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The Big Read: A healthy diet need not cost more, say experts

The Big Read: A healthy diet need not cost more, say experts
Nutritionists and experts interviewed by TODAY said that it is a myth that a healthy diet will burn a hole in one’s pocket, pointing out that there are healthy substitutes that are affordable. Photo: Raj Nadarajan/TODAY

The Big Read: A healthy diet need not cost more, say experts

SINGAPORE – A recent debate in Parliament on the cost of healthier food has cast the spotlight yet again on whether a healthy diet costs more.

Those who argue so point out that brown rice and wholemeal bread – which Prime Minister Lee Hsien Loong had urged Singaporeans to eat more of during his National Day rally - can cost up to twice as much as white rice or bread.

But nutritionists and experts interviewed by TODAY said that it is a myth that a healthy diet will burn a hole in one’s pocket. They pointed out that, despite the fixation of some Singaporeans with brown rice, wholemeal bread and low-sugar food following Mr Lee’s suggestion, there are healthy substitutes that are affordable.

Typical hawker fare at a food centre in Singapore. Consumers are having more high-calorie snacks and soft drinks, highlighted PM Lee. Photo: Nuria Ling/TODAY 

They add that price has little to do with eating well as it ultimately boils down to one’s personal choice and discipline.

This was also a point made by Senior Minister of State for Health Chee Hong Tat in Parliament earlier this month, in response to a question by Member of Parliament for Bishan-Toa Payoh GRC Chong Kee Hiong on why a low-sugar kaya spread costing S$3.95 was priced a dollar higher than a full-sugar version.

Mr Chee explained that a lack of economies of scale made it difficult for some healthier food options to be priced competitively.

But he stressed that eating healthily did not mean that it would cost more or that one had to buy such products, adding that consumers can pick food that is prepared and cooked in a more healthy way such as steaming.

Dieticians said that a healthy diet is first and foremost a balanced one that avoids excessive consumption of any particular food.

“The truth is all foods contain different nutrients and no one food contains all the nutrients our body needs” said Ms Mah Wai Yee, Farrer Park Hospital’s head dietician.

Be it at home or at dining places, eating well can be done on a budget, the experts say.

For those who cook at home, shopping for house brands could be a good way to start.

A house brand wholemeal bread goes for S$1.65 for a 500g loaf, whereas a similar product under a popular brand retails at S$2.50 for a 420g loaf at a supermarket chain.

“Many of the so-called house brands... can be low-cost, yet nutritious,” said National University of Singapore sociologist Tan Ern Ser.

Using cooking methods such as steaming, boiling or stir-frying with minimal oil can also make a difference.

When dining out, consumers can ask for less salt, sugar, oil or trimming of fats, said Mr Louis Yap, a dietician at Parkway East Hospital.

Consumers can have nutritious and affordable fare at hawker centres, food courts and coffee shops too, at S$3 to S$5 a meal.

National University Hospital dietician Lin Wen cited yong tau foo, sliced fish noodle soup and economic rice as options.

Stay away from gravy, she added. Also, pick steamed or grilled meat over fried meat, and opt for brown rice over other variants.

While working professionals may prefer to dine out for the sake of convenience, nutritionists say preparing home-cooked meals need not be a chore.

Meals can be prepared in larger portions and frozen for future consumption for instance, said Raffles Diabetes and Endocrine Centre principal dietician Bibi Chia.

THE NATIONAL PUSH TO EAT WELL

The government has long pushed for Singaporeans to eat healthily, starting with health education lessons in schools.

In 2014, the Health Promotion Board (HPB) introduced the Healthier Dining Programme to get the food and beverage industry to offer meals with healthier ingredients and lower calories and drinks with less sugar.

More than 3,100 stalls from 67 hawker centres and 450 coffee shops have since come on board.

This will increase the availability, accessibility and variety of healthier meal options and improve Singaporeans’ eating habits and dietary quality when dining out, the HPB said in response to TODAY’s queries.

The aim is for 40 per cent of hawker centre and coffee shop stalls to have at least one healthier option by 2019.

The HPB added that it is also working with food manufacturers to develop healthier staple food ingredients such as wholegrain rice, wholegrain noodles and healthier cooking oils through the Healthier Ingredient Development Scheme.

Observers note that a healthy diet has not gotten so much buzz before, and public attention on the issue was likely spurred by PM Lee devoting part of his National Day Rally speech to the topic and why Singapore must step up its fight against diabetes.

Retailers such as NTUC FairPrice, Cold Storage, Giant and RedMart say they have noticed a growing demand for healthier food of late. 

Some of them have also committed to promoting healthier options.

NTUC FairPrice had previously put healthier rice products on offer, and has a current discount for fresh fruits and vegetables on Wednesdays.

Sheng Siong had also followed Fairprice in offering discounts on its healthier rice products shortly after Mr Lee’s rally speech.

The move however inadvertently drew greater attention to the fact that these products cost more than white rice and made some consumers ask if eating healthily was more costly.

Former Nominated Member of Parliament Calvin Cheng generated further debate on the issue by remarking on Facebook that “eating healthy is often not a choice for the low-income”.

Besides the higher costs of brown rice and wholemeal bread, he noted that “eating out healthily is also more difficult for the low-income”.

“Hawker food is often oily and unhealthy, but affordable. Low-income people cannot afford to go to a yuppie cafe and order quinoa with organic chicken breast.”

What followed were a flurry of letters to the media, with some calling for the government to do more to address the perceived high cost of a healthy diet.

TWO WHO MADE THE SWITCH

If Singaporeans do not adopt healthier eating habits, there may be a heavy price to pay.

In the Global Burden of Disease Study 2016, suboptimal diet was the second leading risk factor for deaths, accounting for 18.8 per cent of all deaths around the world last year.

Over half of the deaths linked to a poor diet were due to cardiovascular diseases, according to the study by the University of Washington’s Institute for Health Metrics and Evaluation released last month.

Researchers found that a diet low in whole grains accounted for the largest number of deaths, followed closely by a diet low in fruits and a diet high in sodium.

In his National Day rally speech, PM Lee had also highlighted how Singaporeans were eating an average of 2,600 calories a day in 2010 – up from 2,100 calories two decades ago.

While portion sizes have largely remained the same, consumers are consuming more high-calorie snacks and soft drinks now.

“In today’s busy society, many people are opting for convenience such as fast food, processed food or simply reaching for a snack to replace a meal,” said Ms Lin, the NUH dietician.

Ms Bella Koh was one who decided to change her diet after her unhealthy eating habits led to her suffering from poor health.

In her previous job as a product developer, she would often have dinner only after knocking off work at 9pm or later.

The 36-year-old confessed to overeating due to stress at work and there were times when a single meal of hers would include beef, chicken and prawns.

She started practising yoga after quitting her job around 2009, and tried a vegan diet for two years.

“(Before that), my body was collapsing, and I wasn’t even 30 yet,” she said, adding that she often battled gastric pains in the past.

Since changing her lifestyle, her health has picked up.

“Now I have this motivation - I’ve got to take care of myself and my body,” she said.

“I’ve also influenced my family... my mom would try vegan restaurants together with me.”

Rusmah Binte Lamri, took on a healthy lifestyle after coming across residents in her estate who were in poor health. Photo: Raj Nadarajan/TODAY 

Madam Rusmah Lamri was another Singaporean who started paying more attention to her health a few years ago, after she joined grassroots volunteers on house visits to Marsiling residents - some of whom had chronic illnesses.

It was a wake-up call for her, and she started to pay more attention to her diet.

Rather than cook nasi lemak, laksa and mee siam - her four children’s favourites - at home, she started to create more soup-based or steamed dishes.

Regular dishes on her dining table include assam fish and vegetables.

And if her children crave her laksa, she makes sure to add fish and beansprouts. The sambal chilli that accompanies the dish has “no oil and only a bit of salt”, said the 57-year-old housewife.

When she eats out, Mdm Rusmah makes it a point to pick thosai over roti prata.

“Healthy food may not be so nice, but we must all learn to (eat it),” said Mdm Rusmah.

GOING BEYOND FOOD

Experts and community leaders interviewed by TODAY note that getting more Singaporeans to eat more healthily will be a long-term challenge.

“Old habits die hard,” said Member of Parliament for Marine Parade GRC Fatimah Lateef.

“People have the perception that healthy food will not taste nice. But if you haven’t made the first move, you won’t know.”

As part of her efforts to promote a healthy diet among her constituents in Geylang Serai, she has organised cook-outs for residents to learn healthy recipes, including egg and vegetable sandwiches using hi-fibre bread.

The food demonstrations are the first step to changing mindsets about eating well, she added.

One way to discourage people from eating unhealthy food is to introduce a sin tax on it, said Dr Tan, the NUS sociologist.

Similarly, Dr Chia Shi-Lu, Member of Parliament for Tanjong Pagar GRC and chairman of the Government Parliamentary Committee for Health, suggested a sugar tax, particularly on soft drinks.

He however felt that this would have to be studied carefully.

Like others, Dr Chia note that a healthy diet represents a low-hanging fruit in the more important push for a healthy lifestyle.

“From a behavioural and medical point of view, watching one’s diet is probably the most effective way of being healthy,” said Dr Chia.

“If you drink a can of coke, how many calories have you consumed? Even after running an hour, you’re only even and then you’re thirsty and you have another can.”

The need for regular exercise was also a point made by PM Lee in his rally speech.

He noted that compared to two decades ago, the extra calories that Singaporeans today are consuming amounted to three additional scoops of ice-cream per day.

“I fear the trend is still up. To burn off these three extra scoops of ice cream, you need to run more than an hour every day...Most of us don’t, so obesity has gone up,” he said.

Deep fried Chinese hawker food at a food centre in Singapore. Photo: Nuria Ling/TODAY

There is certainly no lack of options for those willing to exercise.

At the community level, there are a myriad of fitness activities organised by grassroots leaders weekly.

But at the end of the day, it boils down to one’s personal choice.

As Parkway East Hospital’s Mr Yap said: “You’ve only got one life. Why not make that extra effort to live a healthy one?”

Dr Fatimah, the Member of Parliament, added: "Expensive food doesn't equate to better eating or healthier food. You can eat on a budget and still live healthily and happily."