Nutrition Action Healthletter
Jan/Feb 1994 — U.S. Edition

When in Rome...

The next time you reach for the dinner menu at your favorite Italian eatery, consider this:

Order Fettuccine Alfredo and you stuff your arteries with as much saturated fat as three pints of Breyer's Butter Almond ice cream. Have Eggplant Parmigiana and you might as well devour five egg rolls. Eat an order of Fried Calamari as an appetizer and you down more cholesterol than a four-egg omelet.

What's going on here? Isn't Italian food supposed to be healthy? It is . . . in Italy. And it can be here, too, as we discovered when we recently analyzed Italian restaurant food. You can boil our results down to one word: pasta.

For generations, Southern Italians ate mostly pasta, bread, beans, vegetables, fruit, and olive oil. Even though that's now changing, they still have far lower rates of heart disease, colon cancer, and obesity than Americans. Meat and cheese are used almost as condiments (not so in the North, where heart disease and cancer are more common). Unfortunately, we found that American Italian food is more like Northern than Southern.

Following the same game plan we used in our analysis of Chinese restaurant food, we bought dinner-size take-out portions of 15 popular dishes at 21 mid-priced Italian restaurants in New York, Chicago, and San Francisco. Then we shipped them to an independent laboratory to be analyzed for calories, fat, saturated fat, cholesterol, and sodium. (We didn't do pizza, because it's more like a fast food.)

Pasta Perfect

What rice does for Chinese food, pasta does for Italian. It cuts the fat. Order an entree that's largely made of a pasta like spaghetti or linguini and you'll likely stay below the 30 percent of calories from fat that many health authorities recommend. (We say 20 percent.) It can be a tomato sauce or a clam sauce. You can have meat sauce or meatballs. Even adding sausage only bumps the fat to about 35 percent of calories. The only exception is a cream-and-cheese based sauce like an "Alfredo."

The same holds true for artery-clogging saturated fat. Many experts recommend keeping sat fat below ten percent of calories. (We say seven percent.) Except for Fettucini Alfredo, no spaghetti-based dish topped nine percent. That's not nearly as low as Chinese food, but it puts standard American fare to shame. So why not add a side order of spaghetti with tomato sauce to fattier dishes like Eggplant Parmigiana? Many restaurants do. (And we did, too, in ranking all the non-pasta entrees.) Sure enough, add a typical 1 -cup portion of spaghetti to the eggplant and you cut its fat from about 60 percent of calories to about 45.

Better yet, order at least one spaghetti based dish for every meat-or-cheese based entree and divvy up the fat, excuse us, the food among the diners.

Not Veggie Good

It's a relief to know that you can find lowfat entrees at Italian restaurants, but that's not the whole ballgame. Most entrees supply at least 1,500 mg of sodium, making it tough to stay under your 1,800 to 2,400 mg daily limit. What's worse is that many people don't eat vegetables at Italian restaurants. At Chinese restaurants, it's easy to order a plateful of fresh cooked veggies to split or eat as your own entree.

At Italian eateries, only the meat, chicken, or fish typically comes with vegetables on the side. And even then, it's usually less than a cup and coated with oil or butter. Side salads are more common. But they're mostly iceberg lettuce with bits of shredded carrot, red cabbage, and tomato. Add a typical two tablespoon serving of ordinary Italian dressing and you get a quarter of a day's worth of fat.

That's more damage than the vegetables are worth.

The Numbers Please

So here's the scoop on the dishes we analyzed. We can't guarantee that you'll get exactly the same at your local restaurant, but no one (as far as we know) has better information. We've ranked the dishes from lowest to highest percent of calories from fat.

That way they're not subject to the portion size your restaurant serves. But pay attention to the grams of fat, too. Aim for no more than 45 to 65 a day. And don't forget to add two grams of fat and one gram of saturated fat for every tablespoon of Parmesan cheese you sprinkle on. The percent of calories from fat and grams of fat in each dish are in parentheses following the name.

Main Dishes

1. Spaghetti with Tomato Sauce (18%, 17g fat). About half the tomato sauces we tested were made with meat stock. A (meatless) marinara sauce might have even less fat.

2. Linguini with Red Clam Sauce (23%, 23 g fat). Only four percent of calories from sat fat (wow!), but almost a day's worth of sodium (oof!).

3. Spaghetti with Meat Sauce (25%, 25 g fat). Not bad, because all that pasta overwhelms the three to four ounces of greasy ground beef.

4. Linguini with White Clam Sauce (29%, 29 g fat). With only five percent of its calories from saturated fat, it's a good alternative if you're all "tomatoed" out.

5. Spaghetti with Meatballs (30%, 39 g fat). Expect about a third more meat than you'd get with meat sauce.

Make it Better: Ask for your meatballs in a tomato sauce instead of a fattier meat sauce.

6. Chicken Marsala with a side of spaghetti (34%, 33 g fat). Why would the (usually) skinless chicken breasts alone supply 25 grams of fat? Must be the oil or butter that's typically added to the marsala wine in the sauce.

Make it Better: Skimp on the sauce.

7. Spaghetti with Sausage (34%, 39 g fat). Three times more pasta than fatty Italian sausage explains why this dish ends up with a reasonable nine percent of calories from saturated fat. It'll cost you more than 1,000 calories and 2,400 mg of sodium, though.

Make it Better: Order the sausage in tomato sauce.

8. Veal Parmigiana with a side of spaghetti (37%, 44 g fat). Think veal is heart-healthy? How does more than two-thirds of a day's fat, saturated fat, and cholesterol grab you?

Make it Better: Skip the cheese topping and you cut a quarter of the fat.

9. Cheese Ravioli (38%, 26 g fat). Much of the saturated fat comes from the three ounces of cheese. That's half a day's worth. . . but still about a third of what you'd get in an order of Cheese Manicotti.

10. Eggplant Parmigiana with a side of spaghetti (46%, 62 g fat). And you thought eggplant was a health food? We figure that a quarter of the fat comes from the mozzarella cheese topping and the rest from the oil that the fried, breaded eggplant soaks up like a sponge.

Make it Better: Ask for no cheese and you'd cut the sat fat by almost two-thirds.

11. Cheese Manicotti (49%, 38 g fat). Almost half a pound of cheese supplies three-quarters of the sat fat you should eat in a day. About what you'd get in three glasses of whole milk.

Make it Better: Skip the cheese topping and you'll cut the sat fat by a quarter.

12. Lasagna (50%, 53 g fat). All that meat and cheese means a day's worth of saturated fat. Put another way, it's more than two Big Macs.

Make it Better: Skip the cheese topping. Better yet, skip the lasagna.

13. Fettucini Alfredo (58%, 97 g fat). The worst dish you can buy. But what do you expect from cream, butter, Parmesan cheese, and, in a third of the restaurants we looked at, eggs? Its 47 grams of artery-clogging saturated fat are more than twice your daily limit. (Lest you take leave of your senses and eat five McDonald's Quarter Pounders.)

Make it Better: See if your cardiologist is on call before you order

Olive Gardening

It's the only national Italian restaurant chain, it's owned by General Mills, it gives out nutrition information to inquiring diners. . .and we still can't tell you what's in the food. The Olive Garden has more than 370 restaurants in the U.S. and Canada, three times what it had just four years ago. Sales were projected to top $1 billion in 1993. Despite this success and its link to a cereal-maker parent with a laboratory of its own, the restaurant has no analyses of what's on its menu. All it has, according to a spokesperson, are calculations and estimates based on recipes that are "outdated based on changes in our recipes."

But that hasn't stopped Olive Garden from handing out calorie, fat, cholesterol, and sodium numbers to curious diners. Or from tagging some of its dishes "GF" (Garden Fare), "for guests concerned with calories, fat and cholesterol."

The company says that a "worst case scenario" for a "GF" entree is 500 calories, 30 grams of fat, and 140 milligrams of cholesterol. Half a day's fat and cholesterol in only a quarter of a day's calories, and that's using serving sizes that are much smaller than what we were served at Olive Gardens in three cities. In short, "GF" could mean anything from "Good Food" to "Gobs of Fat." We'd ignore it. Most of Olive Garden's calculations were reasonably close to our laboratory results from other restaurants.

Here's the lowdown on some popular Olive Garden dishes:

  • Garden Salad & Side Dishes. To its credit, Olive Garden offers unlimited salad or soup with all entrees. Ask for half the dressing and it's an offer you can't refuse. Another plus: A side of spaghetti (or vegetables) comes with most dishes.

  • Garlic Breadsticks. Slathered with margarine and garlic salt. Order them plain.

  • Minestrone Soup. Chock-full of vegetables. If it's as low in fat and sodium as Olive Garden says, it's a good opener.

  • Pasta E Fagioli. Ground beef mars this otherwise perfectly good bean (fagioli) and pasta soup. Other restaurants may use a beef stock, which means a little less fat.

  • Veal Marsala. Breaded and fried before being sauteed in wine and mushrooms. Watch out.

  • Veal Piccata. "Tender medallions of naturally raised veal sauteed with capers, mushrooms, and fresh lemon." Guess there wasn't enough room on the menu to say "Sauteed in pools of oil with capers...."

  • Venetian Grilled Chicken. Grilled skinless chicken breasts topped with marinara sauce. Should be low in fat.


1. Garlic Bread (44%, 40 g fat). Most restaurants told us that an eight-ounce serving is meant for one person. The equivalent of seven slices of Wonder bread seems like a lot to us, though the 40 grams of fat come from the butter (almost half a stick) or olive oil (nine teaspoons) and, in some restaurants, Parmesan cheese.

Make it Better: Order plain Italian bread.

2. Fried Calamari (61%, 70 g fat). Most of the outrageous 70 grams of fat comes from the deep-fried breading, but you can thank the squid for the three-day supply of cholesterol. The restaurants say a portion serves just one, but even half is enough to make your arteries quiver.

Make it Better: Share it with your table, nearby tables, the waiter....

3. Antipasto (67%, 47 g fat). After weighing the components which include meats, cheeses, and marinated vegetables, plus dressing, lettuce, and tomato we estimate that if you eat the whole lollapalooza (as the restaurants claim) you end up with three-quarters of the fat and saturated fat and all (or more) of the sodium you should eat in an entire day.

Make it Better: Split it with three others. Ask for dressing on the side and use just a touch, or use vinegar instead.

What's A Serving?

We got it by measuring the portions we were served at each restaurant. If you eat less, you'll get less fat, etc. A portion was considered a serving for one (we checked with the restaurants first), except in two New York platter-style restaurants, which told us that a portion serves at least two. (Their portions did weigh about twice what other restaurants served us.)

Italian vs. Chinese

How do these dishes compare to the Chinese food we analyzed? Chinese is generally lower in saturated fat. Other than that, it depends on what you order. A low-fat Chinese entree like Szechuan Shrimp or Stir-Fried Vegetables, for example, has about as much fat as Spaghetti with Tomato Sauce or Linguini with Red Clam Sauce. But no Chinese dish was as life-threatening as Fettucini Alfredo. Even Kung Pao Chicken's 76 grams of fat paled in comparison to Alfredo's 97 grams. And the Fettucini quadrupled Kung Pao's saturated fat as it may quadruple your next bypass. Even the lower-fat entrees had too much sodium. Dishes are ranked from lowest to highest percent of calories from fat, but watch out. When entrees were served to us with a side order of spaghetti with tomato sauce, we included the pasta (which averaged 1 cups) in determining our rankings. That may have dramatically lowered a dish's percent of calories from fat, so check grams of fat as well.

Analyses done at Lancaster Laboratories (Lancaster, Pennsylvania). The use of information from this article for commercial purposes is prohibited without written permission from CSPI. CSPl 's Juliann Goldman coordinated the food testing. Gary Beecher and Joanne Holden of the USDA's Nutrition composition Laboratory in Beltsville, Maryland, provided invaluable technical advice, as well as the use of their lab.

Nutrition Action Healthletter