Eating Right, Living Well:
Reducing the risk of diseases
Assoc Prof Dr Norimah A.Karim
Dept of Nutrition and Dietetics
Faculty of Allied Health Sciences
UKM Kuala Lumpur
The problem
Malaysian scene
Overweight vs obesity in Malaysia

MANS 2006
Overweight = 27%
Obese = 12%
NHMS III 2008
Overweight = 29%
Obese = 14%
BMI- Malaysian Adults Nutrition
Survey (MANS,2006)
60
Prevalence (%)
50
40
30
49.3
20
26.7
10
12.2
9.7
0
Unde rwe ight
N o rm a l
O v e rwe ight
BMI (kg/m 2)
O be s e
BMI- Malaysian Adults Nutrition Survey (MANS)
by sex
Obe s e
14.7
Ove rw e ight
Women
24.8
Norm al
46.4
Unde rw e ight
10.1
Obe s e
9.7
Ove rw e ight
Men
28.6
Norm al
52.0
Unde rw e ight
9.3
0
10
20
30
40
Pre vale nce (%)
50
60
Prevalence of Overweight in children according to
age and sex
18
16.9
15.5
15.4
Percentage (% )
16
13.8
14
11.9
12
12.6
12.4
10.0
10
9.0
7.9
8
6
6.6 6.7
4.9
4.5
4
2
0
6
7
n = 11264
UKM/Nestle study 2002
8
9
10
A g e (ye a r s )
L elak i
P erem p u an
11
12
Healthy Weight Management: Eating
Right, Living Well
Good Eating
Habits
Change in
food habits
Exercise
Managing your
weight
Behaviour
modification
Achieve
Healthy
Weight
Lifestyle approaches that can be
changed to achieve healthy
weight
Dietary practices
Physically activity or exercise
Aim to eat for health
Follow a healthy balanced diet
Make smart food choices
What is your BMI
BMI
(Body Mass Index)
contoh
Under
BMI
=
Normal
=
60
1.6 x 1.6
weight (kg)
height (m)2
= 24.5
overweight
Obese
weight
20
25
BMI is an indicator of obesity and
underweight and normal weight
30
Relationship of BMI to Excess Mortality
300
250
Age at Issue
20-29
30-39
200
150
100
Low
Risk
50
0
15
20
25
30
Moderate
High
Risk
Risk
35
Body Mass Index
Bray, 1987
40
Classification of Body Weight in Adults According to
Body Mass Index, BMI
Classification
BMI, kg/m2
Risk of co-morbidities
Underweight
< 18.5
Low (but risk of other clinical
problems increased)
Normal range
18.5 – 24.9
Average
Overweight
> 25.0
Pre-Obese
25.0 –29.9
Increased
Obese Class I
30.0 – 34.9
Moderate
Obese Class II
35.0 – 39.9
Severe
Obese Class III
> 40.0
Very severe
WHO, 1998
Waist Circumference

Correlates abdominal fat
distribution and associated
ill health.

Increased risk:



Men > 94 cm (37 in.)
Women > 80 cm (32 in.)
Lower values have been
proposed for Asians
men > 90cm
women>80cm
BMI category according to sex (percent)
30
25
Underweight
Normal weight
Overweight
Obese
20
15
10
5
0
men
women
Prevalence of central obesity by age
group according to sex
60
51.1
47.2
50
40
37.1
30
26.1
17.1
20
10
Men
Women
7.9
7.9
5.7
0
30-39
40-49
50-59
60-69
Prevalence of central obesity by
BMI according to sex
60
50.6
50
43.5
men
women
40
28.2
25.8
27.2
22.5
30
20
10
1.1 1.0
0
underweight
normal
overweight
obese
Good dietary practices

Aim to eat for health

Follow a healthy balanced diet

Make smart food choices
How to eat right and live well in
our daily living

Being healthy is about balance
between good nutrition and physical
activity/exercise

Maintaining an ideal body weight
Energy balance and body weight
Energy balance
Input
Fat
CHO
Prot
Stable
weight
Output
Activity
TEF
BMR
Energy balance and body weight
Energy balance
Energy balance and body weight
Energy balance
Balanced Diet
Lemak
25 - 30%
Karbohidrat
50%
Protin
20%
Balanced Diet
Malaysian Food Pyramid
Fats, oils, sugar and salt
Milk, dairy products, fish,
chicken, meats and legumes
Fruits and vegetables
Rice,noodles, breads, cereal
products , and tubers
Rice,noodles, breads, cereal
products , and tubers
Main selection, high fibre foods
Eat in moderation foods which are not good
sources of fibre
Fat will increase caloric content of foods, thus
reduce intake of fried and fatty foods
Fruits and vegetables
Ulam-ulaman / salads are great
choices
Select vegetables prepared
as soups, sauted or stir
fried
Vegetable juices should be taken fresh and
without sugar
Reduce intake of vegetables
prepared either fried or masak
lemak
Fruits and vegetables
Make sure your first choice are fresh fruits
Fruit juices are best drank fresh
without added sugar
Reduce intake of cordial drinks, fruits in
heavy syrup and dried fruits
Milk, dairy products, fish,
chicken, meats and
legumes
Main selection: legumes, tofu, tempeh, egg
white and fish
Select chicken and meats
which are not fried. Skin and
excess fat should be trimmed
Reduce fried fish and
chicken as well as processed
meat.
Fats, oils, sugar and salt
What are the food sources?
Fats and oils
Sugar
Salts
Ghee, butter,
creamer,
santan,margerine,
mayonnaise,
cooking oil
White sugar, brown
sugar, gula melaka,
syrup, honey,
condensed milk
Salt, MSG,
seasonings,
ketchup
Fats, oils, sugar and salt
Fat
+
sugar
Salt
Healthy eating habits
How
• Eat slowly (> 20 mins)
• Eat only when hungry
Why
When
• Stop eating when full
• If you often skip your meals, set an eating
schedule and follow it
Apple & Pear ?

Aim for an ideal body weight
Weigh yourself regularly; “regular”,
once a month
Calculate BMI
Calculate ideal body weight (IBW)
18.5-24.9 (m)2
Eg. If you are 1.6m, then IBW
= (18.5-24.9) 2.56 =47 to 64 kg
Calories in breakfast foods
Food
serving size
 Roti canai 1 set
 Dosai
1 set
 Capati
1 set
 Nasi lemak a plate
 Nasi goreng a plate
 Nasi kerabu a plate
kcal
339
340
322
687
386
535
Nasi lemak
687 kcal
Nasi kerabu
535kcal
mee kari 702 kcal
Calories in varieties of noodles
Food
 Mee goreng
 Mee kari
 Mee sup
 Mee bandung
 Soto ayam
serving size
a bowl
a bowl
a bowl
a bowl
a bowl
kcal
281
702
355
491
528
Calories in varieties of rice
Food
serving size
 Nasi putih
a plate
 Nasi lemak
a plate
 Nasi goreng
a plate
 Nasi kerabu
a plate
 Nasi ayam
a plate
 Nasi beriani
a plate
 Nasi dagang a plate
kcal
250
687
386
535
565
559
508
How can we be physically active
Start being physically active
Involves all movements which use
energy in our daily life eg; working,
recreational activities, exercise and
sports
How can we be physically active
To increase fitness of the heart –
breathing
duration– at least 20-30 minutes
frequency – 3-4 times a week,
preferably everyday
Practice an active lifestyle
 Select
physical activities which suit
you
 Do these activities at least 30 minutes
a day ( can be totalled up to a whole
day ie 10 minutes per session)
Practice an active lifestyle
Exercise correctly
Take time to warm up before
exercising
Always cool down after exercising
Consult your doctor if you are
Over 35 years and male
Over 40 years and female
Have not been exercising regularly
Uncertain of your health
Have hypertension, diabetes, heart
disease
Examples of light physical activities
 60
minutes everyday
 walking
 stretching
 Light gardening activities
Examples of moderate physical
activities
 30
minutes everyday
 brisk walking
 cycling
 Walking up and down staircase
(reduce using lift)
Minutes activity needs to be carried our
by body weight (burn 100 kcal)
Game/exercise
Aerobic dancing
Badminton
Football
Golf
Gardening
50 kg
23 min
26
16
34
38
80 kg
15 min
15
10
21
23
Minutes activity needs to be carried our
by body weight (burn 100 kcal)
Game/exercise
Tennis
Walking (6.4km/hr)
Jogging (8.8km/hr)
Running (11.2km/hr)
Bicycling (8.8km/hr)
50 kg
20
22
13
10
27
80 kg
13
14
8
6
17
Take home message
Invest in a good weighing scale
and weigh yourself once a week
Maintain a healthy weight
Aim to eat for health
Follow a healthy balanced diet
Make smart food choices
Take home message
Start being physically active
Invest in a pedometer (to calculate number of
steps- recommended 10,000 steps per day)
Select physical activities which suit
you
 Do these activities at least 30 minutes
a day, at least 3-4 times a week,
preferably every day
Enjoy your exercise
Thank you for your attention