新加坡卫生部长王乙康答复议员：现在的学生喝珍珠奶茶都会要求少糖

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2024年3月6日，新加坡卫生部长王乙康在国会答复议员关于健康SG计划所取得的成效，以及接下来的方向。

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以下内容为新加坡眼根据国会英文资料翻译整理：

主席先生，虽然我们解决了这些眼前的问题，但我们不应忽视医疗保健的长远战略方向。也就是说，继续促进健康，而不仅仅是治疗疾病。

我们已经明确了这一战略，即以健康SG计划为中心。黄玲玲女士、叶汉荣先生和赛义德哈伦医生要求健康SG计划进行更新。我非常高兴地说，它的进展是令人鼓舞的。

让我报告一些数据。自去年7月启动该计划以来，我们已经邀请了240万年龄40岁及以上的新加坡居民参加。截至上个月，有76.5万人选择了他们选择的家庭医生。60%的人选择了全科医生，其余的选择综合诊疗所。这是一个良好的分配，因为健康SG计划的一个关键重点是赋予我们的全科医生在人群健康中扮演更重要的角色。

超过一半的注册者已经开始咨询他们的医生，制定个人健康计划，并因此获得了价值20新元的健康积分。超过124,000名注册者已经接受了免费的疫苗接种和健康检查。

在过去一年里，由保健促进局组织的活动参与人数增加了16%，从133,000人增至154,000人。由人民协会组织的活动参与人数增加了12%，从约400,000人增至450,000人。而由新加坡体育局组织的活动参与人数增加了20%，从117,000人增至140,000人。

因此，我们看到人们变得更加积极地参与，他们在进行自己私人活动也显得活跃。我认为这种变化是明显可感知的。这就是新的活跃新加坡。

黄玲玲女士问到我们是否预期健康SG计划患慢性疾病的患病率会下降。这确实是我们的目标。随着健康SG计划的良好开端，我们当然希望会实现这一目标，但这需要时间。

我们最近给寻求治疗的健康SG计划参与者提高了慢性疾病药物补贴。在接下来的一年里，我们或进一步改进该计划。

首先，扩大健康协议的范围。全科医生根据健康SG计划协议进行指导，以确保居民享受到一致和高质量的护理。目前已有12个协议，包括筛查、疫苗接种和常见慢性疾病管理。

卫生部将扩大协议的范围，涵盖更多的疾病，例如稳定性缺血性心脏病和稳定性中风。我们计划从2025年初开始逐步推出这些协议。正如之前宣布的，我们也开始着手将心理健康的方面纳入协议中。

其次，我们将改进健康计划。目前，注册医生将共同制定健康计划，作为预防保健咨询的一部分。它涵盖了一些必要的行动项目，如定期健康筛查和疫苗接种。但在生活方式方面，建议通常相当笼统，例如“多锻炼”，“健康饮食”。在2024年，我们将开始更加具体建议。例如，它可能建议你每周进行有氧运动三次。然后，可以使用Healthy 365应用程序找到住家附近合适的运动活动。Healthy 365也将提供多语言支持。

第三，我们将继续通过乐龄SG计划为长者推出干预措施，正如卫生部第二部长马善高所详细阐述的那样。

第四，我们将继续对抗糖和钠的过度消耗。我们对预包装饮料进行的营养评级标签已经在改变消费者行为方面发挥了作用。我将定期亲自检查会员室中的饮料。有些人见过我这样做。我很高兴地告诉大家，它们全部都评级为“A”和“B”，并通过了卫生部的检查。

然而，有一种饮料，“零糖咸荔枝味”。我给我的员工发了短信，问应该如何标签这个饮料？是标为糖分还是钠？他们告诉我只管喝就行。

我还遇到了一些学生，他们要求珍珠奶茶的糖分少一些，这样就能达到营养等级“B”。作为教育部长，我总是告诉学生，不要太在意分数。但在这种情况下，注重分数并争取“A”和“B”是好事。

最近我们已经将营养等级扩展到现调饮料上。我最近会见了两个咖啡店协会并寻求他们的支持。协会领导人完全支持。他们代表新加坡一半以上的咖啡店，并打算提供少糖饮料，即使食客没有特别说明。未来，如果点一杯咖啡，他们会给少糖的咖啡。如果想要更少糖分，我建议喝不加糖的咖啡。

如果摄入过量钠可能导致心脏疾病和中风。它存在于盐、酱油、虾酱和其他调味酱中。在保健促进局的大力推动下，现在有超过60%的盐批发商供应低钠盐。自从去年底推出“少盐多味”运动以来，约有30%的餐饮行业支持该运动。食品饮料行业也有20%左右的企业支持。

最近我在8频道看到了一个鼓舞人心的节目。有两位女主持人，她们进行了为期21天的挑战，减少食盐和酱油的摄入量。在21天结束时，她们的血压测量略有改善，但更重要的是，她们对盐的味觉变得更加敏感。现在她们能够更好地品尝食材，她们以前不知道在品尝食物时，还有大蒜、姜、香料的味道。她们以前只能尝到酱油和虾酱的味道，现在她们更喜欢少吃盐。改变一个终身习惯需要21天的时间。

因为我们每天都要吃东西，食物的影响会在我们一生中逐渐累积。在我们的一生中，食物可以是良药，也可以是毒药。一位明智的中医曾经告诉我，如果你吃得好，就不需要药物；如果你吃得不好，药物也没什么用。

以下是英文质询内容：

Mr Chair, while we address these immediate concerns, we should not lose sight of the longer-term, strategic direction of healthcare. That is, continue to build health, and not just treat illnesses.

We have crystalised this strategy around Healthier SG. Ms Ng Ling Ling, Mr Yip Hon Weng and Dr Syed Harun asked for an update on Healthier SG. I am very glad to say that it has been progressing encouragingly.

Let me report some data. Since the programme was launched in July last year, we have invited 2.4 million Singapore residents, aged 40 and above, to participate. As of last month, 765,000 have enrolled with a family doctor of their choice. Sir, 60% are enrolled with General Practitioners (GPs) and the remaining with polyclinics. This is a good split, because a key thrust of Healthier SG is to empower our GPs to play a greater role in population health.

Over half of the enrollees have started consulting their chosen doctors to develop a personal Health Plan and they have been rewarded S$20 worth of Healthpoints. More than 124,000 enrollees have received their free vaccinations and health screenings.

Over the past year, the number of participants in exercise sessions organised by the Health Promotion Board (HPB) has increased by 16%, from 133,000 to 154,000. For sessions organised by PA, participation has gone up 12%, from about 400,000 to 450,000. For SportSG's sessions, it has increased by 20%, from 117,000 to 140,000.

So, we see a discernible increase in people becoming active and individuals are also up and about on their own. The change, I think, is somewhat palpable. This is the new Active Singapore.

Ms Ng Ling Ling asked if we expect prevalence rate of chronic illnesses to come down due to Healthier SG. That is certainly our aim. With a strong start to Healthier SG, we certainly hope this will happen. But it will take time.

We have recently raised chronic drug subsidies for Healthier SG enrollees seeking care at their Healthier SG GP clinics. In the coming year, we plan to implement further improvements to the scheme.

First, expand the range of health protocols. GPs are guided by Healthier SG Protocols, to ensure that residents enjoy consistent and quality care. There are 12 protocols so far, which include screening, vaccination and management of common chronic diseases.

MOH will expand the range of protocols to cover more conditions, such as stable ischemic heart diseases and stable stroke. We will start to roll them out in early 2025. As announced earlier, we are also starting to work on including aspects of mental health into the protocols.

Second, we will improve the health plans. Currently, your enrolled doctor will co-develop a health plan with you as part of the preventive care consultation. It covers essential action items, such as regular health screening and vaccinations. But on the lifestyle, the advice is always quite generic, such as "exercise more", "eat better". In 2024, we will start to make the advice more specific. For example, it may recommend you do aerobic exercise three times a week. You can then use the Healthy 365 app to identify suitable exercise activities near your home. Key features in Healthy 365 will be made multilingual.

Third, we will continue to roll out interventions for our seniors through the Age Well SG programme, which Second Minister Masagos has elaborated.

Fourth, we will continue to fight against overconsumption of sugar and sodium. Our Nutri-Grade labelling of pre-packaged drinks have been useful in changing consumer behaviour. I will regularly and personally inspect the drinks in the Members' Room. Some of you saw me do it. [Laughter.] I am glad to report they are all graded "A" and "B", and passed the MOH Ministerial inspection.

There is one drink, however, "zero sugar salty lychee". So, I texted my staff to say what do we label this for? For sugar or for sodium? They told me to just drink it.

I also encountered students who are asking for less sugar in their bubble tea, so that it qualifies for Nutri-Grade "B". As the Minister for Education, I always tell students, do not be so grade conscious. But in this case, it is good to be grade conscious and go for "A" and "B".

We have recently extended Nutri-Grade to freshly made beverages. I met the two key coffee shop associations recently and sought their support. The association leaders are fully on board. Together they represent over half of the coffee shops in Singapore, and they intend to start serving "siu dai" or less sugar beverages by default. This means when you order a kopi in future, they give you "siu dai", even though you do not say it. If you want even less sugar, I recommend just drink "kosong".

Sodium is the other culprit that can lead to heart diseases and strokes, if over-consumed. It is found in salt, soya sauce, belachan and other sauces. With much effort from the HPB, over 60% of wholesalers of salt are now supplying lower-sodium salt. About 30% of the catering industry are supporting our "Less Salt, More Taste" movement since it was launched late last year. 20% of the food and beverage industry are also doing so.

I recently saw an encouraging programme on Channel 8. There were two lady hosts, they went on a 21-day challenge to take less salt and less soya sauce. At the end of the 21 days, their blood pressure measurements had moderated somewhat, but more importantly, their taste buds had become much more sensitive to salt. They could now taste the ingredients better, they never knew when they taste something, there are undertones of garlic, ginger, spices. They used to just taste soya sauce and belachan, and they prefer to eat less salt now. It took 21 days to change a lifelong habit.

Remember, because we eat every day, the effect of food accumulates through our lifetimes. Over our lifetimes, food can be medicine, food can also be poison. As a wise Traditional Chinese Medicine (TCM) physician once told me, if you eat well, there is no need for medicine; if you do not eat well, medicine is of little use.

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