This is the final story in our fat series. Part 1 and appeared last Wednesday and Thursday in our print and online editions.

SHEREEN ALI looks at how to lose weight, eat smarter and stay fit and healthy.

SOME of us may balk at the prospect of losing weight. But it may be necessary for health reasons. Many experts say losing weight is entirely possible with a common-sense approach and an attitude of positive persistence.

The important thing is not to gravitate to fad diets or “miracle” pills or mysterious herbal supplements which may only work for a short while, or which may even be unhealthy for you in the long run, say many doctors and nutrition experts. It’s also important not to give up even before you start: weight gained over many years will take some time to lose, but you can indeed lose it, and even have some fun along the way if you choose activities you enjoy.

Medical advice: Prof Dilip Dan

Dilip Dan is professor of surgery and head of the Department of Clinical Surgical Sciences at the UWI Faculty of Medical Sciences at the Eric Williams Medical Sciences Complex in east Trinidad. He is also president of the Caribbean Obesity Society.

His top five suggestions for weight loss are succinct and straightforward:

1. Cut out flour.

2. Cut out processed sugar. Even cut out fruit after 2 pm.

3. Exercise. Make every attempt to get physical: walk instead of riding elevators, park as far away as possible and walk, and make time to walk or go to the gym three to five times a week.

4. Control the portions of your meals – don’t overeat.

5. Consider getting assistance from a professional.

Holistic health advice: Dr Nilash Ramnarine

Nilash Ramnarine is a doctor and holistic health practitioner who works at the Chaguanas-based Ishtara Centre, a holistic medical practice founded by his father, Dr Harry Ramnarine, more than 20 years ago. Nilash Ramnarine has worked there for the past nine years. He is an internist – a medical doctor who specialises in the diagnosis and medical (non-surgical) treatment of adults. His top tips are:

1. Cut down (or cut out) your refined sugar and your flour-based products. “If you cut out all refined sugar from your diet for six weeks (that includes soft drinks and commercially-prepared juices), I challenge you not to lose ten pounds. If you cut out all flour from your diet, whether wholewheat or white – that means no bread, no roti, no pastry or cake or biscuit or doubles or pie – it’s easy to lose another ten pounds.” It’s not all or none, however – you choose what you are ready to do, and the occasional treat is OK.

2. Beware of using sugar substitutes and so-called “diet” beverages, as well as “sports” or “energy” drinks, which studies have proved do not help you lose weight. Also stay away from paediatric meal replacement drinks. Water is the best drink.

3. Cut out or significantly reduce your snacking. “Constant snacking is called grazing, and it has been created by the food industry to keep people constantly eating. Maybe a generation ago, people were eating three square meals a day and they were thinner then than we are now because we’re snacking a lot more now. We are not supposed to be in the fed state all the time. Our metabolism was not designed for that.”

4. There are no perfect diets; but there are different food choices to suit different people’s lifestyles. Ask for help about your own body’s needs and design a food plan to suit you.

5. Get active. “You don’t have to go and spend money in a gym. Get out there and walk for 20 or 30 minutes a day, preferably not on a treadmill because there are benefits to being outside in the sunlight and getting fresh air. If it’s not safe to do that, OK, ellipticals and treadmills can work. But it’s much, much better to get outside…

Find an activity. We have a big yoga movement in TT, which is great to see. In China, for example, you see older people every day in the parks doing tai chi; they may spend an hour doing gentle flowing movements; but how do they get to the park? They walk there and walk back.”

6. Cut out bad fats (trans fats and saturated fats). Eat reasonable amounts of only the healthy fats, like olive oil, coconut oil, butter and ghee made from grass-fed animals, and avocado oil.

7. Make more healthy meals at home instead of buying fast foods. That way you will know what’s in it.

Nutritionist advice: Mweia Elias

Mweia Elias is a clinical nutritionist and registered dietician who runs her own business, Empower Nutrition, in St Augustine. She has a masters degree in pharmacology and cancer biology, and a second masters in clinical nutrition. She returned to Trinidad in 2013 to work as a nutritionist, and started her company in 2015 as a collaboration among registered dieticians. Her business combines tailored food plans and fitness programmes to meet her clients’ specific health goals. She says weight management is the top reason her clients seek her out, followed by diabetes, high cholesterol, and high blood pressure. Her top weight loss tips include:

1. Every day eat a lot more vegetables. Adults should eat about two-three cups of vegetables each day (which equals three to five servings). Remember to add vegetables to blended fruit smoothies, too.

2. Reduce processed foods and instead try to eat whole (unprocessed, natural) foods as much as possible. Change the way you buy food – find and buy more whole foods in markets or your grocery.

3. Eat fruits daily, but do not overindulge in fruits because they contain sugar. For adults who are not very active, eat just one or two fruit servings a day (just one banana, or one medium to large mango, or one mixed fresh fruit salad, etc). If you are more active, eat no more than three to four fruit servings daily.

4. Educate yourself about nutrition. The number-one challenge in TT is severe lack of nutritional knowledge. Do research, ask experts, and inform yourself about what makes up a healthy diet.

5. Consider regulating food franchises, foreign and local, to start including very visible nutrition information for each of the food or drink products they sell in their stores. Break down how many calories are in the meals and drinks, so consumers can make better, more informed choices about what to order and appropriate portion sizes of different items. We are allowing many food franchises into the country but we are not regulating them in any way.

6. How many calories per day should a woman and a man consume? Online sources may tell you 2,000-3,000 calories for a man and 1,600-2,000 for a woman. But that is not for people trying to lose weight. If you are a woman who wants or needs to lose weight, you should eat 1,200-1,500 calories a day. If you’re a man trying to lose weight, you should eat 1,500-2,000 calories per day. There are now apps to help with that, such as MyFitnessPal.

Elias notes that TT has no national nutrition policy, and that even though there is an overweight/obesity crisis, the annual number of UWI-trained dieticians, whose skills are greatly needed to educate the public, struggle to find jobs after they graduate, and often end up leaving the profession.

Elias, who recently had a baby, says she is currently working on creating educational nutritional content for pre-conception, prenatal and postnatal mothers, because poor nutrition starts even before one is born, when one is developing in the womb. She says: “What your mother is eating while you are in the womb is directly setting you up for conditions that later on in life you may be prone to.”

After birth, healthy infant nutrition in those first few months and years is also crucial for healthy development as well as for training young tastebuds and introducing good eating habits that may last a lifetime, she says.

New science is making old food pyramids just plain wrong You may at some point have seen a food pyramid – a graphic to teach the public the best proportions of different foods to eat for good health. These have all changed over the years.

In the 1960s, 70s and 80s, we were told (and shown) that the largest food group to eat was the starches (rice, potatoes, bread, roti, cereal, pasta); followed by smaller amounts of vegetables and fruits, and even smaller amounts of dairy (cheese, milk, yoghurt) and protein (meat, poultry, fish, beans, eggs, nuts), with all fats and oils in the least amounts, as all fats were at that time seen as bad.

Today, vegetables and fruits have replaced starches as the biggest chunk of any recommended meal, followed (in descending order of size) by starches, then possibly a smaller amount of dairy, then some protein (lean meat, poultry, fish, eggs, nuts, seeds, legumes), with healthy fats at the top in smallest proportions.

It is interesting to compare the different food pyramids (or food pagoda, in the case of China) of different countries. Although they differ in details, one thing is clear: fruits, vegetables and other plant-based foods are being recognised as the most important part of any nutritious diet.