Chinese food and cholesterol

Chinese restaurant food unhealthy, study says

WASHINGTON — The typical Chinese restaurant menu is a sea of nutritional no-nos, a consumer group has found.

A plate of General Tso’s chicken, for example, is loaded with about 40 percent more sodium and more than half the calories an average adult needs for an entire day.

The battered, fried chicken dish with vegetables has 1,300 calories, 3,200 milligrams of sodium and 11 grams of saturated fat.

That’s before the rice (200 calories a cup). And after the egg rolls (200 calories and 400 milligrams of sodium).

“I don’t want to put all the blame on Chinese food,” said Bonnie Liebman, nutrition director of the Center for Science in the Public Interest, which did a report released Tuesday.

“Across the board, American restaurants need to cut back on calories and salt, and in the meantime, people should think of each meal as not one, but two, and bring home half for tomorrow,” Liebman said.

The average adult needs around 2,000 calories a day and 2,300 milligrams of salt, which is about one teaspoon of salt, according to government guidelines.

Sheila Weiss, director of nutrition policy at the National Restaurant Association, said that restaurants around the country were already making efforts to offer customers healthier choices. In particular, Chinese restaurants typically offer plenty of options for customers looking to steer clear of fried foods and heavy sauces, she noted.

“Restaurants have a responsibility to provide options and they do,” said Weiss, but “customers also have a responsibility to understand their own dietary needs and know how to make special requests.”

In some ways, CSPI’s Liebman said, Italian and Mexican restaurants are worse for your health, because their food is higher in saturated fat, which can increase the risk of heart disease.

While Chinese restaurant food is bad for your waistline and blood pressure — sodium contributes to hypertension — it does offer vegetable-rich dishes and the kind of fat that’s not bad for the heart.

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However — and this is a big however — the veggies aren’t off the hook. A plate of stir-fried greens has 900 calories and 2,200 milligrams of sodium. And eggplant in garlic sauce has 1,000 calories and 2,000 milligrams of sodium.

“We were shocked. We assumed the vegetables were all low in calories,” Liebman said.

No safe harbor
Also surprising were some appetizers: An order of six steamed pork dumplings has 500 calories, and there’s not much difference, about 10 calories per dumpling, if they’re pan-fried.

The group found that not much has changed since it examined Chinese food 15 years ago. That’s not all bad, Liebman said.

“We were glad not to find anything different,” she said. “Some restaurant food has gotten a lot worse. Companies seem to pile on. Instead of just cheesecake, you get coconut chocolate chip cheesecake with a layer of chocolate cake, and lasagna with meatballs.”

The group says there is no safe harbor from sodium on the Chinese restaurant menu, but it offers several tips for making a meal healthier:

  • Look for dishes that feature vegetables instead of meat or noodles. Ask for extra broccoli, snow peas or other veggies.
  • Steer clear of deep-fried meat, seafood or tofu. Order it stir-fried or braised.
  • Hold the sauce, and eat with a fork or chopsticks to leave more sauce behind.
  • Avoid salt, which means steering clear of the duck sauce, hot mustard, hoisin sauce and soy sauce.
  • Share your meal or take half home for later.
  • Ask for brown rice instead of white rice.

So often, Mexican meals come laden with added sodium and saturated fat. Learn how to bypass the fried tortillas, sour cream and cheese and still enjoy the robust flavors of Mexican fare. When you make a few heart-smart choices, Mexican food can be tasty, fresh and healthy.

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Dietitian Kate Patton and intern Sara Saliba with Cleveland Clinic’s Section of Preventive Cardiology and Rehabilitation offer heart-smart tips for restaurant dining and at-home cooking.

Order up: heart healthy swaps

A few tips for savvy restaurant ordering:

  1. Pick corn tortillas over flour tortillas.
    Corn tortillas are more natural and less processed, making them a good source of fiber and magnesium (great for maintaining healthy muscles), not to mention they are significantly lower in calories, saturated fat, sodium and sugar compared to flour tortillas.
  2. Ask your server not to bring fried tortilla chips to the table. Instead, order some grilled shrimp or veggies for appetizer. The extra protein and fiber will help you feel full.
  3. Pass on carnitas (fried beef or pork) and chorizo (sausage).
    Instead, opt for a leaner grilled chicken breast or grilled fish.
  4. Sub out full-fat sour cream and cheese. Try adding salsa, pico de gallo, cilantro or jalapeno peppers for a burst of fresh flavor. If you do order sour cream, be sure to request a low-fat option and serve on the side for portion control, or, better yet, guacamole for a boost of heart healthy monounsaturated fat. At home, switch plain Greek yogurt in place of sour cream for an add-on that’s lower in fat and packed with protein.
  5. Choose fajitas over quesadillas. Instead of ordering quesadillas, tortillas filled with meat and lots of cheese, opt for chicken fajitas, marinated grilled chicken with onions, green peppers, lettuce and diced tomatoes wrapped in a soft corn tortilla.
  6. Think salad. Choose a taco or fajita salad over tacos, and do not eat the fried shell that comes with it.
  7. Choose sauces wisely. Choose sauces that are tomato-based over creamy or cheese-based sauces.
  8. Side-step extra saturated fat and sodium. Pass on flautas, chimichangas and burritos. Instead, order chicken or beef enchiladas with salsa or red sauce.
  9. Go for unfried beans. Instead of refried beans, order a steaming bowl of frijoles a la charra (pinto beans in a savory broth), black beans or Spanish rice. Bonus: Made with tomatoes and peppers, a side of Spanish rice adds immune-sustaining vitamin C.

Cooking at home: Prep tips

Plan flavorful, balanced meals with these tips:

  1. Char salsas. To achieve maximum flavor, try dry-roasting your tomatoes, onions and chilies. This packs in the flavor, with no need for added fats.
  2. Seek balance. Mexican cuisine revolves around food group balancing. Serve up a protein-packed bean dish, whole grain brown rice or corn tortillas and a variety of fresh salsas while avoiding large amounts of red meats.
  3. Spice it up. Mexican food is famous for its use of flaming hot spices and variety of fresh seasonings. Chilies are known to boost your metabolism. Season your dishes with Mexican spices such as cinnamon, allspice, oregano and cloves for a healthy, flavor-packed dish. The fresh flavors are satisfying, which means less likelihood of craving unhealthy foods later.
  4. Eat green. Mexico farms produce pumpkins, cacti, tomatoes, wild herbs and zucchini. Including a variety of greens in your dishes will keep your meals low in fat and high in fiber as well as vitamins and minerals. Mexican cuisine commonly features avocado. Add some avocado slices to your main dish for heart-healthy monounsaturated fat, which can help lower cholesterol when used in place of saturated fat.
  5. Reinvent the taco. Tacos do not need to include meat. Stuff a corn tortilla with some of your favorite grilled veggies. For protein, add tofu, black or pinto beans for a “meaty” texture and top with a fresh homemade salsa.
  6. Incorporate seafood. Grab a few corn tortillas and fill them with grilled spicy shrimp or fish, such as salmon, which is packed with protein heart-healthy omega-3 oils, for seafood tacos.
  7. Bank on beans. Mexican cuisine features a vast array of beans, including black beans, pinto beans, black eyed beans, lentils, and chickpeas. Beans are packed with protein, fiber, and can be prepared in so many ways, including baked, boiled and pureed. Include them as a side dish or meat alternative.
  8. Add seeds. Seeds were once staples to the Aztec diet, and are making a comeback thanks to their outstanding health benefits. Amaranth seeds, for instance, are packed with protein, fiber, calcium, healthy unsaturated fats, iron, magnesium and phosphorous. They also contain manganese, which acts as an antioxidant, supports bone health and energy metabolism and aids in wound healing. Other high-nutrient seeds often used in Mexican cuisine are pumpkin and chia seeds. Sprinkle any of these seeds on salads, salsa, bean or rice dishes for a nutrient boost.

Healthy Dining Out With High Cholesterol

If you have high cholesterol, you don’t need to give up family nights out, festive occasions, or romantic dinners at your favorite restaurants. Instead, you may just need to educate yourself about the best choices for a diet to lower cholesterol, so you can eat as healthfully as possible when you’re out.

“I think the key message is: Know what you are eating,” says Penny Kris-Etherton, PhD, RD, distinguished professor of nutrition in the College of Health and Human Development at Penn State University in University Park.

This means reading the menu carefully and looking for suspect ingredients, adds Tara Collingwood, RDN, a dietitian in Orlando, Florida, who blogs at Diet Diva.

Here’s what you need to know before your next night out at your favorite restaurant.

Foods to Avoid When You Have High Cholesterol

Surprise: Your main goal is not to avoid cholesterol found in foods.

The latest publication of the USDA’s Dietary Guidelines for Americans, issued in 2015, no longer recommends limiting intake of dietary cholesterol to 300 milligrams (mg) a day, as the 2010 edition did. But this change doesn’t mean that cholesterol is not important — experts still say you should eat as little cholesterol as possible, while following healthy eating patterns.

The current thinking stems from a new understanding about what affects your blood cholesterol levels, and what doesn’t. Scientists now know that, for most people, the cholesterol in your food has a much smaller impact on your blood cholesterol levels than certain types of fats you eat. Many of the foods that are high in cholesterol, such as fatty meats, high-fat dairy, and bakery items, are also higher in saturated fats or trans fats, both of which do raise blood cholesterol.

When your diet is high in saturated or trans fats, your liver produces more cholesterol, according to the American Heart Association (AHA). Replacing saturated fats in your diet with healthier unsaturated fats can help reduce your blood levels of both total cholesterol and LDL cholesterol. Especially good choices are polyunsaturated fats, which are found in olive oil, soybean oil, and fatty fish, such as salmon.

For that reason, both Collingwood and Kris-Etherton agree that when eating out, your goal is to limit or avoid foods high in saturated fats.

What About Shrimp, Eggs, and Cheese and High Cholesterol?

You’ve probably heard conflicting information about whether shrimp, eggs, and cheese are healthy or not if you have high cholesterol. Here’s the current thinking:

  • Shrimp This is high in cholesterol but low in saturated fat, Kris-Etherton says. Her advice is to enjoy it occasionally, maybe twice a month.
  • Eggs In years past, the advice from the AHA was to limit eggs to three yolks per week. Now, eggs are considered part of a healthy diet — when eaten in moderation. Your doctor should guide you with the best advice based on your health and health history.
  • Cheese This is high in saturated fat and often high in sodium, Kris-Etherton says. Moderation is the best approach for cheese when you have high cholesterol.

Now for some specific advice on your ethnic fare of choice.

Chinese Menus and High Cholesterol: Steamed, Not Fried

What to order For starters, consider spring rolls that aren’t deep-fried, Kris-Etherton suggests, adding that spring rolls with rice wraps are an even better choice.

What’s a Chinese dinner without rice? “Steamed rice is best,” Kris-Etherton says. If you must have stir-fried rice, which is higher in fat, she recommends asking your server to prepare it with as little oil as possible.

Seafood can be a good choice, especially if you order steamed dishes, notes Kris-Etherton. Boiled or broiled seafood entrées are also good choices for minimizing added saturated fats, according to the AHA.

Choose entrées with lots of vegetables, the AHA adds. Chop suey is a good option, as are any vegetable-based dishes with water chestnuts added.

What to limit or avoid Duck dishes can be high in fat; switch to chicken instead. And if you can resist the crispy noodles often found on the tables at Chinese restaurants, you’ll save on both fat and calories.

Mexican Menu and High Cholesterol: Add a Side of Black Beans

What to order Fajitas are a good choice, Collingwood says, because they are usually abundant in vegetables. Consider a side of black beans, since they are high in soluble fiber and can help lower cholesterol, she adds.

Choose corn tortillas over white flour tortillas, the AHA suggests, since corn is a whole grain, which can help lower cholesterol.

Grilled fish and chicken are both lower-fat high-protein options. For condiments, pick salsa, cilantro, or pico de gallo.

What to limit or avoid Resist ordering nachos as an appetizer, says Kris-Etherton. “Even if there are a lot of people at the table , these are very caloric.”

Take a pass on the refried beans, which are higher in saturated fat, and skip the fried rice and sour cream, too.

RELATED: 9 Things Dietitians Wish You Knew About High Cholesterol

Indian Fare and High Cholesterol: Go for Vegetables, Skip the Ghee

What to order Indian restaurants typically offer many vegetable dishes, Kris-Etherton notes. Chickpeas, also called garbanzo beans, are often used, and are a good, healthy choice.

Look for dishes with plenty of vegetables and tofu, Collingwood says. She also gives a thumbs-up to chicken tandoori, a grilled entrée.

What to watch or avoid Stay away from dishes heavy with ghee, Kris-Etherton says. It’s a clarified butter made from buffalo’s or cow’s milk.

When ordering many Indian dishes, says Collingwood, it’s crucial to ask if they can be made with minimal oil.

Italian Fare and High Cholesterol: Pick Grilled Options, Pass on the Sausage

What to order Plain pasta with marinara sauce is a good option, suggests Kris-Etherton. Also look for grilled chicken, fish, or roasted vegetable dishes, she adds.

Consider dishes with beans, Collingwood says, as legumes can help lower cholesterol. The Italian staple minestrone soup, for instance, has cannellini beans.

What to watch or avoid “With Italian food, what you really want to be careful about are the casserole dishes, like chicken parmigiana and lasagna,” Kris-Etherton says. “It’s usually a big serving, and very caloric.” The ground beef and cheese in lasagna dishes can make the total saturated fat content soar, she warns.

Beware also of the sausage-based entrées, which are high in saturated fat. Even if they have peppers — a low-cal vegetable — the sausage dishes can be high-fat overall, she says.

Mexican Food: Making Healthier Choices

Here are some tips for making healthier choices when eating at a Mexican restaurant:

  1. Fish first. Fish (when it’s not fried) is often the lowest in fat and saturated fat of the meat choices. Chicken is usually next, followed by steak — if the restaurant uses a leaner cut and doesn’t add extra fat.
  2. Stick with soft tortillas. Most restaurants offer the choice of soft or crispy, corn or flour tortillas. Generally, soft tortillas — whether corn or flour — are lower in calories and fat than the deep-fried, crispy option. And soft corn tortillas can be healthier than flour ones. At Rubios, for example, choosing a stone-ground corn tortilla instead of a flour tortilla will save you 50 calories, 4 grams of fat, 1.5 grams of saturated fat, and 340 mg sodium (while giving you 1 extra gram of fiber).
  3. Skip the sour cream. This saves you 120 calories, 10 grams fat, and 7 g saturated fat for a 2-ounce serving. Some Mexican restaurant salads and entrees also come with creamy dressings, like ranch sauce. Leaving this off can shave 240 calories, 27 grams of fat, 4 grams saturated fat, and 240 milligrams of sodium.
  4. No cheese, please. Leaving the cheese off your grilled meat or fish burrito will usually shave off about 110 calories, 9 grams of fat, and 5 grams of saturated fat.
  5. Guacamole is good for you. While a big side of guacamole (3.5 ounces) adds considerable calories (about 150) and fat (about 13 grams), guacamole made mostly with avocados is low in saturated fat (about 2 grams), high in fiber (6 grams), and most of its fat is the healthy monounsaturated type.
  6. Go for grilled. Instead of fried fish, meats, or veggies, choose grilled fish or shrimp, charbroiled chicken, and grilled vegetables. They will have less fat and still taste great
  7. Add fajita veggies. A flavorful and easy way to boost your daily veggie intake is to add “fajita vegetables” to your burrito or burrito bowl. For just about 20 calories and 0.5 grams of fat, a 2.5 ounce serving of fajita vegetables will add a gram of fiber, about 30% of the Daily Value for vitamin C, powerful phytochemicals, and tons of flavor.
  8. Skip the chips. OK, just steal a few from your tablemate! Half an order of tortilla chips from Chipotle (2 ounces), for example, adds 285 calories and 13.5 grams of fat to your meal total, along with 210 milligrams of sodium.

Elaine Magee, MPH, RD, writes the Healthy Recipe Doctor blog for WebMD and is the author of numerous books on nutrition and health. Her opinions and conclusions are her own.

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