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Wednesday 7 September 2011

Dietary Guidelines For Singaporeans - 2003

Source: Health Promotion Board, Singapore

The Dietary Guidelines for Adult Singaporeans was updated in 2003. The guidelines were first developed in 1988 and revised in 1993, and the latest revision was in 2003. The guidelines are intended for healthy adult Singaporeans between the age of 18 to 65 years and are meant to be applied to the total diet. They are not appropriate for assessing individual food items. Similarly, the guidelines are designed to be used as a complete set and individual guidelines should not be used in isolation.

1. Eat a Variety of Foods using the Healthy Diet Pyramid as a Guide.
No single food can supply all the nutrients in the amounts an individual needs each day. To get all the nutrients and other substances needed for optimal health, use the Healthy Diet Pyramid to guide food choices.

2. Achieve and Maintain Body Weight Within the Normal Range.
Use BMI and Waist Circumference to evaluate the normal range. Individual who need to lose weight have to make changes to their eating habits and amount of physical activity. A gradual weight loss is encouraged in overweight and obese individuals.

3. Eat Sufficient Amounts of Grains, especially Whole Grains.
Eat more grains which is the Rice and Alternatives Group in the Healthy Diet Pyramid. Grains provide carbohydrate (starch), dietary fibre, vitamins, minerals and phytochemicals that are important for good health. Whole grains are unpolished grains containing bran and germ, such as rolled oats, brown rice, whole flour and bread.

4. Eat More Fruit and Vegetables Every Day
Scientific studies show that a diet rich in fruit and vegetables can lower the risk of developing heart disease, stroke, and certain types of cancer by 20-30%. Vegetables and most fruit are fat-free, and they provide essential vitamins, minerals, phytochemicals (such as flavanoids and caretenoids) and dietary fibre (both soluble and insoluble fibres). thereby increasing vitamin A, vitamin C and fibre intakes.

5. Choose and Prepare Food with Less Fat, especially Saturated Fat
Dietary fat provides energy, contains essential fatty acids and acts as a carrier for fat- soluble vitamins A, D, E and K. We need some fat in the food we eat. However, fat is a concentrated source of energy - a diet high in fat can provide excess calories and lead to overweight and obesity. Aim for a diet low in saturated fat and high in unsaturated fats to reduce the risk of coronary heart disease and stroke.

6. Choose and Prepare Food with Less Salt and Sauces.
Table salt contains 40% sodium. Excessive sodium intake can affect blood pressure for people that are sensitive to it. Reduce intake of salt-preserved, cured and smoked foods to help reduce your cancer risk and reduce salt intake.

7. Choose Beverages and Food with Less Sugar.
Added sugar in beverages and food provide empty calories with little nutritional value. Excess energy intake beyond daily requirements can lead to weight gain and obesity. Frequently consuming sweet foods between meals can lead to dental decay, if oral hygiene is neglected.

8. If You Drink Alcoholic Beverages, Do So in Moderation.
Alcoholic beverages supply calories, but provide little or no nutrients. Drinking alcohol excessively is also the cause of health problems such as liver and pancreas damage, hypertension and certain cancers. Excessive alcohol consumption also alters judgement and may cause motor and industrial accidents, as well as social and psychological problems. It can also lead to dependency and addiction.

Source:
Dietary Guidelines 2003: For Adult Singaporeans (18 - 65 years) - Health Promotion Board, Singapore


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Food-based Dietry Guidelines for Adults

Dietary guidelines are crucial in helping people to adopt healthier food consumption habits. In Singapore, the dietary guidelines were first developed in 1990, and revised in 1993. A new set was then released in 2003, which reflected a shift from nutrient-based to food-based recommendations. This was in line with the increasing recognition that food provide not only nutrients, but also other non-nutrient compounds (e.g. phytochemicals such as lycopene, isoflavones, lutein) which appear to be protective against chronic diseases.

The 2003 dietary guidelines are currently being revised. The evidence reviewed will be graded according to the Scottish Intercollegiate Guidelines Network (SIGN) system of grading evidence, which is also used by the Clinical Practice Guidelines (CPG) working groups in Singapore.

The 8 Dietary Guidelines for Adult Singaporeans (18 to 69 years) are as follow:

Enjoy a variety of food using the Healthy Diet Pyramid as a guide


People who have a varied diet, i.e. those who eat from all four food groups and have different types of food from each food group, are more likely to meet their nutrient requirements. The food items chosen should be low in fat, especially saturated fat; low in salt and added sugar. Read about the Healthy Diet Pyramid and its recommendations.

An area of focus under this guideline is on calcium intake. Calcium is vital for maintaining bone health and reducing the risk of osteoporosis. For adolescents and adults up to the age of 30 years, an adequate intake of calcium is one of several factors that have been associated with maximal accumulation of bone mass. Individuals attain their peak (maximal) bone mass before the age of 30 years, after which bone mass gradually declines; though continued consumption of calcium-rich foods can help prevent bone loss.

Milk and dairy products are the best sources of calcium. Other good sources include dark green leafy vegetables (e.g. kai lan, chye sim), fish with edible bones, calcium-fortified products (e.g. calcium-fortified soybean milk and cereals) and tofu (which is set with calcium).

Achieve and maintain body weight within the normal range


Body weight maintenance is achieved by balancing energy intake (e.g. in the form of calories from food) and energy output (e.g. physical activity). When more energy is consumed than expended, weight gain occurs. If a person consistently consumes more energy than they expend over a period of time, they are at risk of being overweight or obese.

A person’s Body Mass Index (BMI) can be used to assess their risk of developing chronic diseases. BMI uses the height and weight of an individual to estimate his or her total body fat. Singaporeans have been found to at risk of developing cardiovascular disease and diabetes at BMI values of 23 kg/m2 and above.

BMI (kg/m2) (for adults) Risk of heart disease, etc
27.5 and above High risk
23.0-27.4 Moderate risk
18.5-22.9 Low risk (healthy range)
<18.5 Risk of nutritional deficiency diseases and osteoporosis

Eat sufficient amount of grains, especially whole grains


At least one serving of rice & alternatives should come from wholegrain food as they contain both the bran (which is high in B-vitamins) and germ (which is rich in Vitamin E & phytochemicals). Refined grains only contain the endosperm (the bran and germ is removed during the milling process) and do not contain as many nutrients or fibre compared to wholegrain foods. Examples of wholegrain food include oats, brown rice and wholemeal/whole wheat versions of noodles, bread and breakfast cereals.
Whole Grains
People who have a diet rich in whole-grains have a lower risk of cardiovascular diseases and Type 2 Diabetes. There is also evidence to suggest that people whose diet is rich in whole-grains have a reduced risk of colorectal and oesophageal cancers. Including whole-grain foods in your diet may assist in weight loss too, although more studies are needed to confirm these findings.

Eat more fruit and vegetables every day


Individuals should aim to eat at least 2 servings of fruit and 2 servings of vegetables every day.

For vegetables, this includes all vegetables fresh, frozen and well-drained canned vegetables, except tubers (e.g. potatoes, yam) and legumes (e.g. beans, lentils). Tubers belong to the Rice & Alternatives food group due to its high starch content, and legumes belong to the Meat & Alternatives food group as they are good sources of protein. For fruit, this includes fresh, frozen, well-drained canned or dried fruit or pure (100%) fruit juice with no added sugar.

A diet rich in fruit and vegetables is associated with a reduced risk of coronary heart disease and stroke. Fruit and vegetables may also protect against cancers of the mouth, pharynx, larynx, esophagus, stomach and lung (fruit only). In addition, fruit and vegetables may be a useful component of programmes designed to achieve and sustain weight loss.

Choose and prepare food with less fat, especially saturated fat


Fat is needed for certain metabolic functions in the body. However, it is also a concentrated source of energy and a diet high in fat can provide excess calories, increasing the risk of overweight and obesity.

Total fat should be limited to 25-30% of total calorie intake, of which less than 10% is from saturated fat. The balance should come from mono- and polyunsaturated fats. Sources of saturated fat include fatty cuts of meat, high-fat dairy products, food made with coconut milk and also food prepared with palm-based vegetable oil. A high intake of saturated fat is linked to an increased risk of cardiovascular diseases.

In addition, there is limited, but suggestive evidence that total fat intake is associated with cancer of the lung and the breast (postmenopausal women only).

Choose and prepare food with less salt and sauces


Salt is one of the main sources of sodium in the diet. The average intake of salt of an average adult in Singapore is 9g per day, which is more than the recommended 5g per day. Studies continue to show that blood pressure can be lowered when intake of salt is reduced to less than 5g per day. Other sources of sodium include sauces, monosodium glutamate (MSG), preservatives and salt substitutes. There is good evidence to show that reducing sodium intake from salt and other sources is able to lower blood pressure in both healthy individuals and individuals with high blood pressure.

An excessive consumption of salt-preserved, cured or smoked food has also been associated with higher risk of stomach and nasopharyngeal cancers. The higher risk is attributed to salt and sodium nitrates commonly used as preservatives in these products.

Choose beverages and food with less sugar


Beverages and food with added sugar usually provide empty calories. Added sugar refers to sugar that is added to food or drinks during manufacturing, cooking or at the table. Excessive consumption of beverages and food high in added sugar can contribute considerably to energy intake and may lead to weight gain if the excess calories are not expended. In addition, these items may displace other more nutritious food in the diet.

Added sugar should contribute to no more than 10% of dietary energy. This translates to approximately 40 – 55g (8-11 tsp) daily. This limit includes sugar added to beverages as well as food such as cakes and candies.

If you drink alcoholic beverages, do so in moderation


Individuals who choose to drink should have no more than 2 standard drinks a day for a woman, and no more than 3 drinks a day for a man. One standard drink contains 10g of pure alcohol and is equivalent to can of beer (220ml), 1 glass of wine (100ml), or 1 nip (30ml) of spirits. People who consume more than the recommended amounts should gradually cut down on their intake.

Studies show that drinking in moderation may protect against heart disease in middle-aged men. But due to the harmful health and social consequences of excessive alcohol consumption, adults who do not drink alcoholic beverages should not be encouraged to start.


Source: Health Promotion Board, Singapore