Healthy Restaurant Eating

1. Healthy Restaurant Eating Write Presentation Title • Date in Footer

2. 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

3. ModernDiet • The result…rising prevalence of : • Heart disease • Diabetes • High Blood Pressure • Obesity

4. 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)

5. 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.

6. Diabetes Mellitus A Serious Disease Leading cause of new cases of blindness 25 times more prone to eye problems 6 times higher risk for Paralysis (stroke) 2-3 times higher risk for heart attack 5 times more prone to Kidney failure 20 times more prone to lower limb amputation Nerve damage causes loss of sensation

7. 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

8. 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

9. 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

10. Healthy Food Choices • 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

11. 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

12. Fats and Oils MUFA = Monounsaturated fatty acids, PUFA= Polyunsaturated fatty acids

13. 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

14. 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

15. 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?

16. 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

17. Indian Cuisine • 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

18. 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

19. 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

20. 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 1Tandoori Roti = 2 home made chappatis 1 Naan = 4 home made chappatis..

21. 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

22. 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?

23. 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

24. 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

25. 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

26. 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

27. 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 isoften put as a garnish over most soups. Avoid fried croutonsin the soup.

28. 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

29. 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

30. 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

31. 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

32. 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

33. 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

34. 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

35. 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

36. 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

37. 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

38. 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

39. 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.

40. 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

41. 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

42. 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

43. 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)

44. 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.

45. 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

46. 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

47. 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

48. Guidelines for Alcohol Consumption • 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.)

49. 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

50. 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