Lessons from China

Optimal dietary macronutrient distribution in China (ODMDC): a randomised controlled-feeding trial protocol.

Unlike other East Asian countries, such as Japan and South Korea, which have generally maintained their traditional cuisines, China seems to be relinquishing its original dietary patterns. From 1982 to 2011, energy intake from fat doubled from 18% to 37% in megacities and daily edible oil nearly tripled from 18 to 49 grams (Figure 1). Correspondingly, carbohydrate energy intake decreased from 72% to 54%. Along with these diet changes, the burden of undernutrition has diminished, but an epidemic of obesity and diet related cardiometabolic disease has emerged. The prevalence of overweight has increased to 26%, which was rare in the past. In parallel, waist circumference, an indicator of central fat distribution, has undergone an increase across all age groups in the past 30 years

From the figure and quote above, it might seem that decreasing carbs while increasing fats and protein intake has led to an increased in obesity in China.

However, that is not the full picture.

The main driver for the increase in obesity is this startling fact: China’s avg per person caloric intake has more than doubled in the last 50 yrs

What are the implications of this?

  • To lose weight, you need to remember the first law of thermodynamics: conservation of energy. i.e. To lose weight you need to EXPEND more calories than you take in.
  • No single macro nutrient is the reason why you are gaining weight. It is the over consumption of calories that is causing you to gain weight.
  • Do not make life difficult for yourself by cutting out entire food groups and/or macro nutrients. All diets work, as long as you stick to them.. Encourage adherence by making your diet enjoyable AND sustainable.
  • Be flexible and be rational with your food choices.
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Sentiment Analysis of Tripadvisor user reviews for the Singapore Zoo

29th April 2018: Please note that phantomjs is no longer supported by selenium. Switch over to chrome headless.

Welp, this is how I spent my weekend.
Made a python script to scrape reviews from Tripadvisor and process the raw text. And another script to do a sentiment analysis and word frequency count. I used the CS50 Sentiments project as a starting point. Scraping was done with a combination of beautiful soup and selenium. The analysis was done using nltk.

https://captmomo.github.io/tripadvisor-singapore-zoo/

Continue reading “Sentiment Analysis of Tripadvisor user reviews for the Singapore Zoo”

Worst eating places in Singapore according to Reddit.

/u/kronograf
What’re your personal dining-out nadirs? Maybe we can crowdsource a list of places to stay the fuck away from.

For me:

The Ramen House @ Selegie – truly the mediocre-st ramen I’ve ever had locally. Flaccid noodles, blander soup than Maggi, straggly chashu…

True Blue @ Peranakan Museum – horrendously, horrendously overpriced basic-bitch Peranakan food

Yeo Keng Nam @ Upp Serangoon – taxi-driver disputes aside, hawker centres have better chicken rice than this

https://www.reddit.com//r/singapore/comments/786f6m/the_terrible_singaporean_restaurants_thread/ Continue reading “Worst eating places in Singapore according to Reddit.”

Is BMI a good measure of health?

Recently, my government has increased it’s focus on its citizens adopting a healthy lifestyle. Today, I decided to look into one metric that is commonly used to determine a population’s health.

What is BMI?

Body Mass Index (BMI) is a person’s weight in kilograms divided by the square of height in meters. A high BMI can be an indicator of high body fatness. BMI can be used to screen for weight categories that may lead to health problems but it is not diagnostic of the body fatness or health of an individual.

What is it used for?

BMI is mainly used to assess weight status of a population. It is a simple screening tool to estimate a person’s body fat, but should be used in conjunction with other body composition tests before a diagnosis is to be made. This is because BMI is unable to discern between body fat percentage and lean mass.

How accurate is it?

This is a tricky question to answer. It’s accuracy differs between populations.

For example, in the USA and Singapore, the use of BMI actually under-diagnoses the prevalence of obesity.

In this study, it was observed that the use of BMI underdiagnosed obesity by 30%!
Accuracy of Body Mass Index to Diagnose Obesity In the US Adult Population

BMI-defined obesity (≥ 30 kg/m2) was present in 21% of men and 31% of women, while BF %-defined obesity was present in 50% and 62%, respectively.

Our findings also suggest that the magnitude of the obesity epidemic may be greatly underestimated by the use of BMI as the marker of obesity 35. In our results, BMI showed an unacceptable low sensitivity for detecting body fatness, with more than half of obese subjects (by body fat measurement) being labeled as normal or overweight by BMI. The true prevalence of obesity might be strikingly higher than that estimated by BMI.

In Singapore, it was observed that the accuracy of BMI differs between ethnic groups.
The paradox of low body mass index and high body fat percentage among Chinese, Malays and Indians in Singapore

RESULTS: Compared with body fat percentage (BF%) obtained using the reference method, BF% for the Singaporean Chinese, Malays and Indians were under-predicted by BMI, sex and age when an equation developed in a Caucasian population was used. The mean prediction error ranged from 2.7% to 5.6% body fat. The BMI/BF% relationship was also different among the three Singaporean groups, with Indians having the highest BF% and Chinese the lowest for the same BMI. These differences could be ascribed to differences in body build. It was also found that for the same amount of body fat as Caucasians who have a body mass index (BMI) of 30 kg/m2 (cut-off for obesity as defined by WHO), the BMI cut-off points for obesity would have to be about 27 kg/m2 for Chinese and Malays and 26 kg/m2 for Indians.

If obesity is defined as excess body fat rather than excess weight, the obesity cut-off point for Singaporeans should be 27 kg/m2 instead of 30 kg/m2. The lowering of the cut-off point for obesity would more than double the prevalence figures in Singapore.

In addition, the study authors also noted that the use of BMI underdiagnosed the prevalence of obesity in Singapore by at least 10%.

Generally, if the cut-off point for obesity in Singapore were lowered to 27 kg/m2, this would have immense impact on the prevalence of obesity among the adult Singapore population. Compared to a BMI cut-off point of 30 kg/m2 the prevalence would increase in females from 6.5% to 15.4% and in males from 5.2% to 17.3%.

Interestingly, it is the opposite for Korea. The use of BMI actually over-diagnosed obesity.

Diagnostic Performance of Body Mass Index Using the Western Pacific Regional Office of World Health Organization Reference Standards for Body Fat Percentage

In the present study, obesity was identified in 38.7% of men and 28.1% of women using body mass index (≥25 kg/m2) and in 25.2% of men and 31.1% of women using body fat percentage. A body mass index cut-off ≥25 kg/m2 had high specificity (89%, men; 84%, women) but poor sensitivity (56%, men; 72%, women).

On the basis of BF%, 25.2% of men and 31.1% of women were classified as obese in the present study compared to 50% of men and 62% of women in American populations (10). Thus, BF% better reflects the current status than population-specific cut-off points for BMI for international comparisons of the prevalence of obesity. The prevalence of BF%-defined obesity was higher in women than in men in Korea, which suggests that Korean women have less lean mass than do Korean men.

What is the significance of BMI?

As mentioned earlier it is mainly used a health indicator of a population but not an individual.

High and low BMI have been correlated with increased mortality rates. However, the increased risk of mortality observed in underweight people could at least partly be caused by residual confounding from prediagnostic disease. i.e. It’s a reverse causation, people are underweight due to their pre-existing conditions (eg. cancer).

An increase in BMI has been correlated with an increased risk for a myriad of diseases such as heart disease and diabetes.

Is “Less Sugar” Always Better?

Healthier food costs more because slow demand leads to inadequate economies of scale: Chee Hong Tat

During a parliament session Senior Minister of State (SMS) for Health Chee Hong Tat attributed the increased cost of “healthier” food options to lack of demand.

“During the initial phase when the healthier products are being introduced, they will have to go through this phase where consumers are getting used to it and the demand is not quite picking up,” he said.

“So when you produce it and there’s inadequate economies of scale, the merchant finds it difficult to price it at a very competitive level.”

Mr Chee was responding to Member of Parliament for Bishan-Toa Payoh GRC Chong Kee Hiong, who asked why healthier foods tend to be more expensive than less healthy options.

As for his question on the price disparity, Mr Chong clarified that he was referring to two variations of the same brand of kaya. The low sugar option costs S$1 more, he said.

Out of interest, I went to take a look at the two types of kaya from Fairprice private label:
Fairprice Nonya Kaya – Less Sugar 400G – $3.95
FairPrice Nonya Kaya 410G – $2.65

Below is a comparison table of the macro-nutrients.

Not only does the less sugar version contain more calories, it also contains MORE carbohydrates and LESS protein.

To reduce the sugar, they added maltitol, a cheap sugar alcohol that has half the calories of sugar per gram and actually cost less than sugar for the same unit of sweetness
Source: http://www.sugar-and-sweetener-guide.com/maltitol.html

So is the “healthier” option always healthier?

Best to be a smart consumer and always remember to always check the nutrition label! Caveat emptor.

 

afterbirth

In most cultures, it is customary for new mothers to follow a set of confinement practices during the month after child birth. The main purpose of these practices is to ensure that both the mother and child recover fully from the trial of pregnancy, labour and childbirth. This confinement period is usually characterized by loads of rest, good food and “home quarantine”. Continue reading “afterbirth”