Everyone’s got a go-to McDonald’s menu item. And if you’re like most people, you probably have some sort of idea as to which McDonald’s menu items are the healthiest, and you’re probably wrong in at least one spot. The healthiest pick in each of these categories might surprise you.
If you’re new here, we like to find the healthiest and unhealthiest menu items from popular restaurants. We see a lot of lists that tell you the middle ground menu items to order, but we think it’s a bit more interesting to know the extremes. That gives you the guardrails to work within. And to let you know that if you’re going to splurge for the double quarter pounder with cheese, that you are making the choice that’s likely the least healthy for you (but we all need a splurge every now and then, don’t we?).
For this list we pitted the 2 extremes in 12 McDonald’s menu categories against one another, and we let McDonald’s own U.S. nutrition information (as of Nov. 9, 2026) settle the debate, which, in many cases, went against our gut. These are not the obvious pairs. Nobody needs us to tell them apple slices beat a large fries. Note that these are the healthiest of two, not necessarily healthy, period. Also note that we ignored seasonal menu items, because there is no point writing about a Cookie Butter Frappe in March.
1. The Big Burgers
Healthiest: Big Mac
Unhealthiest: Double Quarter Pounder with Cheese
Big Mac: 580 calories, 11 grams of saturated fat, 1,060 milligrams of sodium. The Big Mac is basically the face of fast food. It’s been the face of fast food for more than 50 years. And it edges out its signature-burger stablemate, the Quarter Pounder with Cheese, which surprised us. The Quarter Pounder with Cheese clocks in at 520 calories, 12 grams of saturated fat, 1,140 milligrams of sodium. Sure, that is fewer calories, but more of the 2 numbers we care about.
Double Quarter Pounder with Cheese: 740 calories, 20 grams of saturated fat, 1,360 milligrams of sodium. If you want protein (48 grams, to be exact), order the Double Quarter Pounder with Cheese. But that protein comes at a cost: 20 grams of saturated fat (aka, the entire FDA Daily Value for saturated fat).
2. The Doubles
Healthiest: McDouble
Unhealthiest: Double Cheeseburger
McDouble: 390 calories, 9 grams of saturated fat, 920 milligrams of sodium. For years, the McDouble was arguably McDonald’s best Dollar Menu deal, and it’s still arguably McDonald’s best nutritional deal. Same as the Double Cheeseburger, except with 1 slice of cheese instead of 2.
Double Cheeseburger: 440 calories, 11 grams of saturated fat, 1,120 milligrams of sodium. Ever wonder how much of a nutritional difference a slice of American cheese really makes? Now you know: 50 calories, 2 grams of saturated fat, 200 milligrams of sodium.
3. Chicken Sandwiches
Healthiest: McChicken
Unhealthiest: Spicy McCrispy
McChicken: 390 calories, 3.5 grams of saturated fat, 560 milligrams of sodium. McDonald’s most basic offering (a small breaded chicken patty on a plain bun with lettuce and mayo) is also its healthiest.
Spicy McCrispy: 530 calories, 4 grams of saturated fat, 1,320 milligrams of sodium. McDonald’s answer to Chick-fil-A and Popeyes’ chicken sandwiches has nearly the same saturated fat as the McChicken (about 4 grams), because it is fried in the same oil, but more than double the sodium thanks to the bigger piece of chicken, the saltier brine and the addition of spicy pepper sauce. 1,320 milligrams of sodium in 1 sandwich is more than half the FDA’s Daily Value.
4. Breakfast Sandwiches
Healthiest: Egg McMuffin
Unhealthiest: Sausage, Egg & Cheese Bagel
Egg McMuffin: 310 calories, 6 grams of saturated fat, 770 milligrams of sodium. The OG McDonald’s breakfast sandwich is still the healthiest McDonald’s breakfast sandwich, delivering 17 grams of protein courtesy of the egg, Canadian bacon and cheese. (Shout-out to the unsung nutritional hero: the English muffin.)
Sausage, Egg & Cheese Bagel: 710 calories, 16 grams of saturated fat, 1,380 milligrams of sodium. Add a second cheese, swap out the Canadian bacon for a sausage patty and switch the English muffin for a bagel (270 calories before you even pile on the toppings) and you more than double the calorie count and almost triple the saturated fat for a sandwich you’ll still eat in 10 minutes or less.
5. Same Filling, Different Bread
Healthiest: Bacon, Egg & Cheese McGriddles
Unhealthiest: Bacon, Egg & Cheese Biscuit
Bacon, Egg & Cheese McGriddles: 430 calories, 9 grams of saturated fat, 1,230 milligrams of sodium, 15 grams of sugar (13 of which are added). The McDonald’s sandwich that defies expectations. You’d think the one on the maple-flavored pancakes would be the unhealthiest of the bunch, but the McGriddles is actually lower in calories, saturated fat and sodium than the biscuit version.
Bacon, Egg & Cheese Biscuit: 460 calories, 13 grams of saturated fat, 1,330 milligrams of sodium, 3 grams of sugar. It’s the butter and salt in the flour-based biscuit that pushes up the saturated fat and sodium, making it a poor choice for those watching their fat intake or blood pressure. If you’re watching your sugar intake, though, it’s the McGriddles you should avoid (stick with the English muffin-based McMuffins instead).
6. Chicken Pieces
Healthiest: 4-piece Chicken McNuggets
Unhealthiest: 3-piece McCrispy Strips
4-piece Chicken McNuggets: 170 calories, 1.5 grams of saturated fat, 340 milligrams of sodium. Despite their less-than-pristine reputation, McNuggets are actually pretty decent nutritionally speaking, and a 4-piece is the only item on the menu you could technically consider a snack.
3-piece McCrispy Strips: 400 calories, 2 grams of saturated fat, 1,320 milligrams of sodium. Although they look like McNuggets’ older, cooler cousins, the Crispy Strips actually pack almost quadruple the sodium of the 4-piece McNuggets (though they do contain more than triple the protein, 31 grams, thanks to the brined chicken).
7. Potatoes
Healthiest: Hash Browns
Unhealthiest: Large Fries
Hash Browns: 140 calories, 1 gram of saturated fat, 310 milligrams of sodium. It’s fried, and it’s in the shape of a patty, but hash browns are still the least-bad potatoes at McDonald’s. (Apple slices are 15 calories and would win in a walk, but you’re not really choosing between fries and apple slices.)
Large Fries: 480 calories, 3 grams of saturated fat, 400 milligrams of sodium. If you’re going to order them, go small (230 calories, 190 milligrams of sodium) instead of medium (320 calories, 260 milligrams of sodium) or large since you’ll likely eat them all anyway.
8. Desserts
Healthiest: Vanilla Cone
Unhealthiest: M&M’s McFlurry
Vanilla Cone: 200 calories, 3 grams of saturated fat, 23 grams of sugar (17 of which are added). The vanilla cone is the lowest-sugar dessert on McDonald’s menu, and it comes conveniently portioned for you.
M&M’s McFlurry: 570 calories, 12 grams of saturated fat, 74 grams of sugar (62 of which are added). The McFlurry with M&M’s has more sugar than any other item on McDonald’s menu, even more than a medium Coke, and quadruple the saturated fat of the vanilla cone. But it’s still the same soft serve; the candy and bigger cup size are the only differences.
9. Fountain Drinks
Healthiest: Unsweetened Iced Tea
Unhealthiest: Medium Coca-Cola
Unsweetened Iced Tea: 0 calories, 0 grams of sugar, 10 milligrams of sodium. Available at every McDonald’s in the country and chosen by almost no one, unsweetened iced tea is a 0-calorie alternative to soda if you still want something cold and brown with your fries.
Medium Coca-Cola: 270 calories, 70 grams of sugar (all of which are added). A medium Coke contains more than 2 days’ worth of the American Heart Association’s recommended daily intake of added sugar for women, and it comes complimentary with most of McDonald’s meals. (Even a small is 200 calories and 53 grams of added sugar.)
10. Orange Drinks
Healthiest: Minute Maid Orange Juice
Unhealthiest: Hi-C Orange Lavaburst
Minute Maid Orange Juice: 190 calories, 41 grams of sugar (all of which are naturally occurring). While the added-sugar total for Minute Maid Orange Juice is technically 0, that doesn’t mean it’s OK to guzzle a glass or two. There are still 41 grams of sugar in 1 cup. (Though it’s better than the next option.)
Hi-C Orange Lavaburst: 220 calories, 56 grams of sugar (all of which are added). Hi-C Orange Lavaburst and Minute Maid Orange Juice may look the same, but one is fruit juice minus the good stuff (fiber!) and the other is basically flavored sugar water. Go with the former.
11. Sauces
Healthiest: Ketchup
Unhealthiest: Creamy Ranch Sauce
Ketchup: 10 calories, 2 grams of sugar, 90 milligrams of sodium. Ketchup is the lower-calorie dipping option at McDonald’s (mustard is even less at 0 calories and 70 milligrams of sodium).
Creamy Ranch Sauce: 110 calories and 12 grams of fat per cup. Creamy Ranch Sauce has 11 times the calories of ketchup, and most folks don’t just stick to one cup (especially with a 10-piece order of McNuggets). Note: If sodium is your main concern, Spicy Buffalo dipping sauce may sound healthier at just 30 calories per cup, but it’s actually loaded with 520 milligrams of sodium per cup. That’s almost a quarter of the sodium you should eat in a day!
12. The Light-Sounding Options
Healthiest: Filet-O-Fish
Unhealthiest: Ranch Snack Wrap
Filet-O-Fish: 380 calories, 4 grams of saturated fat, 580 milligrams of sodium, 16 grams of protein. Despite the tartar sauce, cheese (well, half a slice) and breading (yes, it’s fried), the Filet-O-Fish is one of the less-caloric sandwiches at McDonald’s.
Ranch Snack Wrap: 400 calories, 6 grams of saturated fat, 970 milligrams of sodium. Just because the Ranch Snack Wrap sounds healthy doesn’t mean it is. The fan-favorite, recently-reintroduced menu item has more calories, saturated fat and sodium than a Filet-O-Fish (the spicy version has 390 calories and 1,000 milligrams of sodium). Think of it less as a salad wrapped in a tortilla and more as a fried chicken strip and ranch dressing with cheese.
The McDonald’s Verdicts at a Glance
| Category | Healthiest in this pair | Unhealthiest in this pair |
|---|---|---|
| The Big Burgers | Big Mac | Double Quarter Pounder with Cheese |
| The Doubles | McDouble | Double Cheeseburger |
| Chicken Sandwiches | McChicken | Spicy McCrispy |
| Breakfast Sandwiches | Egg McMuffin | Sausage, Egg & Cheese Bagel |
| Same Filling, Different Bread | Bacon, Egg & Cheese McGriddles | Bacon, Egg & Cheese Biscuit |
| Chicken Pieces | 4-piece Chicken McNuggets | 3-piece McCrispy Strips |
| Potatoes | Hash Browns | Large Fries |
| Desserts | Vanilla Cone | M&M’s McFlurry |
| Fountain Drinks | Unsweetened Iced Tea | Medium Coca-Cola |
| Orange Drinks | Minute Maid Orange Juice | Hi-C Orange Lavaburst |
| Sauces | Ketchup | Creamy Ranch Sauce |
| The Light-Sounding Options | Filet-O-Fish | Ranch Snack Wrap |
The Order That Wins Every Category
When it comes down to it, sodium was the tiebreaker in most of the showdowns (hello, chicken sandwiches, nuggets, breakfast sandwiches and even the snack wrap). In many cases the calorie difference wasn’t that dramatic, but the sodium almost doubled. Sugar determined the victor in the dessert and beverage categories (and fun fact: McDonald’s sugariest item isn’t a soda. It’s a cup of ice cream.).
Methodology: All nutrition information is for McDonald’s menu items as sold in the U.S., according to McDonald’s published nutrition information (retrieved from mcdonalds.com on November 9, 2026; links appear with menu item names). For drinks and french fries, figures correspond to the size noted. Items have been ranked in relation to other items in the same category according to editorial discretion. Rankings do not constitute an official health score. Menu items and recipes can change; refer to the nutrition information posted on McDonald’s menu boards for the most up-to-date figures.
Cory Jones has spent 20 years in media and publishing and now leads the data and editorial operation behind The Greenest.
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