Updated: 4 days ago
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 identified a consistent 'healthy' dietary pattern that transcended ethnic distinctions.
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 any supporting studies or resources are at the end of page.
If you are unfamiliar with Singapore, this equatorial island nation is a densely populated city of around 6 million, 45km west to east and 25km north to south. The entire country, city-state, is smaller than London, Paris or Los Angeles. In summer of 2023 it was declared a modern Blue Zone version 2.
What did the NUS team find? The eating pattern was marked by high consumption of:
wholegrain breads and breakfast cereals
The diet was coupled with the use of unsaturated cooking oils and it involved low intake of sugar-sweetened beverages. (see link to study at the bottom of page)
This healthy dietary pattern demonstrated significant correlations with lower body mass index (BMI) and waist circumference. It was associated with reduced levels of LDL-cholesterol and triglycerides, independent of BMI and waist circumference. Remarkably, the strength of these associations rivalled or exceeded those observed from established dietary patterns like DASH, aMED (a dietary ranking that focuses on higher consumption of plant foods including plant proteins, monounsaturated fat, fish, and lower consumption of animal products and saturated fat) and aHEI-2010 (an index that assigns ratings to foods and nutrients predictive of chronic disease). Interestingly, the identical 'healthy' pattern emerged within each ethnic group, showcasing consistent preferences for each of the ingredients.
Around the world traditional eating patterns share similar features. Predominantly whole foods - plants - and less meat than might be expected.
Individuals with higher scores for the "healthy" pattern tended to be female, older, non-smokers, and exhibited elevated socioeconomic status and increased physical activity levels. Additionally, they reported higher intake of polyunsaturated fatty acids, fibre and essential micronutrients (such as calcium, vitamin A, and vitamin C), while having lower saturated fat and cholesterol intake. However, some intriguing questions remain regarding the absence of clear links with blood pressure and the observed ethnic disparities in the association of the "healthy" pattern with HDL-cholesterol concentrations.
Eating healthily, in modern city living, can be difficult. Weight loss can be a real challenge in Singapore, for many reasons, but far from impossible. Food is about taste and whilst the Mediterranean diet is much discussed and touted for its health, it is only relevant to certain elements of the Singapore (or any) community.
Enjoying healthy, tasty and culturally appropriate dishes is essential for older populations whose taste buds might be more attuned to traditional eating practices. Especially in light of our local war on diabetes. It is also a great way to encourage the younger generation to enjoy foods that are healthy and provide connection to tradition, community and taste!
A nutritionally dense diet and maintaining a healthy weight are cornerstones of physical health. To maximise long-term health outcomes cardiovascular exercise and strength training are vital, as is quality sleep. If you are in Singapore, the government has engineered fitness (at least the opportunity to be fit) into its very environment. Finally, let's not neglect our social health, a positive work-life balance and having a good circle of friends that can support you.
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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.
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.
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.