CHAPTER
13

Dining Out on the Anti-Inflammation Diet

In This Chapter

As much as fast-food chains and other casual dining restaurants have tried to clean up their act in recent years with healthier menu options, fewer trans fats, and more fruits and vegetables offered, many fast foods still aren’t good for you. Chances are, we’re not telling you anything new here. You probably already know this is true.

The fast-food industry especially has gotten bad press due to documentaries like Super Size Me and eye-opening studies that show just how unhealthy some restaurant foods really are. The obesity rate in the United States is reaching epidemic proportions, if it’s not already there. That’s due, in part, to these quick and convenient—and nutritionally barren—menu options.

In this chapter, we take a look at the dangers and risks of eating fast food in particular and restaurant food in general. We also provide some tips on how to stay on track with the anti-inflammation diet and still drop in at a fast-food counter every once in a while.

The Perils of Fast Food

Many of us like convenience, as well as the taste, of fast food. Or we go there because our children or grandchildren clamor for kids meals.

Most fast-food restaurants are chain or franchise operations. The food is mostly standard from location to location, highly processed, and prepared with a standard formula dictated by headquarters. One of the reliable features of fast-food restaurants is that the products are identical in almost all respects—from taste to size to packaging. A Whopper is a Whopper wherever you order it.

WHAT THE EXPERTS SAY

Fast food is now served at restaurants and drive-thrus, at stadiums, airports, zoos, high schools, elementary schools, and universities, on cruise ships, trains, and airplanes, at K-Marts, Wal-Marts, gas stations, and even at hospital cafeterias. … Americans now spend more money on fast food than on higher education, personal computers, computer software, or new cars. They spend more on fast food than on movies, books, magazines, newspapers, videos, and recorded music combined.

—Eric Schlosser, Fast Food Nation

Fast food has received a super-size chunk of the blame for the obesity epidemic the United States faces. It’s particularly to blame for the high rate of obesity among children. Its high-fat/empty-calories/low-nutrient fare is responsible for the big waists, metabolic syndrome, and silent inflammation victimizing many a fast-food frequenter.

In the United States alone, consumers spend hundreds of billions on fast food. But fast food has been losing market share to fast-casual restaurants, which offer somewhat better and slightly more expensive foods. Fast-casual restaurants are similar to fast-food restaurants in that they don’t offer full table service. However, they do provide a somewhat higher quality of food and atmosphere and more health-promoting choices. Examples are Noodles and Company and Panera Bread Co. The typical cost per meal is in the $6 to $10 range. (More on fast-casual restaurants later in this chapter.)

Fast Fat, Calories, and Sodium

The methods used to cook fast food are part of the reason they’re so bad for us. Even though some fast-food restaurants have eliminated at least some trans fats, deep-fried items are still full of bad-for-us fat.

As a general rule, fast food is high in bad fats; high in calories; high in sodium; low in fiber; and low in nutrients such as vitamin A, C, D, and folic acid. The only nutrient you get plenty of at fast-food restaurants is protein, which most of us get too much of anyway.

What to Avoid

Here are some of the worst offenders at the fast-food counter:

French fries: Depending on the restaurant, a small order of fries could contain as much as 3 grams trans fats. The recommendation for trans fats is to eat no more than 2 grams a day (based on a diet of 2,000 calories a day).

Fried chicken and fish: It’s difficult to detect just how much trans fat is in these foods because they differ from restaurant to restaurant and item to item. The smartest approach is to skip anything fried.

Super sizes: Unless you’re sharing with a table of eight, skip all super-size, biggie, and other extra-large items.

Mayonnaise and other high-fat condiments: Skip these items and you avoid all that unnecessary fat.

Cheese: The cheese on fast-food burgers is highly processed. Skip the cheese.

Value meals: These can sometimes dump half a day’s harmful fat and sodium in your body at one meal.

WHAT THE EXPERTS SAY

See, now’s the time of the meal when you start getting the McStomachache. You start getting the McTummy. You get the McGurgles in there. You get the McBrick, then you get the McStomachache.

—Morgan Spurlock, while consuming a Double Quarter-Pounder Supersize meal for his documentary, Super Size Me, in 2004

Specifically, here’s a list of items you should stay away from at fast-food restaurants:

Stay away from these unhealthy condiments, too:

Is There Anything Nutritious?

Believe it or not, it is possible to eat fast food—every once in a while—and cut your nutritional losses. For example, many fast-food chains now disclose trans fats information in addition to calories, carbohydrates, salt, and more. However, it’s almost impossible to control sodium. Fast food is loaded with it.

Here are some tips for ordering somewhat nutritional items from fast-food restaurants:

For breakfast:

At the sandwich counter:

At the pizza parlor:

At the Chinese or other Asian stop:

At the Mexican restaurant:

INFLAMMATION INFORMATION

A taco salad in the deep-fried tortilla shell can have more than 1,000 calories! Say no thanks to the shell whenever possible.

At the burger joint:

At the coffee shop:

Kids and Fast Food

According to a Harvard study reported in the journal Pediatrics, nearly one third of more than 6,000 children who participated in the study eat fast food every day. Those who ate fast food took in, on average, 187 calories more each day than the kids who did not. They also consumed an average of 9 grams more fat, 24 grams more carbs, 26 grams more sugar, and 228 grams more sweetened drinks.

The differences add up to about 6 pounds extra weight per year in the average child who eats fast food—just from eating fast food two or three times a week. They eat fewer fruits and vegetables, drink less milk, and get less fiber.

There’s no doubt a love for fast food has contributed to the surge in obesity among children in the United States that’s reached epidemic levels. Experts estimate that 15 percent of kids are overweight and another 15 percent are at high risk of becoming overweight. Additionally, two thirds of these overweight kids will become overweight adults.

If you can’t avoid fast-food places with your kids, you can try to get them to make better choices while there. For example, instead of soda, which is high in empty calories and provides no nutrition, see if he or she will drink water or milk instead. Also encourage them to choose the kids’ meal; the portions usually are smaller. And many fast-food restaurants now offer fruit as well as—or instead of—fries or chips.

DID YOU KNOW?

According to the Center for Science in the Public Interest, Americans get about 10 percent of their total calories from fast food.

Fast-Casual Restaurants

With the impression of made-to-order food and slightly better atmosphere, fast-casual restaurants like Panera, Baja Fresh, and others have given the fast-food industry a run for its money. But proceed with caution: a lot of the food they serve is high in fat and calories, not to mention salt.

Scientists at Tufts’ Friedman School of Nutrition, Science, and Policy found that the fat and calorie contents of many of the “healthy” food options at fast-casual restaurants were actually worse than fast food.

Many breads and bakery products in fast-casual restaurants come with a touch of culture with names like ciabatta and artisan three seed. But they’re still made with refined flour.

Soups are also often high in calories and fat—especially trans fat.

What about salads? They’re good for you no matter which restaurant sells them, right? Not so fast. Especially at fast-casual restaurants, salads aren’t always as health-promoting as you might think, topped with fried chicken or cheese, and fatty salad dressings.

Look up some nutritional information on fast-casual restaurants and compare the numbers to the nutritional information on fast-food websites, and you might be very surprised.

If you think ice cream is a necessary part of life, you’re in good company. French philosopher Voltaire said, “Ice cream is exquisite. What a pity it isn’t illegal.” But keep in mind that the fat in ice cream is mostly a bad-for-you fat. And don’t get us started on the excess of calories. For a better sweet treat, opt for frozen yogurt or fruit.

Sit-Down Fat

Although they sometimes do offer such information, restaurants that move at a slower pace than fast-food restaurants and have wait staffs, sit-down tables, real silverware, and food cooked to order are not required to tell you what fats they cook with—or anything else about the food’s ingredients. (Really, fast- and casual-food restaurants don’t have to either, but public pressure has resulted in more and more restaurants revealing their ingredients.)

So when eating out, it’s important to think in terms of not going off your anti-inflammation diet, but that dining out is part of it.

Consider snacking on a healthy, filling snack before you go out to eat. (This is also a great way to keep from eating or drinking too much at parties.) When you arrive at the restaurant feeling hungry, you may launch into the first offering of food, which is often the bread basket, heavy appetizers, and salty snacks.

Some restaurants will meet your special needs if you phone ahead. Ask if your food can be prepared with olive oil, little salt, no butter, no fatty sauce, and broiled instead of fried.

When you first sit down at the restaurant, ask your server not to bring the bread basket or chips. It’s easier to avoid temptation if you don’t even have to look at it to begin with.

Review the menu carefully, and ask questions. Many restaurants also provide nutritional information on all their offerings if you ask for it. A simple, “Does this come without the cream sauce?” or “Can you grill that with olive oil instead of butter?” could keep you on track. If you don’t know what’s in a dish or don’t know the serving size, ask. If you’re on a low-salt meal plan, ask that no salt be added to your food.

If portions are big and/or the food is high in fat and empty calories, try to share it or leave some behind on your plate. Don’t take it home! That just extends the harm to the next day. Ask if it’s possible to order a smaller portion (often called a “half size”).

Try to avoid buffets for this reason, too. All-you-can-eat seems like a good deal, but buffets simply promote eating too much. It’s hard to resist that chocolate cream pie when you’ve already paid for it!

Many restaurants now offer healthy menu choices, and good sit-down restaurants will modify menu items on request. If not, consider going somewhere else.

Most restaurants have foods that fit with the anti-inflammation diet, but they are served in butter and heavy sauces. Request that your entrées and sides be served without them.

Order salad dressing on the side so you can control the amount you eat. Vinegar and a dash of oil or a squeeze of lemon are better choices than high-fat dressings.

If you like the cooperation and choices you have at a particular restaurant, let the manager and chef know. If you want more health-promoting choices, let them know that, too.

Here’s a sampling of health-promoting choices at sit-down restaurants:

DID YOU KNOW?

Main courses that have been baked, broiled, roasted, poached, or steamed are better for you than anything fried. And salads with plenty of fresh fruits and vegetables and lighter dressings are better than salads with croutons, cheeses, meats, and heavy dressings.

When dining out, stay away from any foods the menu describes with any of these labels:

Alfredo

Allemande sauce

Au gratin

Battered

Béarnaise sauce

Béchamel

Breaded

Butter sauce

Buttered

Cheese sauce

Creamed

Crispy

Deep-fried

En croûte

Fried

Hollandaise

Horseradish sauce (plain horseradish is fine)

Newburg sauce

Pan-fried

Pastry

Remoulade

Rich sauce

Sautéed

Scalloped

Supreme sauce

Thai peanut sauce (or any sauce made with coconut milk)

Veloute sauce

White sauce

With gravy

With thick sauce

And stay away from foods high in salt, such as foods pickled, smoked, or in soy sauce.

Labeling Laws

Part of the reason restaurants have gotten away with selling such nutritionally poor foods is because no strict laws or regulations exist. The Food and Drug Administration (FDA) has set rules for the claims restaurants can make about the nutritional values of their food. But the current rules for restaurants are weak compared to the requirements for foods sold in grocery stores.

If a restaurant makes a claim such as “low fat” or “heart healthy” on a menu, the restaurant owner must be able to demonstrate there’s a reasonable basis for believing the food qualifies to bear this claim. However, the rules allow restaurants a lot of flexibility in establishing this reasonable basis and in presenting the information to consumers. And these rules affect only those restaurants that place claims such as “low fat” or “heart healthy” on their menus.

Unlike manufacturers of processed foods, restaurants aren’t required to supply complete nutrition information for their menu selections. In addition, menu items bearing such claims are not held to the same strict standards of laboratory analyses.

Restaurants can use other, more economical methods to meet the standard. For example, a restaurant can show that an item was designed to meet the requirements for the claim because it was prepared using a recipe from a recognized health professional association or dietary group, or that the nutritional values for the dish were calculated using a reliable nutrition database.

Under the rules, nutrition information can be provided to the consumer by any reasonable means. It doesn’t have to be presented in the “Nutrition Facts” format as seen on packaged food labels, nor does it even have to appear on the menu. For example, a restaurant may compile, in a notebook, information on the fat content of all menu items that bear fat claims so long as the nutrition information is available at the restaurant to consumers who request it.

The Least You Need to Know