A magazine for friends of the Warren Alpert Medical School of Brown University.

Food in the 401


Your favorite Rhode Island foods don’t have to sink your diet.

For a small state, Rhode Island has an outsize number of iconic foods. While they may be mouthwatering, those heaping platters of fried seafood, fully loaded hot wieners, and Texas-sized slabs of chocolate cake hardly qualify as healthy.

Does that mean they’re off limits to dieters? No way, says Carly Goldstein, PhD. A clinical psychologist at The Miriam Hospital’s Weight Control and Diabetes Research Center, Goldstein works with cardiac rehabilitation patients to help them lose weight and stick to their goals. And deprivation, she says, does not help.

“In our culture, food is such a part of how we socialize and celebrate things,” Goldstein says. But telling a patient that they can only have the side salad at their favorite seaside clam shack “further reinforces the idea that you can either live your life or you can pursue a healthy lifestyle, and they are mutually exclusive.”

Goldstein, who’s an assistant professor of psychiatry and human behavior at the Warren Alpert Medical School, specializes in developing programs that patients use online or on their smartphones, including games and virtual meetings. She recommends apps to track metrics like calories, salt, and exercise.

One of her online classes helps patients eat healthy within their culture. To navigate the carb-heavy cuisines of Portugal and Italy, for example, Goldstein advises them to pick just one carb per meal. When eating family style, she suggests they dish out their portion on the first pass, rather than picking at it throughout the meal—a recipe for overeating. She tells patients that if they plan ahead, and treat their daily nutrition like a bank account, they may find room in the budget for a clam cake here or a coffee cabinet there.

“Your life should be filled with foods that are delicious, that you find enjoyable,” she says. “It’s about making healthy choices and keeping the big goals in mind.”

Goldstein reviewed the menus at some of Rhode Island’s favorite restaurants and found that, with some strategizing, most healthy diets can forgive a few sins.


The official state appetizer is just 12 calories a pop. But “it’s the size of a quarter,” Goldstein points out. And who eats just one? So when that platter of deep-fried squid lands on your table, “You could say, I’m willing to allot 120 calories to calamari, and you pick out 10,” she says. “And then pass it.” Just don’t let it land back in front of you.

Calamari, fried clams, and other small pieces of seafood are easy to portion out because you can count them. What about fish that’s served in bigger pieces? “You’re not going to bring measuring cups with you. You’re not going to be whipping out your food scale,” Goldstein acknowledges. But she has some tricks. “For example, one portion of protein is about the size of the palm of your hand, not including your fingers, or the size of a deck of cards.”

You can get a head’s up on portion sizes and other details about a dish by checking out photos that previous diners have posted in online reviews. If it looks like way more than one serving, avoid temptation by asking your server to put at least half of it “in a to-go box when you order it, so they don’t even put it on the plate,” Goldstein says.


“The lobster isn’t the problem,” Goldstein says: according to the FDA, there’s just 80 calories in 3 ounces, barely any fat, and lots of protein. But the meat is usually mixed with mayonnaise or butter, and “it’s really hard to know how much is going to be on there … so you’re sort of going in blind,” she says. On top of that, “usually the rolls are grilled and brushed with butter.”

Goldstein recommends asking how it’s prepared; call or email ahead if you worry about holding up a long line with questions. “They want the customer to be satisfied,” she notes. “You’re probably not the first person [to ask about a menu item]. You won’t be the last.”

Since small restaurants like your local clam shack don’t have to post nutrition info, Goldstein checks national chains’ websites. Lobster rolls she found online ranged from 600 to 1,440 calories per sandwich, and 34 to 98 grams of fat. “I’m not saying don’t eat that,” she says. Ask a friend to split it with you; balance your meal with a salad or other healthy side. “We want to pick things that seem pleasurable,” she says, “and also get the joy of knowing that we’re sticking to our plans.”


Some online sleuthing turned up calorie counts in the 140 to 190 range for one serving of stuffed clam, which is half a quahog shell. Not too bad—but “are you going to be full on this much food? No, of course not,” Goldstein says. There are also fat, carbs, and salt that some people have to monitor.

On the plus side, stuffies have lots of protein. “A lot of the foods that we love in this state are higher protein because so many are seafood based,” Goldstein says. “That’s a real strength of local culture.”

So plan what else you’ll eat to round out your meal. And Goldstein always recommends asking yourself where the food you’re craving ranks on your list of favorites. If stuffies are tops, she says, “this might be totally worth accommodating.”


The old-fashioned, family-style chicken dinner is a Rhode Island institution, but the all-you-can-eat format can derail health goals. With some planning, though, it is possible to enjoy your meal without guilt.

The first step is portion control. “When chicken is on bones, it’s a lot harder to know exactly how much you’re eating,” Goldstein says. To gauge a serving more accurately, “ask for an extra bowl and pick it off the bones, and then put it on your plate.” It’s baked with oil and salt, so you may need to mind fat and sodium intake along with calories.

Then there are the side dishes. Load up on salad—but ask for the dressing on the side; a serving size is usually two tablespoons. If you’re concerned about ingredients like salt or sugar, request olive oil and vinegar and dress the salad yourself (just be judicious with the oil). Goldstein suggests asking for spices, too, “to give it some flavor. They’re happy to give that to you. It costs them, what, a cent? And you’re thrilled and you’re going to tip better. It all works out.”

As for the bread, french fries, and pasta on the table, Goldstein advises, “Use your calories wisely.” Make conscious choices by ranking your favorites and considering what else you’ll eat that day. Goldstein tells patients to log an item into their food tracking app before they eat it. “Then you can see how many calories it’s leaving you with,” she says.

And if they’re all your favorite? Try saving some for your next visit. “You don’t need to have all of the enjoyable foods in one day,” she says. “You can spread it out. Spread the joy.”


“The raw bar is really great. It’s usually pretty high in protein, not super high in calories,” Goldstein says. According to the FDA, there’s about 8 calories in one medium Eastern oyster, 14 calories in a littleneck clam, and around 20 in a jumbo shrimp; and there’s very little fat. The only concern may be sodium. As for condiments, “The cocktail sauce is probably somewhat high in salt,” she says, but the mignonette is a safe bet.

While she’s talking raw fish, Goldstein says she’s a fan of the recent popularity of poké, a raw seafood salad, which has lots of fresh vegetables and herbs, and can be prepared with little or no rice, unlike the ubiquitous sushi roll. “Rice isn’t bad for you,” she adds, but it’s a carb that people with diabetes and others need to monitor.


You’ve been good. You ate light all day and saved room for dessert. But you still need to plan ahead before indulging. Since local bakeries don’t supply nutrition info, Goldstein turns to the Cheesecake Factory’s website. They’ve got three kinds of chocolate cake, ranging from a whopping 1,450 to 1,770 calories per slice. Most of her patients are on diets of only 1,500 calories per day. For that many calories, she says, “this better be the best cake of my life.”

While Rhode Island’s favorite cakes may be less caloric, Goldstein says, “we don’t have the evidence to say it’s not this caloric”—and it could be even more. So split your dessert with one (or more) friends, or have your server wrap up some of it to take home. Taking time to savor it may help you eat less. “Between every single bite, I would put the fork down and fold my hands for a minute, and think about, do I want the next bite for sure?” she says. If the answer’s yes, go for it.

Telling patients they must abstain from dessert is simply unrealistic. “It’s important to be mindful of what food means to us, and to our friends and family,” Goldstein says. She asks them to check in with their values: their health, loved ones, living a long life to be with them. “We can live in a way consistent with many values at the same time,” she says. So yes, you can have your cake—and eat a few bites of it, too.


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