Dining Out

A place to get your questions answered from McDougall staff dietitian, Jeff Novick, MS, RDN.

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Dining Out

Postby JeffN » Sat Feb 15, 2020 11:53 am

Dining out is one of the most challenging things to do. When I was at Pritikin, we would call this lecture, Dying Out. :)

The following study has inspired me to organize some of the prior discussions and threads on dining out/restaurants into one thread, which I will be adding to overtime, Hopefully, some of you will find it helpful.

Image

70% of Fast-Food (FF) meals were of poor quality
50% of Full-Service (FS) meals were of poor quality.
< 0.1% of meals at FF and FS were of ideal quality.


Image

Data on the percentage meeting an ideal diet (≥40 points or ≥80% adherence) are not presented due to very small numbers (most of them are zeros) and large statistical uncertainty. Data are weighted to be nationally representative. AHA, American Heart Association.


The Study

Quality of Meals Consumed by US Adults at Full-Service and Fast-Food Restaurants, 2003–2016: Persistent Low Quality and Widening Disparities
J Nutr 2020;00:1–11.
doi: https://doi.org/10.1093/jn/nxz299.
https://www.ncbi.nlm.nih.gov/pubmed/31995199

ABSTRACT
Background: Meals from full-service restaurants (FS) and fast-food restaurants (FF) are an integral part of US diets, but current levels and trends in consumption, healthfulness, and related sociodemographic disparities are not well characterized.
Objectives: We aimed to assess patterns and nutritional quality (using validated American Heart Association [AHA] diet scores) of FS and FF meals consumed by US adults.

Methods: Serial cross-sectional investigation utilizing 24-h dietary recalls in survey-weighted, nationally representative samples of 35,015 adults aged ≥20 y from 7 NHANES cycles, 2003–2016.

Results: Between 2003 and 2016, American adults consumed ∼21 percent of energy from restaurants (FS: 8.5% in 2003–2004, 9.5% in 2015–2016, P-trend = 0.38; FF: 10.5%; 13.4%, P-trend = 0.31). Over this period, more FF meals were eaten for breakfast (from 4.4% to 7.6% of all breakfasts, P-trend <0.001), with no changes for lunch (15.2% to 15.3%) or dinner (14.6% to 14.4%). In 2015–2016, diet quality of both FS and FF were low, with mean AHA diet scores of 31.6 and 27.6 (out of 80). Between 2003 and 2016, diet quality of FF meals improved slightly, (the percentage with poor quality went from 74.6% to 69.8%; and with intermediate quality, from 25.4% to 30.2%; P-trend <0.001 each). Proportions of FS meals of poor (∼50%) and intermediate (∼50%) quality were stable over time, with <0.1% of consumed FS or FF meals meeting ideal quality. Disparities in FS meal quality persisted by race/ethnicity, obesity status, and education and worsened by income; whereas disparities in FF meal quality persisted by age, sex, and obesity status and worsened by race/ethnicity, education, and income.

Conclusions: Between 2003 and 2016, FF and FS meals provided 1 in 5 calories for US adults. Modest improvements occurred in nutritional quality of FF, but not FS, meals consumed, and the average quality for both remained low with persistent or widening disparities. These findings highlight the need for strategies to improve the nutritional quality of US restaurant meals.

Discussion
Based on nationally representative data between 2003 and 2004 to 2015 and 2016, American adults consumed ∼1 in 5 total calories from FS and FF restaurants, with ∼9% energy from FS and 12% energy from FF meals. During this period, the overall nutritional quality of FF, but not FS, meals consumed improved modestly, largely owing to increased nuts/seeds/legumes and decreased saturated fat, and (to a lesser extent) increased whole grains. Conversely, amounts of fruits and vegetables decreased in both FS and FF meals, whereas sodium increased in FS and remained high in FF meals. Notably, overall diet quality scores remained low for both FS and FF restaurant meals, with 50% of FS meals and 70% of FF meals consumed in 2015–2016 having poor diet quality. In addition, persistent or worsening disparities were evident in key population subgroups.
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Re: Dining Out

Postby JeffN » Sat Feb 15, 2020 11:55 am

Dining out is one of the most challenging aspects of this program.

If you remember a few simple basic principles, you will succeed.

1) You need a minimally processed starch as the center of your plate, along with some veggies and possibly fruit
2) Keep it simple
3) Do the best you can
4) Vegan is not always healthy and in most restaurants, isn't.
5) Always be nice :)

Having said that, I like to think of restaurants in tiers in regard to how easy they are to get a healthy meal, especially a MWL meal.

1) Steak Houses, Salad Bar Restaurants, Stir-fry restaurants and Wendy’s - You can find these in almost every town and almost always get a nice baked potato with some steamed veggies, and a salad.

Examples include:
- Outback, Longhorn, Ruth's Chris
- Sweet Tomatoes, Soup Plantation
- Stir Crazy, Flat Top Grill


2) Asian Style Restaurants (Chinese, Japanese, Thai)

The food is almost always made to order. You can always get a nice plate of steamed rice (Starch), often brown, with a nice plate of assorted steamed veggies at most any Chinese or Thai place.. Japanese will make sushi rolls to order and usually have veggie rolls. You can start with steamed edamame.

Example include:
- PF Chang's, Pei Wei, Stir Crazy


3) Italian, Mexican

Many Italian restaurants today have whole grain pasta (Starch), which you can get with an assortment of steamed vegetables and a simple red sauce (marinara, tomato, pomodora) often made to order for you. Mexican food is based on Rice and Beans (starch) with vegetables. Look for the fresh style Mexican restaurants (Baja Fresh, etc) where they make food to order. Mexican bowls are a good option. You have to be more careful of hidden oil, salt and sugar in these restaurants than in the first two types.

Examples Include
- Olive Garden, Maggiano's, Carrabba's,
- Moe's, Baja Fresh,



Sometimes, you don't even have to look at the menu. Based on the style of restaurant, just ask if you can get the above made for you.

Enjoy!

In Health
Jeff
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Re: Dining Out

Postby JeffN » Sat Feb 15, 2020 12:00 pm

Some related threads....

Dining out cards
viewtopic.php?f=22&t=52817

Is your vegan restaurant really vegan
viewtopic.php?f=22&t=12172

When does added sugar (In a restaurant) not count as added sugar
viewtopic.php?f=22&t=51725&p=567612
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Re: Dining Out

Postby JeffN » Thu Mar 25, 2021 9:07 am

We should rename the activity from Dining Out to Dying Out :)

Association Between Frequency of Eating Away-From-Home Meals and Risk of All-Cause and Cause-Specific Mortality
Published:March 25, 2021DOI:https://doi.org/10.1016/j.jand.2021.01.012

https://jandonline.org/article/S2212-2672(21)00059-9/fulltext

Abstract

Background
Dining out is a popular activity worldwide. Evidence on the association between eating meals away from home and long-term health outcomes is still limited.
Objective

The objective of this study was to examine the association of frequency of eating meals prepared away from home with all-cause and cause-specific mortality.
Participants/setting

This study included 35,084 adults aged 20 years or older from the National Health and Nutritional Examination Survey 1999-2014, who reported their dietary habits including frequency of eating meals prepared away from home in a questionnaire during face-to-face household interviews.
Main outcome measures

All-cause mortality, cardiovascular mortality, and cancer mortality were ascertained by linkage to death records through December 31, 2015.
Statistical analyses performed

Multivariable Cox proportional hazards models were used to estimate adjusted hazard ratios of mortality from all-cause, cardiovascular, and cancer mortality.
Results

During 291,475 person-years of follow-up, 2,781 deaths occurred, including 511 deaths from cardiovascular disease and 638 death from cancer. After adjustment for age, sex, race/ethnicity, socioeconomic status, dietary and lifestyle factors, and body mass index, the hazard ratio of mortality among participants who ate meals prepared away from home very frequently (2 meals or more per day) compared with those who seldom ate meals prepared away from home (fewer than 1 meal/wk) was 1.49 (95% CI 1.05 to 2.13) for all-cause mortality, 1.18 (95% CI 0.55 to 2.55) for cardiovascular mortality, and 1.67 (95% CI 0.87 to 3.21) for cancer mortality.

Conclusions
Frequent consumption of meals prepared away from home is significantly associated with increased risk of all-cause mortality. The association of eating meals prepared away from home with cardiovascular mortality and cancer mortality warrants additional investigation.
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Re: Dining Out

Postby JeffN » Fri Mar 26, 2021 11:30 am

‘Healthy’ Plant Based Meals Drowning in Salt (and high in saturated fat)

- New survey by Action on Salt exposes shocking reality of many ‘healthy’ sounding plant based and vegan meals served at UK restaurants, fast food and coffee chains – with some containing more salt than 8 McDonald’s Hamburgers

- Nearly half (45%) of meals eaten out of the home contain 3g or more salt in just a single meal – that’s half the maximum daily limit for an adult

- Additionally, over one in five dishes provide more than half an adult’s maximum daily recommendation for saturated fat

http://www.actiononsalt.org.uk/salt-sur ... me-sector/
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