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Healthy weight and obesity

by Dr Harold Gunatillake, Cosmetic Surgeon

Healthy weight is the natural average weight one achieves, in keeping with one's height and weight, through good nutritious food, eating less saturated fat, regular exercising, not smoking and minimising the stress factors. Reaching a specific weight according to the accepted charts and graphs is not important as much as changes in lifestyle to become healthy.

Your perfect weight/body is personal; it is specific to you, and you alone. As said, it is not something you read on a chart, believe it or not.

Healthy weight is important, for everyday activities, you'll feel better and think positive, relate better to your working colleagues, home front, and most of all have more energy. You also have less chances of getting weight related diseases, such as coronary artery disease, stroke, sleep apnoea, type 2 diabetes, and high blood pressure.

One cannot target a weight loss through regimented diet program, or a fad diet recommended by so many labels available in the market to achieve a healthy weight.

Such commitments cannot be made long term, and once you stop such regimented programs the weight comes back. Research shows that people who are most successful in improving their health are those who shift to a healthier lifestyle rather than focussing on commercially advertised disciplines.

How can one change the lifestyle? First of all you must do a skilful job with less stress, and then create a healthy life plan that's suitable for you, and if married your partner, as well.

Overweight and obese people must cut down on their regular meals, especially portion sizes, and eat more fruits and vegetables. Currently, in the United States, some people seem to practise serving a full plate of food, and then put aside half of the portion onto another plate to share with another member of the family.

Portion size with their calorie, fat and carbohydrate content
White Rice, 
steamed  Serving size  cup,   3.25 oz  92 Cals;   0 Fat;  0 Sat Fat,: 21 Carb.    2 Pro
Medium Serving size 1 cup   6.00oz   184 Cal.;  0 Fat:  0 Sat Fat   42 Carb.    4 Pro

Spaghetti - cooked
Serving size « cup     	2.5 oz    	110 Cals;    0.7 Fat;     21.6 Carb   4 Pro
Medium serving, 	1 cup 5 oz    	220 Cals;    1.4 Fat     43  Carb.     8 Pro

Whole wheat Pasta Spirals- cooked
Serving size        	cup 2.5 oz      	87 Cals;       0.4 Fat   18 Carb.  3.7 Pro
Medium serving, 	1 cup    5 oz 	174 Cals;      0.8 Fat  37 Carb    7.5 Pro

Bread
Pita bread available in our Supermarkets
Serving 8cm diameter           	 140 cals;    6g Pro;    30g carb     2g Fat
Whole wheat bread 1 slice    	69 cals;       3g Pro;    13g Carb;   1g Fat.
White bread thick slice        	88 Cals.       2g Pro     20g Carb    1g Fat.

This is a sure way of losing weight intelligently. In Sri Lanka those depending on rice may limit the quantity to half a cup (92cal) and fill the plate with adequate vegetables and pulses.

Limit your bread to two slices (160cal) per serve and supplement with plenty of vegetables, pulses such as lentils. Stir-frying vegetables with a teaspoon of oil or spray would be a healthy choice, accompanied with small amounts of rice, pasta, noodles or bread as the main meal.

Eat small quantities of food made with flour, like string-hoppers, hoppers, pittus, and others occasionally. And eating small quantities of starchy vegetables like potatoes and yams, with the above foods to restrict calories will help prevent, obesity, type 2 diabetes, and hypertension (high blood pressure). It is tested with animal experiments, including primates, rats, mice, spiders, that lifespan could be extended by restricting the calories.

Another set when overfed in the same trial was found to be less active, lived for shorter period, than the calorie restricted group. In 1934, Clive McCay and Mary Crowell of Cornell University observed that laboratory rats fed a severely reduced calorie diet while maintaining vital nutrient levels resulted in lifespan of up to twice as long as otherwise expected.

Professor Stephen Spindler (University of California) and his collaborators have discovered that reducing calorie intake of humans later in life can still induce many of the health and longevity benefits. Such calorie restriction has also been observed to have anti-cancer effects, too.

It is becoming clearer that there are two sure ways of extending ones life for healthy longevity- calorie restriction (CR) and physical exercises. Furthermore, calorie restriction (CR) has been shown to lower cholesterol, fasting glucose among diabetics, blood pressure, control obesity, and reduce cancer effects.

For purposes of calorie restriction one must measure the daily calorie intake by keeping a food diary and calculating the number of calories eaten during the day. If the food intake is more than the expenditure you gain weight. If the intake is less than the expenditure, you lose weight. The situation will be stable if intake equals expenditure.

Knowing the Basal metabolic rate (BMR) is important. By definition, it is the average daily amount of energy needed by the body when it is at rest. Heredity, height, body composition, and age determine a person's basal metabolic rate. One needs about 1500 calories for this basic metabolism.

This energy comes from your food, mainly carbohydrates, is used to maintain body temperature, to power the heartbeat, breathing, and other organ functions. The average person's basal metabolic rate accounts for about two-thirds of the energy he or she expends.

Those who patronise a gym can calculate the calories burnt through monitors on the machines. On a tred mill at 6.0 speeds and 1.5 incline, burns approximately 100 calories in half hour. On a Rowing machine you burn more calories within that period. If you wish to reduce weight you should aim for a 1-2 pound weight loss per week.

A pound of weight loss per week translates into about 3500 calories, so this means cutting your intake by about 500 calories a day. On a daily workout in a gym this is made easier by knowing the exact amount of calories burnt out during exercises.

Those who have not got the facility to visit a close by health club; a 30 minutes brisk walk daily would be the best alternative. Try to schedule your walking activity the first event in the morning. Drink a few glasses of water, get into a walking kit, join with a friend and do it practically every morning.

Take the stairs instead of the elevator. Walk to the market, grocery stores without driving your vehicle. If you are still young, ride a bike to work, daily. If you like to exert yourself more, join aerobic classes, or take the dog for a walk. All these activities will burn approximately over 100 calories per half hour.

To be continued...

'Be more supportive and sensitive towards breast-feeding working mothers'

by Rosanne Koelmeyer Anderson

Mother's after eighty four days of maternity leave have a common cry, 'They are too stressed out after a hard days work to breastfeed their infants, it is too hectic and very difficult to cope with compelling them to stop breast-feeding'.

Rushing in to 'clock in' and having to meet deadlines, not being able to leave the office even though they are given two hours of feeding time off are all issues faced by these mothers.

Today we see many mothers in Sri Lanka who are employed in the private sector and the semi government sector disappointed and showing great reluctance to have children as the task of combining motherhood and employment has become such a strenuous affair said, Consultant Paediatrician,Base Hospital, Nawalapitiya. Dr. Kamal Perera. As for infants breast-feeding remains the simplest, healthiest and least expensive feeding method that fulfils an infants nutritional needs.

Going by recent breast-feeding indicators calculated and speaking to the Sunday Observer said that most working mothers after childbirth faced a high degree of stress trying to cope with dual roles at home and at work and often find the easy way out, stop breast-feeding as soon as possible and introduce supplementary food to the child, paying very little to the nutritional aspect of the growing child's needs for his steady development.

"In the villages however the prevalence of such a situation is less as most women are confined to the home. Thus, the health conditions of mothers both (physical and mental) are important factors that need to be addressed, and a supportive system in workplaces to ease stress levels where such persons should be given strenuous thought recommended for 135 developing countries by the United Nations states that breast-feeding is also associated with higher mortality among infants and young children in the developing world.

Among the infants aged six months or younger in the developing world, the prevalence of exclusive breast-feeding was recorded as 39 per cent and the prevalence of non breast-feeding is 5.6 per cent, while the prevalence of continued breast-feeding is 86 per cent and 68 pe cent for infants and children aged 6-11 months and 12-23 months respectively in the developing world.

In 2001, the World Health Organisation passed a resolution recommending exclusive breast-feeding for the first six months of life as a global public health recommendation while international concern is that optional breast-feeding practices should be that exclusive breast-feeding be continued up to two years of age and beyond, regardless of quantity or the presence of other food or liquids in the diet.

The Demographic and Health Surveys (DHS) by the UNICEF states that breast-feeding is the most complete, comprehensive and reliable nutritional supplement for an infant. Research also shows that breast-feeding leads to brain development in an infant as well, as it has special ingredients like DHA (docosohexaenoic acid) and AA (arachidonic acid) which contributes to brain and retinal development.

Moreover, the findings states that all breast-feeding babies tend to spend a lot of their time in the 'quiet alert' state which is most conducive to learning while breast-feedings immunologic and development benefits may be particularly important for babies with medical problems such as congenital heart disease, cleft palate and Down Syndrome.

There are very few reasons, particularly from the babies point of view, to avoid breast-feeding. One such is when some authorities recommend that mothers who are HIV positive should not breast-feed due to the risk of transmission from breast milk.

Dr. Kamal Perera speaking on the benefits of breast milk explained that breast milk is a biological fluid which is the baby's first immunisation as it provides antibodies which protect the baby from many common respiratory and intestinal diseases.

The first milk, colostrum in fact is packed with components which increases immunity and protects the newborn's intestines. Also babies from families with a tendency to allergic diseases particularly benefit from breast-feeding. Exclusive breast-feeding, especially if it continues for at least six months is best recommended.

New Growth charts from the World Health Organisation (WHO) confirms that breastfed infants grow differently from formula fed babies. It has also been noted that people who have been artificially fed as babies, have a higher risk of obesity as adults.

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Simple steps for better sleep

If you've got neck or back pain, restless legs or have just had a hard day, you might be sleeping with the enemy. Making a few quick adjustments in your mattress, pillows and the way you position your body in bed, however, can make a big difference, doctors and sleep experts say.

"Most people don't know how poor their sleep is until they get a good mattress," says Dr. Johnny Benjamin, spinal medical expert and chair of the orthopaedics department at the Indian River Medical Center in Vero Beach, Fla.

Ignoring aches and pains caused by a worn-out mattress or poor sleeping habits can exacerbate the problem.

People who wake up with a stiff neck over time may end up with arthritis and can develop bony spurs that pinch the nerve roots reaching from the neck to the arms, Benjamin says. He recommends for people who sleep in the fetal position to place a pillow between their knees, which takes the stress off their lower backs and hips.

Those who sleep on their backs should place a pillow under their knees. Resting your head on more than one pillow is a bad idea because it puts the neck in an awkward position. Benjamin suggests using a contoured or cervical pillow, which supports the neck with a gentle C-shaped curve.

When it comes to mattresses, the most important factors are support and comfort. The mattress should be as firm as you can tolerate, keeping your body in a better position. "That's why when you go to your grandmother's house and the bed is older than you, your back ends up killing you," Benjamin says. "The mattress is worn out."

To choose a firm bed that's most comfortable, figure out whether you want a pillow top, an added layer of foam, cotton or wool.

Nancy Shark, executive director of the nonprofit Better Sleep Council, says people should reevaluate a mattress every five to seven years, depending on its quality. At that point, the mattress might start showing signs of wear and tear and it's likely your body has changed too.

"As you age, you tend to get extra aches and pains, maybe gain some weight [or] gain or lose a sleep partner," Shark says. "That could have an impact on the type of comfort and support you need."

One useful guide is the SLEEP test?

Select a mattress, lie down in your typical sleep position, evaluate its comfort and support, educate yourself about the selection and shop with your partner to make sure the bed suits you both.

But how much should you spend? As much as you want, it turns out, since spending more is no guarantee you're getting a better product. Just make sure its one you can live with for a long time.

"Sometimes people don't think twice? They'll go and enjoy a day at a spa or do a weekend getaway to relax," Shark says. "But for probably less money, they could get a mattress on which they could get a great night's sleep all-year round.