The traditional Vietnamese diet is healthy. Meals emphasize rice, vegetables and fish, and cooking methods often involve steaming or stir-frying. Rice is the staple of the diet, consumed in some form in almost every meal. For Vietnamese adults, all three meals of the day may consist of steamed rice with side dishes of vegetables or fish or meat. Variations on steamed rice include congee - rice gruel; rice vermicelli topped with ground pork, bean sprouts, mint or basil; and pho - rice noodle soup made with beef or chicken broth and slices of meat, garnished with bean sprouts and basil. Pho is sometimes eaten for breakfast. Also popular are salty cakes made of rice flour with minced pork and dried shrimp. The more Americanized Vietnamese may eat breakfasts of oatmeal or French bread with jam and tea. Lunch might consist of bahn mi, a sandwich of carrots, cilantro, onions and daikon with pork or chicken on a French roll; or rice vermicelli; or pork and vegetables wrapped in thin rice-paper wrappers. Dinner is almost always rice, plus a few steamed or stir-fried dishes, typically including vegetables and either fish or pork. Many Vietnamese lack calcium since sources such as milk, dairy products and soy products are not part of the diet. (Vietnamese of Chinese descent, however, may eat tofu and other soy products.) Further, many Vietnamese adults are lactose intolerant. Most Vietnamese children growing up in the U.S., however, drink milk. Vietnamese in America may be susceptible to weight gain, high cholesterol and diabetes. Vietnamese desserts often include coconut milk and coconut oil - high in saturated fat. Vietnamese with diabetes may not realize that an excess of sweets can make their illness difficult to control. Pork and chicken is cheaper here than in Vietnam. Many think of meat as more nutritious than other foods, and don't regard fish and vegetables as particularly nutritious. Further, if a Vietnamese patient already has diabetes, it may be difficult to change their diet, since rice - which converts to sugar and elevates blood sugar - is such a staple of the diet. The Vietnamese diet can be high in sodium, with its reliance on fish sauce and MSG as common condiments, and low in fiber (with its lack of whole grains).