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Like Mother, Like Daughter

This Mother's Day, ask Mum these crucial questions - they'll help you spot diseases that run in your family

Ask Mum: Has Anyone In Our Family Had Breast Cancer?

If your mother had breast cancer, your risk can be at least 25 per cent. Also ask about women on your dad's side of the family. If you have several blood relatives on the same side of the family who have had breast cancer, or if an immediate family member was diagnosed at an early age, you could have inherited a fault in two genes - Breast Cancer Gene 1 (BRAC1) and Breast Cancer Gene 2 (BRAC2). This causes up to 10 per cent of cases. The genetic link is much stronger if a blood relative developed the disease before menopause. So, if your aunt got it before 40, it's a warning sign.

Beat The Odds

Cut Down On Alcohol: Alcohol may alter how the body uses the hormone oestrogen, so women who take two or more alcoholic drinks a day have a higher risk. If you drink, stick to one glass a day.

Stay Trim: A study from the Fred Hutchinson Cancer Research Center in Washington found that obese women (with a body mass index of over 31.1) had two-and-a-half times the risk of developing postmenopausal breast cancer compared to a woman with BMI under 22.6. So exercise for 30 minutes at least five times weekly.

Cut The Fat: Eating too much animal fat increases circulating oestrogen, that can stimulate tumor growth. The much-quoted Nurses Health Study II found women who ate the most animal fat had a 33 per cent higher risk of invasive breast cancer.

Foliate Boost: The health study also showed that women with high folic acid levels had a 27 per cent lower risk. So eat more leafy greens and strawberries, or take a multivitamin with 400 mcg of folic acid.

Ask Mum: Has Anyone In The Family Had A Heart Attack? At What Age?

Your chances of developing coronary heart disease rises if your clad had a heart attack before 55 or your mother did before 65. If you have a family history of premature heart disease, your risk almost doubles, so ask about your grandparents too. Plus, other risk factors for heart disease, such as diabetes, high blood pressure and high cholesterol, can be inherited.

Beat The Odds

Stub Out Your Cigarette: If you smoke, your risk doubles. Dr Irene  says, "In heavy smokers, heart disease risk is elevated four times. If you are also using oral contraceptives and smoking up to 15 cigarettes a day, your risk goes up three to five times." Quit now and you'll cut your risk by half within a year, and reverse all increased risk after 15 years.

Have A Heart-Healthy Diet: Dr Albert, Medical Director and Consultant Cardiologist, says, "The healthy diet for the heart is one low in simple carbohydrates, saturated fat and cholesterol." So eat less fatty meats, deep-fried foods, cakes and full-fat dairy products. Use mono- or poly-unsaturated fats and eat more fatty fish, fruits, vegetables and whole grains.

Keep Weight In Check: Excess weight makes your heart work harder. Dr Albert says, "It increases bad cholesterol and the chances of developing diabetes and high blood pressure." If you are overweight, losing about 4 kg can lower your risk of heart disease.

Get Screened Regularly: Diabetes, high blood cholesterol and high blood pressure all raise your risk of cardiovascular disease. Work with your doctor to keep these under control with lifestyle changes or medication.

Get Tested: Dr Albert says, "Many different tests can help check on your heart, like tests on lipid profile, fasting blood sugar level, blood pressure, body mass index, ankle brachial index (ABI) and C-reactive protein (a marker of inflammation in the blood vessels) levels." The ABI test, uses a doppler to measure the blood pressure at both the arm and leg. Dr Albert explains, "If the difference is more than 10 per cent, the patient is likely to have artery blockage. It is an inexpensive and non-invasive test but very useful in screening patients for heart disease and stroke."

Ask Mum: Do Any Of Our Family Members Have Diabetes?

In a healthy body, insulin transports blood sugar (or glucose) to the cells so that they can convert it to energy. But a person with type 2 diabetes either has a pancreas that fails to crank out enough insulin or the body just ignores it. So, even when blood sugar levels soar, the starving cells can't absorb the glucose. In the long run, the stress can damage the heart, kidneys, nerves and eyes.

The average woman has a 6 per cent risk of developing the disease. However, if one parent is affected, this risk rises to 20 per cent, and to 35 per cent if both parents have it. Your race is also a contributing factor. Dr Kevin, Consultant in Diabetes, Endocrinology and Internal Medicine, says, "Diabetes is most common in Indians (one in six adults) compared to Malays I one in nine adults) and Chinese (one in 14). So, it has something to do with one's race, as well as their genetic make-up.

Diabetes is all about having a family history, plus the unhealthy combination of a sedentary lifestyle and lots of high-calorie foods that add up to being overweight." Other factors such as having gestational diabetes, a super-size baby or polycystic ovarian syndrome, all of which come with insulin resistance, also increase the risk.

Beat The Odds

Get Moving: You can't change your race but you can certainly change your activity levels. Regular exercise increases your body's insulin, lowers blood sugar levels and can reduce diabetes risk by half. Brisk walking for 30 minutes daily and losing 5 to 7 per cent of your weight can slash your odds by almost 40 per cent.

Watch Your Weight: Dr Kelvin advises aiming for a normal body mass index (BMI). Eating healthily will also help you shed kilos. Some research has shown that cutting out white foods like white bread and white rice can reduce risk by almost 40 per cent

Get Screened: Testing every three years is recommended for all women, starting at age 45. But if you have a strong family history of the disease and/or are overweight, Dr Kelvin suggests having yearly blood sugar checks. He adds, "There are symptoms for diabetes such as weight loss, thirst, tiredness, and passing urine often. But most people don't experience them at all, so regular screening is important."

Ask Mum: Has Anyone In The Family Attempted Suicide Or Suffered Anxiety-Related Problems?

It has long been known that depressive illnesses can run in the family but it was unclear whether these are inherited or caused by one's environment. However, more recent research has shown that there is an inherited "vulnerability" to depressive illnesses, and studies show that some people are more likely to develop them than others.

Depression and anxiety are often caused by low levels of key brain chemicals such as serotonin, noradrenaline or dopamine. These "messengers" in the brain help to regulate mood, concentration, sleep, memory and appetite. Everyone has different "normal" levels of these chemicals, due to different inherited factor°s or genes.

If you have a parent or sibling who has had major depression, you are one-and-a-half to three times more likely to develop the condition than someone who has no family history. There's also a higher chance if a close relative has bipolar disorder (a depressive disease where the sufferer often goes back and forth between opposite extremes in mood).

About 50 per cent of those with bipolar disorder have a parent with a history of clinical depression. And when a parent has this disorder, their child has a 25 per cent chance of developing some type of clinical depression.

Beat The Odds

Know The Symptoms: Learn to distinguish feelings, thoughts and behaviors which are not normal. For example, feelings of not enjoying once-pleasurable activities, persistent thoughts about death, or suddenly withdrawing from most social or work activities, are all not normal. Other warning signs include low energy, sleep disturbances, appetite problems, feeling helpless or a drop in self-esteem. If these thoughts and feelings persist for several weeks, get yourself checked. 

Manage Stress: Tackle tasks one at a time. Multi-tasking can put more strain on your brain - so learn to delegate and say "no". Find simple ways to de-stress, such as taking a walk, meditating, deep breathing, or gentle exercises like yoga or tai ji. Having close friends is also useful as they'll act as buffers against depression, and give you an outlet to vent your anxieties.

Think Positive: Depression is often linked to a feeling of hopelessness and a pessimistic outlook. For a start, try to rephrase negative things you say to yourself. For example, instead of saying, "I'm such a failure", a more optimistic approach would be, "I seem to be coping well". Also, take credit for things that turn out well instead of always blaming yourself for the bad. Slowly, this cognitive therapy approach will help you change your mind-set.

Eat More Fatty Fishy: Research has shown that people in countries where consumption of essential fatty acids is high have a lower incidence of depression. Fatty fish not only seems to help prevent depression, some studies also show it may relieve depression and bipolar disorder. Get your omega-3 fatty acids from salmon and sardines or take a supplement.

More Questions For Mum

To help work out your family medical tree, ask Mum these other questions:

Did You Have Any Miscarriage?

Ask Mum whether she had any miscarriages, underweight babies (below 2.5kg), high blood pressure (pre-eclampsia) or gestational diabetes. If she had pre-eclampsia, or pregnancy-induced high blood pressure, your chances of getting it increases six times.

At What Age Did Your Period Stop?

If you mum went through menopause in her 30s, then there's a generic risk that you'll get it early too.

Did You Ever Suffer From An Eating Disorder?

According to studies, you are seven to 12 times more likely to suffer either anorexia or bulimia if your mother had an eating disorder when she was young.


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