“Eating out” and “eating healthy” can often be a difficult combo to pull off — even when trying your best. And for diners attempting to emphasize cancer prevention, restaurants can be particularly daunting for a number of reasons, from unknown ingredients to large portion sizes. However, with a little bit of nutritional know-how, you can add cancer prevention to the menus of your favorite restaurants through healthy additions, subtractions and substitutions. Here are some tips for eating right while dining out from Candice Schreiber, RD, CSO, LD, a JamesCare for Life outpatient clinical dietician. Give your day a healthy kickstart It’s easy to start the day in a healthy way — even at a diner or coffee shop — by focusing on foods with fiber, which has been linked to lower cancer risk. Schreiber recommends a bowl of oatmeal with nuts and fruit as a great way to add some flavorful fiber (and more) to your morning routine. “You get the benefit of the fiber from the whole grains and all the benefits from nuts and fruit.” Contemplate your cup of joe Coffee has been linked to a host of health benefits — with some studies showing a “protective effect” on cancer, according to The James’ David Carbone, MD. As with many foods and drinks, however, coffee made at restaurants and cafes can come with a lot of extra calories, which could add up to weight gain that could increase your risk of cancer and other health problems. “Some of these specialty coffees can have 40 to 50 grams of sugar,” Schreiber says. Do you really want fries with that? French fries are a ubiquitous presence in restaurants, and unfortunately, they bring with them a lot of calories and fat, as well as acrylamide, which has been linked to increased cancer risk and can be produced when potatoes are cooked at high temperatures. Schreiber recommends going green instead, subbing in a salad as your side, which can give you a wide variety of nutrients important for cancer prevention and overall health. “This can be harder to do at fast food and/or hamburger places, where it’s centered around meat and fries, though they’re starting to have more salad options,” she says. “A sitdown restaurant can be pricier but will often give you more options.” Smarter sandwiches When it comes to handheld healthy eating, Schreiber suggests swapping grilled chicken for fried in sandwiches or wraps (hold the mayo), and ordering veggie burgers rather than red meat versions — though the occasional indulgence shouldn’t cause concern. “A plain burger and a salad can be okay as long as you’re not eating at this type of place regularly.” Be mindful about meat Why the call to keep your burger intake to a minimum? For Schreiber, it’s because they come with a double-dose of concern caused by research linking both red and processed meats to cancer, a problem that extends to other meaty meals as well. “There is strong evidence that processed meat (deli meats, bacon, sausage, hot dogs) as well as red meat (beef, pork, lamb) can increase risk for colorectal cancer,” she says. “Avoiding processed meat and limiting red meat are steps you can take to decrease risk.” Think before you drink Beer, wine and mixed drinks have lots of calories and no nutritional value. For example, an eight-ounce margarita has about 280 calories. Also, excessive alcohol consumption can cause a variety of other health issues, including increased risk of some types of cancer. “The recommendation is for no more than one drink a day for women and no more than two for men,” Schreiber says. “And for cancer survivors, it’s recommended that they not drink alcohol at all.” A whole lot of whole grains Swapping whole grain versions of rice and bread for processed types can be great — and delicious — ways to add cancer prevention to your restaurant meals without giving up your favorite entrees. Many restaurants will substitute brown rice for white in sushi, fried rice and other popular items, while you can often switch white bread or buns for wheat or multigrain choices — though you may want to pass on the freebies. “You want to avoid the processed, white flour bread you generally get in the bread bowl they put down on your table,” Schreiber says. Follow your rules The more you eat out, the more you should create — and stick to — a plan, according to Schreiber. “If you eat out regularly, you really need to think about and establish some rules, while also thinking about finding ways to avoid eating out so often,” she says. “I always tell people that leftovers from dinner the night before are the best lunch option the next day.” When you do dine out, you can usually check menus online before you visit to make sure there are healthy options (Schreiber recommends happycow.net). Also, make sure to expand your research to include the nutritional info of specific items so you’re not caught off guard by meals that only look nutritious. “Some foods sound as though they’re healthy but might not be,” Schreiber says. “A portabella sandwich or veggie burger at a restaurant can have as many as 1000 or more calories and be high in fat and sodium.” Schreiber is a board-certified specialist in oncology nutrition. She leads a monthly, free lunch & learn sponsored by JamesCare for Life in which OSUCCC – James patients and their caregivers learn about a wide range of oncology nutrition topics. Click here for a schedule of JamesCare for Life events.