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By Madelyn Fernstrom, PhD

It’s the start of fall, and we all know what that means: pumpkin spice lattes are back! And while the fans of the so-called “PSL” are everywhere, most people don’t know much about the ingredients or nutritional value of their beloved drink. Let’s take a closer look.

A medium, 16-ounce pumpkin spice latte made with reduced fat milk that’s topped with whipped cream is about 380 calories. While that might seem like a compromise — no whole milk, and not the largest size – it’s still the calorie equivalent of a meal! The medium PSL contains 14 grams of fat (half of it saturated) and 50 grams of sugar (12 teaspoons!).

It’s not all bad news, however. A PSL has a good protein boost with 14 grams (the amount in nearly two eggs or half a chicken breast).

The bottom line: If the PSL is part of your fall tradition, enjoy it – but in moderation. Look at it as a special indulgence, rather than a daily go-to drink.

Keep the same taste you know and love, but consider downsizing your portion. Going down a size saves 100 calories and cuts the fat and sugar by 25 percent. If you also swap out the reduced fat milk to skim milk (or unsweetened soy or almond milk) and skip the whipped cream, you’ll save about 140 calories, and wind up with a drink around 250 calories. And if you think 140 calories isn’t much — if you saved that every day, you’d lose a pound at the end of a month!

There are also a number of good alternatives to get the PSL experience, without the added calories, fat, and sugar.

1. Try a pumpkin pie spice ready-to-drink creamer.

At a mere 35 calories per tablespoon, you can get the essence of the PSL with a tablespoon or two added to your coffee. Add a splash of the milk (or alternative) of your choice to boost the flavor.

2. Try this 60-calorie pumpkin spice coffee drink.

Take a large mug and add eight ounces hot coffee (regular or decaf), four ounces reduced fat milk (or unsweetened almond, soy or your choice), one teaspoon pumpkin pie spice, ½ teaspoon vanilla, one teaspoon sugar (or low calorie sweetener).

3. Consider this pumpkin spice chai.

Take a large mug and add one cup of oat milk (or milk of your choice), one chai tea bag, ½ teaspoon pumpkin pie spice, ¼ teaspoon ginger, ½ teaspoon vanilla, and one teaspoon sugar (or low calorie sweetener). Heat in a small pan or the microwave. Stir and enjoy. (around 150 calories).

4. Go to town with this frappuccino-esqe PSL.

Blend together one medium banana, 1/3 cup canned pumpkin puree, one cup unsweetened milk of your choice (non-fat or low fat milk, almond, soy, oatmeal), ½ teaspoon pumpkin pie spice, one teaspoon sugar (or low calorie sweetener). Mix and enjoy — serves two and has just 125 calories per serving.

Madelyn Fernstrom, Ph.D. is the NBC News Health Editor. Follow her on Twitter @drfernstrom.