International Carbohydrate Counting Education: A Diabetes Tool for the Nepali-speaking Bhutanese
by Shannon Ebron, BS Lillie Larsen, RD, LD, CDE
International Carbohydrate Counting Education: A Diabetes Tool for the Nepali-speaking Bhutanese TABLE OF CONTENTS Table of Contents ....................................................................... 2 Introduction to Bhutanese-Nepali culture and cuisine................. 3-8 ! ! ! ! ! ! ! ! !
The Bhutanese-Nepali....................................................... 3 Religious Beliefs................................................................ 4 Caste System.................................................................... 4 Health Customs................................................................. 4 Literacy.............................................................................. 4 Traditional Nepali Eating Practices................................... 5 Purpose, Organization, and Use of Booklet...................... 6 References........................................................................ 7
Pictorial Tools.............................................................................. 8 ! ! ! !
Pictorial Guide: Notes for Educators................................. 9 Carbohydrate Food List.....................................................10 Non-Carbohydrate Food List.............................................11 Traditional Meal Planner....................................................12-17
Traditional Food List...................................................................18 ! !
Food List: Notes for Educators..........................................19 Traditional Exchange List..................................................20-26
Recipes.......................................................................................27 ! ! Cabbage and Potatoes......................................................28 ! ! Cooked Tomato Chutney “achar�.......................................29 ! Green Leafy Tarkari (Sag Tarkari)......................................30 ! Mas ko dal or Mugi dal.......................................................31 ! Mixed Vegetable (mismas)................................................ 32 ! Nepali Egg Curry................................................................33 ! Potato and Cauliflower Pickle............................................34 ! Sikarnai (Yogurt Pudding)..................................................35
3 According to the 2010 United States Census, the Asian population is one of the fastest growing in the United States. Given that Asian Americans are diverse in languages, religions, racial types, social habits and cultural practices; food preferences and diets also differ greatly among their sub-groups and individuals(1). The Bhutanese-Nepali One subgroup, the Bhutanese-Nepali, is suffering an epic refugee crisis and has one of the highest numbers of refugees in the world in proportion to its population. The Nepali speaking Bhutanese or Lhotsampas are primarily Hindu people who moved from Nepal to Bhutan and lived there in peace until the mid-1980s. In the mid-1980s attempts were made to eradicate the cultural heritage of the Lhotsampas due to fear that their presence would diminish the traditional Buddhist culture of the majority group, the Druk Bhutanese. With the goal of forming a Bhutanese national identity, Bhutan’s king and the ruling Druk initiated a cultural campaign, known as “One country, one people,” or Bhutanization,” which established policies that forced the Druk dress code, religious practices, and language on all Bhutanese regardless of heritage. Furthermore, the citizenship of the Lhotsampa people was challenged as well. Complicated requirements showing proof of citizenship were enforced, but even when these requirements were met, citizenship was still denied. Thus, over 100,000 Lhotsampa Bhutanese fled or were forced out of Bhutan and resettled in southeastern Nepal (2). As a result, refugee camps have been the home of more than 105,000 Bhutanese for over 15 years. Resettlement processes have been underway since 2008 with a significant number of registered Bhutanese refugees living in the United States. (46,069 entered the US between 2008 and 2011)(3).
4 Religious Beliefs. Among Bhutanese refugees, 60% are Hindu, 27% are Buddhists, 10% are Kirat, and others follow Christianity (2). Caste System. An intricate caste system is followed by many Bhutanese with a total of 64 castes, groups, and parties represented in refugee camps. Adherence to the caste varies in both the Nepal refugee camps and in U.S. communities; for some it still holds importance, while others have dropped its use (2). Health Customs. Bhutanese-Nepali refugees prefer to receive medical treatment in the form of home remedies first. Then, if symptoms persist or become serious, outside medical care is sought. Additional factors such as modesty, lack of health coverage, and financial demands may also prevent the Bhutanese-Nepali community from seeking preventative medical care. Considering these influences, patients may feel reticent about sharing information about their traditions and health practices (4). Literacy. Typically, Asian Americans are perceived as an ethnic group with high socioeconomic status; however a considerable number of them lack education, income, or job skills. New immigrant communities may encompass academic and technical professionals and students pursing higher education, as well as older immigrants dependent upon family members (5). Most Bhutanese refugees are bilingual. At home, Nepali is spoken, but the Bhutanese language Dzongkha may be spoken as well. Not all refugees, however, can read or write their native language(s). The literacy rate in their own language(s) is estimated to be about 65% (6). Literacy is especially low among older women.
5 Young members of the refugee community may also speak English due to their exposure to this language in the refugee camps. It is estimated that about 35% of refugees in Nepali camps have a functional understanding of English (2). Traditional Nepali Eating Practices Meals are traditionally eaten seated on the ground or while squatting. A large mound of rice or other “bhat” (grain) surrounded by “tarkari”(prepared vegetables), “dal” (lentil soup), and yogurt is served on a large platter. Food is eaten with the fingers of the right hand. Guests, men and children usually eat before the women, who serve the meals while the others are eating. Eating two meals per day with tea and/or snacks between meals is typical. Bread is sometimes eaten with a meal or in place of rice. Bread is often “roti” (flat, round bread of various sizes) or “puri” (deep-fat fried, hollow, puffy bread.) Some Bhutanese-Nepali eat meat, with goat, chicken and fish being the most commonly eaten. Pork and buffalo are eaten by some, and beef is rarely eaten. “Tarkari” or vegetable curries are cooked with many spices and are very flavorful. Butanese-Nepali enjoy the flavor of chili peppers and, in some dishes, these are a major ingredient. Other preferred spices include fenugreek, cumin, turmeric, garlic, ginger, pepper and mustard. “Achars” (pickles or spicy vegetables) can be fresh or fermented, and are a very important part of meals. There are thousands of recipes for “achars;” some are sweet, some are spicy, some contain starchy vegetables such as potatoes while others do not.
6 Snacks are often tea with “biscuits” (international boxed cookies), beaten rice and milk, dried fruit candy or other sweets. Potato chips and instant noodles are also becoming popular. Beverages include tea (often taken with a large amount of milk), coffee (also taken with milk), milk (whole, 2%, condensed or half and half), and some traditional alcoholic beverages. Carbonated drinks are also becoming popular. Purpose, Organization, and Use of this Booklet The aim of this material is to offer a culturally appropriate carbohydrate counting resource for Registered Dietitians (RDs) who counsel Bhutanese-Nepali patients with diabetes. Highlights include: •
A basic overview of Bhutanese-Nepali culture and cuisine
•
A pictorial tool that categorizes traditional foods and differentiates between carbohydrate and non-carbohydrate foods.
•
Pictures illustrating traditional meals in a meal planner format
•
A list of traditional foods preferred by this culture, categorized by food group, with specific information about carbohydrate content.
•
Adaptations of traditional recipes with nutrition facts and number of carbohydrate choices per serving.
It is hoped that this booklet can assist RDs in guiding patients with a BhutaneseNepali background to improve blood glucose control. It was designed to be a practical tool for providing culturally relevant carb-counting information. Some parts of it are meant to be used as patient handouts and others as RD resources. The intended use of these resources will be explained further throughout the materials.
7 References 1. Academy of Nutrition and Dietetics (2012). Asian Indian: Food practices. Retrieved from http://nutritioncaremanual.org/content.cfm?ncm_content_id=80528 2. Centers for Disease Control and Prevention. (2012, June 22). Background: Bhutanese refugee health profile. Retrieved from http://www.cdc.gov/immigrantrefugeehealth/profiles/bhutanese/background/index .html 3. US Department of State, Bureau of Population, Refugees and Migration (PRM) 4. Maxym, M. (2010). Nepali-speaking Bhutanese (Lhotsampa) cultural profile. Retrieved from http://ethnomed.org/culture/nepali-speaking-bhutaneselhotsampa/nepalispeaking-bhutanese-lhotsampa-cultural-profile 5. Misra, R., Patel, T., Kotha, P., Raji, A., Ganda, O., Banerji, M‌Balasubramanyam, A. (2009). Prevalence of diabetes, metabolic syndrome, and cardiovascular risk factors in US Asian Indians: results from a national study. Journal of Diabetes and Its Complications, 24, 145-153. 6. International Organization for Migration
8
PICTORIAL TOOLS
9
Pictorial Guides: Notes for Educators These illustrated carb-counting resources were created following principles of universal design. These resources include carbohydrate and non-carbohydrate food lists depicting traditional Bhutanese/Nepali foods, plus representations of meals using the plate method. The use of these illustrations will hopefully give Bhutanese/Nepali clients of varying literacy levels an opportunity to learn how to manage their diabetes while consuming foods traditional to their culture. The pictorial lists of carbohydrate and non-carbohydrate foods were designed to help clients differentiate between these two groups of foods. The Nepali scripts under the English titles tell clients which foods cause blood sugar to rise and which do not. This wording was chosen since there is no meaningful equivalent for the word “carbohydrate” in Nepali. There are two sets of Bhutanese/Nepali plate planning guides: one intended to be used by the RD/Educator, and the other by the patient/client. Both sets depict traditional meal combinations; however, the RD set contains typical serving sizes, while the patient/client set does not. This allows the educator, with the help of an interpreter, to write appropriate food portions on the patient/client set. It is hoped that these materials will help clients learn how to assemble healthy meals consisting of both carb and noncarb foods. Teaching hints for Educators: 1. Intended use of these materials: teach Bhutanese/Nepali patients or clients what is and is not a carbohydrate food (or which foods will or will not increase blood sugar), and how to piece together a meal with an appropriate number of carb servings. 2. Recommend educators help clients set a goal of how many carbohydrate portions to consume per meal, once they are comfortable with recognizing and choosing them. 3. Suggest educators assess the comfort level of clients in measuring carb portions taking the following into account: • Measuring in Bhutanese/Nepali cookery and recipes is not the norm. • American customs of eating at a table or using individual plates and placing one’s own portions of food on them may or may not be practiced. • When patients have advanced literacy skills, or are motivated to accurately count carbohydrates, the use of measuring cups and spoons to indicate portion size may be possible • If literacy skills are low, recommend using the patient’s fist or other visuals to represent portion size. Likewise, food models can help reinforce serving sizes. It is hoped that these tools will help clients to limit and become more aware of the carbohydrate content of their meals without overwhelming them or their educators, thus ensuring that teaching sessions are effective for all participants.
10
BHUTANESE/NEPALI CARBOHYDRATE FOOD LIST !"#$% "&'()*('+,-) .* $%/ 0!1 2,%34 5%,% (Ragat Ma Guliyo Ko Matra Badaunay Khana) Breads & Grains %&'(
Legumes/Pulses/Daal !"#$
!"#$% ,Beaten Rice
!
Fruit )#)*#!
!
Starchy Vegetables +%,"%(
!
Green Pumpkin '() Milk *+
!"#$%& '()( Sweets & Snacks
!&$ Rice Pudding
BHUTANESE/NEPALI NON-CARB FOOD LIST !"#$% "&'()* +,#- ./%01 2%/%+* 3!-+%! (Ragat Ma Guliyo Ko Matra Kamti Banaunay Khana) Non-Starchy Vegetables !"#$"%
!
!
! !
!
!
!"#,$%&% '( )*!+'% ), $%#+ Meats, Poultry, Fish !
-,#,,./0,12 Fats and! Oils !
)!(* ,Paneer !
!
!"# $% &'(' Sesame Seeds
+,- *'"% .'+/
Red Meats including... Goat (Mutton) Lamb Buffalo/Bison
11
12
BHUTANESE/NEPALI PLATE PLANNER (Examples of acceptable patient meals for educator reference)
Yogurt (Carb) 1/2 cup
Dal (Carb) 1/2 cup
Brown Rice (Carb) 1 cup
Green Leafy Tarkari (Non-Carb) Example of meal with 4 1/2 carbs
13
BHUTANESE/NEPALI PLATE PLANNER (Examples of acceptable patient meals for educator reference)
Apple 1 (Carb)
Brown Rice (Carb) 1 cup
Milk 1 cup
Grilled Chicken Breast (Non-Carb)
Green Leafy Tarkari (Non-Carb) Example of meal with 5 carbs
14
BHUTANESE/NEPALI PLATE PLANNER (Examples of acceptable patient meals for educator reference)
2 Roti (Carb)
Dal (Carb) 1/2 cup
Grilled Chicken Breast (Non-Carb)
Broccoli (Non-Carb) Example of meal with 3 carbs
BHUTANESE/NEPALI PLATE PLANNER
!"#$%& /'($)*+, - .$&$ /0 1-# 23$4* /54* 6&"7 (&8
Yogurt (Carb) !"#
Dal (Carb)
Brown Rice (Carb)
;$)
9$:)
Green Leafy Tarkari (Non-Carb) $%&'%# Example of meal with 3 carb foods
15
16
BHUTANESE/NEPALI PLATE PLANNER
!"#$%&/'($)*+, - .$&$/0 1-# 23$4* /54* 6&"7 (&8
Apple (Carb) <3$=
Milk
&'(
Brown Rice (Carb)
Grilled Chicken Breast (Non-Carb)
9$:)
/;."4$/0 :$5"
Green Leafy Tarkari (Non-Carb) Example of meal with 3 carb foods
!"#$"%
BHUTANESE/NEPALI PLATE PLANNER
!"#$%&/'($)*+, - .$&$/0 1-# 23$4* /54* 6&"7 (&8
2 Roti (2 Carbs)
9 40#*
Grilled Chicken Breast (Non-Carb)
Dal (Carb)
/;."4$/0 <$5"
:$)
Broccoli (Non-Carb)
=0/>)* Example of meal with 3 carb foods
17
18
TRADITIONAL FOOD LIST
19
Written Food Lists: Notes for Educators These lists can be used as a reference for educators or for teaching carbohydrate counting to Bhutanese/Nepali clients who are able to read English and/or Nepali. Other pictorial materials have been developed for clients who do not read or who prefer a picture format. Some words on these lists could not be translated into Nepali because there is no meaningful equivalent in Nepali. For example the word “carbohydrate,” is not meaningful to most Nepali speakers, and those that do understand what “carbohydrate” means would use the English word. Actual food names, however, could be and were translated. Color coding and the Nepali phrases written under page titles can help clients differentiate between which foods cause the blood sugar rise and which do not.
Teaching hints/suggestions: 1. Measuring cups and spoons are unfamiliar to most Bhutanese/Nepali, so a demonstration of how to measure and place specific amounts of food on a plate may be necessary. 2. Recommend that explaining how to measure exact portions be done on an “as needed” basis. Sometimes using a fist or other visual to explain portions is more successful. 3. Since “achars” (pickles or spicy vegetables which can be fresh or fermented) are a very important part of meals, and there are thousands of recipes for them, it is important to ask what ingredients clients use in them. 4. Food is often cooked with copious amounts of oil and salt so these topics may need to be addressed. 5. While meals are traditionally eaten while seated on the ground in a communal fashion, many clients do eat at a table on individual plates. .
20
Carbohydrate Foods--Foods that make the blood sugar go up
Ragat ma guliyo ko matra badaunay khana !"# !" !"#$%& !" !"# !"#$% !"# Bread & Grains: Foods in this list contain 15 grams carbohydrate. !"#$% Food
Translation
Serving Size
Millet, cooked
Kodo !"#"
1/3 cup
Oats, cooked
Jau !"
! cup
Puri 5” diameter
!"#$
Rice Flakes (beaten rice)*
Chyura !"#$%
2 ea., $ 1/3 cup
Puffed rice
Murai !"#$
Rice, white or brown, cooked Chamal !"#$ Roti 6” diameter !"#$
1 cup 1/3 cup 1, & " cup
Cornflakes
!"#$ !"#$%&
Bread- white, wheat, rye
!"#$%&'(!"#$%&
Pasta
)*"+"$%,'(!"#$%&'( 1/3 cup
1oz., 28 g. $% !"#
)%-%( !"!"( 3 small, ' !"#$ Milk List: Foods in this list contain about 12 grams carbohydrate. Dudh !# " Food Translation Serving size Dumplings
Mahi !"#
Buttermilk, non-fat/low fat Half & Half † ***
Varies** 1 cup
Milk - whole, skim, 1%, 2%, or soy
Dudh !# "
1cup
Yogurt, plain, low-fat
Dahi !"#
1 cup
Sweetened condensed milk***
1oz., 28 g. $% !"#
*Beaten rice is dehusked rice that is flattened into light, dry flakes. It is very popular with Bhutanese/Nepali. † 10g carbohydrate & 315 calories ** Serving size varies because buttermilk (liquid left over after butter or paneer is made) is often diluted with water. *** Not recommended for those with DM, however these foods are used by some Bhutanese/Nepali.
.-"//0 !"#$
(
“Serving Size” Terms ( 1$"-0 !"#(
)23'#-0 !"#$!( 4"$520 !"#$ 6%&27(()%8&(%9(&:2(82$;',5(8'<28(%,(&:282(/'8&8(:";2(,%&(=22,(&$",8/"&23(8',>2(&:2$2("$2( ,%(2?#';"/2,&(@%$38(9%$(!"#$%&'()(>#A8(",3(8A%%,8(',(62A"/'B((.%-2(>/'2,&8C(:%@2;2$C( :";2(=22,("=/2(&%(#82(-2"8#$',5(>#A8C(2&>B("9&2$("(32-%(%,(#8',5(&:2-B(D:2(&2$-8(',( &:'8(=%E(:";2(=22,(#823(&%(&$",8/"&2("(92@(%9(&:2(82$;',5(8'<28B((B(
21 Legumes/Pulses/Daal List: Foods in this list contain 15 grams carbohydrate. !"# $ Food Translation Serving Size Black-eyed peas
Bodi !"#$
! cup
Chick peas
Chana !"#
! cup
Fava beans
Bakula !"#$%
! cup
Hummus
!"#$"%
1/3 cup
Lentils
Daal !"# $
! cup
Mung beans
!""#$%&''(%!"#$ !"# $
! cup
Soybeans
Bhatmas !"#$ %
! cup
Red lentils
Moosore daal !"#$%& !"# $
! cup
Split peas
Chana daal !"# !"# $
! cup
Red beans
)'*+' !"#$
! cup
Starchy Vegetable List: Foods in this list contain 15 grams carbohydrate. Tarkari !"#$"% * Food Translation Serving Size Corn
Makai !"#
! cup
Peas
Matar kerau !"# $ !"#$
! cup
Aalu !"#
! cup
Sakar khanda !"#
! cup
Potato (white) Potato (sweet)
!"# Potato curry
Aalu Subji !"# !"#$%
! cup
Pumpkin
Farsi !"#
1 cup
Yam
Pidaloo !"#$%
! cup
*”Tarkari” is the word for vegetable. There is no meaningful translation for “starchy” since Bhutanese/Nepali do not differentiate between starchy and non-starchy vegetables. They are all “tarkari.” Recommend using color-coding and translations of page titles to explain differences between vegetables containing large amounts of carbohydrate and those with little or no carb.
22
Sweets and snacks: Foods in this list contain 15 grams carbohydrate Guliyo, Khaja !"#$%& , !"#" Food Translation Serving size Sugar
Chini !"#$
1 Tbsp.
Honey
Maha !"#
1 Tbsp.
Cake
Kek !"!
small, no frosting !"#$
Cookies
Biskut (guliyo) !"#$%&
2 small, ! !"#$
(!"#$%&)! Crackers
Biskut (nunilo) !"#$%&
5 small, " !"#$
(!"#!$%) Ice cream
Baraf !"#"$
! cup
Jelly, jam
Jam #$
1 Tbsp.
Potato chips
Aloo chips !"# !"#$
"#, %!
Rice pudding
Khir !"#
$!%&'!
23
Fruit List: Foods in this list contain 15 grams carbohydrate. Fall Full !" !"# Food Translation Serving size Apple
Sas !! "
1 small, # !"#$
Apricots
!"#$ !"
4 whole, $
Banana
Kera !"#
Cantaloupe, muskmelon (pale brown husk)
%&"#'$(" )*&"+#,-. !"#% $ & (!"#$)
1 small, # !"#$ 1 cup
Cherries
Paiyun !"#$
12, #%
Grapes
Angur !"#$%
Grapefruit
Bhagate !"#$%&
17 small, #& !"#$ !
Guava
Aamba !"#$%"
Jackfruit, raw*
Katahar '()*
Lychee
Lichhi !"#$
! cup
Mango (small)
Aap +,
! cup
Orange
Mousam !"#$!
Papaya
Mewa !"#
1 small, # !"#$ 1 cup
Peach
Aru !"
1 small, # !"#$
Pear
Naspati !"#$%
1 small, # !"#$
Persimmon
Halwabed !"#$%&
Pineapple
Bhuin Katahar !"#$
2 med. % !"#$! " cup
Plum
'()* Aalubokhada !"#$%&'(
2 small, % !"#$
Pomegranate
Anar -.*
! cup
Pomelo (local grapefruit)
Bhogate !"#$% Strawberries
! cup
Suntala !"#$%& Kharbuja (hariyo) !"#% $ & (!"#$%)
2 small, % !"#$ 1 # cup
Strawberries Tangerine Watermelon (green husk)
*When canned in syrup it contains 22 grams CHO per ! cup.
1 small # !"#$ ! cup
1 # cup
24
Foods that have less sugar Guliyo kamti bhako khadya padartha !"#$%& !"#$ !"#$ !"# !"#$% Non-starchy Vegetable List: Items on this list contain approximately 5 grams carbohydrate in a serving size of ! cup, cooked or 1 cup, raw. Tarkari !"#$"% Food
Translation
Translation
Asparagus
Kurilo
!"#$%&
Beets
Beet root
!"# !"
Bottle gourd
Lauka
!"#$
Bitter gourd
Tite karela
!""# !"# $
Broccoli
Brokauli
!"#$%&
Cabbage
Banda kovi
!"# !"#$
Carrots
Gajar
!"#
Eggplant
Bhanta
!"#
Fenugreek leaves
Methi ko saag
!"#$ !" !"#
Cauliflower
Kauli
!"#$
Chayote Squash
Eiskus
!"#$%&
Cilantro/coriander
Dhaniya
!"#$
Cucumber
Kakro
!"#
Daikon radish
Mula
!"#$
Fennel
Saunf (masala)
!"#$%
Green beans
Ghiu Simi
!"# !"#$
Mustard Greens
Rayo sag
!"#$ $!
Okra
Ramtoriya
!"#$%!&
Onion
Pyaaj
!"#$
Pepper (bell)
Bhede khursani
!"#" !"#% $ &
Pepper (chili)
Khursani
!"#% $ &
Spinach
Palungo
!"#$%
Sponge gourd
Ghiraula/chinchindo
!"#$%
Tomato
Golbheda
!"#$%&
Turnips
Salgam
!"#$
!"#$"$%&
25
Non-carbohydrate Foods Foods that do not make the blood sugar go up Ragat ma guliyo ko matra kamti banaunay khana !"# !" !"#$%& !" !"# !"#$ !"#$"% !"# Meat/Protein List: The foods in this list contain 0 carbohydrate, 7 grams protein, 0-8 g. fat. Serving size is 1 oz.(28 grams) Mangsa !"#$% Food Translation Buffalo
Bhaisi
!"#$
Cheese*
Paneer*
!"#$
Chicken
Kukhura ko masu
!"#"$% !" !"#
Egg
Anda
!"#
Fish
Machha
!"#"
Pork
Sungur
!"#"$
Lamb
Bhera
!"#
Mutton (Goat)**
Khasi
!"#
Turkey
Laukat
!"#$
*Paneer can be made by combining whole milk with buttermilk or lemon juice and then separating the curds from the whey. The end product is similar to cottage or ricotta cheese. **Mutton usually means goat. Note: Beef is not eaten by Bhutanese/Nepali.
Fats and Oils: The foods in this list contain 0 carbohydrate and 5 grams fat. Boso, tel !"#" , !"# Food Translation Serving size Avocado
Avocado !"#$%#
1/8
Butter
Nawani !"!#
1 teaspoon
Coconut
Nariwal !"#$%
! oz.(14 g.) $% !"# 1 teaspoon
Ghee
Ghiu !"#
Oil (canola, mustard, olive, vegetable) Walnuts
Tel !"#
1 teaspoon
Okhar &'!
2Tablespoons
Sesame seeds
Til !"#
1 Tablespoon
26 Free List: Items on this list contain 20 calories or less and 5 grams or less of carbohydrate per serving. Foods that do not make blood sugar go up. Ragat ma guliyo ko matra kamti banaunay khana !"# !" !"#$%& !" !"# !"#$ !"#$"% !"# Food
Translation
Coffee, unsweetened
!"#$
!"#
Tea, unsweetened
%&$'"
!"#$
Diet Soda
($)*+,-."
Crystal Light
Crystal Light
Lemon
Kagati
!"#$%
Spices
Spice, masala
/0$1)2+!"#$
27
RECIPES
28
Cabbage and Potatoes
Recipe Yield: 10 cups
Serving size: 1 cup Ingredients: 7 cups potatoes, chopped 7 cups cabbage 1 tbsp ghee 1 tbsp vegetable oil 1 tsp salt 1 tbsp turmeric (besar) 1/2 tsp methi, ground (fenugreek) 1 1/4 cup onions, chopped 1/2 tbsp mixed spices (ginger, cloves, timur*, etc.) 1/2 cup water Directions: 1. Wash cabbage and potatoes and cut in small pieces. 2. Heat ghee and vegetable oil in a large pan. 3. SautĂŠ onions until browned, add potatoes and cook for 5 minutes. 4. Add the cabbage, salt, and turmeric. 5. After 10 minutes, add the mixed spices. 6. Add 1/2 cup boiled water and cook for 30 minutes. 7. Serve hot.
Carbohydrate choice per serving: 1 *A unique Nepali Spice
Recipe adapted from: Sheffield, M., & Shaha, S. (2013). Cabbage and !potato. Retrieved from http://himalaya.socanth.cam.ac.uk/ collectiona/journals/kailash/pdf/kailash_6_02_04.pdf
29
Cooked Tomato Chutneyâ&#x20AC;&#x153;acharâ&#x20AC;?
Recipe Yield: 3 cups Serving size: 1/2 cup Ingredients: 2 Tbsp. vegetable oil 1/2-1 cup water 2 Tbsp garlic 2 Tbsp ginger, fresh 1/2 cup onion, chopped 1/2 tsp. fenugreek seeds 1/4 tsp. jimbu* 8 chillis, powdered 2 tsp. salt 1 tsp. timur* 1 tsp. cumin seed 2 tsp. chili powder 1/2 cup green coriander (cilantro) 10 tomatoes Directions: 1. Heat 2 Tbsp. vegetable oil and 1/2-1 cup water together 2. Add all other ingredients. 3. Cook for at least 15 minutes or until liquid evaporates to create a thicker consistency.
Carbohydrate choice per serving: 1 * A unique Nepali Spice
Recipe adapted from: Sheffield, M., & Shaha, S. (2013). Cooked Tomato Chutney. Retrieved from http://himalaya.socanth.cam.ac.uk collections/journals/kailash/pdf/kailash_6_02_04.pdf
30
Green Leafy Tarkari (Sag Tarkari)
Recipe yield: 3 1/2 cups Serving size: 1/2 cup Ingredients: 7 cups green leafy vegetables (kale, mustard leaf,spinach) 2 tbsp vegetable oil 1/2 tbsp aniseed (jwanu) 2-3 big dry chillis 1/4 tsp turmeric powder 1/2 tsp salt Directions: 1. Wash and cut the green vegetables. 2. Heat vegetable oil. 3. Put aniseed, dry chillis and turmeric into hot oil and fry till brown 4. Put the greens in the oil and add salt and cook for a minute. Then turn the greens once, completely, and cover. Cook over low heat for 15 minutes. Take the lid off every now and then and stir to prevent scorching. 5. Serve hot. Nonstarchy vegetable choice: 1 Recipe adapted from: Sheffield, M. & Shaha, S. (2013). Green leafy tarkari. Retrieved ! from http://himalaya.socanth.cam.ac.uk/collections/journal/ ! kailash/pdf/kailash_6_02_04.pdf
31
Mas ko dal or Mugi dal (black dal)
Recipe Yield: 3 1/4 cup Serving size: 1/2 cup
Ingredients: 1/2 cup dal 1/2 tsp. salt 1/2 tsp. ground ginger 1/2 tsp. ghee 4 cups water 1 tsp jimbu*/tarragon
Directions: 1. Boil water and 1/2 tsp. of ghee 2. Put the dal in water and cook for an hour for black dal and half an hour for yellow dal 3. Add ground ginger and jimbu 4. Remove from heat 5. Serve hot
Carbohydrate choice per serving: 1 * A unique Nepali spice
Recipe adapted from: Sheffield, M., & Shaha, S. (2013). Mas ko dal or !Mugi dal. Retrieved from http://himalaya.socanth.cam.ac.uk/ collections/journals/kailash/pdf/kailash_06_02_04.pdf
(yellow dal)
32
Mixed Vegetable (mismas)
Recipe yield: 6 cups Serving size: 1 cup Ingredients: 1 Tbsp vegetable oil + 1/2 cup water 2 Tbsp ghee 1 pinch asafoetida (hing), 1 pinch bay leaf, 1 pinch timur* 1 pinch fenugreek, ground (methi) 2 red chilli peppers (khorsani) 2 Tbsp garlic, minced (lasun) 2 Tbsp ginger (aduwa) 3/4 cup onion (pyaj), chopped 4 cups potatoes (alu), peeled and chopped 1/4 tsp. tumeric (besar) 1/2 tsp. salt (nun) 3 cups cauliflower (kauli), cut in pieces 1/2 cup green onion, cut into sections 1/2 cup green peas (matar kerau) Directions: 1. Bring oil and water to a simmer 2. Add 1 Tbsp ghee, put aside 1 Tbsp 3. Add all other ingredients except green onion and peas. 4. Cover and simmer until tender (about 15 to 20 minutes) 5. Add remaining 1 Tbsp ghee 6. Add onion and green peas. 7. Stir for some time until hot.
Carbohydrate choice per serving: 1 *Unique Nepali Spice Recipe adapted from: Sheffield, M., & Shaha, S. (2013). Mixed vegetables. Retrieved from http://himalaya.socanth.cam.ac.uk/collections/journal/ kailash/pdf/kailash_6_02_04.pdf
33
Nepali Egg Curry
Recipe yield: 7 cups Serving Size: 1 cup Ingredients: 8 Boiled eggs 2 cans (14 1/2 oz. each) diced tomatoes 1 cup onion, chopped 1 cup peas 1 cup carrots, chopped 3 tbsp. vegetable oil 1 tbsp. chili powder 1 tbsp. cumin powder 1/2 tbsp. ginger 1/4 tbsp. turmeric 3 tbsp. low-fat yogurt 2-3 tbsp. cilantro, fresh, chopped Directions: 1. Hard boil eggs: in a large pan, cover eggs in cold water and bring to a gentle boil. Boil for 8-10 minutes. Drain hot water immediately and refill the pan with cold water to stop eggs from cooking too long. 2. Gently peel eggs. Cut each egg in half and set them aside in a bowl. 3. Soften carrots by cooking on high in the microwave, in a small amount of water, for 5 minutes. Drain and reserve 1/2 cup of the carrot water (or all the water if less than 1/2 cup). 4. Heat cooking oil on medium heat in a large wok or frying pan. Add chopped onion and cumin, Stir-fry for 5 minutes 5. Add green peas and carrots. Cook for a few minutes. 6. Add chili powder, ginger, turmeric, and stir-fry for 1 minute. 7. Add tomatoes and cook for 5 minutes. 8. Add yogurt and 1/2 cup of the leftover carrot water. Cook for one more minute. 9. Turn off heat, add eggs, and stir well. 10. Garnish with cilantro and serve over rice.
Carbohydrate choice per serving: 1 Recipe adapted from: Horsman, R. (2012). Nepali egg curry. Retrieved from http:// ! www.totstoteensnutrition.com/2012/06/09/nepali-egg-curry/
34
Potato and Cauliflower Pickle
Recipe Yield: 8 cups Serving size: 1 cup Ingredients: 2 1/2 cups cauliflower flowerlets 4 cups potatoes 1 1/2 tbsp. sesame seed 2 tbsp lime (nibuwa) or lemon juice 1/4 tsp turmeric 1 tsp. salt 1 tbsp. vegetable oil 1-2 garlic cloves 3 dry chillis 1/2 tsp fenugreek, ground Directions: Peel potatoes and cut them into small pieces. Boil the potatoes and cauliflower for 15 minutes. Fry and grind sesame seed, chillies and garlic. Mix potatoes, cauliflowers, sesame seeds, chillies, salt, turmeric and juice. Heat vegetable oil, then add fenugreek and fry until brown.
Carbohydrate choice per serving: 1 Recipe adapted from: Sheffield, M., & Shaha, S. (2013). Mixed vegetables. Retrieved from http://himalaya.socanth.cam.ac.uk/collections/journal/ kailash/pdf/kailash_6_02_04.pdf
35
Sikarnai (Yogurt Pudding)
Recipe yield: 1 1/4 cups Serving size: 1/4 cup Ingredients: 2 cups plain yoghurt 1 pinch saffron (optional) 1/2 tsp rose water (optional) 1/4 cup sugar 1/8 tsp cloves 1/4 tsp cinnamon 1/4 tsp cardamon 1/8 tsp black pepper Directions: 1. Prepare curd or yoghurt (dahi) by placing the 2 cups yoghurt in a piece of fine material to drain for several hours or overnight, depending on the consistency preferred (yields about 1 1/4 cups). 2. Place the prepared yoghurt (1 1/4 cups) in a bowl. 3. Put all of the above spices into the curd and stir well. Carbohydrate choice per serving: 1 Recipe adapted from: Sheffield, M. & Shaha, S. (2013). Yoghurt pudding. Retrieved from ! http://himalaya.socanth.cam.ac.uk/collections/journal/ ! kailash/pdf/kailash_6_02_04.pdf