July Blog Summary

SUMMARY

Question one addressed the possible inadequacy of the food frequency questionnaire used in the study versus the questionnaire used in a similar study which had more than twice the amount of questions. The consensus among responders was that the researchers should have used more questions on the survey directly related to soy consumption. Also, it was noted that the researchers could have borrowed the survey tool from the Shanghai study since it was probably validated and contained more than two times the number of soy consumption related questions. Finally, most respondents noted that separating dry from wet tofu may have given the researchers a clearer picture of tofu consumption among respondents. Everyone agreed that the study was limited for these reasons.

Question two asked what blog respondent would do if they were raced with a patient in China that didn’t care for the taste or texture of tofu, but was iron deficient. Many of the responses included hiding the tofu in other foods such as in smoothies, sauces, or soups to incorporate the tofu into the diet without the taste and/or texture hang ups facing the client. Others described teaching the client about various cooking methods to prepare the tofu which could make the food more tolerable and enjoyable for the patient. Still others recommended other iron rich foods to supplement the diet while leaving tofu out all together. Some of these alternatives include red meat, seafood, beans, whole wheat or fortified grain products; however it was pointed out that regional preferences must be taken into consideration when recommending foods. It was also suggested that edamame and its many uses and preparation methods could be used to increase soybean intake. The consensus was that tofu isn’t the end all, be all for iron sources and patients can be educated and encouraged to try new and different foods to supplement their iron consumption.

Question three addressed the fact that there is only a single program in place directly aimed at iron deficiency (they soy sauce intervention project) and asked what types of intervention in China could be implemented to improve their overall iron status as a country. Many of the respondents recommended offering public information regarding iron consumption and deficiency in order to increase public awareness of the issue and help to remedy the problem. It was also pointed out that tea contains chelators which negatively impact iron absorption and the fact that tea is a staple in the Chinese diet. Genetic factors may contribute to the wide spread iron deficiency in China and should be addressed as a method for curbing the iron deficiency issue in that country.

Overall, iron deficiency remains an issue in the Chinese diet. We will see patients of all cultures and backgrounds with iron deficiency issues as well as others and we must be mindful of cultural food differences and really work to address their issues in a way that is sensitive to their cultural tendencies and their specific likes and dislikes. Patients will be much more willing to adhere to recommendations and follow through with plans if they are reasonable, attainable, and at least partially created by the patient.