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Experts answers to
frequently asked questions
FamilyNutritionMatters
ISBN9
78-967-5737-0
2-2
Published by
Nutrition Society of Malaysia
www.nutriweb.org.my
Malaysian Dietitians Association
www.dietitians.org.my
Malaysian Association for the
study of Obesitywww.maso.org.my
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Nutrition Society of Malaysia
www.nutriweb.org.my
Dr Mahenderan Appukutty
Assistant Honorary Secretary,
Nutrition Society of Malaysia
& Nutritionist
Assoc Pro Dr Zaitun Yassin
Honorary Treasurer,
Nutrition Society of Malaysia
& Nutritionist
Malaysian Dietitians Association
www.dietitians.org.my
Ms Indra Balaratnam
President, Malaysian Dietitians
Association & Dietitian
Malaysian Association for the study of Obesity
www.maso.org.my
Dr Zawiah Hashim
Council Member,
Malaysian Association for the
Study of Obesity & Nutritionist
Pro Dr Norimah A Karim
Vice President,
Malaysian Association for the
Study of Obesity & Nutritionist
NATIONAL STEERING COMMITTEE
Dr Tee E Siong, KMN
Chairman, Nutrition Month Malaysia
National Steering Committee & President,
Nutrition Society of Malaysia
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For A
HealthierMalaysia
Diabetes, cardiovascular diseases, cancers, and chronic lung diseases are
now the most common causes o premature death among Malaysians.
Despite programmes and activities instituted to control and prevent these
diseases since the 1990s, results rom the National Health and Morbidity
Surveys have shown that the prevalence o these non-communicable
diseases (NCDs) continues to rise.
Our behaviour and liestyle choices are signicantly infuenced by the
environment that we live in, with the three main risk actors or NCDs
being unhealthy diet, physical inactivity, and smoking. Malaysians need to
not only be more aware o these risk actors, but also take positive stepsto eliminate them rom their lives, and start practising healthy living.
The Ministry o Health has developed and implemented policies and
programmes to help Malaysians live an active lie, eat healthily, and
quit smoking. We, thereore, welcome the initiatives o Nutrition Month
Malaysia (NMM) to reinorce these healthy lie-style messages. However,
this eort is not conned to the Government and proessional bodies
alone; every single one o us has a role to play in making Malaysia ahealthier country to live in. I thereore urge all Malaysians to empower
yourselves, learn and practise healthy eating and active living! Make ull
use o Ministry o Health publications as well as those rom NMM, including
this booklet on Family Nutrition Matters.
Most o us already have the awareness and knowledge but what we need
to do now is to act on it. Start with yourselves, guide your amilies, and
reach out to your riends. Let us all live healthy and productive lives!
Dato Sri Liow Tiong Lai
Minister of Health, Malaysia
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Good eating habits and regular physical activity is crucial as it helps
to prevent non-communicable diseases such as obesity, heart
diseases and diabetes.
In 2012, with the theme Lets Create Healthier Families, NMM
wishes to reinorce this message to the public by promoting greater
awareness o healthy eating and active living as a stepping stone to
nurturing healthier amilies.
There are no short cuts to a healthier lie. We must aim to eat
healthily and engage in regular physical activity every day. We wouldespecially like to urge all parents to play their role in inculcating
good eating practices in their children rom young.
Over the years, NMM has published various educational materials
to assist you and your amily to practice healthy eating and active
living. This booklet is yet another eort to reinorce the act that a
healthy liestyle leads to healthier amilies. Recognizing that there
are various prevailing nutrition concerns and uncertainties amongthe public, this booklet has been prepared to clariy these concerns.
We have compiled 20 requently asked questions that aect
all amily members, and provided detailed clarications to each
question. Our nutrition experts have also provided advice and tips to
help amilies address each concern.
We hope that you and your amily will use the inormation and tips
to start living a healthier lie and build a healthier amily!
Lets Create
HealthierFamiliesDr Tee E Siong, KMN
Chairman
NMM National Steering Committee
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Conte
nts
7
Disclaimer
This book is not in any way intended
to subsitute medical advice from your
doctor or health professionals. When in
doubt, please consult your doctor. The
Nutrition Society of Malaysia (NSM),
Malaysian Dietitians Association
(MDA) and the Malaysian Association
for the Study of Obesity (MASO) are
not liable for any issue arising from the
use of this book.
NSM, MDA and MASO do not
endorse any products and are not
responsible for any claims made in the
advertisements.
Intellectual property is vested in the
Nutrition Month Malaysia (NMM)
programme. No part of this book
shall be reprinted without the written
permission of the National Steering
Committee of NMM.
Copyright reserved Nutrition Month
Malaysia (NMM) 2012.
Editor-in-Chief
Tee E Siong
Members
Zaitun Yassin
Mahenderan Appukutty
Indra Balaratnam
Norimah A Karim
Zawiah Hashim
Editorial Board
TODDLERS &
PRESCHOOLERS7 Shes so picky; but dont
give up!
9 Snack on this!
PRIMARY SCHOOL CHILDREN10 We know youre busy, but
breakast is still important
12 Choosing
healthier
oods at
school
ADOLESCENTS14 My daughter, the model
wannabe
16 Its that time o the monthagain. Help!
ADULTS18 Less at, less diseases
20 Dietary approaches in reducing
high blood cholesterol
22 Increase ruits and vegetables,
reduce risk o cancers
24 Understanding ats and oils
FAMILY26 Eating out, eating healthily!
28 Canned oods: can or not?
30 I am a vegetarian, can I get all
the nutrients I need?32 I spend a lot or my monthly
supply o supplements!
34 Prevent constipation with a
healthy diet
35 Good bacteria as ood?
Weight Management
36 Shopping or
weight loss
plans
is ad ab?
38 Weight gain
in pregnancy exploring the limits
Physical Activity
40 Get moving,
stay healthy
42 Get up, get t,
eel more energetic
30
Secretariat
12A, Jalan PJS 8/4,
Mentari Plaza, Bandar Sunway
46150 Petaling Jaya
Tel: 03-5632 3301Fax: 03-5638 9909
Email: [email protected]
(263773-W) Co-Sponsors
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Dont Be Trapped By Misleading Information:
Ask theExperts
???Tips and inormation on how you
can get the best nutrition or your
health is endless. You can nd it
on the Internet, and rom sales
promoters selling various health
products. Even riends and amily
members have their own advice
or remedies.
But how accurate are these
inormation? Are the messages
and advice based on scientic
evidence? In order to provide
unbiased and correct nutrition
inormation to the public, Nutrition
Month Malaysia has published this
booklet to clariy various amily
nutrition concerns.
This publication explores twenty
requently asked questions on nutrition
and physical activity that cover the
whole amily. I you have any doubts
in relation to your amilys health and
nutrition, get some o the answers
rom this book. You can be sure that
the inormation and tips are credible as
they are provided by nutrition experts
o Nutrition Month Malaysia.
Even questions that you may
have been too embarrassed
to ask are listed here; read
on to nd out more, and start
incorporating the solutions
into you and your amilys
lie today!
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My daughter does not like to
eat vegetables, and will eat
only certain oods, such as
ried nuggets, chicken andpasta. It is difcult to get her
to try new ood and she doesnt
seem to enjoy her meals. I am
araid that she is unable to get
all the essential nutrients or
her growth. How do I deal with
her pickiness and how do I get
her to eat a more balanced,
varied diet?
Shes So Picky;
But Dont Give Up!
Toddlers & Preschoolers
7
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Applying these rules and principles will help your toddler to gradually try and accept a variety o
oods. Be patient with yoursel, and your child, by giving both several chances to keep on trying.
Remember, never orce or push her into eating something she does not want to; most childrenoutgrow this phase and as adults, no longer have problems eating a larger variety o oods!
Have mealstogether!Your toddler may eat better or
have better appetite when sheeats together with the amily.
This is a great way to model
healthy eating habits, and will
also help avoid distractions
that may cause your toddler
to eat less.
Break her in slowly.Try to include something that
your toddler likes in the meals,
such as mashed potatoes, but
encourage her to try whatever
you are having as well, eg grilled
sh or steamed chicken andvegetables.
It is quite common that young children are oten picky and ussy over their oods. And, there are a
ew dierent types o eating issues that young children may ace, such as accepting only a ew types
o oods (eg eating only chicken and rice); active, but is rarely hungry and easily distracted during
mealtimes, eating only a ew bites o ood; and the one who is araid o trying out new oods, crying and
reusing i prompted.
There could be various reasons why children become picky. Some are developmental reasons, such
as trying to show their independence (testing their boundaries), while some children just reuse to try
new things, as they are comortable with things that are already amiliar to them. This is especially true
among toddlers.
Whatever it is, dont despair i your toddler aces any o the issues above; variations in appetite are
normal. Dont orce or scold your child, instead gently encourage and persuade her to eat. It is important
to ensure she gets adequate nutrients and energy to support her growth and development. Here are
some tips to make her eat a variety o nutritious oods!
Keep oering her new oods.Dont give up just because she says No. Just try
again another time, and in smaller portions rst.
Research has shown that it can take up to 15 tries
(with dierent cooking styles and presentations)
beore toddlers can accept a new type o ood.
Entice with do-it-yoursel meals!Provide ingredients or a sandwich, and then let your
toddler make her own meal. You can also make it
more interesting by cutting the sandwiches into
dierent shapes, eg stars, triangles, or you can also lether make ruit skewers with yoghurt dip.
8
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Snack
On This!Fresh & NiceFruits and veggies make extremely healthy and
nutritious snacks. Try:
Fresh or dried ruit, eg bananas, apples, guava,
papaya, honeydew, raisins, and dates;
Home-made ruit juice or milkshake;
Cucumber/carrots/celery sticks;
Salads.
Ready-To-Eat (RTE) andReady-To-Drink (RTD)These snacks can be consumed on-the-spot, including:
Breakast cereals or cereal bars;
Plain, high-bre crackers enriched with vitamins and
minerals;
Red bean/kaya pauor tuna/sardine buns;
Tau fu fah; Milk or soyabean milk;
Malted or chocolate milk drinks.
Quick Cook OptionsI you have the time, you can try these quick cook snacks:
Egg /tuna/cheese sandwiches;
Red/green bean porridge (avoid adding santan);
Corn in cup (avoid adding salt/butter);
Slice o bread with peanut butter/jam;
Oats with warm milk.
Snacks are a great way o providing
energy and nutrients, at the same
time warding o hunger pangs in young
children. They are also useul i your
toddler can only take in small servingso ood during his main meals. Snacks
will be able to ll in the nutrient gaps. It is
important however, to make sure that
you dont give him snacks too close
to his mealtimes to avoid spoiling
his appetite. Thereore, snacks
should be given at least 2
hours beore main meals andin small portions.
I you are unsure about the
types o snacks you should
give, here are some ideas or
healthy and nutritious snacks:
My 5-year-old son oten gets hungry
in between meals. However, I try
not to give him too many snacks,
as I am araid this will spoil his
appetite or main meals. When willbe the right time to provide him with
snacks? What are some nutritious
snacks that are recommended?
10
Toddlers & Preschoolers
9
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10
WeKnowYoureBusy,ButBreakfast
IsStillImportantI fnd it hard to prepare a
healthy breakast when I have
to send my children to school
and then rush to work. Is it
all right or my children to
just eat during their recess at
school? I they skip breakast
in the morning, will it aect
their perormance in school?How does eating breakast
help them in their studies
and other activities in
school?
Primary School Children
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11
Breakast is the most important meal o the day, and evidence
suggests that eating breakast does help children perorm better in
school. Studies have shown that children who skipped their breakast
oten have diculty concentrating and understanding new inormation,
have shorter attention spans, and have trouble remembering things too.
Children who skipped their breakast also appeared less t, less active,
and more likely to be overweight or obese.
Breakast does not have to be a tedious task, and even simple meals can
be nutritious, while being easy to prepare:
A glass o milk (or chocolate malt drink), and a slice o bread with peanut
butter/jam; or
A bowl o breakast cereals and milk; or
Cheese crackers; or
An apple or banana to eat on the go (in the car, bus).
You can even prepare a light meal the night beore and keep in rerigerator
or ood saety purpose, and heat it up (i needed) or breakast; eg porridge,
pancakes/wafes or even llings or sandwiches (tuna/eggs).
Breakast should not be conused with a mid-morning snack, which is usually taken
at recess in school. These snacks typically provide some extra energy and otenkeep hunger pangs away, until lunch.
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12
Choosing HealthierFoods At SchoolThe hype on unhealthy canteen ood in the news today has gotten me
worried about the types o ood sold in my childrens school canteen.
How can I teach my children to choose appropriate oods when
purchasing their morning snacks in the canteen?
Encourage your children to choose these
oods more oten:
Snacks that are less oily and
less sweet, which provide useulnutrients at the same time, such
as sandwiches with egg, meat,
sardine or tuna llings; kuih apam;
steamed pau; or mee hoonsoup with
vegetables and meat. Fruits such
as bananas, guavas, and apples are
good choices too.
Beverages that are less sweetand
nutritious can be taken too. These
include milk (favoured or plain), soya
bean milk, reshly squeezed ruit
juices, and yoghurt drinks.
Snacks taken during recess is not meant to replace your childs breakast or lunch.
Nutritious snacks can help keep him satised until lunch, and most importantly give him
the energy needed to get through the day at school.
To teach your children on how to choose healthier snack options, you may want to take a
trip to the school canteen with your child and help guide him in choosing the right kinds
o oods. Follow these tips on what oods should be taken more oten, occasionally and
avoided as much as possible:
1
Primary School Children
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13
Teach your children to take these oods
occasionally (limit to 1-2 times a week):
Nasi lemak, ried rice or ried noodles/
mee hoon/kuih teow, curry mee.
These oods can be taken occasionallyas they do contain some valuable
nutrients, but may also be high in at.
Your child should take these oods in
small portions.
Teach your children to take these snacks
less oten (not more than once a week):
Foods that are oily and high in at andsalt, eg banana ritters (pisang goreng),
burgers, ried sausages, nuggets, and
French ries.
Foods and drinks those are sweet and
high in sugarsuch as, syrups, ruit
cordials, carbonated drinks, sweets, and
sweetkuih-muih.
Foods that are high in salt andavouring, eg crispy chips/kerepek/
keropok; snacks with articial favouring.
2Lastly, remind your children to always make
sure that the oods they choose are resh and
clean, and not to purchase cooked oods that
are not covered properly.
I you eel that the school canteen is not
serving healthier variety o oods, you
can have a discussion with the teachers
during meetings with the Parents-Teachers
Association (PTA) on how the school canteen
menu can be improved to provide
healthier options.
In act, i you worrythat your child
is not getting
nutritious oods
at the canteen,
you can always
pack a snack-box
or him to eat during
recess. This way you
are almost guaranteedthat your child will be getting all the essential
nutrients he needs to uel his active liestyle!
3
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Recently, I fnd my 15-year-old
daughter constantly skipping dinner
with the excuse that she doesnt eel
hungry. I also noticed that she keepsweighing hersel, complaining i
she has put on even a little bit o
weight. I have read in magazines that
teenagers are oten conscious about
their body. Could my daughter be
acing body image problems? What
are the signs to look out or?
My Daughter, TheModel Wannabe
14
Adolescents
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When children hit puberty, they oten become more conscious
o their bodies. This more commonly occurs in girls, as they
undergo physical changes (eg budding o breasts) and ace
new social pressures, compared with boys. Some teens eel
that they ace body weight problems, and may even restricttheir ood intake to reduce any excess weight. However, some
may take it a bit too ar, and this could cause eating disorders.
An eating disorder is an illness that is caused by a variety o
emotional actors and infuences, which does not only aect
the suerer, but his/her loved ones as well. Eating disorders
are usually brought on by a lack o sel-esteem and condence
about how a person looks and eels about hersel. In general,
there are a ew types o eating disorders:
Some o the common signs that your teen may be
suering rom an eating disorder includes:
An obsession with weight and complaining o
weight problems (even i normal weight or thin).
Obsession with continuous exercise.
Visible ood restriction and sel-starvation.
Does not eat around others.
Mood swings, depression, atigue. Wearing big/baggy clothes to hide body shape and/
or weight loss.
Frequent trips to the bathroom immediately
ollowing meals.
Signicant weight loss in a relatively short period
o time.
It is best to seek your doctors advice i you noticeyour teen showing some o the signs as mentioned
above. Leaving the problem to persist untreated will
cause your teen to be severely malnourished, which
could also be atal!
Anorexia nervosa Anorexics have anextreme ear o weight gain, and a distorted view o
their body shape and size. They oten restrict their
ood intake, or exercise excessively. People who
suer rom anorexia hardly eat at all, and even the
small amount that they eat becomes an obsession.
Bulimia Bulimics will eat normally, or eveneat more than usual, but they will purposely purge
out the ood that they have taken in, either through
sel-induced vomiting or laxative use.
Binge eating Those who suerrom binge eating oten have no control over
their eating, and tend to eat more when they
are emotionally disturbed, eg sad, upset,
disappointed, angry etc. Unlike bulimics,
those who binge-eat do not purge, or exerciseexcessively. As a result, they are oten
overweight, or obese.
15
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Its That Time OfThe Month Again.
Help!Mydaug
hteroften
complainsofseverecr
amps
everytimeshegetsher
period.Isthereap
articular
diet,orcertaintyp
esoffood
thatshecaneat,w
hichhelp
alleviatetheme
nstrualpain
sheexperiences?
16
Adolescents
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LessFat,
LessDise
ases
Moreandmore
Malaysiansare
becomingoverw
eightandobese
.
Whataretheri
skfactorsassoc
iated
withbeingo
verweightorob
ese?
Arethehealthriskshigherif
family
membersareov
erweightorobese?
Whataretheh
ealthhazardsof
beingobese?
Obesity has become a major healthissue in Malaysia, with the numbers
o obese Malaysians tripling over
the past 15 years, rom 4% in 1996
to 14% in 2010. What is even
more distressing is that the rate
o childhood obesity has also been
growing at an alarming rate and
is now one o the most common
nutritional problems globally!
Adults
18
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Frightening Figures!
The main risk actors that result in
overweight and obesity include:
Poor eating habits eating meals that
are not balanced; diets that are high in
calories, sugar and at.
Unhealthy liestyle habits sedentaryliestyles; lack o or no physical activity.
But, these risk actors are preventable.
I you have amily members who are
overweight/obese, you have a higher
chance o becoming obese. However, it
does not mean that you cannot prevent
or decrease the severity o this disease.
Overweight and obesity are major risk
actors to a number o chronic liestyle
diseases. Being overweight itsel
increases your risk o developing high
blood pressure, high blood cholesterol
and high blood sugar. Overweight and
these other risk actors then lead to
diseases such as:
Diabetes;
Stroke;
Heart diseases;
Cancers.
In recent years, there are more children
who are overweight and obese and
because o this more o them are
suering rom diseases such as diabetes
at early age.
Dont be another statistic; prevention
can be as easy as being more active
and eating healthily. Start being active
today by walking up and down the
stairs more oten at your oce every
day. Better still, aim or 10,000 steps
daily! Send your children or swimming,taekwondo or dancing
classes, or take them to
the park or a un game o
basketball, badminton or
skipping. Even doing some
household chores together,
eg washing the car, can
be a great workout or the
whole amily.
Also, dont orget to watch
what you eat. Even i
you exercise, you should
continue to take meals
that are low in at, sugar
and salt. Use the Food
Pyramid as a guide toconsume a more balanced
diet. Remember, use
healthier cooking styles like
steaming, boiling, baking or
grilling, and avoid deep-
rying whenever possible.
2 in 5 adults
are overweight
or obese
Almost 30%o primary schoolchildren (7 12years old) are
overweight andobese
16% o
preschoolchildren
(4 6 years old)are overweight
and obese
19
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Dietary Approaches InReducing High Blood
Cholesterol
A blood test should be carried out regularly, eg
once a year, to examine a persons blood lipid
prole. It is important to determine the levels
o total cholesterol, LDL cholesterol and HDL
cholesterol as these are important determinants
o heart disease. When levels o LDL (low-density
lipoproteins) cholesterol, also known as bad
cholesterol, are raised, they accumulate on arterywalls. This could cause blockage in the blood
vessels, leading to ischaemic heart disease or
heart attack when it aects the coronary arteries.
HDL (high-density lipoproteins) cholesterol on
the other hand, carries cholesterol away rom
cells back to the liver, where it is then broken
down and passed out as waste products. This is
why sometimes HDL cholesterol is also known as
good cholesterol.
Contrary to what many people believe, cholesterol
is actually an important substance in our bodies,needed to protect nerves, make cell walls, as
well as produce certain hormones. Our liver
manuactures cholesterol in the body and in act
contributes much more to our total cholesterol
My husband recently went or a blood
test, which came back with results that
showed his blood cholesterol levels were
slightly elevated than normal.We realised that our diet should change,
as we have been eating without caution.
We began by avoiding high cholesterol
oods such as, egg yolks, prawns, and
butter, among others. Will this help inreducing blood cholesterol levels?
Adults
20
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Increase Fruits& Vegetables,Reduce Risk Of
Cancers
What types o ood should
I avoid/eat more o to
prevent cancer? Does taking
antioxidant supplements help?
22
Adults
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There is no one type o ood that can prevent
cancer. However, ruits and vegetables are a great
source o vitamins, minerals, bre and healthul
substances, known as phytochemicals. Many
phytochemicals have antioxidants properties thatare believed to ght certain diseases, such as
cancer. Its important to eat a wide variety o ruits
and vegetables in dierent colours every day.
Its the various phytochemicals in the ruits and
vegetables that gives them their natural colours,
the antioxidant eect and also other
various health benets.
Yellow/Orange: Fruits andveggies in these colours
are high in carotenes. High
intake o these type o ruits
and vegetables are associated
with strengthening the bodys deense against
inections, and promote good eye health. Eg
Papaya, mangoes, oranges, carrots, yellow
capsicum, sweet potatoes and pumpkin.
Green: These ruits and veggies
also contain carotenes, but are
masked by a green-coloured
pigment, known as chlorophyll.
Other phytochemicals include
lutein and zeaxanthin. High
intake o green leay vegetables are not only
associated with the reduced risk o certain cancersbut it also helps in promoting good eye health. Eg
Green leay vegetables (spinach, kangkung, cekor
manis), green capsicum and kiwi ruit.
Red: Rich in lycopene, a type
o carotenoid. High intake
o lycopene is associated
with the reduced risk o
various cancers as well asheart disease. Eg Tomatoes, red
capsicums, watermelon and papaya.
Blue/Purple: Loaded with phytochemicals such
as anthocyanins. High intake o blue and purple
veggies is associated with the reduced risk o
cancers and heart disease.
Eg Red dragonruit, plums,
blueberries, brinjal and purple
cabbage.
White: White ruits and vegetables
are good sources o vitamin
C, potassium and bre.
Some white produce such as
caulifower and cabbage alsocontain phytochemicals such
as indoles. Eg Guava, bananas, pears,
mangosteen, chinese cabbage and caulifower.
Preventing cancer could also start with some
dietary changes that may reduce the risk o
getting cancer.
Be as lean as possible within the normal range
o body weight.
Be physically active as part o everyday lie. Eat mostly oods o plant origin.
Aim to meet nutritional needs through diet
alone and not through supplements.
Limit consumption o energy-dense oods.
Avoid sugary drinks.
Limit alcoholic drinks.
Limit intake o red meat and avoid processed
meat.
Limit consumption o salt. Avoid mouldy grains
or legumes.
Although antioxidants may be helpul in combating
cancer, it should be obtained through the diet, and
not taken through supplements. Supplements are
not the way to obtain the natural phytochemicals
ound in ruits and vegetables.
Do you know?Kailan, broccoli, pak choy, cabbage,
brussels sprouts and caulifower areexamples o vegetables in the
brassica amily or also known
as crucierous vegetables.
These vegetables are rich
in phytochemicals such as
indoles and glucosinolates
that are associated with
reducing the risk o certain
cancers including breast cancer.
23
Ad lt
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Contrary to popular belie, at has important unctions or the body.
Dietary ats provide essential atty acids, which our body cannotproduce and must be taken rom ood. Fat also helps in the absorption
o at-soluble vitamin A, D, E and K (as a transport). However,
excessive at intake should be avoided, they are high in calories, and
increase the risk o being overweight or obese.
Our body needs a variety o dierent kinds o ats. Fats are made up
o atty acids, which are required in dierent proportions. Main types o
atty acids include:
24
Saturated atty acids: Tend to be solid at roomtemperature and commonly come rom animal sources, ie meats,
milk, dairy products, ghee and lard. Some plant-based oods also
contain saturated at such as santan(coconut milk) and coconut oil.
Unsaturated atty acids: Tend to be liquid at roomtemperature. Mostly ound in plant-based oods such asvegetable oil, nuts, seeds and some marine shes.
There are two types o unsaturated ats:
Monounsaturated atty acids (MUFA): Major
sources include palm oil, olive oil, canola oil,
cashew nuts, peanuts.
Polyunsaturated atty acids (PUFA): Majorsources include soyabean oil, corn oil, sunfower
seed oil, deep sea shes.
Keep ItWithin Limit
Keep to therecommendations o a
daily at intake:
Total at intake should not be
more than 20-30% (45-67g,
around 3 to 5 tablespoons o
oil) o your calorie intake
(based on a 2000 kcal
intake).
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Good to know
Cooking Oil
For generally healthy people, the commonly
available palm oil (which contains a mixture
o atty acids) in the market may be used
or cooking. It may also be appropriate to
use 1 part o palm oil blended with 1 part oother PUFA oils.
For deep-rying, it is advisable to use palm
oil as it is more heat-stable. Unsaturated
oils (MUFA and PUFA) are not suitable
or deep-rying because they are more
unstable; these oils maybe used or salad
dressing and stir-rying.
Do not use cooking oils when they have
changed colour as harmul compounds
maybe ormed.
UnderstandingFats And Oils
Other types o atsTrans atty acids (TFAs): Formed duringhydrogenation o MUFA or PUFA; these atty
acids are associated with the development o
heart disease, and may pose a risk or certain
cancers. Limit oods containing TFAs such as
hydrogenated margarines and shortening.
Cholesterol: Only ound in animal products, eg
internal organs (liver, brain), egg yolk, shrimp,
squid and dairy products. For apparently
healthy persons, moderate amounts o these
oods may be consumed.
25
People say that we should cut down on at but at is also important or
body unctions. What are the dierent kinds o at that our body needs,and what types are good or the body?
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EatingOut,Eating
Healthily!
26
Idontreallyhavethe
timetocookforthewh
olefamily;can
westilleathealthilyw
heneatingout?How
canwechoose
healthieroptionswhen
eatingout?
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Healthy eating is all about ollowing a diet that is varied, balanced and moderate, to obtain
the right amounts o carbohydrates, protein, vitamins, minerals, and even the right types o
ats, according to your daily requirements. Home cooked meals are generally healthier or the
whole amily and is a good way o cultivating healthy taste buds among children. However, some
people may nd it hard to prepare home cooked meals every day, especially since most o themare working 9 to 5 jobs.
Restaurant meals generally have more at, salt, and sugar in them. But, i you know how to
choose the right types o oods or dishes, eating out can be healthy too.
Follow the tips below to make healthier choices when you eat out:
27
Dont addmore taste
to your ood
with table salt or sauces
and ketchup. Additionally,
you can also request
or your order to be
specially prepared (eg
less salt, less sugar, more
vegetables, less gravy)
Avoid ordering ried
oods such as, ried kuih-
teowand breaded oods
such as, chicken chops
i eating out at hawker
centres. Choose oods
that are grilled instead,
ie grilled chicken or sh.Also, oods that steamed
and boiled are much
healthier choices as they
have less at and calories.
Avoid thick curries orgravies that are rich
in santan, and choose
alternatives such as
clear soups or noodle
dishes. For pasta
dishes, try avoiding
cream based gravy as
it contains higher at
content.
Some restaurants serve
large portions, which
are oten too much ora person. You can share
the meal with your child,
or split it between two
children. This avoids
overeating, which may
also lead to weight gain.
Avoid ordering drinks
that are high in sugar,
like carbonated drinks,canned drinks and
syrups. Always take plain
water whenever possible,
and i you would like
something sweet, order
resh ruit juices with
no sugar, which contain
natural sugars instead.
Less
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Canned Foods:Can Or Not?
Im a working mom and I normallydo grocery shopping once a week.
Besides resh goods, I will also
stock up some canned ood (eg
sardines, tuna, corn and baked
beans) or my children to makequick snacks such as sandwiches,
and or me to prepare convenient
meals or my amily. But some
riends told me that canned
oods are bad or health as they
are preserved oods. Is it sae to
consume canned oods? Do they
contain preservatives?
28
y
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Canned oods are generally sae to consume, and it
is ne to use canned oods to add on to resh oods
every once in a while, when preparing meals or theamily. The canning process itsel, which requires
heating the ood at high temperature, preserves
the ood, sealing in the reshness, favour, and
nutrients.
Canned ood, like other processed oods, may also
have some additives added, such as preservatives,
colourings, and favouring substances. However, i
you read the labels and choose the ood you buy
wisely, you will notice that there are also canned
oods that do not contain preservatives or other
additives.
29
Whenchoo
singcanned
oods,use
thesetips:
Check
thequality
othepac
kaging:Do
notpurchaseden
ted,leakin
g,cracked,
orbulging
cans.
Checkth
eingredien
tslistonthepane
l,
andtaken
oteothe
oodadditi
vesadded
totheood
,egpreser
vatives,col
ourings,
favourings,
etc.
Readth
elabelsor
expirydate
sandthe
nutritionin
ormationp
anels.
Withawidera
ngeoprod
uctsavailab
le,
choosewisely:Choo
selowat,l
oworno
salt,reduce
dsugar,orsugar-re
evarieties.
Avoidoo
dsthatare
inheavys
yruporoil.
Storage o canned oods is also very important;
store the canned oods that you have purchased in
a cool or dry place not near pipes, the stove,
a urnace or in direct sunlight. Always keep the cans
dry to avoid the metal lids rom rusting. Rust cancause leaks, which could also lead to ood spoilage.
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My husband and I have been
vegetarians or the past fve years
now. We do not eat meat, dairy
products and eggs. Our two children,
aged fve and seven, however,
have continued to take meat in
their diet. We are now thinking o
introducing the vegetarian diet
to our children, but are worried
about their nutritional status. Can
a vegetarian diet provide all the
essential nutrients needed or the
proper growth and development ochildren?
30
I Am A Vegetarian,Can I Get All The
Nutrients I Need?
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31
According to the Malaysian Food Pyramid, a varied and
well-balanced diet should consist o ood sources rom all
ood groups. However, in certain cases, such as due to
religious or cultural purposes, some amilies may opt to
go on a vegetarian diet. Vegetarians can get most o theessential nutrients that they need, as long as they take
in the right kinds o oods, in the proper amounts.
There are three common categories o vegetarians,
the lacto-ovo-vegetarians who consume eggs, dairy
products, and plant oods; the lacto-vegetarians who
eat dairy products and plant oods, but not eggs; and
vegans, who only eat plant oods (no eggs and dairy
products).
It is indeed possible or the three types o
vegetarians to obtain good nutrition. To achieve
this, it is important that a combination o oods
rom the ood groups be consumed.
Children who go on a strict vegetarian diet such
as the vegan diet, in which they only consume plant-based oods, could be decient in some
nutrients. Nevertheless, it can be managed with proper advice rom a nutritionist/dietitian and
a medical doctor. Some o the nutritional deciencies that may occur, but which are avoidable,
include: -
Vegetarians need to pay more attention to their diet, to ensure that they get all their
essential nutrients rom the oods that they eat. For example, to get enough protein in their
diet, vegetarians should consume a combination o both cereal products (eg wheat, rice)
and legumes (eg dhal, lentils, soy beans, peas).
There are also ortied oods (eg
ortied cereals, ruit juice) that could
supply the adequate requirements
o micronutrients such as vitamins
B-12 and D, calcium, and iron. A
special dietary plan may need to be
considered or vegans due to limited
ood availability. I dietary intake is
too restrictive, seek the advice o anutritionist or dietitian or the need
o dietary supplements.
Insucient
iron intake
Insucient calcium
and vitamin D, i they
remove milk and
dairy products romthe diet.
Insucient
vitamin
B-12, zinc.
Lack o
sucient
quality protein
sources.
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I Spend A Lot ForMy Monthly Supply Of
Supplements!Dietary supplements such as vitamin and mineral supplementation, extractsrom unctional oods and herbal concoctions can be easily obtained in
pharmacies today. Are dietary supplements really necessary? How do we
know i we really need them, and when we should consume them?
Healthy adults, who eat well-balanced meals
comprising o all the ood groups, usually do
not need to take additional supplements. Most
o our nutritional needs can be met through the
oods that we eat, especially i our diet is varied
and balanced, according to the Malaysian Food
Pyramid. In general, whole oods contain much
more benets compared with supplements.
Provides greater nutrition Foods usually
provide a variety o nutrients that you need,
eg oranges provide vitamin C and beta-
carotene, while a vitamin C supplement wouldprovide just that.
Has essential dietary fbre Foods such as
whole grains, ruits, vegetables, and legumes,
provide essential dietary bre, which is
benecial in preventing diseases such as type
2 diabetes and heart disease.
Benefcial protective substances Inaddition to nutrients, some oods contain
naturally occurring substances, such as
32
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supplementation, which can be obtained
rom oods ortied with B-12, or a vitamin
supplement.
Children do not generally need any dietary
supplement. However, i you have a picky child
who eats very little such that his growth is
adversely aected, dietary supplements may
be recommended as a short-term measure to
ensure he meets all his nutritional needs. It is
essential to seek the advice o a nutritionist or
dietitian on the type o supplement to be given
and or how long. Do not take supplements onyour own as excessive intake o single orms
o supplements (eg vitamin A, vitamin E) could
cause toxic eects.
33
phytochemicals in ruits and vegetables.
Phytochemicals help protect you against
cancer, heart disease, diabetes and high
blood pressure. Some are also good sources
o antioxidants, which help to slow down
oxidation a process that causes cell and
tissue damage.
There are however, certain groups o people
who may need to take supplements, such as:
Pregnant women should take prenatal iron
supplements, as well as 400 g o olic aciddaily, which can only be achieved through
olic acid supplements or ortied oods. In
act, olic acid supplementation should be
taken prior to pregnancy too.
Elderly people who cannot eat well or have
problems like dentures.
Vegetarians who consume a limitedvariety o oods require vitamin B-12
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Probiotics are live, benecial bacteria that
actually provide health benets when
consumed in sucient amounts. These
benecial bacteria play an important role in a
ew tasks, such as:
Keeps harmul bacteria under control.
Helps digest and absorb nutrients at thesame time producing certain vitamins,
eg B-12.
Supports the intestinal immune system by
keeping gut cells healthy.
Protects against harmul eects o inectious
organisms that enter the gut.
Helps reduce the eects o harmul toxins
and cancer-causing substances that may beproduced in the intestines.
Pre-biotics on the other hand, are non-
digestible carbohydrates (some dietary bre)
that help the good/benecial bacteria grow,
fourish and stay healthy.
Some o the oods that contain probiotics
include yoghurt, cultured milk drinks, and
ermented oods.
GoodBacteria
As Food?
I have heard that probiotics could
aid in gut health. Is this true?
What are probiotics and the
dierences between probiotics and
prebiotics? What are some o the
benefts o consuming oods/drinks
that contain probiotics?
35
FAMILY: Weight Management
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Shopping ForWeight Loss Plans
Is Fad Fab?Recently, one o my riends went on
a weight loss plan, and I noticed
that she now looks considerably
slimmer. Do these types o addiets (eg no-carb, no at, meal
replacement) really work? What
are the types o ood or diets
that can help in weight loss?
Detoxifcation is also very popularamong some o my relatives. Can
detoxifcation (eg drink certain
teas, eat only ruits and vegetables)
help in losing weight?
36
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Fad diets are weight loss plans that
usually promises dramatic results
in a short period o time. However,
they oten do not result in long-term
weight loss, and some o them can
actually be dangerous to your health!
A ad diet usually excludes certainood groups (eg carbohydrates), or
is extremely low in calories (eg some
meal replacement, liquid diet).
Although people may realise that ad
diets do not carry long-term benets,
many are still willing to try out these
diets. This is because they want to
look, and eel better within a shortperiod o time, and ad diets oten
promise quick and easy weight loss.
However, it is much more likely that
the weight that they lose is rom
water, instead o body at, and people
usually end up gaining back the
weight that they have lost initially.
The best way to lose, AND keep theweight o, is through a healthy diet
and liestyle. This includes taking in
balanced meals, which are varied
and in moderate portions, according
to the Malaysian Food Pyramid, and
being physically active.
Once you have achieved your target
body weight, maintain that weight by
continuing healthy eating habits and
active liestyle.
Detox diets on the other hand, are
believed to help clean out the system;
but it can also cause harmul side eects,
and despite what many people may
think, detox diets DO NOT make you lose
weight. Most detox plans oten involve
laxatives, which cause people to visit
the bathroom more oten, and this cancause dehydration, mineral imbalances,
and problems with the digestive system.
Young children and teenagers especially,
should never go on a detox diet, as they
need enough nutrients or their growth and
development. Restricting nutrients may
impede their proper development.
Tips to lose weight:
Aim or slow and steady weight loss or longlasting eects and better health.
Set a realistic weight loss goal o to 1 kgper week.
Decrease calorie intake without sacricingother nutrients. It is recommended to reduce
500kcal per day, with 250kcal rom your dietintake and 250kcal through physical activity.
Increase daily exercise to 90 minutes per day.
Weigh yoursel regularly, at least once a weekat the same time o the day, preerably
beore breakast.
37
FAMILY: Weight Management
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Weight gain inpregnancy exploring the limits
My cousin who is pregnant eels
that she has put on too much
weight during her pregnancy andhas now started to reduce her ood
intake. Is it sae or her to restrict
her weight gain or be dieting
during pregnancy? How much
weight should a woman gainwhen she is pregnant, and should
she cut down on her meals i she is
gaining too much?
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Pre-pregnancy weight status Recommended total weight gainthroughout pregnancy
Underweight (BMI < 18.5 kg/m2) 12.5 to 18 kilograms (kg)
Normal weight (BMI 18.5 to 24.9 kg/m2) 11.5 to 16 kg
Overweight (BMI 25 to 29.9 kg/m2) 7 to 11.5 kg
Obese (BMI 30 kg/m2 or more) 5 to 9 kg
It is only natural to gain weight during pregnancy, as your babys growth and development
depends on it. However, eating or two doesnt mean that you get to eat twice as much!
Varied, well-balanced meals are important or healthy weight gain during your pregnant
months, and how much you need to gain depends on a ew actors, including your pre-
pregnancy weight and body mass index (BMI) value.
The table below shows how much weight gain is recommended, based on your pre-
pregnancy weight:
It is not recommended to diet, or lose weight
during pregnancy, as your baby may lose out on
some o the essential nutrients needed or his
growth. However, gaining too much weight, more
than the recommended gures, could result inlarger babies and cause complications during
labour, or both mother and child.
The saest bet when gaining weight during
pregnancy would be to eat varied and balanced
meals, which would help you gain weight in a
controlled and healthy manner. Make sure you get
enough exercise too; this will help you maintain
a healthy weight. Ask your doctor to reer you toa dietitian or nutritionist i you are already gaining
too much weight. He or she will help you come up
with a dietary plan to ensure a healthy pregnancy
throughout! Dont orget about exercise during
pregnancy too.
39
FAMILY: Physical Activity
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I am interested in exercising more,
however, I have not been very active
and I am uncertain o the kinds o
exercise that are suitable or me.Could you give me some simple
examples o the types o exercise that
are recommended to stay ft and
healthy? Are there physical activities
that I can do with my whole amily?
Get Moving,Stay Healthy
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FAMILY: Physical Activity
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Get Up, Get Fit,Feel More Energetic
I spend most o my day at work, and when I get back home,
sometimes I just like to relax in ront o the television. I eel that I am
quite sedentary and am unable to get all the exercise I need. My wie
too eels the same way, and my children oten use homework as an
excuse not to do any exercises. Are there any types o exercises that
can be done during working hours, or even when I watch television?How do I ensure that my children get the exercise that they need?
Working long hours in an oce does not giveyou an excuse to be sedentary. In act, regular
exercise can actually help you eel more
energised and make you eel less tired. Exercise
also helps to increase muscle mass and stamina,
improves blood circulation as well as helps to
prevent weight gain. You can try some o these
simple exercises to increase your movement,
whether in ront o the computer, or in ront o
your television!
Building stamina: Use the bottom step o a staircase,
step up and then step down again.
Repeat 10 times.
Toning and/orstrengthening: Stand up and sit down without
using your hands! This can be quite a
challenge even i it sounds simple.
Loosen the hands with air circles.
Clench both ts and stretch out arms in
ront o you. Make 10 circles in the air,
rst in one direction, and then in the
reverse.
Do leg extensions Brace yourselagainst your chair and extend your legs
out straight in ront o you. Flex your
toes ve times, and then release.
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Flexibility: Use an exercise ball and do a ball arm-
leg extension. Lie straight on a ball, and
maintain your balance with your eet and
hands on the foor. Extend your let leg
and right arm up and out, and lower them
ater a short pause. Alternate sides with
each repetition.
At work, get up and move around every hour;
go to the pantry and make a cup o coee by
yoursel, or use the stairs instead o the lit.
Walk over to a colleagues desk and discuss
work instead o just picking up the phone and
calling them.
At home, your children may sometimes nd
doing exercises boring, and are oten lazy to
go out and break a sweat. As parents, we canencourage our children by making exercise
un, and even doing it as a amily while
watching TV programmes or as a weekly aair
at recreational park.
Make it a point to take your children out in
the evenings, to play sports like badminton,
ootball, or basketball. On weekends, when
there is more time, you can even arrange
or a hike, or climb and bring along a healthy
picnic. You can even send your children
or classes that they may enjoy, such as
swimming, taekwondo or dancing. All these
are ways to get your children moving, while
ensuring that they have un at the same
time!
43
10Years
of
moting
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10Y
P
romo
AchievementsofNMM(2002-2011)
Nutrition Month Malaysia (NMM) has been observed every April since its launch in 2002, and this year,
NMM is proud to celebrate its 10th year o promoting healthy eating, with the theme, Lets Create
Healthier Families.
Our nationwide campaign aims to promote greater awareness on healthy eating and active living as the
oundation or general good health and wellbeing. We also aim to inculcate healthy eating habits and
encourage physical activity rom young, so as to improve the nutritional status o Malaysian amilies.
Family CarnivalsOrganised 5 major un-lled carnivals
School & KindergartenRoadshows
Visited 140 primary schools
and provided healthy eating
and active living messages
Visited 175 kindergartens
and conducted interactive
nutrition activities
Publications for PublicPublished 4 practical nutrition guidebooks and
3 recipe books
Visit the Nutrition Society o Malaysias website to obtain more inormation on educational materials rom the
Nutrition Month Malaysia programme. We also welcome eedback/queries. To reach us, please contact:The Nutrition Month Malaysia Secretariat
Tel: (03) 5632 3301/5637 3526 Email: [email protected] Website: www.nutriweb.org.my
Educational Materials forSchool Children &Preschoolers
Published comic
book and activity
book or primary
school children
Published DVD and
worksheets or preschoolers
Educational Press ArticlesPublished over 65
articles in English,
Bahasa Malaysia
& Chinese
newspapers
Mass Media
PromotionsDisseminatedmessages
through radio and
television
MakanSarapan,
PandaiBelaja
r.
Gunakan kerta
saktivitiinisel
epasmenonton
DVDBahagia
n 2
Bahagian2
Kanak-kanak Sihat, NegaraLebih SihatMemupuk GayaPemakananSihatDVDUntuk Kanak-Kanak Pra-sekolah (4-6 tahun) Bahagian 1: Makan Secara Sihat,
MembesarDengan Kuat
Bahagian 2: Makan Sarapan, Pandai Belajar
Bahagian 3: Makan Secara Sihat,Bermain Dengan Cergas
Disokong olehGeran PromosiKesihatan daripada
T er bi ta n De ng an so ko ng an
Kementeri a nKe sih a tan Mala ysia
Healthy NutritionHealthy Nutrition