She rejoices when she puts on weight

SINGAPORE - Unlike most people, housewife Chua Mui Hong, 51, rejoices when she gains weight.

She has every reason to celebrate now, as she has fulfilled her New Year resolution to put on weight.

"Any gain will do," she told Mind Your Body about a year ago.

She is now at her heaviest at 41.5kg, up from just 39kg at the start of the year.

She said with a chuckle: "My husband says I'm more fleshy now, especially in the arms and buttocks."

While the gain may seem insignificant to others, it is a breakthrough for the mother of two grown-up children, who stands at 1.52m tall and has previously not weighed more than 40.5kg.

But she is still 1.2kg shy of the minimum weight of 42.7kg that she needs for a healthy body mass index (BMI) - a measure of the amount of fat based on weight and height - of 18.5.

Severely underweight people may be more susceptible to infections and suffer from hair loss, anaemia, infertility and osteoporosis.

But most healthy people who are underweight or have difficulty gaining weight have a naturally high metabolic rate, burning as many calories as they eat.

Dr Joan Khoo, an endocrinologist at Changi General Hospital, had said that being mildly underweight (having a BMI of between 16 and 18.5) may be due to genes or being physically active and not eating enough.

Madam Chua has decided that her resolution for 2014 will still be to pile on the kilos. In fact, her dietitian has set her ideal weight at 45kg, though she doubts she can achieve it.

In addition, there remains an obstacle which stands in the way of Madam Chua's ambition, as she was diagnosed with impaired glucose tolerance in September last year.

This means she is at risk of getting diabetes, which makes her desire to gain weight a challenge, as the additional intake of food could make her blood glucose levels spike.

Her latest fasting blood glucose test in October, which measures the amount of sugar in the blood after an overnight fast of eight hours, showed the level to be at 5.9 millimoles per litre (mmol/L), which is still a little high.

A person with a fasting blood glucose level of 5.6mmol/L to 6.9 mmol/L is considered prediabetic, while someone with a level beyond 7mmol/L is considered diabetic.

Other than that, Madam Chua's cholesterol and blood pressure levels are normal.

Five days after Mind Your Body published her story on Jan 3, in which two endocrinologists and two dietitians gave her advice on how to gain weight healthily, Madam Chua visited the Toa Payoh Polyclinic to get a doctor's referral to see a dietitian.

In the Mind Your Body article in January, seeing a dietitian had been recommended by Ms Ong Li Jiuen, a senior dietitian at the dietetic and food services department at Changi General Hospital.

Mr Derrick Ong, a dietitian at Camden Medical Centre, had estimated she needed 1,400 kilocalories a day and would need to consume 500 more kilocalories to gain weight.

Madam Chua says she does not know how to count calories, and her dietitian had not gone over this with her.

However, she was given sample meal plans.

No more suppers

No more suppers

She used to have four smaller meals in addition to her three main meals every day, but she has cut that back to two.

She took Mr Ong's advice to stop having a big supper of, for instance, wholegrain beehoon soup with vegetable and minced pork, at 9pm to avoid elevating her blood glucose level.

She has also made other tweaks to her diet.

Instead of spreading butter on two slices of wholemeal bread for breakfast, she uses avocado.

Butter is high in saturated fat, which, after being consumed, is converted into low-density lipoprotein cholesterol, or "bad" cholesterol. This can raise the risk of heart disease and stroke.

On the other hand, avocado contains monounsaturated fat. This is turned into high-density lipoprotein cholesterol, or "good" cholesterol, which can lower levels of "bad" cholesterol.

Madam Chua also snacks on unsalted nuts such as almonds and cashews, which are packed with monounsaturated fat.

Dr Stanley Liew, a consultant endocrinologist at Raffles Hospital, had said Madam Chua could boost her diet by eating food with a low glycaemic index (GI). Carbohydrates in such food are broken down slowly by the body and cause blood glucose to rise slowly.

She has brown rice for both lunch and dinner.

She also took her dietitian's advice to increase her calcium intake to avoid developing osteoporosis. She mixes milk powder with her protein shake for breakfast and drinks a second glass of milk each day.

Her choice of fruit after dinner has expanded to include strawberries and avocado - fruits with low GI values - as advised by Dr Liew. She has also heeded her dietitian's suggestion to eat low-fat yogurt, which contributes to colon health.

Madam Chua said she is a fan of Mind Your Body's fortnightly Get Physical section, and follows the step-by-step exercises at home, sometimes working out with 0.5kg dumbbells.

She has also kept to her exercise regimen of a 30-minute brisk walk with her husband three or four times a week and does an hour of yoga once a week.

Madam Chua is happy about her successful weight gain this year. Her only regret is that she did not visit a dietitian earlier.

She said: "Nobody had ever suggested I see a dietitian. Otherwise, I could've put on weight much earlier."

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