Underweight vs. overweight

Eating food for fuel

Dr Yasmin Ooi Public health nutritionistUniversity Malaysia Sabah

Food Carnival 9 August 2008

Prevalence of overweight and obesity in Malaysia adults

17

27

0

5

10

15

20

25

30

NHMS 1996 MANS 2002

Pe

rce

nta

ge

(%

)

Overweight Obesity

Data from MANS 2003 (MOH, 2007)

School children?

• Standard 1 to 6 in Peninsular Malaysia.

• Surveyed 11,500 school children

• 10% were overweight

• 6% were obese

• (Ismail et al., 2003)

If your BMI is…. BMI (kg/m2)

Risk of co-morbidities

<18.5 UnderweightLow (but risk of

other clinical problems increased)

18.5-24.9 Normal range Average

25.0-29.9 Overweight Increased

30 – 30.4935 – 39.9

> 40

Obese Class IObese Class IIObese Class III

Moderate, severe,

very severe

(WHO, 1998)

BMI for age percentiles for adolescents, 10 – 18 yBMI for age percentiles for adolescents, 10 – 18 y

Age (years)

Males Females

5th percentile 85th percentile 5th percentile 85th percentile

10 14.42 19.60 14.23 20.19

11 14.83 20.35 14.60 21.18

12 15.24 21.12 14.98 22.17

13 15.73 21.93 15.36 23.08

14 16.18 22.77 15.67 23.88

15 16.59 23.63 16.01 24.29

16 17.01 24.45 16.37 24.74

17 17.31 25.28 16.59 25.23

18 17.54 25.92 16.71 25.56

Source: WHO, 1995)

Environmental factors causing weight gain and obesity

Drugs causing weight gain

Inactivity (TV, computers)

Lack of habitual physical activity

Sports activitiesOrgano

chlorines

Birth weight

Breast feeding

Meal size /

energy intake

Dietary fat,

CHO & protein

s

Beer & wine

Soft drink

s

Infections (adenovirus

)

Underweight vs overweight

• Underweight– Anaemia– Low bone mass– Eating disorders

• Overweight– Diabetes– Hypertension– Dyslipidemia– Cardiovascular

diseases

• Healthy weight range for adults:– BMI: 18.5 to 24.9 kg/m2

Children and adolescents

• Overweight and obese children should maintain weight or gain weight slowly rather than lose weight.

• Practise healthy eating habits

• Do physical activity

• Consult nutritionist / dietitian

Weight loss diet

• Balanced proportion of:– carbohydrates (50 – 60%)– Protein (10 – 20%)– Fats (less than 30%)

• Limit the portion sizes eaten, especially energy dense foods, e.g.?

• Increase physical activity, EXERCISE!

Examples of moderate physical activities

• Do these 20 – 30 minutes continuously• Walking briskly• Brisk house cleaning• Recreational sports (badminton, football, sepak

takraw, table tennis, squash, netball, bowling, tennis)

• Mowing lawn• Jogging• Swimming (moderate effort)• Cycling (moderate speed)• Gardening / farming

How much weight loss is safe?

• Start: lose 5 – 10% of initial body weight.

• Reasonable timeline: 5 – 10% weight loss in 6 months

• = per week: about ½ to 1 kg per week.

• = reduction of calorie intake by 500 kcal/day.

How much to eat (kcal / day)

Age Girls Boys

10 – 12 years 1990 2180

13 – 14 years 2180 2690

15 years 2180 2690

16 – 18 years 2050 2840

How much to eat? How many servings?Food group 1500

kcal/day2000 kcal/day

2500 kcal/day

Cereals & grains

8 12 12

Fruits 2 2 2

Vegetables 3 3 3

Meat / poultry

1 2 2

Fish 2 2 2

Milk & alternatives

1 2 2

Legumes 1 1 1

HOW DO YOU OBTAIN A BALANCED DIET?

Follow the Food Guide Pyramid

Food Guide Pyramid- The key to balanced/healthy foods

Fats, oil, sugar & saltUSE SMALL AMOUNTS

Milk & dairy products1-2 SERVINGS

Fish, poultry,meat & legumes, 2-3 SERVINGS

Fruits & vegetables, at least 3-5 SERVINGS

Rice, noodles, bread, other cereals & cereal products, tubers

8-12 SERVINGS

Level 1

rice, mee, breads, grains, cereal and cereal products, potatoes/tubers

Level:

Food Group

Nutritional Value

Recommen

dations

Example of 1

serving

Level 1:

rice, mee, bread, cereal and cereal products, potatoes

•Good sources of complex CHO•Vitamin, mineral, fiber and a bit of protein•Generally low in fat

8-12 servings

• ½ cup of rice•1 piece of bread•½ cup of mee-hoon/mee/pasta•½ small capati •1 cup of plain rice porridge•½ cup of breakfast cereal•1potato

Level 2

Vegetables & Fruits

Level:

Food Group

Nutritional Value

Recommendations

Example of 1

serving

Level 2:

Vegetables & fruits

•Good sources of vitamins, minerals and fiber

3 - 5 servings

vegetables•½ cup green leafy vegetables + stem (cooked)•½ cup of eggplant, tomato (cooked)

Level:

Food Group

Nutritional Value

Recomendations

Example of 1

serving

Level 2:

Vegetables & fruits

•Good sources of vitamins, minerals and fiber

3 - 5 servings

Fruits:•½ of a regular sized guava•1 piece of papaya, pineapple or watermelon•1 regular sized banana,apple or orange

Level 3

Fish, poultry (chicken/duck), meat, nuts(soya bean, dhall)

Level:

Food Group

Nutritional Value

Recomendations

Example of 1

serving

Aras 3:

Fish, poultry (chicken/duck),meat, nuts

(soya bean, dhall)

•Good sources of protein•Rich in vitamin B, iron, zinc and Magnesium

2-3 servings

•1 regular sized chicken thigh•1 regular sized fish (ikan kembung)•2 blocks of lean meats the size of match boxes

Level 3

Milk and milk products (not including condensed milk, butter and cream)

Level:

Food Group

Nutritional Value

Recommendations

Example of 1

serving

Level 3:Milk and milk products (not including condensed milk, butter and cream)

•Important sources of calcium and protein

1-2 servings

•1 cup of milk•1 cup of yoghurt•1 piece of cheese

Level 4

Fats, oils, sugar and salt

Level:

Food Group

Nutritional Value Recomendations

Example of 1

serving

Level 4:

Fats, oils, sugar and salt

•Fats and oils contain essential fatty acids and fat soluble vitamins such as vitamins A, D,E and K

Take sparingly (only a little bit)

•1 – 2 teaspoon

Enjoy a variety of foods

- eat a variety of foods from each food

group

- foods eaten daily should come mostly

from the lowest level of the food pyramid

Malaysian Dietary Guidelines 1999 & summary of the food guide pyramid

Malaysian Dietary Guidelines 1999 & summary of the food guide pyramid

Eat more rice and cereal products, nuts, vegetables and fruits

Reduce fat in the preparation of foods, choose foods low in fat and cholesterol

Malaysian Dietary Guidelines 1999 & summary of the food guide pyramid

choose reduce practice

Malaysian Dietary Guidelines 1999 & summary of the food guide pyramid

Reduce the use of salt and choose foods low in salt

Reduce sugar intake and choose foods low in sugar

Drink plenty of water every day (6-8 glasses a day)

Malaysian Dietary Guidelines 1999

Maintain a healthy body weight by eating balanced foods and by exercising regularly

Malaysian Dietary Guidelines 1999

– Exercise and maintenance of body weight prevents health problems and gives healthier body image

– Being underweight or overweight increases the risk of getting certain diseases

BODY MASS INDEX (BMI)

• is applicable for individuals 18 years

and above

• For body weight monitoring

BMI = weight (kg) height (m) X height (m)

Blog

• http://www.nutritiontalk.wordpress.com

• Today’s talk will be uploaded this evening.

• Please look for the title Nutrition talk for Secondary School Students.

• Thank you and have a nice day.

• Assalamualaykum