Dr. Iain Corness

Is a little bit overweight dangerous? In a word - YES!

The western world has an epidemic of obesity, and guess what, the Asian world is rapidly following. Thirty years ago, it was rare to see an overweight Thai. Not any longer. What has happened?

Quite simply, our diets are far from healthy, and that includes both food and drink, especially the kinds of drinks that come in dark green or brown bottles. I am sure you know the types.

The problem here is the fact that being overweight puts a strain on the cardiovascular system, which sends the blood pressure up. That in turn affects all the organs and systems, and everything goes pear-shaped from there on, as well as your body shape.

You are entering the world of Syndrome X. Unfortunately Syndrome X, which is otherwise known as the Metabolic Syndrome, is a classic example of what we medicos call ‘co-morbidity’. This is the situation where one disease process or ailment affects, or “X”aggerates, another disease process you may have. In these situations, the combined effects can be life threatening. It is also a syndrome possessed by around 40 percent of adults over 40.

Now there can be many occasions when you have more than one ailment at one time. You can have a sore throat and a broken leg all at the same time, and these conditions have no real bearing on each other. The broken leg will get better and the sore throat ditto.

However, the combination of diabetes and obesity can be disaster waiting. The combination of diabetes, smoking, obesity, hypertension and high triglycerides (blood fats) is cardiac dynamite. Your conclusive heart attack is a matter of ‘when’ not ‘if’. The risk factors stemming from all those conditions become not a case of simple addition, but are multiplied.

The problem from your point of view is that most of these factors come on very slowly, and become part of your daily living. You’ve smoked for years and never had a smoker’s cough, so why stop now? Every time you get some trousers made the waistband has to be that little larger. Your belt has been let out two more holes over the past two years. Your doctor said you had a “Little bit of blood pressure” three years ago, but you haven’t been back to check, as you feel quite OK in yourself. Your ‘triglycerides’? “My what?” Your blood sugar? “It was OK last time it was checked five years ago!”

The big problem is that the “Little bit of blood pressure”, even say 150/100, can produce a very dangerous situation when the person with that BP has elevated blood sugar as well. Or smokes. It is the multiplication effect again. Whereas you can (almost) ignore mild elevations like 150/100, if you have nothing else wrong, ignoring it when there are other conditions co-existing brings up that co-morbidity problem again. And the likelihood of a cardiac calamity.

Likewise, a “little bit of extra weight” that we all excuse ourselves for carrying, may (just ‘may’) be fine for someone with no other medical conditions, but represents an enormous risk factor for someone with the Metabolic Syndrome.

For those who like figures with their information, here are some chilling ones. Between 87-100 percent of people with fatal coronary heart disease, or a non-fatal heart attack had at least one of the following risk factors - smoking, diabetes, increased blood fats and high blood pressure. Syndrome X, or the Metabolic Syndrome, is characterized by having Diabetes, increased blood pressure, and raised blood fats. Can you now see the importance of doing something about weight, blood fats and blood pressure? I for one would not like to be sitting with a condition that gives me between 87-100 percent chance of a cardiac problem.

So what is this week’s message? Quite simply, if you have diabetes, do something about the other risk factors. Stop smoking and get your BP and blood fats checked. If you don’t even know what your blood sugar level is, then get a check-up and find about all of it!

In the meantime, take 100 mg of aspirin each morning. It is cardio-protective. I do!

Wednesday, 25 March 2015 16:22

Malaysian GP this weekend

Sepang is the host for the second round of the 2015 F1 calendar. Will we have a repeat of the awful Australian Grand Prix, or will this be another year of different winners, such as we had in 2012?

Wednesday, 25 March 2015 16:21

Fuel cells is the way to go, says Lexus

Lexus chief backs fuel cells, not hybrid technology, as the propulsion of the future. The head of Lexus’s international division has taken a shot at plug-in hybrids as the company’s rivals go more towards that technology.

Wednesday, 25 March 2015 16:19

More madness

Koenigsegg Regera tops 1119 kW and 2000 Nm and accelerates to 400 km/h in 20sec.

The new Regera hybrid hypercar boasts a combined petrol-electric output of more than 1119 kW of power and 2000 Nm of torque, making it the “fastest accelerating, most powerful production car ever”.

The new car was displayed at the Geneva Motor Show, and just 80 examples of the Regera will be hand-built at the company’s Angelholm production facility in Sweden, but Koenigsegg said in a release that the number 80 also represents “the principle of domination, control and achievement in Pythagorean Numerology”. (These PR jocks leave me speechless at times!)

Krazy Koenigsegg RegeraKrazy Koenigsegg Regera

Koenigsegg’s twin-turbo aluminium 5.0 liter V8 powers the 1628 kg two-seater, pumping out 821kW and 1250 Nm.

Three YASA-developed electric motors - one 180 kW/260 Nm on each rear wheel and another 160 kW/300 Nm motor on the crankshaft - supplement the energy from the internal combustion engine and allows for torque vectoring, regenerative braking and “extreme” driver response.

According to Koenigsegg, the electric motors make up the “most powerful electrical motor set-up in production car history”.

A hybrid-specific transmission, invented by the founder and dubbed the Koenigsegg Direct Drive transmission (KDD), directs drive to the rear axle without the need for multiple gears, reducing drivetrain losses by up to 50 percent when compared with a regular automatic or continuously variable transmission (CVT).

A 9.27 kWh liquid-cooled battery pack feeds the motors that produce 520 kW/820 Nm. When paired with the internal combustion engine, the power tops out at more than 1119 kW and 2000 Nm.

The performance is staggering. Zero to 100 km/h in 2.8 seconds, 150-250 km/h takes 3.2 seconds, while 0-400 km/h is covered in less than 20 seconds. Top speed is said to be more than 450 km/h, making the Bugatti Veyron quite pedestrian by comparison.

The coupe can also be charged via a Type 2, mode 3 charging point, with the plug hiding behind the registration plate at the rear. It also offers 50 km of electric-only driving.

All body closures - including the doors, boot and bonnet and more - are automatic, a feat the company says is a world first.

Wheels and tyres are 19 inch front and 20 inch rear, and other standard gear includes power windows, adjustable pedals and steering column, leather interior, six-way electronically adjustable carbon sports seats, carbon ceramic brakes, tyre pressure monitoring system, leather interior, power folding wing mirrors and a titanium exhaust system.

No need to rush, there’s not too many in this market!

Wednesday, 25 March 2015 16:18

Tesla introduce the ‘Buy Back’ program

Tesla has introduced a finance plan for its Model S luxury sedan, which guarantees the resale value of its high-performance electric vehicles after three years.

The American car-maker is offering to buy back any Model S purchased under the Tesla Resale Value Guarantee program for at least half the price of a 60 kWh variant after 36 months. That is equivalent to leasing with a 50 percent residual after three years.

There are some catches (there always are) as the full guarantee value is only offered for vehicles that have covered fewer than 60,000 km and the Model S must have been financed for a repayment term of between 36 and 60 months.

In Australia, the guarantee is the result of a deal struck between Tesla and Australian finance provider Macquarie Leasing and offers a resale price “among the highest of any premium sedan made in volume.”

Tesla Australia spokesperson Heath Walker said the finance and guaranteed value package gives further peace of mind to Model S owners.

“Every car owner wants a fair and transparent financing program and an assurance that their car will retain its value,” he said. “Only Model S gives us the ability to combine that for them. I am proud that Tesla can offer Model S owners increased confidence in the value of their purchase.”

Wednesday, 25 March 2015 16:18

Autotrivia

Last week I noted that there was a very simple device stopping vehicles from running backwards, seen in vintage cars. The same principle is used today in automatic gearboxes. What was it called? It was called a “sprag”. Now that was more difficult for the googlers!

So to this week. An easy one, what did Lt. Zebulon Pike do when he got to the top of Pike’s Peak?

For the Automania free beer this week, be the first correct answer to email This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

The Eastern Seaboard networking was hosted by the Australian Chamber of Commerce in Thailand (AustCham) and held together with the American Chamber of Commerce in Thailand (AMCHAM), the British Chamber of Commerce Thailand (BCCT), the German-Thai of Commerce (GTTC) and the South African Chamber (SATCC).

The Amari’s Mantra restaurant was the venue for their latest wine dinner, overseen by the Amari’s new executive chef, native Italian Maurizio Susan, and featured wines from Australia, with the main vineyard being McGuigan.

Wednesday, 25 March 2015 12:37

Just in Time

It stands to reason. Early diagnosis improves the prognosis. A news item a couple of years ago claimed that if you lived in Taiwan you had a better chance of cancer survival, than if you lived in the UK. This was put down to the fact that your cancer diagnosis was done more quickly in Taiwan than it was in the UK.

If my mother’s experience of the UK National Health System was anything to go by, you will be lucky to live long enough for the diagnosis to be made. By the time you get given a specialist’s appointment and then wait for the test results and then see the specialist again after another wait. But, I suppose, if nothing else, it does help cut down the numbers on the waiting lists!

The message is simple - timely cancer diagnosis does improve your chances of survival. This is not really rocket science or some new breakthrough. If you leave battery acid on your shirt long enough, it will eat a hole in the fabric. If you leave cancer cells in your body long enough, they can eat so many good cells your life and living is compromised.

Unfortunately, the diagnosis of cancer is generally not made (or the diagnostic procedure even started) until the cancer produces some abnormal symptoms. Those abnormal symptoms are also not made by the cancer itself, but by the organs that have been attacked, or by the sheer physical size of the cancer causing physical problems. The cough from cancer of the lung is a good example of the first case, and constipation from cancer of the bowel is an example of the second type.

We are actually very lucky in Thailand, as there are several centers of excellence in the capital and in the provinces, and I include my own hospital, the Bangkok Hospital Pattaya in this.

Now when I say “centers of excellence” I am referring to the speed of diagnosis that is possible, not the treatments that are available. There are many factors that can influence that speed (the following table has been extracted from Jiwa et al, BMC Family Practice 2007 8:27):

1. Need to travel to clinics in the capital may have financial and logistical implications for the patient and therefore lead to procrastination.

2. Health professional, different gender of GP may deter some patients from presenting with embarrassing symptoms that require intimate examination for diagnosis.

3. Equivocal tests necessitate repeat visits to clinic.

4. Lack of coordination for individual patients’ needs may result in inconvenient scheduling of appointments.

5. Limited scope to obtain second opinions.

6. Access to specialists limited by distance from capital.

As you can see from the table, we are very lucky in Thailand, as the centers of excellence can easily cover the six factors. What is also not expressed in the six point table, is the speed of test result returns. Where we enjoy a one hour turnaround for blood tests, patients in the UK receive their results in days, not minutes. Similarly, our appointments for CT scans and MRI’s can be ‘same day’ with results usually the same.

So, timely diagnosis is very possible in this country, but unfortunately there are still instances of late diagnosis, but in the majority of cases this has occurred through ignoring the symptoms or ignorance of the importance of the symptoms. The simple advice is to never ignore any deviation from ‘normal’ in your body - after all, you know your body better than anyone else.

There is also a somewhat mistaken idea that your annual check-up will uncover hidden or early cancers, so you don’t have to do anything until next year. Certainly there are some cancers that are detected in this way, but whilst the annual check-up can discover many endocrine problems, blood problems and cardiac abnormalities, it is not going to uncover cancer in the brain, bones or skin, unless they are very advanced and causing symptoms.

Timely diagnosis does come back to your ability to inform your doctor of changes. Do not feel embarrassed that it “might be nothing”. All doctors prefer telling people that they do not have a problem after diagnostic testing, rather than the other way around!

Thursday, 19 March 2015 11:23

124 Spider from Maziat (or perhaps Fizda?)

The long awaited sports car from Alfa Romeo, built on the Mazda MX-5 platform, has gone through another name change. Now FIAT Chrysler Automobiles (FCA) has revealed that the new sports car will be sold as a Fiat and called the 124 Spider, resurrecting the name after 30 years. This was confirmed by FCA CEO Sergio Marchionne at the Geneva Motor Show.

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