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Fill up on fruits, vegetables and dairy foods such as yoghurt daily for satiety and reduced hunger pangs.
A low-calorie diet and regular exercise equals a healthy lifestyle. Dietician DR WINNIE CHEE tells overweight Malaysians that there's no easy way out if they are dead serious about reducing health risks through weight loss.
MALAYSIANS are getting fatter! Research shows that about 25 per cent of Malaysians are overweight or obese, especially in the urban areas and among women. We all know that having too much weight can increase the risk of many chronic diseases and even cause death.
As your body weight increases, your risk of getting hypertension, heart disease, diabetes and certain cancers increase by at least two-fold!
Your joints also give way sooner or later after having to support all that excessive weight and thus, we often hear of obese individuals frequently complaining of knee and joint pains caused by arthritis. Obese persons also have breathing disorder, poor self-image and the list goes on!
These are enough reasons why one should work towards maintaining a healthy weight! |
Exercise 30 to 45 minutes daily to help boost your metabolic rate and burn those calories. |
Why do people get fat?
Some people just blame it on their genes — “all my family members have big bones” or “I have a big frame size".
Well, there is some truth that obesity is genetically linked. Nevertheless, genes do not act alone. Gene activity is moulded by behaviour and vice-versa. You have a choice to alter how you and your body cope with your genes.
However, there are physiological changes which take place as we grow older, making us prone to gaining weight. For instance, a 25-year-old would have more muscle mass (47 per cent of body weight) and less body fat (20 per cent body weight) than a 60-year-old.
As seniority sets in, muscle mass goes down while body fat percentages increase to about 36 per cent. Hence, with less muscle, the metabolic rate of the older person slows down, i.e. the ability to burn food slows down, making one more prone to gaining weight.
Nevertheless, the major reason why people get fat is because they eat too much and spend too little energy! Yes, it is all a matter of energy balance! Similarly, to lose weight, eat less and spend more energy.
Benefits of weight loss
Over the years, there have been several large-scale clinical trials which have proven that overweight and obese individuals benefit from some amount of weight loss.
For example, a Finnish study published in the New England Journal of Medicine in 2001 was the first study to show that diabetes is preventable by lifestyle changes.
The study followed up on 522 individuals for 3.2 years. They randomised the participants into a control group as well as a diet and exercise group.
The results showed that participants in the latter group were able to lose 3.5kg at the end of the study and incidence of diabetes was significantly lowered by 50 per cent, compared with the control group that lost only 0.9kg over the same period.
Similarly, the Diabetes Prevention Programme (DPP) in the United States was another major clinical trial, or research study, aimed at discovering whether either diet and exercise or the oral diabetes drug metformin (Glucophage) could prevent or delay the onset of Type 2 diabetes in more than 3,234 individuals with impaired glucose tolerance (IGT).
The answer is yes. In fact, the DPP found that over the three years of the study, diet and exercise sharply reduced the chances of a person with IGT developing diabetes.
The participants in the diet and exercise group lost 5.6kg over those years and the prevalence of diabetes was again almost 50 per cent lower than in the control group. The metformin group lost weight and reduced their diabetes incidence as well, but less dramatically.
Other clinical trials have also shown that weight loss through lifestyle modification can lower blood pressure in overweight hypertensive and non-hypertensive patients, and improve serum cholesterol levels — thus reducing the risk of cardiovascular diseases.
Hence, when your doctor advices you to loose some weight, he bases that advice on sound scientific evidence of the benefits. It is clear that lifestyle changes, i.e. diet and exercise, can significantly reduce your risk of chronic diseases and the changes in weight need not be drastic!
Aim for long-term, weight maintenance
An interesting study published in the reputable American Journal of Clinical Nutrition in 2005 measured the duration of weight loss maintenance and the risk of weight regain among 4,000 successful weight losers in the United States.
The results clearly showed that if individuals can succeed at maintaining their weight loss for at least two years, they can reduce their risk of subsequent regain by nearly 40 per cent.
Thus, if you want to lose weight and successfully keep the weight off, aim for long-term! Drastic weight loss over a short period of time (for example, 10-20kg over two weeks) as promised by some quick-fix weight loss programmes is unlikely to be sustained over time.
Key strategies to effectively keep weight off
DATA from 4,000 individuals who successfully lost weight in the United States as published by Wing and co-workers in 2005 listed six key strategies for long-term successful weight loss and maintenance:
- Eat a diet low in calories and fat
- Engage in high levels of physical activity
- Eat breakfast and do not skip meals
- Maintain a consistent eating pattern
- Self-monitor your weight on a regular basis
- Catch “slips” before larger regains
Let’s establish several steps towards weight loss.
Step 1:
Know your weight status. Do a simple calculation of your body mass index (BMI) and check your category.
*BMI > weight (kg) ¸ [height(m) X height (m)]
Step 2:
Set a realistic weight goal. A survey of obese individuals in the US showed that many who started with a weight of 100kg aimed to have an ideal weight of 65kg. Many of them only achieved a weight of 90kg when put on a weight loss programme and were highly disappointed!
A sound weight loss programme should aim to achieve an average of 5-10 per cent weight reduction initially. Health benefits have been documented with even as little as five per cent reduction in weight as shown in the clinical trials mentioned earlier.
So, set a realistic goal that you can see results and it will help motivate you to continue! Take between three and six months to achieve the target. Remember, drastic weight loss in a short period of time is not sustainable!
Step 3:
Know how much you need to eat. Being on a weight loss programme does not mean you have to starve! You still eat a nutritious and balanced meal.
You just need to know what to eat and how much. You may seek the help of a dietician. He or she will normally follow these rules:
- A low-calorie diet is what works. There are at least 34 randomised control trials showing that low-calorie diets (for example, 1,200 to 1,500 kilocalories per day) promote up to eight per cent weight loss in six to 12 months.
- A simple rule of thumb is, if you are overweight or obese, you will need to cut down 500 calories a day from your current intake to achieve a weight loss of 1/2 to 1kg a week. This usually amounts to approximately 1,200 kcal (for women) and 1,500 kcal ( for men) as a low-calorie weight loss diet.
- A very low-calorie diet of less than 1,000 kcal per day will require close medical and dietetic supervision.
- You should focus on reducing fat in your diet because it is the most energy-dense nutrient compared with carbohydrates and proteins.
- It would be sensible to also reduce added sugars in your diet as sugars provide extra calories and low nutrient content.
- Follow the Malaysian Food Pyramid for a balanced diet. Eat:
1. Cereals
2. Fruits and vegetables
3. Protein and dairy foods
4. Minimise fats and sugars
5. Drink plenty of water daily.
Here are examples of how much to eat from cereals, protein foods and fat for a low-calorie diet of approximately between 1,200 to 1,500 kcal per day.
You should consult a dietitian for an individualised meal plan, especially if you have other health conditions such as diabetes, hypertension, cardiovascular, kidney or other diseases)
- While you need fat to provide fuel and essential fatty acids, remember that fats and oils make you fat! The easiest way to reduce 500 calories from your diet is to cut down on oils and fats.
- Remember to fill up on at least five servings of fruits and vegetables daily. This helps provide fibre which helps give satiety and reduces hunger pangs. Choosing wholegrain products also helps increase fibre intake. A high-fibre diet will help control blood sugar and blood cholesterol levels as well.
- Eat two servings of dairy products a day to meet your calcium requirements and lose weight! Recent studies have shown that dairy products may assist in weight loss and reduce fat, especially around the abdomen. Go for skim or low fat products.
Step 4:
Have proper meal times and maintain a consistent eating pattern. Don’t skip meals, especially breakfast. It will only make you feel hungry and eat more the next meal. Instead, eat small frequent meals. Snack on fruits or low-calorie biscuits if hungry.
The US study showed that individuals who are able to keep their weight off have a consistent eating pattern. Stick to your diet plan as much as possible, whether at parties, kenduri or festivities.
Step 5:
Exercise will help boost your metabolic rate and burn the calories, leading to faster weight loss. You need to exercise 30 to 45 minutes daily or break it up to 10-minute sessions daily. If you have other medical conditions, such as diabetes, heart disease or arthritis, seek the advice of a healthcare professional before beginning an exercise programme!
Vary the activity you do to keep off boredom. You can also increase your energy expenditure through tasks such as taking the stairs instead of the lift, washing the car, mopping, gardening etc.
Step 6:
Studies have also shown that individuals are able to keep the weight off for more than a year if they combine diet control with exercise and behaviour changes.
Follow these tips to control stimulus which can trigger excessive food intake:
- eat only at the dining table
- don’t shop for food when hungry
- do not store unhealthy food
- practice self-restraint
- eat slowly to allow satiety signals from the stomach to the brain
Monitor your weight
Individuals who monitor their weight tend to always have better compliance and better control of their disease conditions.
Similarly, with weight control, monitoring of your own weight will help you stay motivated and catch ’slips’ before larger regain of weight.
In the US study, individuals who kept their weight off were found to weigh themselves frequently.
While weighing yourself several times a day would be manic, it is advisable to weigh yourself at least once a week. Invest in a reliable weighing scale and weigh yourself at the same time of the day (preferably before food) and with minimum clothing.
Fad diets don’t sustain weight loss
Finally, don’t believe in fad diets (high-protein, low-carbohydrate, fruit, celebrity diets, etc). They may work for a while but because they do not promote proper eating habits, you are not likely to sustain it. Practice healthier eating patterns, increase physical activity and you will be able to keep your weight under control for a lifetime.
Dr Winnie Chee is a dietician at Universiti Kebangsaan Malaysia and is also a member of the Malaysian Dietitians’ Association. This article is courtesy of the association.
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