Reduce your risk of cancer

Healthy body weight

More than 3 in 5 Australian adults are either overweight or obese, meaning they carry too much (excess) body fat.

Excess body fat is associated with a number of chronic diseases including type 2 diabetes and cardiovascular disease. Research also shows that being overweight or obese increases the risk of a number of cancers, including cancer of the bowel, uterus, kidney, liver, gall bladder, ovary, cervix, thyroid and breast (in post menopausal women) as well as leukaemia.

A healthy diet and regular exercise can help prevent overweight and obesity. Poor food and drink choices and not enough physical activity often lead to weight gain. Maintaining a healthy weight reduces your risk of cancer.

This brochure provides practical information to help you to stop gaining weight, then reach and maintain a healthy body weight.

Healthy body weight to reduce your risk of cancer

What are overweight and obesity?Overweight and obesity are defined as having excess (too much) body fat.

How do I know if I am overweight or obese?There are two ways you can find out if you are overweight or obese. One is the body mass index (BMI) and the other is waist circumference. Neither method is perfect but when used together they are useful in determining how healthy your weight is. Doctors and health professionals often use BMI and waist circumference with other clinical measures to assess health.If you find that you are in the overweight or obese category, the first thing to do is to stop gaining weight. Sudden attempts to lose weight quickly can be unhealthy and are often unsuccessful. Stabilising your weight is a good first step towards attaining a healthy lifestyle, before losing those extra kilos and moving into the healthy weight category. Try to make healthier food choices and gradually increase your activity levels. Every small change you make counts! Your doctor or an Accredited Practising Dietitian can also give you advice.

Body Mass Index (BMI)BMI compares your weight to your height. You can work out your BMI by dividing your weight in kilograms (kg) by your height in metres (m) squared.

BMI = weight (kg)

height (m) × height (m)For example:If John weighs 95 kg and is 180 cm tall, the calculation will be:

95= 29.3

1.8 × 1.8

His BMI is 29.3.

About overweight and obesity

After you have worked out your BMI, use this table to tell you which body weight category you fall into:

BMI Category

Below 18.5 Underweight

From 18.5 to 25 Healthy weight

From 25 to 30 Overweight

30 and above Obese

The chart below shows an easier way to work out which category you are in:

You need to know your height and your weight. Find your height on the bottom (x-axis) and your weight on the left hand side (y-axis). Find the point on the graph where your height and weight meet to see the weight category you fit into. For example, if your height is 160 cm and your weight is 60 kg, the point where your height and weight meet is in the green section, which means you are in the healthy weight range for BMI.

If your BMI is between 18.5 and 25, you are in the healthy weight range. You should maintain your current weight.

If your BMI is 25 or greater, you are above the healthy weight range, which increases your risk of developing cancer and other chronic diseases.

120

115

110

105

95

90

100

80

75

85

60

65

70

55

50

Wei

ght

(kg)

Height (m) 2.001.951.901.851.801.751.701.60 1.651.551.50

Obese

Overweight

Healthy weight

Underweight

BMI = 18.5

BMI = 25

BMI = 30

Waist circumference indicates how much fat you have around the middle of your body, or abdomen (stomach). Having weight around your middle is more of a health risk than the weight on your hips or thighs.

Use a measuring tape to measure your waist circumference around the narrowest point of your waist (see diagram). Measure at the end of a normal breath, and ensure that the tape is firm; not too tight or too loose.

The table shows how your waist circumference can be used to estimate your risk of chronic disease:

Waist circumference

HealthyMale Less than 94 cm

Female Less than 80 cm

Increased risk of disease

Male 94 – 102 cm

Female 80 – 88 cm

Greatly increased risk of disease

Male More than 102 cm

Female More than 88 cm

Waist circumference

Now you have worked out the weight category you fit into, let’s look at how to put a stop to gaining weight and how to reach the healthy weight category.

Energy in and energy outYou obtain energy from the food and drinks (including alcohol) you consume, and you burn energy by the activity that you do. Energy is burned during a) Normal body function such as breathing and

pumping your heartb) Physical activity as part of daily life such as

climbing stairs or gardeningc) Planned activity (exercise) such as playing sport

or cyclingIf you already have a healthy body weight, you can maintain it by balancing your energy intake and output. This means that the energy you take in through food and drinks is balanced by the energy you use for your daily activities.

If the amount of energy you take in from food and drinks is more than the amount you use in daily physical activity, your body stores the excess energy as fat, and over time you will gain weight.

If the energy you take in from food and drinks is less than the energy you use in daily activities your body will burn your stored fat and over time you will lose weight.

How much brisk walking do I need to do to burn off a:55 g bar of milk chocolate

(1185 kJ) 56 minutes

375 mL can of soft drink

(655 kJ) 31 minutes

Packet of takeaway hot chips

(1838 kJ) 1 hour and 28 minutes

Energy balance

Energy density

Very low Low Moderate High

You can eat large portions and use these foods to bulk up meals

These foods should make up the bulk of what we eat and you can eat satisfying portions

Eat only a moderate amount of these foods and control your portion sizes

These foods should only be eaten occasionally and in small amounts

Examples

Soups (e.g. vegetable) Mixed salad (no dressing)Broccoli Apple Pear

Baked potatoBananaBaked beans Chicken breast (no skin)Rice Pasta

CheeseSalad dressingSalmonLasagneSteak

ChocolateNutsChipsButter Oil

Eating well provides you with nutrients and energy, and will help you to reach and maintain a healthy weight. Understanding energy density and portion control will help you to eat well.

Energy densityAll foods and drinks, except water, contain energy that is measured in kilojoules (kJ) or calories. The energy density of a food is the amount of energy (kiloJoules or Calories) per gram of food. Foods with a high energy density provide more kilojoules than foods with a low energy density of the same serve size. The higher the water content of a food, the lower its energy density. Fat is the most energy dense nutrient and provides 37 kJ of energy per gram while carbohydrate and protein provide around 17 kJ of energy per gram. If you base your meals and snacks mainly on lower energy density foods with some moderate energy density foods and limit high energy density foods, this will help you to reach and maintain a healthy weight.

Eating well

TIPS: Reducing the energy density of your diet• Start your meal with a low energy density entrée

(starter) such as a broth-based soup or a salad (without oily or creamy dressing)

• Bulk up your meals with lower energy density foods:– Add vegetables and legumes to pasta sauce– Add lentils or pearl barley to soups, stews and

casseroles– Make vegetables the main meal and meat

a side dish

• Prepare foods using healthy cooking methods:– Choose to grill, steam or bake foods

without adding fat– Limit foods that are fried or baked in fat

• Swap energy-dense foods for less energy dense options:– Choose reduced-fat dairy products instead of

full fat versions – Choose tomato-based pasta sauces instead

of creamy or cheese-based ones– Choose reduced-fat and low sugar products

such as reduced-fat mayonnaise and fruit canned in natural juice instead of syrup

– Snack on fruit and vegetables instead of lollies and crisps

– For dessert, choose fruit salad and reduced-fat yoghurt instead of ice cream or cream

• Eat smaller portions of high energy-dense foods – Handle your chocolate craving by having a

small chocolate instead of a regular or king size bar

– Eat small servings of desserts and pastries, for example half a muffin, one small scoop of ice cream or share dessert with a friend

Limit sugary drinksDue to their water content, drinks tend to be less energy-dense than foods. Sugary drinks provide lots of kilojoules with little or no nutrients. Water is the best choice. Drinks such as fruit juice, soft drinks and cordials should be avoided, or at least drunk infrequently and in small amounts.

Fruit and vegetablesEating more fruit and vegetables is an easy and nutritious way to reduce the energy density of your diet. You should aim for at least 5 serves of vegetables and 2 serves of fruit every day. Try to include at least one fruit or vegetable in all your meals and snacks.

TIPS: How to eat more fruit and vegetables• Add bananas, oranges, sultanas, or grated

carrots, zucchini or apple to muffins• Add banana or berries to porridge and breakfast

cereals • Make a vegie omelette for breakfast or brunch

on the weekend • Top toast with banana or avocado• Enjoy a smoothie made from fresh or frozen fruit

and reduced-fat yoghurt or milk• Eat fruit-based desserts such as chopped fresh

fruit, stewed fruit or baked apples• Make vegie pizzas using leftover roasted or

grilled vegies• Increase the amount of vegies in your stir fries • Bulk up soups, stews and pasta with vegies and

legumes such as lentils• Keep a selection of reduced salt or no added salt

canned and frozen vegetables in your cupboard and freezer so you always have a substitute when fresh ones aren’t available

AlcoholJust like any food or drink you consume (except water), alcoholic drinks contain energy. In fact, alcohol contains few nutrients but is very energy dense.

In Australia, one ‘standard drink’ contains 10 grams of alcohol, which gives you 290 kJ of energy. If the alcohol is mixed with other sugary drinks (mixers), it contains even more energy. For example, one can of bourbon and coke provides about 1100 kJ of energy, almost double the same amount of soft drink.

Another downside of alcohol is that it is easy to consume much more than a standard drink! This diagram shows you what a standard drink looks like:

100 mL (1 glass wine)

285 mL (1 middy full

strength beer)30 mL

(1 nip spirit)

The drinks served in restaurants and pubs are often much larger than one standard drink. For example, a small glass of wine in a restaurant is about 150 mL, which is one and a half standard drinks.

If you are trying to achieve or maintain a healthy weight, it is best to avoid drinking alcohol. Alcohol itself also increases your chances of developing cancer in specific parts of the body, including the mouth, throat (pharynx and larynx), oesophagus (food pipe), bowel, breast and liver.

There is no safe alcohol level with regards to cancer. If you do choose to drink alcohol, the recommendations are that men and women should have no more than two standard drinks per day, and have some alcohol-free days.

To compare:

1 gram of alcohol = 29 kJ of energy; whereas

1 gram of protein or carbohydrate = 17 kJ of energy

Portion controlReaching and maintaining a healthy weight is not only about what you eat, but also about how much you eat. Portion control is very important in helping you to achieve your healthy weight goals.

For the best nutrition health professionals recommend adults consume the following number of serves from each of the five main food groups every day:

Food Group People aged 19-56+ years

People aged 56+ years

Breads and cereals

6 serves (females)6 serves (males)

4 serves (females)6 serves (males)

Vegetables 5 serves (females)6 serves (males)

5 serves (females)5½ serves (males)

Fruit 2 serves 2 serves

Reduced-fat dairy 2½ serves 4 serves (females)2½ serves (males)

Meat and alternatives

2½ serves (females)3 serves )males)

2 serves (females)2½ serves (males)

It is important for you to know what appropriate serving sizes are so you can avoid eating too much.

This guide gives you an idea of what one serve from each of the five food groups looks like:

Breads and cereals1 serve looks like: 1 slice of bread, 1 medium bread roll ½ cup of cooked rice, pasta or noodles½ cup of cooked porridge 2∕3 cup of breakfast cereal¼ cup of untoasted muesli

Vegetables1 serve looks like: ½ cup of cooked vegetables1 cup of salad vegetables ½ small potato½ cup of cooked legumes such as

dried beans, peas or lentils

Fruit1 serve looks like:1 medium piece, such as an apple,

orange or pear2 small pieces, such as

apricots,kiwifruits or plums1 cup of diced or canned fruit

(in natural juice) 1½ tablespoons of sultanas or 4 dried

apricot halves ½ cup (125 mL) of 100% fruit juice

Meat and alternatives 1 serve looks like:65 grams of cooked lean red meat

e.g. ½ cup of lean mince80 grams cooked poultry e.g.

chicken or turkey100 grams of cooked fish fillet½ cup of lean mince2 large eggs1 cup of cooked legumes, such as lentils,

chickpeas, dried or canned beans30 grams of nuts such as peanuts or almonds

Milk, cheese and yogurt1 serve looks like: 1 cup of milk (250 mL) 40 grams of cheese200 grams (tub) of yoghurt

ExtrasEnergy dense foods that are high in fat and sugar, such as desserts, biscuits, cakes, sugary drinks and chips, are extra or discretionary foods that should not be part of your every day diet, especially if you are trying to lose weight. Remember that ‘extra’ foods do not fill you up as much as healthy, lower energy density foods, so it is easy to overeat them.

TIPS: Controlling your food portions• Use smaller plates, and wait before going back

for seconds• Store foods in individual portions rather than

in bulk containers• Don’t eat from the bag or packet – put a small

amount of snack food into a bowl and put the packet away

• Order entrée (starter) sizes or small meals at restaurants

• Eat slowly and enjoy the food. It takes 10 to 20 minutes for your stomach to signal to your brain that you are full

• Resist up-sizing or purchasing ‘value meals’ at fast food restaurants

• If you eat food from the ‘extras group’, share it with a friend

Source: Draw the Line © 2009

Being active has an important role in helping you achieve and maintain a healthy weight. It also helps you sleep better and feel healthier!

Remember, to maintain your weight, you need to balance the energy you take in with the energy you use in daily activities:

Energy In = Energy Out

For weight maintenance, aim for at least 30 minutes of moderate-intensity physical activity on most, preferably all, days.

For weight loss and cancer prevention the more physically active you are the better. As fitness improves aim for at least 60 minutes of moderate-intensity activity or 30 minutes of vigorous-intensity activity every day.

National Physical Activity Guidelines for Adults

National Physical Activity Guidelines for Children (5-12 years) and Young People (13-17 years)

• Doing any physical activity is better than doing none. If you currently do no physical activity, start by doing some, and gradually build up to the recommended amount.

• Be active on most, preferably all, days every week.

• Accumulate 150 to 300 minutes (2½ to 5 hours) of moderate intensity physical activity or 75 to 150 minutes (1¼ to 2½ hours) of vigorous intensity physical activity, or an equivalent combination of both moderate and vigorous activities, each week.

• Do muscle strengthening activities on at least 2 days each week extra health and fitness.

• For health benefits, children and young people should accumulate at least 60 minutes of moderate to vigorous intensity physical activity every day

•Children and young peoples’ physical activity should include a variety of aerobic activities, including some vigorous intensity activity.

• On at least three days per week, children and young people should engage in activities that strengthen muscle and bone.

• To achieve additional health benefits, children and young people should engage in more activity – up to several hours per day.

Source: Department of Health and Ageing, Commonwealth of Australia

Being active

How do I know the intensity of the activity I am doing?Use the Talk Test. While performing light-intensity activity (such as slow walking, light housework or gardening) you should be able to sing. During moderate-intensity activity (such as brisk walking, flat cycling) you should be able to carry on a conversation comfortably, with the occasional break to draw breath. During vigorous-intensity exercise (such as running, cycling uphill) you should be too out of breath to carry on a conversation.

It’s easy to include some physical activity every day

TIPS: Increasing your physical activity

• Organise a weekly group activity with your friends such as a netball game or a long walk. Exercising with friends helps with motivation and commitment

• Use physical activity as transport to get from one destination to another (e.g. walk, cycle)

• Park your car further away from your destination and walk some of the way

• Do gardening and housework • Do stretching exercises while watching

television• Take a brisk walk during your lunch break• Join a fitness centre near your work, and work

out before or after work while you avoid rush hour traffic

• Walk your dog• Use the stairs instead of the lift• If you have children, plan active family time

such as going to the beach for a swim, or bushwalking

• Get off the bus or train a few stops earlier and walk

• Cycle to work• Go for a walk after dinner or before breakfast –

or both!• Join your local sports group

Goals:1. I will include one extra serve

of vegetables with lunch and dinner

2. I will walk for 30 minutes every day

3. I will drink water instead of juice and soft drink

Diets don’t workFor healthy weight loss, ‘dieting’ is not recommended. Rather, we recommend gradual and realistic changes to your food and activity routine that will last a lifetime.

It’s about balancing your food and activity and enjoying the positive changes you are making towards a healthier lifestyle. Start by setting three goals. Once you have achieved these goals include three more goals and so on. Making small changes is a realistic way to a healthier lifestyle that you can maintain forever.

To maintain a healthy body weight

• Eat mainly lower energy density foods such as fruit and vegetables

• Control your portion sizes

• Be physically active every day

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To access any of our services, programs or information about cancer, call one of our Cancer Nurses on 13 11 20. This is a confidential service, available Statewide for the cost of a local call Monday to Friday 8 am – 6 pm.

www.cancerwa.asn.au