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Underweight vs. overweight
Eating food for fuel
Dr Yasmin Ooi Public health nutritionistUniversity Malaysia Sabah
Food Carnival 9 August 2008
Prevalence of overweight and obesity in Malaysia adults
17
27
0
5
10
15
20
25
30
NHMS 1996 MANS 2002
Pe
rce
nta
ge
(%
)
Overweight Obesity
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 co-morbidities
<18.5 UnderweightLow (but risk of
other clinical problems increased)
18.5-24.9 Normal range Average
25.0-29.9 Overweight Increased
30 – 30.4935 – 39.9
> 40
Obese Class IObese Class IIObese Class III
Moderate, severe,
very severe
(WHO, 1998)
BMI for age percentiles for adolescents, 10 – 18 yBMI for age percentiles for adolescents, 10 – 18 y
Age (years)
Males Females
5th percentile 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
Source: WHO, 1995)
Environmental factors causing weight gain and obesity
Drugs causing weight gain
Inactivity (TV, computers)
Lack of habitual physical activity
Sports activitiesOrgano
chlorines
Birth weight
Breast feeding
Meal size /
energy intake
Dietary fat,
CHO & protein
s
Beer & wine
Soft drink
s
Infections (adenovirus
)
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/day2000 kcal/day
2500 kcal/day
Cereals & grains
8 12 12
Fruits 2 2 2
Vegetables 3 3 3
Meat / poultry
1 2 2
Fish 2 2 2
Milk & alternatives
1 2 2
Legumes 1 1 1
HOW DO YOU OBTAIN A BALANCED DIET?
Follow the Food Guide Pyramid
Food Guide Pyramid- The key to balanced/healthy foods
Fats, oil, sugar & saltUSE SMALL AMOUNTS
Milk & dairy products1-2 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
Level 1
rice, mee, breads, grains, cereal and cereal products, potatoes/tubers
Level:
Food Group
Nutritional Value
Recommen
dations
Example of 1
serving
Level 1:
rice, mee, bread, cereal and cereal products, potatoes
•Good sources of complex CHO•Vitamin, mineral, fiber and a bit of protein•Generally low in fat
8-12 servings
• ½ cup of rice•1 piece of bread•½ cup of mee-hoon/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
Recommendations
Example of 1
serving
Level 2:
Vegetables & fruits
•Good sources of vitamins, minerals and fiber
3 - 5 servings
vegetables•½ cup green leafy vegetables + stem (cooked)•½ cup of eggplant, tomato (cooked)
Level:
Food Group
Nutritional Value
Recomendations
Example of 1
serving
Level 2:
Vegetables & fruits
•Good sources of vitamins, minerals and fiber
3 - 5 servings
Fruits:•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
Recomendations
Example of 1
serving
Aras 3:
Fish, poultry (chicken/duck),meat, nuts
(soya bean, dhall)
•Good sources of protein•Rich in vitamin B, iron, zinc and Magnesium
2-3 servings
•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
Recommendations
Example of 1
serving
Level 3:Milk and milk products (not including condensed milk, butter and cream)
•Important sources of calcium and protein
1-2 servings
•1 cup of milk•1 cup of yoghurt•1 piece of cheese
Level 4
Fats, oils, sugar and salt
Level:
Food Group
Nutritional Value Recomendations
Example of 1
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
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
Malaysian Dietary Guidelines 1999 & summary of the food guide pyramid
Eat more rice and cereal products, nuts, vegetables and fruits
Reduce fat in the preparation of foods, choose foods low in fat and cholesterol
Malaysian Dietary Guidelines 1999 & summary of the food guide pyramid
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
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