As the old adage says, 'you are what you eat'. If that be the case, the people of Hong Kong do not have a clue what they are. Andrea Yu reports.

That ignorance can prove fatal. Careless eating habits place Hong Kong people at greater risk for developing diabetes, heart disease, high blood pressure, joint problems and even cancer.

Most of these ailments arise from what many consider to be the most worrying outcome of careless eating - getting fat. Nearly four of ten Hong Kong people are overweight. The numbers are likely to get worse unless people learn to pay more attention to what they're putting in their mouths. The problem is that eating a nutritious diet is not a high priority for most people here.

"Nutrition education in Hong Kong is not as mature as in other countries," says Sylvia Lam. In her role as the chair of the Hong Kong Dietitians Association, Lam does her best to try to improve nutritional awareness and educate people on how to cultivate a healthier lifestyle.

It doesn't help either that long working hours and cramped living and cooking quarters in Hong Kong also make it difficult for families to prepare regular and nutritious meals at home. They depend on restaurant meals and pre-packaged foods. Professor Albert Lee, director of the Centre for Health Education and Health Promotion at the Chinese University of Hong Kong, cites the dislike for cooking at home as a major contributor to obesity in Hong Kong.

"We need to emphasize that home-cooked meals are not only part of healthy eating, but are also part of family life," he says.

People here can't be bothered reading nutrition labels on food packaging. The Coca Cola Company commissioned a survey by the University of Hong Kong's Public Opinion Programme (HKU POP). Only 13 percent of the people who answered the questions said they read nutrition labels.

One, (and only one) actually could recite the components, listed on nutrition labels: energy, and seven nutrients - protein, total fat, saturated fat, trans fat, carbohydrates, sugars and sodium.

Western countries have had nutrition labelling for a long time.

Hong Kong didn't start mandatory labelling until July 2010. And while local experts find the endeavor commendable, they all agree the city has a long way to go before it can boast a population that eats "smart."

"The percentage of people reading nutrition labels is not the majority as (nutrition labeling) is just being launched," says Lam. She says that labelling is an important tool for guiding people toward balanced eating. Even then, if people did read the nutrition labels, most don't have a clue how to interpret them.

Wong Chi Hung, 46, is not greatly concerned about nutrtion. "I never read nutrition labels when buying food in the supermarket," he says. "I rely on advertisements or what my friends say is good to eat," says Wong, when explaining how he decides what foods to buy.

Wong admits that his wife does most of the shopping and cooking for the household, which includes their 12-year-old son. But Wong says that he isn't worried about what his son might eat at school.

While the HKU POP's survey sampled individuals aged 12 to 49, a recent study conducted by the Centre for Health Education and Health Promotion at the Chinese University of Hong Kong found that unhealthy eating habits begin much earlier than age 12.

The center interviewed parents of kindergarten students, (aged 2-7) about their children's eating habits. Statistics from the Department of Health already indicate that one in five children are overweight, but the center's study revealed that nearly half of parents identified their children as being picky eaters, preferring "tasty food" offering little nutritional value. The study found that only 12 percent of kindergarten-aged children consume the full recommended daily intake of fruits and vegetables. In contrast, almost 70 percent of children met the requirement for grains.

Professor Lee, the center director, said he wasn't surprised by the findings.

"It confirms that we've got to do something about this much earlier in life," Professor Lee said. He also indentifies one particularly harmful tactic adopted by many Hong Kong parents.

"They give candies or unhealthy drinks to their children as a way to calm their emotions when they are crying or screaming," he says. "Or, for example, if they get up late for school and don't want to go, their parents will use food as an incentive. By getting up late, (the child) gets the reward of a candy. In this way, parents are reinforcing unhealthy eating."

As children will mimic the habits of their parents, Sylvia Lam says that parents should be taking the first step by practising a healthy lifestyle themselves.

"Often when you see obese children, their parents are overweight as well," says Lam. "We see this in clinical settings and I get quite frustrated with parents blaming their kids for eating bad foods. But, guess who is giving them the money to buy these foods?"

The good news is that both Lam and Professor Lee agree that there's plenty of opportunity for improvement. They have highlighted ways in which the government could help to improve public health on a large scale. At the same time, they have identified healthy eating habits that families can practice at home.

"I think ECE (Early Childhood Education) centers could do a lot more to improve eating behaviours," suggests Professor Lee, since ECEs have greater flexibility in their schedules without mandatory examinations.

"The schools themselves are wiling to do more and are keen to do more," he says, "but they need to be given more support, more resources and more training." Professor Lee says that a main component of ECE education should be teaching children how to lead healthy lives.

Sylvia Lam says more screening programs will help to shift the focus from secondary prevention to primary prevention. This means identifying potential problems like obesity through early warning signs, such as unhealthy eating, before the situation goes out of control.

"Screening programs in the community help parents to know if their children are overweight," Lam says, promoting the spread of such programs. "The government has to have more initiative to help people maintain a healthy lifestyle."

Lam also reminds the public that sensible eating is only one part of a healthy way of life. According to the HKU POP's survey, 70 percent of respondents don't engage in enough aerobic exercise, and only 30 percent believe that diet and exercise are equally important for weight management.

"It's about having an overall healthy lifestyle, instead of just dieting," Lam says. "Even if we are eating more, or occasionally eating so-called bad foods, we can use exercise to burn it off."

Professor Lee says that parents should avoid using food as a reward or incentive. "Food is a daily event," he says. "We don't want to use it to reinforce certain behaviours."

When it comes to nutrition labelling, companies like Coca-Cola are taking steps to increase consumer awareness of their products. Coinciding with the HKU POP's survey, in the beginning of 2011, Coca-Cola launched a front-of-package labelling initiative for all of the company's products in Hong Kong.

"We are the first beverage company worldwide to make a global commitment to place energy information on the front of nearly all of our products and packaging worldwide by the end of 2011," says Karen So, General Manager of Coca-Cola China Limited for the Hong Kong and Macau Region.

"The front of package energy labelling represents another step in our aim to meet evolving consumer needs around portion control, weight management and lifestyle choices," So says.

Lam says that front-of-package labelling can help consumers make better nutritional choices. "If they don't have time to read the back of the package, or they don't understand what 1+7 is, (energy plus seven nutrients listed on the label) , they can just have a quick glance at the (front of the) package," she says.

Some people still find it difficult to interpret the meaning of nutritional information, according to Professor Lee. "They might read it, but they don't understand it," he says.

Professor Lee says that front-of-package labelling initiatives, or other methods to make nutritional content easier to understand, are just one part of a successful nutrition labelling scheme. He says that education of the public is essential alongside this. And eventually in the future, "summary statements" could be printed on packages which alert consumers to products with, high salt or fat content, for example.

"This type of labelling could also be encouragement for food manufacturers to make healthier food," Professor Lee says.

He recognizes that eating out is simply a way of life for many Hongkongers, but Professor Lee says that the public could even make healthier choices in restaurants. "They have to understand the content of the food," he says. "While it could be healthy food, the way (restaurants) have prepared it could make it less healthy."

Professor Lee recommends using a scheme, such as the food pyramid or traffic light system, to help the public make better food choices. "Red" items at the top of the pyramid should be eaten rarely, while those in the middle or labelled as "yellow" should be eaten in moderation. Finally, "green" food items at the bottom of the pyramid should be eaten often.

Lam says that education is just half the battle. While some people may have gained an understanding of nutrition and disease, actually putting that information into action is another story.

"In some cases, the knowledge is there, but practising it is another thing," says Lam. "That's the most difficult part."

(HK Edition 06/16/2011 page4)