April 2010 Issue

Good Eats From Around the Globe
By Andy Bellatti, MS
Today’s Dietitian
Vol. 12 No. 4 P. 38

Culinary delights and staples in other cultures, these healthy foods are great additions to clients’ diets.

Surely I am not the only one who has been asked, “What is the healthiest diet?” during a nutrition presentation’s question-and-answer session. When people ask me that question, I suspect they believe I will respond with the name of a popular diet book (The Zone, Atkins) or a relatively new, scientifically inaccurate fad (the Blood Type Diet).

Most people seem surprised when my answer is, “Eat your way around the world!” By this, I do not mean eating chocolate croissants in honor of France, tempura vegetables as homage to Japan, or large pots of fondue to show love for Switzerland. Instead, what I often like to point out to clients is that by extracting the nutritional “cream of the crop” from different cultures, they can reap many health benefits while exciting their taste buds. I always encourage my clients to try one new food per month as a way to gradually expand their culinary repertoire.

The next time one of your clients expresses boredom about eating the same foods over and over again or if you want to add some zest to their meal plans, consider some of the following healthful foods from around the globe.

Sea Vegetables
A study by the Japan Public Health Center-Based Study Cohort I published in the January 2006 issue of Circulation determined that the average omega-3 fatty acid intake in Japan is approximately 7.5 times higher than that in the United States. While some of this is attributed to higher intakes of fish, there is another food responsible for this figure: sea vegetables (ie, seaweed).

All sea vegetables are great low-calorie sources of most B vitamins, calcium, copper, iodine, magnesium, manganese, potassium, zinc, and vitamins A, C, and K. Most varieties also provide substantial amounts of lignans, the compounds found in flaxseed that are linked to decreased cancer risk and lower LDL cholesterol levels.
Sea vegetables are a solid source of EPA and DHA long-chain omega-3 fatty acids for vegetarians and vegans, as well as for omnivores who do not normally eat seafood. These underwater vegetables also provide their own share of unique phytonutrients and antioxidants that help lower the risk of heart disease and many different cancers.

Although most people think seaweed has a slimy texture, that isn’t always the case. Let your clients know that they can purchase a variety of different seaweeds, each with its own distinct flavor and texture.

• Nori is the seaweed that is perhaps most familiar to people because it is the variety used in sushi rolls. People can also consume it in several others ways: Sheets of thin, crunchy nori are wonderful sliced into strips and added to salads or even used to wrap vegetables and avocado for a quick snack.

• Kombu is a type of seaweed mainly used for stocks, while kelp is often added to soups (eg, miso) or used in granule form to add fishy flavors to vegetarian and vegan items that aim to mimic seafood.

• Arame is used in many savory dishes, including stews and grain-based sides, while hijiki is often steamed and served as a side dish. One restaurant I frequent serves hijiki as part of a platter alongside brown rice, chickpeas, and stir-fried tofu.

• Dulse is mainly available as granules to add fishy flavor to food, although whole, dried dulse can be eaten straight from the bag as a snack or used as a salad topper. Unlike nori, it is chewy and has a unique, love-it-or-hate-it cheeselike flavor.

Give clients a few words of caution concerning seaweed. Most seaweed salads at Japanese restaurants are high in added fats and sugars. Also, as a study in the October 2002 edition of the Journal of Nutritional Science and Vitaminology confirmed, most sea vegetables (basically all of them, except for wakame, a type of kelp) are not good sources of vitamin B12 since they contain B12 analogues, compounds that mimic the vitamin. Vegetarians and vegans must be mindful of B12 analogues, as they attach to B12 receptors in the body and prevent it from properly absorbing real B12 in the diet. Additionally, since seaweed is very high in iodine, patients with thyroid issues should carefully monitor their intake.

In Portugal, kale is a central component of many traditional soups. In the United States, spinach is commonly considered the healthiest green leafy vegetable, but even it pales in comparison to this great curly leaf. A cup of cooked kale contains 1,100% more vitamin C than a cup of cooked spinach and as much absorbable calcium as 2⁄3 cup of milk.

Unlike spinach, kale’s oxalate content is very low. End result? Its calcium and iron are highly absorbable in the human digestive system. Kale is also an excellent source of vitamin K; a mere 1⁄2 cup of steamed kale delivers six times the Daily Value. Vitamin K helps improve bone density by regulating calcitonin, a protein that locks calcium in the bone matrix, thereby making it more difficult for osteoclasts to break it down. And if osteoclasts are more active than osteoblasts, which help create new bone tissue, osteoporosis risk increases significantly.

While clients may try kale in its whole-leaf form as part of a salad or stir-fry, remind them of alternative options. If they own a high-speed blender, they can add a small bunch of kale (from 1/2 to 1 cup) to a smoothie for a truly delectable flavor combination. One of my favorite homemade recipes combines bananas, unsweetened almond milk, vanilla extract, mango, and kale.

Indian cuisine utilizes myriad spices, all of which add flavor—and plenty of nutrition—to dishes. Encourage clients to replace salt in dishes by experimenting with different spices.

Garam masala, a common Indian condiment, is made from a mixture of cinnamon, cloves, cardamom, cumin seeds, ginger, coriander seeds, and peppercorn. Its deliciousness aside, it is a phytonutrient and antioxidant powerhouse.

A study conducted in Pakistan by the USDA and published in the December 2003 issue of Diabetes Care found that subjects who consumed 1⁄2 teaspoon of cinnamon daily experienced noticeable decreases in total cholesterol and triglyceride levels. Specifically, subjects lowered total cholesterol by as much as 26% and LDL cholesterol by 7% to 27%.

Cardamom provides high levels of the antioxidant limonene. A 2002 study published in the Japanese Journal of Cancer Research identified limonene as a component that helped slow down the proliferation of carcinogenic tumors in rats.

Cumin and cloves are good sources of magnesium, a key mineral involved in regulating blood pressure. Cumin also contains anti-inflammatory flavonoids.

Ginger is not only a powerful anti-inflammatory food—remember, cellular inflammation is the principal factor behind the development of most degenerative diseases—but it has also been shown (most recently in a study published in the September 2009 issue of Chemico-Biological Interactions) to significantly slow the reproduction of tumor cells and to be a powerful weapon against free radicals. Ginger is so effective at reducing inflammation that it is a natural remedy to help alleviate arthritis symptoms (as long as it is consumed consistently, of course). Ginger has also been shown to help reduce blood platelet aggregation, thereby helping lower atherosclerosis risk.1

Another classic spice used in Indian cooking is turmeric, the central ingredient in any curry. Turmeric is an excellent source of curcumin, a compound with strong anti-inflammatory properties and a great free-radical fighter.

Ask the average American to name a vegetarian meat substitute and he or she will likely offer tofu. While this soy-based substitute can be tasty and healthy in its own right, its lesser known, nuttier-flavored cousin tempeh, which originated in Indonesia, may be even better.

Tempeh’s fermentation process gives the food a nutritional and probiotic boost. Fermentation reduces soybeans’ phytate content, thereby making their zinc and iron much more bioavailable.

While tofu is made by coagulating soy milk with a precipitating agent (in most cases, calcium sulfate, thus the high amounts of calcium in tofu), tempeh is made from whole soybeans. The presence of soybeans—in some cases, along with wild rice or flax—makes tempeh a high-fiber food. While 4 oz of tofu provides 1.5 g of fiber, the same amount of tempeh provides 11 g.

Tempeh is also significantly higher in manganese, magnesium, and potassium than tofu and is a better source of protein and omega-3 alpha-linolenic fatty acids.

In case your clients find preparing regular tempeh intimidating, let them know that companies such as Turtle Island Foods offer organic, non-GMO marinated tempeh strips in flavors such as sesame garlic and coconut curry. They can add them to salads right out of the box or heat them for a few minutes on the stovetop for a quick and healthy entrée.

Additionally, Lightlife Foods produces Fakin’ Bacon strips that make tasty side dishes to a homemade brunch. Consumers can heat them for two to three minutes before eating.

Coconut Water
Brazil, Thailand, and the Caribbean
Long before fluorescent, sugar-laden sports drinks flooded the market, there was coconut water. Ironically, a beverage that people have consumed for hundreds of years in Brazil, Thailand, and the Caribbean is now emerging as one of the hottest new products in the United States.

A standard 11.2-oz pouch of coconut water contains a mere 60 kcal and 50% more potassium than a medium banana. It’s also a good source of magnesium and phosphorus, making it a great postexercise, electrolyte-fueled drink.

Coconut water can also replace juices in smoothies for a refreshing, unique flavor.

Grass-Fed Beef
Dietitians should encourage clients who eat red meat to limit their frequency to no more than two times per week. The American Institute for Cancer Research suggests capping weekly intake of red and processed meats at no more than 18 oz, as the evidence linking their consumption to a higher risk of colorectal cancer is too strong to ignore.

Additionally, based on epidemiological evidence and meta-analysis of studies, the Italian Association for Cancer Research states, “Red meat intake [is] an important factor … in the nutritional etiology of human cancer.”

If your clients eat red meat, it is certainly wise to advise them to seek grass-fed beef whenever possible. (The majority of cattle in Argentina subsist on pasture as opposed to corn.) Not only is a diet of grass healthier for cows’ digestive systems and a more environmentally friendly choice—cattle feedlots, where they are fed grain and corn, produce significant amounts of waste—but it also offers nutritional benefits for humans.2

Grass-fed beef is significantly lower in saturated fat than corn-fed beef and also offers substantially higher amounts of the polyunsaturated conjugated linoleic acid. Many studies, such as one published in the December 2000 issue of Pharmacological Research, have shown promising links between conjugated linoleic acid consumption and inhibition of cancer cell growth, as well as lowering of triglyceride levels and even a boost in immune system health.

Let clients know that vegetarian fed is not the same as grass fed. A vegetarian feed can refer to the cheap corn-and-wheat diet that cows in feedlots receive. That diet is so unhealthy for them (it causes acute acidosis, as explained by the Extension Beef Cattle Resource Committee in the Beef Cattle Handbook trade publication) that they must receive copious amounts of antibiotics to stay healthy.

Roughly 40% of adults in the United States don’t consume any whole grains on a given day. As if that weren’t disheartening enough, here is another downer: Most of them have never even heard of the delightfully healthy pseudograin known as quinoa.

Although quinoa is often discussed in the context of whole grains, mainly because it cooks and tastes like one, it is actually a seed belonging to the same family of dark leafy green vegetables as spinach. This staple of Incan culture—it was considered as valuable as gold—is a nutritional powerhouse. Like soy, it is a complete plant protein, meaning it contains all eight essential amino acids. Unlike most grains, quinoa offers considerable amounts of lysine.

Quinoa is also an excellent source of magnesium, which helps to relax blood vessels. One-half cup provides 50% of the daily requirement for a 2,000-kcal diet, making it a great food for patients with hypertension. One cup of cooked quinoa packs 503 mg of potassium, another key mineral in preventing hypertension and offsetting the problems of too much sodium. That amount of potassium is equivalent to the amount in a large banana.

It gets better. Quinoa is a prebiotic and is also gluten free so everyone can enjoy it and reap its health benefits. Be sure to let your clients know to rinse quinoa prior to cooking to wash away a bitter coating. Fortunately, prerinsed varieties are the easiest to find on store shelves.

Model Diets
While the foods mentioned in this article are central to many cultures, it is important to help clients realize that the inclusion of one food does not have as much of an effect on health as general dietary patterns. There is no doubt that quinoa and seaweed are healthful additions to a diet. However, regardless of their geographical placement, cultures that enjoy longevity and low rates of disease have one common thread: diets low in processed, artificial foods, and added sugars. Those truly are the models to follow.

— Andy Bellatti, MS, is on the registered dietitian track in New York University’s department of nutrition, food studies, and public health and is the creator of the Small Bites blog (http://smallbites.andybellatti.com).


1. Nicoll R, Henein MY. Ginger (Zingiber officinale Roscoe): A hot remedy for cardiovascular disease? Int J Cardiol. 2009;131(3):408-409.

2. Dhiman TR, Anand GR, Satter LD, Pariza MW. Conjugated linoleic acid content of milk from cows fed different diets. J Dairy Sci. 1999;82(10):2146-2156.