If you are lucky enough to live near an In-N-Out Burger, then you likely know how delicious the food is. The first In-N-Out opened in 1948 in California, with a focus on serving up tasty meals with the freshest ingredients possible. In fact, the founder, Harry Snyder, would visit local markets to buy fresh meat and vegetables to bring right into the kitchen, where he would make everything by hand himself. The franchise has grown over the years, and now there are many more locations scattered throughout the West Coast and southwestern U.S. Currently, In-N-Out exists in seven states: California, Nevada, Arizona, Utah, Texas, Colorado, and Oregon.

The In-N-Out menu is small and simple, but the chain has mastered the flavors of everything on it. In-N-Out offers several styles of burger, french fries, and various beverages like milkshakes, sodas, Minute Maid Zero Sugar Lemonade, iced tea, milk, coffee, and hot cocoa. And if you haven’t heard, there’s also the secret menu, or, as In-N-Out calls it, the "Not So Secret Menu." If you’re trying to avoid the unhealthiest things on the menu, we’ve compared everything to help you decide what to order during your next visit to In-N-Out Burger.

1. Double-Double

At In-N-Out, besides ordering the classic hamburger or cheeseburger, you can get a Double-Double, which is basically a double cheeseburger. The Double-Double comes with two beef patties, two slices of American cheese, onion, lettuce, tomato, and In-N-Out’s specialty sauce, all served on a fresh bun. This option comes with more calories compared to a cheeseburger for obvious reasons — it’s got double the meat and cheese. The cheeseburger has 480 calories, while the Double-Double clocks in at 670.

If you’re trying to keep a healthy diet, it’s common to consider the amount of calories a meal contains. The calories you eat need to balance out the amount of physical activity you get in a day to help support a healthy weight. The amount of calories you should try to consume in a day varies based on your age, body type, how active you are, and your biological sex at birth. This is because certain hormones impact the rate of calorie usage, as does your stage in life, height, and weight. In general, it is recommended that females consume 2,000 calories per day and males aim for about 2,500 each day.

To get the Double-Double but with less calories, you can order it Protein Style, which replaces the bun with lettuce, bringing the calorie count down to 520. Or you can substitute the special spread with just ketchup and mustard, which makes the burger come out to about 590 calories.

2. Quad Quad

In-N-Out storefront

At first glance, the menu of In-N-Out Burger may seem quite small — but not if you know about the "Not So Secret Menu." These are items not listed on the general menu, but you can order them at any time, and the employees will know exactly what you mean. The options on this menu include the Triple Triple, Quad Quad, Grilled Cheese, Protein Style, and Animal Style. Out of all of the "not so secret" items, the Quad Quad is one of the unhealthiest menu choices.

The Quad Quad is basically like a double Double-Double. It comes with four beef patties, four slices of cheese, and the usual toppings of lettuce, tomato, onion, and special sauce. While In-N-Out doesn’t provide specific nutritional information about the Quad Quad, it would presumably be in the vicinity of double everything in the Double-Double. In other words, that’d be roughly 1,300 calories, 80 or so grams of fat, 30-some grams of saturated fat, and around 2 grams of trans fat. While most foods contain some amount of fat, some types of fat are considered less healthy than others.

Even 2 grams of trans fat is 2 grams too many. According to Harvard Health Publishing, trans fat doesn’t have any health benefits and it isn’t safe to consume. In addition, eating foods high in saturated fat has been linked to high cholesterol, a leading cause of heart disease.

3. Animal Style

In-N-Out Animal Style burger

Ordering something Animal Style is a customer favorite — in fact, the Not So Secret Menu was created simply as a collection of common ways customers would ask for their meals to be prepared. You can order any burger Animal Style, which means you will get a mustard-cooked meat patty, added pickles, extra special sauce, and grilled onions inside. You can also ask for Animal Style french fries, which is the basic fries topped with a slice of melted American cheese, special spread sauce, and cut up grilled onions. While these items are absolutely delicious, all that extra stuff adds extra calories and fats to your meal. An Animal Style meal also means you’ll be consuming a whole lot more sodium compared to something on the basic menu.

While the human body does need some sodium to survive, the standard American diet is swimming in too much salt. Unfortunately, eating high amounts of sodium has been associated with high blood pressure, which can lead to heart disease or even stroke (via Centers for Disease Control and Prevention). The recommended daily intake of sodium is about 2,300 milligrams. A regular hamburger at In-N-Out contains about 650 milligrams of sodium, and the cheeseburger has 1,000 milligrams. The Double-Double contains 1,440 milligrams, which is more than half the recommended sodium intake to maintain a healthy diet. And that’s not counting if you upgrade your meal to Animal Style — more sauce and cheese means more sodium.

4. Roadkill fries

In-N-Out Animal Style fries

Roadkill fries are another not entirely secret menu item that might be best to avoid if you’re trying to monitor your calories, fat, and salt consumption. Essentially, roadkill fries are Animal Style fries, plus two added beef patties with a slice of melted cheese nestled in between them. Specific nutrition information for this specialty item is not available on the In-N-Out website, but if it’s similar to the combo of the Double-Double (with no bun) plus fries, you’d be looking at around 890 calories, 54 grams of fat, 18.5 grams of saturated fat, 1 gram of trans fat, and 1,410 milligrams of sodium. And that’s not including the extra special sauce.

For a healthier choice, it’s best to stick with the regular fries. In-N-Out uses fresh, hand-sliced potatoes and cooks them in pure sunflower oil. While there is only one size to choose from, the serving size of the classic In-N-Out french fries is about the same as a medium McDonald’s french fry. The In-N-Out fries have about 370 calories, 15 grams of fat, 1.5 grams of saturated fat, 0 grams of trans fat, and only 250 milligrams of sodium.

5. Extra-large strawberry shake

In-N-Out strawberry, vanilla, and chocolate shakes

In-N-Out offers three different flavors of milkshakes: chocolate, vanilla, and strawberry. While you might think that the fruit option would be the healthiest choice out of the three, think again — out of all the drinks on the menu, the extra-large strawberry shake is the unhealthiest. A regular 15-ounce strawberry shake contains 590 calories, 24 grams of fat, 15 grams of saturated fat, and 1 gram of trans fat. It even has 310 milligrams of sodium and a whopping 100 grams of sugar. And that’s the smallest size. An extra-large cup is 30 ounces, so double that. The American Heart Association recommends that adults limit their intake of added sugar to 24 grams per day for women and 36 grams for men.

Not only are all of the calories, fats, and salts unhealthy, but the sugar content is harmful to your health. Our body uses sugar as fuel, so we need some to have energy to function throughout the day; however, consuming sugar in whole foods is very different than consuming processed sugar. The added fiber of whole foods helps slow down the digestive process so that your body slowly receives this sugar over time. But consuming high amounts of added sugar in processed foods like soda and milkshakes has been linked to health issues like weight gain and diabetes, as well as heart disease (via Harvard Health Publishing).

6. Extra-large chocolate Shake

In-N-Out bag and cup

In-N-Out’s chocolate milkshake isn’t far behind the strawberry one — one 15-ounce serving size contains 580 calories, 28 grams of fat, 18 grams of saturated fat, 1 gram of trans fat, and 65 grams of sugar. And an extra large would double those numbers. Not only is excess sugar consumption linked to obesity, heart disease, and diabetes, but it has also been associated with many other chronic health conditions, including acne, depression, and even cancer. Plus, diets high in sugar can increase your chances of getting cavities. Eating too much sugar has also been known to negatively impact brain function, leading to higher chances of developing dementia or Alzheimer’s disease (via Healthline).

A 2018 scientific study examined the blood of generally healthy men after they consumed a milkshake, and the results were surprising. The participants’ blood vessels had a hard time dilating, and their red blood cells slightly changed in appearance. The study concluded that these shifts were likely temporary, but more research needs to be done. This finding may help explain the rare reports of people having a heart attack directly after a high-fat meal. "The take-home message is that your body can usually handle this if you don’t do it again at the next meal and the next and the next," Dr. Julia Brittain, one of the researchers, told Augusta University’s Jagwire. The cliche is true: Moderation is key.

7. Barq’s Root Beer

Another unhealthy beverage choice on the In-N-Out menu is Barq’s Root Beer. Pretty much all soda is considered empty calories — which is food that is high in calories but has little to no nutritional value. While the Coca-Cola, 7-Up, Dr. Pepper, and Pink Lemonade all contain similarly high amounts of calories and sugar, Barq’s Root Beer tops out at number one on In-N-Out’s menu. The smallest serving size, which is 11 ounces, contains 150 calories and 39 grams of sugar. The extra-large Barq’s Root Beer has a massive 400 calories and 107 grams of sugar. These high amounts of sugar can be harmful to your health.

Switching to Diet Coke may not be a healthy alternative, either. Even though diet soda offers zero calories and zero sugar, it is usually sweetened with aspartame. In addition, a scientific study conducted in 2018 found that switching to diet soda may not actually lower one’s chances of developing diabetes. Out of all the drinks on the menu, the healthiest option is the iced tea, which has no calories or added sugar. And if you still crave a little sweetness, one serving of the sweet tea only has about 90 calories and 22 grams of sugar.