Dieters Can Draw Line When Eating Out

Terri Blackwell was eating out recently when she made a simple request. She wanted her fresh vegetables steamed without any butter or sauce added. At first, the response from restaurant personnel was an emphatic “no.”

The vegetables were already prepared in a butter sauce, she was told.

But Blackwell, a registered dietitian who believes in maintaining a low-fat and low-sodium diet, stood her ground.

“I insisted and I got ‘em,” she says with satisfaction.

Blackwell, who works with cardiac and diabetic patients at Western Medical Center in Santa Ana, teaches her patients to stand their ground.

She instructs them to make choices and special requests that will lower the fat and sodium content in their restaurant meals. And she says most restaurants tend to be surprisingly cooperative.

That’s why she’s “totally appalled” when she finds restaurants that are reluctant to comply with such requests. “It’s such a healthy way to eat and everybody should be eating this way.”

Eating out is a way of life in Southern California. It may be a quick meal on the run during your lunch hour, dinner out because you don’t want to cook, a fast meal after a Little League game, a power lunch or sometimes all of the above.

Unfortunately, if you are not careful, too much of this can be hazardous to your waistline, your cholesterol count and your blood pressure.

But there is something you can do about it.

By improving your nutritional IQ with a few simple principles suggested by dietitians, it is possible to substantially reduce fat, sodium and calorie content in restaurant meals, and enjoy a healthier approach to eating.

More people are finding that by making the right choices, watching portions and being politely assertive, they can really have it their way when eating in restaurants.

And more restaurants are going out of their way to offer “alternative” or “light” cuisine for health-conscious patrons because it is what a growing number of people prefer. More than 100 restaurants in Orange County responded positively to American Heart Assn. inquiries about honoring special requests from patrons watching their fat and sodium intake.

Menu selections at the Newport Beach Four Seasons Hotel, for instance, include “alternative cuisine” that is nutritionally balanced, reduced in calories, cholesterol, sodium and has low fat levels. The idea of maintaining taste is at the heart of these dishes, according to Ali Kasikci, executive assistant manager at the hotel.

“In the early ‘80s, the company (Four Seasons) came up with the idea of developing an alternative cuisine, alternative to what restaurants normally served,” he says, “which consisted of food items as good-tasting as any other items on the menu, but low on cholesterol, sodium, calories and fat.”

Swallow’s Cove in San Clemente offers American and Continental cuisine, with all entrees made to order, no sodium added in cooking and no butter added to pasta. The Revere House in Tustin has been a steak and prime rib house for years, but now offers broiled fish, chicken and turkey prepared per customers’ requests.

Even Carl’s Jr. is heavily advertising its “lite menu” items such as baked potatoes, salads and a broiled chicken sandwich. MacDonald’s offers salads these days and both fast-food chains have brochures available that tell diners the nutritional content of menu items. These brochures can be eye-openers. You discover that a broiled chicken breast sandwich has one-sixth of the fat of a hamburger. However, when you add cheese and bacon to that chicken sandwich, the fat content takes a considerable jump.

Only a few years ago, people did find it a hardship to make special requests in restaurants, but now “restaurants are much more accommodating,” says Kathy Hall, a registered dietitian who shows clients at La Costa Hotel and Spa in Carlsbad how to lower fat, sodium and calories.

She says most of her clients find information on how to cut fat and sodium when eating out very helpful. Many, she says, arrive at the resort thinking their fate is sealed because they have to eat out frequently for business reasons. They find out, however, that adjusting their restaurant eating is easier than they think.

First of all, Hall suggests limiting alcohol consumption to only one drink, because alcohol stimulates appetite. Next, read the menu carefully and ask waiters or waitresses any unanswered questions, such as how meat is prepared and the size of portions.

Select meat entrees--preferably fish or poultry--that are baked or broiled. If what you want isn’t prepared this way, ask if it can be. And it’s a good idea to ask to have any visible fat trimmed from meat before cooking. If you are limiting sodium intake, ask that no salt be added when your entree is being cooked.

“Dry broiled” is an important term to remember when ordering in a restaurant, according to Molly O’Hanlon, a registered dietitian with the Cardiac Rehab Program at Saddleback Memorial Hospital and Health Center in Laguna Hills.

“You have to be specific when you order broiled and say ‘dry,’ ” she says, because in many restaurants even fish is basted with butter before broiling, which adds unwanted fat and calories.

However, John Kaires, manager of the Revere House, says maintaining taste is a concern to many of his health-conscious patrons. He says that about 10% to 15% of his customers request their meat dry broiled, but many others ask that a small amount of butter or garlic butter be added to enhance flavor.

O’Hanlon advises that you request that the skin be removed from poultry before it is cooked. Most of the fat in poultry is “in the skin or just lying under the skin,” she says. “If you pull the skin off after you cook it, there’s going to be some fat absorption into the meat.” If it’s not possible to remove the skin before cooking, she says, at least peel it off before eating the poultry.

Portions are another consideration. Hall advocates eating no more than a four-ounce portion of meat per meal. She tells her clients “to just eat half of a large portion of meat . . . or let the waiter know you want more of vegetables and pasta and less meat.”

If dining with a friend, consider splitting a meal and ordering an extra salad, says Susan Magrann, who is a registered dietitian with the Heartwise Nutrition and Lifestyle Changes classes at Anaheim Memorial Hospital and program manager of the hospital’s Optifast weight-loss program. Many restaurants will charge a fee for meal splitting, but you’ll save on calories. And, Magrann says, consider ordering a la carte instead of a full meal with salad, bread, entree, vegetables and a baked potato.

All of the dietitians advocate requesting some items “on the side.” Blackwell encourages her patients to “ask for things on the side, especially items that are high in fat, such as salad dressings, butter or margarine, sour cream, cheese sauces.”

Use just enough salad dressings and sauces to add some flavor, but not enough to significantly hike fat consumption. That means drizzling only a small amount of garlic butter on your fish or using a teaspoon or two of salad dressing.

“That way you have more control over your food,” O’Hanlon says. “Don’t throw away taste. We still want you to eat things that taste good. . . . Have the toast with the jelly and leave out the butter.”

Opinion on the use of butter and margarine is divided. Some of the dietitians advocate eating bread and baked potatoes without the addition of either, while others are more forgiving and say it is OK to use a sparing portion--maybe one-third of a pat--to enhance taste.

Blackwell suggests dipping your salad fork into dressing on the side before spearing your vegetables. This enhances taste, but adds very little fat-laden dressing. Other suggestions are to request lemon slices and squeeze those over a salad or to use a very small amount of dressing and stretch it by sprinkling vinegar on too.

Magrann advocates gradually reducing the amount of salad dressing you use. “If you’re used to a lot, then you’re probably going to have a hard time going down to one tablespoon. But if you’re used to a lot and you use a little less, and then a little less and then a little less, you get to the point that if you had it the old way, your taste buds have adjusted and you don’t even want it the old way.”

Salads can be a good choice to reduce fat consumption, but that doesn’t mean it’s a good idea to hit the salad bar and load up with everything.

First, Magrann says, choose dark greens like romaine lettuce or spinach. Then add raw vegetables such as broccoli, cauliflower, tomatoes and garbanzo beans. She says it is best to avoid any prepared salads that have mayonnaise in them because they will have a high fat content. Pasta salads, she says, can also be higher in fat than you might think because they are probably loaded with salad oil.

When it comes to the fruit bar, pass on canned fruits that may have sugar added and enjoy the fresh fruits, but steer clear of ambrosia salads because they are “just deadly” with whipped cream.

People watching calories also need to beware of those large muffins so popular at salad bars these days. Magrann estimates that the average muffin contains 300 to 400 calories. If you must have one, she suggests eating only half, or at least leaving off any butter or margarine.

Changing your eating habits takes practice, Magrann says. “Each time you practice, you do better,” she says. “People are under the impression (they) have to do perfectly. . . . Nobody’s ever going to be perfect, but you can make better choices and get closer to what the ideal is.”

And then she admits with a chuckle: “Dietitians don’t do it perfectly either.”