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Healthy Healthy Restaurant Restaurant

EatingEating

Modern Living and Eating Habits Are they causing a health havoc?

Mismatch between need and supply

Modern living with limited physical activity does not need

food which is refined : high simple sugar

calorie dense

high fat

This is the type of food we normally eat

Modern Diet The result…rising prevalence of :

• Heart disease

• Diabetes

• High Blood Pressure

• Obesity

Diabetes An Increasing Problem

Rising prevalence

Almost 30 million people with diabetes in India - highest in

the world. Likely to become 60 million in 25 years

Occurs a decade earlier in Indians – affects people in their prime

– 40-60 years

Often associated with high level of blood fat (Cholesterol and

Triglycerides)

Equally large number have a pre-diabetes state (IGT)

What is Diabetes?

Diabetes is a condition in which there is too much sugar

(glucose) in the blood. Although sugar is needed to provide

energy for the body, when in excess, it causes problem.

Persons with diabetes have excess sugar because they lack or

have deficient supply of insulin.

Diabetes Mellitus A Serious Disease

Leading cause of newcases of blindness 25 times more prone to eye problems

6 times higher risk forParalysis (stroke)

5 times more prone toKidney failure

20 times more prone tolower limb amputationNerve damage causes loss of sensation

2-3 times higher risk forheart attack

What is healthy food ? Food that helps attain and maintain normal weight &

growth

Is not harmful or does not increase risk of an illness

Provides satisfaction

Supplies daily requirement of : Calories Correct proportion of CHO, Protein & Fat Vitamins & Minerals Roughage Water

Healthy Food Vs Tasty Food

Often the two are considered to be non compatible

Often good healthy food is made unhealthy by the way we process it

Need of the hour is to ensure that we give the right concepts and change behaviour

You are the trend setters for eating habits and food choices

How to Destroy Good Healthy Food

Roti - Naan - Paratha – Butter Naan

Boiled Rice - Pulao – Biryani

Steamed Idli – Idli With Ghee – Fried Idli

Plain Dosai – Masala Dosai – Ghee Roast Masala Dosai

Fresh Green Salad – Salad With Thousand Island Dressing or

Mayonnaise Dressing

Lauki(Sorekai) - Vegetable Koftas - Malai Kofta

Bhindi - Bhindi Masala Fry or Do-piazza

Tomato Rasam - Cream of Tomato Soup

Steamed Fish - Fish Tikka - Fish Fry - Fish in Lemon Butter Sauce

Signal system based on traffic light concept

Red Preferable to avoid :

Biryani, Fried rice, Puri, Paratha etc

Yellow Not a healthy choice : Biscuits, Bun,

White Bread

Green Healthy choice :

Chappati, Rice, Whole Wheat Bread, Idli

Healthy Food Choices

Problem with Restaurant Food : Fats and Oils

The biggest problem in food is high amount of fat used in

cooking

Saturated fats ( ghee and oils that freeze at room temp) are most

dangerous

Vanaspati is one of the most unhealthy cooking medium

Repeated use of oil for frying changes its composition and makes

it atherogenic (cis-trans)

No one type of oil is best – combinations of oils are better

Fats and OilsFat Distribution in commonly used oils

Fatty acid (g/100g)

Saturated FA MUFA PUFA (n-6) PUFA (n-3)

Olive Oil 14 70 15 1

Canola Oil 6 58 26 10

Rapeseed Oil 7 57 32 14

Corn Oil 13 25 61 1

Peanut Oil 18 48 34 -

Soyabean Oil 15 24 54 7

Sunflower Oil 11 20 69 -

Ghee 66 30 2 2

Safflower Oil 8 17 74 1

MUFA = Monounsaturated fatty acids, PUFA= Polyunsaturated fatty acids

Problem with Restaurant FoodSalt And Sodium

Another important element of unhealthy food - most Indian gravies and curries contain high amount of salt

Salt also used for marination and pickling

Baking powder is often used and contains high sodium

Most chutneys and pickles are rich in salt

Ajinomoto is often used in Chinese and Thai cooking

Modern Life Requires Eating out

Eating out is very common today - for some a way of

life Work takes us away from home Eating at work Special occasions like birthdays, anniversaries, festivals, or success Too tired to cook, parties or Friends drop in suddenly so a “take out”

meal is ordered

With each of these ‘special occasions’ becoming more and more common our diabetes and heart conditions are worsening, waistlines increasing and blood pressures shooting up

Eating Out

Should people with diabetes or heart ailments

Stop eating in restaurants?

Stop going out and isolate themselves?

Are there no healthy choices while eating out?

Is it possible to eat healthy in a restaurant?

What you should know about eating healthy?

Indian Cuisine

The culinary styles of Indians are actually a conglomeration of

many different cuisines

The popular ones are – Moghlai, Punjabi, Avadhi, Hyderabadi,

Goan, Bengali, Gujrathi, Kashmiri, and the different versions of

South Indian cuisine

The unifying factors being the use of spices, dals, curds, and

ghee

Basically Indian food is healthy, unfortunately, the modern

practise of using abundant oil in the gravy or deep-frying, high

salt use makes the food unhealthy

Indian Cuisine

A Typical Indian meal

Rice or Roti (at times both)

Dal, Rajmah, Chole or Sambhar

Vegetables dishes 1 or 2

Curds or Raita

Salad or Kachumber

Papad and/ or pickles

Non-vegetarians add a dish of meat, fish or chicken

Indian Cuisine

Indian CuisineSoups or Shorba

Rasam or Tomato Shorba - 2-5 grams of fat/serving.

Chicken Shorba - 10 grams of fat.

Mulligatawny soup - 15 grams of fat/serving.

Lamb or Paya Shorba -15 grams of fat/serving.

Rasam and Tomato Shorba are healthy and low in calories and

fat.

Client may ask the chef not to add any cream, ghee or butter

before serving

Indian CuisineCereals

Plain steamed rice, Chappati, Plain Tandoori Roti 1 serving - less than 1 gram of fat.- Healthy choices

Kulcha, Jeera Pulao, Lemon rice, Tomato rice 1 serving - not more than 5 grams of fat

Parathas, Missi Roti, Khasta Roti 1 serving - upto 15 grams of fat

Puri, Bhaturas, Kachoris are deep fried - rich in fat

Biryani (Chicken, Vegetable, mutton)1 serving - more than 70 grams of fat

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Indian CuisinePulses

Sambhar, Yellow Dal, Moong Dal, Panjrathni Dal, Chole and Rajmah

are healthy options

A serving around 10 grams of fat

Dal Makhini

A serving more than 30 grams of fat

The fat comes mainly from the Tadka or Baghar

Client may ask the chef not to do takda or baghar

before serving

Indian CuisineVegetables

Methi Palak, Aloo Palak, Khumb Palak, Khumb Makai, Khumb Matar, Gobi

Matar, Sabj Punch Mahal, Jeera Aloo, Tandoori Gobi, Tawa sabzi may all

have less than 7 grams of fat/serving –healthier

Bhindi do Pyaza, Masala Bhindi, Baghade Baigan, Baigan Bhaja – rich in

oil

Dum Aloo, Banarsi Dum Aloo, Shahi Kofta, the Koftas and potatoes are

deep-fried and the gravy is rich. The fat content could go upwards of 30

grams

Paneer (cottage cheese) rich in both protein and fat. 1 serving approx. 15 –

25 gm of fat. Is it necessary to fry it before putting in the gravy?

Indian CuisineFish, Chicken or Meat

Fish is considered good for health. But, depends on how it is

cooked? Is it fried, baked, roasted, stir fried or steamed?

Chicken Tikka, Reshmi Kabab, Fish Tikka, Tangdi Kabab,

Tandoori chicken low in fat

Tawa Machili, Tawa Chicken cooked on the Tawa or griddle use

less oil - are a healthy choice if less than 10 gram of fat per

serving

Indian CuisineFish, Chicken or Meat

Malabar (Kerala) Fish Curry, Malabar Lamb Curry, Murg Makhani, Mutton do Pyaza, Mysore Chilli Chicken, Osmani Korma, Butter Chicken Curry, Achar Ghost, Chicken Korma, Ghost Korma are all loaded with fat

One serving could be upwards of 25 grams of fat

One serving with coconut added to it could have up to 40 grams of fat

Indian CuisineSnacks

Idli, Dhokla (without the coconut), Fruit Chaat, Aloo Chaat,

Uppma etc are healthy choices

1 Masala Dosa could have nearly 10 grams of fat

Onion Pakora, Vadas, Aloo Bonda, Samosa, Kachori, Paneer

Pakoras - all deep fried - rich in fat

Papdi in the Papdi Chaat and Vadas in the Dahi-Vadas are deep-

fried - rich in fat

Continental Cuisine

French, Italian, American, and English

In a Continental restaurant, meals are served on individual

plates and even if the portion size is large, food is not

shared

Use lighter sauces

Continental Cuisine Soup Cream of asparagus, chicken, tomato, or mushroom - rich in calories

and fat

One serving of mushroom cream soup - 6-8 grams of fat and 110 calories

Consommé - 50 calories, 2/3 grams of fat – healthy option

Vegetarian farinaceous soup - pumpkin lentil soup or lentil soup – healthy option

Client may ask the chef to hold the cream, which is often put as a

garnish over most soups. Avoid fried croutons in the soup.

Continental CuisineCereal

Breads

Whole wheat, multigrain, corn and rye bread are healthy

Croissants, Danish pastries - rich and not good

Pasta

Tomato based pasta (Puttanesca) healthy

Spaghetti bolognaise or macaroni with cheese are rich

Continental CuisineVegetables

Vegetables are served as accompaniment or as stew, grilled,

stuffed, augratin or ratatouille

Usually served as sautéed or buttered assorted vegetables,

(carrots, broccoli, mushrooms, capsicum etc)

Potato -Baked, roasted, boiled and mashed potatoes, sautéed

potatoes (with or without butter or dill cream sauce) and also

fried or as potato croquettes

Continental CuisineVegetables

Ratatouille is a healthy vegetable choice

Vegetable au gratin is rich in fat, because of white sauce and

cheese

Client may ask the chef to serve the vegetables boiled or

steamed as an accompaniment and not sautéed in butter, to

hold the butter and cream in mashed potatoes

Continental Cuisine Sauces / Dressings Make the Difference

Continental dishes can be made lighter or heavier depending on

what sauce has been used and if cream was avoided in the end

Difference could be of 10-15 grams of fat

Hollandaise, Mayonnaise, Tartare, have egg, oil and vinegar as

the main ingredients. – rich sauces

Continental Cuisine Sauces / Dressings Make the Difference

White sauce has equal quantities of flour and butter or oil.

cheese, mustard, mushroom sauces are prepared with white

sauce as a base - rich in fat

Thousand Island is an oil and egg based dressing - rich in fat

Vinaigrette dressing the main ingredients are vinegar, olive oil

and mustard – rich

Continental Cuisine Sauces / Dressings Make the Difference

Brown sauce (Black pepper) is relatively healthier sauce

Plain tomato based sauces - healthy

Plain lime and vinegar dressing - healthy

Low fat Yoghurt would make a healthy choice

Chutney made of tomatoes, black grapes, and cherries are a healthy accompaniment to roast or grilled meat

Continental Cuisine Fish, Chicken or Meat

Steamed, poached or grilled fish – healthy If lemon butter, dill cream or parsley sauce added - rich If served with Dijon mustard – healthy

Roast, grilled chicken – healthy If Mushroom sauce is added – rich If black pepper sauce is added - healthy If Chutney is added – healthier

Chicken chasseur, Coq au vin, Chicken stroganoff - rich Remove cream – healthy

Continental CuisineFish, Chicken or Meat

Beef Tenderloin Steak is healthier than Beef Stew, Shepherd’s

pie, or Lamb chops

Chicken al Kiev- 60 grams of fat

Crumb fried Chicken, Shepherd’s pie, Fried fish or Fish cutlet –

deep fried – rich

Lobster Thermidor, which despite its fame, is not what a health

conscious gourmet should look for

Client may ask the chef to avoid serving any cream, egg,

and mayonnaise based sauce with the meat

Chinese / Thai Cuisine

A traditional Chinese meal : Steamed rice or noodles Generous amount of vegetables,Soybean products Dried or fresh fish and/or small quantities of meat

A traditional Thai meal : Steamed rice Spicy or pickled vegetables Spicy meat/fish curries (many with coconut milk added)

In India people like to eat fried rice, fried noodles, American Chop Suey

Chinese/ Thai Cuisine Soup

Hot and Sour, Wonton, Mixed Vegetable Clear, Tom Yum soup - light and healthy

Sweet Corn Chicken or Egg Drop - heavy and rich

Tom Kha Kai - rich as coconut milk is added

Client may ask the chef not to add the egg or fried meat

pieces

Chinese/ Thai CuisineCereals

Rice or Noodles (plain / steamed) - healthy

Vegetable, chicken, pork, or shrimp fried rice 1 serving - 25 grams of fat

Pan-fried noodles (Szechwan) 1 serving –10-13 gm fat

Crisp fried noodles (American chop suey) 1 serving –25 grams of fat

Phad Thai – fried noodles with tamarind and bean sprouts 1 serving - 400 calories

Chinese/ Thai CuisineVegetables

Salt and Pepper Vegetables- Deep-fried

Cauliflower or Vegetable Manchurian - Deep-fried

Spinach With Hot Sesame Sauce or Bok Choy - Healthy

Stir-fry Vegetable Dish – Healthy *

Phad Khao Pot Orn Bai Krapao (Stir-fried Baby Corn) – Healthy

Som Tam Esan (Raw Papaya Salad) – Healthy

* In a stir-fried dish ask the chef not to deep-fry the vegetables before

stir-frying.

Chinese/Thai Cuisine Fish, Chicken or Meat

Steamed Pomfret with vegetables or a pan-fried chicken – healthy

Chicken/Pomfret in garlic or ginger sauce – rich in fat (as chicken is first deep-fried, then stir-fried and then the sauce is added)

Pla Jeramet Neung Manao (Steamed Pomfret), Phla Koong (Prawn salad), Kai Yang Esan (Northeast grilled chicken), Kai Phad Bai Krapao (Stir fried Chicken with hot Basil) are healthy choices

Pla Jeramet Sam Ros (Deep fried Prawns) - rich in fat 1 serving may have more than 22 grams of fat

Ask the chef not to deep-fry the meat, fish or chicken in a stir- fried dish

Sugars and Sweets

Fruit Salad

Fruit Sorbet, Rasogulla, Phirni, Caramel Custard, Fruit

Yoghurt - healthier choices Can also be made lighter with artificial sweetener

Kulfi - 1serving - 500 calories

Jalebis and Gulab-Jamuns - deep-fried and then put in

sugar syrup - rich

Continental desserts are rich in cream and egg yolk

Souffles, mousse, custard, shakes can be made with skimmed

milk and artificial sweeteners

Sugars and Sweets Healthy tips

Take a fruit salad instead of the dessert If you do want to take a dessert, eat less than half the portion

served Take advantage of smaller portions available in restaurants or

ice cream spots Check with the chef if they have any low calorie dessert, or

one prepared with artificial sweeteners May be a cup of coffee sweetened with an artificial sweetener

would satisfy the sweet urge

Avoid sweets with a lot of cream, or which have been deep fried

Beverages

Healthy choices for beverages are:

Tomato juice

Plain Nimbu pani

Unsweetened fruit juice

Raw vegetable juice like raddish,carrot etc

Lassi (without sugar)

Tea/coffee (without sugar)

Delayed Meals

Meal Delay Over 1-½ hours

If you take Repaglinide (NovoNorm) – delay taking the

medicine till just before the meal as you normally do.

If you take sulfonylureas or insulin only in the morning: Eat your next snack at the usual time of the meal that has been

delayed. Eat the delayed meal at your usual snack time.

Do not eat another snack after the delayed meal.

Delayed Meals Meal Delay By About One Hour

If you take Repaglinide (NovoNorm) – delay taking the medicine

till just before the meal

If you take a Sulfonylurea or insulin before the meal you can

delay taking the medicine until just before the meal

If you take the medicine earlier, say in the morning, as with

many sulphonylurea and some insulin preparations and the

dinner is to be delayed. In this situation it is important to take

about 15gms of carbohydrate such as fruit or biscuits

Guidelines for Alcohol Consumption

Preferable to restrict alcohol

The ADA recommends

one drink per day for women

two drinks per day for men

If drinking alcohol several times a week, the doctor should be

aware

To prevent hypoglycemia, alcohol should be consumed with

meal

Guidelines for Alcohol Consumption No alcohol to be taken in presence of pregnancy,

pancreatitis, dyslipidemia, neuropathy

Do not drive or plan to drive for several hours after you drink

alcohol

Alcohol contains 7 calories per gram and is utilized by the body like fats. Calculate alcoholic drink as part of calorie intake, substitute it for fats in the meal plan.

For example: 1 alcoholic drink equals 1 fat exchange (90 calories)

(One alcoholic beverage is 12 oz. light beer, 5 oz. wine or 1 ½ oz. distilled spirits such as, vodka, whiskey, gin, etc.)

Guidelines for Alcohol Consumption

Guidelines for Alcohol Consumption Healthy Tips to Sip By

Drink only if blood glucose is under control Test blood glucose to decide if you should drink alcohol For drink mixers, use calories-free choices—diet soda, club

soda, diet tonic water, or water Drink alcohol with a snack or a meal not empty stomach Quench thirst with water or a no calorie beverage and not

alcohol Wear Diabetes identification card that notes you have diabetes Healthy choice for snacks - fat free popcorn, crackers, or

salads

Nutritive and Non Nutritive Sweetener

Non Nutritive (Artificial) sweeteners Saccharin - Bitter after taste Aspartame - Has a delayed sweetness taste, is unstable at high

temperatures

Nutritive sweeteners Fructose – 4 cal/g Sorbitol – 4 cal /g Mannitol- 2 cal/g

Artificial Sweeteners is added to tea and coffee, used

to make sweets/ desserts at home

Eating out in India People with diabetes or heart ailments can eat in restaurants – with

your care and understanding

They can get healthy choices while eating out -with your expertise

Give your client the option to choose a healthy meal

Put it on your menu card

Experiment and popularize healthier Indian curries

Be the trend setters and your clients will follow and appreciate your initiatives

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