Combating fat when dining out

One prostate cancer survivor illustrates how he coped with limiting weight gain and cholesterol intake without giving up his favorite restaurants.

By John Russo Jr., Vicus.com

Their actions reflect the dietary preferences of their clientele and they cause a problem for those of us who eat out regularly but who want to limit the amount of fat we eat. I am a frequent diner, who after being diagnosed with prostate cancer, decided to go on a 10% fat diet.

The literature relating fat consumption to prostate cancer is clear. Epidemiologically, men living in societies with the highest dietary fat intake have the highest rates of prostate cancer. But the health consequences of dietary fat and obesity in America extend beyond prostate cancer. Obesity is associated with Type 2 diabetes, heart disease, hypertension, stroke, dyslipidemia, osteoarthritis and degenerative joint disease, sleep apnea, gallbladder disorders, respiratory problems and malignancy.

Once you have prostate cancer, going on a low-fat diet is a little like closing the barn door after the horse is out. But for many other diseases, weight control is the foundation of any successful therapy. For example, a reduction of only 5% to 10% of body weight in an obese patient with Type 2 diabetes, hypertension or dyslipidemia can improve glycemic control, decrease blood pressure and improve the lipid profile. 

Here are some practical recommendations to combating fat that helped me lose 15 pounds in about four months. Eighteen months later, my weight is still down. 

The U.S. Department of Agriculture recommends that Americans limit their intake of total fat to not more than 30% of calories consumed and saturated fat to less than 10% of calories. 

The maximum number of fat grams you should eat will depend on the number of calories you eat daily. So the first step in learning to live with less fat is to compare recommended levels of fat intake to how much fat you are eating. Table 1 (below) shows that the upper limit of fat for an average person who consumes 2,200 calories per day should be 73 grams, with saturated fat at 24 grams or less per day. Table 2 (below) shows how much saturated fat is in a variety of popular foods compared with low-fat counterparts.

Please note that a person on a 2,200-calorie diet can easily exceed the recommended fat intake. For example, if you start the day with a croissant for breakfast (7 fat grams) and then have a hamburger with cheese (14 grams) for lunch and have an afternoon snack of ice cream (4.5 grams), you have exceeded the recommendation for saturated fat for most people (24 grams). And you haven't even had dinner yet.

To control fat intake, nutritional experts advise to keep track of the fat content in your diet by memorizing the fat content of foods, weighing foods and adjusting intake accordingly.

I, on the other hand, am not a dietitian and do not feel constrained by such logical but cumbersome tasks. I also eat out a lot and have a difficult time determining portion sizes and food weights in restaurants as well as how much and what kind of oil or fat the chef has added to my order. 

Here are 10 recommendations for eating out that helped me to lose weight and control my cholesterol levels. Perhaps they will help you too.

1)     Limit your intake of nuts. They range from 71% calories from fat (peanuts, dry or oil roasted) to 90% fat (macadamia, oil roasted; Table 3, below)

2)     Change your salad dressing from cream- and oil-based dressings to balsamic vinegar, red wine vinegar or lemon wedges. A typical serving of cream- or oil-based dressings contains about 150 calories, including 10 to 20 grams of fat (more than 90 calories).

3)     Cut out mayonnaise, margarine and butter. Believe it or not, even so-called fat-free and "light" varieties of margarine get all of their calories from fat.

4)     In a restaurant, order grilled rather than sautéed or fried meats. Never order anything that is "stuffed."

5)     Order baked, not fried potatoes, and season with pepper and salt, not sour cream and butter.

6)     Tell the waiter that you would like the chef to prepare your meal with no added oil or fat. The waiter will reply that the chef has to use some oil. Then you say that even a little is too much for you. Say this just to drive the point home that you want as little oil in and on your food as possible. And if it comes out too oily, don't be afraid to send it back. Be prepared to try many restaurants until you find a chef who cooks "light."

7)     Order all dressings and sauces "on the side" so you can control how much you add to your meal.

8)     Never order dessert for one. Always share it with the rest of your party.

9)     Order coffee with milk (skim if possible), never cream.

10) Take home half of what you order. You may not be able to control the portions, but you can at least make them last twice as long.