The Most Unhealthy Menu Items at America’s Fast-Food Chains

Fast food is not traditionally associated with healthy eating. However, to reflect growing health awareness among consumers in recent years, fast-food chains have added salads to their menus and reduced sodium and calorie content. The Washington Post reports that Salad and Go is now America’s second-fastest-growing fast-food chain.

However, healthy options remain just that: alternatives to the main menu. Chains like McDonald’s have cut healthy options since the pandemic, citing the need to streamline during the pandemic and now blaming consumer demand. “I don’t think the U.S. consumer is coming to McDonald’s looking for the McPlant or other plant-based proteins,” McDonald’s U.S. president, Joe Erlinger, told the Wall Street Journal Global Food Forum.

Ultimately, healthy eating comes down to taking control of what you eat. That might mean avoiding fast food altogether, but it can be as simple as making an informed decision about which fast-food chains to visit and which of their products to choose.
We have analyzed the nutritional value of five classic fast-food items across 24 popular chains to highlight the health differences between restaurants.

What We Did

We defined a set of products (cheeseburger, regular fries, etc.) and identified the closest possible product at 24 leading U.S. fast-food chains. Using each chain’s nutritional menu, we compared the Calories (Kj), Sugar (g), Saturated Fat (g), and Sodium (mg) values for all the available products. We scored them according to the Department of Health's nutrient profiling method. Finally, we added up each product’s total “unhealthiness score” at each fast-food chain and ranked them across the restaurants.

Key Findings

• Five Guys has the unhealthiest cheeseburger, with a 50-point unhealthiness score. This chain also offers the least healthy fries (28 points).
• The unhealthiest chicken burger is the Chicken Sandwich Classic at Popeyes (39 points), and McDonald’s Chicken McNuggets are the least unhealthy chicken nuggets (18 points).
• Fatburger’s Vanilla Shake is the unhealthiest in its class, scoring 63 points, eight points more than Sonic's second-placed Medium Vanilla Shake at Sonic (55).

Five Guys Cheeseburger is Unhealthiest in Class

Many Americans believe that burgers are healthy — and it’s true that slow-cooked lean ground beef on a healthy bun can provide protein, iron, and vitamin B12. But the World Health Organization (WHO) has found red meat and ultra-processed foods to be carcinogenic, which is basically what you’re getting with a fast-food cheeseburger.
 
According to our calculations, the Five Guys cheeseburger is the most unhealthy in its class, primarily because it has 73% more saturated fat than any other fast-food cheeseburger.

Burger King and McDonald’s cheeseburgers are tied on relatively low unhealthiness scores (18 points). They each have less than a quarter of the saturated fat of a cheeseburger at Five Guys and less than half that of a Wendy’s cheeseburger. While some fats are healthy, saturated fats carry a heart disease risk and can lead to weight gain.

McDonald’s McChicken is the Least Unhealthy Fast-Food Chicken Burger

The McChicken (14 points) at McDonald’s is the healthiest of its type among the fast-food chains we surveyed. The McDonald’s chicken burger scores roughly half the unhealthiness points of its equivalents at Burger King (31 points) and KFC (27 points). 

While the McChicken is significantly less unhealthy than other fast-food chicken burgers, it is still high in sodium, fat, and calories. Because it is made of ground chicken patty, the nutrients it does contain are not high-quality.

Sodium is the big offender among fast-food chicken burgers. Too much sodium can lead to high blood pressure, stroke, and heart disease.

The U.S. Food & Drug Administration (FDA) recommends a maximum sodium intake of 2,300 milligrams (mg) daily. There’s more than that in a single Fatburger Crispy Chicken Sandwich, and the average sodium level among the ten unhealthiest chicken burgers above is 1642.6 mg — higher than the American Heart Association’s “ideal daily limit” of 1,500 mg.

The Least Healthy Chicken Nuggets Are at Popeyes

We found nine fast-food chains with comparable chicken nugget products. Of these, Popeyes Nuggets (30 points) and Arby’s Premium Nuggets (29 points) are the least healthy. All of the nuggets except for McDonald’s have sodium scores in the double figures. Still, Popeyes stands out due to saturated fat levels that are around double or more than any other nuggets.

KFC (19 points) and McDonald’s (18 points) offer the least unhealthy nuggets. Notably, both the saturated fat and sugar levels of KFC’s new “100% white meat” nuggets are zero. However, beware that dipping sauces can boost a typical nuggets-based meal's sodium and sugar levels.

Five Guys Fries Are Nearly 50% More Unhealthy Than Other Fast-Food Fries

A fast-food meal may feel incomplete without fries. But add fries at Five Guys (28 points), and you add 953 calories to your meal, and KFC’s Secret Recipe Fries (17 points) add around 1,100 mg of sodium. Five Guys has by far the least healthy fries in our study, while KFC is the fifth least healthy, with significantly fewer calories and lower saturated fat than Five Guys fries.

French Fries have high salt and fat levels, which can tip an already unhealthy fast-food main into the danger zone. If they feel indispensable, try opting for the smallest portion, sharing with a companion, or simply not finishing them. You’ll find the least unhealthy fries at McDonald’s (Medium Fries carry 7 points) and In-N-Out (6 points).

At 890 Calories, Fatburger's Vanilla Shake is the Least Healthy of Its Kind

Vanilla shakes have the lowest sodium offenders compared with the other products in our study. The average vanilla shake still carries a significant 365.7 mg sodium hit. But where vanilla shakes really do the damage is with their massive sugar and fat counts, which make shakes the most unhealthy category in our study.

Fatburger’s Vanilla Shake (63 points) is the least healthy of all, carrying 890 calories, 30 grams (g) of saturated fat, and 86 grams of sugar. This busts through the recommended daily limits of 22 g of saturated fats and 50 g of sugar per day, based on a 2,000-calorie diet. McDonald’s Vanilla Shake (26 points) is the least unhealthy in our study and has the fewest calories.

Half of Americans want Healthier Food

The World Economic Forum reports that around half of Americans are trying to eat more healthily, but 46% say food pricing makes this more difficult. 

Fast food is hard to beat for cost and convenience, but keeping it healthy means making informed decisions. McDonald’s is the least unhealthy fast-food chain—but only as long as diners don’t pile their tray high.

Methodology & Sources

These are the steps we followed when analyzing the nutrient profiles of equivalent items at America's most popular fast-food chains:

1. We defined a set of products: cheeseburger, chicken burger, regular fries, regular vanilla shake, and nuggets (10 pieces).
   
   
2. We looked for the closest possible product at In-N-Out, Burger King, McDonald's, Shake Shack, Wendy's, Sonic, Carl's Jr., Jack in the Box, Five Guys, Culver's, A&W, Steak n Shake, Fatburger, Smashburger, Dairy Queen, KFC, Chick-fil-A, Zaxbys, Popeyes, Raising Cane's, Arby's, Church's Chicken and Bojangles.
   
   
3. We consulted each chain's nutritional menu to collect the Calories (Kj), Sugar (g), Saturated Fat (g), and Sodium (mg) values for all the available products.
   
   
4. We used the Department of Health's nutrient profiling method to assess the relative unhealthiness of each item on our list. In short, each item receives an individual score for energy (kJ), saturated fat (g), total sugar (g), and sodium (g), based on the weight of these components, which combine for an overall "unhealthiness score." 
   
   Total nutrient points = (points for energy) + (points for saturated fat) + (points for sugars) + (points for sodium)
   
   The following table indicates the points scored, depending on the amount of each nutrient in the food or drink: