Staying Fit in a Food Paradise

Eat to live, and not live to eat? Easier said than done when one lives in Penang!

There is something to eat at every street corner in Penang, at any time of day. Unfortunately, all that delicious food – combined with our sedentary lifestyles – go straight to the heart and gut.

That doesn’t mean we should all forego that plate of char koay teow or stop the banjir in our nasi kandar. Balance is the key word, according to clinical dietitian Lim Aun Ling of Gleneagles Penang.

Ischemic heart diseases were the main cause of death among Malaysians in 2016. Given our hectic schedules these days, is it possible to maintain a healthy lifestyle by only eating in moderation and without exercise?

Having a balanced diet is fundamental in maintaining good health and preventing chronic diseases like heart attacks and diabetes. As a dietitian, I do stress the importance of a healthy diet; however, exercise must also go hand-in-hand with this. Exercise has proven to lower cardiovascular events such as stroke and coronary heart diseases by reducing body weight, blood pressure and LDL (lower-density lipoprotein), otherwise known as the bad cholesterol, and increasing HDL (high-density lipoprotein), the good cholesterol.

The US Department of Health and Human Services recommends at least 150 minutes of moderate-intensity exercise each week. So, going for jogs or brisk walks, or even doing cardio on the treadmill really helps. It’s a matter of choice to keep active.

Penang is famed for its street food and unfortunately, recycling cooking oil is a common practice among hawkers. What are the long-term consequences of this?

Reheated cooking oil contributes to higher risks of cardiovascular events and colorectal cancer. Currently there is no available guideline on how many times the same cooking oil can be used, but medical literature does state that the process of reheating cooking oil reduces the natural antioxidant levels and produces free radicals, which causes oxidative damage to cells and the hardening of blood vessels.

Recycling cooking oil is a common enough practice among hawkers, but we can’t avoid street food altogether as it is very much a part of the Penang lifestyle. We can, however, choose healthier food options: for example, instead of fried chicken, opt for the baked or grilled alternatives. If we can deep-fry foods at home, that would be ideal. If not, substitution is the next best thing.

The fast food culture driven by the likes of McDonald’s, KFC, Wendy’s and Texas Chicken is widespread in Penang. Though the meals are generally thought to be unhealthy, some argue that a fast food burger has everything required by the food pyramid: carbs (buns), protein (patty) and vegetables. What is your opinion on this?

No doubt these foods do appear to contain the three main macronutrients the body needs, but it is the content in these macronutrients that makes the difference. The burger bun is made of white bread versus the healthier alternative, whole grain; unlike a fresh, lean cut of meat, the protein in the patty has been processed and contains high saturated fat.

Additionally, while it relieves the sweet cravings of my diabetic patients, carbonated beverages such as Coca-Cola Zero should be consumed in moderation. To date, there is no medical literature that says its consumption is bad for health, but where there are no prior evidences, I think caution should be exercised.

We are also constantly tempted by fast food advertisements and food trends on social media. How is one to practice moderation in the face of temptation?

Of course a healthy person, even if he is diabetic, is allowed some level of simple sugar in his daily diet (i.e. 10% of total calories daily can come from sugar). Having said that, Asians, especially South-East Asians, have higher risk of developing Type 2 diabetes mellitus. We need to control our sugar intake more than Caucasians.

Our individual taste buds can be altered to be accustomed to less sugary foods over time. Personally, I practice control by having one to two teaspoons (5-10g) of sugar for each food serving, especially beverages. But if the food has to be eaten sweet, such as pineapple tarts and cendol, then it is advisable to reduce the frequency of eating such foods.

There is a need to establish community health centres around the country – primary prevention is vital for Malaysians to make educated food choices. I find that sometimes, injecting a healthy dose of fear can go a long way. We give in to temptations too easily these days, and without much thought about the repercussions; the patients I see here have unfortunately been diagnosed with either diabetes or renal disease from too much indulgence. As dietitians, we do our best to prevent such situations from deteriorating further, although this is now considered secondary prevention.

Clinical dietitian Lim Aun Ling explaining the importance of different sources of protein

Can vitamins and health supplements make up for what we lack in our diet, and are they advisable in the long term??

We must understand that consuming more vitamins and minerals will not help reduce the risk of chronic diseases. Though it can help to complete the nutritional profile of our diet and is at no harm to take, there’s no specific benefit either. The better option would be to have a varied amount of vegetables and fruits – that’s where the natural source of vitamins and minerals come from. But having said that, in terms of specific people groups, for example if one is unable to have enough milk, calcium pills can make up for the deficiency. For pregnant women, iron supplements are encouraged, to prevent iron-deficiency anaemia. Patients with heart disease can also benefit from omega-3 supplements, which can improve their lipid profile.

What about non-religious vegetarianism or veganism?

A vegetarian or vegan diet does not promise the reduction of chronic diseases. We all need protein, and only animal protein can supply the complete amino acids profile the body needs. Moreover, vegetable protein (i.e. bean curd) can be deep fried too, causing the diet to be high in saturated fat. Meat, milk and eggs are not the culprits in increasing saturated fat intake – what matters is the preparation and cooking process.

Last December, The New York Times reported that Malaysia is the “fattest country in Asia”. Curries and other sugar-laden street foods are said to be key contributors. What effective localised methods can our street vendors use to balance between health and factors such as taste and price?

It is difficult to bridge the gap for several reasons, the first being the rising cost of ingredients. If food vendors are willing to spend a little more on purchasing good cooking oil, then it is already a step forward. Soy bean oil is an affordable healthier alternative. Food vendors can consider adding additional fibre into their dishes, such as increasing the portion of vegetables served – this is an inexpensive way of improving the nutritional quality of the meals they sell.

The nutritional profile of a food can also be predominantly determined by its preparation method. Curries can be made healthier by substituting coconut milk with low-fat milk or yoghurt. Instead of deep frying foods, other methods can be used instead such as roasting, grilling, stir frying and stewing. But at the end of the day, it’s a steep hill to climb as Penangites are quite set in their eating habits and the way they like their food prepared.

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