Tips to healthier lifestyle - Nutrition Society Malaysia

a
o
t
Tips
Healthier
Lifestyle:
ISBN 978-967-5737-03-9
A Practical Nutrition Guide
for The Family
Published by
Nutrition Society of Malaysia
Malaysian Dietitians’ Association
Malaysian Association for the
Study of Obesity
Nutrition Month Malaysia 2012
National Steering Committee
Chairman
Contents
Dr Tee E Siong, KMN
Members
Nutrition Society of Malaysia:
Assoc Prof Dr Zaitun Yassin, KMN
Dr Mahenderan Appukutty
Malaysian Dietitians’ Association:
Ms Indra Balaratnam
Malaysian Association for the
Study of Obesity:
Prof Dr Norimah A Karim
Dr Zawiah Hashim
3
Towards A Healthier You, Healthier Family
4
6
8
Don’t Be a Heavyweight
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
Disclaimer
Guide to Achieving a Healthier Diet
Eating Healthily Even When You Dine Out
9 Eat Healthily – Cook Your Own Meals
Healthy Shopping: 10 What
are Nutrition Labels?
12 Be Active!
This book is not in any way intended to
subsitute medical advice from your doctor
or health professionals. When in doubt,
please consult your doctor. The Nutrition
Society of Malaysia (NSM), Malaysian
Dietitians’ Association (MDA) and 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) 2012.
Growth Reference Charts
14
15
BMI-for-Age Charts (2 to 5 years old)
BMI-for-Age Charts (5 to 18 years old)
Towards A Healthier You, Healthier Family
Chronic lifestyle diseases have become a plague of modern living. The prevalence of
diseases such as obesity, hypertension, diabetes, heart diseases and cancers are at
an all time high, and are the leading causes of mortality in the world. The World Health
Organization has reported that 36 million out of the 57 million (or 63%) global deaths in
2008 were due to chronic lifestyle diseases. In Malaysia, these diseases are estimated
to account for 67% of all deaths!
These diseases, also known as non-communicable diseases, do not just manifest
overnight. They are the result of sedentary lifestyles and unhealthy diets, practised
over the years. These diseases are in fact easily preventable by practising a healthy
lifestyle. Hence, prevention should start from a young age, and the best place to begin
is within the family.
The Malaysian Dietary Guidelines have provided 14 key messages to help guide you
and your family towards a healthier lifestyle.
1. Eat a variety of foods within the recommended
intake.
2. Maintain body weight in a healthy range.
3. Be physically active every day.
4. Eat adequate amounts of rice, other cereal
products (preferably whole grain), and tubers.
5. Eat plenty of colourful fruits and vegetables
every day.
6. Consume moderate amounts of fish, meat,
poultry, eggs, legumes and nuts.
7. Consume adequate amounts of milk and milk
products.
8. Limit intake of foods high in fats and minimise
fats and oils in food preparation.
9. Choose and prepare foods with less salt and
sauces.
10. Consume foods and beverages low in sugar.
11. Drink plenty of water daily.
12. Practise exclusive breastfeeding from birth until
six months and continue to breastfeed until two
years of age.
13. Consume safe and clean foods and beverages.
14. Make effective use of nutrition information on
food labels.
Don’t Be A HEAVYWEIGHT
Body weight is a major influence on health throughout life. Overweight people (even
children) are generally less healthy and are more prone to illnesses such as diabetes,
hypertension, heart diseases and cancers. This is why it is important for everyone to
maintain a healthy weight within the recommended range.
To assess the nutritional status of yourself or your family members, the best way is
to weigh regularly at least twice a month at the same time. It would help to invest
in a good weighing scale to ensure that the readings are accurate and precise. Just
knowing the weight is not enough; you must also calculate the body mass index (BMI)
as well. BMI is a simple index of weight-for-height that is commonly used to classify
overweight and obesity in individuals.
Calculating BMI
Step 1: Measure
Weight
Step 2: Measure Height
Step 3: Calculate BMI
When you have measurement for weight and height, you can
now calculate BMI according to the formula:
BMI =
weight (kg)
height (m) x height (m)
Chubby and Cute, But Are They Healthy?
Chubby kids are always cute, but do you often wonder if your child has the right weight
for his height and age? The simplest and most effective way of determining your child’s
nutritional status and whether he is receiving optimal nutrition is by calculating his BMIfor-age and comparing the values to the WHO growth standard (refer page 14-15 for
the BMI-for-age charts for your children). Regular assessment of your child’s BMI-forage can help you find out if your child is normal, underweight, overweight, or obese.
Do remember to use the appropriate BMI-for-age charts, as they are gender specific.
Risky Weights & Waists for Adults
Adults too should regularly assess their health as it helps determine their current
nutritional status, as well as risk for chronic diseases. Measure your BMI, and if your
BMI is more than 25, you are at a higher risk of developing diseases such as heart
disease, diabetes, certain cancers, etc.
Do take note that for adults, we need to use the following BMI cut-off points:
Body weight classification
BMI cut-off points for
definition (kg/m2)
Health risk
Underweight
<18.5
Normal range
18.5 to 24.9
Overweight
25.0 to 29.9
Moderate
≥ 30.0
High
Obese
Low
Waist circumference is another way of assessing your nutritional status and health
risk of an adult. Excess fat accumulated at the abdominal (stomach) area is associated
with greater health risk (e.g. heart disease, diabetes) compared with fat around other
regions of the body. Measuring your waist circumference will help determine your
abdominal fat. Take care that these measurements do not exceed the cut-off points!
Waist circumference cut-off points
Health risk
Men
Women
< 90cm (35 inches)
< 80cm (32 inches)
Low
≥ 90cm (35 inches)
≥ 80cm (32 inches)
High
It is important to carry out regular weight assessments, for both you and your children,
to determine your family’s nutritional status. This will not only aid you in maintaining
a healthy body weight and waist circumference, it will also help in preventing chronic
lifestyle diseases.
Guide To Achieving A Healthier Diet
With so many food choices available in Malaysia, we sometimes tend to forget about
eating healthily!
Healthy eating is as simple as eating regular meals that provide the proper combination
of nutrients and energy required for your body. A healthy diet, together with consistent
physical activity is the key to a healthy body weight, as well as to overall health and
well-being.
You can ensure that you and your family will obtain all the necessary nutrients and
energy by using the Malaysian Food Pyramid. It is a simple visual tool to guide you to a
healthier diet by helping you and your family to make appropriate choices in the types
and amount of foods to be consumed daily. The pyramid will help you to achieve:
BALANCE
Eat all the 5 food groups daily. Foods at the bottom should be eaten
adequately, while those at higher levels should be eaten less.
Each food group performs different main functions and the right
combination of these is essential for optimal health.
MODERATION
Follow the number of servings that is recommended to prevent
overeating, which may lead to being overweight. Each time you eat
a meal, be mindful of the serving size so as not to overeat. Do not
participate in “eat-as-much-as-you-like” promotions.
VARIETY
Ensure that you have a mix of foods from each level of the pyramid, as
no single food can give you all the nutrients you need. This practice
also makes your meals more interesting to all in the family!
Fats, oil, sugar
and salt
Eat less
Fish, poultry, meat
and legumes
Milk and milk
products
½–2 servings of meat/
poultry/egg/day
½–1 serving legumes/day
Eat in moderation
1–3 servings/day
Eat in moderation
Fruits
Vegetables
2 servings/day
Eat plenty
3 servings/day
Eat plenty
Rice, noodle,
bread, cereals,
cereal products
and tubers
4-8 servings/day
Eat adequately
Malaysian Food Pyramid
Eating Healthily Even When You Dine Out
Malaysia, a multiracial and multicultural country, is well known as a food haven. Various
cuisines from different ethnicities leave us spoilt for choice, but it is still important to
choose wisely (and in moderation- watch out for portion), especially when eating out.
Here are some tips for different cuisines when you eat out:
Cuisines
Healthier Tips
Malay
• Avoid those cooked with lots
of santan (eg masak lemak,
rendang).
• Choose healthier dishes
such as, masak pindang,
asam pedas, tom yam soup).
• Avoid deep fried meat and
opt for grilled or “bakar”.
Nasi goreng paprik
• Avoid those cooked with too
much oil or ghee.
• Avoid beverages that contain
condensed milk or too much
sugar.
Roti canai with dhal gravy
Plain tosai with dhal gravy
Briyani rice (cooked with
ghee) + dishes
White rice + dishes and
vegetables
Indian
Chinese
Western
• Avoid those cooked with too
much oil.
• Choose steamed or roasted
meat instead of deep fried.
• Choose dishes made with
tomato-based sauce rather
than cream-based.
• Opt for fresh fruit instead of
high-calorie cakes and tarts
for dessert.
Choose Less Often
Choose More Often
White rice paprik
Curry mee
Asam laksa
Fried fish
Ikan bakar
Pisang goreng
Fresh banana
Kuih seri muka
Red bean pau
Vadai
Puttu mayam
Fried chicken
Tandoori chicken
Chicken rice with fried chicken Chicken rice with steamed
chicken & pak choy
Fried kuih-teow
Kuih-teow soup
Fried dumpling, fried yong
tau fu
Dumpling in soup, yong tau fu
in soup
Char kuey
Steamed popiah
Fried fish and chips
Grilled fish and
baked potatoes
Chicken burger with French
fries
Tuna sandwich
Spaghetti carbonara (white
cream sauce)
Spaghetti marinara (tomato and
seafood)
Doughnut
Sardine bun
Use these tips as guidelines when eating out:
• Choose meals that are steamed, grilled, roasted, boiled, or broiled, instead of those
that are fried or deep-fried.
• Ask for food to be prepared healthier, eg less oil, less salt or soya/oyster sauce, and
more veggies, and less sugar in drinks.
• Choose “small” or “medium” portions; do not fall for ‘economical size-up’ gimmicks.
You can also share large meals between family members.
Eat Healthily – Cook Your Own Meals
Eating home-cooked meals will give you more control over the food you serve for
yourself and your family. Get creative when cooking your meals – you can use
alternative ingredients or different cooking styles when preparing your favourite dishes.
This way, you can still enjoy delicious meals, just more nutritious and healthy!
Use healthier ingredients/condiments to substitute some of the more high fat, sugar, or
salt ingredients. Some of these include:
• Spices (eg cinnamon, ginger, turmeric, mustard);
• Herbs (eg basil, parsley, lemon grass, mints, celery (daun sup), coriander (daun ketumbar);
• Low-fat milk instead of coconut milk (santan);
• Fruit puree or pure fruit juice – natural sweetness.
Good to know…
• Each tablespoon of oil you use when frying
adds more than 100 calories!
• When you deep-fry meats with skin, eg
chicken, which contains saturated fat, you
simply add more fat to them.
• Deep-frying for long periods cause
degradation of the oils – the oil is then
not suitable for further use to prepare
other dishes.
• Starchy foods, eg fries, potato chips,
bread-crumbed foods, cooked in fats
heated to more than 160°C contain
significant amounts of acrylamide
– a chemical that may cause cancers
(carcinogen).
Cooking styles can determine how healthy and nutritious your meals will be.
Certain cooking styles are healthier than others, and also result in different tastes,
textures, and presentations of the foods. Some of these methods include:
• Steam
• Soup
• Stew
• Roast
• Grill
• Poach
• Stir fry
• Sauté
Healthy Shopping:
What Are Nutrition Labels?
These labels, also known as nutrition information panels (NIP), are tables found on the
label of a packaged food and show the amount of energy, carbohydrates, protein and
fat, and sometimes, vitamins, minerals and other nutrients contained in the product.
Reading these labels can help you choose healthier options of foods and beverages,
as well as:
• Compare the nutritional value of different brands of similar foods.
• Help you decide which foods fit into your eating plan or is appropriate, especially if
you have certain health conditions such as, high blood pressure or high cholesterol.
• Use them as a tool to plan a healthy, balanced diet.
Understanding the
Serving size: 5 pieces (20g) / Servings per package: 5
Nutrients
Per 100g
Per serving (20g)
Energy, kcal
525
105
Carbohydrate, g
56.2
11.2
Protein, g
8.0
1.6
Fat, g
29.8
6.0
• Nutrient listing
– List of energy,
carbohydrates, protein
and fat, as well as
vitamins and minerals
contained in the
product.
• Amount of
nutrients
– The amount
of energy and
nutrients per 100g
(solid foods) or per
100ml (beverage).
10
• Amount of
nutrients per
serving – Amount of
nutrients and energy
each serving of the
food provides.
Other items in the food label
There are other important information on the food label of packaged foods that you
should pay attention to when shopping.
• Ingredient list – Listed in a descending order of predominance and weight.
Important to know that same ingredients may have different names, eg sugar
could also be called sucrose, honey, syrup, molasses, maltodextrin, etc.
• Expiry date – Indicated as “Best Before”, “Use by”; refers to the last date you
should consume the food, as after this date, the food is not guaranteed to be
safe to eat.
• Net weight/net volume – The total weight or volume of the packaged/canned
goods.
• Storage method – Check if the foods or beverages should be stored at room
temperature, refrigerated, or frozen.
• Instructions of use – Read to see how the food/drink should be prepared
before it can be consumed.
• Potential allergen content – Check for allergens, eg peanuts, milk and its
products, eggs, wheat, etc, especially if any member of your family is allergic to
a particular item!
Keep these tips in mind…
• Always read the ingredient list to find
out what the main ingredients are.
• Make food/beverage choices based on
the overall nutrient content of a product.
• Always compare based on 100g or
100ml of the product. Serving sizes
may not be suitable as it may differ
among brands.
• Know serving sizes to avoid overconsumption of the product.
11
Be Active!
Good nutrition alone is not sufficient to maintain a healthy and balanced life. It is
equally important to carry out physical activity, which can be as simple as doing
daily chores, or walking to nearby destinations.
The Physical Activity Pyramid is a simple guide to help us be more physically active
everyday. Activities listed at the bottom of the pyramid are activities that should be
done more often, if possible, on a daily basis. On the other hand, those listed right
at the tip of the pyramid are sedentary activities and should be limited as much as
possible.
LIMIT
Limit sedentary
activities
• Watch TV
• Play computer game
2 – 3 TIMES A WEEK
Participate in activities that increase
flexibility, strength and endurance
of the muscle
• Stretching body
• Partial sit up • Push up
• Weight lifting (dumb bell)
5 – 6 TIMES A WEEK
Do moderate intensity physical activity; 30 minutes per day
• Brisk walking • Cycling • Aerobic exercise
• Swimming • Dancing • Skipping rope
• Football • Badminton • Basket ball • Hiking
EVERYDAY
Be active everyday in many ways
• Walk up and down the stairs
• Walk to the shop/office
• Housework • Gardening
Physical Activity Pyramid
12
If you are overweight or
obese…
Start out with something simple such
as, walking up and down the stairs,
or gardening, which can help you
get on track to exercising right. You
can then move on to stretching,
brisk walking, aerobic exercises
and swimming, and eventually even
play some sports like badminton and
cycling.
• To lose weight, more than 30 minutes daily of moderate-intensity
physical activity is recommended;
• To prevent the transition from
overweight to obese, about 45-60
minutes is needed daily;
• To maintain and prevent re-gain
of weight among former obese
individuals, a total of 60-90 minutes is
necessary daily.
Health benefits that you can gain from
losing weight:
•
•
•
•
Lower blood pressure levels;
Lower cholesterol levels;
Lower blood sugar levels;
Reduce pressure on joints
Regardless of age and size, it has been proven that physical activity can add years
to your life. Also, it is important to remember that physical activity does not mean
strenuous activities that constantly leave you breathless after. Instead, start with the
simple and basic activities; by ensuring these become a routine, you can work towards
building a steady stream of physical activity in your daily life!
13
underweight
Growth Reference Charts
Age (years, months)
For Children 2 – 5 Years Old
BMI-for-Age (BOYS)
overweight
BMI (kg/m2)
risk of
overweight
normal
GROWTH REFERENCE CHARTS /
underweight
CARTA RUJUKAN PERTUMBUHAN
FOR CHILDREN 2 – 5 YEARS OLD / UNTUK KANAK-KANAK 2 – 5 TAHUN
Age (years, months)
BMI-for-Age (GIRLS)
}
overweight
BMI (kg/m2)
risk of
overweight
normal
underweight
Age (years, months)
14
Growth Reference Charts
For Children 5 – 18 Years Old
BMI-for-Age (BOYS)
obese
BMI (kg/m2)
overweight
normal
underweight
Age (years, months)
BMI-for-Age (GIRLS)
obese
BMI (kg/m2)
overweight
normal
underweight
Age (years, months)
15
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materials from the Nutrition Month Malaysia programme. We also welcome feedback/queries. To reach us, please contact:
The Nutrition Month Malaysia Secretariat
Tel: (03) 5632 3301/5637 3526 Email: nutritionmonth@nutriweb.org.my
www.nutriweb.org.my