Alda LeeNZ Registered Dietitian

Senior Lecturer AUT University

Healthy Options for the

Chinese Diet

TopicsServices Traditional Chinese FoodsHeart Healthy GuidelinesEducation – Reading LabelsCase StudiesConclusion

Allergies / Anorexia MalabsorptionBlood Pressure Nutrient deficiencyCholesterol Obesity / OsteoporosisDiabetes PCOS Eating Disorders RespiratoryFood Intolerances Salicylate SensitivityGastric Reflux Teenage NutritionHiatus Hernia UnderweightIrritable Bowel Vegetarian / VegansKidney Weight managementDigestive Health

Some nutritional issues:

Traditional Chinese Diet Low in fat and high in fibreHigh intake of vegetablesLean meat, fish, tofu and beansRiceAdequate intake of fruitUsing cooking methods such as steaming,

grilling and stir frying

Meal Patterns - BreakfastAsianRice porridge (congee)NoodlesRice and vegetablesSavoury steamed or

fried bunsDumplingsKumara

EuropeanCereal (Weetbix,

muesli, cornflakes, Special K)

PorridgeToastYoghurtFruit

WeekendsCooked: e.g. eggs +

bacon+ toast + tomato

LunchAsianRice or noodles or buns +Vegetables + meat or

chicken or fish or eggBuns – steamed or fried

Snacks: Rice crackersInstant noodlesPeanuts, cashew nutsPrawn crackers (deep

fried)Fruit

EuropeanSandwichFilled RollsPiesSaladYoghurtTakeawaysSnacks:FruitCheese and crackersScones / BiscuitsCake / chocolatePotato chips

DinnerAsianRice +Meat or chicken or

fishVegetablesSoup

Dessert:Fresh fruit

Drinks: Tea/Wine

EuropeanChicken meat or fishPotato or kumara orRice or PastaVegetables or saladTakeaways: e.g. Fish &

chips Dessert: FruitYoghurtIce creamChocolate/ BiscuitsDrinks: Wine/beer/sodas

But: Eating OutChinese restaurants are certainly quick and

easy. But the typical sauces can be sugary-sweet or way too salty, and a lot of options come battered and deep-fried, e.g. lemon chicken, sweet and sour pork / fish

Bigger portions of meat and rice eaten

Family DinnersMore is Better!

Yum CharDeep-fried, high in fatHigh in salt, mono sodium glutamate (MSG)High in sugar such as in desserts

Health ConsequencesOverweightHigh CholesterolDiabetesHypertension

Heart Healthy Eating Guidelines

1. Eat a variety of foods from each of the major four food groups each day.

2. Prepare meals with small amounts of salt and sugar added.

3. Choose prepared foods, drinks and snacks that are low in fat, sugar and salt.

4. Maintain a healthy body weight by regular activity and by healthy eating.

5. Drink plenty of liquids each day, especially water.

6. If you drink alcohol, do so in moderation.

Healthier Options:Less Fat Remove visible fat during preparation (e.g. chicken skin) Choose mono / poly unsaturated fats Use small amount of oil Removing skin from chicken and duck before eating Limit pieces of roast pork (special occasions only) Choose steamed dishes e.g. tofu or organic chicken instead of crispy deep fried

Polyunsaturated FatsSafflower oil, sunflower oilCorn oil, Canola, soya bean oilPolyunsaturated margarinesWheat germWholegrain cereals and breadsSeedsWalnuts, BrazilFish oils naturally present in fish

Mono-unsaturated FatsAvocadoPeanuts and peanut

butterCanola oilOlive oil and olivesOlive oil-based

margarinesAlmonds, CashewsHazelnuts, PistachioMacadamiaRice bran Oil

Photo source from http://images.google.co.nz/imghp?hl=en&tab=wi

Recommended fat intake levelsTotal fat intake should provide 30 – 35% of

total energySaturated fats should provide no more than

15% of total energyFemales less than 30g/fat per dayMales less than 40g/fat per day

Less Salt Use Lo Salt or salt reduced soy sauce

(Kikkoman)Prepare meals with minimum salt addedUse herbs and spices to add flavour eg garlic,

ginger, chillis, lemon juice, 5 spice powder, aniseed

Limit salty foods such as salted fish, oyster sauce, hoisin sauce

Less SugarImportant for managing weight, diabetes and

high triglyceride levelsUse sugar substitutes such as stevia or

artificial sweeteners Choose diet drinks, diet or light yoghurts,

canned fruit in water or juiceChoose green tea or water

How To Read Labels per 100gFat – Total 10g or less - Saturated 2g or less

Carbohydrates - Sugars 15 - 20g Sodium Under 450mg

Fat Content of Crackers Total fat per 100gRyvita, assorted flavours 1.9 Crispbread, rye 2.1Rice/prawn 3.7Salada, Arnotts 8.2Wholemeal and Sesame 15.7Cheese 22.4Sesame 22.6Snax, Griffins 24.5Meal Mates, Griffins 25.7

Fat Content of Cheese % FatLow Fat Cottage cheese 3

Bega Super slim 9.5

Mainland Lite Slice 14

Mozzarella 18

Medium

Feta 22

Camembert 23

Brie 23

Edam 24

% FatHighProcessed Cheese 28Gruyere 30Gouda 30Parmesan 30Blue Vein 31Colby 32Cream Cheese 34Cheddar 35

Case Study 1Patient X Male 64 years oldHeight: 1.73m Weight: 87.9kg (ideal 70kg) BMI: 29.2Total Cholesterol: 7.2 mmol/lHDL: 0.93 mmol/lTotal: HDL Ratio: 8Cardiovascular risk (5 years): 15-20% (High)Impaired glucose tolerance HBA1c =43

Family History – Father had stroke in his 50’s now deceased

Medications: Lipitor 20 mg, asprinStopped smoking for over a yearNot very compliant with taking his lipitorLOVES his food

Food HistoryBreakfast: 10.30am Muesli, 2x weetbix and soy milk

Lunch: 2.00pm 4x bowls white rice with 250g -350g meat

and stir fry veges or 4-6 slices bread with avocado or Double whopper burger king with cheese,

regular fries and soft drink or Large pizza

Dinner: 8.00pmBurger King – double whopper, chips and soft

drink2x bowls rice, 2x small kumara and quarter of

chickenChinese restaurant – fried pork chops, 2 bowls of

rice, tofu and vegetablesQuarter of chicken, 2 small kumara, 2 x bowls of

rice, tofu and stir fried vegetables

Average fat intake per meal 45 g fat = 9 tsp fat

Diagnosis:Too much carbohydrates, fatsugar and salt

Healthy ChangesDecrease portion sizes – palm size for meat and

handsize for fish or tofuDecrease amount of rice to only 1 bowlIncrease his fish intakeIncrease vegetable intake, increase water intakeDinner mainly tofu and vegetablesWater with mealsIncreased exercise to 6 times per weekWeight dropped from 87.9kg to 83.8 kg in 5 weeks

Results: Feels better, more energy, stomach smaller work in progress

Case Study 2Patient Y Female 62 years oldHeight: 1.59m Weight: 57kgBMI: 22Cholesterol 3.9mmol/LTriglyceride: 1.3 mmol/LHDL: 1.25 mmol/LLDL: 2.1 mmol/LChol/HDL Ratio: 3.1HBA1C = 49 mmol/mol

MedicationsStatinsMetformin – not started

Ex-nurse now tutor working from home

No exercise

Food HistoryBreakfast: 7 - 9.30pm1 slice plain toast orV8 Juice orOatmeal porridge + banana + 1 tablespoon

sultanasWaterLunch: 12-2pmYum Char daily when husband home or2x week or2 eggs/bacon/sausage and toast or Macaroni

Dinner: 9.30pmFish once a weekSalmon or tofuRice only once a week when outMainly vegetables

Diagnosis:Too much food at Yum Char, too many calories,

no exercise and eating too late

Healthy ChangesDecreased Yum Char – only once a week better choices – steamed rice roll, congee,

vegetables, steamed vegetable and meat dumplings, green

teaReading labelsSmaller portion sizesWater with mealsWalking 4x week for 20 minutes

Results: Feeling better, more energy, blood test results improved, more aware of how much to eat!

Where to from here?

Traditional Chinese Diet Low in Fat and high in fibreHigh intake of vegetables, 2-3 pieces of fruit dailyPalm size serving of lean meat or chickenHandsize serving for fish, tofu and beansRice ( 1 bowl for men and half –three quarter bowl for

females)Choosing more steamed dishes when eating out, no

msg

Conclusion:Work together as allies to improve the health of

our Chinese patients in our community

Doctors + Dietitians + Allies

There is NO magic pill!

Questions?