Declaring fast food a no-fry zone

Q: If you have to eat fast food, what are the healthiest options?

A: One key premise I promote is that you can choose to eat healthfully in most restaurants, from fast food to upscale. Especially today, most restaurants, including fast-food chains, offer a cadre of healthier options.

Let's dig in.

"Fast food" defined

The term "fast food" conjures up the increasingly dated notion of burgers with a side of fries. Today, a wider-than-ever array of foods are ready fast, including subs and sandwiches, pizza, ethnic fare and more.

Fast-food restaurants "are where customers select foods and pay a per-person tab between $3 and $9 before eating. Speed and convenience are king," according to Mary Chapman, senior director of product innovation at Technomic, a restaurant industry research firm. Chapman adds that "fast casual," now growing faster than traditional fast food places, combines fast service with higher-quality ingredients and foods that ring up an average tab between $10 and $13.

But don't bestow the halo of health on fast-casual restaurants. Just like nearly all restaurants, these places serve meals across the nutritional spectrum - and it's up to you to make healthful decisions.

The risks of restaurant meals

Eating restaurant meals healthfully is downright challenging regardless of the fare. Portions are often excessive. Large quantities of fats and sugars abound. Sodium can skyrocket. "Research shows that most restaurant meals contain too many calories and not enough fruits, vegetables and whole grains," says Deborah Cohen, a physician with the Rand research group in Santa Monica, Calif., and lead author of the report Performance Standards for Restaurants. Eating away from home frequently is a risk factor for poor health, Cohen adds, which is why people who dine out frequently are more likely to be overweight and at greater risk for diet-related chronic diseases such as high blood pressure, heart disease and Type 2 diabetes.

Healthful fast food?

Hear me out: Key characteristics of fast food can combat a few pitfalls of restaurant meals. No foods are delivered to your table to whet your appetite before your food arrives. There's nearly no waiting for your food. It's order and eat. Foods come in a wide range of portion sizes, from small to jumbo.

Over the past couple of decades, fast-food chains have made moves to satisfy the cry for more healthful alternatives, such as salads with lower-calorie dressings, grilled chicken sandwiches, baked potatoes, six-inch subs, whole-grain breads and beverages such as bottled water and low-fat milk. Today, the default sides for kids' meals are more healthful: apple slices, clementines, baby carrots. That's true for their beverages as well.

Lastly, fast-food chains have given us a sneak peek at their nutritionals, healthful or not, for years. This information is now easily accessible on their websites and in many restaurants.

More nutrition information, coming soon

The Affordable Care Act will require most restaurants with 20 or more outlets serving the same menu to display calories on menus or menu boards by late this year. And other data, including fat, sodium and more, must be made available to customers upon request. "Consumers will be able to know the calories of their menu selections at over 220,000 restaurants nationwide," says Joy Dubost, dietitian and senior director of nutrition for the National Restaurant Association.

Research to date hasn't conclusively shown that having a calorie count at hand prompts everyone to make better food choices. But experts are optimistic that constant exposure to calorie totals will eventually impact menu decisions. Recent research by Sara Bleich and colleagues at Johns Hopkins Bloomberg School of Public Health shows that a byproduct of this regulation may be new lower-calorie menu items.

Tips and tactics

Eating better fast-food meals goes beyond simply choosing more healthful options. Use these tips and tactics to control portions, calories, fat, saturated fat and sodium:

• Say no to "special sauces"; they're usually mayonnaise-based, making them fat- and sodium-dense.

• Use lower-calorie spreads and toppings: mustard, ketchup, barbecue sauce, salsa, pico de gallo.

• Skip or go light on cheese, cheese sauce or bacon.

• Pile extra vegetables on subs, sandwiches and pizza.

• Order salad dressing on the side, use it sparingly and dilute it with vinegar.

• Pass up tuna, chicken or seafood salad. Mounds of mayonnaise make them high in fat and calories.

• Order less to eat less.

• Just have to have a favorite guilt food? Split the serving with your dining companion and share the guilt.

- - -

A sampling of smarter fast food options

For burgers, chicken, fries:

• Entree or side salads (light on dressing)

• Single, regular or junior burgers

• Grilled chicken sandwiches or strips

• Roasted chicken with sides of corn, green beans, carrots, potatoeslKids' meals with fruits and/or vegetables

For subs and sandwiches:

• Whole-grain bread or a wrap

• Order small size: six-inch sub, a half-sandwich or a mini wrap

• Poultry or lean meat: turkey, chicken breast, ham, roast beef

• Load up with vegetables

• Pair with carrots, a side salad, baked chips, pretzels, broth-based soup or fruit

For pizza:

• Thin crust (whole grain if available)

• Pile on vegetable toppings, go light on meat and extra cheese

• Pair with a salad

For Mexican:

• Veggie or chicken bowl, hold the tortilla

• Soft tacos, enchiladas or burritos with beans, chicken or beef

• Mexican salad

• Sides: black beans, guacamole