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Nutritious Fast-Food for Special Needs Patients On the Go
By Lindsey Getz

While RDs would prefer their clients eat only fresh foods and zoom past the drive-in window, the fact is most people are busy and fast food is convenient. Fortunately, many fast-food chains have added healthy choices to their menus. Now even patients with challenging nutritional issues can find healthy picks on the go. Here are five food choice recommendations for your clients with common conditions.

It’s critical your patients with diabetes watch their sugar intake. But as you know, fast food menus are filled with sugary sodas and lots of carbs that can raise blood glucose levels. Fortunately, there are healthful options on the menu, too. Advise patients to choose grilled items instead of “crispy.” In addition, many chains offer various salads. “There are salads chock-full of grilled chicken and vegetables, which make a nice choice for those watching their sugar intake,” says Kristin Reisinger, MS, RD, CSSD, fitness trainer, nutritionist, and weight loss consultant.

Reisinger’s favorite pick? McDonald’s Premium Southwest Salad with Grilled Chicken or Wendy’s Berry Almond Chicken Salad. Both are lower in sugar than most other menu options.

Heart Disease
You’ve told your heart disease patients that a heart-healthy diet means limiting unhealthful fats and cholesterol. While fast food traditionally is packed with trans fats, today there are healthier choices. Robin Plotkin, RD, LD, a culinary and nutrition expert based in Dallas, recommends these patients look for foods high in fiber, low in sodium and saturated and trans fats. That means forgoing the fries. “For side dishes, opt for apple slices, bean salads, a fruit cup, or a low-fat yogurt with unsweetened tea, water, or low-fat milk for the drink,” Plotkin advises.

“Foods low in fat, high in fiber, and rich in healthy fats help to lower triglycerides in the blood and keep a person lean and trim,” Reisinger explains.

Reisinger’s favorite pick? Subway’s 6-inch Veggie Delite, which is rich in fiber and low in fat.

Irritable Bowel Syndrome (IBS)
In most cases of IBS, diarrhea is the predominant symptom, so water-soluble, fiber-rich foods are essential, Reisinger says. It’s also important to avoid fatty and oily foods that can exacerbate symptoms. Plotkin recommends a cup of broth-based soup such as chicken noodle or chicken and rice along with a simple side garden salad, which provides a light but filling meal. “If able to tolerate, fresh fruit, vegetables, and whole grains are excellent fiber-rich choices,” she adds. “Also, don’t forget to drink plenty of water throughout the meal. Fluid is important to help recover from bouts of diarrhea and helps to prevent constipation.”

Reisinger’s favorite pick? Wendy's Small Chili with Garden Side Salad and Apple Slices on the side. These are high in insoluble fiber, which is important in small quantities for IBS patients.

America’s love affair with fast food no doubt has contributed to the obesity epidemic. But with more healthful choices available, even obese patients sometimes can pull up to the fast-food window with a good conscience. One simple switch is to ask for the grilled chicken instead of the fried. Plotkin suggests asking for lettuce in place of the bun or perhaps using just one half of the bun. Also ask to hold the cheese. Plotkin suggests ordering from the kid’s menu for easy portion control. Every once in a while a little splurge can help patients stay on track. “A small order of French fries and a diet soda will feel indulgent but not be so bad,” Plotkin adds.

Reisinger says that overall any patient looking to lose a significant amount of weight should select small and frequent low-calorie meals. She advises patients stick to one or two key items when eating on the go and forgoing the temptation to order several.

Reisinger’s favorite pick? Panera’s Thai Chopped Chicken Salad. It’s only 390 kcal for the entire meal.

Celiac Disease
Dining out with celiac disease may be the most challenging of all five conditions simply because cross-contamination in the kitchen easily occurs. While many sit-down restaurants like Outback Steakhouse and Carrabba’s Italian Grill have led the way with separate gluten-free menus and stringent kitchen regulations, many fast-food restaurants have yet to follow suit. But that’s not the case everywhere. “Salads might be gluten-free as long as the toppings or salad dressings don’t contain gluten,” Plotkin says. “Bunless burgers or baked potatoes also may be options. Be on the lookout for foods that are fried or contain sauces, as they may be cross-contaminated or even contain gluten.”

Reisinger’s favorite pick? Subway’s Tuna or Turkey Salad, which the menu says is gluten-free.

— Lindsey Getz is a freelance writer based in Royersford, Pa.