You sit down to dinner at your favorite restaurant, peruse the menu options, and then order grilled swordfish marinated in herbs and olive oil, sauteed vegetables, and a dinner salad with Italian dressing. The waiter brings a basket of fresh baked bread with garlic butter, which you enjoy while sipping a glass of wine.  

Seems like a fairly healthy meal, except that it's loaded with hidden calories, fat, cholesterol and sodium. Can something that sounds so good really be so bad?

“It's a challenge for consumers when they go to restaurants. They think they're ordering something healthy, but in reality, it's often not very healthy at all,” says Susan Goldstein, the Orange County regional director for the book, "Healthy Dining in Orange County," a guide to health-conscious cuisine featuring healthy menu items from dozens of local restaurants.

“Each restaurant prepares their dishes differently – different recipes, different quantities, different presentations,” adds Goldstein. “Two restaurants may have the identical dish, but they could be very different in their nutrition content. When you cook at home, you know what you're putting in your food and how much you're putting in, but that changes when you go out to dine.”

NUMBERS (diners and calories)

Goldstein says Americans are dining out in greater numbers than ever before, and more of them want healthy cuisine. “Everyone is either eating healthier, trying to eat healthier, wants to eat healthier, or knows someone who is eating healthier.”  

Healthy dining is a matter of using common sense, and learning a few basic concepts to help maneuver through the menu maze. Appearances can be deceiving; so too are menu descriptions. Unless you're dining at a restaurant that actually provides nutritional content on the menu, making a healthy selection is harder than it looks. Some restaurants base their reputations on providing decadent delights, but now more diners prefer to make their meal a healthy one whenever possible, which usually means scanning a menu and reading between the lines.

A delicious chicken entrée can be deadly for your diet with the addition of cream sauces; fish can be foul when it's cooked with too much oil; and pasta is a poor choice when it's heaped with Alfredo or marinara sauce. Even vegetables can turn ugly when sautéed in butter and broth.

Fortunately, you don't have to go far to find a healthy restaurant meal. Thanks to repeat requests for healthier dining choices, many restaurateurs have responded by altering recipes and offering nutritional information on their menus. Creative chefs are concocting exotic dishes that meet the health needs of consumers while satisfying demanding taste buds.

“Restaurants have been challenged to offer healthy dining options, and they have risen to that challenge and come up with flavorful, healthy, beautiful looking dishes,” say Goldstein.

ASK THE TABLE EXPERT

You can help take the guesswork out of ordering healthy by asking your waiter or waitress how certain dishes are prepared. If they don't know, they can ask the chef. After all, this is your meal, not theirs, so you deserve to know how your food is cooked. And many restaurants will make substitutions, so don't think you are limited by the menu description. For example, don't be afraid to order dressings or toppings on the side. That way, you control the amount.

“There is more interest on the part of the consumer to ask questions and interact with servers and other restaurant staff,” says Goldstein. “Restaurants know this is an important part of their business, and want to be able to accommodate their guests.”

Goldstein regularly visits restaurants and talks to the staff about nutrition and how to turn certain dishes on their menu into healthy dining options. She says the restaurant staff is always excited to learn how they can offer their guests a range of options.

“They are there to serve the customer, and superior customer service is a big part of what restaurants try to achieve, so this ties into all of that. It's a new way of doing business.”

TIPS FOR THE MENU

Whether you dine in the corner coffee shop for breakfast or at a four-star restaurant for dinner, there are ways to make sure you get the most nutrition for your money.

Della Lisi, health education associate for the Orange County Health Care Agency, eats out frequently and says restaurants are usually willing to accommodate her dietary requests.

In Italian restaurants, for example, Lisi has a salad with spices and lemon juice sprinkled on top, or orders pasta primavera minus the pasta and adds an order of shrimp. In a Mexican restaurant, she will order a shrimp fajita without the tortilla, and extra salsa. Hold the chips.  

Sometimes, eating healthy means minimizing the damage. Here are a few basic guidelines that Lisi says will help consumers eat out and stay healthy.

BREAKFAST

A traditional country-style breakfast is just the thing for clogging arteries, so use common sense and skip the cholesterol product. You'll still enjoy your meal, and live to tell about it. If you want an egg dish, use an egg substitute (most restaurants offer this). Skip the hash browns, sausage, ham, bacon and anything else that looks either fried or fatty. Order a garden-style omelet, and when possible use feta cheese. It has 1/3 less fat than cheddar. If you need a treat, have 2 pieces of bacon, less than half the fat of a piece of sausage. Pancakes are OK; they have about 5 grams of fat apiece, before butter and syrup. Skip the butter (12 grams of fat per tablespoon) and use low-fat syrup or jam. Same for the toast. A fruit cup is always a safe bet.

LUNCH

Ever wonder why you feel sleepy in the afternoon? It probably has something to do with your carbohydrate-laden lunch. Skip the all-you-can-eat lunch specials, avoid the burger joints, and keep it simple: try a chicken or turkey sandwich on wheat bread with lettuce and tomato (hold the mayo and cheese and use mustard instead), low-fat cottage cheese and fruit instead of French fries, and ice tea instead of a soft drink. Beware of salad bars. It's easy to add terrible toppings or drench a salad in fatty dressings, which can turn a dream meal into an unhealthy nightmare.

DINNER

This is where the damage control often comes into play. You can do well with Italian food, as long as you know which dishes are hiding the most fat. Skip the antipasta and the bread sticks and go for a salad with dressing on the side, Linguine with red clam sauce (much better than the rich white sauce), or a chicken dish that is not fried or cooked in too much oil. Despite its reputation, Mexican food offers even easier healthy dining options. Skip the chips and refried beans and go for the chicken and bean (whole beans) burrito with sauce and no cheese, or a soft chicken or fish taco with white rice and whole beans. Or try a chicken fajita minus the cheese. A seafood restaurant is usually a terrific choice, as long as your fish is baked or broiled and not battered and fried. But even then, find out how much oil is used during preparation. For accoutrements, ask for veggies, not fries or a baked potato with sour cream, and beware of the bread basket.

Christopher Trela is a regular contributor to Churm Publishing, Inc.