Making Healthy Choices at Fast Food Restaurants

Last Updated May 2023 | This article was created by familydoctor.org editorial staff and reviewed by Beth Oller, MD

Eating at fast food restaurants can be tempting. For ease and convenience — and sometimes price — fast food is tough to beat. And when you’re constantly on the run, fast food is something simple to grab and go.

But fast food is almost always high in calories, fat, sugar, and salt. For example, if you eat a double burger, fries, and a shake, you will have eaten:

  • Almost 2,000 calories. That is about the total number of calories you should eat in a whole day.
  • A day’s worth of saturated fat
  • More sodium than is recommended for the entire day

And while some cities have banned the use of hydrogenated vegetable oils for frying, certain fast food restaurants still use them. These are the types of oils that contain trans fats. And trans fats increase your risk of heart disease.

Path to improved health

Healthy fast food may seem impossible. But that doesn’t have to be the case. There are ways to eat at fast food restaurants and still stick to a healthy eating plan. Here are some things to think about.

Limit your fast food visits. Eating at a fast food restaurant should be a treat. If you think of it that way, you’ll enjoy it more when you go. And the choices you make there won’t matter quite so much. Once or twice a month is plenty.

Plan in advance. Most people duck into fast food restaurants when they’re on the go. Take a few minutes before you go to decide what you’re going to order. And stick to it.

Know what you’re eating. Many restaurants now list the number of calories as well as the amount of fat and salt in their products. If the information is not posted, ask an employee for a copy of the nutrition information. You can often find this information online as well.

Say no to supersize. Choose the smallest size when ordering a combo meal. Paying a few cents more to supersize your meal may sound like a great deal. But you’ll be adding a lot of fat, calories, and salt. And you’ll probably eat more than you want to. An interesting fact: When people are served more food, they eat more food — even if they don’t need it. Don’t let the employees pressure you into ordering larger sizes because of the price break. Stick to your plans.

Pick places with menu options. Plenty of fast food restaurants now offer salads, soups, and vegetables. Don’t add high-fat items to your salad, such as creamy dressings, bacon bits, and shredded cheese. Choose veggies, a baked potato (skip the sour cream!), or fruit and yogurt on the side instead of french fries. And start your meal with a broth-based soup. You’ll eat less during the meal.

Walk away with food on your plate. The old saying, “You have to finish everything on your plate” no longer applies. When you’re satisfied — not necessarily full — you can stop eating. Ask for a to-go box, or split a meal with a friend.

Rethink your drinks. Sweet, sugary drinks are calorie bombs. It’s easy to drink hundreds of calories without realizing it. A 20-ounce soda, for instance, has about 230 calories. The same size fruit punch clocks in at even more at 320 calories. Skip the sweetened drinks and opt for water or seltzer.

Things to consider

There are plenty of choices when it comes to fast food. Here’s what to look for — and what to pass up — when eating at a fast food chain.

Chinese chains

Do order: Grilled, steamed, or stir-fried lean meat or veggies, edamame, cucumber salad, hot and sour or wonton soup, tea, low-sodium soy sauce.

Avoid: Fried or crispy anything, tempura, peanut sauce, sweet and sour, regular soy sauce.

Italian chains

Do order: Thin-crust pizza with less cheese and more vegetables, antipasto with vegetables, pasta (whole wheat if possible) with tomato sauce and vegetables, grilled lean meats, tomato-based soup.

Avoid: Thick crust or butter crust pizzas, extra cheese, meat lovers’ pizzas, garlic bread, antipasto with meat, meat lasagna, mozzarella sticks, cream- or butter-based sauces.

Sandwich chains

Do order: Regular or junior-sized lean meats (like roast beef, chicken breast, lean ham), whole-grain breads, vegetables, mustard.

Avoid: Fatty meats, tuna salad, bacon, meatballs, cheese, mayo, white bread, croissants, biscuits.

Mexican chains

Do order: Grilled lean meats, fish or shrimp, soft tacos, black beans, veggie burritos.

Avoid: Crispy shells or wraps, refried beans, sour cream, extra cheese, chips.

Burger chains

Do order: Single-patty hamburgers that are grilled, baked, roasted, or broiled, grilled chicken, veggie burger, garden salads, extra lettuce, tomatoes, and onions, baked potatoes, yogurt parfait, mustard.

Avoid: Extra cheese, mayo, special sauces, fries, breaded or fried meat or fish, bacon, heavy dressings, milkshakes, chicken nuggets or tenders, onion rings. When eating a burger, consider skipping the bun and ask for a fork and knife to eat the patty.

Fried chicken chains

Do order: Skinless chicken breast without breading, grilled honey bbq chicken sandwich, garden salad, baked potato.

Avoid: Fried chicken, original or extra-crispy, teriyaki wings or popcorn chicken, Caesar salad, chicken and biscuit “bowls,” extra gravy and sauces, french fries, onion rings.

Questions to ask your doctor

  • If fast food is my only option, what do you recommend I order?
  • How often do you recommend eating fast food?
  • Am I at risk for anything that means I should watch my trans fat intake?

Resources

National Institutes of Health, MedlinePlus: Fast food tips 

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