Knowing the right way to eat is one thing, but doing it is not always easy, especially when dining out.
But some Baltimore-area restaurants are making heart-healthy dining easier and more attractive for their diners.
Restaurants like Zia's in Towson are drawing new customers with a menu approach that makes eating heart-healthy almost foolproof. The cafe's menu is completely free of white flour, hydrogenated oils and refined sugars. "We have doctors, nutritionists, trainers, coaches recommending people to us," said Zia's owner, Daniela Troia.
"We like to accommodate all eaters," said Troia. "We don't like to preach to people. but we like to offer people the best choices."
It's when customers don't have healthy choices, or when they're tempted by bad ones, that heart-healthy eating suffers.
National brands like Boston Market are trying to make it easier for their customers to maintain a heart-healthy program. George Michel, chief executive officer for Boston Market, said his company has been improving the nutritional quality of its offerings. "We hope to make it a little easier for diners to make more balanced choices," Michel said. "We believe it's possible to have great-tasting food options that fit with a healthier lifestyle, while leaving room for the occasional indulges."
The company, headquartered in Golden, Colo., is now promoting its "100 meals under 550 calories," which include combinations like a quarter rotisserie chicken (white meat, no skin), with fresh steamed vegetables and cinnamon apples, which comes in at 540 calories.
At Galen Sampson's Dogwood restaurant in Hampden, the move to a heart-healthy menu was partly personal.
"I've made a commitment to being healthier," said Sampson. "My cholesterol is high. My doctor said, 'You're going to fix this or go on medication.'" Working with Karen Fick, a nutrition consultant, Sampson has been revamping his menu. "We're still going to have the favorites," Sampson said. "We're not getting rid of the short rib. But a large subset of the menu is going to be vegetable-based. Meat will be more of a condiment."
Sampson been introducing some of the new dishes over the past few months. "The vegetarian dishes have been popular," Galen said, "but we're not holier than thou."
At Tark's Grill in Lutherville, where customers clamor for chicken pot pie and meatloaf, chef Chris Golder offers alternatives to meat and potatoes that go beyond simple broiling, like black cod in a Thai-flavored broth, served with rice noodles and plenty of vegetables.
Golder said he's been introducing heart-healthy items slowly and subtly. "We're thinning down some of our heavier sauces," Golder said, "and running healthier items as specials."
One of the biggest obstacles to healthy eating in restaurants, according to Dr. Roger Blumenthal, founder of the Ciccarone Center for the Prevention of Heart Disease at Johns Hopkins, is portion control.
"Restaurants like to give customers their money's worth," Blumenthal said. "Portion sizes back in the 1960s and 1970s were much smaller." Restaurants, he said, will often load plates up with cheap fillers like potatoes and other high-glycemic food.
One of the keys to a healthy restaurant dinner, Blumenthal said, can begin at breakfast. "People are ravenous by the time dinner comes. Eat something in the morning," Dr. Blumenthal tells his patients. "Eating in the morning takes the edge of your hunger. Have a healthy snack between lunch and dinner."
Blumenthal is a co-founder of Heartfest, a gala benefiting the Johns Hopkins Heart and Vascular Institute that will be held this Saturday at Martin's Valley Mansion. Zia's and Tark's Grill are among the 20 local restaurants and caterers that will be providing dishes for the event.
"We've always know that there was a lot of association between different types of diet and different types of heart disease," said Richard T. Lee, professor of medicine at Brigham and Women's Hospital in Boston, Mass. "What has emerged over the past several decades is rigorous investigation into different diets. The wealth of evidence is so strong that we can make these recommendations with confidence."
Lee is an editor of the "Harvard Health Letter," whose January issue includes a cover story on heart-healthy eating. It recommends making one change each month toward the long-term goal of achieving a heart-healthy diet. The advice for January, for instance, is to serve, once a week, a broth-based soup loaded with vegetables and beans before or instead of the main course.
The basic goals line up neatly with those found on the American College of Cardiology's Cardio Smart website, which has dozens of fact sheets devoted to healthy eating and weight management, including ones focusing on grocery shopping and dining out.
"A heart-healthy diet," Cardio Smart says, "has lots of vegetables, fruits, nuts, dried beans, and whole grains, and is low in salt. It limits foods that are high in saturated fats, trans fats, and cholesterol."
His patients do know, for the most part, what the bad foods are, Blumenthal said. They're aware of trans fats and know that to avoid fried food. Americans know the rules, but they break them, Blumenthal said. The evidence, he said, is all around us. "Most Americans are overweight or obese."
The best chance for success, he said, comes when his patients take a consistent approach. "Certain types of food, with lots of sugar and fat, should be reserved for special occasions," he said.
Blumenthal prefers not to focus on the things healthy eating shouldn't be. "People shouldn't feel overly deprived. We try to emphasize following a healthy, nutritious diet. People do better If you emphasize the good stuff to eat. Fruits, vegetables, nuts and fibers tend to fill you up more," he said, "and they're healthier for you than high-glycemic food like potatoes, rice and white bread."
For those who are more comfortable with packaged programs, Blumenthal advocates the South Beach Diet, whose faddish-sounding name belies the fact that it was developed by a cardiologist, Dr. Arthur Agatson. He also likes the website myfitnesspal.com, which helps users keep a journal of their caloric intake and exercise.
Sampson and Fick will present, along with Dr. Dana Simpler, a workshop on healthy eating on Friday at the Dogwood. Simpler, who will discuss some of the science underpinning nutritional guidelines, thinks that institutional advice could be more explicit about the benefits of a whole-food, plant-based diet.
"I understand it," Simpler said. "Rather than ask a lot and get nothing, they'd rather ask a little and get something. But I think people need to see the science and decide for themselves," Simpler said.
But the basic search for good advice, Lee said, should be over. "There are always things in the gray zone. What's not in the gray zone is that people should exercise more, lower number of calories, less salt, more potassium."
Things that are getting a little easier, even when not dining at home.
The coming weekend is full of events devoted to heart-healthy eating:
On Friday, Galen Sampson will present a workshop on healthy eating at Dogwood with Dr. Dana Simpler and nutrition consultant Karen Fick. The event will include background on the science of heathy eating, information about implementing a healthy diet, a cooking demonstration and lunch prepared by Sampson. The event is 10 a.m. to 2 p.m. Friday at Dogwood, 911 W. 36th St. The cost is $75. For information call 410-563-1700.
On Saturday, chef, journalist and author Diane Kochilas will lead a master class in Greek country cooking at the Greek Orthodox Cathedral of the Annunciation. The event, a fundraiser for the church's women's guild, will highlight some of Kochilas' favorite recipes and culinary techniques. Tickets are $65 per person and include a tasting reception and signings of Kochilas' new book, "The Country Cooking of Greece," which will also be on sale at the event. The master class in Greek cooking with Diane Kochilas will be held at 11:30 a.m. on Jan. 19 at the Greek Orthodox Cathedral of the Annunciation, 24 W. Preston St. The cost is $65. Go to http://www.goannun.org for more information.
On Saturday night, the Johns Hopkins Heart and Vascular Institute holds its Heartfest benefit with "heart-healthy cuisine prepared by local restaurants including Zia's and Tark's Grill and musical performances by the Heart Attackers, whose band members are composed of cardiologists, a gastroenterologist, a urologist and other medical professionals. There will also be educational and interactive displays created by Johns Hopkins Heart and Vascular Institute. The event is 7:30 p.m. to midnight at Martin's Valley Mansion, 594 Cranbrook Road, Cockeysville. Tickets are $125. For information, call 410-560-0677.