The C, D and E Rules for Strong Bones

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Health Tips
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Early Detection Can Save Your Life
2
Regular Screening for Diabetics
3
Eat, Drink and be Merry
4
Jom Kita Makan, Minum dan Bergembira
5
6
Learn more about chronic diseases
and their management
7
Your Journey to Better Health
7
Upgrading Woodlands Polyclinic
7
Compliments
8
A newsletter for patients • Oct/Nov 2OO7
The C, D and E
Rules for Strong
What is osteoporosis?
Osteoporosis, also known as porous bones, is a
condition in which your bones become brittle and
weak. The consequences can be serious if you leave
the condition untreated. It can lead to fractures,
loss of ability to carry out daily routines e.g. walking,
bathing and feeding yourself.
With no early signs and symptoms, it is easy to
overlook this silent disease.
To build strong bones – follow these C, D and E
rules.
Take enough
Calcium
Bones
Food rich in calcium:
• Milk, cheese and yoghurt (low-fat versions are
recommended)
• Canned fish with bones, e.g. sardines and dried
‘ikan bilis’
• Beancurd, tofu and soya bean drink
• Dark green leafy vegetables, e.g. ‘kailan’, spinach,
‘chye sim’ and broccoli
You may need calcium supplements if your dietary
calcium is inadequate or if you have already been
diagnosed with osteoporosis. There are many types
of calcium supplements in the market. Talk to your
pharmacist to choose the most suitable supplement.
Calcium is mostly stored in the bones and your bone
mass will be reduced if you start losing calcium from
your bones. After the age of about 30 years, bone
is lost faster than it is built. It is important to take
enough calcium throughout your life to build and
maintain strong bones.
Common side effects:
• Bloatedness, intestinal gas
• Nausea
• Constipation (calcium citrate products reduce the
effect of constipation)
Category
Recommended
Daily Allowance for
Calcium (mg/day)
Recommended
Daily Allowance
for Vit. D (IU)
Before you start on Calcium supplements,
inform your pharmacist/doctor if you have/are:
7-9 years old
700
100
10-18 years old
1000
100
19-50 years old
800
100
> 50 years old
1000
100
Pregnant or
Breastfeeding
Women
1000
400
Source: Strong Bones For Life, Health Promotion Board
Article contributed by Ms See Yen Theng, NHG Pharmacy
MICA (P) 264/01/2007
• Allergies
If you are allergic to seafood, choose a calcium
supplement from vegetarian source instead of
one that is derived from shellfish.
• Certain medical conditions
E.g. kidney disease, kidney stones, heart disease,
difficulty absorbing nutrition from food
(malabsorption syndrome).
• Taking other medications
Eg. digoxin, cellulose, sodium phosphate, certain
phosphate binders (e.g. calcium acetate).
cont’d on page 2
page 1
Health Tips
cont’d from page 1
• Do not start, stop, or change the dosage of any
medicine before checking with your doctor or
pharmacist.
• Calcium can decrease the absorption of other
drugs such as certain antibiotics (doxycycline,
ciprofloxacin). Space your dosing at least 2 hours
apart.
Other Tips:
• Increase your fluid and fibre intake to reduce risk
of constipation
• Take your calcium tablet with meals to increase
its absorption
• Divide your intake of calcium to no more than
500 mg per dose to maximise absorption
• Do not exceed 2500 mg of calcium per day, either
from supplements or from food
Include Vitamin
D
Vitamin D helps in the absorption of calcium.
Sunshine is your best source of vitamin D, so get
at least 30 minutes of sunshine per day. However,
avoid the hottest period of the day (i.e. 11 am – 3
pm) to avoid the risk of getting sunburnt. Other
sources of vitamin D include fortified dairy products
and eggs.
Exercise for Healthy Bones
Weight-bearing and resistance exercises stimulate
bone growth, so exercise for 30 minutes a day for
5 or more days per week. Consult your doctor if
you have not been exercising or if you have any
underlying medical condition.
Examples of weight-bearing exercise are jogging,
dancing, ball games, and that of resistance exercise
are push-ups and weight lifting.
Besides building your bones, exercise also helps to
improve posture, balance and co-ordination.
Start now to build strong bones and reduce
your risk of osteoporosis!
Early Detection Can Save Your Life
Breast cancer is the most common cancer in
Singaporean women while cervical cancer ranks
fifth. Both of these cancers, if detected early, confer
a high chance of long-term survival.
BREAST CANCER CHECK AND PREVENTION
It is important for women to conduct monthly breast
self-examination (BSE) which helps in the early
detection of breast cancer.
The following are signs to look out for:
• skin changes over the breast
• changes in the appearance of the nipple
• nipple discharge
• abnormal breast lumps
Even if some of the above signs are detected, it
does not naturally mean that you have breast cancer.
It is therefore important that you see your doctor
immediately to get an assessment and, where
necessary, be referred to a specialist for further
investigation.
Mammography is an X-ray investigation of the
breasts to detect lumps that cannot be detected
through BSE. Women above 40 years of age may
join the BreastScreen Singapore national programme
that is available at all NHG Polyclinics (except at
Choa Chu Kang). Under this programme, female
Singaporeans and Permanent Residents may enjoy
a subsidised rate of $50 and $75 respectively for
mammograms performed at NHG Polyclinics.
It is advisable to conduct your mammography one
week after your menses, as your breasts will be
less tender and sensitive during that time. You
page 2
should also avoid putting perfume, deodorant,
powder or cream on your underarms or breasts as
these can affect the quality of the X-ray.
CERVICAL CANCER CHECK AND PREVENTION
Pap smear helps to detect cervical cancer at an early
stage. The National Health Survey (2004) revealed
that although four out of five women in Singapore
knew about the importance of a regular Pap smear,
only 52 per cent of women were being screened
regularly.
Women who have had sexual intercourse are advised
to undergo their first Pap smear by the age of 25
years. CervicalScreen Singapore is the national
cervical cancer-screening programme that
encourages women aged 25 to 69 to have Pap smear
once every three years. Female Singaporeans and
Permanent Residents may enjoy a subsidised rate
of $15 and $22.50 respectively for a Pap smear
performed in NHG Polyclinics.
For greater accuracy, you are encouraged to have
your Pap smear conducted 14 - 20 days after the
start of your menstrual period. It is also advisable
to avoid sexual intercourse and refrain from the use
of spermicides, vaginal creams, lubricants or vaginal
medications in the 48 hours preceding the test.
Breast and cervical cancer are preventable and
potentially curable diseases. Play your part in ensuring
healthy life for yourself.
Call 6355 3000 to make an appointment for
Mammography and Pap smear.
Article contributed by Ms Jancy Mathews, Health Promotion & Prevention Care
Health Tips
Regular Screening for Diabetics
Diabetes is a leading cause of blindness in Singapore and people with diabetes are 15 times more likely to
have a limb amputation. This is why, if you are diabetic, you should be careful about keeping your diabetes
under control or it could lead to complications.
Many diabetics are aware of these possible complications. However, they do not know that these complications
can be easily prevented or treated early through regular eye and foot screening.
EYE SCREENING
FOOT SCREENING
Eye screening for diabetes is known as Diabetic
Retinal Photography (DRP). During eye screening, a
photograph is taken of your retina. The retina is
located at the back of the eye and our ability to see
depends on it. DRP enables the doctor to pick up
microscopic abnormalities in the retina before they
start to affect the vision. Early diagnosis allows for
treatment or close follow-up by an ophthalmologist
(eye specialist). An appointment for Diabetic Retinal
Photography can be made at any polyclinic.
Trained nurses at the polyclinics also perform diabetic
foot screening yearly. Regular foot screening has
been shown to reduce the risk of amputations by
up to 85 percent.
Some diabetics think that there is no need for eye
screening if they have good vision. However, there
is usually significant damage to the retina by the
time vision is affected and the progressive loss of
vision is frequently irreversible at this stage.
Diabetes can affect the foot in the following ways:
• Decrease blood supply to the foot
• Damage nerves in the foot causing loss of
sensation (more prone to injury)
• Increase risk of infections from bacteria or fungi
• Increase risk of ulcer formation
If you have diabetes, you should go for eye screening
every year to prevent complications or treat them
early.
During foot screening, the feet are examined to
ensure that blood supply is adequate. The feet are
also tested for numbness and screened for infections.
Patients will also be taught appropriate footwear
and tips on foot care. Those who are found to have
early signs of diabetic feet complications will be
closely monitored and, in some cases, be referred
to a podiatrist.
Tips on Caring for the Eyes
Tips on Maintaining Healthy Feet
• Maintain good diabetes control
• Attend regular eye screening
• See a doctor immediately if you have problems
with your vision
• Check your feet daily. Look out for cuts or broken
skin. Clean any wound with antiseptic wash and
apply a sterile dressing. See a doctor if it does
not heal within two days.
• Keep your feet clean. Ensure that your feet are
dry after washing and apply some moisturiser if
the skin on your feet is too dry.
• Ensure that socks and shoes are not too tight.
Change socks daily.
• Maintain good diabetes control.
Article contributed by Dr Sabrina Wong, Bukit Batok Polyclinic
page 3
Health Tips
Eat, Drink and be Merry
It is the festive season once again, starting with Hari Raya Puasa in October and Deepavali in November.
By all means, eat, drink and be merry. With some knowledge and personal effort, you can still have all that
food without sending your cholesterol and blood sugar levels soaring.
Here are some tips on how you can tuck into your favourite dishes and
still keep your weight, blood pressure, cholesterol and glucose within healthy range.
Before Your Meal
• Check out the food & drinks spread before you decide on the type and amount of food you are going to eat.
• Drink one glass of plain water before you start eating.
Favourite
Food
Calorie
Content (kcal)
Chicken Briyani
1 plate - 877
Muruku
If you take half of your
regular portion (kcal)
Healthier
Alternatives
Calorie
Content (kcal)
1
/2 plate - 439
Tomato Rice
1 plate - 495
4 pieces - 440
2 pieces - 220
Love letters
2 rolls - 112
Pineapple Tart
4 tarts - 328
2 pieces - 164
Pineapple, fresh
1 slice - 30
Prawn Sambal
3 prawns - 192
2 prawns - 128
Prawn with Vegetable,
Stir Fried
3 prawns - 161
Bandong Drink
1 glass - 152
1
Diet Cola
1 can - 1
/2 glass - 76
During Your Meal
• Practise portion control. You can eat anything you
like – but in small portions.
• Remove poultry skin or the fat from meat.
• Try to have more vegetables, salads, beans or
legumes instead of meat – this will make you feel
full. Go easy on the salad dressing, though.
• Try fruits for dessert – remember you need two
servings of fruits a day.
• Instead of making food the focal point, use this
festive occasion as an opportunity to socialise with
your family and friends.
HEALTHY RECIPES
After Your Meal
• After you have had your fill, stay away from the
food table.
Cooking Method
• Heat olive oil in a pot. Add cinnamon sticks & star
anise.
• Add chopped onions, garlic & ginger paste. Stir
fry till light brown.
• Add the chopped tomatoes and continue to fry.
• Add the basmati rice & mix well.
• Finally add 41/2 cups of water in a rice cooker, pour
in rice mixture and coriander leaves. Cook as per
normal!
Other Useful Tips
• Don’t Forget Medication
Put your medicine into pillboxes
and bring them along with you.
You might not reach home on
time for your next dose.
It always pays to be prepared.
• Balance with Exercise
So you over-indulged? Instead of
feeling guilty or lousy, put on
those sports shoes and go for a walk!
Brisk walking for 30 minutes can
help you burn about 100 kcal
of extra energy.
Article contributed by Ms Sarah Shamila Sinaram, Dietitian
page 4
Healthy Tomato Rice (Serves 5)
Ingredients
• 4 cups of Basmati Rice
• 5 Tomatoes, finely chopped
• 2 tbsp of Olive Oil
• 1 tsp of Ginger & Garlic Paste
• 5 Shallot Onions, finely chopped
• 2x Cinnamon Stick
• 2x Star Anise
• 1 bunch of Coriander Leaves - chopped
• 41/2 cups of water
Mango Salad (Serves 5)
Ingredients
• Unripe Mangoes, 2 medium, grated into thin strips
• 1 medium Onion, finely sliced
• 2x Chilli Padi, finely sliced
• 1 small bunch of Coriander leaf,
finely chopped
• 3 tbsp of Lime Juice
• 1/2 tsp of Sugar
Cooking Method
• Mix all the ingredients
together for a yummy mango salad!
Recipes contributed by Ms Lydia George, a patient with NHG Polyclinics
Health Tips
Jom Kita Makan, Minum dan Bergembira
Musim perayaan telah tiba sekali lagi, bermula dengan hari Raya Puasa pada bulan Oktober dan Deepavali pada
bulan November.
Ayuh, marilah kita makan, minum dan bergembira. Dengan sedikit pengetahuan dan dengan usaha sendiri, anda
boleh mengambil semua makanan itu tanpa meningkatkan paras kolesterol dan gula dalam darah anda.
Berikut adalah petua-petua bagaimana anda boleh menikmati makanan kegemaran anda sambil mengekalkan
berat badan, tekanan darah, kolesterol dan glukosa anda dalam julat yang sihat.
Sebelum Menikmati Sajian
• Periksa dahulu hidangan makanan dan minuman sebelum anda menentukan jenis dan jumlah makanan
yang anda ingin makan.
• Minum segelas air kosong sebelum anda bermula makan.
Semasa Menikmati Sajian
• Amalkan sukatan dalam hidangan. Anda boleh makan apa yang anda suka – tetapi pastikan ia dalam sukatan
yang kecil.
Makanan
Kegemaran
Kandungan
Kalori (kkal)
Briyani Ayam
1 pinggan - 877
Jika anda mengambil separu
peruntukan biasa anda (kkal)
1/
2
pinggan- 439
Alternatif/Pilihan
yang lebih sihat
Kandungan
Kalori(kkal)
Nasi Tomato
1 pinggan - 495
Muruku
4 keping - 440
2 keping - 220
Kuih Sepit
2 keping - 112
Tart Nanas
4 keping - 328
2 keping - 164
Nanas segar
1 potongan - 30
Sambal Udang
3 ekor udang - 192
2 ekor udang - 128
Udang dengan Sayur,
goreng
3 ekor udang - 161
Sirap Bandung
1 gelas - 152
1/
2
Minuman Diet Cola
1 tin - 1
gelas - 76
• Buang kulit ayam atau lemak daripada daging
• Cuba lebihkan pengambilan sayur-sayuran, salad,
RESIPI YANG SIHAT
Selepas Menikmati Sajian
• Setelah anda ‘mengisi perut’, jauhkan diri daripada
meja makan.
Cara Memasak
kekacang daripada daging - ini akan membuat anda
rasa kenyang. Kurangkan sedikit penggunaan kuah
salad.
• Cuba mengambil buah-buahan sebagai pencuci mulut
(dessert) - ingat bahawa anda memerlukan dua
hidangan buah-buahan setiap hari.
• Jangan membuat makanan sebagai tumpuan utama,
sebaliknya gunakan masa perayaan ini sebagai suatu
peluang untuk bersosial dengan ahli-ahli keluarga
dan sahabat handai anda.
Petua-petua Lain yang Berguna
• Jangan Lupa Ubat Anda
Letakkan ubat anda dalam kotak
pil dan bawanya bersama anda.
Anda mungkin tidak sempat mehaambil
dos seterusnya sebelum sampai ke rumah.
Eloklah anda sentiasa bersedia.
• Imbangkan dengan Senaman
Jadi anda telah terlebih makan?
Usah berasa bersalah ayuh pakai
kasut sukan anda dan terus pergi
berjalan! Berjalan dengan pantas
selama 30 minit dapat membantu
membakar sekurang kurangnya 100
kcal tenaga yang berlebihan.
Article contributed by Ms Sarah Shamila Sinaram, Dietitian
Nasi Tomato yang Menyihatkan (Untuk 5 orang)
Bahan-bahan
• 4 cawan Beras Basmati
• 5 biji Tomato, dicencang halus
• 2 camca besar Minyak Zaitun
• 1 camca kecil pes Halia & Bawang Putih
• 5 butir Bawang Merah, dicencang halus
• 2x Kulit kayu Manis
• 2x Bunga Lawang
• 1 genggam Daun Ketumbar - dicencang
• 41/2 cawan air
• Panaskan minyak zaitun dalam periuk. Masukkan
kulit kayu manis & bunga lawang.
• Masukkan bawang yang dicencang, pes halia &
bawang putih. Goreng dan kacau sehingga warna
kekuningan.
• Masukkan tomato yang dicencang dan teruskan
menggoreng.
• Masukkan beras basmati & kacau sehingga rata.
• Akhirnya masukkan 41/2 cawan air dalam periuk nasi,
tuangkan campuran beras dan daun ketumbar. Masak
seperti biasa!
Salad mangga (Untuk 5 orang)
Bahan-bahan
• Mangga muda, 2 biji sederhana, diparut halus
• 1 biji bawang sederhana, dihiris halus
• 2x Cili Padi, dihiris halus
• 1 genggam daun Ketumbar, dicencang halus
• 3 camca besar Jus Limau nipis
• 1/2 camca kecil Gula
Cara Memasak
• Gaulkan semua bahan-bahan untuk menjadikan salad
mangga yang lazat!
Recipes contributed by Ms Lydia George, a patient with NHG Polyclinics
page 5
Health Tips
Article contributed by Ms Sarah Shamila Sinaram, Dietitian
page 6
Recipes contributed by Ms Lydia George, a patient with NHG Polyclinics
Health Tips
Your Journey to
Better Health
To help those suffering from medical conditions such
as diabetes and hypertension to stay healthy, NHG
Polyclinics introduces the Healthy Food Discovery
Journey programme, and the destination is - GOOD
HEALTH!
Learn more about chronic
diseases and their management
Catch “Livewise” – the new NHG docu-drama over
Channel 8 that started on 1 September. The eightpart series aims to raise awareness and knowledge
of chronic disease management that plague many
elderly Singaporeans.
This TV series is part of NHG’s ongoing efforts to
empower Singaporeans with information and tools
to live a healthier life. It is especially beneficial to
viewers with chronic diseases.
This is the first time a TV series on comprehensive
chronic disease is produced with a strong call-toaction message. At the end of each episode, viewers
are encouraged to call up an NHG hotline for a free
starter kit to help them get started on better
management of their disease conditions. This
programme features real case studies with hard
facts about the various chronic
diseases.
“Livewise” is sponsored by the
Singapore Totalisator Board and
Aviva, and supported by the
Ministry of Health. The series will
subsequently be dubbed in
English and broadcasted on
Channel 5 in February 2008.
Catch the next episode of “Lifewise” on Saturday,
9.30pm on Channel 8.
For these people, eating wisely is key to keeping
their medical conditions under control. However,
choice of food and deciding how much to eat can
be challenging and very often confusing. This
educational journey aims to help them and their
caregivers understand healthy eating and appreciate
the fact that healthy food need not be bland and
boring.
The journey begins with a health talk on specific
diseases such as diabetes and hypertension. This is
followed by an interactive tour to the supermarket
with a nurse educator. In the supermarket, the
nurse will point out the various types of healthy
food choices and teach participants how to read and
understand nutritional information on the food labels.
The participants will then sit down to a healthy lunch
that contains less salt, less sugar, low fat and more
vegetables (and is still very tasty!) at a food outlet
recommended by the Health Promotion Board.
Interested parties may call 6355 3000 to sign up
or for more information.
Article contributed by Ms Yeo Loo See, Nursing Services
Upgrading
Woodlands
Polyclinic
to serve you better
NHG Polyclinics is modernising its facilities to provide
better and more efficient service for its patients. In
line with this continuous effort, and with the successful
upgrading of Jurong Polyclinic, it will next close
Woodlands Polyclinic for major renovation and
upgrading with effect from 9 November 2007.
Woodlands Polyclinic
will reopen its doors
by 1 February 2008.
For enquiries,
please call 6355 3000.
page 7
Compliments
Bukit Batok Polyclinic
To: NM Oo Suat Lui
By: Ms Oh Geok Thoe
I was at Bukit Batok Polyclinic for my follow-up
appointment. As I shared with Suat Lui about my
personal diet, she took the time to study my diet
plan and explained to me the needs of a wellbalanced diet. She further offered to arrange an
appointment for me to meet the dietician. After the
meeting, Suat Lui called to remind me to make my
appointment with the dietician. I was impressed by
her excellent service and committed care.
Call Centre
To: CSO Jaya
By: Ms Daphne Khoo
I called the Call Centre to arrange for an earlier
appointment for my mom when I realised that her
medication was running out. As my mom was
concerned that this might disrupt her regularised
care, Jaya, who attended to my call, offered to get
a nurse to call us and address our concerns.
Subsequently Jaya called to ensure that the nurse
has replied us. I was impressed by her service.
Choa Chu Kang Polyclinic
To: PSA Ng Bee Lan
By: Ms Audra Yeo Lee Eng
I visited the dental clinic in Choa Chu Kang Polyclinic
and requested for Bee Lan to schedule my next
appointment as soon as possible, explaining to her
my reasons. She patiently scrolled through her
calendar to find me the earliest slot, and she did
this despite having to also attend to other patients.
This kind gesture of hers showed her sincerity and
commitment towards her job, and definitely made
my visit a more pleasant one.
Hougang Dental Clinic
To: Dr Bey Yee Hau
By: Mr Chan
Dr Bey was very patient as he gave me a thorough
explanation of the condition of my teeth and why
I had to go for an operation to extract my wisdom
tooth. He made sure that I was clear with the
diagnosis before giving me further advice. He also
demonstrated the proper way of flossing to keep
my teeth and gums healthy. His pleasant disposition
really made my day.
Hougang Polyclinic
To: Dr Lim Chee Kong and Dr Mary John
By: Ms Rebecca Lee
I visited Hougang Polyclinic and did an X-ray of my
foot. After that, Dr Lim contacted me personally to
explain to me the assessment of my X-ray result.
He gave me a clear and thorough explanation to
make sure that I fully understood the report. I really
appreciated his patience and effort.
I would also like to give thanks to Dr Mary John for
accommodating me by seeing me before the clinic
closed for lunch on a busy morning. Her
thoughtfulness saved me 2 hours of waiting.
Deeparaya Promotion
Chairperson
Dr Tung Yew Cheong, Woodlands Polyclinic
Editor
Ms Eleanor Toh, Corporate Communications, HQ
Members
Ms Jancy Mathews, Health Promotion & Preventive Care, HQ
Ms Pauline Ang, Singapore Footcare Centre
Ms See Yen Theng, NHG Pharmacy
The information produced is for reference and educational
purposes only. As each person’s medical condition is unique,
you should not rely on the information contained in this
newsletter as substitute for personal medical attention,
diagnosis or hands-on treatment. If you are concerned about
your health, please consult a healthcare professional.
Reproduction of the articles in whole or part without permission
is prohibited.
For advertising rates and enquiries, please call Ms Audrey Lee
at 64966696 or email [email protected]
page 8