The 4 Best and 4 Worst McDonald’s Menu Items You Can Order, According to a Dietitian

 The 4 Best and 4 Worst McDonald’s Menu Items You Can Order, According to a Dietitian

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Introduction: Fast Food in a Health-Conscious World

As a global fast-food giant, McDonald’s stands among the most well-known brands, operating over 40,000 restaurants across the world it has become a convenient go-to for busy people, families, and even travelers who want something familiar. But along with convenience comes concern: fast food often gets criticized for being high in calories, sodium, saturated fat, and added sugar while being low in fiber and essential nutrients.

Still, not every item on the McDonald’s menu deserves a spot on the “bad” list. Some choices are surprisingly balanced and can fit into a healthy eating pattern if chosen mindfully. As a dietitian would explain, it’s not about labeling McDonald’s as “good” or “bad”—it’s about making informed choices that align with your health goals.

This article explores the four best and four worst McDonald’s menu items from a nutrition standpoint. If you’re someone who occasionally visits McDonald’s but still wants to stay on track with health, weight management, or fitness goals, these insights can help you navigate the golden arches with confidence.

How a Dietitian Evaluates McDonald’s Menu Items

Before diving into the list, it’s important to understand the nutritional lens through which these items are judged. A dietitian typically considers:

1. Calories & Portion Size – Does the meal provide appropriate energy for one sitting, or is it oversized?

2. Protein Content – Is the meal satisfying and supportive of muscle health?

3. Added Sugar & Sodium – Are levels excessively high, raising risks for blood pressure, diabetes, and heart disease?

4. Balance of Nutrients – Does it contain some fiber, vegetables, or whole grains, or is it mostly refined carbs and fat?

5. Frequency of Consumption – Can this item fit into a diet occasionally, or does it deliver excessive calories/nutrients of concern in one serving?

With those criteria in mind, let’s look at the four best and four worst McDonald’s options.

✅ The 4 Best McDonald’s Menu Items

1. Egg McMuffin

• Calories: ~310

• Protein: 17 g

• Sodium: ~770 mg

The Egg McMuffin is one of the original breakfast items at McDonald’s, and it remains one of the best-balanced choices today. With an English muffin, egg, Canadian bacon, and a slice of cheese, it offers a good mix of protein and carbs without being excessively high in calories.

Why it’s dietitian-approved:

• Provides lean protein to keep you full.

• Portion-controlled and not oversized.

• Contains less saturated fat than heavier options such as the Sausage McMuffin with Egg

Smart tip: Pair with black coffee or water instead of a sugary latte to keep the meal balanced.

2. Apple Slices (Kids’ Meal Side)

• Calories: 15

• Sugar (natural): 3 g

• Fiber: 1 g

It may seem trivial to highlight apple slices, but this small side option shows that McDonald’s offers fruit as a choice. While it’s not a full serving of fruit, it adds fiber and natural sweetness without excess sugar.

Why it’s dietitian-approved:

• A whole-food option on an otherwise processed menu.

• Zero added sugar, fat, or sodium.

• Great way to add nutrients if you’re building a meal.

Smart tip: Add apple slices as a side to a grilled chicken sandwich or a burger to lighten up the meal.

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3. Hamburger (Regular Size)

• Calories: ~250

• Protein: 12 g

• Sodium: ~510 mg

Sometimes, keeping it simple is the smartest option. The basic hamburger at McDonald’s may seem small, but it’s a reasonable portion compared to oversized burgers. With one beef patty, pickles, onions, ketchup, and a bun, it’s a modest choice that won’t derail your day.

Why it’s dietitian-approved:

• Reasonable calories for a meal or snack.

• Provides protein without overloading on fat and sodium.

• Less processed than fried items like nuggets or fries.

Smart tip: Skip the fries and soda—pair the hamburger with a side salad or apple slices for a more balanced meal.

4. Southwest Grilled Chicken Salad (when available)

• Calories: ~350

• Protein: 37 g

• Fiber: 6 g

Not every McDonald’s location still offers this salad, but when it’s available, it’s a standout. Made with grilled chicken, black beans, corn, tomatoes, cheese, and greens, it’s one of the few menu items with real vegetables.

Why it’s dietitian-approved:

• High in lean protein and fiber.

• Provides a serving of vegetables.

• Lower in calories than fried options.

Smart tip: Choose a light vinaigrette instead of creamy dressing to keep calories in check.

4. Southwest Grilled Chicken Salad (when available)

• Calories: ~350

• Protein: 37 g

• Fiber: 6 g

Not every McDonald’s location still offers this salad, but when it’s available, it’s a standout. Made with grilled chicken, black beans, corn, tomatoes, cheese, and greens, it’s one of the few menu items with real vegetables.

Why it’s dietitian-approved:

• High in lean protein and fiber.

• Provides a serving of vegetables.

• Lower in calories than fried options.

Smart tip: Choose a light vinaigrette instead of creamy dressing to keep calories in check.

2. Large French Fries

• Calories: ~510

• Fat: 24 g

• Sodium: ~350 mg

Fries are one of McDonald’s most iconic items, but portion size matters. A large fries provides over 500 calories with little protein or fiber—mostly refined carbs and fat.

Why dietitians caution against it:

• High in calories without satiety.

• Easy to overeat due to addictive salt-fat combo.

• Offers little nutritional value beyond starch.

Better swap: Order a small fries to satisfy the craving while keeping calories reasonable.

3. McFlurry with M&M’s (Regular Size)

• Calories: ~640

• Sugar: ~86 g

• Fat: ~22 g

Desserts at McDonald’s can be fun, but the McFlurry is a sugar bomb. With nearly 90 grams of sugar, it exceeds the daily recommended sugar limit in one serving.

Why dietitians caution against it:

• Extreme sugar spike followed by a crash.

• More calories than a full meal.

• Increases long-term risk of obesity and diabetes if consumed often.

Better swap: Opt for the vanilla soft-serve cone (around 200 calories) for a lighter treat.

4. Big Breakfast with Hotcakes

• Calories: ~1,340

• Sodium: ~2,070 mg

• Fat: 64 g

This breakfast platter combines scrambled eggs, sausage, biscuits, hash browns, and pancakes with syrup. It’s one of the heaviest items on the menu.

Why dietitians caution against it:

• More than half the average person’s daily calorie needs.

• Extremely high in sodium and saturated fat.

• Encourages overeating with oversized portions.

Better swap: Choose an Egg McMuffin or oatmeal for a lighter start to the day.

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Practical Tips for Eating Healthier at McDonald’s

• Watch portion sizes: Choose regular or small instead of large.

• Balance your plate: Add fruit or salad when possible.

• Avoid sugar-filled beverages and opt for water, plain coffee, or unsweetened iced tea instead.

• Customize your order: Ask for no mayo, extra lettuce, or grilled instead of fried.

• Treat McDonald’s as occasional: It can fit into a healthy lifestyle if enjoyed in moderation.