Chapter 10: How to Make This Book Work for YOU

So far, you’ve learned about the health and nutrition pitfalls of restaurant foods and meals and gathered skills and strategies to combat these pitfalls. In this last chapter of Section 1, you’ll learn how to make the rest of the book, the chapters in Sections 2 and 3, work for you. Section 2 covers restaurants under the umbrella of American fare. Section 3 covers restaurants that serve ethnic fare.

On the Menu

Eat Out, Eat Well aims to include the broad landscape of restaurants that line America’s highways and byways, main streets, and city streets and to help you make healthier choices in these restaurants, whether you eat in the restaurants or take out.

Think of this On the Menu section as an introduction. It paints a picture of the types of restaurants included in that chapter. In some chapters the types of restaurants will be quite obvious. For example, in Chapter 14: Sandwiches, Subs, Soups, and Snacks, you know what you’ll find. But you may wonder whether you’ll find breakfast sandwiches in this chapter or in Chapter 11: Breakfast, Brunch, Bagels, and Bakeries. Or you may go to Chapter 19: Italian, figuring you’ll find pizza, but because pizza has become such a ubiquitous restaurant food in America, it’s got its own in-depth chapter—Chapter 20: Pizza.

The Menu Profile

The Menu Profile in each chapter offers a detailed description of the menu items served in each type of restaurant covered in Sections 2 and 3. You’ll find details on the nutrition strengths and pitfalls of the specific category of restaurant covered in each chapter and whether it’s easy or a downright challenge to eat a healthy meal at that type of restaurant.

Nutrition Snapshot

The nutrition numbers are telling, perhaps convincing. In most of the chapters in Sections 2 and 3 you’ll find two tables with snapshots of nutrition information—Health Busters and Healthier Bets. There is no Nutrition Snapshot section for Chapter 16: Going Upscale—Fine Dining or Chapter 24: Indian, because there’s too little nutrition information available from these generally independent, single-location restaurants.

A note about serving size in these tables: For many of the items listed in Health Busters and Healthier Bets, the serving size is specific (for example, “1 bagel” or “2 pieces”), but when the serving size is listed as “1 portion” that means that the nutrition information given is based on one portion of the item as served by the restaurant.

Health Busters

In the Nutrition Snapshot section you’ll find a chart with about 15–25 Health Busters. These are foods or menu items that break the proverbial calorie, carbohydrate, fat, and/or sodium bank, and you’ll see why when you look at the nutrition counts. Use the Health Busters for shock value and to help you realize just how easy it is to exceed your nutrition limits with restaurant foods.

Healthier Bets

The second list under the Nutrition Snapshot section is Healthier Bets, which will help you identify a sampling of healthier restaurant options for the restaurant type covered in each chapter. This is a list of about 25–35 foods or menu items selected based on the specified nutrition criteria developed for this book (see Table 10.1 below). These Healthier Bets are just a sampling of healthier choices from these restaurants. For much more complete restaurant nutrition information get the Eat Out, Eat Well companion app.

*Appetizers are often larger portions which are intended for splitting among several diners. A whole order/serving of a healthy appetizer can be a good option instead of ordering an entrée. These nutrition criteria are for a whole order.

∧To lessen the calorie and carbohydrate load of desserts, consider splitting and sharing them, eating them only on occasion, and balancing extra carbohydrate with insulin adjustments (if you take insulin and can afford the calories).

When possible, the nutrition information in the Nutrition Snapshot section is specific, meaning you’ll see the name of the chain restaurant that serves that food listed next to the menu item. For some menu items, particularly those in the ethnic restaurant chapters, the nutrition information will be more generic and not restaurant specific (think pad thai in Thai restaurants or hummus in a Middle Eastern restaurant). The nutrition information for Health Busters and Healthier Bets has been made available through FoodCare Inc. (http://www.foodcare.com), a “community nutrition transformation company” that brands nutrition apps.

More About Healthier Bets

As you’ll learn throughout this book, you can make many restaurant foods healthier just by practicing the skills and strategies detailed in Chapter 4. Also check out the Menu Samplers in each chapter in Sections 2 and 3 for ideas about putting healthier meals together. The following nutrition information is provided for Healthier Bets: calories, carbohydrate, fiber, protein, fat, saturated fat, cholesterol, sodium. See Table 10.1 for the full nutrition criteria for Healthier Bets.

The diabetes exchanges/choices for the Healthier Bets and Menu Samplers have been calculated and are provided based on Choose Your Foods: Food Lists for Diabetes, 2014. There is no one right way to fit restaurant foods into your eating plan. Figuring out what food group the grams of carbohydrate come from to calculate your total grams of carbohydrate or exchanges/choices, depending on the approach you use, for each item in Healthier Bets and Menu Samplers is the biggest challenge. The following approach was used in this book: When it appears that the grams of carbohydrate come from a starch—be it potato, bread, or starchy vegetable—choices are listed as Starch. If the carbohydrate comes from a vegetable, fruit, or milk, the exchanges/choices are designated as such. One food group in Choose Your Foods: Food Lists for Diabetes is called “Sweets, Desserts and Other Carbohydrates.” This group contains foods such as sweets, frozen desserts, spaghetti sauce, jam, and maple syrup. The calories and carbohydrate grams in many of these foods come from added sugars. Therefore, in calculating the exchanges/choices for this book, we’ve designated foods that fit into the Other Carbohydrate group as such. Exchanges/choices for fast-food shakes and frozen and regular desserts, for example, are listed as Other Carbohydrate.

For protein dishes, the exchanges/choices were calculated based on the group that the protein itself fits into, regardless of how it’s prepared. For example, fish fillet sandwiches and chicken fingers both fall under the Lean Protein choice category even though they have a lot of fat by the time they are served. On the other hand, sausage, in any form, is classified as a High-Fat Protein because that’s the food group sausage fits into. If the dish has several types of protein, then Medium-Fat Protein is used.

Beverages

Chapter 9 offers a full discussion of beverages served at restaurants. At the end of that chapter you’ll find nutrition information for common nonalcoholic and alcoholic beverages.

Condiments

You’ll find a chart at the end of this chapter (Table 10.3, below) with the nutrition information for the condiments you commonly find in restaurants, such as ketchup, mustard, mayonnaise, cream cheese, honey, and basic salad dressings. Chapter 15, dedicated to salads, offers details about choosing and using salad dressings.

*The nutrition information provided in this table for these condiments is an estimate and not specific for the actual brand or restaurant condiment you consume. Use the specific information for the condiments you use when it is available and particularly if you use these in a restaurant you frequent.

∧Most nutrition information for this table was obtained from U.S. Department of Agriculture, National Nutrient Database for Standard Reference, Release 26: http://www.ars.usda.gov/nutrientdata.

Accuracy of Restaurant Nutrition Information

Do be aware that the nutrition information from chain restaurants is close but not exact. The same is true for nutrition information on packaged foods. Many restaurant chains state that their nutrition information (if it’s made available) is based on the specific ingredients and preparation they use. But, think about it: the same restaurant chain, especially if it is a larger chain, has locations all over the country and perhaps the world. Different ingredients and foods are purchased from different food vendors and wholesalers. For example, a Wendy’s in California might purchase lettuce, tomatoes, and hamburger buns from food suppliers in California, whereas a Wendy’s in Connecticut buys foods from another company. The same is true internationally. Granted, the differences between the products is probably not significant because these large restaurant chains have very detailed specifications on the ingredients and food items they use or have made for them. The nutrition information used in this book is for the foods served by these restaurants in the U.S., not in their international locations.

Adding to the inaccuracy of nutrition information is the fact that restaurant foods are prepared by different people on different days. Even in the same restaurant and even in chain restaurants that pride themselves on quality control, on different days you might get a bit more or less cheese on your pizza, more pickles or ketchup on your hamburger, or a slightly smaller or larger steak even though you ordered the 6-ounce filet. Wherever and whenever humans are involved, portions aren’t exact. Use your eyes to always assess the foods and portions you eat alongside looking at the nutrition information provided by a restaurant. Using all the information you have at your fingertips will help you make the best decision about your carbohydrate and calorie counts and/or the blood glucose–lowering medication you take.

Green-Flag and Red-Flag Words

Most of the chapters in Sections 2 and 3 contain the lists Green-Flag Words and Red-Flag Words. As you’ll see, these words are ingredients, cooking methods, menu descriptors, and menu items that you’ll commonly see on the menus of the particular type of restaurants covered in the chapter. Review these carefully. Knowledge of these words will help you navigate restaurant menus to decide what you want and don’t want to eat.

Healthy Eating Tips and Tactics

Throughout Eat Out, Eat Well you’ll find tips and tactics to help you eat healthier restaurant meals and snacks. The Healthy Eating Tips and Tactics sections in most of the chapters in Sections 2 and 3 assemble a convenient go-to list of healthy eating strategies for the particular type of restaurants covered in that chapter.

Get It Your Way

In each of the chapters in Sections 2 and 3, you’ll find a list of special requests pertinent to the type of restaurant being discussed. You’ll be able to use this list to make special requests and get your food as you want and need it. For helpful tips and strategies for making special requests, see Chapter 4.

Tips and Tactics for Gluten-Free Eating

In most chapters in Section 2 and 3, you’ll find tips and tactics for going gluten-free in that type of restaurant. To learn more about celiac disease and following a gluten-free eating plan, read Chapter 6.

Tips and Tactics to Help Kids Eat Healthy

In most chapters in Section 2 and 3, you’ll also find tips and tactics to help the kids in your life eat restaurant meals heathfully, whether or not they have diabetes. The earlier children and teens master these skills, the better it will be for their weight and health. To learn more about healthy restaurant eating with kids, read Chapter 7.

What’s Your Solution?

Eating healthier restaurant meals entails a variety of skills and strategies. It’s not just about gazing at a menu or menu board and picking out the healthier choice. To be successful takes willpower (or “won’t power”) and application of the 10 skills and strategies detailed in Chapter 4. To help you test your knowledge and skills, each of the chapters in Sections 2 and 3 present you with a common situation pertinent to the particular type of restaurant, followed by a few possible solutions. The answers (yes, there may be more than one right answer!) are found at the end of each chapter. Use the tips, skills, and strategies integrated into the pages of this book to help you find the best solutions to these situations.

Menu Samplers

One of the most challenging aspects of eating healthy restaurant meals is figuring out how to put them together. To illustrate how to assemble healthier meals in the types of restaurants covered in the book, under Menu Samplers you’ll find six sample meals based on the nutrition criteria in Table 10.2. The Menu Samplers in each chapter show how to mix and match foods to achieve your nutrition goals and how to apply the 10 skills and strategies for healthier restaurant eating that are outlined in Chapter 4.

∧Total calories per meal are based on the estimated calorie needs in U.S. Department of Agriculture and U.S. Department of Health and Human Services: Dietary Guidelines for Americans, 2010. Available at http://www.health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf.

*An effort was consistently made to minimize the amount of saturated and trans fat in all meals. This can be a challenge in restaurant meals. If you eat a restaurant meal that is high in fat, balance this out with healthier meals other times of the day.

#According to American Diabetes Association: Nutrition Therapy Recommendations for the Management of Adults with Diabetes, Diabetes Care 37 (Suppl. 1): S120–S143, 2014.

§Research shows that eating a lower percentage of calories as carbohydrate may help some people lose more weight initially, but research also shows that this pattern of eating doesn’t result in better long-term weight loss, weight maintenance, or glycemic control.

Note that the nutrition criteria may be less strict than what you would consider healthy for a meal you prepare at home. The reality is that most restaurant meals tend to be higher in calories, fat, and sodium. Plus, fruit, vegetables, and milk may be nowhere on the menu. Keep in mind that you can make special requests to have high-fat or high-sodium ingredients left in the kitchen, or you can axe restaurants that make it particularly hard to eat healthy from your list of options. Zero in on restaurants that make it easy for you to eat healthy—that’s a self-defense strategy.

Why include six meals in each chapter? Because there’s no longer one “diabetic diet” or any one-size-fits-all approach to diabetes meal planning and achieving good health. Plus, typically speaking, women require fewer calories than men. For this reason you’ll find three meal samplers for women and three for men, One of each for each of the three types of menus—Light ’N’ Healthy, Hearty ’N’ Healthy, and Lower Carb ’N’ Healthy. See Table 10.2 for the Menu Samplers nutrition criteria. Read more about today’s healthy eating goals to manage diabetes in Chapter 2.

Light ‘N’ Healthy

The Light ’N’ Healthy Menu Samplers are designed for women and men who have weight loss as one of their diabetes and nutrition goals. The Light ’N’ Healthy meals are based on the following calorie percentages: about 45–55% of the calories come from carbohydrate, 15–25% from protein, and 25–35% from fat, with more total calories allotted for men than women. This calorie split among carbohydrate, protein, and fat—our main sources of calories—is what’s common and comfortable for many Americans. This is a moderate amount of carbohydrate from healthy sources. These meals are not high in carbohydrate.

Hearty ‘N’ Healthy

The Hearty ’N’ Healthy Menu Samplers are designed for women and men who want to maintain a healthy weight. Like the Light ’N’ Healthy samplers, these Menu Samplers are based on calorie percentages of about 45–55% of the calories from carbohydrate, 15–25% from protein, and 25–35% from fat, with more calories allotted for men than women. This calorie split among carbohydrate, protein, and fat—our main sources of calories—is what’s common and comfortable for many Americans. This is a moderate amount of carbohydrate from healthy sources. Hearty ’N’ Healthy meals are not high in carbohydrate.

Lower Carb ‘N’ Healthy

The Lower Carb ’N’ Healthy Menu Samplers are designed for women and men who have weight loss as one of their diabetes and nutrition goals. These Menu Samplers are based on calorie percentages of no more than 45% of calories from carbohydrate, 20–30% from protein, and 25–35% from fat, with more calories allotted for men than women. This calorie split among carbohydrate, protein, and fat—our main sources of calories—is a bit lower in carbohydrate than what is common and recommended for many Americans.

Menu Lingo

Most of the chapters in section 3 contain Menu Lingo, a cuisine glossary. Here you’ll find explanations for unfamiliar terms, such as for ingredients, preparation methods, or menu offerings, that are commonly used in the particular type of restaurants covered.