Singaporeans exceed sodium and calorie limits despite exercise

Yong tau foo stuffed with fish paste can also be high in sodium, so Tan said it is about balancing these items with vegetables and plain tofu.

Even hydration habits can be misconstrued as healthy. Tan said that some people drink a bottle of isotonic drink or more after 30 to 45 minutes of brisk walking, line dancing or recreational cycling, but this is typically unnecessary and adds extra sodium and even calories.

The Health Promotion Board said soupy dishes are among the foods commonly consumed by residents with the highest sodium intake. Certain gravy-based dishes can also hide a lot of sodium. A bowl of mee siam contains 3,800mg of sodium today, up from 2,700mg in 2023, HPB said.

Ng Teng Fong General Hospital’s principal dietitian Lim Ruey Jiun said most people opt for clear soup-based meals as part of healthier eating. But soup can be high in sodium, especially when made with stock cubes, seasoning powders, sauces and processed ingredients.

One teaspoon of stock powder can add about 750mg of sodium, while one teaspoon of dark soya sauce can have 400mg of sodium, she said. A bowl of sliced fish noodle soup can have 1,400mg of sodium, so people should halve their sodium intake by drinking half the broth or leaving most of it behind, she said.

Also, watch out for the sodium content in these commonly consumed items: one cup noodle has about 1,900mg, one salted egg has 1,500mg and one tablespoon of ikan bilis has 450mg, Lim said.

Exercise cannot work in a vacuum

This disconnect extends beyond daily eating habits to how patients view chronic disease management.

At the National University Hospital, Tai E Shyong, a senior consultant at the Division of Endocrinology, said many patients refuse medication, telling him instead that they will just exercise.

“Patients often fall into the trap of thinking in silos, for example, believing that eating sugar is the only thing that causes diabetes, or that a high-salt diet is the only thing that causes high blood pressure,” said Tai.

But most conditions have multiple risk factors, and every choice interacts with bodies in different ways and across different time frames, he said. “People often underestimate the amount of lifestyle modification they make. They are consuming less sugar, but if their calories have gone up, they are not going to lose weight.”

Caloric excess can lead to obesity, which already affects 12.7% of residents aged 18 to 74, according to the 2024 National Population Health Survey, while rising sodium intake can cause even higher rates of hypertension.

“As blood pressure rises across the board, we will see a corresponding increase in severe, life-altering complications, specifically things like chronic kidney disease and strokes,” warned Tai.

In addition, while protein intake is largely adequate for the population, sarcopenia or age-related muscle loss remains a lingering concern among older adults.

According to the survey, half of those aged 50 to 69 still do not meet their daily protein target of 1.2g per kilogram of body weight.

Overestimating activity levels while overeating

Although total physical activity levels here – defined as participating in at least 150 minutes of moderate-intensity physical activity or 75 minutes of vigorous-intensity physical activity – are high on paper, it is unclear if they align with overall health.

Tai said there is evidence showing that when people self-report their activities in surveys – the National Population Health Survey was conducted via household interviews – they tend to over-report moderate- and high-intensity activity and under-report the total.

Much also depends on the type of exercise performed – active commuting may contribute to total physical activity but may not be sufficient to burn off excessive calories. “Walking to the bus stop, some people will say that is moderate intensity,” Tai said.

Meanwhile, Mary Chong, assistant dean of education at the NUS Saw Swee Hock School of Public Health, said that relatively new culinary options such as hotpots, mala tang and xiang guo have gained popularity here. As these dishes are heavily seasoned, their intense spicy or rich herbal profiles can often mask high sodium levels, she added.

Even trendy items commonly viewed as sweet snacks or desserts, such as salted caramel items and salted egg or spicy Korean snacks, contain sodium.

But as more people become more aware that high sodium intake can cause high blood pressure and other long-term health risks, they will actively ask for less salt, gravy or sauces, which would encourage more eateries to use less sodium in their cooking, Chong said.

The good news is that dietary tweaks are helpful. Research demonstrates a clear link between a low-sodium diet and better blood pressure control, which in turn protects kidney health and reduces the long-term risks associated with hypertension, Tan said.

“If someone’s salt intake is very high and the blood pressure is borderline high, I will typically say, short of adding more medicine, just by decreasing your sodium intake. I am very confident that the blood pressure will hit optimal control,” she added.