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Second Opinion: “Heartbreakers of Chain Restaurants” Lose on Both Quantity and Quality

Last week, New York Times health columnist Jane Brody examined the nutrition at popular restaurants in “The Heartbreakers at Chain Restaurants.” Brody found that MacDonald’s didn’t even make the cut as one of the worst offenders in terms of caloric, fat and sodium density in their food. Many other chains were bigger offenders: Cheesecake Factory, Chile’s and Ruby Tuesday.

Brody’s reporting focused on the quantity of food such as The Cheesecake Factory’s breakfast burrito, a “warm tortilla filled with scrambled eggs, bacon, chicken chorizo, cheese, crispy potatoes, avocado, peppers and onions, over spicy ranchero sauce.” This belt-buster contains an alarming 2,730 calories, 4,630 milligrams of sodium and 73 grams of saturated fat – values that are recommended to be consumed over the course of an entire day or more.


Calorie packed meals are bound to add inches to America’s waistline and contribute to the growing obesity crisis. But even though some of these offenders are now trying to decrease the calorie content in their meals -- albeit to levels still well above what’s required in a single serving --- the missing piece of this discussion is that the food misses the mark in terms of nutritional quality, even in a smaller quantity.

What types of food does our body need more and less of on a daily basis? National and global health organizations, such as the National Institute of Health, The World Health Organizations and the Centers for Disease Control and Prevention, concur or what constituted an optimal diet – a whole foods plant-based diet. Does that mean you have to go vegan to improve your health? While studies have shown that the mortality risk among vegetarians is lower than meat eaters, eating a whole foods plant-based diet is not a mandate to give up meat. Instead, we need to take a critical look at the volume of animal fats and proteins in the western diet and see if we can make meaningful reductions. Can we do a meatless Monday? Or commit to avoiding animal products in two of three meals each day?

Equally as important is whether we can dramatically increase the amount of fruits and vegetables we eat each day. Fruits and vegetables are the primary source of disease fighting nutrients to prevent virtually all common chronic conditions including heart disease, diabetes and even cancer. And yet, the according to the CDC, only one in 10 Americans eat the daily recommended daily intake of 5 fruits and vegetables. The catch-22 is that if we’re not eating the fruits and vegetables, the least calorie dense foods available, we’re likely replacing it with nutrient poor but calorie dense food. And that means we’re contributing to the skyrocketing incidence of obesity and incidence type 2 diabetes.

At Blue Shield of California, we offer a Diabetes Prevention Program as a benefit to all members who are at risk for getting type 2 diabetes. Members can see if they are at risk by taking a 1-minute quiz at If eligible, they can choose from in-person programs such as weight watcher, or digital programs such as Health Slate or Retrofit. All programs provide tools that our members need to incorporate a whole foods plant-based diet and lose weight to prevent diabetes.

  • After a year and a half, our Diabetes Prevention Program has nearly 18,000 enrolled members, and an average weight loss of about 3.5 percent for those completing the program. This accounts for a 38 percent reduction in diabetes risk, and all with only the positive side effects of better health.
  • If a person who is pre-diabetic can lose 5 percent to 7 percent of their body weight, they could mitigate their risk of ever becoming diabetic at all.
  • The cost for a member to go through our Diabetes Prevention Program is less than $1,000 versus an average of $80,000 to $100,000 for treating a diabetic patient. Plus, it avoids having to draw blood several times a day to check glucose levels, or the horrific side effect many diabetics face of potentially needing to amputate their hands or toes due to their illness.

We also offer the Ornish heart disease reversal program, an in-person hospital-based intervention that guides patients diagnosed with heart disease in reversing their condition through diet and lifestyle. Again – a whole foods plant-based diet approach is prescribed – encouraging participants to eat a wide array and volume of fruits and vegetables.

And here’s how we’ve performed:

  • PET scans of heart disease patients, before and after a nine-week lifestyle medicine intervention, showed significant improvement in blood flow, decreased arterial blockage and reversal of heart disease.
  • The cost of going through our undo-it with Ornish heart disease reversal program is approximately $10,000 compared to $1.4 million for a heart transplant, which will only last about 11 years on average.

Americans on average eat about 1/3 of their meals outside the home – which means if we want to optimize our health we need to careful about what we choose. Seems like it might be in our best interests to just walk past the fast food eatery and opt to take a stroll into the produce aisle at the supermarket.