Professional Documents
Culture Documents
ISBN 978-967-5737-05-3
Move More,
Fight
Obesity
Published by
Nutrition Society of Malaysia Malaysian Dietitians’ Association Malaysian Association for the
Study of Obesity
www.nutriweb.org.my www.dietitians.org.my
www.maso.org.my
Promoting
Healthy
Nationwide
Eating
Achievements of NMM (2002-2013)
Since its launch in 2002, Nutrition Month Malaysia (NMM) has been observed every April to promote greater
awareness of the practice of healthy eating habits among Malaysians. In this 11th year, NMM focuses on the
prevention of non-communicable diseases with the theme, “Eat Right, Be Active: Stay Free from Diet-Related
Diseases.”
Our nationwide campaign aims to promote greater awareness on healthy eating and active living as the foundation
for general good health and wellbeing. We also aim to inculcate healthy eating habits and encourage physical
activity from young, so as to improve the nutritional status of Malaysian families.
✪✪ P
ublished DVD
DVD
Untuk Kanak-Kanak Pra-sekolah (4-6 tahun)
Memupuk Gaya Pemakanan Sihat
• Bahagian 1: Makan Secara Sihat,
DVD Untuk Kanak-Kanak
Membesar Dengan
Pra-sekolah (4-6Kuat
tahun)
preschoolers
Kementerian Kesihatan Malaysia
2
Bahagian
onton DVD
as men
ini selep
kertas aktiviti
Gunakan
Mass Media
Promotions
✪✪ Disseminated
messages through radio, television &
website
Visit our website to obtain more information on educational materials from the Nutrition Month Malaysia
programme. We also welcome feedback/queries. To reach us, please contact:
Based on the National Health and Morbidity Survey (NHMS) from 1996 to 2011,
the obesity rate in Malaysia has increased by almost three and a half times, from
4.4% in 1996 to 15.1% in 2011. Meanwhile, the prevalence of overweight increased
29.4% in 2011, which means about 50% or 1 out of 2 Malaysian adults are either
overweight or obese.
In recognition of this growing problem, NMM has selected the theme of “Eat
Right, Move More: Fight Obesity”. This is to emphasise the importance of obesity
prevention as it is one of the major risk factors for non-communicable diseases
(NCDs). The promotion of healthy eating and being physically active should start
together with your family as this is the key to maintain a healthy body weight
and prevent diet-related diseases.
This guidebook explores the risk factors of obesity and provides practical
tips to achieve healthy body weight. You will also be able to learn now
ways to improve your diet and lifestyle, including how to use healthy and
delicious cooking methods. This guidebook also includes the importance
of physical activity in maintaining a healthy lifestyle. For individuals
who are overweight and obese, there is a section on weight loss to
guide you on how to lose weight safely.
Dr Tee E Siong,
Chairman of NMM Steering Committee
Nutrition Month Malaysia National
Content
Steering Committee
About Obesity
4 Dangers of Being Obese
CHAIRMAN 6 Achieving Healthy Weight for Life
Dr Tee E Siong
8 Physical Activities Required to Burn Calories from
Food
MEMBERS
Nutrition Society of Malaysia:
Eat Right
9 3 Keys of Eating Right: B-M-V (Balance-Moderation-
Variety)
10 Balance & Variety with the Power of 5
12 Keep Portions in Moderation
Assoc. Prof Dr Dr Mahenderan 14 Putting B-M-V into Practice!
Zaitun Yassin Appukutty
16 Figuring Out Food Labels
Malaysian Dietitians’ Association: 18 Eating Right Wherever You Are!
20 Cook Up Healthy Meals
Move More
22 Get Up, Be Fit For Your Health
23 Use the Physical Activity Pyramid to Get You Active
Prof Winnie Chee Mr Ng Kar Foo
Weight Monitoring
Malaysian Association for
the Study of Obesity: 26 Assess Your Weight Status
Weight Loss
Prof Dr Norimah Dr Zawiah Hashim
A Karim 32 Lose Weight Safely
34 Healthy Diet to Lose Weight
Disclaimer
36 Be Physically Active
This book is not in any way intended to substitute medical
advice from your doctor or health professionals. When in 38 Questions and Answers:
doubt, please consult your doctor. The Nutrition Society of
Malaysia (NSM), Malaysian Dietitians’ Association (MDA) and
Weight Loss Guide
the Malaysian Association for the Study of Obesity (MASO) are
not liable for any issue arising from the use of this book.
NSM, MDA and MASO do not endorse any products and are
not responsible for any claims made in the advertisements.
Intellectual property is vested in the Nutrition Month Malaysia
(NMM) programme. No part of this book shall be reprinted
without the written permission of the National Steering
Committee of NMM.
Copyright reserved © Nutrition Month Malaysia (NMM) 2014.
Secretariat
(263773-W)
12A, Jalan PJS 8/4, Mentari Plaza, Bandar Sunway,
46150 Petaling Jaya
Tel: 03-5632 3301 Fax: 03-5638 9909
Email: versahealth@versa-group.com
cknowledgement
Nutrition Month Malaysia, NMM is managed and implemented by professional bodies
and supported by the private sector. The initiative reflects the spirit of partnership that is
essential to facilitate the dissemination of appropriate nutrition information to the general
public for the wellbeing of all.
We would like to thank the following organizations for contributing towards the successful
implementation of NMM activities for 2014.
Co-sponsors
Media partners
We also place on record our sincere appreciation to the mass media of Malaysia for helping
us to disseminate the message of healthy eating across the nation.
About Obesity
Dangers
of Being
Obese
Being overweight or obese means having a body
weight that is greater than what is considered a
healthy weight range for a given height. It results
from excessive fat accumulating in your body.
Obesity is a life-threatening condition that can
negatively affect practically all aspects of your
health in the long run.
THROAT BRAIN
Excess tissue restricts airways, Obese children have higher rates of
which can cause sleep apnea, depression, negative body image and
in which breathing stops low self-esteem
periodically
HEART
LIVER Cholesterol build up can thicken
Cholesterol build up can artery walls, restrict blood flow
thicken artery walls, restrict and increase the risk of diseases
blood flow and increase the risk and stroke
of heart disease and stroke
|6|
Body mass index (BMI) is an index of weight-for-height
that is used to categorise overweight and obesity in adults.
An adult with a BMI between 25 and 29.9 is overweight while
BMI of 30 or higher is obese.
*refer page 28 to calculate your BMI
|7|
About Obesity
Achieving
Healthy
Weight
for Life
Your food choices and the level of physical activity you engage in
daily, play an important role in helping you to maintain a healthy body
weight. The energy that you expend through your daily activities has to
equal the energy that you consume as calories. If your energy use and
energy consumption are equal, then you are in “energy balance”.
Striking a Balance
To keep a healthy weight, you need to
understand the principles of energy
balance. This means, you must maintain a
balance between the energy derived from
the food you eat, and the energy you use
through physical activity.
|8|
Energy
IMBALANCED
If your daily food intake is regularly too low If your daily food intake regularly exceeds
and you are very active physically, you will the amount of physical activity you do, you
lose weight. Being underweight can affect your will gain weight and become overweight
overall health by causing problems such as and obese. This brings about increased
muscle atrophy, weakened immunity, inability to risk to serious health problems i.e. non-
concentrate and eventually organ failure. communicable diseases such as diabetes,
cardiovascular diseases and cancers.
Understanding this basic principle is the first step towards maintaining a healthy weight.
Next, you’ll need to watch your food intake by eating right, in accordance with
the Malaysian food pyramid.
4
Category Energy requirement
per day (in calories)
• Sedentary women 1500 kcal
• Older adult
• Most children 2000 kcal
• Teenage girls Golden Keys to Maintaining a
• Moderately active women Healthy Weight
1
• Sedentary men Follow the principle of Balance,
• Teenage boys 2500 kcal Moderation and Variety (B-M-V)
• Active men from the Malaysian food pyramid
2
• Very active women
• Underweight men & women Make healthier food choices
3
• Pregnant women Plus additional 400 kcal
daily from 2nd trimester Engage in physical activity
4
onwards
Monitor your weight regularly to
• Breastfeeding women Plus additional 500 kcal keep it within a healthy range
daily if breastfeeding
|9|
Physical
About Obesity
Activities
Required
to Burn Calories
from Food
One way to know if you are balancing your energy intake and expenditure is to be mindful of the
calories in your food. Below are some examples of common foods and the equivalent physical
activities needed to expend this energy.
Tips to c Keep your calorie limit in mind when deciding what to eat and drink.
balance c Keep track of what you eat in a food diary to avoid unconscious
energy in overeating
real life c Go for an activity that is easily achievable, like walking around your
neighbourhood after eating
c After having heavy meals, walk or use the staircase as much as you can
c Think twice before you order your dessert
c If you eat high calorie foods (e.g. fried chicken) for lunch, choose a
lower calorie option for dinner (e.g. steamed fish)
| 10 |
3 Keys to
Healthy Eating
Eating Right:
B-M-V (Balance-Moderation-Variety)
The first step to maintain a healthy Malaysian Fat, oil, sugar and salt
weight is to eat right. Practise eating Eat less
B
1. Balance
M
2. Moderation
V
3. Variety
To eat a balanced meal, Eat the right amounts of foods Consume different types of
your diet should contain by observing the number of foods from each food group
a combination of foods servings recommended for so that you get all the different
from all the food groups each food group. This will help nutrients that your body needs.
in the Pyramid. you maintain a healthy weight No one food contains all the
and optimize your body’s nutrients our body needs.
metabolic process.
| 11 |
Balance and Varie
Makan Secara Sihat
Each food group in the Food Pyramid has different functions and
benefits. You can achieve balance in your diet by consuming food
Balanced and Varied from all five food groups during main meals at the recommended
diets are keys to number of servings. As no single food can provide you with all
obtaining all the the nutrients you need, you should select various types of foods
from each food group in order to achieve variety and increase
essential nutrients your chances of consuming a multitude of nutrients and other food
your body needs. components.
Group 1:
Group 2: Group 3:
Grains and grain-
Vegetables Fruits
based products
Benefits: Benefits: Benefits:
* Great sources of * Wonderful sources of fibre, * Wonderful sources of
energy, B vitamins, phytonutrients, vitamins and fibre phytonutrients,
minerals and dietary minerals vitamins and minerals
fibre. * Help to boost the immune * Help to boost the
* Eat whole grain system, support normal growth immune system, support
products as they and development and help cells normal growth and
contain higher dietary and organs to function well development, and help
fibre, vitamins and Sources: Green leafy veggies cells and organs to
minerals (kangkung, spinach), root function well
Sources: Rice, wheat, veggies (carrots, white radish), Sources: Guava, papaya,
oats, barley, and grain fruit veggies (tomato, brinjal), bananas, watermelon, ciku,
products such as noodles, cruciferous veggies (cabbage, apples, pears, oranges
bread, biscuits and broccoli), legume veggies (French
breakfast cereals beans, long beans).
| 12 |
5
ty with the
Power
of
Tips to achieve
Group 4:
Group 5:
balance and
Fish, meat, poultry,
Milk and dairy products variety:
eggs, and legumes
U Include all food groups in
Benefits: Benefits:
your daily meals. Don’t omit
* Provide high quality * Rich sources of calcium, any food group even if you
protein protein, vitamins and minerals. intend to lose weight.
* Essential for the body’s * Calcium is needed for building
growth and maintenance bones and teeth as well as U Choose different types of
maintaining bone mass. food for your daily meals.
* Protein is also needed
For example, choose fish for
to produce enzymes and * Calcium is important for
lunch and opt for chicken for
hormones, repair and children as their bone mass is
dinner; or spinach for lunch
form blood cells, and still being built.
and long beans for dinner.
strengthen the immune Sources: Milk, yoghurt, cheese,
system ice cream.
Sources: fish, chicken, duck, Note: Bear in mind that sweetened
beef, mutton, lamb, pork, condensed milk is not considered as a milk
eggs, tofu, various legumes product as it is low in nutritional value and
high in sugar content.
Goodne
ss of Fib
c Consumption of too much oil and
sugar could lead to excess energy
c Helps
promote re
healthy g
ut
gular bow
el movem
re
ent and a
intake, thus leading to overweight and c Helps
lower blo
glucose le od choles
obesity. vels terol and
c Good
c Consumption of too much salt could source
increase risk to diseases such as mung bea s of fibre: Legume
ns, dhal, s (e.g. red
grains an chickpeas /
hypertension. d whole g ), whole
vegetable rain produ
s and fruit cts,
s
| 13 |
Healthy Eating
Keep Portions
In
Moderation
One of the keys to maintaining a healthy
weight is to eat in moderation. Control
portion sizes by taking the right number
of servings to avoid overeating. A serving
is the recommended amount of foods
that you consume daily using household
measures for foods and drinks e.g. a cup,
plate, bowl, tablespoon and teaspoon.
*To know which category you fall in, please refer to page 9 under the topic Energy Balance.
| 14 |
Food group Energy needs
1300 kcal/day 1600 kcal/day 2000 kcal/day
(4-6 years) (7-9 years) (10-12 years)
Cereals & cereal products 3 servings 5 servings 6 servings
Vegetables 2 servings 3 servings 3 servings
Fruits 2 servings 2 servings 2 servings
Meat, poultry, fish and legumes
Meat / Poultry ½ serving 1 serving 1 serving
Fish 1 serving 1 serving 1 serving
Legumes ½ serving 1 serving 1 serving
Milk and Dairy products 2 servings 2 servings 2 servings
| 15 |
Put B-M-V
Healthy Eating
(Balance-Moderation-Variety)
Into Practice!
Now that you understand the food pyramid and the keys to healthy eating through the concept of balance,
moderation and variety, it’s time to put your knowledge into practice. Use the table below as a guide on how
much should you be eating at each meal.
The illustrations of food below show the correct recommended number of servings for each food group.
1 banana
(Group 3)
1 cup brown rice
Evening Snack Dinner (Group 1)
1½ cup bihun
1 piece tosai (Group 1)
(Group 1)
Note:
Each dish shows an
example of 1 serving
for each meal
If you total up the number of servings from the meal above, you will find that the numbers of
servings per day (based on 2000 kcal) are as below:
| 16 |
ls
Plan Your Mea orporate the
idea on how to inc
You now have an rv ing s into your daily
d nu m ber of food se
reco m m en de y or even weekly)
meals ahead (dail have control
meals. Plan your to ensure that you
ur fa m ily
for you an d yo e each day. This
an d ho w much you consum ded
over wh at in the recommen
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wa is als
e. Meal planning
daily energy intak riety from meal
re s ba lan ce , m oderation and va
c Ensu
to meal m
s to avoid boredo
rotate your dishe
c Allows you to
ts wastage
oney and preven
c Saves time, m sed
y’s meal plan ba
examples of 2 da
Below are some
t:
on 2000 kcal die
| 17 |
Healthy Eating
Figuring
Out Food
Labels
When purchasing pre-packaged foods at the supermarket, we often overlook to read food labels on the
packaging. Reading food labels in fact can play a major role in weight maintenance as it helps us make
healthier food choices.
By reading the nutrition information on food labels, you can find out the energy and nutrient content of
the product as well as other information such as nutrient content claims.
Knowing what nutrition information to look for, can help you make better choice for your health and
avoid unnecessary fat, salt, sugars and energy (calories). Here’s what to look for when you’re reading a
food label:
Legends:
| 18 |
3 Nutrient Content Claims
Certain food products contain claims that highlight
the level of nutrients (e.g. energy, fat, sugar) in
a food product. A food product labeled as ‘low
fat’ has a level of fat recognised by the health
Multi Grain Cereal authorities as low. However, it should be noted
that it does not mean that it is low in calories.
Similarly, a product that claims to be ‘cholesterol
free’ has a negligible amount of cholesterol. It
may, however, still be high in fat. A product with
a claim of ‘high in vitamin C’ may also be high in
sugar content.
2
Hence, don’t make your decision based on the
nutrition claims alone. Instead, consider the
energy and other nutrients listed in the NIP before
purchasing the food item.
4
Energy Icon
Energy icon on the
front of the pack
indicates the amount Ingredient List
of energy (in calories)
The ingredients in a pre-packaged food are always listed in descending order,
found in one serving
with the ingredient with the highest amount to the ingredient with the least
of the food product
quantity. Thus, when making food choices, use this list to understand what
and the percentage
are the main ingredients contained in the product. When sugar or fat are listed
of energy it provides
high in the listing of a food, it is likely that it contains high amounts of these
based on a person’s
ingredients.
average daily energy
requirement (2000 In some products, the words ‘sugar’ and ‘fat’ may not be listed as such in the
kcal). ingredient listing. Sometimes it may seem that sugars and fats are not in
the ingredients list. Here are some alternate names you can watch out for to
identify sugars and fats in the food product:
c Sugar – honey, raw sugar, confectioner’s sugar, brown sugar, corn
sweetener, corn syrup, molasses, malt extract, fruit juice concentrate,
fructose, dextrose, maltose and sucrose.
c Fat – cocoa butter, coconut, coconut oil, coconut cream, egg solids and egg
yolk solids, hydrogenated vegetable fat or oil, lard, palm oil and palm kernel
oil, vegetable oil, vegetable shortening and animal shortening, animal fat,
non-milk fat, and whole milk solids.
| 19 |
Eating Right
Healthy Eating
Wherever
You Are!
Given the variety of cuisines available in
Malaysia, we are often spoiled for choice
when it comes to food. However, when
it comes to maintaining a healthy weight
and eating plan, the principles of balance,
moderation and variety should follow you
wherever you go – whether you are at home,
in school, at a fancy restaurant or a buffet.
Below are some tips to help you practise
healthy eating habits anytime, anywhere to
maintain healthy body weight and keep waist
slim.
General tips
U Choose foods that are prepared with less oil/ U Go for more wholegrain foods e.g. brown rice,
santan, salt and sugar wholemeal bread or cereals
U Choose foods that are cooked using healthy U Select eateries or restaurants that offer healthier
cooking methods such as stewing, grilling, food choices and has a clean environment
roasting, braising, steaming, or stir-frying U Eat together with the family to inculcate healthy
U Choose appropriate portion sizes eating habits in kids
U Ask for more vegetables and fruits U Avoid eating while watching TV as it may lead to
overeating
| 20 |
Type of
FoodChoose
to Choose Always
Always FoodChoose
to Choose
LessLess
Cuisine
cuisine
Paprik, nasi
whiteputih
rice Paprik, nasi
fried goreng
rice
Asam laksa Mi kari
Mee, curry
Ikan,
Fish, dipanggang
grilled Ikan,
Fish, digoreng
fried
Pisang,
Banana,segar
fresh Pisang,
Banana,digoreng
fried
Pau
Pau,kukus kacang
steamed, red merah
bean Kuih
Kuih seri
seri muka
muka
Tosai dengan kuah kacang dhal
Tosai with dhal gravy Roti
Roti canai dengan
canai with dhalkuah kacang dhal
gravy
Local food Nasi putih dengan lauk & sayur Nasi briyani (dimasak dengan minyak sapi)
Nasi putih with lauk & sayur Nasi briyani (cooked with ghee)
Putu mayam dengan sedikit kelapa parut Vadai
Puttu mayam with less grated coconut Vadai
Ayam, tandoori / dipanggang Ayam, digoreng
Chicken, tandoori / grilled Chicken, fried
Nasi ayam dengan ayam kukus Nasi ayam dengan ayam goreng
Chicken rice with steam chicken Chicken rice with fried chicken
Kuey teow, sup Kuey teow, digoreng
Kuey teow, soup Kuey teow, fried
Wantan, sup Wantan, digoreng
Wantan, soup Wantan, fried
Yong tau fu, dikukus Yong tau fu, digoreng
Yong tau fu, steamed Yong tau fu, fried
Popia, basah Popia, digoreng
Popiah, fresh Popiah, fried
Ikan panggang dengan kentang bakar Ikan dengan kentang goreng
Grilled fish
Burger withlembu
daging bakedtanpa
potato
lemak yang Fish and
Burger chips lembu dengan kentang goreng
daging
Western dipanggang dan kentang
Grilled lean beef bakar
burger with baked potato Beef burger with French fries
Western
food
food Spaghetti marinara (berasaskan sos
(tomato based tomato)
sauce) Spagetti
Spaghettikarbonara
carbonara(berasaskan sossauce)
(cream based krim)
Bun sardin
Sardine bun Donut
Doughnut
Note: The recommended calorie intake of a healthy person is 2000 kcal per day, and should be spread out through
out your daily meals which include breakfast, lunch, dinner and snacks. If the calorie content of one serving of a
particular food is more than what is recommended for each meal (>600 kcal for each of the 3 main meals and >150
for snacks), then it is considered a high-calorie meal.
| 21 |
Cook Up 1
Healthy Eating
Healthy
c Steaming keeps nutrients and
flavours in
c Stir frying cooks small pieces of
food quickly using minimal oil in
Meals
non-stick pan
c Grilling and roasting in high heat
allows fat to drip away from meats
c Baking/Microwaving helps to keep
Eating out too often can be unhealthy, as flavours and aromas in while using
food sold in hawker stalls and restaurants minimal oil
tend to be high in fat, oil, salt and sugar.
Therefore, you are encouraged to cook and c Braising is an ideal way to soften
eat at home with your family, as this enables tough meats without oil
you to use healthier ingredients and cooking c Stewing is an easy and fast way to
methods. Below are some tips to help you cook different types of foods using
2
prepare healthier meals. a slow cooker
| 22 |
Tomato Meat Rice
(Serves 4)
Ingredients
183 g (1 cup) uncooked rice
50 g (2 whole) tomatoes, diced
200 g (¾ cup) lean beef, thinly sliced
30 ml (2 tbsp) tomato puree
250 ml (1 cup) tomato sauce
30 g (½ medium-sized) green capsicum, sliced
250 ml (1 cup) water
30 ml (2 tbsp) vegetable oil
10 g (2 cloves) garlic, pounded
10 g (½ cm) ginger, crushed
10 g (1) shallot, sliced
Salt, sugar and pepper to taste
Method
Portuguese Stea med F ish 1. In an electric rice cooker, cook rice with tomato
puree, ½ cup of tomato sauce and water.
(Serves 5) 2. In a separate pan, sauté garlic, ginger and
shallots. Add in chopped tomatoes and remaining
Ingredients tomato sauce.
600 g (5 whole) kembong fish, gutted and cleaned 3. Add beef slices into the pan and cook until meat
60 g (5) lady’s fingers, sliced thinly is tender. Add salt and pepper to taste. Add extra
4 pieces aluminum foil sized 20 cm x 20 cm water, if needed.
1 piece banana leaf 4. Remove from flame and set aside.
18 g (½) lime, juice squeezed
5. Scoop cooked rice into small round jelly moulds.
30 g (4) red chilies
Make a hole in the center of rice and scoop in the
80 g (8) shallots Diet Tips
stir-fried beef.
20 g (4 cloves) garlic blended
60 g (2) lemon grass
• It is recommended to 6. Turn out the tomato rice with beef onto a plate and
together consume 1 serving of fish
5 g (1 tsp) belacan serve.
every day. Choose fatty
10 g (1 tbsp) chili powder fish such as sardines, sea Suggestion
45 g (4) candlenut (buah keras) perch (siakap), hairtail
scad (cencaru), black 1 Beef can also be replaced with chicken.
2 pieces kaffir lime leaves
250 ml (1 cup) water promfret (bawal hitam)
and mackerel (tenggiri) Nutrient Content Per Serving
45 ml (3 tbsp) oil because it contains
Salt and brown sugar to taste Calorie 389 kcal Carbohydrate 49.9 g
unsaturated fatty acids
(Omega-3 fatty acids). Protein 14.9 g Fat 14.4 g
Method
1. Grill the banana leaf lightly over low heat until slightly soft.
Cut the banana leaves into smaller pieces sufficient to
wrap one fish individually. Set aside.
2. Heat the oil and sauté the blended ingredients with
candlenut over medium heat until fragrant and slightly
crispy. Add in the lime juice, kaffir lime leaves, sugar and
salt to taste. Stir fry until well mixed. Add in some water if
necessary.
3. Simmer for 1 minute and cook until the sambal is thick. Add
in the lady’s fingers. Turn off the heat.
4. Put 1 piece of banana leaf on the aluminum foil, enough to
line 2-3 fishes.
5. Coat the fish well with all the cooked sambal (gravy) and
wrap the fish neatly with the aluminum oil so that there will
be no air coming out while cooking. Repeat the step with
other fishes.
6. Put the wrapped fish on a flat frying pan and cook en
papillote for 10 minutes.
7. Serve with warm rice.
| 23 |
Get Up, Be Fit
Move More
| 24 |
Use the Physical
Move More
Activity Pyramid
to Get You Active
Being physically active is beneficial for people of all ages. “Not having enough time” should not be an excuse
anymore. Even 10 minutes of exercise a day counts. So make physical activity a part of your daily life. Use the
physical activity pyramid below as a guide to help you get started.
1
| 25 |
Energy Expenditure based on physical activity
It is important to know the types of physical activity and the amount of energy used for each activity. Calories
burnt during any physical activity are influenced by your body weight as well as workout intensity. A heavier
person will use more calories compared to a lighter person. The more vigorous the physical activity you engage
in, the more calories you will burn.
| 26 |
4 Limit: physical inactivity and sedentary habits
Definitions
*Moderate phys
Note: The calories burnt ical activity: wh
physical activity, ile performing
are estimated based on the breathing an
is noticeably faste d heart rate
activities of a 58.5 kg r but you can still
conversation. carry on a
person in 1 hour
*Vigorous phys
ical activity: He
increased substa art rate is
ntially and you ar
hard and too fast e breathing too
to have a conver
sation.
You should aim to achieve at least 10,000 steps everyday. If you do not have a
pedometer, it is approximately an extra 1 hour brisk walking in addition to daily
activities.
Apart from walking more steps every day, upgrade your physical activity level
to ensure that you are doing enough for optimum health. The guide below can
help give you a good start:
Begin with activities at the base of the Be more consistent with activities in Choose a mix of aerobic,
pyramid the middle of the pyramid flexibility, and strengthening
c Walk whenever you can c Plan physical activity into your activities
c Make physical activity a part of your daily schedule c Mix up your routine to keep
leisure time c Set weekly and monthly goals it fun
c Set realistic goals, and work your c Partner with a friend or family c Try new physical activities
way up toward the middle of the member to do physical activity c Challenge yourself with
pyramid together new goals
| 27 |
Weight Monitoring
Assess
Your Weight
Status
The simplest method to know if you are at a healthy weight
is by assessing your body mass index (BMI) and your waist
circumference. This can be done at home and is essential
for both children and adults to monitor their risk of obesity.
The BMI must be monitored once every month for people
with weight problems and once every three months for
normal weight person.
1 Formula:
Weight (kg)
Example: Weight 56kg, Height 1.64 m
56
= 20.82
BMI = 1.64 x 1.64
Height (m) X Height (m)
So, BMI = 20.82
2 Interpretation – Adults:
Weight
Underweight Normal Overweight Obese
Status
BMI values r< 18.5 < 18.5 – 24.9 ≥ 25 ≥ 30
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3
Weight Monitoring
Age Normal BMI Range
Interpretation – Children:
(Year) Boys Girls
*While BMI is calculated using
the same method for children and 2 13.8 – 17.3 13.8 – 17.1
adults, the criteria used to interpret
3 13.4 – 16.9 13.1 – 16.8
the BMI values for children are
different as it takes into account 4 13.1 – 16.7 12.8 – 16.8
their growth and development. 5 12.9 – 16.6 12.7 – 16.9
6 13.0 – 16.8 12.7 – 17.0
7 13.1 – 17.0 12.7 – 17.3
8 13.3 – 17.4 12.9 – 17.7
9 13.5 – 17.9 13.1 – 18.3
10 13.7 – 18.5 13.5 – 19.0
11 14.1 – 19.2 13.9 – 19.9
12 14.5 – 19.9 14.4 – 20.8
13 14.9 – 20.8 14.9 – 21.8
14 15.5 – 21.8 15.4 – 22.7
15 16.0 – 22.7 15.9 – 23.5
16 16.5 – 23.5 16.2 – 24.1
17 16.9 – 24.3 16.4 – 24.5
18 17.3 – 24.9 16.4 – 24.8
Waist Circumference
(Only applicable for adults)
Body fat located at the abdominal region is a good
indicator of the risk of obesity-related diseases. In
general, there are two types of obesity – Android
and Gynoid:
c Android obesity/central obesity (Apple-like
body shape)
xcess fat accumulates around
E
abdominal region
H
igher risk of having illness related
to obesity, eg heart disease,
diabetes, high blood pressure, and
cancers
c Gynoid obesity (Pear-like body shape)
Excess fat accumulates around hip
and thigh areas
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To check your waist
circumference, all you need is a
measuring tape.
How to measure?
1. Place a measuring tape
directly on the skin or no more
than one layer of light clothing
2. The tape should be placed
halfway between the lowest rib
and the top of hip bone; this
is roughly in line with the belly
button, also known as the
navel
3. Breathe normally and take the
measurement
4. Make sure the tape is snug but Interpretation:
without compressing the skin
Female < 80cm Male < 90cm
If the waist circumference is more than the normal values indicated above, it can be classified as
central obesity. This condition increases the risk to diet-related chronic diseases
Adults:
If you are within the normal range, Children:
KEEP UP THE GOOD WORK! If your child is underweight, aim to ensure
However, don’t take it for granted. optimal nutrition and gradually get back to
Continue working towards preventing normal growth.
obesity by practicing a healthy If your child is overweight or obese, consult
lifestyle. a dietitian for professional advice on how to
If your BMI is in the overweight or develop an appropriate weight for loss plan.
obese ranges, don’t be disheartened. As children have high nutrient needs for
Weight problems ARE reversible optimal growth, it is important not to practice
by putting in some effort as an strict dietary restrictions. Inculcating healthy
investment. Consult a dietitian to eating habits and encouraging physical
personalize a healthy weight loss activity and lifestyle changes are the preferred
plan, find out exercises you can do approaches. Parental support and involvement
to burn those extra calories. Most are crucial for any successful weight
importantly, stick to your regime and management plan.
don’t give up. If your child is at normal range, keep up the
If you are good work. All you need to do is make sure he
underweight, receives optimal nutrition. Check regularly to
strive towards a ensure that his growth is maintained within the
healthy weight normal range.
by practicing a If your child’s weight gain fluctuates greatly
healthy lifestyle between measurements, seek advice from a
by following dietitian, nutritionist or paediatrician.
the advice of
a dietitian or
nutritionist.
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Question
Soal Jawab
and Answer
Ask the
Experts
About
Weight
Management
Being a
vegetarian does not
necessarily mean that a Is it
person will not become overweight true that
or obese. Vegetarians consume women are
grains, legumes, and tubers, which also Can I stay bound to put on
contain calories. Indeed, any type of slim by being a
food, if taken in excess of energy needs, some weight
vegetarian? after having
can cause weight gain. Deep fried
vegetarians dishes also contain to a children?
substantial amount of calorie.
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Is it true that
eating red meat
and rice can cause
obesity?
Fast food
and sweetened
beverages are
always on demand
It is untrue that eating any
in my household.
one food will increase risk to
obesity. Therefore, eating red meat What can I do?
or rice is not going to increase risk to
obesity as long as they are consumed in
moderation. Achieve a balance on energy These foods are high in
intake and calorie expenditure is the key calories. Try to introduce healthy
in preventing obesity. Therefore, one snacks to your family members and
should consume a variety of foods, children and turn it into a habit. Slowly
but in moderate amounts that are reduce, and eliminate, all fast food, snacks
appropriate for his body weight, and sweetened beverages from your
age, and physical activity shopping list. Most importantly, be a role
level. model for your children and guide
them to practise healthy eating habits.
Avoid rewarding your child with food
and do other interesting activities
together instead.
Is weight loss
safe for my
overweight
Young children under child?
the age of 7 years who are
overweight or obese with no other
health concerns, should maintain weight
or gain weight slowly rather than lose weight.
Overweight older children (> 7 years old) can
benefit from weight loss, but this should be a slow
and steady process. For instance, losing between
0.5 kg a week and 2 kg a month is reasonable,
depending on the child’s ability and environmental
support. Inculcate healthy eating habits and
encourage physical activity and lifestyle changes
instead of restricting his diet. Parents should
support and work together with the child in
any weight loss programme and help
monitor his progress.
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Weight
Loss
Lose Weight Safely
Healthy Diet to Lose
Weight
Be Physically Active
Questions and Answer:
Weight Loss Guide
| 33 |
Weight Loss
Lose
Weight
Safely
Being overweight and obese adversely affects your overall
health and life as well as the lives of your loved ones. Losing
the extra weight brings about a whole host of benefits. It
keeps you in shape, makes you feel good and confident
about yourself. More importantly, losing weight decreases
your risk of developing non-communicable diseases such as
diabetes and hypertension. So let’s take that important step
towards a healthier and better life today. It’s easy and we’ll
show you how.
PHYSICAL
ACTIVITY
Engage in physical activity by
starting with small steps but
regularly and continuously
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Set Your Goals and achieve them
Below are some goals you can set for yourself to help you start off on your weight loss programme.
Make them achievable and don’t overextend or you’ll get tired, bored and ultimately lose interest.
c Aim for weight loss goal of 5-10% of your total body weight in 6 months, or 0.5 to
Right goals 1 kg per week.
c Aim for slow and steady weight loss for long lasting effects and better health.
c Aim for calorie reduction of 500 kcal/day; reduce 250kcal from your food intake
and 250kcal through physical activity.
Right Diet c Aim for foods which are low in calories, sugar, fat, and salt. Aim for high fibre
foods such as fruits and vegetables, legumes and brown rice and wholemeal
bread instead.
c Ask a friend or family members to join you through your weight loss programmes.
Get support c For more effective weight loss, consult a dietician or nutritionist for a weight loss
programme tailor-made specifically for you.
If you find your weight loss insignificant or negligible at best even after taking the aforementioned steps, then
preventing further weight gain becomes the goal.
1
Watch for your old bad habits that could be contributing your weight plan.
Skipping breakfast – This is a bad habit because breakfast is the most important meal of
the day that helps you stay energized at the beginning of the day and it prevents you from
2
overeating later.
Snacking unnecessarily – Make sure you have regular meal times to avoid
unnecessary eating in between meals. If you need to snack, choose only healthier
3
snack options.
Unmindful eating / emotional binge eating – When feeling sad, do other
activities instead of eating. Many overweight people don’t realise they have
been using food as their own personal “therapist” which lead to overeating.
5 Being a couch potato – Be disciplined and allocate adequate time for your
favourite TV programmes, games and gadgets. You can do some movements
6
while watching TV such as sit up or push up.
Eating supper – Supper has been so popular especially with the abundance of 24
hour restaurants. Consider sticking to a comprehensive eating schedule and avoid supper
as that is the time your body is getting ready to rest.
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Weight Loss
Healthy Diet
to lose weight
A fundamental requirement to achieve
weight loss is to control calorie intake.
But this doesn’t mean you should be
severely restricting all food intakes and
go on a very low calorie diet. Your body
still needs energy and nutrients to be able
to perform all its functions normally. A
balanced and healthy diet is therefore still
essential. This also helps facilitate a more
consistent weight loss and the effects are
usually long-term.
B M V
d d
Practice a balanced and moderate diet in Manage your meal portions and plan serving
accordance with the guidelines advocated by sizes appropriate to your needs. (Refer to page
the Malaysian Food Pyramid, and incorporate 14 under “Keep Portions in Moderation” on the
the principles of B-M-V – Balanced, serving size of each food group).
Moderation and Variety. (Refer to page 11)
menu
d d d
Plan your daily menu based Go for healthier food Emphasise on reducing
on 1500 kcal diet to help options and use healthier consumption of unnecessary
you monitor your meal and ingredients while cooking calories for example sugary
write down what you eat on (Refer to page 23 for beverages. There are many
that day. healthier food alternatives). types of food which is high
in calorie but low in nutrient
content. Choose wisely.
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Sample Menu Planner
The menu plan provided here (based on 1500 kcal/day) will help you plan your daily calorie intake
and avoid overeating.
Note: Besides eating right, do not forget to drink 8 glasses of water everyday
| 37 |
Be Physically
Weight Loss
Active
In addition to a good dietary plan, a good physical workout plan is
needed to achieve the intended weight loss. You can try and follow
the “Physical Activity Pyramid” for suggestions on what type of
physical activities you can do to keep those extra pounds at bay.
The more intense the physical activity, the more calories you burn.
Losing weight through physical activity doesn’t just cut off unwanted
fat, it also helps to strengthen body posture and maintain overall
well-being.
c Frequency:
How many times per week?
c Intensity:
How intense is your physical activity
(often quantified using heart rate)?
c Time:
How long you perform the
activity?
c Type: The table below can help you plan
What kind of activity is performed? your physical activity everyday in your
weight loss programme:
Prevent transition
Prevent transition from overweight
To lose weight from overweight to
to obesity
obesity
Frequency Everyday Everyday Everyday Less than Everyday
Intensity Moderate intensity Moderate intensity Moderate intensity Vigorous intensity
Less than 60-90
Time >30 mins 45-60 mins 60-90 mins
minutes
Type Aerobic exercise Brisk walking Swimming laps
Cycling Skipping rope Jumping rope
Gardening Playing tennis Running
Pushing a child in a stroller Football
Washing a car Basketball
Heavy gardening
(continuous digging
or hoeing)
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Alternatively, you can choose other forms of activities that you
feel comfortable with and enjoy doing. You can participate more
in household chores or activities such as mowing the lawn or
gardening. Even a mundane task like hosing the plants can
become a less-intensive form of physical activity routine.
Make sure to also participate in activities that increase your
flexibility, strength and endurance. A simple set of physical activity
2-3 times a week in addition to the above activities should help
you get in shape. Persistence will surely pay off resulting in a
healthier more active you.
Individuals who are either overweight or obese should initiate physical activity slowly and
gradually increase intensity over time.
Tips to do so:
1 2 3 4
Start with a 10 Increase it to Increase frequency to Keep on gradually
minute walk 30-45 minutes five times a week and try increasing your
three times a of brisk walking other forms of moderate exercise duration
week. three times a intensity activities and intensity.
week. i.e. jogging.
You may also opt to do so in several short periods such as 10 minutes three times a day instead of
one single 30 minute session.
Safety Rules
Get advice from healthcare professionals before you
start any exercise programme and get a physical/
medical check-up to see if you have any illnesses or
complications that might worsen if you do a certain
form of exercise.
Start at a level you feel comfortable with. Over
time your body will adjust to the frequency of your
activities and increase your overall fitness. Gradually
increase the level of intensity of your physical
activity. Basically there are 3 phases of physical
intensity, namely:
c Beginning phase – The body adjusts to the new
type and level of activity.
c Progress phase – Fitness increases.
c Maintenance phase – The targeted level of
fitness is sustained over the long term.
Intensifying your activities abruptly may result in
muscle soreness, fatigue, increased cardiac risk and
decreased motivation.
| 39 |
Weight Loss
Questions and
Answers:
Weight
Loss
Guide
1
Don’t get too discouraged, it’s
I’ve substituted my normal for weight loss to slow or
unhealthy snacks even stop. It’s called the weight
with fruits to lose loss plateau that occurs because
weight as advised. Why your body’s metabolism slows as
doesn’t my weight go you lose muscle. During this time,
down? the calories you eat are now equal to
2
Substituting unhealthy the amount of calories you use.
snacks with fruits is a I’ve reduced
good practice and not just my calorie
for losing weight. Fruits intake by If you’re still committed to losing
also contain various cutting my portion more weight, try these safer
phytonutrients that are sizes and I exercise healthier options:
known to exert beneficial regularly every day. c Cut more calories. Reduce your daily calorie
health effects. To reduce I managed to lose intake by 200 kcal — make sure it doesn’t go
more weight, you might a few kilos, but below 1,200 kcal. If it does, it may not be enough
need to consider reducing after 3 months, I to keep you from feeling hungry; this increases
calories from other food didn’t lose any more your risk of overeating.
taken throughout the weight despite going c Increase your workout. Increase duration and
day. Just taking away the through the same intensity of workouts. Another option is to do
snack is not the solution. routine and diet. exercise focusing on increasing muscle mass
Also remember that Why isn’t it working which are quite intense and burn calories even
physical activity must anymore? after working out.
be increased so as to c Pack more activity into your day. Increase
burn away the excess fat general physical activity throughout the day by
stored in the body. walking more and using your car less, or try doing
more chores around the house to keep yourself
busy.
| 40 |
3
With so many Any diet that promises fast weight loss without a scientific basis is called a fad
different types diet. These diets often eliminate entire food groups and as a result don’t provide
of fast-acting the wide range of important nutrients that our body needs. Results are usually
diet plans these short-lived and are difficult to sustain since most of the weight loss involves
days which one primarily water. Nutrient deficiency is also not uncommon in persons using fad
should I choose? diets.
How about weight There are numerous weight loss products in the market. Many new products
loss products, are are put on the market, ranging from various pills, supplement drinks to herbal
those safe? products. Do your homework and consult the proper authorities to determine if
these products are indeed effective and safe for use before you decide to buy.
In certain situations, special drugs may be prescribed to patients who have difficulty losing weight. These
drugs help compliment the whole weight loss programme and are not an “end-all-be-all” solution in itself.
Prescribed drugs may include:
c Appetite suppressant – They work by blocking the re-uptake of the chemicals in the brain which
creates that feeling of satiety you get after eating a big meal.
c Prescription fat blockers – Inhibits the enzyme lipase in the digestive system which prevents fat from
being broken down and absorbed but instead exits the body through bowel movement.
Always remember that no drug nor pill or supplement can substitute a good holistic diet coupled with
regular daily exercise.
4
I am obese and suffer both diabetes and arthritis, so I find it very difficult to move around.
However, I’ve tried losing weight through practicing a healthy diet and I exercise frequently but
it doesn’t seem to work. I hear surgery is also a good option to consider, is this true?
Yes, there is a surgical procedure called Bariatric If you fit these criteria below then surgery may be an
Surgery which is used to treat severely obese option for you:
people. The surgery involves
1 Body mass index (BMI) greater than 40.
c reducing the size of the stomach with a gastric
band, 2 BMI greater than 35 and you have obesity-related
health problems that may improve with weight
c removal of a portion of the stomach (sleeve
loss, such as obstructive sleep apnoea, severe
gastrectomy or biliopancreatic diversion with
arthritis, and diabetes.
duodenal switch)
c resecting and re-routing the small intestines to a 3 Conventional diet and exercise have no effect
small stomach pouch (gastric bypass surgery). towards your weight.
4 Committed to permanent lifestyle changes after
Before Surgery After Surgery
surgery.
Stomach Stomach (bypassed)
5 Has gone through counselling session and
understands the risks and benefits of weight loss
Gastric surgery.
Pouch
Only certified medical practitioners can prescribe
this method and even then, it is considered to be
a last resort as there are risks and side effects
associated with this type of surgery. Weigh your
options carefully and ask people who’ve been
Jejunum through the same experience for added perspective.
Although the surgery might give good results to you,
Duodenum Duodenum (bypassed) you still need to practise healthy eating habits and
active lifestyle to maintain your weight.
| 41 |
Nutrition Society of Malaysia Malaysian Dietitians’ Association Malaysian Association for the
www.nutriweb.org.my Study of Obesity
www.dietitians.org.my
www.maso.org.my
Email : enquiry@nutritionmonthmalaysia.org.my
Website : www.nutritionmonthmalaysia.org.my
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