Today, Italian food is served in a wide array of settings, from inexpensive eateries in airports or food courts to elegant four-star sit-down restaurants. Italian food, besides pizza (which is covered in Chapter 20), is served in lots of independent restaurants, as well as in a growing list of national sit-down chains, such as Buca di Beppo, Carmines, Carrabba’s Italian Grill, Maggiano’s Little Italy, Olive Garden, and Romano’s Macaroni Grill. Other national chains with locations in food courts or along city streets are California Pizza Kitchen and The Old Spaghetti Factory. Then there are the order-at-the-counter restaurants, such as Sbarro, Fazoli’s, and Noodles & Company.
Italian cuisine is so richly integrated into menus across America that you can find traditional Italian dishes on many menus, including those at American family-style restaurants. Even a few of the big pizza chains, such as Domino’s and Pizza Hut, have widened their menus to now include a few pasta dishes. Speaking of pizza, it is, without a doubt, one of the foods Americans—particularly children and young families—eat most frequently in and from restaurants. This statement is truer today than ever before as more people look for fast and easy meals that please the palates of all family members. Chapter 20 will tell you everything you want to know (and more) about eating pizza healthfully. Yes, it can be done!
On the Menu
Italian cuisine ranks in the top three on Americans’ hit parade of ethnic favorites. There is no doubt that you can eat healthfully in Italian restaurants; a cup of minestrone, linguine with white clam sauce, and a demitasse of espresso, for example, are great choices for a meal. At the opposite end of the spectrum, however, you can easily end up with a meal loaded with fat, cholesterol, and sodium. An unhealthy Italian meal might start with garlic bread slathered with butter and an antipasto of Italian cheeses, Genoa salami, marinated artichokes, and olives followed by an entrée of fettuccini Alfredo, and a cannoli for dessert.
A wide range of choices, from healthy to not so healthy, awaits you at Italian restaurants. And portion sizes are often large. Portion control, as usual, will be a key skill to help you avoid overeating in Italian restaurants.
Upscale Italian restaurants typically follow a traditional Italian meal structure, which includes several courses—appetizers, a pasta course, a meat course, and more. If you’re tempted to follow the old adage of “when in Rome,” think twice. Italians typically only eat each of these courses during celebratory meals. Plus they keep portions in check and walk a lot to burn off any large influx of calories. One Italian strategy you’ll want to follow is sharing, which works wonderfully at family-style restaurants such as Buca di Beppo and Maggiano’s Little Italy. Just remember, order several fewer dishes than there are people at the table.
Pasta, the quintessential Italian dish, can be a surprisingly healthy choice as long as you top it wisely and control the portion size. Yes, you read this correctly. Pasta has unfairly gotten a bad rap with criticism of its carbohydrate content and glycemic effect. The reality is that pasta can hold the line on fat and calories better than some burger-and-fry combinations. Pasta can fit with today’s diabetes nutrition goals: it is low in fat and protein and moderate in carbohydrate. Enjoy pasta in reasonable quantities and top it wisely. Though healthier whole-grain pastas are very available on supermarket shelves, they’re still a rarity on restaurant menus. Too bad, because that would make pasta an even healthier option. Today you can request whole-grain pasta at Olive Garden. Maybe in time it will be available in other restaurants as well.
Another benefit is that vegetables are plentiful in Italian dishes, from vegetable-based soups and tomato sauces to sautéed vegetables served on top of pasta or as a side. Take advantage of this and load up on low-calorie vegetables to feel full and keep pasta portions in check. Don’t bury them in cream and cheese sauces.
The Menu Profile
Bread
Ah, the bread. Italians have mastered the art of bread baking. As the menu is placed in front of you in an Italian restaurant, crusty Italian bread with butter or olive oil, garlic rolls, breadsticks, or focaccia (Italian flatbread) may well land on the table too. Unadulterated whole-grain bread is your best option, but it’s a rarity in Italian restaurants. Before you reach out for the bread basket, make sure that the bread is really worth the carbohydrate grams. If your calorie and carbohydrate-gram goals allow for it, have one piece of bread and ask for a small dish of tomato (or marinara) sauce or balsamic vinegar to dip it in. If you have more calories and fat grams to spare, dip it in olive oil (rather than spreading on butter). With olive oil, you’ll eat some good fats and limit unhealthy ones. After grabbing one piece, pass the bread as far away from you as possible. Keep in mind that a request to take it back to the kitchen is perfectly reasonable.
Antipasti (Appetizers)
Antipasti typically include starters like charcuterie (an assortment of Italian deli meats), cheeses, bruschetta, and vegetables. Sometimes you’ll find shrimp, calamari (squid), mussels, or clams on the menu. At fast casual or more Americanized restaurants, the chefs love to fry, so you’ll likely find deep-fried mozzarella and zucchini sticks as well as an assortment of flatbreads.
When you look at the menu, can you spot the all-star appetizers versus those that should get the boot? For a healthy starter try shrimp, squid, mussels, or clams in a tomato sauce or a sauce that uses any combination of lemon, garlic, herbs, and/or wine. Or select an antipasto of marinated vegetables—peppers, pickles, and olives—if you’ve got some wiggle room with your sodium count.
You may find fresh tomatoes featured as the star ingredient in crostini or bruschetta (tomatoes and garlic brushed on slices of Italian bread), but these options can be high in calories and carbohydrate depending on the thickness of the bread slices. Caprese salad, in which slices of fresh tomato, fresh mozzarella, and basil are layered, is a frequent appetizer option in Italian restaurants. Fresh mozzarella, like most cheese, has a significant amount of total and saturated fat; fat providing about 75% of the calories in a Caprese appetizer. If the Caprese is calling your name, go ahead and enjoy, but limit the cheese and other high-fat items you eat throughout the rest of your meal. You may also want to ask if they can add extra tomatoes to your dish.
Antipasti loaded with cheeses and Italian cold cuts, such as in charcuterie, are high in fat with a goodly dose of saturated fat. Avoid these options. Steer clear of deep-fried calamari, mozzarella, and zucchini sticks as well.
Soups and Salads
If you don’t find any healthy antipasti on the menu, you’re sure to have better luck with a soup or salad. Popular Italian soups are minestrone, stracciatella, pasta e fagioli, and Italian wedding. These are all tomato- or broth-based soups, making them a relatively low-calorie way to begin your meal. The beans in the minestrone and the pasta e fagioli can even add a bit of fiber to your meal.
Insalata, the innocent-sounding crunchy greens, can be filling and low in calories (depending on what’s atop the greens). Look for salads made with radicchio (red leaves), arugula (a peppery-tasting green), endive, tomatoes, broccoli, mixed baby field greens, spinach, beets, peppers, onions, and/or other raw or marinated vegetables. A few olives or condiments like sun-dried tomatoes aren’t a problem, but some Italian salads are loaded with high-fat items like cheese, pasta salad, proscuitto (Italian ham), bacon, pancetta (Italian cured bacon), or nuts. Avoid these high-fat items.
Order salad dressing on the side and try to choose a light option. Or, better yet, try a bit of olive oil with a vinegar of your choosing or a few squeezes of fresh lemon wedges. Some Italian restaurants use a variety of vinegars, from red wine and balsamic to flavored vinegars, such as tarragon or rosemary. If you spot one of these vinegars used on the menu, you know it’s in the kitchen. Ask for vinegar on the side to use alone or to stretch the dressing you’ve ordered. (You can use it to dip your bread in as well.)
Caesar salad, with egg, grated cheese, anchovies, and thick and creamy dressing, is one salad option you need to limit. Just so you know, a traditional Caesar salad is dressed with an oil and lemon–based dressing, which is a healthier choice. Upscale restaurants often serve them dressed this way. If you’ve just got to have a Caesar salad ask them to go light on the cheese and serve dressing on the side with lemon wedges.
Panini
If you eat Italian for lunch, you may be tempted to order a panini, the Italian version of a toasted or grilled sandwich. The bread can often be hefty and the sandwich is usually oozing with high-fat cheese. Your best strategy is to order a half of a panini or split one with a dining companion. Pair it with a cup of healthy soup or a salad for a more balanced, lower-calorie lunch. If the kitchen won’t accommodate a half-panini order and there’s no one willing to share, then request a carry-out container and immediately put half of your sandwich in it to enjoy tomorrow.
Primo Piatto (First Course)
A featured item on most Italian menus is pasta, which is traditionally offered as the first course in a multi-course meal. Pasta is made by combining flour, water, and eggs (optional). Pasta takes many different shapes and forms, some large, some small, some stuffed, some not. Familiarize yourself with the variety of pastas at the end of this chapter (Know Your Pasta). Some healthier pasta choices include angel hair, linguini, fusilli, fettuccini, or ziti. Try flavored pastas: spinach, squid ink, or tomato.
Pasta on its own contains no fat; it’s just carbohydrate with a bit of protein. One cup of cooked pasta (with no sauce) has about 220 calories and about 43 grams of carbohydrate. Though whole-grain pasta isn’t typically available, it’s beginning to make an appearance. Restaurants like Fazoli’s, Olive Garden, and Noodles & Company have added it as an option on their menus. Perhaps the other large national chains will follow suit in the not too distant future. Order it if it’s an option; you’ll pick up a couple of grams of fiber and some other nutrients from the whole grain.
One of the challenges of eating pasta in restaurants is that it’s served in huge portions. What’s your portion-control weaponry? Split an order, take home half, or order an appetizer-size serving. Calories are another challenge when it comes to pasta. The calories in pasta dishes can add up fast depending on what your pasta is topped or stuffed with. Is the sauce tomato-based and loaded with onions and garlic, such as a marinara sauce? Or is it a sauce that’s loaded with high-fat ingredients such as cheeses, sausage, cream, and/or bacon, such as a carbonara sauce? Your strategy is to keep an eye out for the Green-Flag Words for Italian cuisine and avoid menu items that use or contain the terms listed under Red-Flag Words.
No need to sweat it. You can always find healthy pasta choices. Look for pasta marinara, pasta primavera (sautéed vegetables), or pasta with red or white clam sauce or Bolognese sauce. Limit stuffed items such as ravioli, cannelloni, and manicotti because they are usually stuffed with cheese or ingredients that are combined with cheese or butter. You can order one of these stuffed pastas if it’s stuffed with vegetables, but ask for details before you order—it may be topped with a cream sauce.
If you are carefully watching your calories and fat grams, then leave pesto alone. Pesto is made with basil, which is a good start, but then three high-fat ingredients are usually blended in: pignoli (pine) nuts, olive oil, and Parmesan cheese. Just because it’s green doesn’t mean it’s healthy. But, if you’ve got a few extra calories and fat grams to spare, go ahead. A small amount of flavorful pesto spreads around a small pile of pasta.
Two other primo piatto treats found more commonly in upscale Italian restaurants are risotto and polenta, which are grain-based dishes native to Italy. Risotto is made with Arborio rice, a short-grain rice with stubby kernels. It traces its ancestry to the Po Valley region of Italy, where it is grown in abundance. Unfortunately, chefs typically prepare risotto with lots of butter, cheese, sausage, and other high-fat ingredients. The taste might be great, but the calories count and fat and cholesterol content will be high. If you wish to try it, look for a risotto dish that blends spices, herbs, and vegetables. For example: risotto with spinach and mushrooms or risotto primavera. Polenta is like cornmeal pudding. Cornmeal, water, and salt are the three main ingredients. Polenta is a staple in the Veneto region of Italy. It is often served with sauces, many of which may load on the fat, so use caution if you order polenta. Sometimes you’ll see triangles of polenta that have been grilled. These are low in fat grams.
Secondo Piatto (Main Course)
Moving on to the traditional secondo piatto, or main course, you might find pollo, pesce, or carne—that’s poultry, seafood, or meat. If you’re having pasta, don’t feel compelled to order a main course, unless you split it or take half home. Most main courses are simply too much protein for one meal. When you do order a main course, try to choose grilled fish, scallops, or chicken breast. Again, as with pasta, the magic question is “how is it prepared?” Look for tomato-based sauces or sauces with vegetable, mushroom, or wine prepared without cream. It’s common to see different proteins prepared with the same sauces on the menus. Limit the high-fat and high-sodium Prosciutto ham, pancetta, cheese, and cream sauces. Also, tread lightly with anything prepared parmigiana (or Parmesan) style, such as chicken or eggplant parmigiana. Anything prepared in this style has been deep-fried, then layered with cheese. Give these dishes the boot.
One popular Italian entrée is veal. Misconceptions about veal exist. Many people believe that veal is relatively low in calories, fat, and cholesterol. It’s true that veal cutlet, the lean cut often used in Italian restaurants, is low in calories (about 40–50 per cooked ounce), but the cholesterol content is similar to that of lean beef (about 20–25 milligrams per ounce cooked). On the other side of the veal spectrum is veal breast, which is higher in fat at about 60–70 calories per cooked ounce. The main problem is that veal is most often prepared by being dredged in flour before being sautéed in butter or oil. If you have a few extra calories to spare, veal marsala, cacciatore, or piccata is a decent choice. If calories are tight, stick with grilled fish or chicken and enjoy veal cutlet at home, where you can prepare it healthfully.
Contorni (Side Dishes)
Traditional Italian side dishes are often served alongside the main course. They are usually vegetables served hot or cold, raw or cooked. Grilled asparagus, Brussels sprouts, sautéed broccolini or broccoli rabe, and roasted mushrooms are just a few options you may find on the menu. As always, be on the lookout for high-fat sauces that may be added to the vegetables. If there is a vegetable you like on the menu, but it has a red-flag word in the description, ask if it can be prepared differently. Most restaurants can easily accommodate this request.
Dolce (Dessert)
For dessert, Italian menus list items such as panna cotta, spumoni, cannoli, gelato, sorbetto, Italian ices, and fresh berries with liqueur and whipped cream to quench the sweet tooth. Think about splitting a dessert among several diners or choose a lower-fat Italian ice or sorbet. Better yet, go for the fresh berries. Another option: End the meal as they do in Italy—with a demitasse of espresso. Buon appetito!
The Lowdown on Olives and Olive Oil
In central and southern Italy, olive oil replaces butter as the fat of choice in recipes. Today, olives and olive oil wear a nutrition halo. That’s because the fats in olive oil, mainly monounsaturated and (less so) polyunsaturated fats, are being touted for their health value. Olive oil contains minimal saturated fats. Monounsaturated fats help lower LDLs (bad cholesterol) without decreasing HDLs (good cholesterol). Fatty ingredients that contain mainly monounsaturated fats and don’t come from animals, such as olive, canola, and peanut oils and nuts, and avocado, have the added benefit of being cholesterol-free. For these reasons, olive oil is one of the healthier fats you can consume both at home and away from home. However, do remember that any type of olive oil contains the same number of calories (50 calories per teaspoon) as every other fat, from butter to lard and hard shortening.
When it comes to olives themselves, try the many varieties available. Enjoy them on salads, in Italian sauces, or just as a tasty side item. Remember, however, that they fall into the high-sodium food category and, just like the oil that they are processed into, they contain mainly fat.
Nutrition Snapshot
Green-Flag Words
Ingredients:
• Artichoke hearts—not marinated in oil
• Broccoli, broccolini, broccoli rabe
• Capers (high in sodium)
• Grilled chicken, fish, seafood
• Herbs (basil and oregano)
• Marinated vegetables—not in oil
• Olives, olive oil
• Pasta (all types other than those stuffed with cheese)
• Spinach, kale, and other greens
• Sun-dried tomatoes
• Tomatoes—raw or cooked
• Tomatoes, onions, peppers, mushrooms
Cooking Methods/Menu Descriptions:
• Light mushroom and wine sauce
• Light red- or white-wine sauce
• Lightly sautéed with onions and shallots
• Piccata
• Primavera (without cream)
• Tomato sauce and meatballs
• Tomato-based sauces—marinara, Bolognese, cacciatore, pomodoro, puttanesca
• White or red clam sauce
Red-Flag Words
Ingredients:
• Butter
• Cheese—mozzarella, Gorgonzola, Parmesan, provolone
• Eggplant or zucchini (if fried)
• Italian cold cuts
• Pancetta, prosciutto, or bacon
• Sausage, veal, or pork
Cooking Methods/Menu Descriptions:
• Alfredo
• Cannelloni
• Carbonara
• Charcuterie
• Creamy sauces (wine, mushroom, cheese)
• Fried or deep-fried
• Lasagna
• Manicotti
• Parmigiana (veal, chicken, eggplant)
• Saltimbocca
• Stuffed shells
• Stuffed with cheese
At the Table:
• Butter
• Grated cheese
• Salad dressing
Healthy Eating Tips and Tactics
• Share multiple courses with your dining companions. This lets you sample a lot of different dishes without overdoing it.
• Make marinara sauce (or light tomato sauce) your go-to sauce. Use it as a topping for your pasta or as a dip for your bread.
• Ask for a take-home container. Even when you share a dish, in some restaurants you’ll still have plenty left over to enjoy for a meal on another day.
• Along with pasta, munch on a healthy garden salad to fill yourself up but not out.
• The red pepper flakes you’ll probably find sitting right on your table (or in your spice cabinet for takeout) will add zip to your pizza, pasta, or salad without adding calories.
• Decline the bread basket before it even hits your table.
Get It Your Way
• Manage your portions. Request a half-order (possibly called “appetizer size”) of pasta if you don’t have someone to split it with. Or take home half of a regular order.
• Swap sauces. Instead of a cream- or oil-based sauce, ask that your pasta be tossed with a tomato-based sauce, such as marinara or Bolognese sauce.
• Add in extra vegetables. See a favorite pasta dish on the menu? Ask that broccoli or another favorite vegetable be added to it. This will help you fill up on fewer calories.
• Request that the chef hold or use less cheese, bacon, olives, or pine nuts in your dish.
Tips and Tactics for Gluten-Free Eating
• Avoid all meats, poultry, and seafood that has been dredged in flour, breaded, battered, or fried. Meatballs typically contain breadcrumbs, so they probably contain gluten. Order a protein that has been roasted, baked, broiled, or grilled on clean surfaces. Check all sauces, marinades, and seasonings for gluten.
• All breads and pasta, unless otherwise stated as gluten-free, are made from wheat. Beware of restaurants that make their own pasta from scratch as there may be residual flour in the air.
• Order risotto or polenta prepared in a gluten-free broth.
• Fresh vegetables or salad with balsamic or red wine vinegar and olive oil on the side are good choices. Try a Caprese salad with sliced tomatoes, mozzarella, and basil.
• Olive Garden stocks gluten-free rotini to serve on request and will give you additional nutrition or food allergy information and gluten-free menu items upon request. Make sure that gluten-free pasta is cooked in fresh, clean water and that a clean strainer, tongs, etc., are used to serve it.
Tips and Tactics to Help Kids Eat Healthy
• Think about how you can add a vegetable serving to your child’s meal. At many Italian restaurants, pasta or chicken strips (grilled or deep-fried) are the default kids’ meal options and vegetables are nowhere to be found. Can you order a side of broccoli to share with your child? Or a cup of minestrone soup?
• Choose marinara over cream-based sauces. Sure, it’s messy, but, like you, your child will benefit from this tomato-based topping that’s low in fat. Now is a good time to use that old napkin-asa-bib trick.
• Take advantage of family-style ordering to give your child the grown-up responsibility of picking a dish that the whole family will share. Want to increase the odds that your child will eat his or her veggies? Ask your child to pick the vegetable dish for the table.
• Share, share, share! Most portions at Italian restaurants are big enough for two or three to share. Rather than order a special kids’ meal for your child, bring him or her in on the sharing of regular menu items, just like the Italians do.
What’s Your Solution?
Your family is at a festive Italian restaurant where the food is served family style. You recently set a family wellness goal together to eat more healthfully, which involves watching portions and eating more vegetables. Yet most of the choices that your family members are requesting are large portions of foods topped with layers of cheese.
What can you say and do to help your family stick to the wellness goal everyone agreed to?
a) Establish a plan for the meal in advance. Agree to order at least one to two servings of vegetables. Then, depending on the number of people and the individual preferences of each person, decide how many pasta and entrée dishes you will order.
b) Start with a big family-style salad. Nosh on that while you peruse the rest of the menu.
c) Request that take-home containers hit your table at the same time as your entrées.
d) Make special requests. Challenge every family member to think of a way to make each dish a little bit healthier. For example, request that no extra cheese top your meal before it leaves the kitchen. Decline the bread basket. Substitute marinara or a light wine sauce for a heavy cream-based sauce.
See the end of the chapter for answers.
Menu Samplers
Know Your Pasta
Pasta, meaning “paste” or “dough,” is found on the menu of every Italian restaurant. Pasta is created from flour (durum or all-purpose flour), water, and sometimes eggs. These ingredients are used to create a wide variety of different shapes of pasta, from angel hair to ziti. Unlike in Italy of yesteryear, you see many different-colored pastas available in America today: whole-wheat and whole-grain pastas (though not served in most restaurants) and flavored pastas, such as tomato, spinach, artichoke, and more. This pasta primer will help you “know your pasta” and have an easier time distinguishing the healthy from the not-so-healthy choices.
• Agnolotti: pieces of pasta, often shaped like crescents, that are stuffed with one ingredient or a combination of cheese, meat, and spinach.
• Angel hair: the thinnest and finest of the “long” pasta family. It is quite light in consistency and is often served topped with light, vegetable-based sauces.
• Cannelloni: large, tubular pasta, similar to manicotti. It is stuffed with one ingredient or a combination of cheese, meat, and spinach.
• Capelletti: (meaning “little hats”) these are small, stuffed pastas that look like little tortellini. They’re often stuffed with cheese or meats.
• Fettuccini: flat, long noodles about 1 inch wide (wider than linguine).
• Fusilli: spiral-shaped long pasta.
• Gnocchi: little dumplings in 1/2-inch pieces made from either flour or potatoes, or a combination of the two.
• Lasagna: the widest noodle among the long, flat pastas. It has either smooth or scalloped edges. Typically, lasagna is used in making a multi-layered casserole dish that is served in squares.
• Linguine: flat, long noodles about 1/8 inch wide (thinner than fettuccini).
• Manicotti: long, tubular noodles about 2 inches in diameter. Manicotti is most often stuffed with cheese and/or meat and served with tomato sauce.
• Mostaccioli: short, tubular noodles about 1 1/2 inches long.
• Penne: short, tubular noodle quite similar to mostaccioli and rigatoni.
• Ravioli: two pieces of pasta with a pocket in the middle. Traditionally, they come in 2-inch squares, but today they are often found smaller and are either square or round. Ravioli are traditionally stuffed with cheese, spinach, and/or meats, but today you can find most anything stuffed in ravioli from butternut squash to duck confit.
• Rigatoni: short, tubular noodles quite similar to penne and mostaccioli.
• Shells: noodles in the shape of conch shells. These are called conchiglie in Italian, and can be found in a variety of sizes. Sometimes the larger ones are stuffed, and most are served topped with tomato sauce.
• Spaghetti: a round pasta, which is the most commonly known and eaten pasta in America. Spaghetti is available in a variety of widths.
• Tortellini: small pasta that is stuffed and joined at the ends to form a ring; a larger version of capellitti.
• Ziti: a short, tubular pasta similar to mostaccioli.
What’s Your Solution? Answers
a) Developing a plan in advance is a key strategy to eating out. Agree on your priorities and choices before you’re tempted by the sights and smells of the restaurant.
b) Starting with a healthy salad is a great way to get in an extra serving or two of vegetables. It will also help satiate you from the start, making it less likely that everyone will overeat. Just be sure to order the salad wisely: limit meats and cheeses and get the dressing on the side.
c) When dining family style, sometimes everyone wants a special dish. Rather than deprive someone of his or her order, go ahead and order all requests (within reason), but plan to box up extra portions. Leaving uneaten food in the center of the table can be tempting, even when everyone feels full. You’ll hopefully have dinner for the next night ready to just heat and eat.
d) Little changes can add up to big nutrition differences. Making special requests can help ensure that you get all your family’s favorites while still meeting your wellness goals. It’s a wonderful idea to involve your whole family in implementing healthy eating strategies!