Fibre in the typical HK Chinese diet: An unscientific discussion

Fibre's always been a pet issue for me because it's one of those rare nutrition things that you can see the effects of almost right away. To oversimplify things a little, if you're getting enough fibre (and drinking enough fluids), then you'll be regular, and if you're not, then you won't. The "adequate intake" value in the DRIs for fibre are 25 g for women between the ages of 19-50, and 38 g for men of the same age.

Aside from keeping you regular, fibre does a lot of other great things; soluble fibre helps reduce your blood cholesterol by binding to bile in the digestive tract, making it unavailable for reabsorption, forcing your body to use the cholesterol in your body to make more bile. In addition, foods that are high in soluble fibre, such as oatmeal, have a low glycemic index, meaning they give a slow, steady release of energy (especially important if you're into endurance training) instead of giving you a sugar high and then leaving you to crash and burn. Scientists are also beginning to link fibre intake with risk reduction in a variety of diseases, such as obesity, diabetes, and hypertension.

So why am I making a big deal about the issue of getting enough fibre in Hong Kong when really, it's an issue anywhere else? Because the recommendations made for getting fibre are different.

Think about it: if I asked you to name a source of fibre, you would probably say whole grains. Based on what I've unscientifically observed, I would venture that a significant proportion of people in Hong Kong only eat refined grains. White rice is obviously a staple in the diet, but even other high-carbohydrate foods, such as noodles, dumplings (i.e. the wrapper), congee, and buns of various fillings are all made of refined grains.

When it comes to bread, if you think Wonder Bread is the symbol of empty calories, then you would be horrified at the bread sold here. The crusts are removed, the heels are thrown away—it literally looks like you're buying a white sponge.

Why is this so appealing here? I think it stems from the fact that the Chinese didn't have ovens, and traditional Chinese breads were steamed, giving it a soft texture. Even in "western-style" breads, companies add "flour improver" to make it softer. Many of my friends who have visited Hong Kong or China always comment on how the bread is so soft.

My own experience in finding a nice, high-fibre (i.e. at least 3 g of fibre per slice) was an adventure on its own. My first attempt resulted in a bread that contained SHORTENING (read: trans-fat)

I've found a place close to my work that sells an "original wholemeal" bread that doesn't have all that silly flour improver and added fat, has a crust and heels, and is ironically made by the same company that makes that crustless sandwich bread. The supermarket close to my house (which is under the same company of the place close to my work) technically stocks it (there's a price tag), but I've never seen it there, and of course, the bread costs a LOT more than the crustless sandwich type.

So if people aren't getting their fibre from whole grains, then what do we tell them? Fruits and vegetables.

As much negativity there is surrounding the "new" Canada's Food Guide, one thing I do like is the shift from having grains to vegetables & fruit as the "largest" food group.

This is reflected in the "plate rule" that we've been taught to teach our clients.

In Hong Kong, the food pyramid looks very much like the old US Food Pyramid, and their "3, 2, 1 plate rule" is a little different from what we're teaching...

So basically, although they're telling people to eat more fruits and vegetables to meet their fibre needs, they're still telling people to eat more grains, and for the most part, most of those grains will be refined. So how easy is it to get fibre from fruits and vegetables as opposed to grains?

	Food Guide Serving	Fibre (g)
All-Bran cereal	30 g (~½ cup/125 mL)	10.1
Whole wheat bread	1 slice (35 g)	2 - 3
Oatmeal (quick cooking)	¾ cup (175 mL)	2.8
Oatmeal (instant)	¾ cup (175 mL)	2.4
Whole wheat spaghetti	½ cup (125 mL)	2.4
Brown rice	½ cup (125 mL)	1.5
Enriched (regular) spaghetti	½ cup (125 mL)	1.3
Corn Flakes	30 g (~1 cup/250 mL)	0.8
White rice	½ cup (125 mL)	0.4
Sweet potato (蕃薯/faan shue)	1 medium	3.8
Spinach (菠菜/bŏ choi)	½ cup (125 mL)	2.3
Carrot (紅蘿蔔/hoong lŏ baak)	½ cup (125 mL), sliced	2.2
Potato (薯仔/shue jai)	1 medium	2.1
Lotus root (蓮藕/leen ngau)	½ cup (125 mL)	2.0
Broccoli (西蘭花/sai laan fa)	½ cup (125 mL), chopped	2.0
Cauliflower (椰菜花/yeh choi fa)	½ cup (125 mL) pieces	1.8
Shiitake mushrooms (冬菇/doong goo)	½ cup (125 mL)	1.6
Chinese broccoli (芥蘭/gai lan)	½ cup (125 mL)	1.2
Bok choy (白菜)	½ cup (125 mL), shredded	0.9
Lettuce (生菜/saang choi)	1 cup, shredded	0.8
Bean sprouts (芽菜/nga choi)	½ cup (125 mL)	0.5
Apple, with skin	1 medium	2.6
Orange	1 medium	2.3
Kiwi	1 medium	2.3
Banana	1 medium	2.1
Mango	½ fruit	1.9
Apple, without skin	1 medium	1.7
Lychee (荔枝)	½ cup	1.3
Grapes	½ cup	1.0

Source: Canadian Nutrient File All vegetables are assumed to be boiled and drained. The sweet potato and potato are skinless.

So going back to those recommendations, and assuming that a quarter of a plate is ½ cup, then we can estimate how much fibre you can get in a typical meal if you follow the recommendations (who does, really?)

All right, so let's assume that our Chinese person fills half their plate (what kind of Chinese person eats from a plate?) with white rice, or 1 cup. That's 0.8 g of fibre. Even if the Western person fills a quarter of their plate (½ cup) with spaghetti, they're already getting 1.3 g of fibre. Change that to whole wheat, and we're up to 2.4 g.

Our Chinese person continues to follow the recommendations and fills ⅓ of their plate (⅔ cup) with vegetables. If this person was like me, they'd choose my favourite veg, Chinese broccoli. That would give about 1.7 g of fibre, for a total of 2.6 g. The Western person goes for salad, with most of their half-plate (1 cup) allotment going to lettuce, giving maybe 1 g of fibre, for a total of 2.3 g if they chose regular spaghetti, and 3.4 g if they chose whole wheat.

(In case you didn't know, there's no fibre in meat.)

So it's really just a matter of playing your cards right. At the end of the day, it's probably still harder for the Chinese person to get the same amount of fibre as a Western person just because they're limited by the low fibre content of white rice, but if lettuce is the Western person's vegetable of choice, then they'll be limited by that in the same way.

Either way, if we're only averaging about 2 or 3 g of fibre per meal, then it's probably *really* hard to get the recommended 25-38 g of fibre per day. That's why choosing good snacks, like fruit with whole wheat crackers, or yogurt with granola (or All-Bran buds) and dried fruit, are also important.

Still a little worried? Then go for the "magical" fruit. That's right, beans. Adzuki beans, better known as red beans (紅豆/hoong dau) in Hong Kong, are found in everything from the traditional red bean dessert soup to red bean ice cream and popsicles (though the actual bean content is a little sketchy). In a ¾ cup (175 mL) food guide serving, it packs in 12.4 g of fibre! ½ cup of edamame will give you 4 g of fibre, but a cup of soy milk only gives you about 1 g of fibre, and tofu barely gives you any fibre at all.

If you really feel like you need a *lot* of fibre in one go, then Metamucil and Benefibre are good choices. I like the latter because I can just throw some in my water and not have to worry about it changing taste or texture or anything. And having it in water means I keep drinking too. A word of warning - start slow, especially if you don't have high fibre intake to begin with, or else you'll feel major discomfort and will be turned off fibre forever. And we don't want that, right?