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Never before have Americans eaten more meals in restaurants or ordered more restaurant meals to take out or have delivered to, well, wherever they may be. The number of restaurant chains and independent restaurants in our midst is at an all-time high. We have access to a wider array of cuisines, foods, and ingredients than ever before. Experts in the prediction business expect these restaurant growth trends to continue due to our dual quests for convenience and flavor as we deal with the hustle and bustle of daily life.

Yet, as the consumption of restaurant meals has skyrocketed, we’ve witnessed an epidemic of the diseases exacerbated by carrying around excess weight—prediabetes, type 2 diabetes, heart disease, high blood pressure, certain cancers, sleep disorders, fatty liver problems, and more. Is there a connection? Researchers and nutrition experts say “yes!” Why? The simple answer is that unhealthy foods surround us while healthier foods are harder to find. All things considered, it’s simply tougher to eat healthy when you eat away from home.

But on to the good news—yes, there’s plenty! There are more healthy foods and meals to choose from at restaurants than ever before. Plus, it’s becoming easier to help your children eat healthier restaurant meals. We have more nutrition facts at our fingertips than ever before due to regulations, and more are on the way. For people with diabetes and their caregivers, this is all good news. With this book in hand, you’ll be a pro at healthy restaurant eating in no time.

A Few Statistics:

• There are nearly one million restaurants within our borders.*

• Americans spend about $1.8 billion a day on restaurant foods.*

• Restaurant sales were projected at over $660 billion, equal to 4% of the U.S. gross domestic product.*

• More than 7 out of 10 eating and drinking locales are independently owned, single-unit restaurants.*

• Consumers spend 47% of their food dollars away from home. (That’s 47% of food dollars, not food consumption. Generally, restaurant foods cost more than foods purchased for preparation or assembly at home or another non-restaurant location.)*

• On average, American adults eat about 5 of the 21 traditional weekly meals away from home.*

• Americans eat roughly one-third of their calories from foods purchased away from home.

• Nutritionally speaking, restaurant meals tend to be higher in fat and calories than home-prepared meals. Higher, in fact, than most people guess. And these meals, as you would guess, are light on vegetables, fruit, whole grains, and low-fat dairy foods—just what we should be eating more of.

*From National Restaurant Association, Pocket Factbook.

A Historical Refresher

What a difference a few hundred years makes! Taverns and boarding houses of the 1700s, where food was often an afterthought to alcohol-containing refreshments, preceded restaurants. Taverns, mainly inhabited by men, morphed into the first restaurants, such as Delmonico’s in New York City, which opened in the mid-1800s. Two hundred years ago it was a novelty and a rarity to sit down to dine on a hot meal away from home. Restaurant dining was done mainly by the wealthy residing in metropolitan areas.

Fast forward another hundred years to the mid-1900s. Restaurant meals were mainly enjoyed by the wealthy and relished only on special occasions—to celebrate a birthday or anniversary. Oh yes, and on Mother’s Day, when moms around the country got to hang the “kitchen’s closed” sign.

Fast food was born in the mid-1900s and relatively quickly became fully integrated into our eating-away-from-home culture. In 1954 Ray Kroc discovered the San Bernardino, California, restaurant being run by brothers Dick and Mac McDonald. In 1955, he became president of the McDonald’s Corporation and 6 years later bought out the brothers McDonald. The rest, as they say, is history.

In 1950, according to the National Restaurant Association, the average American spent about a quarter of their food dollars eating away from home.

Restaurant Eating Today

Americans spend nearly half of our food dollars eating away from home today. In 60 years, restaurant meals have catapulted from a special-occasion treat to a major way Americans get the job of eating done. According to the National Restaurant Association, 45% of Americans say restaurants are an essential part of their lifestyle.

Let’s face it, it’s just so darn easy to eat restaurant meals. Restaurants are everywhere in metropolitan areas and small towns and cities. Restaurant foods are available from morning until night, if not 24 hours a day, in plenty of urban centers. Why bother doing the daily grunt work of planning, shopping, food preparation, and cooking with this amount of access to ready-to-eat foods and meals? (Actually there are plenty of good reasons. One good reason is nutrition, another is your health.)

We also order takeout regularly. We pick up and tote restaurant foods for breakfast or lunch to our places of employment, traveling from here to there, or to school. We grab a ready-to-serve dinner on the way home or order a pizza for delivery to the sports field, social events, or meetings. And it’s not just meals being purchased at restaurants, plenty of snacks are purchased too. Perhaps it’s an afternoon coffee drink, a piece of fruit, a sweet treat, a crunchy favorite, or a nutrition bar. Yes, procuring restaurant foods is one big way we get the job of eating done today.

Restaurant and Food Trends in Sight

Restaurants and Service:

• Burgers and fries are just the tip of the iceberg when it comes to the types of fast food available now. Today, many restaurants serve food fast, from chicken restaurants, to pizza and sub shops, to plenty of ethnic restaurants. This book refers to this genre of restaurants as “walk up and order.” (Just so you know, in the restaurant industry they’re known as Quick Service Restaurants, abbreviated as QSRs).

• Coffee and bagel shops and bakery cafes appear to be on nearly every street corner in metro areas. And they want to serve you drinks, foods, and snacks all day long, not just for breakfast.

• Frozen yogurt shops have made a comeback.

• Chain restaurants serving you sit-down style are on a growth curve, too, with a hefty dose of the all too similar fusion of American fare mixed with a scattering of popular ethnic favorites.

• Plenty of ethnic restaurants—from the common Chinese, Mexican, and Italian, to less common Korean, Vietnamese, and Peruvian—are open for your business.

• Fine dining establishments have exploded in the last decade. They celebrate a myriad of cuisine fusions and their celebrity chefs, who might also double as a TV cooking star.

Foods in Vogue:

• The use of locally grown ingredients or those purchased at nearby farmers markets has become common. Some restaurants even tout their own outside or rooftop garden. This is known as hyper-local food sourcing.

• The use of organically grown ingredients, grass-fed meats, non-GMO foods, and hormone-free poultry is also gaining in popularity.

• Chefs sleuth out uncommon ingredients and serve lesser-known foods. When it comes to vegetables, they’ve slowly but surely put kale, Brussels sprouts, and cauliflower steak (a full slice of the whole cauliflower) on the “in” list. They’ve introduced us to pork belly and raised interest in venison, Kobe beef, and quail.

• With an increase in diners going vegetarian, restaurants, from upscale to mainstream, regularly list at least one or two vegetarian options, and many restaurants are testing the waters with vegan offerings.

Meal Sizes and Styles:

• Many people are “grazing” instead of eating full meals. They’ll have a snack here and a nibble there.

• Our appetite for handheld foods that fit our on-the-go lifestyles is at an all-time high and will likely continue. To satisfy our desires, you see items like smoothies, wrap sandwiches, fruit and cheese snack packs, and pretzel bites with hummus. These foods are plentiful at airports. That’s good news because there’s not much to eat, even peanuts or pretzels, on most flights today.

• Tapas, the famous little plates served in Spanish restaurants, have gone mainstream and multiethnic. Some restaurants build their whole menu, or a large section of it, around small plates. They can be a boon to the health- and calorie-conscious diner as long as you choose wisely and limit the number of plates you order.

• Value meals tout plenty of volume for your dollars. Meal deals, such as kids eat free, two for the price of one, and all-you-can-eat buffets, encourage overeating.

Health and Healthy Eating Factors:

• There’s pressure on restaurants to offer healthier foods and tighten their belts on portions. (Though many seem to find this very hard to do.)

• Healthier kids’ meals, both in fast food and some sit-down restaurants, are now available due, to an extent, to public health concerns and pressure on restaurants to take actions to help prevent childhood obesity.

• More fruits, vegetables, and whole grains as well as fat-free milk, yogurt, and bottled water are available in fast food restaurants and some sandwich shops.

• Fast-food restaurants and other types of chains are aware of possible allergens and let consumers know if foods do or do not contain nuts, wheat, dairy, gluten, or others.

• Nutrition information for foods served in chain restaurants is plentiful and will become even more available

Environmentally Friendly Focus:

• Many restaurants, particularly upscale restaurants, pride themselves on serving only sustainable seafood and locally sourced meats and produce.

• Some large chains serve takeout in eco-friendly containers and ask you to place your recyclables in their recycling containers.

Conveniences for the Fast-Paced and Frequent Diner:

• Drive-up and to-go windows go well beyond just fast-food burger chains today.

• Diners can explore various restaurants’ menus via desktop computers or smartphones.

• You can place an order, either by phone, on the restaurant’s website, or on an app, and some restaurants can deliver directly to your GPS coordinates.

• Several restaurants feature new ordering technology: you sit down at a table and order on a tablet-based device in place at every table, or your server places your order with a handheld device.

• Many restaurants have frequent diner reward programs and they’re in constant contact with you.

• You can stay connected with your favorite restaurants using social media.

• Diners can rate a restaurant, good or bad, on the restaurant’s website, TripAdvisor, Yelp, or plenty of other websites/apps.

Let’s face it, restaurant meals—whether you eat them in or out—are, and will continue to be, part of dealing with our fast-paced lifestyle. Eating restaurant meals is time-efficient and one of the ways we socialize. According to the National Restaurant Association, nearly 80% of American adults say that restaurant meals with family or friends give them an opportunity to socialize and they’d rather spend leisure time in a restaurant than at home cooking and cleaning up. Restaurant meals are and, even more so, will continue to be part of our children’s reality.

Knowing the large role that restaurant eating plays in our reality and recognizing the pitfalls of restaurant foods, it might seem like a person with diabetes will have to strictly limit restaurant meals and significantly change his or her lifestyle. But this is not a workable solution for many. While you can certainly tweak your lifestyle in a healthier direction, it’s hard for most people to make wholesale changes and make these stick long term. The challenge for people with diabetes, as for anyone and everyone who wants to eat healthy, is to learn to make healthier choices and eat reasonable portions . . . at least most of the time.

This book is designed specifically to help you do just that, step by step. For starters, take a look at the table of contents. As you see, the book is divided into three sections. Section 1 focuses on helping you master the basics of healthy restaurant eating. You’ll read about how to apply today’s Nutrition Therapy Recommendations for the Management of Adults With Diabetes to restaurant eating. You’ll delve into the pitfalls of restaurant eating and gather strategies to conquer each pitfall. You’ll learn how to deal with diabetes-specific restaurant dilemmas in Chapter 5. If you’ve got celiac disease or a gluten sensitivity as well as diabetes, be sure to read Chapter 6. If you’re raising or caring for a child or children with diabetes, you can pick up some tips and tactics in Chapter 7. Get the ins and outs of ordering both alcoholic and nonalcoholic beverages in Chapter 9. Then in Sections 2 and 3 you’ll learn all about the different types of fare and ethnic cuisine. Look to Chapter 10 for an in-depth rundown of everything you’ll find in Sections 2 and 3.

Good luck on your journey towards eating and enjoying healthier restaurant meals! Make sure this book tags along with you on your journey and becomes your restaurant companion!