Almost no progress made in improving nutrition of kids' menus, report finds

The menu offerings for children rely heavily on items such fried chicken fingers, burgers, French fries, and sugar-sweetened drinks and few include healthy options such as fresh fruit or vegetables.

Margo Wootan, PhD, director of nutrition policy for CSPI, said the results did not come as a shock, but the intransigence of the problem was something of a revelation.

“I was disappointed. We have been interested in and concerned about kids’ meals for some time. Given the high rates of childhood obesity and the high amount of attention to the issue, a lot of restaurant chains have made announcements about improvements they are making to their children’s meals. I was expecting more progress than we found,” ​Wootan, told FoodNavigator-USA. 

She noted that the last time the organization assessed the nutritional quality of children’s meals was in 2008.

“Over the last four years we did find some improvements in kids’ meals; more of the meals have less sodium and fewer calories than before.  But still the overwhelming majority of choices are unhealthy.​

“We found that over the last four years the percentage of the kids meals that were healthy went from 1% to 3%,”​ she said.

Standards set, but not met​

Wootan said CSPI’s standards for what constitutes a healthy kids’ meal were developed via an expert committee that weighed in with recommendations for the ideal nutritional profile.  

To meet CSPI’s nutrition criteria, kids’ meals must not exceed 430 calories, more than 35% of calories from fat, or more than 10% of calories from saturated plus trans fat.  Meals that meet CSPI’s criteria cannot have more than 35% added sugars by weight nor more than 770 milligrams of sodium.  

The criteria require meals to make a positive nutritional contribution either by providing at least half a serving of fruit or vegetable, including an item that is 51% or more whole grain, or including specified levels of vitamins or fiber.  CSPI’s criteria exclude sugar drinks in favor of water, juice, or low-fat milk.  

The National Restaurant Association’s standards are quite similar, though they allow more calories, Wootan noted. But situation is only slightly less bleak using this somewhat  more lenient yardstick.

“Even against the industry standards only 9% of the meals met their own standards,”​ Wootan said.

“The restaurant industry in the US has cultivated this concept of a kids meal that consists of chicken fingers, pizza or a burger with a side of fries and a sugar drink. That is exactly the kind of meal that undermines children’s health,”​ she said.

“The last thing we should be doing is training them to eat unhealthfully for the rest of their life.”​

Many of the restaurant chains that offer unhealthy choices for kids do have healthy choices for adults, but Wootan noted that there is a strong financial disincentive for parents to make that choice, when an adult meal might cost $10 as opposed to $2 or $3 for a kids’ menu choice.

The report did laud one restaurant chain for getting it right. ​All eight of Subway restaurants’ Fresh Fit for Kids meal combinations met CSPI’s nutrition criteria.  Subway is the only restaurant chain that does not offer sugar drinks as an option with its kids’ meals, instead including low-fat milk or bottled water along with apple slices with all of its kid-sized subs.

Rogues gallery​

But that’s a rare success story.  Much more common menu items were these:

• Applebee’s Grilled Cheese on Sourdough with Fries and 2% Chocolate Milk. 1,210 calories,  62 grams of total fat (46% of calories), 21 grams of saturated fat (16%), and 2,340 milligrams of sodium.  That meal has nearly three times as many calories, and three times as much sodium, as CSPI’s criteria for four-to eight-year-olds allow.
• Chili’s Pepperoni Pizza with Homestyle Fries and Soda. 1,010 calories, 45 grams of total fat (40% of calories), 18 grams of saturated fat (16%), 2,020 milligrams of sodium.
• Denny’s Jr. Cheeseburger and French Fries.  980 calories, 55 grams of total fat (50% of calories), 20 grams of saturated fat (18%) and 1,110 mg of sodium.
• Ruby Tuesday’s Mac ’n Cheese, White Cheddar Mashed Potatoes, and Fruit Punch.  860 calories, 46 grams of total fat (48% of calories) and 1,730 mg of sodum.

The report found that at 19 chains, not a single possible combination of the items offered for children met CSPI’s nutrition standards.  At nine of those 19 chains, including McDonald’s, Popeye’s, Chipotle, and Hardee’s, not a single kids’ meal even met the NRA’s Kids LiveWell standards.  At Wendy’s, only 5% of 40 possible kids’ meals met CSPI’s standards—most items were too high either in sodium or saturated fat; at Burger King, just 20% of the 15 possible kids’ meals met CSPI’s criteria.

Not a luxury anymore​

Wootan said a shift in thinking on the part of restaurants is needed.  Restaurant meals are no longer luxury items; they form a mainstay of the US diet.

“American families are really relying on restaurants more and more to feed themselves.  That doesn’t mean we are bad parents, it means we’re busy and eating out has become more affordable,”​ Wootan said.

“Restaurants need to get out of this mindset that eating out is this big splurge that people are only occasionally doing.  Most people are eating out regularly, so nutrition matters when we eat out. Now for many kids, eating out is a regular part of their diet.”​