Eating out can be a challenge for many people who are on a weight loss program or who are trying to eat a heart-healthy diet. The reasons for the challenge, as well as some strategies for overcoming it, are described in this article. It is important to remember that these strategies are presented only as guidelines for people interested in eating heart-healthy foods. None of this information is presented in the form of what people “should” or “should not” be eating. Each person makes that choice for him or herself. People interested in additional information are encouraged to contact a licensed or registered dietitian.

Why is it challenging to eat healthy when eating out?

There are a number of reasons why it is challenging to eat healthy when eating out. For example, the portions served in restaurants tend to be far greater than what a person requires at one sitting. Studies have shown that the bigger the portion of food served, the more people eat of that food. Experts reveal that restaurant owners actually make more money from serving larger portions because people are more likely to come back, increasing business. In the last couple of decades, restaurants have also been serving food on increasingly larger plates to enhance the appearance of a large meal. Furthermore, fast food restaurants encourage people to "super size" their portions to receive more food for just a little more money. The subtle message is that people want as much food as they can get for their money.

The larger portions served in many restaurants also tend to provide large quantities of calories, fat and sodium. In addition to the all-you-can-eat loaves of bread and butter that may be on the table, people can order one meal that includes a bowl of creamy soup (filled with saturated fats from cream and butter), a large salad (full of cheese and and high-fat, high-salt salad dressing), a high-caffeine beverage, a high-alcohol drink, the main dish (which may be fried or in a rich sauce) and side dishes (often high in butter). This meal is often followed with coffee/tea (also high in caffeine) and a high-calorie, high-fat dessert. Some people choose to eat at all-you-can-eat buffets, returning for seconds or thirds, resulting in even larger portion sizes. It is not uncommon in our culture for people to lean back and announce that they are “stuffed” or even in pain from over-eating.

Another factor is that people may pay very little attention to the food that they are eating. While participating in a conversation, people’s minds tend to be on the topic at hand rather than the flavor, texture and aroma of each bite of their food. This is particularly true when the purpose of being at a restaurant is expressly stated to be something other than enjoying a meal. Examples include a business lunch, a party, a “study session,” a dinner cruise, dinner theater, a night out to watch the game and so forth. People may eat and/or drink more than they realize simply because they are not paying attention to what passes their lips. The large servings; the calorie, fat and sodium content of the menu items; and the distracting atmosphere can easily lead anyone to consume an unhealthy meal.

What are some strategies for heart-healthy restaurant dining?

There are a number of strategies that you can use when eating out to ensure that you will eat a more heart-healthy meal:

• Begin by planning ahead and choosing a restaurant that offers heart-healthy options. For example, call the restaurant in advance and ask about their menu, if substitutions can be made for a meal and whether they are willing to prepare foods to meet your dietary needs.
• If you frequently dine out, develop a list of restaurants in your area that meet your nutritional goals. Try to avoid those restaurants that may be challenging such as buffets or all-you-can-eat establishments. Most restaurants are happy to adjust their menu items to meet your needs. Dining out can also be a wonderful opportunity for increasing the variety in your diet. For example, if you usually don’t eat fish at home, choose a sushi or seafood restaurant.

Once you have chosen a restaurant the next challenge will be making a selection from the menu. Ideally, the meal should be flavorful and enjoyable as well as nutritious and heart- healthy. Therefore, when making a selection, consider the calorie, fat and salt content as well as nutritional value of the foods to be consumed. For example, an order of fried onion rings as an appetizer will provide a lot of calories, fat and salt but not much nutrition. Instead start with a small tossed salad (with a low fat dressing or vinaigrette on the side) or a broth-based vegetable or bean soup. These selections will provide plenty of heart-healthy nutrition and fiber without the added fat or salt.

Once you have navigated through the restaurant selection and menu choices, you will be faced with the last challenge: serving sizes. The menu portions of food served at most restaurants are usually much larger than the recommended serving sizes. Some strategies to controlling serving sizes are:

• Ordering your entrée from the appetizer section of the menu,
• Sharing an entrée with a friend, or
• Asking the waiter to only bring half the entrée and wrapping-up the other half to take home.
  

Tips for choosing from a restaurant menu

After a long wait to be seated, you may be feeling exceptionally hungry as you are presented with the menu. Most restaurants take this opportunity to satisfy your senses (and curb your hunger) by bringing those beautiful, warm, buttered rolls. Then, the first question asked may be, “would you like a drink?” Looking through the menu, those hot rolls not only smell great but also, along with a nice drink, can ease almost any diner into a good mood as they take a few sips and bites. Unfortunately, before the waiter returns to take your order, you may have consumed hundreds of calories with little nutritional value.

Value? Before one can have a heart-healthy dining experience one should also define what gives food their value. Taste, smell, nutritional content and cost are just a few aspects of food that a diner must take into account before making their selection. The trick to a heart-healthy dining experience – whether eaten at home or out – is to keep your nutritional goals in mind. To that end, a heart-healthy meal should be not only satisfying to your senses or to your wallet but also to your heart. This means avoiding excess calories, fat, saturated fat, cholesterol and salt without compromising taste or budget.

The fat content of the meal can be controlled by keeping in mind the types of foods that are particularly high in fat. For example, high-fat meat choices include marbled steaks; fatty cuts of pork or beef; buffalo chicken wings; bacon, sausage or kielbasa; and pepperoni and high-fat deli meats such as salami or corned beef. Instead, look for leaner cuts such as sirloin steak, London broil or filet mignon. Other items on the menu that are high in fat to avoid are cream based soups, fried foods and high-fat desserts.

Next, find out how the food is prepared. In general, choose foods that are steamed, poached, baked, grilled, roasted or broiled. Menu items described as fried, crispy, creamy, au gratin, battered or breaded are likely to contain added fat and typically are higher in calories and saturated or trans fats. Examples include the following:

• Fried chicken
• Chicken fried steak
• Fried fish
• Fried burgers
• Fried rice
• French fries
• Onion rings
• Donuts
• Refried beans

Once you have determined how your food will be cooked, check to see if it will be served with one of the following high-fat or high-salt sauces or dressings:

• Alfredo sauce
• Béarnaise sauce
• Hollandaise sauce
• Lobster sauce
• Soy sauce
• Cheese sauce, melted cheese or shredded cheese
• High-fat sour cream
• Gravy
• High fat salad dressings
• Melted butter

If you choose to have a sauce, keep it on the side so you can control how much is used. Remember that it is in the restaurant’s best interest to lather food in tasty (and unhealthy) sauces.

An entrée is often served with one or more side dishes. Consider rice and steamed vegetables as healthy alternatives to sides such as

• French fries
• Home fries
• Fried rice
• Deep-fried mushrooms, okra or other vegetables
• Deep-fried egg rolls/spring rolls
• A baked potato swimming in butter or high-fat sour cream

Finally, choose water instead of high-caffeine beverages. If you want to drink wine, drink no more than a glass or two. The average bottle will serve about four wine glasses. If you cannot find any heart-healthy choices on the menu, then perhaps it would be wise to consider avoiding that restaurant in the future or, at least, not going there frequently.

What are some tips for eating the meal?

There are some simple requests that people can make when ordering to enjoy a healthy and nutritious meal. Don’t be shy about asking questions, making special requests or asking to substitute ingredients, as most restaurants are eager to please you. To make the most of every meal, while still being heart-healthy, the following strategies are offered:

• If you choose to eat bread before dinner, keep in mind that whole wheat bread is a healthier alternative to white bread. Request unbuttered bread or rolls and add butter or olive oil sparingly, if at all. Finally, your server may be able to serve you raw vegetables with salsa instead of chips and salsa.
• Choose a small tossed salad with a low-fat or fat-free dressing served on the side. Avoid toppings such as croutons or cheeses that increase not only calories but also the fat and sodium content of your salad.
• Choose broth-based soups instead of cream-based soups or chowders. Ask your waiter if a low-sodium option is available and look for heart-healthy soups full of vegetables and legumes. For example, minestrone, lentil or split pea soups or gazpacho are great choices. Avoid added toppings such as croutons, sour cream or cheese.
• When ordering your meal, ask that the food be prepared without added butter or salt and to use oil sparingly, if at all. Investigate if the meal is prepared with ingredients, toppings, dressings or sauces that may add unwanted calories and fat.
• Request low-fat meal preparation techniques such as asking that the meat or fish be baked, grilled or broiled instead of fried or sautéed in fat.
• Trim visible fat from meat and remove the skin from poultry before eating.
• If the serving sizes are large, request that only half the meal is served and the other half is wrapped-up to take home. Or, split the entrée with a companion.
• Make sure that the side dishes are also prepared without added fat or salt. If they are not, ask to substitute items. For example, instead of french fries, request a baked potato or steamed or grilled vegetables. Instead of having butter, sour cream or cheese on your baked potato, be creative and try salsa or fat-free dressing on the side.
• Avoid all-you-can-eat buffets or restaurants. At self-serve salad bars, use a small plate and choose a variety of fresh vegetables and fresh fruits instead of marinated salads or fruit salads with whipped cream. Avoid prepared salads with mayonnaise dressings such as creamy coleslaw or potato salad. Instead, choose low-fat or fat-free dressings on the side.
• When choosing condiments and spices, mustard is generally a healthier choice than butter or mayonnaise. Inquire if they have flavored vinegars or salsa to add flavor without the fat. Feel free to pile on vegetables such as lettuce, tomato and onions.
• Order your food without salt and refrain from using the saltshaker on the table.
• Be sure that the food is cooked thoroughly to the proper temperature. Don’t hesitate to send it back if it is not. When taking food home, be sure to refrigerate leftovers within one to two hours to avoid possible food contamination or food poisoning.
• Eat slowly, taking small bites and chewing each bite thoroughly (experts recommend at least 20 times) and really tasting the food. Thorough chewing will allow more digestive enzymes in the saliva to mix with the food, improving digestion and increasing the nutrients that can be absorbed from the food. Eating more slowly also tends to result in eating less food because it takes 15 to 30 minutes for your brain to realize that your stomach is full.
• Drink lots of water, which helps to fill the stomach and improves digestion. Limit drinks high in sugar such as soft drinks or fruit shakes. Substitute fat-free (skim) milk instead of whole milk or cream. Alcohol can also add a lot of calories and should be consumed only in moderation if at all.
• Stop eating when you are full, not when you are stuffed.
• At the end of the meal choose fresh fruits, sorbets or low-fat frozen yogurt, instead of the high-calorie and high-fat desserts.