Promoting health, one hawker meal at a time: Ang Hak Seng

Eat, drink, and be merry, for tomorrow, we may diet? Not if Health Promotion Board chief Ang Hak Seng can help it. He tells Susan Long about his war on obesity and the health revolution he's starting.

The Straits Times, 5 Oct 2012

HE STARTED life as a kopi kia, wiping down tables and serving coffee as soon as he could cradle a cup. Now Mr Ang Hak Seng has set about dishing out a new menu at coffee shops and hawker centres, cutting grease, adding greens.

His mission: to sell healthier choices to food-loving Singaporeans. He wants to ignite a "health revolution" here and galvanise those whose diet always begins tomorrow to start today.

A tall order, but the spindly, ordinary-looking man who weighs all of 62kg and is deferential to everyone, including the tea lady, is up to it.

For starters, the 52-year-old chief executive of the Health Promotion Board (HPB) is waging an all-out war on obesity. Obesity, defined as being 20 per cent or more above one's ideal weight, has crept up in Singapore from 7 per cent in 2004 to 11 per cent in 2010, by about 1 percentage point a year.

But drawing from the experience of the United States, Britain and Australia, where respectively, 35, 26 and 25 per cent of its people are obese, once obesity hits the tipping point of 16 per cent of the population, the next spike is exponential, climbing 2 to 3 percentage points, thereafter 3 to 5 percentage points a year, he says.

There's no time to waste, he intones urgently. "We effectively have about five years to be in control. After that, being fat becomes the norm. People just accept it and give up hope," he warns.

What vexes him is that coupled with that, Asians are predisposed to diabetes. Half of those who are obese will become diabetic, which raises the risks of stroke, heart and kidney failure and blindness. In Singapore, 11 per cent are now diabetic and a further 14 per cent are pre-diabetic, he notes. The latest National University of Singapore's Saw Swee Hock School of Public Health study shows that Singapore could have as many as one million diabetics by 2050.

Despite a 2010 HPB survey showing that 90 per cent of Singaporeans know what it takes to stay healthy, he laments knowledge doesn't translate to action. One third still don't exercise enough (at least 150 minutes per week) and 80 per cent don't eat enough fruit and vegetables (at least two servings of each daily).

But he won't be threatening them off the couch. He is forgoing "scarecrow tactics" such as "Eat fibre or get cancer". Instead, he is anchoring his campaign on "aspirations for a higher life quality", a "nobler motive" than fear.

No hectoring either. It's futile to nag Singaporeans - close to 70 per cent of whom eat at least one meal at a hawker centre daily - to eat healthily when there is no supportive eco-system in place, he feels. Instead, he's paired up a chef and a nutritionist to work with hawker centres and coffee shops to produce "healthy, tasty and affordable food".

So far, five hawker centres - Yuhua, Eunos Crescent, Haig Road, Geylang Serai and Marine Terrace - and six coffee shops in Woodlands, Bedok, Bukit Batok and Jurong East have taken part. "We cannot just say use less oil and less salt. We must show them how to draw out flavour in an inexpensive way," he says, adding that using more spices and herbs instantly increases the depth of flavour in soup stock.

Next is changing "norms". By default, at these places, unless you specify otherwise, you will get the less oil, less sugar, less salt version of your prawn mee order. The objective: to re-educate tastebuds.

Thus far, these made-over hawker centres and coffee shops have seen an up to 25 per cent jump in business. Mr Ang, who plans to ramp this up to 25 hawker centres and coffee shops by the year end, believes that it will take off "the moment hawkers start to see the business case for selling healthy food".

He is also making food healthier at source. Since Singaporeans eat at least one serving of noodles a day on average, HPB has worked with home-grown Jia Jia Wang Trading to produce noodles coated with wholegrain. Since the Sakura brand of wholegrain noodles was launched at NTUC FairPrice and Giant supermarkets last year, Jia Jia Wang's sales have shot up four times. There is also import interest from South Korea, Malaysia, Australia and the US.

Mr Ang is also mincing down the Herculean task of getting fit into bite-sized morsels. Don't have 30 minutes a day to spare at the gym? He is advocating modular blocks of "exerciselets", such as mopping the floor and using the stairs, that add up to 150 minutes a week.

Where he hopes his health revolution will lead to is a land where a visit to the doctor is a "rare occurrence" and where people are hospitalised for critical diseases rather than lifestyle diseases like diabetes.

Kopitiam lessons

HE IS the third of five children of Hockchew parents who ran a coffee shop in Upper Changi. He learnt to chat with "towkays and coolies" alike, taking six-hour shifts by age 12.

When he hit 15, he was asked to take charge of brewing the coffee, a coming-of-age ritual in his family. By noon, he was relieved of the job. "You have failed the test," his father said, pointing to the many half-drained cups on the tables. "I was a coffee shop reject," he declares, remembering his dejection and how his mum told him to forge his own path.

Today, all his brothers and sisters work in the coffee shop business. He was the only one to make it to university, after attending the now defunct Telok Kurau East Primary School and Siglap Secondary School. His family cobbled enough money for his first year at New Zealand's Massey University. He earned the rest himself, working part-time as a bartender, a tannery worker, tutoring and through scholarships. Before he came home a chartered accountant, he also packed in a master's in business studies at Massey.

For the next 23 years, he joined the Ministry of Home Affairs which sponsored his master's in management of technology at the Massachusetts Institute of Technology. He held many command positions, including commander of the Central Police Division, deputy director of the Criminal Investigation Department and senior director of Singapore Police Force's International Cooperation Department. He paved the way for the Interpol Global Complex to be set up here and rolled out many community policing efforts such as Neighbourhood Watch.

Assistant Commissioner of Police Tan Hung Hooi, 43, director of the Singapore Police Force manpower department, credits Mr Ang's infectious "positive energy" and ability to "make things happen".

What helps him, Mr Ang says, is his grassroots experience as a district counsellor with the Southwest Community Development Council and chairman of the Yuhua Community Club management committee for the past decade. "As a policeman, I'm used to command and control. But grassroots work honed my skills to influence people," says the man who was asked to helm HPB two years ago for his community engagement skills. Under him, HPB recently won the 2012 Public Service Best Practices Award for stakeholder engagement.

Roping in others

HE KEEPS fighting fit through a regime of careful eating - two servings of vegetables, a portion of brown rice and half a serving of meat for each meal - as well as running 25km a week.

He used to have two slices of bread slathered with kaya and margarine. Now he sits down to a breakfast of cherry tomatoes and blueberries with his wife, a housewife, and their two university-going sons, aged 21 and 23, whom he has also roped into his sporty lifestyle. "Revolutionaries need family support, " he says.

He is now busy amassing a battalion of 10,000 health ambassadors on the ground by 2015. Eventually, he hopes to have at least one in every household.

He has 4,000 on board so far, who go through 12 hours of health and nutrition training and help run most of HPB's offerings, like community health screenings.

He recounts how at a screening for the elderly in Whampoa last year, a portly 72-year-old agreed to take part, only upon a health ambassador's pestering. His blood pressure test showed he was a walking time bomb. The health ambassador who lived near him then phoned his family to ensure he sought treatment. The man's condition is now under control and he has taken to brisk walking.

Such ground-up local solutions work best for local problems, Mr Ang says. Taking another leaf from his law enforcement days, he's also learnt to hit where it hurts. "Know where the battleground is. Go for minimum effort and maximum result," he says.

In the fight against ah longs (loan sharks), he says the police don't swoop in on the runners but the book- or record-keeper. "Two things happen: You get the evidence to charge them. And without records, they don't know who to collect from."

Likewise, he is starting young to get the greatest leverage in shaping eating habits. From the crib, HPB promotes breastfeeding, which lowers the risk of obesity. For children between three and six, HPB goes to pre-schools to steer them towards fruits and vegetables, and drinking water instead of sodas. For six- to 12-year-olds, it works with school canteens - 25 are on board now and 40 more in the pipeline - to serve healthy bento box sets.

Mr Ang, who received the Singapore Human Resource Institute's Leading CEO Award this year, is well-known for telling his HPB staff of about 900: "Don't plan to do. Do to plan."

He enjoins them to roll out ideas, refine them as they go along and celebrate quick wins. Over the past two years, HPB has launched no fewer than 50 initiatives, often on Facebook or Twitter.

These include targeting youth binge drinking by mobilising bartenders to serve mocktails to the intoxicated.

There is also Lose to Win, a 12-week programme to help the overweight shed pounds. And iDAT, an interactive Diet and Activity Tracker to monitor food intake and physical activity, which is now a top iPhone app.

The chief revolutionary's ultimate goal is to work himself out of his job and get Singaporeans to police their own health again.

Mr Ang's views on...

His philosophy of life

One line from the movie, Kung Fu Panda, captures it: "Past is history. Future is mystery. Today is a gift. That's why it's called the present." It reflects me very well because I don't regret about yesterday. I don't over-worry about tomorrow. I look forward to today, seizing the moment and acting on the opportunity. That's the spirit of all revolutionaries.

The recent Bloomberg health survey showing that Singapore is the healthiest nation in the world

When I read that, my concern is that we become a victim of our own success, start to get complacent and the sense of urgency drops. To reach there is one thing, but sustainability is the challenge that keeps me awake at night.

His management style

It's like a thumbtack. The round head means I will first harness the collective thinking of everybody and bring about a shared vision. But after enough consultation, there must be swift and focused action and results.