Mind your plate and weight

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By 2018-01-07

By Upeksha Bandara

In today's day and age finding a home where the inmates themselves or a friend or relative of theirs haven't suffered a heart attack or have not fallen prey to high blood pressure or diabetes is a task tedious in nature; it can be considered akin to seeking a handful of mustard seeds from a house where no death has occurred.

In Sri Lanka 75% of total deaths are attributed to such non communicable diseases and the majority of these deaths occur after forty years.

Obesity
Non Communicable Diseases such as Cardiovascular Disease, Type 2 Diabetes and certain Cancers are associated with obesity. In individuals of South Asian descent, the risk for NCDs such as Type 2 Diabetes starts at a lower Body Mass Index (BMI) when compared to Caucasians. The BMI is calculated by dividing the body mass from the square of body height. The units of the calculated BMI are in kg/m2 as mass is measured in kilograms while height is measured in metres. A BMI value below 18 is considered underweight, between 23 and 30 is overweight and more than 30 is considered as obese.

The increase in mean caloric intake and decrease in physical activity contributes to obesity. It has been found out that preventing weight gain is easier than to produce sustained reductions in body weight. Thus, preventive strategies are a timely investment.
If someone is overweight or obese the target weight loss should be 5-15% of their current body weight. It is a realistic goal which can be reached by adopting healthy dietary habits and increasing physical activity. If your child is obese, limiting availability of unhealthy foods at home and encouraging physical activity while avoiding over dieting will help them to reduce weight. Weighing oneself once or twice a week will be beneficial to keep track of one's progress.

Dietary habits
The energy density of a meal is highly dependent on the fat and sugar content. Low cost and easy availability of convenience foods particularly in urban areas, have contributed to the increased consumption of high-saturated-fat snacks, refined carbohydrates and sweetened carbonated beverages. High consumption of fruits and vegetables are associated with a better health outcome.

The plate method focuses on reducing the energy density of food and decreasing portion sizes. According to this method half of the plate should contain vegetables and only one quarter should be grains/starch while the remaining quarter should include proteins. At least nine tablespoons of cooked vegetables or three cups of raw vegetable salads should be consumed per day. Half of the grains on a person's plate should preferably be whole grain. It is best to avoid processed or deep fried meat. A healthy choice of proteins to be included in the diet will be lean meat, fish, eggs and pulses.
One or two servings of milk or milk products are recommended per day.

A medium sized fruit (e.g. a banana or an orange) or half a cup of cut fruit /fruit salad should be consumed on a daily basis. Fruit is preferably taken as a snack than a dessert and is a healthier replacement for biscuits, confectionery and cakes eaten as snacks during the day. Adding sugar to blended fruit juices should be discouraged.

It is best to limit sweetened drinks including fizzy drinks. The sugar content of drinks available for sale have been recently colour coded in red , orange and green which signify high, medium and low sugar content respectively. To quench one's thirst the best drink is water. An adult should drink about six to eight 200 ml glasses of water a day.

Daily intake of salt is two or three times higher in the Sri Lankan diet than WHO recommendations. As high salt intake is a cardiovascular risk factor, resolving to use around one teaspoon of salt per day (High calorie foods such as coconut milk, chocolate cake, beer and liquor should be minimized. Most are in the habit of eating high caloric food with the hope of burning the excess calories with exercise later on. Unfortunately to burn out the extra calories one has to engage in exercise for an extensive period of time which is difficult achieve with the busy working schedules of present times. For example, if someone eats a 64g slice of chocolate cake to burn out that extra calorie one has to exercise for an extra 64 minutes. Thus, it would be wiser not to succumb too often, to the temptation of luscious thick slices of cake, milkshakes dripping with ice-cream topping, burgers, pastries and scrumptious deep fried delicacies for a healthy diet is the cornerstone of a healthy lifestyle.

With all these restrictions one might question the need to eat but eating three healthy main meals with a variety in the recommended quantities is vital. Skipping meals especially breakfast has been found out by research as having an association with childhood obesity.

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