The Big Read in short: Are S'poreans eating healthily enough?
Each week, TODAY’s long-running Big Read series delves into the trends and issues that matter. This week, we look at Singaporeans' eating habits amid rising health consciousness and the Government's push for preventative healthcare. This is a shortened version of the full feature, which can be found here.
- The Healthier SG programme will be rolled out from next year to promote preventive healthcare among Singaporeans
- In line with this national effort, the Health Promotion Board also announced new measures to encourage Singaporeans to adopt a healthier diet, comprising less sugar and salt
- While there seems to be growing health consciousness among Singaporeans, many regularly eat food from hawker centres and coffee shops
- Although food from these places are inexpensive and tasty, they are not the healthiest, nutrition experts said
- While healthier food options still tend to cost higher, the experts added that eating well and right does not require one to break the bank or devote a lot of effort to it
SINGAPORE — Post-graduate student Imran Khan decided to pay more attention to his diet after coming across advertisements on the nation’s war against diabetes three years ago.
Increased news coverage of Singaporeans suffering from diabetes also spurred the 26-year-old to improve his eating habits — out of fear that he, too, may end up with the disease which has affected about 14.2 per cent of the adult population here, according to the latest figures by the International Diabetes Federation.
Apart from including more fruits and vegetables in his diet, Mr Imran also started eating salads from his university canteen at least twice a week this year, which according to him has helped him to become more alert and feel better.
Unlike Mr Imran, 32-year-old Muhammad Nur Hidayat does not have the luxury of picking healthier food options.
Working long shifts which range from nine hours on weekdays to 14 hours on weekends, as well as juggling parental duties and fetching his wife to and from work, has left the delivery rider with little time to prepare his own meals.
He often ends up eating fast food or cooked Malay dishes from hawker centres and food courts daily.
The likes of Mr Hidayat are among those whom the Government is targeting in its efforts to improve population health, as part of the new Healthier SG programme that focuses on promoting preventive care.
First announced by Health Minister Ong Ye Kung during his ministry’s Budget debate in March, the programme will be rolled out from next year.
In line with the nation’s shift towards preventive care, the Health Promotion Board (HPB) also announced on Sept 28 its target to bring down sodium consumption among Singaporeans by 15 per cent over five years, to help tackle the prevalence of hypertension.
The HPB’s plan includes making healthier salt and seasoning products more readily available to consumers and encouraging food and beverage (F&B) operators to adopt these healthier options.
This follows its latest nutrition survey in 2018, which found that despite an improvement in Singaporeans’ diet quality, high amounts of salt and sugar intake still remain a problem.
Singaporeans total sugar intake increased to 60g in 2018, from 59g in 2010.
For salt intake, 90 per cent of Singaporeans exceeded the recommended amount of 5g per day, with the average daily salt intake in 2018 at 9g.
The new measures will complement HPB’s current programmes to encourage Singaporeans to develop healthier eating habits.
The Healthier Dining Programme (HDP), for example, was started in 2014 to encourage F&B businesses to provide healthier food and drink options by providing them with grants and support.
The scheme was then expanded in 2017 to include stalls at hawker centres and coffee shops. The aim was to have four in 10 of these stalls selling at least one healthier dish by 2019.
As of March this year, the proportion was 6 in 10 (or about 7,000 out of the total number of hawker centre and coffee shop stalls), said HPB in response to TODAY's queries.
Healthier dishes could include those with lower calories, lower sugar or higher amounts of wholegrains.
Separately, there is also the Healthier Choice Symbol (HCS) programme, where healthier packaged food and drinks are labelled with a HCS logo.
As of March, more than 4,500 HCS products were available across various food categories, such as packaged beverages, rice, noodles, bread and sauces, said HPB.
A SNAPSHOT OF S'POREANS’ EATING HABITS
After Ms Tjut Rostina Said Arby, 42, realised that she had put on 8kg during the pandemic — a result of increased snacking and a lack of activity when she and her family were spending more time at home — she knew that it was time to change her diet.
“I’ve been overweight for the most part of my life and the pandemic made it worse,” said the mother of two.
She weighed around 80kg before the pandemic but shed 16kg in around 10 months after removing processed food and introducing healthier ingredients into her diet.
Although the communications manager has her lunches outside when she is working, she would typically go for healthier options such as poke bowls or a plate of brown rice with vegetables and protein.
University student Auston Lim also dines out almost every day, and has most of his meals on the school campus.
But unlike Ms Tjut Rostina, the 21-year-old said that he eats whatever he wants as he is not very health conscious.
On the other hand, digital content creator Namita Sinha cooks at home every day, save for the weekends.
The 35-year-old mother would use healthier ingredients such as adding grated carrot, beetroot and cauliflower in the roti prata which she prepares for her children.
Adhering to a healthy diet has also become second nature for 27-year-old Daniel Tan.
The personal trainer would usually have meals would consisting of a significant amount of protein, vegetables, and whole grains.
He added that he would still dine at hawker centres at least a few times a week, but would often order chicken rice and request for chicken breast and extra cucumbers.
Indeed, when it comes to food, hawker centres and coffee shops are a big part of the typical Singaporean lifestyle, with many regularly consuming their daily meals from these places.
On their part, hawkers interviewed by TODAY said that they are seeing more health-conscious customers who would request for their dishes to be “healthier”, such as including less salt or soya sauce.
Mr Jonathan Tan, who has been running his Kin Men Seng Heng stall at Amoy Street Food Centre for the past seven months, said that he had to reduce the sodium in his original recipe by 10 per cent within the first month of opening his store due to feedback from customers.
However, the 27-year-old said that making a dish healthier is more difficult, citing factors such as costs and keeping the original recipe as authentic as possible.
Similarly, 46-year-old hawker Alan Goh, who runs the Ang Mo Kio 453 Wanton Mee stall at Mayflower Food Centre, said that he has reduced the amount of oil and salt in his dishes as “that is the only way to bring back customers” since many are more health conscious now.
But Mr Haziq Halim, 35, who runs the Ché Ani Chicken Rice stall at Bukit Batok, said that such requests for less salt and soya sauce are more than welcome as they help him to save money.
“They help me to save money... nothing to complain (about) “he told TODAY with a laugh.
But for Mr Daren Lionel Oliveiro, making his dishes healthy does require extra time and cost.
The 41-year-old uses carrots and onions to bring out the natural sweetness instead of using sugar or canned sauce for his pasta.
However, these extra ingredients and manpower to prepare the sauce from scratch would incur an additional cost of around 42 per cent as compared to simply using canned ready-made pasta sauces.
HOW HEALTHY IS THE TYPICAL S'POREAN DIET?
A typical Singaporean diet revolves around hawker culture, with people consuming a variety of food from all three major ethnic groups, said Dr Kalpana Bhaskaran, who heads the Glycemic Index Research Unit at Temasek Polytechnic.
Dr Kalpana is also the president of the Singapore Nutrition and Dietetics Association.
A sizable proportion of Singaporeans eat out on a regular basis, noted Dr Kalpana, citing a poll on Singaporeans’ eating habits done by Nielsen this year which found that one in four Singaporeans eat out daily.
“While hawker centres provide us with inexpensive and excellent cuisine, and also healthier choice hawker items, some items are still typically rich in salt and oil, and are quite unhealthy when consumed frequently,” said Dr Kalpana.
Dr Mary Chong, from the Saw Swee Hock School of Public Health at the National University of Singapore (NUS), said that she has noticed a greater awareness among Singaporeans on the importance of having a healthy diet.
However, whether they turn this awareness into action depends on factors such as social support and convenience.
For instance, people working at home during the pandemic may have taken on a more proactive approach in changing their diet, said Dr Chong.
However, Ms Loong noted that as people return to working in the office as the pandemic situation improved, such proactiveness to prepare home-cooked food seems to have waned.
“Covid-19 also meant that there was a bloom of restaurants joining food delivery services, and that has meant more choices at our fingertips, and the habit of ordering is perhaps now more ingrained.”
However, food delivery companies told TODAY that despite an increased number of customers on their platforms, there seems to be a growing consciousness towards healthier choices.
A spokesperson from Deliveroo said: “In the last two years, Deliveroo has seen a significant increase in orders for our ‘Healthy’ and ‘Healthy Options’ categories. Popular healthy dishes include salads, poke bowls and wraps.”
Similarly, a Foodpanda spokesperson said that there has been an increase in people choosing healthier options since the pandemic. This extends beyond food deliveries to include grocery and other orders.
DOES SOCIO-ECONOMIC STATUS HAVE ANY BEARING?
Cleaning up one’s diet does come with a price tag, said those who have started eating more healthily.
Hence, it was not surprising that during the debate over the Healthier SG White Paper, Members of Parliament (MPs) from both sides of the aisle stressed the importance of paying attention to the lower-income segment in the community.
Mr Xie Yao Quan, a People’s Action Party MP from Jurong Group Representation Constituency, said that Healthier SG needs to be inclusive socioeconomically while Non-Constituency MP Hazel Poa, from the Progress Singapore Party spoke about the the importance of making healthier food choices and ingredients more affordable.
The 2020 National Population Health Survey report, published in November last year, indicated a consistently higher crude prevalence of chronic diseases such as diabetes and hypertension among residents whose highest education qualification was primary school, compared to those with secondary or post-secondary qualifications.
In its response to TODAY, HPB said that as of March, there were over 4,500 HCS products available across 100 food categories, such as packaged beverages, rice, noodles, bread and sauces.
HPB also highlighted its Healthier Ingredient Development Scheme, which offers grants to encourage food manufacturers to develop healthier ingredient products.
“By March 2022, 95 suppliers across nine ingredient categories were on board the scheme, offering over 300 healthier ingredient products,” it said.
Nevertheless, TODAY’s checks at major retail stores found that there is still a jarring price disparity between healthier ingredients and regular ones.
For cooking oils, a bottle with a HCS label can be 30 per cent more costly than a regular one. A bag of mixed brown and white rice can cost more than double that of white rice when compared per gram.
Despite the higher prices, a spokesperson from Fairprice told TODAY that there has been an increase in sales for healthier choice products by more than 10 per cent from 2019 to 2022.
She added that the company has increased the number of healthier choice products in stores by about 10 per cent over the past year.
The experts interviewed acknowledged that socioeconomic status does influence diet choices, and disparities in diet are especially compounded by soaring food prices.
Dr Chong from NUS said that lower-income families sometimes do their marketing periodically to buy in bulk and cut down costs, and may forgo healthy food items such as fruits and vegetables if supplies run out in between.
HEALTHY DIET IMPORTANT, BUT ISN’T EVERYTHING IN PREVENTIVE HEALTHCARE
Singapore’s ageing population is one of the factors driving the Government’s “long-term and profound reform effort” of adopting preventive care, Health Minister Ong told Parliament on Tuesday.
Preventive healthcare consists of measures — including adoption of a healthy diet — taken to prevent illnesses and the onset of diseases.
About one in four Singaporeans will be aged over 65 by 2030, up from one in six today.
Mr Ong added that the rise in healthcare spending cannot be reversed due to an ageing population.
“But what we can hope for is to slow down the rate of increase of healthcare spending,” he said.
Of the many components in preventive healthcare, Dr Kalpana said that having a healthy diet is of “paramount importance”, as minor changes can help to prevent chronic diseases.
HPB, too, said that healthy eating is one of the key focuses in preventive health efforts to address key lifestyle risk factors, which can lead to poor health and chronic diseases such as diabetes, hypertension and heart disease.
According to Dr Kalpana, other components of preventive healthcare include regular screening for chronic diseases and regular vaccination.
TIPS ON HEALTHY EATING — ORGANIC FOOD NOT NECESSARILY HEALTHIER
While healthier food options still tend to cost higher, the experts said that eating well and right does not require one to break the bank or devote a lot of effort to it.
Dr Kalpana said: “People have this misconception that in order to eat healthily, they would need to buy organic foods and specialty products that are expensive.”
And despite the widespread perception that organic food is healthier, this is not necessarily the case.
“While organic foods have fewer synthetic pesticides and fertilisers and are free of hormones and antibiotics, they do not have a nutritional advantage compared to non-organic types,” said Dr Kalpana.
Instead, a cost-effective way of eating healthier could include small changes, such as cutting out foods that are high in sodium or avoiding sugary beverages and drinking water instead.
NUS' Dr Chong also suggested buying frozen vegetables or meat, in addition to fresh ones, could be another way of eating healthy yet saving on costs, as they would be able to last longer.
Another way to reduce food costs is to buy house brands, which tend to be cheaper, the experts said.
For those who often dine out due to long working hours and may not have the time to cook, Dr Chong suggested cooking several dishes in bulk over the weekend, portioning them and then freezing them, so that they can be eaten any day of the week.
But if this is not possible, it is important to “choose very wisely” when eating out.
“There are a lot of food options in Singapore and sometimes it can be a double-edged sword because you may be tempted to go for more delicious and higher calorie foods," she said.
But there are ways to avoid these temptations such as picking a route to avoid walking past stores selling less healthy food, she added.
Though changing one’s eating habits may seem like a Herculean task to some, for others it is a necessary step in order to live a healthier life well into their sunset years.
Ms Tjut Rostina said: “I’m 42 and I’m already thinking about ageing gracefully. I don’t want to be susceptible to things like high-blood pressure and diabetes in the years to come."