Health legacy for the future

NUS Saw Swee Hock School of Public Health (SSHSPH) held a symposium on 2 November highlighting key findings from the Singapore Chinese Health Study (SCHS) — the first population-based cohort study to be established in Singapore — and paid tribute to founding principal investigator Dr Mimi Yu. The cohort study — one of the largest based in Asia — has provided significant findings in diverse areas such as cancer, diabetes, cardiovascular disease, musculoskeletal diseases and nutrition.

Initiated more than two decades ago, SCHS — currently helmed by Professor Koh Woon Puay from SSHSPH and Duke-NUS Medical School as Principal Investigator — saw the recruitment of 63,275 middle-aged and senior Chinese men and women between April 1993 and December 1998. 

In his welcome remarks, Professor Chia Kee Seng, SSHSPH Dean, said, “What I like about the cohort is that it is not only of great academic value, but the cohort also provided a lot of research findings that could be translated to public health applications and public health policies both for Singapore as well as for the region, as befitting our School’s mission of turning discovery into healthier communities.” 

Kicking off the symposium, Prof Koh shared that to date, 222 research papers resulting from the cohort study have been published or accepted for publication. Addressing the applicability of the study to other races, she said that the findings “will benefit all Singaporeans regardless of ethnicity as many of the risk and protective factors of disease are not modified by genetic differences among the different races”. Prof Koh and her team are now working on an ageing study involving individuals aged at least 85 years, conducted in collaboration with the Center for Supercentenarian Medical Research, Keio University.

SSHSPH Associate Professor Rob Martinus van Dam, who is also Domain Leader (Epidemiology) at the School, shared that by replacing one serving of rice with vegetables, fruits, white bread or whole wheat bread, one could lower the risk of contracting cardiovascular disease. Assoc Prof van Dam, who holds joint appointments at NUS Yong Loo Lin School of Medicine (NUS Medicine) and NUS Graduate School for Integrative Sciences and Engineering, also spoke about a study on indoor air pollution by incense conducted by Prof Koh and Professor Pan An, formerly from SSHSPH and currently with Tongji Medical College, highlighting it as an additional opportunity for prevention of the disease.

Assistant Professor Teng Gim Gee from NUS Medicine, together with her research team, found that contrary to popular belief, soy and legumes do not appear to increase the risk of gout. On the other hand, meat (such as poultry, fish and shellfish) is associated with an increased risk of gout. Their findings have had important implications on dietary advice proffered to gout patients and those at risk of the debilitating disease.

Prof Pan and Professor Yuan Jian Min from the University of Pittsburgh Cancer Institute also presented at the symposium.

At the event, Dr Yu was presented with the inaugural SSHSPH Distinguished Service Award for her immense contributions in setting up and managing the Study, to the extent of uprooting her family from the US and moving to Singapore with her two young children so that she could live among the people she was studying.

Dr Yu said shared that cohort studies were massive exercises involving large numbers of subjects, unlike case-control studies, many of which she had carried out prior to SCHS. “The better way to study disease etiology is what we call a cohort study; it’s a lot more difficult to put together but the value is a hundred times better…The value lasts not just a few years but as long as the cohort survives,” she explained.

Her co-founding principal investigator SSHSPH Emeritus Professor Lee Hin Peng, shared how he found the concept exciting when Dr Yu first approached him in 1989 to discuss the study. “It’s her passion, knowledge and capability which made me comfortable to accept the idea,” he said.

The event was attended by some 100 NUS faculty and researchers from overseas.