Eating Out? How to Avoid Ultraprocessed Foods

The evidence is mounting: diets high in ultraprocessed foods are associated with higher risk for chronic disease. On the other hand, it’s clear that dietary patterns built around whole and minimally processed foods (like fruits, vegetables, whole grains, legumes, nuts, seeds, low fat and fat free dairy, and unprocessed lean proteins) are associated with lower chronic disease risk.

Cooking at home, using basic ingredients, allows you control over what you put in your body and how much you eat. Eating out can provide an opportunity to try new foods, experience new flavors, have a change of scene, and give those who normally prepare the food a break. Fortunately, it’s possible to make healthy choices and reduce your intake of ultraprocessed foods without giving up the joys (and convenience) of restaurants.

What to Avoid. Studies are consistently finding an association between higher intake of ultraprocessed foods and higher risk for diseases and conditions, including obesity, high blood pressure, cardiovascular disease, type 2 diabetes, cancer, and cognitive decline.

There is no standard definition for what constitutes an ultraprocessed food, but “ultraprocessing” generally involves altering food components to the point where they no longer retain much (or any) of their original composition, form, or cell structure. Ultraprocessed foods are essentially assembled from a combination of components which are either extracted from nature or man-made. They are usually described as containing ingredients not normally used at home, including colorants, flavor enhancers, emulsifiers, thickeners, stabilizers, hydrolyzed proteins, isolated fibers, and bulking, gelling, and foaming agents. Ultraprocesseing makes foods look and feel appealing, gives them a longer shelf life, provides a sweet or salty taste, and sometimes adds unnecessary vitamins and minerals.

Ultraprocessed foods tend to be high in refined starch (like white flour), added sugars, and sodium and low in healthful components like natural fiber. Examples include flavored chips, processed meats (including bacon, ham, sausage, hot dogs, and deli/sandwich meats), white breads/rolls/pastas, formed chicken nuggets or patties (as opposed to whole, breaded pieces of boneless chicken), energy bars, shakes, and packaged cookies and cakes. When these foods replace more nutritious choices on our plates, we not only take in things that might not be good our us, we also miss out on things that support good health.

What to Look For. Look for menu items that have the most whole or minimally processed ingredients. Does the food you would be served look like the ingredients it started out as (like a piece of fish and some vegetables), or does it not (like formed chicken nuggets and fries with a cheese-like sauce)? Many restaurants have their menus online (and chain restaurants have nutrition information available as well), so it’s possible to do a bit of research ahead of time if you choose. Here’s a look at the best way to approach ordering at a variety of restaurant types. If nutrition information is available, take advantage of it while planning.

Fast Food. The toughest place to find minimally processed food choices is at a fast-food restaurant. This is because these establishments are designed to focus on speed, low price, and convenience over nutritional value and freshness. You’re likely to see fewer whole ingredients and more heat-and-serve, ultraprocessed foods. If you’re on-the-go and don’t have other options, try these tips in addition to the ones in the Take Charge! box:

➧ Keep it real. If you have a choice between a fast-food restaurant that uses whole pieces of chicken for their nuggets, strips, and sandwiches and one that uses a slurry of chicken parts formed into shapes, choose the real chicken. Swap sweet drinks for water.

➧ Look for veggies. Is there a salad on the menu? Are baby carrots an option for a side dish?

➧ Don’t automatically go for meat substitutes. Plant-based meat substitutes are ultraprocessed foods, so, although they are an option for those who wish to cut back on animal products, they are not a minimally processed choice.

➧ Bet on beans. Does the fast-food establishment offer a chili with beans or a whole-bean-based burrito or taco? Beans are a whole food that raise the health quotient of almost any dish.

➧ Un-supersize it. In general, it’s a good idea to choose smaller sizes, when available. If you can’t avoid ultraprocessed foods, at least you’ll be eating less of them!

Fast Casual. If you have a little more time (and money), try fast casual. While fast-food restaurants tend to have drive-through windows, late hours, counter service, and limited seating, fast casual restaurants have more limited hours and step the ambiance and service up a notch, while still focusing on speed. You will typically order at the counter, and your food is often delivered to your table when ready. Some have a preset menu, but, at many fast casual spots, customization is the word. You get to build your own bowls, wraps, salads, etc., usually from fresh ingredients you can see behind the glass. Make the most of this opportunity to load up on vegetables, beans, whole grains, and lean proteins.

Casual Dining. At a casual dining establishment, a server will take your order at the table. This means you are choosing off a menu. While casual dining menus are more likely to have pictures of their food than fine dining establishments, you still don’t really have the ability to see the ingredients before you order like you do at some fast casual places. Still, menu descriptions will generally make it pretty clear if you’re getting whole foods (like meat, poultry, fish, vegetables, beans, and whole grains). If you’re not certain (are these chicken strips actually breaded strips of chicken breast, or not? Are the mashed potatoes made from potatoes, or flakes?), don’t be afraid to ask.

Look for whole grain options (like whole wheat toast, brown rice, and whole wheat pasta) where available and try to avoid refined grains, sugar-sweetened beverages, and processed meats. If options like whole wheat bread or brown rice aren’t listed on the menu, ask for them. They may be available, or you may encourage the restaurant to make them available in the future.

Fine Dining. Fine dining restaurants are the most likely to focus on whole ingredients. The menu will clearly state what is in each dish, and the staff can usually answer questions. Many fine dining establishments today proudly advertise their “farm-to-table,” “natural,” “organic,” and “local” offerings. While the words “natural” and “organic” on food packaging does not indicate processing level, these terms on a restaurant menu are a pretty reliable sign that they cook from fresh ingredients.

Snacks. If you’re picking up a snack from a vending machine or convenience store, it can be tough to find minimally processed options. Processing increases the shelf-life of food, making ultraprocessed foods ideal for sitting in a machine or on a shelf. Here are some tips:

➧ Go whole grain. For chips and crackers, whole grain options are a step above refined. Look for whole grain chips and oat-based granola bars in vending machines.

➧ Avoid the protein bars. Don’t be fooled by healthy-looking snack bars. Many are ultraprocessed. Protein bars, in particular, contain ultraprocessed protein powders and many are high in added sugars or sugar substitutes. Check labels for ingredients you can recognize and nutrient facts that indicate lower levels of added sugars.

➧ Flip it. Flip bags and boxes over so you can see the Nutrition Facts label and ingredients list. Choose the options with the lowest numbers in the “added sugar,” “sodium,” and “saturated fat” rows (and the highest numbers under “dietary fiber”). Ingredient lists with lots of hard-to-pronounce, unrecognizable words are also a hallmark of ultraprocessed products.

➧ Look for whole foods. If you’re in a corner store or mini mart, look around for whole fruit (like bananas or apples) and check refrigerated cases for options like cut fruit or vegetables, hard-boiled eggs, cups of unsweetened yogurt, and low-fat mozzarella sticks. Unsalted or low-salt nuts and trail mix are often an option in stores and in vending machines.

Eating ultraprocessed foods now and then is not going to have a big impact on your health. The danger comes when ultraprocessed foods replace much of the whole and minimally processed foods on your plate and in your glass. When you’re eating out (or getting take-out), aim to emphasize minimally processed foods like fruits, vegetables, beans, lentils, whole grains, nuts, seeds, fish, and low fat or fat free dairy.

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