Dining Out on the DASH Diet

You can’t beat cooking and eating at home in terms of choosing the healthiest foods, but you may not always be able to get into the kitchen every day. Your schedule probably varies from day to day or month to month. You also probably travel every so often, whether it’s for business, to visit relatives, or simply to get away from it all. This article aims to help you make heart-healthy (or at least better) choices when cooking and dining at home isn’t an option.

There may be times when you may not be able to meet every goal of the DASH diet (Dietary Approaches to Stop Hypertension diet) when dining out. That’s okay. Just do your best and pick up where you left off at the next meal. You may also not have too much control over sodium at times, so keep this in mind, and reduce sodium at other meals and over the next day.

Dining out with DASH, generally speaking

The DASH diet focuses on adding more fruits, vegetables, nuts, and seeds to your diet. So when dining out, keep those food groups at the front of your mind. Look for the vegetables on the menu and sneak in some milk or low-fat dairy foods when you can.

DASH limits sodium, which is more difficult to control when dining out. Rather than worry too much about that, focus on what you can include with your choices. Consider these guidelines the next time you head out to eat:

• Rethink appetizers as possible entrees. Portions matter because the larger the portion, the higher the calorie content but also the higher the sodium content. Create a meal with an appetizer and add a side salad and baked potato.
• Look for vegetables. Be sure to add a side salad or a vegetable to your meal. To ensure you don’t go overboard with the salad dressing, ask for it on the side. Watch out for crouton overload, as they can add 50 to 100 calories to your salad.
• Choose the side vegetable for your side dish. Choosing the green side veggie (such as asparagus, green beans, or a vegetable medley) adds antioxidants.
• Limit fried food; choose broiled, grilled, or baked instead.
• Going out to breakfast? Order the veggie omelet and ask for it to be made with two eggs rather than three. Once taboo, egg yolks are a great source of choline (essential for healthy metabolism and brain health), so it’s fine to include them.
• Ask about changes to menu items. Often the cook or chef can skip the sauce, skip the salt, or lighten something up for you if you ask for it. Ask for sauces on the side.
• Rethink chicken. Chicken is known to be low in saturated fat, but restaurant chicken is often loaded with salt. Frozen chicken often has a salt solution added to it to retain moisture and extend its freezer life. Fresh beef or pork is often lower in sodium when dining out.
• Consider portion size. As we’ve said, the bigger the portion, the more sodium and fat. Choose 5-ounce steaks at the steakhouse, split an entree with someone, or eat half your meal and take half home.
• Skip the extra cheese. Though low-fat dairy is part of the DASH diet, chances are, the processed cheese used at most restaurants is full-fat and higher in sodium. Also, because most restaurant meals are generally higher in sodium, holding the cheese can help you reduce total sodium in that meal.
• Drink water with meals and monitor other beverages. Drinks high in sugar or alcohol can rack up calories and are not good for your blood pressure. If you enjoy them, limit alcoholic beverages to no more than one or two, and limit any sugary beverages to 8 ounces or less.
• Check out the nutrition information that chain and fast food restaurants offer on their websites.

Restaurant food is usually higher in sodium, so the next time you think about using the salt shaker on your food at the table, shake it into your hand. Just a few shakes can yield a quarter teaspoon (or about 600 milligrams of sodium).

Share and share alike

When dining out, sharing appetizers, meals, side dishes, or desserts is a great way to enjoy foods that you love. It’s also a simple way to control your portion size. Considering the overly generous portions of food served up as entrees at restaurants these days, there’s usually plenty on the plate for two (and your wallet will thank you as well).

Why worry about portions? Because bigger portions mean you get more of everything — good and bad. For the nutrients you want more of (like potassium, calcium, and vitamins A and C), be sure to have adequate portions from the food groups that provide them (fruits, vegetables, beans, nuts, seeds, and low-fat dairy). As for sodium, the larger the portion, the higher the sodium content. For high-sodium foods, this can really be a big deal. Half the portion means half the sodium too.

Healthy options at various types of restaurants

Though sodium can be a major issue in a fine dining setting, you typically have plenty of choices to help you steer clear of high-sodium foods. In addition, you may have some bargaining power in the special request department, although it’s often okay to make requests at fast food restaurants too. Ethnic restaurants can also have some healthy options, as long as you know what you’re looking for.

Sit-down restaurants

Sit-down restaurants come in a few different flavors. At the lowest level are the casual chain restaurants. Next come the privately owned casual restaurants, followed by the more upscale restaurants (both chain and privately owned). In general, you have fewer choices at a chain restaurant than a privately owned establishment because most chains have set recipes and menus. Still, it doesn’t hurt to ask your server if the kitchen can hold the salt or put the sauce on the side. You can also request the nutrition information from chains or check their websites or apps. Many now post the calories, at least, on the menu boards.

Following are our suggestions for finding the most DASH-friendly options when dining at sit-down restaurants:

• Always add a side salad, preferably mixed field greens or added vegetables and nuts (look for healthy toppings such as roasted beets, almonds, or walnuts).
• Choose the vegetable of the day for your side dish rather than fries or a potato, especially in steakhouses, where the potatoes are generally gigantic. (If you must have a steakhouse potato, just eat half.) You can also shake things up with a baked sweet potato once in a while.
• If you’re dining at a steakhouse, choose the smallest steak. Filet mignon is lowest in fat and is often offered as a 4- to 8-ounce portion.
• For the sake of calorie control, it’s best to skip dessert or to share dessert with a friend. “Better” choices: fruit crisp/cobblers, crème brûlée (milk and egg–based, often served with fresh berries), or sorbet.

Fast food places

Whether it’s from a drive-through or a fast sit-down place, fast food gets a bad rap. No, it shouldn’t be a daily (or even weekly) source of your food, but you can make informed choices when you get a fast food craving or if you’re traveling and need a quick bite. Because you get a choice of portions (small, medium, large, humongous), you’ll do best by sticking with the small or medium option (sometimes “medium” is the smallest choice). Value-type menus often have smaller-portion items, so they may be a safe bet too.

Saturated fat and sodium are two nutrients of concern on fast food menus, so be sure to take a look at them and choose the lower-sodium options. That smaller-portion rule works here (smaller portions mean less saturated fat and less sodium).

Take a look at the simple math in this table to see how you can reduce fat and sodium with smaller portion sizes at a typical chain steakhouse or a coffeehouse/bakery.

Comparison of Various Portions of Similar Foods

Other options that may surprise you are some typical café/bake-shop breakfast items, which we list in the following table. Though the bagel is lowest in fat, it’s still high in calories and sodium. The cheese in the egg sandwich adds about 450 milligrams of sodium (so if you just hold the cheese, you can reduce the sodium to 170 milligrams and the calories to around 550).

As you can see from the numbers in the following table, the parfait is a DASH diet winner! Keep balance in mind as you make choices as well. While this table highlights fat and sodium, protein is important to satiety (helping you stay full longer and thus not take in more calories than you need through the day). Both the parfait and the egg sandwich offer you some protein as well. And, don’t forget about the calories, sugar, and fat in fancy sweetened coffeehouse drinks. Ask for the breakdown if they aren’t posted.

Calories, Fat, and Sodium in Typical Quick-Stop Breakfast Food

Ethnic options

Just about every ethnicity offers beautiful traditional foods that are both healthy and not-so-healthy (but tasty no doubt). Saving those not-so-healthy options for special occasions and holidays is your best bet.

This table focuses on the good choices you can make at various ethnic restaurants. Keep in mind, though, that sodium levels will still be higher than in food you cook at home (this is especially true with Chinese and Thai food, which can have more than 2,000 milligrams of sodium per serving). Skip fried choices. Ordering more vegetables is still a good addition to your diet. Ask for sauces on the side or ask for no monosodium glutamate (MSG) so you can better control the sodium.

Planning Ahead to Follow DASH on the Road

Planning ahead is the best strategy to ensure DASH-friendly eating, particularly when you’re going to be traveling for any length of time. Vacations are often scheduled differently than your normal week, so when your environment changes, a little more planning can go a long way.

A road trip may require different planning than going by air or boat, but it’s all doable. Packing some snack items for the road helps avoid poor choices at convenience stops, and saves money. Although you can’t bring water bottles through airport security, you can pack an apple and a bag of almonds and buy water before you board.

Travel tips to help you stick to your goals

When you leave home for another destination, your routine is likely to change. You can go with the flow and still stick with your overall diet and exercise goals. Try not to get trapped into the mindset of, “Well, I’m on vacation, so it’s a free-for-all!” Instead, meet yourself halfway and think about how good you’ll feel if you have some activity daily and eat well. You can still hold on to traditions and have that ice cream cone from that special ice cream parlor that you love, but you’ll balance it out with healthy food and some exercise through the week.

Here’s a simple game plan to think about the next time you leave town:

• Pack a healthy snack to go.
• Pack at least one set of exercise clothes and lightweight athletic shoes.
• Plan some physical activity daily: walking, biking, kayaking, dancing.
• Think about your meal plan at the beginning of the day.
• Consider a larger lunch and a lighter dinner. You’ll save money and have more time during the day to work it off!
• Plan ahead if your hotel room has a kitchenette. If you pack a microwaveable egg cooker, you can make an egg sandwich in the morning on a whole-grain English muffin, or microwave a bowl of quick oats with fruit.
• Do a grocery run, if possible, to pick up breakfast items and healthy snacks like eggs, quick-cooking oatmeal, fruit, carrot sticks, yogurt, cottage cheese, string cheese, whole-grain bread, nut butter, and nuts.
• Don’t skip breakfast because it’s a chance to get important DASH foods in, such as low-fat dairy and fruit.

Simple portable snacks

Often, when you’re away from home, you may not have access to the same amount of space or conveniences. If you have a small refrigerator available, pack it with grab-and-go snacks. If you have a small kitchen available, plan to use it for breakfast each day. While we generally recommend you don’t allow processed food to be a focus in your diet, some conveniences such as individually packaged nuts or snack bars can come in handy when traveling.

Consider these healthy convenience foods for the road:

• Low-fat string cheese
• Fruit cups, unsweetened or packed in their own juice (peaches, mixed fruit, applesauce)
• Apples, bananas, pears (all are pretty hardy for travel bags compared to more delicate fruits)
• Almonds, walnuts, or mixed nuts
• Fruit and nut trail mix
• Fruit and nut snack bars (look for brands that are comprised of mostly fruit and nuts — not chocolate-coated or sugary chewy types)
• Yogurt cups (if you travel by car, a cooler is a great idea to have along)
• Raw carrots, celery, or pepper strips
• Whole-grain cereal (portion out snack bags to take along)
• Water bottles