Fight Obesity Eat Right, Move More, Published by

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Fight Obesity Eat Right, Move More, Published by
Eat Right,
                                                                                     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
Fight Obesity Eat Right, Move More, Published by
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.

Family Carnival                                               Educational
✪✪ Organised 7 major                                          Materials for
   fun-filled carnivals                                       School Children &
                                                              Preschoolers
School & Kindergarten                                         ✪✪ Published comic              n2

Roadshows                                                         book and activity
                                                                                        Bahagia
                                                                                                          n,
                                                                                                   Sarapa
                                                                                             Makan Belajar.
                                                                                              Pandai
                                                                  book for primary
✪✪ Visited 160 primary schools                                                                                                                                      Kanak-kanak Sihat, Negara Lebih Sihat

                                                                  school children                                                                                                 Memupuk Gaya

   and provided healthy eating
                                                                                                                                                                                  Pemakanan
                                                                                                                                                                                  Sihat                                                       Kanak-kanak Sihat, Negara Lebih Sihat

                                                              ✪✪ 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)

   and active living messages
                                                                                                                                                                                  • Bahagian 2: Makan•Sarapan,
                                                                                                                                                                                                         BahagianPandai
                                                                                                                                                                                                                   1:      Belajar
                                                                                                                                                                                  • Bahagian 3: Makan Secara
                                                                                                                                                                                                         MakanSihat,
                                                                                                                                                                                                                Secara Sihat,
                                                                                                                                                                                                         MembesarCergas
                                                                                                                                                                                                Bermain Dengan      Dengan Kuat
                                                                                                                                                                                                                                • Bahagian 2:
                                                                                                                                                                                                                                  Makan Sarapan,
                                                                                                                                                                                                                                  Pandai Belajar Disokong oleh

                                                                 and worksheets for
                                                                                                                                                         Terbitan                       Dengan sokongan
                                                                                                                                                                                                                                • Bahagian
                                                                                                                                                                                                                                      Geran Promosi Kesihatan daripada
                                                                                                                                                                                                          Kementerian Kesihatan Malaysia
                                                                                                                                                                                                                                              1:
                                                                                                                                                                                                                                  Makan Secara Sihat,
                                                                                                                                                                                                                                  Bermain Dengan Cergas
                                                                                                                                                                                                                                                                                                          Terbitan

✪✪ Visited 175 kindergartens
                                                                                                                                                                                                                                                                                                                  Disokong oleh Geran
                                                                                                                                                                                                                                                                          Dengan sokongan
                                                                                                                                                                                                                                                                                                               Promosi Kesihatan daripada

                                                                 preschoolers
                                                                                                                                                                                                                                                                         Kementerian Kesihatan Malaysia

                                                                                                                                                                         2
                                                                                                                                                         Bahagian
                                                                                                                                             onton DVD
                                                                                                                                       as men
                                                                                                                              ini selep
                                                                                                              kertas aktiviti
                                                                                                    Gunakan

   and conducted interactive
   nutrition activities
                                                              Educational Press
                                                              Articles
Publications for Public
                                                              ✪✪ Published over 73
✪✪ Published 6 practical nutrition guidebooks, 3 recipe
                                                                 articles in English,
   books and 1 mini-booklet
                                                                 Bahasa Malaysia
                                                                 & Chinese
                                                                 newspapers

                                                              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:

                    The Nutrition Month Malaysia Secretariat
 Tel: (03) 5632 3301/5637 3526 Email: enquiry@nutritionmonthmalaysia.org.my
                  Website: www.nutritionmonthmalaysia.org.my
                                 Nutrition Month Malaysia
Fight Obesity Eat Right, Move More, Published by
Eat Right,
     Move More:
   Fight Obesity
Obesity has become a serious concern in Malaysia nowadays. According to a
study by World Health Organization (WHO) in 2010, Malaysia has been ranked the
fattest country in South-East Asia and the sixth in all of Asia. Although there are
Malaysians who are aware of the concerns of obesity, there are still many who do
not realise its consequences.

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.

     There are no shortcuts to become healthy. Regardless of age, everyone
     should practice a healthy eating diet and be physically active every day. As a
     parent, your role is important in inculcating a healthy eating lifestyle among
     your children since young.

    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.

            We hope that this guidebook will inspire you to start a healthy
            lifestyle by eating right and staying active with your family.

               Dr Tee E Siong,
               Chairman of NMM Steering Committee
Fight Obesity Eat Right, Move More, Published by
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

                                                                  Question and Answer
                                                                  29 Ask the Experts about Weight Management

                                                                  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
Fight Obesity Eat Right, Move More, Published by
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

                                    With support from

                                                                                     Serba Wangi Sdn Bhd
Ace Canning Corporation
       Sdn Bhd

                                     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.
Fight Obesity Eat Right, Move More, Published by
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.

                Consequences of Overweight and
                Obesity
                Having excessive weight (and fat) adversely impacts several organs and parts of your body,
                resulting in various diseases such as:

                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

                Fatty liver                                                        SKIN
                Obesity leads to abnormally                                        Dark, velvety patches on
                large organs                                                       the neck or armpits can
                                                                                   be a sign of obesity related
                Cirrhosis                                                          health problems like diabetes
                Damaged cells are replaced by
                scar tissue
                                                                                   KIDNEYS
                                                                                   Sustained high blood pressure,
                HORMONES                                                           or hypertension, can damage
                Too much adipose tissue                                            the kidneys and lead to kidney
                may lead to early puberty (at the                                  failure
                age of 10) where it causes sex organs
                to mature earlier.                                                 PANCREAS
                                                                                   Excess fat can impair the pancreas’s
                                                                                   ability to use insulin to control blood
                                                                                   sugar, leading to Type 2 diabetes

                                                                 |6|
Fight Obesity Eat Right, Move More, Published by
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

Main Causes of Obesity
Being overweight or obese does not
happen overnight; it occurs when you
continue practicing an unhealthy lifestyle
over a period of time, which leads to
energy imbalance. The biggest problem
often lies in having unhealthy eating
habits and a lack of physical activity.
By frequently consuming more energy
than your body needs and not utilising
the consumed energy through physical
activity, there is a large excess of
unutilised energy. What does the body do
with this unutilised energy? It will store it
as fat.

  Common mistakes people do that can cause
  energy imbalance:

  1     Choosing foods that are energy dense –
        high in fat and sugar

  2     Regularly consuming large portion sizes
        and frequent binge eating/snacking

  3     Giving in to a sedentary lifestyles – not
        engaging in any form of physical activity
        and exercises, choosing to walk less
                                                             Fight the Flab
        and sitting down more often in front of              Today!
        computer or TV
                                                             A healthy weight is crucial for people of all
                                                            ages. Besides looking and feeling good, a
                                                            healthy body weight helps you to prevent
  Childhood Obesity: What                                    from diet-related chronic diseases (e.g.
  every parent needs to know                                   diabetes, hypertension, heart disease
                                                                and cancers). Attaining and maintaining
  Chubby is not always cute especially because                    a healthy weight starts with healthy
  your child is more likely to be overweight or                    eating and a physically more active
  obese as an adult. This will lead to additional future             lifestyle. Even if you are already
  risks such as breathing difficulties, increased risk                 overweight or obese, it’s never
  of fractures, hypertension, insulin resistance, and                    too late to do something. Start
  psychological effects (low self-esteem).                                 making changes now, for
                                                                            yourself and your family!
  The first step to find out if your child is at risk of overweight          (Refer to the Weight
  or obesity is to measure your child’s BMI.                                   Management Section)
  Turn to page 28 to find out how.

                                                       |7|
Fight Obesity Eat Right, Move More, Published by
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.

                                        31      things to keep in mind when reading this section:
                                                    You need energy to maintain your body’s vital processes
                                                    (e.g breathing) and for your basic everyday activities
                                                    (e.g sleeping, bathing, walking or other daily activities).

                                               2    Energy you need comes from the food
                                                    you eat.

                                               3    Kilocalorie (Kcal) is the measurement unit for energy.
                                                    E.g. 1 plate fried mamak mee = 660kcals

                                                               |8|
Fight Obesity Eat Right, Move More, Published by
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.

How Much Energy Do You
                                                                    Daily energy requirements for
Actually Need?
                                                                    children:
Your gender, age, height, weight, body size, physical               c   Babies (0-1 years): ~ 550 – 640 kcal
activity level and your basal metabolic rate are some of                (0-6 months – breast milk only)
the factors that determine the amount of energy you need            c   Toddler (1-3 years): ~ 900 kcal
in a day. For instance, the more physically active you are,         c   Pre-school (4-6 years): ~ 1300 kcal
the more energy (calories) you will need for each day.
                                                                    c   Primary school (7-9 years):
You can refer to the table below to find out your daily                 ~ 1700 kcal
energy requirement based on which category you fall                 c   Early adolescent (10-12 years):
into:                                                                   ~ 2000 kcal

                                                                                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|
Fight Obesity Eat Right, Move More, Published by
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.

                                                                                Duration of Physical Activity Needed
                                                       Calorie content in
                               Food                                               to Burn the amount of Calorie in
                                                           1 serving
                                                                                       1 serving of the Food
                  1 plate nasi lemak with fried
                                                            640 kcal        Jog for 1 hour and 45 minutes
                  chicken
                  1 plate fried Kueh-Teow                   320 kcal        Play badminton for 1 hour
                  1 piece roti canai                        300 kcal        Brisk walk for 1 hour and 15 minutes
                  1 piece fried chicken                     260 kcal        Dance for 45 minutes
                  1 bowl of curry noodle                    530 kcal        Swim for 1 hour and 15 minutes
                  1 whole chicken burger                    440 kcal        Jog for 1 hour and 15 minutes
                  1 glass teh tarik                         140 kcal        Brisk walk for 35 minutes
                  1 can carbonated drink                    140 kcal        Sweeping the floorfor 1 hour
                  3 pieces banana fritters                  390 kcal        Cycle for 2 hours
                  2 pieces curry puff                       260 kcal        Walk for 1 hour and 20 minutes

                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

a healthy diet so that you can gain                    Food
a proper combination of essential                      Pyramid
nutrients and energy to go about your                                                                     Fish, poultry, meat,
                                                                                                          eggs and legumes
daily activities.                                                                                         ½-2 servings of poultry/
                                                                                                          meat/ egg/ day
                                                              Milk and milk                               1 serving of fish/day
Use the Malaysian Food Pyramid as a                           products
                                                                                                          ½-1 serving of legumes/day
                                                                                                          Eat in moderation
                                                              1 –3 servings /day
tool to guide you. It will help you obtain                    Eat in moderation

proper nutrition by eating a balanced
meal comprising of a variety of food in
moderate amounts.                                        Fruits                                                         Vegetables
                                                         2 servings/day                                                 3 servings/day
                                                         Eat plenty                                                     Eat plenty

Here are a few things you should know about
the food pyramid:                                                                                                   Rice, noodle,
                                                                                                                    bread, cereals,
c   It has four levels that represent various food                                                                  cereal products
                                                                                                                    and tubers
    groups                                                                                                          4-8 servings/day
                                                                                                                    Eat adequately
c   It shows the amount (in servings) of food you
    should eat from each group daily
c   From the bottom to the top of the food pyramid,
    the number of servings of each food group
    becomes smaller.
c   Foods at the base of the pyramid should be eaten the most daily as
    they contain the highest source of energy, while foods at the top of pyramid should be consumed less.
c   There is a range of servings indicated for each food group in the pyramid. This is to cater for the varying needs of
    individuals. For individuals who are not physically active, opt for the smaller number of servings, especially for the
    food group at the base.
    It allows you to practise 3 key principles of eating right:

                                                     M
c

            B
         1. Balance                               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).

                                                                         c Oils, salt and sugar are situated at the peak of
                                            Oil, salt, sugar –             pyramid. These are not considered as essential
                                             eat less                      food groups and must be consumed in small
                                                                           amounts.
                                                                         c Avoid consuming foods that are prepared with
                                                                           excessive amounts of oils, salt and sugar especially
                                                                           processed foods like cookies, doughnut, and
                                                                           various chips.

                                                                    | 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.

                 Eat according to the number of servings for each group recommended in
                 the food pyramid
                 Do you know exactly how many servings of foods you need to consume daily based on the food pyramid?
                 The table below will show you just how much you need to eat every day based on the energy (calorie) your
                 body needs.

                  Food group                                                                                   Food group
                                                                               1500 kcal/day*              2000 kcal/day*   2500 kcal/day*
                  Cereals & cereal products                                        4 servings                  6 servings      8 servings
                  Vegetables                                                       3 servings                  3 servings      3 servings
                  Fruits                                                           2 servings                  2 servings      2 servings
                  Meat, poultry, fish and legumes
                       Meat / Poultry                                              ½ serving                    1 serving      2 servings
                       Fish                                                        1 serving                    1 serving       1 serving
                       Legumes                                                     ½ serving                    1 serving       1 serving
                  Milk and Dairy products                                          1 serving                   2 servings      3 servings

                 *To know which category you fall in, please refer to page 9 under the topic Energy Balance.

                 Portion Sizes for kids
                 Children need adequate amounts of energy and nutrients from healthy sources for optimum growth and
                 development. Too much or too few calories can cause problems like childhood obesity, being stunted and
                 underweight which can lead to bigger problems when they grow up. The table below will help you to estimate
                 the amount of calories and the number of servings of foods that your child needs throughout the day.

                                                                                 | 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

                    Examples of 1 serving according to Food Pyramid
                  Use the table below to understand what one serving for various foods mean:

   Group 1:                      Group 2:                    Group 3:                  Group 4:                       Group 5:
Cereals & cereal                Vegetables                    Fruits               Meat/Fish/Poultry/                Milk & dairy
   products                                                                           Legumes                         products
1 cup white rice,          ½ cup green leafy            1 whole apple/             1 piece chicken               1 slice cheese
  cooked                     vegetables with              pear/orange/               drumstick                   1 glass milk
1½ cup mee hoon,             edible stem,                 banana                   1 medium kembung              1 cup yoghurt
  soaked                     cooked (eg.                  (berangan,                 fish                        4 dessert spoon
6 Pieces crackers            sawi, kangkung)              medium)                  2 tablespoon sliced             milk powder
2 slices bread             ½ cup fruit                  1 slice papaya/              lean beef
2 cups porridge              vegetables,                  watermelon               2 whole eggs
1 cup noodle/                cooked (eg.                4 small prunes             2 medium squid
  kuey teow, wet             tomato)                    3 pieces durian            1 cup dhal/chickpea
                           1 cup ulam, raw              8 small grapes             1½ glasses soya
                                                                                     bean drink
 Note: To know how to translate the serving size into daily meals, please refer to the example in the chapter “Put B.M.V into Practice!”
                                                              on page 16.

                  Practical Portion Control Tips                                                           Eat to live, not
 c Avoid using big plates so that you don’t tend to put large amounts of                                     live to Eat
   food on it.
                                                                                                           Too much of anything
 c Imagine the plate has four quadrants. Fill half the plate with                                           whether it is good or
   vegetables, leaving a quarter for rice and meat or legume products                                      bad will not bring any
   equally.                                                                                                  good to your body.
                                                                                                              When it comes to
 c Whenever possible, eat your vegetables first as high fibre foods
                                                                                                           eating, always take a
   tend to make you feel full faster and prevent you from overeating.
                                                                                                           moderate approach -
 c Practise regular meal and snack times. Skipping meals tend to                                           not too much and not
   make you overeat at the next meal.                                                                       too little. Remember
                                                                                                          to eat according to the
 c Avoid going to buffet-style restaurants or “eat-as much as you can”
                                                                                                           right portions from an
   type of meals if you tend to overeat.
                                                                                                            early age in order to
                                                                                                              prevent obesity.

                                                                    | 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.

                             Breakfast                           Mid-morning snack                                        Lunch
                                         1 glass milk           1 glass chocolate                             ½ cup spinach
                                          (Group 5)               milk (Group 5)                                (Group 2)
                 1 cup of breakfast                                                                                              ½ whole guava
                  cereal (Group 1)                                                                     1 piece chicken             (Group 3)
                                                           6 pieces cream cracker                         drumstick
                                                                  (Group 1)                               (Group 4)

                                      1 banana
                                      (Group 3)
                                                                                                                         1 cup brown rice
                                                  Evening Snack                                 Dinner                      (Group 1)

                                                                                     ½ cup sawi and bean
                                              1 cup
                                                                                       sprout (Group 2)            2 tbsp sliced lean
                                           cooked dhal            ½ cup mixed
                                            (Group 4)                                                              meat (Group 4)
                                                                  vegetables
                                                                   (Group 2)

                                                                                                                         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:

                                      Group 1 (Cereal s and cereal products):             5 servings
                                      Group 2 (Vegetables):                               3 servings
                                      Group 3 (Fruits):                                   2 servings
                                      Group 4 (Fish / Chicken / Meat / Egg):              2 servings
                                      Group 4 (Legumes):                                  1 serving
                                      Group 5 (Milk & dairy products):                    2 servings

                                                                            | 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
     y, yo u wi ll be  able to stay with             o gr ea t as it:
  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

Meal                             E.g Weekday 1                             E.g Weekday 2
Breakfast                        1 cup wholegrain breakfast cereals        2 pieces wholemeal bread
            Keep calorie to      1 banana                                  1 egg omelette
              < 600kcal          1 glass milk                              1 whole apple
                                                                           1 glass milk

Mid-Morning                      4 small apam, steamed                     3 pcs cream crackers
Snack     Keep calorie           Plain water                               Plain water
             to < 150kcal

Lunch                            1 cup brown rice                          1½ cup spaghetti
                                 1 chicken drumstick,steamed               ½ cup carrot and broccoli, sliced
            Keep calorie to      ½ cup kangkung, stir fried                ½ cup meatballs
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:

                 1   Nutrition Information Panel (NIP)
                     The NIP is a table found on the label of pre-packaged foods that lists the amount of energy and several
                     nutrients contained in the food. This is provided so that you can understand the amount of energy and
                     nutrients you are taking in when consuming the food. This helps you to manage the total amount of
                     energy consumed in a day. NIP also enables you to compare the nutritional content among different
                     brands of similar food and find out which ones are higher or lower in certain nutrients.

                         Nutrition Information (Cereal Brand A)                         Nutrition Information (Cereal Brand B)
                   Serving size: 45g • Servings per package: 4                Serving size: 45g • Servings per package: 4
                       Nutrients       Per 100 g      Per serving (45g)           Nutrients         Per 100 g     Per serving (45g)
                   Energy (kcal)          411               185               Energy (kcal)            334               150
                   Carbohydrate (g)       85                38.3              Carbohydrate (g)          69              31.1
                   Sugars (g)             18.5               8.3              Sugars (g)               11.3              5.1
                   Protein (g)             11                5.0              Protein (g)              10.1              4.5
                   Fat (g)                 3                 1.4              Fat (g)                   1.9              0.9

                                                                    Legends:

                     Nutrient Listing                     The Amount of                       The amount of nutrients per
                     Pre-packaged foods must              Nutrients                           serving
                     list the energy, carbohydrate,       Refers to nutrients                 This is the amount of nutrients and
                     protein and fat content.             contained in every 100g (if         energy you receive in each serving. If
                     Vitamins and minerals may            solid) or every 100 ml (if          you consume 2 servings, the energy and
                     also be listed                       liquid) of a food or drink.         nutrients will be doubled.

                                                                     | 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.

                                                           It is therefore important to understand what these
                                                           claims mean and make appropriate use of them.
                                                           Claims such as those above do not necessarily
                                                           mean that the products are the healthiest choices.

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.

                                                         IMPORTANT! Tips when comparing different
Comparing the example of Brand A to Brand B:
                                                         brands of similar products:
 Content               Brand A       Brand B
                                                         c Serving sizes cannot be used for comparison
 Protein                   Higher       Lower               because they may differ from one brand to another.
 Sugar and Fat             Higher       Lower               Always compare different brands of a similar product
 Calorie                   Higher       Lower               based on per 100g or per 100ml.
                                                           c   Don’t make the decision to purchase a particular
CONCLUSION:                                                    brand based on one nutrient alone. Consider the
If you are looking for a product with lower sugar,             other nutrients listed in the NIP and other nutrient
fat and calorie, choose Brand B.                                information available on the packaging.

                                                         | 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

                   Snacks                              Beverages                            At Restaurants
                   U Always go for fresh               U Always go for plain                U If the portion size is too big,
                     fruits, salad, nuts and             water to quench your                 don’t force yourself to finish the
                     seeds                               thirst                               meal if you are full. Share it with
                                                       U Reduce intake of                     friends or family members or
                   U Have a healthy snack
                                                         sugar-sweetened                      pack up the leftovers to eat later
                     prepared to avoid eating
                     energy-dense and low                beverages and                      U Ask for gravy and sauces to be
                     nutrient foods                      alcoholic beverages                  served separately
                   U Choose low fat salad              U Choose 100% fresh                  U At buffets, only take a little of
                     dressing or replace with            fruit juices instead of              food from each food group to
                     vinegar, or lime juice              carbonated drinks or                 explore a variety of food without
                                                         cordials                             over-indulging. Remember the
                   U Reduce sweet and
                                                       U Choose low fat milk                  balance and moderation concept
                     savory desserts like,
                     kuih koci, keledek                  instead of sweetened               U Choose a fruity or vegetable
                     goreng, sagu, ais                   condensed milk or full               gravy/sauce instead of a sweet
                     kacang, cendol, bubur               cream milk for coffee                and creamy gravy/sauce
                     cha-cha and ladoo                   or tea
                                                                                            U Go for healthier alternatives
                                                       U Carry a water bottle                 such as:
                                                         everywhere to keep
                                                         you hydrated

                                                                     | 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

                  Calorie Content of Common Foods to Watch Out for!
                                 Types of Food                                        Portion Size      Calorie (kcal)
 Main Meals
 Western fast food set (2 pieces fried chicken, 1 bun, 1 mashed potato,                   1 set                1250
 2 potato wedges, 1 carbonated drink)
 Fried mamak mee                                                                         1 plate               660
 Briyani rice with chicken curry and dhal gravy                                           1 set                630
 Chicken rice (Rice, chicken, salad)                                                     1 plate               565
 Mee rebus                                                                               1 bowl                555
 Nasi lemak (with dried chilli paste, ½ egg (boiled), fried anchovies and                 1 set                480
 fried groundnuts)
 Beef burger with fries and carbonated drink                                              1 set                960
                                                       Snacks
 Cheese cake                                                                             1 piece               320
 Idli with dhal gravy and coconut chutney                                                 1 set                240
 Curry puff                                                                              1 piece               140
                                                        Drinks
 Mocha Frapucchino                                                                  1 cup (Grande)             400
 Bubble milk tea with pearls                                                          1 cup (large)            340
 Teh tarik/kopi tarik                                                                    1 glass               300

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

                                                                            Prepare healthy meals using the
                                                                            methods below:

                 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

                                                         Exchange with healthier ingredients
                                                         c   Use low fat milk instead of santan
                                                         c   Substitute mayonnaise with yoghurt or low fat salad
                                                              dressing, low fat mayonnaise
                                                         c   Choose wholegrain bread instead of white bread
                                                         c   Eat brown rice instead of white rice
                                                         c   Use herbs and spices instead of sauces or salt
                                                         c   Use fresh or dried fruits instead of sugar

                                                 3         Tips for healthier meal preparations
                                                           c   Remove visible fats and skins from meats
                                                           c   Remove the prawn’s head as it is high in cholesterol
                                                           c   Wash vegetables and fruits before you cut
                                                           c   Use vegetables of different colours in your meals for more
                                                               variety and to get more phytonutrients.
                                                           c   Cook fish, chicken and meat thoroughly to kill
                                                               microorganisms

                                                         If you don’t usually cook and need something simple to whip
                                                         up healthy meals for your family, here are two all-in-one
                                                         recipes for you to try:

                                                                 | 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.

                    Nutrient Content Per Serving
      Calorie 158 kcal              Carbohydrate 0.6 g
      Protein 17.9 g                Fat 9.3 g
                                                                                   These recipes were obtained from Nutritionist’s Choice Cookbook vol. 1&2.
                                                                                  For more information about the cookbook, please visit www.nutriweb.org.my.

                                                                         | 23 |
Get Up, Be Fit
Move More

                                        for Your Health!
            In order to achieve and maintain a healthy body weight, you need to balance your food intake with regular
             physical activity. The more calories you consume, the more physical activity you must do in order to burn
            these calories. Therefore, apart from helping with weight control, being physically active can bring greater
                                                       benefits to your body!

            Stronger heart reduces heart disease                                  Reduces risk of hypertension
             Aerobic type of activities help to strengthen the                    and stroke
            heart muscle as it needs to pump more blood                           Moderate impact exercise (e.g.
            to the body. Regular exercise also helps in                           walking, swimming), helps in
            increasing good HDL cholesterol, thus reducing                        controlling blood pressure, thus
            the risk of heart disease.                                            reducing the risk of hypertension
                                                                                  and stroke.

                                                                                 Improves mood, reduces stress
                                                                                 Physical activity will stimulate
            Reduces risk of                                                      the release of feel-good
            diabetes                                                             hormones called endorphins that
                                                                                 positively impacts your mood
            Helps in increasing
                                                                                 and concurrently reduces stress
            uptake of glucose
                                                                                 levels.
            from blood to cells and
            muscles, which then
            stabilize blood glucose
            levels, thus reducing the
            risk of diabetes.
                                                                                         Stronger body & joints
                                                                                         Physical activity that
                                                                                         involves strength training
                                                                                         increases or maintains your
                                                                                         muscle mass and strength,
            Stronger bones,                                                              thus lowering the risk of
            prevent osteoporosis                                                         injuries and improving your
                                                                                         day to day tasks.
            Regular weight-bearing
            exercises increase bone                                                      Stronger muscles and joints
            mass and density, thus                                                       also helps prevent falls and
            reducing the risk of                                                         injuries
            osteoporosis. Weight
            bearing exercises have
            an impact on bone and
            muscle pull which helps                                                Improves digestive health
            the bones build more                                                   Aerobic exercises accelerate
            cells and make them                                                    your breathing and heart rate
            stronger.                                                              that helps to stimulate the natural
                                                                                   contraction of intestinal muscles
                                                                                   and helps move stools out
                                                                                   quickly.

                                                                 | 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.

            Recommended Physical Activities for General Populations

                                    4

                      3

     2

 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.

         1          Do it everyday! Anytime, anywhere

            Example                                               Calories(kcal)      Tips
                                                                  burnt per hour
            At office/malls:                                             354          Any kind of activities burn
            walk up stairs instead of using elevators                                 more calories than just
                                                                                      sitting down! Imagine if you
            At home:                                                     165
                                                                                      accumulate these activities
            Playing with children
                                                                                      for an hour! Incorporate more
            Cleaning, dusting the house, sweeping the floor              148          physical activity as exercise
            Gardening                                                    236          in life.

   2         Engage 5-6 times a week: Cardiorespiratory exercises
             (strengthening the heart and lungs)

  Example                                   Calories (kcal) burnt        Tips
                                                  per hour
  Moderate intensity                                                     1. When fitness improves, try
  i. Play badminton                                     266                 to increase the intensity level
  ii. Brisk walking                                     224                 and amount of time spent on
  iii. Aerobic exercise                                 384                 physical activity
  iv. Activities in gymnasium                           325              2. Aim for 30 minutes a day
  Vigorous intensity
  i. Fast walk                                          384
  ii. Cycling                                           472
  iii. Football                                         531
  iv. Tennis                                            413
  v. Basketball                                         472

              3          Engage 2-3 times a week: Flexibility, Strength and
                         Endurance activities

              Example                                      Calories (kcal) burnt     Tips
                                                                 per hour
              Flexibility activities                                                 4 repetitions for each muscle
              i. Yoga                                              236               group
              ii. Tai chi                                          236
              Resistance and strength exercise                                       8-12 sets of repetition for each
              i. Push ups                                          207               major muscle groups
              ii. Weight lifting (dumb bells)                      177
              iii. Boxing, punching bag                            354
              Endurance activities                                                   Spread out across the week to
              i. Running                                            472              avoid excessive fatigue and risk
              ii. Marathon                                       372 – 472           of injury
              iii. Distance bicycling                               472

                                                        | 26 |
4         Limit: physical inactivity and sedentary habits

   Example                       Calories (kcal)          Tips
                                 burnt per hour
   i.   Sitting with light                 89             1. Limit to 2 hours or less a day
        office work                                       2. Attempt to perform some simple activities
   ii. Surf internet                                         such as stretching (e.g. sit ups) during
   iii. Sitting around                                       intervals of watching TV or working at
                                                             the computer

                                       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.

  Start today!                                                                Number of steps
  You can start being physically active by walking as much as                                        Activity Level
                                                                              per day
  you can. If you would like to monitor the number of steps you               < 5,000                Sedentary
  do each day, use a pedometer (step counter). By using the
  pedometer, you can determine which activity level you are in                5,000 – 7,499          Low Active
  by referring to the table below:                                            7,500 – 9,999          Somewhat Active
                                                                              10,000 – 12,500        Active

                              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:

                                                    If You Do Physical Activity               If You Do Physical
  If You Rarely Do Physical Activity
                                                            Sometimes                            Activity Often

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.

                    Body Mass Index (BMI)
                    Why is it important? It is used to check if your current weight is proportionate with your height. In order to
                    measure your BMI, you will need:
                    c   A weighing scale        c    A height measurement scale

                    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:

                                  This BMI value
                                  referts to the
                                  classification of
                                  baby weight status
                                  by World Health
                                  Organization (WHO)

                                       Weight
                                                        Underweight               Normal       Overweight            Obese
                                        Status
                                      BMI values            r< 18.5          < 18.5 – 24.9           ≥ 25              ≥ 30

                                                                         | 28 |
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

                                                      Source: WHO, BMI-for-Age (z-scores) 5 to 19 years old, 2007; BMI-
                                                      for-Age (z-scores) 2 to 5 years old, 2006.

             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

                                                        | 29 |
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

What do you do with your BMI results?

  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.

                                                   | 30 |
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.

                                                                      It is not necessarily that a
                                                                woman will gain weight after giving
                                                               birth. Pregnant mother put on weight
                                                             during during pregnancy to cater for the
                                                           needs of the foetus. However, after delivery
                                                           of the baby, the woman will be able to lose
                                                            the extra weight gained if she follows the
                                                            right practices. It is vital that she does not
                                                             overeat during confinement, breastfeeds
                                                            the newborn, adopt healthy eating habits
                                                               and an active lifestyle. Over time, she
                                                                will be in the healthy weight range.

                                                  | 31 |
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.

                                                | 32 |
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