Best and Worst Fast-Food Breakfasts

Eating on the run? Here's how to choose healthier breakfast foods.
By Elaine Magee, MPH, RD
WebMD Weight Loss Clinic-Feature
Reviewed by Louise Chang, MD

Market figures show that more and more people are buying breakfast from fast-food chains and places like Starbucks. It makes sense; after all, many people are already at one of those places buying coffee. Others just don't think they have enough time in the morning to get a bite at home, so they grab it on the go. But are any of these early morning offerings even remotely healthy?
In Search of a Better Breakfast

Finding a healthier fast-food breakfast means looking for items with some fiber and protein (which makes them more satisfying), but not too much saturated fat or total fat. Fiber is important for baked offerings, too -- even when these items are relatively low in fat, they can be high in sugar and white flour.

A look at the nutrition information some popular fast-food chains provide on their web sites shows that few of their breakfast items fit the bill. Some offer one or two items that are reasonably low in fat and saturated fat and contain some protein, but they're usually lacking in fiber. Others have not even one main-dish breakfast item that's low enough in fat and saturated fat to be considered healthy.

At Carl's Jr., for example, there was only one main-dish item with less than 20 grams of fat per serving (the French Toast Dips, with 18 grams of fat). It has some protein, 9 grams, but is lacking in the fiber department (1 gram). However, that's far better than the worst choice on their breakfast menu: the Carl’s Jr. Loaded Breakfast Burrito, with 820 calories and 51 grams of fat.
Best and Worst Fast Food Breakfasts

No matter which fast food chain you visit, high fat and high-calorie breakfast choices abound. But there are some better choices out there. Here are some of the best and worst-case scenarios at several major chains:

McDonald's BEST Breakfast Choices:

* Egg McMuffin: 300 calories, 12 grams fat, 5 grams saturated fat, 260 mg cholesterol, 820 mg sodium, 2 g fiber.
* Hotcakes (without syrup and margarine): 350 calories, 9 grams fat, 2 grams saturated fat, 20 mg cholesterol, 590 mg sodium, 3 g fiber.

McDonald's WORST Choices:

* Deluxe Breakfast with regular size biscuit, without syrup & margarine: 1070 calories, 55 grams fat, 18 g saturated fat, 575 milligrams cholesterol, 2090 mg sodium, 6 g fiber.
* Deluxe Breakfast with large size biscuit, without syrup & margarine: 1140 calories, 59 g fat, 20 g saturated fat, 575 mg cholesterol, 2250 mg sodium, 7 g fiber.
* Big Breakfast (large size biscuit): 790 calories, 51 g fat, 18 g saturated fat, 555 mg cholesterol, 1,660 mg sodium, 4 g fiber.

Burger King's BEST Breakfast Choices:

* Ham Omelet Sandwich: 290 calories, 13 g fat 4.5 g saturated fat, 85 mg cholesterol, 870 mg sodium, 1 g fiber.
* French Toast Sticks, 3 piece: 240 calories, 13 g fat, 2.5 g saturated fat, 4 g protein, 0 mg cholesterol, 260 mg sodium, 1 g fiber.

Burger King's WORST Choices:

* Double Croissan’Wich with sausage, egg, & cheese: 680 calories, 51 grams of fat, 18 grams of saturated fat, and 220 mg cholesterol, 1,590 mg sodium.
* Enormous Omelet Sandwich: 730 calories, 45 grams of fat, 16 grams of saturated fat, and 330 milligrams of cholesterol, 1,940 mg sodium.

Jack in the Box BEST Breakfast Choices:

* Breakfast Jack: 290 calories, 12 g fat, 4.5 g saturated fat, 220 mg cholesterol, 760 mg sodium, 1 g fiber.
* Bacon Breakfast Jack: 300 calories, 14 g fat, 5 g saturated fat, 215 mg cholesterol, 730 mg sodium, 1 g fiber.

Jack in the Box WORST Choices:

* Extreme Sausage Sandwich: 670 calories, 48 g of fat, 17 g saturated fat, 290 mg cholesterol, 1,300 mg sodium, 2 g fiber.
* Sausage, Egg & Cheese Biscuit: 740 calories, 55 g fat, 17 g saturated fat, 280 mg cholesterol, 1,430 mg sodium, 2 g fiber.
* Sirloin Steak & Egg Burrito with Fire Roasted Tomato Salsa: 790 calories, 48 g fat, 15 g saturated fat, 450 mg cholesterol, 1,440 mg sodium, 6 g fiber.

Carl's Jr. BEST Breakfast Choices:

* French Toast Dips (5 pieces, no syrup): 430 calories, 18 g fat, 2.5 g saturated fat, 0 mg cholesterol, 530 mg sodium, 1 g fiber.

Carl's Jr. WORST Choices:

* Loaded Breakfast Burrito: 820 calories, 51 g fat, 16 g saturated fat, 595 mg cholesterol, 1,530 mg sodium, 2 g fiber.
* Breakfast Burger: 830 calories, 47 g fat, 15 g saturated fat, 275 mg cholesterol, 1,580 mg sodium, 3 g fiber.

Dunkin’ Donuts BEST Breakfast Choices:

* Blueberry Bagel: 330 calories, 2.5 g fat, .5 g saturated fat, 10 g protein, 0 mg cholesterol, 600 mg sodium, 2 g fiber.
* Wheat Bagel:, 330 calories, 4 g fat, 1 g saturated fat, 12 g protein, 0 mg cholesterol, 610 mg sodium, 4 g fiber.
* Reduced Fat Blueberry Muffin: 400 calories, 5 g fat, 2 g saturated fat, 8 g protein, 60 mg cholesterol, 490 mg sodium, 3 g fiber.
* Honey Bran Raisin Muffin: 480 calories, 15 g fat, 2.5 g saturated fat, 8 g protein, 60 mg cholesterol, 480 mg sodium, 5 g fiber.

Dunkin’ Donuts WORST Choices

* Triple Chocolate Muffin: 660 calories, 33 g fat, 7 g saturated fat, 10 mg cholesterol, 460 mg sodium, 4 g fiber.
* Peanut Butter Cup Cookie: 590 calories, 29 g fat, 13 g saturated fat, 50 mg cholesterol, 530 mg sodium, 3 g fiber.

Subway BEST Breakfast Choices:

* Cheese Breakfast Sandwich on 6” bread: 410 calories, 18g fat, 8 g saturated fat, 190 mg cholesterol, 1,010 mg sodium, 5 g fiber.

Subway WORST Choices:

* Chipotle Steak & Cheese Breakfast Sandwich on 6” bread: 600 calories, 32 g fat, 11 g saturated fat, 220 mg cholesterol, 1,470 mg sodium, 6 g fiber.

Eating on the run? Here's how to choose healthier breakfast foods.
(continued)
A Starbucks on Every Corner

And what about the Starbucks Coffee cafes you'll find on nearly every corner in cities across America?

The specific items that are available vary by region, as many Starbucks markets buy fresh bakery products from local suppliers. But -- at least in the California area -- there are a number of nutritionally reasonable offerings among the lineup of muffins, scones, loaf cakes, coffee cakes, croissants, and bagels. The trick is finding lower-fat items that also boast some fiber, so look for foods made with whole grains when available.

"We provide options to all our customers," explains Alan Hilowitz, a spokesman for Starbucks. "We have indulgent items, and each Starbucks also carries some healthier items."

Here are some of the healthier items you might find at your local Starbucks (keeping in mind that bakery items vary regionally):

* Low Fat Bran Muffins: 360 calories, 4.5 g fat, 0 g saturated fat, 40 g cholesterol, 290 mg sodium, 7 g fiber
* Reduced Fat Cranberry Apple Muffin: 310 calories, 9 g fat, 1 g saturated fat, 60 mg cholesterol, 460 mg sodium, 5 g fiber.
* Low-Fat Oat Fruit Scone: 310 calories, 2.5 g fat, 1 g saturated fat, 9 g protein, 30 mg cholesterol, 280 mg sodium, 3 g fiber
* Spinach Roasted Tomato, Feta & Egg Wrap: 240 calories, 10g fat, 3.5 g saturated fat, 140 mg cholesterol, 730 mg sodium, 7 g fiber.
* Reduced Fat Blueberry Coffee Cake: 320 calories, 6 g fat, 4.5 g saturated fat, 4 g protein, 10 mg cholesterol, 390 mg sodium, 1 g fiber.
* Reduced-Fat Cherry Lemon Coffee Cake with Oatmeal-Pecan Streusel: 370 calories, 9 g fat, 2.5 g saturated fat, 7 g protein, 50 mg cholesterol, 540 mg sodium, 3 g fiber.
* Reduced Fat Cinnamon Swirl Coffee Cake: 290 calories, 4 g fat, 3 g saturated fat, 4 g protein, <5 mg cholesterol, 330 mg sodium, <1 g fiber.

Is Skipping Breakfast Better?

Is it better to skip breakfast or grab a bite at a fast food restaurant? If fast food is your only option, go ahead and go for some of the healthier choices on the menu. It’s definitely better to eat breakfast than to go without.

Results from a recent University of Minnesota study that noted breakfast habits and weight changes in 2,200 teens over a 5-year period, indicated that regular breakfast eaters tended to have the lowest body mass indexes (BMIs). As the frequency of breakfast skipping went up, so did the body mass indexes of these teens.
The Bottom Line

The truth is that fast food is here, and it isn't going away. An analysis of the Continuing Survey of Food Intake by Individuals by researchers from the Pennington Biomedical Research Center found that 37% of the adults and 42% of the children surveyed reported eating fast food at least once over two survey days.

Should fast food take all the blame for our obesity crisis? No. Should we all try to make healthier choices when we find ourselves in a fast food restaurant? Absolutely, experts say.

"Fast food likely contributes to over consumption, and a sedentary lifestyle reduces energy expenditure," notes University of Minnesota nutrition researcher David Jacobs Jr. Yet, he notes, the causes of the obesity epidemic are many, and our susceptibility to weight gain varies from person to person.

The bottom line: When you find yourself at a fast-food or quick-serve chain before 11 a.m., choose a better breakfast option, keep your portions reasonable, and keep (or start!) exercising.

Watch Your Sleep, Watch Your Weight

Can Too Much or Too Little Sleep Lead to Unhealthy Weight Gain?
By Kelley Colihan

April 1, 2008 -- Ah, sweet sleep. We seem to get too little. Now researchers are finding that too much or too little sleep could lead to unhealthy weight gain.

Researchers at Laval University in Quebec looked at 276 people for six years who were part of a larger Canadian study.
Sleep duration was determined from a questionnaire and the participants were classified into three groups: short sleepers slept five to six hours a night, the average got seven to eight hours, and the long sleepers put in nine to 10 hours of sleep every night.

Some of the findings:

* Over six years, short sleepers were 35% more likely to gain 11 pounds than average-duration sleepers.
* Over the same time period, long sleepers were 25% more likely to gain 11 pounds than average-duration sleepers.
* Short sleepers gained 58% more around their waists and 124% more body fat than the average sleeper.

Sleep Sweet Spot?

Researchers also think there might be an "optimal sleeping time" to stay healthy.

The American Academy of Sleep Medicine recommends that adults sleep between seven and eight hours a night.

Study researcher Jean-Philippe Chaput of Laval University says in a news release the findings provide "evidence that both short and long sleeping times predict an increased risk of future body weight and fat gain in adults."

Chaput adds that "these results emphasize the need to add sleep duration to the list of environmental factors that are prevalent in our society that contribute to weight gain and obesity."
A Nation Deprived?

Study authors say people in the United States are losing sleep, with Americans sleeping one and a half to two hours less a night than we did 40 years ago.

Previous studies have shown similar findings linking a lack of sleep to creeping obesity. Researchers say this new study adds to a growing body of evidence showing a sleep connection to weight gain involving fluctuating hormone levels.

According to the American Academy of Sleep Medicine, nearly a third of adults say they sleep less than six hours a night.
Dreams of Good Sleep

Here are some tips for getting good sleep from the American Academy of Sleep Medicine:

* Follow a consistent bedtime routine.
* Establish a relaxing setting at bedtime.
* Get a full night's sleep every night.
* Avoid caffeine or any other stimulants before bedtime.
* Be worry-free at bedtime.
* Don't go to bed hungry, or too full.
* Avoid rigorous exercise within six hours of your bedtime.
* Make your bedroom quiet, dark, and a little cool.
* Get up at the same time every morning.

The study is published in the April 1 issue of the journal Sleep.
View Article Sources Sources

SOURCES:

Chaput, J-P. Sleep, April 1, 2008; vol 31: pp 517-523.

News release, American Academy of Sleep Medicine.
© 2008 WebMD, LLC. All rights reserved.

Cholesterol Testing Not Enough for Some

Test for Protein Called ApoB Better Measure of Heart Attack, Stroke Risk
By Salynn Boyles
WebMD Medical News
Reviewed by Elizabeth Klodas, MD

March 27, 2008 -- People at high risk for heart attacks and strokes may need even more aggressive cholesterol control than is currently recommended, experts now say.

In a joint statement released Thursday by the American Diabetes Association (ADA) and the American College of Cardiology (ACC), the experts concluded that measuring LDL, or bad, cholesterol may no longer be the best measure of heart health in these patients.

The panel found that once LDL cholesterol is lowered to recommended levels in high-risk patients, testing for the protein ApoB may more accurately identify those still at risk for cardiovascular events.

If ApoB levels are high, patients may need more aggressive lifestyle interventions or larger doses of lipid-lowering statin drugs, even if LDL cholesterol levels are within normal range, the panel concluded.

"LDL measurement is still very important," ADA Vice President of Clinical Affairs Sue Kirkman, MD, tells WebMD. "But for high-risk people who are on statin therapy it may not be enough to get LDL down below 100 or even 70."
LDL and ApoB

Achieving an LDL of below 100 milligrams/deciliter is now widely recommended for patients with two or more risk factors for heart disease and for those with diabetes but no other major heart disease risk factors.

Guidelines call for a target LDL at or below 70 for patients with established heart disease or diabetes with additional risk factors for heart disease.

These risk factors include high blood pressure, tobacco use, and family history of heart disease.

While aggressive cholesterol treatment has contributed to reductions in heart attacks and strokes, these events are still common among high-risk patients who reach the target goals, Kirkman says. This could occur if other cholesterol particles that contribute to risk are still elevated.

ApoB is a molecule that is present in all the cholesterol particles that significantly contribute to the development of atherosclerosis (also known as plaque or hardening of the arteries). The hope is that measuring ApoB will help patients and their doctors better gauge actual risk because ApoB will be a more accurate measure of the total number of all artery-clogging particles (not just LDL). There is growing evidence that ApoB levels are a better indicator of heart risk than total cholesterol or LDL.

For this reason, the joint panel recommends a target ApoB level of less than 90 for high-risk patients without established heart disease and less than 80 for the highest-risk patients with heart disease or with diabetes and other cardiovascular risk factors.
Statins and Lifestyle

The report could lead to more aggressive treatment of high-risk patients with lipid-lowering statins, but the panel concluded that more research is needed to confirm the benefits of this approach.

The group also called for public health initiatives aimed at promoting lifestyle changes that reduce cardiovascular risk.

Kirkman says patients and their doctors often focus on drug treatments, forgetting that lifestyle changes can also have a big impact on risk.

"It is important to remember that lifestyle is a big part of this," Kirkman says. "Getting patients to improve their diets, stop smoking, and exercise are all critical. It isn't all about drugs."

Healthy Habit No. 13: Plan

There is, perhaps, no better word in the English language to better illustrate how you can incorporate healthy habits into your everyday life.

"A little planning goes a long way," says Johnson. "Eating healthy never happens by accident."

For the most part, neither do good fitness, skin protection, healthy teeth, weight loss, and social ties. Many of these habits take effort that need to be scheduled into busy lives.

To eat healthy, for example, it would help to set aside time to draft a menu, make a grocery list, go to the store, prepare meals, and pack breakfast and lunch.

Healthy Habit No. 12: Take a Daily Walk

We already mentioned the merits of exercise in habit No. 5. Now, here's a tip on how to incorporate physical activity into your daily life: WALK.

We're not talking about taking the time out of your busy schedule to work out -- that's important, too -- but infusing life- and limb-saving movement into your waking hours.

"Just move. Pace during phone calls, while you're brushing your teeth, while watching your son's soccer game," says Bryant, noting that every 20 steps a person takes is 1 calorie burned.

An eight-year study of 13,000 people also showed that people who walked 30 minutes daily had a significantly reduced chance of premature death compared with those who rarely exercised, reports the American Council on Exercise.

And there are plenty of opportunities to move those legs:

* Take the stairs instead of the elevator.
* Walk to the store.
* Window shop at the mall.
* Leave your desk and visit your co-worker instead of sending him an email.
* Walk and talk with friends instead of meeting for a meal.