Healthy Heart - 29 September 2014

StarSpecial
THE STAR Monday 29 September 2014

Serving the public with excellence > 6 Nutrients for living well > 13
HEALTHY HEART
What will you
do for your
heart today?
2 HEALTHY HEART StarSpecial, Monday 29 September 2014
M
ANY Malaysians have high
cholesterol levels because
of the unhealthy lifestyles
that they lead.
High cholesterol is not like a cut
or infection. It cannot be treated
with a plaster and left forgotten.
You need to be constantly mindful
of your cholesterol levels so that
healthy levels are maintained
throughout your life. The ideal
cholesterol level for a healthy
adult is less than 5.2mmol/L.
How you can maintain
your cholesterol levels
You will need to make a
major change in your lifestyle.
This includes changing your diet
and engaging in more physical
activities. These changes will
effectively help lower your
cholesterol levels and the risk of
heart disease.
Even if your doctor has
prescribed a cholesterol-
lowering drug, you will still
need to change your dietary
patterns and live an active
lifestyle as this will
improve your overall
cardiovascular health.
Here are some
simple steps that
can help keep your
cholesterol levels in check:
l Watch what you eat
Reduce your consumption of
foods that are high in cholesterol
such as innards, deep-fried foods,
eggs and shellsh. Next, increase
your intake of foods that are high
in bre such as fruits, vegetables
and wholegrains.
Also eat more foods that are
high in unsaturated fats such
as nuts and olive oil, which are
considered the healthy fats
and are encouraged as part of a
healthy diet.
Increasing your consumption
of these foods will greatly reduce
your risk of contracting heart
disease.
What is Acticol?
Acticol is made up of plant
sterols. Plant sterols are found
naturally in fruits, vegetables,
nuts, seeds, cereals and legumes.
Plant sterols also have similar
molecular structures as
cholesterol.
Plant sterols help block the
absorption of cholesterol from the
digestive tract.
Without plant sterol,
cholesterol can be easily absorbed
Why you should drink
Nestl Omega Plus milk
DRINKING two glasses of
will help you manage your
cholesterol levels as it is
the only milk that contains
Acticol.
Acticol helps reduce
cholesterol absorption into
your bloodstream.
is easy to integrate into your
lifestyle. You can drink one
glass with breakfast and
another glass before going to
sleep.
You can also add more
excitement to your glass of
Nestl Omega Plus milk by
blending it with fruits such as
bananas and strawberries.
One glass of Nestl Omega
Plus milk has only 122 calories
and complements your daily
meals.
It is lower in fat compared
to full cream milk, high in
calcium and helps manage
your cholesterol levels while
keeping you feeling full.
Drinking Nestl Omega
Plus PLUS milk daily also
provides you with the daily
dose of calcium you need to
strengthen your bones.
In addition, drinking two
glasses of Nestl Omega Plus
milk every day, which has
Acticol that proactively helps
reduce cholesterol absorption
into your bloodstream, is like
two doses of extra care for
your heart.
Nestl Omega Plus milk is
available at all supermarkets,
grocery stores and
convenience stores.
The next time you go
grocery shopping, be sure to
include Nestl Omega Plus
milk in your shopping list.
Keeping
cholesterol
levels in
check
The Malaysian Food
Pyramid is a great
guide for designing a
healthy diet.
into the blood stream and
excessive cholesterol can lead to
heart diseases.
l Be physically active
Thirty minutes of physical
activities performed ve days
a week can help lower LDL
cholesterol levels and raise HDL
cholesterol levels.
If 30 minutes of non-stop
exercise puts too much stress on
your body, you can opt to break
your exercise up into 10-minute
increments.
Regular exercise also helps
maintain your ideal body weight
and greatly reduces your chance
of developing clogged arteries.
Aerobic and cardiovascular
exercises such as walking can
lower the risk of stroke and heart
diseases.
These activities can also help
you to manage your weight and
The body produces 75% of
cholesterol through the liver.
Cholesterol is useful in the
body as it helps the formation
of cell membranes. High-
density lipoprotein (HDL) is
often referred to as good
cholesterol and helps keep
cholesterol away from
arteries. It also removes
excess arterial plaque, which
can help prevent heart
disease.
Low-density lipoprotein
(LDL) is often referred to
as bad cholesterol. It
circulates in the bloodstream
and may build up in arteries.
The build-up forms plaque,
which narrows the opening
of arteries and makes them
less flexible. This condition
is known as atherosclerosis.
If a clot forms in one of the
narrowed arteries that leads
to the heart or brain, it can
result in a heart attack or
stroke.
Interesting facts on
cholesterol
You will need
to make a
major change in
your lifestyle.
This includes
changing
your diet and
engaging in
more physical
activities.
These changes
will effectively
help lower your
cholesterol levels
and the risk of
heart disease.
keep your bones strong. Start with
a 10-minute walk and you can
increase your workout intensity
from there.
l Be responsible for your
health
If you have high cholesterol
levels, there are a number of steps
that you can take to help lower
your cholesterol levels.
These include improving your
diet, losing weight and exercising
regularly.
Your doctor will advise if
you are required to take any
cholesterol-lowering medication.
Working out a daily diet plan
and exercise plan can help you
stay on track.
You can also nominate a friend
or a family member to be your
motivator to help you get through
it.
You should remember that
even though your cholesterol
levels can be lowered, it can
increase just as easily if you
continue your old habits of not
watching your diet and not
exercising.
The key to a healthy
heart starts with you
managing your cholesterol
levels every day.
StarSpecial 3
Monday 29 September 2014
Your life in
your hands
By ANUSHIA KANDASIVAM
M
EDICAL science is
constantly evolving
and improving through
research and study by medical
professionals and other scientists.
Heart disease being the No.1
killer of men and women around
the world, there are numerous
studies on its causes and risk
factors, preventative measures
and cures, and processes of
rehabilitation and recovery.
Here are just a few of the
numerous studies that have led to
breakthroughs that will improve
the lives of people living with
heart disease and help prevent
more people from developing it.
Drug that reduces
risk of heart failure
A study recently published
online by the New England Journal
of Medicine reports that a new
drug could possibly be one of the
biggest advances in combating
heart failure in more than a
decade.
The study involved about 8,500
people in 47 countries, the largest
experiment that has ever been
conducted on heart failure. It was
designed and paid for by a Swiss
pharmaceutical company.
The drug, which is as yet
unnamed, was compared to
the current standard drug.
The study was stopped by
independent monitors seven
months early after a 27-month
study according to pre-specied
rules, when the boundary for an
overwhelming benet for the new
drug had been crossed.
The people in the study
were already taking three to
ve different drugs to control
their risk of heart failure. One of
these drugs, an ACE inhibitor (a
pharmaceutical drug used to treat
hypertension and congestive heart
failure), was tested against the
new drug in this study.
The new drug is a combination
of two medicines used to block the
effects of substances that harm
the heart while preserving the
ones that help protect it.
It is taken twice a day in pill
form.
The study found that the new
drug reduced the chances of
dying of heart-related causes by
20% and for any other reason by
16% compared to the older drug,
and reduced the chances of being
hospitalised for heart failure by
21%.
According to the study, the
new drug also seems relatively
safe. There were more cases of
too-low blood pressure and non-
serious swelling beneath the skin
with the new drug, but more
cases of kidney problems, excess
potassium in the blood and cough
with the older drug.
The pharmaceutical company
will seek approval for the drug by
the end of this year in the United
States and early next year in
Europe.
Dairy good
for the heart
New research by international
scientists suggests that there
is a correlation between the
consumption of dairy and heart
disease.
At the recent 12th Euro Fed
Lipid Congress in Montpellier,
France, researchers from
Wageningen University in the
Netherlands explained that as
total dairy, low-fat dairy and milk
(a little more than two cups a day)
consumption increased, the risk
for high blood pressure decreased,
which relates to a reduced risk of
cardiovascular disease.
The study also reveals that the
association between coronary
heart disease, stroke or total
mortality and the intake of milk
was not statistically signicant.
The research results are based
on nine studies with 57,256
individuals and 15,367 cases of
hypertension.
A clinical trial published in
the American Journal of Clinical
Nutrition in May this year reveals
supporting results.
It shows that the addition of
four servings of non-fat dairy
per day to a persons usual diet
lowered blood pressure in middle-
aged and older adults.
A similar study published
online in July this year by the
Journal of the American College
of Nutrition states that a small
serving of dairy food daily may
reduce the risk of heart disease or
stroke even in communities where
such food are not traditionally
part of the diet.
This study involved about 4,000
Taiwanese people who, living in a
dominantly Chinese food culture,
were unaccustomed to dairy
foods. It was found that even in
these communities, consuming
dairy foods up to seven times a
week does not increase mortality.
The optimal rate of
consumption is about ve
servings per week, with one
serving being equivalent to 8g of
protein one cup of milk or 45g of
cheese.
The study also found that such
quantities rarely cause trouble
even for people considered to be
lactose intolerant.
Good background checks
could save more lives
In a joint statement released
earlier this month, the American
Heart Association and the
American College of Cardiology
recommended that health
care professionals include 14
key elements that can be used
as a checklist for screening
young people aged 12 to 25 for
congenital and genetic heart
disease. If any of the elements are
positive, further testing may be
needed.
Screenings using
electrocardiograms (ECG) to
detect underlying genetic and
congenital heart disease in this
age group prior to employing this
checklist has not been shown to
save lives.
ECGs record the hearts
electrical activity and may detect
some cases of congenital heart
disease that can lead to sudden
cardiac death. The 14-element
questionnaire should be part of
history taking and used together
with an ECG or other tests and
physical examination.
The questionnaire is actually an
expansion of a 12-item checklist
that was recommended in 2007.
Since then, two questions were
added.
Included in the 14-element
checklist are questions relating to:
l unexplained fainting
l chest pain upon exertion
l excessive shortness of breath or
fatigue during exercise
l family history of premature
death or disability due to heart
disease or known cardiac
conditions involving the heart
muscle or heart rhythm before
age 50
l if the individual has been
restricted from participation in
sports in the past
l if the individual has had prior
testing for the heart, ordered by a
health care provider
Although media coverage has
brought sudden cardiac arrest and
death in young people, especially
athletes, to the attention of the
wider public, the authors of the
statement point out that there is
no evidence that sudden cardiac
arrest is more common in athletes
than in the general population of
young people.
The statement also notes that
broader availability of automatic
external debrillators (AEDs) in
public gathering places such as
schools and sports arenas can be
highly effective in saving young
lives on the sports eld and
elsewhere when cardiac arrest
occurs.
THE World Heart Federation
has declared today World Heart
Day 2014, when everyone is
encouraged to reduce their
cardiovascular risk and help
create a heart-healthy planet.
According to the World
Heart Federation, at least 80%
of premature deaths from
cardiovascular disease can be
avoided if the four main risk
factors tobacco use, unhealthy
diet, physical inactivity and
harmful use of alcohol are
controlled.
For more information on heart
health and what you can do this
World Heart Day, visit
www.malaysianheart.org,
www.yjm.org.my or
www.world-heart-federation.org
World Heart Day
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StarSpecial, Monday 29 September 2014 HEALTHY HEART 5
Heart disease and the athlete
Underlying causes
A
YEAR ago, 25-year-old
national basketball player
Jacky Ng Kiat Kee collapsed
while on the bench during a
game in China and later died of
suspected heart failure.
Two years ago, 23-year-old
Fabrice Muamba, a professional
footballer in Britain, suffered a
massive cardiac arrest while on
the eld; he survived.
Over the years, there have
been numerous cardiac-related
medical emergencies and deaths
of athletes.
These emergencies are caused
by sudden cardiac arrest, when the
heart abruptly ceases functioning.
If immediate life-saving action is
not taken such as performing
CPR death will occur.
According to Dr Aizai Azan
Abdul Rahim, senior consultant
cardiologist at the National Heart
Institute (known by its Bahasa
Malaysia acronym IJN), the causes
of sudden cardiac arrest in athletes
are variable, and most of them
depend on the age of the person in
question.
In younger athletes, it is
usually due to an underlying
congenital heart condition that
the intense physical activity has
aggravated. In older athletes, it is
usually a coronary event such as a
blockage of the coronary arteries
leading to a heart attack, he
explains.
Anyone, anytime
The reason heart attacks in
athletes is so shocking is because
people think that an active and
healthy person would be immune
to such things.
When it comes to congenital
heart diseases, the person is born
with the condition and so it is to a
certain extent out of their control.
However, in cases of athletes
without a congenital condition
suffering a heart attack, it is
more often than not caused by an
unhealthy lifestyle.
Being active does not
necessarily mean being healthy.
A person who plays badminton
every week but who is also a
heavy smoker or has diabetes
caused by an unhealthy diet is
still at high risk of getting a heart
attack.
While playing sports, there are
two types of triggers for a heart
attack.
One is an emotional trigger that
causes the heart rate and blood
pressure to rise, putting strain on
the heart.
The other is physical the heart
cannot cope with the increased
demand of having to pump harder
to deliver more oxygen during the
physical activity and suddenly
stops.
In your hands
At the current level of
knowledge, about 80% of the
time, heart disease is controllable
or preventable as it is caused
by unhealthy habits or non-
communicable diseases, while
about 20% of the time it is caused
by unalterable factors such as
genes and gender, says Dr Aizai.
In crafting a healthy
lifestyle for yourself, you should
concentrate your efforts on that
80% that is controllable.
If you are inactive you can
become more active, if you smoke
you can make yourself stop
smoking, you can change your
diet, he says.
Heart disease does not
differentiate between ordinary
HERE are some congenital
heart conditions that may cause
young athletes to suffer from a
sudden cardiac death.
When these conditions are
aggravated by intense physical
activity, they may cause
ventricular brillation (VF),
where there is uncoordinated
contraction of the cardiac
muscles, making them seem to
quiver instead of contract.
This leads to sudden death if
not treated immediately.
Long QT syndrome
This is basically when there
is a disorder in the cardiac
rhythm that can cause very
quick or chaotic heartbeats.
This is quite a rare inherited
condition.
Steve Konowalchuk, an
American professional ice
hockey player, retired in 2011
after a regular heart screening
detected Long QT syndrome.
Arrhythmogenic
right ventricular
dysplasia
ARVD is caused by genetic
defects of parts of the heart
muscles.
Several professional
footballers have died from the
condition English player Matt
Gadsby (age 27) collapsed on
the pitch in 2006 and later died,
American midelder Kirk Urso
(age 22) collapsed and died
when out with friends in 2012,
and Spanish international player
Antonio Puerta died (aged
22) three days after suffering
several cardiac arrests in 2007.
Hypertrophic
cardiomyopathy
This is basically where
the muscles in the heart are
thickened and the heart is
bigger than normal.
It causes disruptions in the
electrical functions of the heart.
It is a leading cause of sudden
cardiac death in young athletes.
Numerous professional
athletes have died of this
condition, the most famous of
whom is perhaps Cameroon
international footballer Marc-
Vivien Foe who collapsed on the
pitch in 2003 (aged 28) and died
shortly afterwards.
Several professional athletes
have retired after regular heart
screenings diagnosed them
with the condition: American
former basketball player Robert
OKelley, English footballer
Mitchell Cole (who later died
from the condition in 2012, aged
27) and most recently former
Arsenal and Watford goalkeeper
Manuel Almunia, who retired in
August this year.
people who do not take part
in much physical activity and
active people or even professional
athletes, so its up to you to be
responsible for your health and go
for a check-up.
It is always a good idea to
go for a medical check-up and a
heart screening before starting
on a sports regime, especially if
there is a history of heart disease,
hypertension or stroke in your
family, he continues.
Regular yearly heart screenings
are recommended for men above
the age of 45 and women above
the age of 55.
A heart screening will involve
detailed history taking, physical
examination, blood tests and an
exercise stress test, where the
person will go through a graded
physical activity, usually involving
walking or running on a treadmill,
and the condition of their heart
during this stress will be
recorded and examined.
Athletes should also take
precautions when they are playing
sports.
There are several things to
avoid to ensure that your heart
continues to function at optimal
levels during intense physical
activity:
l Dehydration too much
water loss causes a drop in blood
pressure. It is easy to lose too
much water through sweat in
the hot and humid Malaysian
weather. Drink lots of water to
stay hydrated.
l Alcohol drinking alcohol just
before a game is not a good idea
it not only impairs your responses,
it is also a diuretic and thus can
cause dehydration.
l Exercising immediately after
a meal the heart needs to pump
blood to the digestive system and
the muscles being used for the
physical activity. This may cause
Dr Aizai Azan Abdul Rahim, senior
consultant cardiologist at the National
Heart Institute.
angioplasty, you can resume
exercise two to four weeks
afterwards.
It is a good idea to take part in a
cardiac rehabilitation programme
or consider going for a stress test
before returning to competitive
sports.
Because you have been unwell
and have not been active for a
while, you have to start slowly and
gradually build up the strength
of your heart and stamina of your
body. Just use your common sense
and listen to your body. Once you
feel better, you can go further,
says Dr Aizai.
If you are on medication, take
your normal dose before playing
sports and be aware of your
physical limits during the activity.
If you have any discomfort in
your chest, diculty breathing,
or feel nauseous and dizzy
during exercise, stop the activity
immediately and see your doctor
before resuming it.
There is always some risk
involved in vigorous physical
activity, even in sports, but as long
as you keep within reasonable
limits, you will be ne, says
Dr Aizai.
Overall, the risk of a cardiac
complication happening during
physical activity is extremely low
less than 0.001%, so dont let that
stop you from exercising.
Hippocrates, the father of
modern medicine, said If we
could give every individual the
right amount of nourishment and
exercise, not too little and not too
much, we would have found the
safest way to health.
too much strain. Wait at least an
hour after the meal to exercise.
l Extremes of temperature
being too hot or too cold
will put strain on the heart to
pump sucient blood to the
bodily functions that require
it. In Malaysia, this could be
compounded by dehydration
caused by excessive sweating,
making the situation worse.
l Avoid exercise if you are
unwell with fever, u or cold.
Resume once you feel better.
l Always warm up before
beginning exercise and cool down
afterwards.
l Wear comfortable clothes and
good footwear.
Back on form
Staying active and leading a
healthy lifestyle are important for
everyone to prevent heart disease.
But what if you have already had a
heart attack can you go back to
physical activity?
After treatment and
recuperation, the healthier your
lifestyle is, the faster you will
heal, says Dr Aizai.
Each individual heals at
different rates, so always consult
your doctor before resuming
physical activity.
After cardiac surgery, it
normally takes about two months
before you will feel well enough to
engage in some form of exercise
involving your upper limbs such as
lifting weights, golf and tennis but
leisurely daily walks are a good
form of exercise at this point.
If you have had an
uncomplicated heart attack or
have undergone a successful
Over the years, there
have been numerous
cardiac-related
medical emergencies
and deaths in
athletes. These
emergencies are
caused by sudden
cardiac arrest, when
the heart abruptly
ceases functioning.
It is a good idea to go for a full
medical check-up, including a
heart screening, before you start
an intensive sports regime.
Serving the public
with excellence
A
RA Damansara Medical
Centre is a 220-bed
hospital with facilities and
services able to provide 24-hour
emergency and primary care.
One of the main services is the
hospitals Centre of Excellence
dedicated to cardiovascular care.
Though a relatively new
hospital it was ocially opened
in March 2012 it is steadily
building a reputation for itself.
Setting up a Centre of
Excellence for heart in this
hospital was part of a bigger plan
to provide quality services and
facilities to the public, as heart
disease is now the leading cause of
death among Malaysians, says Sue
Lee, the hospitals CEO.
We want to be the hospital
that is at the top of peoples mind
when they think about cardiac
treatment. Our clinical team has
expertise of various complex
diagnostic and therapeutic cardiac
services.
This hospital provides a
full spectrum of diagnoses
and treatment services for
cardiovascular diseases for adults
and children.
In the course of it being a stand-
alone private hospital catering
to cardiac care, the hospital also
attracts patients from overseas
Indonesia, Myanmar, Bangladesh,
Maldives, Cambodia, among
others.
When it comes to medical
tourism, apart from the
Top technology for the heart
WHEN it comes to heart care,
cardiac specialists use all kinds
of equipment to determine heart
function and condition.
Here are some of the latest
equipment available in Malaysia.
l Cathertisation
laboratory
The Cath Lab is equipped
to carry out intracardiac
electrophysiology study,
coronary angiography and
angioplasty, and vascular
and interventional radiology
procedures.
This includes radiofrequency
ablation, permanent pacemaker
insertion, cardiothoracic
surgeries and cardiac
rehabilitation.
l Electrophysiology lab
An EP study is done to
diagnose the source of your
problem before a catheter
ablation is performed.
Catheter ablation is used
primarily to treat people who
have problems with heart
racing or rapid beating of their
heart.
Radiofrequency energy is
used to burn
the heart tissue

that is causing the abnormal
heart beat.
l Telemetry monitoring
Cardiac telemetry is
continuous monitoring of a
patients heart rate and rhythm
that takes place at a remote
location, usually a nursing
station in a special ward. This
service is offered to patients
recovering from heart events,
those who may be at risk of
heart events and individuals
experiencing ongoing heart
problems.
l Tilt table
A tilt table test, occasionally
called upright tilt testing, is a
medical procedure often used
to diagnose dysautonomia or
syncope.
Patients with symptoms of
dizziness or light headedness,
with or without a loss of
consciousness (fainting),
suspected to be associated with
a drop in blood pressure or
positional tachycardia are good
candidates for this test.
This test allows the
doctors to evaluate the bodys
cardiovascular response to the
change in position.
l Cardiac MRI
The 3-Tesla MRI machine is
designed for patient comfort
and enhanced levels of clinical
performance. With up to 40%
faster protocols, this MRI is able
to execute its operations faster
and more precise than any other.
This allows the cardiologist or
radiologist to clearly see any
indication of abnormality in the
muscles.
With its enhanced image
quality and consistency, it
provides a new benchmark
for cardiac imaging which is
likely to become a mainstream
application in high-eld MRI.
l Computerise tomography
scan
The Dual Source Flash CT is
able to deliver excellent image
quality for better diagnosis. At
present, it is the fastest scanner
and has the best temporal
resolution and the shortest
rotation time, which is essential
for cardiac applications.
In addition, it is a low dose
cardiac scan with only 10% to
20% of the radiation dose in
comparison with other types of
similar machines.
It is used to scan patients
with any cardiac conditions,
including low or high heart rate,
irregular heartbeat, and to detect
breathing diculties.
Sue Lee, CEO of Ara Damansara Medical
Centre.
After a cardiac event, a patient goes
through a cardiac rehabilitation
programme to improve heart function.
governments efforts in promoting
the hospital, most patients nd
Ara Damansara Medical Centre
online through word-of-mouth.
Its location, ve minutes
away from the Skypark Subang
Terminal, also makes it convenient
for overseas patients as well as
emergency air ambulance cases
from other parts of the country.
We are proud to say
that this hospital has been
recognised by Pemandu as part
of the governments Economic
Transformation Programme for
medical tourism.
Of course we are still growing
and we aspire to be the leading
private referral centre for
cardiovascular care, says Lee.
Recovery programme
AFTER a person has had a cardiac
event a heart attack, for example
the next steps after treatment
are rehabilitation and recovery.
Cardiac rehabilitation is a
process where a patient who
is recuperating after a cardiac
event goes through a prescribed
exercise programme in order
to improve heart function and
prevent another cardiac event
from happening.
We draw up an individualised
exercise programme to help
patients improve their heart
function.
The programme can be a
simple one or it can be complex,
depending on the patients
condition, says Dr Lydia Latif, a
visiting rehabilitation physician at
Ara Damansara Medical Centre.
The programme incorporates
two main components physical
exercise and education.
Dr Lydia explains that when
the patient comes to the hospital
experiencing a cardiac event, they
are usually concentrating just on
that event and the treatment they
are receiving.
During the rehab process, the
rehabilitation physician takes
things slower to create a calm and
reassuring atmosphere.
We provide education on
the risk factors that caused the
cardiac event in the rst place and
advise the patient on secondary
prevention measures, which
usually involve lifestyle changes,
she says.
The patient will be given
advice about dietary modication,
quitting smoking and stress
management, among other
recovery and rehabilitation
measures.
In devising a programme for
a patient, the doctors will put
the patient through an exercise
stress test to determine current
heart function as well as assess
the risk of another cardiac event
occurring.
The patient will then be
prescribed an appropriate set of
exercises.
He will be advised as to the
intensity and frequency of the
physical activity he can carry out.
There are two types of
exercises:
l Endurance after a cardiac
event, the hearts endurance
will be poor. In other words,
the patient will have very little
stamina and is easily fatigued.
Endurance exercises are aerobic
exercises such as swimming or
cycling that challenge the heart
to pump harder. As with any
other muscle, the heart needs
to be exercised in order to reach
optimal function.
l Resistance exercises such as
lifting weights not just exercises
arm and leg muscles, they also
help the heart pump better.
At the start of the rehabilitation
process, the patient will come
to the rehab centre for about six
to eight weeks where he will go
through the physical exercises in
a controlled environment under
supervision.
Eventually, the patient will have
to incorporate these exercises into
his daily life.
Cardiac rehab is part of long-
term cardiac management and
care. Its not sucient to just
prescribe medication; we need
to take management to the next
level.
Medicines restore primary
heart function, but the rehab
process and lifestyle changes
the patient makes are to prevent
another cardiac event, explains
Dr Lydia.
When it comes to heart health,
each patients level of knowledge
of what caused the event and how
to prevent another one is different.
The physician assesses the
patients level of knowledge, his
or her daily practices and attitude
towards heart health and making
changes. From there, we will be
able to streamline the rehab needs
to the patient, says Dr Lydia.
It can take as few as two or
three sessions for the patient
to receive all the knowledge he
needs, and change his attitude
and lifestyle, so the rehabilitation
process is not one that has to go
on for the rest of the persons life.
However, the lifestyle changes
and taking care of ones health
have to go on forever.
The hospital has a
Centre of Excellence
dedicated to cardiovascular care.
Dr Chua Seng Keong, consultant
cardiologist at Ara Damansara Medical
Centre.
Dr Abdullah Asad Siddiqui is an
emergency physician and head of
the Emergency Department at Ara
Damansara Medical Centre.
Getting down to the core
W
HEN people think about
magnetic resonance
imaging scans, they
usually think of brain scans. But
the cardiac MRI an MRI scan for
the heart has been in clinical
use in Malaysia for nearly 12 years
now.
The use of this technology
has gained popularity over the
past few years, but there are
still a limited number of centres
that perform cardiac MRIs in the
country, explains Dr Chua Seng
Keong, a consultant cardiologist at
Ara Damansara Medical Centre.
Cardiac MRIs are considered
the gold standard of non-invasive
tests used to assess right and left
heart function and are commonly
used to ascertain in detail the
tissue health of heart muscles
and provide information to the
You will be asked if there is
any metal device or implant
in your body. Because the MRI
uses strong electromagnetic
waves, metal in the body can
significantly distort the images,
cause the device to heat up
or to malfunction. Patients
with pacemakers, orthopaedic
implants or metal implants in
the ear or eye usually cannot go
through an MRI scan unless they
have been tested and certified
MRI-safe.
Inform your doctor should
you be uncomfortable in tight
spaces. Your doctor can take
measures to help you relax
and undergo the MRI scan
successfully.
You will hear knocking and
humming sounds during the
scanning. The scan itself is
painless. Padded headphones
reduce the noise and music can
be played if desired.
Throughout the procedure,
you will be required to hold your
breath each time an image is
taken.
Expect mild discomfort from
tube that is inserted into your
vein for injecting the dye into
your system. This dye provides
the information on blood flow
and heart muscle tissue. You
will be required to go through a
mandatory blood test to ensure
normal kidney function before
this is done.
The whole procedure usually
takes 1 to 1.5 hours; you will
be able to take short breaks in
between and the technicians
will communicate and check on
you throughout the procedure.
What going through an
MRI is like
cardiologist or surgeon on whether
or not an invasive procedure
(angioplasty or bypass surgery)
is required when dealing with
coronary artery disease.
Nowadays, cardiac MRIs are
used in a multitude of ways:
Assess left and right heart
structure and pump function
Assess heart valve function,
especially leaky valves
Assess large blood vessels of
the heart
Determine the presence of
heart muscle scarring, primary
heart muscle diseases and extent
of damage caused by heart attacks
in patients with weakened hearts
As a cardiac stress test to
determine if there is signicant
coronary artery disease
To detect excess iron
deposition in the heart (especially
useful in Thalassemia patients
requiring regular blood
transfusions)
Cardiologists turn to cardiac
MRIs when one of the more
basic tests or scans, such as an
echocardiogram or a treadmill
stress test (an ultrasound of the
heart) is unsuitable or do not
provide adequate answers.
Cardiac MRIs become
indispensible when monitoring
adults with congenital heart
diseases because tests on them
need to be repeated serially and
the MRI does not carry any risk of
radiation. says Dr Chua.
Pros and cons
Compared to other tests, MRIs
have a signicant number of
advantages:
No radiation risk
Non invasive
Best non-invasive test
available to determine heart
function
The adenosine stress
perfusion cardiac MRI used
to detect signicant coronary
artery disease is superior to the
equivalent nuclear perfusion
study that involves radiation and
has a lower resolution
There are, of course, a few
disadvantages:
Cost it is the most expensive
non-invasive test
Conned space - the space
in which the patient lies in the
MRI scanner is small, typically
60-70cm in diameter
Long scan time patients
may have to lie in the scanner for
an hour or more
Limited availability there
are limited cardiac MRI-enabled
equipment, software and trained
personnel in Malaysia
MRIs are not for everyone and
are indeed a luxury, but now that
this technology is available we
have a robust alternative should
other initial imaging modalities
fail to provide answers.
Hopefully, with more trained
cardiologists and radiologists
this service will become more
affordable and easily available to
the heart patients that need it,
says Dr Chua.
A matter of life and death
A HEART attack is a serious
thing that requires immediate
medical intervention. Not only is
it important to know the signs of
heart attack, everyone should also
know where to go during such an
emergency.
Hospital emergency rooms (ERs)
are usually equipped to deal with
all kinds of emergencies, including
those related to the heart.
An ER physician in Malaysia will
see trauma cases where there
has been injury to the heart, such
as when a person is stabbed in the
chest and medical emergency
cases such as heart attacks or acute
pulmonary oedema (accumulation
of uid in the lungs) leading to a
cardiac arrest.
Most of the time, when
patients come into the ER with
chest pains, it does turn out to
be a heart attack, or something
like an unstable angina, which
is one step away from becoming
a full-blown heart attack, says
Dr Abdullah Asad Siddiqui,
emergency physician and head of
the Emergency Department at Ara
Damansara Medical Centre.
When a patient comes into the
ER with chest pains, it is taken very
seriously, says Dr Asad. He explains
that the doctors and nurses
immediately start to diagnose
whether or not the patient is
having a cardiac event or one is
imminent using a few methods:
l Electrocardiogram this
machine records the hearts
electrical activity and will pick
up any unusual activity, allowing
doctors to determine if the patient
is experiencing a heart attack
l Blood examination this tests
the enzymes in the blood and
takes a few minutes
If it turns out that the patient
is having a heart attack, medical
management starts straight away.
If it is a severe heart attack,
what doctors refer to as
STEMI (ST segment elevation
myocardial infarction), the
patient will immediately be sent
to the catheterisation lab for an
angioplasty, a procedure where
the blocked artery is opened with
a balloon-like device.
An angioplasty is the most
preferred treatment in such an
emergency. In STEMI cases, time
is critical from when the patient
comes into the ER to the life-
saving procedure. Ideally, the
door-to-balloon time should be no
more than 90 minutes.
Of course, not all patients who
come in will need this procedure.
Some just require medication,
which can be administered
through the bloodstream, he
continues.
There is a wide range of heart-
related issues that an ER will see
in a given week. For example, out
of 10 cases Dr Asad sees in the ER
on a given day, on average seven of
them will be heart-related.
It is important for people to
know where they can go during a
heart emergency, says Dr Asad.
During a cardiac medical
emergency, the person must
go to the right hospital that is
equipped with the right facilities
and services so that vital time is
not lost.
Cardiac MRIs are used to
assess heart function and
are considered the gold
standard of non-invasive
cardiac tests.
Cardiac conditions seen in the ER
HERE are some common heart-related emergencies that an ER
physician will deal with:
l Unstable angina a condition where there is not enough
blood ow or oxygen to the heart. Patients experience chest pains of
increasing intensity and duration, but often when an ECG or blood
test is administered, results are normal. This means a heart attack
may occur at any time and the patient should go for an angiogram
within the next 24 hours.
l Arrhythmia this is basically where the heart pumps at an
irregular rhythm or there is ventricular brillation (where the
cardiac muscles of the ventricles contract in an uncoordinated
manner). Blood that should be sent out of the heart becomes
compromised.
l Acute pulmonary oedema this happens when the heart is
not strong enough to send out all the blood that the lungs send to
it and there is a backow of blood into the lungs, causing the lungs
to ood. The patient will start feeling breathless, and eventually
experience a cardiac arrest. The doctor will intubate the patient to
improve oxygen ow and administer medication to draw the liquid
out of the lungs.
World Heart Federation
Women, children and heart disease:
ACT NOW to protect the hearts of
those you love
Cardiovascular disease (CVD), including heart disease and stroke,
takes lives prematurely. Contrary to common belief, women are
affected equally to men, and children are vulnerable too. Most
deaths caused by CVD are preventable. Individuals, families,
communities and governments must work together to avoid the
physical, emotional and financial burden caused by CVD. Immediate
action is required to ensure a heart-healthy future for all: encourage
healthy eating and physical activity, and ban tobacco use.
The burden of cardiovascular disease
It is a myth that CVD mostly affects
affluent, male, older populations -
it can affect all ages and
population groups, including
women and children
20
19
18
17
16
15
14
13
12
11
10
9
8
7
6
5
4
3
2
1
0
Cardiovascular disease
3.86 million deaths a year
Malaria, HIV/AIDS &tuberculosis
CVD can
develop
before birth
17.3 million deaths a year
Heart disease causes
1 in 3 female deaths
each year
Number of babies born each
year worldwide with a
congenital heart defect
Playing an outdoor game with the children
Taking the stairs
Doing household chores
Cycling to work
Together we can prevent heart disease and stroke
Most heart disease and stroke can be prevented by
making healthy changes: eating healthily, being active
and stopping smoking
Physical activity is not just exercise
but also includes:
Eating a heart-healthy diet:
If you take
public
transport,
get off a
stop early
and walk the
rest
Worldwide, one in 10 schoolchildren are estimated to be
overweight, a risk factor for heart disease and stroke
Try reducingthe portion size of
less healthy food and increasing
the portion size of healthy food
Try swappingfoods if you
have a sweet tooth, try mango
instead of chocolate
Diets high in saturated and
trans fat, sugar and salt
increase the risk of heart
disease and stroke
You dont have to stop eating the foods
you love completely!
A balanced diet rich in fruit
and vegetables helps
prevent heart disease and
stroke
About the World Heart Federation
The World Heart Federation leads the global fight against heart
disease and stroke with a focus on low- and middle-income
countries via a united community of more than 200 member
organizations that brings together the strength of medical
societies and heart foundations from more than 100 countries.
Through our collective efforts we can help people all over the
world to lead longer and better heart-healthy lives.
Follow us on Twitter: www.twitter.com/worldheartfed
Join us on facebook: www.facebook.com/worldheartfed
www.worldheart.org
After stopping smoking for
15 years, the risk of heart
attack falls to the same level
that it would be for someone
who has never smoked
Efforts to encourage healthy changes in womens and
childrens lives are required from conception through to
life end (a life-course approach)
All of society (policy-makers, healthcare professionals,
parents and employers) have a role to play in
encouraging and enabling heart-healthy living
On 29 September for World Heart Day, take action for you
and your family to live better, longer, heart-healthy lives
www.worldheartday.org
www.facebook.com/worldheartday
#worldheartday
Your doctor, pharmacist, employer
and friends may all be able to help
you to stop smoking
Non-smokers, including children, are
killed each year from exposure to
second-hand tobacco smoke. Half of
the worlds children regularly breathe
air polluted by tobacco smoke.
Smoking causes 10 per cent of CVD
Say no to tobacco:

Children may suffer a
double burden from CVD,
seeing a loved one becoming
ill, or experiencing congenital
or acquired heart disease
themselves
Disease does not discriminate
HEART disease is the No.1 killer
in Malaysia for both men and
women. Though most people
believe that it is a mans disease,
the reality is that with our modern
lifestyles, everyone is vulnerable
to cardiovascular disease (CVD),
even children.
Today is World Heart Day, the
day designated by the World Heart
Federation to bring awareness and
knowledge of heart disease to the
people all around the world.
This years theme is Creating
Heart-Healthy Environments. The
idea behind this is that the places
in which people live, work and
play should not increase their risk
of CVD.
However, individuals may not
be able to make heart-healthy
choices due to environmental
factors such as the availability of
healthy food or smoke-free zones.
Changing this starts with
the individual. You can start by
making changes in your home
such as making healthy food
choices and banning smoking.
You can encourage change
in your community by working
together to create a safe
environment for people to
exercise in, ensuring schools
provide healthy and nutritious
food.
To make an impact on a
national level, you can lobby
policymakers for more regulation
on the amount and reach of fast-
food advertising on TV and radio
or ensuring timely detection of
CVD and cost-effective treatment
to modify the risk factors in high-
risk individuals.
Here is some vital information
about the risk of CVD to women
and children, and what you can do
to reduce this risk.
StarSpecial 9
Monday 29 September 2014
Managing your cholesterol level
B
ETA-glucan obtained from
oats is known for its ability to
reduce LDL (bad) cholesterol.
The Malaysian Ministry of Health
recommends 3g of oat beta-glucan
to be consumed daily to produce
cholesterol-lowering effects.
Taking less than the
recommended amount will incur
minimal or have no effect on LDL
cholesterol levels.
A study by the University of
Toronto, Canada, revealed that
the ability of oat beta-glucan to
lower LDL cholesterol (ecacy)
is related to its molecular weight
and viscosity while in the gut.
Consumers need to ensure that
they are taking the recommended
amount of 3g oat beta-glucan
daily to ensure that the ingested
oat beta-glucans produce an effect
enough to reduce cholesterol in
the human body.
Consuming oat bran cereal
containing 3g of high-molecular
weight oat beta-glucan daily
has been proven to lower LDL
cholesterol by 5%.
Higher molecular weight oat
beta-glucan (more than 2,200kDa)
is shown to produce a higher
viscosity effect in the upper gut
or small intestine, thus having
a greater effect on reducing LDL
cholesterol levels.
Low molecular weight (less
than 210 kDa) oat beta-glucan, on
the other hand, had minimal or no
effect on LDL cholesterol levels.
To ensure that a products
performance lives up to its
claim, the molecular weight and
viscosity effect of oat beta-glucans
in the human body should be
taken into consideration when
choosing a brand to use.
There are ve reasons why
Biogrow Oat BG22 Oat Bran
Powder and Biogrow Oat BG22
Crispy Cereal are effective for
cholesterol problems.
l Both are made purely of natural
ingredient(s) Swedish oat
bran. They are free of articial
ingredients, thickeners and llers.
l Two scoops or sachets (about
18g) of oat bran powder or one
packet (30g) of crispy cereal
provide 3g and above of high
molecular weight oat beta-glucan.
l They are high in bre.
Both choices offer a balanced
combination of soluble (for
cholesterol health) and insoluble
bre (for gut health).
l They have good solubility and
viscosity effect. The powder
dissolves well in cold or lukewarm
water. Both the powder and crispy
cereal are scientically shown
to produce good viscosity or
gelling effect in the gut to produce
optimal cholesterol-lowering
effect.
l There has been proven
cholesterol-lowering effects from
more than 30 clinical studies
(European Food Safety Authority
Journal 2010).
How to consume
Biogrow Oat BG22 Oat Bran
Powder: Mix one scoop or one
sachet with 200ml of cold or
lukewarm water and drink
immediately before meals.
Take at least twice a day for
optimal cholesterol-lowering
effect. You can also mix in honey,
soy milk, a chocolate drink or fruit
juice.
Biogrow Oat BG22 Crispy
Cereal: Can be eaten straight from
the packet as a high bre snack
or enjoyed with low fat milk, soy
milk or yogurt.
n For more information,
call 03-7956 2220 or e-mail
info@biogrow.com.my
Children are also at risk
HEART disease is not only
a concern in adults, but in
children as well. Here are
descriptions of some conditions
known to be found in young
children.
Congenital heart disease
Congenital heart disease
(CHD) describes a number of
different problems that affect
the heart.
It is a type of birth defect
that can be described more
accurately as a defect or
abnormality of the heart or
blood vessels near the heart.
According to the world
heart federation, the majority
of children born today with
CHD will survive and lead a
normal or near-normal life with
proper treament. CHD may be
diagnosed during infancy (mild
CHD) or soon after birth (severe
CHD). Some are diagnosed
during prenatal screening.
Acquired heart disease
There are heart diseases
that are not present at birth but
acquired.
The two major types are
rheumatic heart disease and
Kawasaki disease.
Rheumatic heart disease
Rheumatic heart disease
(RHD) is the most commonly
acquired heart disease in
many countries, especially in
developing countries.
It is a condition where the
heart muscle and heart valves
are damaged due to rheumatic
fever, which is caused by
streptococcal bacteria.
Rheumatic fever is an
inammatory reaction and
begins as a consequence of the
streptococcal infection of the
throat (strep throat).
Most strep throat infections
do not lead to rheumatic
fever but when the infection
is undiagnosed, untreated or
undertreated, rheumatic fever
can occur.
According to the World Heart
Federation, rheumatic fever and
RHD are responsible for about
233,000 deaths annually and
affects mostly children and
young adults.
Kawasaki disease
Kawasaki disease is
characterised by fever, rash,
swollen hands and feet,
bloodshot eyes, swollen
lymph nodes, a strawberry
apprearance to the tongue and
an acute inammation of the
blood vessels, especially the
coronary arteries.
The cause of the disease is
unknown but may be caused by
some kind of infectious agent.
The disease occurs in young
children. According to the
World Heart Federation, 80% or
more that are affected are less
than ve years old and it occurs
more in boys than in girls.
Children who are
undiagnosed or untreated may
suffer serious heart damage.
Obesity
Obesity is one of the factors
that causes cardiovascular
disease and is determined by
the dietary habits of individuals.
It is a major public health
concern and is steadily affecting
many low- and middle-income
countries, particularly those
living in urban settings.
There are several
environmental factors
associated with childhood
obesity.
In many economic-driven
nations, increased consumption
of energy-dense, high-calorie
foods and drinks and decreased
physical activity contribute to
uncontrolled weight gain in
children.

The information above was
taken from the World Heart
Federation website.
n For more information, visit
www.world-heart-federation.org
Get a good
cardio workout
C
ARDIOVASCULAR disease (CVD) is the
worlds No.1 killer, causing 17.3 million
deaths per year and this number is
expected to increase to 23 million by 2030,
according to the World Heart Federation.
You can lower the risk of CVD when you
quit smoking, eat healthily and do regular
physical activities.
In conjunction with this years World
Heart Day theme of creating heart-healthy
environments in places we live, work and
play, Fitness Concept has introduced the
latest in home exercise equipment, the
ProForm Hybrid Trainer.
You and your loved ones can start
exercising your way to a healthier heart at
the convenience and comfort of home with
this hybrid trainer from ProForm, which is
the worlds No.1 in home tness.
It can work as a recumbent bike for lower
body toning or as a crosstrainer for total
body endurance by simply adjusting the
pedals of the hybrid trainer. It also saves
space and money, making it the preferred
choice at home.
The hybrid trainer is equipped with 14
digital resistance levels that will allow you
to progress from beginner to advanced
levels as you get stronger.
You can also maximise your workout by
keeping track of your heart rate with the
EKG heart monitor.
Its front mounted wheels allow you
to conveniently move this two-in-one
machine out of the way when not in use.
The ProForm Hybrid Trainer also has
these features:
l Two machines in one: The hybrid
trainer offers comfort, variety and a low-
impact cardio workout. Pedals can be
easily adjusted to make it a crosstrainer or
bike. The console can also be adjusted, so
whether you are sitting or standing, you can
easily monitor your workout on the large
LCD window.
l Target pacer: You can customise your
workout with the target pacer. An indicator
light tells you when to speed up or slow
down to maximise your workout and
achieve your weight loss goals.
l Upper-body grips: Improve muscle tone
with the upper-body crosstrainer resistance
arms that provide a great total-body
workout and increased cardio benets.
l 14 smart workout apps: The 14
programmes are designed by a certied
14 Smart
workout apps.
Oversized,
adjustable
pedals.
SMRsilent
magnetic
resistance.
personal trainer and automatically
adjust the resistance of the crosstrainer/
recumbent bike to maximise your time for
faster results.
The simple navigation of the apps makes
it quick and easy to select your workout and
get moving.
The ProForm Hybrid Trainer is available
exclusively at all Fitness Concept outlets
nationwide. Fitness Concept is Malaysias
largest tness specialist chain as certied by
The Malaysia Book of Records with 45 outlets
in leading shopping malls nationwide.
Fitness Concept is running Sit Less, Move
More promotion with exciting deals on
treadmills, crosstrainers, exercise bikes,
gym stations and tness accessories with
in-store gifts, purchase-with-purchase
offers and many more great offers.
Fitness Concept will be running
roadshows at Aeon Rawang Shopping
Centre and Aeon Cheras Selatan on
Sept 30 where visitors can try out the
ProForm Hybrid Trainer.
n For more information, call 03-8026 2222,
e-mail enquiries@tnessconcept.com.my or
visit www.tnessconcept.com.my
The ProForm
Hybrid Trainer.
UBIQUINOL is the active antioxidant form of Coenzyme Q10 (CoQ10).
Our body naturally produce CoQ10 and convert it to UBIQUINOL - the nutrient
essential for cellular energy 'function and antioxidant protection.
However, our body's ability to produce UBIQUINOL signicantly decreases as we
age. Without proper levels of these vital substances, the body produces less energy
and lacks a strong defence against oxidative stress.
Because UBIQUINOL is pre-converted, it is ready for immediate use by the body,
making it ideal for those unable to efciently convert CoQ10 in the body.
Thus, taking a supplement containing UBIQUINOLbecomes increasingly important
to maintain good health.
K.K.L.I.U No : 0999/2013
**Available at all leading pharmacies.
Product Owner:
VITAMODE HEALTHCARE (AUSTRALIA) PTY LTD
Distributed By:
MEDISPEC (M) SDN BHD (137156-U)
Toll Free: 1300-800-228
Tel : 082-483450
(J Bio Medic Marketing Sdn Bhd, Sarawak)
Tel: 088-215312
(UMH Pharmacy Sdn Bhd, Sabah)
Quality drinking water
WATER is the matrix of all life.
The human body constitutes
70% of water. However, 75%
of the modern population in
the United States suffer from
chronic dehydration.
This is because a mere drop
of 2% in body water percentage
can result in fatigue and a 10%
drop can lead to serious health
problems while greater loss can
be fatal.
Chronic dehydration can lead
to:
l Allergies
l Alzheimers
l Arthritis
l Attention decit disorder
l Autoimmune disorder
l Cancer
l Cravings
l Depression
l Fatigue
l Headache and migraine
l Heartburn
l Impatience
l Insomnia
l Osteoporosis
l Parkinson
l Diabetes
Ordinary tap water forms
large clusters. These large
clusters do not easily permeate
into our cellular membrane
and hence, does not adequately
hydrate our tissues. Most of the
time, we are drinking recycled
water, which is water that has
had its structure altered.
Naturalist and scientist
Johanne Grander reveals that
water is capable of storing
information and vibrational
frequencies. Hence, no matter
what ltration or purication
process is performed on water,
disease markers will remain in
the memory of the water.
For a long time now, disease
markers from waste products of
people and animals have been
digitally recorded in the water.
Drinking VWA Cellular
Functional Water will give
you a different experience.
The resulting living water is
more hydrating and it provides
an abundance of benecial
properties such as antioxidants.
VWA Cellular Functional
Water is a registered medical
device by the Korea Food and
Drug Administration.
It is rated as the worlds No.1
water ioniser in the United
States with advanced hybrid-
ionisation technology.
It is able to convert tap water
into a natural antioxidant and
is a standout system in the
water treatment industry that
provides you with near-instant
cellular absorption.
The proprietary dual-lter
is made up of fermented total-
microorganism Pi ceramic
that emits a special resonance
characteristic that destroys
disease markers or frequencies.
This subsequently
re-energises water molecules
to form smaller clusters and
crystalline structures for better
absorption, hence achieving
near-instant cellular hydration.
call 1300 222 123 or visit
www.vwawater.com
The VWA
Cellular
Functional
Water is a
water ioniser
equipped
with
advanced
hybrid-
ionisation
technology.
Milking benefits for your health
W
ORLD Heart Day began in
1999 and was created to
raise awareness around
the world of heart diseases and
stroke, which are the worlds
leading causes of death.
About 17.5 million people
died from cardiovascular disease
in 2005, representing 30% of all
global deaths.
Risk factors for heart disease
and stroke include raised blood
pressure, cholesterol and glucose
levels, smoking, inadequate
intake of fruits and vegetables,
being overweight and physical
inactivity.
Heart disease in Malaysia
Similarly, heart disease is also
the leading cause of death in
Malaysia, according to The Heart
Foundation of Malaysia (Yayasan
Jantung Malaysia).
While many people think of
heart disease as generally being
a mans problem, women are also
at risk.
Based on data collected by
the Health Ministry of Malaysia,
cardiovascular disease accounts
for about 25% of deaths among
women and causes almost two
and a half times more deaths than
cancer.
As a woman gets older, it is
more likely that she will develop
heart disease, especially during
menopause.
Today, there are 10 million
Malaysians with unhealthy
cholesterol levels.
One in ve Malaysians are
diabetic and about 40% are
overweight or obese.
Cultivate a healthy lifestyle
According to WHO and the
World Heart Federation, at least
80% of premature deaths are due
to heart disease and stroke.
These can be avoided if the
main risk factors such as smoking,
having an unhealthy diet and
physical inactivity are taken care
of.
This years World Heart Day
is focused on cultivating a healthy-
heart environment where we can
take steps towards healthier living
through performing activities such
as eating healthy and nutritious food
and exercise.
This includes reducing intake of
saturated and trans fat, sugar and
salt, and eating a balanced diet rich
in fruits and vegetables.
Start eating plenty of fruits and
vegetables as they contain bre,
vitamins, minerals and antioxidants,
which are benecial to the body.
An easier way will be to
incorporate two glasses of Marigold
HL Low Fat Milk with Plant Sterols
into your daily diet.
A good milk option
Marigold HL Low Fat Milk with
Plant Sterols has been shown to
lower blood cholesterol. Plant sterols
occur naturally in foods such as
nuts, seeds, legumes, fruits and
vegetables.
It works by blocking the bodys
cholesterol absorption. It is also
low in fat, containing only 1% fat
compared to regular milk (4% fat),
which helps keep you healthy and
slim.
In addition, the high calcium
content helps keep bones strong to
prevent osteoporosis and its high
protein content builds and repairs
muscles.
It is also low in lactose to suit
people with lactose intolerance
and fortied with nine essential
vitamins, including vitamin A,
B1, B3, B6, B12, C, D, E and folic
acid.
These meet most of the
recommended daily allowance
(RDA) of vitamins, providing
more nutritional benets than
what other regular milk can
offer.
Including Marigold HL Low
Fat Milk with Plant Sterols in
your daily diet, coupled with
exercise, can help maintain
your cholesterol levels at a
healthy range.
Two glasses of Marigold HL
Low Fat Milk with Plant Sterols
every day will provide you with
1.6g of plant sterol esters.
This will ensure that getting
your daily dosage of plant
sterols is made easy.
Marigold HL Low Fat Milk is
available in four variants plant
sterols, plain, chocolate and
strawberry.
Being the rst to introduce
high-low milk in Malaysia 26
years ago, Marigold HL low-
fat milk continues to reign as
consumers No.1 choice for
pasteurised low-fat milk in the
market.
Kordels has a
range of dietary
supplements for
people with various
requirements.
Nutrients
for living well
I
MAGINE continuously moving without
a single moment of rest for your entire
life. That pretty much sums up how your
heart works. The heart is the organ that is
responsible for nutrient and oxygen delivery
to your entire body.
The coordinated contractions of this
organ produce the continuous beat that
ensures ecient delivery of nutrients and
removal of toxins.
To have a healthy body, it is important
to adopt a balanced diet and lead an active
lifestyle.
Scientic research has helped identify
nutrients that are essential for a healthy
body, such as omega-3, co-enzyme Q10 and
beta-glucan.
Omega-3 Fatty Acids
Kordels Hi-Omega Fish Oil contains
50% eicosapentaenoic acid (EPA) (300mg)
and docosahexaenoic acid (DHA) (200mg),
two of the most studied omega-3s for the
maintenance of overall health.
Kordels Hi-Omega Fish Oil is molecularly
distilled, a process that eliminates heavy
metals and the shy odour.
Getting your
daily requirement
Kordels Omega 3 Fish Oil contains
180mg EPA and 120mg DHA in each
Vegicaps soft capsule. It provides all the
benets of omega-3 for the maintenance of
good health.
The oil is obtained from deep-sea cold
water sh such as anchovies and sardines.
This product is molecularly distilled
to remove toxins such as dioxins, PCBs
(polychlorinated biphenyl), mercury and
other heavy metals.
Kordels Omega 3 Fish Oil is a convenient
way to help you achieve your daily
requirement of omega-3 fatty acids.
More than regular
omega-3
Kordels Krill-Xanthin 500mg is
extracted from krill, a shrimp-like creature
from the Antarctic Ocean. Omega-3 in krill
oil is in phospholipid form, which makes its
entry into the bodys cells much easier.
The absorption of the phospholipid form
of omega-3 is two times better, as displayed
by the omega-3 index. Phospholipid-bound
omega-3 also blends well with gastric juices
and does not produce a shy aftertaste.
As a bonus, krill oil is rich in naturally
occurring astaxanthin, a potent antioxidant
that is responsible for limiting free radical
damage.
Wild and natural
salmon oil
Kordels Wild Alaskan Salmon Oil
1,000mg is 100% wild salmon oil. It contains
a wide spectrum of omega fatty acids as
well as the antioxidant astaxanthin in the
ratio that you would nd in wild salmon.
The orange-pinkish hue of the salmon
oil indicates that this is an unrened form
of salmon oil. Unlike farm-raised salmon,
wild salmon swim freely in the sea and do
not require the use of articial colouring,
antibiotics or hormones to ensure yield and
sustainability.
This product supports the sustainable
use of wild salmon through contributions to
the Pacic Salmon Foundation, making it an
environmentally friendly product.
Power up the beat
with co-enzyme Q10
Co-enzyme Q10 is also known as
ubiquinone. CoQ10 is highly concentrated in
most of the vital organs, such as the heart,
liver and kidneys. These organs are very
active and require high amounts of energy.
Eat the rainbow
EVERYONE knows that vegetables and fruits
are great sources of vitamins, minerals and
bre besides being relatively low in calories.
To get the full benet of the goodness
of fruits and vegetables, make sure that
you consume them in a variety of different
colours. Each colour indicates the different
nutrients they contain and many of them
are also benecial for heart health.
Red fruits and vegetables are naturally
coloured by lycopene that reduces risks of
several types of cancer, including prostate
cancer, or anthocyanins that are powerful
antioxidants that protect cells from damage.
Antioxidants are linked to keeping our
hearts healthy, too.
l Tomatoes, watermelon and pink
grapefruit are pigmented by lycopene
l Strawberries, raspberries and red grapes
are pigmented by anthocyanins
l Other red roughages are red cabbage,
cherries, red peppers and red apples
Orange and yellow fruits and vegetables
are pigmented by carotenoids. Foods that
are rich in carotenoid can help reduce
risks of cancer, heart disease and improve
immune system functions.
One study found that men with high
cholesterol who ate plenty of carotenoid-
rich food had a 36% lower chance of a heart
attack and death than their counterparts
who shunned them.
l Vegetables: Cantaloupe, carrots, yellow
peppers, pumpkin, sweet corn and sweet
potatoes.
l Fruits: Grapefruit, mangoes, oranges,
papayas, pears and pineapple.
Green is the most abundantly available
type of fruits and vegetables. They are
naturally coloured by the chlorophyll
pigment.
The darker the green colour is, the
higher the chlorophyll content. Some dark
leafy greens contain lutein. In general, this
chemical works with another chemical,
zeaxanthin found in orange and yellow
roughage, to reduce risks of muscular
degeneration.
l Vegetables: Asparagus, green beans,
broccoli, celery, cucumber, green peppers,
lettuce, peas, spinach and green onions.
l Fruits: Green apples, avocados, honeydew
melon and kiwi.
Blue and purple fruits and vegetables
are the rarest coloured roughage. They
are coloured by the natural plant pigment
called anthocyanins, which are antioxidants
that work against chances of cancer, stroke
and heart diseases.
l Vegetables: Brinjal and purple cabbage.
l Fruits: Blueberries, plums, prunes and
purple grapes.
According to the Mayo Clinic, it is best to
choose fruits and vegetables that are fresh.
Alternatively, if you are choosing
varieties that are seasonal, frozen ones are a
good option.
Avoid fruits and vegetables that are
canned in high sodium brine or syrup with
high sugar content.
CoQ10 is packed in the cell of the body
and is required to convert food into energy
to power up the bodys activities. The
generation of this chemical energy supplies
the vital force for even the simplest actions
such as breathing and maintaining a
heartbeat.
Being a fat-soluble antioxidant, CoQ10
is better absorbed in oil form. Kordels
CoQ10 75mg + Omega 3-6 ensures the
bioavailability of CoQ10 by using the
two essential fatty acids omega-3 and
omega-6 as carriers.
Kordels supports World Heart Day. Make
healthy choices wherever you live, work and
play, to help reduce health risks, for both
you and those around you.
This information is brought to you by an
in-house pharmacist at Cambert (M) Sdn
Bhd.
n For more information, call 1300 881 712,
e-mail ask-kordels@cambert.com.my or
visit www.kordels.com.my
(KKLIU 1648/2014)
Keeping things in check
HEART disease is the No.1 killer
among Malaysians. One of the
major risk factors for coronary
heart disease is high blood
cholesterol levels.
Cholesterol is a fatty
substance that circulates in the
bloodstream. It is produced
naturally in the body and may
also come from the food that
we eat such as eggs, meat and
dairy foods. There are two
types of cholesterol LDL
cholesterol (bad) and HDL
cholesterol (good).
Elevated levels of LDL-
cholesterol in the blood can
cause the formation of plaque
and clogging of arteries, making
them less exible.
This condition is known as
atherosclerosis, which may put
you at risk of coronary heart
diseases and stroke. On the
other hand, HDL cholesterol
helps prevent atherosclerosis
by ushing out excessive LDL
cholesterol to the liver for
disposal.
Weight, genes and age
are important factors that
determine cholesterol levels.
Other factors such as living
a sedentary lifestyle, stress,
smoking and regular alcohol
consumption can also elevate
cholesterol levels.
Maintaining a healthy
cholesterol level is essential
in reducing the risk of
cardiovascular diseases. The
American Heart Association
(AHA) recommends that the
average intake of fat should not
be more than 30% of the total
daily calories.
Fat intake should consist of
balanced fat, which provides
nutrients that are essential
to sustaining a healthy life.
A balanced fat intake should
contain approximately
30% saturated fat, 33%
polyunsaturated fat (containing
essential fatty acids) and 37%
monounsaturated fat.
Among all fats, rice bran
oil (RBO) has the most
balanced fatty-acid prole
that is closest to meeting AHA
recommendations.
The health benets of RBO
are largely attributed to the
presence of gamma oryzanol,
the most notable feature of RBO
that is not found in any other
edible vegetable oils.
Gamma oryzanol is a potent
antioxidant that has been
shown to selectively reduce
bad LDL cholesterol while
improving good HDL cholesterol
in the blood.
It is known as the worlds
healthiest edible oil due
to the high proportion of
monounsaturated fatty acids
(40%-50%) and polyunsaturated
fatty acids (29%-42%), which
are potentially useful in
the maintenance of healthy
cholesterol proles.
RBO is naturally rich in
vitamin E a mix spectrum of
tocopherol and tocotrienol. Both
types are potent antioxidants
that can protect the body from
the harmful effects of free
radicals.
Tocotrienols have been
shown to reduce triglycerides,
strengthen the arterial wall and
support blood ow through the
arteries.
call 03-7729 3873.
Rice bran oil (RBO) contains a balanced
fatty-acid profile that provides nutrients
essential to sustaining a healthy life.
Power up your cells
E
VERYDAY, the 100 trillion or
so cells in your body work
hard to multiply, digest
nutrients, remove waste and
ensure that you can perform your
daily activites.
To perform these tasks, your
cells require an adequate supply of
energy in the form of a adenosine
triphosphate (ATP). This requires
a sophisticated production system
that relies on Coenzyme Q10
(CoQ10).
Without sucient amounts
of CoQ10 in your body, your cells
cannot produce ATP eciently,
resulting in serious disease or
even death. To understand how
CoQ10 helps to produce energy,
you need to know a little about
mitochondria.
Imagine that within each
of your cells are tiny power
companies called mitochondria
that produce 95% of the total
energy found in your body.
Mitochondria transform the
carbohydrates in your food into
ATP, the fuel on which your body
runs. This is where CoQ10 comes
into play. CoQ10 is the catalyst
that makes it possible for the
mitochondria to produce ATP,
which is the molecule that all
cellular functions in the body
depend on.
The difference between a child
and an elderly person is the varied
levels of CoQ10 in their bodies
ageing depletes natural CoQ10
levels and produces more free
radicals.
Ageing is not the only factor
that causes the body to be short of
CoQ10. Stress and exercise as well
as drug interactions also deplete
this energy nutrient.
Do you know that commonly
prescribed medications deplete
CoQ10? Blood-pressure lowering
drugs (beta-blockers) and
cholesterol-lowering drugs
(statins) block the production of
CoQ10.
In fact, statins can reduce blood
levels of CoQ10 by up to 40%.
Other drugs that reduce
CoQ10 levels in the body include
hormone replacement therapy
(HRT) and oral contraceptives.
Patients on these types of drugs
may nd themselves tired,
irritable, unable to handle stress
well and aggressive.
Since it is dicult to obtain
adequate CoQ10 levels from
the diet, supplementation can
be useful. With so many CoQ10
formulations out there, it is not
unusual for consumers to be
confused over which to choose.
CoQ10 comes in two forms
ubiquinone and ubiquinol.
Ubiquinone is more common
and widely known because it is
the form most commonly sold
commercially.
Ubiquinol has only been
commercially available for about
seven years, but there are already
more than a hundred studies
demonstrating its health benets.
People have been taking
CoQ10 supplements to improve
their heart health for decades,
but most probably do not realise
that Ubiquinol is a better form of
CoQ10.
Ubiquinol is the active,
antioxidant form of CoQ10 that
is ready for immediate use by
the body. Conventional CoQ10
supplements, however, use the
inactive form of Coenzyme Q10
called ubiquinone.
Both ubiquinol and CoQ10
are essential nutrients found in
every cell of your body. Ubiquinol
is the fully reduced state or the
un-oxidised form of coenzyme Q10,
which the human body can easily
use for energy.
Ubiquinol in its readily available
state also provides greater
antioxidant levels protecting cells
from free radical damage. Your
body must rst convert CoQ10 into
ubiquinol to use its full antioxidant
properties, which, as we age,
becomes more dicult for our
bodies to do.
When compared to conventional
CoQ10, ubiquinol is easier to absorb
into our systems, fully utilising its
antioxidant protection. In a healthy
adult, 95% or more of the total CoQ10
in the body is in the ubiquinol form.
How does ubiquinol works?
There are molecules in your
system with unpaired electrons
called free radicals. These free
radicals are unstable and search
out cells in your body to steal an
electron.
This causes damage to the
cell and is called oxidation.
Antioxidants have extra
electrons that they donate to
free radicals to neutralise them.
Ubiquinol is an antioxidant that
helps protect against oxidative
stress and free radical damage.
After ubiquinol donates an
electron, it turns into CoQ10.
Your body has a process
to recycle CoQ10 back into
ubiquinol, making it ready to go
back out and donate an electron
to another free radical.
This process happens in our
body 24 hours a day, seven days
a week. However, preliminary
studies have shown that
ubiquinol levels are signicantly
diminished with ageing.
Your body has CoQ10 in your
system but it is not in a form
that can go out and donate
electrons. Taking ubiquinol
supplements help to maintain
healthy levels of ubiquinol in
your body.
n This article is courtesy of
Vitamode Sdn Bhd.
Heart-y good rice
RICE, despite its popularity
among many consumers, has
high sugar content that can
affect heart health.
Excess sugar increases blood
pressure, bad cholesterol and
triglyceride (a type of fat found
in blood) levels. One bowl of rice
is equivalent to 10 teaspoons of
sugar and a teaspoon of sugar
contains approximately 16
calories.
The consumption of added
sugar can lead to the formation
of cavities in teeth, cause weight
gain and does little for ones
health as it lacks nutrients such
as bre, vitamins and minerals.
This realisation about the
effect of rice should compel
people to monitor their rice
intake.

Making rice healthier

The key lies in the way rice
is cooked to remove its sugar
content. To achieve this, the
researchers at Grayns Labs USA
Inc and Ascenteus Research
have developed the Grayns
Rice Cooker, which uses an
innovative technology to
remove sugar from rice with
its four-stage cooking process
known as RevoCook.
Rice is a carbohydrate and it
contains two starches amylose
and amylopectin. However, rice
is high in amylopectin and low
in amylase and this causes the
rapid rise of blood sugar levels.
People traditionally
cooked rice with lots of
water, which they threw
away to discard the
unhealthy starch that
dissolves in the water
during the cooking process.
This differs from the
typical rice cooker found
in most homes, which
cooks rice without
dissolving and
discarding the
unhealthy
starch, leaving
the sugar to be
consumed with
your bowl of rice.
This explains
the intense sleepiness one
experiences post-lunch as
The Grayns Rice Cooker removes
sugar from rice during the cooking
process, making it healthier to
consume.
Better diabetes control
T
HE primary objective of
managing diabetes is to
constantly maintain near-
normal blood sugar levels to
prevent diabetes complications
such as heart disease and kidney
disease.
Self-monitoring of blood
glucose (SMBG) is an important
part of managing diabetes.
It provides a timely reading
of blood glucose levels and
enables diabetes patients to safely
manage their condition, detect
hyperglycemia and hypoglycemia
and generate information for
adjusting medications, dietary
content and physical activities.
While it is already
acknowledged that proper use
of SMBG is associated with a
reduction of glycated hemoglobin
(HbA1c) as compared with those
not using SMBG, structured
testing could reduce HbA1c
more signicantly than random
performance of SMBG.
Structured testing is testing
during the right time, in the
right situation, and at the right
frequency enough to generate Self-monitoring of blood glucose is an important part of managing diabetes.
useful information to support
better decisions. After-meal
testing is one of the examples of
structured testing.
Blood sugar peaks occur mainly
after meals. The higher the level
of after-meal blood glucose, the
greater the risk of developing
serious heart diseases.
The recommended target value
for blood sugar level after meals is
less than 8mmol/L.
Testing blood sugar levels
after meals can not only help
identify episodes of after-meal
hyperglycemia, it also gives
feedback on how a particular
meal or food affects the blood
sugar level.
It helps to understand which
food may be the best for blood
sugar control.
Accu-Chek Performa Blood
Glucose Monitoring System
features easy-to-use tools that
help to simplify the management
of after-meal hyperglycemia.
Users can also set a reminder to
do post-meal testings.
Before- and after-meal marker
functions make it easier to
identify and compare values taken
before and after meals.
n For more information, visit
www.accu-chek.com.my
Timely reading
of blood glucose
levels enables
diabetes
patients to
safely manage
their condition.
sugar peaks prompt a ood
of insulin into the body,
shocking the body from a
state of hyperglycemia to
hypoglycemia.
Here is where Grayns Rice
Cooker positions itself as a
frontier in healthy rice cooking.
Similar to how our
forefathers traditionally cooked
rice, Grayns dissolves the
amylopectin in rice so that
consumers can enjoy their
favourite carbohydrate without
the sugar.
As a result, rice will have a
lower glycemic index (GI) and
this means you will not only be
full and energetic for longer but
rice will be made healthier for
consumption.
With Grayns, you will no
longer need to worry about
keeping rice as a staple part of
your diet at the expense of your
heart.
By removing sugar from
rice, Grayns Rice Cooker allows
you to enjoy rice the way our
forefathers have, keeping
it wholesome, hearty and
delicious, and good for your
heart.
call 1300 887 474 or visit
www.grayns.com
Wholegrains for wellness
D
IET plays a key role in
reducing your risk of
developing heart disease.
Wholegrains such as oat bran
and brown rice can be helpful
as consuming wholegrains may
reduce your cholesterol levels,
while the bre content may help
with weight loss.
Oat bran and brown rice both
retain the outer layers of the grain,
which improves their cholesterol-
lowering effects and nutritional
value.
In fact, the consumption of
wholegrain products and dietary
bre has been shown to reduce
the risk of high blood pressure and
heart attacks.
Start your day
with wholegrains
Having a bowl of oatmeal
or other wholegrain cereals for
breakfast can provide you with
all-day benets.
Wholegrains such as oats and
brown rice contain high levels of
bre and complex carbohydrates,
which will help you feel fuller for
longer, making you less likely to
overeat at lunch.
It also helps lower your LDL
(bad) cholesterol levels and can
help you lose weight.
Oatmeal and brown rice also
contain plenty of soluble bre,
which have been proven to lower
LDL cholesterol levels by reducing
the absorption of cholesterol into
the bloodstream.
A versatile ingredient
Despite knowing its heart
health benets, it is a challenge
for many Malaysians to have
oatmeal as a staple breakfast.
The good news is that
Kordels Active Oat 35 is neutral
in taste and the powder is white
or off-white in colour with a
smooth and ne texture, which
makes it easy to add to food and
drinks.
The versatility of Kordels
Active Oat 35 allows it to
be easily incorporated into
everyday meals.
glucan dissolves in water and
forms a thick gel in the digestive
tract.
This gel is able to bind to excess
cholesterol and cholesterol-like
substances in the gut and helps
prevent it from being absorbed by
the body. The gel and cholesterol
are then excreted as part of the
bodys waste.
Oat beta-glucan
and blood glucose levels
Oat beta-glucan has been well
documented to help control blood
glucose levels.
The carbohydrate found in
oat bran is highly recommended
as an energy source because it is
converted into glucose gradually.
This provides sustained energy
and greater control of blood
glucose levels. It is really good for
pre-diabetics who are trying to
lower their blood glucose levels.
Studies have also shown that oat
beta-glucan has benecial effects
on diabetes.
Patients with Type 2 diabetes
who were given oat beta-glucan
experienced smaller rises in blood
sugar levels compared to those
who were given other grains.
This information is brought to
you by an in-house pharmacist at
Cambert (M) Sdn. Bhd.
n For more information, call
1300 881 712, e-mail ask-kordels@
cambert.com.my or visit
www.kordels.com.my/activeoat35
cholesterol levels and reduce LDL
cholesterol levels.
Try consuming Kordels Active
Oat 35 before or after exercising to
provide you more energy for the
day.
Oat beta-glucan
and LDL cholesterol
Oats contain a form of soluble
bre called oat beta-glucan,
which is concentrated mostly in
the outer layers of the grain (oat
bran). Most of the research into
the cholesterol-lowering effects
of soluble bre has centred on oat
beta-glucan.
As a soluble bre, oat beta-
When losing
means winning
If you are overweight, getting
rid of the extra kilos is one of
the best things you can do to
help prevent heart disease and
reduce the chances of getting high
cholesterol, high blood pressure
and Type 2 diabetes.
All these conditions affect the
lining of your arteries, making
them more likely to collect plaque
from cholesterol.
A good combination of healthy
meals and exercise can help you
lose weight, raise HDL (good)
Kordels Active Oat 35 is versatile
enough to be incorporated into
everyday meals.
Having a bowl
of oatmeal or
other whole-
grain cereals for
breakfast can
provide you with
all-day benefits.
Wholegrains
such as oats
and brown rice
contain high
levels of fibre
and complex
carbohydrates.

Healthy Heart - 29 September 2014

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