Eating out cheaply, healthily (by Grace Chua )

The Straits Time, Dec 14, 2010, Tuesday

Eating out cheaply, healthily

For a start, give info on nutrition value and offer more healthy options
By Grace Chua

I ONCE tried replicating one of my favourite hawker-centre dishes, fish soup, at home. Fish slices, check. Vegetables and clump of seaweed, check. Rice noodles, check.

But when I tasted it, there was something vital missing, some magic bullet of flavour.
It turned out to be the artificial flavouring MSG. And tantalising morsels of lard.

Fish soup is not the only dish commonly available in hawker centres and coffee shops that is stealth-unhealthy - appearing lower in fat and calories than other dishes, but with a sodium level higher than is good for you.

There is of course a healthy way of adding flavour to soup without too much salt or artificial flavourings - boil your own stock from meat or vegetables for hours. Not many hawkers do that, and most resort to the short cut of flavour enhancers.

That is one reason eating out is a veritable minefield, with even 'healthier' dishes such as yong tau foo and gado gado containing too much salt and calories and too little fibre.

Sodium gives flavour, but also adds to fluid retention and high blood pressure, while fibre aids digestive health.

Singaporeans are eating out more than ever: A recent Health Promotion Board (HPB) survey found six in 10 people ate out each week this year, up from 49 per cent in 2004. Half of those surveyed ate out eight or more times times a week. Eating out is correlated with higher levels of obesity, which has gone up from 6.9 per cent in 2004 to 11 per cent this year.

Hawker and coffee shop food is relatively inexpensive, providing easy sustenance for those who do not cook at home.

Eating out is an integral part of Singapore's immigrant culture, dating back to when labourers had no access to kitchens or had to eat on the go. Singapore's food culture is also actively encouraged as a pastime and tourist attraction.

There is nothing inherently wrong with eating out, and nothing inherently more virtuous about cooking at home.

What matters is the nutritional content of your food. At home or even at restaurants, with dishes cooked for your table, you can have some say over the cooking method if you insist. Not so at hawker centres, especially at stalls selling the ubiquitous 'economical rice' with a variety of pre-cooked dishes to choose from.

Rarely does one encounter nutritional information at an eatery, perhaps because numbers on calories, sodium and sugar are the surest way to kill appetite. But information is vital to give people a choice of what to eat. Information helps make healthy food more widely known and available, as Duke-NUS health economist Eric Finkelstein put it in a lecture in Singapore recently.

Apart from information, access to healthy food is also key to healthy eating.

In the United States, researchers found that people who live near fast-food stores are more likely to be unhealthy and obese than people who live near higher-end, full-service restaurants.
The authors - Neil Mehta and Virginia Chang - of the study reported in 2008 concluded: 'This suggests that in a culture where eating out is common, the type of restaurant food chosen is important to determining weight status'.

This has clear implications for Singapore, where the majority live in Housing Board estates surrounded by hawker centres and coffee shops.

If the food most conveniently accessible is high in fat and salt, then that is the regular diet for most.

While individuals may say they like the taste of food cooked this way, there is a collective good in trying to make hawker and coffee shop food healthier, to reduce levels of obesity and lower the risk of all the attendant diseases that result from diets high in fat, sodium and cholesterol.

Past campaigns to promote healthy eating focused on getting individuals to make 'healthier' food choices. But as the latest surveys show, so-called healthier dishes are not so healthy after all.
There is an urgent need for society- wide initiatives to improve the health level of food at these eating outlets where most people get their daily meals. These outlets have to be incentivised to offer a broad range of healthy food choices.

This is essential if Singapore does not want to risk entrenching a health-wealth divide. In the West, lower income and socioeconomic status is associated with a higher rate of overweight and obesity.

The National Health and National Nutrition surveys conducted by health agencies here do not show obesity rates by housing type or income level.

But studies on the Chinese and Malay populations here have found that lower- income women, in particular, tend to have higher rates of obesity and of being overweight.

So what is to be done? Here are two practical suggestions.

One: Information. The HPB should assess the real nutritional value, salt and fibre content of its healthier choices as well as a broader range of popular Asian dishes than it currently does. This information should be posted right by eateries and stalls. A phone application could be developed so people have it at their fingertips - the HPB's DietTracker is a good start.

Two: Improve access to healthy food options.

Currently, about 400 stalls bear the HPB Healthy Choice mark - a fraction of the more than 15,000 hawker stalls in Singapore. This programme should be stepped up, and healthy stalls promoted as healthy-food champions.

The longer-term plan should be to grade hawker stalls on how healthy their offerings are - in the same way the National Environment Agency now rates hawkers for hygiene standards. The objective is to raise the overall healthiness level of food in hawker centres.

The experience of developed countries shows the danger of inaction in the face of large numbers of unhealthy food outlets in a neighbourhood: rising obesity levels, especially among the low-income.

Singapore's obesity rates are already creeping up, no thanks to unhealthy food offerings when eating out. Action now can arrest the girth of this problem.