Are ‘healthy’ restaurant items really so healthy?

It's great when restaurants offer "healthy" options on their menus, and more and more eateries are doing so. Foods that are described as “homemade,” “organic,” and “natural” have an aura of healthfulness and sound like they’d be good for you. But how nutritious are they, really?

Turns out, they’re often not very nutritious at all.

A 2021 study published in the American Journal of Preventive Medicine revealed that restaurant menu items with descriptions like “healthy,” “fresh,” “organic,” “vegan,” “vegetarian,” “low calorie,” and “gluten-free” were not necessarily lower in saturated fat, sodium, or sugar than menu items that weren’t described in similar terms.

The truth about ‘healthy’ restaurant foods

In the study, researchers analyzed items on the menus at 96 of the top-selling United States restaurant chains between 2012 and 2018. With the exception of "organic" items, most main dishes with healthy descriptions were lower in calories than less-healthy sounding counterparts. However, the healthy-sounding dishes had the same or higher sugar content than items without these descriptions. Excess sugar is linked to higher blood pressure, increased inflammation, and a greater risk of many chronic conditions such as type 2 diabetes.

That's not all. Most “healthy” main dishes received more than 10 percent of their calories from saturated fat. The American Heart Association (AHA) urges people to strive for 6 percent of calories or less from saturated fat. Too much saturated fat in your diet can raise the risk of heart disease.

What's more, most “healthy” menu items were lower in salt than their less healthy counterparts, but not by much. “Healthy” main dishes contained only about 180 milligrams (mg) less sodium than items without a healthy claim. On average, they still contained about 1,300 mg sodium, or more than half of the AHA's recommended salt intake of 2,300 mg per day. Vegan and vegetarian desserts actually contained more sodium than other desserts. Eating too much sodium increases the risk of high blood pressure, heart disease, and kidney issues among other chronic health conditions.

Nutrient overload

But what's a few more milligrams of salt or grams of sugar here and there?

Considering that about half of your risk for heart disease comes from factors you may have some control over—including your diet—it matters quite a lot. Avoid relying on what a restaurant menu might say, since it might inadvertently let "healthy" menu choices sidetrack your healthy eating.

Instead, take proactive steps to maximize the healthfulness of your meal when you dine out. Here’s how:

Be wary of portion sizes

Some individual restaurant entrees could feed entire families, which means extra calories, saturated fat, salt, and sugar in every order. Retrain your eye on what makes a healthful portion size.

If a dish arrives from the kitchen piled high, it’s probably too much food for one meal—regardless of whether the menu calls it a healthy option. Enjoy as much as you like until you start to feel about 80 percent full and then ask for a carry-out carton. Better still, set aside half of the plate up front, enjoy the other half, and keep the rest for tomorrow’s lunch.

Be choosy with your sides

In the study, some side dishes described as healthy contained the same amount or more sugar than items without the healthy labeling. Choose healthful sides like steamed vegetables instead of those loaded with extras like butter, cheese, or syrupy and sticky sauces.

Be picky with processed foods

Want to replicate your favorite restaurant treats with a premade version? Be sure to read nutrition labels when you’re shopping the packaged food or frozen aisles at the supermarket. Just because an item is sold in the grocery store doesn’t necessarily mean it’s more wholesome than something you’d find at a restaurant.