By Barbara Martinez-Benavides, First Mile Care DPP Coach

Most people will find themselves occasionally pulling into a restaurant drive-through lane on the way home from work, or perhaps when on a road trip. The hustle and bustle of everyday life tempts us to rely on convenience. In a 2013–2016 survey, more than one-third of U.S. adults said they consumed fast food on a given day.

Recognizing this fact of life, First Mile Care Diabetes Prevention Program (DPP) coaches guide participants on how to maintain healthy eating habits when fixing a healthy meal at home isn’t possible or requires too much time. “Healthy fast food” may sound like a contradiction in terms, but that’s not the case. Even in fast-food restaurants, it’s possible to find healthier items on the menu.

Everyone has their favorite indulgences. The goal of First Mile Care is to help participants make lifestyle changes that stick for the long term, without having to deny yourself the things you love. Learning to make healthier swaps when eating out can give your body the nutrients it needs, while avoiding the things that could sidetrack your progress toward prediabetes intervention.

Planning for temptation

Have you ever sat near someone on an airplane who brought aboard McDonald’s French fries? It’s hard not to begin fantasizing about their golden crispy deliciousness, despite being aware of their levels of fat, salt, sugar, and additives

The smell and appearance of fast food can influence you to order something you wouldn’t otherwise have considered eating. The reason for this is what we think of as “junk food” is highly processed and designed to be addictive —as well as ultra-pleasing to your taste buds and olfactory system. It lights up the pleasure centers of your brain to keep you coming back for more. This makes craving processed foods a very real thing.

The way to combat temptation is to take a few minutes to review the menu before you enter the restaurant, decide what to order, and follow through. Many restaurants list the calories, saturated fat, trans fat, sodium, carbohydrates, and other nutrients in their offerings. If you can’t find it, ask an employee for a copy of the nutritional information. If the description reads like a chemistry project, move on to something — or somewhere — else.

Here are some other tips to keep in mind when you dine in a fast-food restaurant.

  1. Choose wisely. Many fast-food restaurants now offer vegetables, soups, and salads —  but avoid adding crackers, croutons, bread, grated cheese, bacon bits, and creamy dressings.  If you load toppings, it may defeat the purpose of making the “healthier choice” in the first place. Choose plain vegetables (grilled or steamed, no butter), a baked potato instead of fried, and fruit for dessert. Make sure that toppings are on the side so you can control what, and how much, is included. 
  2. Rethink liquids. Sweet drinks (including tea and natural drinks like lemonade) and milkshakes are calorie bombs that make it easy to swallow hundreds of calories without realizing it. Skip the sugary sodas and opt for plain water, sparkling water, infused water, unsweetened tea, or water with lemon juice.
  3. Don’t upsize your meal. Choose the smaller size when ordering a combo meal. Paying a few cents more to get a much larger portion may seem like a great deal, but it will add a lot of fat, calories, and sodium. And, probably, you will eat more than your hunger requires. Usually when people are served more food, they eat more, instead of eating mindfully and listening to their body’s hunger signals.
  4. Leave some food on the plate. You don’t have to finish everything on your plate. When you feel satisfied —  but not necessarily full — you can stop eating. You might be able to get a to-go container, although fast food does not always age well.
Making meals happier

There are many options when it comes to eating at a fast-food restaurant. Here’s what to look for and what to pass up at each of the most common types of establishments.

Hamburger restaurants

Best Options: plain single grilled burger (if possible without a bun, with a lettuce wrap, no ketchup/mayonnaise), grilled chicken, veggie burger, salads (lettuce, tomato, cucumber, no cheese), extra lettuce, tomatoes and onions, baked potatoes, mustard, pickles

Limit/Avoid: extra cheese, mayonnaise, ketchup, special sauces, French fries, breaded or fried meat or fish, bacon, heavy dressings, chicken nuggets and strips, onion rings, chili, milkshakes 


Fried chicken restaurants

Best Options: skinless unbreaded grilled chicken breast, salad (tomato, lettuce, cucumber), baked potato

Limit/Avoid: fried chicken, extra crispy teriyaki wings or fried chicken chunks, chicken and biscuits, Caesar salad, coleslaw, French fries, onion rings, mashed potatoes with gravy, extra sauces, ketchup


Sandwich restaurants

Best Options: lean regular or junior sized meats (such as roast beef, chicken breast, lean ham), whole grain breads, vegetables, mustard, vinegar, olive oil

Limit/Avoid: fatty meats, tuna salad, bacon, meatballs, cheese, mayonnaise, special dressings (eg. buffalo), white bread, croissants, crackers, chips, cookies


Mexican restaurants

Best Options: lean grilled meats (fajitas), fish or shrimp, vegetable burritos, vegetables, beans, corn tortilla, guacamole, salsa, pico de gallo

Limit/Avoid: crispy toppings or wraps, street corn, refried beans, sour cream, extra cheese, chips and queso


Italian restaurants

Best Options: thin crust pizza with less cheese and more vegetables, antipasti with vegetables, pasta (whole wheat if possible) with tomato sauce and vegetables, grilled lean meats, tomato-based soup, balsamic vinegar/olive oil as dressing

Limit/Avoid: thick or buttery crust pizza, meat lover’s pizza, stuffed-crust pizza, extra cheese, garlic bread, meaty antipasti, meat lasagna, caprese salad, mozzarella sticks, cream or butter-based sauces (eg. alfredo), tiramisu


Asian restaurants

Best Options: lean meat, vegetables (broiled, steamed or sautéed), edamame, cucumber salad, low-sodium soy sauce

Limit/Avoid: anything fried or crispy, tempura, fried rice, peanut sauce, sweet and sour sauce, regular soy sauce, fortune cookies, sugary drinks


Fast food is convenient, inexpensive, and tasty, but it is also packed with fats, sodium, dyes, preservatives, and sugar — all things that could raise your risk of obesity, diabetes, high blood pressure, heart disease, and stroke.

However, you don’t need to cut fast food completely out of your life. Learning to enjoy things in moderation through healthy swaps is key to lifestyle change and maintaining a healthy life balance.

To learn more about how you can benefit from the First Mile Care Diabetes Prevention Program, take the prediabetes risk test and get started today!