Fast fraud? Avoid major pitfalls in the new salad craze

Kristine Kieswer

We all know why fast food is a hit. It's quick and inexpensive--a tempting combination for busy folks. As of late, many fast-food and quick-serve restaurants have introduced an array of entree-sized salads, some featuring exotic greens, oranges, walnuts, cilantro and zingy new dressings. "Wonderful!" exclaim your precious arteries (not to mention your waistline). But, wait--not so fast. Old habits often die hard and many traditional burger-and-sandwich eateries are loading hefty portions of meat and cheese atop their latest garden creations, making the word "salad" a bit of a misnomer. The added fat causes many dietitians to give these salads a nutritional "thumbs down."

THE SKINNY

A recent survey of 34 popular quick-serve salads revealed that only two were exceptionally healthy. With zero cholesterol and minimal fat, Au Bon Pain's Garden Salad and Subway's Veggie Delite received five shining stars--the highest score possible. Analyzed according to fat, saturated fat, sodium, cholesterol and fiber content, each of the 34 salads examined received between one and five stars, with one star indicating significant room for improvement. Top salads relied on ingredients such as mixed greens, tomatoes, green peppers, onions, olives, carrots, cucumbers, cabbage and sprouts--the sort of ingredients you'd expect to find in a low-fat salad.

Other study results were quite unexpected. "What we found, unfortunately, is that many of these new salads are just another way of dressing up fatty foods, which is what most of us are trying to avoid," says Brie Turner-McGrievy, M.S., R.D., who led the study. "In fact, McDonald's Crispy Chicken Bacon Ranch Salad has more fat and calories than a Big Mac sandwich--a big surprise to us and, I'm sure, to many dieters." The salad and sandwich also contain the same amount of cholesterol.

Seventeen salads received a dismal one-star rating. Au Bon Pain's Cobb Salad, for instance, packs a whopping 220 grams of cholesterol, while Wendy's Taco Supremo Salad with all the extras contains nearly 15 grams of saturated fat. Burger King's Chicken Caesar Salad with Creamy Caesar Dressing, croutons, and parmesan cheese has 1,850 milligrams of sodium, a poor choice for diners concerned about high blood pressure--a condition affecting one in five Americans. In fact, physicians recommend most people consume no more (and preferably less) than 2,400 milligrams of sodium per day.

The creators of McDonald's new "premium" salads did turn over a new leaf, so to speak, by adding more than a dozen varieties of lettuce (e.g., tat soi, tango, lolla rosa and radicchio) to the menu. However, all six salads are topped with chicken and carry an average of 1,400 milligrams of sodium. "Chicken is not a health food," Turner-McGrievy explains. "Its cholesterol content is similar to that of beef. Smarter protein sources for salads are chickpeas, kidney beans, black beans or even marinated tofu. With no saturated fat or cholesterol, these choices are very heart healthy." Since Wendy's self-serve salad bars went the way of McDonald's McLean Deluxe, these ingredients became harder to find on the go, she acknowledges.

Startlingly high in total fat, Taco Bell's Taco Salad with Salsa weighs in with about 50 grams. Its greasy shell, ground beef and cheese bring its rating way down. Ordering the salad without the shell cuts the fat in half. At Panera, the smart choice is the Classic Cafe Salad, containing no cholesterol and plenty of fresh greens.

FAST-FOOD AND QUICK-SERVE SALAD ENTREES

Au Bon Pain

Caesar Salad                                                       ****
Charbroiled Salmon Filet & Yellow Peppers Salad                    ****
Chef's Salad                                                          *
Chicken Caesar Salad                                                 **
Cobb Salad                                                            *
Garden Salad                                                      *****
Mediterranean Chicken Salad                                        ****
Mozzarella & Red Pepper Salad                                         *
Nicoise Salad                                                        **
Thai Chicken Salad                                                 ****
Tomato & Mozzarella Salad with Basil Pesto                           **
Tuna Salad                                                         ****

Burger King

Chicken Caesar Salad with Creamy Caesar Dressing, Croutons, and
  Parmesan Cheese                                                     *

McDonald's

Crispy Chicken Bacon Ranch Salad with Newman's Own Ranch
  Dressing                                                            *
Crispy Chicken Caesar Salad with Newman's Own Creamy Caesar
  Dressing and Croutons                                               *
Crispy Chicken California Cobb Salad with Newman's Own Cobb
  Dressing                                                            *
Grilled Chicken Bacon Ranch Salad with Newman's Own Ranch
  Dressing                                                            *
Grilled Chicken Caesar Salad with Newman's Own Creamy Caesar
  Dressing and Croutons                                               *
Grilled Chicken California Cobb Salad with Newman's Own Cobb
  Dressing                                                            *

Panera

Asian Sesame Chicken Salad                                           **
Caesar Salad                                                          *
Classic Cafe Salad                                                 ****
Fandango Salad                                                      ***
Greek Salad                                                          **
Grilled Chicken Caesar Salad                                          *

Subway

Meatball Salad with Fat-Free Italian Dressing                         *
Subway Club Salad with Fat-Free Italian Dressing                   ****
Veggie Delite Salad with Fat-Free Italian Dressing                *****

Taco Bell

Taco Salad with Salsa                                                 *
Taco Salad with Salsa (w/o shell)                                     *

Wendy's

Chicken BLT Salad with Homestyle Garlic Croutons and Honey
  Mustard Dressing                                                    *
Mandarin Chicken Salad with Roasted Almonds, Crispy Rice
  Noodles, and Oriental Sesame Dressing                              **
Spring Mix Salad with Honey-Roasted Pecans and House
  Vinaigrette Dressing                                               **
Taco Supremo Salad with Taco Chips, Sour Cream, and Salsa             *

Ratings include salads plus two ounces of the dressing served with it
(or the lowest fat dressing offered). Salads averaged around 400
calories with condiments.

PHYSICIANS COMMITTEE FOR RESPONSIBLE MEDICINE

RATING SYSTEM

Salads received one star for each of the following healthy attributes.

* 13 or fewer grams of fat

* 4.5 or fewer grams of saturated fat

* 50 or fewer milligrams of cholesterol

* 1000 or fewer milligrams of sodium

* 3 or more grams of fiber

PHYSICIANS COMMITTEE FOR RESPONSIBLE MEDICINE

THE BIGGER PICTURE

The fast-food industry stands accused of adding bucketfuls of fat to the American diet, exacerbating what health experts now call a national obesity epidemic. Facing lawsuits that might conclude with Big Tobacco-sized settlements, it appears the industry's case may receive little help from the salad movement.

Diet-related illness is a critical challenge facing the United States government and health care system at large. According to the Centers for Disease Control, obesity may cause more than 300,000 deaths in the United States each year. The annual cost of related medical expenses? About $100 billion.

An online report from the Surgeon General's office lists some grim reminders of the consequences of carrying excess weight--high blood pressure is twice as common in obese adults compared to normal weight adults, a weight gain of just 11 to 18 pounds doubles the risk for developing type 2 diabetes and women gaining 20 extra pounds by middle age double their risk for postmenopausal breast cancer.

While fast-food giants struggle to strike a balance between profits, customer preferences and better nutrition, consumers will have to look beyond the labels to sort the good from the bad. A Forbes report from market research firm NPD Group found safes of quick-serve salad entrees up 9 percent from last year, indicating that our intentions, at least, are on the right track. Healthy food choices are increasingly in demand, but as busy families know all too well, convenience often reigns supreme. Restaurants that meet the challenge by catering to both of these needs will be lifesavers, in some cases literally.

"For now, I tell my patients this quick rule of thumb," Turner-McGrievy adds. "Move away from heavy dressings, meats and cheeses. Request as many colorful vegetarian foods as restaurants offer and you'll be moving in a much healthier direction."

For more information on the fast-food salad survey, visit the Physicians Committee for Responsible Medicine's Web site, www.pcrm.org.

A STEP IN THE RIGHT DIRECTION

McDonald's restaurants are expanding a program designed to prompt families to incorporate physical fitness into their daily lives, one step at a time. The program, "Step With It!"[TM], developed by The Coca-Cola Company, features "stepometers" (i.e., small pedometers that track the number of steps taken in a day) and encourages participants to increase daily walking to maintain good health. "Step With It!"[TM] also includes educational guidelines and suggestions on how to increase physical activity.

This initiative expands upon Coca-Cola's successful program for middle school children, which was developed in coordination with The National Association for Sport and Physical Education (NASPE) and The President's Challenge Physical Activity and Fitness Awards Program. Now, through the participation of McDonald's restaurants around the world, "Step With It"[TM] will reach millions of consumers, young and old. It is part of McDonald's recently announced "Healthy Lifestyles" activities, designed to help people lead balanced and healthy lifestyles through informed menu choice and variety, education and physical activity promotion.

"McDonald's serves more than 46 million customers each day worldwide," explains Ken Barun, McDonald's Corporation vice president, who leads McDonald's "Healthy Lifestyles" activities. "This reach provides a strong opportunity to educate people about the important role physical activity plays in their overall health and is consistent with the leadership and direction put forth by Tommy Thompson, United States Secretary of the Department of Health and Human Services. Our goal with 'Step With It'[TM] is to make physical activity fun and easy for everyone." The program will be piloted this fall in the United States and will expand to international McDonald's markets in 2004.

Kristine Kieswer is a health writer and editor of Good Medicine magazine. She lives in Richmond, Virginia.

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