ONE of the most alarming statistics that we have seen recently is the increase in the number of obese persons in Singapore. The latest figure stands at 10.9 percent of the population aged 18 to 69. This means that almost 1 in 10 adults in Singapore are obese and have a body mass index of 30 and above.
So what is this statistic due to? I would say that our local diet is a big culprit followed by a sedentary lifestyle. To come to grips with this problem, I would explain certain matters to my patients.
Firstly was the matter of the metabolic rate. All of us need a certain amount of energy daily to keep our hearts pumping, our lungs breathing, maintain our blood pressure and have enough sugar in our blood to feed our brains. This is called the basal metabolic rate. To measure the basal metabolic rate, we will have to put the patient into a thermal cage and measure the temperature of his breath, urine and feces. This is not possible in our daily setting. As such we can only estimate the basal metabolic rate from formulas. For most men, we are looking at 2,500 calories or kcals daily. For women, we are looking at 2000 calories daily.
Now comes the mathematics, if you eat an extra 500 calories daily over your metabolic rate, you will put on weight. You will put on about half a kilogram every week. Therefore if you eat 500 calories less than your metabolic rate, you will lose half a kilogram every week.
The difficult part will be how to cut your calories? I have six rules that I tell my patients to observe.
Rule 1
A soup noodle is about 200 calories, the dry version with the sauces is about 400 calories and a fried noodle can be anywhere from 800 to 1000 calories. Please try to eat noodles in soup when you choose a noodle to eat.
Rule 2
A plate of chicken rice, nasi briyani or nasi lemak can contain up to 1000 calories as the rice is cooked with chicken oil, ghee and coconut milk respectively. Please avoid these three rice dishes when you can.
Rule 3
Gravy contains tons of calories, you have chicken curry gravy, satay gravy and Indian rojak gravy. A plate of satay bee hoon can set you back 1000 calories. Sometimes in Chinese restaurants you have old ladies who ask for a bowl of soup to wash all the gravy off their food before popping it into their mouths. That is how they keep their figures trim.
Rule 4
Fast foods are a definite non starter as a burger, french fries and a milk shake can set you back a 1500 calories. A piece of deep fired chicken breast can contain 300 to 400 calories. I would suggest you stay completely out of all fast food joints.
Rule 5
I would group drinks into soft drinks, beverages like coffee or tea and fruit juices. Soft drinks are about 150 calories per can or tetrapak, you can drink diet drinks as they contain zero or one calorie per can. Coffee and tea are best without condensed milk as that can increase the calorie to 150 calories per beverage. I would suggest drinking evaporated milk tea or coffee and in the case of café lattes; to drink “skinny” lattes. Fruit juices in a carton are bad news as they contain corn syrup and can be 300 calories per glass. If you drink fresh juices, make sure that the vendor does not add sugar syrup or fish the fruit pieces out of syrup filled containers.
Rule 6
Fresh fruits like peach, apple orange and pear contain about 50 calories. Bananas are best avoided as they contain 100 calories. Also be careful of all melons, mangoes and pineapples. Grapes, lychees and longans should be eaten sparingly in a quantity of 10 to 20 pieces. Beware of durian, this fruit has the most amount of fat found in a fruit.
The 6 rules are by no means exhaustive and I would urge patients to look at the Health Promotion Board website (www.hpb.gov.sg) where they have a list of 6000 local foods with all the caloric values. Other healthier foods would be pasta in tomato sauce or olive oil, grilled meats where the grease drips off the meat, Japanese foods and Mediterranean diets.
When my patients have hunger pangs on starting of their diet, I tell them to buy low calorie crackers and stash them in the car, office and at home. When hunger strikes, please eat a couple of these crackers to kill the hunger pangs. You can even eat them half an hour before lunch or dinner to take the edge off your hunger. Otherwise you might be very hungry and overeat at your meal times. I would say that these hunger pangs will last for about 3 weeks and if you have not gone off you diet by then, you would notice the difference.
Finally when you lose weight, you feel better, lighter and happier. After the weight loss, you will not want to go back to where you were previously.