Thailand Culture

Emerging Trends in Dietetics Project

Aramark Dietetic Internship

Jordan Scheinberg, Stephanie Erbacher, Kathryn Schneider

PROJECT OVERVIEW

- This project was designed to highlight the trend of

developing cultural competency in dietetic and

nutrition-related professionals.

- An educational handout on the specific country's food

and culture was created.

- A seven-day menu similar to the specific country's

culture developed using Aramark's current Patient

Services menu.

- A nutritional analysis of the menu was completed.

- PowerPoint was developed to present the findings.

EDUCATIONAL

HANDOUT

GENERAL INTRODUCTION

17.3 million Americans (5.6%) identify as Asian, either

alone or in combination with one or more other

races.1

The largest numbers of Thai people living in the U.S.

reside in Southern California (about 30%).

East Hollywood has seen a proliferation of Thai culture.

Thai owned businesses and markets that specialize

in Southeast Asian groceries and traditional dishes

are common in that area.2

The educational handout provides important health related information regarding Thailand

culture. RD’s and other nutrition-related health professionals can read this brochure to gain

competence, so that they are able to provide the best quality care to this population.

TRADITIONAL MEAL PATTERNS

Thai meals are typically served family style, but does not include

an appetizer. Instead there are several components to a meal:

soup, a deep-fried dish, a stir fry, and a curry.

● Thai food is generally spicy, hot, and high in sodium.

● Rich in carbohydrates (rice, noodles, tropical fruits,

vegetables)

● High in protein- pork, beef, chicken and fish

● Rice is the main staple- Jasmine rice is long grain sweet

smelling rice that is native to Thailand.

● Thai noodles stir-fried with pieces of meats and

vegetables- Pad Thai is Thai style fried noodles.

● Curry and soups are served at every meal. Most curries are coconut-milk based. Tom

Yum Goong is a spicy shrimp soup and Tom Kha Kai is a chicken and coconut soup.

● Thai salad made of raw vegetables mixed with chili, lime, and a fish sauce- Som Tum is a

spicy green papaya salad.

● Fruits such as banana, pineapple, watermelon, coconut, mango, and papaya are plentiful.

As well as exotic fruits, such as dragon fruit, chompu, durian, jackfruit, tamarind and Kaffir

lime.

● Thai desserts are usually a combination of rice, coconut milk and fruits, although

sometimes it includes cakes and ice cream- Rolled ice cream is a specialty of Thailand.4

TRADITIONAL DISHES

HEALTH BELIEFS & PRACTICES

Buddhism has a huge influence on Thailand’s traditional health beliefs.

A principle concern of Buddhism focuses on eliminating suffering and keeping balance and

harmony.

Traditional Thai medicine believes the human body is composed of 4 basic elements:

Earth, Wind, Fire, Water

In order to stay healthy, we need to have the four elements in perfect harmony.

Illness can be caused by supernatural powers, powers of nature/universe or by Kimijati (a

microorganism/parasite induced illness).

Herbal medicines and Western medicine is practiced by Thai people. 5

BARRIES TO GOOD NUTRITION

2 million Asian Americans do not have insurance in the U.S.

1 in 5 Asian Americans between ages 18-64 have no health insurance or have been

uninsured at some point in the past year.

• Asian Americans with limited English proficiency have difficulties in understanding the

U.S. health care system.

• Many Asian-Americans may not know about disease risk factors or the role of preventive

health care.

• Cultural beliefs about health and illness often conflict with Western medicine, which

keep some Asian-Americans from seeking help for symptoms or sticking with treatment. 9

COMMUNICATION GUIDELINES

Thai people greet each other with a "wai" (why). They place the palm of their hands together,

with their fingers extended at chest level close to their body. Foreigners are not expected to

initiate, but it is an insult not to return the “wai”.

❖ Touching someone of the opposite sex in public is taboo.

❖ You also never touch or pass anything over anyone's head.

❖ Do not put your hands in your pockets while talking to someone.

❖ Don't wave your hands about as you talk.

❖ One’s head is considered sacred in Thailand and must be respected.

❖ Feet are regarded as unclean. Never point your feet at anyone or use your feet to move

anything.

❖ And never pass anything with your left hand, only the right hand is used. And never point

with your hand. 8

NUTRITION COUNSELING CONSIDERATIONS

It would be beneficial to replace white Jasmine rice with brown

Jasmine rice.

Increase the consumption of traditional fruits and vegetables

such as banana, pineapple, watermelon, coconut, mango,

papaya, lime, asparagus, corn, chili, broccoli, carrots, cucumbers, eggplants and onions

will add fiber and variety.

Choose lean cuts of meat, such as poultry and fish instead of beef and pork will

decrease the intake of saturated fat.

Decrease the amount of fat used in stir-frying by choosing unsaturated fats like

vegetable oils.

SEVEN

DAY MENU

SEVEN DAY MENU

House diets were created for:

Regular

Heart Healthy

Various food changes were made those diets to reflect a

more culturally appropriate Thai meal.

CHO controlled/2 GM Sodium

Consistent Carbohydrate

Original Food Item WHY not Culturally Acceptable Cultural Food Selected

Chocolate Pudding Fresh tropical fruits are more prevalent in the Thai

diet

Pineapple

Chilled Peaches Prefers fresh tropical fruits Pineapple

Herbed Potato Wedges Rice is the more common carbohydrate choice White Rice

Mashed Potatoes Rice is the more common carbohydrate choice White Rice

Fresh Apple Banana is a more common fruit choice Whole Banana

Chicken Vegetable Noodle

Soup

Pho & Tofu is a Asian cultured dish Pho & Tofu Broth Bowl

Macaroni and Cheese Thai enjoy spicy food similar to a creole seasoning Chicken & Shrimp Creole

Roasted Herb Pork Loin Fresh fish is found more commonly over pork Baked Cod with Lemon Dill

Sauce

Roasted Red Potatoes Noodles are a more common carbohydrate choice Lo Mein Noodles (Yakisoba)

CULTURAL SUBSTITUTIONS

o Limited availability of fresh tropical fruits on the pick list.

o No option for coconut milk. Coconut milk is highly prevalent in

the Thai diet being present in most sauces/soups.

o Jasmine rice is eaten at almost every meals, was not available

on the pick list, so we settled for white rice.

o Limited availability of fresh shellfish dishes on the pick list.

o Small accessibility of spicy foods.

CULTURAL SUBSTITUTIONS

• Difficulties with making cultural menu changes:

NUTRITIONAL

ANALYSIS:

TUESDAY Carb Control/

2GM Sodium Diet

NUTRITIONAL ANALYSIS: BREAKFAST Item KCAL PRO TOTAL FAT CHO NA FIBER K+ P

Apple Juice 59.424 0.124 0.161 13.618 11.761 0.124 85.422 8.666

Cream of Wheat 104.362 3.006 0.438 21.958 19.621 1.044 35.762 31.309

French Toast 621.35 10.314 24.516 91.524 832.55 2.322 20.51 31.334

2% Milk 125.502 8.564 4.725 12.23 127.963 0 398.654 246.083

Coffee 0 0.2 0 0 4.7 0 128 2.4

Butter 35.85 0.043 4.056 0.003 32.15 0 1.2 1.2

Half & Half 14.723 0.335 1.302 0.487 4.643 0 14.723 10.759

Diet Syrup 1.417 0 0 0.34 62.397 0.227 5.5 0

Yellow Sug Sub 3.36 0 0 0.912 0 0 0.04 0

Meal Subtotal 965.988 22.586 35.198 141.072 1095.785 3.717 689.811 331.751

Percent of Goal % 46 28.50 50.20 48.80 54.70 14.80 18.60 26.50

NUTRITIONAL ANALYSIS: LUNCH Item KCAL PRO TOTAL FAT CHO NA FIBER K+ P

Broth Bowl, Pho, Tofu 168.979 9.645 4.45 24.035 557.129 3.559 293.971 112.438

Creole, Chicken, Shrimp 245.049 17.199 4.157 33.839 240.891 1.966 425.702 126.21

2

Green Beans 18.628 0.991 0.113 4.291 0.665 1.996 105.778 19.293

Fresh Fruit Cup 35.72 0.499 0.115 9.161 6.993 0.756 150.252 10.206

WW Bread 61.828 3.069 0.579 11.888 118.147 1.664 62.082 53.287

Iced Tea 2.37 0 0 0.711 7.11 0 87.688 2.37

Butter 35.85 0.043 4.056 0.003 32.15 0 1.2 1.2

Pepper 0.3 0 0 0.1 0 0 1.3 0.2

Herb Seasoning 1.9 0.1 0 0.4 0.5 0.1 7.6 1.3

Meal Subtotal 570.624 31.546 13.47 84.428 963.585 10.041 1135.57

3 326.50

6

Percent of Goal % 27.10 39.90 19.20 29.20 48.10 40.10 30.60 26.10

NUTRITIONAL ANALYSIS: DINNER Item KCAL PRO TOTAL FAT CHO NA FIBER K+ P

Cream of Broccoli Soup 205.537 9.821 12.776 13.718 340.917 1.735 234.771 73.32

Honey Baked Chicken 202.07 25.895 3.063 17.32 81.035 0.173 235.366 191.092

Carrots 68.27 1.049 2.5 11.244 77.87 4.082 314.953 40.207

Roasted Red Potatoes 123.179 2.774 2.715 22.041 44.551 2.474 593.013 75.371

Pineapple, Fresh 41 0 0 11 1 1 90 7

WW Roll 100.8 2.6 1.4 19.6 176.5 1.7 16.2 14

Iced Tea 2.37 0 0 0.711 7.11 0 87.688 2.37

Butter 35.85 0.043 4.056 0.003 32.15 0 1.2 1.2

Herb Seasoning 1.9 0.1 0 0.4 0.5 0.1 7.6 1.3

Pepper 0.3 0 0 0.1 0 0 1.3 0.2

Meal Subtotal 781.276 42.282 26.51 96.137 761.633 11.264 1582.091 406.06

Percent of Goal % 37.20 53.50 37.80 33.20 38 45 42.70 32.40

NUTRITIONAL ANALYSIS: ENTIRE DAY

KCAL PRO TOTAL FAT CHO NA FIBER K+ P

DAY TOTAL 2317.88

8

96.41

4

75.178 321.63

7

2821.00

3

25.022 3407.47

5

1064.31

7

Percent of

Goal(%)

110.30 121.9

0

107.20 111.20 141 100 91.90 85

REFERENCES

1. Hoeffel EM, Rastogi S, Kim MO, Shahid H. The asian population: 2010. U.S. Census Bureau. Washington, DC; 2012.

https://www.census.gov/prod/cen2010/briefs/c2010br-11.pdf

2. Our community. Thai Community Development Center Web site. http://thaidc.org/ourcommunity. Accessed December 4,

2016. http://www.ediplomat.com/np/cultural_etiquette/ce_th.htm

3. Health and nutrition benefits from eating thai food. The Thai Food Company Ltd Web site.

http://thai.iu/health_and_nutrition.html. Accessed December 4, 2016.

4. About thai food. Tourism Authority of Thailand Web site. http://www.tourismthailand.org/About-Thailand/Food-Drink.

Accessed December 13, 2016.

5. Roundy C, Chaudhari M, Castro D. Traditional thai medicine. Westminster College’s Thailand May Term Blog Web site.

https://maytermthailand.org/2011/05/01/traditional-thai-medicine. Published May 1, 2011. Accessed December 4, 2016.

6. Thailand. World Health Organization Web site. http://www.who.int/countries/tha/en/. Accessed December 4, 2016.

7. Suwal S. Water in crisis-thailand. The Water Project. https://thewaterproject.org/water-crisis/water-in-crisis/thailand.

Accessed December 13, 2016.

8. Cultural etiquette. eDiplomat Web site. http://www.ediplomat.com/np/cultural_etiquette/ce_th.htm. Accessed December

13, 2016.

9. Asian American health initiative. Department of Health and Human Services. Montgomery County, MD; 2005.

http://www.aahiinfo.org/english/asianAmericans.php. Accessed January 29, 2017.

10.All images are from http://www.freeimages.com.