Why is healthy eating so hard to do in a food paradise like Singapore? (2024)

SINGAPORE: Mr Terence Koh used to be overweight at 105kg, but his desire to be a good role model for his then-newborn son in 2021 saw him changing his lifestyle, eating clean and exercising more.

In just eight months, he lost 35kg.

“I had been struggling with weight loss for close to 10 years. I had been stress eating and leading an inactive lifestyle, so I wanted to get healthy and active for my son,” said Mr Koh, who started by reading up about nutrition and coming up with a progressive health plan.

“In the first month, I only exercised once per week. I didn't change my diet, except (cutting out) supper. In the second month, I started to get serious. I increased my exercise frequency to three times a week, and I started implementing a healthy diet by removing processed food.”

These days, Mr Koh follows a diet that he finds easier to keep to, one that allows him to indulge in his favourite fried chicken occasionally.

“I need a diet that's sustainable. I need to constantly have an awareness of what I'm putting into my mouth. If I feel that I'm indulging too much into salty food and processed food, then I will remind myself,” he told CNA podcast Heart of the Matter.

“Seventy per cent of the time, I eat as clean as possible, and 30 per cent of the time, I eat whatever I want. So at least there's a balance to it.”

However, Mr Koh is among the exceptions.

UNHEALTHY FOOD CAN BE LIKE "POISON"

Nine in 10 people in Singapore are consuming more salt than the recommended intake, with the prevalence of hypertension or high blood pressure almost doubling since 2010, according to findings from surveys by the Ministry of Health (MOH) and Health Promotion Board (HPB) released last month.

Singapore Nutrition and Dietetics Association president Kalpana Bhaskaran, who joined Mr Koh on the show, said it is a real struggle for many people to change their habits as “food is available 24/7” in Singapore.

Highlighting how unhealthy food can be like a poison, the nutritionist said: "It's not going to kill you immediately. But it might lead you on the pathway to chronic diseases, which eventually will lead to complications, and of course, your mortality rate will be higher."

For instance, the daily sodium intake of residents here has gone up to 3,620mg in 2022, from 3,480mg in 2019, according to HPB's National Nutrition Survey 2022.

The recommended daily limit is less than 2,000mg of sodium, or just under one teaspoon of salt.

“Over the years, maybe our taste perception also has changed. Without our knowledge, we have been increasing the salt and we are used to that taste,” said Dr Kalpana.

“In fact, until these results came, we were definitely not aware that we have been eating so much sodium.”

Observers said lowering one’s salt intake requires discipline and consistency.

“For some, completely removing sodium is not going to work. So you go for sodium alternatives like potassium-based salt, they naturally taste less salty,” said Dr Kalpana. “So you get used to it.”

Ms Candy Goh, clinical dietitian at Parkway MediCentre, said it can take time before one forms good eating habits.

“It's about retraining our taste buds,” she added. “Sometimes when you cut down on taste (salt), it doesn't taste as good. But if you keep taking it over a period of time, it becomes a new normal so that you'll be able to accept it better.”

“CAN’T OUT-EXERCISE A BAD DIET”

HPB’s survey also found that Singapore residents are eating more, with their mean calorie intake going up from 2,360kcal in 2019 to 2,410kcal in 2022.

Around 61 per cent of residents exceeded what is recommended, which is estimated based on an individual's age, gender, weight and level of physical activity. This was up from 55 per cent in 2019.

“A lot of Singaporeans are foodies, and we bond over food,” noted Ms Goh, who specialises in weight management and patient education.

“That's when calories can pile up, because the food options generally are not so healthy. In gatherings, you would tend to over-order and after a meal, you could have desserts and drinks. So it quickly adds up.

“People need to be more conscious about the portion that they consume, then that will help to manage the calorie intake.”

The prevalence of obesity has also risen, from 10.5 per cent between 2019 and 2020 to 11.6 per cent between 2021 and 2022. The increase was mainly observed among residents aged 18 to 29 and 40 to 59.

The proportion of residents here engaging in sufficient physical activity - defined as at least 150 minutes of moderate intensity in a week - also fell from 84.6 per cent in 2019 to 74.9 per cent in 2022.

This was seen across most age groups, said MOH, adding that the trend was likely because of reduced commuting with more people embracing hybrid work arrangements.

“You really cannot out-exercise a bad diet,” said Ms Goh.

“When we talk about trying to manage your health (and) weight, diet plays 80 per cent. 20 per cent comes from exercise. Eventually, you still need to work on improving your diet quality.”

IS HEALTHY EATING EXPENSIVE?

On whether eating well is more expensive, observers said price has little to do with healthy eating. It boils down to an individual’s choice and awareness, they added.

“It depends on what you want to choose and how you choose it. It cannot be a reason that because it's expensive, you are not able to follow a healthy lifestyle,” said Dr Kalpana.

She added that consumers can choose brands that are cheaper, and healthier food options such as brown rice are now less pricey than before.

However, she acknowledged that some instant or processed foods such as instant noodles are even cheaper.

“There are some items like that, so maybe people tend to buy that often. This boils down to the choice they make,” she said.

Experts noted that salads are not the only healthy food option available. In fact, not all salads are nutritious, they pointed out.

“People always think if you want to eat healthier, you have to eat salads,” said Ms Goh, adding that hawker centres have healthier options too.

“But you can also eat healthy if you eat economy rice. So you can have plain rice, you can have two stir-fry vegetables, and then you choose a lean meat option - it can be like a steamed fish or like stir fry meat.”

As a rough guide, a well-balanced meal would consist of a half plate of fruit and vegetables, a quarter plate of a good protein source and a quarter plate of wholegrains.

“So when people don't have that carbohydrate, they tend to get hungry very quickly,” said Ms Goh.

“They may overeat later on because they don't have that energy from that carbohydrate from that meal.”

Dr Kalpana added salads may not be the most nutritious, noting that salad bowls filled with lettuce only offer “a little bit of dietary fibre”.

“I know all the salad lovers will hate me,” she quipped.

Salad dressings and cold cuts can add sodium to one’s meal, she added. “So that's where I feel salad is also sitting in a disguised form as healthy, but it's not always healthy.”

HOW CAN WE MAKE HEALTHIER EATING A HABIT?

For individuals who are clueless about where to start in their healthy eating journey, nutritionists said it is important to avoid drastic changes in diet and explore alternative food options.

“Try and avoid doing a whole overhaul to your diet because that can be very overwhelming. So start small, identify a few things that you want to change first,” said Ms Goh, adding that consumers can choose ingredients with natural flavours like onions and garlic, instead of using too much salt and oil.

“Once you're able to do that, then you can move on to make more changes. In that way, it's easier to stick to the changes that you make, and overall you would have improved from where you started out.”

On whether one can still indulge in unhealthy food cravings, experts said the key is in controlling quantity portions.

“Food is not an all-or-nothing kind of thing. It's about how often you consume. It's the amount that you consume that matters,” said Ms Goh.

“For example, if you're only having fried chicken once in a month, or like a less healthy option once in a month, that's okay. It's not gonna throw your health entirely off.”