Educating Patents on Making Healthy, Quality Choices When Eating Out is the Low-hanging Fruit of Lifestyle Modification

Christopher Still, DO, FACN, FACP, Co-Clinical Editor, Bariatric Times; Medical Director for the Center for Nutrition and Weight Management, and Director for Geisinger Obesity Research Institute, Geisinger Medical Center, Danville, Pennsylvania.

Dear Colleagues,

Lifestyle modification is fundamental to any weight loss program. We discuss wLifestyle modification is fundamental to any weight loss program. We discuss with our patients the importance of adhering to prescribed diet and exercise plan, but there is another essential part of this conversation that might be missing between provider and patient on which a new report sheds light—eating on the run.

According to a data brief published by the National Center for Health Statistics,¹ between 2013 and 2016, about 37 percent of adults in the United States reported consuming fast food on any given day. These data were collected through in-person interview sessions that asked participants to recall their diet in the last 24 hours as well as source. Food reported as “restaurant fast food/pizza” was considered fast food for these analyses. The term fast food usually evokes an immediate negative reaction as studies have shown it to be associated with high caloric intake and poor diet quality, but just because a meal is fast doesn’t mean it has to be unhealthy.

Fast food establishments have made great strides over the years, eliminating trans fats and adding more healthy food and drink options. Most menus prominently display nutrition information, a change I believe is a helpful educational tool when an individual is deciding whether to order 10-piece chicken nuggets (990 calories) or a Southwest grilled chicken salad (350 calories) from McDonald’s. Total calories are often in large, bold print along with total fat, saturated fat, carbohydrates, and sugar, so you can see the side-by-side comparisons. Although seeing the nutrition information might someone think twice, the ultimate decision comes down to individual choice.

A lot of things come into consideration when one ponders, “What’s for dinner?” It’s no secret that human beings are constantly faced with time constraints that affect their meal decision making. Long work hours and children’s extracurricular activities in particular make convenience among the top criteria. Home preparation meal kits are attempting to allow families to have both home-cooked meals and convenience, but the expense and even time it takes to plan and cook those meals can be an obstacle to some families, not to mention clean up.

Another consideration is the simple human temptation/desire for fast food. If you go out to eat with the intention of ordering a high-calorie meal, chances are you are going to get it. And research shows that whenever you go out to eat, wherever that may be, you end up taking in more calories than if you eat at home.² A comedian best summed it up when asking, “When do you eat an entire loaf of bread before eating dinner at home?”

The evolution of the fast food model is interesting. It was built on speed, convenience, and customer satisfaction, but over the years it began to focus on food quantity instead of quality. Remember the days of supersizing, extra value meals, and all-you-can-eat buffets? Fortunately, we’ve seen the industry move away from the bigger is better philosophy and start to meet new demands to retain customers—reporting on food ingredients and source. In addition to removal of trans fats, many companies in the fast food industry now boast offering quality products; fresh instead of frozen meat, “100-percent real beef and chicken,” customization of side items (e.g., side salad instead substitute for French fries), and foods that are non-genetically modified (GMO) and free of artificial flavors, colors, and preservatives. It’s actually scary to think about what was in that food before these changes occurred and how such ingredients affect overall health.

I think that’s the take-home message about fast food and eating out in general: beware of the hidden ingredients, such as added sodium and other preservatives. For us as clinicians, taking inventory of how often patients are eating out and educating them on making healthy, quality choices are the low-hanging fruit of lifestyle modification.

Sincerely,

Christopher Still, DO, FACN, FACP

References

1. Fryar CD, Hughes JP, Herrick KA, Ahluwalia, N. Fast food consumption among adults in the United States, 2013–2016. NCHS Data Brief, no 322. Hyattsville, MD: National Center for Health Statistics. 2018.
2. Cha AE. Why eating out at restaurants may be just as bad for your health as grabbing fast food. July 16, 2015. https://www.independent.co.uk/life-style/food-and-drink/news/why-eating-out-at-restaurants-may-be-just-as-bad-for-your-health-as-grabbing-fast-food-10394392.html Accessed October 1, 2018. 

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