing will also make a healthy person tired, perhaps it is not realistic for you to do it, given your condition. VALUE Value yourself. Be kind to yourself, and see yourself as worthy. Do things to soothe yourself instead of entertaining the selfcriticism and self-blame in your mind. Acceptance is a process and not a state. It takes time for us to accept. There will be days where we are more accepting. There will be days when we will be in denial or when we feel angst. Accept at your own pace but never give up.

10 12 FEATURE A DIABETIC S HAWKER FOOD SURVIVOR GUIDE Derrick Ong Director, Eat Right Nutrition Consultancy HOW TO GET AROUND LOCAL DELIGHTS WITHOUT SPIKING YOUR BLOOD SUGAR LEVELS! For people with diabetes, eating out at hawker centres, coffee shops or food courts can be a tricky experience. This is because the hawkers and stall owners cook for the masses and tend to not pay much attention to portion size (particularly carbohydrate-rich dishes) as well as salt, oil, sugar through sauces and condiments. Most hawker dishes (with a few exceptions) tend to be low in fibre where vegetables and wholegrains are concerned. 1. Watch your carbohydrate exchange servings. The general rule of thumb is that three dessert spoons of rice or noodles (minus the added meat/vegetables) is equivalent to a standard carbohydrate serve of 15 grams. Estimated carbohydrate needed for main meals i.e. lunch or dinner should be 45 to 75g (3 to 5 carbohydrate exchange servings), depending on one s calorie requirements. If you find that the carbohydrate serve in a dish is too large, order a smaller portion or share with someone. (Note: dessert spoons are smaller than tablespoons.) 2. Be aware of additional carbohydrate from directly added sugars e.g. in rojak or sauces e.g. sweet and sour dishes, tomato or chili sauce, or gravies e.g. mee siam or soups e.g. prawn noodles. Try to limit your intake of these, or alternatively reduce your rice/noodle portion accordingly to compensate for the added sugars. MORE VEGETABLES, LESS SOUP/GRAVY & NOODLES less sauce/oil

11 13 3. Try to choose meals containing wholegrains or lower Glycaemic Index (GI) foods, where possible. These would make you fuller for a longer time and help control blood sugar levels. Examples of these include brown/red rice, brown rice vermicelli (bee hoon), basmati rice (in nasi briyani), chappati (containing wholemeal flour) and mung bean vermicelli (tung hoon) basmatic rice & wholegrain staples 4. For nutritional balance, try to choose dishes with the three main food groups (grain, meat/protein and vegetables) present. Examples of these include lontong (minus the coconut gravy), economical rice or nasi padang ( two vegetables and one meat/ egg/tofu), yong tau foo (a classic set of six items should contain three vegetables and three non-fried protein items like beancurd and go easy on the sweet sauce and chilli), handmade noodles soup with extra vegetables, sliced fish soup with rice or noodles with added vegetables, or chicken rice set with vegetables. 5. Go for dishes that employ healthier cooking methods such as steaming and boiling rather than fried or deep fried foods. Eating out can admittedly be a nutritional minefield for diabetics, but with proper planning, it can be a surprisingly enjoyable experience. more vegetables Steamed/braised, NOT FRIED

12 14 FEATURE Gr8 delights! We live in a food paradise, and there is no escaping the lure of wanton hawker delights. But seriously, who s complaining? You can t always have your carrot cake and eat it, but knowing what goes inside that plate of oyster omelette and mee rebus can help you cut down on the unwanted calories, and salt and sugar intake. We look at 8 scrumptious hawker favourites that you can even try making at home! Oyster Omelette A mixture of cornstarch (two to three tablespoons) and beaten eggs with salt is scrambled and five to six oysters are added near the end of the cooking. One serving (253g) of oyster omelette provides 645kcal, 354mg of cholesterol, 746mg of sodium! Your daily cholesterol intake should be less than 300mg. This simple, skillet-food is easy to prepare at home. You only need three eggs, scrambled, eight to 10 oysters and a tablespoon of olive/sunflower/corn oil. No corn starch. Beware: one tablespoon of corn starch yields 30 calories! To make it kid-friendly, you can add cheese or milk to the scrambled egg for fluffiness and mushroom for flavour. Add the oysters, cook for two minutes and garnish with scallions! This healthy and colourful dish can be shared by three. Kohila Govindaraju nutritionist, The Berries Nutrition Consulting Chinese Rojak Satay One serving of this salad with cut pineapple, cucumbers, turnip, bean sprouts and dough fritters (you tiao) and tossed with sauce made of chilli, red ginger plant bud, tamarind, lime, lime peel provides 559kcal and 857mg of sodium. Share this among three to four people to minimise the sodium intake. Chinese rojak is easy to prepare at home. You can always avoid or reduce the sweet apple sauce and hot chilly sauce and add more of your favourite fruits and vegetables! It is the turmeric that gives satay its yellow colouring and mild flavour. One satay stick (about 10 to 11gm of beef/chicken/mutton) is worth 24/24/31kcal and 23/26/32mg of sodium respectively. It is wise not to eat more than three satay sticks. It is easy to make satay at home with your favourite meat and marinades. This way, you can manage the amount of sugar and salt. Char Kway Teow You get 744kcal and 1,459mg of sodium from one serving of this stir-fried dish. That s a lot of sodium and a lot of calories! Best shared among loved ones. This is another skillet-food that can be made at home in a few minutes with less oil and more vegetables. You can add salt instead of soy sauce if you prefer a paler version.

13 15 Fried Hokkien Mee While dining out, ask for more chives and sprouts to this prawn broth noodle dish. One serving of 442g gives 522kcal and 1,423mg sodium. The sodium is more than 50% of the daily recommendation! So, it is wise to share the dish. An average healthy adult needs no more than 2000mg of sodium per day; 400mg of sodium sounds pretty decent and definitely much healthier for one meal. Roti Prata This flying bread is usually eaten with dalcha (a lentil curry) or fish/chicken curry. A plain prata is packed with 209kcal and 386mg of sodium while an egg/ onion prata has 288/304kcal, 175/210 mg of cholesterol and 363/429mg of sodium. Nasi Lemak This is a hot favourite among Malays, Chinese and Indians. The Malay version is offered with fried ikan bilis (fried anchovies) and nuts, fried fish and cucumber. The Chinese version is often served with fried chicken drumstick, fish cake and vegetable curry. Both versions are usually accompanied by hot chilli sambal. You can easily get 474 kcal and 430mg of sodium from a single serving of 250g! Nasi lemak is an easy rice dish to make at home. You can use less coconut milk and add more vegetables like long beans or string beans. Homemade achar (cucumber, carrot, pineapple, etc) is another wonderful, colourful addition to nasi lemak. My friend makes prata at home, so she can always control the type and amount of oil used while flattening the bread. She adds mushroom, scallions and cheese to the prata for flavour. So can you! Mee Rebus The most crucial component of this Malay dish is the gravy that is made from a rich stock of dried shrimp and fermented soy bean (tau cheo), and garnished with boiled egg, beansprouts, Chinese celery, green chilli and fried shallot plus a squeeze of calamansi for that extra something. Mee rebus in general is loaded with sodium, found mainly in the gravy. One serving of mee rebus with gravy gives 571kcal, 206mg of cholesterol and 2,164mg of sodium. One serving of mee rebus without gravy gives 474kcal, 204mg of cholesterol and 1,896mg of sodium. You can make the sauce at home, with less sugar and spice. Your daily cholesterol intake should be less than 300mg. An average healthy adult needs no more than 2000mg of sodium per day. 400mg of sodium per meal is pretty decent.

14 16 FEATURE THE GOOD, THE BAD AND THE UGLY GO EASY ON THESE! Laksa Energy (Kcal) 696 Carbohydrate (g) 58 Total Fat (g) 39 Saturated Fat (g) 14 Dietary Fibre (g) 2 Cholesterol (mg) 104 Sodium (mg) 7904 Janie Chua dietitian, National Healthcare Group Polyclinics Chicken Rice (roasted) Energy (Kcal) 596 Carbohydrate (g) 73 Total Fat (g) 22 Saturated Fat (g) 9 Dietary Fibre (g) 2 Cholesterol (mg) 46 Sodium (mg) 1264 Chicken Briyani Energy (Kcal) 922 Carbohydrate (g) 107 Total Fat (g) 36 Saturated Fat (g) 15 Dietary Fibre (g) 8 Cholesterol (mg) 165 Sodium (mg) 1742 Carrot Cake (black) Energy (Kcal) 493 Carbohydrate (g) 41 Total Fat (g) 35 Saturated Fat (g) 14 Dietary fibre (g) 6 Cholesterol (mg) 109 Sodium (mg) 1289 SAFE BETS! Chicken Porridge Energy (Kcal) 181 Carbohydrate (g) 20 Total Fat (g) 5 Saturated Fat (g) 2 Dietary Fibre (g) 0 Cholesterol (mg) 61 Sodium (mg) 1307 MIncemeat Noodle Soup Energy (Kcal) 380 Carbohydrate (g) 50 Total Fat (g) 12 Saturated Fat (g) 5 Dietary fibre (9g) 8 Cholesterol (mg) 36 Sodium (mg) 1731 Popiah Energy (Kcal) 187 Carbohydrate (g) 14 Total Fat (g) 11 Saturated Fat (g) 3 Dietary fibre (g) 4 Cholesterol (mg) 44 Sodium (mg) 675 Healthier Hawker Centres/ Coffee shops/foodcourts: 1. Yuhua Blk 347 Jurong East Ave 1 2. Eunos Crescent - Blk 4A Eunos Crescent 3. Haig Rd - Blk 13/14 Haig Road 4. Geylang Serai - 1 Geylang Serai 5. Marine Terrace - Blk 50A Marine Terrace 6. Clementi Blk 448 Clementi Ave 3 7. Seah Im Seah Im Road 8. Rasa Rasa Blk 2A Woodlands Centre Road 9. Rasa Rasa Blk 537 Bedok North St Food King Blk 233 Bukit Batok East Ave Meng Soon Huat Blk 359 Bukit Batok St Food House Blk 289H Bukit Batok St Happy Hawkers Blk 132 Jurong East 14. Bukit Batok Village Eating House (Blk 21 Bukit Batok Central) 15. Sengkang Rivervale Mall 16. IMM Cafeteria at IMM #04-09 Source: Health Promotion Board Singapore

15 18 COOKOUT Salad Roll serves 1 Ong Fangyi dietitian, National University Hospital Singapore INGREDIENTS 1 sheet popiah skin 1 tablespoon low fat mayonnaise ¼ teaspoon wasabi sauce ¼ cup cucumber, sliced thinly lengthwise ¼ cup julienned carrots ¼ cup shredded lettuce 1½ matchbox size chicken breast, shredded 1 tablespoon chicken floss 2 tablespoons whole wheat cereal, pounded into bits 2 teaspoons split ikan bilis (see hot tips) NUTRITION INFORMATION per serving Energy 200kcal Protein 21g Carbohydrate 15g Fat 7g Saturated fat 0.9g Cholesterol 44mg Dietary fibre 1.2g METHOD OF PREPARATION Sodium 350mg Carbohydrate exchanges: ~ 2.5 exchange 1. Mix wasabi sauce together with the mayonnaise. 2. Spread evenly onto popiah skin. 3. Add cucumber, carrots, lettuce (arrange neatly) 4. Add chicken breast shreds and chicken floss. 5. Mix the whole wheat cereal and ikan bilis together before scattering evenly onto the ingredients above. 6. Roll in the sides of the popiah skin before rolling up lengthwise tightly. 7. Cut into five slices to serve. HOT TIPS Buy ikan bilis with heads and entrails removed. Cut them into small pieces and roast them in the oven for 15 minutes at ~150 degree Celsius till golden brown and fragrant. You can just about fill popiah skins with anything. Try filling with a variety of sprouts and even add strips of mango if you are going vegetarian. You can make a dipping sauce for that extra kick: ½ cup of sweet Thai chili sauce 2 tbsp of lime juice 2 tsp of rice wine vinegar 2 tsp of water

16 20 COOKOUT Stir-fried Tung Hoon serves 4 Ong Fangyi dietitian, National University Hospital Singapore INGREDIENTS 2 bundles dry tung hoon (~80g) 1 cup shredded cabbage ½ cup julienned carrots g chicken mince 6 pieces fresh shitake mushrooms, sliced 1 square firm beancurd 2 tablespoons oyster sauce 1 tablespoon black pepper sauce 1 teaspoon sesame oil 1 teaspoon dried prawns, diced (optional) 2 cloves garlic,chopped finely 1 small onion, diced finely 1½ tablespoon 100% peanut oil 1cup water METHOD OF PREPARATION NUTRITION INFORMATION per serving Energy 240kcal Protein 11g Carbohydrate 27g Fat 10g Saturated fat 7.6g Cholesterol 21mg Dietary fibre 1.6g Sodium 346mg Carbohydrate exchanges: ~1 exchange 1. Soak the tung hoon in warm water at least for 15 minutes. 2. Heat up the oil in a non stick frying pan/wok 3. Add garlic and onion and stir fry until fragrant and lightly brown 4. Add dried prawn(if using)and fry till fragrant. 5. Add chicken mince and stir fry till it is cooked through. 6. Add mushrooms, cabbage and carrots and stir fry for about 2 minutes. 7. Add beancurd followed by the mixture of black pepper sauce and oyster sauce from above. 8. Add water. 9. Add tung hoon and let it simmer till most of the water has evaporated. 10. Add sesame oil and turn off the heat. Serve hot. HOT TIPS Unbleached tung hoon can be purchased from organic food shops. Diabetes Singapore Jan - Mar 2014 You can get beancurd enriched with omega 3 at the supermarket. If you want to get the full nutritional benefit of tung hoon, two methods boiling and frying are highly recommended. For saucy dishes, cook tung hoon in the broth for the last five minutes to retain its mineral content. If you are preparing a dry dish, boil the tung hoon separately for about three minutes before mixing with the other ingredients. Cooked tung hoon can keep for up to five days in the refrigerator.

17 SHAPE UP 21 Pre- Post- & workout meals Ray Loh exercise physiologist Sports Medicine and Surgery Clinic Tan Tock Seng Hospital The two main components of having a healthy lifestyle are eating healthy and workout regularly. Although research has shown that diet is the key to weight control, the benefits of exercise cannot be overlooked. Exercise helps to exhaust excess calories that otherwise would be stored as fat. It also helps to boost metabolism, improve insulin sensitivity, prevent many diseases and improve overall health. Eating and exercise must work together for a healthier you. We need a healthy diet to support our exercise regime and we need exercise to maintain healthy cardiovascular fitness, tone up, maintain or gain lean muscle mass to accelerate metabolism to control weight, raise energy, and improve vitality. Energy for physical activity The most common advice to lose weight is to control one s diet to reduce calorie intake and increase physical activity to expend more calories. Although it sounds simple and straightforward, the interaction between energy intake and physical activities is actually rather complex. During physical activities, our body metabolises fuel such as carbohydrates and fat for the energy we need to overcome inertia and move our body. When intensity is low, a higher proportion of the energy comes from fat metabolism and as exercise intensity increases, a higher proportion of the required energy comes from carbohydrates than fat. Since our body has limited storage of carbohydrates, and fat metabolism is too slow to replenish the expenditure, we get exhausted rather quickly when the intensity is high. The rate of exhaustion differs from every individual depending on his or her fitness level. Although exercising in low intensity sounds more favourable, it expends fewer total calories and is not an effective way to improve fitness. To lose weight or fight diseases such as diabetes, an additional expenditure of about 2000 calories from exercise per week is suggested. Usually, if we stick to a healthy diet with enough calories to support our daily activities, we would not require any additional snacks before the additional 30 to 60 minutes of moderate intensity exercise. Consuming sports drinks (carbohydrate drinks) and snacks during low to moderate intensity or short bouts of exercise sessions actually cancels out the calories we have expended. This makes losing weight through exercise more difficult. Thus, careful planning of diet and exercise intensity is needed to achieve energy deficit for weight loss or improve athletic performance, and food selection becomes an essential skill to enhance the outcome of our workout and to reach our goal quickly. Check out some of my food ideas before and after a workout for best results.

18 22 SHAPE UP Pre-workout meals Some research suggests that exercising with an empty stomach in the morning metabolises more fat. However, other research shows that it affects exercise performance and leads to overeating after the workout. A small snack or light meal which is low in fat, higher proportion of carbohydrates and some protein taken about 30 to 60 minutes before workout is recommended. The higher proportion of fat in the food we eat, the longer we have to wait for digestion before the workout. At home, a good example of a pre-workout snack is a medium-sized banana with half a cup of Greek yoghurt. If we need a full meal, eat two to three hours before the workout. If I am having a late lunch and going for a run in two hours time, my favourite hawker food is sliced fish clear soup with some rice. It is easy to digest and gives me the carbohydrate and protein needed for my workout. However, always avoid drinking the soup as it could contain too much sodium and fat. Post-workout meals Post-workout meals are as important as pre-workout meals as they should provide enough nutrients to replenish the vitamins and minerals lost, restore glycogen, as well as repair and build muscles. It is suggested that post-workout meals should be taken within one to two hours after a workout to maximise the recovery. A good recovery meal should consist of a slightly higher proportion of protein, carbohydrate and be low in fat. An example of a good recovery meal after a hard workout is omelette with grilled chicken and mixed vegetables. It is nutrient-dense with proteins, carbohydrates and fibre to make you feel full and satisfied. If you are eating at the hawker centre, yong tau foo in a clear soup would be my choice as the variety of items can provide the nutrients we need. Ask for more vegetables to make it more filling and do not drink the soup. An effective workout refers to meeting the goal or purpose of an exercise session. For example, if we target to expend 500 to 600 calories in a single workout session and we presume that we expend 65 calories every kilometre we travel, we will need to walk, jog or run about 8 kilometres to achieve that. Running will take less time than walking. We need to exercise at a slightly higher than comfortable intensity to improve our aerobic capacity and with the right amount of muscular exertion to raise the muscular sensitivity to insulin.