Category: Weight Management

Zits and now, cellulite? That’s preposterous! Yes, cellulite is the slight bulge you see on your thighs, hips, buttocks and abdomen. Some called it the “orange-peel”; it commonly affects adolescent and adult women. And, it is downright unsightly! I mean, how are you going to boast of your slim body if cellulite is in sight?

What is cellulite?

Cellulite is not harmful.  It is simply unattractive dimpled-fat-lump that most women wish to be rid of. Cellulite is commonly found in body parts with fat reserves such as thighs, hips, and buttocks. What happens is that the tissues connecting the fats to the muscles change their positioning between layers of various tissues. Called septa, the connective tissues may stretch, break down or pull tight. Under this condition, the fat bulges out near to the skin surface and bam, cellulite! It can happen to anyone regardless of age, gender, and body size.

Here are the 3 grades of cellulite.

• Grade 1: No visible cellulite observed, but a microscopic cell examination can identify the changes.
• Grade 2: No visible cellulite observed. But, an “orange peel” texture is observed when the skin is pinched.
• Grade 3:  Cellulite is visible with rough skin texture along with Grade 2 signs. But, it may disappear when lying down.

What causes it?

There are some theories that can perhaps explain its occurrence:

• Hormones: Hormones such as oestrogen and prolactin are believed to play a role in cellulite production. Low levels of oestrogen, for instance, are associated with cellulite development.
• Genes: Certain genes can contribute to cellulite development. These genes affect characteristics associated to cellulite production such as gender, race, slow metabolism, and fat distribution.
• Hereditary: Your risk of cellulite is increased if your mother or grandmother has them too.
• Diet: People who consume too much fat, carbohydrates, high-sugar products, salt and too little fibre have higher risk of developing cellulite., Dehydration seems to play a role too.
• Lifestyle: Cellulite is more likely to happen to those who are inactive, smoke and sit or stand in one position for long periods.
• Age:  Yes, age can be a factor. As a woman ages, her body produces less oestrogen and this can lead to of cellulite formation. Plus, the skin loses its elasticity overtime.

What can you do?

Lose some kilos:

•  Regularly perform exercises that involve muscle strengthening in the legs, thighs, buttocks and abdomen. 
• The firming and toning of the muscles will tighten the skin over time; hence creating the illusion that cellulite is not present.
• Practise strength training moves such as lunges

A healthy diet:  

• Eat a well-balanced diet –especially plant-based foods–to improve your unsightly “orange peel”.
• Eat fruits and vegetables which contain more than 90% water such as cucumbers, radishes, tomatoes and bell peppers
• Consume anti-oxidant rich foods such as berries and red kidney beans.
• Reduce intake of refined, processed and artificial foods that contain sweeteners, additives and chemicals.
• Cut down on dairy, high-fat products and sugary products.
• Stay hydrated

Surgical and lasering treatment: 

If you’re looking to remove cellulite, consult a dermatologist. Here are some options you can take to remove cellulite.

• Laser and radio-frequency treatment:
  • Stimulates collagen production.
  • Alters the septa so that they do not cause dimples and hence, no more cellulite.
  • May require 1 or 2 maintenance treatments per year to remove cellulite.
• Laser-assisted liposuction: 
  • Destroys fat cells and tightens the skin
  • May take up to 6 months for the skin to tighten around the treated area

Should I use…?

Take caution if you plan to use alternatives such as cellulite creams as they may not be effective. Some common ones are:

Cellulite creams

There are no proven studies to prove their efficacy. They usually contain a mixture of ingredients such as vitamins, minerals, herbal extracts and antioxidants that are said to improve cellulite. When used, it can cause skin rashes or allergic reactions in some people.

Mesotherapy

This involves injection of substances such as enzymes, vitamins, and amino acids into the tissues below the skin. It may bring slight improvement to cellulite. But it can also cause infection or swelling.

Massage and spa treatments

This form of treatment offers temporary effects and do not remove cellulite.

References:

Harlow, C.R., et al. (2007). Oestrogen formation and connective tissue growth factor expression in rat granulose cells. Journal of Endocrinology. 192(1), 41-52

Health. Available from www.health.com

Healthline. Available from www.healthline.com

Mayo Clinic. Available from www.mayoclinic.org

Medical News Today. Available from www.medicalnewstoday.com

MedicineNet. Available from www.medicinenet.com

MedlinePlus. Available from www.nlm.nih.gov/medlineplus

WebMD. Available from www.webmd.com

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Prof Dr Winnie Chee   Dietitian & Professor, Division of Nutrition & Dietetics, International Medical University

Madam G is a busy 40-something career woman, wife and mother. Over the past 3 years, she gained 30kg and became obese.  When the doctor informed Madam G that she might not live to see her children get married if she didn’t do something about her weight, she embarked on a crash diet – replacing her daily meals with protein shakes.

To her delight, she lost 35kg in 1 month. This new weight lasted only 6 months, unfortunately. She couldn’t keep up her liquid diet any longer, went back to her old eating habits, and her weight ballooned again until she became 20kg overweight.

The truth is, there is no secret or short cut to obtaining and maintaining a healthy weight. It is all about balancing the intake of food with the amount of physical activities done to burn off the excess calories; all done in a sensible and sustainable way.

Aim for 5- 10% in 6 months

Madam G made the mistake of thinking she needed to lose all of her excess weight to be healthy.

The scientific truth is that no matter whatever your weight loss goal may be, a modest weight loss of 5-10% of your initial body weight is likely to produce health benefits.

For example, if you are 80 kg, you need to lose 4 kg to see improvements in blood pressure, blood cholesterol level, and blood sugar level.

Numerous clinical studies have shown that when you lose as little as 5- 7% of your body weight, there are remarkable improvements to your body’s ability to process blood sugars, reducing your risk of diabetes by 50%! You may still be overweight or obese, but you will learn new habits that can help you live a healthier lifestyle. These habits may help you maintain your weight loss over time.

The 5-10% weight loss should be achieved gradually. Drastic weight loss methods don’t give the individual the chance to learn how to cultivate healthy eating habits which are sustainable throughout life.  Scientific studies have also shown that weight loss goals usually take 6 months to achieve.

Lose it good

Scientific studies show that only 20% of individuals are able to lose weight and keep it off for longer than a year. But never let that discourage you. The dilemma of weight loss and maintenance has spurred researchers to observe the behaviour of 3000 individuals in the United States from the National Weight Control Registry (NWCR). They had successfully lost weight mainly through diet and exercise and maintained a healthy weight at 5 and 10 years later!  Here’s how and why:

Consistently choose foods with lower calorie and lower fat.

Body weight is very much dependent on the amount of energy we eat and the amount of energy we expand. Hence, the participants in the study ate around 1,800 kcal a day, about 500-1,000 kcal less than their energy expenditure for Americans. Malaysians who wish to lose weight and ensure they maintain their weight should eat around 1,500-1,800 kcal a day, especially if they lead a mostly sedentary lifestyle. 

Fat is one of the main contributors of calories in food. One gram of oil contributes twice the calories of one gram of sugar or protein.  Hence, when we switch from high-fat foods to lower fat choices, as shown below, we save 100-200 calories or more in a day and this will help maintain a healthy weight.

Eat breakfast every day of the week.

In the study, 78% of registry members report eating breakfast every day of the week and reported eating cereals and fruits as the most frequent breakfast eaten. Breakfast eaters tend to eat fewer calories, less saturated fat and cholesterol and have better overall nutritional status than breakfast skippers.

One study in 2005 found evidence that people who skip breakfast compensate later in the day with more refined carbohydrates and fats and fewer fruits and vegetables.  But when you eat breakfast, your body feels nourished and satisfied, making you less likely to overeat the rest of the day. Choose healthier options when eating breakfast, preferably incorporate wholegrain choices such as capati, wholemeal bread, brown rice porridge and oats with fruits.

If you never eat breakfast, try starting on the weekend when you have more time, then expand your routine to weekdays. You may be surprised how much easier your morning goes, and how much more healthily you eat throughout the day!

Eat home-cooked foods more often.

Those who are successful in losing and maintaining weight report consuming only 2.5 meals a week in restaurants and less than once a week of their meals in fast food establishments.  

A recent study by John Hopkins University Researchers examined the self-reported food records obtained from more than 9,000 adults, aged 20 and older.  The study showed that the most frequent home cooks consumed around 200 fewer calories daily, and around 16 grams of sugar (4 teaspoons).

Recently with the increase of food costs in restaurants and eateries, Malaysians have been bringing their own lunch from home, perhaps a healthy consequence of GST implementation. Suitable meals to bring from home include wholemeal sandwiches or a balanced meal of rice with vegetables and chicken/ fish (which may be heated leftovers from dinner last night, topped up with vegetables and fruits).

Engage in high levels of physical activity.

Another characteristic observed by researchers of weight maintainers was their engagement in high levels of physical activity. They performed at least 1 hour of moderate-intensity activity, most days of the week and majority (76%) of the participants did brisk walking.  If you have rarely been active, you could begin with at least 30 minutes of exercise 3 times a week and gradually build it to 5 days a week and a longer duration of 60-90 minutes. The table below shows the energy you would expend if you were to perform the various activities for half an hour. 
 

Monitor weight once a week.

This frequent monitoring of weight would allow you to catch small weight gains and initiate corrective behaviour changes.

A study conducted on 1,226 adults who were enrolled in a weight gain prevention trial, and 1,800 adults who were enrolled in a weight loss trial showed that higher weighing frequency was associated with greater 24-month weight loss or less weight gain and lower fat intake.

Hence, perhaps one of the best things to do if you wish to have a healthy weight is to invest in a good durable weighing machine at home, weigh yourself once a week before meals and take action early if you see the needle going up before it gets worse!

Be consistent in your eating habits. How many times have we looked at a piece of cheesecake and thought, “I’ll start my diet again tomorrow!”?  Well, being consistent is the final secret to maintaining a healthy weight!

Interestingly, results from the NCWR study indicated that participants who reported a consistent diet across the week were 1.5 times more likely to maintain their weight over the subsequent year compared to participants who dieted more strictly on weekdays.  Individuals who were “flexible” and ate high-calorie foods on holidays had greater weight re-gain than those who were more disciplined and maintained consistent healthy eating habits.

Hence, it is perfectly fine if 9 out of 10 times we choose to have fruit salad instead of cheesecake at the buffet lunch table!

References:

M. N. Ismail, S. S. Chee, H. Nawawi, K. Yusoff, T. O. Lim and W. P. T. James. (2002). Obesity In Malaysia. Obesity reviews 3: 203–208.

J. Graham Thomas, Dale S. Bond, Suzanne Phelan, James O. Hill, Rena R. Wing. (2014). Weight-Loss Maintenance for 10 Years in the National Weight Control Registry. American Journal of Preventive Medicine; 46 (1): 17. DOI: 10.1016/j.amepre.2013.08.019

Farshchi HR, Taylor MA, Macdonald IA. (2005). Deleterious effects of omitting breakfast on insulin sensitivity and fasting lipid profiles in healthy lean women.  Am J Clin Nutr.; 81(2):388-96

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