Heart-Healthy Dining Out and Socializing

ʺStaying committed to Ornish Lifestyle Medicine doesn’t mean you have to sacrifice your social life or dining out. You’ll have more success, however, if you plan ahead and use some effective strategies for navigating through any menu whether it’s fast food or fine dining.

If a menu doesn’t have a low-fat or vegetarian option, then look for food on the menu that you can use to create your own meal.

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Locate Ornish-Friendly Restaurants

Many good restaurants are willing to accommodate you by modifying menu selections or preparing something special to fit the Ornish Lifestyle Medicine (see Updated Ornish Lifestyle Medicine Nutrition Guidelines). Participants in the Dr. Dean Ornish Program for Reversing Heart Disease are given pocket restaurant cards with the reversal guidelines listed on them that they can give to the chef to provide clear instructions on meal preparation.

Ornish Lifestyle Medicine Dining Out Guidelines

This individual is following a special low-fat vegetarian diet for their health. The diet is based on whole grains, fresh vegetables, fruits, legumes such as beans, lentils, dried peas and soy products. The following are the guidelines to be followed in meal preparation:

VEGETARIAN: No meat, chicken, fish, egg yolks or dairy products. Egg whites and nonfat dairy products can be used in limited amounts. FAT FREE: No added oil, butter, margarine, mayo or cream sauces. No nuts, seeds, or nut butters. No avocado or coconut. May spray very lightly with canola oil non-stick spray. SUGGESTIONS: Pasta with oil-free tomato sauce or chopped tomatoes with garlic and herbs; oil free vegetable stir fry; steamed vegetables; mixed green salad with fat free dressing or balsamic vinegar or squeezed lemon; beans such as garbanzo or black beans; fat free beans and rice; steamed tofu, if available; oil free roasted or grilled vegetables; baked potato topped with steamed vegetables; veggie sandwich on whole grain bread, salads that meet the above guidelines.

The customer comes first, and most often the chef will be able to accommodate your needs. At restaurants that have a chef rather than cooks, you will be more likely to experience a more creative and flavorful meal based on your requests. You may even end up with a better dish than those who order from the menu because a good chef enjoys using their skills and creativity to please their patrons. The chef may even pay you a special visit to ask about any specific questions for your meal preparation.

Call Ahead

Ask to talk with the manager or head chef and then explain that you are following a very low-fat vegetarian diet that has been prescribed by your doctor. Ask if the chef is able to prepare a dish that meets the Ornish Lifestyle Medicine guidelines.

Remember You Are a Valued Customer 

You are the customer and the restaurant should do their best to serve and please you. Don’t hesitate to ask for what you need and make special requests. 

Key Questions to Ask: 

• How is this prepared?
• Are the vegetables prepared with oil or butter?
• Is oil added to the pasta?
• Is the pasta made with egg?
• Is oil or butter added to the sauce (such as marinara, teriyaki or black bean sauce)?
• Is whole wheat bread available?
• Is brown rice available?
• Is there fat-free salad dressing available, balsamic vinegar, or fresh lemon wedges?
• Are soups prepared in a meat stock? Even vegetarian soups are often made with a chicken or meat stock.
• Do you have fat-free salad dressing?

Important Requests: 

• Prepare without oil or butter
• Steamed; “no oil or butter”
• Fresh or steamed tofu; not fried tofu

Be a Menu Detective

Every menu contains hidden low-fat, vegetarian options. Some menus take more detective work than others. If a menu doesn’t have a low-fat or vegetarian option, then look for food on the menu that you can use to create your own meal. Avoid foods that are fried, crispy, sautéed, smothered, au gratin, or in cheese, cream or white sauces. Any of these items may be able to be modified in how they are prepared. Check the entire menu including side dishes, appetizers, and ingredients in the main dishes to discover what ingredients the kitchen has available. Here area few examples:

Steak House: A steak house restaurant may not have a vegetarian option, but it will likely have baked potatoes, vegetables in a butter sauce, and a dinner salad. You could ask for a baked potato with no butter and topped with steamed vegetables. Ask if they have a non-fat ranch or other fat-free dressing to drizzle over the baked potato, or add some salsa. Order a dinner salad with non-fat salad dressing or balsamic vinegar and lemon wedges, or ask if they can prepare a plate of steamed or roasted vegetables with no added butter or oil. Check if they have  garbanzo beans for the salad or baked beans that can be served as a side if no oil is added.

Mexican: The menu almost always has sides of beans, rice, and corn tortillas. Ask how they prepare the beans to make sure they are not prepared in fat such as lard or oil. Rice and beans with salsa and a green salad is just one simple option for Mexican dining. You can also create your own heart healthy burrito without cheese or a vegetarian tostada on a steamed corn tortilla. Make sure to hold the sour cream and guacamole.

Healthy Options:

• Low fat sauces: Tomatillo sauce, hot sauce, salsa or Pico de gallo, red sauce
• Steamed corn tortillas
• Black or pinto beans
• Rice (ask if prepared with oil)
• Lettuce
• Fresh or steamed vegetables
• Soups: gazpacho, black bean soup (ask how prepared)
• Grilled vegetables that are used for fajitas

Italian: Italian can be an easy option with a simple request of pasta with freshly chopped tomatoes, garlic and herbs, paired with a fresh salad.

Healthy Options:

• Eggless pasta prepared without oil, with oil-free marinara sauce or freshly chopped tomatoes, onions and herbs
• Pasta primavera: pasta with vegetables (ask for no added fats such as oil and butter)
• Minestrone soup
• Leafy greens salad with balsamic vinegar or fat free salad dressing, if available
• Vegan pizza (no cheese): pizza crust with tomato sauce and vegetables such as with mushrooms, tomatoes, bell peppers, garlic, asparagus 

Asian: Chinese restaurants can be a great option, if you know what to look for and ask for. Most Asian restaurants have vegetarian options with lots of vegetable choices. You can almost always get steamed rice, vegetables, tofu and lightly drizzle your meal with a soy sauce unless you’re sodium restricted.

Healthy Options:

• Steamed rice, vegetables and tofu
• Brown rice
• Low-fat sauces include black bean, brown, garlic, plum, sweet and sour, and hoisin sauce (ask how they are prepared – typically low-fat, but may be high in sodium)
• Soy sauce

Indian: Indian restaurants have a lot of vegetarian options, but they not necessarily low-fat. This can be a great place to make a special request to the chef to prepare a low-fat vegetarian dish made without oil or ghee, or to use the variety of vegetarian ingredients to create your own heart healthy meal.

Healthy Options: 

• Steamed rice, vegetables, and tofu
• Lentils (not cooked with oil)
• Chutney
• Roti or chapatti (whole wheat bread – ask to be made in tandoor with no oil)

Bring Your Own Food

Sometimes it’s just easier to bring your own food because then you have complete control of your choices. My son has severe food allergies and we often bring his own food to a restaurant if there are limited choices and we want to avoid any chance of cross contamination. This is always well-received by the restaurant staff and those with whom we are dining. Whether you have food allergies or health concerns with specific dietary needs, bringing your own food is an excellent option.

Additional Dining Out Tips 

• Go at off-peak hours.
• Schedule business meals at an Ornish-friendly restaurant.
• Avoid being overly hungry.
• Place tempting items such as chips and buttered bread sticks out of reach or remove them from the table.
• Eat slowly and mindfully, and try to focus on enjoying your company for portion control.
• Ask for a to-go box ahead of time. Place half the entrée in the box before you start eating to take home for leftovers for another meal.
• Split a meal with a friend who is also following the program or merely open to your menu needs.
• Enjoy the social experience. The food is only part of it if you’re dining with others, so try to focus on enjoying the company and conversation.

What strategies have you found most helpful in staying committed to your heart health while dining out?