Burger, please, and a glass of Beaujolais

At a Hardee’s restaurant in Champaign, Ill., two food psychologists recently did some redecorating. Half the seating area was left as-is—the strong lights, bright colours and hard metal chairs typical of fast-food places—while the other half was transformed with white tablecloths, plants and paintings. “We softened the surfaces to make it quieter, put in nice lights, played some Miles Davis,” says Brian Wansink, director of Cornell University’s Food and Brand Lab, author of Mindless Eating: Why We Eat More Than We Think.

As the lunch rush arrived, customers were randomly selected to eat in the regular restaurant or on the made-over side. Wansink and collaborator Koert van Ittersum of the Georgia Institute of Technology thought people on the fine-dining side would linger at their tables and order more food. But even though those customers spent longer in the restaurant, they consumed less food. And they rated what they ate as more enjoyable.

Restaurants influence us in all sorts of ways—everything from lighting and music to words on the menu can cue us to indulge. The trouble is, for most of us, restaurants are no longer for special occasions; they’re an everyday thing. A new study in the American Journal of Preventive Medicine (AJPM) says Americans spend nearly half their food budget on, and consume about one-third of their daily calories from, food outside the home. Canadians do better; according to Statistics Canada figures published in April, households spent an average of $7,443 on food in 2010, $2,066 of that in restaurants. (In 1997, we spent an average of $5,608, $1,152 of it in restaurants.) All that eating out isn’t very healthy, as the new Symptom Profiler quality-of-life survey results show: the more respondents ate out, the more negative health symptoms they reported.

There are plenty of reasons people opt to dine out, says Elaine Chin, chief medical officer of Executive Health Centre in Toronto, which partners with Maclean’s on the Symptom Profiler. “With a lot of outside obligations, it’s easier to just grab and go.” There is a proliferation of restaurants, preparing food quickly and cheaply and offering more choice. “It’s a big hassle to cook a Peking duck,” says Wansink, but no hassle to order it off a menu.

But the salt, fat and sugar in restaurant food are often invisible, and their effects can accumulate more quickly than most of us realize. In a new study, presented Oct. 1 at the Canadian Stroke Congress, rats were fed what’s called the “cafeteria diet”: high-calorie, high-sugar, high-sodium food. After two months, they were showing symptoms. “We saw obesity develop,” says lead researcher Dale Corbett, scientific director of the Heart and Stroke Foundation Centre for Stroke Recovery and a professor at the University of Ottawa’s faculty of medicine. “They were diabetic or pre-diabetic. They had excessive levels of bad cholesterol.” That kind of diet increases the risk of stroke or death at a younger age, the study notes.

Even a single high-fat meal has an effect. In another new study, a group of non-smoking university students ate two breakfast sandwiches—the kind sold at fast-food places and coffee shops—amounting to 900 calories and 50 g of fat. Two hours later, researchers measured their velocity time integral (a measure of how much blood flows into the arm after briefly constricting it with a blood-pressure cuff) and found it decreased by 15 or 20 per cent compared with days when they didn’t eat any breakfast before testing. “Within two hours of a single dietary indiscretion, there was an adverse effect on the way blood vessels behave,” says Todd Anderson, head of cardiac science at the University of Calgary and a Heart and Stroke Foundation researcher who supervised the work, led by student Vincent Lee. The body bounces back from eating the rare greasy breakfast, but in the long term, high-fat diets are a risk factor for arteriosclerosis, a narrowing of the arteries.

Unfortunately, the restaurant diner faces more of a minefield than ever. Portions are getting bigger and bigger, the AJPM notes, like the Wendy’s Triple Baconator (1,300 calories), or the Hardee’s Monster Thickburger (1,420 calories). “You’re paying for something, so you want more,” says Lisa R. Young, co-author of the study with Marion Nestle, both New York University professors in the faculty of nutrition. “It leads to this competitive environment. If one company is making something bigger, the others will, too.”

Some offer better choices: T.G.I. Friday’s has the “right-portion-right-price” option, and salads have become a fixture on fast-food menus. But Wansink has found that consumers eating fast food they saw as “healthy” (like Subway sandwiches) were more likely to underestimate their caloric intake by an average of 151 calories. They were also more prone to order sides, drinks and desserts, adding up to 131 per cent more calories. “We eat a sub sandwich, then congratulate ourselves by ordering chips and cookies,” Wansink says.

Young and Nestle suggest a few ways to get portion sizes under control, such as better educating the public on portion control and what constitutes a serving size (which might encourage people to pack up half their entrée and bring it home), or even public-policy approaches of the kind recently adopted in New York City. Like Chin, Young is a big supporter of New York’s new ban on supersize sodas. It’s created an outcry, she acknowledges, but “people will get used to it,” just as they did with higher cigarette taxes, or the ban on smoking indoors.

It would be even better to prepare more meals at home. But when that’s impossible, just as the Hardee’s study suggests, Wansink recommends lingering over a greasy meal instead of wolfing it down. “I eat quite a bit of fast food. It’s great when it’s hot, but when it’s cold it’s not great. If you stay a bit longer, and your food starts to cool off, you might not finish your fries. You might not even finish your hamburger.”