The Singapore Healthy Diet. Blue Zones Eating in Practice.
- Alastair Hunt
- Nov 3, 2023
- 6 min read
Updated: Apr 15
A 2018 study, by a team from the National University of Singapore, researched the eating practices of Singaporeans from Chinese, Indian, and Malay ethnic backgrounds. The study sheds light on what a healthy diet might look like across three major Asian ethnic groups - Chinese, Malay, and Indian.
Drawing from the food habits of over 8,000 people, researchers identified a dietary pattern that not only mirrored established healthy diets like the Mediterranean and DASH diets, but also showed promising links to better heart health.
As ever, please talk to your doctor or medical practitioner most familiar with your medical history before implementing any changes in diet, exercise or lifestyle, especially if you are under treatment. Links to all studies at bottom of page.
What Makes Up This "Healthy" Asian Diet?
The “healthy” dietary pattern identified in the study was surprisingly consistent across all three ethnic groups, despite cultural differences in cuisine. It was marked by:
High consumption of:
Fresh fruit and vegetables
Wholegrain products like brown rice and wholemeal bread
Dairy items such as milk or yoghurt
Unsaturated oils used in cooking (e.g., sunflower or canola oil)
Low consumption of:
Western-style fast foods (e.g., fried chicken, burgers)
Sugar-sweetened drinks (e.g., soft drinks, packet teas)
Processed meats (e.g., sausages, luncheon meat)
Flavoured rice dishes (e.g., nasi lemak, briyani with added fats)
This reflects a shift towards more fibre-rich, nutrient-dense meals and a conscious reduction in refined carbs and saturated fats.
The Heart Health Benefits: By the Numbers
Participants who more closely followed this eating pattern experienced measurable improvements in several heart health markers:
BMI (body mass index) dropped by 0.26 kg/m², or about 1% lower weight per standard dietary improvement.
Waist circumference shrank by 0.6 cm, a sign of reduced abdominal fat.
Total cholesterol and LDL ("bad") cholesterol fell by about 1 to 2%, while HDL ("good") cholesterol slightly increased.
Triglycerides, another blood fat linked to heart risk, also saw a modest reduction. While these percentages might seem small, they’re significant when scaled across a population - and they occurred even after adjusting for age, gender, exercise and income.
Turning These Findings into Local Food Choices
You don’t need to reinvent your diet from scratch to eat this way. Many traditional Asian dishes already include heart-friendly ingredients—it’s about how often we choose them, how they’re cooked, and what we pair them with.
Here are some practical, culturally specific swaps and tips:
For Chinese diets:
Replace white rice with brown rice or mix the two for gradual adjustment.
Choose vegetable stir-fries cooked with less oil or unsaturated oils instead of deep-fried dishes.
Opt for steamed tofu with vegetables, or soups like lotus root with peanuts, instead of fatty meats.
Snack on fresh fruit rather than sugary pastries or bubble tea.
For Malay diets:
Try grilled ikan bakar instead of fried fish.
Choose sayur lodeh with light coconut milk or use a smaller portion.
Swap nasi lemak rice (cooked with coconut milk) for plain or lightly seasoned rice.
Drink unsweetened tea or infused water instead of teh tarik or syrup drinks.
For Indian diets:
Choose roti made with wholemeal flour (atta) over refined-flour naan.
Make dals (lentil stews) with less ghee and add vegetables like spinach or okra.
Opt for grilled tandoori items over creamy curries.
Include yoghurt (plain, low-fat) with meals to support digestion and add calcium.
These suggestions keep cultural identity intact while nudging the diet in a healthier direction.
Why Not Just Follow the Mediterranean Diet?
That’s a common question - and the answer is twofold. First, cultural compatibility matters. People are more likely to stick to changes when the food feels familiar and enjoyable. Second, the study found that the Singapore-derived “healthy” diet had just as strong, and sometimes stronger, associations with heart health than global gold-standard diets like DASH or the Mediterranean diet. This suggests that culturally adapted eating patterns are not only more sustainable, but also effective.
Challenges and Nuances
The study did find some variation in how different ethnic groups responded. For instance:
Chinese and Indian participants showed clearer benefits in weight and cholesterol reduction.
Malay participants saw smaller improvements in weight metrics, possibly due to cooking methods or ingredient choices.
Indian participants had lower HDL cholesterol despite healthier eating—raising questions about how different bodies process food.
This reminds us that even the best dietary advice isn’t one-size-fits-all. Food preparation methods, portion sizes, and individual biology all play a role.
Final Thoughts
This research offers a hopeful message: a heart-healthy diet doesn’t have to mean adopting Western eating habits. Many people in Asia are already eating in ways that protect their heart - perhaps without even knowing it. Emphasising whole grains, fresh produce, unsaturated oils, and moderation in processed and sugary foods is a strategy that transcends borders.
By making small but consistent choices - like choosing wholemeal noodles, adding a side of stir-fried greens, or drinking water instead of sweetened drinks—you’re already moving in the right direction. And the best part? You don’t need to give up your cultural favourites to do it.
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Stay Healthy,
Alastair
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Related Studies
The study in question:
Whitton C, Rebello SA, Lee J, Tai ES, van Dam RM. A Healthy Asian A Posteriori Dietary Pattern Correlates with A Priori Dietary Patterns and Is Associated with Cardiovascular Disease Risk Factors in a Multiethnic Asian Population. J Nutr. 2018 Apr 1;148(4):616-623. doi: 10.1093/jn/nxy016. PMID: 29659965.
Other
Temba GS, Pecht T, Kullaya VI, Vadaq N, Mosha MV, Ulas T, Kanungo S, van Emst L, Bonaguro L, Schulte-Schrepping J, Mafuru E, Lionetti P, Mhlanga MM, van der Ven AJ, Cavalieri D, Joosten LAB, Kavishe RA, Mmbaga BT, Schultze JL, Netea MG, de Mast Q. Immune and metabolic effects of African heritage diets versus Western diets in men: a randomized controlled trial. Nat Med. 2025 Apr 3. doi: 10.1038/s41591-025-03602-0. Epub ahead of print. PMID: 40181181.
Cordova R, Viallon V, Fontvieille E, Peruchet-Noray L, Jansana A, Wagner KH, Kyrø C, Tjønneland A, Katzke V, Bajracharya R, Schulze MB, Masala G, Sieri S, Panico S, Ricceri F, Tumino R, Boer JMA, Verschuren WMM, van der Schouw YT, Jakszyn P, Redondo-Sánchez D, Amiano P, Huerta JM, Guevara M, Borné Y, Sonestedt E, Tsilidis KK, Millett C, Heath AK, Aglago EK, Aune D, Gunter MJ, Ferrari P, Huybrechts I, Freisling H. Consumption of ultra-processed foods and risk of multimorbidity of cancer and cardiometabolic diseases: a multinational cohort study. Lancet Reg Health Eur. 2023 Nov 14;35:100771. doi: 10.1016/j.lanepe.2023.100771. PMID: 38115963; PMCID: PMC10730313.
Lăcătușu CM, Grigorescu ED, Floria M, Onofriescu A, Mihai BM. The Mediterranean Diet: From an Environment-Driven Food Culture to an Emerging Medical Prescription. Int J Environ Res Public Health. 2019 Mar 15;16(6):942. doi: 10.3390/ijerph16060942. PMID: 30875998; PMCID: PMC6466433.
Buettner D, Skemp S. Blue Zones: Lessons From the World's Longest Lived. Am J Lifestyle Med. 2016 Jul 7;10(5):318-321. doi: 10.1177/1559827616637066. PMID: 30202288; PMCID: PMC6125071.
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