Q: I am a 19-year-old woman. I eat two meals a day and I do not snack at night. But, in spite of that, I have been gaining weight steadily.
I am 1.68m tall and weigh 62kg. When I was 16, my weight was only 52kg.
I do not take a lot of rice and I eat more meat than vegetables. For breakfast, I may have a bowl of cereal or some bread.
I usually eat out for lunch or dinner. It can be a meal from a fast food restaurant or a plate of fried rice or hor fun. Sometimes, I will have a snack like a curry puff or bubble tea but I don't overeat.
I seldom exercise because of my school and work schedules. Please advise me on how I can change my diet to lose weight.
A: You have a healthy Body Mass Index (BMI) of 22. In general, a healthy BMI for Asians ranges from 18.5 to 22.9.
A BMI of 23 and above will increase the risk of health problems such as obstructive sleep apnoea and increased weight on joints (causing pain), Type 2 diabetes, coronary artery disease and cancers such as breast cancer, endometrial cancer and colon cancer.
However, a BMI that is below 18.5 is not advisable as there are long-term effects associated with being underweight, such as irregular menses, anaemia and osteoporosis.
It is more important to focus on eating healthily, rather than dieting to lose weight.
The Health Promotion Board has a visual guide for creating balanced and healthy meals for adults, known as My Healthy Plate.
Your diet shows a lack of milk, vegetables and fruit.
Milk and dairy products are good sources of calcium, which will help build up your bone density and prevent osteoporosis in future.
Vegetables and fruit are high in fibre, which will help you feel full. They are also rich in phytochemicals, which are plant-based compounds that protect against diseases like cancer and heart disease.
You can incorporate these important food sources into your diet through the following ways:
•Adding low-fat or high-calcium milk, or soya milk with reduced sugar to your breakfast cereal or having a low-fat yoghurt as a snack.
•Making vegetables a part of your meal. For instance, get a salad with your sandwich or wrap, go for a plate of economy rice with meat and vegetables or opt for a bowl of yong tau fu with noodles and vegetables.
•Having a fruit for dessert or as a snack. To promote good heart health, you can also try replacing meat with fish, lean chicken or tofu twice or thrice a week.
Skipping meals will only slow down your metabolism and make you feel sluggish and less active.
Hence, it is better to have three small meals and one or two in-between meal snacks, rather than two big meals a day.
Mindful eating is key to successful weight control. Eating while watching television or checking e-mails is not recommended.
Eat slowly by chewing each mouthful of food at least 15 times so there is time for the stomach to send a signal to your brain to indicate that you are full. Once you feel full, put your plate away so that you are not tempted to nibble on leftovers.
When you want to satisfy a craving once in a while, take time to enjoy the food. Do not feel guilty about it.
To successfully maintain a healthy weight, avoid buying highly tempting, unhealthy foods. If you have such foods at home or in school, keep them out of sight. It is good to enlist the support of family and friends' in your healthy eating attempts.
It is also important to incorporate exercise into your lifestyle as it will boost your metabolic rate, especially if you combine strength training with cardiovascular exercise.
Resistance- or strength-training help build muscle, which is more metabolically active than fat.
Aim to do 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity aerobic activity each week. Try to include strength-building exercises more than twice a week.
Exercises that engage the mind and body, such as yoga and pilates, can provide stress relief and improve the quality of sleep.
Getting enough sleep will help prevent long-term weight gain. Studies have shown that insufficient sleep results in cravings for high-carbohydrate foods and high-fat snacks, as well as poor impulse control.
You may also end up taking more caffeinated and sweet drinks to keep you awake during the day.
Furthermore, you will not be motivated to exercise as you will feel lethargic and tired.
If you have addressed all these aspects of your lifestyle and your weight continues to rise, do consult a physician for an assessment of underlying medical conditions, such as an underactive thyroid gland.
Dr Jean-Jasmin Lee
Associate consultant, family medicine service, KK Women's and Children's Hospital
Senior principal dietitian, department of nutrition and dietetics, KK Women's and Children's Hospital