March 2015 - May 2015

MCI (P) 137/11/2014 fb.com/heartfoundationmyheart.org.sg twitter.com/heartSG Heart4Life

PREGNANCY &HEART DISEASE

03

PETS MAY HELP REDUCE YOUR RISK OF HEART DISEASE

孕妇及心脏病

05

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Official Publication of the Singapore Heart Foundation

PATRONESM Goh Chok Tong

NATIONAL HEART COUNCIL

PRESIDENTDr Richard Hu

VICE PRESIDENTSMr Sat Pal KhattarMr Lee Koon ChoyMr Shaw Vee Meng

CHAIRMAN EMERITUSDr Low Lip Ping

SHF 44TH

BOARD OF DIRECTORS

CHAIRMANProf Terrance Chua

VICE-CHAIRMENDr Tan Yong SengMs Tan Lee-Chew

HONORARY SECRETARYA/Prof Tan Huay Cheem

ASSISTANT HONORARYSECRETARYMr Goh Chiew Seng

HONORARY TREASURERMr Chong Chou Yuen

MEMBERSDr Chee Tek SiongMrs Elsie FohDr Goh Ping PingMdm Koh Teck SiewA/Prof Carolyn LamMrs Regina LeeA/Prof May LwinDr Mak Koon HouMr Peter SimDr C SivathasanMrs Tan-Wee Beng YanDr Wu Dar ChingMr Melvin Yap

SPECIAL ADVISORMr Tan Boon Chiang

HONORARY ADVISORSProf Koh Tian HaiMr Liak Teng LitMr Lim Soon HockA/Prof Lim Yean TengDr Lily NeoMr Tan Kin LianMr Wong Yew Meng

EDITORIAL COMMITTEE

EDITORMr Patrick Deroose

MEMBERSProf Terrance ChuaDr Chee Tek SiongDr C Sivathasan

SECRETARIATMr Vernon KangMs Stephanie HoMs Mabel Tang

heartline is a quarterly publication of the Singapore Heart Foundation.9 Bishan Place, #07-01 Junction 8 (Office Tower), Singapore 579837Tel: 6354 9340 • Fax: 6258 5240 • Email: info@heart.org.sg

The information provided in heartline is for educational purposes only. It should not be used for diagnosingor treating a heart problem or a disease, and should not be substituted for professional health care. Opinions expressed by contributors and advertisers do not necessarily reflect those of the SHF.The SHF does not endorse any products or services in heartline advertisements.

All rights reserved. Copyright is held by SHF.No portion of this publication can be reproduced without the permission of SHF.To advertise in heartline, please email info@heart.org.sg or call 6354 9340. Terms and conditions apply.

Want a copy of heartline delivered to your doorstep? Call 6354 9340 for a copy of the subscription form.

Designed by: Extent Communication Pte Ltd • Printed by: NPE Print Communications Pte Ltd

DEAR READERS,

Has your doctor ever advised you to reduce your intake of red meat and consume more fish instead? This sounded like a good piece of advice, back then. However last year , the Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA) in the USA, issued a revised draft on fish consumption that created a lot of confusion in the minds of many healthcare professionals. The report focused on the unhealthy effects of mercury present in certain type of fish, be it canned or fresh.

Adjunct Professor Philippe Grandjean at the Harvard School of Public Health, reminds us of the importance of a nutritious diet and to avoid toxic substances, such as mercury and pesticides. He also recommends that a varied diet should normally include fish for dinner twice a week, but to choose smaller fish low in the food chain.

On another note, do you remember your doctor telling you to keep your body mass index (BMI) within a certain range, mostly18 to 25? Everyone used to swear by those numbers. Over the past few years however, BMI has seemed to lose out in importance, as compared to waistline measurement. Fats may not weigh very much, but it certainly takes up a lot of space, especially around the waist area.

The above are two examples, illustrating that there is no such thing as exact science. Medical science is constantly evolving, progressing and pushing the boundaries. This may all seem very exciting and encouraging, but it also creates confusion. That is why, it is important to have an independent source of information that can process and validate the explosion of information and opinions, and put common sense in the maze of conflicting recommendations. The Singapore Heart Foundation has been doing this for many years - translating scientific developments related to the prevention of heart and vascular diseases, into layman terms for the Singaporean population to understand better.

I encourage you to read the two feature articles in this heartline issue as we discuss about pregnancy & heart disease, and the positive impact a pet can have on your heart. Read

them with a critical mind and provide us with your feedback. We want to know from you, our members, if heartline still meets your needs and expectations. Please email your comments to heartline@heart.org.sg or fax to 6258 5240.

We hope to hear from you soon and remember to Keep Calm and Go Red for Women!

Patrick Deroose

2 Editor’s Note

Feature 3 3Feature

PregnancyHeart Disease&

Pregnancy is a time of joyous anticipation and

fulfillment for most women, but it is also a time where the body has to undergo a spectrum of physiological adaptations to cope with the demands and rigours of pregnancy. These changes can act as an additional stress to the heart, especially in patients with underlying heart conditions - resulting in new or worsening symptoms during pregnancy.

CHANGES IN THE HEART AND BODY DURING PREGNANCYDuring pregnancy, the output from the heart increases by 30-40% and blood volume increases by 20-25%, resulting in increased blood flow to most of the body especially to the kidneys, skin and the womb. Blood pressure falls in early pregnancy and rises again in late pregnancy. Heart rate also increases gradually up to 32 weeks of pregnancy.

All these changes can affect pregnant women with underlying hear t conditions.

HEART CONDITIONS IN PREGNANCY • Coronary heart disease

Coronary heart disease is more prevalent in older pregnant women with underlying high blood pressure, diabetes, high cholesterol and history of smoking. The risk of heart attack in women is estimated at 1 in 10,000 and occurs more frequently in the 3rd trimester and in pregnant women older than 33 years of age. The increased in blood volume and output from the heart, coupled with additional hormonal changes and a higher

risk of clot formation, will contribute to the overall risk. Pregnant women with risk factors as mentioned above,

will require further evaluation if they develop

new onset chest pain during pregnancy. The medications

used for heart blockage in pregnant patients may also affect

the foetus and careful evaluation and consideration will have to be made for

each medication. Acute heart attack caused by blockage of the coronary arteries can still be

treated with balloon dilatation and stenting, but with a risk of radiation exposure to the foetus.

• Valvular heart disease (conditions affecting heart valves)There are 4 heart valves inside the heart (tricuspid, pulmonary, mitral and aortic). These valves may be stenosed (narrowed) and unable to open fully, or regurgitant (leaky) and unable to close competently. The normal physiological changes in pregnancy can exacerbate the valvular dysfunction. As a result, these patients can feel more breathless when walking or develop leg swelling during pregnancy. Most valvular lesions unless severe, are generally well tolerated during pregnancy and do not require any surgical or non-surgical intervention during pregnancy. These patients may however require a closer degree of monitoring by their cardiologist and obstetrician during their pregnancy and delivery.

Women of child-bearing age whose native valve is severely diseased requiring prosthetic valve replacement, are usually given a biological valve (animal tissue valve) rather than a metallic valve, as the latter requires taking lifelong blood thinning medication such as warfarin - which can cause foetal deformities and bleeding risk during pregnancy. In addition,

Article contributed by Dr Tan Ju Le

4 Feature

pregnancy increases the risk of clot formation, especially in the metal valves and this can severely affect the function of this type of valve.

• Cardiomyopathy (conditions of the heart muscle)Cardiomyopathy is a condition affecting the heart muscle. During pregnancy, the heart can become weak and enlarged. This condition is called peripartum cardiomyopathy and presents usually in the last month of pregnancy or up to 5 months post-delivery. The exact cause of this condition is uncertain, but it is certainly associated with pregnancy. The patient can present with breathlessness, heart failure and may require medication to remove excess fluid in the body (e.g. diuretics) and to strengthen the heart muscles. If the heart function does not recover after 6-12 months of medical treatment, the patient will be strongly advised against future pregnancy which may carry a risk to her life.

Sometimes, women born with hypertrophic cardiomyopathy (thick heart muscles) which is an inherited form of cardiomyopathy, may be first diagnosed during pregnancy as she becomes more breathless and symptomatic. The diagnosis is made with an echocardiogram (heart ultrasound) which is harmless to the foetus. The outcome of pregnancy in this group of patients depends on the thickness and function of the heart muscles and whether there is any obstruction to blood flow caused by the thickened heart muscles. As this type of cardiomyopathy is heritable, the foetus has a 50% chance of inheriting this condition and will have to be screened after birth.

• Congenital heart diseaseCongenital heart disease (CHD) is a collection of heart conditions present at birth. This can range from simple CHD such as hole in the

heart (atrial septal defect, ventricular septal defect) to moderately complex CHD such as Tetralogy of

Fallot (combination of heart defects resulting in patient being ‘blue’ or cyanosed) to the very complex

CHD (single heart chamber). Besides the underlying anatomy, the risk of pregnancy in women with CHD is

also dependent on their underlying heart function, whether there is cyanosis (mother is blue), the severity of the CHD

lesions, the presence of high lung pressure and whether there is associated heart rhythm problems. All women with congenital heart

defects should have a full heart assessment and frank discussion with their cardiologists, before contemplating pregnancy. Sometimes, the congenital heart defects may need to be repaired or palliated before the woman get pregnant, to improve the outcome of the mother and foetus during pregnancy.

MEDICATIONS DURING PREGNANCYMost heart medications are not licensed to be taken during pregnancy, as they can cross the placenta and affect the baby’s growth and development. Heart medications are sometimes necessary when the mother develops symptoms during pregnancy such as palpitations and heart rhythm disturbance, or high blood pressure during pregnancy. The benefits of these medications to the mother and the risks to the baby, will need to be carefully evaluated and discussed with the patient and her spouse before prescribing these medications.

CONCLUSIONPregnancy in women with heart disease may carry a higher risk depending on the type of heart defects and its underlying severity. Pregnancy itself results in changes in the body such as hormonal changes, expansion of blood volume, redistribution of blood flow, increased in heart rate and overall added demands to the heart. It is important for women with heart disease to understand their heart conditions and have their heart properly assessed, before they become pregnant to ensure an uneventful and successful pregnancy outcome.

Adjunct Assistant Professor Tan Ju Le is a Senior Consultant with the Department of Cardiology and Director, Adult Congenital Heart Disease at the National Heart Centre Singapore. For more information, please visit www.nhcs.com.sg.

Pregnancy in women with heart disease may carry a higher risk depending on the type of heart defects and its underlying severity.

A ccording to an American Heart Association scientific statement, having a pet might lower your risk of heart disease. “Pet ownership, particularly dog ownership, is probably associated with a decreased risk of heart disease” said Glenn N. Levine, M.D., Professor at Baylor College

of Medicine in Houston, Texas, and Chair of the Committee that wrote the statement after reviewing previous studies of the influence of pets.

Research shows that:• Dog ownership in particular may help reduce cardiovascular risk. People with dogs may engage

in more physical activity because they walk them. In a study of more than 5,200 adults, dog owners engaged in more walking and physical activity than non-dog owners, and were 54% more likely to get the recommended level of physical activity.

• Owning pets may be associated with lower blood pressure and cholesterol levels, and a lower incidence of obesity.

• Pets can have a positive effect on the body’s reactions to stress. Playing with a pet can elevate levels of serotonin and dopamine, which help to calm and relax oneself.

• Pet ownership is probably associated with a reduction in heart disease risk factors and increased survival among patients. But the studies are not definitive and do not necessarily prove that owning a pet directly causes a reduction in heart disease risk. “It may be simply that healthier people are the ones that have pets, not that having a pet actually leads to or causes reduction in cardiovascular risk,” Levine said.

He continued by saying, “In essence, data suggest that there probably is an association between pet ownership and decreased cardiovascular risk. What’s less clear is whether the act of adopting or acquiring a pet could lead to a reduction in cardiovascular risk in those with pre-existing disease. Further research, including better quality studies, is needed to more definitively answer this question.”

Even with a likely link between pet ownership and heart disease, one should not adopt, rescue or buy a pet solely to reduce cardiovascular risk, especially when you are unable to handle the demands of owning a pet. Instead, you may choose to walk your neighbour’s dog or volunteer at an animal shelter. It is of little use to own a pet and still continue with unhealthy habits. Hence, everyone is encouraged to lead a heart healthier lifestyle by exercising regularly, eating right, going for health screenings and stop smoking.

Pets may help reduce your risk of heart disease

5Feature

Join us at SHF’s very first Woof-a-thon on 12th April 2015! Visit www.myheart.org.sg for more information.

SOME WAYS PETS CAN HELP YOU MAKE HEALTHY LIFESTYLE CHANGES

• Increasing exercise: Exercise does not have to involve boring repetitions at a gym. Taking a dog for a walk or simply chasing a kitten around, are fun ways to fit healthy daily exercise into your schedule.

• Reducing anxiety: The companionship of an animal can offer comfort, help ease anxiety, and build up one’s self-confidence. Even watching fish in an aquarium can help reduce muscle tension and lower pulse rate.

• Adding structure and routine to your day: Many pets, especially dogs, require a regular feeding and exercise schedule. No matter your mood - depressed, anxious, or stressed - you will always have to get out of bed to feed, exercise, and care for your pet.

• Providing sensory stress relief: Touch and movement are two healthy ways to quickly manage stress. This could involve petting a cat or playing with a dog.

Sources: American Heart Association and Helpguide.org

6 特写

MDI15003_Heartline_HeartTruth4Size: 210(W)x297(H)mm-ISO39L 1

CYS CC15-006CC320364 GP4B 22.01.2015_175#Goodfellas

MDI15003_Heartline_210x297mm_HeartTruth4_FA_pth.ai 1 22/01/2015 21:21

77特写

MDI15003_Heartline_HeartTruth4Size: 210(W)x297(H)mm-ISO39L 1

CYS CC15-006CC320364 GP4B 22.01.2015_175#Goodfellas

MDI15003_Heartline_210x297mm_HeartTruth4_FA_pth.ai 1 22/01/2015 21:21

7Health Bites

High blood pressure, also known as hypertension, is one of the major risk factors for cardiovascular disease, which was one of the top 2 killers in Singapore in 2013. Past studies have shown that a diet high in sodium may increase one’s risk of developing high blood pressure, thus prompting a call from the World Health Organization for a 30% global salt reduction by the year 2025. However, researchers recently found out that “sugar may be much more meaningfully related to blood pressure than sodium, as suggested by a greater magnitude of effect with dietary manipulation.” In the 8 weeks (and more) trial, the study saw that a higher intake of sugar significantly increased the systolic (6.9 mmHg) and diastolic blood pressure (5.6 mmHg). In addition, those who had consumed 25% or more calories from added sugar, had an almost threefold increased risk of death due to cardiovascular disease. It is important to note that everyone, except those with specific and rare medical conditions or circumstances, should take in less than 1,500 mg of sodium a day.

Despite the many smoking cessation methods to help smokers ditch the cigarette for good, studies have shown that as many as 60% of them start smoking again in the first week. Recent research has suggested that a blood test could aid in choosing a feasible strategy, to give them the best chance of quitting smoking. A total of 1,240 participants received behavioural counselling, and were given either a nicotine patch, varenicline (a non-nicotine based drug) or treatment with a dummy pill. They were then accessed through blood tests, to determine if the nicotine in their bodies broke down at a normal or slow rate. Those whose nicotine broke down at a normal rate had a better chance of quitting by using varenicline, as compared to those who used the nicotine patches. At the end of the day, the key is to keep trying - but statistics show that people who try to quit unaided, have only a 4% chance of success in a year.

A large study assessed nearly 15,000 men and women in six categories – abstainers (those who did not consume alcohol at every visit by the researchers), former drinkers, people who drank up to 7 drinks a week, between 7-14 drinks, 14-21 drinks, and 21 or more drinks a week. Taking into account the various contributing factors such as age, health status, physical activity, body mass index and more - results showed that men who drank up to 7 drinks a week in early to middle age, were associated with a 20% lower risk of developing heart failure in the future, as compared to those who did not drink at all. Women had a more modest 16% reduced risk. This could be due to the fact that women metabolise alcohol in a different way as men, and it can affect them differently. However, it is important to note that the net risk-benefit balance varies with different age groups, populations and medical conditions.

More than salt, Blood test to help Drinking moderate amounts of

may contribute to high blood pressure

‘find best way to quit’ may lead to a reduced risk of heart failure

sugars smokers alcohol

Do you wish to receive heart health related news on a regular basis? Subscribe to our e-newsletter Heart Matters by emailing mabel@heart.org.sg with your name, email address and contact number.

To read more about Alcohol and the Heart, please scan the QR code.

9

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StreSS, Heart & HealtH Study recruitment drive 征询心脏病患者参与研究

The Stress, Heart & Health Study is a collaboration between the Singapore Heart Foundation and Nanyang Technological University (NTU). We are seeking individuals with heart disease, as well as their spouses or partners (optional) to participate in a one-year study.

Through the study, we hope to understand stress and related experiences in heart patients, and how this may affect their health and recovery over time.

此 项 研 究 是 由 新 加 坡 心 脏 基 金 和 南 洋 理 工 大

学 合 作 进 行 。 我 们 正 在 寻 找 心 脏 病 人 参 与 一

项 为 期 一 年 的 研 究 调 查 。

研 究 目 的 在 于 了 解 压 力 及 相 关 的 心 理 社 会 因

素（ 如 情 绪 、 社 会 支 持 、 自 信 心 等 ） 如 何 对

心 脏 病 人 的 健 康 及 生 活 品 质 所 造 成 的 影 响 。

WHO We are SeeKinG 谁 能 参 与 :

Individuals with heart disease of minimum age 21 years old, who are English or Mandarin speaking. You will be required to complete 3-5 questionnaires which will be conducted over a year, and provide related health information. If you are interested, please contact us to determine your eligibility. We also welcome your spouse or partner to participate in this study (optional).

凡 年 满 2 1 岁 、 已 被 诊 断 患 有 心 脏 病 的 个 人 。 在 参 与 此 研 究 ， 您 会 将 在 这 一 年 中 填 写

3 - 5 次 的 问 卷 和 提 供 有 关 的 健 康 资 料 。 我 们 也 欢 迎 您 的 配 偶 或 家 人 能 和 您 一 起 参 与 这

项 研 究 。 您 可 以 联 络 我 们 的 研 究 人 员 侦 讯 您 的 参 与 资 格 。

incentive 奖 励 :

As a token of appreciation for your time and effort, each participant will be given $10-25 for the completion of each questionnaire.

为 表 您 的 时 间 和 精 力 谢 意 ， 我 们 将 会 在 您 完 成 问 卷 后 , 给 予 每 个 参 与 者 1 0 - 2 5 元 。

For interested participants, please email healthpsy@ntu.edu.sg or call 84551057 for more information.

Alternatively, you may visit blogs.ntu.edu.sg/healthpsy/.如果您对这项研究有兴趣，请发电子邮件到 healthpsy@ntu.edu.sg

或是致电 8455-1057垂询。有关我们研究的更多信息，请浏站 blogs.ntu.edu.sg/healthpsy。

In support of Singapore Heart Foundation’s Go Red for Women campaign, $2 from the sale of each Red Velvet Large Jar or Large Tumbler candle (retailing at $41.90 each), will be donated to the SHF.

The funds raised will go toward increasing awareness of heart disease among women in Singapore, as well as help provide treatment for underprivileged women suffering from cardiovascular disease.

For Yankee Candle Singapore store locations, visit www.yankeecandle.com.sg.

Yankee Candle Singaporecelebrates Go Red for Women!

In support of:

13Go Red For Women 2015

14 Event Reviews

O n the 27th and 28th of November 2014, MediaCorp held a two-day lunchtime roadshow at its premises, to educate staff on heart health and spine wellness. With

regards to heart health, the roadshow aimed at creating awareness on cardiovascular disease (CVD), which can be prevented by taking good care of one’s heart and adopting good dietary & lifestyle habits.

As hypertension is one of the major risk factors for CVD, the Singapore Heart Foundation set up a booth to conduct blood pressure measurements. More than 200 employees came forward to take part and they also gained useful knowledge by participating in SHF’s interactive ‘Sandwich Game’.

Heart healthy lunchtime

A continuous wet spell almost caused the cancellation of a much anticipated heart healthy walk, organised and sponsored by the Mount Elizabeth Hospital. Fortunately,

the skies cleared just in time for a leisurely stroll on Sunday, 30th November 2014 at the iconic Singapore Botanic Gardens. There were a total of more than 50 participants, which included heart patients and staff from the Mount Elizabeth Orchard Hospital and the Singapore Heart Foundation (SHF).

At 8.30am, the walk kick-started with a mass warm-up session led by Ms Cindy Lim, SHF’s friendly resident physiotherapist. This was then followed by a treasure hunt, where participants were required to pick up jigsaw pieces along the walking trail, and the fastest teams to complete the entire jigsaw puzzle were rewarded with shopping vouchers, Tupperware sets, bottles of Manuka honey and other attractive prizes.

Next, the group settled down near the Shaw Foundation Symphony Stage, to have their picnic breakfast. Checkered blue picnic mats lined the green pastures with happy yet hungry participants tucking into the healthy breakfast bento boxes, specially prepared for the event. Each bento consisted of a gourmet low-fat tuna sandwich, yummy cookies, a bottle of mineral water and a juicy red apple.

As a remembrance of the morning’s activities, many participants had fun snapping selfies and wefies (aka group shots) against the beautiful country props, set up by the Organiser. They also went home with a goodie bag each and colourful balloons. As one participant summed up his feelings, “Exercise, healthy food and prizes... It can’t get any better than this!”

Heart Healthy Walk

A Fun Treasure Hunt with Mount Elizabeth Hospitals

15Event Reviews

O n behalf of our beneficiaries, the Singapore Heart Foundation (SHF) would like to thank General Insurance Association of Singapore (GIA) for selecting us as one

of the two beneficiaries for their GIA “Swing for Charity 2014”. We have received an amount of $64,500 and all proceeds will go towards SHF’s life-saving programmes, as well as help provide financial assistance to needy heart patients. Thank you GIA for your kind generosity, in working together with us towards a heart healthier nation!

FROM LEFT TO RIGHT: Mr Ronnie Yang, Executive Vice President, Business Development of Liberty Insurance Pte Ltd. Ms Jeslin Sin, Programmes Director of Singapore Heart Foundation. Mr A.K. Cher, President of General Insurance Association of Singapore. Mr Derek Teo, Executive Director of Insurance Association of Singapore.

Traditionally, the December year end period is a time which we all look forward to – a time of revelry, strengthening of family ties and rekindling the bonds of friendship through

all the gatherings and celebrations. This is also true for our Heart Wellness Centre (HWC) clients, who very much look forward to our Christmas party every year!

Many of our clients are true blue gourmets with discerning, refined palates and as such, they are also extremely good cooks. Without fail every year, they would bring along their signature dishes that have wowed their fellow HWC friends. To date, some of the dishes include suckling pig, roast turkey, Penang fried kway teow, durian crepes, ultimate chocolate cake and many more.

The programme this year showcased home-grown talents and our clients became singing sensations overnight. Mr Victor Chan, HWC’s ‘Elvis Presley’ belted out “The Wonder of You”. Mr Loganathan, a veteran community performer, gave a resounding rendition of a

SWING FOR CHARITY

CHRISTMAS CHEER WITH HWC CLIENTSTamil song. Mdm Lim Ah Siew, a 61-year-old grandmother of three, performed a Hokkien song that impressed the crowd. While Mr Roger Ravi, Mdm Gay and Ms Kathy Wong, our physiotherapist, formed a trio to sing the English and Mandarin versions of Frankie Laine’s hit song “Rose, Rose, I Love You”.

For the finale, Mdm Gay together with HWC staff - Ms Lauren Ho, Ms Jacqueline Leong and Ms Kathy Wong, danced to the 1960s getai song ‘欢乐今宵’ and got everyone else gyrating to the infectious beat of the song as well.

So who says that heart patients have to live very restricted and boring lives with no fun at all? This party has shown that our heart patients not only work hard to keep themselves healthy, but they also know how to play hard and in doing so, live enriching and fulfilling lives too.

SHF would like to say a big thank you to all our clients for their wonderful contributions and we look forward to the next memorable event!

16

Crossword Puzzle

Answers for

“Know Your Fats”

B U T

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D R O OG E N NA T iH Y

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9 Across:

4. Exposing cooking oils to air, heat and light cause them to oxidise and become .

6. Corn, soybean and sunflower oils are examples of this type of cooking oil.

7. Another term for “smoke point” that describes the temperature of a cooking oil, at which it will start to break down and give off smoke (two words).

9. This bread spread is high in saturated fat with a low smoke point.

10. This oil comprises approximately 50% saturated and 50% unsaturated fatty acids.

11. This manufacturing process turns liquid oil into a semi-solid fat, with a high trans fat content.

Down:

1. A method of extracting oils from fruit or seeds without the use of chemical solvents or high temperatures, thus preserving their flavour, aroma and nutritional value (two words).

2. “Good fats” contain the same amount of total fat and calories as “bad fats”, and it should not be consumed excessively, but in .

3. A source of trans fat.

5. Oil pressed from this fruit can be used for high-heat cooking, due to its high smoke point.

7. Reusing cooking oils can create these molecules that can damage the DNA of a cell (two words).

8. Fatty fish, such as salmon, is a good source of -3 fatty acids.

CONGRATULATIONS TO ALL WINNERS* & THANK YOU FOR YOUR PARTICIPATION!*Winners have been notified via phone or email.

The DIRECT DONOR DEBIT PROGRAMME (DDDP) is designed to encourage individuals to give small donations to SHF on a regular basis, for our life-saving

programmes. SHF would like to thank the following DDDP Event Site Sponsors, who have generously provided their venues for our various roadshows.

TOGETHER, WE CAN WORK TOWARDS A HEART HEALTHIER NATION!

Red: 100m, 100y, 10k Blue: 100c Yellow: 20m,100y

PP Type Option1/single 3/31/03 3:47 PM Page 1

C M Y CM MY CY CMY K

Blue = Pantone 286ProcessCyan = 100 %Magenta = 85 %Yellow = 0 %Black = 0 %

Green = Pantone 382ProcessCyan = 30 %Magenta = 0 %Yellow = 100 %Black = 0 %

MANAGED BY

16 Nutrition

(Dec 2014 - Feb 2015)

17Nutrition

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SmartsAcross:

2. size is the amount of food actually eatenat one time.

6. E numbers are codes for substances which canbe used as food .

7. One of the easiest ways to recognise sugar on afood label is by recognising the suffix.

8. It is best to avoid grocery shopping when youare , as you are likely to buy food items that are higher in calories.

10. The order in which ingredients are listed in theingredient list.

Complete the crossword puzzle with the correct

answers, and stand a chance to win 1 of 5 hampers

(worth more than 70) in our lucky draw!

Down:

1. You can use the Nutrition Information Panel to similar products, to select healthier options.

3. “High in fibre”, “low in sodium” and “cholesterol-free” are examples of nutrient .

4. Packaged food products with this logo are generally healthier options, as compared to regular ones without the logo (abbreviation).

5. A unit of energy; 4.184 = 1 kilocalorie.

9. size is the amount of food listed on a Nutrition Information Panel.

We wish to thank the following prize sponsors:

Lam Soon Singapore Pte Ltd, Captain Oats, Salba Singapore, HAP Nutrition Pte Ltd and iTrade Marketing.

Simply email/fax this page to heartline@heart.org.sg / 6258 5240 by 31 May 2015.

All winners will be notified via phone or email. Good luck!

Look out for the answers in the next issue of heartline or visit www.myheart.org.sg after 1 June 2015.

Name:

NRIC:

Email:

Mobile:

Hamper comprises of one 750ml bottle of Naturel Extra Virgin Olive Oil, one 500g packet of Naturel Organic Hom Mali Mixed Brown Rice & Red Rice, 1kg packet of Captain Oats, one bottle of Salba Chia Seeds, two bottles of HASBO Deep Ocean Water, two Korean real nano dual bristle toothbrushes and one imported pill box with 3 functional usages.

PRIZE!

孕妇及心脏病文章由陈茹意医生

怀孕对大多数妇女来说是个充满喜悦和期待的时段，但在这期间内孕妇的身体正经历生理适应，以应付怀孕所需求和严峻的考 验 。 尤 其 对 心 脏 患者，这些变化可增加心脏的负荷，造成新的或恶化的症状产生。

孕期的心脏和身体变化

在怀孕期间，心脏的输出量增加30%-40%而血容量也增加20-25%，从而增加血液流动至身体尤其是肾脏、皮肤和子宫。血压将会在怀孕初期下降而在后期再上升。心率也逐渐增加，到妊娠 32周。

所有这些变心脏疾病患有潜在高血压、糖尿病、高胆固醇与吸烟史的高龄孕妇通常也被诊断患有冠状动脉心脏疾病。每一万女性中估计一位将面临心脏病发作的风险，尤其是年龄超过33岁或在后妊娠期的孕妇。升高的血容量及心脏的输出量、再加上额外荷尔蒙的变化和风险较高的凝块形成将加重整体风险。孕妇如有所述的风险，若在孕期间感觉胸痛，将需要进一步的评估。由于患心脏堵塞的孕妇药物治疗可影响胎儿，因此十分需要谨慎评估。冠状动脉阻塞引起的急性心脏发作仍然可以用球囊扩张和支架植入治疗，但胎儿却面对辐射照射的风险。

• 心脏瓣膜病(影响心脏瓣膜的状况）

我们的心脏是由四个心脏瓣膜所组成的（三尖瓣、肺动脉瓣、二尖瓣及主动脉瓣）。这些阀门可狭窄而不能完全打开，或返流

（漏）导致无法胜任关闭。妊娠间的生理变化可加剧瓣膜功能异常，从而导致患者行走时呼吸困难或腿部肿胀。除非严重，

否则一般的瓣膜病在怀孕期间不需要任何手术

或非外科手术干预。然而这些病患者在怀孕和分娩期

间可能需要心脏科和产科医生的仔细监督。

需要人工瓣膜置换的育龄女性，是因为瓣膜遭遇严重疾病，而常得到的是生物瓣膜

（动物组织阀），而不是含金属的瓣膜。这是因为含金属的瓣膜需要患者服用终身血液稀释药物，如华法林，服用它可导致胎儿畸形和怀孕期间出血风险。此外，妊娠增加凝块形成的风险，尤其和含金属的瓣膜，这会严重影响它的功能。

• 心肌病（心脏肌肉的状况）

心肌病是指一个有关心脏肌肉的状况。在怀孕期间，心脏会扩大也会变得软弱。这种情况被称为围产期心肌病，通常发生在怀孕的最后个月或在分娩后长达5个月。造成这种确切原因还不确定，但它肯定是与怀孕有关。患者可能会经历呼吸困难，心脏衰竭甚至需要药物来清除体内多余的液体（如利尿剂），并加强心脏肌肉。如果过了6 – 12 个月后的医疗心脏功能却没康复的话，病人将被劝导避免再孕，因为这将对她带来生命危险。

有时天生肥厚型心肌病（厚心脏肌肉）是一些女性遗传而来。她在怀孕的期间确诊时会变得更加喘不过气及症状。诊断是用超声心动图（超声心脏），对胎儿无害。孕妇患者的预后取决于心脏肌

18 特写

19

肉的厚度和功能，及是否增稠心脏肌肉会阻碍血流。因为这种类型是遗传的，胎儿继承心肌病有50%的可能性，所以胎儿出生后就得进行体检。

• 先天性心脏疾病

先天性心脏疾病是在出生时集的心脏疾病。简单的先天性心脏疾病包括心脏有孔（房间隔缺损、室间隔缺损）、以中等复杂程度如法乐四联症（心脏缺陷造成患者变“青紫”或发绀）到非常复杂的疾病（如单腔心脏）。除了基本的构造，患有先天性心脏疾病的孕妇的风险也依赖于他们的心脏功能，是否有紫绀，冠心病的病变程度，高肺压力的存在和是否有相关的心律问题。患有先天性心脏缺陷的妇女在打算怀孕之前，都应该与心脏病专家有个完整的心脏评估和坦诚的讨论。有时候，为了改善母亲和胎儿在孕期间的情况，先天性心脏的缺陷需要在妇女怀孕之前修复或 缓解。

1919特写

陈茹意医生是新加坡国家心脏中心心内科的高级顾问医生。有关更多信息，请游览: www.nhcs.com.sg.

患有心脏疾病的孕妇面对的风险取决于心脏缺陷类型及其潜在的严重性

怀孕期间的药物

大多数心脏药物是不许可在怀孕期间服用，因为它可以通过胎盘影响胎儿的生长发育。但有时候心脏药物是必要的，尤其是当孕妇开始出现症状如心悸、心律紊乱、或妊娠期高血压。这些对母亲有好处的药物对胎儿却带着危险，所以在药物的处方前医生需要与患者和配偶进行仔细的评估。

结论

患有心脏疾病的孕妇面对的风险取决于心脏缺陷类型及其潜在的严重性。怀孕导致体内激素变化，扩充血容量，血流量的再分配，心率增加，和总体以心脏增加的需求。只有了解自己心脏的状况和接受适当的评估后，患有心脏疾病的妇女才能够确保平安无事的妊娠。

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根 据 美 国 心 脏 协 会 的 科 学 声 明 ， 养 宠 物 可 以 降 低 心 脏 病 的 风 险 。 在 休 斯 敦 德 克萨，及委员会主席贝勒医学院的教授，格伦菜文医学博士，在回顾以往后写的声明 <宠物的影响>，说：“养宠物，尤其是狗，可降低心脏病的风险”。

研究表明 :

• 由于狗主会带着狗散步，从事更多的体力活动，因此可有助于减少心血管疾病的危险。一个超过5200人的研究显示，养狗的人比非狗主从事更多的步行和体育活动，当中54%的狗主也比较容易达到体力活动的推荐量。

• 拥有宠物可与降低血压、胆固醇、和一个较低的肥胖率有关。• 宠 物 能 对 人 体 的 反 应 应 力 产 生 积 极 影 响 。 与 宠 物 玩 耍 可 提 高 羟 色 胺 和 多 巴

胺，导致平静和放松的身心。• 宠 物 主 可 与 心 脏 疾 病 的 降 低 率 有 关 ， 及 增 加 患 者 的 生 存 率 。 但 研 究 并 没 明

确显示拥有宠物和降低心脏病风险的直接联系。格伦博士也说：“不是说拥有宠物就会减少心血管疾病的风险。拥有宠物的人可能已经是常运动的健康 人士。”

他继续说：“在本质上，数据表明，宠物和降低心血管疾病的风险之间是可能有关。不清楚的是如果那些已经是心脏病的患者会不会因为领养宠物后而减低心血管 的 风 险 。 只 有 进 一 步 的 研 究 , 包 括 质 量 更 好 的 资 料 ， 才 能 够 更 明 确 地 回 答 这 个 问题。”

他继续说：“在本质上，数据表明，宠物和降低心血管疾病的风险之间是可能有关。不清楚的是如果那些已经是心脏病的患者会不会因为领养宠物后而减低心血管的风险。只有进一步的研究,包括质量更好的资料，才能够更明确地回答这个问题。”

宠物可以帮助减少 患心脏病的风险

一些与宠物的生活方式较健康的改变

• 增加锻炼 : 锻炼不必涉及在健身房枯燥的重复。一些有趣的方式如带狗散步或是追逐小猫都可以包括在日常锻炼的计划内。

• 减少焦虑 : 动物的陪伴可以提供舒适的环境, 有助于缓解焦虑, 并建立自信。即使是看着鱼儿水中游也可以帮助降低肌肉张力和脉冲率。

• 添加生活日常 : 很多宠物, 尤其是狗, 需要经常喂食和锻炼计划。不管您的心情如何, 您都得起床照顾宠物的健康和需求。

• 消除感官应力 : 触及和移动, 如抚摸小猫, 是两个快速处理压力的健康方式。

和我们一起在4月12日参与SHF首小狗步行筹款。询问详情，请游览www.myheart.org.sg。

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资料来源: 欸过心脏协会helpguide.org

特写

22 Recipes

with Unpolished Rice, Raisins & Walnuts

Baked Peppers Stuffed 以糙米，葡萄干和核桃酿烤灯笼椒

Recipe contributed by Ms Lauren Ho, Dietitian/Nutritionist at SHF. Modified from the Kitchen Culture Food & Travel Magazine, February 2014.本食谱由新加坡心脏基金（SHF）营养师何鳳女士。从厨房文化美食旅游杂志2014年2月版修改。

NUTRIENTS PER SERVING每 份 量 营 养 含 量

Energy 能量 320 kcal 千卡

Protein 蛋白质 6.5g 克

Fat 脂肪 13g 克

Carbohydrates 碳水化合物 46mg 毫克

Fibre 纤维 5g 克

Sodium 钠 305mg 毫克

METHOD 做法 :

1. Wash and cook the unpolished rice (1 cup of rice + 2 cups of water). Leave the cooked rice to cool. 把糙米洗净和煮熟（1杯米+2杯水）。将煮好的饭放置一边冷却。2. Preheat oven to 150˚C.

烤箱预热至150摄氏度。3. Combine all the stuffing ingredients in a bowl and mix well. Then, add

salt and pepper into the mixture.

将所有馅料放入碗中拌匀。然后, 加入盐和胡椒粉混合在一起。4. Stuff each pepper to the brim with the mixture.

以馅料填满灯笼椒。5. Bake the stuffed capsicums for 30 minutes, or until they

are cooked.

烘烤塞满的灯笼椒30分钟, 或直到煮熟。6. Finally, garnish with some mint leaves and serve.

最后, 饰以薄荷叶。 大功告成!

Preparation & Cooking Time: 40 minutes 准备及烹饪时间 : 40 分钟

Serves 份量 : 4 人份

Add minced lean meat, chicken or fish into the stuffing for a non-vegetarian option! 非素食主义者可以添加剁碎的瘦肉, 鸡肉或鱼成馅。

INGREDIENTS:

• Raw unpolished rice, 1 rice cup (120 g) • Raisins, 1

3 cup • Red & yellow capsicums,

4 medium (remove the top and de-seeded)• Red onions, 2 medium • Mint, ½ cup (chopped) • Unsalted dry roasted walnuts, 30 g (chopped) • Shitake mushrooms, 5 large (cubed) • Olive oil, 2 tablespoons • Salt, ½ teaspoon • Pepper, ½ teaspoon

材料:

• 原料糙米, 1杯米（120克） • 葡萄干, 1

3 杯• 红色和黄色的灯笼椒,

4粒中等大小（除去顶端和种子)• 红洋葱, 2 粒中等大小• 薄荷, ½杯（切碎）• 无盐干烤核桃仁, 30克（切碎）• 香菇, 5 粒大型（切块） • 橄榄油, ½汤匙 • 盐, ½茶匙

232323食谱

quick & easy

mushroom soup

Preparation & Cooking Time: 30 minutes 准备及烹饪时间 : 30分钟

Serves 份量: 4 人份

INGREDIENTS: 材料:

Shitake mushrooms, 1 packet (washed & sliced) 香菇, 1包（洗净切片）Onion, 1 medium (sliced) 洋葱, 1粒中等大小Flour, 1 tablespoon 面粉, 1汤匙Canola or corn oil, 1 tablespoon 菜籽油或玉米油, 1汤匙Skimmed milk powder, 1 cup 脱脂奶粉, 1杯Water, 4 cups 清, 4杯Salt, ¼ teaspoon 盐, ¼ 茶匙Black pepper, 1 teaspoon 黑胡椒, 1茶匙Coriander (cilantro) leaves, 1 handful 芫荽（香菜）叶, 1小撮

METHOD 做法 :

1. Heat the oil in a non-stick saucepan and fry the onion for 1 minute. 在不粘锅里, 热油1分钟炒洋葱。

2. Add mushrooms and stir for 3 minutes. 加入香菇, 搅拌3分钟。

3. In a bowl, combine the flour with skimmed milk powder and some water until well mixed, without lumps. 在碗里把面粉, 脱脂奶粉和一些水拌, 无肿块。

4. Add the flour and skimmed milk mixture to the saucepan. Stir to mix well, then add the rest of the water, salt and black pepper. Cook for a few minutes until the mixture boils. Turn off the heat and leave the soup to cool.

添加面粉和脱脂奶混入锅。 搅拌均匀, 然后加入剩余的水, 盐和黑胡椒。 煮几分钟, 直到混合物沸腾。 关火, 把汤放置一边冷却。

5. Once the soup has cooled, transfer half of it into a blender, and puree until well blended.

当汤冷却后, 转移一半放入搅拌机, 直到充分均匀。6. Repeat the process with the rest of the soup.

用其余的汤再重复此过程。7. Finally, garnish with some coriander leaves and serve.

最后, 洒上一些芫荽叶即成。

快速方便蘑菇汤

Recipe contributed by Ms Lauren Ho, Dietitan/Nutritionist at SHF.本食谱由新加坡心脏基金（SHF）营养师何鳳女士。

NUTRIENTS PER SERVING每 份 量 营 养 含 量

Energy 能量 131 kcal 千卡

Protein 蛋白质 9g 克

Fat 脂肪 4g 克

Carbohydrate 碳水化合物 17g 克

Fibre 纤维 2g 克

Calcium 钙 225mg 毫米

Sodium 钠 246mg 毫克