DIET-related chronic diseases such as heart disease and cancers are the major cause of death in this country. The major cause of these diseases is an unhealthy lifestyle, comprising of unhealthy eating patterns and a sedentary lifestyle.

Yes, it would therefore mean that these diseases are preventable. We have to be convinced of that. We must have the will and determination to take preventive measures. We have to take immediate positive actions to practise healthy eating and active living.

The MDG can help

The Malaysian Dietary Guidelines (MDG) 2010 are a set of advisory statements that aim to promote appropriate dietary patterns. These guidelines encourage Malaysians to adopt appropriate food habits, be more active, and make wiser food choices. These statements are unbiased messages, developed by professionals in the country, based on currently available nutrition science.

I have summarised the 14 key messages contained in the MDG 2010 in a previous write up in this column. These messages cover the whole range of food and nutrition issues, from the importance of consuming a variety of foods to guidance on specific food groups. The revised guidelines also include specific messages to encourage physical activity, consuming safe food and beverages, and making effective use of nutrition information on food labels.

In this, and other subsequent write-ups, I would like to provide more in-depth information on these key messages. I will commence with the first key message: enjoy a variety of foods.

A healthy diet needs to be adequate, balanced, moderate and varied

Let us begin from the basics, from understanding what is a healthy diet and why is it important. A healthy diet is a diet which provides the proper combination of energy and nutrients needed by the body. This is important to ensure that the individual is neither deficient of certain nutrients nor is having an excessive intake of other nutrients.

At least four characteristics are needed for a healthful diet - adequate, balanced, moderate, and varied. An adequate diet provides enough energy, nutrients, and other healthful components to maintain an individual's health. It must be noted that the energy and nutrient requirements of individuals vary considerably, depending on gender, age, and activity level. Hence, a diet that is adequate for one person may not be adequate for another.

A balanced diet is a diet that contains the combination of foods that provide the proper balance of nutrients. The body needs many types of foods in varying amounts to maintain health. The right balance of nutrients needed to maintain health can be achieved by eating a proper balance of all healthful foods, including cereals and cereal products; fruits and vegetables; meat, fish and egg; and milk and milk products.

Moderation is key to a healthy diet. Moderation refers to eating the right amounts of foods to maintain a healthy weight and to optimise the body's metabolic process. Moderation means avoiding excessively large serving sizes and eating frequently.

Graphic: The Star

Variety is important for a healthful diet

Variety refers to eating many different types of foods each day. Different foods contain different types and amounts of nutrients and healthful components. Even within each food group, such differences are considerable. Hence, within the fruits and vegetables groups, one has to eat a variety of these. Similarly, one is encouraged to consume different types of meat, fish, cereal products, etc.

By selecting a variety of foods, the chances of consuming the multitude of nutrients the body needs are optimised.

It should be noted that variety does not mean eating large amounts of foods. It is still important to eat in moderation, consume foods within one's recommended intake. Variety certainly does not mean eating in excessive amounts of food.

After understanding the requirements of a healthy diet, let us see how we can achieve this diet. The food pyramid is recommended as a tool to guide in designing a healthy diet.

The food pyramid is intended as a visual guide to provide for the selection of the types and amounts of food that can be eaten in combination to provide a healthy diet. A food pyramid consists of four levels that represent various food groups. Indicated beside each food group is the recommended number of servings per day from each group. From the bottom to the top of the food pyramid, the size of each food group becomes smaller, indicating that an individual should eat more of the foods at the base of the pyramid and less of the foods at the top of the pyramid.

The food group to be consumed the most is at the base of the pyramid and this comprises complex carbohydrate foods. It has been recognised that carbohydrate should form the bulk of our caloric needs and therefore should be eaten the most. These foods include rice, noodles, bread, other cereals and cereal products, and tubers. These foods, also called "energy-giving foods", are not only good sources of energy but they also contain dietary fibre and small amounts of minerals and vitamins. The general recommendation is to consume four to eight servings of these foods a day.

The second level of the food pyramid is smaller and comprises fruits and vegetables. The recommendation is to consume at least two servings of fruits and three servings of vegetables daily. You may have heard them being called "protective foods" because they are good sources of vitamins, minerals and dietary fibre.

Level three of the pyramid becomes smaller still and is divided into two sections. One section comprises fish, poultry, meat and legumes (e.g. soya bean and its products, mungbeans, red beans and dhall). These foods, two to three servings recommended to be consumed a day, are good sources of protein but also provide dietary fibre and some minerals.

Milk and dairy products (excluding condensed milk, butter and cream) are in the other section of this level. The recommendation is to consume one to three servings of these foods. These two subsections do not replace one another. You should select foods from both groups daily.

At the tip of the pyramid are foods to be consumed the least. These are fats, oil, sugar, and salt. It does not mean that a person does not need fats and oils, and neither does it mean that these are "bad foods" - if indeed these are "bad foods", as widely misconstrued. On the contrary, the dietary guidelines explain that these are important components of the diet. From the above description, it can be seen that the food pyramid emphasises the principle of relative amount of foods to be eaten. Bear in mind that it is only a rough guide for the consumer. It is also not meant to be a "one-size fits all" guide. Nevertheless, when used together with the other messages contained in the dietary guidelines, the food pyramid helps in arriving at healthy diets.

MDG key message 1: Eat a variety of foods within your recommended intake

There are two key recommendations within this key message. Within each of the following key recommendations, the MDG has provided several tips on how to achieve these recommendations.

1. Choose your daily food intake from a combination of foods based on the Malaysian Food Pyramid.

a. To ensure your body gets all the nutrients needed, choose foods from the five food groups based on the Malaysian Food Pyramid.

b. Vary food choices within each food group in your meals.

c. Choose healthier cooking preparation methods such as steaming, grilling, baking, boiling and reduce frying methods. Reduce adding santan to the dishes you prepare.

2. Choose your daily food intake according to the serving size recommended.

a. Determine the number of servings that you should eat daily to maintain your body weight. This is based on your energy (calorie) need which is dependent on various factors, e.g. age, gender, physical activity level, weight status as well as physiological state (e.g. pregnancy and breast feeding).

b. The more physically active you are, the more energy (calories) is required per day. On the other hand, if you are very sedentary, less calories are needed per day.

Nutrient supplements are generally not needed

Eating a variety of foods daily as guided by the Malaysian Food Pyramid should provide all the nutrients needed by the body. Therefore, supplements are not necessary for most individuals. Supplements of vitamins, minerals or fibre do not supply the nutrients and other essential components present in foods that are important to health.

Nutrient supplements cannot be used as a substitute for proper food choices and supplements of some nutrients taken regularly in large amounts are harmful. However, supplements may be needed to meet specific nutrient requirements such as during convalescence, in pregnant and lactating women and for the elderly. Nutrient supplements should only be taken on the advice of nutritionists, dietitians or medical doctors.

Take charge today

What you eat and drink has tremendous impact on your health and wellbeing. Eating right is certainly possible, even within our contemporary lifestyle, with busy schedules and heavy responsibilities.

Let the MDG 2010 guide you and your family members in adopting healthy eating habits and an active lifestyle.

Further information on determining number of servings according to calorie needs of individuals can be obtained from the complete MDG in the Ministry of Health website: www.moh.gov.my. The Nutrition Society of Malaysia has also made available leaflets of these MDG suitable for the public (www.nutriweb.org.my).

NutriScene is a fortnightly column by Dr Tee E Siong, who pens his thoughts as a nutritionist with over 30 years of experience in the research and public health arena. For further information, e-mail starhealth@thestar.com.my. The information provided is for educational and communication purposes only and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader's own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

-The Star/Asia News Network