The Fat and Skinny on Restaurant Dining

Restaurant dining is a critical yet often overlooked factor in the relationship between diet and health status. Busy schedules, travel, two-career families, socializing, celebration, relaxation and convenience have made dining out a way of life today. According to the National Restaurant Association, 44% of the American food dollar was spent on meals eaten away from home in 1995. In a recent survey, 48% of those surveyed reported eating out on the day preceding the survey, an increase from 41% in previous years.

Nutrition-related risk factors for cancer, diabetes, obesity, heart and circulatory diseases include inadequate consumption of fruits and vegetables, high fat and saturated fat intake. According to the 1995 California Dietary Practices Survey, "eating away from home was up significantly," and "people who ate out ate ¼ fewer fruits and vegetables." Most restaurant meals are also excessively high in fat (50 to 100 grams) and calories (800 -1,500).

The three leading causes of death in the United States – heart disease, cancer, and stroke – are strongly linked with the typical high-fat, low-fiber American diet. Approximately one-third of cancer and one-fifth of heart disease cases are nutrition-related, translating into 300,000 diet-related deaths per year at an estimated cost of $35 billion in 1993. Diet has also been implicated in a number of other costly and debilitating conditions, including hypertension, osteoporosis, obesity and diabetes.

In 1993, the Center for Science in the Public Interest (CSPI), a consumer advocacy group, began conducting a number of "Restaurant & Food Studies." Their research consisted of chemical analyses to determine the nutrient content of popular dishes under such categories as "Chinese Restaurant Food," "Italian Restaurant Food," etc. CSPI evaluated the calorie, fat and saturated fat, cholesterol, and sodium content of a selection of dishes and found that, while exceptions exist, most restaurant meals have excessively high levels of the very nutrients that Americans are being advised to cut back on: fat and saturated fat, calories, cholesterol and sodium. For example, of 26 entrees examined by CSPI in Chinese and Italian restaurants, the average fat content was 43 grams; calorie content was 1106. If one includes appetizers, side dishes, bread and butter, and perhaps dessert in the calculation, the fat content of one restaurant meal could easily climb to 50 to 100 grams, a level that exceeds recommendations of fat intake for an entire day.

The CSPI Restaurant & Food Studies generated massive amounts of media coverage -- electronic and print. According to the Nation’s Restaurant News, "CSPI reports have had a major impact on restaurant sales in the form of sudden declines at dining establishments ¼ operators have been talking up the healthful side of their menus as never before." Some restaurants, for example, began identifying certain dishes with a *or including them in a menu section entitled, "On the Light Side." Unfortunately, there were often no criteria for identifying dishes as "healthful," so these designations were often misleading.

The Food and Drug Administration (FDA) recently implemented regulations to prevent misleading information on menus, but that still does not solve the problems. The regulations are confusing to both restaurant owners and diners. Many restaurant owners are not even aware the regulations exist, and the regulations appear not to be consistently enforced. In addition, the regulations are based on the weight of the food, which is confusing to consumers. In any case, the regulations don’t address the basic problem of poor nutritional quality of restaurant meals.

Another problem is that recipes, ingredients, food preparation techniques and portion size -- for identically named and described dishes -- vary widely from restaurant to restaurant. In addition, dishes that "sound" healthy may not be. For example, a "grilled fish" is generally considered a safe bet for the nutrition-minded diner. In a restaurant, however, "grilled" often reflects the cooking method; it doesn’t preclude the addition of fats that are brushed, basted or included as marinades to make the dish highly palatable. Short of conducting a nutrition analysis based on the recipe’s actual composition, it is virtually impossible to determine the fat and calorie content or fruit/vegetable content of restaurant meals.

A New York Times article appearing on April 2, 1997, discussed a study in which more than 200 dietitians and nutritionists were asked to estimate the fat and calorie content of several restaurant dishes. The food professionals estimated a tuna salad sandwich as providing 374 calories and 18 grams of fat. It actually contained 720 calories and 43 grams of fat. They estimated a lasagna as containing 694 calories and 35 grams of fat, while the actual count was 960 calories and 53 grams of fat. One can only imagine the errors in estimations made by those who are not trained as dietitians. Gaynelle Clay-Williams, nutritionist in the obesity research center at St. Luke’s Roosevelt Hospital Center (New York), summed it up: "The average American doesn’t have a clue."

Some studies have shown that customers choose more healthful meals when nutrition information is available, but many times consumers are ambivalent about the health message. While most Americans rated nutrition as moderately to very important, it appears that many people don’t want to make restaurant selections based on health, nutrition, fat or calories. They prefer to enjoy a pleasant, relaxing meal with friends or associates, free from pressure and constraint. The Treat Yourself Well campaign is designed to offer nutritious meals that also satisfy consumers’ desires to fully enjoy the dining experience.