Question 2
Question 2: As a dietitian in China, what would you recommend to someone who didn’t care for the taste or texture of tofu, but was iron deficient?
posted by Anonymous @ 6:04 PM
18 comments
ISU Dietetic Internship Journal Club
Objective: To become familiar with current scientific literature on a variety of nutrition topics and to gain experience in gathering, organizing, critically evaluating, presenting and facilitating group discussion of the literature and the implications to practice.
18 Comments:
Like the study mentioned, China has initiated an intervention plan by fortifying their highly consumed soy sauce with iron. I think this is a good start. Additionally, I would recommend the intake of edamame, which is a soybean product with a high iron content. Edamame can be added to salads, soups, made into hummus, or simply eaten raw. Beans and other legumes would also be great choices, and obviously meat, fish and poultry are high in iron too.
I would first ask them how they are cooking with the tofu and what recipes they have tried. I would then maybe come up with alternative ways to cook the tofu and other recipes for my client to try. Good ways to “hide” tofu are in smoothies, soups/stews, or casseroles. If that did not work and they still didn’t like the tofu, I would explain that there are other good food sources that are high in iron. There are also other soy products on the market besides tofu. I would also recommend: liver, lean red meats (beef, pork, lamb), seafood (oysters, clams, tuna, salmon, and shrimp), beans (kidney, lima, navy, black, pinto, soy beans, and lentils), iron fortified whole grains (cereals, breads, rice, and pasta), greens (collard greens, kale, mustard greens, spinach, and turnip greens), vegetables (broccoli, swiss chard, asparagus, parsley, watercress, brussel sprouts), chicken, and turkey.
-Sam
Brittney-
Great recommendations for edamame, I like your ideas for adding edamame to different dishes. There are a variety of other soy products besides tofu that people can choose and cook with. This is important information to explain to clients and to offer a variety of recipes and tips for cooking with different soy products.
First, I would stress to them that if they did not want to eat tofu, there are other ways to get iron in their diet. Like the article mentioned, there is iron fortified soy sauce, assuming that soy sauce is a staple condiment in their diet. Depending too heavily on the soy sauce however, can lead to an excess intake of sodium.
I would recommend they consume more meats, beans, rice, and legumes to intake adequate amounts of iron. I might also suggest eating soy-based products other than tofu such as cheeses and milks.
Carrie,
I agree that the soy sauce intervention can take a turn in the opposite direction as far as health. High sodium intake can lead to other health problems.
I would want to find out first what forms of tofu they have tried. There is a form of silk tofu that they may not have tried. Also cooking and marinating techniques could be worked on to improve the taste and texture. If this still doesn't work I would then move to the soy sauce. During this whole process I would want to be working in education on the disease and other foods that can be consumed that contain iron.
Britt,
I love the idea of the edamame. It is a great example of soy in a differnt form that would add variety to their diet. I think finding different ways to cook tofu and incorporate it into dishes would be a great education session since no one wants to eat the same meal everyday.
If they did not like the taste and texture of tofu and had already tried different cooking techniques then I would recommend other food alternatives such as meat, beans, whole wheat/fortified breads and cereals. I would encourage a small amount of red meat be consumed if available due to the absorbability of heme iron versus nonheme iron in plant foods. If all else fails and the price is affordable, an iron supplement or multivitamin could help prevent anemia.
I would provide them with a handout of regional foods that are also high in iron, including the iron fortified soy sauce mentioned in the supporting article. I would have a discussion with the client about what he/she thought he/she could do in order to increase iron in the diet to meet needs. I would explain the importance of iron sufficiency and work with the client to find a plan suitable to their needs. Meats are not ususally consumed in high amounts in rural China, but I would recommend animal sources of protein, simultaneous consumption of vitamin C and the avoidance of drinking tea with protein containing foods (iron chelators). I would want the client to absorb as much of the iron as possible. Finally, if nothing else seemed to be a option, I would discuss iron supplementation.
Sam and Tori,
I like that you would discuss cooking techniques...have they tried all possible ways? I didn't even think of that. Also, Sam, "hiding" the tofu is a good suggestion. Since it is an affordable and fairly stable source of protein, it may be more feasable than meat products.
Emily
Don't eat it. There are many other options to take in iron. I would go over other sources based on the culture. There population does not largely consume organ foods or red meat but it could be incorporated in small amounts. I would recommend the fortified soy sauce and other food sources such seafood, legumes, rice and greens---All based upon their culture. But on a side note the tofu may be able to be masked and added in by blending it into a soup or sauce for added iron consumption.
Susan
Good thinking Em,
Vitamin C and the addition of supplements would be beneficial!
Susan
If someone did not like the texture of tofu I would recommend other food sources that are high in iron. The most obvious is red meat but they may not be accustomed to eating a lot of red meat. Another option is to increase their green leafy vegetables such as spinach. This could be easily done in a salad alongside their main meal. The article does mention fortified soy sauce but I would only recommend that if they don't like many of the high iron foods.
Colin,
Good point about the heme iron in red meat which is better absorbed versus the non heme iron in plant sources.
Meredith
Sam,
I liked your suggestion on "hiding" tofu. If tofu is something the Chinese consume frequently and is more readily available than animal sources, finding new ways to eat it is a great idea. Tofu can be easily hidden because it doesnt have a particular taste; it is relatively bland. Using the flavors of the smoothie, for example, the taste and texture of the tofu would be easily covered up.
Sam,
Good idea about hiding the tofu in other foods. I have never been a fan of the texture of tofu and would much rather have it hidden in other foods.
There are many food options available that are iron rich. I would recommend green leafy vegetables (like kale) and even non-ethnic foods like spinach and greens to increase intake. I would also, unless the client was vegetarian, try to get them to increase their meat intake. I would also recommend a multi-vitamin that contains iron.
Myra
I agree with you Emily. There are so many foods out there and I would try to get my client not to limit themselves to tofu, since they don't enjoy it.
Myra
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