The 4 Best In-N-Out Items for Healthy Blood Sugar Levels

If you love to head out to eat, you’re in good company: 3 out of 5 Americans dine out for dinner at least once a week. With all the busyness that comes from being a working adult or managing schedules as a parent, it may seem as if you have to throw in the towel when it comes to achieving your health goals while maintaining a life. However, we’re here to assure you that is not the case!

In fact, our quest to show you how you can dine on-the-go while still keeping nutrition top of mind leads us straight to the home of California-based burger chain In-N-Out.

Full disclosure, I am a California native whose first fast-food experience was at an In-N-Out.  Believe me, I can say there is a reason for the endless lines at all hours of the day at these restaurants across the West Coast. Regardless of what time you pop into their chains, they are making your menu items to order, which allows more blood sugar-friendly swaps.

Still, if you’re concerned about your blood sugar due to diabetes or prediabetes, you may want to keep a few guidelines in mind when ordering at In-N-Out. So, let’s take a closer look at blood sugar management and find out what registered dietitian nutritionists recommend ordering at In-N-Out. 

What to Look For When You Order

If you have diabetes, you need to choose foods thoughtfully to help manage your blood sugars, including keeping an eye on your carbohydrate intake. That can be a challenge when ordering fast food. “Carbohydrates are broken down into glucose during digestion, which then enters the bloodstream, causing blood sugar levels to rise,” says Patricia Bannan, M.S., RDN, author of From Burnout to Balance. “Foods with higher carbohydrate content, especially those with simple carbohydrates like sugar and refined grains, tend to raise blood sugar levels more quickly and to a greater extent,” she explains.

Eating macronutrients together (think pairing protein with carbs and dietary fat) can impact how carbohydrates affect your blood sugars. Be sure to monitor how you individually respond to fast-food choices if you dine out more often.

Because many menu items at In-N-Out (we see you, animal-style fries loaded with that secret sauce, or those impossibly thick milkshakes) are higher in carbohydrates—and in an amount that may be too much for someone who is monitoring their blood sugars—you’ll likely want to make menu modifications when you order. And, thankfully, In-N-Out locations across the U.S. are on board with these swaps.

The 4 Best In-N-Out Options That Won’t Spike Your Blood Sugar 

1. Protein-Style Burger 

“Protein style” means that your burger is wrapped in lettuce leaves instead of a bun, and both Bannan and Vandana Sheth, RDN, CDCES, a diabetes care and education specialist, are big fans of this swap. By asking for your burger to be prepared “protein style,” you significantly reduce the carbohydrate content. “Choosing protein style for the hamburger with onion will shave 29 grams of carbohydrate off your meal,” says Bannan. “The standard hamburger ordered as-is contains 37 grams of carbohydrate, whereas the protein style contains only 8 grams of carbohydrate with the lettuce bun,” she says. Plus, the burger provides plenty of protein, and protein helps with satiety, keeping you full after your meal.

Nutrition info, per In-N-Out:

• Calories: 200
• Total Fat: 14 g
• Saturated Fat: 4.5 g
• Protein: 12 g
• Carbohydrates: 8 g
• Fiber: 2 g
• Sodium: 390 mg

This meal is low in carbs, which may leave you some leeway for fries. What’s more, pairing fries with a burger that has protein and fat will help reduce the blood sugar spike. If you’re craving french fries, one order contains 49 grams of carbs, so be sure to share them with the table.

On another note, if your protein needs are higher (due to an active lifestyle, for instance), Sheth recommends considering a “Double-Double.” Two stacked hamburger patties with cheese, protein style, contain 30 grams of protein.

2. Cheeseburger with a Tomato Bun 

If you want to add a bit more protein to your order, try an In-N-Out cheeseburger with a “tomato bun” in place of the traditional carbohydrate-based bun. This option adds an additional 4 grams of protein to your burger thanks to the cheese, while also keeping the carbohydrate content in check. One potential downside: adding cheese to your hamburger provides an additional 3.5 grams of saturated fat, so order wisely if you’re already nearing your saturated fat allotment for the day. The Dietary Guidelines for Americans recommend keeping your saturated fat intakes to less than 10% of your total calories, which equals about 22 grams of saturated fat per 2,000 calories.

Nutrition info, per In-N-Out (for protein style, since tomato “bun” is not listed):

• Calories: 270
• Total Fat: 19 g
• Saturated Fat: 8 g
• Protein: 16 g
• Carbohydrates: 10 g
• Fiber: 2 g
• Sodium: 800 mg

3. Grilled Cheese with Extra Veggies 

Are you following a vegetarian lifestyle? Avoiding meat at In-N-Out can be a challenge—unless you ask them to hold the meat, which is an option Sheth recommends. “Opting for a grilled cheese with extra veggies is a good vegetarian option that can be satisfying without spiking your blood sugar levels,” she says.

While In-N-Out does not offer nutrition information for this “Not So Secret Menu” item, we estimate that this meal offers about 8 to 10 grams of protein. Given that it’s higher in carbohydrates than the protein-style burgers, it’s important to monitor your blood sugar and learn how this meal affects you. “Since response to blood sugar is individualized, if you monitor your blood sugar, you can tweak your order based upon your body’s blood sugar response,” Sheth says.

4. Unsweetened Beverages

When you need a sip to quench your thirst, go for low-calorie unsweetened beverages, like water, unsweetened tea, black coffee, diet sodas or sparkling water, both Bannan and Sheth recommend. “Water is always a healthful beverage choice, providing hydration without any added sugar or calories. Or, consider unsweetened ice tea for a bit of flavor without added sugar, and health benefits such as antioxidants,” Bannan says.

While it may be tempting to go for one of the legendary thick milkshakes, see if you can steal a couple of spoonfuls from your dining partner instead. A small 15-ounce chocolate shake packs 74 grams of carbohydrates and 61 grams of sugar, a large nutritional price to pay for a drink that accompanies a meal.

Guidelines on Choosing a Blood-Sugar-Friendly Order

Here at EatingWell, we believe everything can be included in moderation in a balanced diet, including tasty items from In-N-Out. But if you’re trying to manage your blood sugars, keep these suggestions in mind when choosing your order:

• Aim for meals that pack at least 10 grams of protein per serving.
• Choose a lettuce wrap (or tomato slices) in place of a bun to reduce carbohydrate content of the meal.
• Ask for extra vegetables, including lettuce, tomato, onion and chiles. (You can request chopped chiles on your burger, or order the yellow chiles on the side.)
• Skip their standard spread, which tends to be higher in saturated fat, and instead choose mustard and ketchup to reduce the fat content of the meal.
• Opt for unsweetened beverages like ice tea or water. Or, go for milk for more protein. Pass on the drinks that contain added sugars, such as regular soda, ice cream shakes and hot chocolate.
• You may want to skip the french fries or share them with the table.
• Walk for 10 to 15 minutes right after you eat a meal to improve your blood sugar, says Sheth.

The Bottom Line 

Dietitians agree that you can enjoy a trip to In-N-Out without having your blood sugars take a rollercoaster ride. Consider your own personal health needs and blood sugar levels, then place your order accordingly. For instance, for those who enjoy animal proteins, a hamburger can easily be made “protein style” to lower the carbohydrate content while simultaneously upping your veggie intake with a lettuce bun, tomatoes and onions. Pair your burger with an unsweetened tea for a little antioxidant boost. Remember, eating in real life is about moderation, not deprivation. And, In-N-Out can certainly fit into a healthy lifestyle on occasion.