CONVERSATIONS WITH… A Dietitian

From snacking smartly to preventing your child from overeating, senior dietitian Lee Yee Hong has eat-well advice for parents…

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As a parent, you may think that a little bit of baby fat on your kiddo makes them look cute and cuddly. But the truth is, overweight kids may face health issues when they are older.

A study on obesity that the Health Promotion Board (HPB) carried out last year has found seven in 10 children who are overweight at age 7 will remain that way well into adulthood. In fact, 10 per cent of 5-year-olds in Singapore are overweight.

Mount Elizabeth Novena Hospital’s senior dietitian, Lee Yee Hong, 30, notes that childhood obesity is one of the most common health issues she treats. Her answer? Parents can prevent obesity in their kids by getting their offspring to quit playing with their gadgets and head outdoors to get some exercise.

Lee, who has seven years’ experience, points out, “Exercising also helps their motor and sensory development, enhances brain development, their emotional responses and so on.”

Another tip ― change the size of your offspring’s serving dishes to prevent them from overeating. Lee explains, “Serving food on a smaller plate creates a visual difference and makes the meal look bigger. So, it may help to control the food portion and your kids' intake.”

“Snacks help to refuel their body in between meals, when necessary. It’s the choice of snacks that matters most.”

Needless to say, if your child continues to pile on the kilos, their risk of suffering from chronic conditions such as diabetes, hypertension and heart disease increases as they age. Lee’s dad suffers from diabetes ― it was his unhappiness about talking to doctors and dietitians that motivated her to become one.

“I witnessed all my father’s frustration and struggles for more than 10 years and we are very close to each other. I decided to pursue a dietetics degree, so that he can at least listen to my advice as a dietitian. Now, I have achieved it [my goal]!”

What role do parents play in shaping their children’s dietary habits?

Parents have a great influence over their child’s eating and dietary preferences. So, eating a balanced meal and providing the right foods will go towards shaping your child’s dietary preferences. Parents can start by stocking up on healthy foods at home and have meals more often with their child. In addition, repeatedly exposing your child to certain foods increases their tendency to accept new foods.

How can parents prevent their children from overeating?

First of all, skipping a meal may lead to overeating, so it’s vital to stick to three meals and one to two snacks a day. These snacks shouldn’t be foods and drinks that are high in fat or sugar. Separating your child’s food or snacks into smaller portions will also control how much they’re eating each time. And don’t forget to include high fibre foods like fruit and vegetables — it will make them feel fuller. Parents should also refrain from serving large portions of food and expecting their kids to “clean” their plate, it’ll lead to overeating. Lastly, try not to rush through the meal. Just enjoy the precious family time, and savour your food! It’ll give your stomach more time to feel full.

Let’s talk about snacks ― what do you recommend?

Kids actually have different nutrient requirements at different ages. And their intake of food during their meals can be limited by the capacity of their stomachs. Snacks help to refuel their body in between meals ― it’s the choice of snacks that matters most. Pick healthier choices such as fruits, vegetable sticks, yoghurt, cheese or even nuts. Also ensure that there’s a suitable time interval between snacks and meals to prevent your kids from eating too little during their mealtime. Otherwise, having a regular mealtime and having a meal plan for breakfast, lunch and dinner ensures that your child feels full. It’ll prevent snacking.

Is social media to blame for poor eating habits among teens and tweens?

Undeniably, social media has a great influence on our youngsters. There are a lot of food ads on social media and this may influence their food choices and intake. Then, there’s the issue of distorted body images being posted on social media. As a result, some kids may become obsessed with being slim, or even ultra-slim because they think this will make them seem flawless and desirable — these factors can alter a person’s eating habits and intake negatively.

 

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We can download many calorie tracking apps on our phones today. How should we make sure that our diet is balanced?

Calories are not the sole indicator of a balanced diet. There are other aspects such as the amount of macronutrients — like proteins, carbohydrates and fats — in the food, its fibre content and the richness of vitamins and minerals.

When families dine out, how can they ensure they stick to a healthy diet?

You should use the HPB’s My Healthy Plate visual guide as a simple and easy-to-understand way to create a balanced and healthy meal. Parents can apply the ideas from it to design a healthy balanced meal when dining out. For instance:

* Fill half of your plate with fruit and vegetables.

* Fill a quarter with wholemeal or whole grain food, such as brown rice and so on.

* Fill a quarter with meat or other protein-rich foods, such as fish, chicken, eggs, tofu or beans.

“I usually tell my patient there’s no bad food in the world, only a bad amount. Eating everything in moderation is always the best policy to follow. Your body needs a variety of nutrients to support its growth.”

Certain foods are labelled “superfoods” that we should add to our diets. Is there really such a thing as a “superfood”?

The term “superfood” is used to refer to food with rich vitamins, minerals or some certain nutrients that are believed to improve our health. I do not totally agree with the concept of superfoods and I usually tell my patient there’s no bad food in the world, only a bad amount. Eating everything in moderation is always the best policy to follow. Your body needs a variety of nutrients to support its growth.

But these stories appear everywhere online and they often cite studies or research from reputed universities to back their claims…

Parents should read or get nutritional information from reliable sources, such as the HPB’s Health Hub portal or the World Health Organization’s website. Sometimes, some hospital websites do provide evidenced-based information regarding paediatric nutrition — those can be good references, too.

How do you work with the parents of children you treat?

Often, parents are anxious over their child’s growth and development and their nutrient intake. So, I help these parents by using tools like a growth chart to help them visualise the pattern of growth, and food models to advise them on the adequate portions of food to serve. We will also provide tips to help parents who encounter feeding or nutrient issues. I’ll usually encourage parents to involve their child in some simple food preparation to stimulate their interest and increase their willingness to eat fruit and vegetables. This may take a few attempts before parents see the change, but it usually works.

What are some of the tools you use to explain dietary concepts to your younger patients?

We usually use a lot of food models to attract their attention. And, we will show the patient how a meal looks like by using actual plates or bowls and food models to help them visualise the portions better.

 

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What do you love most about your job?

I love that my days are never the same. I can meet different people every day, hear different stories and the fact that I help people with the most basic thing in life ― food!

Any challenges you face in your job?

It is never easy to convince a patient to change his or her diet, despite the widely known benefits of doing so. When a patient is in denial, it can be very challenging to conduct a consultation or expect any changes from them.

What misconceptions do people have about your job?

They think that nutrition or nutrient intake is not as important in their treatment. There was once a patient told me that its medication and not food that’ll help him get better. I’ll explain to patients that getting a good nutritional status is like living in a house with a strong foundation, it allows you to build more levels on it or even add luxury decoration. Without a strong foundation, a building will be shaky and fragile. Likewise, a poor nutritional status leads to poor medical outcomes.

“A good nutritional status is like living in a house with a strong foundation… Without a strong foundation, a building will be shaky and fragile. Likewise, a poor nutritional status leads to poor medical outcomes.”

Any encounters that have left a deep impression on you?

I was seeing a patient who’s an 11-year-old boy from another country. He suffered from an infection of the heart and underwent major heart surgery in Singapore. He was referred to me for nutritional support as he needed nasogastric tube feeding. In this procedure, a tube is fitted from the patient’s nose to their stomach for feeding purposes. Whenever I greeted him, he always smiled shyly. I can’t imagine how tough the treatment and stress must have been for the little boy and his family, but I never saw him or his parents cry. His parents were always so cheerful, especially his mother, who was actively involved in the whole treatment process. She told me that she has to be strong, so that her kid will continue to fight the difficulties of the treatment. She has another two young boys who need her at home. In her eyes, I saw a mother with unwavering power and strength, carrying the weight of caring for her kids without any complaints.

What keeps you going?

Hearing encouraging words from patients and their families really gives me the strength to keep going. It’s also very reassuring to witness the recovery or improvement of my patient’s condition — it shows that I am doing something to improve other’s lives.

What do you do to destress?

Whenever I’m stressed out, I will look at my daughter’s photos on my phone. Her innocent, carefree smile and actions just dissolves my stress. I hope one day she is proud to have a mother who’s helping people with her nutritional knowledge.

Complete these sentences…

* One superpower I’d like to have is… To stay awake forever without feeling tired.

* To me, a healthy diet is… To enjoy all kinds of food ― in moderation.

* If you didn’t become a dietitian you would be a… Tour guide.

This interview has been edited for clarity.

 

Photos: Lee Yee Hong/Mount Elizabeth Novena Hospital & iStock

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