Christmas is traditionally a time of overeating, and New Year a time to think about healthy eating! HTU asked Nutrition Volunteer Tom Dunn and Public Health Nutritionist Anna Denny, of The Food Chain, to write a piece for African people with HIV new to Britain, or in Britain and new to HIV, who may be struggling to eat well on a budget.
Healthy eating is for everyone and January is the time to kick-start those healthy eating habits! In this article we look at African foods and healthy eating, how to find UK alternatives to African foods and eating well on a budget.
Adapting to European or ‘western’ foods
Visiting or moving to a new country often brings challenges and difficulties but it can also be a great opportunity to try new things. Many people find they enjoy mixing new dishes and ingredients with their more traditional diet, replacing some ingredients with more readily available local alternatives.
‘Western’ food is often based around convenience so be careful about the type of foods you choose. Many of the foods available that are quick to prepare, appealingly packaged, or cheap, are high in fat, salt and sugar.
Try to cook using fresh ingredients or those that are processed when fresh (most tinned or frozen foods are fine), rather than pre-cooked ones like microwave ready-meals (though these may have a place when you are ill), and check food labels to see the amount of fat, salt and sugar in foods.
Healthy eating
The following is a basic guide to the balance of foods we should be eating to stay healthy:
Starchy foods: Bread, rice, potatoes, pasta and other starchy foods
These foods should make up about one third of what we eat. They are a good source of energy and provide us with fibre, calcium, iron and B vitamins. They are also low in fat (though be careful how much fat you add when cooking them!). Starchy foods include rice, cassava, sweet potato, plantain, millet, potatoes, maize meal (ugali), fufu, banku, gari, chapattis, pasta and bread.
Top tip: Choose wholegrain varieties when you can (such as wholemeal chapattis, brown rice and wholewheat pasta) because they provide more fibre.
Fruit and vegetables
Try to eat at least five portions of fruit and vegetables a day. This food group includes sweet bananas (but not plantain or green bananas), pumpkin, mango, avocado, pineapple, papaya, tomatoes, greens (e.g. spinach, callaloo), carrots, apples, broccoli and many other types of fruits and vegetables. A portion of fruit or veg is about the amount that fits into the palm of your hand. (see www.5aday.nhs.uk/WhatCounts/PortionSizes.aspx). To make it easy to get your 5-a-day, try adding extra veg to stews, snacking on fruit instead of sweet treats and making the most of frozen veg and dried fruit.
Protein: Meat, fish, eggs, beans etc.
Aim to eat three portions of protein foods each day (one at each meal including breakfast). This could be chicken, mutton, goat, fish, lamb, pork or seafood, or vegetarian sources of protein such as beans, lentils, eggs and nuts.
Milk and dairy foods
Try to eat three portions of lower-fat dairy foods a day: cow’s and goat’s milk (check it’s pasteurised), lower-fat cheeses and low-fat yoghurts. Lower-fat dairy foods are better for your heart, but you may want to choose full-fat varieties if you’re trying to gain weight. If you find that dairy products give you a bad tummy, eat live natural yoghurt, and try hard cheeses such as cheddar, edam and emmental, which contain very little lactose. If you can afford fresh milk it’s a better choice than powdered milk or tinned/UHT milk because it contains more vitamins.
Top tip: If you’re not familiar with UK dairy foods, why not try low-fat soft cheese, cottage cheese, goat’s cheese and ricotta. These are all low in ‘bad’ saturated fat!
Fats and oils
These should only be used in small amounts. Unless you are underweight, try to use only one teaspoon of oil per person when you are cooking. Try to use less palm oil, coconut cream and butter (as these are high in saturated fat, which can give us high cholesterol) and try to cook with rapeseed oil, olive oil and coconut milk instead.
Sugary foods and drinks
These foods contain a lot of extra energy (calories) that most of us don’t need and they’re bad for our teeth – gum disease is especially common in people with HIV. Even so-called ‘diet’ drinks are acidic, which is bad for your teeth. Try to cut back on fizzy drinks, cola and malt drinks, chocolate, biscuits, sweets, cakes and pastries. Better to eat more slow-release carbohydrates instead such as rice, sweet potato and wholemeal chapattis, especially if you have diabetes.
Salty foods
Salt and salty foods can lead to high blood pressure, if eaten in large amounts, and this can increase the possibility of having a stroke. Reduce the amount of salt you use in cooking (by using more spices, garlic and lemon to add flavour), and remove the salt shaker from your table. Try to eat less salted fish and meat.
African foods in the UK
African foods tend to be naturally nutritious and healthy, because they are high in fibre and low in ‘bad’ saturated fat. But if you’re living in the UK, you may find that a lack of available African foods, the high cost of foods, and unfamiliarity with British foods can make it difficult for you to eat a healthy, balanced diet.
In inner-city London and other large UK cities it is relatively easy to find at least some African food shops, but in smaller cities it can be more difficult to find familiar foods. It’s worth knowing about some good substitutes for African foods that you can find easily in the UK – and how to adapt to the UK diet.
UK alternatives to African foods
If you can, ask people in your local community about nearby shops that stock foods you’re familiar with. Remember that buying African foods in the UK can be expensive, and often foods are not as fresh as foods that are grown here. For this reason it’s a good idea to find some UK substitutes for African foods.
You may be able to find yams, millet, plantain, cassava and sweet potato. These are a healthy choice because they are high in fibre and low in fat. If you cannot find them, butternut squash, pumpkin, swede and parsnips are good alternatives – cook them in the same way as yam or sweet potato. Because these foods grow readily in the UK in the winter, they are often cheaper than African starchy foods. They do not contain many vitamins and minerals so it’s important to eat lots of brightly coloured fruits and vegetables as well (try to eat a ‘rainbow’ of colours of fruit and vegetables!). How about growing greens or tomatoes in a window box or bin or finding out about allotments?
You may find fufu flour in some shops but, if not, a similar food can be made from rice flour or powdered instant potato, which are more readily available in the UK. Garri or eba can also be made using powdered potato flakes, if you can’t find cassava flour. Most UK supermarkets sell semolina, corn meal (polenta), rice, sweet potato and tapioca (cassava flour) more cheaply than African stores. Sadza, ugali, nshima, sima and banku can all be made from corn meal (polenta) but be aware that ‘cornflour’ sold in UK shops is not the same as corn meal so look out for ‘fine polenta’!
'Western' food is often based around convenience so be careful about the type of foods you choose.
African fruits such as mango, pineapple, guava and papaya (paw-paw) are a great source of vitamins but they are expensive in the UK. British fruits such as apples, pears, blackberries and (in summer) strawberries and raspberries provide just as many vitamins and may be fresher. Fresh or frozen spinach makes a good alternative to greens or callaloo and the UK courgette or marrow is fairly similar to cho cho.
Fish such as tilapia and red snapper can be expensive so try cooking with pollack or coley. If you don’t know what these fish look like, ask the fishmonger in the supermarket to help you. Sardines, mackerel (fresh or canned) and canned salmon are cheap varieties of fish and contain healthy ‘omega 3’ – a type of ‘good’ fat that we need for our hearts and brain.
Goat meat can be difficult to buy in the UK but beef, lamb, mutton, chicken and pork are easily found. More and more butchers and supermarkets now offer Halal meat. Game birds such as guinea fowl are seasonal and expensive in the UK but chicken and turkey are cheap, nutritious alternatives. Groundnuts are a good source of protein – these are called peanuts or monkey nuts in the UK so look out for peanut butter/oil in the shops rather than groundnut paste/oil.
Finally, remember that some ingredients are widely available in the UK but are called a different name – eggplant is known as aubergine, ochroes/green fingers as okra, and cilantro/gilantro as coriander so keep your eye out for what looks familiar.
Living on a budget
Lidl, Aldi, Netto and Asda are often the supermarkets with the largest range of more affordable products, though they do not always stock a lot of African foods. Other supermarkets, such as Tesco and Sainsbury’s, have ‘value’ ranges to help reduce the cost of regular items used every day. Many of these supermarkets offer large packs of foods that keep a long time (e.g. rice) for less money per kilo than the smaller packets cost. This can save you a lot of money in the long term. Try buying larger bags of rice and flour and splitting them with a friend or neighbour.
Small shops and convenience stores are generally more expensive than larger supermarkets so try to only use these to top up your food stores in an emergency. But beware of offers in supermarkets that might make things you don’t really need appear much cheaper than they actually are. Also, try not to go shopping when you are hungry!
Kitchen items
If you have just arrived in the UK it might be hard to find accommodation with a kitchen or cooking facilities. Some of the following things should help make it possible for you to cook for yourself and prepare at least some foods from scratch:
- Get hold of a tin opener, a sharp knife, a chopping board and, if you have a cooker, a saucepan. You can often find these items cheaply in charity shops or supermarkets.
- Try to get access to a portable hob, cooking rings or microwave and if you can, a fridge.
- Ask if there’s a sink with hot water you can use and buy some washing up liquid. If not, a plastic bowl with a kettle to heat water makes a good alternative.
- Remember to wash your hands, equipment and surfaces when you’re preparing food to reduce the chances of getting ill, especially if you’re sharing a kitchen with other people.
- If it is not possible to get access to a fridge, try to buy dried or canned food and always cook and eat meat or fish on the day you buy it.
For more information
For more information on eating well when you’re living with HIV contact The Food Chain on 020 7354 0333, visit www.foodchain.org.uk or email info@foodchain.org.uk. The Food Chain also runs free healthy eating and practical cookery classes for people living with HIV in London, where you can learn how to cook some of the UK alternatives to African foods mentioned in this article. To register for classes call 020 7354 0333 or email info@foodchain.org.uk.
For a free copy of NAM’s Nutrition booklet, written for people living with HIV, contact NAM on 020 7837 6988 or email info@nam.org.uk.