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  1. News Release

  2. Jun 8, 2021

Physicians Warn Consumers to Avoid “Sickening Six” on Fast-Food Summer Menus

McDonald’s New BTS Meal Earns Dishonorable Mention

WASHINGTON—The Physicians Committee, a nonprofit of 17,000 doctors, has reviewed recently released summer fast-food items and is urging consumers to avoid the most “Sickening Six” summer menu options:


Restaurant and Food Item*



Total Fat/Saturated Fat (g)

Cholesterol (mg)

Sodium (mg)

Burger King Hand-Breaded Crispy Chicken Sandwich






Burger King Spicy Hand-Breaded Crispy Chicken Sandwich






Wendy’s Bourbon Bacon Cheese Single**






Subway 6” Tuna Melt






Sonic Twisted Texan Cheeseburger






Sonic Twisted Texan Footlong Chili Cheese Coney






McDonald’s BTS Meal – Dishonorable Mention






*Sources:, **This sandwich is available as a double, triple

“Putting new twists on old high-fat, high-cholesterol, and high-sodium foods as part of a ‘new’ summer menu has become an annual marketing ploy for fast-food outlets,” says Susan Levin, MS, RD, director of nutrition education for the Physicians Committee. “Summer 2021 is no different, and consumers deserve to know the truth about these items’ poor nutritional content.”

According to the Centers for Disease Control and Prevention, more than 42% of U.S. adults are now obese. A study published in the journal Circulation  found that people who eat fast food once a week increase their risk of dying from heart disease by 20%. Two to three fast-food meals a week increase the risk of premature death by 50%. Four or more fast-food meals a week increase the risk of dying from heart disease by nearly 80%.

Despite this health crisis, fast-food restaurants continue to introduce foods that are exceedingly unhealthful. Among several items added for Summer 2021, the Physicians Committee suggests that consumers avoid the “Sickening Six,” designated as such because of the exorbitant amounts of cholesterol, fat, calories, and sodium per item. Some items also contain carcinogens.

“Though it did not make the list because it consists of two items rather than one, McDonald’s new BTS meal receives our Dishonorable Mention because it uses South Korean pop band BTS to peddle long-offered 10-piece Chicken McNuggets and french fries” Levin says. “Sonic’s Twisted Texan Chili Cheese Coney contains more than 50 grams of processed meat, which significantly increases the risk of colorectal cancer if eaten daily.”

Studies show that a plant-based diet can help people prevent and even reverse diabetesheart disease, and high blood pressure, among other conditions. To that end, consumption of meat and dairy products has been declining for years, and consumers are embracing meat alternatives

“There are plenty of healthful menu options available, including at some quick-serve restaurants, like the Veggie Delite at Subway and a bean, rice, and veggie bowl at Chipotle,” Levin says. “I often see hummus and pita chips and carrot and celery sticks available at gas stations.”

Key Factors

Physicians Committee doctors and dietitians looked at several key factors to determine the healthfulness of each item:

High Fat Content: Scientific research links diets high in fat to increased risk of cancers, diabetes, and heart disease. High-fat, low-fiber foods boost the hormones that promote cancer. Specifically, diets high in meat, dairy products, fried foods, and vegetable oils cause an increase in the production of estrogen. Extra estrogen increases cancer risk in the breast and other organs sensitive to sex hormones. In January 2010, the Centers for Disease Control and Prevention found that 20% of adolescents ages 12 to 19 have at least one abnormal lipid level (LDL cholesterol, HDL cholesterol, or triglycerides). Among overweight and obese adolescents, those rates were higher, with 22% of overweight and 43% of obese children having one or more abnormality. Trans fats raise LDL (“bad”) cholesterol levels and lower HDL (“good”) cholesterol levels, increasing the risk of cardiovascular disease. Naturally occurring trans fats are only contained in animal products. Fat contains 9 calories per gram and is typically more abundant in animal products, especially saturated fat, which significantly increases bad cholesterol.

Cholesterol: Cholesterol is a waxy substance found in the bloodstream and in the body's cells. Every animal cell contains cholesterol, as it is a necessary component of the cell’s membrane. The body naturally makes more than enough cholesterol to serve this biological function. High blood-cholesterol levels are strongly linked to risk of heart disease. High levels of LDL (“bad”) cholesterol and low levels of HDL (“good”) cholesterol increase the risk of heart disease and stroke. Saturated fats and trans fats both increase LDL levels. Consuming large amounts of cholesterol in one’s diet may eventually lead to reduced heart function. Fiber helps to remove blood cholesterol and is only found in plant foods. The latest Dietary Guidelines for Americans recommend “dietary cholesterol consumption to be as low as possible.”

Chicken can raise cholesterol levels as much as red meat. Researchers tested the effects of diets that drew their protein from red meat (beef and pork), white meat (chicken and turkey), or nonmeat sources (legumes, nuts, grains, and soy products). Both white and red meat raised LDL (“bad”) cholesterol, compared with plant-based proteins, and did so to about the same extent. The researchers pointed out that their findings supported favoring meatless protein sources and that white meat was no better than red meat when it comes to heart disease risk.

Carcinogens: The World Health Organization has determined that processed meat is a major contributor to colorectal cancer, classifying it as “carcinogenic to humans.” Just one hot dog or a few strips of bacon consumed daily increases cancer risk by 18%. The World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AIRC) have also found that “the evidence on processed meat and cancer is clear-cut.” Processed meat also increases the risk of breast cancer, prostate cancer, pancreatic cancer, and overall cancer mortality.

Carcinogens also occur naturally in chicken. In a 2008 Physicians Committee study, 100% of chicken samples from top restaurant chains in California contained PhIP, a federally recognized carcinogen that has been linked to breast, prostate, and other cancers. PhIP forms naturally from substances found in tissue when the tissue is exposed to direct high heat.

Sodium: Diets high in sodium can increase the risk of high blood pressure, a condition that can lead to cardiovascular disease and kidney problems. The Institute of Medicine (IOM) recommends that healthy adults’ intake of sodium should be no more than 1,500 milligrams per day.

Media Contact

Leslie Raabe



Founded in 1985, the Physicians Committee for Responsible Medicine is a nonprofit organization that promotes preventive medicine, conducts clinical research, and encourages higher standards for ethics and effectiveness in education and research.

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