Category Archives: Health

Saturated Fat Found Not Related to Heart Disease

Stuart Miles/

Stuart Miles/

A recent article from the Annals of Internal Medicine had found that saturated fat was not related to heart disease. That was after a BMJ article said roughly the same thing.

Almost all guidelines around the world still ask everyone to avoid saturated fat. Amazingly, even after all the recent data, the British Heart Foundation had no plans to alter the guidelines as yet.

This is a huge study looking at the relationship between both self-reported saturated fat and measured saturated fat, and risk of heart disease and stroke. No relationship was found.

A few other important observations of the study:

1. Omega-3 fatty acids (fat from fish) are good for you.

2. Trans-fatty acid (fat from margarine, biscuits and other baked products) are bad for you.

3. Fat from dairy products are good for you.

4. Arachidonic acid (omega-6 fatty acids from chicken, eggs and beef) are good for you.

The points about fish and trans-fat are probably not surprising to most of us. However, for too long we had been advising patients to avoid milk and egg. Those food are turning out to be really good for us!

What I usually advise my patients is to eat a Mediterranean diet, with lots of non-starchy vegetables, fish, nuts and olive oil. Milk and eggs are alright. Avoid sugar and refined white starch such as white bread and white rice.

But in view of the latest evidence, I would not say no to the chicken and the beef. Bon appetit!

8 Causes of Dry Skin & Solutions


Photo credit:  photostock/

Amazingly, medical journals only look at skin diseases, but have always overlooked the humble dry skin. It is however an extremely common problem that patients have. I was so happy when I found this article written by Dr Anneke Andriessen, a Consultant at UMC, St Radboud Nijmegen, Netherlands at the British Journal of Nursing, published in January 2013. That is an extremely comprehensive article, unfortunately not for public assess. So here are the causes:

1. Dry weather.

2. Central heating and air-conditioning.

3. Tight clothing.

4. Detergents, deodorant, soaps (especially anti-bacterial ones) that strip away the lipids and water from the skin.

5. Sun exposure.

6. Aging.

7. Zinc, essential fatty acid and vitamin D deficiency.

8. Diseases such as hypothyroidism (low thyroid levels), kidney failure, diabetes, HIV, skin diseases and nerve problems that decrease sweating.

Here are the solutions:

1. Consider an air humidifier indoor.

2. Use gentle washers such as those that are suitable for babies.

3. Use moisturizers generously.

4. Take a healthy and balanced diet. Zinc is available in many food. Essential fatty acids are the omega-3 and omega-6 that are rich in fish, nuts and oil olive, amongst others. A study done last year found that low vitamin D levels is associated with dry skin, and using a moisturizer enriched with vitamin D improves the situation. Milk and salmon are rich sources of vitamin D, and we can also make our own under sunlight. However, lack of vitamin D is common, 90% in winter in Switzerland (expected), but is actually worse in Singapore, a country in the equator. Singaporeans mostly work indoor and avoid the hot sun whenever possible.

The Art of Fast Food Eating


Since I have become an endocrinologist, I had mostly stopped eating fast food. However, I do indulge once in a while, because fast food tastes very nice. When my friend Ansgar and Moonlake asked me to try Jollibee, I gladly agree. My meal of 2-piece fried chicken consists of 2 juicy and tender fried chicken, a serving of rice, and sugar-sweetened lemon tea.

The chicken is the most tender one that I have ever eaten in my life.

How is one supposed to eat healthy given that fast food is so nice? Even writing the last paragraph evoked the joyous feeling of the crunchy skin, the tender and juice meat, and my “hmmm” feeling in my mouth!

It is well known that fast food eating increases obesity and the risk of diabetes.

There is only one defense. I did not eat the rice. A serving of rice has 80g of carbohydrates, or 320 Calories. By cutting the rice from the equation, I can have my sinful meal with slightly reduced “sin” level. The difference is huge. Each piece of fried chicken contains about 250 Calories, and the drink about 120 Calories. By cutting the rice, I took in only 620 Calories, and not 940 Calories.

The fact is, my basal metabolic rate is about 1900 Calories. That is the amount of energy that I burn. If I take 940 Calories for both lunch and dinner, even if I take a normal breakfast about 400 Calories, I would take a total of 2280 Calories. Where would the extra 380 Calories go? It would become part of me, probably at the waist level.

One can also choose to eat 2280 Calories, but in order not to lose weight, one would have to burn of 380 Calories. That is about 45 minutes of jogging or swimming. But most people in Singapore do not do that. In fact, the last Singapore Nutrition Survey showed that most Singaporeans take in more energy than they burn!

No wonder the rate of obesity and diabetes have shot up over the years. Fortunately, it can be prevented by simple choices and discipline in our daily lives.