Eating out

Take-aways and restaurant foods

When eating out, it can be difficult to find safe and healthy options. Post-transplant, there are certain restaurant foods recipients must be wary of, and this section is designed to help navigate your choices.

Hot foods are safest, while uncooked seafood (sashimi, oysters) and cold cut meats (ham, salami) are risky for transplant recipients.

Sauces and salad dressings containing raw egg products which recipients need to avoid include (but are not limited to) aioli, Caesar salad dressing and hollandaise sauce. Salad dressings can be substituted with lemon juice, balsamic vinegar or pepper; these options also have less calories.

Desserts with uncooked products like raw eggs are risky for recipients and should be avoided. Examples include meringue and tiramisu which contain raw egg whites. Transplant recipients can have cakes, ice cream and fruit-based desserts from the menu instead.

For individualised dietary advice, please speak to your doctor or dietitian.

Fast food

It can be difficult to make healthy choices at a fast food restaurant, as many foods are high in fat, salt and sugar. Some better choices include:

Burgers and wraps: A ‘build your own burger’ or wrap can be a healthy choice. Choose grilled meat, chicken or fish, cheese and plenty of salad. Try to avoid high-fat meats such as bacon or fried/crumbed chicken, battered fish, fried eggs, or creamy sauces like aioli or mayonnaise. Choose tomato sauce, BBQ sauce, chilli sauce or salsa instead.

It’s best to skip chips and nuggets offered with a ‘meal deal.’ Where possible choose water or a diet soft drink instead of juice or full-strength soft drinks.

wrap
chicken salad

Chicken/ fish and chips: Charcoal chicken can be a healthy takeaway option.

Choose salads with lots of vegetables and fresh salad ingredients. Avoid cream-based potato or pasta salads which are high in calories.

You can also serve charcoal chicken with vegetables such as baked potatoes, pumpkin, carrots, peas, corn and beans, or make a wrap at home using charcoal chicken and extra salad.

Grilled fish is the best option; add fresh salad, and if you have to have chips, share them between family/friends. Aim for about ¼ of the plate to be fish, ½ salad and about ¼ chips. Limit battered fish and crumbed seafood (like calamari) and potato scallops which are high in calories.

Asian cuisine, e.g. Chinese, Thai, Vietnamese, Japanese

dumplingsEntrees

Steamed, not fried. Choose steamed or poached dumplings and fresh rice paper rolls rather than fried entrees such as spring rolls.

Soups such as tom yum soup, pho, miso soup, chicken & corn soup, short or long soup are good choices.

Main meals

Choose steamed rice and stir-fry-based main dishes that are high in protein. For example: chicken, beef, pork, prawn or fish stir-fry with vegetables and nuts such as almonds or cashews. It’s good to include one vegetable-based dish when ordering a few dishes with family and friends.

Try to avoid creamy sauces such as satays, coconut milk-based curries or deep-fried dishes such as tempura or katsu-don.

Noodle dishes such as pad thai or pad see eew can also be a good choice when paired with vegetables.

Reminder: recipients should avoid sushi and sashimi options on Japanese menus.

Indian

tandooriIndian foods can be very rich and high in fat. You can choose wisely to make your meal as healthy and nutritious as possible.

Entrees

Many entrees are deep-fried at Indian restaurants. Choose lentil-based or vegetable-based dishes entrees where possible like idly or dhokla.

Main meals

Tandoori items are better for you as these are baked in the tandoor oven rather than fried.

Choose vegetable-based or lentil-based dishes: Indian cuisine has many vegetarian options that are nutritious and lower in fat than creamy/coconut-based meat curries.

Yoghurt (raita) can be used as a way to cool down if your meal is too spicy. Try to avoid having soft drinks or juice with your meal, and stick with water.

Watch the carbs: ¼ of the plate should be rice or bread and the rest should consist of vegetables (about ½ the plate) or protein (about ¼ of the plate).

Roti is a suitable accompaniment. Naan bread is often high in saturated fat.

Lebanese, Mexican and Italian

lebanese foodLebanese food can be very healthy.

Choose lean proteins such as chicken, lamb and beef. Pair these with salads such as tabbouleh or tomato/cucumber salad. Dips such as hommus, babaghanoush or yoghurt can also make the meal tasty.

Be aware that 1 Lebanese bread wrap equals the same number of calories as 4 slices of bread. It’s best to fill up on salads and proteins, and use the bread as a side.

Recipients should avoid ordering kibbeh which consists of minced raw lamb. This dish can also be referred to as kibbeh nayyeh.

tacoMexican can be a great choice for recipients, with plenty of salads and vegetable options available.

Tacos or burritos are a good option with meat, chicken or fish fillings. However, tacos and burritos are often quite high in salt and fat; this comes from the cheese and taco shells if they’re fried. Salad options include lettuce, tomato, carrots, cucumbers, corn, onions and avocado.

Try to avoid toppings like sour cream. Salsa, guacamole and lime juice are tasty alternatives. You can ask for cheese on the side so you can control how much is added.

Italian: Choose a wood-fired or traditional thin-base pizza with mainly vegetable toppings (tomato, capsicum, mushrooms, artichokes, olives, onions, pumpkin, zucchini, spinach, jalapenos, chilli, pineapple). Add meat/seafood for protein (chicken, ground beef, sliced lamb, prawns, mixed seafood, ham).

Limit processed meats like salami, sausages, prosciutto and bacon. Mixed seafood could be a potential source of food poisoning organisms depending upon how long it has been sitting on the pizza.

Bakeries and sandwich shops

Roast beef & Chutney SandwichChoose wholegrain bread, rye bread or a wholemeal wrap. Some bakeries have freshly-made salad sandwiches or rolls which would be a better choice. However, they would not be a healthier option for recipients if they’ve been pre-prepared and sitting on display.

Add lean protein like chicken, sliced beef, tuna, egg, reduced-fat cheese.

Choose plenty of salads for your fillings like lettuce, tomato, carrot, cucumber, beetroot, onions, chargrilled vegetables and mashed avocado for a creamy spread.

Pies and sausage rolls are very high in fat. Try to opt for pies with a meat and vegetable filling like chicken and vegetable; beef tomato & onion or a vegetable pastie.

  • The best options include the ‘6g of fat or less’ sandwich and salad range; wraps and mini subs. Choose fillings such as salad and lean meats (chicken breast, teriyaki chicken, roast beef, turkey) rather than the pizza sub, classic breaded chicken or Italian BMT
  • It’s best to skip the cookie and avoid toasties as these do not contain nutritious fillings
  • Best sauces include BBQ sauce, honey mustard, hot chilli sauce, sweet chilli sauce and tomato sauce. Avoid dressings such as ranch/thousand island and sauces such as chipotle southwest or garlic aioli

Acknowledgements

Transplant Australia gratefully acknowledges the Department of Nutrition & Dietetics at The Children’s Hospital at Westmead as the authors of this article and Helen Vidot, Specialist Dietitian, Liver Disease and Transplantation at the Royal Prince Alfred Hospital for additional comments and input.