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Underweight vs. overweight Eating food for fuel Dr Yasmin Ooi Public health nutritionist University Malaysia Sabah Food Carnival 9 August 2008 Prevalence of overweight and obesity in Malaysia adults Overweight 30 Obesity 27 Percentage (%) 25 20 17 15 10 5 0 NHMS 1996 MANS 2002 Data from MANS 2003 (MOH, 2007 School children? • • • • Standard 1 to 6 in Peninsular Malaysia. Surveyed 11,500 school children 10% were overweight 6% were obese • (Ismail et al., 2003) If your BMI is…. BMI (kg/m2) Risk of comorbidities <18.5 Underweight 18.5-24.9 Normal range Low (but risk of other clinical problems increased) Average 25.0-29.9 Overweight Increased 30 – 30.49 35 – 39.9 > 40 Obese Class I Obese Class II Obese Class III Moderate, severe, very severe (WHO, 1998) BMI for age percentiles for adolescents, 10 – 18 y Males Age (years) 5th percentile Females 85th percentile 5th percentile 85th percentile 10 14.42 19.60 14.23 20.19 11 14.83 20.35 14.60 21.18 12 15.24 21.12 14.98 22.17 13 15.73 21.93 15.36 23.08 14 16.18 22.77 15.67 23.88 15 16.59 23.63 16.01 24.29 16 17.01 24.45 16.37 24.74 17 17.31 25.28 16.59 25.23 18 17.54 25.92 16.71 25.56 Environmental factors causing weight gain and obesity Soft drink s Beer & wine Dietary fat, CHO & protein s Infections (adenovirus ) Inactivity (TV, computers) Meal size / energy intake Lack of habitual physical activity Breast feeding Birth weight Drugs causing weight gain Organo chlorines Sports activities Underweight vs overweight • Underweight – Anaemia – Low bone mass – Eating disorders • Overweight – – – – Diabetes Hypertension Dyslipidemia Cardiovascular diseases • Healthy weight range for adults: – BMI: 18.5 to 24.9 kg/m2 Children and adolescents • Overweight and obese children should maintain weight or gain weight slowly rather than lose weight. • Practise healthy eating habits • Do physical activity • Consult nutritionist / dietitian Weight loss diet • Balanced proportion of: – carbohydrates (50 – 60%) – Protein (10 – 20%) – Fats (less than 30%) • Limit the portion sizes eaten, especially energy dense foods, e.g.? • Increase physical activity, EXERCISE! Examples of moderate physical activities • • • • • • • • • Do these 20 – 30 minutes continuously Walking briskly Brisk house cleaning Recreational sports (badminton, football, sepak takraw, table tennis, squash, netball, bowling, tennis) Mowing lawn Jogging Swimming (moderate effort) Cycling (moderate speed) Gardening / farming How much weight loss is safe? • Start: lose 5 – 10% of initial body weight. • Reasonable timeline: 5 – 10% weight loss in 6 months • = per week: about ½ to 1 kg per week. • = reduction of calorie intake by 500 kcal/day. How much to eat (kcal / day) Age Girls Boys 10 – 12 years 1990 2180 13 – 14 years 2180 2690 15 years 2180 2690 16 – 18 years 2050 2840 How much to eat? How many servings? Food group 1500 kcal/day Cereals & grains Fruits Vegetables Meat / poultry Fish Milk & alternatives Legumes 2000 kcal/day 2500 kcal/day 8 12 12 2 3 1 2 3 2 2 3 2 2 1 2 2 2 2 1 1 1 HOW DO YOU OBTAIN A BALANCED DIET? Follow the Food Guide Pyramid Fats, oil, sugar & salt USE SMALL AMOUNTS Milk & dairy products 1-2 SERVINGS Fish, poultry,meat & legumes, 2-3 SERVINGS Fruits & vegetables, at least 3-5 SERVINGS Rice, noodles, bread, other cereals & cereal products, tubers 8-12 SERVINGS Food Guide Pyramid- The key to balanced/healthy foods Level 1 rice, mee, breads, grains, cereal and cereal products, potatoes/tubers Level: Food Group Nutritional Value Recommen dations Level 1: rice, mee, bread, cereal and cereal products, potatoes •Good 8-12 sources of servings complex CHO •Vitamin, mineral, fiber and a bit of protein •Generally low in fat Example of 1 serving • ½ cup of rice •1 piece of bread •½ cup of meehoon/mee/pasta •½ small capati •1 cup of plain rice porridge •½ cup of breakfast cereal •1potato Level 2 Vegetables & Fruits Level: Food Group Nutritional Value Level 2: •Good Vegetables sources of vitamins, & fruits minerals and fiber Recomme Example of 1 ndations serving 3-5 vegetables servings •½ cup green leafy vegetables + stem (cooked) •½ cup of eggplant, tomato (cooked) Level: Food Group Nutritional Value Level 2: •Good Vegetables sources of vitamins, & fruits minerals and fiber Recomend Example of 1 ations serving 3-5 Fruits: servings •½ of a regular sized guava •1 piece of papaya, pineapple or watermelon •1 regular sized banana,apple or orange Level 3 Fish, poultry (chicken/duck), meat, nuts (soya bean, dhall) Level: Food Group Nutritional Value Recomend Example of 1 ations serving Aras 3: Fish, poultry (chicken/du ck),meat, nuts (soya bean, dhall) •Good 2-3 sources of servings protein •Rich in vitamin B, iron, zinc and Magnesium •1 regular sized chicken thigh •1 regular sized fish (ikan kembung) •2 blocks of lean meats the size of match boxes Level 3 Milk and milk products (not including condensed milk, butter and cream) Level: Food Group Nutritional Value Recomme Example of 1 ndations serving Level 3: Milk and milk products (not including condensed milk, butter and cream) •Important 1-2 sources of servings calcium and protein •1 cup of milk •1 cup of yoghurt •1 piece of cheese Level 4 Fats, oils, sugar and salt Level: Food Group Nutritional Value Recomenda Example of 1 tions serving Level 4: Fats, oils, sugar and salt •Fats and oils contain essential fatty acids and fat soluble vitamins such as vitamins A, D,E and K Take sparingly (only a little bit) •1 – 2 teaspoon Malaysian Dietary Guidelines 1999 & summary of the food guide pyramid Enjoy a variety of foods - eat a variety of foods from each food group - foods eaten daily should come mostly from the lowest level of the food pyramid Malaysian Dietary Guidelines 1999 & summary of the food guide pyramid Eat more rice and cereal products, nuts, vegetables and fruits Malaysian Dietary Guidelines 1999 & summary of the food guide pyramid Reduce fat in the preparation of foods, choose foods low in fat and cholesterol choose reduce practice Malaysian Dietary Guidelines 1999 & summary of the food guide pyramid Reduce the use of salt and choose foods low in salt Reduce sugar intake and choose foods low in sugar Drink plenty of water every day (6-8 glasses a day) Malaysian Dietary Guidelines 1999 Maintain a healthy body weight by eating balanced foods and by exercising regularly Malaysian Dietary Guidelines 1999 – Exercise and maintenance of body weight prevents health problems and gives healthier body image – Being underweight or overweight increases the risk of getting certain diseases BODY MASS INDEX (BMI) • • is applicable for individuals 18 years and above For body weight monitoring BMI = weight (kg) height (m) X height (m) Blog • http://www.nutritiontalk.wordpress.com • Today’s talk will be uploaded this evening. • Please look for the title Nutrition talk for Secondary School Students. • Thank you and have a nice day. • Assalamualaykum