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laureth's avatar

What restaurants are the most Coumadin-friendly?

Asked by laureth (27073 points ) March 21st, 2009

My husband takes the anti-coagulant Coumadin (warfarin). It is important not to eat too many foods that are rich in vitamin K while on Coumadin because they interfere with each other. So, we try to keep his K intake constant from day to day, avoiding large swings.

The hard part is when we dine out. If something is cooked in soy or canola oil, it contains much more vitamin K than the same thing cooked in, say, peanut or corn oil. Because of this, we have to ask questions about what oil restaurants use, and it’s hard when we get answers like “we cook with non-hydrogenated oil” or “we use Sysco brand” when we’re really looking for an answer like “We use 100% soybean oil” or “our fries are made using peanut oil.”

Do you know which oil any various restaurants use? (Have you perhaps worked there and are in the know, or have done Coumadin-related research that you want to share?) We’re especially looking for ones that use oils other than soy (“vegetable”), canola, or olive, but even knowing for sure that a particular chain uses one of those will help us rule it out as well.

(I know that results may vary based on franchises, and that if we want to be 100% sure we should just stay home. Sometimes, though, like when travelling, that is just not possible – and we are also unwilling to stop living and never venture forth from the house.)

Thank you for reading. It gets old, eating at home all the time because we don’t know what restaurants are cooking with.

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17 Answers

elijah's avatar

This sounds like a real headache to deal with. I’m sorry I don’t have any answers for you, but I suggest maybe eating grilled foods and oil wouldn’t be a factor. Instead of fries do a baked potato or a side salad.

laureth's avatar

Thanks! Yeah, we do try to do stuff like that. (Salads are out because lettuce is amazingly high in K and salad dressings are made from oil.) There are a couple restaurants that are OK, like Outback (a steak, a cup of veggies, and the baked potato is pretty friendly K-wise), but, variety, spice of life, you know?

sdeutsch's avatar

You might have better luck calling the restaurants ahead of time (say, at 2pm when they’re not very busy) – that way, you can explain exactly what you need to know, and whoever you’re talking to can go and talk to the chef about it and get your answers for you. Restaurant kitchens are getting much better about understanding and even catering to special diets, so as long as they’re not in the middle of the dinner rush, they’re usually happy to tell you whatever you need to know.

I’m gluten-intolerant, so I often have to do the same thing – I definitely get better (and more accurate) results by calling and asking if they use wheat flour in something, rather than asking the waiter once we’re there…

Cardinal's avatar

Maybe a different med would be worth looking at. Plavix in low doses or ASA in higher concentrations may achieve the same results as the rat poison but food intake wouldn’t be so critical.

casheroo's avatar

I asked my husband, he said he’ll look at the box of Sysco oil to see whats in it.
He said it varies from each restaurant. The one he works at now uses “salad oil and olive oil”, a different restaurant he worked at used “grapeseed oil and a blend”. It really depends.
I’d definitely call ahead of time, between 2–4, and ask. It’ll give the chefs time to prepare.

bezdomnaya's avatar

Having been a waitress before, I would second the suggestion to call restaurants ahead of time. I’ve gone to great lengths to figure out ingredients for customers (e.g. digging through the stock room for four different bags of tempura flour), but it is so much easier to do when the restaurant is not busy.

Otherwise, you might have to figure out what the K content of the snot in your stew is…

Ok, totally kidding. :) But seriously, call ahead and they’ll bend over backwards for you.

laureth's avatar

We have called ahead, and that’s usually when we get answers like “we use oil with no trans fat,” so it’s been hit-or-miss at best.

Also, when we looked up Sysco oil, we found that there are many varieties, all of which seem to have some proportion of soy and/or olive.

But thanks, folks! Keep ‘em comin’! :)

@Cardinal – thanks, but it’s what the Doc says.

sdeutsch's avatar

You might want to try telling them specifically what you’re trying to avoid – rather than “What kind of oils do you use?”, try “My husband can’t have soy or canola oil – can you tell me what kind you use?” Even if there are other kinds of oil that he can’t have, phrasing it that way will clue them in to what you’re asking, so you’ll get the right sort of answer…

Mr_M's avatar

Is your husband THAT sensitive to regular eating? I take Coumadin and my only warning from MY Cardiologist is not to have the “high in K” stuff day after day after day. I CAN have it periodically. I never worry about coumadin when I go out and my levels are constant.

laureth's avatar

Perhaps it’s only that his doctor is more sensitive. He really read us the riot act when it comes to K. (As in, keep the level constant or it will be REALLY BAD.)

It’s not that he’s particularly sensitive to it per se, but keeping it constant is harder work if we don’t know what he’s eating. That broasted chicken could be just fine if it’s peanut oil, but if it’s soybean, he’s sucking in a lot of K. If we know it’s K-rich, we can compensate by eating low-K all day and the next. But if we don’t know, we can’t compensate.

It’s not necessarily about avoiding high-K, it’s about fitting it in and working around. Knowing is half the battle, as they say.

Also, his number has been mysteriously dropping lately.

Mr_M's avatar

Why don’t you just ASSUME it’s K-rich and compensate the next day? What if you went to a wedding?

laureth's avatar

If we assume it’s K-rich and then compensate by eating low-K, that could mean too much coumadin in the system. The meds are geared for a certain level of K-consumption, and if that consumption isn’t there, it’s like overcompensating, right?

Funny you should ask about weddings. We went to one recently, and he was all careful about the food. Not eating salad, avoiding fried food, etc., because the frosting on the cake is probably sugar+crisco (hydrogenated soy) and he thought having a piece of the wedding cake would be more important than some side salad.

Mr_M's avatar

How are his Pt-INR’s? All over the place or what?

Does he get them taken monthly? Or after 2 weeks if the values were abnormal?

I’ve never been warned about restaurant eating.

laureth's avatar

He was in the hospital with clots all down his leg (and a couple in the lung) this January. The hospital wouldn’t release him until he had enough medicine in the bloodstream, so he was there for about five days. His first test was a day after getting out of the hospital, so it was at clinical levels, they said “come back next week.”

He tested every week for a few weeks and then they told him a month. After a month, he was at about 177, and they said to come back in a week, take the same 4mg. Long story short, it was slipping, and they’re watching it weekly nowadays.

It’s so recently that he was put on the meds that it’s still sudden and wrenching to us. We’re big vegetable eaters – he loves brussels sprouts and cabbage, and minimizing those was sad. The booklet that the hospital gave is said that one tablespoon of soy (or canola) is a “high” K food, and it’s hard to guesstimate how much cooking oil might have soaked into some food (like broasted chicken, for example).

It’s easy to avoid obvious sources (we don’t eat tons of brussels sprouts anymore), but oil is sneaky. They warned us about eating food that has any quantity of unknown oil in it.

Mr_M's avatar

With clots down his leg and in the lung just 2 months ago he’s got to be more careful then I. I eat brussels sprouts and enjoyed cabbage on St. Patrick’s day. I take coumadin for atrial fibrillation, i.e., an abnormal heartbeat which can cause a clot in the brain (stroke) or heart (attack).

Fish Oil supplements will screw up the pt-INR. Watch out.

Good luck.

blairabelle's avatar

Laureth, I am glad you posted this question! I am struggling through the same thing. I have been on warfarin/coumadin for about 4 months due to multiple DVT’s and a PE.

I have been trying very hard to follow the diet, but I must be eating hidden sources of ingredients rich in Vitamin K, as my INR levels keep dropping, even though they keep increasing my Coumadin levels. I imagine this happens when I eat out. I have found one rule of thumb to be helpful, though. Restaurants that have more natural (less processed) and less fried food (because fried food is usually cooked in oil) are generally safer. Sometimes this kind of food is referred to as “raw food.” If you live in a fairly large city, try searching for restaurants that serve this kind of food. In bigger cities, there are a surprisingly large number of these kind of restaurants. Other restaurants I’ve found to be pretty safe are Tex-Mex restaurants like Moe’s Southwest Grill, Outback Steakhouse (I think steakhouses tend to be pretty good choices), and actually even Cracker Barrel (but only certain dishes there, like their grilled choices). Those are the ones I have discovered so far, but I, like you, am still trying to find more! I hope that helps. I feel your frustration. It is certainly a tough diet!

laureth's avatar

Thanks! It’s been a while since I posted this question, and while he no longer takes Coumadin, we still try to be mindful of the Vitamin K intake, and try to balance it out when he does eat it by also eating ginger or taking low-dose aspirin so he doesn’t have clotting troubles. Thanks for the advice! It’s still useful, as we’re always looking for friendly places to eat.

I wish you the best of luck with your diet. It’s not the easiest to maintain when K is everywhere. And welcome to Fluther! :D

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