Dining at Restaurants Is a Recipe for Unhealthy Eating — How You Can Eat Better
By Moira McCarthy
- Researchers say eating at restaurants is generally bad for our overall health.
- They note that 50 percent of full-service restaurant meals and 70 percent of fast-food meals are of poor dietary quality.
- Experts say you can avoid unhealthy eating habits at restaurants by checking the menu beforehand and saving a portion of your meal for lunch the next day.
There was a time not so long ago when dining out was a rare treat and most of our meals were prepared at home.
Today, restaurants are lined up along main roads, and fast-food joints are tucked into every corner of our world. We even have the ability to summon just about any kind of food to our couch with the tap of an app.
The result: A solid 20 percent of the calories we consume as a nation comes from some type of restaurant.
Those factors are bad news for the health of people in the U.S., according to a studyTrusted Source published today in The Journal of Nutrition by the Friedman School of Nutrition Science and Policy at Tufts University in Massachusetts.
The study analyzed the dietary selections of more than 35,000 U.S. adults from 2003 to 2016 in the National Health and Nutrition Examination Survey (NHANES) to determine how often they dined at full-service or fast-food restaurants.
The researchers assessed nutritional quality by evaluating specific foods and nutrients in the meals, based on the American Heart Association 2020 Diet Score.
The researchers found that at fast-food restaurants, about 70 percent of the meals Americans consumed were of poor dietary quality.
At full-service restaurants, about 50 percent were of poor nutritional quality.
The researchers also report that less than 0.1 percent of all the restaurant meals consumed over the study period were of ideal quality.
The study authors point out that consumer choice comes into play here, but they add that restaurant choices don't make healthy ordering easy.
"Our findings indicate that major efforts are needed to improve the nutritional quality of meals consumed at U.S restaurants — both what's available on the menu and marketed, and what Americans actually choose," Dariush Mozaffarian, MD, BS, dean of the Friedman School of Nutrition Science and Policy at Tufts University and a co-author of the study, told Healthline.
"Looking at how close or far each meal was from ideal, the biggest problem is actually too few healthy components," he said.
"Adding more healthy foods to restaurant meals, while reducing salt, is the biggest opportunity for improving their healthfulness," he said.
Making Quality Food Available
Eight years ago, while driving along a suburban Boston highway and realizing her young son with type 1 diabetes needed to eat quickly, Shannon Allen was faced with the realization that not one of the many restaurants she passed — fast food or otherwise — came close to offering the kind of meals she chooses to feed her children.
In reaction, Allen took action. She formed Grown, a group of organically certified restaurants.
Her goal is to place a healthy spot to eat quickly close enough for anyone to access.
So far, Grown has four locations, including one in the Florida stadium that will host Super Bowl 2020.
Allen agrees personal choice plays a role in ordering, but she places the responsibility squarely on the restaurants themselves.
"I think that for the most part, the food industry is broken," Allen told Healthline. "For some families, it's cost prohibitive to eat real food. Delicious, fresh, nutrient dense, organic ingredients are about three times more expensive than conventional grown ingredients, and it only costs pennies to eat traditional fast food, like burgers, tacos, and fries."
Allen says those choices aren't necessarily a bad thing if they're an occasional meal. However, if that's the only kind of food a person can afford, it will affect their health over time.
"If we lead with what's right, what is real, and what is obvious — that real food made with fresh, organic ingredients should be the right of every family," she said, "now we are really doing something to change busy people's lives for the better."
Getting the Government to Act
Mozaffarian agrees that restaurants must take action, but he adds this problem should be attacked with a societal and governmental effort as well.
He says federal, state, and local governments should reward restaurants that are doing the right thing.
Those officials, for example, can link the Opportunity Zones legislation to healthier menu items, or provide tax or regulatory policy that encourages and lowers the cost of healthier options and eating.
He adds that more messaging is needed to consumers about how critical their food choices are for health and healthcare costs.
"Many chefs are showing that healthier options can taste even better than unhealthy ones. We need more of this innovation," Mozaffarian said.
What You Can Do
So, what's a busy diner to do?
Susan Weiner, MS, RDN, CDE, FAADE, owner of Susan Weiner Nutrition, suggests diners take time to think ahead, study menus, and not fall prey to special "value deals."
"If you're with other people, it's always best to order first," she told Healthline. "You are less likely to be peer influenced."
She also suggests the following:
- Review the menu before you go to the restaurant so you have a heads-up on the offerings. You can also call in advance to see if food can be prepared in a way that's satisfactory to you.
- Try to avoid the "upsell" meal deals. Stick to the basics.
- Your server is your friend. Be kind, and ask for recommendations that would fit your needs.
- Put some away for lunch tomorrow. Think about how much you would eat at home. Chances are restaurant portions are much larger. Or, share a meal.
Mozaffarian would also like to see the presidential candidates not just take this up as a talking point, but take action on the campaign trail.
"With the 2020 elections in full swing, everyone is talking about healthcare and healthcare costs, but no one is addressing a leading driver: poor food," he said.
"In fact, it sometimes seems like the candidates are trying to outdo each other on the campaign trail by eating the worst food possible. We will never get healthcare costs under control until we fix our food system. This is a leading opportunity for innovation and better health," Mozaffarian said.
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Since even moderate-intensity workouts offer a slew of benefits, walking is a good choice for people looking to stay healthy.
How to Rock Your Walk<p>Walking isn't just fun and healthy. It's accessible.</p><p>"Walking is cheap," says Dr. John Paul H. Rue, a sports medicine doctor at <a href="https://mdmercy.com/" target="_blank">Mercy Medical Center in Baltimore</a>. "You can do it anywhere at any time; [it] requires little to no special equipment and has many of the same cardio benefits as running or other more intense workouts."</p><p>Want to up your walking game? Try the tips below.</p>
Use Hand Weights<p>Cardio and strength training can go hand-in-hand when you add weights to your walk.</p><p>A <a href="https://journals.lww.com/acsm-msse/Fulltext/2019/03000/Associations_of_Resistance_Exercise_with.14.aspx" target="_blank">2019 study</a> found that weight training is good for your heart, and <a href="https://www.mayoclinicproceedings.org/article/S0025-6196(17)30167-2/abstract" target="_blank">research</a> shows it reduces the risk of developing a <a href="https://www.healthline.com/health/nutrition-metabolism-disorders" target="_blank">metabolic disorder</a> by 17 percent. People with metabolic disorders have a higher chance of being diagnosed with high cholesterol, high blood pressure, and diabetes.</p><p>Rue suggests not carrying weights for your entire walk.</p><p>"Hand weights can give you an added level of energy burning, but you have to be careful with these because carrying [them] over a long period of time or while walking could actually lead to some overuse injuries," he says.</p>
Make It a Circuit<p>As another option, consider doing a circuit. First, put a pair of dumbbells on your lawn or somewhere in your home. Walk around the block once, then stop and do some bicep curls and tricep lifts before walking around the block again.</p><p>Rue recommends <a href="https://www.healthline.com/health/exercise-fitness/running-with-weights" target="_blank">avoiding ankle weights</a> during cardio workouts, as they force you to use your quadriceps rather than hamstrings. They can also cause muscle imbalance, according to the <a href="https://www.health.harvard.edu/staying-healthy/wearable-weights-how-they-can-help-or-hurt" target="_blank">Harvard Health Letter</a>.</p>
Find a Fitness Trail<p>Strength training isn't limited to weights. You can get stronger by <a href="https://www.healthline.com/health/bodyweight-workout" target="_blank">simply using your body</a>.</p><p>Often found at parks, fitness trails are obstacle courses with equipment for pullups, pushups, rowing, and stretches to build upper and lower body strength.</p><p>Try searching "fitness trails near me" online, checking out your local parks and recreation website, or calling the municipal office to <a href="https://calisthenics-parks.com/" target="_blank">find one</a>.</p>
Recruit a Friend<p>People who workout together stay healthy together.</p><p><a href="https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-017-0584-3" target="_blank">One study</a> showed that older adults who exercised with a group improved or maintained their functional health and enjoyed their lives more.</p><p>Enlist the help of a walking buddy with a regimen you aspire to have. If you don't know anyone in your area, apps like <a href="https://www.strava.com/" target="_blank">Strava</a> have social networking features so you can get support from fellow exercisers.</p>
Try Meditation<p>According to the <a href="https://www.nccih.nih.gov/research/statistics/nhis/2017" target="_blank">2017 National Health Interview Survey</a>, published by the National Institutes of Health, meditation is on the rise, and for good reason.</p><p>Researchers <a href="https://pubmed.ncbi.nlm.nih.gov/29616846/" target="_blank">found</a> that mind-body relaxation practices can regulate inflammation, <a href="https://www.healthline.com/health/biological-rhythms" target="_blank">circadian rhythms</a>, and <a href="https://www.healthline.com/health/glucose" target="_blank">glucose</a> metabolism, as well as lower <a href="https://www.healthline.com/health/high-blood-pressure-hypertension" target="_blank">blood pressure</a>.</p><p>"Any form of exercise can be turned into a meditation of some type, either by the surroundings you are walking in, like a park or trail, or by blocking out the outside world with music on your headphones," Rue says.</p><p>You can also play a podcast or download an app like <a href="https://www.headspace.com/headspace-meditation-app" target="_blank">Headspace</a> that has a library of guided meditations to practice while you walk.</p>
Do Fartlek Walks<p>Typically used in running, fartlek intervals alternate periods of increased and decreased speed. These are <a href="https://www.healthline.com/nutrition/benefits-of-hiit" target="_blank">high-intensity interval training (HIIT)</a> workouts, which allow exercisers to accomplish more in less time.</p><p><a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0154075" target="_blank">One study</a> showed that 10-minute interval training improved <a href="https://www.healthline.com/health/metabolic-syndrome" target="_blank">cardiometabolic</a> health, or lowered the risk of heart disease, stroke, and diabetes, just as well as working out at a continuous pace for 50 minutes.</p><p><a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0111489" target="_blank">Research</a> also shows that HIIT workouts increase muscle <a href="https://www.healthline.com/health/fast-twitch-muscles" target="_blank">oxidative</a> capacity, or the ability to use oxygen. To do a fartlek walk, try walking at an increased pace for 3 minutes, slow down for 2 minutes, and repeat.</p>
Gradually Increase Pace<p>A faster walking pace is associated with a lower risk of <a href="https://www.healthline.com/health/copd" target="_blank">chronic obstructive pulmonary disease (COPD)</a> and respiratory diseases, according to a <a href="https://pubmed.ncbi.nlm.nih.gov/30303933/" target="_blank">2019 study</a>.</p><p>Still, it's best not to go from a stroll to an Olympic-worthy power walk in a day. Instead, increase your pace gradually to prevent injury.</p><p>"Start by walking at a brisk pace for about 10 minutes per day, 3 to 5 days per week," Rue says. "Once you've done this for a few weeks, increase your time by 5 to 10 minutes per day until you get to 30 minutes."</p>
Add Stairs<p>You've likely heard that taking the stairs instead of an elevator is a way to add more movement into your daily routine. It's also a way to step up your walking. Stair climbing has been shown to <a href="https://www.sciencedirect.com/science/article/pii/S2211335519301123?via%3Dihub" target="_blank">decrease the risk of mortality</a> and can easily add a bit more challenge to your walk.</p><p>If you don't have stairs in your home, you can often find them outside a local municipal building, train station, or at a high school stadium.</p>
Is Your Walk a True Cardio Workout?<p>Not all walks are equal. A walk that's too leisurely may not provide enough burn to qualify as cardio. To see if you're getting a good workout, try to <a href="https://www.healthline.com/health/how-to-check-heart-rate" target="_blank">measure your heart rate</a> using a monitor.</p><p>"A target goal for a good walking workout heart rate is about 50 to 70 percent of your maximum heart rate," Rue says, adding that maximum heart rate is <a href="https://www.healthline.com/health/fitness-exercise/fat-burning-heart-rate" target="_blank">typically calculated</a> by 220 beats per minute minus your age.</p><p>You can also monitor how easily you can carry on a conversation while you walk to gauge your heart rate.</p><p>"If you can walk and carry on a normal conversation, that's probably a lower intensity walk," says Rue. "If you are slightly breathless but can still have a conversation, that's probably a moderate workout. If you are out of breath and can't talk normally, that's a vigorous workout."</p>
Takeaway<p>By shaking up your routine, you can add excitement to your workout and reap even more rewards than a basic walk provides. Increasing the pace and intensity of a workout will make it more effective.</p><p>Simply pick your favorite variation to add some spice to your next walk.</p>
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