September 19, 2005

Why is Weight Management Important ?

With urbanisation, economic development and changing lifestyles and diets, excess weight and obesity have become increasingly common in Asia. The consequences of this are escalating rates of ill health associated with excess weight, including Type 2 diabetes, heart disease, strokes and high blood pressure.

Obesity and overweight also increase the risk of developing some cancers, gall stones, gout, osteoarthritis, infertility and other diseases.

Overweight and obese individuals are also more likely to suffer low self-esteem and increased rates of depression because of a poor body image.

In short, carrying excess weight reduces the quality of life and the pleasure of living.

Generalised advice can never be a substitute for personalised medical review and treatment, and anyone with serious health concerns is strongly advised to consult a qualified medical practitioner.

5 Diet Tips for Weight Management

1. Generous amounts of fruit, vegetables, whole grains and pulses. These foods are bulky and less energy dense, helping you to feel full longer.

2. Moderate amounts of lean meat, fish, low fat dairy and other proteins. Protein foods are the most effective in satisfying appetite.

3. Occasional moderate portions of energy dense foods. Cutting out these foods completely may leave you feeling deprived. So, plan the occasional indulgence without feeling guilty, and stick to a planned, balanced diet the rest of the time.

4. Regular meals and snacks are most helpful to avoid binge eating.

5. Control portion sizes. Research indicates portion sizes have been increasing over the last 20 years and could be an important cause of excess consumption.

5 Physical Activity Tips for Weight Management

1. Adults should aim for 30 minutes per day, most days of the week, children need 60 minutes per day of active play, walking, running, and sporting activities

2. Activities such as brisk walking and taking the stairs instead of the elevator are as beneficial as formal sporting activities

3. 30 minutes of daily physical activity can be broken into shorter periods. For example 3 brisk walks or cycle rides of 10 minutes each.

4. A mixture of strength building and cardiovascular (raising heart and breathing rate) activities is generally recommended.

5. Find ways to build physical activity into your normal daily routine, so that you can sustain this even when under time pressure.

Understanding Healthy Weight, Overweight, Obesity

Body Mass Index - The global standard for classification of body weight as normal, underweight, overweight or obese is Body Mass Index (BMI). BMI is calculated by dividing a person's weight in kilograms by their height in metres squared. A BMI of 18.5 to 25 is traditionally classified as healthy weight range; 25 to 30 is classified as overweight and is associated with increased risk of developing weight-related disorders, and above 30 is classified as obese and at high risk of developing weight-related illness.

More recently, experts have observed that weight-related disorders are more common in some Asians ethnic groups at BMI levels above 23. An expert group of the WHO has therefore recommended a lower BMI scale for Asians: 18.5-23 for increasing but relatively low risk of developing weight- related ill-health; 23-27.5 for increased risk; and 27.5 or more signals high risk.

Waist-to-hip ratio (WHR) - WHR can be calculated by dividing waist circumference by hip circumference. WHR, is an easy measure to assess distribution of body fat. For most people, and perhaps especially Asian populations, abdominal fat causes more health problems than carrying extra weight around their hips or thighs. A WHR of 0.90 or less is considered healthy for men and a ratio of 0.80 or less is considered a sign of good health for women. A WHR of 1 or higher signals increased risk of ill health and an indicator that action to shed some body fat from the tummy would be wise.

Achieving Weight Management

A fixed amount of energy (measured as kilocalories or Kcalories) is used each day just to maintain vital body functions (e.g. brain activity, heartbeat, breathing) even when at rest. This figure is known as the basal metabolic rate (BMR) and usually accounts for about half or more of the Kcalories needed in a day. A person’s BMR increases slightly with increasing total body weight, but even more with increasing proportion of muscle to fat in the body. Most people’s BMR decreases as they age, making it harder to control their weight. Researchers think that the decline in BMR with age has more to do with the loss of muscle as we age, rather than the aging process itself, and thus can be slowed with strength-training exercise.

Weight gain is most commonly associated with both eating too many Kcalories and a sedentary lifestyle. To maintain a healthy body weight or to achieve weight loss goal, it’s important to consider making modest changes on both sides of the energy equation: the energy inputs (food Kcalories) and the energy outputs (Kcalories used in BMR and physical activity):

Over-consumption of food Kcalories leads to weight gain - Weight gain most usually happens gradually over time. Eating only 100 excess Kcalories a day will result in a 1 kg weight gain in a year. Similarly, reducing total dietary energy consumed by 100 Kcalories per day, could help you to keep your weight stable, so the modifications to diet required to prevent weight gain may be quite small.

Lack of physical activity leads to weight gain - Research shows that people who include physical activity in their daily routines are more likely to keep their weight under control than people who rely only on diet. Physical activity reduces abdominal fatness, even in the absence of weight loss. Physical activity also helps to maintain muscle tissue which increases BMR. Increasing physical activity levels by just 100 Kcalories per day may be enough to prevent weight gain.

What is the best way to lose weight?

Most of us want to lose weight to look and feel better. The current fashion trend to be thin also pressures many people to lose weight quickly, just to fit in.

The best reason to lose weight if you’re overweight or obese is for your long-term good health. And the best way to achieve this is to take a long term approach.

Forget quick weight-loss gimmicks and diets. Study after study has proven that a slow, sustained weight loss is much healthier and more sustainable in the long-term than crash diets. Except in special circumstances, doctors advice people who are overweight or obese to lose only 0.5 - 1 kg a week, and definitely not more than 1.5 kg a week. What is more important is to keep the weight off permanently, rather than lose and regain the weight quickly.

Weight loss need not be drastic to be effective: The Heart Study carried out at Boston University found that obese middle-aged men and women who lost about 0.5-1 kg a year actually reduced their risk of diabetes by more than 60%. The benefits were sustained, so long as the weight loss was sustained. Another finding of the study was that those participants, who lost 0.5 kg a year for four years and kept that weight off for another four years, lowered their risk of hypertension by 25%.

In other words, even if you don’t think you look any better losing just 0.5 or 1 kg, you will be in better health. Remember also, the heavier you are, the more you stand to gain by losing weight.

Children and Adolescents