Nutrition Society of Malaysia Malaysian Dietitians’ Association Malaysian Association for the Study of Obesity
Published by
A Practical Nutrition Guide for The Family
ISBN
978
-967
-573
7-03
-9
HealthierLifestyle:Tips to a
Nutrition Month Malaysia 2012 National Steering Committee
Chairman
Dr Tee E Siong, KMN
Members
Nutrition Society of Malaysia:
Assoc Prof Dr Zaitun Yassin, KMN Dr Mahenderan Appukutty
Malaysian Dietitians’ Association:
Ms Indra Balaratnam
Malaysian Association for the Study of Obesity:
Prof Dr Norimah A Karim Dr Zawiah Hashim
Secretariat
Contents3 TowardsAHealthierYou,
HealthierFamily
4 Don’tBeaHeavyweight
6 GuidetoAchievingaHealthierDiet
8 EatingHealthilyEvenWhenYouDineOut
9 EatHealthily–CookYourOwnMeals
10 HealthyShopping:WhatareNutritionLabels?
12 BeActive!
Growth Reference Charts
BMI-for-AgeCharts(2 to 5 years old)
BMI-for-AgeCharts(5 to 18 years old)
1415
Contents
12A, Jalan PJS 8/4, Mentari Plaza, Bandar Sunway46150 Petaling JayaTel: 03-5632 3301Fax: 03-5638 9909Email: [email protected]
(263773-W)
Disclaimer
This book is not in any way intended to subsitute medical advice from your doctor or health professionals. When in doubt, please consult your doctor. The Nutrition Society of Malaysia (NSM), Malaysian Dietitians’ Association (MDA) and the Malaysian Association for the Study of Obesity (MASO) are not liable for any issue arising from the use of this book.
NSM, MDA and MASO do not endorse any products and are not responsible for any claims made in the advertisements.
Intellectual property is vested in the Nutrition Month Malaysia (NMM) programme. No part of this book shall be reprinted without the written permission of the National Steering Committee of NMM.
Copyright reserved © Nutrition Month Malaysia (NMM) 2012.
Chroniclifestylediseaseshavebecomeaplagueofmodernliving.Theprevalenceofdiseasessuchasobesity,hypertension,diabetes,heartdiseasesandcancersareatanalltimehigh,andaretheleadingcausesofmortalityintheworld.TheWorldHealthOrganizationhasreportedthat36millionoutofthe57million(or63%)globaldeathsin2008wereduetochroniclifestylediseases.InMalaysia,thesediseasesareestimatedtoaccountfor67%ofalldeaths!
Thesediseases,alsoknownasnon-communicablediseases,donotjustmanifestovernight.Theyaretheresultofsedentarylifestylesandunhealthydiets,practisedovertheyears.Thesediseasesareinfacteasilypreventablebypractisingahealthylifestyle.Hence,preventionshouldstartfromayoungage,andthebestplacetobeginiswithinthefamily.
TheMalaysianDietaryGuidelineshaveprovided14keymessagestohelpguideyouandyourfamilytowardsahealthierlifestyle.
Contents
Eatavarietyoffoodswithintherecommendedintake.
Maintainbodyweightinahealthyrange.
Bephysicallyactiveeveryday.
Eatadequateamountsofrice,othercerealproducts(preferablywholegrain),andtubers.
Eatplentyofcolourfulfruitsandvegetableseveryday.
Consumemoderateamountsoffish,meat,poultry,eggs,legumesandnuts.
Consumeadequateamountsofmilkandmilkproducts.
Limitintakeoffoodshighinfatsandminimisefatsandoilsinfoodpreparation.
Chooseandpreparefoodswithlesssaltandsauces.
Consumefoodsandbeverageslowinsugar.
Drinkplentyofwaterdaily.
Practiseexclusivebreastfeedingfrombirthuntilsixmonthsandcontinuetobreastfeeduntiltwoyearsofage.
Consumesafeandcleanfoodsandbeverages.
Makeeffectiveuseofnutritioninformationonfoodlabels.
1.
2.3.4.
5.
6.
7.
8.
9.
10.11.12.
13.14.
Towards A Healthier You, Healthier Family
�
�
Don’t Be A HEAVYWEIGHTBodyweightisamajorinfluenceonhealththroughoutlife.Overweightpeople(evenchildren)aregenerallylesshealthyandaremorepronetoillnessessuchasdiabetes,hypertension,heartdiseasesandcancers.Thisiswhyitisimportantforeveryonetomaintainahealthyweightwithintherecommendedrange.
Toassessthenutritionalstatusofyourselforyourfamilymembers,thebestwayistoweighregularlyatleasttwiceamonthatthesametime.Itwouldhelptoinvestinagoodweighingscaletoensurethatthereadingsareaccurateandprecise.Justknowingtheweightisnotenough;youmustalsocalculatethebodymassindex(BMI)aswell.BMIisasimpleindexofweight-for-heightthatiscommonlyusedtoclassifyoverweightandobesityinindividuals.
Calculating BMI
Step 1: Measure WeightStep 2: Measure HeightStep 3: Calculate BMI
Whenyouhavemeasurementforweightandheight,youcannowcalculateBMIaccordingtotheformula:
BMI =weight (kg)
height (m) x height (m)
Chubby and Cute, But Are They Healthy?
Chubbykidsarealwayscute,butdoyouoftenwonderifyourchildhastherightweightforhisheightandage?Thesimplestandmosteffectivewayofdeterminingyourchild’snutritionalstatusandwhetherheisreceivingoptimalnutritionisbycalculatinghisBMI-for-ageandcomparingthevaluestotheWHOgrowthstandard(referpage14-15fortheBMI-for-agechartsforyourchildren).Regularassessmentofyourchild’sBMI-for-agecanhelpyoufindoutifyourchildisnormal, underweight, overweight, or obese.DoremembertousetheappropriateBMI-for-agecharts,astheyaregenderspecific.
�
Risky Weights & Waists for Adults
Adultstooshouldregularlyassesstheirhealthasithelpsdeterminetheircurrentnutritionalstatus,aswellasriskforchronicdiseases.MeasureyourBMI,andifyourBMIismorethan25,youareatahigherriskofdevelopingdiseasessuchasheartdisease,diabetes,certaincancers,etc.
Dotakenotethatforadults,weneedtousethefollowingBMI cut-off points:
Waist circumferenceisanotherwayofassessingyournutritionalstatusandhealth
riskofanadult.Excessfataccumulatedattheabdominal(stomach)areaisassociated
withgreaterhealthrisk(e.g.heartdisease,diabetes)comparedwithfataroundother
regionsofthebody.Measuringyourwaistcircumferencewillhelpdetermineyour
abdominalfat.Takecarethatthesemeasurementsdonotexceedthecut-offpoints!
Itisimportanttocarryoutregularweightassessments,forbothyouandyourchildren,
todetermineyourfamily’snutritionalstatus.Thiswillnotonlyaidyouinmaintaining
ahealthybodyweightandwaistcircumference,itwillalsohelpinpreventingchronic
lifestylediseases.
Body weight classificationBMI cut-off points for
definition (kg/m2)Health risk
Underweight <18.5Low
Normalrange 18.5to24.9
Overweight 25.0to29.9 Moderate
Obese ≥30.0 High
Waist circumference cut-off pointsHealth risk
Men Women
<90cm(35inches) <80cm(32inches) Low
≥90cm(35inches) ≥80cm(32inches) High
�
Guide To Achieving A Healthier DietWithsomanyfoodchoicesavailableinMalaysia,wesometimestendtoforgetabouteatinghealthily!
Healthyeatingisassimpleaseatingregularmealsthatprovidethepropercombinationofnutrientsandenergyrequiredforyourbody.Ahealthydiet,togetherwithconsistentphysicalactivityisthekeytoahealthybodyweight,aswellastooverallhealthandwell-being.
YoucanensurethatyouandyourfamilywillobtainallthenecessarynutrientsandenergybyusingtheMalaysianFoodPyramid.Itisasimplevisualtooltoguideyoutoahealthierdietbyhelpingyouandyourfamilytomakeappropriatechoicesinthetypesandamountoffoodstobeconsumeddaily.Thepyramidwillhelpyoutoachieve:
Eatallthe5foodgroupsdaily.Foodsatthebottomshouldbeeatenadequately,whilethoseathigherlevelsshouldbeeatenless.Eachfoodgroupperformsdifferentmainfunctionsandtherightcombinationoftheseisessentialforoptimalhealth.
BALANCE
MODERATION
VARIETY
Followthenumberofservingsthatisrecommendedtopreventovereating,whichmayleadtobeingoverweight.Eachtimeyoueatameal,bemindfuloftheservingsizesoasnottoovereat.Donotparticipatein“eat-as-much-as-you-like”promotions.
Ensurethatyouhaveamixoffoodsfromeachlevelofthepyramid,asnosinglefoodcangiveyouallthenutrientsyouneed.Thispracticealsomakesyourmealsmoreinterestingtoallinthefamily!
�
Vegetables3 servings/day
Eat plenty
Milk and milkproducts
1–3 servings/dayEat in moderation
Fruits2 servings/dayEat plenty
Eat less
Fats, oil, sugar and salt
Fish, poultry, meatand legumes½–2 servings of meat/poultry/egg/day½–1 serving legumes/dayEat in moderation
Rice, noodle, bread, cereals,
cereal productsand tubers
4-8 servings/dayEat adequately
Malaysian Food Pyramid
�
Eating Healthily Even When You Dine OutMalaysia,amultiracialandmulticulturalcountry,iswellknownasafoodhaven.Variouscuisinesfromdifferentethnicitiesleaveusspoiltforchoice,butitisstillimportanttochoosewisely(andinmoderation-watchoutforportion),especiallywheneatingout.Herearesometipsfordifferentcuisineswhenyoueatout:
Cuisines Healthier Tips Choose Less Often Choose More Often
Malay Avoidthosecookedwithlotsofsantan(egmasaklemak,rendang).Choosehealthierdishessuchas,masakpindang,asampedas,tomyamsoup).Avoiddeepfriedmeatandoptforgrilledor“bakar”.
•
•
•
Nasigorengpaprik Whitericepaprik
Currymee Asamlaksa
Friedfish Ikanbakar
Pisanggoreng Freshbanana
Kuihserimuka Redbeanpau
Indian Avoidthosecookedwithtoomuchoilorghee.Avoidbeveragesthatcontaincondensedmilkortoomuchsugar.
•
•
Roticanaiwithdhalgravy Plaintosaiwithdhalgravy
Briyanirice(cookedwithghee)+dishes
Whiterice+dishesandvegetables
Vadai Puttumayam
Friedchicken Tandoorichicken
Chinese Avoidthosecookedwithtoomuchoil.Choosesteamedorroastedmeatinsteadofdeepfried.
•
•
Chickenricewithfriedchicken Chickenricewithsteamedchicken&pakchoy
Friedkuih-teow Kuih-teowsoup
Frieddumpling,friedyongtaufu
Dumplinginsoup,yongtaufuinsoup
Charkuey Steamedpopiah
Western Choosedishesmadewithtomato-basedsauceratherthancream-based.Optforfreshfruitinsteadofhigh-caloriecakesandtartsfordessert.
•
•
Friedfishandchips Grilledfishandbakedpotatoes
ChickenburgerwithFrenchfries
Tunasandwich
Spaghetticarbonara(whitecreamsauce)
Spaghettimarinara(tomatoandseafood)
Doughnut Sardinebun
Use these tips as guidelines when eating out:
Choosemealsthataresteamed,grilled,roasted,boiled,orbroiled,insteadofthosethatarefriedordeep-fried.
Askforfoodtobepreparedhealthier,eglessoil,lesssaltorsoya/oystersauce,andmoreveggies,andlesssugarindrinks.
Choose“small”or“medium”portions;donotfallfor‘economicalsize-up’gimmicks.Youcanalsosharelargemealsbetweenfamilymembers.
•
•
•
�
Eat Healthily – Cook Your Own Meals Eatinghome-cookedmealswillgiveyoumorecontroloverthefoodyouserveforyourselfandyourfamily.Getcreativewhencookingyourmeals–youcanusealternativeingredientsordifferentcookingstyleswhenpreparingyourfavouritedishes.Thisway,youcanstillenjoydeliciousmeals,justmorenutritiousandhealthy!
Usehealthieringredients/condimentstosubstitutesomeofthemorehighfat,sugar,orsaltingredients.Someoftheseinclude:
Spices(egcinnamon,ginger,turmeric,mustard);
Herbs(egbasil,parsley,lemongrass,mints,celery(daunsup),coriander(daunketumbar);
Low-fatmilkinsteadofcoconutmilk(santan);
Fruitpureeorpurefruitjuice–naturalsweetness.
•
•
•
•
Cookingstylescandeterminehowhealthyandnutritiousyourmealswillbe.Certaincookingstylesarehealthierthanothers,andalsoresultindifferenttastes,textures,andpresentationsofthefoods.Someofthesemethodsinclude:
Good to know…Eachtablespoonofoilyouusewhenfryingaddsmorethan100calories!
Whenyoudeep-frymeatswithskin,egchicken,whichcontainssaturatedfat,yousimplyaddmorefattothem.
•
•
SteamSoup
••
StewRoast
••
GrillPoach
••
Deep-fryingforlongperiodscausedegradationoftheoils–theoilisthennotsuitableforfurtherusetoprepareotherdishes.
Starchyfoods,egfries,potatochips,bread-crumbedfoods,cookedinfatsheatedtomorethan160°Ccontainsignificantamountsofacrylamide–achemicalthatmaycausecancers(carcinogen).
•
•
StirfrySauté
••
10
Healthy Shopping: What Are Nutrition Labels?
Theselabels,alsoknownasnutritioninformationpanels(NIP),aretablesfoundonthelabelofapackagedfoodandshowtheamountofenergy,carbohydrates,proteinandfat,andsometimes,vitamins,mineralsandothernutrientscontainedintheproduct.
Readingtheselabelscanhelpyouchoosehealthieroptionsoffoodsandbeverages,aswellas:
Comparethenutritionalvalueofdifferentbrandsofsimilarfoods.
Helpyoudecidewhichfoodsfitintoyoureatingplanorisappropriate,especiallyifyouhavecertainhealthconditionssuchas,highbloodpressureorhighcholesterol.
Usethemasatooltoplanahealthy,balanceddiet.
•
•
•
Serving size: 5 pieces (20g) / Servings per package: 5
Nutrients Per 100g Per serving (20g)
Energy,kcal 525 105
Carbohydrate,g 56.2 11.2
Protein,g 8.0 1.6
Fat,g 29.8 6.0
Nutrient listing–Listofenergy,carbohydrates,proteinandfat,aswellasvitaminsandmineralscontainedintheproduct.
• Amount of nutrients –Theamountofenergyandnutrientsper100g(solidfoods)orper100ml(beverage).
• Amount of nutrients per serving–Amountofnutrientsandenergyeachservingofthefoodprovides.
•
Understanding the
11
Other items in the food label
Thereareotherimportantinformationonthefoodlabelofpackagedfoodsthatyoushouldpayattentiontowhenshopping.
Ingredient list–Listedinadescendingorderofpredominanceandweight.Importanttoknowthatsameingredientsmayhavedifferentnames,egsugarcouldalsobecalledsucrose,honey,syrup,molasses,maltodextrin,etc.
Expiry date –Indicatedas“BestBefore”,“Useby”;referstothelastdateyoushouldconsumethefood,asafterthisdate,thefoodisnotguaranteedtobesafetoeat.
Net weight/net volume–Thetotalweightorvolumeofthepackaged/cannedgoods.
Storage method–Checkifthefoodsorbeveragesshouldbestoredatroomtemperature,refrigerated,orfrozen.
Instructions of use –Readtoseehowthefood/drinkshouldbepreparedbeforeitcanbeconsumed.
Potential allergen content –Checkforallergens,egpeanuts,milkanditsproducts,eggs,wheat,etc,especiallyifanymemberofyourfamilyisallergictoaparticularitem!
•
•
•
•
•
•
Keep these tips in mind…Alwaysreadtheingredientlisttofindoutwhatthemainingredientsare.
Makefood/beveragechoicesbasedontheoverallnutrientcontentofaproduct.
Alwayscomparebasedon100gor100mloftheproduct.Servingsizesmaynotbesuitableasitmaydifferamongbrands.
Knowservingsizestoavoidover-consumptionoftheproduct.
•
•
•
•
12
Be Active!Goodnutritionaloneisnotsufficienttomaintainahealthyandbalancedlife.Itisequallyimportanttocarryoutphysicalactivity,whichcanbeassimpleasdoingdailychores,orwalkingtonearbydestinations.
ThePhysicalActivityPyramidisasimpleguidetohelpusbemorephysicallyactiveeveryday.Activitieslistedatthebottomofthepyramidareactivitiesthatshouldbedonemoreoften,ifpossible,onadailybasis.Ontheotherhand,thoselistedrightatthetipofthepyramidaresedentaryactivitiesandshouldbelimitedasmuchaspossible.
LIMIT
2 – 3 TIMES A WEEK
Participate in activities that increase flexibility, strength and endurance
of the muscle
5 – 6 TIMES A WEEK
EVERYDAYEVERYDAY
• Stretching body• Partial sit up • Push up
• Weight lifting (dumb bell)
• Watch TV• Play computer game
Do moderate intensity physical activity; 30 minutes per day
• Brisk walking • Cycling • Aerobic exercise• Swimming • Dancing • Skipping rope
• Football • Badminton • Basket ball • Hiking
Be active everyday in many ways
• Walk up and down the stairs • Walk to the shop/office• Housework • Gardening
Limit sedentary activities
Physical Activity Pyramid
1�
If you are overweight or obese…
Startoutwithsomethingsimplesuchas,walking up and down the stairs,orgardening,whichcanhelpyougetontracktoexercisingright.Youcanthenmoveontostretching,brisk walking, aerobic exercisesandswimming,andeventuallyevenplaysomesportslikebadmintonandcycling.
Toloseweight,more than 30 minutes dailyofmoderate-intensityphysicalactivityisrecommended;
Topreventthetransitionfromoverweighttoobese,about45-60 minutesisneededdaily;
Tomaintainandprevent re-gain of weight amongformerobeseindividuals,atotalof60-90 minutesisnecessarydaily.
Healthbenefitsthatyoucangainfromlosingweight:
Lowerbloodpressurelevels;Lowercholesterollevels;Lowerbloodsugarlevels;Reducepressureonjoints
•
•
•
••••
Regardlessofageandsize,ithasbeenproventhatphysicalactivitycanaddyearstoyourlife.Also,itisimportanttorememberthatphysicalactivitydoesnotmeanstrenuousactivitiesthatconstantlyleaveyoubreathlessafter.Instead,startwiththesimpleandbasicactivities;byensuringthesebecomearoutine,youcanworktowardsbuildingasteadystreamofphysicalactivityinyourdailylife!
1�
BMI-for-Age (GIRLS)
BMI-for-Age (BOYS)
risk of overweight
overweight
risk of overweight
overweight
normal
underweight
underweight
FOR CHILDREN 2 – 5 YEARS OLD / UNTUK KANAK-KANAK 2 – 5 TAHUN
GROWTH REFERENCE CHARTS / CARTA RUJUKAN PERTUMBUHAN
BM
I(kg
/m2 )
BM
I(kg
/m2 )
Age (years, months)
Age (years, months)
}
normal
Growth Reference ChartsFor Children 2 – 5 Years Old
BMI-for-Age (GIRLS)
BMI-for-Age (BOYS)
risk of overweight
overweight
risk of overweight
overweight
normal
underweight
underweight
FOR CHILDREN 2 – 5 YEARS OLD / UNTUK KANAK-KANAK 2 – 5 TAHUN
GROWTH REFERENCE CHARTS / CARTA RUJUKAN PERTUMBUHAN
BM
I(kg
/m2 )
BM
I(kg
/m2 )
Age (years, months)
Age (years, months)
}
normal
1�
overweight
normal
underweight
BMI-for-Age (BOYS)
BM
I (kg
/m2 )
obese
Age (years, months)
Growth Reference ChartsFor Children 5 – 18 Years Old
overweight
normal
underweight
BMI-for-Age (GIRLS)
BM
I (kg
/m2 )
obese
Age (years, months)
Thiseducationalbookletispublishedby
Co-Sponsors
VisittheNutritionSocietyofMalaysia’swebsitetoobtainmoreinformationoneducationalmaterialsfromtheNutritionMonthMalaysiaprogramme.Wealsowelcomefeedback/queries.
Toreachus,pleasecontact:
The Nutrition Month Malaysia SecretariatTel: (03) 5632 3301/5637 3526 Email: [email protected]
www.nutriweb.org.my