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Mr. Lingham is a 63‐year‐old man with a history of obesity, type 2 diabetes mellitus (T2DM), hypertension (HTN), hypercholesterolemia, obstructive sleep apnea, and osteoarthritis who presented for medical weight‐loss management.

His initial anthropometric measurements include a weight of 113kg, height of 176 cm and fat mass of 22.6% measured by bioelectrical impedance analysis. In his mid‐30s he was fully  inactivity and overeating, and continued gaining weight over the next 25 years. Fifteen years ago, he developed T2DM, HTN, hypercholesterolemia, and began to have trouble with gout and arthritis. He was diagnosed with obstructive sleep apnea 2 years ago and placed on continuous positive airway pressure (CPAP), which he uses intermittently. His primary care physician (PCP) recently started insulin glargine 20 units for persistently elevated blood glucoses despite sulfonylurea and metformin use.

Mr. Lingham had been inactive for approximately 25 years, then 2 years ago started playing tennis and working with a personal trainer. His diet has been high in fat and calories, unless eating with his health‐conscious wife. He runs an industrial test kitchen company, where different kinds of food are available to taste. He ate doughnut for breakfast on the way to work. At work he ate food brought in by others. For lunch he had at least 2 pieces of pepperoni pizza with sausage. He often eats chicken nuggets while driving home. He regularly overeats to excessive fullness. He and his wife eat out 2 to 3 times per week and he typically has 2 alcoholic drinks.

Review of systems was revealing of bilateral knee pain and shoulder pain, but otherwise negative.

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1. Education to the public must be concise, validated and not misleading.
2. There are truthfullness in the facts that he is presenting however the facts that he is sharing is short and not detailed enough and his method of delivering it to the audience can pottentially spark fued between professionals and the

public.

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Moreover, these food companies take advantage on some Malaysian’s lack of knowledge with psychological marketing strategies, where the product packaging is colorful, appealing and featuring all of the product's most important qualities. They invest more in these type of convenient food products that fulfills our daily energy requirement, with excess sugar in it to make it more tastier.

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The claimed food companies, stake holders has failed on their obligations on producing and promoting healthy foods, where they insisted that sugar content in their products are still acceptable. However this particular energy drink has become increasingly sweeter over the years and no further action has been taken.

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- Diet and Exercise must go together to reduce weight effectively.
- Exercise does help in improving someone's health.
- 30 minute of moderate physical activity (according to the Malaysian Dietary Guideline)

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- (Controversial topic) Milk is bad ? vegetables and exercise can do the work.
- milk is good source for calcium which functions to build strong bones and to prevent osteoporosis.

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He said that fats are good for us but did not specify the amount of fat to be consumed.

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- western diet characterised by high oily rice, noodles, white bread, etc.
- becoming more popular in non-western populations

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He also stated that increasing physical activity without altering our food pattern or diet will not aid in weight loss.

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He also stated that increasing physical activity without altering our food pattern or diet will not aid in weight loss.

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This point is very much acceptable where most of the calories (60-75%) is used for resting metabolism rate, while only 15-30% will be used during physical activity.. So the excessive calories we consume which are not used for metabolism, physical activity or thermic effect of food will lead to weight gain..

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We are agreeing with his statement regarding the nestle product, where the company has never improve or alter the sugar content of the product even after many studies has found that excessive sugar consumption is harmful for humans ..
This shows how careless is the company in consumer's health. And all they want is to increase their profit

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1. Stakeholders need to work together to overcome this problem.

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2. Companies such as Nestle didn’t update certain recipes such as Milo since 60’s, although claim to be world’s greatest health and wellness company.

• Companies need to update their recipes to avoid being boycotted.

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3. Claim Malaysian not educated and food companies take advantage by using powerful psychological marketing.

• Agree, as Malaysian easily influenced by marketing.

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4. Stated that Malaysian relies on these convenience food (more convenient and tasty).

• Agree

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5. Suggesting - Go to authentic Malaysian market, using rule of thumbs ( buy food that have 5 ingredients or less).

• Food that contain more than 5 ingredients might be even healthier

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6. Misconceptions about healhty food - 5 truth he said

•Sugar lead to health problem - Agree

•Fats are good - Agree, many people still think that fats are bad

•Don’t need to count calories - Did not agree, need to be counted for energy balance

•Exercise did not make us healthier - Exercise is needed to achieve good cardio health in general.

•Milk is bad for you - too much of everything can be bad, taking optimum amount of milk daily is needed.

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Simple way to control calorie intake and lose more weight can be a useful educational tool.

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- It is true that natural food is healthier than processed foods.
- Usually natural foods can have higher price and not accessible to all.
- Natural foods are easily rotten and have a short shelf life.

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- Diet and Exercise must be done together to effectively reduce weight.
- Exercise may not entirely helps in reducing weight, but it does help in improving someone's health.

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- He mentioned that high fat and low carb diet is an optimal weight loss diet.
- He should mention amount of fat needed to be consumed and what type of fats.

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The food production is responsible toward society including the  product's contents and on how they psychological advertise the product until consumer keep continue buying the product.

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He also mention that milk and dairy product is bad for health. He mention that bone dissolve problem can be manage by taking vegetables and strength training.
- Dairy products contain high calcium and can help with bone maintainance.
- We can consume low fat dairy products than normal dairy products.

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Malaysia Is The Most Obese Nation In Asia - Here's Why: FULL VIDEO Version

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- Encourage to consume fresh fruits and vegetables instead of taking convenience food.

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- He mention sugar is bad. By doing this he give bad perception on sugar, this will encourage people not to take sugar at all.
- We can choose healthier types of sugar or maybe reduced amount of sugar instead of totally exclude sugar from diet.

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- go for natural food
- choose food that has lower number of ingredients
- limit consumption of sugar
- choose healthy fat
- match dietary intake with nutrients needed by body
- diet & exercise have to be done together
- limit consumption of dairy product, and increase by eating vegetables and strike strength
- sugary drinks to gain weight
- avoid low fat food

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Apart from the advantages of powerful advertisement to make the population eat things wrong, the accessibility, convenient and good taste make them to forget the facts of healthy food choices. Its true whenever the factors become a major concerned of populations.