Guide to Healthy Fast-Food Eating. Hope S. Warshaw

are getting the job of eating done. With some skills, strategies, and nutrition facts in your hands, you can reach your goal to eat healthier; control your blood glucose, blood lipids, and blood pressure; and stay healthy for many years to come.

      I encourage you to keep asking for nutrition information from any restaurant in which you dine and support legislation that is seeking to require restaurant chains to provide this information. If enough of us keep asking, eventually they’ll give us the facts.

      In health,

      Hope S.Warshaw, MMSc, RD, CDE, BC-ADM

Acknowledgments

      This book would have been impossible to create without the willingness of many large national and regional restaurant chains to be forthcoming with the nutrition numbers for their foods by making them available for the world to see on the Internet. To these restaurants, on behalf of the people with diabetes who will benefit from the information in the pages ahead, I am indebted. They set an example of consumer responsibility for the rest of the chain restaurant industry.

      No book is completed by just the author alone. In this case, many manuscript pages and a large nutrient database became a book with many people’s help. I am grateful to Paula Payne, RD, who assisted with the development of the nutrient database and other aspects of the book. Thanks also to all those at ADA who supported this effort: Rebekah Renshaw, Development Editor; Melissa Sprott, Production Manager; Abe Ogden, Managing Editor; and Rob Anthony, Director, Book Publishing.

      And a last thanks goes to my professional colleagues who consistently lend their ears and ideas. They continue to be a source of inspiration and encouragement.

Section 1:

       Healthy Restaurant Eating

Today’s Diabetes Eating Goals

      During the 1990s, diabetes eating goals underwent a minor revolution. In fact, the phrase “a diabetic diet” has become a misnomer. No such diet exists. No longer must you ax sugary foods and sweets from your list of acceptable foods. Now you can savor the taste of a few slices of pizza at your local pizza parlor or cruise to the drive-thru for a hamburger or grilled chicken sandwich when time is not on your side. The bottom line is that today’s diabetes eating recommendations echo the healthy eating goals for everyone—whether the goals are from the government or respected health associations.

      As a person with diabetes, you want to eat healthy to get to, and stay at, a healthy weight. You want to eat healthy to keep your blood glucose levels in the normal range as much as possible. Today, it’s well known that eating and staying healthy with diabetes isn’t just about blood glucose control. Recent research and recommendations suggest that you also get and keep your blood pressure and your blood lipids under control (check out the annually published Standards of Medical Care for Diabetes published each January within the Clinical Practice Recommendations found at www.diabetes.org).

      Your diabetes eating and care plan should work around your needs and lifestyle and not vice versa. Your health care providers have many more medications and monitoring tools today to help you formulate a diabetes care plan that fits your lifestyle needs. The end goal, of course, is to keep you healthy and prevent or slow down long-term diabetes complications, such as eye, heart, and kidney problems.

      Diabetes Eating Goals in a Nutshell

      The latest American Diabetes Association (ADA) Nutrition Recommendations and Interventions for Diabetes put forth these key goals:

      1. Achieve and maintain healthy ABCs

      A: Blood glucose levels in the normal range or as close to normal as is safely possible

      A1C: <7%

      Fasting and before-meals blood glucose:

      70—130 mg/dl

      2 hours after the start of a meal: <180 mg/dl

      B: Blood pressure levels in the normal range or as close to normal as is safely possible:

      At or under: 130/80 mmHg

      C: A [blood] lipid and lipoprotein profile [includes total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides] that reduces the risk for vascular disease [diseases of the blood vessels in the circulatory system]

      LDL: under 100 mg/dl

      HDL: above 40 mg/dl (men), above 50 mg/dl (women)

      Triglycerides: under 150 mg/dl

      2. Prevent, or at least slow, the rate of development of the chronic complications of diabetes by modifying nutrient intake and lifestyle.

      3. Address individual nutrition needs, taking into account personal and cultural preferences and willingness to change.

      4. Maintain the pleasure of eating by only limiting food choices when indicated by scientific evidence.

      Those are the key nutrition goals. But what foods should you eat to achieve them? Here are general pointers to focus on:

      

Eat six or more servings of grains, beans, and starchy vegetables each day. Make at least three servings of whole grains.

      

Strive for at least 2 1/2 cups of vegetables and 2 cups of fruit a day.

      

Include two to three servings of fat-free or low-fat dairy foods each day—milk, yogurt, and cheese—within your calorie allotment. They provide calcium and other important nutrients. (Children, pregnant and breastfeeding women, and some adults have higher requirements for dairy foods.)

      

Eat a moderate amount of meat and other protein foods. Two 3-oz servings each day are enough for most people. Not only does eating less meat help you eat less protein, it also makes it easier for you to eat less total fat, saturated fat, trans fat, and dietary cholesterol.

      

Go light on fats and oils. Limit fats and oils high in saturated fat and trans fat, such as butter, cheese, solid shortenings, and partially hydrogenated fats, which contain trans fats. Trans fats find their way into restaurant food mainly in the frying oil (therefore fried foods). Limiting fried foods is a good way to limit trans fats, as well as many calories, when you eat in restaurants.

      

Limit foods that contain cholesterol (such as red meats; seafood; poultry; whole-milk, full-fat cheeses; egg yolks; and organ meats).

      

Enjoy small amounts of sugary foods and sweets once in a while. If you have some pounds to shed or your blood glucose or blood fats are not in a healthy range, eat sweets more sparingly. If you’re on the slim side, you can splurge on sweets a bit more often if you want to as long as you can control your blood glucose adequately.

      

Drink no more than one alcoholic drink a day if you are a woman and two drinks a day if you are a man. One drink is defined as 1 1/2 oz of hard liquor (a shot), 12 oz of beer, or 5 oz of wine.

      To