THE STAR, TUESDAY 24 OCTOBER 2017

OBESITY AWARENESS

More than numbers

As the country with the highest rate of overweight people in
South-East Asia, Malaysians now face more obesity-related mortalities
than ever. Turn the page to find out more and how you can avoid obesity.
2 Obesity Awareness
Denial of disease
By DHARSHINI CHANDRAN
MORE often than not, cultural
celebrations involve some form
of feasting. This means
multicultural Malaysia is
drowning in everything edible
a celebration that we indulge in
almost daily.
Take the standard kuih
peddled on our roadsides, for
example. Coconut milk, sugar
and oil are the bulk of the
ingredients and we wash them
all down with rich, frothy teh
tarik.
Everyone deserves to indulge
once in a while but when those
indulgences lead to the country
having the highest obesity rate in
the region, it may be time to take
notice.
A little further away from
home, in the isles of Tonga, its
national diet is wreaking havoc
on obesity rates in the country.
The culprit mutton flaps
imported from New Zealand. The
fatty, cheap offcuts are
considered not fit for
consumption in New Zealand but
Tonga receives them all the
same.
The Pacific islands reception
Maintaining a healthy liver
VISCERAL fat protects and
surrounds the vital internal organs
such as liver, pancreas and
kidneys. However, too much of
visceral fat is harmful to our body
and it is closely related to
hyperlipidaemia and fatty liver.
In cases where the adipose tissue
is absent, deficient or insulin
resistant with a limited ability to
store excess energy, a surplus of
triglycerides will be deposited at
undesirable sites such as the heart,
muscle and liver.
Normal liver contains some fat.
However, if the weight of fat is
more than 5% of the liver weight,
then it is called a fatty liver
(steatosis). Fatty liver or non-
alcoholic fatty liver disease
(NAFLD) tends to be more common
among people who are overweight
or obese.
The silent killer
Fatty liver is a silent killer
because the progression of the
disease is very gradual. Most
patients experience little to no
of other nations offcuts for
national consumption has led to it
being the most obese country in
the world. Not unlike Malaysia,
Tongans believe good food to be
lots of food. This begs the question
is food the only problem?
Obesity was not even recognised
as a disease until recently, with
many Malaysians thinking of it
as a cosmetic issue. Another
contributing factor to obesity could
be that, for less developed
countries, thinness is synonymous
with poverty.
For many of us, calls from elders
to eat more or comments about
our weight were a regular part of
growing up habitual remnants
from a generation that lived
through food scarcity during the
Malayan emergency. For some, the
rise in obesity may be a sign of
success and it is easy to understand
why.
However, the fact remains that
obesity is a serious condition that is
gaining prevalence in Malaysias
modern society, and our social
eating habits are doing nothing to
help curb its progress.
Malaysians love their food and
they have easy access to food
around the clock. Rather than
symptoms, leaving them unaware
of their condition until it is critical.
In fact, the patients will probably
never know about it unless they
have been diagnosed.
Occasionally, some people may
experience extreme tiredness and
an ache at the top right of the
tummy. In later stage, you can get
more obvious symptoms such as
jaundice, itchy skin and swelling in
the legs, ankles, feet or tummy due
to water retention.
Is it reversible?
If fatty liver is left untreated, the
condition will progress into non-
alcoholic steatohepatitis (NASH).
NASH causes the liver to swell.
Over time, a swollen liver may
cause scarring (cirrhosis) and lead
to liver failure.
Since cirrhosis is an irreversible
condition, the only treatment for
this stage will be liver transplant.
Adopt a healthy lifestyle
If you are overweight or obese,
Malaysians love
their food and they
have easy access
to food around the
clock. Rather than
cooking at home,
eating out is a
norm.
Prof Dr Lee Yeong Yeh
cooking at home, eating out is a
norm. There has been a rapid
expansion of fast food joints and
cafes in the country.
Taking late-night suppers, often
for social reasons, is also a typical
Malaysian habit, says Prof Dr Lee
Yeong Yeh, professor of medicine
and consultant of gastroenterology,
hepatology and internal medicine
at Universiti Sains Malaysia.
Despite being told time after
time that obesity is a known risk
factor for heart attacks, strokes
and diabetes the figures show
more and more people not caring
adopting a healthy lifestyle can
help manage NAFLD.
l Gradual weight loss Lose
0.5kg of weight per week and aim
for an ideal BMI
l Regular exercise Set for at
least 150 minutes of moderate-
intensity activity per week
l Healthy diet Cut down on
foods that are high in fat, sugar
and salt
l Stop smoking Smoking
increases the risk of developing
cardiovascular diseases
l Avoid drinking alcohol
Drinking alcohol may worsen
NAFLD condition
The alternative therapy
Along with a healthy lifestyle,
Silybum marianum or milk thistle
can be used as a natural remedy
for fatty liver or other types of liver
disease.
Milk thistle contains a group of
flavonoids collectively known as
silymarin whereby its most active
constituent, silybin, works as an
antioxidant to neutralise free
Fats and figures
THE Economic Intelligence Unit
recently released a report this
year that was commissioned by
the Asia Roundtable on Food
Innovation for Improved
Nutrition Tackling obesity in
ASEAN: Prevalence, impact, and
guidance on interventions.
The following are excerpts
from the report that focus on
Malaysia and how serious
obesity in this country really is,
impacting almost every area of
the economy including work
performance and indirect costs
from obesity-related illnesses.
l Among obese males,
Malaysia displayed the second
most significant reduction in
productive years as a significant
consequence of obesity
(between six and 11 years).
A significant number of
productive years are lost due to
conditions related to obesity
among Asean-member
countries, but there are high
levels of variation by gender
and no clear correlation with
countries development level.
l Among obese women, on
the other hand, Malaysia
displayed the highest number
of productive years lost due to
obesity (between seven and 12
years).
l Malaysia spends the most
both directly and indirectly in
obesity-related matters and in
treating obesity. The actual
figure comes up to between
10% and 19% of total national
healthcare spending.
l Those living in an urban
about the lasting effects of their
overindulgent diets.
People with obesity often have
difficulty feeling full or sated.
Despite their normal or even
higher metabolic capacity
compared to thinner people, they
often overeat due to the satiety
dysfunction, says Dr Lee.
As to whether satiety is a
mental or chemical construct, it is
unclear.
radicals and inhibit lipid
peroxidation. Besides, silybin
assists in liver detoxification
process by preventing toxins from
entering while exporting them out
of the liver.
Milk thistle is best to be taken
together with essential
phospholipids, B vitamins and
vitamin E to help replace damaged
liver cells.
Phospholipids serve as the
building block to regenerate and
repair the damaged liver cells.
THE STAR, TUESDAY 24 OCTOBER 2017
environment in Malaysia are
1.29 times more likely to suffer
from obesity compared to
someone living in a rural
environment.
The report states that in
South-East Asia, urban living
has been consistently associated
with obesity in all age groups
and both genders.
l According to the same
study, among the full Asean-
member grouping, Malaysia
scored the second highest
prevalence of overweight
children in the country. The
study examined 30,284 school
children across the region.
l In terms of anti-obesity
efforts, Malaysia has promoted
its Malaysian Dietary Guidelines
through roadshows, exhibitions,
leaflets, educational booklets
for different ages, a website,
newspapers, a cookbook for
infants and young children and
educational models for primary
school children. The effects
have not yet been measured.
l There are also other Asia-
specific factors to take into
account. Common measures of
obesity, which originated in
Caucasian-based standards,
may not apply well to Asian
populations due to differences
in body type and body fat
distribution.
Consequently, the body mass
index (BMI) may not be the best
measure of obesity, which
means the disease might be
more widespread than current
statistics suggest.
Development and growing
fatter
Gods of prosperity and wealth
are often depicted with bulging
stomachs and often with a
handful or two of food, again
reinforcing the fat is rich mindset.
Malaysias hunger has not just
been for its cuisine, however.
> TURN TO PAGE 4
B vitamins enhance liver
metabolism, thus facilitating better
detoxification.
Meanwhile, vitamin E, one of the
most effective antioxidants, serves
as a protector for liver health and
maintenance.
This article is brought to you by
BiO-LiFE Marketing Sdn Bhd.
n For more information, call
03-7499 7999 or e-mail
health@biolife.com.my.
THE STAR, TUESDAY 24 OCTOBER 2017
THE National Health and Morbidity
Survey 2015 found that about 30%
of Malaysians above the age of 18
were overweight and another
17.7% were obese. This is a sharp
rise from the 4.4% of Malaysians
classified as obese in 1996.
About 50% of Malaysian citizens
are overweight or obese. Thats a
figure that is too high, said Health
Minister Dr S. Subramaniam
earlier this month.
The World Health Organization
describes poor diet, sedentary
lifestyles and lack of exercise as
serious threats to life, health and
the development of a nation.
Exercising regularly and eating a
healthy diet are ways to combat
obesity. Other benefits of exercise
include maintaining muscle tone,
improving heart or lung function
and reducing stress level.
The United States No.1 fitness
brand, ProForm, introduces its
latest piece of home fitness
equipment, the Cardio HIIT Trainer
a unique hybrid that combines
the benefits of a stepper and
elliptical trainer that works the
upper and lower body
simultaneously with less impact
on the joints.
The ProForm Cardio HIIT
Trainer is the right step towards
reaching your fitness goal in the
comfort of your own home.
With 24 digital resistance levels,
the Cardio HIIT Trainer allows you
to start out easy and progress in
intensity.
The transition between levels is
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the patented Silent Magnetic
Resistance.
Not only does this machine
provide a great lower-body
exercise, it allows you to engage
your upper body for a more
complete workout using the
Fitness begins at home
multifunctional handlebars.
The Cardio HIIT handlebars
move you through boxing-like
motions to amplify calorie burn.
By gripping these handlebars in
different ways, you can tone
different muscle groups in your
arms, shoulders, back and core.
The easy-to-read seven-inch
backlight display tracks your
speed, time, distance and calories
burned every time you work out.
You can also track your statistics at
The ProForm Cardio HIIT Trainer is a hybrid of a stepper and
an elliptical trainer to simultaneously work the upper and
lower body.
any time and beat your own
record.
One of the biggest concerns
people have about an in-home
fitness machine is the amount of
space it takes up.
The ProForm Cardio HIIT
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up half the space of the average
elliptical trainer, leaving you with
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moving around using its front-
beginning any exercise
programme.
Wristband for free.
to raise awareness of heart disease
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When you step on the pedals of
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It comes with many other
features such as an integrated
tablet holder, CoolAire workout
fan, iPod-compatible audio and
EKG (electrocardiogram) hand-grip
heart rate monitor for heart rate
training.
Obesity Awareness 3
Consult your physician before
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In conjunction with World Heart
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Drop by any of its stores today
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4 Obesity Awareness
Weighing in on a weighty issue
> FROM PAGE 2
Rapid, greedy development in the name
of urbanisation is slowly laying us to
waste.
Ten years ago, most small towns
were devoid of any fast food joints
but now, we see them everywhere.
Fast food outlets offer cheap,
convenient access to foods and beverages
and these are often high in calorie.
Urbanisation also offers better connectivity
as provided by the likes of LRT lines, but
limits walkability, says Dr Lee.
Preventing obesity
In 2012, the Health Ministry announced
the possibility of it implementing an anti-
obesity law by 2020 to halt the drastic rise in
non-communicable diseases (NCD) in the
country.
Believing that the country is not yet ready
for such a sudden measure and concern
over whether the anti-obesity law will
increase workplace discrimination is reason
for the delayed start.
The policy, modelled after Japans,
involves periodic monitoring of employees
waistlines and weight and reduces
employability of an overweight or obese
applicant.
This is a great effort on the ministrys
part. However, the law should involve
multiple ministries and industry sectors to
succeed. It is not enough that people should
cut down on calories and take up exercising
but there should be effort in cautionary
labelling (just as for smoking) of foods by
the industries and a firm as well as
sustainable enforcement by governmental
agencies, says Dr Lee.
As to local anti-obesity awareness
campaigns, Dr Lee observes that they were
not too effective and are disjointed, small-
THE STAR, TUESDAY 24 OCTOBER 2017
which emerged as a particular example of
In recent years, the this mindset within the sample.
concept of body image Seeing allowance in acceptance
and body positivity
In recent years, the concept of body image
has swept the world, and body positivity has swept the world,
encouraging those who are overweight or
encouraging those who obese to be more confident with their
bodies, especially if their overweight stature
are overweight or obese is the result of a disease and is not easily
to be more confident with controlled.
However, recognising their heightened
their bodies, especially risk for obesity-related diseases in the long
run is key.
if their overweight The gender disparity in obese body
stature is the result of a images is also apparent and varies from
country to country.
disease and is not easily Generally, Asian females view thinness as
their ideal body image but this image does
controlled. not necessarily apply to males.
Although the recent movement in being
comfortable in any body size can certainly
boost confidence, this does not erase their
scale and unsustainable efforts at best. susceptibility to disease. Therefore, such
This year, a report on obesity rates and movements need to be viewed cautiously,
anti-obesity campaigns among Asean- says Dr Lee.
member countries, commissioned by the
Asia Roundtable on Food Innovation for
Improved Nutrition reflected how
serious of a problem
obesity really is.
The report found that
some populations
within the region
consider the
treatment of obesity
the concern of the
healthcare system,
instead of something
that can be simply
remedied through
lifestyle choices.
The paper pays
special mention to Malaysia,
THE STAR, TUESDAY 24 OCTOBER 2017
CURBING the nations appetite has
not proved easy, but there are
tentative steps being taken to
reduce obesity rates in Malaysia.
It is widely accepted that a major
part of Malaysias mortality rate is
caused by obesity-related ailments,
which prompted a revision of the
previous nutrition plan already in
place.
The Malaysian Dietary Guidelines
was released in 2010. Developed by
experts in nutrition and public
health, the recommended practices
in the guidelines encourage the
incorporation of foods from
different ethnic groups,
vegetarians and other groups with
specific diets into the standard
Malaysian diet.
Although the guidelines were
developed mainly for nutritionists,
dietitians, healthcare educators
and policymakers, the document
can also be adopted by families
and individuals as a baseline upon
which to build their lifestyle
changes.
The following points explain the
key aspects of The Malaysian
Dietary Guidelines.
l Eat a variety of foods
within your recommended
intake Based on the
Malaysian food pyramid, a
balanced diet is expected to
Carving footholds
for healthier citizens
fulfil all nutritional requirements
without the need for supplements.
However, the guidelines
recognise that supplements may be
needed to meet specific nutrient
requirements in cases of
pregnancy, convalescence and
lactation in women.
l Maintain body weight in a
healthy range A balance of
physical activity and a suitable diet
is impressed in this key message.
Weighing oneself at least once a
week is also recommended for
individuals trying to lose weight.
l Be physically active every
day At least 30 minutes of
moderate-intensity physical
activity is encouraged at least five
or six days of the week, but
ideally daily.
This key message tackles
the prevalence of
sedentary habits and
aims to limit physical inactivity.
l Eat adequate amounts of
rice, other cereal products
(preferably whole grains) and
tubers Cereal products that are
high in fibre and low in fat, sugar
and salt are recommended, and
half of that intake should be made
up of whole grain cereals.
l Eat plenty of fruits and
vegetables every day At least
five servings of fruits and
vegetables per day is the ideal
intake.
l Consume moderate amounts
of fish, meat, poultry, eggs,
legumes and nuts Protein
products should be cooked with
healthier methods that skimp on
sugar, fats and salt such as
steaming, boiling and baking.
l Consume adequate amounts
of milk and milk products The
main focus of this key message is to
replace the popular sweetened
condensed milk with unsweetened
liquid or powdered milk.
l Limit intake of foods high in
fats and minimise fats and oils in
food preparation Despite the
focus of this key message on limits,
it encourages the intake of
unsaturated, monounsaturated
Obesity Awareness 5
and polyunsaturated fatty acids should choose safe and clean
while curbing the consumption of premises.
high-cholesterol foods. l Make effective use of
nutrition information on food
l Choose and prepare foods labels Be aware of nutrition
with less salt and sauces Salt claims. For example, recognising
intake is ideally limited to one the difference between real
teaspoon per day. orange juice and orange juice
product is important in
l Consume foods and distinguishing products that have
beverages low in sugar no positive nutritional value.
l Drink plenty of water daily
The recommendation for daily
water intake is six to eight glasses
daily, supplemented by fluids from
food sources.
l Practise exclusive
breastfeeding from birth until
six months and continue to
breastfeed until two years
of age Breastfeeding
provides rich nutrition
for newborn babies.
Breastfeeding
support is widely
available in all
healthcare institutions
nationwide.
l Consume safe and clean
foods and beverages Concerns
regarding safety and cleanliness of
food preparation, storage,
packaging and handling can
usually be abated by avoiding
eating outside. If dining out, one
6 Obesity Awareness
Protein for all ages
THE typical Malaysian diet these
days is packed with carbohydrates
from simple starch, animal
fats from red meats, trans fats
and sugars from processed
foods.
Hence, it is difficult for an
average person to get enough
protein and fibre from his or her
diet. Being the constituent of all
living cells such as muscle, bone,
skin, hair and nail, protein holds
several key functions.
Apart from helping to build
and repair body tissues, protein
is essential for growth and
development.
It also provides amino acids that
are necessary for the synthesis of
proteins such as collagen and
keratin.
As we age, our body starts
to lose its ability to synthesise
protein to maintain lean muscle
tissues, which leads to loss
of physical strength due to
important to start preventing
Everybody muscle loss early in life.
According to the European Food
wants a protein Safety Authority, daily vitamin D
powder that is not
supplementation combined with
calcium has shown to improve
only high-quality muscle function and thus reduces
the incidence of falls, especially
and easy to digest among the frail elderly.
but one that is
An adequate intake of dietary
protein, calcium and vitamin D3
made without provides the following benefits:
l Building blocks for cell
antibiotics from regeneration, muscle maintenance
and tissue repair
dairy, lactose, added l Slows down muscle tissue
sugar and artificial breakdown and enhances exercise
recovery
sweeteners. l Consuming a complete protein
with nine essential amino acids
alongside a regular exercise
programme can help regenerate
muscle degeneration. lean mass and physical strength.
Age-related muscle loss
dramatically increases the risk of Everybody wants a protein
falls in the elderly. Therefore, it is powder that is not only high-
THE STAR, TUESDAY 24 OCTOBER 2017
It is important
for every
individual to
have a
sufficient
amount of
protein for
healthy living.
quality and easy to digest but one
that is made without antibiotics
Health Ministry in promoting
regular bowel movement for
from dairy, lactose, added sugar
and artificial sweeteners.
constipated individuals.
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Biogrow HPF-5s high protein- has bone health-enhancing
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Slim
down
and
shape up
KEEPING in shape can be a great
challenge. Men tend to carry
excess fat in their belly while
women are more likely to store
it in their hips, butt and thighs.
Why is it so hard to get rid of
those stubborn, wobbly bits?
You may skip meals, work out
and do anything to shed those
extra kilogrammes but still make
no progress. Some even turn to
extreme weight-loss regimes for
a quick fix. When the body
Not only do these cost a
fortune, but the results are often does not have
temporary. For sustainable
solutions, lifestyle and dietary
readily accessible
changes must be made. glucose, it uses
Eat a balanced diet, exercise
regularly to burn calories and be stored body fat
consistent. Supplementing with
the right weight-loss nutrition
as an alternative
can help accelerate the process. source of energy.
Green coffee extract has
emerged in recent years as a
natural weight-loss supplement.
Derived from unroasted, green body fat accumulation.
coffee beans, it is loaded with Unfortunately, brewed coffee
naturally occurring chlorogenic does not give the same weight
acid (CGA), a predominant loss benefits. Most of the CGA is
antioxidant that has been shown degraded when the beans are
in scientific research to support roasted.
healthy weight loss. Besides that, coffee beverages
CGA suppresses the glucose-6- contain high levels of caffeine
phosphatase enzyme, which is plus added fat, calories and
responsible for the production sugar, which are bad for health.
of glucose in the liver, thus Excessive intake of caffeine
limiting the release of glucose can lead to a host of undesirable
into the bloodstream. side effects such as anxiety,
When the body does not have drowsiness, insomnia, headache,
readily accessible glucose, it uses increased heartbeat and bone
stored body fat as an alternative loss.
source of energy. This results in On the other hand, green
a decrease in fat deposits and coffee extract can help lower
stops the body from producing blood pressure and maintain
more fat stores, eventually healthy blood sugar levels.
leading to weight loss.
Not only does it help to slow This informational article is
down absorption of fats from brought to you by VitaHealth.
the intestines, it also activates
fat metabolism to burn fat n For more information, call
faster, thereby suppressing 1800 183 288.
THE STAR, TUESDAY 24 OCTOBER 2017
Burden on the body
BEING obese is not just a
cosmetic concern. The excess of
fat deposits around internal
organs can cause myriad
complications if left untreated.
Over time, organs may
deteriorate and eventually lose
functionality, causing stress to a
body that is not able to handle it.
The following is a list of affected
parts in an obese body.
l Brain
Fat deposits narrow your
arteries and can cause blood
clots to form, blocking off blood
supply to the brain and
consequently causing a stroke.
Obesity is also associated with
hypertension (high blood
pressure), which is another risk
factor for stroke.
l Airway
Sleep apnoea is a condition in
which the airway partially
collapses during sleep.
Obstructive sleep apnoea is
more prevalent in obese people
due to fat deposits in the neck
area. However, this condition
can be treated with a breathing
apparatus (short term) and
weight loss (long term).
l Heart
High cholesterol levels and
an excess of other blood fats are
something obese people will
probably be familiar with.
The buildup of fatty deposits
on artery walls (atherosclerosis)
can cause chest pain or even a
heart attack due to lessened
blood flow through the
narrowed blood vessels. This
situation is known as coronary
heart disease.
l Lungs
Reduced lung function and
weakened muscles involved in
breathing are only a couple of
effects of obesity on breathing.
The association between
asthma and obesity is unclear,
but asthma symptoms have been
known to improve in obese
people when they lose weight,
likely due to reduced pressure
on their breathing mechanism.
l Wrist
Carpal tunnel syndrome
(compression of a nerve in the
lower arm area causing pain,
tingling or numbness of the
fingers and a weak grip) is four
times more common in people
who are obese than in people
who are not.
l Liver
Obese people carry a greater
risk of contracting alcohol-
related liver diseases such as
cirrhosis and hepatitis.
Obesity also increases the risk
of fatty liver disease, which
involves fat accumulation in the
liver that causes a range of
conditions.
l Gallbladder
Gallstones are more common
in people who are overweight or
obese than in people of standard
weight, which can also be
related to abnormal cholesterol
levels.
While weight loss could be a
lasting solution for avoiding
gallstone formation, rapid
weight loss is also a catalyst and
risk factor for gallstones.
Gradual, progressive weight loss
is often recommended instead.
l Oesophagus and stomach
The higher your body mass
Obesity Awareness 7
If left untreated,
obesity can cause
complications to
many parts of the
body.
index (BMI), the greater your increases the risk of stress
risk of developing cancer of the incontinence (leakage of urine
oesophagus, which is strongly when you laugh, cough, sneeze,
linked to obesity. In addition, exercise or lift something heavy)
obese people are also more and urge incontinence (a sudden
likely than non-obese people to strong urge to urinate, followed by
develop cancer of the upper leakage of urine).
stomach, known as gastric
cardia. l Knee
Obese people are more likely than
l Kidneys people with a BMI in the healthy
Research suggests that obesity range to have osteoarthritis,
increases the risk of kidney especially of the knee, hip, hand
failure the higher the BMI, and lower back.
the greater the risk of kidney If you have knee osteoarthritis
failure. and you are obese, losing 4.5kg or
This may be because obesity more should improve your insufficiency. In this condition, there Obesity is also a risk factor for
forces the kidneys to work symptoms. Obesity also increases is not enough blood flow through the gout, a condition in which uric acid
harder. Obese people, especially the risk of rheumatoid arthritis. veins back to the heart. builds up in the joints. The most
women, are also more likely This means that blood may pool in common body part to be affected by
than other people to develop l Veins the legs, causing swelling and pain gout is the big toe, but other joints in
cancer of the kidney (renal cell Obesity increases the risk of deep with redness and thickening of the the body can be affected as well.
cancer). vein thrombosis (DVT), a condition skin.
in which blood clots in the deep In most of these conditions, weight
l Pancreas veins, often in the legs. l Feet loss is the first step in treating or
Type 2 diabetes a disease In people with DVT, a blood clot The niggling heel pain some of us alleviating symptoms and
cited again and again in this can break off and lodge in the blood experienced when going through the discomfort.
issue is most commonly caused vessels in the lung. This process, first stages of puberty is the result of If you are obese, get a medical
by obesity. called pulmonary embolism, can be Severs disease, which involves check-up and determine your course
A condition where the body fatal. inflammation from bone growth and of action with a physician to
does not respond appropriately Carrying too much weight also is more common in obese children eliminate these risk factors for your
to the insulin hormone and increases the risk of chronic venous than in other children. health and well-being.
makes blood sugar levels go
berserk, type 2 diabetes
manifests in a large percentage
of people who are overweight or
obese.
Excess fat in the body is also a
factor in how effectively
diabetes may be controlled in
the body. For the obese, diabetes
medication can display reduced
function compared to people
within the normal weight range.
Diabetes sufferers should find
their blood sugar levels more
manageable the more their
weight falls within the normal
range.
l Colon and rectum
Cancer of the colon or rectum
(bowel cancer) is more common
in obese people than in people
with a BMI within the healthy
range.
Large waist size (abdominal
obesity) seems to be especially
important when it comes to
developing bowel cancer.
l Reproductive system:
uterus (womb)
Women who are severely
obese are three times more
likely to have menstrual
problems than women who are
of a healthy weight.
Obese women also have three
to four times higher risk of
cancer of the endometrium
(lining of the womb). Women
who are obese and have
diabetes have an even greater
risk of endometrial cancer.
l Reproductive system:
fertility and pregnancy
Obesity reduces fertility in
both men and women. For
women, being obese before
getting pregnant increases the
risk of pregnancy complications
such as high blood pressure,
preeclampsia and gestational
diabetes.
When it comes to giving birth,
obese women seem to be more
likely to have an overdue birth,
induced labour or longer labour.
Obesity is also linked to an
increased caesarean section rate
and greater blood loss during
birth, thus increasing the risk of
complications after labour.
l Bladder
Among women, obesity
8 Obesity Awareness
Strengthening
weak defences
DID you know that the gut plays an
incredibly important role in battling
diseases? Around 70% of the immune system
is in the gut and it is the first line of defence
against unwanted germs, viruses and
bacteria.
As newborns, our gut is sterile, but at one
year old, the gut floras composition is like
that of an adult.
At this point, the gut is believed to contain
approximately 1,000 different species of
bacteria totalling more than 100,000 billion
more than ten times the number of cells in
the human body.
Changes to your gut flora or any imbalance
can lead to unpleasant consequences and
weaken the guts own immune system.
Too many bad bacteria can increase the
risk of ulcers, irritable bowel syndrome and
food poisoning whereas scientific studies
have shown that the good bacteria could
help with digestion, vitamin synthesis and
support of the immune system.
BION 3 is a three-in-one multivitamin and
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The nutrients in BION 3 support the
immune system, help in digestion and
absorption of nutrients into the body,
replenish the body with vital nutrients and
revitalise metabolism for all day energy.
A worldwide innovation developed by
Bypassing risks
BARI or baros in modern Greek means
weights, burden, obese. Bariatric surgery is
intended for obesity treatment and is
currently the only effective and sustainable
weight loss method for those who have
difficulty losing significant weight despite
food restriction and exercise.
Obese people tend to have multiple
medical problems such as diabetes,
hypertension and high cholesterol.
Bariatric surgery is not only for obesity
but can also improve or cure obesity-related
conditions.
There are different types of surgery that
have restrictive (reduced amount of food
intake) and hormonal effects (changes in
body hormones to reduce absorption and
digestion of food). The acceptable, standard
procedures are as follows:
l Sleeve gastrectomy This procedure
involves reducing the size of the stomach,
which will help reduce food intake. This
procedure removes most of the stomach and
is irreversible.
l Roux-En-Y Gastric Bypass (RYGB)
This procedure involves creating a small
stomach pouch (bag), leaving a small upper
chamber and big lower chamber.
The small intestine is then divided at a
certain length (usually about 100cm from
the duodenum). The first end is joined to the
upper chamber. The second join is from the
lower chamber (the disconnected stomach
and duodenum) to the small intestine.
This procedure does not remove any part
of the stomach or intestine. The amount of
food intake will be reduced as food that
enters the stomach will bypass the
duodenum (first part of the small intestine)
and jejunum into the later part of the small
intestine.
This will delay digestion and absorption.
RYGB is a restrictive and malabsorptive
procedure.
l Adjustable gastric band This
researchers from Merck, the vitamins,
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BION 3 tablets have a special protective
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Give your body the nutritional support it
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KKLIU No.2421/2017
Dr Lim.
No operation, diet
or medication can be a
permanent cure for obesity.
Bariatric surgery along with
lifestyle modifications can
lead to long-term results
for good health and weight
loss.
involves inserting an inflatable balloon into
the upper part of the stomach. The balloon is
attached to a port placed underneath the
skin in the abdomen for adjustment.
This band helps to create a small pouch of
the stomach, limiting food intake and
delaying food from entering the remaining
stomach. This will help to create fullness.
l Other types of procedures Other
procedures include biliopancreatic
diversion with duodenal switch and single-
Consuming healthy snacks
THE Malaysian Association for the Study
of Obesity found a drastic increase in the
consumption of fat and sugar between
1960 and 2000 but reported a decrease in
the consumption of fibre from cereals
within the same time.
Such change in dietary pattern has a
negative impact on overall health among
adults and children. In fact, one in seven
children in Malaysia is affected by obesity.
Breakfast cereals are an important source
of nutrition in childrens diet. Depending on
the type bought, breakfast cereals may have
relatively low fibre due to added sugar and
therefore do not effectively increase
childrens fibre intake levels.
In accordance to the Malaysian Dietary
Guidelines for Children and Adolescents, it is
highly advisable for everyone, especially
parents, to identify and give children cereal
foods that are high in fibre and low in fat,
sugar and sodium.
Effects of fibre intake
The most obvious link between dietary
fibre and obesity is its effects on energy
intake control. Children who eat a high-
fibre diet tend to eat much less energy-
dense, sugary foods such as candies, potato
chips, chocolate bars and ice cream.
In addition, high fibre intake has been
associated with bowel regularity and
improved bowel function. Paediatric
Oesophagus
anastomosis gastric bypass. A few others
types are still in the investigational/research
stage.
The end goal of bariatric surgery is weight
loss. While losing weight, the body may
undergo several other physiological changes
due to restriction in dietary intake. For those
with diabetes, sugar control will improve
significantly.
However, with excessive weight loss, skin
may sag and hair loss may occur, especially
if dietary intake does not focus much on
protein intake. Vitamin deficiency may also
occur if there is no proper consumption of
vitamin supplements.
No operation, diet or medication can be a
permanent cure for obesity. Bariatric
surgery along with lifestyle modifications
can lead to long-term results for good health
and weight loss.
It helps accelerate weight loss especially
in morbidly obese individuals, who
most likely have limited mobility and are
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unable to exercise.
Those who are obese and meet certain
criteria are eligible for bariatric surgery.
General recommendation in Malaysia by the
expert committee is as follows:
l Morbid obesity without co-morbidities
(without any illness) with BMI > 37.5
l Morbid obesity with co-morbidities
(such as subfertility, obesity-related spine or
joint problems) with BMI > 32.5
l Morbid obesity with metabolic
syndrome (diabetes mellitus, hypertension,
central obesity, raised cholesterol level) with
BMI > 32.5
l Acceptable age of between 18 and 65
Long-term follow-ups, lifestyle changes
and regular check-ups are a must post-
surgery. Just like other surgeries, there are
risks involved, but proper practices after
surgery can reduce these risks. By Dr Lim
Huay Cheen, consultant general and
upper gastrointestinal tract surgeon,
Regency Specialist Hospital