We all love to have food prepared for us, whether it is take-out, fast foods or at a sit-down restaurant. We don't have to cook or wash the dishes - it's easy! It is possible to eat out often and still make healthy food choices; however, this can be a challenge. Before you can eat out successfully, you need to learn about the different food groups and how to incorporate different foods into your diet.
In healthy meal planning for diabetes, there are three questions to ask yourself:

• What am I eating?
• How much am I eating?
• When am I eating (what time of day and how often?)

What?
Under the question of 'what am I eating?' there are two components you need to consider for healthy eating:

• The first is the carbohydrate content, which is important in terms of blood glucose management.
• The second is fat content. This is important in terms of weight management and heart health.
  

Food choices always fit into the following food groups: Starch, Fruits and Vegetables, Milk, Protein Foods, Fats and Oils, Sugars, and Extras.
First of all, identify what you are going to order, and which food group they fit into. For example:

• Soup is a starch; don't forget to account for it in your Starch choices.
• Pasta with tomato sauce provides Starch form the pasta, and Fruits and Vegetables from the tomato sauce.
• A quarter chicken dinner provides protein and fat from the chicken.

Consider what is served with the entrée:

• You may have a choice between baked potato and french fries. Both are Starch choices, but the fries are high in fat content.
• The baked potato can be low in fat. Choosing toppings like yogurt or mustard can keep the fat content low, but when you add butter or sour cream, the fat content increases.
• A side salad is an Extra, but watch out for all the dressings that add up to more Fat choices.
  

 

When eating out, the fat content is often much higher than when you eat at home. Fats and oils can add a satisfying taste. It is often easier and faster to prepare and cook foods in a high-fat way. Always think about how the food is prepared. Even if you don't add extra fat to the meal, the fat may have been added in the preparation or cooking process.
Things to watch for:

• Choose foods that are baked, broiled, poached or steamed; for example, a boneless, skinless chicken breast served with lemon juice.
• Stir-fried foods can be low in fat or high in fat if lots of oil is used in the cooking process.
• Choose foods that enable you to control what you add to them. For example, choose a baked potato instead of mashed potatoes. With the baked potato, you can add toppings to keep it a low-fat choice, whereas mashed potatoes may already have butter, oil or cream added to them, making them very high in fats and oils.
• Add condiments like mustards and vinegar, lemon juice and seasonings (pepper, garlic, onions) for flavour.
• Don't skip your starch unless you are saving it for a small dessert.
  

Planning certainly helps make ordering your meal easier.
How Much?
This question can be the most difficult to answer because each person has different needs and requirements. It is important to be familiar with your meal plan in order to be able to answer this question most accurately. A meal plan is developed with you by a registered dietitian. If you are familiar with appropriate portion sizes because you have done some measuring at home, it is easier to estimate portions in a restaurant. The difficulty in a restaurant is judging the portions before the meal is served. You may have to ask your server a few extra questions to gather more information about the portion sizes. Many restaurants serve larger portions than you need. Just because a large portion is served doesn't mean you must eat it all! If you are on a meal plan, you may want to make some substitutions to maintain carbohydrate consistency when eating out. Here are some ideas you can try in order to increase your flexibility:

• 1 Fruit or Vegetable choice can replace 2 milk choices (i.e. one orange = 250 mL/one cup of milk)
  
• 2 Fruit or Vegetables choices can replace 1 ½ Starch choices (i.e., one apple = 200 mL/¾ cup rice or pasta)

If you use carbohydrate counting as your method of meal planning, it is useful to know that many fast food restaurants have nutrition information booklets available. This can increase your flexibility in food choices while maintaining carbohydrate consistency.

When?
This question has two components. The first component refers to the timing of meals. The second component refers to the frequency of eating. With diabetes management, the timing of meals is important. Dietitians develop meal plan to distribute the carbohydrate evenly over meals and snacks throughout the day. In order to allow the body to use up carbohydrate most efficiently, the goal is to eat a meal or snack every four to six hours. When you are eating out, you have to think about the timing of your meals. Meals that are delayed or skipped can increase the risk of having a low blood glucose reaction for those people who manage their diabetes with pills or insulin. This can often be avoided. Again, the way to eat out successfully is to plan ahead.
It is best not to take your insulin at home and then head out to a restaurant. What if there is a line-up and you can't be seated for 30 minutes?
Planning to go out for dinner may take a little extra time, but things are sure to run more smoothly if you do plan. If snags come up, planning ahead may help you deal with these situations more easily, rather than panicking at the time and possibly ruining your enjoyment of the meal.
The second component of timing is 'how often'. If you eat out regularly, you need to be more particular about portions and food choices. If you eat out only rarely or go out for an occasional meal, you may not need to pay as close attention to portion sizes or choices. Once in a while, a special treat will not ruin your diabetes management. It may affect blood glucose levels for a day, but as soon as you return to your usual routine, things will fall back into place.
If you eat out in restaurants frequently, you may want to test your blood glucose a little more often, especially if you often visit the same types of restaurants or take-out stands. Testing your blood sugar more often will provide you with useful information about how that particular food choice and portion size affects your blood glucose. Maybe adjustments to food choices or portions can be made to improve those blood glucose levels. Maybe you did a great job estimating portions and your food choices were right on track with your meal plan.
Now you have all the tools you need to sit down to a meal in a restaurant, pick up food on the go or order in your favourite meal. Look at the menu, choose your meal, then ask yourself: 'Is there a better choice?'
All the hard work is done before the meal, so that once the food comes, you can sit back, relax and enjoy your meal.