I am happy to be here this morning to officiate at the opening of the Symposium on Nutrition and Healthy Ageing in Asia

Food plays an important part in our life. It is not only a physical need, providing us with nourishment. Eating is also a social activity which helps bond relationships as we eat together. Sometimes we take eating so much for granted that we forget the impact of what we eat on our health.

We are what we eat. Food choices have an impact on our nutritional status. Recent evidence points towards unhealthy diet as a risk factor for chronic diseases e.g. heart disease, stroke, hypertension and diabetes mellitus. These diseases are now the leading causes of death in many of the Asian countries. Conversely, not getting enough nutrients like calcium and iron makes us more likely to suffer diseases related to them such as bone fractures from osteoporosis and iron deficiency anaemia, respectively. Hence, proper and adequate nutrition is important, especially in an ageing population.

The improvement in the Asian standard of living, with better nutrition and better health care, has led to a longer life-span. At the same time, the family size has become smaller. These changes occurring within a generation has resulted in our experiencing a rapidly ageing population.

Singapore is not spared this experience either. In 1970, the elderly or those over 65 years and above made up about 3% of the population. By 1998, this increased to 7%. It is expected that by the year 2030, the elderly will form 18% of the population. This is about one -fifth of the population. It will by then be comparable to that of the United States at 20% and the United Kingdom at 22%. But our Asian neighbours, Japan and Hong Kong will have even larger proportions of such elderly in their populations, at 26% and 28% respectively.

World Health Organization has defined active ageing as: (quote) ‘the capacity of people, as they grow older, to lead productive and healthy lives in their families, societies, and economics’.(unquote) One of the biggest challenges facing an ageing population is how best to prevent and postpone disease and disability; to maintain the health, independence and mobility of an ageing population. What can we do to prepare ourselves for these challenges? What should the average person do to meet them?

The answer to these questions lies in healthy and active ageing. Healthy and active ageing focuses on promoting optimal nutrition as well as physical and mental health of all older people. It ensures that the elderly remain physically and mentally active for as long as possible. It also enables them to continue to enjoy a longer lifespan. It delays the onset of chronic degenerative diseases associated with growing old. And healthy and active ageing will enable the elderly to be gainfully employed and thus continue to be contributing members of the economy and society.

The key to healthy and active ageing is adopting a healthy lifestyle from young. Healthy lifestyle habits are no secret. We are all familiar with them – regular exercise, a balanced diet, no smoking, moderate consumption of alcohol and having a good mental health. Of these, I feel food choices and physical activity influence our health more than anything else.

The American Surgeon General stated in his 1988 Report on Nutrition and Health: (quote) " For the two out of three adults (Americans) who do not smoke and do not drink excessively, one personal choice seems to influence long-term health prospects more than any other: What we eat. What some of us eat isn’t in tune with our personal health risks. So, sooner or later, we are in trouble. Because we live longer than our ancestors did, we must focus more on preventing nutrition related diseases." (unquote). However, food habits are difficult to change.

Singapore's Health Report Card points to this difficulty. Let's compare some of the findings of the 1998 National Health Survey to that of the 1992. The number of those who smoke has reduced and the number of Singaporeans who exercise regularly has increased. Smoking rates dropped from 18.3% to 15% while the exercise rates went up from 13.6% to 16.8%. But, the number of those with high total cholesterol has gone up. It increased from 19.4 % to 25.4%. And, this is in spite of ongoing health promotion on healthy eating. This is a challenge we have to address.

In Singapore, upon recognizing the impact of physical activity on the health of individuals and communities, is committed to promoting an active lifestyle for elderly through community groups.

Everyone has a stake in addressing proper nutrition in the ageing population – the professionals, the policymakers and even the layman.

The various segments of the population - the baby, the growing child, the expectant mother, - have differing nutritional needs. The elderly too have their special nutritional needs. Often their nutritional needs are related to many factors. Their decreasing physical activity, the presence of chronic diseases and the normal reduction in organ function associated with ageing, for example, loss of teeth and changes in the digestive system.

Although much has gone into the research of nutrition and ageing, more remains to be done. What is the Recommended Dietary Allowance for the Asian elderly? What is the efficacy of herbal preparations, the use of which has always been an integral part of the Asian culture? How does it affect the health of the elderly? Clearly, these are some of the areas that would require research. Looking through the symposium’s programme, I am happy to note that some of these issues will be discussed and debated over the next two days.

What about the policy makers? We recognise that a supportive environment is vital for behaviour change. Policies that emphasise personal responsibility for one’s health and programmes that emphasise health education, health promotion and disease prevention are crucial to successful healthy ageing.

One such programme is as our National Healthy Lifestyle Programme. Awareness of the different aspects of healthy living is raised and the public are taught skills to practice healthy living. For example, in the area of nutrition, the Department of Nutrition, Ministry of Health has developed resource materials to inform on the what, why and how of healthy dietary practices. Collaborations with various sectors of the food industry has led to the increasing availability of healthier food and menu choices. While these measures are at best general, they will have an impact on the health of the ageing population in years to come.

For a more comprehensive coverage of elderly needs, the government has set up an Inter-Ministerial Committee (IMC) on Health Care for the Elderly to address these needs over the next 5 to 10 years. The aim is to integrate the needs of the older people in terms of housing, financing, employment, social integration and health care delivery.

The societal fabric in many Asian countries has also changed. The elderly of tomorrow will be very different from the elderly of today. The majority will be women since women have a longer life expectancy than men. The elderly will be more dependent on themselves and the community for support particularly with the erosion of extended family structure. At the end of the day, good nutrition will help the elderly delay premature disability, and remain physically active and independent for as long as possible.

I would like to congratulate the International Life Sciences Institute and the Department of Nutrition, Ministry of Health for the timely organisation of this symposium to address the issues related to nutrition and physical activity in the ageing population. I wish all participants, both local and overseas, a very stimulating and fruitful meeting.

It now gives me great pleasure to declare the Symposium on Nutrition and Healthy Ageing in Asia open.

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