Replacing food


  • Fitness
  • Sunday, 16 Dec 2007

starhealth@thestar.com.my 

Can meal replacements really help you lose weight for good?  

FOOD: one moment on the lips, next moment on the hips,” struck a chord with the Malaysian crowd.  

When consultant dietitian Mary Easaw-John followed up with the comment with “weight: easy come, hard to go,” the crowd applauded and laughed as she captured our general sentiment about food in just two quotes.  

In fact, more and more Malaysians are fighting a losing battle against the bulge.  

For the year 2005/2006, the NCD surveillance (surveillance of the risk factors of chronic non-communicable diseases) found 31.6% and 16.3% out of 2,572 Malaysians aged between 25-64 are overweight and obese respectively1. 

As Malaysians (who too often love food but hate its effect on the waist and hips), we are always on the constant lookout for ways to lose or maintain our weight.  

While adherence to various popular weight loss diets and skipping meals seem to be the trend to shed pounds, there is one way to lose weight that most people have tried, but never really talked about. 

Remember those shakes and meal bars that make you feel full after consuming them? These milkshake “weight busters” are called meal replacements.  

Not many people have talked about meal replacements in the past, but there is an increasing body of evidence saying that it may have a role to play in obesity, said Easaw-John.  

However, just like any other weight-loss programme, you need to know how to do it right. 

Dietitian Mary Easaw-John ... ‘Don’t beoverly ambitious, because you may not beable to achieve your goals in the end. Youmust lose weight in a positive way.’

The theory  

According to the Canadian Food Inspection Agency, meal replacements are formulated food that, by themselves, can replace one or more daily meals2.  

In simple terms, “Instead of having a burger, you have a drink or a meal bar,” Easaw-John explained. 

Available in the form of drinks, shakes and meal bars, what a meal replacement does is help you control your calorie intake without you having to whip out your calculator. 

While dietitians can coach you on the types of food and calories, counting the calories of every piece on your plate can prove to be a bit difficult if you are constantly dining out, and where you have less control over the portion and content of your food. 

If used correctly, meal replacements will give you adequate proteins, fat, carbohydrates, vitamins and minerals, with the extra advantage of letting you know exactly how much calories you take each time you consume it.  

 

Losing weight 

“The recommended initial weight loss should be 5% to 7% of your initial weight ... and you should be able to do it with increased physical activity,” Easaw John said. 

“Don’t be overly ambitious, because you may not be able to achieve your goals in the end. You must lose weight in a positive way,” she added. 

If a person is taking 3,000 to 4,000 calories a day, asking him to adjust to a 1,200-calorie diet suddenly would be cruel, if not impossible. 

A lot of times, crash diets will leave people feeling deprived of food. This may induce cravings and result in bingeing later on, said dietitian Teng Yu Yuet. 

As weight rebounds due to the return to unhealthy diets after crash diets is quite common, it is important for us to work out a diet that adjusts a person’s calorie intake progressively to achieve attainable weight goals. But are meal replacements the answer? If you are thinking about a short-term effect, the answer is probably yes. For a long-term solution, think twice before you proceed.  

“I would recommend people who are still able to go on a healthy, balanced diet to try controlling their diet, unless there are situations where they can’t,” Teng said. 

Whether you have problems with your weight or you’re just looking for a slimmer figure, Easaw-John advises the same: evaluate your eating habits, lifestyle and behaviour patterns before embarking on any weight management programme. 

“Before you think about diet interventions, please go and see your doctor and check if you have any other underlying medical conditions,” Easaw-John elaborated.  

Then visit a dietitian to find out how you should go about losing the extra weight. 

According to the look AHEAD (Action for Health in Diabetes) study designed to determine whether intentional weight loss reduces cardiovascular morbidity and mortality in overweight individuals with type 2 diabetes, several randomised, controlled trials have shown that study subjects achieved a mean loss of 7% to 10% initial weight in four to six months by diet, exercise and behaviour therapy. 

In this study, meal replacements were introduced as one of the means of portion control in dietary intervention. However, as the study showed, even though meal replacements may help you in taking some weight off, it does not replace the good old practise of good eating habits, lifestyle modifications and physical exercise. 

“If you are on a meal replacement, but still do not have the ability to control your own appetite, it defeats the purpose of you replacing your meals in the first place,” Teng said, stressing that meal replacements are best used for only the short term. 

“Meal replacements can help you (lose weight), but they will not be your life-long solution,” Easaw-John stressed. 

From ‘nasi lemak’ to milkshakes 

Drawing from her experience, she empathises with the difficulty of changing someone’s food habits. “It is difficult to ask someone to take “foreign” food. How can you tell someone not to eat their own (cultural) food?” 

Imagine replacing your daily roti canai for a milkshake every morning. Easier said than done. 

For those who want to start on a meal replacement programme, they must be committed and ready for the changes that will ensue, Easaw-John said.  

There are a few things to look out for before using a meal replacement, including the manufacturer’s profile and the studies done to substantiate their claims, she added.  

“You can look at the studies done on the Net. Note where the study is done, and how they did it. If you do not understand it at first, you can download it and read it.” 

Most importantly, consumers should also read carefully the nutrient content of the product and determine whether it is of a balanced composition that will give you the nutrients you need for a meal. 

However, nothing could quite measure up to a healthy, balanced meal where all your vitamins, minerals, fibre and bioactive compounds are neatly stashed up in that tasty salad or pasta. 

Nevertheless, with our “I want it now” mentality, it is difficult to restrain us from replacing some of our meals to get fast results. But Easaw-John usually advises her patients to take it slowly. 

“Normally people will start with replacing their breakfast, because it is easiest for them. 

“When they are comfortable with the replacement, then they may start replacing their lunch too,” said Easaw-John, adding that some persist with only replacing their breakfast. In an Asian setting, replacing dinner is a tad more difficult as communal dining with the family is practised widely.  

Even so, replacing all three meals a day may not be healthy for you, Teng said. 

The next question is: how long should you replace your meals? 

Well, that depends on you. “The problem is, people will get ‘taste buds fatigue’,” Easaw-John said, observing that some people on meal replacements eventually get bored with it. “That is why you should put your mind to lose weight within the recommended period of time.” In replacing your meals, “the more the better” may not apply. 

Eric Skubish, senior global brand manager of Abbott Laboratories International, was aghast when he first heard about the way some people were taking meal replacements for breakfast, lunch and dinner every day.  

“Yes, meal replacements can give you the complete nutrition you need, but the question is whether you should do it,” said the young executive. 

According to a nutritional expert from the United States, Dr Krishnan Sriram, “eating has psychosocial effects attached to it. It has an effect on satiety and the actions of your gastrointestinal hormones.” 

Taking meal replacements without proper guidance may also leave you vulnerable to the risks of malnutrition, Easaw-John cautioned. So, if you decide to forgo the tasty nasi lemak for a nutritious meal replacement drink, make sure you are well informed about the safe and healthy ways to use it. 

 

References: 

1. Malaysia NCD Surveillance 2005/06 Summary of the Results http://www.dph.gov.my/ncd/surveillance/index.php?option=com_content&task=view&id=20&Itemid=37 

2. Canadian Food Inspection Agency Nutrition Labelling Toolkit, Section I - Glossary of Terms. http://www.inspection.gc.ca/english/fssa/labeti/nutrikit/sectie.shtml 

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