Restaurants have become more accommodating of dietary restrictions, but it’s still tough with diabetes or hypertension

As awareness has risen of conditions like celiac disease, it’s become relatively easy to avoid gluten. But avoiding sugar is still difficult, and salt is even harder.


Illustration by Kyle Ellingson

Like a lot of people, I love eating. It’s my favorite hobby after sleeping. In fact, I am a professional food lover, one of those blessed souls who get to dine out and write about it—or at least I used to be.

For a while I turned it into a joke. “I’m a food critic who is diabetic and lactose intolerant,” I would say, explaining to some chef or another why I wasn’t going to try their cheesecake. Unfortunately, as I continue to evolve into my ultimate form as a cranky old lady, I keep adding new and exciting medical problems with new and very tiresome things I am not allowed to eat. Currently on the “no” list: sugar in any form, bovine dairy products, and salt.

“I’m not saying you can never eat out again,” my doctor told me. Of course not, I told myself. I’ll just research restaurant menus and find out what I can eat. Spoiler alert: salad. But beware the dressings, cheeses, croutons, dried fruit (added sugar), sunflower seeds (usually salted), and, of course, candied nuts.

As awareness has risen of conditions like celiac disease, it’s become relatively easy to avoid gluten. There are entire bakeries devoted to gluten-free baked goods, like Hell Yeah Gluten Free in Inman Park. Still, only 1 percent of the U.S. population has celiac disease; there are no good numbers on gluten sensitivity, but that’s estimated at about 6 percent. By contrast, more than 10 percent of the population has diabetes, and a whopping 47 percent of U.S. adults have hypertension.

But avoiding sugar, which is not only in desserts but in many sauces, is quite difficult. And avoiding salt is nearly impossible: Prepared and processed food, my doctor explained, inevitably has too much. Any restaurant that premakes its sauces, marinades, or batters—which is to say, almost every restaurant—is likely to serve you more sodium per meal than you should eat in a day. Chains are worse, probably, but hardly the only contributors to the problem.

Arguably, the ubiquity of sugar and salt in our diet is part of the reason why that hypertension number is so high. The problem is that attempts to replace them tend to meet with mixed results. Most sugar substitutes have an unpleasant bitter aftertaste when baked, and the ones that don’t can be expensive. A few bakeries—Zambawango in Sandy Springs, Baker Dude on the Westside—do make low-carb desserts, and Decatur’s Southern Sweets Bakery will make sugar-free cakes if you order ahead. None of them do dairy-free as well, alas.

Salt is an even bigger problem.

“Salt is hard,” acknowledged Julia Kesler Imerman, owner of Daily Chew. “It’s in how chefs are trained: salt, fat, acid, heat. Salt literally changes the chemistry of the food.” It’s the thing that gives food its flavor, presenting a challenge to chefs and restaurant owners: “We want our customers to come back. We want our food to taste good,” Imerman said.

If you can live with the amount of salt that’s inevitably in bread, that expands your options. In Vine City, Local Green has an excellent vegan, vegetarian, and pescatarian menu—shrimp burgers, barbecue jackfruit sandwiches, and more—that was created with the prevalence of diabetes and hypertension, especially among Black people, in mind. And after talking to my server at Shorty’s pizzeria in Tucker about the ingredients in their white sauce (garlic and oil), I ordered a white pizza with goat cheese, basil, tomatoes—no extra salt.

Another option for diners minding their diets: Go upscale. “Fine dining might be the easier way to go to be confident that you’re not getting something that you don’t want,” said Frances Quatrano, the general manager of Bacchanalia. “We always prepare everything to order, and we know where things are hiding.” The restaurant spends a lot of time educating its staff about ingredients, Quatrano says, and people are always asked when they sit down if they have any dietary restrictions. Plus, nothing is presalted except for stock—and there is always an alternative way to prepare something. This extends to dessert: Quatrano’s assurances that pastry chef Carla Tomasko can and will produce a sugar-free, dairy-free cake means I know what I want for my birthday. Every year. From now on.

Planning ahead also helps, says Poorvi Chordia, a faculty member at Morehouse School of Medicine (and the owner of Herbs & Kettles, which sells single-origin teas from India). As a vegetarian who loves to eat at places like Talat Market and Kamayan ATL, Chordia is used to calling ahead to make sure that she can get versions of dishes without fish sauce or other meat-based ingredients. “I try to call when the chef is going to be there, so I can talk about what is in the food,” Chordia said.

Whether on the high end, like Bacchanalia, or more modest, a restaurant that cooks to order is pretty much essential, especially if you have multiple things you need to avoid. But if you’re trapped somewhere surrounded by bacon, premade batter, and sauce out of a can, remember that scrambled eggs are always made à la minute, and that only a scoundrel presalts fruit. What you do on your own plate is between you and God.

This article appears in our July 2023 issue.