Sunday, July 15, 2012

Why it is so hard to eat healthily in China


At least since the 1960's, Americans have been praising the healthiness of the Chinese diet. Fresh ingredients, lots of vegetables, minimal cooking, little meat, no desserts – a great improvement over the large slabs of fatty meat, over-cooked vegetables, and masses of sugar which makeup the American diet. Whether scientific studies like T. Colin Campbell and Thomas M. Campbell's, The China Study on the health benefits of eating like the rural Chinese in 1983 or anecdotal versions like BuWei Zhang's How to Cook and Eat in Chinese or Ellen Schrecker and John E. Schreckers' Mrs. Chiang's Szechwan Cookbook, we know that Chinese food is good for you (or at least much better than American food).
In 42 years of eating Chinese food in China, I have seldom had a bad-tasting meal. Indeed, I cannot imagine eating consistently better tasting food. But I have seldom had a meal which was good for me, if by such one means complex carbs, low salt, low fat, and low sugar. Outside of Buddhist establishments in Taiwan and Hong Kong (or doing my own cooking), a vegetarian diet is out of the question. If Chinese food is so healthy, why is maintaining a healthy diet here almost impossible?
In large part, the problem is social. For much of the 20th century, rural Chinese were taxed literally almost to death, and very few people had enough to eat. White rice and flour, salt, fat, meat and sugar were rationed in the cities from World War II until the 1990's, and were often totally unavailable in rural areas. A huge portion of the north Chinese population subsisted on sorghum porridge and picked vegetables. Middle class Chinese my age remember their families running out of food at the end of the month.
Since the 1980's, China's food supply issues have changed dramatically. There are no more shortages, and no rationing, People don't generally worry about having enough food. Restaurants are everywhere, and unlike in the old days, they actually have almost everything on the menu. Supermarkets, both domestic and international, are bursting with choices. Ignoring problems with the integrity of the food supply (melamine in the milk, sewer-skimmed oil, contaminated meat, pesticides, etc.) food-related health problems should have vanished.
But now that white rice and flour, salt, fat, meat and sugar are freely available, no one will eat anything without them.
Whole grains were always considered fit only for animals or the very poor. One of my former teachers (Harriet Mills) was imprisoned as an American spy in the early years of the Peoples' Republic. She told us that she knew she was about to be released when the prison switched her diet from whole grains to white-flour steamed bread. In Taiwan 40 years ago, whenever I bought brown rice the shop keeper would ask about my dog. The Manchurian-style whole-grain fried cakes which I used to be able to get at most breakfast kiosks in Beijing are now bought only by migrant workers in a few remaining holes-in-the-wall. Everyone else has switched to white-flour flatbread filled with egg and meat.
Since whole grains are universally considered poverty food, there is no demand for them. No self-respecting person will eat them. Supermarkets and grocery stores don't sell them, except for a few imported Western products at large markups. The only restaurants which serve them are a few which specialize in expensive “peasant banquets” catering to Chinese boomers nostalgic for their years down on the farm during the Cultural Revolution. Outside of such restaurants, no one would EVER serve them to someone else – the loss of face would be extreme. The only way to avoid white rice or white-flour is not to have any grains at all. That is socially accepted, especially if you substitute meat and fat.
I suspect from my neighbors' shopping bags that behind closed doors, people still eat a vegetable-heavy diet. But no one would eat like that in public, and even low-end restaurants go heavy on the meat and oil. Face requires it. Except in Taiwan with Buddhist monks or nuns at the table, I have never been able to convince a Chinese friend or colleague to order even mostly vegetarian dishes (or more correctly, vegetable, since there is almost always a significant admixture of meat in mainland dishes labeled “vegetarian”). When I go out with Americans and order all such dishes, the waitress usually objects that the order is “too vegetarian,” and often the cook comes out to point out where the meat dishes are on the menu. In restaurants where I have been eating on a regular basis for several years, I note that the amounts of meat in the vegetable dishes is significantly greater than it was a few years ago.
Since most people used to eat a large amount of grain with a little to flavor it, the sauces tend to be very high sodium. Pickled beans, pickled vegetables, or just plain salt are added to everything. Sugar not only gets added to the sauces (at least in Shanghai), but during the summer, meals tend to be washed down with sugary “fruit” drinks, soda, and sweetened ice tea.
In short, before 1980 most rural Chinese probably did eat a fairly healthy diet, through necessity rather than choice. Today, few Chinese do. It's popular to blame the increases in obesity, diabetes and heart disease on Western fast foods, but the fatty pork which now makes up 20% of the bowl of fermented soybean flavored noodles and the sugary bottles of “fruit juice” promoted for their vitamins probably deserve more blame than KFC and McDonalds.