By Chia Ee Khim in consultation with Ms Chan Sau Ling Dietitian, National Healthcare Group Polyclinics

The Need for Healthy Eating Habits

According to official statistics, one in nine Singaporeans between the age of 18 and 69 are obese; nearly one in four have hypertension, and one in nine are diabetic. Perhaps prompted by these numbers, and nudged by various national public health programmes, more Singaporeans are tweaking their eating habits by cutting down on sugar, sodium and fat. But in doing so, are we being misled or misinformed?

More Going for Wholegrain

Opting for wholegrain foods like wholemeal bread, oats and brown rice has been growing in popularity, with brown rice and wholemeal noodles now available in food courts and hawker centres. In fact, three in 10 adults consume at least one serving of wholegrain foods a day, according to the 2010 National Nutrition Survey, and this is a good sign.

Ms Chan Sau Ling, Dietitian with National Healthcare Group Polyclinics, says, "Wholegrains help to promote satiety or the feeling of 'fullness'. They also provide more fibre, vitamins, minerals and phytochemicals, which are linked to a lower risk of developing heart disease, type 2 diabetes and hypertension."

​But although the survey recorded an improvement in wholegrain consumption from an earlier study in 2004, it also revealed a parallel worsening in other areas, with more people consuming excessive calories and fat.

Salt Intake Remains High

Eight in 10 adult Singapore residents exceed the salt intake recommendation of less than 5g per day, with a daily average intake of 8.3g. This suggests that while Singaporeans are increasingly inclined to choose healthier options, many still lack an understanding of what exactly goes into the food they eat.

How To Reduce Salt Intake? Know Your Salts

The use of sea salt, popularised by gourmet chefs, is an example. Many people are under the impression that compared with table salt, sea salt is lower in sodium content and contains more minerals because it is less processed.

Manufacturers use it in potato chips and other snacks because it's "all-natural". But other than containing trace amounts of additional minerals, there are no real health advantages to sea salt.

As Ms Chan explains, "Sea salt and table salt have the same basic nutritional value and contain comparable amounts of sodium by weight." Go for sea salt if you like its coarse texture and stronger flavour, but bear in mind that excessive intake of salt still increases your risk of high blood pressure, which in turn places you at higher risk of heart disease and stroke.

Adjust the Amount of Salt Used with MSG

Conversely, for years critics have discouraged the use of monosodium glutamate (MSG) as a food additive, with vague claims that it is no good for the body. Many restaurants have consequently declared themselves as "MSG-free" in response to demands for healthier dining options.

But according to the United States Food and Drug Administration (US FDA), MSG is "generally recognised as safe", and the Food Standards Australia New Zealand states that there is no convincing evidence that MSG causes reactions resulting in severe illness or mortality.

Consumers who are sensitive to it may have reactions like headache, flushing and even nausea, but otherwise, it is generally safe to consume.

Just remember, a teaspoon of MSG contains 615mg of sodium (vs 1,960mg in a teaspoon of table salt) which means that using it in cooking would require some adjustment of the seasoning.

Some Sugar Substitutes Are Not Lower in Calories

Sugar is another ubiquitous ingredient whose true effects have been somewhat misunderstood. Many people believe that less-refined alternatives like honey and brown sugar, popularly used as sugar substitutes to add to teas and in baked goods, are better than white sugar. A closer inspection of each of these reveals only slight differences.

Brown Sugar is Still Sugar

One teaspoon of brown sugar (4g) provides 15 calories and 3.9g of carbohydrates, while a teaspoon of white sugar contains 16 calories and 4g of carbohydrates; both increase your blood sugar level in a similar fashion.

And while brown sugar contains molasses, which is said to offer benefits like improving bone health and strengthening the immune system, the negligible presence of it means it is not likely to have much of an effect.

Honey Packs More Calories

Sometimes referred to as "nature's perfect food", honey contains 29.4 calories and 7.7g carbohydrates per 9g teaspoon, which is more calories than white sugar. And even though people tend to use less of it because it is so sweet, they still end up taking in the same amount of calories and carbohydrates.

As for benefits, some nutrition experts say that honey, unlike refined cane sugar, contains small amounts of vitamins and minerals and aids digestion. But "both honey and sugar are linked to tooth decay, diabetes and obesity," says Ms Chan.

Calorie-Free Artificial Sweeteners

Artificial sweeteners meanwhile suffer a bad reputation even though they are essentially calorie-free. "Since artificial sweeteners are many times sweeter than sugar, smaller amounts are needed.

Using artificial sweeteners in place of sugar can thus help prevent tooth decay and improve blood sugar control in people with diabetes." 

Reduce Sugar and Salt to Cultivate Healthier Eating Habits

Ultimately though, instead of using substitutes, it may be easier to reduce the sugar and salt by cutting down on the amount you normally would use. It is also important to realise that salt and sugar do not just come from what we add to our food during cooking.

Sugars like glucose, fructose and sucrose occur naturally in fruits, honey and syrups. Many of these substances are also hidden in processed food; these often pose a bigger danger to the consumer as they are many times sweeter than regular food.

Health Claims on Nutritional Labels

Along the supermarket aisles, shoppers are often easily distracted and swayed by the food health claims splashed across the front of food packages, buying into buzz-words like "reduced", "natural" or "enriched". While not all of them are suspect, many could create a false sense of healthiness.

The Truth About “Gluten-Free” Products

Gluten-free products, for example, are popular among the health-conscious who believe that a gluten-free diet helps in weight loss and is better for digestion and health in general. Gluten is a protein composite found in wheat and related grains including barley and rye.

While it is essential for people with coeliac disease to avoid it, there is no evidence to show that there are health benefits to gluten-free eating for the general population, Ms Chan points out.

More importantly, just because a product is advertised as gluten-free, it doesn't mean it won't contain high levels of sugar, sodium or fat, not to mention other fillers and binding ingredients. To determine the quality of your food purchase, always scrutinise the nutrition label and ingredient list rather than take trendy terms at face value.

The Truth About “Low-Fat” and “No Sugar Added” Products

"Low-fat" products could be chock-full of sugar and calories instead; juices that claim they have "no added sugar" can still contain a substantial amount from "sugars naturally present in fruit"; and the US FDA has no firm definition for an "all-natural" label as long as the product doesn't contain added colours, artificial flavours or synthetic substances.

The Truth About “Trans-Fat-Free” Products

In "trans-fat-free" products, manufacturers can label their goods as having no trans fat as long as it contains less than 0.5g per 100g. If you spot partially hydrogenated oil or shortening in the ingredients list, it is nearly always an indication of the presence of trans fat, which is harmful to your heart.

Healthy Eating Begins with A Balanced Diet

Your body is shaped by everything you feed it, but maintaining a healthy diet requires more than simply cutting your intake of fat, salt and sugar.

Sodium and fat are necessary for our body to function. Just watch out for saturated and trans fats as they can raise the level of cholesterol in your blood, which increases your risk of heart disease. Instead eat more of monounsaturated or polyunsaturated fats from fish, nuts and vegetable oils.

The key is to eat a well-rounded variety of nutritious foods, opting for fresh ingredients, using healthier cooking methods such as steaming, grilling or baking will help you maintain healthy eating habits. Ms Chan stresses that eating foods from many different groups increases the body's ability to absorb nutrients.

Ultimately, knowing what your food is made up of enables you to make informed decisions about what to eat, and avoid being misled by cleverly marketed nutrition label the next time you go to the supermarket.

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