The Misleading Menu

Don’t believe everything you read, on the menu that is. You’d think a dietitian would be able to choose the healthiest items on a menu blindfolded. Wrong! One problem may be that menus may emphasize lovely parts of a dish (“sweet fresh-picked organic carrots”) while leaving out perhaps unnecessary but costly details (the carrots arrive in a heavy cream reduction). More than once, I’ve selected harmless-sounding foods that end up more damaging to the waistline than other richer-sounding menu items.

To verify this problem, I experimented at McDonald’s, now a common destination as my finicky son has fallen for their French fries. McD’s lists nutrition information on all their items, so my task was to choose what I believed were the 3 healthiest entrees, based only on their title and photo, and then compare the nutrition breakdown with similar entrees. Trying to compare apples with apples, I chose items that were about the same size and type of food. My top picks: the Premium Grilled Chicken Classic Sandwich, Chicken Selects Premium Breast Strips (5 pc), and the Premium Asian Salad with Grilled Chicken, mainly because of the words “grilled,” “premium,” and “breast.”

The results: Thumbs up for the Grilled Chicken Sandwich, which has the least amount of fat of all the sandwiches, but I would have been better off with the 6 piece Chicken McNuggets than the Premium Breast Strips (saving over 350 calories and 20 grams fat). The Asian salad qualifies as a healthful choice (at 300 calories, 10 grams fat), but both the Premium Bacon Ranch Salad with Grilled Chicken and Premium Caesar Salad with Grilled Chicken have even less fat and calories! Portion size is key, for example with the nuggets vs. strips: the strips weigh almost double the amount of the nuggets, and therefore have more calories. However, you wouldn’t know this based only on the description of “5 pieces” vs. “6 pieces.”

There’s a reason why studies show that the more people eat out, the fatter they are. Restaurant portions are big, and descriptions are deceiving. Going for typically “healthful” items like salads or chicken isn’t always the best option. Better to choose what you really want, eat just enough food to fill you regardless of how much comes on your plate, and view eating out as a treat rather than a daily ritual.

A Calorie Is a Calorie

More proof that when it comes to weight loss, a calorie is a calorie is a calorie. A new study published this week in the New England Journal of Medicine compared four different diets and found that all of them helped people to lose similar amounts of weight. The diets varied in carbohydrate, protein, and fat―the major components that make up calories in a food. After two years, all the groups lost weight, ranging from 7 to 10 pounds―enough to improve cholesterol and insulin levels. Cravings and feelings of hunger and fullness were also about the same.

For decades, diet gurus have been trying to pitch their magic bullet combinations of high protein/low carb or low fat/high carb or moderate-everything foods to lose weight. Personally I think people just buy into the advertising of a good-looking doctor on a book cover or the hype that may come from a suddenly svelte celebrity. My bottom-line motto when people ask me about weight loss is a most inelaborate “eat less!” It sounds callous and the enormous mental discipline required is another story, but it is the true magic bullet. Sure, some have a sluggish thyroid (as made famous by Oprah) that can lower your ability to burn calories and lose weight, but most just need to stop idolizing food. A little hunger never hurt anyone! 

A colleague who worked as an outpatient dietitian and saw dozens of patients each week for weight loss told me that after thoroughly interviewing and then following those patients for several months, the number one cause of their weight gain and continued inability to lose weight was oblivious overeating. People rarely correctly guesstimate how much food they eat, especially underestimating calories from restaurants and fat free foods. According to the NEJM study, if you want to lose weight, choose a diet that closely fits the way you eat now to increase your chances of sticking with it, and so you don’t have to learn dozens of new recipes. Also, find a local weight loss group or friend to cheer you on, as the study noted that those in a support group were more likely to lose and keep the weight off.

Click here to see the NEJM study: Comparison of Weight-Loss Diets

Dunkin Donuts Flatbreads: Too Good To Be True?

Dunkin Donuts isn’t exactly known for healthful food items, especially breakfast. But they’ve recently made room among their grease and sugar-laden items for the “DDSMART” menu, overseen by a Nutrition Advisory Board. I thought that was a “wow, really?” idea, and after checking their credentials, the Board seems completely legit. The DDSMART line includes some old items that already qualified (e.g., black coffee and tea are naturally sugar and fat-free; add only artificial sweetener and skim milk and they’re still “healthier” choices), and the newer multigrain bagel with reduced-fat cream cheese and egg white flatbread sandwiches.

The sandwiches in the ads looked tasty but I wasn’t believing the calorie info (only 290 with less than 10 grams of fat) especially since they looked pretty big in Rachel Ray’s hand. So, highly skeptical, I taste-tested both the egg white veggie and the egg white turkey sausage flatbreads. I had some trouble ordering since the clerk didn’t know what I meant by "the healthy flatbread sandwich" -- "Wuts that?" he said. I realized later that I had to ask specifically for "egg white flatbreads" as they have other flatbreads with double the fat and calories. The multigrain bread studded with seeds (brown flax and millet) was flavorful even without any hint of added oil or butter. The omelette inside was flecked with red pepper and chives (veggie version) or with small pieces of turkey sausage. The slight dryness gave away the lower fat content but a slice of reduced-fat provolone covering the omelette did wonders. Overall, I loved both versions of this sandwich and so did my picky son! At less than four bucks each, I could eat these regularly. They're nutritious and filling for breakfast, and if you add a few side items like a veggie or pasta salad, they also make a decent fast food lunch or dinner.