Battling the Hong Kong bulge
We are Asia's biggest consumers of junk food, and a dietician is determined to see it doesn't become a fatal attraction
3 December 2005
South China Morning Post

WE ARE WHAT we eat and, unfortunately, we generally eat badly. Hong Kong excels at many things, but perhaps the most worrying of all is an apparently insatiable appetite for fast food.

According to a recent survey by market researchers AC Nielsen, we are Asia's biggest consumers of "junk" food, where 61 per cent of adults eat at fast-food restaurants weekly, and this is not only making us fat. It is also harming our health.

Laden with sugar and edible oils, fast food may be cheap and even tasty, but the payback penalties are dangerously high cholesterol levels clogging our arteries and reservoirs of fat leading to obesity.

Combined with an aversion to exercise, another of modern society's unfortunate traits, fast-food addiction can be a fatal attraction. Clogged arteries cause numerous degenerative diseases including diabetes, coronary heart disease and life-threatening heart attacks and strokes.

As a dietician, Ivan Chung is at the front-line of Hong Kong's fight against flab and all its potentially devastating consequences. In a perfectly healthy world, of course, we would not need dieticians or diets at all. But for as long we remain sedentary, fat-gorging sweet-toothed slobs, dietetics, as the science is known, continues to be what might be called a growth profession.

Mr Chung, who teaches at Polytechnic University and has practised as a dietician at private clinics and public hospitals as well as frequently lecturing us about our diets in the media, never set out to become an expert in the field.

Back in 1979, when he went to Australia to study a general science degree, majoring in biochemistry and physiology at the University of New South Wales, diet was not nearly as high on the public agenda as it is today.

"I was studying more out of interest in how living organisms work," he said. "They were paramedical studies, basic medical subjects. I had no plans to be a dietician."

He was not the first to study at university without stopping to think what career it might lead to. Neither will he be the last. "But as I neared the end of my degree, I realised it might be difficult to find a job back in Hong Kong with just a basic science degree," he said. "I decided I needed some professional training as well, to give me a bit more versatility when it came to a career."

He considered several other life sciences, including physiotherapy, occupational therapy and speech therapy. But many other graduates were also studying these at universities in Hong Kong.

"It occurred to me that I would still have to compete with local students for jobs, so I looked for a subject that was not available in Hong Kong at that time." What he picked was a postgraduate diploma in nutrition and dietetics, an 18-month programme at the University of Sydney incorporating a practical six-month clinical attachment in a hospital.

"Australians were far more concerned about diet than Hong Kong back then," he said.

It led to qualification as a dietician in 1985 with membership of the British Dietetic Association. On returning to Hong Kong, "I realised I had made the right choice. There were only about 50 or 60 dieticians so it was easy to find a job."

He worked in public hospitals for a few years, then in a private hospital, and finally as a sort of "freelance" dietician-nutritionist for the entire health sector.

Since 1989 he has been lecturing on the topic at PolyU, although only as part of the general studies curriculum. While diet has become more of a concern, he lamented that formal study opportunities in Hong Kong remain remarkably limited. Only one postgraduate degree is offered, the Master of Science in Human Nutrition and Dietetics, at the HKU School of Professional and Continuing Education (SPACE) in collaboration with the University of Ulster, with spaces only available for 30 or 40 graduates a year. But demand for professionals in the field has never been higher. "Life has changed a great deal in Hong Kong," Mr Chung said.

"People in Hong Kong are getting fatter and fatter. They eat unhealthy fast food to reward themselves for working hard and just sit in front of computers. They don't exercise. The more the economy improves, the more unhealthy their diets and lifestyles become.

"When I started in the profession, people did not start suffering degenerative diseases like diabetes, high blood pressure, high cholesterol and some cancers until their 30s. Now you see them in much younger people in their late 20s. These are diseases associated with worn-out bodies in old age, but victims are getting younger and younger."

Most alarming of all is that Hong Kong's childhood cholesterol level is second highest in the world. Over a fifth of children are obese by the age of 11.

It is a sorry legacy and Mr Chung places the blame firmly on fast food. When Hong Kong topped the global rankings in the AS Nielsen survey, it emerged that not only 61 per cent of the population eat takeaways at least once a week, many eat it more than once a day. In the United States, where obesity is prevalent, only 35 per cent eat takeaways at least once a week.

The problem is not just with fast food, Mr Chung said, but that it is eaten at the expense of dietary essentials like fibre and vitamins, found in grains, fruit and vegetables. Without fibre, the risk of gut cancer increases.

"Europeans get fibre from grain breads, breakfast cereals and salads, but these are not traditionally part of the Chinese diet," he said. On top of all the oil and salt, Chinese dishes also tend to get the vitamins cooked out of them in searing woks.

A major role of dieticians such as Mr Chung is therefore to try to alert and educate the public. "It's about educating the community," he said. "Victims of degenerative disease are more willing to follow strict diets, but by then it's a bit late. People have to understand that if they get fat, degenerative disease is just around the corner."

As society slowly does come to terms with the risks, demand for professional dieticians and nutritionists is rising, but at a private rather than public level. Slimming clinics are all the rage, yet there is no official organisation or body for dieticians or nutritionists in Hong Kong.

In its wisdom, the Hospital Authority even suspended a policy of hiring dietician graduates a few years ago. But the official tide is turning. The government has mounted an advertising campaign alerting the public to diet risks and Mr Chung is hopeful public hospitals will resume hiring young nutritionists and dieticians soon.

Adolescents warned as obesity soars
26 October 2006
Hong Kong Standard

A startling 42 percent of Hong Kong's adolescents are struggling with excessive body weight, high blood pressure and abnormal levels of blood fat, according to joint research by the Department of Health and the Chinese University of Hong Kong.

And, in a bid to reverse the rising obesity trend among adolescents aged between 11 and 18, the government has launched a series of initiatives within 140 primary schools across the territory to promote educational training for teachers on nutritional facts and healthy eating habits.

Juliana Chan Chung-ngor, professor of medicine and therapeutics at the Chinese University, who led the research, said the move was prompted by an alarming increase in the number of metabolic syndrome cases among obese adolescents.

``We realized that these children, in the prime of their lives, could be suffering from organ damage and major disabilities, when they could be contributing most to society,'' Chan said, warning that the onset of obesity and metabolic syndrome could impose a heavy burden on the health-care system.

The research found that more than 40 percent of adolescents had at least one risk factor for metabolic syndrome, while more than 2 percent had three risk factors or more.

According to the study, more than 35 percent of boys suffer from high blood pressure, while 29.5 percent of girls are affected.

``Boys also run a higher risk of getting cardiovascular diseases,'' Chan said.

Metabolic syndrome _ a condition usually associated with a higher risk of heart disease, stroke, kidney failure, diabetes and various forms of cancer _ has been found to be more prevalent among youngsters with family histories of obesity and diabetes.

Chan also said the relationship between the school environment and risks of metabolic syndrome largely reflects differences in socio-economic backgrounds.

Regina Ching Cheuk-tuen, assistant director of health promotion at the Centre for Health Protection, believes community effort is the key to tackling the issue.

``Although we're not competing against fast food restaurants, we find that when promoting health, we're forced to work against existing attitudes, especially with the growing fast food culture,'' Ching said, urging businesses and restaurants to join the campaign to promote healthier diets.

The Department of Health has created a thematic Web site where all members of the community, including parents, students, teachers and food traders, can log on for nutritional information as well as educational resources and guides.

According to Francis Chow Chun- chung, president of the Hong Kong Association for the Study of Obesity, adolescent obesity is a growing trend.

Although only 2-3 percent of obese adolescents suffer from metabolic syndrome, Chow claims Hong Kong is currently moving closely behind Western countries such as the United States, where 3-6 percent of obese adolescents are afflicted with the condition.

Chow describes the current situation of adolescent obesity as an ``accumulating bomb'' waiting to explode.

``We'll not be able to see the results of these initiatives until almost a decade or two after implementation,'' he said, suggesting that the current generation of obese youngsters aged 11 to 18 are already at high risk of cardiovascular diseases and organ damage.

``At present, cardiovascular diseases are the No1 killers in the entire world,'' said cardiologist Lau Yuk- kong of the Hong Kong College of Cardiology.

I can imagine this since I buy a whole lot of potato chips when I happen to be in the neighbourhood Park N Shop or Wellcome. And yes I always eat at Mc Donalds and ordering a Big Mac meal.

But I'm still medium build. We mostly walk around HK and I go to the gym, lift weights and so on.

Also, HKers walk alot, at least they get their exercise.

I can imagine this since I buy a whole lot of potato chips when I happen to be in the neighbourhood Park N Shop or Wellcome. And yes I always eat at Mc Donalds and ordering a Big Mac meal.

But I'm still medium build. We mostly walk around HK and I go to the gym, lift weights and so on.

Also, HKers walk alot, at least they get their exercise.

I do agree we walk a lot.

When I was in Hong Kong last summer, I ate 5 big meals a day and didn't gain any weight after three months. The walking just burnt out all those extra calories.

This is not a good thing for us skinny HKers. We eat so much *trying* to gain weight and we lose them so fast... ><

This is not a good thing for us skinny HKers. We eat so much *trying* to gain weight and we lose them so fast... ><

I'm much the same. If I eat a large amount of food, it all ends up in my stomach and no where else. It is quite hard for me to gain weight. I guess I have too much stress.

The bags of chips are much smaller in HK (ie. Calbee chips) than in North America.

I'm much the same. If I eat a large amount of food, it all ends up in my stomach and no where else. It is quite hard for me to gain weight. I guess I have too much stress.

The bags of chips are much smaller in HK (ie. Calbee chips) than in North America.

Sometimes, I even find those Calbees tastier than US chips with the exception of the Kettle Chips. If not Calbee, I get Walkers at the nearest Olivers.

Anyway, most HKers are skinny. To find an obese local is pretty rare.

Even McDonald's tastes better in HK than the US. Have anyone tried the rice burger? I didn't when I was there.

Even McDonald's tastes better in HK than the US. Have anyone tried the rice burger? I didn't when I was there.

I did, but I didn't like it. It taste really weird, I rather eat a real rice dish instead.

Even McDonald's tastes better in HK than the US. Have anyone tried the rice burger? I didn't when I was there.

Agree, everything is fresh while the ones in the US seems like they were made hours ago. Also, the price is cheaper in HK. The only thing I don't like is the cheapness of napkins, they give you like two or three while in the state you can get as much as you want.

I agree too. But portions at McD in HK are smaller. I'm used to American-sized foods.

I never got the chance to try the FANtastics

Anyone have a McChicken in Hong Kong? It has a different kind of meat thean the US kind.

Yea, I just remember that McDonalds in HK, there are some McCafe, a concept we havent seen here in the States yet.

Yea, I just remember that McDonalds in HK, there are some McCafe, a concept we havent seen here in the States yet.

Mc Cafe is very common in most Asian cities. And yes Mc Donalds taste much better in HK compared to other places. My favorite one is in Star House which is like a mini museum showing the history of Mc Donalds, etc.

McCafes are also common in Australia (well Melbourne anyway, I haven't been to the other cities to check) and I love how the interior has been changed. It no longer looks like a cheap fast food restaurant.

Maybe 'Super Size Me' should be compulsory viewing for all students? :)

McCafes are also common in Australia (well Melbourne anyway, I haven't been to the other cities to check) and I love how the interior has been changed. It no longer looks like a cheap fast food restaurant.

Maybe 'Super Size Me' should be compulsory viewing for all students? :)

I agree that the interior in alot of Mc Donalds has changed alot.

I don't find anything wrong with Mc Donalds but I think it's a problem for those who frequent this place and don't exercise.

There are a few McCafes in N. America. I saw one in Montreal once. What is a Rice burger?

There are a few McCafes in N. America. I saw one in Montreal once. What is a Rice burger?

Rice burger is just like any other hamburger except instead of bread, you have rice for a bun.

Honestly I don't really like those burgers. I prefer those with sesame seed bun :D

Trans fat concerns are close to legislators' hearts as ban is sought
Hong Kong Standard
Thursday, March 15, 2007

Lawmakers have passed a non-binding motion demanding a ban on trans fat - an artery-clogging substance usually found in snack and fried foods - in restaurants.

Limited levels of trans fat, however, will be permissible in imported and locally produced food, the motion said.

Trans fat, or trans fatty acid, is a type of unsaturated fat, a small amount of which can be found in meat and natural dairy products. Normal consumption poses no risks to humans. However, artificial trans fats used to make food tastier and for extended shelf life could clog up the cardiovascular system, research has shown.

Secretary for Health, Welfare and Food York Chow Yat-ngor told legislators Wednesday he had to consult the catering and food manufacturing industries before deciding whether to proceed with legislation.

"We need to study how trans fats are regulated among international regulators, and Hong Kong's own special food and people's consumption pattern before drafting the law," he said.

The Consumer Council revealed last month it had found 15 misleading food labels on bakery goods containing trans fat taken from local supermarkets and bread chains, but Chow said the Food Safety Centre is still studying whether there is enough evidence to prosecute them.

The council also warned that food containing artificial trans fat can significantly increase cholesterol levels and raise the risk of heart disease.

The motion, moved by Albert Cheng King-hon, was later amended by democrat Fred Li Wah-ming, who urged the government to mandate that trans fat be listed on food packaging.

"As many of us in Legco are suffering from cardiovascular diseases, I can't see why anyone would vote down this motion," Cheng said while kicking off the motion debate.

Presenting a pack of medium-sized fries from McDonald's, Li said it contained about 2.8 grams of trans fat, but nutritionists suggest no more than 2 grams of consumption per day.

Tommy Cheung Yu-yan, who represents the catering sector, said rather than rushing to regulate, it would be better to inform the public about trans fat.

U getting FAATTT!!!!! bwahahahahaha. Just stay away from McDonalds..and anything really to do with American Food.

U getting FAATTT!!!!! bwahahahahaha. Just stay away from McDonalds..and anything really to do with American Food.

I'm one of those who eat at Mc Donalds almost everyday :D But I'm not overweight since I walk alot.

I used to get a Big Mac meal supersized but now I get those Flatbread meals which is healthier.

Those from the US should try our Mc Donalds cause it taste good. Personally I think it taste better compared to those in the US.

Not looking overweight may not mean immunity to diabetes and cholesterol problems, among other health concerns due to a bad diet.

I'm one of those who eat at Mc Donalds almost everyday :D But I'm not overweight since I walk alot.

I used to get a Big Mac meal supersized but now I get those Flatbread meals which is healthier.

Those from the US should try our Mc Donalds cause it taste good. Personally I think it taste better compared to those in the US.

Don't forget the cheapness of HK "Mc Gei"... :lol:

Young fall prey to heart disease
4 June 2007
Hong Kong Standard

Coronary disease is on the rise in Hong Kong, and even people in their 20s or 30s are not immune.

Seto Ka-ming was in his mid-30s when doctors found that several of the major arteries in his heart were blocked.

Urging Hong Kongers to be careful with their health, he stressed the importance of prevention.

``In the past, I never did any exercise because I could not feel the joy of doing sport. For example, cycling meant I would feel pain,'' said Seto, 39.

Three years ago he discovered he had coronary heart disease although he had no history of heart trouble, and had to undergo balloon angioplasty.

``I was really frightened at the time. I felt a sense of helplessness,'' Seto said. ``After doctors told me not to smoke while I was still in bed in hospital, I decided to give it up once and for all.''

After being discharged from hospital, he took part in a rehabilitation program and found he had been indulging in many bad habits _ refusing to do exercise, eating greasy food, smoking, staying up late at night, and leading a stressful lifestyle.

But he soon changed, including doing regular exercise and taking pills on doctors' instructions.

Cardiologist Duncan Ho Hung-kwong warned that coronary heart disease is affecting more and more people in the territory. Last year, 6,300 angioplasties were performed _ a rise of 20 percent over 2004. The number is expected to climb by 10 to 15 percent this year.

Ho urged people to be aware that heart disease is a silent killer. He said angioplasty _ a technique to halt the narrowing of an artery without surgery _ is becoming more common among people in their 20s. Earlier onset of diabetes, more cases of hypercholesterolemia among children and teenagers, and an unhealthy lifestyle are to blame.

Hong Kong Baptist Hospital consultant cardiologist Kenneth Lam Ka-hing urged men and women in the 35-40 and 40-45 age brackets to seek regular body check ups.

Past decade saw rise in obesity in children
5 July 2007
South China Morning Post

More schoolchildren have become obese over the past decade, the health minister announced yesterday.

But the rate of diabetes and high blood pressure - conditions usually associated with excessive weight - had not increased, York Chow Yat-ngok said.

About 18 per cent of primary and secondary school pupils were obese last year, up from 16 per cent in 1997.

But the percentage of children suffering high blood pressure dropped, with 1.7 per cent of them affected by the disease last year, down from 2.8 per cent in 2004.

Speaking at a Legislative Council meeting, Dr Chow said there was no evidence to suggest that chronic diseases such as diabetes, heart disease and high blood pressure had been affecting people at a younger age.

But since obesity could lead to other complications and chronic illness in the long run, the government would closely monitor the health of obese children.

"The Student Health Service has tested the sugar level in urine of obese schoolchildren since the 2004-05 school year, and children who test positive will be referred to paediatrics under the Hospital Authority for follow-up and check for diabetes," he said.

Dr Chow said the government had not conducted any comprehensive quantitative study to assess how suffering chronic diseases at a younger age had affected Hong Kong's productivity and medical expenditure. But he said they planned to look into individual diseases in a study that might take four or five years.

Asked if the government would look into offering tax discounts to people who take out medical insurance, Dr Chow said it was not being considered.

"The insurance packages available in the market normally do not cover the chronic diseases which we are discussing. In view of that, we will not consider [giving tax discounts to medical insurance purchasers]."

^^ We suffer the opposite tho, hkskyline...

School lunchbox offerings contain too much salt and too little calcium
Hong Kong Standard
Saturday, July 07, 2007

Hong Kong's primary school children are being fed lunchboxes containing too little calcium and too much salt, it was disclosed Friday.

Four months after primary schools were given guidelines on meals for children, the Department of Health and the Centre for Food Safety jointly conducted a nutrient study of lunchboxes in January.

A total of 78 lunch samples served to primary one to primary three students were collected from 23 primary schools.

The meals originated from 19 school lunch suppliers. It was found that 99 percent of the lunch samples contained far less calcium than the recommended intake of 267 milligrams per meal, while 99 percent contained sodium far in excess of the recommended level of 400mg per meal.

Senior medical officer Raymond Leung Wai-man said a lack of calcium could affect bone and tooth formation.

It is believed inadequate calcium intake during childhood is also a cause of osteoporosis in adulthood. An excessive intake of salt is a contributing factor of increased blood pressure, coronary heart disease and stroke. Leung believes lunchbox suppliers, schools and parents have a vital role to play in ensuring students are served nutritionally balanced lunchboxes.

He pointed out low-fat cooking methods such as steaming and stewing, together with fresh and natural ingredients, are the keys to a healthy and nutritionally balanced lunchbox.

"Practical training should be provided to chefs of the school lunchbox suppliers so that they can prepare meals according to the healthy food recipes we gave them," Leung said.

To guarantee a healthy diet for school children, lunchbox suppliers have been advised to serve sauce or gravy with high salt or fat content separately and sparingly.

An increased provision of fruit and vegetables is also suggested.

However, one big challenge for the lunchbox suppliers is the dilemma of providing healthy yet less tasty lunchboxes and receiving complaints from school children who refuse to eat the "tasteless" lunchboxes, the center's research officer Virginia Tao Wing-yan said.

To tackle this problem, Tao suggested healthier but flavorsome food choices including brown or red rice, calcium-fortified soy milk and dark green vegetables such as broccoli.

"Homemade fresh tomato sauce can be used instead of ketchup, while fresh curry powder mixed with low-fat milk can replace instant curry sauce with coconut milk to reduce the fat and salt consumed," Tao added.

Schools should join hands with parents to advocate a healthy eating environment and parents should observe healthy eating principles when preparing meals and snacks for their children, she said.

LCQ15: Childhood obesity
Wednesday, April 23, 2008
Government Press Release

Following is a question by the Hon Frederick Fung and a written reply by the Secretary for Food and Health, Dr York Chow, in the Legislative Council today (April 23):

Question:

Data from the Department of Health reveal that the obesity problem among primary school students is worsening, with the obesity rate increasing from 19.4% in 2005-2006 to 20.2% in 2006-2007. The causes can be attributed to such factors as children's life style and their eating habits, etc., which include their preference for foods that are high in fat, sugar or salt (generally referred to as "junk food"). Obesity not only affects children's physical and psychological development, but also increases their risk of developing a number of chronic diseases in the future, which in turn adds to the burden of health care on the community. In view of this, the authorities in the United Kingdom have, since last year, gradually imposed a ban on the broadcast of junk food advertisements during or soon before and after children's television (TV) programmes and programmes which are especially popular with children under 16. In this connection, will the Government inform this Council whether, apart from keeping up its efforts to promote EatSmart in schools, it will, following the practice in the United Kingdom, restrict the broadcast of junk food TV advertisements during children's programmes or family viewing time, and regulate the contents of such advertisements, so as to reduce children's access to information about such food, thereby promoting the development of healthy eating habits among children from childhood; if not, of the reasons for that?

Reply:

Madam President,

Generally speaking, childhood obesity is mainly attributable to two factors: first, unhealthy eating habits, such as high consumption of unhealthy foods (including foods high in fat, sugar, salt or low in nutrient levels) with low consumption of fruits and vegetables, and second, inadequate exercise. Both factors are closely related to the lifestyle of individuals. Hence, to effectively address obesity, we should start with changing our living habits.

Adopting and consolidating a healthy eating habit and performing regular exercise since childhood help prevent various diseases such as heart disease, diabetes, stroke and cancer. The most effective way to help children develop healthy living habits is by publicity and education. As such, the Government has been disseminating knowledge of healthy eating and benefits of exercise to school children through various channels. Apart from this, the Government also works with the community, schools, the trade and parents to create a favourable environment conducive to developing healthy lifestyle among children. The "EatSmart@school.hk" Campaign and the "Eatsmart@restaurant.hk" Campaign are two such examples.

Realising the influence of the mass media on children, the Department of Health has been disseminating information on healthy lifestyle through the mass media and different channels to the public. To tackle childhood obesity, we will continue with our publicity and educational efforts and strive to build a favourable environment to facilitate children to make healthy food choices and exercise. At this stage, the Government is open-minded about the regulation of food advertisements. We have to gather more evidence, draw on the practical experiences of other countries and places, and listen to the opinions of experts and the public.