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: versahealth@versa-group.com

(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: nutritionmonth@nutriweb.org.my

www.nutriweb.org.my