There are two laws in the universe, playwright Neil Simon once said: the law of gravity, and everyone likes Italian food. And he was right — who could turn down a savory lasagna or a creamy bowl of fettuccini Alfredo? When it comes to healthy eating, though, a delicious meal at an Italian restaurant can pose some challenges.

Many dishes found at Italian restaurants are loaded with sodium, saturated fats and refined carbohydrates, which can contribute to chronic illnesses like heart disease, hypertension and Type 2 diabetes. But when you know what to order, Italian food can also be beneficial to your health.

Italian food, Italian style

Paige Macauley

“The dishes we find in many Italian restaurants are Americanized versions of Italian food — pizza and lasagna,” said Paige Macauley, a registered dietitian at CoreLife Novant Health in Kernersville. “If we go to Italy, we may find versions of those foods. But we’d also find a variety of different flavors and textures.”

That variety is at the heart of Italy’s traditional cuisine, which naturally aligns with the Mediterranean diet, according to Macauley. A far cry from Italian-American restaurant favorites like pepperoni pizza and spaghetti with meatballs, a truly Italian dining experience includes a bounty of delicious, nutrient-dense foods, including:

  • Seasonal fruits and vegetables.
  • Whole grains, beans and legumes.
  • Abundant seafood and lean poultry.
  • Low-fat dairy, including yogurt, feta cheese and mozzarella.
  • Olive oil, nuts, seeds and other healthy fats.
  • Infrequent, moderate portions of red meat.
  • Nutrient-packed herbs and spices.

Of course, pasta really is popular in Italy, but it seldom forms the main course. And any meatballs you encounter are likely to be served as a side dish, rather than nestled in a mound of spaghetti under a blanket of sauce and cheese as an entree. Italian cooks also tend to use sauces, butter and garlic more sparingly, focusing instead on simpler dishes made with farm-fresh ingredients served in moderate portions, often with a glass of wine.

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You can do it

“Red wine is really rich in antioxidants,” Macauley said. “Its benefits are recognized in the Mediterranean diet and by the American Heart Association. A moderate-to-low amount — one 5-ounce glass a night for women, and up to two for men — can be really heart-healthy.”

Planning to visit an Italian restaurant soon? Whether your favorite is a small mom-and-pop place or a national chain, you can enjoy your favorites stress-free with Macauley’s suggestions:

1. Go easy on the bread

“It’s not that bread or carbs are a bad thing, but if you're really excited for your favorite meal, and then automatically fill up on bread, you almost lose out on your meal,” Macauley said.

Consider asking the server not to bring a bread basket, or to remove it after you’ve enjoyed a slice to avoid mindless eating. Another option is to order bruschetta — toasted bread smothered with tomatoes and other herbs and vegetables — as an appetizer.

“It allows you to still get the crunch and the warmth of your bread, but with a lot more color, a lot more fiber.”

2. Opt for red sauces

Because Alfredo and vodka/pink sauces are made with heavy cream, they are high in both calories and saturated fat. Pesto is a more heart-healthy option but also comes with a high calorie count. To keep things light, Macauley suggests sticking with plant-based red sauces.

“Marinara and other tomato-based sauces are made from produce — tomato puree or crushed tomatoes with a little oil, broth or even wine,” she said. “So they’re a lighter, fiber-full option.”

3. Keep an eye on olive oil
Olive oil, an essential element of the Mediterranean Diet, is heart healthy, contains antioxidants and anti-inflammatory agents and is a source of vitamins E and K. But, like other fats, it is also a high-calorie food (about 125 calories per tablespoon).

Dining at an Italian restaurant often involves a lot of olive oil, both at the table and in the kitchen, so it’s easy to take in hundreds of hidden calories. To reduce your fat intake, consider using just lemon juice or balsamic vinegar on your salad, order steamed (instead of sautéed) vegetables and ask the kitchen staff to go easy on the oil when prepping your meal.

4. Pass (on) the salt

It’s no secret that restaurant foods can contain unhealthy amounts of sodium. At one popular Italian-American restaurant chain, appetizers like fried mozzarella with marinara or spinach and artichoke dip with flatbread crisps contain more than 2,000 milligrams of sodium. That’s almost as much as the maximum daily intake (2,300 milligrams) recommended by the U.S. Department of Health and Human Services.

“If you’re paying attention to heart health or your blood pressure, it’s OK to ask your server to tell the kitchen staff not to add extra salt to your food,” Macauley said. “If you don't advocate for yourself, nobody else will.”

5. Quality over quantity

Faced with a huge plate of calorie-dense, creamy or cheesy foods? Keep portion size in mind. For example, an order of lasagna is often as big as the plate it’s served on. To lighten things up, put half the lasagna in a to-go box (ask for one when you order) and enjoy it with a salad.

“You’ll still get all the flavor, warmth and heartiness of the lasagna,” Macauley said. “And with that salad, you’ll have a full plate. All those colors, all that texture — it’s a more well-balanced meal.”

6. Quit the clean-plate club

If you find yourself feeling satisfied before your meal is finished, give yourself permission to stop eating.

“Be comfortable leaving food on your plate. As Americans, that can be a hard concept for us to understand,” Macauley said. “If you don’t want to waste money, grab a to-go box and bring it home for lunch the next day.”

7. Avoid skipping meals earlier in the day

Any time you’re planning to go out for a big meal, Macauley recommends eating breakfast and lunch, rather than skipping meals to build your appetite or save calories. Arriving at the restaurant feeling famished just makes it harder to make healthy decisions.

“You really want to be sure you’re fueling your body through the day, going about business as usual,” she said. “While it’s not something you’re cooking at home, at the end of the day it’s just another meal.”

8. Embrace the experience

Special meals are a communal event. We gather around the table and enjoy the food, but the real focus is on the people around you. So, instead of stressing about what you choose to eat or not eat, focus on being present in the moment and enjoying the company. And if you do overindulge? Let it go.

“Make sure not to be too hard on yourself,” Macauley said. “If you feel like you went overboard at any point, just start over.”