Ask anyone to choose between being slightly overweight and skinny, and most would pick the latter.
However, Adrian Hutber is adamant that a person is better off being plump and fit rather than skinny and unfit. If the person is physically active, the risks of heart disease, type 2 diabetes, cancer and other chronic diseases would decrease, he says.
"People usually exercise to lose weight and when they don't, they give up. You do not need to look at the scales every day to see if you are losing weight. It does not matter if you do not lose weight.
"Do not make losing weight your primary goal, make that as a side effect of exercising. The aim of exercising is to be healthy, to make you feel better. When you exercise, your body benefits immediately. If you follow the right diet and exercise, losing weight will be the bonus."
Hutber, vice president of Exercise Is Medicine, explains that while physical activity is not the only answer to health issues, it is an under-utilised tool that is part of the prevention approach. People often feel that they are physically active but in reality, they may not be.
He said in the United States, a survey found that 40 to 50 per cent of people state they are physically active. However, when a pedometer was was used to test that, only about 5 per cent really were.
This is because people usually exercise without understanding the actual specifications, such as the duration and frequency, he says. To achieve better results, people should be involved in a high level of exercise - 150 minutes in a week. If they cannot do it during the week, they should do 75 minutes of exercising on Saturday and another 75 minutes on Sunday.
"As for the form of exercising, it can be anything that's fun for the person. When they are doing something which they do not enjoy, it is likely they would give up. The good thing about exercise is that as far as the body is concerned, it does not care what type of exercise you are doing as long as you are moving. If you do 150 minutes of jogging, dancing or any other cardio activity, that would be enough."
Exercise Is Medicine is a programme by the American College of Sports Medicine and the American Medical Association, launched three years ago. It focuses on encouraging primary care physicians and other healthcare providers to include exercise when designing treatment plans for patients, or to refer the patient to a qualified health and fitness or other allied healthcare professional for exercise counselling.
Exercise Is Medicine is now practised in Australia, Italy, Canada, Mexico, Costa Rica, Columbia, Portugal, China, Brazil, South Africa and other countries.
Hutber says Exercise Is Medicine provides the educational tools for doctors and nurses. The goal is that every physician and professional healthcare provider know that they should be doing this in their practice.
"We are also proposing that physical inactivity should be classified as a disease. Once it is considered such, doctors have the responsibility to treat it and to advise their patients on physical activities."
Hutber says introducing it here is still in the stage of preliminary discussions.
In addition to exercising, staying healthy also involves eating the right foods. According to Adam Drewnowski, the director of Centre For Obesity Research, University Of Washington, people should eat low density energy foods that are rich in nutrients. Unfortunately, they tend to crave high density energy foods which are sometimes nutrient-poor, such as chocolate or potato chips.
Drewnowski said in the US, energy-dense grains, sweets and fats not only taste good but are also cheaper, providing substantial calories per unit cost. In comparison, many of the recommended healthy foods, including seafood, fresh vegetables and fruit, cost more and this was one reason Americans generally do not eat more of these.
"But sometimes it is better to pay more and eat less than to pay less and eat more. For example, if you eat a slice of watermelon or mango, it is about 20 to 30 calories. The same size of chocolate bar is about 500 calories. So you are taking different amount of calories in the same volume of food. With chocolate, it is also easy to overeat, which means more calories. With fruit, even if you overeat, the calories are still low."
Of course, some low-density energy foods are not as tasty, which is why people would rather eat foods that are high in salt or saturated fat. However, he said, fruit and vegetables can be prepared in such a way that you can increase their energy density.
"In Malaysia, fruit and vegetables do not cost more, compared to the US. So I suggest you go for it more. To make these tasty, mix the vegetables with a little fat, some sodium and some nuts - these also increase energy density. The whole point is, you need to have a balanced diet. Up to 40 per cent of calories can come from high energy density but 60 per cent must be from low density foods."
Drewnowski says showing consumers how all foods and beverages can fit within a healthy diet and identifying affordable dense foods within each food group are among the measures to improve diet quality.
Hutber and Drewnowski were in Kuala Lumpur recently at the workshop for an active healthy nation organised by the Coca-Cola Company and Olympic Council of Malaysia.