Hi glomor,
If you're talking about Amtrak first class meals, they allow you to make special orders if you call them directly more than 24 hours ahead. I don't know about IP meals, but you can ask -- I asked for a vegan meal, and they were happy to provide. But it came in a reheated box and wasn't very appetizing -- the fresh-from-menu meals are much better.
However, the dining attendants are quite flexible about adding other things (ie fruit, etc) if you want something else and just don't eat your carbs. You can also buy food from the meal car, but it's not particularly delicious (and overpriced).
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