Elderly and Children Diagnosed with Illnesses and Health Conditions Due to Malnutrition in Recent Years

Dr Chia Shi-Lu asked the Minister for Health how many vulnerable persons, particularly the elderly and children below 18 years of age, have been diagnosed with illnesses and health conditions due to malnutrition in the last five years and what measures are in place to assist them.

According to the 2017 Global Burden of Disease study, nutritional deficiencies such as protein-energy malnutrition, iodine, vitamin A and dietary iron deficiencies, accounted for less than 1% of the total disease burden in Singapore. Among Singaporeans less than 20 years of age, malnutrition accounted for about 4.5% of the disease burden in this age group. Based on data from health Promotion Board's (HPB) School Health Services in 2017, the prevalence of children in K1 and K2 who were underweight and severely underweight was 7.6%.

As for older Singaporeans, a National University of Singapore study published in 2017 estimated the prevalence of under-nutrition among Singaporeans aged 55 and older at 2.8%. A study published in 2018 by the Centre for Ageing Research and Education, Duke-NUS Medical School, found that the prevalence of underweight in a nationally representative cohort of over 4,500 Singaporean residents aged 60 and above was 6.6%.

MOH and HPB undertake efforts to encourage Singaporeans to eat healthily, such as raising the consumption of whole grains, fruits and vegetables, while reducing the in-take of trans fat, sugar and salt.

There are also specific efforts to address under-nutrition in children and seniors. For example, we have engaged maternity hospitals to implement WHO's Baby Friendly Hospital Initiative, which supports mothers in breastfeeding their infants as breast milk provides infants with all the essential nutrients for optimal growth and health. HPB has also introduced Healthy Meals programmes in pre-schools and mainstream schools. The programme enables children to have well-balanced meals and cultivate in them healthy eating habits.

For families unable to afford basic living expenses, MSF's social service offices provide them with ComCare financial assistance, which cover their food expenses and other expenses. As part of the initiatives announced by the HealthySG taskforce, HPB will also be piloting a targeted programme with activities and incentives that are customised to the needs and circumstances of lower income families. For a start, HPB will focus on improving nutrition for these families. Examples of activities would include guided healthier eating trails, supermarket tours, cooking classes and nutrition workshops.

For children from lower income families, the Early Childhood Development Agency (ECDA) has partnered with KK Women's and Children's Hospital (KKH) to deliver the KidSTART Home Visitation Programme. ECDA will also be working with the National University Hospital (NUH) to extend the Programme to more children and their families. Through regular visits by ECDA and hospital home visitors, parents will receive support in acquiring skills and practical knowledge across areas of child development, health and nutrition.

Under the National Seniors Health Programme, MOH and HPB also support seniors through community based education efforts such as regular health talks and cooking demonstrations. These help our seniors learn about the importance of a healthy balanced diet, as well as practical ways to incorporate key nutrients such as protein and calcium into their daily diet.

In 2012, the Agency for Integrated Care (AIC) introduced the Nutrition Movement to support our Community Care service providers in preparing and providing nutritious and tasty meals for seniors. The movement partners with professional chefs to deliver initiatives such as AIC's Culinary Training and Chef Partnership Programme. To date, more than 200 cooks from over 70 Community Care organisations have taken part in the Culinary Training initiative to improve their culinary capabilities and cooking standards. Activities include practical training on preparing normal and soft-textured meals, and demonstrations by professional chefs on nutritious meal preparation based on the recommendations by dietitians.

In the community, AIC's Meals-On-Wheels programme, which delivers meals to homebound clients who may be unable to prepare their own meals, has also adopted HPB's Healthier Catering guidelines.

We will continue to look at ways to support better nutrition for all Singaporeans.