Eat Well to Be Well: Fast food and eating healthy? It’s possible with a little help

Fast food and eating healthy – seems like such a dichotomy doesn’t it? Yet when you realize that every day, 1 in 4 Americans eats at a fast food restaurant and that French fries are the most eaten vegetable in this nation, we need help. Help as in making better, healthier food choices at these restaurants. It’d be nice if we all cut back on our consumption of fast food but reality tends to dictate. Reality being that fast food is still relatively cheap, satisfying and, well, fast – exactly what many people are looking for.

“Fast food is woven into the social fabric of America,” said Dr. David Samadi, chairman of urology and chief of robotic surgery at Lenox Hill Hospital, in New York City. “We’re living in a country where the economy of food plays a huge role.”

Only one problem though. A recent Gallup-Healthways Well-being Index showed that the percentage of U.S. adults who are obese rose to 27.7 percent in 2014, which is a disappointing upward trend considering that in 2013 the obesity rate was 27.1 percent and in 2008 it was 25.5 percent. The age group where obesity increased the most was among Americans aged 65 and older. Interestingly, the percentage of Americans who are underweight has remained steady at 2.0 percent.

And if that news isn’t bad enough, another more recent analysis published in JAMA Internal Medicine reveals 75 percent of men and 67 percent of women ages 25 and older are either overweight or obese. As of 2012, 67.6 million Americans were obese and 65.2 million were overweight, making it the first time the obese outnumber people who are overweight. This information is from the National Health and Nutrition Examination Survey conducted by the Centers for Disease Control and Prevention (CDC). Obesity is defined as having a body mass index of 30 or higher while overweight is a body mass index between 25 and 29.9.

Because of this continued upward trend in obesity, the rates of heart disease, diabetes, hypertension, and certain types of cancer, will also most likely increase right along with it.

“There’s no doubt the high consumption of fast food has contributed to the rise in obesity and Type 2 diabetes,” Dr. Samadi said. “I think most people enjoy a Big Mac every now and again, but the question is how do we ensure we’re not consuming it as a regular food group in our overall diet?”

Is fast food to blame for this rise in obesity? Certainly it does share some of the responsibility. From supersized meals to heavy-handed and effective advertising to drive-through windows, all have played a role, along with other factors, in helping us put on the pounds over the years.

“Fast food can be somewhat addicting,” said Dr. Samadi. “The other important point to understand is food really shouldn’t be engineered to be prepared at lightning speed. The slow food approach, a new and more thoughtful approach to eating and living a healthy life, I think is the future of eating, especially in America. Think about the food you’re eating, the brands you’re purchasing it from and taking time to prepare it yourself.”

Back to fast food and eating healthy. Can it be done, and if so, what can people do to make better, healthier choices? Fast food restaurants aren’t going away anytime soon so we might as well learn how to make healthier choices when visiting them. By understanding and making a few changes in what you order, you’ll save calories thus reducing your risk of weight gain and yet still enjoy a fast food meal – on occasion. Here’s how:

  • Decrease the number of times you eat at a fast food restaurant. If it’s several times a week, cut back to once a week. Then cut back further to only once or twice a month, if even that frequently.
  • Check out the website of fast food places before you go there. All of them now have extensive nutrition information on their websites that can guide you on making healthier choices. Many fast food restaurants also now have calorie levels on the menu boards – choose items with no more than 500 calories at the most.
  • Ordering a single hamburger with veggies like lettuce, tomato and onions will have less calories than a quarter pounder or one topped with cheese.
  • Salads can be deceiving. If you order a salad topped with crispy chicken along with cheese, croutons or bacon, the calories skyrocket. Instead choose salads with lots of vegetables, grilled chicken and use the dressing sparingly.
  • If there is a veggie burger on the menu, try it. It will have fewer calories than hamburgers, fried chicken or fried fish sandwiches.
  • Pass on the meal deals. They sound like a good deal, but a calorie-loaded main entrée in addition to large fries and a soft drink is not a good deal for your waistline. You will feel uncomfortably full and increase your risk of chronic disease.
  • Liquid calories add up quickly – so quickly that you may not feel as full or realize how many calories you are consuming compared to eating and chewing food. A 32-ounce cola beverage ranges anywhere from 310 to 375 calories with an average of 77.5 grams of sugar in that serving size. One teaspoon of sugar equals 4 grams of sugar so 77. 5 grams of sugar is equivalent to putting a little over 19 sugar cubes in your cup. How many of us would deliberately do that? Order either a diet beverage or preferably water.
  • When ordering a meat item, think grilled. Anything that’s been fried, breaded or labeled “crispy” will be higher in calories and fat.

Below are six fast food restaurants many people frequent. Let’s look at what are some “healthier” options, primarily in terms of fewer calories. I’ve chosen menu items that have no more than 400 calories each. Keep in mind I did not factor in any other menu item that someone would order to go along with the item. Also, even though the calorie levels fall below 400, the grams of fat on many of the items are still quite high. For example, Burger King’s chicken apple and cranberry garden salad wrap grilled has only 380 calories but 19 grams of fat. There are 9 calories per gram in fat so 171 out of the 380 calories or 45 percent of the calories are coming from fat – that’s a lot! It’s best to keep the percentage of fat less than 30 percent as much as possible. Check out their websites for additional menu items that have less than 400 calories.

McDonalds – foods under 400 calories

  • Hamburger – 240 calories, 8 g of fat, 12 g of protein
  • Ranch snack wrap with grilled chicken – 290 calories, 13 g of fat, 18 g of protein
  • Filet-o-fish – 390 calories, 15 g of fat, 19 g protein (leave off the cheese, ask for tartar sauce on the side and the calories will be less)
  • Premium southwest salad with grilled chicken – 330 calories, 11g fat, 32 g protein

Starbucks – foods under 400 calories

  • Perfect oatmeal with toppings – anywhere from 140-390 calories depending on toppings used
  • Reduced-fat turkey bacon breakfast sandwich – 230 calories
  • Chicken and greens Caesar salad bowl – 340 calories
  • Greek yogurt raspberry lemon parfait – 310 calories

Taco Bell – foods under 400 calories

  • Fresco black bean burrito – 380 calories, 11 g fat, 12 g protein
  • Chipotle chicken loaded griller – 350 calories, 16 g fat, 15 g protein
  • Fresco soft taco with steak (one) – 150 calories, 4 g fat, 12 g protein
  • Double Tostada – 270 calories, 11g fat, 12 g protein

Wendy’s – foods under 400 calories

  • Ultimate chicken grill – 370 calories, 7 g fat, 34 g protein
  • Grilled chicken wrap – 260 calories, 10 g fat, 19 g protein
  • Jr. hamburger – 240 calories, 9 g fat, 13 g protein
  • Asian cashew chicken salad, full size – 380 calories, 13 g fat, 36 g protein

Burger King –foods under 400 calories

  • Cheeseburger – 270 calories, 12 g fat, 11 g protein
  • Tendergrill chicken sandwich – 350 calories, 16 g fat, 29 g protein
  • Chicken BLT garden fresh salad wrap grilled – 380 calories, 19 g fat, 22 g protein
  • Chicken apple and cranberry garden salad wrap grilled – 380 calories, 19 g fat, 22 g protein

Subway – (all sandwiches are 6”)

  • Turkey breast sandwich – 280 calories, 3.5 g fat, 18 g protein
  • Roast beef sandwich – 320 calories, 5 g fat, 24 g protein
  • Subway club sandwich – 310 calories, 4.5 g fat, 23 g protein
  • Black forest ham sandwich – 290 calories, 4.5 g fat, 18 g protein

“Remember, fast food is cheap and cheap food equals cheap ingredients. This equation isn’t universal, but it’s almost always true,” said Dr. Samadi. “When it comes to fast food meat, over 90 percent of the burger is made from fillers and other non-meat products. I would say, treat fast food like a dessert. It should be considered a special treat that you have a few times throughout the year. But when you do visit any fast food restaurant, thinking about making better choices across some of the healthier options offered is the way to go.”

The power to make a positive change in healthier fare at fast food restaurants is within our choices and pocketbook. Every time we order a healthier menu item, the more we ask for healthier options and the more we embrace these options, the more these restaurants hear us loud and clear in what consumers are wanting. Even though not considered health food, fast food has been moving in the right direction over the years in creating a little bit more nutritious environment for those of us wanting something fast yet healthy to eat. Keep it up and who knows maybe someday fast food will become better known as fast and healthy food.

Until then, Dr. Samadi warns, “I encourage everyone to avoid treating fast food as part of your daily diet regimen. This is never going to be a healthy way of eating and will contribute to the development of chronic diseases like heart attack, stroke and even cancer.”


Cheryl's-Headshot-2015-80x1Cheryl Mussatto MS, RD, LD, is a registered dietitian and an adjunct professor at Allen Community College, Burlingame, where she teaches Basic Nutrition, and at Butler County Community College, Council Grove, where she teaches Therapeutic Nutrition. She is also a certified health and wellness coach. She writes Eat Well to Be Well, a column about health and nutrition, and is also a blog contributor for Dr. David Samadi at www.samadimd.com. Contact her at [email protected].


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