alda lee nz registered dietitian senior lecturer aut university healthy options for the chinese diet
TRANSCRIPT
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Alda LeeNZ Registered Dietitian
Senior Lecturer AUT University
Healthy Options for the
Chinese Diet
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TopicsServices Traditional Chinese FoodsHeart Healthy GuidelinesEducation – Reading LabelsCase StudiesConclusion
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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:
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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
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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
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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
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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
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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
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Family DinnersMore is Better!
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Yum CharDeep-fried, high in fatHigh in salt, mono sodium glutamate (MSG)High in sugar such as in desserts
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Health ConsequencesOverweightHigh CholesterolDiabetesHypertension
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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.
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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
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Polyunsaturated FatsSafflower oil, sunflower oilCorn oil, Canola, soya bean oilPolyunsaturated margarinesWheat germWholegrain cereals and breadsSeedsWalnuts, BrazilFish oils naturally present in fish
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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
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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
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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
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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
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How To Read Labels per 100gFat – Total 10g or less - Saturated 2g or less
Carbohydrates - Sugars 15 - 20g Sodium Under 450mg
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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
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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
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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
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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
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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
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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
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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
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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
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MedicationsStatinsMetformin – not started
Ex-nurse now tutor working from home
No exercise
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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
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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
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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!
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Where to from here?
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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
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Conclusion:Work together as allies to improve the health of
our Chinese patients in our community
Doctors + Dietitians + Allies
There is NO magic pill!
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Questions?