Prevention of Cardiovascular Disease

Heart health often takes a backseat in the hustle and bustle of everyday life. But here’s a friendly reminder: prioritising your well-being isn’t just an option—it’s a necessity. Let’s dive into key preventive measures for cardiovascular disease that every Singaporean should know about.

1. Adopt a Heart-Healthy Diet

A balanced diet is your first line of defence against heart disease (1). Include a variety of fruits, vegetables, whole grains, and lean proteins into your diet. Avoid foods rich in saturated fats, trans fats, cholesterol, and sodium. Choose heart-healthy fats such as those present in avocados, nuts, and olive oil.

2. Stay Active

Regular physical activity is crucial. Aim for at least 150 minutes of moderate-intensity exercise, such as brisk walking, each week (2). Exercise helps maintain a healthy weight, lowers blood pressure, and reduces stress.

3. Maintain a Healthy Weight

Excess weight, particularly around the abdomen, increases the risk of heart disease (3).  A balanced diet and consistent exercise will help to achieve and maintain a healthy weight.

4. Quit Smoking

Smoking is a significant risk factor for cardiovascular disease. Seek support from smoking cessation programmes or counselling to help you quit since it will significantly reduce the risk of cardiovascular problems (4).

5. Limit Alcohol Consumption

Excessive alcohol intake can lead to high blood pressure and other heart-related issues (5). Enjoy alcohol responsibly by consuming it in moderation.

6. Control Blood Sugar and Cholesterol Levels

Regular screenings can help you keep track of your blood sugar and cholesterol levels. Manage these through diet, exercise, and medications if necessary.

7. Manage Stress

Chronic stress can harm your heart. Use stress management practices such as mindfulness, meditation, and regular physical activity.

Common Questions About Heart Disease Risk

What are the main risk factors for heart disease?

The primary risk factors include smoking, diabetes, high cholesterol, physical inactivity, obesity, excessive alcohol consumption, and genetic predisposition (6).

Can heart disease be prevented if it runs in my family?

While genetic predisposition increases your risk, many lifestyle changes can significantly reduce your risk. A healthy diet, regular exercise, and avoiding smoking are key preventive measures (7).

How often should I get screened for heart disease?

It is recommended to have regular health screenings. Speak with your healthcare provider about the appropriate frequency based on your personal and family medical history (8).

Preventing cardiovascular disease involves adopting a healthy lifestyle, staying informed, and seeking regular medical advice. By making these changes, you can significantly reduce your risk and enjoy a healthier, longer life.

References

1. Diab, A., Dastmalchi, L. N., Gulati, M., & Michos, E. D. (2023). A Heart-Healthy Diet for Cardiovascular Disease Prevention: Where Are We Now? Vascular Health and Risk Management, 19(19), 237–253. https://doi.org/10.2147/VHRM.S379874
2. American Heart Association. (2024). American Heart Association recommendations for physical activity in adults and kids. American Heart Association. https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults
3. Obesity. (n.d.). British Heart Foundation. https://www.bhf.org.uk/informationsupport/risk-factors/obesity#:~:text=Excess%20weight%2C%20especially%20round%20your
4. Joseph, A. M., & Fu, S. S. (2003). Smoking Cessation for Patients with Cardiovascular Disease. American Journal of Cardiovascular Drugs, 3(5), 339–349. https://doi.org/10.2165/00129784-200303050-00005
5. Johns Hopkins Medicine. (n.d.). Alcohol and Heart Health: Separating Fact from Fiction. Www.hopkinsmedicine.org. https://www.hopkinsmedicine.org/health/wellness-and-prevention/alcohol-and-heart-health-separating-fact-from-fiction#:~:text=Excessive%20alcohol%20intake%20can%20lead
6. CDC. (2024, April 24). Heart Disease Risk Factors. Heart Disease. https://www.cdc.gov/heart-disease/risk-factors/index.html
7. Buttar, H. S., Li, T., & Ravi, N. (2005). Prevention of cardiovascular diseases: Role of exercise, dietary interventions, obesity and smoking cessation. Experimental and Clinical Cardiology, 10(4), 229–249. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716237/
8. American Heart Association. (2019, March 22). Heart-Health Screenings. Www.heart.org. https://www.heart.org/en/health-topics/consumer-healthcare/what-is-cardiovascular-disease/heart-health-screenings

Ways to Reduce Risk for Lung Cancer

Lung cancer remains one of the leading causes of cancer-related deaths globally (1). Despite its prevalence, lung cancer can be largely preventable. By understanding the risk factors and adopting preventive measures, individuals can significantly reduce their chances of developing this chronic disease.

Overview of the Risk for Lung Cancer

Lung cancer primarily affects the respiratory system, starting in the lungs and potentially spreading to other parts of the body. While smoking remains the most significant risk factor, non-smokers are not entirely immune. Other factors such as exposure to second-hand smoke, radon gas, asbestos, air pollution, and genetic predispositions also contribute to the risk.

Ways to Prevent Lung Cancer

1. Avoid Smoking

The most effective way to reduce the risk of lung cancer is to avoid smoking altogether (2). Cigarette smoke contains carcinogens that damage lung tissue, leading to cancer. For smokers, quitting can drastically reduce the risk. According to the World Health Organisation (WHO), the relative risk of lung cancer decreases steadily after smoking cessation, dropping to half after 10 to 15 years of cessation (3).

2. Minimise Exposure to Second-hand Smoke

Non-smokers exposed to second-hand smoke have a significantly higher chance of developing lung cancer. Second-hand smoke, or passive smoke, is a major risk factor for lung cancer among non-smokers, increasing the risk by about 20-30% (4). No amount of exposure to second-hand smoke is safe. Ensuring homes and vehicles are smoke-free can protect non-smokers from the harmful effects of tobacco smoke.

4. Avoid Exposure to Carcinogens at Work

Certain occupations expose workers to carcinogens such as asbestos, arsenic, and diesel exhaust (5). Ensuring proper safety measures, using protective equipment, and following safety protocols can significantly reduce the risk of lung cancer associated with occupational exposure. Employers are also mandated by law to provide a safe working environment, and employees should be proactive in adhering to safety guidelines.

5. Maintain a Healthy Diet

A diet rich in fruits and vegetables can help lower the risk of lung cancer. These foods contain antioxidants and phytochemicals that protect cells from damage. Studies have shown that a high intake of vegetables and fruits, particularly cruciferous vegetables like broccoli and cabbage, is associated with a reduced risk of lung cancer (6).

6. Reduce Air Pollution Exposure

Prolonged exposure to polluted air can increase the risk of lung cancer. Air pollution, particularly in highly polluted cities, has been identified as a significant risk factor for lung cancer. During periods of poor air quality, staying indoors, using air purifiers, and wearing masks can help reduce exposure to harmful pollutants. According to estimates from the World Health Organisation, air pollution causes over 4 million unnecessary deaths globally each year and Lung cancer is one of the primary causes (7).

Conclusion

Reducing the risk of lung cancer involves a combination of lifestyle changes, environmental awareness, and proactive health measures. By avoiding smoking, minimizing exposure to second-hand smoke and other carcinogens, maintaining a healthy diet and exercise routine, and being mindful of air quality, individuals can significantly lower their chances of developing lung cancer.

References

1. Barta, J. A., Powell, C. A., & Wisnivesky, J. P. (2019). Global Epidemiology of Lung Cancer. Annals of Global Health, 85(1). https://doi.org/10.5334/aogh.2419
2. Benefits of Reduced Smoking on Lung Cancer. (2024, February 9). Cancer.gov; Cancer.gov. https://dceg.cancer.gov/news-events/news/2024/reducing-smoking-lung-cancer#:~:text=A%20new%20analysis%20quantifies%20the
3. Faselis, C., Nations, J. A., Morgan, C. J., Antevil, J., Roseman, J. M., Zhang, S., … & Ahmed, A. (2022). Assessment of lung cancer risk among smokers for whom annual screening is not recommended. JAMA oncology, 8(10), 1428-1437. https://jamanetwork.com/journals/jamaoncology/fullarticle/2794805
4. CDC. (2022, November 28). Health problems caused by secondhand smoke. Www.cdc.gov; CDC. https://www.cdc.gov/tobacco/secondhand-smoke/health.html
5. Cani, M., Turco, F., Butticè, S., Vogl, U. M., Buttigliero, C., Novello, S., & Capelletto, E. (2023). How Does Environmental and Occupational Exposure Contribute to Carcinogenesis in Genitourinary and Lung Cancers? Cancers, 15(10), 2836. https://doi.org/10.3390/cancers15102836
6. Ağagündüz, D., Şahin, T. Ö., Yılmaz, B., Ekenci, K. D., Duyar Özer, Ş., & Capasso, R. (2022). Cruciferous Vegetables and Their Bioactive Metabolites: from Prevention to Novel Therapies of Colorectal Cancer. Evidence-Based Complementary and Alternative Medicine, 2022, 1–20. https://doi.org/10.1155/2022/1534083
7. Lung Cancer. (n.d.). www.singaporecancersociety.org.sg. https://www.singaporecancersociety.org.sg/learn-about-cancer/types-of-cancer/lung-cancer.html#risk-factors

Understanding Lung Cancer: What Every Singaporean Should Know

Lung cancer is a prevalent health concern in Singapore. Understanding its nature, types, and symptoms can empower you to take proactive steps for your health. This article provides a comprehensive overview of lung cancer, helping you stay informed and vigilant. 

Overview of Lung Cancer

Lung cancer often begins in the cell lining of the lung’s air passage. It is one of the most common cancers worldwide.

In Singapore, lung cancer has the highest mortality rate among males and the third highest among females. According to the Singapore Cancer Registry 2019 Annual Report, lung cancer made up 25.6% of cancer deaths in males and 15.5% of deaths in females in Singapore between 2015-2019(1)

Lung cancer had the second poorest survival rate for males 25.5% and the lowest survival rate for females 29.3%.(2)

While anyone can develop lung cancer, it is more prevalent among:

• Smokers : Smokers are 15-30 times more likely to get lung cancer.
• Individuals exposed to secondhand smoke: Secondhand smoke increases the risk by 20-30%.
• People exposed to pollutants and certain chemicals.

Types of Lung Cancer

Lung cancer is broadly classified into two main types:

1. Non-Small Cell Lung Cancer (NSCLC): This is the most common type, accounting for about 85% of cases. It includes subtypes such as adenocarcinoma, squamous cell carcinoma, and large cell carcinoma.
2. Small Cell Lung Cancer (SCLC): Less common but more aggressive, SCLC accounts for about 15% of cases. It tends to spread quickly and is often found in heavy smokers.(3)

There are also other types of cancer that may affect the lung.

Signs and Symptoms

Early detection of lung cancer can significantly improve treatment outcomes. Here are the common signs and symptoms to watch out for:

• Persistent Cough: A cough that doesn’t go away or gets worse over time.
• Chest Pain: Discomfort or pain in the chest that may worsen with deep breathing, coughing, or laughing.
• Shortness of Breath: Difficulty breathing or feeling winded with minimal exertion.
• Hoarseness: A change in voice or hoarse sound.
• Weight Loss: Unexplained loss of appetite and weight.
• Coughing Up Blood: Even a small amount of blood in the cough can be a sign of lung cancer.
• Fatigue: Persistent tiredness and lack of energy.

If you experience any of these symptoms, it is important to consult a healthcare professional promptly.

Stay informed and proactive about your health. Early detection and treatment can make a significant difference in managing lung cancer effectively. Seek medical advice without delay If you have any concerns.

Remember, your health is in your hands. Stay vigilant and take charge of your well-being!

References:

• What Is Lung Cancer – Health365.sg
• Singapore Lung Cancer Statistics – Health365.sg
• https://www.cancer.org/cancer/types/lung-cancer/about/what-is.html

Understanding Liver Cancer

Liver cancer is a significant health concern worldwide, with a particularly high incidence in Asia, including Singapore. As the primary filtration system for our blood, the liver plays a crucial role in maintaining overall health. Understanding the differences between liver cancer and liver disease is essential for early detection, effective treatment, and prevention.

Overview of Liver Cancer

Liver cancer, also called hepatic cancer, begins in the liver cells. The most common type is hepatocellular carcinoma (HCC), accounting for about 75% of all liver cancers. (1) Less common types include intrahepatic cholangiocarcinoma and hepatoblastoma.

According to the Singapore Cancer Registry, there were over 1,500 new cases of liver cancer diagnosed between 2015 and 2019.

Signs and Symptoms of Liver Cancer

Early detection of liver cancer can be challenging as the symptoms often do not appear until the disease is in an advanced stage. However, recognising the early signs is crucial for timely medical intervention. Common symptoms include:

• Unexplained Weight Loss: Sudden and unexplained weight loss is a common symptom. (2)
• Loss of Appetite: A noticeable decrease in appetite and feeling full after eating small amounts.
• Abdominal Pain and Swelling: Persistent pain or discomfort in the upper right side of the abdomen, which can sometimes spread to the back or shoulder.
• Nausea and Vomiting: Frequent episodes of nausea and vomiting.
• General Weakness and Fatigue: Persistent tiredness and weakness that does not improve with rest.
• Jaundice: Yellowing of the skin and eyes, indicating a liver problem.
• White, Chalky Stools: Changes in stool color can also be a sign. (3)

Risk Factors for Liver Cancer

Several behaviors and conditions increase the risk of developing liver cancer:

• Obesity: Being overweight or having obesity increases the risk.
• Diabetes: Having diabetes can increase the risk of liver cancer.
• Smoking: Cigarette smoking is linked to a higher risk of liver cancer.
• Alcohol Consumption: Drinking alcohol excessively can lead to liver damage and increase cancer risk.
• Hemochromatosis: This condition, where the body stores more iron than needed, can increase risk. (4)
• Chronic Hepatitis Infections: Long-term hepatitis B or hepatitis C virus infections are significant risk factors.
• Cirrhosis: This scarring of the liver, often caused by hepatitis or alcohol use, significantly raises cancer risk.
• Nonalcoholic Fatty Liver Disease (NAFLD): The presence of extra fat in the liver not caused by alcohol is a risk factor.
• Aflatoxin Exposure: Consuming foods contaminated with aflatoxins, a type of fungus that grows on improperly stored grains and nuts, is a risk factor. (5)

How Liver Cancer Differs from Liver Disease

Liver cancer is a specific malignancy within the broader category of liver diseases. While both can cause liver dysfunction, they differ in cause, progression, symptoms, diagnosis, and treatment. Liver cancer often arises from chronic infections (hepatitis B/C), cirrhosis, or excessive alcohol intake, and progresses rapidly, with symptoms like weight loss and jaundice appearing later. Conversely, liver disease encompasses a wider range of conditions like hepatitis, fatty liver disease, and genetic disorders, with variable progression and symptoms depending on the type. Diagnosing both may involve blood tests, imaging scans, and biopsies, but treatment differs significantly. Liver cancer treatment focuses on removing or destroying cancerous tissue (surgery, ablation), while liver disease treatment depends on the cause, ranging from antiviral medications (hepatitis) to lifestyle changes and potentially liver transplant (cirrhosis).

While liver cancer is a specific type of cancer affecting the liver cells, liver disease is a broader term encompassing various conditions that impair liver function. The primary differences between liver cancer and liver disease include their causes, progression, and treatment.

Prevention and Early Detection

Preventing liver cancer involves addressing the risk factors associated with liver disease. Key preventive measures include:

• Regular Screening: Individuals at high risk, such as those with chronic hepatitis or cirrhosis, should undergo regular screening for early detection of liver cancer.
• Healthy Lifestyle: Maintaining a healthy weight, limiting alcohol consumption, and avoiding exposure to aflatoxins can reduce the risk of liver disease and cancer.
• Safe Practices: Using clean needles, practicing safe sex, and ensuring blood products are tested can prevent hepatitis B and C infections.
• Vaccination: Hepatitis B vaccination helps protect against preventable chronic liver disease. (6)

References

1. Types of Liver Cancer: Common, Rare and More Varieties. (2018, October 5). Cancer Treatment Centers of America. https://www.cancercenter.com/cancer-types/liver-cancer/types  
2. Bhattacharya, R., Hwang, J. H., & Ko, C. (2020). The Patient with Unexplained Weight Loss. Yamada’s Handbook of Gastroenterology, 37.
3. Mayer, L., & Bhikha, R. (2014). Changes in Colours of the Body–the Determinants of Disease. skin, 1, 270.
4. Elmberg, M., Hultcrantz, R., Ekbom, A., Brandt, L., Olsson, S., Olsson, R., … & Askling, J. (2003). Cancer risk in patients with hereditary hemochromatosis and in their first-degree relatives. Gastroenterology, 125(6), 1733-1741.
5. Jackson, P. E., & Groopman, J. D. (1999). Aflatoxin and liver cancer. Best Practice & Research Clinical Gastroenterology, 13(4), 545-555.
6. Hepatitis B Foundation: Hepatitis B Vaccination. (n.d.). Www.hepb.org. https://www.hepb.org/prevention-and-diagnosis/vaccination/

What is Hepatitis A?

Hepatitis A is a vaccine-preventable liver infection caused by the hepatitis A virus (HAV) (1), typically spreads through contaminated food or water, or close contact with someone infected with the virus. (2)

In Singapore, historically, most reported cases of Hepatitis A stemmed from consuming contaminated raw or undercooked shellfish (3).

Due to improved sanitation and food safety measures, the incidence of Hepatitis A in Singapore has significantly declined. However, it’s still crucial to be aware of the risks, especially for travelers visiting regions with high HAV prevalence (4).

Symptoms of Hepatitis A

Hepatitis A symptoms may not always appear, especially in children. However, when present, they can include (5):

• Fatigue
• Loss of appetite
• Nausea and vomiting
• Abdominal pain or discomfort
• Fever
• Dark-colored urine
• Pale stools
• Jaundice (yellowing of the skin and whites of the eyes)

Preventing Hepatitis A with Immunisation

The best defense against Hepatitis A infection is vaccination. There are two main types of hepatitis A vaccines:

• Single-antigen vaccine: Protects solely against hepatitis A.
• Combination vaccine: Protects against both hepatitis A and hepatitis B, typically recommended for adults 18 years and older (6).

Protecting Yourself

Beyond vaccination, practicing good hygiene is essential to prevent Hepatitis A infection. This includes (7):

• Thorough hand washing with soap and water after using the toilet and before preparing food
• Drinking only treated or boiled water, particularly when traveling to regions with high HAV prevalence
• Consuming thoroughly cooked food, especially shellfish
• Avoiding close contact with individuals infected with Hepatitis A

By understanding the symptoms and importance of vaccination and good hygiene practices, you can effectively protect yourself from Hepatitis A. Talk to your doctor about getting vaccinated and discuss any concerns you might have.

References

1. NCI Thesaurus. (n.d.). Ncit.nci.nih.gov. Retrieved June 18, 2024, from https://ncit.nci.nih.gov/ncitbrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&ns=ncit&code=C3096
2. Fiore, Anthony E. (2004). Hepatitis A Transmitted by Food. Clinical Infectious Diseases, 38(5), 705–715. https://doi.org/10.1086/381671
3. Goh, K. T., Doraisingham, S., Monteiro, E. H., & Ling, A. E. (1987). Acute hepatitis A in Singapore: importance of shellfish ingestion in a non-epidemic period. Annals of the Academy of Medicine, Singapore, 16(4), 591–594.
4. Cao, G., Jing, W., Liu, J., & Liu, M. (2021). The global trends and regional differences in incidence and mortality of hepatitis A from 1990 to 2019 and implications for its prevention. Hepatology International, 15(5), 1068–1082. https://doi.org/10.1007/s12072-021-10232-4
5. World Health Organization. (2023, July 20). Hepatitis A. Who.int; World Health Organization: WHO. https://www.who.int/news-room/fact-sheets/detail/hepatitis-a
6. (2024, May 6). Hepatitis A Vaccine. Hepatitis A. https://www.cdc.gov/hepatitis-a/vaccination/index.html
7. Services, D. of H. & H. (n.d.). Hepatitis A. Www.betterhealth.vic.gov.au. https://www.betterhealth.vic.gov.au/node/1313

Heart Disease in Men

Heart disease is an umbrella term for several heart conditions, including coronary artery disease and heart attack. Let’s find out the signs and symptoms specific to men’s heart disease for early detection and treatment.

Signs and Symptoms of Heart Disease in Men

While some men might experience no symptoms at all, here are some common signs and symptoms of heart disease in men to be aware of:

• Chest pain or discomfort: This is often described as a squeezing, pressure, or tightness in the chest. It can also radiate to the shoulders, arms, jaw, neck, or back.
• Shortness of breath: This can occur at rest or during exertion.
• Pain in the arm, jaw, or shoulder: This pain can sometimes be mistaken for indigestion or heartburn.
• Fatigue: This can be a general feeling of tiredness or lack of energy and is occasionally a non-specific sign of heart problems.
• Dizziness or lightheadedness: This can be a sign that the heart is not pumping blood effectively to the brain.
• Sweating: This can be a sign of a heart attack, especially if it is accompanied by other symptoms.
• Swollen legs or ankles: This can be a sign of heart failure, a condition in which the heart is not able to pump blood effectively. The blood instead starts to pool.

Risk Factors for Heart Disease in Men

There are several factors that can raise a man’s risk of heart disease. Some of the most typical ones include:

• Age: As men get older, their risk of heart disease increases (1).
• High blood pressure: Uncontrolled high blood pressure can damage the heart and blood vessels.
• High cholesterol: High levels of LDL (bad) cholesterol and low levels of HDL (good) cholesterol can increase the buildup of plaque in the arteries.
• Diabetes: Diabetes can damage the heart, blood vessels, and nerves.
• Overweight and obesity: Carrying excess weight can put a strain on the heart.
• Smoking: Smoking damages the blood vessels and increases the risk of blood clots.
• Physical inactivity: A lack of exercise can increase the risk of heart disease.
• Unhealthy diet: A diet high in saturated fat, trans fat, cholesterol, sodium, and sugar can increase the risk of heart disease.
• Stress: Chronic stress can increase blood pressure and damage the heart (2).
• Sleep apnea: A sleep disorder that causes breathing to stop and start during sleep (3).

Ways to Take Care of Your Heart

The good news is that there are many ways to reduce their risk of heart disease and live a longer, healthier life:

• Maintain a healthy weight: Losing even a small amount of weight can improve heart health for overweight or obese individuals.
• Eat a healthy diet: Choose a diet that is low in saturated fat, trans fat, cholesterol, sodium, and sugar. Focus on plenty of fruits, vegetables, and whole grains.
• Get regular exercise: The American Heart Association recommends at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week (4).
• Quit smoking: Smoking is one of the leading causes of heart disease. The best thing you can do for your heart health is to stop smoking.
• Manage stress: Find healthy ways to cope with stress, such as exercise, relaxation techniques, or spending time with loved ones.
• Control your blood pressure: Have your blood pressure checked regularly and take medication as prescribed by your doctor.
• Control your cholesterol: Have your cholesterol levels checked regularly and take medication as prescribed by your doctor
• Get regular checkups: Schedule regular checkups with your doctor to monitor your blood pressure, cholesterol, and other risk factors for heart disease. Your heart health can be considerably improved by early detection and treatment.
• Limit alcohol consumption: Excessive alcohol consumption can increase your risk of heart disease. The Ministry of Health Singapore recommends that men limit their alcohol intake to two standard drinks per day (5).
• Get enough sleep: Aim for 7-8 hours of sleep each night. Sleep deprivation can be detrimental to your overall health and has been found to increase your risk of heart disease (6).
• Manage diabetes: If you have diabetes, it is important to manage your blood sugar levels carefully to reduce your risk of heart disease.
• See a doctor if you experience any symptoms: Don’t ignore any symptoms of heart disease and consult a doctor right away if you experience any of the symptoms mentioned above. Early diagnosis and treatment can make a big difference in your health outcome.

Heart disease is a serious health condition, but it is preventable. By making healthy lifestyle choices and managing your risk factors, you can significantly reduce your risk of developing heart disease. Don’t wait till you have a heart attack to take action. Start taking care of your heart today!

References

1. https://pubmed.ncbi.nlm.nih.gov/22499900/
2. https://link.springer.com/chapter/10.1007/978-1-4615-3712-0_9
3. https://pubmed.ncbi.nlm.nih.gov/11208620/
4. https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults
5. https://www.moh.gov.sg/news-highlights/details/alcohol-recommended-limits-and-public-education
6. https://pubmed.ncbi.nlm.nih.gov/29206050/