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The #1 Worst Order at McDonald's, According to a Dietitian

Spoiler alert: It's not the Big Mac.

If you're looking for a healthy fast-food choice, or even a reasonably nutritious one, there is one menu item at McDonald's you're going to want to avoid.

Simply put—we repeat, do not go anywhere near this Mickey D's staple.

Sorry to break it to you, but even if you're planning on fully treating yourself, you should know the facts beforehand.

So, without further ado, the worst menu item at McDonald's is…

McDonald's Double Quarter Pounder with Cheese

McDonalds double quarter pounder
Courtesy of McDonald's
740 calories, 42 g fat (20 g saturated fat, 2.5 g trans fat), 1,360 mg sodium, 43 g carbs (2 g fiber, 10 g sugar), 48 g protein

As a rule, a meat and cheese entree with the word "double" in its name is grounds for extreme caution, and this menu item is no exception. The Double Quarter Pounder with Cheese packs 740 calories, which is at least one-third of what many people require for an entire day. But a high calorie count is hardly this burger's biggest fault.

That honor is reserved for its fat content—the amount and the type—according to registered dietitian nutritionist Hillary Wright, author of The Prediabetes Diet Plan.

"For starters, the Double Quarter Pounder with Cheese serves up 42 grams of fat, or 54% of what you require on a 2,000-calorie eating plan, never mind the other dangerous fat it supplies," she says.

If you think Wright is referring to saturated fat, you're correct—there's nearly 100% of the suggested daily maximum intake of the artery-clogging stuff lurking in a Double Quarter Pounder with Cheese. But she's also talking about trans fat, a type of fat that doesn't always garner as much attention as saturated, even though it's worse for your health. While the U.S. has banned trans fat, it is is found in full-fat milk and cheese, butter, and fatty meat, as well as some fried foods.

Trans fat raises LDL, or "bad" cholesterol, and lowers HDL, or "good" cholesterol, setting the stage for blocked arteries that can lead to heart disease and stroke.

Trans fat also stokes inflammation that further contributes to these cardiovascular diseases, and may promote the build-up of fat around the belly, which exacerbates heart disease risk.

Experts recommend eating no trans fat or coming as close to zero as possible.

However, adhering to that advice is impossible with a McDonald's Double Quarter Pounder with Cheese, which provides 2.5 grams of trans fat. Trans fat is so potent that it makes saturated fat look good, and 2.5 grams is considered a relatively large amount.

As with many fast food choices, the sodium levels in the McDonald's Double Cheeseburger are through the roof: 1,360 milligrams or about 60% of the daily suggested upper limit.

"Having to use a comma for the sodium content of a single food item is never good," Wright says. "A consistently high intake of sodium is linked to elevated blood pressure, which increases the risk for stroke and heart attack."

Looking for helpful tips? Your ultimate restaurant and supermarket survival guide is here!

What should a burger-lover order instead?

Wright would never suggest choosing a fish sandwich and apple slices at McDonald's when you're craving beef and cheese. But there's no reason to go over the top, either.
She recommends opting for a McDouble.

"You'll satisfy your hankering for a cheeseburger, but for just 400 calories, which is 340 fewer than the Double Quarter Pounder with Cheese, and half the total and saturated fat."

You'll also slash trans fat from 2.5 grams to just one, and you'll save about 400 milligrams of sodium. Oh, and you'll do your body a big favor!

Elizabeth M. Ward, MS, RDN
Elizabeth M. Ward, MS, RDN is an award-winning nutrition communicator, writer, and recipe developer, as well as a former spokesperson for the Academy of Nutrition and Dietetics. Read more about Elizabeth M.