Eating Abroad with Diabetes – Hong Kong

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How do people with diabetes embrace their inner Julia Child (insert favorite chef here) when traveling abroad?  Do we stick with what we know because it is safer? How can we enjoy food and manage our blood sugars when everything is unfamiliar?  And what do you do if you relocate abroad, as I have, leaving everything behind including your local market, favorite restaurant or Whole Foods store (not to mention extended family, friends and medical connections)?

For the past year I’ve lived in Hong Kong, and while it is not exactly China, it is Cantonese.  And there is a Cantonese saying, “Anything that walks, swims, crawls, or flies with its back to heaven is edible.”  If you are brave enough to meander through the alleys of a Hong Kong wet market—famous for density and oddities—you’ll understand.  Look up and you’ll see loins of pork and other fresh or dried meats dangling above on metal rods or wire.  Remind yourself that it is 30°C (86°F) in the market and keep walking.  Continue forward, but this time look down and survey the maze of fish and fish intestines on the fishmonger’s table – and remember fish are the symbol for luck and money.  The Chinese eat every single fish part; in fact, the Chinese eat almost every part of every animal.  Look down farther below and you’ll find stacked cages of turtles, and frogs or ducks, geese and chicken – too alive and wide-eyed for any westerner to consider eating.   Had enough?

Now is probably a good time to head straight for the pastel circus of vegetables and fruit  – gorgeous zucchinis and gourds, mushrooms and cabbage or Chinese grapefruit (pomelo), dragon fruit and mangos.   Much of the fruit is imported from Thailand or the Philippines, while vegetables are sourced from local farmers.  It is hard not to appreciate their hard work and low prices, but it is also difficult to get excited when rumor has it that local goods grow extra green from “night soil” (soil fertilized with human waste).

What’s a western girl with type 1 diabetes (and a family to feed) to do?

Dining In

I could always head straight for the US, Aussie or European expatriate market and buy a jar of Newman’s tomato sauce, chilled package pasta and a head of iceberg lettuce – for $25 American dollars or more.  At least then I would be able to read the nutrition labels.  But the truth is, with a little compromise and ingenuity,  I can take care of healthy diabetes eating, manage a budget and even eat local .  I know I am crossing the “green” line when I don’t buy completely local, but I go halfway.  I buy almost all veggies and produce locally (I ask about fertilizer when I can) – ditto for grains, rice and noodles.  I buy imported meat, fish and dairy.

A typical meal in my Hong Kong kitchen always comes down to the use of my wok, as it does for the seven million Chinese that live here.  It is a way to flash cook ingredients without losing nutrients.  I substitute olive oil for vegetable oil—and I have developed a self-taught mix and match system for the wok.  Children love it. Below you’ll find five main ingredients—all you need to do is chose one grain, one protein, add two or three vegetables, and flavorings.

1. Grains, 400-500 grams: White or brown rice, rice or wheat noodles.  They all need to be boiled and cooked through.  You can toss them in the wok or serve directly from the pot or strainer.  If you don’t own a wok, a very hot large frying pan will do.

2. Protein (skinned and chopped), 300 grams: pork loin or other, chicken, shrimp (whole), fish (red snapper is a good option) or tofu

3.  Chopped vegetable, 300 grams:  Chinese cabbage (Choi Sum), broccoli, carrots, spinach, beans, asparagus, sweet potato, mushrooms (whatever is seasonal)

4.  Fresh flavors (diced), 20-35 grams:  onion, garlic, ginger – whatever you like

5.  Brown sauce:  Combine 1 tablespoon soy sauce, 1 tablespoon hoi sun sauce, 2 tablespoons rice wine in a bowl and stir– all of these ingredients are available at most US and UK markets, and all have about 3-5 grams of sugar per tablespoon.)

6. Olive oil, water

Example:  Ginger Pork with Carrots and Choi Sum over rice

Coat wok with 1 tablespoon olive oil, then heat on highest flame, and add ginger. Toss for 60 seconds and add pork.  Sear pork for flavoring and brown for two minutes with a pinch of salt.  Remove ginger and pork, set aside.  Add carrots, choi sum, garlic and onion to wok, then add a teaspoon of water, stir and cover for two minutes.  When the vegetables are just tender, add the ginger and pork (again) and pour in dark sauce.  Cook and toss for 2-3 minutes until pork is done (without overcooking the vegetables) and the sauce is slightly reduced.  Serve over 1/2 cup of rice.

30 grams of carbohydrate (depending on how much rice you use)

Fat:  approximately 4-5 grams

Dining Out

Eating out is a major pastime in Hong Kong – perhaps because most locals live in apartments no larger than a couple of hundred square feet – and no food is more popular than Dim Sum.  Dim Sum means “from the heart” and on any morning or Saturday afternoon you’ll find extended Hong Kong families or business men seated at round tables choosing a variety of items from the trolley carts.  It’s important to learn how to navigate through the huge assortment of fatty foods cooked in heavy oil and syrupy sauces.  The table will be covered with a palette of brown (sugar or fat) or white (dough) with soy or sweet sauces for dipping.

Sadly, vegetable dishes are not a part of Dim Sum dining, instead, it’s all about rice noodles and pork or pork fat, dumplings which are steamed or fried with shrimp and meat and a tiny bit of shredded cabbage.  Choosing the steamed option is best, but watch out – a steamed pork bun has more than 30 grams of sugar, and barbecue sauce used for duck dishes and pork is very high in fat and sugar.  When I have had enough of dumplings, spring rolls, pot-stickers and noodle rolls, I usually ask for a bowl of rice and choi sum, even though the waiter might grimace and walk away sucking his lips (a sign of disappointment).

Bottom Line

Eating Dim Sum (and many other high fat/high carb Asian dishes) is not easy for diabetics, but with common sense and moderation, it can be done without a sugar overload.  Eating in requires more work, but guarantees a great meal and better control of my blood sugar.  And I love the flash cooking!

For over twenty years, Elizabeth Snouffer worked in marketing and advertising in New York, London, and Paris with Grey, WPP and Publicis in the pharmaceutical and health-care communications sector while also dedicating much of her energy in a volunteer capacity to juvenile diabetes and JDRF.  Today she lives in Hong Kong where she continues to consult in healthcare communications.  She is also working on her first book.  See her diabetes blog at www.diabetes24-7.com

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Comments (3)

  1. What a walk down memory lane!  Thanks!  My wife is very good with Chinese vegetables and likes the wet market.  She lived and worked there for five years before she came to the US, and I was fortunate to be able to visit her twice.  Even I loved the wet market and it did not bother me after having spent almost four years in Africa and buying food in the markets there.

  2. Carolyn Robertson at

    Elizabeth, I want to thank you for your article on Hong Kong and eating abroad. Diabetes is a disease that requires commitment and perseverance; the ability to be creative and the skill of a juggler.   Your strategies   illustrate how to modify a meal (both at home and eating out) to eliminate saturated fats, reduce simple sugars and choose lower glycemic foods (the cornerstone of a diabetes meal plan).   You proved that it is possible to live healthy and well with diabetes even when living or eating abroad. Kudos’s to you

  3. Irene Bennett at

    Well-written, Elizabeth!  You captured the culture shock of Westerners new to Hong Kong and the challenges of diabetic eating in Hong Kong very well.  And, your vivid descriptions, sly humor, accurate instructions for cooking, and great recipe are delightful.  GOOD JOB writing for people with diabetes and new to Hong Kong!

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