Source: www.nst.com.my
Malaysia is now officially the fattest country in South East Asia. Our overweight prevalence is around 44.2 % in 2011. Many of my patients told me that they have lost their hope and have given up on their fight against obesity. Some of them have spent thousands of ringgit on products and food supplements thought to help them to reduce weight but eventually failed. Some did achieve positive results, but only for a while and gained back weight after some time, mostly after spending all their hard earned cash on some weight loss products. Well, we can’t blame them. There are many commercial products or methods to lose weight readily available in Malaysia and there are not much control on these products or services by health authorities because of legislative limitations.
Most people will go for the fastest and easiest way available in trying to lose weight with the least effort involved even though it may cost them a lot of money. These methods, though may help some to lose weight rapidly is not sustainable in long run and does not work with majority of people, not to mention its serious side effects to human health. In most cases, the weight loss achieved is just temporary. Most who took this diet products will start gaining weight the moment they stopped the product or the treatment. It is the supplement industries’ evil and unethical marketing strategies which have conned most people into buying these products or weight losing treatments, not the true scientifically backed evidences of such products .
Why it is easier to gain weight back if you lose your weight rapidly using all these readily available diet products? I will try and explain this in the simplest way possible. Our body has a memory and a sensor for out fat storage. Because of this memory, the body will convert other readily available nutrients in our body i.e glucose and protein into fat storage when the body senses rapid fat loss in order to meet back the fat level based on existing body memory.
An example would be, if your fat % for all these years is around 33.2 %, your body will make sure that they store more fat and convert other nutrients into fat to maintain the 33.2 % of body fat in the event of rapid weight loss. This is also the reason why some obese patients undergoing Liposuction procedures need to perform this expensive procedures repeatedly and frequently simply to maintain their weight . Another example would be , obese patients who had few kilograms of their fat removed during surgical operations will simply gain back weight postoperatively. If you take a product which facilitates rapid weight loss, you will only lose weight while taking the product (during the short period of time )and the moment you stop taking it or go back to your normal diet, your body will start storing the fat back to its usual level prior to taking the product.
So, you can’t be spending a lot of money per month to continue taking this product forever isn’t it? It will not be a sustainable and economical solution to lose weight this way. Not to mention the severe life threatening side effects of rapid weight loss involving some products which resulted in Liver Failure and eventually death. So, how to ensure a sustainable and safe weight loss ?
Source: www.cool-health.com
Losing weight steadily over a longer period of time is more sustainable than losing weight rapidly. The body’s memory on our fat storage will not change in a rapid weight loss but will change in a sustainable and steady weight loss. Basically, what we are doing here is to modify the memory of our body with regards to our fat storage level steadily to prevent re-storing of fat after a steady weight loss. An example of steady but sustainable weight loss would be to lose about 12 kg over a 6 month period at a rate of 2 kg per month. So, how can we achieve this sustainable and steady weight loss?
The answer to this is to stop spending unnecessary amount of money on expensive products, treatment or equipments etc… and go back to the basics, the way our ancestors did it, through healthy diet and structured physical activity regime. In losing weight, 80 % of the effort involves healthy diet while only about 20% is due to physical activity and workouts. This is also the reason why many people exercise for hours every day but still not losing any weight because the healthy diet component is being neglected. You can work yourself out until you break your back but you will never achieve your target weight loss unless you start eating healthy. But dieting alone without the physical activity alone is also not healthy and will not work in most cases. I will elaborate further on this when I explain more on the dietary tips in my next section. Remember, Fit is not a goal, but it is a way of life.
So how can you lose weight? I will cover the following steps and tips in trying to lose weight / trim your belly fat in my next article using a Q & A approach:
- How to detox your body to improve overall body health, energy and help optimize basal metabolic rate.
- How to apply the principle of healthy diet aiming at maximizing fat burn while maintaining sufficient nutritional requirements of the body. In this section, I will explain why the use of the Malaysian Food Pyramid in the promotion of healthy eating for obese patients is entirely useless and misleading and will most probably not help you to lose weight. I will also explain why certain food items marketed by the multi-billion food industries as healthy foods are not the right foods to be taken when trying to lose some weight.
- How to exercise when trying to lose weight? A common advice from all the doctors are to exercise 20 to 30 minutes for at least 3 times a week and that is all. I will explain why this general guideline is only sufficient for general health but not enough to help you lose weight . I will explain on how can you perform a simple 15 minutes daily workout at home and achieve far greater results. I will also explain on the principles of High Intensity Interval Training ( HIIT ) and other governing principles for weight loss exercises. Most people will simply jog or buy expensive exercise equipments but do not exercise correctly using the right principles. While any type of exercise in general is good for your health and fitness level, it may not be the best if you are trying to lose weight. In general, I will cover on Structured Physical Exercise aiming at achieving weight loss through specific exercise regime with the following objectives:
-
- Increasing Basal Metabolic Rate (BMR) and Fat Loss.
- Body Toning to improve overall body muscle mass and increase BMR.
- Improving Endurance and overall fitness .
- Employment of age specific/ physical condition specific exercises. This is due to the fact that many conditions such as old age, knee and back injury etc. may require different and specific exercise regimes designed specifically for these conditions.
This is part 1 of this 4 part series on Losing weight. Stay tuned for the continuation.
Lt Col (Dr) Mohd Arshil was previously the Director for Preventive Medicine and Medical Ops , Military Health Division and is currently pursuing his DrPH. Find out more about him at The Team page.
[This article belongs to The Malaysian Medical Gazette. Any republication (online or offline) without written permission from The Malaysian Medical Gazette is prohibited.]
References:
- Claessens M et al. Glucagon and Insulin responses after ingestion of different amounts of intact and hydrolised proteins. Br J Nutr. 2008 Jul; 100(1):61-9
- Andrew R. All About Dietary Acids and Bases . http: www.precisionnutrition.com/all-about-dietary-acids-and-bases. Accessed 20 Jan 2014.
- WHO Report On Global and regional burden of disease and risk factors, (2011).
- Report of the Dietary Guidelines Advisory Committee, 2010 Dietary Guidelines for Americans. Evidence based guidelines: http:// www.cnpp.usda.gov/DGAs2010- DGACReport.htm.Accessed Jan 16, 2013
- Suitor CW, Kraak VI. Adequacy of Evidence for Physical Activity Guidelines Development: Workshop Summary. Institute Of Medicine. Washington,DC:National Academic Press; 2007.
Dr, i find that the adult RNI also confusing. an average female should consume around 1800 to 2000 kcal perday. isnt that too much? could you comment on this?
Yes. I got this in my brain for long time. If you can clarify this dr, i appreciate that very much.
The term “Average kcal intake” is misleading to some extent as it only gives you your average kcal intake per day based on d average Basal Metabolic Rate for specific age group and sex. In reality, there are significant individual variations in Basal Metabolic Rate due to genetic make up, dietary habits, levels of physical activity etc….Therefore, the best way to know how much kcal you should take per day is to measure your Basal Metabolic Rate using a Body Fat Analyzer machine. This machine will give you your body fat % as well as your Basal Metabolic Rate.The only problem is the more accurate readings of the BMR and Body Fat % comes from the high end models which are usually very expensive. However, there are cheaper models like The Omron Karada HBF 375 model which is reasonably accurate but will not cost you as much. Look for Body Fat Analyzers which have both the upper limb and lower limb sensors for better accuracy in body fat measurements as well as the BMR. By knowing your BMR, you should be able to calculate your calorie intake per day as to not exceed your BMR . Please understand that BMR is your metabolic rate at rest…i.e when u are not doing much physical activity.If you exercise regularly, your daily kcal requirements may be more than your BMR. The general rule is, if you do not exercise that day, try your best not to exceed your BMR as to achieve a negative energy balance to help you lose weight but if you exercise and is generally an active person I.e walking to work, cyling, taking up stairs etc…u may eat a bit more
gud job dr..
A more detailed answer to your question : The Malaysian RNI is the daily nutritional intake recommendation based on average Basal Metabolic Rate as well as average activity level of Malaysians of different age group and gender. In reality, individual Basal Metabolic Rate varies from one individual to the other due to factors such as muscle build, genetic factors, insulin sensitivity and other factors. The level of activity, on top of your Basal Metabolic Rate is an important factor which determine your daily nutritional requirements. For an active person, the daily nutritional requirements will be more than someone who is living a sedentary lifestyle. Therefore, it is important to know your own specific BMR, and also to know how to calculate additional calories intake needed based on your activity level to accurately estimate your actual individual RNI. The easiest and more accurate way to do this is know how to calculate your BMR ( http://www.myfitnesspal.com/tools/bmr-calculator) and use of Calories tracker such as Heart Rate Monitors ( Suunto, Polar, etc…) or newer products i.e Nike Dual Band or Fitbit (http://www.livescience.com/41556-best-fitness-trackers.html). You can also get your BMR reading using some good upper range body fat analyzers. You can then sum up your average calories burned for that day with your BMR to accurately estimate your RNI. If you don’t have any calories tracker and not planning to buy one, you can calculate you daily RNI by the following factoring based on your physical activity below :
Factoring Exercise into the BMR Equation
Amount of Exercise Daily Calories Needed
Little to no exercise BMR x 1.2
Light exercise (1 to 3 days per week) BMR x1.375
Moderate exercise (3 to 5 days per week) BMR x 1.55
Heavy exercise (6 to 7 days per week) BMR x 1.725
Very heavy exercise (intense workouts twice per day) BMR x 1.9
You don’t have to buy this equipment. Some high end gymnasium or fitness centre provide this analysis for you for free. But having a reasonably good Body Fat Analyzer ( don’t buy the cheap unaccurate one) is good to monitor your fat loss progress. Please understand that in the initial phase of workout, you may find that your weight may remain d same. Please do not give up. The reason to this is , when u start exercising and working out after long period of sedentary lifestyle, you will gain muscle mass from your workout. The gain in muscle mass, though may displaced the body fat and make you appear leaner, may also make your weight remain the same initially. This is the reason why u need body fat analyzers, as it is a more accurate short term predictors of your weight losing exercise. Reduction in body fat % despite having d same weight is considered good in the initial phase of your workout. I will explain further in d remaining parts of this article later.
A few questions concerning BMR that I hope are included in the Q&A.
As I understand it BMR is linked to calorie expenditure (for lack of better word). Can you advise on how this is measured/calculated?Further, how does activity-level get factored into this? Assuming a sedentary lifestyle versus an active lifestyle how would this affect the daily calorie consumption?
Assuming diets being constant, will a boost in an active lifestyle lead to an increase in BMR? If so, what kind of mechanics are involved? Let’s say for example that a guy/girl goes nuts in the gym for the first month after a sedentary lifestyle, will his BMR be raised or will his BMR remain a constant? Does other things factor into this, like hormones for example?
Further, how do fat-types go into this equation. I hear that there are white, brown and visceral fats and something about subcutaneous fats.
How do we target any specific types and is there a way to find out what kind of percentages we have in our bodies for those?
Another way to increase your body metabolism is to increase your muscle bulk. More muscle help you burn more energy efficiently.
Can’t wait for the next article
Dear Steve, thank you for your excellent questions. I am writing my next part and will surely include your questions in it. It is better to give d answers in my article then to put in this thread as it involves lengthy explanation. The next part will be out over d next few days. Tq
While waiting for d next article I will try and provide a brief answer to some of your questions. Your BMR remain constant in general. There is no such thing as working hard to increase your BMR level and then stay relax and do nothing. It does not work that way. However, You can modify your BMR indirectly day by day by constantly living a healthy live by eating healthy i.e taking some metabolism booster foods like almond, organic coconut oil, green salads, brocolli, etc…. ( will be explained later in next article) and also by exercising first thing in the morning. By exercising first thing in the morning, you kickstart your metabolism and will achieve the Afterburn ( the term used to describe where your body is burning more energy ) throughout the day. This is also d reason why exercising in early morning is better than any othet time of the day. In summary, BMR( will be explained later in next article) and also by exercising first thing in the morning. By exercising first thing in the morning, you kickstart your metabolism and will achieve the Afterburn ( the term used to describe where your body is burning more energy even when you are already at rest for hours even after your workout ) throughout the day. This is also d reason why exercising in early morning is better than any other time of the day. In summary, BMR remain constant in general for most people even though there are individual variations on the BMR rate but we can modify our BMR constantly by living a healthy way of living consistently. If you dont exercise that day, your Kcal should not exceed your BMR because you will not have the Afterburn effect explained above for that day. In summary, BMR remain constant in general for most people even though there are individual variations on the BMR rate but we can modify our BMR constantly by living a healthy way of living consistently.
Hehehe, Afterburn eh?
There’s a reason why I asked about activity levels factoring in.
So BMR is pretty constant but cab vary depending on the individual’s build perhaps(muscles contribute to it, etc?)
Btw, you’re saying the way to avoid a negative-feedback-loop-ish effect is to keep the effort constant so your body adapts to having lower bf% and the like?
Dear Steve, tq for your questions. I think you are also good in this stuff and would appreciate if you can share in this column. . We have yet to discuss on BMR in detail etc…as this is just an introduction article but I will try and answer some of your questions above. Yes, of course activity level factoring in is important in determining how much kcal can u take per day. Your BMR is your metabolism rate at rest, and therefore is a rough estimator of your daily kcal intake if you are a physically inactive person. If you are active for any particular time , your metabolism rate for that period of time will be more than your average BMR and therefore your actual kcal requirement for that day will be more. Same goes with eating some healthy metabolism boosters food consistently. Increase in muscle bulk will help to increase your metabolism rate but this too is not sustainable if you do not continue to work out consistently to maintain the muscle mass. However, your body muscles have good memory I.e if u have worked out and built your muscle b4, building back d muscle after some period of not working out is not that difficult. Tq
good article..well said..contribution to the knowledge frontier…..
The Malaysian RNI is the daily nutritional intake recommendation based on average Basal Metabolic Rate as well as average activity level of Malaysians of different age group and gender. In reality, individual Basal Metabolic Rate varies from one individual to the other due to factors such as muscle build, genetic factors, insulin sensitivity and other factors. The level of activity, on top of your Basal Metabolic Rate is an important factor which determine your daily nutritional requirements. For an active person, the daily nutritional requirements will be more than someone who is living a sedentary lifestyle. Therefore, it is important to know your own specific BMR, and also to know how to calculate additional calories intake needed based on your activity level to accurately estimate your actual individual RNI. The easiest and more accurate way to do this is know how to calculate your BMR ( http://www.myfitnesspal.com/tools/bmr-calculator) and use of Calories tracker such as Heart Rate Monitors ( Suunto, Polar, etc…) or newer products i.e Nike Dual Band or Fitbit (http://www.livescience.com/41556-best-fitness-trackers.html). You can also get your BMR reading using some good upper range body fat analyzers. You can then sum up your average calories burned for that day with your BMR to accurately estimate your RNI. If you don’t have any calories tracker and not planning to buy one, you can calculate you daily RNI by the following factoring based on your physical activity below :
Factoring Exercise into the BMR Equation
Amount of Exercise Daily Calories Needed
Little to no exercise BMR x 1.2
Light exercise (1 to 3 days per week) BMR x1.375
Moderate exercise (3 to 5 days per week) BMR x 1.55
Heavy exercise (6 to 7 days per week) BMR x 1.725
Very heavy exercise (intense workouts twice per day) BMR x 1.9
Excellent article bro. I truly support the notion of slow and steady is more sustainable for long term success. Thank you for the article. Keep up your good work bro.
Dr, is it true body fat related with water intake? my slimming therapist said if i take 2 liter water per day my body fat will melt??
Drinking plenty of water during the course of weight loss effort is very important. Not only it help in rehydration and regeneration body cells, it also help to optimize your fat metabolism indirectly but you should stick to daily requirements and drink way too much day and night till you find it difficult to sleep at night because you have to go to the toilet often. Please understand that good night sleep is very important as well for you to lose weight. As to the indirect relation of water intake and fat metabolism, i will try and explain it here. From the standpoint of fat loss, you want to be in a position metabolically where the liver is converting stored fat to energy. The liver has other functions, but this is one of its main jobs. Unfortunately, another of the liver’s responsibilities is to pick up the slack for the kidneys, which need a lot of water to work properly. Actually, your kidneys need a lot more water than most people realize. If the kidneys are water-deprived, the liver has a double duty assignment. It has to do the work of the kidneys along with its own work. This double time assignment only serves to lower the actual productivity of the liver. It then can’t metabolize fat as quickly as it could when the kidneys do their job with efficiency. So, the effect on fat metabolism here is an indirect effect, not a direct diluting effect on fat by water as explained to you. Hope this helps.
If you allow this to happen, not only are you being unfair to your liver, but you’re also setting yourself up to store fat because you’ve made the liver less efficient at turning stored body fat into energy.
Correction for the above explanation : Don’t drink way too much day and night…..not drink way too much day and night. Sorry for the typo error.
thank you very much doctor for your explanation. can’t wait for your next article
Great to have a doctor advising on this interesting topic,the usual comments and review usually come from dieticians, nutritionists and fitness experts but rarely from medical doctors.
Keep up the good work!
We doctors are not experts in this field but we realise we must do something to reduce chronic diseases in this country through community empowerment so we share whatever we know and try our best to juggle between evidence based medicine and experts opinions on weight loss mainly by fitness experts and nutritionist. We know they are better experts out there and are happy to learn something from them too here. MMG is a platform for knowledge sharing on health matters for all. But before we empower d community, doctors must walk d talk and lead by example, so let”s shed some weight!!
Dr. Arshil, thank you so much for writing such an elaborate and concise articles on weight loss. Looking forward to read future articles from you.