Between the shopping and social obligations this holiday season, you and your family may find yourselves eating at restaurants more often. While it can be a challenge to find a healthy meal on a kids menu amid the chicken fingers, french fries, and mozzarella sticks, some restaurants have been trying to remedy that within the past five years or so by making changes, such as removing soda from kids menus, adding fruit, and offering vegetable choices other than fries.
But according to a study published in the March issue of the American Journal of Preventive Medicine, those moves have not made a dent in the nutritional quality of restaurant kids food.
In the study, the researchers looked at the nutritional numbers for more than 4,000 beverages, entrées, side dishes, and desserts at 45 chain restaurants—from fast-food joints to sit-down eateries—listed on kids menus between 2012 and 2015.
According to the researchers, several restaurants introduced initiatives to improve the healthfulness of kids meals during that time period. The most expansive of such commitments was an effort launched by the National Restaurant Association (NRA) in 2011 called the Kids LiveWell program. Restaurants that choose to participate have to offer at least one meal (entrée, side, and drink) and one side dish that meet healthful nutritional guidelines for calories, fat, sodium, and other nutrients. Fifteen of the 45 restaurants in this current study were LiveWell participants.
Their findings: If you’re looking for healthy options on kids menus, it’s still slim pickings.
Even among the chains that were part of the LiveWell program there was little improvement, according to the study’s lead author, Alyssa Moran, M.P.H., R.D., a doctoral candidate in the department of nutrition at the Harvard T.H. Chan School of Public Health.
“When we set out to do this study, we were expecting that we would see an improvement . . . so we were surprised that calories, saturated fat, and sodium remained pretty stable over time,” she says.
And although several chains dropped soda from their kids menus, sugary drinks still made up a whopping 80 percent of children’s beverage offerings across chains. “This implies that restaurants are swapping out soda for other sugary drinks, such as flavored milk,” Moran says.
This research builds on prior studies from other teams, which have looked at the nutritional content of combo meals, entrées, and side dishes offered on kids menus, Moran says, but those studies did not involve as large a sample of national restaurant chains as this one did.
It’s important to note that these results represent an average across the restaurant industry, and they may not reflect the big changes that some chains are making individually. (The chart below highlights some healthier options at five popular chains.) Additionally, the team did not determine which foods kids—or their parents—actually order from the menus.
When the study was first published last March, we asked the NRA for comment. “We have just received this study and are currently reviewing it,” said Leslie Shedd, vice president of communications at the NRA. “Kids LiveWell was started to promote healthy eating among children, and we welcome any opportunity to encourage children to make healthy choices.” (We have more recently asked for further comment, but the NRA has not yet responded to our request.)
Moran’s team found that an average kids meal with a beverage, entrée, side dish, and dessert has about 1,000 calories. According to the Department of Agriculture, kids ages 4 to 8 should consume between 1,200 and 2,000 calories in an entire day, depending on gender and activity level.
How to Order Wisely From the Kids Menu
Kids menus can seem like a nutritional minefield. Keep these tips in mind when placing orders for your young ones:
Watch the sides. “Peripheral parts of a meal can add up to have a big impact,” says Julie Downs, Ph.D., associate professor of decision science at Carnegie Mellon University. “Someone choosing a lower-calorie main dish may feel like they’ve made a pretty good choice, only to undo it with a caloric side dish, a sugary beverage, or a dessert.”
A McDonald’s Happy Meal with a cheeseburger, fries (without ketchup), low-fat strawberry yogurt, and fat-free chocolate milk, for example, has 590 calories, 18 grams of fat, 920 milligrams of sodium, and 35 grams of sugar. Order the burger without cheese and swap the yogurt for apple slices and the chocolate milk for regular low-fat milk, and you’ll save 110 calories, 2 grams of fat, 240 milligrams of sodium, and 14 grams of sugar.
Let your child pick an entrée, Downs says, but you choose healthier sides to go with it, such as fruit instead of fries, or milk instead of juice.
Stray from the kids menu. Kids menus are usually just for kids, but that doesn’t mean the rest of the menu is off-limits to them, says Amy Keating, R.D., a dietitian in Consumer Reports’ food-testing lab. “Regular menus have foods that kids may be accustomed to eating at home, such as grilled chicken or a lean cut of steak,” she says. An appetizer may make for a better choice than what’s available on the kids menu, too. Or you might see that green beans, sweet potatoes, or other vegetables are offered as a side on a dish on the regular menu. “If the restaurant serves healthier options, ask that a vegetable replace fries in your child’s entrée,” Keating says.
Split a dish with your child. Share something from the regular menu that you both enjoy. Portions at restaurants are oversized, so this has the added benefit of making your meal healthier, too.
Watch what you drink. Liquid calories from sugary drinks like sodas and flavored milks can add up quickly. Order plain water or seltzer with a splash of orange juice instead of soda, or regular milk in place of chocolate.
Allow treats occasionally. Every once in a while, let your child have fries, dessert, or chocolate milk if he or she wants to—but just one option per meal. And when it comes to dessert, order one and share among everyone at the table. Even kid-sized desserts can easily have as many calories as an entrée and twice as much saturated fat, Moran says.
Stay away from what’s cheesy, creamy, and saucy. Anything with cheese or a sauce is practically guaranteed to be loaded with fat and sodium, says Maxine Siegel, R.D., a dietitian and head of the Consumer Reports food-testing lab. Request sauces and dressings on the side, and use just a little bit. Also try simply asking your server whether the dishes your family orders can be prepared with less salt, and choose grilled over fried or breaded items.
Look for the Kids LiveWell logo. Roughly 100 chains participate in the program nationally. Although there may not be many options on a menu, Moran says that when you see dishes accompanied by the symbol, you can be sure it is a better choice for your child.
According to the program’s criteria, an entire meal (entrée, side, and beverage) will have 600 or fewer calories; will limit fats, sodium, and sugars; and will contain at least two servings of the following: fruit, veggies, whole grains, lean protein, or low-fat dairy. Side dishes will have 200 or fewer calories and contain a serving of fruit, veggies, whole grains, lean protein, or low-fat dairy.
The above was first reported by Consumer Reports.