Fast food: so temptingly convenient, but so fraught with danger. Most fast food joints specialize in exactly the sort of starchy, crispy, greasy food that people with diabetes are supposed to avoid. Nothing triggers those frustrating sticky blood sugar highs like the delicious blend of fat and carbs found in pizza or French fries. And it doesn’t help that they’ve been loaded with lip-smacking sodium, expertly engineered to keep you reaching for more—and why not order a large soda to wash it all down?
There’s no doubt about it, a fast food menu can be a minefield. But despite some notable recent setbacks—like in 2020, when McDonald’s discontinued its salads—the fast food options for healthy eaters are mostly growing. And as diners continue to demand more healthy options, it means you’re less and less likely to get a weird look when you ask for a lettuce-wrapped burger.
We’ve ranked America’s ten biggest fast food chains, from the healthiest to least healthy, and selected the best diabetes-friendly option at each one.
Panera Bread must be the only major chain that specializes in food that most Americans would identify as healthy. The chain has grown like crazy in the last decade, proving that we can crave more than just grease and sugar. And while you might not guess it from a restaurant with the word “bread” in its name, it’s also a great option for people with diabetes. There’s a beautiful variety of low- and medium-carb salads and soups, some of which don’t need much customization at all. Skip the pastries—and don’t even think about the mac & cheese bread bowl—and you’ll probably do just fine.
It’s tough to beat a classic Caesar Salad with Chicken. This dose of delicious lean protein only has about 500 calories and 17 grams of net carbohydrates, even with the croutons included.
Chipotle stands alone in the fast food landscape as an exemplary keto-friendly option. It’s always been easy to customize your order at Chipotle, and as a result the chain has been popular with the low-carb crowd for years. (Double protein? No problem.)
Chipotle has always prided itself on using high quality ingredients prepared fresh on the premises. While doctors may bristle at the characterization of sour cream and slow-cooked carnitas as “healthy,” at least we can be sure that they’re not likely to spike your blood sugar. And Chipotle has embraced the carb-avoiding community to a unique and commendable degree: the latest innovation is cauliflower rice, launched nationally in January 2021.
For easy one-click ordering, choose from Chipotle’s line of “Lifestyle Bowls,” including several different Keto Bowls. Or start with a Salad, which swaps the Burrito Bowl’s white rice for lettuce, and add whichever ingredients you feel comfortable with.
It’s very easy to eat low-carb at Subway—any time you can see your food assembled in front of your eyes, it’s going to be easier to control what ends up in your body. Subway has also recently Chipotle-fied their menu and now offer a selection of salads and protein bowls.
The Black Forest Ham Protein Bowl has only 9 grams of net carbs, and less sodium than other dishes in the category, along with a ton of chopped veggies.
Wendy’s has several healthy options, at least as far as fast food burger joints go, and is easily a better choice than the more popular burger chains coming next on this list. The chain offers multiple salads, both as entrees and sides, and savory wraps. (And you can always order a burger without the bun.)
The Southwest Avocado Salad is a complete meal that doesn’t require any fuss when you order it. Grilled chicken, bacon, avocado and southwest ranch dressing: all told, it’s 560 calories, and only 10 grams of net carbs.
Tortillas everywhere means blood-sugar spiking simple carbs can be tough to avoid here. Taco Bell is one of several joints on this list that have recently de-emphasized salads, but in this case it’s not much of a loss, as the salads here tended to just be tacos and burritos in a slightly different shape. But Taco Bell has always been happy to customize your order, and a newer menu addition has really opened up the possibilities.
The Power Menu Bowl is Taco Bell’s attempt at Chipotle-style fare, and they want you to customize your order. You can go light on the rice and beans, or omit them entirely, add extra meat: whatever you’d like.
You might be surprised to learn that the crispy chicken juggernaut, not often associated with prudent dining, has openly courted keto diners. Chick-fil-A has grilled chicken sandwiches and several salad options, and it’s an easier place to find healthy choices than you probably imagined.
Perhaps the single healthiest entry on the entire list, and certainly the simplest, Chick-fil-A’s Grilled Nuggets are pretty much just chunks of marinated chicken breast, served fresh off the grill. Okay, meat on a plate isn’t terribly exciting, but combine with a side salad and some less sugary dressing—try the buffalo or ranch sauces—and you’re in business.
Just like Domino’s and its “Pizza”, Dunkin’ has dropped its “Donuts” in a bid to grow its menu and its market share. Good news: that means more options for us. You’ll still want to avoid any donuts, and tiptoe around the rapidly growing menu of super-sugary coffees and teas. But people love Dunkin’s black coffee for a reason, and the newer hot breakfast menu has some diabetes-friendly possibilities.
Try a Turkey Sausage Wake-Up Wrap. Dunkin’s wraps top out at just 15 grams of carbohydrates, and in addition to the traditional ham, sausage and bacon, you can choose turkey or BeyondMeat’s vegan sausage. They also offer sandwiches on thin multigrain bread—and of course you can ask them to hold the starch entirely.
Our first real challenge. Domino’s has dropped the “pizza” from its name, but most of the newer entrees remain tricky, like pasta and sandwiches.
Domino’s does have a Caesar’s salad available, but we’ve already recommended two salads, and besides I’m not sure that Domino’s is the first place I’d go for fresh ingredients.
If you’re bored with salads already, try the Chicken Wings. They are dusted with a little starch to make them crispier, but even so don’t pack much of a carby punch. A side of Mild Buffalo Wings clocks in at 260 calories and about 10 grams of net carbohydrates. Some of the other sauces can get pretty sugary—it’s probably best to avoid anything with “sweet” or “pineapple” in the title.
Burger King seems to have mostly removed salads from its menu, which makes healthy ordering a challenge. And while there’s plenty of fish and chicken on the menu, nearly every last scrap of it has been enrobed in breadcrumbs and deep-fried. Grilled chicken may be available at certain locations. Just about the only thing on the national menu within spitting distance of “healthy” is the side of apple sauce—hardly a meal.
Your best bet is probably to order any Burger with No Bun. The chicken nuggets may be another option—an order of 10 has only 25 grams of carbs. If you’re lucky, your location has Grilled Chicken Sandwiches and Side Salads too, but these are not reliably available.
The world’s biggest fast food chain does not make it easy to eat healthy. It was, admittedly, pretty big news in the 80’s when McDonald’s unveiled a line of salads. It was somewhat less noticed more recently when McDonald’s pulled them off American menus entirely. The fast food behemoth no longer has so much as a single side salad on the menu. The grilled chicken was lost to the same purge. It’s slim pickings now!
Errrr … do we have to pick one? The only really healthy choice at McDonald’s is to eat less instead of more. The simplest burgers, from the Hamburger to the Double Cheeseburger, use a bun with about 28 grams of net carbohydrates. You can manage to put together a keto meal by refusing the bun altogether. Either way, please hold the fries.
Fruit & Maple Oatmeal is a lonely healthy-ish (but high carb) option for breakfast. The Sausage Breakfast Burrito has more potential as a keto option, if you were to scrape the filling off of its tortilla.
In some ways, it’s easier than ever to find healthy and diabetes-friendly fast food. Chipotle has led the way in the protein bowl revolution, and now there are many joints that will dish you up meat and veggies with little or no added starch and sugar. If there’s a single takeaway here, it’s to be wary of the biggest burger chains, which are sliding backwards, contrary to the trends, and making their menus even less healthy. If you choose the wrong restaurant, you might find that there’s no right answer.