Online Health Chat with Maxine Smith, RDN

March 22, 2016


Do you want to make healthy changes in your eating pattern but feel that it takes too much time and effort? Have hope. There are strategies that can help you and your family to eat nutritiously while not having to put on the apron and live in your kitchen.

March is National Nutrition Month, and it is time to focus your attention on the importance of making informed food choices while developing sound eating and physical activity habits.

This web chat will focus primarily on tips to eat healthy in a fast-paced world, including:

  • Techniques to break through the “time barrier” to building a healthy lifestyle
  • ‘Time savers’ to address ways to save time with meal planning, purchasing and preparation

If you find yourself eating out often or relying on a work cafeteria for meal choices, it is time to discuss strategies to keep calories down and nutrients up when dining out.

About the Speakers

Maxine Smith, RDN, is a registered clinical dietitian working in the Department of Nutrition Therapy at Cleveland Clinic. Her specialty areas include weight management, and disease prevention. She is a member of the Academy of Nutrition and Dietetics /Weight Management Nutrition Practice Group of the Academy of Nutrition and Dietetics and has earned the Level 2 Certificate of Training in the Adult Weight Management Program from the Commission on Dietetic Registration.

Let’s Chat About Healthy Restaurant Dining

Reading Restaurant Menus

knappk: When going out to dinner and the menu has "healthy" options, how healthy are they?  What are foods that you should stay away from when eating out?

Maxine_Smith,_RDN: "Healthy" menu options are often designed to meet specific criteria, such as fewer calories or less fat and sodium, and can be more nutritious than "regular" menu options. You may want to discern what is important to you, personally, and identify whether these nutrients are considered in the restaurant’s definition. Often, the definitions of these special menu items are described somewhere on the menu. You can always ask the manager. Less healthy foods to limit/avoid are fried foods, desserts, butter, red meat, foods made with rich sauces and foods based on white flour. 

robtoby: Aren't there initiatives (by state, I believe?) to make restaurants (of a certain size) clearly post the calorie content of all the food they serve? I'm starting to see this (in Massachusetts) on some fast food chain menus, but haven't really seen it in restaurants yet. Thanks.

Maxine_Smith,_RDN: The FDA has a requirement that chains with 20 or more restaurants must offer nutrient availability. The date of compliance has been extended to December 1, 2016. If you do not see information on the menu board, request a copy from the clerk/manager. You may also find information on the restaurant website. 

Specific Foods

alvarezl: Is drinking a daily cup of low-fat milk (in coffee or cereal) bad for your health? There are a lot of myths about this.

Maxine_Smith,_RDN: Milk is a healthy, "quick" food for most  people. It is a rich source of protein and is rich in minerals such as calcium, potassium and Vitamin D. Dairy intake has been associated with weight management and decreased blood pressure. Those with lactose intolerance or milk allergies may consider non-dairy alternatives.

BergL: Are sushi/rolls a healthy option for those of us trying to lose weight? The sauces they sometimes pour over the rolls seem like they would have the same high-caloric effect as some salad dressing do on salads.

Maxine_Smith,_RDN: The calories in sushi, like many other foods, depend on the ingredients and preparation method. Some sushi will have more fat, such as the "fancy" sauces or tempura-prepared seafood. Stick to the simplest rolls to keep the calories down. Also, brown rice can make a healthier option.

bbofranpd: I try to order fish at a restaurant, but I’m confused about which ones are healthiest?

Maxine_Smith,_RDN: Ordering a simply prepared fish is best. Consider baked, broiled or grilled options. Most fried fishes can be prepared in a healthier manner, if requested. Including cold -water, higher-fat fishes in your diet, such as salmon, trout, sea-bass and tuna are healthy options that offer more omega-3 fats. Limit tuna, due to mercury content. There are fish/seafood calculators online such as the one from Environmental Working Group to assist in identifying fish with higher environmental contaminants. It also recommends portions based on weight and other factors, including pregnancy.

alvarezl: As far as red meat, how much is too much?

Maxine_Smith,_RDN: Red meat can be part of a nutritious eating plan, but it should be a smaller part. Red meat has been associated with a higher risk of chronic disease and some cancers, including colorectal cancer. Choosing a leaner cut, preferably an organic/grass-fed option, can improve the health aspects, but still should be limited due to other risks. The guidelines vary from 3oz a week to no more than 18oz a week.  

Trykkergirl: Can you think of a simple sauce to make grilled chicken or fish tastier? I hate simple dishes; they are just too boring to me.

Maxine_Smith,_RDN: A salsa-type or pesto sauce can be a healthy option. Try experimenting with various herbs and marinades based on olive oil, lemon or vinegar. A bit of healthy fat adds flavor.

Limited Quantities

chickbull: This is an excellent subject, but it’s difficult to know how to go out for dinner at most restaurants and get a healthy meal, well almost healthy. One of our major issues is salt and not knowing how to limit salt consumption. Perhaps salads are the only way to go. I would appreciate your suggestions other than don't go to most restaurants.

Maxine_Smith,_RDN: I have heard that "salt and butter are a chef's best friends." Yes, you need to make wise choices when dining out to control the salt (sodium chloride). About 80 percent of the sodium in the diet comes from processed foods, so the fresher, less processed the better. Simply prepared foods such as fish or poultry that is baked, broiled or grilled, and starches such as a baked potato in addition to your salad are good choices. Typically, the more complex the dish with more sauces and cheeses, the more salt, so keep it simple. Condiments such as relish, ketchup, soy-sauce, mayonnaise, tartar sauce and barbecue sauce are loaded with salt, so request those on the side and minimize. Also request "no salt added to my food."

alvarezl: Is it true  that eating sugary foods (cakes or milk chocolate, for example) is related to cancer? There is a lot of misleading material on the Internet. I am a cancer survivor and want to avoid recurrence.

Maxine_Smith,_RDN: High-sugar foods are related to the process of inflammation in the body, which may increase the risk of cancer. A high-sugar diet may also potentially negatively affect other pathways in the body, which can increase cancer risk. Too much sugar in the diet can also replace healthy foods that can fight cancer, and they contribute to excess body weight, which increases cancer risk. Keep to a small amount such as a small dessert once or twice a week. Fruit makes a tasty, nutritious, cancer-fighting dessert.

alvarezl:  What is a safe amount [of sugar] per day? Some juices have 20g to 30g of sugar. Should I stop drinking or using sugar?

Maxine_Smith,_RDN: Sugar, whether naturally occurring in a food or added, is listed as "sugar" on the food label. Added sugars should be limited to a maximum of 10 percent of your calorie needs or about 100 calories-worth for women and 150 calories-worth for men a day. Avoid foods with any type of sugar in the first five ingredients (i.e. sugar, corn syrup, honey, concentrated fruit juice), and you will be decreasing your sugar intake. Choose whole fruit over juices, as it is handled by your body in a healthier manner.   

ccligal: I have limited food choices due to diabetes (well-maintained with medication), proteinuria (no significant change over 13 years) and edema (light). To add to that, if something tastes too good, I will eat too many portions, not necessarily binge, but I do need to lose weight. Do you have any suggestions?

Maxine_Smith,_RDN: A healthy eating plan with diabetes should offer a wide array of foods. Controlling portions that you make available to yourself is important. Cooking smaller amounts, eating off smaller plates, ordering "small plates" or lunch portions and limiting courses can help. You can request the waiter to have half the meal served and the other half packaged up to be provided with the check. Check out the Website: Healthy Dining that offers restaurants in your area, healthier options and nutrient information and go into the restaurant with your meal planned and strategies intact!

Meal Making Matters

KimWar110: Working full-time, I am finding that my family eats out more than I like. I find it difficult to make a home-cooked meal in a timely fashion due to my work schedule. I also find it difficult to cook healthy when I am able to cook rather than throwing something frozen together. We eat lots of cans and boxes more than we should, because there’s no time to make a homemade, balanced dinner in the evening. Do you have any suggestions?

Maxine_Smith,_RDN: A few suggestions that may be helpful: Bulk cook on the weekends and freeze a few meals as well as keep some staples such as baked sweet potatoes, brown rice, hard-cooked eggs and steel-cut oats in the fridge, cooked and ready to go. Use a slow-cooker for one-pot meals (overnight works well), use frozen vegetables and fruits and small cuts of protein that can be cooked up quickly (i.e. chicken tenderloins, small fish fillets). Keep washed bags of salad on hand, as well as a vegetable tray. 

KimWar110: I’m looking to get some healthy, quick cooking recipes. Can you suggest any particular cookbooks?

Maxine_Smith,_RDN: Any Mediterranean cookbook can offer healthy options. There are also "healthy" crock-pot cookbooks available. Many report enjoying the America's Test Kitchen line of cookbooks. The Cleveland Clinic Healthy Heart Lifestyle Guide and Cookbook  is available from I recommend reading reviews as to the complexity of the recipes. Sometimes, pictures can also speak a thousand words, so look for those. The Cleveland Clinic Wellness ‘Eat Well’ website and the Cleveland Clinic Heart and Vascular Institute’s Heart Healthy Recipe Corner also have recipes online.

MineOrYours2: I am a person who is constantly on the go. The majority of my day is spent at work. I have two jobs, and I am usually only home for about two hours a day before I fall asleep for the night. I have a horrible habit of eating junk food. I am not big on fast food, so that is not a concern, but I would like to know how to have better eating habits with a constant, on-the-go lifestyle. I have tried protein shakes but I mainly only like to have one shake a day, not for every meal. I don't know what to make or how to make something healthy, or even what to buy. Help!

Maxine_Smith,_RDN: As mentioned before, bulk cooking and freezing, making your own healthy frozen meals is a time-saver in the long run. There are also healthier frozen meals with fewer preservatives and healthier ingredients, such as Luvo, Artisan Bistro and Kashi brands. Picking up salads, stir-fry and healthy prepared items at a grocery store can also help. Keeping healthy snacks such as nuts and fruit can make a good quick snack. American Heart Association, and American Diabetes Association are a few great places to gather some information. There are also meal delivery programs available.  

Lifestyle Effects

ldsuz: My biggest challenge is going out to dinner with family/friends and being able to "mainstream" and not be a total drag on my companions. It's easy to watch at home, but I really like the socialization of dining out.

Maxine_Smith,_RDN: There is an adjustment process in terms of others accepting your new, healthy eating habits. If you keep a positive attitude about your changes, they will accept the new you more favorably. Eating slowly helps to make a smaller portion last longer so that you appear to be engaging in the meal. If you are holding a beverage in your hand, others perceive you as engaging in meal. Carry on pleasant conversation, show a few pictures. There is more to the meal than the foods. Keep smiling.


That is all the time we have for questions today. Thank you, Maxine Smith, RDN, for taking time to educate us about healthy dining.

On behalf of Cleveland Clinic, we want to thank you for attending our online health chat. We hope you found it to be helpful and informative. If you would like to learn more about the benefits of choosing Cleveland Clinic for your health concerns, please visit us online at

For Appointments

To make an appointment with Maxine Smith, RDN, or any of the other specialists in our Digestive Disease Institute, Department of Nutrition at Cleveland Clinic, please call 216.444.3046 or toll-free at 800.223.2273, ext. 43046, or visit us online at

For More Information

Cleveland Clinic
The Center for Human Nutrition provides evaluation, education and treatment to people who have disease-related nutrition problems. Additionally, the Center is involved with a multitude of programs to promote health and wellness. Both of these efforts are driven by a dedicated team of registered dietitians, dietetic technicians, nurses, pharmacists, physicians and surgeons who work together to provide comprehensive support for patients with specialized nutrition needs. 

Cleveland Clinic Health Information
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For more information about Cleveland Clinic’s Center for Human Nutrition, please visit

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