Young people making healthy choices at a fast-food restaurant.
More on Fast Food

On any given day, 37 percent of American adults will eat something from a fast-food restaurant, according to a new report from the National Center for Health Statistics (NCHS) involving 10,000 people. The number is even higher for younger adults, with 45 percent of those ages 20 to 39 heading to fast-food eateries on a typical day.

It’s a significant number, says Sean O’Keefe, Ph.D., professor of food science at Virginia Tech, who was not involved in the study, and also one that’s concerning. “People who frequently eat fast food may not be getting the vitamins and nutrients they need for a healthy diet.”

“This survey did not capture which restaurants people ate at, or what they chose from the menu,” says Cheryl Fryer, M.P.H., an author of the study and a health statistician at the NCHS. But because eating fast food has been linked to health concerns, such as obesity and poor diet quality, she says that it’s important for people to make smart choices when they go to these restaurants.

Fast Food Is Hard to Avoid

A large part of the reason people continue to eat fast food is “saturation,” according to O’Keefe. “When fast food restaurants are everywhere, sheer convenience will drive many consumers to eat there,” he says.

Given the fact that much of fast food is high in calories, sodium, and fat, seeking out the healthier options is key. “People aren’t just going to stop eating at fast-food restaurants tomorrow,” says Sara Bleich, Ph.D., a professor of public policy at Harvard’s T.H. Chan School of Public Health who focuses on obesity. “A more achievable goal is for more people to pick healthier items when they eat there.”

Making Healthier Choices

Pay attention to calorie counts. Chains with 20 or more locations are required to post calories on menu boards and menus. You might be surprised to find that some seemingly healthy options, such as salads, pack the same amount or even more calories, sodium, and sugars than notoriously less healthy options. For example, a crispy chicken club salad with ranch dressing and croutons at Jack in the Box has 827 calories, 13 grams of saturated fat, and 1,789 mg of sodium. “That’s more calories, saturated fat, and sodium than you’d get in their Jumbo Jack burger,” says Ellen Klosz, a Consumer Reports nutritionist. A better choice would be a salad with grilled chicken, half the dressing, and hold the croutons.

Plan ahead. Calories aren’t the only thing to consider, however. “Fast food can be packed with other nutritional components you should eat less of, such as sodium, sugars, and saturated fat,” Klosz says. Check nutritional info on restaurant websites in advance and pick one or two dishes that look healthy and appealing. Then, when you’re at the checkout counter, you might be less swayed by high-calorie options.

Watch your beverages. Liquid calories from sodas, shakes, and other sugary drinks can add up quickly. “One easy thing [consumers] could do to shave hundreds of calories off their meal is choosing a noncalorie beverage,” Bleich says. Stick with plain water or seltzer, which is naturally calorie-free, she says. If you want something a little heavier, go for low-fat milk instead of a shake.

Order off the kids menu. “Kids menus offer similar options as regular menus but in smaller portions,” Klosz says. “This will save you calories, fat, and sodium.” For example, the kids meal roast beef sandwich at Subway has 200 calories and 390 mg of sodium compared with 320 calories and 660 mg of sodium in the regular-sized 6-inch roast beef sandwich. You also get a side of apple slices. Just opt for milk or water instead of fruit punch.

Plan your pie. One in eight people eats pizza on any given day, according to the National Health and Nutrition Examination Survey, and that pizza accounts for 25 percent of the average adult’s calories and a third of the sodium. But thinking about ordering more healthfully can make a huge difference.

Ordering a medium slice of cheese pizza instead of a large at Papa John’s, for instance, can save you 80 calories, 3 grams of saturated fat, and 190 mg of sodium. Other tips: Choose regular over stuffed crust, thin over deep-dish, and veggie over meat toppings, and skip calorie- and fat-laden dips, such as garlic butter or ranch dipping sauce.

Get creative with menu options. If you’re at a chain with a bigger menu—think an Applebee’s or a Cheesecake Factory—an appetizer may make for a better entrée choice than what’s available on main menu, Klosz says. You can round it out with a salad or a side of vegetables, such as green beans or sweet potatoes.   

Avoid the crispy. Fried menu options, such as chicken, fish, and veggies, are certainly tasty, but they pack a much bigger calorie, fat, and sodium punch. Swapping grilled for crispy chicken in Jack in the Box’s chicken club salad, for example, will save you 143 calories, 8 grams of fat, and 163 mg of sodium. And ordering Chik-fil-A’s chicken sandwich grilled instead of fried cuts out 130 calories, 13 grams of fat, and 530 mg of sodium.

Make smart swaps. Swapping less healthy parts of a meal for healthier options can give you big calorie, fat, and sodium savings. At McDonald’s, choosing a hamburger over a cheeseburger and a side salad (without the dressing) instead of a small order of fries will save you 260 calories, 15 grams of fat, and 350 mg of sodium. At Panera Bread, a sprouted whole-grain roll has 170 calories, 1 gram of fat, and 360 mg of sodium. An apple, on the other hand, has just 80 calories and no sodium or fat.

Have a strategy for sides. The best thing to do is to pack your own fruits and veggies, such as an apple or bell pepper slices, to munch on with your meal instead of ordering a side. But if you’re in the mood to splurge, order the smallest size of fries, soda, or shake available. Ordering a mini chocolate shake at Sonic instead of a medium, for example, cuts out 440 calories, 20 grams of fat, 12 grams of saturated fat, and 230 mg of sodium. And ask for sauces and dressings on the side, so you can use just a little bit.