How to eat smart like a doctor

There is a reason why Singapore and Malaysia are world-famous for being food havens — good food is everywhere! The foodie culture and the importance that food plays in social and cultural settings in both Singapore and Malaysia means there is a wealth of choice when it comes to eating. From five-star dining to traditional hawker stalls, both countries have an amazing variety of cuisines and options to suit every palate.

Despite this abundance, in recent years, there has been a greater awareness and understanding of the importance of eating right and living better. Of course, we're still foodies at heart, but making smart food choices every day can lead to a better life in the long run!

No one knows this better than Dr Koh Hau-Tek, the Medical Director of Shenton Medical Group who is all too familiar with diet- and weight-related issues among his patients in Singapore. Here, he chats with Great Eastern about the safest and most effective ways to eat healthily and losing weight this year.

Can you give us a general overview of the average Singaporean or Malaysian diet in 2014?

I think our diets are generally quite oily and salty. The salt may increase our fluid retention and lead to some weight gain. Similarly, if the oil we consume on a regular basis is converted into storage, it can also lead to sustained weight gain. I think it's also become a habit for people to pair soft drinks and desserts with meals. Desserts, and especially soft drinks, have large amounts of simple sugars and can cause a quick rise in the body's sugar levels. If not expended, this sugar will be converted to storage and when that happens, one can become fatter.

Other than diet, are there any other factors that influence weight gain?

In Singapore and Malaysia, we have different ethnic groups and certain ethnicities tend to be more overweight and obese. There are two contributing factors: genetics and lifestyle habits. I feel the part that can be controlled is the lifestyle. For example, cutting down on carbohydrates can help and I would substitute rice with brown rice or more vegetables.

A lot of people are going to be on diets as part of their New Year’s Resolution — especially low- or no-carb diets? How effective are these diets?

There are several types of carbohydrates. Those that work best are complex carbohydrates, which help generate glucose as fuel for our bodies. Essentially, these are slow-release carbohydrates that release glucose and hormones over a longer period of time. This means blood sugar levels are not increased too quickly.

There are diets which has little or no carbohydrate. . People who are on these low- or non-carb diets start to mobilise the sugar stored in their liver earlier and, if that's not sufficient, fat and muscles will start to be metabolised. That's how people who are on the diets lose weight. It's not the healthiest thing to do, because you still need some glucose to be the first-line fuel for your body to maintain your muscle mass.

Not eating sufficient carbohydrates can also potentially lead to catabolic state. This is a condition that is mainly caused by overtraining, with insufficient glucose “fuel” and generally not getting adequate nutrition. Symptoms can include extreme fatigue, joint and muscle pain, and sleeplessness.

Some diets also require cutting dairy and wholegrain out — both rich sources of calcium. Are there any local foods you can recommend as good alternate sources of calcium?

A common alternative would be ikan bilis, as the edible bones in the anchovies contain a high concentration of calcium. Of course, healthy bones are not reliant on calcium alone. In fact, very little of the calcium we consume will end up in our bones, so it's important to get a certain amount of vitamin D as well. Vitamin D is present in sunlight and it facilitates calcium absorption in our bodies.

Exercise is very important. If you don't do enough weight-bearing exercise, your body will not be sufficiently hungry to absorb enough calcium into the bones, where it's needed the most. Good weight-bearing exercises include tai chi, golf, hiking, racquet sports and strength training and weight lifting.

If people do want to lose weight this year, what's the safest and most effective way of doing so?

You need to exercise regularly and have a balanced diet to lose weight. A balanced diet means eating complex carbohydrates, some protein and a small percentage of simple carbohydrates. I'd recommend eating fresh vegetables, wholemeal or wholegrain bread and a moderate amount of protein in the form of lean meat. Of course, soy-based proteins are good as well. The key for most people, I think, is moderation. Although for people who are overweight or obese, it would be better to abstain completely from unhealthy food. If you're eating at home, then it's much easier for the ingredients to be adjusted accordingly. If you're eating out, then ask for smaller amounts of oil to be used in the food preparation. The salad bars that are entering Singapore and Malaysia tend to be quite healthy too, except for some of the dressings that they put on. If you can choose your own ingredients, like yong tau foo, that's even better. You can stick to the fresh vegetables and avoid the fried ingredients.

You also need to exercise regularly to lose weight. I like my carbs and red meat a lot, but I exercise like crazy to get these out of my system and maintain some cardiovascular health. Exercise and get your weight down to your target BMI, then you can enjoy a little more indulgence. Not only will you feel good, the range of food you can enjoy will be much wider as well. You can start by walking or going for hikes, where you can enjoy the process of walking, the scenery and the companionship — or even start by simply walking your dog.

I'd say the ratio between dieting and exercising is about 50/50. You cannot rely on diet without exercising, and vice versa. When it comes to weight loss, there are simply no short cuts.

So if you're looking to lose weight; follow medical advice to eat and exercise in moderation - and lose weight like a doctor. For healthy meal ideas enjoy some of celebrity chef Willin Low's recipes; find out the best races in Singapore and Malaysia; or read up on the local foods that will help boost your metabolism.

About the contributor
Dr Koh Hau-Tek is Medical Director of Shenton Medical Group and Assistant VP of Clinical Services at Parkway Shenton. He has been a practicing physician for over a decade.

He graduated from the National University of Ireland with a medical degree, and also completed basic specialist training in general surgery in Ireland. He obtained his Membership and Masters in Medicine (Surgery) at the Royal College of Surgeons in Ireland and National University of Singapore respectively. To develop breadth of practice, he pursued and completed a Graduate Diploma in Family Medicine in 2007 and Graduate Diploma in Occupational Medicine in 2012. With a keen interest in sport and fitness, he has been actively involved in sports like marathons, cycling, trekking, kayaking and diving.