Bridge
This Newsletter aims to promote communication between schools and the Student Health Service of the Department of Health
June 2015 Issue No.67
Published by the Student Health Service, Department of Health
Editorial
Breakfast is the most important meal among the three main meals in a day. What kind of breakfast should we take? What kind of breakfast could be regarded as a healthy breakfast?
Hong Kong is one of the most talked-about dining destinations in the world. We can have many choices for breakfast. Apart from eating breakfast at home, we may also have breakfast at fast food chains, Hong Kong - style teahouse, congee and noodle restaurants or even convenience stores. Bakery also has a variety of bread and cakes for us to choose, too. We may go for some dim sum in Chinese restaurants with our family in holidays.
How can we take breakfast in such a short time every morning while keeping it tasty and well-balanced? To overcome such challenge, we have invited Dietitians to help in this Issue.
Healthy Breakfast
Student Health Service Dietitian
CHUI Tung-kin, Lily LAM
A lot of people might have heard of the hidden meaning of "Breakfast" i.e. "Break" "Fast" which means "breaking the fast" . After having dinner to the following day breakfast, the period is at least 10 hours. Body has consumed lots of energy; therefore, breakfast is very important to us. A nutritious breakfast not only provides adequate energy for students to handle school activities, but also provides nutrients for body growth and tissue repair. Different types of breakfast are available in the street every morning. Based on the varieties of breakfast, breakfast can be summarized into following groups:
A) Noodles Breakfast Set
"Satay beef noodles with sausage, fried egg and free drink" is commonly seen on the menu in a Hong Kong - style teahouse. How much energy and fat do we get from this type of breakfast? Please read the following analysis¹:
| Food | Weight | Energy (kcal) | Fat (g) |
| Satay beef noodles | 1 bowl (approx. 450g) | 540 kcal | 24.8 g |
| Sausage | 1 piece (approx. 68g) | 183 kcal | 14.3 g |
| Fried egg | 1 piece (approx. 46g) | 90 kcal | 7.0 g |
| Total | 813 kcal | 46.1 g | |
| Daily value (%) | ~40.7% | ~76.8% |
|
*Based on 2000kcal/day
Usually the type of noodles used in "Satay Beef noodles" is instant noodles. As the instant noodles has undergone a deep-frying process, the fat content is relatively high. Sausage is processed meat and most of them are made from high fat meat. In addition, satay sauce is also a kind of high fat sauce. After having this breakfast, it seems like we have consumed about 9-10 teaspoons of oil. Let's try to switch to rice vermicelli in soup or macaroni in soup instead when we order noodles breakfast set at a Hong Kong - style teahouse. For the same amount, the energy of rice vermicelli and macaroni is lower than instant noodles¹.
| Food | Weight | Energy (kcal) | Fat (g) |
| Instant noodles | 100 g | 473 kcal | 21.1 g |
| Macaroni (cooked) | 100 g | 158 kcal | 0.93 g |
| Rice vermicelli (cooked) | 100 g | 109 kcal | 0.2 g |
B) Congee Breakfast Set
The examples of relatively healthy congee are: plain congee, corn congee, pumpkin congee, lean meat congee and fish congee. But pork bone congee, boat congee (congee with squid, pork skin and beef) and congee with pig giblets are relatively high in fat.Try to compare the energy and fat content of the following congee¹:
| Food | Weight | Energy (kcal) | Fat (g) |
| Boat congee | 100 g | 64 kcal | 3.1 g |
| Congee with pig giblets |
100 g | 60 kcal | 2.5 g |
| Plain congee | 100 g | 32 kcal | 0.69 g |
Many people would order other foods at the same time when they have congee for their breakfast such as: steamed rice-roll, fried fritter or fried noodles. Among the foods listed above, steamed rice-roll is relatively lower in fat but it also depends on whether other sauce like sesame sauce and sweet sauce added or not. When eating steamed rice-roll, try not to add too much sauce because 1 table spoon of sesame sauce contains about 15.6 g fat and 189 kcal energy.
C) Steak Breakfast Set
The steak breakfast set that certain fast food chain stores provide usually includes a piece of steak or deep fried fish fillet, plus luncheon meat, sausage, scrambled eggs, toast and a glass of sweet drink. For example, a piece of 3 oz steak and two eggs, which is about 70%-80% of the daily need from meat, fish, egg & alternatives group for a male secondary school student (i.e. 5-6 taels meat). The remaining amount from meat allowed for his lunch and dinner for that day will be about one and a half the size of a ping-pong ball. That means he will eat more protein than his needs for the whole day if he has this steak breakfast set, plus other food. High protein intake increases workload of our kidneys and may cause high uric acid level in our blood, which in turn increases the risk for gout.Besides protein, a steak breakfast set is also high in saturated fat, high in cholesterol, high in salt, and high in energy, but low in dietary fibre. This is exactly the opposite to the principles of healthy eating food pyramid that we know of, that is high dietary fibre, low-fat, low-salt and low-sugar.
D) Dim Sum Type Breakfast
Dim sum type breakfast is well known for its high energy, high fat, high salt, but low in dietary fibre. Besides, since dim sum does not have a set amount compared to other breakfast sets in a Hong Kong - style teahouse, it would be easy for us to eat dim sum more than our actual needs as we can order as much as we want.
Let us make an analysis on a dim sum breakfast (see the below table): for example, if we eat one piece of ha-gau, one piece of siu-mai, ⅓ plate of pork ribs, one piece of spring roll, and one piece of steamed rice-roll with barbecued pork without soy sauce added in a Chinese restaurant, we will consume about 458 kcal. The amount of dim sum listed above may not be enough for most people. But the total sodium intake of this amount of dim sum is already 1020 mg, which is about 51% of the recommended daily sodium intake (daily value %). And the total fat intake is 27 g, which is about 45% of the recommended daily total fat intake (daily value %). Excess sodium intake increases risk for hypertension, cardiovascular diseases and even kidney failure.
| Food and portion² | Energy (kcal) | Sodium (mg) | Fat (g) |
| 1 piece of streamed prawn dumpling (Ha-gau) | 50 kcal | 120 mg | 2.1 g |
| 1 piece of streamed pork dumpling (Siu-mai) | 61 kcal | 160 mg | 3.8 g |
| ⅓ plate of pork ribs | 87 kcal | 220 mg | 5.7 g |
| 1 piece of spring roll | 150 kcal | 210 mg | 11 g |
| 1 piece of steamed rice-roll with barbecued pork (no soy sauce added) |
110 kcal | 310 mg | 4.3 g |
| Total | 458 kcal | 1020 mg | 27 g |
| Daily value (%) | ~23% | ~51% | ~45% |
*Based on 2000kcal/day
Nowadays, most people like to have instant dim sum as their breakfast because it is convenient and time-saving. In addition, dim sum is more popular among the children compared to other healthy breakfast. But why is dim sum so popular among the children? The reason is simple, dim sum contains more flavor enhancer e.g. MSG (monosodium glutamate), which makes dim sum tasty. So, if children get used to eating less healthy breakfast with stronger flavor, they will lose their interest in eating healthier breakfast with less flavor, such as high calcium low-sugar soymilk, oatmeal with skimmed milk and raisins, and peanut butter on whole wheat bread etc.
E) Bread/Sandwich Breakfast Set
The living pace of Hong Kong people is fast. It is not difficult to see students eating bread while rushing to school every morning. Among different types of bread, the relatively popular bread for students are pineapple bun and sausage bun. But the saturated fat of these two types of bread would increase the bad cholesterol in our blood which in turn affect the health of blood vessels if we eat in a long run. Let's compare the fat content of the following bread as below¹
| Food | Weight (g) | Energy (kcal) | Total fat (g) | Saturated fat (g) |
| Baked barbecued pork bun | 100 g | 280 kcal | 9.9 g | 3.2 g |
| Sausage bun | 100 g | 280 kcal | 13 g | 3.5 g |
| Pineapple bun | 100 g | 350 kcal | 11 g | 3.4 g |
| Oat bread | 100 g | 236 kcal | 4.6 g | 0.6 g |
Drinks
Most of the Hong Kong - style teahouse, convenience stores or fast food shops would offer free drink when buying a breakfast set. When choosing drinks, try to avoid drinks with high sugar content. Too much sugar consumption would cause obesity and tooth decay. The common drinks we often order are coffee, milk tea, and lemon water and lemon tea. If we add 2 teaspoons of sugar (e.g. 10 g sugar, ~40 kcal) in a drink every day, we will get 1200 kcal in a month and then 14600 kcal in a year which in turn theoretically gain about 4 pounds. To reduce sugar intake, try to remind the waiter/waitress "less sugar" or "no sugar" when ordering drinks. For packaged drinks, low-fat milk, skimmed milk, high calcium low-sugar or high calcium no added sugar soymilk are better options.The following table shows the sugar content of some of the common drinks¹
| Cold drink ( 1 glass = 300ml ) |
Energy (kcal) | Sugar content in 1 glass (g) | Equivalent to "teaspoons of sugar" (approximation) |
| Iced lemon tea | 140 kcal | 25 g | 5 teaspoons |
| Iced milk tea | 130 kcal | 22 g | 4.4 teaspoons |
| Iced lemon cola | 99 kcal | 23 g | 4.6 teaspoons |
| Iced lemon honey | 100 kcal | 21 g | 4.2 teaspoons |
| Iced coffee | 140 kcal | 20 g | 4 teaspoons |
Healthy DIY Breakfast Choices
If we think we do not have enough time to prepare our breakfast we would just get a sandwich or instant dim sum from convenience store as breakfast. Actually we only have to spend a little bit of time to plan our breakfast the night before, we can then prepare a healthy breakfast for ourselves. The followings are some suggestions of easy-made healthy breakfast:| 1. | Corn and egg (or tuna) sandwich (with less than 1 teaspoon low-fat mayonnaise) + skimmed milk |
| 2. | Corn and shredded chicken salad sandwich (with less than 1 teaspoon low-fat mayonnaise) + skimmed milk |
| 3. | Plain cornflakes (no added sugar) + high calcium low-sugar soymilk + berries/raisins/nuts |
| 4. | Oatmeal with high calcium low-sugar soymilk + raisin/nuts |
| 5. | Peanut butter on whole wheat bread + high calcium low-sugar soymilk |
| 6. | Noodles in soup (rice vermicelli/buckwheat noodles/udon) with seaweed and lean pork + high calcium low-sugar soymilk |
| 7. | Fried udon with shredded cabbage and egg (less than 1 teaspoon of oil when frying) + high calcium low-sugar soymilk |
| 8. | Macaroni in soup with mushrooms and shredded chicken + skimmed milk |
| 9. | Plain bun/raisin bun + banana + skimmed milk |
| 10. | Low-fat cheese and tomato sandwich + small apple |
| 11. | Corn and lean pork congee + high calcium low-sugar soymilk |
| 12. | Boiled sweet potato/taro/corn + high calcium low-sugar soymilk |
Summary
A healthy breakfast should include grains e.g. bread, noodles or cereals as a foundation. The amount of meat should not be more than grains. In addition, breakfast fulfilling the "1 high 3 low" principles (e.g. high dietary fibre, low-fat, low-sugar and low-salt) are considered to be healthy.
Reference
| 1. | Centre for Food Safety. Available at https://www.cfs.gov.hk/english/nutrient/searchmenu.php (accessed Feb 2015) |
| 2. | Health@work.hkProject. Available at https://www.healthatwork.gov.hk/en/content.asp?MenuID=37 (accessed Feb 2015) |
Bridge Blog
Students' favorite choice for breakfast:
| ・ | Low-fat milk + egg |
| ・ | Sandwich + water |
| ・ | Low-fat milk + bread + banana |
| ・ | Cornflakes + soymilk |
| ・ | Oatmeal + apple |
| ・ | Soymilk + biscuits |
| ・ | Lean pork congee |
Bridge Chat
| Hoi-yee﹕ | I got dizziness and stomach ache during the morning lesson. |
| Ying-ying﹕ | You omitted the breakfast, haven't you? |
| Hoi-yee﹕ | Yes. I was in a hurry. |
| Ying-ying﹕ | Excessive stomach acid would be produced if no food intake nearly ten hours. That's why your stomach ached. |
| Hoi-yee﹕ | Ok. |
Junior Health Pioneer
Junior Health Pioneer saw Hau-ming eating the breakfast in the playground.......
| Junior Health Pioneer : | Your sandwich was full of ingredients. |
| Hau-ming : | Of course, with boiled egg, cheese, lettuce and tomato. |
| Junior Health Pioneer : | Well. All are healthy food. |
| Hau-ming : | Also, low-fat, low-salt and low-sugar. |
For enquiries of student's health problem, please send e-mail to "Health Box".
Email Address: shsbridge@dh.gov.hk
Editorial Board Members: Dr. HO Chun-luen, David, Ms. CHAN Shuk-yi, Karindi, Ms. CHOI Choi-fung, Ms. WONG Kwai-kwan, Betty, Ms. CHAN Hoi-yan
Tel : 2349 4212 / 3163 4600
Fax : 2348 3968
(Revised in June 2015)