| Danial Norjidi |
BRUNEIANS eat not only too much but also too much of wrong foods – that is the problem with their current diet.
They consume too much sugar and starchy carbohydrates. Just by reducing their amount, we can live healthier lives, said Dr Justin Wong Yun Yaw, Medical Superintendent of Public Health, in a recent interview with the Borneo Bulletin.
If this trend continues, Brunei’s next generation may have a shorter life expectancy than the current generation, he added.
Towards realising its vision of ‘Together towards a Healthy Nation’, the Ministry of Health (MoH) has highlighted the importance of instilling a culture of health and encouraging people to make healthy choices naturally. Developing a culture of health is one of the ministry’s big challenges and goals, Dr Justin noted.
He explained that having a culture of health means that making healthy choices is not just a chore that people do, but becomes a default option – people do it naturally.
As an example, he said that not many people view a trip to the supermarket as a matter of making a healthy choice, but he affirmed that, in reality, every food item you pick contributes to your overall health status.
Having a culture of health means that it becomes a norm for people to think about what they should do, what they should eat, when they should exercise etc – that this is incorporated in default into people’s everyday lives.
“So when we talk about culture, what we mean is three things really: It’s people’s knowledge and beliefs; their attitudes towards health; and their health practices.”
He noted that while it can be difficult for an individual to change his or her complete behaviour, “if you have a community surrounding you and supporting you, and you go through it together, then it becomes different. That’s what we mean by culture – where everyone believes and practices these kinds of beliefs. Not just individuals at a shop, but perhaps the shopkeeper as well. Even the producers of the foods will know about healthy foods. And when you go to a restaurant, it’s about healthy choices being available.”
“So it’s not just individual choice which matters for health outcomes, but it becomes shaping of the social environment determinants, the social cultural determinants that make up individual choice,” he continued. “Choice itself is not simply a standalone thing that people decide to do or other. It’s based on the options you have available to you, it’s based on what you’re used to and your knowledge, etc.
“So when we talk about building up a culture of health, it’s about ensuring that the healthy choice is the default choice – it’s the easy choice to make.”
On what it means to eat healthily, he said, “50 per cent of our diet should comprise of fruits and vegetables, with a quarter of lean protein and a quarter of carbohydrates. In a nutshell, that’s what a healthy plate looks.
The Ministry of Health (MoH) places great importance on instilling a culture of health and encouraging people to make healthy choices naturally. – MINISTRY OF HEALTH
“The problem with our diet currently, as it stands, is that we eat too much and we eat too much of the wrong things. So what are some of the wrong things? The major one is sugar, actually. Sugar plays a very strong determinant towards leading us to a healthy diet. If you think about it, one can of soft drink or even just a 3-in-1 packet of hot drink will actually contain more than our daily need for sugar. We call it our recommended daily allowance. It contains more than that already.
“So we consume far too much of it, and just by reducing the amount of sugar we consume, we can live healthier lives. So we’re not asking people to cut out sugar completely. Sugar is tasty and it makes food taste better, but it’s about being aware of how much sugar you’re putting in, being aware of what the safe limits are and when people are trying, for example, to lose weight, sugar is a major issue and hindrance to that.
“The second thing that we probably need to touch on as well is carbohydrates. We eat too many starchy carbohydrates. If you look at a typical plate in Brunei, you see not too many fruits and vegetables, a little bit of protein and quite a lot of carbs – so a big plate of noodles or rice. Carbohydrates are good, they’re essential for everyday consumption, but by and large we eat far too much of it.
“So we’re not just eating too much as a whole, we’re eating too much of the wrong kinds of things. What we’re not eating enough of is fruits and vegetables. Only eight per cent of people in Brunei consume five portions of fruits and vegetables a day. It should be 100 per cent, not eight per cent. And it’s worse in children – two per cent of them consume five portions of fruits and vegetables a day.
“So if this trend continues, then what we will see is the next generation may well have a shorter life expectancy than the current generation.”
The official highlighted that, with regard to being healthy, people aren’t lacking in knowledge in Brunei. “Knowledge and awareness-building is not so much an issue. Actually most people know that they should probably eat more vegetables. They know that they shouldn’t eat so much sugar, that maybe they should try and avoid sugary soft drinks. People know that. It’s the ready availability of some of these foods. We’re not saying limit the choices, we’re saying provide healthier choices.
“For example, it can be two kinds of teh tarik – it can be the regular kind or it can be the unsweetened kind. That’s not something where we say the choices are limited. In fact it’s providing more choices.
“In our surveys, most people want to live healthier lives, but they’re hindered by a lack of choices and lack of affordability, so one of our strategic priorities is working with the private sector to try and encourage them and build up a competitive advantage for them, in terms of offering healthier choices for individuals.”
On whether eating healthy costs more, he said, “This is a belief that is quite pervasive and quite common. So we have gone out to the districts, and one of the things is always about why does healthier food cost more? I think it’s about choosing what kind of food. So if you go to high-end restaurants, some of which choose to serve healthier food, of course it will cost more. But there is a lot of food available in Brunei that actually cost an equivalent amount to the less healthy options.
“So for example, if you go to the tamu, you can buy lots of fresh vegetables for a dollar. That’s not out of the price range for a lot of people.
“But we do want to make this point as well: In terms of healthier options, when speaking to private companies, one of the reasons why healthier food costs more is because it costs more to import, and because not a lot of people buy the product.
“So, if you increase the demand for the product, and then you can generate more sales and revenue, and then your profit margin doesn’t necessarily have to be as high for each particular product.
“Essentially, it’s a catch-22. People don’t want to buy it because it costs too much, but also it costs too much because not many people buy it.
“But actually, if you think about the locally produced foods that we already have, and this is part of the culture of health as well, it’s not just about finding food or whatever that’s trendy – so it’s not about eating kale, for example – but it’s about being sustainable.”
He also noted the carbon footprint of food, saying that when things are grown locally and don’t have a lot of carbon associated from import and shipment, they are probably better for the environment.
“I think this also ties in with the government’s broader agenda of supporting micro, small and medium enterprises (MSMEs),” he said.
“Local MSMEs need to understand an advantage here for them. For example, if they keep providing nasi katok, and their only provision is nasi katok, people do want healthier choices, so if they can provide a healthier choice of particular boxed lunches or dinners, then actually they may stand to gain a competitive advantage over and above the other people in the market.
“How many people are doing healthier options of nasi katok, and at affordable cost? It’s not out of the question. There is a competitive advantage available for local businesses, particularly food industry, to try and develop along these lines.
“Cost plays a big determinant in what we buy, and it can be a driver or a motivator for purchasing certain products above others,” he said, sharing an example that if someone was at a supermarket and saw a soda selling for 20 cents more than diet soda, it would play into that person’s decision-making process.
On whether the ministry is looking into raising awareness on how to cook healthy food, he said, “We’re working with the food industry first, and then we want to engage the people who provide weight-loss services and help them see how their services can be expanded in other directions.”
He added that concrete plans are in place for an initiative to teach people how to cook healthily with local and affordable ingredients. This is an initiative of the Ministry of Health.
Dr Justin also noted that the MoH recently launched its healthier choice initiative, which involves restaurants, food industry, manufacturers and retailers. Under this initiative, the ministry has a logo that they can put on certain products that meet their nutrient guidelines. This is so that when people go to the shop they don’t have to read the label in terms of what the salt and sugar content etc are, but instead see a logo that marks a product as a healthier choice that’s endorsed by the Ministry of Health.
“We want to make it easier for people and more visible for people so that they can easily choose the healthier options that they want, because they are out there,” he said.
He also noted, in terms of physical activity, the introduction of Bandarku Ceria, Bangarku Ceria, Kuala Belaitku Ceria and Tutongku Ceria.
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