Have fast food restaurants become healthier for children? progress, purchases, and public relations

Introduction: In 2010, 15 of 3,039 kids' meal combinations met nutrition criteria for children and restaurant employees automatically provided an unhealthy side dish in 84% of kids' meal orders. Since then, major fast-food chains have announced further improvements in nutrition quality and healthy defaults for kids' meals. This presentation evaluates these changes and their potential to increase purchases of healthy options for children in fast-food restaurants. Methods: Using the same methods as our 2010 Fast Food FACTS report, we collected nutrition information for menu items at the largest fast food restaurant chains, conducted mystery shopping to identify default offerings for kids' meals, and surveyed parents to measure fast-food purchases for their children. Results: Several of the largest fast-food restaurants have introduced healthier kids' meal options and more restaurant employees offer healthier sides as the default. The proportion of kids' meal combinations that qualify as healthful according to established nutrition standards for children's meals also slightly increased. However, parents increasingly purchase less expensive but higher-calorie value menu items instead of kids' meals for older children. Discussion: Fast-food restaurants have made some progress in improving the nutritional quality of kids' meal offerings, but the majority of fast-food meals purchased for children remain high in calories, saturated fat, and/or sodium. In addition, pricing of value menu items relative to kids' meals makes the lower-calorie kids' meals less attractive, especially for older children. Restaurants must do more to make healthier choices for children the easiest choice and the best value.